Javier Martínez-Torres

Performance of Two Bioelectrical Impedance Analyses in the Diagnosis of Overweight and Obesity in Children and Adolescents: The FUPRECOL Study.

This study aimed to determine thresholds for percentage of body fat (BF%) corresponding to the cut-off values for overweight/obesity as recommended by the International Obesity Task Force (IOTF), using two bioelectrical impedance analyzers (BIA), and described the likelihood of increased cardiometabolic risk in our cohort defined by the IOTF and BF% status. Participants included 1165 children and adolescents (54.9% girls) from Bogotá (Colombia). Body mass index (BMI) was calculated from height and weight. BF% of each youth was assessed first using the Tanita BC-418® followed by a Tanita BF-689®. The sensitivity and specificity of both devices and their ability to correctly classify children as overweight/obesity (≥2 standard deviation), as defined by IOTF, was investigated using receiver operating characteristic (ROC) by sex and age groups (9–11, 12–14, and 13–17 years old); Area under curve (AUC) values were also reported. For girls, the optimal BF% threshold for classifying into overweight/obesity was found to be between 25.2 and 28.5 (AUC = 0.91–0.97) and 23.9 to 26.6 (AUC = 0.90–0.99) for Tanita BC-418® and Tanita BF-689®, respectively. For boys, the optimal threshold was between 16.5 and 21.1 (AUC = 0.93–0.96) and 15.8 to 20.6 (AUC = 0.92–0.94) by Tanita BC-418® and Tanita BF-689®, respectively. All AUC values for ROC curves were statistically significant and there were no differences between AUC values measured by both BIA devices. The BF% values associated with the IOTF-recommended BMI cut-off for overweight/obesity may require age- and sex-specific threshold values in Colombian children and adolescents aged 9–17 years and could be used as a surrogate method to identify individuals at risk of excess adiposity.

Factores asociados a la deficiencia de zinc en niños colombianos: resultados de la Encuesta Nacional de Salud 2010; estudio transversal

INTRODUCTION Zinc (Zn) is an essential micronutrient for cell growth, protein synthesis and cell differentiation. This deficiency affects the growth, development, energy metabolism and immune response in Colombian childrens. OBJECTIVE To examine factors associated with Zn deficiency in a representative sample of Colombian children. PATIENTS AND METHODS A cross-sectional descriptive study was conducted of data from the 2010 National Nutrition Survey of Colombia (ENSIN 2010), in 4.279 children aged between 12-59 months of age. Plasma levels of Zn were determined by atomic absorption spectrophotometry, and associated factors (sex, age, ethnicity, SISBEN score, and geographic region) were collected by structured questionnaire. Associations were established through a multivariable regression model. RESULTS We found a range of Zn of 78.5 μg/dl, (95% CI 76.7 to 80.4 μg/dl). 43.3% (95% CI 42.2%-44.3%) of children had lower Zn levels to 65 μg/dl. Children belonging to an ethnic groups (indigenous) or residing in rural areas; showed Zn deficiency (56.3% and 47.8%) respectively. Regression models show that to be indigenous (OR 1.76, 95% CI 1.29 to 2.41), and to reside in rural areas (OR 1.39, 95% CI 1.16 to 1.67) were associated with Zn deficiency. CONCLUSIONS The study population shows a high prevalence of Zn deficiency, so it is recommended that comprehensive interventions which are involved nutritional and educational component.

Prevalencia de deficiencia subclínica de vitamina A y factores sociodemográficos asociados en niños de 12-59 meses de edad en Colombia

OBJECTIVE To examine the sociodemographic factors associated with subclinical vitamin A deficiency in a representative sample of Colombian children. Subjects and methods A cross-sectional, descriptive study was conducted of data from the 2010 National Nutrition Survey of Colombia (ENSIN 2010) on 4,279 children aged 12 to 59 months. Plasma vitamin A levels were measured using high resolution liquid chromatography (HRLC), and sociodemographic factors (sex, age, ethnicity, SISBEN score, and geographic region) were collected using a structured survey. Prevalence rates and associations were established using a multivariate regression model. RESULTS Vitamin A levels ranged from 7.5-93.7 μg/dL (mean=26.2; 95% CI, 25.9 to 26.5μg/dL). Vitamin A levels less than 20 μg/dL (subclinical deficiency) were found in 24.3% of children. Children belonging to ethnic groups of African ascent, those living in the Orinoquia and Amazonia regions, and those aged 12-23 months had the greatest subclinical vitamin A deficiencies (29.5%, 31.1%, and 27.6% respectively. Regression models showed that age ranging from 12 and 23 months (OR 1.32; 95% CI, 1.01 to 1.73), a SISBEN score 1 (OR 1.66; 95% CI, 1.18 to 2.34), an African ascent (OR 1.35; 95% CI, 1.05 to 1.74), and living in the Orinoquia and Amazonia regions (OR 2.38; 95% CI, 1.62 to 3.51) were factors associated to subclinical vitamin A deficiency. CONCLUSIONS The study population shows a high prevalence of subclinical vitamin A deficiency, and comprehensive interventions involving nutritional and educational components are therefore recommended.

