Effects of disordered eating behaviors and sedentary lifestyle prevention program in male and female Mexican adolescents / Efectos de un programa de prevención de conductas alimentarias de riesgo y sedentarismo en adolescentes mexicanos, hombres y mujeres

Abstract Introduction Adolescents are the group with the highest risk of developing disordered eating behaviors (DEB). Preventing this problem is of the utmost importance due to the physical and psychological consequences. Objective To evaluate the effects of a universal prevention program for disordered eating behaviors (DEB), thin ideal internalization (TII), drive for muscularity (DM), and sedentary lifestyle among Mexican adolescents. Method A quasi-experimental study with repeated measures (pre-test, post-test, six-month, and one-year follow-up) was carried out in a non-probabilistic sample of 523 adolescents (46.7% of females) aged 15-19 years (Mage = 16.07). We worked in two private high schools, one of them was designed as control group (CG), and the other as intervention group (IG). For both, female and male adolescents', data were collected using the Brief Questionnaire for Disordered Eating Behaviors (BQDEB) and the short form of the International Physical Activity Questionnaire (IPAQ). To evaluate TII the Attitudes toward Body Figure Questionnaire was applied in females, while in males Drive for Muscularity Scale (DMS) was used. Results After one-year, repeated measures analyses of variance (ANOVAs) revealed a significant reduction of the mean DEBs scores both in female (p = .01) and male (p = .03) adolescents of the IG with respect to CG. In IG, females decreased significantly the mean TII score as well as the mean DM score in males. Physical Activity increased in IG females from pre-test to posttest; however, the effect was not maintained over time. Discussion and conclusion These findings have important implications for future interventions with Mexican adolescents. We must take sex differences into account to choose activities and strategies that will enhance the effects of the program.

Resumen Introducción Los adolescentes constituyen el grupo con mayor riesgo de desarrollar conductas alimentarias de riesgo (CAR). Prevenirlas es de suma importancia debido a las consecuencias físicas y psicosociales. Objetivo Evaluar los efectos de un programa de prevención universal en conductas alimentarias de riesgo (CAR), interiorización del ideal de delgadez (IID), obsesión por la musculatura (OM) y sedentarismo en adolescentes mexicanos. Método Estudio cuasi-experimental con medidas repetidas (pre-test, post-test, seguimiento a seis meses y un año) en una muestra no probabilística de 523 adolescentes (46.7% mujeres) de 15-19 años de edad (Medad = 16.07). Se trabajó en dos escuelas preparatorias privadas, una como grupo control (GC) y otra como grupo intervenido (GI). Para mujeres y hombres, los datos se recolectaron usando el Cuestionario Breve para Conductas Alimentarias de Riesgo (CBCAR) y la versión corta del Cuestionario Internacional de Actividad Física (IPAQ). Para evaluar el IID en mujeres, se utilizó el Cuestionario de Actitudes hacia la Figura Corporal (CAFC) y en hombres la Escala para Obsesión por la Musculatura (DMS). Resultados Después de un año, el ANOVA de medidas repetidas mostró una reducción significativa en la media de CAR, tanto en mujeres (p = .01) como en hombres (p = .03) del GI respecto al GC. En el GI, la media de IID en mujeres disminuyó significativamente, así como la media de OM en hombres. La actividad física aumentó en las mujeres del GI desde el pre-test hasta el post-test; sin embargo, el efecto no se mantuvo en el tiempo. Discusión y conclusión Estos hallazgos tienen implicaciones para futuras intervenciones con adolescentes mexicanos. Se deben tomar en cuenta las diferencias por sexo para elegir las actividades y las estrategias que potenciarían los efectos del programa.

Efecto de un programa de educación nutricional y actividad física en profesores del Instituto de Ciencias de la Salud. Estudio piloto

RESUMEN El objetivo del presente trabajo consistió en evaluar el efecto de un programa de educación nutricional y actividad física, en los conocimientos de alimentación y nutrición, en la realización de actividad física moderada-vigorosa(AFMV), la frecuencia de consumo de frutas y verduras, así como en indicadores antropométricos en profesores mexicanos universitarios de un Instituto de Ciencias de la Salud. Para ello, se diseñó un estudio de campo cuasi-experimental de medidas repetidas (pre-test, post-test y seguimiento a 3 meses) en 48 adultos, divididos en grupo control (GC) y grupo intervenido (GI). Se aplicó un cuestionario sobre conocimientos básicos de alimentación y nutrición (CBAN-Conocimientos), junto con el cuestionario Internacional de Actividad Física (IPAQ, por sus siglas en inglés), y un cuestionario semi-cuantitativo de frecuencia de consumo de alimentos. A partir del peso y la talla, se calculó el índice de masa corporal (IMC), y se midió el porcentaje de grasa corporal (%GC) mediante bioimpedanciometría. Los hallazgos mostraron, en el GI, un incremento significativo de los CBAN-Conocimientos (p<0,001), la AFMV (p<0,001), de la frecuencia de consumo de frutas (p= 0,049) y verduras (p= 0,020) a lo largo del tiempo. El efecto del programa fue parcialmente alcanzado, debido a que los CBCAN-Conocimientos fue la única variable dependiente que alcanzó una diferencia estadísticamente significativa entre grupos. Para lograr un mayor efecto del programa se propone extender el tiempo de implementación. Urgen este tipo de programas para mejorar y mantener una buena salud en docentes durante todo el ciclo escolar.

ABSTRACT The objective of this research was to assess the effect of a nutritional education and physical activity pilot program, on food and nutrition knowledge, moderate vigorous physical activity (MVFA) performance, fruits and vegetables intake, as well as on anthropometric indicators among Mexican university professors of a Health Sciences Institute. A quasi-experimental study with repeated measures (pre-test, post-test and 3 months follow-up) was carried out in 48 adults, divided in control group (CG) and intervention group (IG). A food and nutrition basic knowledge (FNB-Knowledge) questionnaire was applied, together with the International Physical Activity Questionnaire (IPAQ), and a semi-quantitative food frequency questionnaire. Weight and height were measured to calculate the body mass index (BMI); body fat percentage (BF%) was evaluated through bioimpedanciometry. A significant increased in FNB-Knowledge (p<0.001), MVFA (p<0.001), as well as frequency of fruits (p= 0.049) and vegetables p= 0.020) intake was observed in the IG over time. The program effect was partially achieved, as FNB-Knowledge was the only dependent variable that showed a statistically significant difference between groups. To acheive a higher program effect it is proposed to extend the implementation time. Such programs are urgently needed to improve and maintain good health among professors throughout scholar cycle.

