Age Body Mass Index Research Articles

Effect of Antiretroviral Therapy on Growth Parameters of Children With HIV Infection.

Children living with HIV (CLHIV) commonly experience growth failure. We report growth parameters in CLHIV at baseline and during 3 years of antiretroviral therapy (ART). Records of CLHIV who had completed at least 3 years on ART were reviewed after excluding subjects who died, were lost to follow-up or developed treatment failure to assess impact of sustained administration of ART. Height-for-age (HFA) and body mass index for age (BFA) Z scores were calculated, and proportion of CLHIV with wasting and stunting estimated at baseline, 6, 12, 24 and 36 months after starting ART using the linear mixed model. Factors influencing significant changes in growth parameters were assessed. HFA Z score improved steadily from -3.12 at baseline to -2.33 at 36 months of ART. The prevalence of stunting declined from 77.7% to 59.2% during this period. BFA Z scores improved from -1.2 at baseline to -0.4 at12 months on ART but declined to -1.0 at 36 months. The proportion of subjects with wasting was 29.3%, 9.7% and 16.7% at baseline, 12 and 36 months, respectively. Baseline clinical stage (1 + 2), absence of wasting and lower HFA Z score had significant positive influence on changes in HFA Z score, while younger age at ART initiation and a low baseline BFA Z score had a positive influence on catch-up in body mass index. Including data of children who died or developed treatment failure did not impact upon the results. Majority of CLHIV are stunted at the start of ART. ART was only partially effective in countering malnutrition and growth failure in CLHIV.

Effect of synbiotic supplementation in children and adolescents with cystic fibrosis: a randomized controlled clinical trial.

Cystic fibrosis (CF) is characterized by excessive activation of immune processes. The aim of this study was to evaluate the effect of synbiotic supplementation on the inflammatory response in children/adolescents with CF. A randomized, placebo-controlled, double-blind, clinical-trial was conducted with control group (CG, n = 17), placebo-CF-group (PCFG, n = 19), synbiotic CF-group (SCFG, n = 22), PCFG negative (n = 8) and positive (n = 11) bacteriology, and SCFG negative (n = 12) and positive (n = 10) bacteriology. Markers of lung function (FEV1), nutritional status [body mass index-for age (BMI/A), height-for-age (H/A), weight-for-age (W/A), upper-arm fat area (UFA), upper-arm muscle area (UMA), body fat (%BF)], and inflammation [interleukin (IL)-12, tumor necrosis factor-alpha (TNF-α), IL-10, IL-6, IL-1β, IL-8, myeloperoxidase (MPO), nitric oxide metabolites (NOx)] were evaluated before and after 90-day of supplementation with a synbiotic. No significance difference was found between the baseline and end evaluations of FEV1 and nutricional status markers. A significant interaction (time vs. group) was found for IL-12 (p = 0.010) and myeloperoxidase (p = 0.036) between PCFG and SCFG, however, the difference was not maintained after assessing the groups individually. NOx diminished significantly after supplementation in the SCFG (p = 0.030). In the SCFG with positive bacteriology, reductions were found in IL-6 (p = 0.033) and IL-8 (p = 0.009) after supplementation. Synbiotic supplementation shown promise at diminishing the pro-inflammatory markers IL-6, IL-8 in the SCFG with positive bacteriology and NOx in the SCFG in children/adolescents with CF.

KETERKAITAN DENSITAS GIZI, HARGA PANGAN, DAN STATUS GIZI PADA ANAK SEKOLAH DASAR NEGERI PEKAYON 16 PAGI

The purpose of this study was to analyze the relationship between energy density and food price, the relationship between nutrient density and food price, and the relationship between nutrient intake density and nutritional status using Body Mass Index for Age (BMI/A). Study design was cross-sectional and subjects were selected using stratified random sampling with proportional allocation. Population were 3rd, 4th, and 5th grade students atPekayon 16 Pagi Elementary School with the total subjects 158 students. Nutrient density was measured by NRF (Nutrient Rich Food) 9.3 index method. The study found that most of the subjects had adequate protein and energy intake density but low calcium, vitamin A, and vitamin C intake density. Energy, vitamin A, vitamin C, calcium, iron intake density were not correlated with BMI/A (p>0.05). Energy density was negatively correlated with food price (r=-0.622). Nevertheless, nutrient density was positively correlated with food price (r=0.614).

