Eficiencia de indicadores antropométricos en el diagnóstico de obesidad abdominal infantil

Introduction: Abdominal obesity, determined by excess in Visceral Adipose Tissue (VAT), increases the risk of metabolic syndrome. The most common method to evaluate childhood obesity is body mass index (BMI), but recently studies also suggest the use of waist circumference (WC) and waist to height ratio (WHR). Objective: Evaluate the efficiency of anthropometric indicators in VAT prediction and classify overweight-obesity (OW/OB). Material and method: Cross-sectional, analytical and comparative study. 59 children (47.5% girls) of 10.6 ± 2.1 years of age in public schools of Hermosillo, Sonora, Mexico were evaluated; anthropometric variables were examined, estimating BMI and WHR, VAT was determined by Dual Energy X-ray Absorptiometry (DEXA); multiple linear regression, Bland Altman's concordance and Cohen's Kappa index were analysed.  Results: The most efficient model to predict VAT was the WC (R2=0.90). The anthropometric indicators reported good concordance with each other in the diagnosis of OW/OB (Kappa ≥ 0.6), although the Bland Altman analysis only reported good agreement between WC-TAV and WHR-TAV. Conclusions: WC and WHR were better predictors of VAT. Results suggest that WC and WHR can be used to assess abdominal obesity and diagnose OW/OB in Mexican children.Introducción: Caracterizada por un exceso del tejido adiposo visceral (TAV), la obesidad abdominal incrementa el riesgo del síndrome metabólico. El método más popular para evaluar la obesidad infantil es el índice de masa corporal para la edad (IMC), aunque estudios recientes sugieren la circunferencia de cintura (CC) o el índice cintura-estatura (ICE). Objetivo: Evaluar la eficiencia de indicadores antropométricos para predecir TAV y clasificar sobrepeso más obesidad (SO/OB). Material y Método: Estudio transversal, analítico y comparativo. Se evaluaron 59 niños (47.5% mujeres) de 10.6 ± 2.1 años de edad en escuelas públicas de Hermosillo, Sonora, México; se examinaron variables antropométricas, estimando el IMC e ICE, se determinó el TAV mediante Absorciometría Dual de Rayos X (DEXA); se analizó mediante: regresión lineal múltiple, concordancia con el modelo de Bland y Altman e índice Kappa de Cohen. Resultados: El modelo más eficiente para predecir TAV fue el de la CC (R2=0.90). Los indicadores antropométricos tuvieron buena concordancia entre sí en el diagnóstico de SO/OB (Kappa ≥ 0.6), aunque el análisis de Bland y Altman indicó buena concordancia entre CC-TAV e ICE-TAV. Conclusiones: Los mejores predictores del TAV fueron CC e ICE. Los resultados sugieren que CC e ICE resultan los mejores indicadores para evaluar obesidad abdominal y diagnosticar SO/OB en niños y adolescentes mexicanos

Comparison of Measurements of Bone Mineral Density in Young and Middle-Aged Adult Women in Relation to Dietary, Anthropometric and Reproductive Variables

The objective of this study was to compare current measurements of bone mineral density (BMD) of the lumbar spine (LS), femoral neck (FN), and total femur (TF) regions with initial values recorded 12 years ago in women from Northwest Mexico, and evaluate their correlation with dietary, anthropometric, and reproductive variables. BMD was assessed by Dual-energy X-ray absorptiometry. Participants were grouped as follows: Nulliparous (G1); women who were mothers 12 years ago (G2); and women who were nulliparous 12 years ago, but are now mothers (G3). In all three groups, current LS BMD was higher than initial (p ≤ 0.05) and current TF BMD in G2 was higher than initial values (p ≤ 0.05). When comparing current FN and TF BMD among the three groups, G2 had higher values than G3 (p ≤ 0.05). G2 also showed higher LS BMD than G1 and G3 (p = 0.006). Age at menarche was inversely-correlated with FN and TF BMD in G1 (p < 0.01), while the body mass index (BMI) correlated positively with all three bone regions in G2 (p < 0.05). This study shows that in women without and with children, age at menarche, BMI, and age were factors associated to BMD in healthy subjects in reproductive age

Food Security and Obesity among Mexican Agricultural Migrant Workers

Mexican migrant farm workers are one of the poorest and most marginalized social groups within the country. They face the double burden of malnutrition, food insecurity, as well as harsh living and labor conditions. Objective: To examine the relationship between household food insecurity (HFI) and obesity in a population of migrant farm workers in highly modernized agribusiness areas of Northwest Mexico. Methods: This was a cross-sectional study with a concentric (site) (n = 146 households) and systematic selection of participants (adult men and women). Methods included questionnaires regarding socio-demographic characteristics, food security, diet (two non-consecutive 24-h recalls), and physical activity (PA). Anthropometric data included height, weight, and waist circumference. Data analysis covered descriptive statistics, multivariate linear and logistic regression. Results: Sample showed 75% prevalence of overweight and obesity, while 87% of households reported some level of HFI. Mild HFI resulted in five times more probability of farm workers’ obesity (OR = 5.18, 95% CI: 1.37–19.58). However, there was a protective effect of HFI for obesity among men (OR 0.089, 95% CI: 0.01–0.58) in a context of intense labor-related PA. Conclusion: There is a difference by gender in the relationship of HFI with obesity prevalence related perhaps to the energy expenditure of male agricultural migrant workers

