Relación entre resiliencia y conductas alimentarias de riesgo / Relationship between resilience and risk eating behaviors

Resumen: Los trastornos de la conducta alimentaria son de las enfermedades crónicas más frecuentes en adolescentes y mujeres jóvenes. En México se han encontrado porcentajes desde 5 hasta 18% de conductas alimentarias de riesgo en muestras de mujeres estudiantes universitarias (Unikel-Santoncini, et al., 2004). Por otro lado, la resiliencia se define como un constructo que incluye ciertos fenómenos que consisten en la adecuada adaptación del individuo ante situaciones traumáticas, privación extrema, amenazas graves o estrés elevado (González-Arratia, 2008, en Camacho-Valadez, 2016). Esta investigación examina la relación entre la resiliencia y las conductas alimentarias de riesgo por medio de la aplicación de los instrumentos EAT-26 y RESI-M a 201 mujeres mexicanas, con un promedio de edad de 22 años. Se realizó un análisis de correlación de Producto Momento de Pearson, el cual demostró que, aquellas mujeres con mayores niveles de resiliencia mostraban menos conductas alimentarias de riesgo. Se propone realizar el mismo estudio con poblaciones más jóvenes, así como con participantes de sexo masculino.

Abstract: Eating disorders are one of the most frequent chronic diseases in adolescents and young women. In Mexico, percentages from 5 to 18% of risk eating behaviors have been found in samples of female university students (Unikel-Santoncini, et al., 2004). On the other hand, resilience is defined as a construct that includes certain phenomena that consist of the individual's adequate adaptation to traumatic situations, extreme deprivation, serious threats, or high stress (González-Arratia, 2008, in Camacho Valadez, 2016). This research examines the relationship between resilience and risk eating behaviors through the application of the EAT-26 and RESI-M instruments to 201 Mexican women, with an average age of 22 years. A Pearson Product Moment correlation analysis was performed, which showed that those women with higher levels of resilience showed less risk eating behaviors. It's proposed to carry out the same study with younger populations, as well as with male participants.

Sex and Body Mass Index differences after one-year follow-up of an eating disorders risk factors universal prevention intervention in university students in Mexico City / Diferencias por sexo e índice de masa corporal a un año de seguimiento de una intervención de prevención universal para disminuir factores de riesgo para los trastornos de la conducta alimentaria en estudiantes universitarios de la Ciudad de México

Abstract Introduction Interventions based on cognitive dissonance theory are the most effective for preventing eating disorders. Objective To identify the changes at one year follow-up of a universal prevention intervention in disordered eating behaviors (DEB), thin-ideal internalization (TII), and drive for muscularity (DM). Method A pre-experimental, pretest-posttest study was conducted on 602 university student subjects (76.1% women and 23.9% men) with an average age of 20.74 years at a public (30.6%) and a private university (69.4%) in Mexico City. A Split Plot ANOVA was performed with the intrasubject variable equal to each measurement (pretest, posttest, and follow-up), as well as the sex and body mass index (BMI) intersubject variables to analyze whether there was a significant interaction between these variables and the changes in dependent variables, as well as the changes through each measurement by group. Results In the intrasubject analyses, statistically significant differences were found for DEB through the various measurements, without taking the interactions into account. Statistically significant interactions were observed between each measurement and BMI, and between each measurement and sex and BMI for the DM variable. Discussion and conclusion Since a reduction of TII in women and DM in men was achieved, together with a decrease in DEB in women, the workshop can be said to have fully achieved its objectives for women and partly so for men.

Resumen Introducción Las intervenciones basadas en la teoría de la disonancia cognoscitiva son las más efectivas para la prevención de los trastornos de la conducta alimentaria. Objetivo Conocer los cambios a un año de seguimiento de una intervención de prevención universal en las conductas alimentarias de riesgo (CAR), interiorización del ideal estético de la delgadez (IED) y la motivación por la musculatura (MM). Método Se llevó a cabo un estudio pre-experimental pretest-postest en 602 (76.1% mujeres y 23.9% hombres) sujetos estudiantes universitarios con una edad promedio de 20.74 años en una universidad pública (30.6%) y una privada (69.4%) de la Ciudad de México. Se realizó un ANOVA split plot con la variable intrasujetos igual a cada medición (pretest, postest y seguimiento) así como el sexo y el índice de masa corporal (IMC) variables intersujetos, para analizar si existía una interacción significativa entre dichas variables y los cambios sobre las variables dependientes, así como los cambios a través de cada medición por grupo. Resultados en los análisis intrasujetos se encontraron diferencias estadísticamente significativas para las CAR a través de las distintas mediciones, sin tomar en cuenta las interacciones. Se observaron interacciones estadísticamente significativas entre cada medición y el IMC, y entre cada medición con el sexo y el IMC para la variable MM. Discusión y conclusión Se logró la reducción de la IED en las mujeres y de la MM en los hombres, así como la disminución de las CAR en las mujeres por lo que se considera que el taller logra sus objetivos para las mujeres y parcialmente para los varones.

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.

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.