Growth and nutritional status of adolescents of public education system

Introduction: The prevalence of obesity in children and adults has increased worldwide exponentially over the past two decades, becoming an important issue of global public health. Objective: To describe the growth and nutritional status of adolescents of public schools. Method: Epidemiological, cross-sectional study, a representative sample of students aged 10 to 14 years of the public schools of the Metropolitan Region of Grande Vitória (MRGV), State of Espírito Santo, Brazil. Data on gender, age, skin colour/race, pubertal stage, socioeconomic class, weight and height were obtained. In the nutritional evaluation, the Height/Age (H/A) and Body Mass Index/Age (BMI/A) indexes, in z-score, of the WHO reference (2007) were considered. For statistical analysis, we used the Qui-square test and Student's t test (Mann-Whitney test for non-normal distribution), and significance level of p <0.05. Study approved by the Institutional Research Ethics Committee. Results: There were assessed 818 adolescents, with average age of 12.8 ± 1.1 years, female predominance (58.3%), mixed skin colour/race (41.7%), post-pubertal stage (53, 4%) and socioeconomic class C (59.5%). It was identified very low stature in 0.4% and low stature in 1.8% of adolescents. Overweight was diagnosed in 227 (27.7%) students, represented by overweight (18.7%), obesity (8.4%) and severe obesity (0.6%); While 0.2% presented severe thinness and 2.7% thinness. The mean z-score of girls' height (p = 0.024) was higher than the WHO reference, as well as the BMI z-score of girls (p = 0.0001) and boys (p = 0.0002). Conclusion: Adolescents of public schools of MRGV achieve adequate growth, even higher, on average, proposed by WHO (2007). However, they also present a high prevalence of overweight, indicating that the region is at an advanced stage of nutritional transition.

Nutritional status, nutrient intake and use of enzyme supplements in paediatric patients with Cystic Fibrosis; a European multicentre study with reference to current guidelines

BackgroundThe New European guidelines have established the most updated recommendations on nutrition and pancreatic enzyme replacement therapy (PERT) in CF. In the context of MyCyFAPP project - a European study in children with CF aimed at developing specific tools for improvement of self-management - the objective of the current study was to assess nutritional status, daily energy and macronutrient intake, and PERT dosing with reference to these new guidelines. MethodsCross sectional study in paediatric patients with CF from 6 European centres. SD-scores for weight-for-age (WFA), height-for-age (HFA) and body mass index-for-age (BMI) were obtained. Through a specific 4-day food and enzyme-dose record, energy and macronutrients intake and PERT-use (LU/g lipids) were automatically calculated by the MyCyFAPP system. Comparisons were made using linear regression models. ResultsThe lowest quartiles for BMI and HFA were between 0 and -1SD in all the centres with no significant differences, and 33.5% of the patients had a SD-score <0 for all three parameters. The minimum energy intake recommendation was not reached by 40% of the children and mean nutrients intake values were 14%, 51% and 34% of the total energy for protein, carbohydrates and lipids respectively. When assessed per centre, reported PERT doses were in the recommended range in only 13.8% to 46.6% of the patients; from 5.6% up to 82.7% of children were above the recommended doses and 3.3% to 75% were below. ConclusionAmong the 6 centres, a large variability and inconsistency with new guidelines on nutrition and PERT-use was found. Our findings document the lack of a general criterion to adjust PERT and suggest the potential benefit of educational and self-managerial tools to ensure adherence to therapies, both for clinical staff and families. They will be taken into account when developing these new tools during the next stages of MyCyFAPP Project.

