Vivien Gattas Z

Hábitos de ingesta y actividad física en escolares, según tipo de establecimiento al que asisten

Background: The increased infantile obesity rates are related to faulty dietary intake (DI) and physical activity (PA) habits, that are probably related to a prolonged stay at school during the day. Aim: To investigate DI and PA among elementary and high school students and their association with type of school that they attend. Material and Methods: Quality of DI and PA was assessed, using specially designed questionnaires, in 1136 elementary school and 1854 high school children attending public schools managed by city halls (ME), subsidized private (SE) and private (PE) of the Metropolitan Region. The responses to the questionnaires, were qualified using a numeric scale that ranged from 0 to 10 points. A higher score indicated a better habit. Results: Percentile 25 (p 25 th) PA score was 4 and 3 in elementary and high school children respectively and the p 25 th for DI were 5.7 and 4.3, respectively. No differences in DI scores, according to the type of school, were observed. However, physical activity scores were significantly lower in children and adolescents from ME schools than from PE schools. Sixty percent of ME schools had less than 2 hours per week of programmed physical activity compared to more than 3 hours, in 70% of PE schools. Elementary school children and high school adolescents expended 8 and 11 hours per day, respectively, in minimum expenditure activities. Conclusions: There is a greater deterioration of PA than DI among school age children and adolescents. Those attending ME schools have the worst physical activity scores. This fact must be addressed in future healthy lifestyle encouragement policies (Rev Med Chile 2008; 136: 53-63). (Key words: Child behavior; Child preschool; Exercise)

La mantención de peso en humanos: ¿podría ser equivalente a la restricción calórica de los modelos animales?

Background: Energy restriction (ER) extends life span in animals, by decreasing oxidative stress. Aim: To compare adiposity, metabolic variables and DNA oxidative damage, among adults, reporting a constant body weight (weight maintainers), versus those reporting a progressive increase (weight gainers). Subjects and Methods: Clinical history, dietary recall, anthropometric measures, abdominal CT scan and fasting blood samples (to measure lipoproteins, glucose and insulin), were obtained in 44 males. These subjects were classified as weight maintainers if they had a change in weight of 3 kg or less in the last 10 years, or weight gainers, if they had a weight increment of more than 6 kg in the same lapse. Oxidative damage was assessed by 8-hydroxydeoxyguanosine (8-OHdG), in DNA extracted from circulating lymphocytes, in 5 weight maintainers, 8 weight gainers and 5 healthy elders. Results: Energy intake was 18% higher in weight gainers (p <0.01). Adiposity and central fat were higher among weight gainers (p <0.01). Abdominal fat correlated with serum lipoproteins, glucose and insulin sensitivity, assessed by the Homeostasis Model Assessment (HOMA). 8-OHdG levels did not differ between groups. Conclusions: The analysis of weight change based on the clinical history correlates with actual body composition, thus it may be a reliable indicator of long term energy intake. This method could be comparable to weight clamp models employed in animals to study aging (Rev Med Chile 2004; 132: 1166-72)

Perfil metabólico de riesgo cardiovascular en niños y adolescentes obesos con menor sensibilidad insulínica

Infantile obesity is associated with metabolicdisturbances (hiperinsulinism, impaired glucose, dislypidemia) that determine a higher risk oftype 2 diabetes, high blood pressure and atherosclerotic vascular disease in adulthood. Insulinresistance is a central mechanism of complications of obesity and is associated to body fat mass.

Características biológicas, familiares y metabólicas de la obesidad infantil y juvenil

Obesity is the most prevalent nutritional disease in people of less than 20 years old. Aim: To report biological, familial and metabolic characteristics in obese children. Patients and methods: A retrospective review of 187 children seen at obesity clinics and that had a complete metabolic study. Results: Ninety five prepuberal and 92 puberal children, aged 8.7±2.2 and 12.6±2.2 years old respectively, were studied. Body mass index was over 4 standard deviations in 48.4% of prepuberal children and in 39.1% of puberal children. Paternal obesity was twice more prevalent (30.2%) than in the general population. The daily caloric intake and basal metabolic rate (BMR) were within the normal range; nevertheless there was a positive caloric balance due to minimal physical activity. The mean daily fat intake was normal (26.4±8.5 and 25.3±9.1% of total calories in prepuberal and puberal children respectively). The daily fiber intake was under 70% of recommendation. The total cholesterol was over 200 mg/dl in 26.6 and 23.9% of prepuberal and puberal children. LDL cholesterol was over 130 mg/dl in 27.3 and 26.6% and triacylglycerol was over 150 mg/dl in 16.9 and 25% of prepuberal and puberal children respectively. Basal serum insulin was over 20 uIU/ml in 27.7 and 42.2% of prepuberal and puberal children, respectively. Post glucose serum insulin was over 60 uIU/ml in 40 and 63% of prepuberal and puberal children, respectively. Conclusions: Infantile and juvenile obesity is a chronic disease with a high incidence of metabolic alterations (Rev Med Chile 2001; 129: 1155-62)

Tratamiento integral de la obesidad infantil: Efecto de una intervención psicológica