Handgrip strength cutoff for cardiometabolic risk index among Colombian children and adolescents : The FUPRECOL Study

Evidence shows an association between muscular strength (MS) and health among young people, however low muscular strength cut points for the detection of high metabolic risk in Latin-American populations are scarce. The aim of this study was twofold: to explore potential age- and sex-specific thresholds of MS, for optimal cardiometabolic risk categorization among Colombian children and adolescents; and to investigate whether cardiometabolic risk differed by MS group by applying the receiver operating characteristic curve (ROC) cut point. MS was estimated by using a handle dynamometer on 1,950 children and adolescents from Colombia, using MS relative to weight (handgrip strength/body mass). A metabolic risk score was computed from the following components: waist circumference, triglycerides, HDL-c, glucose, and systolic and diastolic blood pressure. ROC analysis showed a significant discriminatory accuracy of MS in identifying the low/high metabolic risk in children and adolescents and in both genders. In children, the handgrip strength/body mass levels for a low metabolic risk were 0.359 and 0.376 in girls and boys, respectively. In adolescents, these points were 0.440 and 0.447 in girls and boys, respectively. In conclusion, the results suggest an MS level relative to weight for having a low metabolic risk, which could be used to identify youths at risk.

LMS tables for waist circumference and waist-height ratio in Colombian adults: analysis of nationwide data 2010.

Background/Objectives:Indices predictive of central obesity include waist circumference (WC) and waist-to-height ratio (WHtR). These data are lacking for Colombian adults. This study aims at establishing smoothed centile charts and LMS tables for WC and WHtR; appropriate cutoffs were selected using receiver-operating characteristic analysis based on data from the representative sample.Subjects/Methods:We used data from the cross-sectional, national representative nutrition survey (ENSIN, 2010). A total of 83 220 participants (aged 20–64) were enroled. Weight, height, body mass index (BMI), WC and WHtR were measured and percentiles calculated using the LMS method (L (curve Box-Cox), M (curve median), and S (curve coefficient of variation)). Receiver operating characteristics curve analyses were used to evaluate the optimal cutoff point of WC and WHtR for overweight and obesity based on WHO definitions.Results:Reference values for WC and WHtR are presented. Mean WC and WHtR increased with age for both genders. We found a strong positive correlation between WC and BMI (r=0.847, P< 0.01) and WHtR and BMI (r=0.878, P<0.01). In obese men, the cutoff point value is 96.6 cm for the WC. In women, the cutoff point value is 91.0 cm for the WC. Receiver operating characteristic curve for WHtR was also obtained and the cutoff point value of 0.579 in men, and in women the cutoff point value was 0.587. A high sensitivity and specificity were obtained.Conclusions:This study presents first reference values of WC and WHtR for Colombians aged 20–64. Through LMS tables for adults, we hope to provide quantitative tools to study obesity and its complications.

Ferritin levels in pregnant Colombian women

OBJECTIVE Ferritin deficiency is associated with many adverse health outcomes and is highly prevalent worldwide. The present study assesses the prevalence and socio-demographic factors associated with ferritin deficiency in a representative sample of pregnant women in Colombia. METHODS We used data from the cross-sectional, nationally representative survey National Nutritional Survey (ENSIN, 2010). A total of 1,386, (13-49 years old) pregnant women were enrolled. Serum ferritin a concentration was determined by chemiluminescence and sociodemographic date (age, urbanicity geographic region, ethnicity and socioeconomic level-SISBEN), was assessed by computer-assisted personal interview technology. Multivariate analyses using unordered binomial logistic regression models were conducted in the main analysis. RESULTS The overall prevalence of ferritin deficiency (serum.

Body adiposity index performance in estimating body fat percentage in colombian college students: Findings from the FUPRECOL-adults study

Recently, a body adiposity index (BAI = (hip circumference)/((height)(1.5))−18) was developed and validated in adult populations. The aim of this study was to evaluate the performance of BAI in estimating percentage body fat (BF%) in a sample of Colombian collegiate young adults. The participants were comprised of 903 volunteers (52% females, mean age = 21.4 years ± 3.3). We used the Lin’s concordance correlation coefficient, linear regression, Bland–Altman’s agreement analysis, concordance correlation coefficient (ρc) and the coefficient of determination (R2) between BAI, and BF%; by bioelectrical impedance analysis (BIA)). The correlation between the two methods of estimating BF% was R2 = 0.384, p < 0.001. A paired-sample t-test showed a difference between the methods (BIA BF% = 16.2 ± 3.1, BAI BF% = 30.0 ± 5.4%; p < 0.001). For BIA, bias value was 6.0 ± 6.2 BF% (95% confidence interval (CI) = −6.0 to 18.2), indicating that the BAI method overestimated BF% relative to the reference method. Lin’s concordance correlation coefficient was poor (ρc = 0.014, 95% CI = −0.124 to 0.135; p = 0.414). In Colombian college students, there was poor agreement between BAI- and BIA-based estimates of BF%, and so BAI is not accurate in people with low or high body fat percentage levels.

