La relación cintura-estatura puede ser un indicador alternativo al índice de masa corporal para identificar adolescentes colombianos con factores de riesgo cardiometabólicos

ABSTRACT: there is limited information about the usefulness of the waist-to-height ratio (WHtR) to identify Colombian adolescents with cardiometabolic risk factors (CRF). Objective: to compare the utility of WHtR, body mass index (BMI), and waist circumference (WC) to identify adolescents with CRF. Methods: a study with 346 youths (aged 14.0 ± 2.3 years) was performed. Anthropometric measurements were collected and BMI, WC and WHtR were calculated. Fasting blood lipids, glucose and insulin were measured; the homeostasis model assessment of insulin resistance (HOMA-IR) was computed. The presence of multiple non-WC metabolic syndrome (MetS) factors (high HOMA-IR, high triglycerides and low high-density lipoprotein cholesterol [HDL-C]) was analyzed. The area under the curve (AUC) and the odds ratios (OR) were calculated. Results: the BMI, WC and WHtR were comparable at identifying adolescents with high HOMA-IR (AUC = 0.686, 0.694 and 0.641, respectively), low HDL-C (AUC = 0.623, 0.652 and 0.572, respectively) and multiple non-WC MetS factors (AUC = 0.694, 0.715 and 0.688, respectively). The OR of having multiple non-WC MetS factors was similar in overweight adolescents (1.65, 95% CI: 0.86-3.14) and those with WHtR ≥ 0.50 (3.76, 95% CI: 1.95-7.3). There were no OR differences of having multiple non-WC MetS factors among adolescent with obesity (9.88, 95% CI: 3.1-31.7), WC ≥ P90 (18.3, 95% CI: 4.0-83.5) and WHtR ≥ 0.55 (11.0, 95% CI: 3.0-4.4). Conclusions: WHtR, BMI and WC have similar capacities to identify Colombian adolescents with CRF. WHtR showed to be an alternative tool to BMI and WC measurements when screening adolescents for cardiometabolic risk.RESUMEN: hay información limitada sobre la utilidad de la relación cintura-estatura (rCE) para identificar adolescentes colombianos con factores de riesgo cardiometabólicos (FRC). Objetivo: comparar la utilidad de la rCE, el índice de masa corporal (IMC) y la circunferencia de cintura (CC) para identificar adolescentes con FRC. Metodología: se evaluaron 346 jóvenes (14,0 ± 2,3 años). Se obtuvieron medidas antropométricas, IMC, CC, rCE, glucosa, insulina y lípidos sanguíneos en ayunas e índice HOMA-IR. Se analizó la presencia de múltiples factores del síndrome metabólico (MetS) diferentes a la CC (HOMA-IR alto, triglicéridos aumentados, concentración del colesterol de alta densidad [HDL-C] baja). Se calculó el área bajo la curva (AUC) y razón de ventajas (OR). Resultados: el IMC, CC y rCE fueron similares para identificar adolescentes con alto HOMA-IR (AUC = 0,686, 0,694 y 0,641, respectivamente), bajo HDL-C (AUC = 0,623, 0,652 y 0,572, respectivamente) y múltiples factores del MetS diferentes a la CC (AUC = 0,694, 0,715 y 0,688, respectivamente). La OR de tener esta última condición fue similar en adolescentes con sobrepeso (1,65, IC 95%: 0,60-3,14) y aquellos con rCE ≥ 0,50 (3,76, IC 95%: 1,95-7,3). La presencia de múltiples factores del MetS diferentes a la CC en adolescentes con obesidad (9,88, IC 95%: 3,1-31,7), CC ≥ P90 (18,3, IC 95%: 4,0-83,5) y rCE ≥ 0,55 (11,0, IC 95%: 3,0 a 4,4) fue similar. Conclusión: rCE, IMC y CC tienen capacidades similares para identificar adolescentes colombianos con FRC. El rCE demostró ser una herramienta alternativa al IMC y la CC cuando se tamizan adolescentes para identificar la presencia de FRC

Desarrollo y validación de ecuaciones antropométricas para estimar la composición corporal en mujeres adultas