Exploring the association between body mass index and dental caries in 3–7-year-old children, living in Łódź, Poland

Dental caries and childhood obesity are major problems affecting the health of children and preventing these conditions in children have been recognized as public health priorities (Hong et al. 2008; Odgien et al. 2010). The aim of the present study was to analyze the association between age-specific body mass index (BMI-for age) and dental caries in 3- to 7-year-olds. A cross-sectional study was conducted on 729 children from randomly chosen kindergartens and elementary schools in the urban area of Lodz, Poland. Anthropometric measurements were taken and the BMI-for-age was calculated for each child. Dental examinations were performed according to the WHO criteria. The sum of decayed, missing, filled primary/ permanent teeth and surfaces - dmft/DMFT and dmft/DMFTS, and caries prevalence were computed. The percentage distribution of the BMI categories in the study group was: 72.7% normal weight, 8.92% underweight, 12.89% overweight and 5.49% obese. Caries prevalence in the primary dentition was significantly lower in underweight children than in those who were of normal weight (p=0.004) or were overweight (p=0.039). However, controlling for age and gender, no significant association was noted between BMI and caries prevalence in either dentition group. The Kruskal-Wallis test failed to reveal any significant differences in mean dmft across the four BMI groups in the whole population, nor within particular age groups, nor in DMFT in 5- to 7-year-olds. There was no association between BMI and dental caries either in the primary dentition or permanent teeth in the early period after eruption.

Exclusive Enteral Nutrition versus Infliximab in Inducing Therapy of Pediatric Crohn's Disease.

Aim To compare the effectiveness of exclusive enteral nutrition (EEN) and infliximab (IFX) therapy in pediatric Crohn's disease (CD). Methods In a prospective study of children initiating EEN or infliximab therapy for CD, we compared clinical outcomes using the pediatric Crohn's disease activity index (PCDAI), growth improvement, endoscopic mucosal healing, and adverse effects. Data were measured at baseline and after 8 weeks of therapy. Results We enrolled 26 children with CD; of whom, 13 were treated with infliximab, 13 with EEN. Clinical response (PCDAI) reduction ≥ 15 or final PCDAI ≤ 10 was achieved by 83.3% in the EEN group and 90.9% in the IFX group. Body mass index for age (BMIFA) z-scores were significantly increased in both groups (P < 0.05). No significant differences were observed in PCDAI, height for age (HFA), or BMI recovery between two groups. Adverse effects were detected in 30.7% on infliximab and 0% on EEN. Mucosal healing was achieved in 71.4% cases in the EEN group versus 85.7% in the IFX group. Conclusion EEN provided similar improvements as IFX in clinical symptoms, mucosal healing, and BMI. EEN therapy has less adverse effects when compared with IFX. This trial is registered with the Clinical Registration Number: ChiCTR-OON-17010834.

Adequacies and inadequacies in the anthropometric and dietetic profi les of preschool children

Introduction: Nutritional conditions and food patterns in preschool children are elements that emphasise the importance of health monitoring in this period of nutritional transition, both to ensure nutritional adequacy and how much to intervene in identifi ed inadequacies. Hence, it may also constitute a strategy for public programs and school health services to make decisions. Objective: To analyse the anthropometric and dietary profi les of pre-schoolers of a pole city in Northeastern Brazil. Method: This is a cross-sectional evaluative study with 114 children aged 2–5 years, of both genders, in three municipal centres of early childhood education. Anthropometry was used to measure weight and height, and the nutritional condition was assessed using the indexes Height for Age (H/A), Weight for Age (W/A), Weight for Height (W/H) and Body Mass Index for Age (BMI/A) in z-score values with classifications established by the World Health Organization. The food intake record was done by direct weighing of the food menu offered during a week in the three institutions. This procedure allowed for the evaluation of the nutritional composition of menus, from the estimates in percentages, average and standard deviations of total calories, macronutrients (proteins, carbohydrates and lipids) and micronutrients (calcium, iron, vitamins A and C), to the adjustments and comparisons to the reference values of the Recommended Dietary Allowances, National Research Council and the PNAE recommendations, by age stages, in full-time units, 1–3 years, 700 kcal; 4–5 years, 950 kcal (70% coverage prediction of daily nutritional requirements) and the part-time units, these same ranges of age, respectively, 200 and 270 kcal (20% coverage for forecasting nutritional needs daily), considering adequate consumption to that with a variation of up to 10% above or below 100% of these recommendations. Results: Most of the preschool children had adequate nutritional conditions, especially those of full-time units, with relative frequencies (W/A: 94.5%; W/H: 89.5%, BMI/A: 81.7%). There were registered also overweight percentages higher than the defi cits, in the indices W/A (22.2%), P/E (33.3%) to municipal early childhood centre CMEI-A girls; the indices W/A, W/H, BMI/A (23.8% each) in CMEI B-boys. In relation to the adequacy of the food profi le, there was only convergence between the offer and the recommendation of 70% coverage of the daily energy needs, for pre-schoolers of 4–5 years from the centre of full-time units (mean: 951.2 ± 172.3 kcal). As for nutrients, inadequacies had a trend in the coverage of the daily needs on the menu offered in part-time units. Conclusion: Although most children do not present indicative of nutritional risk, requires attention to food portion that was with inadequacies of nutritional condition, with emphasis on weight surplus, while the readjustments in per capita and in portions of the menu implemented in those locations.