Riesgo para desarrollar interiorización del ideal estético de la delgadez en adolescentes mexicanas Título abreviado: Asociación de riesgo e ideal estético de delgadez / Risk to develop body thin-ideal internalization in Mexican female adolescents

Resumen En mujeres se ha reportado que a mayor índice de masa corporal (IMC), mayor interiorización del ideal estético de la delgadez (IIED), y mayor seguimiento de conductas alimentarias de riesgo (CAR). El objetivo de esta investigación consistió en determinar la presencia de CAR y de IIED en mujeres adolescentes de Hidalgo, México y su asociación tanto entre ellas como con el IMC, el porcentaje de grasa corporal (PGC), los tiempos de comida (TC) y la actividad física (AF). El estudio fue de tipo transversal con un diseño no experimental descriptivo y de asociación en una muestra no probabilística de 220 mujeres de preparatoria, de entre 14 a 18 años de edad (Medad= 15.9 ± .99), quienes respondieron una batería de cuestionarios validados. Para obtener el IMC, cada participante fue pesada y medida, mientras que el PGC se obtuvo por bioimpedancia eléctrica. Los resultados arrojaron que 17.3 % de la muestra presentó riesgo moderado y 15.5 % alto de CAR; mientras que 23.2 % registró riesgo de IIED. Se encontró que el IMC aumenta significativamente 2.7 veces el riesgo de IIED y de CAR 2.5 veces; la IIED incrementa 11.8 veces el riesgo de CAR (Odd Ratio; . < .05). Se concluye que, en la muestra de estudio, las CAR y la IIED están presentes; que a mayor IIED mayor riesgo de estas y que un exceso de peso corporal, basado en el IMC, aumenta el riesgo tanto de CAR como de IIED. Es necesario que los programas de prevención para mujeres adolescentes consideren lo anterior de manera conjunta para garantizar su éxito.

Abstract It has been reported that when females increase their body mass index (BMI), body thin-ideal internalization (BTII) increased too, as well as disordered eating behaviors (DEB). The aim of this study was to assess the presence of DEB and BTII in adolescent females from Hidalgo, Mexico. We also analyze the association between both variables, and between BMI, body fat percentage (BFP), meal times (MT) and physical activity (PA). A cross-sectional non-experimental descriptive and of association study was carried out in a no probabilistic sample of 220 high school females, aged from 14 to 18 (Mage= 15.9 ± .99). Self-reported validated questionnaires in Mexican samples were used to assess each one of the variables: the Brief Questionnaire for Risky Eating Behaviors, the Attitudes toward Body Figure Questionnaire, Risk Factors Associated to Eating Disorders for Mexican Pubescents Questionnaire (only the meal times factor was used) and the short version of the International Physical Activity Questionnaire (IPAQ). BMI was obtained by measuring each subject's weight and height; the body fat percentage (BFP) was measured through Biolectrical Impedance. The protocol was revised and approved by the Ethics and Research Committee of Health Sciences Institute of the Universidad Autónoma del Estado de Hidalgo. Descriptive analyses were held, as well as Odd Ratio to estimate the risk association. Total sample showed 17.3 % of moderate risk and 15.5 % of high risk for developing DEB; 23.2 % of the sample reported risk for BTII. From the total of females with DEB (moderate and high risk) 68.6 % also scored risk of body thin-ideal internalization. According to the BMI, results showed that 29.5 % of the sample had overweight and obesity; meanwhile for the BFP in the same categories the value was 85 %. The analysis by BMI showed that adolescents with overweigh (50 % and 39.1 %, respectively) and obesity (47.4 % and 31.6 %, respectively) achieved the highest values for both, DEB and BTII. Interestingly, participants with normal BMI had also important percentages for DEB (26.9 %) as well as BTII (17.9 %). With respect to BFP, females with overweight (41.5 % and 24.4 %, respectively) and obesity (35.6 % and 25.3 %, respectively) had the highest percentages for both DEB and BTII. Again, adolescents with normal BFP showed percentages for DEB (6.4%) and BTII (9.7 %). Findings showed that 68.6 % of the participants with risk of IIED, "never" and "few times" used to eliminate the dinner, and that 80.5 % of the sample had low level for PA. We found that BMI increases significantly 2.7 times the risk of BTII as well as 2.5 times the risk of DEB; BTII increases 11.8 times the risk of DE (Odd Ratio; p < .05). From the present data, it can be concluded that DEB and BTII are present in the sample studied, and its prevalence were higher than other studies among Mexican females. We also concluded that overweight and obese subjects, for both BMI and BFP, were the ones that obtained the higher percentages of DEB and BTII. Finally, BMI increased significantly the risk of DEB and BTII, as well as BTII increased significantly the risk of DEB. It is necessary that female adolescent prevention programs take into account this in a joint way to guarantee their success.

Eating disorder symptomatology: Comparative study between Mexican and Canadian university women / Sintomatología de trastornos alimentarios: Estudio comparativo entre mujeres universitarias mexicanas y canadienses

Abstract The objectives of this study were: (1) to compare Mexican and Canadian university students regarding disordered eating behaviors (DEB), body thin-ideal internalization (BTHIN), and body image dissatisfaction (BID); and (2) to examine the relationship of these three variables to body mass index (BMI) and waist circumference (WC). This cross-cultural study was carried out in a sample of 129 university women students aged from 18 to 25 years (M = 20.18, SD =1.59): 52% were Canadian (Moncton University [MU]) and 48% were Mexican (Universidad Autónoma del Estado de Hidalgo [UAEH]). The Brief Questionnaire for Disordered Eating Behaviors and Attitudes Towards Body Figure Questionnaire were applied while the BID was evaluated using a continuum of nine silhouettes. In addition, the weight, height and WC of each participant were recorded. Mexican students had greater values of overweight, obesity, abdominal obesity and DEB, with 4.6 times greater risk than UM students. In contrast, the presence of BTHIN and BID was similar between samples. Considering these findings, women from at least two different ethnic groups are vulnerable to the development of eating disorder symptomatology.

