The effect of exercise on cardiovascular risk markers in Mexican school-aged children: comparison between two structured group routines

Objective. To assess the effects of two groups of exercise routines on cardiovascular disease risk markers. Material and Methods. An intervention study was conducted with 319 Mexican school-aged children in which routines were implemented Monday through Friday for 12 weeks. Routine A was the reference group, with 20 min of less intense activity and routine B was the new group with 40 min of aerobic exercises. Body mass index (BMI), waist circumference, fat mass percentage (FM%), systolic and diastolic blood pressure, lipids, lipoproteins, glucose and insulin were measured before and after the intervention. Results. Routine A had an effect on diastolic pressure, while routine B had an effect on BMI, FM%, blood pressure and triglycerides. Routine B had a greater effect on blood pressure than routine A. The prevalence of obesity, high blood pressure and hypertriglyceridemia decreased in both groups. Conclusion. Aerobic exercise is an effective health promotion strategy to reduce some cardiovascular disease risk markers

FACTORES SOCIOCULTURALES Y DEL ENTORNO QUE INFLUYEN EN LAS PRÁCTICAS ALIMENTARIAS DE GESTANTES CON Y SIN OBESIDAD

Identificar y describir factores socioculturales y del entorno que afectan las prácticas alimentarias de un grupo de gestantes mexicanas con y sin sobrepeso u obesidad. Estudio transversal descriptivo realizado en Instituto Nacional de Perinatología durante el 2009. Se invitó  a embarazadas asistentes a control prenatal y se dividieron en dos grupos: gestantes con peso normal y con sobrepeso u obesidad. A todas se aplicó una encuesta para identificar autopercepción del peso y  alimentación, preferencias de alimentos, creencias y fuentes de información.  Se calcularon medidas de dispersión y tendencia central, X2 de Pearson y T de Student. Participaron 301 gestantes. Las mayores de 30 años con sobrepeso u obesidad tuvieron mayor inconformidad con su peso corporal que las de IMC normal (42 vs 14%, p=0.001). El 34% de las gestantes practicó algún tratamiento para bajar de peso antes del embarazo. Una mayor proporción de participantes con peso normal reportó tener una alimentación buena o excelente comparadas con las de sobrepeso u obesidad (61% vs 39%, p=0.004) independientemente del nivel socioeconómico. La mayoría de las gestantes (95-97%) consideraron el sobrepeso u obesidad como factor de riesgo para presentar alguna co-morbilidad. La información sobre dietas y alimentación en todas las participantes se obtuvo principalmente de la familia (14% p=0.022). El 88% de las gestantes reportaron una influencia positiva de su pareja y/o madre. El 30% de las embarazadas omitieron un tiempo de comida de dos a tres veces por semana, y no consumieron los tres grupos de alimentos en forma constante. La falta de voluntad y de poder adquisitivo para la compra de ciertos alimentos fueron limitantes para una alimentación correcta. La obesidad es un problema prevalente en el embarazo. La falta de orientación resulta en prácticas alimentarias inadecuadas, posiblemente por falta de información o a que la información obtenida no siempre es la correcta. Es indispensable establecer estrategias educativas para brindar información veraz, tomando en cuenta el contexto de las mujeres, así como a sus familias. Abstract Identify and describe sociocultural and environmental factors affecting feeding practices in a group of Mexican pregnant women with and without obesity. Descriptive cross-sectional study conducted at the National Institute of Perinatology during 2009. Pregnant women who attend antenatal care were invited to participate and were divided into two groups: pregnant women with normal weight and overweight or obese. A survey was applied in all women in order to identify the self-perception of their weight and diet, food preferences, beliefs and sources of information. Measures of dispersion and central tendency (Pearson's X2 and T-Student) were calculated. A total of 301 pregnant women participate in this study. Overweight or obese women over 30 years were more dissatisfied with their actual weight than those with normal weight (42 vs 14%, p = 0.001). 34% of pregnant women underwent a loss weight treatment before pregnancy. A greater proportion of women with normal weight reported having a good or excellent diet compared with overweight or obese women (61% vs 39%, p = 0.004) regardless of socioeconomic status. Most pregnant women (95-97%) considered overweight or obesity as a risk factor for presenting comorbidities. The information about diet and nutrition was mainly obtained from the family (14% p = 0.022). A positive influence of their mother/partner was observed in 88% of pregnant women.  One third of the women skipped one meal time two to three times a week, and not always consumed foods from the three main food groups. The lack of will and money to purchase certain foods limited the practice of good eating habits. Obesity is prevalent problem in pregnancy. Lack of nutrition education results in inappropriate feeding practices, possibly because of lack of information or because the information obtained is not always the correct. It is essential to establish educational strategies to provide truthful information, taking into account the context of women and their families.Palabras clave: Embarazo, obesidad, creencias, prácticas alimentaria