Growth in children with pulmonary arterial hypertension: a longitudinal retrospective multiregistry study

To enable adequate interpretation of growth measurements in the management of children with pulmonary arterial hypertension (PAH), we assessed growth and its associated determinants in children with PAH. We did a retrospective longitudinal study of height and body-mass index in reference to WHO growth standards by pooling data from four contemporary prospective registries of paediatric PAH representing 53 centres in 19 countries. The main outcome measures were median height for age and body-mass index for age percentiles and longitudinal deviation of height for age and body-mass index for age Z scores from WHO standards. 601 children were followed up for a median of 2·9 years (IQR 1·5-4·4). Baseline median height for age percentile was 26 (IQR 4-54) and baseline median body-mass index for age percentile was 41 (IQR 12-79). Mean height for age Z score was significantly lower than the reference (-0·81, 95% CI -0·93 to -0·69; p<0·0001), as was body-mass index for age Z score (-0·12, -0·25 to -0·01; p=0·047). Height for age Z score was particularly decreased in young patients (aged ≤5 years) with idiopathic or hereditary PAH and in all patients with PAH associated with congenital heart disease. Although Z scores increased in some patients and decreased in others, we detected no significant trend in height for age Z score (p=0·57) or body-mass index for age Z score (p=0·48) before taking account of covariates. Multivariable linear mixed effects modelling showed that age, cause of PAH, ex-prematurity, WHO functional class, trisomy 21, and time since diagnosis were associated with height for age Z score, whereas age, ethnicity, and trisomy 21 were associated with body-mass index for age Z score. A favourable WHO functional class course was independently associated with increases in height for age Z score. PAH is associated with impaired growth, especially in younger children and those with pulmonary arterial hypertension associated with congenital heart disease. The degree of impairment is independently associated with cause of PAH and comorbidities, but also with disease severity and duration. Because a favourable clinical course was associated with catch-up growth, height for age could serve as an additional and globally available clinical parameter to monitor patients' clinical condition. Actelion Pharmaceuticals.

Anthropometrical indexes as nutritional indicators in 5 years-old macedonian children

Evaluation of sex-specific differences of anthropometrical indexes that were used as indicators for assessment of nutritional status in children aged 5. The study included 226 healthy children (113 boys, 113 girls) aged 5 from Macedonian nationality. With standard methodology (IBP) were taken following body measurements (body weight, height, mid upper arm circumferences-MUAC and skinfolds thickness triceps–SFTr and subscapular-SFSc), and according to standard formulas were calculated: weight-for-age (BW), height-for-age (BH), body mass index-for-age (BMI), mid upper arm circumferences-for age (MUAC), and skinfolds thicknes-for-age (SFTr and SFSc). Results showed sex-specific differences in a large number of the examined anthropometrical parameters (BW, BH, BMI) in favour of the boys. On the other hand, skinfolds thickness (SFTr and SFSc) were significantly higher in girls. Values of the 50th percentile in boys were as follows: 21 kg for BW, 115 cm for BH, 15.48 kg/m2 for BMI, 15.5 cm for MUAC, 4.1 mm for SFSc, and 7 mm for SFTr. The values of these parameters in girls were: 20 kg for BW, 113.5 cm for BH, 15.01 kg/m2 for BMI, 16cm for MUAC, 4.7mm for SFSc and 7.8 for SFTr.These results can be used as criteria for the assessment and detection of deviations in the nutritional status in children aged 5.