Obesity in Mexican Children and Adolescents: Association to Pubertal Alterations and Muscular Strength

Objectives: Interventional strategies aiming to prevent obesity in children do not always consider how obesity influences the process of pubertal maturation and its implications. Additionally, maturation status could play a vital role in performing specific physical capabilities. This study aims to analyze the association of obesity, pubertal timing and tempo, and muscular strength in children and adolescents from a developing country. Methods: We measured height, weight, sitting height, estimated leg length, and waist circumference (WC) and estimated the age at peak height velocity (APHV) of 125 children (58% girls, 8.9 ± 0.4 years) and 82 adolescents (45% girls, 12.8 ± 0.3 years) from public schools in Northwest Mexico. We also collected data on physical activity, handgrip strength, and socioeconomic and demographic information. Results: Waist circumference (WC) was associated with early APHV (β = 0.006, p = 0.010) but not with a faster height gain (β = -0.012, p = 0.146). Earlier APHV and higher WC were both associated with higher handgrip strength (β = 3.86, p < 0.001; β = 0.098, p = 0.005, respectively). Conclusions: Results suggest that higher WC was related to pubertal maturation patterns and results in better muscular strength performance. This data could improve the design and implementation of interventional strategies and public policies to decrease childhood obesity

Depression and quality of life before and after breast cancer diagnosis in older women from the Women\u27s Health Initiative

PURPOSE: Distress and reduced quality of life (QOL) are common among people with cancer. No study has compared these variables after breast cancer diagnosis to pre-cancer diagnosis levels. METHODS: Data on women with breast cancer 50 years of age or older (n = 6949) were analyzed from the Women\u27s Health Initiative (1993-2013). Health-related QOL (physical function, mental health) was measured using Rand-36. Depressive symptoms were measured with the six-item Center for Epidemiologic Studies Depression scale. Assessments occurred before and after the cancer diagnosis. Hierarchical linear modeling compared pre-cancer QOL and depressive symptoms to levels post-diagnosis and tested whether pre-cancer physical activity, stressful life events, sleep disturbance, and pain predicted post-diagnosis outcomes. RESULTS: Compared with pre-cancer levels, depressive symptoms increased (20.0 % increase at 0-6 months, 12.9 % increase at 6-12 months), while physical function (-3.882 points at 0-6 months, -3.545 at 6-12 months) and mental health decreased (-2.899 points at 0-6 months, -1.672 at 6-12 months) in the first year after diagnosis (all p \u3c .01). Depressive symptoms returned to pre-cancer levels after 10 years, but QOL remained significantly lower. At more than 10 years post-diagnosis, physical function was 2.379 points lower than pre-cancer levels (p \u3c 0.01) while mental health was 1.922 points lower (p \u3c 0.01). All pre-cancer predictors were associated with all outcomes. Pain predicted uniquely greater decreases in physical function post-diagnosis. CONCLUSIONS: Depressive symptoms increased and QOL decreased following breast cancer diagnosis compared with pre-cancer levels, particularly in the first year. IMPLICATIONS FOR CANCER SURVIVORS: QOL may remain lower for years after breast cancer diagnosis, although decreases are small

Depression and quality of life before and after breast cancer diagnosis in older women from the Women's Health Initiative.

PurposeDistress and reduced quality of life (QOL) are common among people with cancer. No study has compared these variables after breast cancer diagnosis to pre-cancer diagnosis levels.MethodsData on women with breast cancer 50 years of age or older (n = 6949) were analyzed from the Women's Health Initiative (1993-2013). Health-related QOL (physical function, mental health) was measured using Rand-36. Depressive symptoms were measured with the six-item Center for Epidemiologic Studies Depression scale. Assessments occurred before and after the cancer diagnosis. Hierarchical linear modeling compared pre-cancer QOL and depressive symptoms to levels post-diagnosis and tested whether pre-cancer physical activity, stressful life events, sleep disturbance, and pain predicted post-diagnosis outcomes.ResultsCompared with pre-cancer levels, depressive symptoms increased (20.0% increase at 0-6 months, 12.9% increase at 6-12 months), while physical function (-3.882 points at 0-6 months, -3.545 at 6-12 months) and mental health decreased (-2.899 points at 0-6 months, -1.672 at 6-12 months) in the first year after diagnosis (all p < .01). Depressive symptoms returned to pre-cancer levels after 10 years, but QOL remained significantly lower. At more than 10 years post-diagnosis, physical function was 2.379 points lower than pre-cancer levels (p < 0.01) while mental health was 1.922 points lower (p < 0.01). All pre-cancer predictors were associated with all outcomes. Pain predicted uniquely greater decreases in physical function post-diagnosis.ConclusionsDepressive symptoms increased and QOL decreased following breast cancer diagnosis compared with pre-cancer levels, particularly in the first year.Implications for cancer survivorsQOL may remain lower for years after breast cancer diagnosis, although decreases are small