ABSTRACT: To develop anthropometric equations to predict body fat percentage (BF%). Methods: In 151 women (aged 18-59) body weight, height, eight-skinfold thickness (STs), six- circumferences (CIs), and BF% by hydrodensitometry were measured. Subjects data were randomly divided in two groups, equation-building group (n= 106) and validation group (n= 45). The equation-building group was used to run linear regression models using anthropometric measurements as predictors to find the best prediction equations of the BF%. The validation group was used to compare the performance of the new equations with those of Durnin-Womersley, Jackson-Pollock and Ramirez-Torun. Results: There were two preferred equations: Equation 1= 11.76 + (0.324 x tricipital ST) + (0.133 x calf ST) + (0.347 x abdomen CI) + (0.068 x age) - (0.135 x height) and Equation 2= 11.37 + (0.404 x tricipital ST) + (0.153 x axilar ST) + (0.264 x abdomen CI) + (0.069 x age) - (0.099 x height). There were no significant differences in BF% obtained by hydrodensitometry (31.5 ±5.3) and Equation 1 (31.0 ±4.0) and Equation 2 (31.2 ±4.0). The BF% estimated by Durning-Womersley (35.8 ±4.0), Jackson-Pollock (26.5 ±5.4) and Ramirez-Torun (32.6 ±4.8) differed from hydrodensitometry (p <0.05). The interclass correlation coefficient (ICC) was high between hydrodensitometry and Equation 1 (ICC= 0.77), Equation 2 (ICC= 0.76), and Ramirez-Torun equation (ICC= 0.75). The ICC was low between hydrodensitometry and Durnin-Womersley (ICC= 0.51) and Jackson-Pollock (ICC= 0.53) equations. Conclusion: The new Equations-1 and 2, performed better than the commonly used anthropometric equations to predict BF% in adult women.RESUMEN: Desarrollar ecuaciones antropométricas para predecir el porcentaje de grasa corporal (% GC). Métodos: En 151 mujeres (18-59 años) se midieron peso corporal, estatura, ocho pliegues cutáneos (PCs), seis perímetros (PEs) y el %GC por hidrodensitometría. Se formaron dos grupos al azar, desarrollo de ecuaciones (n= 106) y validación (n= 45). En el grupo desarrollo ecuaciones se calcularon modelos de regresión lineal, con las medidas antropométricas como predictores, para encontrar la mejor ecuación de predicción del %GC. El grupo validación se utilizó para comparar el desempeño de las nuevas ecuaciones con las de Durnin-Womersley, Jackson-Pollock y Ramírez-Torun. Resultados: Se seleccionaron dos ecuaciones: Ecuación-1= 11.76 + (0.324 x tríceps PC) + (0.133 x pantorrilla-medial PC) + (0.347 x abdomen PE) + (0.068 x edad-años) - (0.135 x estatura) y Ecuación-2= 11.37 + (0.404 x tríceps PC) + (0.153 x axilar PC) + (0.264 x abdomen PE) + (0.069 x edad-años) - (0.099 x estatura). No hubo diferencias significativas en el %GC obtenido por hidrodensitometría (31.5 ±5.3) y Ecuación-1 (31.0 ±4.0) o Ecuación-2 (31.2 ±4.0). Los %GC estimados por Durning-Womersley (35.8 ±4.0), Jackson-Pollock (26.5 ±5.4) y Ramírez-Torun (32.6 ±4.8) fueron diferentes del obtenido por hidrodensitometría (p <0.05). El coeficiente de correlación intraclase (ICC) fue alto entre hidrodensitometría y las Ecuaciones 1 (ICC= 0.77), 2 (ICC= 0.76), y Ramírez-Torun (ICC= 0.75). El ICC fue bajo entre hidrodensitometría y Durnin-Womersley (ICC= 0.51) y Jackson-Pollock (ICC= 0.53). Conclusión: Las nuevas ecuaciones 1 y 2 presentaron mejor rendimiento que las ecuaciones tradicionales para predecir el %GC en mujeres adultas

Validation of bioelectrical impedance equations for predicting body composition in women