Growth reference for Saudi preschool children: LMS parameters and percentiles

BACKGROUNDPrevious growth charts for Saudi children have not included detailed tables and parameters needed for research and incorporation in electronic records.OBJECTIVESThe objective of this report is to publish the L, M, and S parameters and percentiles as well as the corresponding growth charts for Saudi preschool children.DESIGNCommunity-based survey and measurement of growth parameters in a sample selected by a multistage probability procedure.SETTINGA stratified listing of the Saudi population.SUBJECTS AND METHODSRaw data from the previous nationally-representative sample were reanalyzed using the Lambda-Mu-Sigma (LMS) methodology to calculate the L, M, and S parameters of percentiles (from 3rd to 97th) for weight, length/height, head circumference, and body mass index-for-age, and weight-for-length/height for boys and girls from birth to 60 months.MAIN OUTCOME MEASURESLength or height and weight of Saudi preschool children.RESULTSThere were 15 601 Saudi children younger than 60 months of age, 7896 (50.6 %) were boys. The LMS parameters for weight for age from birth to 60 months (5 years) are reported for the 3rd, 5th, 10th, 25th, 50th, 75th, 90th, 95th, and 97th percentiles as well as the corresponding graphs. Similarly, the LMS parameters for length/height-for-age, head circumference-for-age, weight-for-length/height and body mass index-for-age (BMI) are shown with the corresponding graphs for boys and girls.CONCLUSIONUsing the data in this report, clinicians and researchers can assess the growth of Saudi preschool children.LIMITATIONSThe report does not reflect interregional variations in growth.

Development of Height and Body Mass Index After Pediatric Kidney Transplantation: Experience of the Nephrology Pediatric Service at HCFMRP- USP, 2005-2014.

Chronic kidney disease in children often determines poor nutritional status. Although renal transplantation (RTx) resolves endocrine and metabolic disorders, growth continues to be suboptimal and excessive weight gain may result in obesity. Evaluating the development of height and body mass index in renal transplanted children and adolescents and identifying associated factors with final nutritional status. We reviewed the medical records of 17 patients with regular follow-ups up to 24 months after RTx. Nutritional status was assessed by height-for-age (H/A) and body mass index-for-age (BMI/A). It was considered catch-up growth the increase in z-score H/A ≥ 0.5 standard deviation. Multiple linear regression was used to estimate the influence of factors clinical and demographic variables on anthropometric indicators at 24 months after RTx. Mean age was 9.1 ± 4.1 years old. Twenty-four months after RTx the mean z-score H/A increased from -2.66 ± 1.66 to -1.93 ± 1.08 (p ≤ 0.05), 47.0% of the patients showed catch-up growth and the same proportion showed z-score H/A < -2. Mean z-score BMI/A increased from -0.48 ± 1.03 at RTx to 0.80 ± 0.94 at third month after RTx (p < 0.001) and remained unchanged up to 24 months. The frequency of weight excess increased from 5.9% at RTx to 41.2% at 24 months. Age (r = -0.66; p = 0.006) and z-score H/A (r = -0.72; p = 0.002) at RTx were inversely associated with growth. Twenty-four months after transplant it was verified inadequate growth to recovery from stunting and excessive weight gain. RTx promoted greater growth in the youngest patients and most stunted at RTx.

Factors Affecting Underweight and Obesity Among Elementary School Children in South Korea

The purpose of the study was to determine factors associated with underweight and obesity in elementary school children in Korea. Study participants included 4,895 children attending 59 elementary schools across Korea. Children were grouped into underweight [< 5% body mass index (BMI)-for-age], normal weight (5%-85% BMI-for-age), and overweight/obese (≥ 85% BMI-for age). The questionnaire included demographic characteristics, health status, and diet and exercise behavior of children, and environmental characteristics of schools. Twelve percent of the children were overweight or obese. The results showed that demographic (age and gender), health status (atopic dermatitis and poor subjective health), and the characteristics of diet and exercise (unbalanced diet and diet experiences) were associated with underweight (p < .05), while demographic (age and gender), health status (poor subjective health), behavioral characteristics (fast food consumption and diet experiences), and school environmental characteristics (rural area) were associated with overweight/obesity (p < .05). Programs and interventions to reduce underweight and overweight/obesity in Korean elementary schools must consider behavioral and environmental characteristics of children.