Ideales estéticos, imagen corporal, actitudes y conductas alimentarias en hombres con diferente orientación sexual / Aesthetic ideals, body image, eating attitudes and behaviors in men with different sexual orientation

Resumen Aun cuando existe amplia información disponible sobre imagen corporal y trastornos alimentarios, se sabe poco sobre estos tópicos en minorías sexuales, y especialmente en Latinoamérica. Por tanto, el propósito de este estudio fue comparar la satisfacción corporal, la interiorización de ideales estéticos (delgadez y musculatura), así como las actitudes y las conductas alimentarias entre varones con diferente orientación sexual. Participaron 217 varones (94 heterosexuales, 30 bisexuales y 93 gais), de 14 a 41 años de edad (M = 22.0, DE = 4.59). Los hombres bisexuales y gais reportaron mayor malestar con la imagen corporal, interiorización del ideal de delgadez y motivación por adelgazar, en comparación con los varones heterosexuales. Los bisexuales informaron mayor preocupación por la comida que los heterosexuales y los gais, pero estos últimos presentaron mayor restricción alimentaria. Los resultados apoyan la hipótesis de que en la insatisfacción corporal de los hombres de minorías sexuales predomina el deseo de adelgazar, resultado de una mayor interiorización del ideal corporal de delgadez. Por el contrario, los resultados relativos a la muscularidad no registraron una tendencia clara en función de la orientación sexual, de lo que destaca la necesidad de profundizar en su análisis, priorizando el empleo de instrumentos de evaluación más específicos sobre la motivación de incrementar musculatura.

Abstract Although there is a lot of information available about body image and eating disorders, little is known about the issue in sexual minority groups, especially in our culture and context. Therefore, the purpose of this study was to compare the body satisfaction, the internalization of aesthetic ideals (thin and muscular), the attitudes and eating behaviors in a sample of Mexican men with different sexual orientation. A total of 217 men (94 heterosexuals, 30 bisexuals and 93 gays), with an age range from 14 to 41 (M = 22.0, SD = 4.59) participated in the study. Bisexual men and gay men, compared to heterosexual men, reported greater body image discomfort, influence of thin shape and more motivation to lose weight. Bisexual men reported more concern about food than heterosexual men and gay men, but gay men had greater food restriction. These results support the hypothesis that body dissatisfaction in men of sexual minority groups is not oriented towards the development of the musculature, since they have internalized a thinner ideal body. On the contrary, the results related to muscularity did not register a clear tendency based on sexual orientation, which highlights the need to deepen its analysis, prioritizing the use of more specific evaluation instruments on the motivation to increase muscle.

Parental negative weight/shape comments and their association with disordered eating behaviors: A systematic review / Comentarios negativos paternos acerca de peso/forma corporal y su asociación con las conductas alimentarias de riesgo: Una revisión sistemática

Abstract The purpose of this study was to find the association between receiving negative parental weight and shape comments, and the presence of disordered eating behaviors (DEBs) in young adults. A systematic review was conducted answering the following PECO question: Population / young adults; Exposure / negative comments, criticism or teasing about weight and shape by parents; Comparison groups / not applicable; and Outcome / DEBs. Due to the use of different statistical measurements, a narrative was chosen to present the results. An association between negative comments and DEBs was found in male and female university students. Women reported more negative comments, higher body dissatisfaction and DEBs than men. Body dissatisfaction was found as a mediator of negative comments and DEBs, and sex as a moderator between body dissatisfaction and DEBs. The results have implications for the influence social pressure has on the internalization of the thin-ideal and on body dissatisfaction as risk factors for the development of disordered eating behaviours.

Resumen El objetivo de este estudio fue examinar la asociación entre ser receptor de comentarios negativos paternos acerca del peso y la figura corporal, y la presencia de conductas alimentarias de riesgo (CAR) en adultos jóvenes. Se llevó a cabo una revisión sistemática respondiendo a la pregunta PECO siguiente: Población / adultos jóvenes; Exposición / comentarios negativos, críticas o ridiculización por parte de los padres por el peso y la figura corporal; Comparación / no aplicó; y Resultado / CAR. Debido a las diferentes medidas estadísticas utilizadas, se eligió un formato narrativo para presentar los resultados. Estos indicaron asociación entre los comentarios negativos paternos y las CAR en hombres y mujeres estudiantes universitarios. Las mujeres reportaron recibir más comentarios negativos, así como presentar mayor insatisfacción corporal y CAR que los hombres. Entre los comentarios negativos y las CAR se encontró como mediadora a la imagen corporal, y al sexo como un moderador entre la insatisfacción corporal y las CAR. Los resultados tienen implicaciones acerca de la influencia de la presión sociocultural en la interiorización del ideal estético de delgadez y de la insatisfacción corporal como factores de riesgo para el desarrollo de CAR.