Resumen Los objetivos de este estudio fueron: 1) comparar entre estudiantes universitarias mexicanas vs. canadienses respecto a conductas alimentarias de riesgo (CAR), interiorización de la figura corporal delgada (IFCD) e insatisfacción con la imagen corporal (ISC); y 2) examinar la relación de esas tres variables con el índice de masa corporal (IMC) y la circunferencia de cintura (CC). En este estudio transcultural participaron 129estudiantes universitarias de 18 a 25 años de edad (M = 20.18, DE =1.59): 52% canadienses (Universidad de Moncton [UM]) y 48% mexicanas (Universidad Autónoma del Estado de Hidalgo [UAEH]). Fueron aplicados el Cuestionario Breve para medir Conductas Alimentarias de Riesgo y el Attitudes Towards Body Figure Questionnaire, mientras que la ISC se evaluó mediante un continuo de nueve siluetas. Además se registró el peso, la talla y la CC de cada participante. Las estudiantes mexicanas registraron significativamente mayor presencia de sobrepeso, obesidad, obesidad abdominal y CAR, con 4.6 veces mayor riesgo que las estudiantes de la UM. Por el contrario, la presencia de IFCD y de ISC fue similar entre las muestras. Con base en estos hallazgos se puede concluir que las mujeres de dos grupos étnicos diferentes son vulnerables al desarrollo de sintomatología de trastornos alimentarios.

Imagen corporal e índice de masa corporal en mujeres indígenas del Estado de Hidalgo, México / Body image and body mass index of indigenous women from Hidalgo state, Mexico

El objetivo de este estudio fue examinar la relación entre el índice de masa corporal (IMC) y la imagen corporal de mujeres indígenas de Hidalgo, México. En 167 mujeres adultas (M edad = 34.45, DE = 6.76), la satisfacción/insatisfacción corporal se estimó según el IMC y la técnica parcial del marcado de imagen. El 83% de las mujeres evaluadas presentaron algún grado de insatisfacción corporal, mayormente relacionado con el deseo de adelgazar (51%) que con el de ser más robustas (32%). Las mujeres más satisfechas con su imagen corporal fueron las normopeso (21%) o con bajo peso (20%); por el contrario, las menos satisfechas fueron aquellas con obesidad (57%). Sin embargo no se identificó una asociación significativa entre el IMC y la satisfacción/insatisfacción corporal. Una de las principales aportaciones de este estudio es haber analizado la correspondencia entre dos variables poco estudiadas en mujeres adultas indígenas: el IMC y la imagen corporal, cuyos resultados fundamentan la necesidad de seguir investigando este tipo de población, así como el desarrollo de programas de prevención y de promoción de la salud específicos a grupos indígenas.

The objective of this study was to determine the relationship between the body mass index (BMI) and the body image of indigenous women from Hidalgo, Mexico. Body dissatisfaction/satisfaction was evaluated in 167 adult women (M age = 34.45, SD = 6.76) based on BMI and on the partial markup technique of image. The 83% of women assessed had some degree of body dissatisfaction specially related to the desire of thinness (51%) than with the desire of being robust (32%). Normal weight (21%) and low weight (20%) women were those who were more satisfied with their body image; on the contrary, women with obesity (57%) were the less satisfied. However a significant association among BMI and body satisfaction/dissatisfaction was not identified. One of the main contributions of this study was to analyze the correspondence between two little studied variables in indigenous adult women: BMI and body image. These findings strength the need to keep studying this kind of population as well as the development of preventive and promoting health programs aimed to indigenous groups.

Obesidad infantil y su relación con indicadores cardiopulmonares en escolares mexicanos / Childhood Obesity and its Relation to Cardiopulmonary Indicators in Mexican School Children / Obesidade infantil e sua relação com indicadores cardiopulmonares em estudantes mexicanos

Objetivo: determinar la relación entre obesidad y anormalidades de parámetros cardiopulmonares en escolares. Materiales y métodos: participaron 78 escolares entre 5 a 11 años de edad, 47 hombres (60,3%) y 31 mujeres (39,7%), pertenecientes a una escuela primaria particular de la ciudad de Pachuca (México). Se evaluó: índice de masa corporal (IMC), circunferencia de cintura (CC), grasa corporal (GC), frecuencia cardiaca (FC), presión arterial (PA), frecuencia respiratoria (FR) y espirometría. Se emplearon las pruebas estadísticas chi-cuadrado (x2), odds ratio y correlación de Spearman (rs). Resultados: 23,1% de los escolares evaluados presentaron sobrepeso y 29,5%, obesidad. El 38,5 y 11,5% presentaron FC y PA superiores a los parámetros normales, respectivamente; 3,8% de la población presentó FR arriba del promedio y 11,5% mostró valores espirométricos anormales. Se encontraron relaciones entre IMC con GC y CC, GC y CC, CC y FC, GC y PA, y FC y FR. Conclusiones: las prevalencias de sobrepeso y obesidad obtenidas en este estudio fueron altas. Los niños con sobrepeso u obesidad podrían tener mayor riesgo de presentar anormalidades cardiopulmonares en comparación con niños de peso normal. Se sugiere continuar con estudios en el tema en una muestra más amplia.

Objective: Determine the relationship between obesity and abnormal cardiopulmonary parameters in school children. Materials and Methods: The sample involved 78 children between five and 11 years of age: 47 males (60.3%) and 31 females (39.7%). All were enrolled in a specific elementary school in the city of Pachuca (Mexico). Body mass (BMI), waist circumference (WC), body fat (GC), heart rate (HR), blood pressure (BP), respiratory rate (RR) and spirometry were evaluated. A chi-square (x2) statistical test, the odds ratio and Spearman's rank-order correlation (rs) were used. Results: In all, 23.1% of the students who were evaluated were overweight and 29.5% were obese; 38.5% and 11.5% had a HR and BP above the normal parameters, in that order; 3.8% of the population in question had a HR above average and 11.5% showed abnormal spirometric values. A relationship was found between BMI and BF and WC, BF and WC, WC and HR, BF and BP, and HR and RF. Conclusions: The prevalence of overweight and obesity found in this study was high. Children who are overweight or obese might be at increased risk of experiencing cardiopulmonary abnormalities compared to children of normal weight. It is suggested that studies on this subject be continued with a broader sample.