Cryptosporidiosis: a neglected infection and its association with nutritional status in schoolchildren in northwestern Mexico.

Undernutrition is a recognized public health problem in Mexican children and cryptosporidiosis is probably a factor contributing to this problem. However, it remains a neglected and poorly attended infection in Mexico. This study aimed to determine the prevalence of Cryptosporidium parvum and to establish its association with the nutritional status in schoolchildren of northwestern Mexico. A total of 405 schoolchildren between 6 and 13 years of age were included in this study. Weight-for-age (W/A), height-for-age (H/A) and body mass index-for-age (BMI/A) Z scores were calculated. The Faust technique was used to detect intestinal parasites in stool samples and C. parvum coproantigen was detected by enzyme-linked immunosorbent assay (ELISA). The overall prevalence of C. parvum was 28.4%. Some of the study children were C. parvum free (n = 86) and some were C. parvum infected (n = 77). The prevalences of risk of undernutrition found in both groups of children for H/A, W/A, and BMI/A Z scores were 18%, 21% and 28%, respectively. Weight, ZW/A, and ZH/A were significantly higher in the C. parvum-free group compared to the C. parvum-infected group (p ≤ 0.05). The children with cryptosporidiosis were 2.7 times more likely to be at risk of undernutrition by W/A Z score and 2.9 times more likely to be at risk of undernutrition by ZH/A than were the C. parvum-free children. Cryptosporidiosis may be a contributing factor to childhood undernutrition in northwestern Mexico. The proper authorities must implement control and prevention measurements in Mexico and other developing countries.

Fatores associados à subestimação materna do peso da criança: um estudo de base populacional

Objetivo Investigar os fatores associados à subestimação materna do peso de crianças menores de cinco anos de Goiânia, Goiás. Métodos Estudo transversal, de base populacional, domiciliar, com 673 crianças menores de cinco anos de idade. A percepção materna do peso da criança foi obtida pela pergunta: "Atualmente, o que a senhora (mãe) acha do peso do seu filho?", e o estado nutricional da criança foi avaliado pelo índice de massa corporal por idade. Regressão múltipla de Poisson foi realizada a um nível de significância de 5%. Para a análise de concordância, foi utilizado o teste Kappa. Resultados Das crianças estudadas, 1,6% estavam magras, 87,7% eutróficas e 10,7% com excesso de peso. A maioria das mães (66,0%) identificou corretamente o peso de seus filhos; 5,2% superestimaram, e 28,8% subestimaram. Mães de crianças com excesso de peso, idade superior a 24 meses, apresentaram maior prevalência de subestimação, enquanto as mães com excesso de peso e maior escolaridade apresentaram menor subestimação do peso das crianças. A concordância entre a opinião materna sobre o peso da criança e o real estado nutricional da criança foi de 0,12 (p&lt;0,001). CONCLUSÃO Existe uma distorção na percepção materna do peso de crianças menores de cinco anos. A subestimação materna do peso da criança apresentou associação direta com idade e estado nutricional da criança e associação inversa com escolaridade e estado nutricional materno. Sugere-se atenção no atendimento a essas mães com o objetivo de evitar o ganho de peso excessivo nessa idade e prejuízos na saúde da criança.

Nutritional status of adolescents with cystic fibrosis treated at a reference center in the southeast region of Brazil.