ABSTRACT: The application of bioimpedance to estimate body composition in Colombia has increased in the last years. Objective: To validate bioimpedance equations to assess fat mass percentage (%FM) in women from Medellín-Colombia. Materials and methods: This is a cross sectional study with a sample of 52 women 18 to 40 years old. The %FM was assessed by the reference method hydrodensitometry and by hand-to-feet bioimpedance with the equations of Sun and Kotler, and feet-to-feet bioimpedance with a Tanita scale. Results: The %FM estimated by Kotler (31,9±6,0) and Tanita (25,6±6,1) were different (p<0.001) from hydrodensitometry (29,6±5,3). These techniques showed low agreement with the reference method, Kotler (Bland-Altman: -2,3 IC95%: -10,9; 6,1) and Tanita (BlandAltman: 4.0 IC95%: -6,3; 14,3). The %FM estimated by the Sun equation was similar to hydrodensitometry (29,6±5,3 Vs. 28,6±5,2, p=0,098). However, this equation showed low agreement with this method (Bland-Altman: 0,9 IC95%: -7,1; 9,0). Conclusions: The hand-to-feet bioimpedance with the Kotler equation and feet-to-feet bioimpedance with Tanita scale were not valid to assess the %FM of this specific population of women. The hand-to-feet bioimpedance with the Sun equation estimated accurately the average group of %FM, but it lacked of validity to assess the individual %FM in this population.RESUMEN: La aplicación de la bioimpedancia para estimar la composición corporal se ha incrementado recientemente en Colombia. Objetivo: evaluar la validez de la bioimpedancia para estimar el porcentaje de grasa corporal (%GC) en mujeres de Medellín-Colombia. Materiales y métodos: estudio transversal con una muestra de 52 mujeres entre los 18 y 40 años. El %GC se estimó por hidrodensitometría, bioimpedancia mano-pie con las ecuaciones de Sun y Kotler, y bioimpedancia pie-pie con báscula Tanita. Resultados: los %GC obtenidos por Kotler (31,9±6,0) y Tanita (25,6±6,1) fueron diferentes (p<0,001) del obtenido por hidrodensitometría (29,6±5,3), asimismo, estas técnicas presentaron un bajo grado de acuerdo con este método de referencia, Kotler (Bland-Altman: -2,3 IC95%: -10,9; 6,1) y Tanita (Bland-Altman: 4.0 IC95%: -6,3; 14,3). La ecuación de Sun estimó valores similares a la hidrodensitometría (29,6±5,3 vs. 28,6±5,2, p=0,098) pero presentó un bajo grado de acuerdo con este método (Bland-Altman: 0,9 IC95%: -7,1; 9,0). Conclusiones: la bioimpedancia mano-pie con la ecuación de Kotler y pie-pie con báscula Tanita, no fueron válidas para estimar el %GC de las mujeres evaluadas. La bioimpedancia mano-pie con la ecuación de Sun estimó de forma adecuada el %GC grupal, pero presentó poca validez para estimar el %GC individual en esta población

Comparison of body composition assessment by bioimpedance versus hydrodensitometry in women 38 to 60 years old from Medellin-Colombia