Objetivo: determinar a relação entre obesidade e anormalidades de parâmetros cardiopulmonares em estudantes do ensino fundamental. Materiais e métodos: participaram do estudo 78 estudantes entre 5 a 11 anos de idade, 47 do gênero masculino (60,3%) e 31 do feminino (39,7%), pertencentes a uma escola primária particular da cidade de Pachuca (México). Avaliaram-se o índice de massa corporal (IMC), a circunferência de cintura (CC), a gordura corporal (GC), a frequência cardíaca (FC), a pressão arterial (PA), a frequência respiratória (FR) e a espirometria. Utilizaram-se os testes estatísticos qui-quadrado (x2), odds ratio e correlação de Spearman (rs). Resultados: 23,1%o dos estudantes avaliados apresentaram excesso de peso e 29,5% obesidade. 38,5 e 11,5% apresentaram FC e PA superiores aos parâmetros normais, respectivamente; 3,8% da população apresentou FR acima da média e 11,5% mostraram parâmetros espirométricos anormais. Constataram-se relações entre IMC com GC e CC, GC e CC, CC e FC, GC e PA, e FC e FR. Conclusões: as prevalências de excesso de peso e obesidade obtidas neste estudo foram altas. As crianças com excesso de peso ou obesidade poderiam ter maior risco de apresentar anormalidades cardiopulmonares em comparação às de peso normal. Sugere-se continuar com estudos sobre o tema com uma amostra mais ampla.

Disordered eating behaviors in Mexican patients with and without type 2 diabetes mellitus / Conductas alimentarias de riesgo en pacientes mexicanos con y sin diabetes mellitus tipo 2

The aim of this work was to compare the distribution of disordered eating behaviors (DEB) in Mexican adult patients, with and without type 2 diabetes. A cross-sectional descriptive and comparative field research was carried out in a sample of 169 subjects (54% females; 46% males) with a mean age of 47.9 years. The sample was matched in two groups: patients with type 2 diabetes and patients without diabetes. DEB were assessed with a valid Mexican scale named EFRATA (Escala de Factores de Riesgo Asociados a Trastornos Alimentarios). Results confirmed significant differences in food and weight concern (t = 4.15, df 152.09, p = 0.000), normal eating behavior (t = 4.03, df 151.45, p = 0.000) and emotional eating (t = 1.93, df 160.76, p < 0.05), EFRATA's factors in which diabetic subjects obtained higher values in comparison with no diabetic patients. Subjects without diabetes achieved higher value only in binge eating behavior with statistically significant difference (t = 2.11, df 128.8, p < 0.05) in contrast with diabetic patients. Since these findings have been open the possibility to propose specific strategies that encourage healthy eating behaviors, both in adult patients with and without diabetes.

El objetivo de este estudio consistió en comparar la distribución de conductas alimentarias de riesgo en pacientes mexicanos adultos con y sin diabetes tipo 2. Se efectuó un estudio de campo de tipo descriptivo y comparativo en una muestra de 169 sujetos (54% mujeres; 46% hombres) con una media de edad de 47,9 años. Los sujetos fueron divididos en 2 grupos: pacientes con diabetes y pacientes sin diabetes. Para medir las conductas alimentarias de riesgo se empleó la Escala de Factores de Riesgo Asociados a Trastornos Alimentarios (EFRATA). Los resultados confirmaron diferencias significativas en preocupación por el peso y la comida (t = 4,15, df 152,09, p = 0,000), conducta alimentaria normal (t = 4,03, df 151,45, p = 0,000) y en comer por compensación psicológica (t = 1,93, df 160,76, p < 0,05), factores de la EFRATA en los que los pacientes diabéticos registraron valores más altos. En contraste con los pacientes diabéticos, los sujetos sin diabetes alcanzaron el valor más alto con diferencia estadísticamente significativa en el factor comer compulsivo (t = 2,11, df 128,8, p < 0,05). A partir de estos hallazgos se abre la posibilidad de proponer estrategias puntuales que favorezcan conductas alimentarias saludables, tanto para pacientes adultos diabéticos como sin diabetes.

Medio ambiente social y conductas alimentarias de riesgo: una exploración en mujeres adolescentes en México / Social environment and risky eating behaviors: an exploratory study in adolescent females in Mexico / Ambiente social e hábitos alimentares de risco: um estudo com mulheres adolescentes no México

Los objetivos de este trabajo fueron explorar: (1) la asociación entre medio ambiente social a niveles municipal y familiar, y conductas alimentarias de riesgo, en mujeres adolescentes; y (2) la interacción entre medio ambiente social y cultural e índice de masa corporal (IMC). La información se obtuvo de una encuesta representativa de las estudiantes de preparatoria en el Estado de México, México (15-19 años). Se aplicó un cuestionario para conductas alimentarias de riesgo y datos sociodemográficos. Se evaluó el medio ambiente social y cultural municipal mediante el índice de marginación del municipio. El análisis se hizo mediante regresión multinivel. La prevalencia de conductas alimentarias de riesgo fue 4,23%. El IMC y el nivel socioeconómico familiar se asociaron directamente con conductas alimentarias de riesgo. El índice de marginación municipal no se asoció con conductas alimentarias de riesgo. Esto puede deberse a que no se midieron los componentes relevantes del medio ambiente social y cultural, o a que el nivel municipal no ejerza un efecto contextual sobre conductas alimentarias de riesgo. El efecto del IMC sobre conductas alimentarias de riesgo fue mayor en municipios más marginados.

The objectives of the current study were to explore: (1) the association between the social environment at the city and family levels and risky eating behaviors in adolescent females and (2) the interaction between the social and cultural environment and body mass index (BMI). The data were obtained from a representative survey of female high school students in Mexico State , Mexico (15-19 years). A questionnaire was applied on risky eating behaviors and socio-demographic data. The municipal social and cultural environment was evaluated using the municipal marginalization index. Data analysis used multivariate regression. Prevalence of risky eating behaviors was 4.23%. BMI and family socioeconomic status were directly associated with risky eating behaviors. The municipal marginalization index was not associated with risky eating behaviors. Possible explanations for the latter are that the relevant components of the social and cultural environment were not measured, or that the municipal level does not exert a contextual effect on risky eating behaviors. The effect of BMI on risky eating behaviors was greater in more marginalized municipalities.