Body Image Self-Perception and Risky Eating Behaviors in Medicine Undergraduate Students in Xalapa, Veracruz, Mexico (2014) / Autopercepción de la imagen corporal y conductas alimentarias de riesgo en estudiantes universitarios de medicina en Xalapa, Veracruz, México (2014) / Autopercepção da imagem corporal e condutas alimentares de risco em estudantes universitários de medicina em Xalapa, Veracruz, México (2014)

Abstract Introduction: The current beauty standard is associated with thinness, a situation that alters the body perception and can lead to the development of an eating disorder. Objective: To determine the relationship between the indexes of body image dissatisfaction and body image distortion and risky eating behaviors (REB) in a university population of medicine students in Veracruz, Mexico. Materials and Methods: Cross-sectional analytical study, with a sample of 187 students. A register was drawn up that included the SFS-test to evaluate the body image and to estimate the indices of dissatisfaction and distortion of the body image, the Brief Questionnaire of Risky Eating Behaviors validated in Mexican population, as well as social variables. A descriptive analysis was carried out with basic measures of frequency and dispersion, bivariate and multimodal analyses were performed too. Results: 43 % were female, and the average age was 21 (± 1.7) similar in both sexes. The prevalence of high risk of REB was 8.6 %, higher in men (9.4 % versus 7.4 %) and medium risk (23.5 %) with the distribution reversed by sex (28.4 % in women and 19.8 % in men). The dissatisfaction index was 59.4 % covering those who perceived having a higher weight than they would like to have. Concerning the distortion of the own body image it was observed that 41.2 % supposed to haveing a higher weight than what resulted from the anthropometric evaluation. Discussion: Dissatisfaction rates showed a positive correlation gradient with REBs, being this more evident in men.

Resumen Introducción: el estándar de belleza actual se asocia con la delgadez, situación que puede alterar la percepción corporal y consecuentemente conducir al desarrollo de algún trastorno alimentario. Objetivo: determinar la relación de los índices de insatisfacción y distorsión de la imagen corporal y las conductas alimentarias de riesgo (CAR), en una población universitaria de estudiantes de medicina en Veracruz, México. Materiales y métodos: estudio transversal analítico en una población de 187 estudiantes. Se elaboró una cédula que incluyó el SFS-test para evaluar la imagen corporal y estimar los índices de insatisfacción y distorsión de la imagen corporal; el Cuestionario Breve de Conductas Alimentarias de Riesgo validado en población mexicana, así como variables sociales. Se realizó análisis descriptivo con medidas básicas de frecuencia y dispersión, bivariado y multimodal. Resultados: el 43 % eran mujeres y la edad promedio 21 años (±1.7) similar en ambos sexos. La prevalencia de alto riesgo de CAR fue de 8.6 %>, superior en los hombres (9.4 % frente a 7.4 %>) y del mediano riesgo 23.5 % con la distribución invertida por sexo (28.4 % en las mujeres y 19.8 % en los hombres). El índice de insatisfacción fue del 59.4 %, quienes percibieron tener mayor peso del que les gustaría tener y en la distorsión de la imagen corporal se observó que un 41.2 % suponía tener mayor peso que el arrojado por la evaluación antropométrica. Conclusión: los índices de insatisfacción mostraron gradiente de correlación positivo con las CAR, siendo más evidente en los hombres.

Resumo Introdução: o standard de beleza atual associa-se com a magreza, situação que pode alterar a percepção corporal e consequentemente conduzir ao desenvolvimento de algum transtorno alimentar. Objetivo: determinar a relação dos índices de insatisfação e distorção da imagem corporal e as Condutas Alimentares de Risco (CAR), em uma população universitária de estudantes de medicina em Veracruz, México. Materiais e métodos: estudo transversal analítico, em uma população de 187 estudantes. Elaborou-se uma cédula que incluiu o teste SFS para avaliar a imagem corporal e estimar os índices de insatisfação e distorção da imagem corporal; o Questionário Breve de Condutas Alimentares de Risco validado em população mexicana, assim como variáveis sociais. Se realizou a análise descritiva com medidas básicas de frequência e dispersão, bivariado e multimodal. Resultados: o 43 % foram mulheres e a idade média 21 anos (±1.7) similar em ambos os sexos. A prevalência de alto risco de CAR foi de 8.6 %, superior nos homens (9.4 %> versus 7.4 %>) e do mediano risco 23.5 %> com a distribuição invertida por sexo (28.4 % nas mulheres e 19.8 % nos homens). O índice de insatisfação foi de 59.4 %, quem percebera ter maior peso do que gostaria ter, e a distorção da imagem corporal observara-se que um 41.2 %>, quem supunha ter maior peso que o obtido pela avaliação antropométrica. Conclusão: os índices de insatisfação mostraram gradiente de correlação positivo com as CAR, sendo mais evidente nos homens.

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.

Prevalencia y factores asociados a conductas de riesgo alimentario en población indígena de Colombia / Prevalence of risky eating behaviors and associated factors in indigenous population in Colombia

Resumen La información sobre conductas alimentarias de riesgo (CAR) entre indígenas latinoamericanos es escasa. El objetivo de este estudio fue estimar la prevalencia de CAR en población indígena de Colombia, así como identificar factibles factores de riesgo sociodemo-gráficos e individuales. De la Encuesta Nacional de Salud Mental se retomaron los registros de 493 indígenas adultos (Medad =29.5 años, DE =7.39), hombres y mujeres. Las CAR evaluadas fueron: dieta restrictiva, malestar al comer, atracón y vómito autoinducido. El 19.5% de los participantes reportaron presentar al menos una CAR, y aquellas con mayor prevalencia fueron la dieta (8.5-9.6%) y el atracón (6.1%). Ninguno de los factores sociodemográficos evaluados se asoció a la presencia de CAR; por el contrario, de entre los factores individuales, la presencia de trastorno afectivo mostró ser un factible factor de riesgo de estas conductas. Las CAR no son infrecuentes en la población indígena adulta colombiana, e incluso su prevalencia puede duplicar la documentada en población general. Este estudio pretende aportar al escaso conocimiento existente sobre el tópico en poblaciones indígenas. Hallazgos que, ya sea a mediano o largo plazo, deberán incidir en el planteamiento de políticas de salud públicas acordes a las minorías indígenas presentes en Latinoamérica.