ABSTRACT: Body composition assessment by bioimpedance is non-invasive, inexpensive and portable. Objective: To assess the validity of bioimpedance to estimate fat mass percentage (%FM) in women. Materials and methods: This is a cross-sectional study with a sample of 50 women, 38 to 60 years old. Hydrodensitometry with simultaneous measurement of the lung residual volume was used as the reference method. The %FM was assessed by the bioimpedance hand-to-feet technique using the equations of Sun and Kotler. A Tanita body composition scale was used to estimate the %FM with the bioimpedance feet-to-feet technique. Results: The %FM estimated by Sun (34,0±4,8) and Kotler (34,4±6,0) were not different (p>0,05) from the %FM obtained by hydrodensitometry (33,3±5,6). The %FM estimated by Tanita differed from the reference method (30,1±5,8, p=0,000). BIA equations and Tanita showed low agreement with hydrodensitometry: Sun (Bland-Altman: -0,73 CI95%: -9,9; 8,4), Kotler (Bland-Altman: -1,1 CI95%: -10,7; 8,5) and Tanita (Bland-Altman: 3,2 CI95%: -5,8; 12,2). Conclusions: In this specific population of women, hand-to-feet bioimpedance with Sun and Kotler equations accurately estimated the %FM of the whole group, but these equations lacked validity to assess the individual %FM. The Tanita body composition scale lacked validity to assess both; individual and group %FM.RESUMEN: La bioimpedancia es un método de estimación de la composición corporal rápido, económico y portátil. Objetivo: comparar la composición corporal obtenida por bioimpedancia e hidrodensitometría en mujeres de Medellín-Colombia. Materiales y métodos: se evaluó el porcentaje de grasa corporal de 50 voluntarias. Se utilizó como método de referencia la hidrodensitometría con medición simultánea del volumen residual pulmonar. Se midió la bioimpedancia mano-pie y se estimó el porcentaje de grasa corporal con las ecuaciones de Kotler y Sun. La bioimpedancia pie-pie se midió con báscula Tanita. El análisis estadístico empleó t-student pareada, error estándar del estimado y prueba Bland-Altman. Resultados: el porcentaje de grasa corporal obtenido por hidrodensitometría fue (33,3±5,6). Sun y Kotler estimaron porcentajes de grasa similares (p>0,05) a la hidrodensitometría (34,0±4,8 y 34,4±6,0, respectivamente). Tanita estimó un porcentaje de grasa diferente al método de referencia (30,1±5,8, p=0,000). La bioimpedancia presentó un bajo grado de acuerdo con la hidrodensitometría: Sun (BlandAltman: -0,73 IC95%: -9,9; 8,4), Kotler (Bland-Altman: -1,1 IC95%: -10,7; 8,5) y Tanita (Bland-Altman: 3,2 IC95%: -5,8; 12,2). Conclusiones: las ecuaciones de Sun y Kotler estiman de forma adecuada el porcentaje de grasa corporal grupal, pero presentan poca concordancia con la hidrodensitometría en la estimación de la composición corporal individual. La báscula Tanita presentó las mayores diferencias con la hidrodensitometría en la estimación del porcentaje de grasa corporal grupal e individual

Concentrations of plasma free palmitoleic and dihomo-gamma linoleic fatty acids are higher in children with abdominal obesity

ABSTRACT: Increased plasma free fatty acids (FFAs) are associated with cardiometabolic risk factors in adults with abdominal obesity (AO). However, this association remains controversial in children. This study analyzed plasma FFA concentration in children with and without AO. Twenty-nine children classified with AO were matched by age and sex with 29 non-obese individuals. Blood samples were collected after fasting for 10–12 h. Plasma concentration of glucose, insulin, triglycerides, total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were determined by automatized methods. FFAs were analyzed by gas chromatography. Children with and without AO had similar age (7.1 ± 2.6 vs. 7.2 ± 2.7 years; p > 0.05) but obese children showed higher (p 0.05). However, children with AO had higher palmitoleic acid (0.94 vs. 0.70 wt %; p < 0.05) and dihomo-gamma linoleic acid (DHGL) (2.76 vs. 2.07 wt %; p < 0.05). Palmitoleic and DHGL acids correlated (p < 0.05) with BMI (r = 0.397; r = 0.296, respectively) and with waist circumference (r = 0.380; r = 0.276, respectively). Palmitoleic acid correlated positively with systolic blood pressure (r = 0.386; p < 0.05) and negatively with HDL-C (−0.572; p < 0.01). In summary, children with AO have higher plasmatic concentrations of free palmitoleic and DHGL fatty acids, which correlate with cardiometabolic risk factors

Evaluation of agraz consumption on adipocytokines, inflammation, and oxidative stress markers in women with metabolic syndrome