Background: Disrupted eating behaviors and psychological issues can have a role in the development of childhood obesity. Aim: To assess the effects of psychological support as an adjunct to the treatment of obesity among children. Material and Methods: Retrospective analysis of a group of 152 obese children aged 3 to 16 years, who received medical, Nutritional and physical training treatment. Seventy three (Group I) were invited to participate in a protocol of psychological support and 79 formed the control group (Group 2). Body mass index, body fat mass, waist circumference, insulin sensitivity, lipid profile, eating and physical activity habits were evaluated. Family structure, history of food rejection, psychological, physical and social development, and adherence to the program were also analyzed. To analyze responses to treatment, Group I was further divided into those who attended the psychology sections (intervened group) and those who did not attend (non intervened group). Results: At baseline, there were no differences in anthropometric, metabolic, familial and psychological profile among Groups I and 2. Family structure, eating behaviors and physical and social development were normal. Those associated with lack of control appeared as negative characteristics. There was a significant improvement in eating habits and physical activity among intervened children of Group 1 and Group 2. No significant change in weight was recorded in all three groups. Compliance with the program was significantly better among intervened children in Group 1 (62.1% at sixth months), compared with non intervened children of Group 1 (15.9%) and Group 2 (30.3%). Conclusions: Obese children who attended psychological support therapy as an adjunct to a weight reducing program, had a better compliance with treatment but did not achieve a higher weight loss.

RELACIÓN ENTRE LA INGESTA DE ÁCIDOS GRASOS, LA OXIDACIÓN DE SUBSTRATOS ENERGÉTICOS Y LA RESPUESTA INSULÍNICA

La presente revision analiza los roles de los acidos grasos dietarios; en primer lugar a nivel celular en lo que respecta a la diferenciacion adipocitica, expresion genica de enzimas y la sintesis de proteinas involucradas en el metabolismo energetico. En segundo lugar, se analiza los efectos de los acidos grasos en el mejoramiento de la sensibilidad o de la resistencia insulinica, en particular sobre la relevancia de los acidos grasos saturados versus los poliinsaturados. Finalmente, se describen los efectos de las distintas calidades de acidos grasos sobre el metabolismo oxidativo de sustratos energeticos. En la actualidad se conoce que la mayoria de estos efectos pueden ser modulados a traves de modificaciones dieteticas simples como por ejemplo la variacion en el tipo de aceite ingerido. La relevancia de estos procesos en relacion a la obesidad y sus alteraciones metabolicas se enfatizan de manera especifica

Absorción de minerales de una nueva fórmula láctea propuesta para el Programa Nacional de Alimentación Complementaria

La leche de vaca tiene un contenido excesivo de calcio y fosforo e insuficiencia de zinc y cobre. En la formulacion de una leche modificada se han cambiado las concentraciones de estos minerales, para acercarlas a las recomendaciones normales. Se estudio la absorcion de estos nutrientes en 9 lactantes hospitalizados en recuperacion nutricional (x P/T: *85%). Cada nino recibio leche de vaca y leche modificada por 6 dias, usandose los tres ultimos dias de cada periodo para balance. Encontramos ingestas inadecuadas de cobre (50%) y zinc (50%) y absorciones bajas de cobre (13 *g*kg*d), en relacion a las correspondientes recomendaciones, cuando se empleo leche de vaca no modificada. Con la leche modificada solo la ingesta de zinc (60%) fue insuficiente. Las ingestas de calcio (140%) y fosforo (117%) fueron excesivas mientras los ninos recibian leche de vaca, pero adecuadas con leche modificada. La leche modificada empleada en este estudio asegura ingestas y absorciones mas adecuadas que la leche de vaca no modificada para los minerales evaluados

Nueva formula Láctea para el Programa Nacional de Alimentación Complementaria: balance nitrogenado y calórico

Nitrogen, fat and energy retention were measured in 10 male infants (mean age = 6.8 mo) recovering from marasmic malnutrition while they were fed with either cows milk based formula (LP) or a modified cows milk formula (LPM). Their mean weight for age ratio was 72% and their weight for length ratio was 95% (NCHS standards). They went through two consecutive balance periods of 6 days each (3 d. for adaptation and 3 d. for urine and feces collection) beginning with either formula randomly. Both formulas had 85 kcal/dl with 11% protein calories in LPM and 13% in LP. Energy intake, absorption and relative retention were slightly greater with LPM than LP. Fat intake was greater under LPM than LP (5.4 vs. 4.5 g-kg-d, p < 0.025), which resulted in significant differences in fat absorption (LPM 4.3 vs. LP 3 g-kg-d, p < 0.025). Nitrogen intake was significantly lower under LPM than LP (487 vs. 571 mg-kg-d, p < 0.025) with lower urinary nitrogen excretion for LPM than for LP (304 vs. 417 mg-kg-d, p < 0.001). Apparent nitrogen retention averaged 115 mg-kg-d for LPM and only 69 mg-kg-d for LP (NS). A significant correlation was observed between nitrogen intake and nitrogen retention: r = 0.70 (y = 0.57x -167; p < 0.05) with LPM, and r = 0.77 (y = 0.63x -291, p < 0.01) with LP. A correlation was also found between energy intake and weight gain: r = 0.55 (NS) with LPM, and r = 0.88 (y = 0.26x -26; p < 0.001) with LP.(ABSTRACT TRUNCATED AT 250 WORDS)