Os objetivos deste trabalho foram: (1) explorar a associação entre ambiente social, no nível municipal e familiar, e hábitos alimentares de risco em mulheres adolescentes; e (2) explorar a interação entre ambiente social e cultural e o índice de massa corporal (IMC). Os dados foram conseguidos através de uma pesquisa representativa entre estudantes do segundo grau no Estado de México, México (15-19 anos). Foi aplicado um questionário sobre hábitos alimentares de risco e dados sociodemográficos. O ambiente social e cultural municipal foi avaliado pelo índice de marginalização do município. A análise utilizou o modelo de regressão multinível. A prevalência de hábitos alimentares de risco foi de 4,23%. O IMC e o nível socioeconômico familiar foram diretamente associados a hábitos alimentares de risco. O índice de marginalização municipal não foi associado a hábitos alimentares de risco. Isso pode ser devido ao fato que não foram medidos os componentes relevantes do ambiente social e cultural, ou ao fato que o nível municipal não exerce um efeito contextual sobre hábitos alimentares de risco. O efeito do IMC sobre hábitos alimentares de risco foi maior nos municípios mais marginalizados.

Asociación de impacto entre factores socioculturales, insatisfacción corporal, e índice de masa corporal en estudiantes universitarios de Hidalgo, México

Después de identificar la presencia de factores de riesgo asociados a la predicción y prevención de trastornos de la conducta alimentaria (TCA), en estudiantes, hombres y mujeres, de una universidad del sector privado de Pachuca, Hidalgo; el propósito de este estudio consistió en reafirmar las siguientes hipótesis: 1) La insatisfacción con la imagen corporal, guarda estrecha relación tanto con la influencia de factores socioculturales como con el Índice de Masa Corporal (IMC); 2) Las mujeres participantes, reportan más insatisfacción con la imagen corporal, e indican mayor influencia de factores socioculturales que los hombres. Se llevó a cabo un estudio transversal, descriptivo y de asociación en una muestra a conveniencia de 490 estudiantes universitarios (57% mujeres y 43% hombres), de 16 a 30 años de edad(X=19.63, DE=± 2.11), a quienes se les aplicó un cuestionario multidimensional que mide factores socioculturales e imagen corporal. Cada sujeto fue pesado y medido para obtener su IMC. A partir de las medidas de asociación de impacto obtenidas mediante Razón de Momios, los resultados arrojaron asociaciones significativas (p.

After to identify risky factors involved in the prediction and prevention of eating disorders (ED), in a sample of university males and females students from an urban setting in Hidalgo, Mexico; the main purpose of this paper was to reaffirm the following assumptions: 1) Dissatisfaction with body shape is closely related to both, the influence of sociocultural factors as Body Mass Index (BMI); 2) The participating women reported more dissatisfaction with body shape, indicating greater influence of sociocultural factors than men.Transversal, descriptive and association field research was carried out in a sample of 490 students (57% females, 43% males), from 16 to 30 years old (X¯ = 19.63, SD = ± 2.11). Multidimensional self-reported questionnaire were applied. BMI was obtained by measuring each subject’s weight and height. Regarding the impact association measures obtained by Odds Ratio, there were significant association (p.

Validez de un instrumento multidimensional para medir factores de riesgo asociados a trastornos de la conducta alimentaria en púberes mexicanos / Validity of a multidimensional questionnaire to measure risk factors associated to eating disorders in Mexican pubescents

Objective: To obtain the validity and internal consistency of a questionnaire for the screening of risk factors associated to eating disorders in Mexican pubescent males and females. Subjects and methods: The questionnaire was applied to a non-probabilistic sample of 504 males and 511 female students in México City from 11 to 15 years of age with a median of 12,13. Statistical methods included internal consistency analysis (Cronbach's alpha) and principal components factor analysis with oblimin rotation. Results: Both instruments obtained five-factors structure, showed a good total Cronbach's alpha score: males 0,75 (55,6 percent), and females 0,83 (57,6 percent) of the total explained variance. Males displayed a normal eating behavior factor, while for females a restrictive dieting factor was obtained. Conclusions: This questionnaire is a valid measure in pubescent boys and girls for assessing risk factors associated with eating disorders, in particular socio-cultural factors, eating behaviors and pubertal development.

Objetivo: obtener la validez y consistencia interna de un cuestionario para púberes mexicanos, hombres y mujeres, que evalúe factores de riesgo asociados a trastornos de la conducta alimentaria. Sujetos y método: El cuestionario se aplicó a una muestra no probabilística, de púberes estudiantes de la ciudad de México (504 hombres y 511 mujeres), con edades de 11 a 15 años de edad, con una media de 12,13. Se realizó un análisis de consistencia interna (alfa de Cronbach) y un análisis factorial de componentes principales con rotación oblimin por el método de máxima verosimilitud. Resultados: Ambos instrumentos arrojaron 5 factores, con una buena consistencia interna, alcanzando un valor total de alpha de Cronbach de 0,75 para hombres (55,6 por ciento de varianza explicada) y 0,83 para mujeres (57,6 por ciento de varianza explicada). Conclusión: El instrumento resultó válido en hombres y mujeres, para medir factores de riesgo asociados a trastornos alimentarios, principalmente socioculturales, conductas alimentarias y desarrollo puberal.