ABSTRACT: Metabolic syndrome (MetS) is characterized by increased oxidative stress and a pro-inflammatory state. Vaccinium meridionale Swartz (known as “agraz”) is a berry rich in polyphenolic compounds with demonstrated antioxidant activity and anti-inflammatory effects in preclinical studies. The aim of this study was to evaluate the effects of agraz consumption on inflammatory and oxidative stress markers in women with MetS. Forty women with MetS (47 ± 9 years) were randomly assigned to consume daily either 200 mL of agraz nectar or placebo over four weeks in a double-blind, cross-over design study, separated by a 4-week washout period. Metabolic and inflammatory markers in serum and antioxidant/oxidative stress markers in serum and urine were assessed at the end of each period. Serum antioxidant capacity measured by the 2,2-diphenyl-1-picrylhydrazyl (DPPH) method was significantly higher (p = 0.028), while urinary 8-hydroxy-2-deoxyguanosine (8-OHdG) was lower (p = 0.041) after agraz consumption, compared to placebo. In conclusion, consumption of agraz during four weeks increased serum antioxidant capacity and decreased a marker of DNA oxidative damage in women with MetS, compared to placebo. These results suggest that agraz consumption may play a protective role in patients with MetS

Effect of Agraz (Vaccinium meridionale Swartz) on high-density lipoprotein function and inflammation in women with metabolic syndrome

ABSTRACT: Metabolic syndrome (MetS) is associated with low-grade inflammation and high-density lipoprotein (HDL) dysfunction. Polyphenol-rich foods may improve these alterations. Agraz is a fruit rich in polyphenols (mainly anthocyanins); however, there is limited information about its effects on human health. We evaluated the effects of agraz consumption as compared to placebo on HDL function and inflammation in women with MetS. Forty volunteers (25–60 years) were included in this double-blind crossover study. Women consumed agraz or placebo over 4 weeks; separated by a 4-week washout period. HDL function (apoliprotein-A1; paraoxonase 1 (PON1) activity; cholesterol efflux capacity), oxidative stress (myeloperoxidase (MPO), advanced oxidation protein products) and inflammatory markers (serum cytokines/chemokines and peripheral blood mononuclear cell nuclear factor-kB) were measured after each period. Compared to placebo, agraz consumption did not significantly change any of the biomarkers measured. Interestingly, only after agraz period there were significant positive correlations between PON1 activities and cholesterol efflux. Additionally, there were significant inverse correlations between changes in inflammatory markers and HDL function markers and positive correlations with oxidative markers. Although polyphenol-rich foods have been shown to be beneficial for certain conditions; polyphenol-rich agraz fruit consumption did not impact inflammation and HDL function in the current study of women with MetS

Confiabilidad intraobservador de mediciones antropométricas en niños y adolescentes sudamericanos: Estudio SAYCARE

ABSTRACT: The South American Youth/Child Cardiovascular and Environmental (SAYCARE) feasibility study aims to develop valid and reliable indicators to investigate health-related behavior and nutritional status in children and adolescents. Anthropometric measurements are one of the evaluated indicators in the study. The accuracy of the anthropometric data is very important and relies in the quality of the measurements. Objective: to describe the intra-observer reliability of ten anthropometric measurements: weight, height, circumferences (neck, arm, waist, hip) and skinfolds (triceps, subscapular, biceps and suprailiac) of children and adolescents from six South American cities: Lima, Medellin, Montevideo, Santiago, San Pablo and Teresina. Methods: prior to the study, fieldworkers from the seven centers participated in central training to ensure the application of standardized pro- cedures in the anthropometric measurements. Intra-observer precision, technical error of measurement (TEM) and coefficient of reliability (R) were estimated for each measurement. Results: reliability of weight and height was above 99% in almost all cities. TEM for skinfold thickness was below 1.4 mm in children and 2.13 mm in adolescents, while reliability was above 95% in most of the skinfold measurements. TEM for circumferences was below 1.8 cm in children and 0.64 cm in adolescents, while reliability was above 99% in almost all circumferences. Conclusions: reliability of the anthropometric measurements in this study was high. In comparison with similar European or American studies, the reliability of the measurements taken in our study was, in most cases, similar or even higher.RESUMEN: El estudio piloto South American Youth/Child cARdiovascular and Environmental (SAYCARE) tiene como objetivo desarrollar indicadores válidos y confiables para investigar el estado nutricional y las conductas vinculadas a la salud en niños y adolescentes. Uno de estos indicadores son las mediciones antropométricas. La precisión de los datos antropométricos es muy importante y se basa en la calidad con que se toman las mediciones. Objetivos: describir la confiabilidad intraobservador de diez mediciones antropométricas: peso, talla, circunferencias (cuello, brazo, cintura, cadera) y pliegues (trÍceps, subscapular, bÍceps y suprailIaco) de niños y adolescentes de seis ciudades de Sudamérica: Lima, Medellín, Montevideo, Santiago, San Pablo and Teresina. Métodos: previo al estudio, los trabajadores de campo de los seis centros participaron de un entrenamiento centralizado, para asegurar la aplicación de procedimientos estandarizados en la toma de las mediciones antropométricas. Para determinar la precisión intraobservador, se estimó el error técnico de medición (TEM) y el coeficiente de confiabilidad (R) para cada medición. Resultados: la confiabilidad de las medidas de peso y la talla estuvo por encima del 99% en casi todas las ciudades. El TEM para el grosor de los pliegues estuvo debajo de 1,4 mm en los niños y de 2,13 mm en los adolescentes, mientras que la confiabilidad fue superior al 95% en la mayoría de las mediciones de los pliegues. El TEM para las circunferencias estuvo por debajo de 1,8 cm en los niños y de 0,64 cm en los adolescentes, mientras que la confiabilidad fue superior al 99% en casi todas las circunferencias. Conclusiones: la confiabilidad de las mediciones antropométricas en este estudio fue alta. Comparada con estudios similares realizados en Europa y Estados Unidos, la confiabilidad de las medidas tomadas en nuestro estudio es, en la mayoría de los casos, similar o aún más elevada

