Comparación de dos patrones de incremento de peso durante el embarazo / Comparison of 2 standards of weight gain during pregnancy

Se presentan aquí los resultados de un estudio que comparó la habilidad diagnóstica y la capacidad predictiva de los puntos de corte de dos instrumentos para guiar el incremento de peso durante el embarazo. Ellos son la curva de Rosso y Mardones (RM), que utiliza el porcentaje del peso estándar para clasificar nutricionalmente a la embarazada, y una propuesta de puntos de corte que utiliza el índice de masa corporal para el mismo propósito. Los datos de 1.745 madres de Santiago de Chile, sirvieron para realizar estos análisis. Las variables dependientes fueron las incidencias de peso al nacer de riesgo < 300 g para las madres de bajo peso => 4000 g para las madres con sobrepeso. Los puntos de corte se compararon a la semana 10 y a la semana 40 de edad gestacional. La mayoría de los estadígrafos para la confiabilidad diagnóstica y para la capacidad predictiva fueron mayores en la curva RM, indicando que es un mejor examen para el tamizaje. La similitud de los puntos de corte para diagnosticar sobrepeso de ambos patrones contribuyó a que varios estadígrafos no tuvieran diferencias, especialmente para el peso al nacer => 4000 g al inicio del mismo

Propuesta de un nuevo estándar de evaluación nutricional en embarazadas / Proposal of a new standard for the nutritional assessment of pregnant women

Background: There is evidence to suggest that the criterial for nutritional assessment of pregnant women, uses by the Chilean Ministry of Health, overestimates nutritional disturbances. Aim: To propose a new reference table to assess the nutritional status of pregnant women, based on body mass index. Material and metbods: The table was theoretically defined using criteria for normality proposed by FAO and the weight increase during pregnancy that is associated with a lower maternal and fetal morbidity and mortality. In 665 pregnant women, weight, height, mid arm circumference and skinfolds were measured using standard techniques. Body mass index, arm fat and muscle area and percentage of body fat were calculated. Body composition for each nutritional category, derived from the body mass index or "Rosso-Mardones classification", was analyzed. Results: According to the new table, under weight women had lower percentage of body fat and mid arm circunference and overweight women had higher weight, skinfold thickness and percentage of body fal than the homologous groups defined according to Rosso-mardones tables. Conclusions: The proposed reference table may be useful to correct distortions generated by the current norms for nutritional assessment of pregnant women, proposed by the Chilean Ministry of Health. It has to be validated, analyzing its sensitivity, specificity and predictive value to predrict fetal and maternal variables

Desarrollo de una curva patrón de incrementos ponderales para la embarazada / Design of a standard weight chart for pregnant women

Background: A low weight for height of pregnant women at the start of pregnancy has a negative impact of fetal growth. Aim: To report the design of a weight gain chart for pregnant women that allows to classyfy mothers according to their nutritional status and to monitor weight gain during gestation. Material and methods: Data from 1745 Chilean mothers who delivered their newborns in 1983 and 1984 were used to build this chart. Results: The instrument could diagnose, from gestational week 10 onwards, mothers at risk of delivering babies with birth weight under 3000 g and set weight gain goals for each individual mother based on ber nutritional status. Similarly, mothers at risk of delivering babies with birth weight over 3999 g could be early diagnosed during pregnancy and guided to have a prudent weight gain. Conclusions: The chart can be easily used in prenatal clinics of developing countries and is currently applied in several Latin American countries

Plan anual de nutrición 1996 / Annual plan of nutrition 1996

Documento elaborado tomando como referencia las estrategias y acciones contempladas en el Plan Quinquenal de Acción para la Nutrición, con el fin de adaptarlas y modificarlas para que correspondan a als prioridades y circunstancias sociales y económicas del país. Contempla diez ejes fundamentales de acción y son los siguientes: Mejoramiento de la oferta de alimentos de la canasta básica; Seguridad alimentaria nutricional a nivel del hogar; Educación alimentaria y nutricional; Vigilancia, monitoreo y evaluación; Micronutrientes; Lactancia materna; Control de la calidad higiénica y nutricional de los alimentos; Prevención y control de enfermedades infecciosas que inciden en el estado nutricional; Alimentación complementaria a grupos de riesgo; Saneamiento ambiental básico y calidad del agua

Malnutrición de la embarazada: ¿un problema sobreestimado? / Malnutrition in pregnancy woman: an overestimated problem?

The aim of this work was to compare the nutritional classification of pregnant women and their predictive value for the low birth weight, using the criteria of the Ministry of health (Rosso-Mardones curves) with the curves developed at the Department of Nutrition of the Faculty of Medicine and the body mass index. One thousand eight hundred four pregnancy women of the Metropolitan Region, that were devoid of factors affecting birth weight, were studied retrospectively. Initial and final nutritional status was calculated according to the three criteria in study. Results showed that 47 to 75 percent of women classified as undernourished using Rosso-Mardones curves, were normal according to the curves of the Department of Nutrition and body mass index. Rosso-Mardones curves had the lower predictive value, relative risk and risk attributable to maternal nutritional deficit, for low birth weight. Also these curves showed a higher of obesity and a low predictive value for macrosomia. It is concluded that the curves used by the Ministry of Health must be revised

Protocolo alimentar do bebê de zero a três anos de idade / The infant diet: a protocol

É objetivo deste estudo apresentar ao clínico-geral e/ou odontopediatra informaçöes atualizadas em relaçäo ao aconselhamento dietético para uma faixa etária entre 0 e 3 anos de idade. Para tanto, é apresentado um protocolo alimentar, sequenciando a época mais adequada para a introduçäo dos alimentos, desde o aleitamento materno ou aleitamento artificial até a alimentaçäo completa da criança de três anos