Abstract Data on risky eating behaviors (REB) in Latin American ethnic groups is scarce. The aim of this study was to determine the prevalence of REB in adult indigenous from Colombia, as well as to identify feasible sociodemographic and individual risk factors. A total of 493 records of adult indigenous men and women (Mage = 29.5 years, SD = 7.39) were retrieved from the National Survey of Mental Health. The REB assessed were: restrictive dieting, eating discomfort, binge-eating and self-induced vomiting. Participants (19.5%) reported having at least one REB, being restrictive dieting (8.5-9.6%) and binge eating (6.1%) those with higher prevalence. None of the sociodemographic factors evaluated was associated with the presence of REB, on the contrary, among the individual factors, the presence of affective disorder showed to be a feasible risk factor for these behaviors. The REB are common in the indigenous population in Colombia, even its prevalence may double the one reported in general population. This study aims to contribute to the scarce existing knowledge about the topic in indigenous populations. Findings that, whether in the medium or long term, should influence the approach of public health policies according to the indigenous minorities in Latin America.

Influencia de pares en preadolescentes y adolescentes: Un predictor de la insatisfacción corporal y las conductas alimentarias anómalas / Peer influence in preadolescents and adolescents: A predictor of body dissatisfaction and disordered eating behaviors

Los pares contribuyen a la presencia de insatisfacción corporal y conductas alimentarias anómalas, mismas que tienen su pico de ocurrencia durante la adolescencia; sin embargo, se ha sugerido que los pares pueden incidir desde edades más tempranas. Por ello, los propósitos de este estudio fueron: evaluar la influencia de pares, la interiorización del ideal corporal, la insatisfacción corporal y las conductas alimentarias anómalas en preadolescentes vs. adolescentes; y analizar la influencia de pares en la predicción de la insatisfacción corporal y las conductas alimentarias anómalas. Participaron 273 preadolescentes y 175 adolescentes, hombres y mujeres, quienes completaron cuatro cuestionarios, además de recabar su peso y estatura. La prueba t de Student solo reveló diferencias entre los grupos en índice de masa corporal, interacción con pares, interiorización del ideal corporal y conductas alimentarias anómalas, siendo los adolescentes quienes obtuvieron mayores puntuaciones en las primeras tres variables. Los análisis de senderos mostraron que en ambos grupos los pares tuvieron efecto directo sobre la insatisfacción corporal, misma que actuó como mediadora del efecto sobre el comportamiento alimentario. Se concluye que la insatisfacción corporal no difiere entre preadolescentes y adolescentes, y que en ambos la influencia de pares mostró ser un importante factor predictor.

Peers contribute to the development of body dissatisfaction and disordered eating behaviors, conditions that show their peak occurrence during the adolescence; however, literature has suggested that peers may influence since earlier ages. Therefore, the objective of this study was to evaluate peer influence, internalization of the body ideal, body dissatisfaction and disordered eating behaviors, in preadolescents vs. adolescents; and to analyze the peer influence in the development of disordered eating behaviors and body dissatisfaction. A total of 273 preadolescents and 175 adolescents' men and women answered four questionnaires, additionally weight and height was measured. The t Student test showed differences between groups only in body mass index, interaction with peers, internalization of body ideal and eating behaviors, being adolescents who obtained higher scores in the first three variables. Path analysis showed that in both groups peers influenced body dissatisfaction, which act as a mediator of disordered eating behavior. It is concluded that body dissatisfaction is not different between preadolescents and adolescents and in both groups peer influence was an important predictive factor.

Conductas alimentarias de riesgo y correlatos psicosociales en estudiantes universitarios de primer ingreso con sobrepeso y obesidad / Disordered eating behaviors and psychological correlates among overweight and obese freshmen College students