Conductas alimentarias de riesgo, interiorización del ideal estético de delgadez e índice de masa corporal en estudiantes hidalguenses de preparatoria y licenciatura de una institución privada / Disordered eating, internalization of the body thin-ideal and body mass index in high school and college students from a private institution in Hidalgo, Mexico

The term <> is immediately related to food consumption. However, eating is a complex behavior mediated by external factors. Eating is not exclusively related to satisfying individual's needs or nutritional requirements. Eating behavior alteration has originated disordered eating (DE) and eating disorders (ED), such as anorexia nervosa, bulimia nervosa and binge eating syndrome, where patterns of food ingestion are altered and people forget the importance of maintaining a balance between caloric ingestion and caloric expenditure, with repercussions in the nutritional status and in the individual's health. Recent studies carried out in Mexican population have confirmed the presence of DE, particularly among adolescents and young adults, and predominantly in females. Data from a representative sample of students with a mean age of 14.5 years reported an increase in the proportion of DE between the 1997 and the 2003 assessments (1.3% in males and 3.4% in females) compared to the 3.8% in males and 9.6% in females registered in 2003. More recent data from the National Nutrition and Health Survey 2006, in a representative sample of adolescents 10 to 19 years of age, indicated a prevalence of 0.8% (1% in females and 0.4% in males), with higher scores in the north and center-west areas of the country, followed by the central and south-south-east areas, with almost two-fold percentages in the urban settings compared to the rural ones. The multifactorial origin of ED is well known and among the most studied risk factors are: eating behaviors, high body mass index (BMI) and body thin-ideal internalization. Research findings indicate that overweight and obese adolescents are at more risk for body dissatisfaction, as their physical appearance is farther away from being as the one promoted by society and the media. The sociocultural pressure to be thin has promoted the internalization of the idea that being thin is synonymous to success, greater social acceptance, femininity (among females), self-control, and self-esteem. Based on the above, the main purpose of this paper was to evaluate the prevalence of DE and its relationship to body thin-ideal internalization and BMI in high school and college male and female students from an urban setting. An additional objective was to provide data on reliability and validity of the scales used in a sample of males, as well as additional validity data in females. Data analyzed in this research come from a larger study on risky factors associated to ED carried out in high-school and college students in the city of Pachuca, Hidalgo, during the 2007-2008 school years. After censing the school, a sample of 845 students was selected (381 males, 464 females), 45.1% was from high school, with a range of 15 to 17 years(× =15.82; D.E.=0.78), and 54.9% from college with a range of 18 to 23 years(× =19.81; D.E.=1.41) and that completed the questionnaires adequately. Two previously validated questionnaires in Mexican samples were used to assess DE and body thin-ideal internalization: the Brief Questionnaire for Risky Eating Behaviors and the Attitudes toward Body Figure Questionnaire. Cutoff points for these questionnaires were used to determine the prevalence rates. BMI was obtained by measuring each subject's weight and height by standardized experts and divided in categories according to NCHS those under 18 years old, and to the World Health Organization Experts Committee for those above 18. Self-reported questionnaires were applied to students after verbal consent was received from the school authorities and students, who were previously informed about the voluntary, anonymous, and confidential nature in the study. The protocol was revised by the Ethics Committee of the institution were the field work was carried out. Descriptive analyses were held, as well as Student t tests for comparisons between groups, and a logistic regression analysis to estimate the risk for DE. Results showed that 70% of the women had a normal weight, and there were fewer students in the very underweight and underweight categories (high-school 2.9% and 8.7% college) than those in the overweight and obese categories (high-school 15.2% and 8.3% vs. 18.6% and 6.6% in college). Among the males, a similar distribution was found, 71.3% of the high-school and 58.2% of college students have normal weight, 2.7% and 4.8% low weight, 19.1% and 26.1% were overweight, and 6.9% and 10.9% were obese, respectively. The prevalence of DE was 8.4% in females (9.0% in high school and 7.9% in college), and 2.9% in males (1.6% in high school and 4.2% in college). DE was more prevalent among females, with the exception of binge eating and lack of control while eating. The analysis by BMI showed that neither females nor males with very low or low weight scored high on DE. The higher percentages were obtained for the overweight students of both sexes, and obese males obtained the higher percentages of all. From the total of females with DE, the 84.2% of high-school and 80% of college students also scored high on body thin-ideal internalization, while in males the results were 33.3% and 62.5%, respectively. The regression analysis indicated that the two variables associated with DE were body thin-ideal internalization (OR=27.27) and sex <> (OR=2.33). The model correctly classified 94.5% of the cases and explained 35% of the DE occurrence. The DE scale yielded a reliability score of 0.72 in females and of 0.63 in males. For both males and females, the scale yielded 3 factors with a congruent conceptual structure. The Attitudes toward Body Figure Questionnaire had a reliability of 0.94 in females and of 0.89 in males. In the case of females, the structure obtained nearly replicated the one obtained in Mexico City's students, but in the case of the male's questionnaire, three questions were eliminated leaving a two-factor structure. From the present data, it can be concluded that DE is present in the sample studied, mainly in females. It was also found that the preoccupation with gaining weight, dieting, and excessive exercising with the purpose of losing weight are also present in a high percentages in Mexican youths not only from the largest metropolis, but also in other urban settings such as Pachuca, Hidalgo. The prevalence found was similar to the one from the Student Survey from Mexico City in adolescents. A positive relationship between DE, educational status, and age was also found; overweight women and obese men were the ones that obtained the higher percentages of DE. The fact that obese men displayed the higher percentages is an important finding regarding the development of future preventive interventions, as it has been so far a neglected population in relation to this topic. The psychometric properties of the validated questionnaires in females were adequate and factorial structures were conceptually congruent. Nevertheless, in the case of males, it is important to continue working in the development of screening questionnaires sensible to their conceptions, beliefs, and attitudes regarding eating, weight control, and beauty ideal, in a way to count with reliable and valid instruments for the detection of DE and body thin-ideal internalization, so we recommend to use caution in interpreting the use of these scales in male populations.