BackgroundSeveral factors can interfere with the full physical and emotional growth of adolescents, among them chronic diseases. The aim was to determine the nutritional status of adolescents and to associate it with puberty, pancreatic sufficiency, lung function and age range of Cystic Fibrosis (CF) diagnosis.MethodsAn observational, cross-sectional, retrospective and analytical study was conducted using the data of medical records. Setting: Reference center in the northeastern region of the state of São Paulo – Brazil. Patients: All adolescents with CF attended in 2010 were included. Some variables included: pancreatic sufficiency (steatocrit >2 %), pancreatic enzymes replacement (yes/no), pubertal status-Tanner criteria (prepubertal: M1/G1, pubertal: M2/G2 to M4/G4, postpubertal: M5/G5), age at CF diagnosis (<2 and ≥2 years of age), Lung function, measured as a predicted forced expiratory volume in 1 s (FEV1). Main outcome measures Nutritional indicators: body mass index for age (BMI/A) and height for age (H/A) with z-score calculated with Anthro Plus software. Cut-off reference points: ≥ z-score −3 and < z-score −2 (thinness); z-score −2 and ≤ z-score-z +1 (normal weight); >z-score +1 (overweight or obesity), and z-score <−2 (low or very low H/A). The groups were compared by the Kruskal-Wallis test. Level of significance: p < 0.05.ResultsThirty adolescents. Median (min;max) age: 14.4 (10.1;19.8) years. BMI/A and H/A z-score, respectively: early diagnosis of CF (−0.8; −1.1) or late diagnosis of CF (−0.5;-0.8); with pancreatic insufficiency (−0.7; −0.8) or without pancreatic insufficiency (−0.8; −0.5) and prepubertal (−0.8; −0.7) pubertal (−0.2; −1.5) or postpubertal (−0.7; -0.5). No significant difference (p > 0.05) was observed. Patients with and without pancreatic insufficiency, presented H/A borderline z-score (p = 0.05). Association between H/A and FEV1 was borderline (p = 0.05).ConclusionsAdolescents presented adequate nutritional status, although with slightly lower values than those of developed countries. FEV1 lower levels occurred more frequently in adolescents with low H/A.

Prenatal factors associated with birth weight and length and current nutritional status of hospitalized children aged 4-24 months.

The objective of the present study was to investigate the associations of prenatal factors with birth weight and length, as well as current nutritional status, of children hospitalized in southern Brazil. We conducted a cross-sectional study of 300 child-mother pairs. Children were between 4 and 24 months old. They were at the inpatient unit or pediatric emergency department of the Hospital de Clínicas de Porto Alegre. Anthropometric data were collected, and a questionnaire on gestational data was answered by the children's mothers. Maternal variables of interest were: prepregnancy body mass index (BMI), gestational weight gain, smoking and/or use of alcohol, use of illicit drugs, gestational diabetes and/ or high blood pressure. Children's variables of interest were: sex, gestational age, birth weight (BW) and birth length (BL), and current anthropometric data [body mass index for age (BMI/A), height for age (H/A), and weight for age (W/A)]. The gestational weight gain and smoking were associated with BW. We also found that H/A was associated with BW and BL, W/A was associated with BW, and BMI/A was associated with BL. The gestational weight gain was associated with BL, diabetes was associated with BW and BL, and high blood pressure was associated with low height in the first two years of life. We concluded that prenatal factors may have an influence on both BW and BL, causing the birth of small and large for gestational age children, and thus affecting their growth rate during the first years of life.

Evaluación nutricional e indicadores de grasa visceral y subcutánea en niños con síndrome de Down

BackgroundThere are only few publications related to body composition in Down syndrome (DS). ObjectiveEvaluate the relationship between indicators of nutrition assessment by Catalan references and CDC/NCHS and indicators of body composition, and compare the concordance between weight/height index (IW/H), body mass index/age (BMI/A) and weight/age (W/A) to evaluate nutritional status in children with DS. Materials and methodsAnalytical cross-sectional study in which 40 children with DS, 20 girls and 20 boys between 3 and 13 years old were studied. Anthropometric measurements were performed to obtain indicators of nutrition assessment as IW/H, BMI/A and W/A and indicators of subcutaneous and visceral fat and muscular compartment. Correlation tests and Kappa index were evaluated to establish relationship and agreement respectively. ResultsThe nutrition assessment in children with DS shows that 60% presents overweight and obesity according to BMI/A, and 75% according to IW/H. Correlation analysis indicates that waist circumference, fat brachial area, % fat mass by Slaughter and Weststrate and Deurenberg have a high positive correlation with BMI/A (p-value<0.05). A logistic regression model showed that no indicator of fat mass is clinically significant in predicting an increase of the indicator W/A. It was determined that the BMI/A and IW/H indicators have a higher concordance (Kappa = 0.59; p =.0000). ConclusionsWe determined a high correlation between nutritional diagnosis (BMI/A and IW/A) with indicators of visceral fat (waist circumference) and subcutaneous (% fat mass and fat brachial area) in children with DS. A greater agreement was found between indicators of BMI/A and IW/A suggesting that they are optimal for assessing the nutritional status.

