María del Pilar Díaz

Overweight and obesity: a review of their relationship to metabolic syndrome, cardiovascular disease, and cancer in South America

Socioeconomic and demographic transformations are occurring very rapidly in some areas of the world, especially in South America, and are accompanied by changes in lifestyle, dietary patterns, and the epidemiological profile of prevalent diseases. This review examines whether obesity and overweight are related to metabolic syndrome, cardiovascular disease, and cancer in South America. Research carried out in more than 6,000 cases and controls was evaluated, along with most of the available publications related to South America. In South America, obesity and risk factors for cardiovascular disease are related mainly to aging, ethnicity effects, and preventable risky lifestyle conditions. Most of the studies that found an association between cancer and obesity are from the Southern Cone, the geographic area most affected by this pathology. Overall, the prevalence of metabolic syndrome was highest in Chile, followed in decreasing order by Colombia, Peru, Argentina, and Ecuador, with differences noted between urban and rural areas or between urban and periurban areas. Obesity and cancer may be preventable, at least in part, by healthy behavior; hence, exercise, weight control, and healthy dietary habits are important to reduce the risk of these major chronic diseases.

Endosulfan induces changes in spontaneous swimming activity and acetylcholinesterase activity of Jenynsia multidentata (Anablepidae, Cyprinodontiformes).

We assessed changes in spontaneous swimming activity and acetylcholinesterase (AchE) activity of Jenynsia multidentata exposed to Endosulfan (EDS). Females of J. multidentata were exposed to 0.072 and 1.4 microg L(-1) EDS. Average speed and movement percentage were recorded during 48 h. We also exposed females to EDS at five concentrations between 0.072 and 1.4 microg L(-1) during 24 h, and measured the AchE activity in brain and muscle. At 0.072 microg L(-1) EDS swimming motility decreased relative to the control group after 45 h, while at 1.4 microg L(-1) EDS swimming motility decreased after 24 h. AchE activity significantly decreased in muscle when J. multidentata were exposed to EDS above 0.072 microg L(-1), while no significant changes were observed in brain. Thus, changes in swimming activity and AchE activity in muscle are good biomarkers of exposure to EDS in J. multidentata.

Adaptación transcultural del cuestionario KIDSCREEN para medir calidad de vida relacionada con la salud en población argentina de 8 a 18 años

BACKGROUND Health related quality of life (HRQOL) measures are increasingly used in research and clinical practice. The KIDSCREEN is a questionnaire developed in Europe for an 8 to 18 year-old population. OBJECTIVE To cross-culturally adapt this questionnaire for the Argentinean population, and to evaluate its cultural adequacy and semantic equivalence against the original version. METHODS Forward and backward translation according to international recommendations for cross-cultural adaptation of questionnaires, including the translation by professional linguists, cognitive interviews with people of different ages, gender and socioeconomic status to analyze cultural adequacy, and comparison of the Argentinean with the original versions to establish semantic equivalence. RESULTS The language required adaptation in the use of pronouns and verb tenses. Most of the items were considered to have low translation difficulty and high semantic equivalence. Boys and girls 8-11 years (n= 7), 12-15 years (n= 7), and 16-18 years (n= 2) participated in the interviews, as well as 6 mothers. There were no major difficulties in understanding, but younger children being in the lower socioeconomic status had some difficulties to answer the questionnaire. Eight questions were modified to achieve greater semantic equivalence. CONCLUSIONS The Argentinean version of the KIDSCREEN questionnaire obtained through cross-cultural adaptation process, was equivalent to the European version. Future studies should establish its reliability and validity. It provides a useful measure of HRQOL for studies in clinical, school or community settings, with the possibility to establish international comparisons.

Characterization of meat consumption and risk of colorectal cancer in Cordoba, Argentina.

BACKGROUND The Argentinean food pattern, rich in beef and fats and poor in fibers, may be related to an risk of increased colorectal cancer (CRC). To examine the relation between CRC risk and meat type, we carried out a case-control study in Córdoba, Argentina. METHODS We interviewed 287 patients with colorectal adenocarcinomas and 566 control subjects admitted to the largest hospitals in greater Córdoba. Dietary habits were assessed by a food-frequency questionnaire, and different meat types were evaluated. Regression analyses determined the contribution of meat to total energy and macronutrients. Unconditional multiple logistic regression was performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Median intake of all meats, predominantly bovine, was high, reaching almost 300 g/d in men. Meats provided approximately 50% of total energy intake and 64% to 67% of total protein. Patients obtained significantly more cholesterol and total lipids from meats than did controls. Consumption of total meat, red meat, and other types of meat were not related to increased risk of CRC. However, an increased risk of CRC was found for those consuming relatively large amounts of cold cuts and sausages (OR, 1.47; CI, 1.02-2.15) and bovine viscera (OR, 1.73; CI, 1.18-2.54). Lean beef was associated with a decreased risk of CRC at the second (OR, 0.64; CI, 0.43-0.94) and third (OR, 0.67; CI, 0.40-0.97) tertiles. CONCLUSIONS Red meat produced a different pattern of risk according to its fat content. Further studies should assess the possible role of cooking meat and other non-nutritional components.