El término <> se asocia de manera inmediata con el hecho de ingerir alimentos; sin embargo, es una conducta compleja mediada por factores externos a la persona y no exclusivamente porque los individuos quieran satisfacer sus necesidades alimentarias y sus requerimientos nutricios. La alteración de esta conducta ha dado origen a lo que se conoce como trastornos de la conducta alimentaria (TCA) tales como la anorexia nervosa, la bulimia nervosa y <>, en los cuales se ven distorsionados los patrones de la ingestión de alimentos, olvidándose la importancia de mantener un balance entre ingestión y gasto de energía, lo que repercute de manera importante en el estado nutricio y por ende en la salud del individuo. Es bien sabido el origen multifactorial de los TCA, y dentro de los factores de riesgo más estudiados están: las conductas alimentarias, el Índice de Masa Corporal (IMC) y las actitudes hacia el cuerpo provenientes de la interiorización de una figura corporal delgada. El objetivo principal de este estudio fue conocer la prevalencia de las conductas alimentarias de riesgo (CAR) y su relación con la interiorización del ideal estético de delgadez y con el IMC, en estudiantes de ambos sexos de nivel preparatoria y licenciatura en una escuela privada de la ciudad de Pachuca, Hidalgo. Un objetivo adicional fue el de proporcionar datos de confiabilidad y validez de las escalas utilizadas en una muestra de hombres, así como datos adicionales de validez en las mujeres. Se trabajó con una muestra de 845 sujetos (381 hombres y 464 mujeres) de los cuales 45.1% eran de nivel preparatoria con un rango de edad de 15 a 17 años (× =15.82; D.E.=.78) y 54.9% de nivel licenciatura en un rango de edad de 18 a 23 años (× =19.81; D.E.=1.41). Se aplicaron el Cuestionario Breve de Conductas Alimentarias (CBCAR) y el Cuestionario de Actitudes hacia la Figura Corpora l. El IMC se obtuvo partir de la medición del peso y la estatura de cada sujeto. La distribución por categorías del IMC por nivel escolar mostró que el 70% de las mujeres tiene peso normal, y que el porcentaje de las que se encuentran en las categorías de peso muy bajo y bajo (preparatoria 2.9% y licenciatura 8.7%) es mucho menor que las que se hallan en sobrepeso y obesidad (preparatoria 15.2% y 8.3% vs. licenciatura 18.6% y 6.6%). En los hombres se encontró una distribución similar: 71.3% de los de preparatoria y 58.2% de los de licenciatura tienen peso normal, 2.7% y 4.8% bajo peso, 19.1% y 26.1% sobrepeso, y 6.9% y 10.9% obesidad, respectivamente. La prevalencia de CAR en mujeres fue de 8.4% (9.0% en preparatoria; 7.9% en licenciatura) y de 2.9% en hombres (1.6% en preparatoria; 4.2% en licenciatura). <>. Del total de mujeres con CAR elevadas, el 84.2% de preparatoria y el 80% de licenciatura también obtuvo puntuaciones altas en el cuestionario sobre interiorización del ideal estético de delgadez, en tanto que en los hombres fue el 33.3% y el 62.5%, respectivamente. La escala CBCAR en mujeres arrojó un alfa de Cronbach de 0.72 y de 0.63 en hombres. El instrumento de actitudes alcanzó valores de confiabilidad de 0.94 para mujeres y de 0.89 para hombres. Se puede concluir que en la población estudiada están presentes las CAR características de los TCA, y que a mayor interiorización de una figura delgada mayor aparición de dichas conductas, principalmente entre las mujeres. Igualmente se comprobó que la práctica de dietas y de ejercicio para bajar de peso, aunadas a la preocupación por engordar, se presentan en porcentajes importantes en estudiantes del Estado de Hidalgo, lo que confirma que esta problemática no es exclusiva de las grandes urbes.

Conductas alimentarias de riesgo e imagen corporal de acuerdo al índice de masa corporal en una muestra de mujeres adultas de la ciudad de México

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Abstract: Studies conducted in adolescent and young women have showed that body image perception and dissatisfaction are highly related with risk eating behaviors, particularly with compensatory behaviors. It has also been found that these women tend to overestimate their body size, showing more dissatisfaction. Many studies on eating disorders have been developed in adolescents, but, what happens with adult women? Adult women show periods of pregnancy, nursing, menstrual disorders and, a decrease in physical activity and, at the psychological level there is a lack of emotional stability and depression. These episodes in general, have influence in feeding and body image, that could lead to risky eating behaviors (restricted dieting, fasting, skipping meals among others) affecting directly the state of health, because latter they can develop into eating disorders. Undoubtedly, inadequate feeding can cause malnutrition and nutrimental deficiencies, provoking physiological alterations such as osteoporosis, anemia or hypokaliemia, and also, somatic complications during pregnancy, including abortions and low weight in the new born. Objective. To determine the relationship between body mass index (BMI), risky eating behaviours, body perception and body dissatisfaction in Mexican adult women from 25 to 45 years of age in Mexico City. Methods. A non probabilistic sample of 659 women from 25 to 45 years of age (X=38.27; SD=4.4) was used. To collect the sample, an area of the Questionnaire for Health and Feeding called scale of risk factors associated to eating disorders (EFRATA) and body image was used. This is a self-report questionnaire, validated for this population. Its main purpose is to measure risk eating behaviors and body image. Questions refer to risky eating behaviors (binge eating, compensatory behaviors, restricted dieting, preoccupation about weight and figure), with 4 answering options: 1) Never, 2) Sometimes, 3) Frequently, and 4) Always. Body Image was measured through two dimensions: (a) Body perception was measured through five specific items and (b) Body dissatisfaction was measured with a nine body figure scale, from thin to obese. The BMI was obtained from weight and height self-report (BMI=kg/m2). Self report measures of weight and height have been found reliable; as there is a high correlation with data taken directly, the difference between them is 1.14 kg/m2, which does not interfere significantly. The cut points recommended by the Expert Committee (OMS), are: low weight from 15 to 18.5; normal weight from 18.51 to 24.99; overweight from 25 to 29.99; obesity from 30 to 39.99 and morbid obesity higher than 40. Results. Body Mass Index distribution of the sample was: 1.1% low weight, 53.6% normal weight, 32.3% overweight, 12.4% obesity, and 0.6% of women were morbidly obese. Body perception distribution was: 0.9% very thin, 15.3% thin, 44.4% normal, 32.6% overweight and 6.8% obese. Results related to body dissatisfaction, showed that more than % of the sample was dissatisfied; 70.1% of the women were dissatisfied with their body image and wanted to be thinner and, 8.7% wanted to gain weight. It was found that a large percentage of women (79%) are dissatisfied with their body image. From this percentage 70.1 wanted to be thinner and, 8.7% wanted to gain weight. As to the relationship between BMI distribution and body dissatisfaction it was found that 14% of underweight and 54.2% normal weight women want to be even thinner. The findings of the study showed that women with higher BMI, displayed more risky eating behaviors. Women with overweight and obesity displayed the higher percentages in binge eating. A Pearson correlation was carried out to look for significant differences between BMI, risky eating behaviors and the two dimensions of body image (perception and dissatisfaction). Results indicated that BMI was significantly correlated with binge eating, body dissatisfaction and body image perception. Discussion. This study supported important information about the relation between BMI and risky eating behaviors in Mexican adult women. The most important result was to confirm the presence of disordered eating typical of eating disorders among adult women. Even though the data obtained do not demonstrate the diagnosis of an ED, it shows the presence of some of the characteristic symptoms, which means that these are commonles found among the general population. Although isolated symptoms are not a necessary indicator of the development of the disease, in a way they point out the individuals who are at risk of threatening their physical and mental health. On the other hand, one of the risks that adds to this particular population is the fact that all of them are mothers, as some research findings have confirmed the relationship between the mother's eating behaviors and the appearance of eating disorders in their children. The results obtained in this research show that the BMI of the sample tends to be in the overweight (32.3%) and obese ranges (13%). These results agree with those of the National Nutrition Survey of 1999, were 52.5% of the women were classified as overweight or obese (30.8% as overweight and 21.7% as obese). These scores are important not just because they favor chronic-degenerative diseases, but also because of the great association between overweight and obesity with risky eating behaviors, something that could be confirmed in this study, as individuals with higher BMI, displayed more risky eating behaviors. The results of this study have consistently supported the positive relationship between BMI, binge eating, body dissatisfaction and body image perception, although group differences attributed to age were not statistically significant. Finally, another important contribution of this study, is the use of a reliable and valid multidimentional questionnaire developed in Mexico, specifically designed for the study of two very complex issues such as risky eating behaviors and body image. The main limitations of the study were that the findings were primarily based on self-report data and the use of a non-probabilistic sample of Mexican adult women.