Low Glycemic Index Carbohydrates versus All Types of Carbohydrates for Treating Diabetes in Pregnancy: A Randomized Clinical Trial to Evaluate the Effect of Glycemic Control

Background. Due to the higher prevalence of obesity and diabetes mellitus (DM), more pregnant women complicated with diabetes are in need of clinical care. Purpose. Compare the effect of including only low glycemic index (GI) carbohydrates (CHO) against all types of CHO on maternal glycemic control and on the maternal and newborn’s nutritional status of women with type 2 DM and gestational diabetes mellitus (GDM). Methods. Women (n=107, ≤29 weeks of gestation) were randomly assigned to one of two nutrition intervention groups: moderate energy and CHO restriction (Group 1: all types of CHO, Group 2: low GI foods). Results. No baseline differences in clinical data were observed. Capillary glucose concentrations throughout pregnancy were similar between groups. Fewer women in Group 2 exceeded weight gain recommendations. Higher risk of prematurity was observed in women in Group 2. No differences in glycemic control were observed between women with type 2 DM and those with GDM. Conclusions. Inclusion of low GI CHO as part of a comprehensive nutrition intervention is equally effective in improving glycemic control as compared to all types of CHO. This strategy had a positive effect in preventing excessive maternal weight gain but increased the risk of prematurity

Accuracy of SenseWear Pro2 armband to predict resting energy expenditure in childhood obesity.

OBJECTIVE: We evaluate the accuracy of the SenseWear Pro2 Armband (SWA) in estimating resting energy expenditure (REE) in children and adolescents with obesity, using indirect calorimetry (IC) as a reference. DESIGN AND METHODS: REE was assessed using both the SWA and IC in 40 obese subjects (26 M/14 F, age 11.5±2.57 years, z-score BMI 3.14±0.53). The agreement between methods was assessed by the Bland-Altman procedure. The relationship between REE assessments and patients' characteristics was also analyzed. RESULTS: SWA- and IC-derived estimates of REE showed a significant correlation (r=0.614; P<0.001), but the SWA overestimated mean REE by 13% (P<0.001). Age and kg of fat-free mass (kgFFM) were significantly correlated with both REE estimation by SWA (r=0.434 and r=0.564; respectively) and IC (r=0.401 and r=0.518; respectively). Only kgFFM was demonstrated to be the main predictor factor of REE variability (r2 79% SWA; 75% IC). CONCLUSIONS: The SWA overestimated mean REE in childhood obesity, suggesting that the SWA and IC are not yet interchangeable methods. This would require improving the SWA by developing better algorithms for predicting REE and, probably, bias in each individual REE could be reduced by an adjustment for subjects' kgFFM

Predisposition to Obesity: Should We Target Those Most Susceptible?

Obesity prevention should remain a priority, even if there is some suggestion that the epidemic may presently have reached a stable level. However, previous interventions have not been effective in preventing overweight and obesity, and at the same time studies suggest that some subgroups are more predisposed to future obesity. The purpose of this paper is to review interventions on obesity prevention published during the past year, and to examine if interventions targeting predisposed groups or individuals seem more efficient in preventing obesity than studies targeting general populations. Among 15 identified studies, 7 targeted predisposed children or adolescents. More of the studies targeting predisposed individuals were able to show significant effects than the studies targeting general populations. Most studies targeting predisposed defined the predisposition based on ethnicity or socioeconomic status. Thus, we may be more successful in preventing obesity when targeting predisposed individuals, but more studies are needed before a firm conclusion can be drawn

The effect of exercise on cardiovascular risk markers in Mexican school-aged children: comparison between two structured group routines

Objective. To assess the effects of two groups of exercise routines on cardiovascular disease risk markers. Material and Methods. An intervention study was conducted with 319 Mexican school-aged children in which routines were implemented Monday through Friday for 12 weeks. Routine A was the reference group, with 20 min of less intense activity and routine B was the new group with 40 min of aerobic exercises. Body mass index (BMI), waist circumference, fat mass percentage (FM%), systolic and diastolic blood pressure, lipids, lipoproteins, glucose and insulin were measured before and after the intervention. Results. Routine A had an effect on diastolic pressure, while routine B had an effect on BMI, FM%, blood pressure and triglycerides. Routine B had a greater effect on blood pressure than routine A. The prevalence of obesity, high blood pressure and hypertriglyceridemia decreased in both groups. Conclusion. Aerobic exercise is an effective health promotion strategy to reduce some cardiovascular disease risk markers