Cancer incidence and pattern of arsenic concentration in drinking water wells in Córdoba, Argentina

Cancer occurrence is associated with Arsenic (As) in drinking water. In Argentina, there are high As concentrations in groundwater but there is no published evidence yet of an association between geographic patterns of cancer incidence and the distribution of As in groundwater supplies. The purpose of this study is to assess the association between cancer incidence patterns and As in Córdoba provinces aquifers. Age standardized incidence rates (ASIRs) were obtained from Córdoba Cancer Registry (CCR), and As data from official reports of monitoring wells. A multilevel model was applied. Total ASIRs by aquifers for males/females were 191.01/249.22 (Rioja plain); 215.03/225.37 (Pampa hills); and 239.42/188.93 (Chaco-Pampa plain). As was associated with increased risk of colon cancer in women, and lung and bladder cancers in both sexes. It had no association with breast cancer. ASIRs were related to As, controlling for unobserved heterogeneity. An overlapping pattern of higher As and higher risks was evident for lung, bladder and female colon cancers.

Cancer incidence pattern in Cordoba, Argentina.

Cancer is the second cause of death in Argentina; nevertheless the distribution of the cancer incidence rates throughout the country is unknown. This study was conducted to describe cancer incidence patterns in Córdoba Province. Incidence data were supplied by the Government Córdoba Cancer Registry. Demographic information (age, sex, and place of residence) and diagnosis, certified by a pathologist, about all incident cases from June 2003 to May 2005 by type and 5-year age groups were obtained. Comparison of the incidence rate of cancer in various counties was performed by using standardized incidence rates (SIR) per 100 000 inhabitants using the world standard population. Estimated SIRs were used to build up incidence maps. Two indicators were created: sex ratio and site-specific ratio. Mixed Poisson models were fitted. Taken as a whole for all counties, SIR was 121.42 and 141.57 for men and women, respectively. The most common sites in men were prostate (13.62), lung (10.12), colon (7.53), and bladder (7.03); in women were breast (22.51) and colon (3.31). The highest and lowest rates were in urban and rural areas, respectively. Cancer registry has a pivotal role in cancer control. Such information is the primary resource of information not only for epidemiological research on cancer determinants but also for planning and evaluating health services for the policies of prevention, diagnosis and treatment of the disease.

Prostate cancer mortality trends in Argentina 1986-2006: an age-period-cohort and joinpoint analysis

The aim of this study was to give an overview of the magnitude, variation by age and time trends in the rates of prostate cancer mortality in Córdoba province and in Argentina as a whole from 1986 to 2006. Mortality data were provided by the Córdoba Ministry of Health and the World Health Organization cancer mortality database. Prostate cancer mortality time trends were analyzed using joinpoint analysis and age-period-cohort models. In Argentina prostate cancer age-standardized mortality rates rose by 1% and 3.4% per year from 1986 to 1992 and from 1992 to 1998 respectively. There was a decreasing trend (-1.6%) for Argentina from 1998 and Córdoba (-1.9%) from 1995. Age-period-cohort models for the country and the province showed a strong age effect. In the country there was an increased risk in the 1996-2000 period, whereas there was decreased risk for birth cohorts since 1946, principally in Córdoba. A decreasing trend in prostate cancer mortality was found in Córdoba as well as in Argentina, which might be attributed to the improvement in treatment in this country.

Dietary habits and prostate cancer prevention: a review of observational studies by focusing on South America.

There exist several works considering the association between diet and prostate cancer (PC) risk, but the issue is largely unsettled. This article systematically reviews the epidemiological studies on diet and risk of PC focusing on those carried out in countries of South America. There is some suggestion that dairy products, red meat, processed meat, α-linolenic fatty acids, as well as dietary patterns characterized by higher intakes of red and processed meat, eggs, and grains may play some role in the development of PC. There is no clear association with the intake of vegetables and fruits, lycopene, fats, and different types of fatty acids. The evidence on diet and PC is therefore inconclusive in general and specifically in South America. Particular attention must be paid to the study of cancer risk in some countries of South America because of the singularly risky dietary pattern consumed by its population.

Overweight and obesity: Prevalence and their association with some social characteristics in a random sample population-based study in Córdoba city, Argentina

SUMMARY BACKGROUND Obesity has become a threat to public health, as the epidemic is not confined to developed countries but is affecting many developing countries. Because obesity is known to vary according to socio-cultural factors, including socio-economic position and social roles, a multi-stage random sample population-based study was conducted in Córdoba, Argentina, from January 2005 to December 2006, to explore the effect of selected social factors on the prevalence of obesity. METHODS Information was obtained about demographic, anthropometric, lifestyle, dietary and physical activity characteristics. Logistic regression (LR) and proportional odds models (POM) were used in data analysis. RESULTS The prevalence of overweight and obesity was 52 and 17%, respectively. LR models revealed that overweight was positively associated with gender (men), decreasing socio-economic status (SES), married and divorced status and negatively with increasing levels of physical activity whereas obesity was positively associated with decreasing SES levels, married status and negatively associated with physical activity levels. POM revealed strong associations between variables and the outcomes and an effect modification among women aged 30 years or older with a low SES. CONCLUSIONS Our data indicate a high prevalence of overweight and obesity in this population; several social factors and lifestyle characteristics are associated with both overweight and obesity. However, a prospective cohort study would be needed to investigate causality.

Age-related seroprevalence study for St. Louis encephalitis in a population from Cordoba, Argentina

A serological screening was performed in 615 individuals aged 0-87 years, living in the city of Cordoba, Argentina to study the relationship between antibody prevalence for the SLE virus and age. A 13.98% prevalence of neutralizing antibodies was obtained and its relation to age was significantly high (p = 0.045). The highest seroprevalence was noted on individuals over 60 years old (>20%), whereas no subject under 10 was seropositive for this virus. Our results confirm that the agent is endemic in this area and neurological pathology studies should be performed on those individuals aged 60 since they represent the most susceptible group to SLE virus.