Resumen: INTRODUCCIÓN: El comienzo de los estudios universitarios es un estresor importante para los jóvenes que se asocia con un incremento en la incidencia de depresión, ansiedad, abuso de alcohol y CAR. OBJETIVO: Analizar la relación entre CAR e IMC, su asociación con variables demográficas y psicológicas y la interacción con el IMC. MÉTODO: En una muestra de 892 estudiantes universitarios de nuevo ingreso (502 mujeres y 390 hombres) (Xedad=19.7; DE=2.9) se midió peso y estatura y se utilizaron cuestionarios validados. RESULTADOS: La prevalencia de CAR fue de 6.1% en mujeres y de 4.1% en hombres. La prevalencia de sobrepeso y obesidad en mujeres fue de 22.6% y de 7.4%, y en hombres fue de 26.6% y de 9.3%, respectivamente. Las mujeres y los hombres con obesidad 10.8% y 11.1% presentaron CAR de frecuencia alta, y las mujeres y hombres con sobrepeso 13.2% y 3.8%, respectivamente. En las mujeres el IMC aumenta el riesgo de CAR 1.6 veces (p < 0.05) y en los hombres 1.4 veces (p > 0.05). No se encontró interacción del IMC en la asociación de CAR con el resto de las variables. DISCUSIÓN Y CONCLUSIÓN: En ambos sexos, las variables relacionadas con la imagen corporal aumentan el riesgo de CAR significativamente (p < 0.05). Los síntomas depresivos, la baja autoestima y el IMC aumentan el riesgo entre las mujeres, y el deseo por la musculatura, nivel socioeconómico y el área de estudio entre los hombres. Se recomienda llevar a cabo una investigación específica sobre CAR en varones, para evitar el subregistro de casos.

Abstract: INTRODUCTION: The beginning of college studies involves important stress, which is related to an increase in the incidence of depression, anxiety, alcohol abuse and DEB. OBJECTIVE: To analyze the relationship between DEB and nutritional status measured with BMI, its association with demographic and psychological variables, and the interaction with BMI. METHOD: A sample of 892 college students in their freshman year (502 females and 390 males) (Xage=19.7; SD=2.9) was studied. Weight and height were measured, and validated questionnaires were used. RESULTS: The prevalence of DEB was 6.1% in females and 4.1% in males. The prevalence of overweight and obesity in females was 22.6%, and 7.4% and 26.6% and 9.3% in males, respectively. Among women and men with obesity 10.8% and 11.1% showed high-DEB, whilst among overweight women and men 13.2% and 3.8% showed high-DEB, respectively. BMI increases the risk for DEB 1.6 times among women (p < 0.05), 1.4 times among men (p > 0.05). There was no interaction found between BMI and the other variables. DISCUSSION AND CONCLUSION: The variables related with body image increase the risk of DEB significantly (p < 0.05) in both sexes. Depressive symptoms, low self-steem increase the risk among women, and socioeconomic status and study area increase the risk of DEB among men. The specific research of DEB among males is highly recommended to avoid the under registration of cases.

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.

Systematic review of disordered eating behaviors: Methodological considerations for epidemiological research / Revisión sistemática de las conductas alimentarias de riesgo: consideraciones metodológicas para la investigación epidemiológica

Disordered eating behaviors (DEB) such as dieting, fasting, laxatives or diuretics abuse, self-induced vomiting and binge eating may lead serious physiological and psychological consequences in individuals. Epidemiological data helps to the understanding of the magnitude of this problem within population; however point prevalence rates and the trend of DEB are still a subject of constant debate. Therefore the aim of this study is to systematically review empirical studies that have estimated the prevalence of DEB in women and provide some methodological considerations for future epidemiological studies. The search of articles was made through MEDLINE and SCIENCE DIRECT databases from 2000 to 2013. According to inclusion and exclusion criteria 20 studies were reviewed. Results yielded that the point prevalence range of dieting (0.6-51.7%), fasting (2.1-18.5%) and binge eating (1.2-17.3%) are higher than purgative behaviors (0-11%). However finding a trend in DEB over time was difficult since methodologies were significantly different. Methodological considerations for future research in DEB are proposed.

Las conductas alimentarias de riesgo (CAR) de los trastornos alimentarios, tales como dieta, ayuno, abuso de laxantes o diuréticos, vómito autoinducido y atracón, pueden causar graves consecuencias fisiológicas y psicológicas en el individuo. Los datos epidemiológicos ayudan a la comprensión de la magnitud de este problema en la población, sin embargo las tasas de prevalencia puntual y la tendencia de las CAR aún son tema de constante debate. Por lo tanto, el objetivo del presente estudio es revisar sistemáticamente estudios empíricos que estimen la prevalencia de las CAR en mujeres y proveer consideraciones metodológicas para futura investigación epidemiológica. La búsqueda de artículos fue a través de las bases de datos de MEDLINE y SCIENCEDIRECT de 2000 a 2013. Con base en los criterios de inclusión y exclusión 20 estudios fueron analizados. Los resultados arrojaron que el rango de la prevalencia puntual para dieta (0,6-51,7%), ayuno (2,1-18,5%) y atracón (1,2-17,3%) son mayores que el de las conductas purgativas (0-11%). Sin embargo, fue difícil encontrar una tendencia en las CAR a través del tiempo debido a que las metodologías utilizadas fueron significativamente diferentes. Se proponen consideraciones metodológicas para futuras investigaciones en CAR.