Physico-chemical characterization and antioxidant capacity of the colombian berry (Vaccinium meridionale Swartz) with a high-polyphenol content: potential effects in people with metabolic syndrome

ABSTRACT: Colombian berry (agraz) has demonstrated a high antioxidant content in vitro. In the present study, it was elaborated and characterized an agraz nectar, designed a placebo with similar physicochemical and sensorial characteristics of the agraz nectar, but without polyphenols; and evaluated their antioxidant capacity both in vitro and in vivo in adults with cardiovascular risk factors. The polyphenolic concentration of the agraz nectar and its antioxidant capacity was superior than other reported for this fruit. A high content of total cyanidins was observed in the freeze-dried agraz, but not delphinin was detected by HPLC. For the intervention study, sixty-six subjects, with at least three cardiometabolic risk factors, consumed agraz nectar or placebo daily during 4 weeks each, separated by a 4-week washout period. Total phenol concentration and antioxidant capacity in the participants’ serum were not statistically different after consuming agraz nectar and placebo. However, women increased significantly their serum DPPH scavenging capacity after consuming agraz nectar, compared to placebo. This is one of the first studies showing data about the effects of this colombian berry on the antioxidant capacity in people with metabolic syndrome

Reliability and validity of a questionnaire for physical activity assessment in South American children and adolescents: The SAYCARE Study

ABSTRACT: The objective of this article is to test the reliability and validity of the new and innovative physical activity (PA) questionnaire. Methods: Subsamples from the South American Youth/Child Cardiovascular and Environment Study (SAYCARE) study were included to examine its reliability (children: n 5 161; adolescents: n 5 177) and validity (children: n 5 82; adolescents: n 5 60). The questionnaire consists of three dimensions of PA (lei-sure, active commuting, and school) performed during the last week. To assess its validity, the subjects wore accelerometers for at least 3 days and 8 h/d (at least one weekend day). The reliability was analyzed by correlation coefficients. In addition, Bland-Altman analysis and a multilevel regression were applied to estimate the measurement bias, limits of agreement, and influence of contextual variables. Results: In children, the questionnaire showed consistent reliability (q 5 0.56) and moderate validity (q 5 0.46), and the contextual variable variance explained 43.0% with 222.9 min/d bias. In adolescents, the reliability was higher (q 5 0.76) and the validity was almost excellent (q 5 0.88), with 66.7% of the variance explained by city level with 16.0 min/d PA bias. Conclusions: The SAYCARE PA questionnaire shows acceptable (in children) to strong (in adolescents) reliability and strong validity in the measurement of PA in the pediatric population from low- to middle-income countries