Validación del índice nutricional en preadolescentes mexicanos con el método de sensibilidad y expecificidad / Validation of the nutritional index in Mexican preadolescents with the sensitivit and specificity method

Objetivo. Determinar la validez diagnóstica del índice nutricional (IN) en una muestra de preadolescentes mexicanos. Material y métodos. Se trabajó con un grupo de 256 escolares de la Ciudad de México, de entre 10 y 12 años de edad, de ambos sexos. Se utilizó el método de sensibilidad y especificidad para establecer la validez diagnóstica de IN. Resultados. Los puntos de corte convencionales para el IN tienen buena sensibilidad y especificidad para el diagnóstico de bajo peso, normalidad y obesidad, no así para sobrepeso. Estos valores, así como los de la potencia de predicción, se otimiza en todas las categorias cuando se utilizaron puntos de corte normalizados. Conclusiones. En el diagnóstico del estado de nutrición de los preadolescentes, los nuevos puntos de corte del IN resultan más confiables que los tradicionales

Validez diagnóstica del IMC (índice de masa corporal) en una muestra de escolares preadolescentes y adolescentes mexicanos / Validity in the diagnosis of the BMI (Body Mass Index) in mexican preadolescents and adolescents

El propósito del presente estudio fue determinar la validez diagnóstica del uso del índice de Masa Corporal (IMC) en muestras de preadolescentes (N=134) y de adolescentes <(N=142) hombres y mujeres mexicanos a través de la comparación de tres diferentes criterios y utilizando el método de sensibilidad y especificidad. Los resultados obtenidos con la muestra de adolescentes mostraron que el criterio propuesto por Vargas y Casillas para el diagnóstico de bajo peso fue el más adecuado, en tanto que el de Goméz Peresmitré resultó ser operacional y funcionalmente el más conveniente para el diagnóstico o clasificación de sobrepeso y obesidad. Encontramos, en cambio, que en la muestra de preadolescentes ninguno de los criterios sometidos a estudio mostró validez diagnóstica, razón por la cual se concluyó que no se recomienda el uso del índice de masa corporal en este tipo de población

Validez diagnóstica del índice de masa corporal en una muestra de adolescentes mexicanos / Diagnostic validity of body mass index in Mexican adolescents

El objetivo del presente estudio fue determinar la validez diagnóstica del índice de masa corporal (IMC) o índice de Quetelet, comparando tres diferentes criterios para la clasificación del estado nutricio, en adolescentes mexicanos. Para ello se trabajó con una muestra (N = 540) de adolescentes a quienes se registró peso, talla, edad y sexo. El método de sensibilidad y especificidad fue el utilizado para establecer la validez diagnóstica, estableciendo como criterio de verdad o estándar de oro al IMC tomando los valores de peso y talla de las tablas NCHS y de la NOM-088-SSA2. De acuerdo con los resultados, el criterio de IMC propuesto por Vargas y Casillas, clasificación ampliamente aceptada, fue el más sensible (98.6 por ciento) y tuvo altos niveles de especificidad (77.8 por ciento) para el diagnóstico de bajo peso. Por otro lado, para el diagnóstico de sobrepeso, el criterio empleado por Gómez Peresmitré y col. fue el más adecuado (sensibilidad = 94 por ciento especificidad = 87.9 por ciento). Para identificar la obesidad, el de Sepúlveda Amor (sensibilidad = 61.5 por ciento; especificidad = 99.7 por ciento) fue el que mejor equilibrio registró sin embargo, desde el punto de vista operativo, se recomienda emplear el IMC de Gómez. Peresmitré para el diagnóstico de sobrepeso y de obesidad. Dependiendo del objetivo de investigación será el criterio utilizado, se pueden efectuar combinaciones entre los IMC validados

Relación entre estado de nutrición y la experiencia de soledad en niños / Relationship between nutritional status and loneliness in children

Con el propósito de evaluar las diferencias entre niños obesos y no obesos en cuanto a la experiencia de soledad y las conductas que emplean para afrontarla, se aplicó un cuestionario muldimensional que evalúa conductas de afrontamiento y componentes de soledad a una muestra intencional de 90 niños (30 obesos, 30 de bajo peso, 30 con peso normal) con edades entre 10 y 12 años. Las variables control fueron el género y el estado nutricio de los niños. Los resultados describen las condiciones sociodemográficas contribuyentes, los componentes y las conductas de afrontamiento que emplean los niños obesos ante la soledad en contraste con los que no lo son. Los resultados analizan las posibles repercusiones de la soledad sobre la salud infantil