Identificación de casos de riesgo de trastornos alimentarios entre estudiantes de Querétaro / Eating disorders identification of risk cases among students from Queretaro

Los Trastornos de la Conducta Alimentaria [TCA] constituyen un grave problema de salud pública, reconocido a nivel internacional. A través del proyecto "Razones de Peso" en el año 2013 se desarrolló una investigación en secundarias públicas de la localidad de Santiago de Querétaro, con el objetivo de identificar el riesgo de padecer TCA entre adolescentes mujeres y varones, con base en la presencia Conductas Alimentarias de Riesgo [CAR] y preocupaciones asociadas con TCA. La muestra estuvo compuesta por 435 estudiantes (224 mujeres y 211 varones) con una edad promedio de 13.83 años (DE=.72). El instrumento empleado fue una versión del cuestionario EAT-26 adaptada, validada y recomendada por Garner (2004a), autor original de dicho cuestionario. Entre los resultados de la investigación destaca la elevada prevalencia de preocupaciones asociadas a TCA (5.9%) y de CAR (33.1%), en estudiantes de ambos sexos. Además, tanto el grupo considerado "en riesgo de padecer algún TCA", como el grupo de estudiantes que declararon incurrir en CAR, estuvieron conformados por un mayor porcentaje de varones que de mujeres. Se recomienda implementar estudios a dos fases, con muestras estadísticas integradas por mujeres y varones, y la validación con población mexicana, de la versión del EAT-26 empleada para la presente investigación.

Eating Disorders [ED] are a serious public health problem, internationally recognized. Through the project "Razones de Peso", (Reasons that Determine Weight) in 2013 research was carried out in public junior high schools in the City of Santiago de Querétaro. The objective was to identify the risk of suffering from ED among adolescents based on the presence of Disordered Eating Behaviors [DEB] and preoccupations associated with ED. The sample consisted of 435 students (224 girls and 211 boys) with an average age of 13.83 (SD=.72). The instrument used was a version of the EAT-26 questionnaire, adapted, validated and recommended by Garner (2004a), the original questionnaire author. The results highlights the elevated prevalence of concerns associated with ED (5.9%) and DEB (33.1%) in male and female students. Moreover, both the group considered "at risk of developing an ED" as the students group that expressed having DEB, were composed by a higher percentage of boys rather than girls. It is recommended the implementation in two phases studies, with statistical samples made up of girls and boys and the validation with a Mexican population of the EAT-26 version used for this study.

Disordered eating behaviors and binge drinking in female high-school students: the role of impulsivity / Conductas alimentarias de riesgo y consumo escesivo de alcohol en mujeres estudiantes: el papel de la impulsividad

Introduction It is widely accepted that psychiatric comorbidity can increase the severity, chronicity, and treatment resistance of psychiatric disorders. In various studies worldwide, it has been estimated that the prevalence of alcohol use disorders in women with disordered eating behaviors (DEB) is situated at between 2.9 and 48.6%. It is worth noting that previous studies have not considered the analysis of the variables that could explain the comorbidity between DEB and alcohol use in adolescents, such as impulsivity, which is the key variable for explaining this comorbidity. On the other hand, most studies have addressed the adult population in psychiatric hospitals or people with eating disorders (ED) or alcohol use disorders. It is considered that those subjects have already developed psychiatric comorbid disorders. Impulsivity could be an unspecific trait that aggravates the psychiatric condition of a determined person and it is therefore more likely for that person to seek specialized care. According to the above, the role of impulsivity in the comorbidity of ED and alcohol use might not be similar to that of the general population, mostly among those who have not yet developed a whole clinical syndrome. Therefore, we consider that it is important to clarify the involvement of impulsivity in the comorbidity between disordered eating behaviors (DEB) and binge drinking (BD) in high school students. It is also crucial to analyze the association between impulsivity and the coexistence of DEB and binge drinking (BD) in female students aged between 15 and 19 years at public high schools in the State of Mexico. Methods Data for this study were drawn from the Project entitled "Prevalence and Factors Associated with Disordered Eating Behaviors in Adolescent Women with Different Levels of Urbanization and Migration Intensity" (CONACyT-SEP-2004-46560). The design for this study is cross-sectional and analytical. A sample of 2357 female students at 11 public high schools in the State of Mexico was randomly selected during the 2006-2007 school year. For data collection for this project, a questionnaire was used that included socio-demographic variables, the Plutchik Impulsivity Scale (PIS), the Brief Questionnaire to Measure Risky Eating Behaviors (BQREB), and the questions on alcohol use included in the Questionnaire of Surveys on Substance Use in Students in Mexico (2003 version). Data were analyzed with the STATA version 10 survey function. Results Impulsivity was associated with the coexistence of DEB and BD (U=224427; p<0.01). The 3.5% of female students with impulsivity presented DEB and BD together vs. 0.6% who did not; 19.6% of female students with impulsivity presented one of the two behaviors vs. 7.8% without this trait. Impulsivity was associated positively and significantly with the coexistence of DEB and BD (t=3.8; p<0.01), regardless of socioeconomic variables, such as the father's educational attainment, the mother's educational attainment, and the number of services in the household. Conclusion The results of this paper indicate a statistically significant association between impulsivity and the coexistence of DEB and BD. This means that there is a greater percentage of coexistence of DEB and BD in female high school students considered to be impulsive in comparison with adolescents without this trait. This occurs regardless of socioeconomic variables, such as the father's educational attainment, the mother's educational attainment, and the number of services in the household. Future research should establish the role of other variables such as depression and examine the association of impulsivity with socioeconomic variables.