A Cross Sectional Study of the Prevalence of Metabolic Syndrome and Associated Factors in Colombian Collegiate Students: The FUPRECOL-Adults Study.

Metabolic syndrome (MetS) is one of the major public health problems worldwide. The objective of the present study is to investigate the prevalence and the associated variables of MetS in Colombian collegiate students. This cross-sectional study included a total of 890 (52% women) healthy collegiate students (21.3 ± 3.2 years old). The prevalence of MetS was determined by the definition provided by the International Diabetes Federation (IDF). We further examined associations between the prevalence of MetS and related factors, such as age, gender, anthropometric and body composition, weight status, and nutrition profile. The overall prevalence of MetS was 6.0% (95% CI = 4.5% to 7.6%), and it was higher in men than women. The most prevalent components were low high-density lipoprotein cholesterol, high triglyceride levels, waist circumference, and blood pressure levels. The predisposing factors for having a MetS included: being male, over 23 years old, overweight or obese, and having an unhealthy waist-to-height ratio. In conclusion, the occurrence of MetS in young adults is substantial. These findings may be relevant to health promotion efforts for collegiate students in order to develop prospective studies and screening for young adults, which will aid in targeted intervention development to decrease cardiometabolic risk factors.

Vitamin B12 concentration and its association with sociodemographic factors in Colombian children: Findings from the 2010 National Nutrition Survey

OBJECTIVE Rapid changes in dietary patterns, economic development, and urbanization in low- to middle-income countries are fueling complex malnutrition states that need better characterization using population-level data. The aim of this study was to describe the key findings related to vitamin B12 status to identify the prevalence and associated sociodemographic factors in a representative sample of children in Colombia, based on the 2010 National Nutrition Survey. METHODS We analyzed cross-sectional data from 6910 Colombian children between the ages of 5 and 12. Serum vitamin B12 concentrations were determined by chemiluminescence. Sociodemographic data was assessed by computer-assisted personal interview technology. RESULTS Of the children assessed, 2.8% had vitamin B12 deficiency, defined as levels <200 pg/mL, and 18.1% had marginal vitamin B12 deficiency, defined as levels between 200 and 300 pg/mL. A multivariate logistic regression analysis revealed increased risks for vitamin B12 deficiency among children ages ≥9 y and for those living in the eastern, western, and southern regions of the country. No significant associations were found for ethnic groups, socioeconomic status, or urbanity levels. Being 11 y of age (odds ratio [OR], 2.16; 95% confidence interval [CI], 1.56-3.00; P = 0.0001), living in the west (Pacific) region of the country (OR, 3.92; 95% CI, 3.14-4.90; P = 0.0001), and being male (OR, 1.41; 95% CI, 1.20-1.65; P = 0.0001) were the factors most strongly associated with an increased risk for vitamin B12 deficiency. CONCLUSIONS Compared with data from other Latin American countries, Colombian children have a lower prevalence of vitamin B12 deficiency; however the prevalence of marginal deficiency is substantial. Continued surveillance and implementation of interventions to improve dietary patterns among the high-risk groups identified should be considered.

Body composition, nutritional profile and muscular fitness affect bone health in a sample of schoolchildren from Colombia: The fuprecol study

The objective of the present study is to investigate the relationships between body composition, nutritional profile, muscular fitness (MF) and bone health in a sample of children and adolescents from Colombia. Participants included 1118 children and adolescents (54.6% girls). Calcaneal broadband ultrasound attenuation (c-BUA) was obtained as a marker of bone health. Body composition (fat mass and lean mass) was assessed using bioelectrical impedance analysis. Furthermore height, weight, waist circumference and Tanner stage were measured and body mass index (BMI) was calculated. Standing long-jump (SLJ) and isometric handgrip dynamometry were used respectively as indicators of lower and upper body muscular fitness. A muscular index score was also computed by summing up the standardised values of both SLJ and handgrip strength. Dietary intake and degree of adherence to the Mediterranean diet were assessed by a 7-day recall questionnaire for food frequency and the Kidmed questionnaire. Poor bone health was considered using a z-score cut off of ≤−1.5 standard deviation. Once the results were adjusted for age and Tanner stage, the predisposing factors of having a c-BUA z-score ≤−1.5 standard deviation included being underweight or obese, having an unhealthy lean mass, having an unhealthy fat mass, SLJ performance, handgrip performance, and unhealthy muscular index score. In conclusion, body composition (fat mass and lean body mass) and MF both influenced bone health in a sample of children and adolescents from Colombia. Thus promoting strength adaptation and preservation in Colombian youth will help to improve bone health, an important protective factor against osteoporosis in later life.