Nutrition assessment and indicators of visceral fat and subcutaneous fat in children with Down syndrome

BackgroundThere are only few publications related to body composition in Down syndrome (DS). ObjectiveEvaluate the relationship between indicators of nutrition assessment by Catalan references and CDC/NCHS and indicators of body composition, and compare the concordance between weight/height index (WHI), body mass index/age (BMIa) and weight/age (WA) to evaluate nutritional status in children with DS. Materials and methodsAnalytical cross-sectional study in which 40 children with DS, 20 girls and 20 boys between 3 and 13 years old were studied. Anthropometric measurements were performed to obtain indicators of nutrition assessment as WHI, BMIa and WA and indicators of subcutaneous and visceral fat and muscular compartment. Correlation tests and Kappa index were evaluated to establish relationship and agreement respectively. ResultsThe nutrition assessment in children with DS shows that 60% presents overweight and obesity according to BMIa, and 75% according to WHI. Correlation analysis indicates that waist circumference, fat brachial area, % fat mass by Slaughter and Weststrate and Deurenberg have a high positive correlation with BMIa (P-value<0.05). A logistic regression model showed that no indicator of fat mass is clinically significant in predicting an increase of the indicator WA. It was determined that the BMIa and WHI indicators have a higher concordance (Kappa=0.59; P=0.0000). ConclusionsWe determined a high correlation between nutritional diagnosis (BMIa and WA) with indicators of visceral fat (waist circumference) and subcutaneous (% fat mass and fat brachial area) in children with DS. A greater agreement was found between indicators of BMIa and WA suggesting that they are optimal for assessing the nutritional status.

ESTADO NUTRICIONAL E CRESCIMENTO DE CRIANÇAS QUILOMBOLAS DE DIFERENTES COMUNIDADES DO ESTADO DO PARÁ

Neste artigo são avaliados o estado nutricional e o crescimento de crianças de três comunidades quilombolas vivendo em diferentes condições sócio-ecológicas no Estado do Pará. Trata-se de um estudo de delineamento transversal constituído por 48 crianças de 0 a 5 anos de idade, representando mais de 70% desta faixa etária nos quilombos Santo Antônio, África/Laranjituba e Mangueiras. A antropometria seguiu técnica padronizada internacionalmente e os dados foram convertidos em escores-Z utilizando-se o programa WHO-Anthro. Os índices Peso/Estatura (P/E), Estatura/Idade (E/I), Peso/Idade (P/I) e o Índice de Massa Corporal/Idade (IMC/I) foram os descritores do estado nutricional. Observa-se que um elevado percentual de crianças apresenta desvios em relação aos padrões de crescimento preconizados nas curvas internacionais de referência. Ao avaliar os índices P/E e IMC/I, se encontram percentuais consideráveis de crianças acima do escore-Z +1, totalizando 29,9% da amostra, evidenciando casos de sobrepeso e obesidade. Entretanto, ao analisar E/I, 31,1% das crianças estão abaixo do escore-Z -2, mostrando que o déficit estatural ainda é um problema entre a população infantil destes remanescentes de quilombos. Nota-se que as crianças quilombolas analisadas ainda apresentam dificuldades em atingir seus potenciais de crescimento, entraves potencialmente relacionados com as características sócio-demográficas, sanitárias e ecológicas nas quais estas populações se encontram. Concomitantemente a casos de desnutrição, observa-se também excesso de peso em algumas crianças, ratificando o processo de transição nutricional ocorrendo na região amazônica. Palavras-chave: Crianças, quilombolas, avaliação nutricional, transição nutricional, Amazônia