Introducción En términos generales, se acepta que la comorbilidad psiquiátrica puede incrementar la gravedad, la cronicidad y la resistencia al tratamiento de los trastornos psiquiátricos. En diversos estudios en todo el mundo se ha estimado que la prevalencia de trastornos por consumo de alcohol en mujeres con conductas alimentarias de riesgo (CAR) se sitúa entre el 2.9 y el 48.6%. Es importante señalar que los estudios anteriores no han considerado el análisis de las variables que podrían explicar la comorbilidad entre las CAR y el consumo de alcohol en los adolescentes, tales como la impulsividad, que es la variable considerada como la más importante para explicar dicha comorbilidad. Por otro lado, la mayor parte de la literatura ha estudiado a población adulta en hospitales psiquiátricos o a sujetos que ya han cumplido con los criterios diagnósticos de los trastornos de la conducta alimentaria (TCA) y de los trastornos por uso de alcohol. Se ha considerado que dichas poblaciones ya han desarrollado trastornos psiquiátricos comórbidos y que la impulsividad puede ser un rasgo inespecífico que agrava la situación psiquiátrica de una persona y que de esa forma sea más probable que acuda a una institución hospitalaria. Por lo tanto, es posible que la participación de la impulsividad en la comorbilidad entre los TCA y el consumo de alcohol no sea similar en la población general, sobre todo en la que no ha desarrollado los trastornos aún. Por lo tanto, consideramos importante aclarar la participación de la impulsividad en la comorbilidad entre las conductas alimentarias de riesgo (CAR) y el consumo excesivo de alcohol (CEA) en la población general y especialmente en aquellos sujetos en riesgo de presentar estos trastornos. Para ello se consideró importante analizar la asociación entre la impulsividad y la coexistencia de las conductas alimentarias de riesgo y el consumo excesivo de alcohol en estudiantes de sexo femenino de entre 15 y 19 años en escuelas públicas del Estado de México. Método Los datos para este estudio fueron obtenidos del Proyecto "Preva-lencia y Factores Asociados a Conductas Alimentarias de Riesgo en Mujeres Adolescentes en Localidades con diferente Nivel de Urbanización e Intensidad de Migración" (CONACyT-SEP-2004-46560). El diseño del estudio es transversal-analítico. La unidad de análisis fueron las estudiantes de sexo femenino entre 15 y 19 años de edad en instituciones educativas públicas de nivel medio superior en el Estado de México. Para la selección de las estudiantes, se utilizó un muestreo aleatorio estratificado. La muestra consistió en 2357 estudiantes de 11 escuelas públicas en el Estado de México durante el año escolar 2006-2007. Para la recolección de datos se empleó un cuestionario que incluía variables sociodemográficas, la Escala de Impulsividad Plutchik, el Cuestionario Breve de Conductas Alimentarias de Riesgo, y las preguntas sobre el consumo de alcohol, incluidas en el cuestionario de estudiantes (versión 2003) de las encuestas sobre consumo de sustancias en estudiantes de México. Los datos fueron analizados con la función survey del programa estadístico STATA versión 10 con una ponderación de la muestra que correspondió a la probabilidad de selección debido al nivel de marginación y estatus migratorio. Para determinar la asociación entre la impulsividad y la coexistencia entre las CAR y el CEA, se realizó un análisis de regresión ordinal. Resultados La impulsividad se asoció con la coexistencia entre las conductas alimentarias de riesgo y el consumo excesivo de alcohol (U=224427, p<0.01). El 3.5% de las estudiantes con impulsividad presentaron CAR y CEA de manera conjunta vs. el 0.6% que no cumplieron con dicha definición, mientras que el 19.6% de las estudiantes con impulsividad presentaron una de las dos conductas vs. 7.8% sin dicho rasgo. La impulsividad se asoció de manera positiva y significativa con la coexistencia CAR & CEA (t=3.83; p<0.01), de manera independiente a las variables socioeconómicas como la escolaridad del padre, la escolaridad de la madre y el número de servicios en la vivienda. Conclusión Los resultados de este trabajo indican una asociación estadísticamente significativa entre la impulsividad y la coexistencia de CAR y CEA. Lo anterior significa que hay un porcentaje mayor de la coexistencia de CAR y CEA en las estudiantes que cumplieron la definición operacional de impulsividad en comparación con las estudiantes sin dicho rasgo, de manera independiente a las variables socioeconómicas como la escolaridad del padre, la escolaridad de la madre y el número de servicios en la vivienda. Los resultados del presente estudio muestran que la impulsividad está asociada con una serie de conductas que pueden incrementar el desarrollo de un TCA comórbido con un trastorno por consumo de alcohol, y por lo tanto, sugieren un peor pronóstico para las adolescentes incluidas en el estudio. Lo anterior plantea la necesidad de detectar a los sujetos en riesgo de desarrollar ambos trastornos y su canalización a los servicios de salud especializados. Queda pendiente establecer el papel de otras variables como la depresión, y estudiar la asociación entre la impulsividad con las variables socioeconómicas mencionadas.

Las conductas alimentarías de riesgo no se asocian con deficiencias de micronutrimentos en mujeres en edad reproductiva de la Ciudad de México / Abnormal eating behaviours are not associated with micronutrient deficiencies among women of childbearing age from Mexico City

El objetivo de este trabajo fue evaluar la asociación entre las conductas alimentarias de riesgo (CAR) y las deficiencias de vitaminas y nutrimentos inorgánicos en una muestra de mujeres en edad reproductiva. Participaron 282 mujeres de 12 a 49 años (21.9 por ciento adolescentes) no embarazadas ni lactando, muestreadas de manera sistemática con arranque aleatorio en 6 colonias del poniente del Distrito Federal. Se evaluaron las concentraciones de las vitaminas A, C, E, B12 y ácido fólico así como de hemoglobina, ferritina y hierro y zinc séricos. Para las CAR se usó un cuestionario validado en la población mexicana. La información se analizó con estadística descriptiva y la prueba de Fisher. Aproximadamente el 68 por ciento de la muestra fue de nivel socioeconómico medio-bajo o inferior. El 14.8 por ciento tuvo un puntaje de riesgo para las CAR, sin diferencias entre adolescentes y adultas. Las CAR más frecuentes fueron la preocupación por engordar y comer demasiado. El 10 por ciento de las mujeres, aproximadamente, usaron diuréticos o laxantes durante el trimestre anterior a la encuesta. Las deficiencias más importantes fueron las de Vitamina E, zinc y hierro, que afectan al 47 por ciento, 44 por ciento y 27 por ciento de la población, respectivamente. No hubo asociación significativa entre las CAR y las deficiencias de micronutrimentos de manera global ni al analizar por conductas aisladas. A pesar de ello, y dada la alta prevalencia de las CAR y la obesidad en esta población, es necesario hacer campañas para promover la adopción de conductas saludables que permitan alcanzar un peso adecuado.

The aim of this study was to evaluate the association between the risk of abnormal eating behaviors (AEB) and vitamin and mineral deficiencies among women. Women of childbearing age (n=282) were systematically sampled with a random start (21.9 percent adolescents) in 6 suburbs in the west side of Mexico City, they were non pregnant or breastfeeding. Vitamin A, C, E, B12, folic acid, hemoglobin, ferritin, cupper, iron and zinc concentrations were measured. A questionnaire validated in the Mexican population was used for screening AEB. Data were analyzed by descriptive statistics and by using Fisher´s test. Approximately 68 percent of the sample belonged to a mid-low or lower socioeconomic status. 14 percent had risk of AEB, without statistical differences between adults and teenagers. 10 percent used diuretics or laxatives to reduce weight within the trimester preceding the survey. Vitamin E, zinc and iron were the most widespread deficiencies affecting 47 percent, 44 percent and 27 percent of the population, respectively. There was no association between the AEB and micronutrient deficiencies neither when AEB were analyzed globally nor individually. Considering these results and the high prevalence of the AEB and overweight in this population, it is important to promote the adoption or healthy behaviors to achieve an adequate weight.

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.

Perspectiva interdisciplinaria de hábitos alimentarios en adolescentes: transición nutricional y conductas alimentarias de riesgo / An interdisciplinary perspective on eating habits in adolescents: nutritional transition and risk eating behaviors

Introducción: La adolescencia constituye una etapa de promoción y consolidación de los hábitos alimentarios. De allí que resulta de interés el estudio del estado nutricional y hábitos alimentarios en adolescentes, en el contexto de la transición nutricional. Es importante identificar si los adolescentes presentan conductas alimentarias riesgosas, tanto nutricionales como psicosociales para efectuar intervenciones oportunas. Materiales y métodos: Estudio descriptivo, transversal. Muestra: 125 adolescentes escolarizados. El instrumento consideró: datos antropométricos, datos sociodemográficos y alimentarios, ítems correspondientes a la dimensión Deseos de Adelgazar del Inventario de Conductas Alimentarias (ICA). Resultados: La proporción de valores bajos para el indicador peso según talla (P/T) fue 11%. Sobrepeso y obesidad representaron un 17% y 2% respectivamente. La circunferencia de cintura identificó riesgo cardiovascular en el 7%. Fue excesivo el consumo de hidratos de carbono refinados (azúcares y dulces) y de aceites y grasas. Las comidas rápidas de alto valor calórico y graso alcanzaron un consumo diario promedio de 1 unidad, el consumo de alfajores y/o chocolates alcanzó una ingesta promedio diaria de 2 unidades en el 91%. Considerando estilos de vida, sólo el 54% realizaba actividad física, ocupando el ejercicio aeróbico y deportes un promedio de 35 minutos/ día. Se encontró una dependencia entre los deseos de adelgazar y la presencia de un diagnóstico de Índice de Masa Corporal por exceso. El 21% presentó comportamientos riesgosos respecto al cuerpo. Conclusiones: El 29% presentó un estado nutricional inadecuado. La antropometría mostró indicadores de riesgo asociados a la obesidad. El análisis de la ingesta permitió vislumbrar un escenario favorecedor para la obesidad, expresión de la transición nutricional. Los estilos de vida no contribuyen a revertir esta tendencia.

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.