Malnutrition in Relation with Dietary, Geographical, and Socioeconomic Factors among Older Chinese / 生物医学与环境科学（英文）

Objective@#Nutrition is closely related to the health of the elderly population. This study aimed to provide a comprehensive picture of the nutrition status of elderly Chinese and its related dietary, geographical, and socioeconomic factors.@*Methods@#A total of 13,987 ≥ 60-year-old persons from the 2010-2013 Chinese National Nutrition and Health Survey were included to evaluate various aspects of malnutrition, including underweight, overweight or obesity, and micronutrient inadequacy.@*Results@#Overall, the prevalence of obesity, overweight, and underweight was 12.4%, 34.8%, and 5.7%, respectively, with disparities both geographically and socioeconomically. The prevalence of underweight was higher among the older old (≥ 75 years), rural residents and those with low income, with low education status, and residing in undeveloped West areas. More than 75% of the elderly do not meet the Dietary Reference Intakes for vitamins A, B @*Conclusions@#Obesity epidemic, inadequacy of micronutrient intake, and high prevalence of underweight and anemia in susceptible older people are the major nutrition challenges for the rapidly aging population in China.

WHO body mass index for age charts overestimate thinness and overweight compared to international and US charts applied to indigenous and non-indigenous Mexican children

Assessments of whether children are thin (low body mass index for age) or overweight are based on body mass index (BMI for age and sex) charts published by the World Health Organization (WHO), the International Obesity Task Force (IOTF), and the US Centers for Disease Control and Prevention (CDC). We aimed to determine whether these charts indicated different prevalence of thinness and overweight (obesity included) in indigenous and non-indigenous school aged children from different regions and ethnic groups in Mexico. A probability proportional to size, cluster sampling method was employed in four regions of the country. We recruited 1,731 children aged 7.0-9.9 (507 indigenous from six ethnic groups and 1,224 non-indigenous). BMI was calculated according to age, and thinness and overweight classifications were compared according to cutoff values in the WHO, IOTF, and CDC references. The WHO reference generated the highest rates for thinness (12.5%) and overweight (30%) in children across regions and ethnic groups. The CDC reference estimated the lowest rates of thinness in children (5.5%), and the IOTF reference estimated the lowest rates of overweight (24.7%). Estimates of both thinness (8.3%) and overweight (13.4%) rates were lower in indigenous than non-indigenous groups (14.3% and 37.5%, respectively). The WHO BMI for age chart estimated higher rates of thinness and overweight in children compared to the CDC and IOTF charts. Because thinness as indicator of undernutrition status is relatively new, differences in body composition among indigenous and non-indigenous children may justify the need for more appropriate screening criteria to compare the growth status(AU)

La clasificación del estado nutricio de los niños con delgadez o con sobrepeso se realiza empleando el índice de masa corporal (IMC para la edad y el sexo) con las tablas de la OMS, IOTF y CDC. El objetivo de esta investigación fue determinar si estas referencias resultan en diferentes prevalencias de delgadez y sobrepeso (obesidad incluida) en niños escolares indígenas y no indígenas de diferentes regiones de México. Se empleó un muestreo por conglomerados en cuatro regiones del país. Se reclutaron 1,731 niños con edades entre 7,0-9,9 (507 indígenas de cinco grupos étnicos y 1,224 no indigenas) durante 2006 y 2008. El IMC se calculó y se clasificó como delgadez y sobrepeso con los puntos de corte sugeridos por las referencias internacionales. Cuando se compararon las clasificaciones, la referencia de OMS generó la prevalencia más alta de delgadez (12,5%) y sobrepeso (30%) en niños de todas las regiones y grupos étnicos. La referencia de los CDC estimó las prevalencias más bajas de delgadez (5,5%) y la referencia IOTF produjo las proporciones más bajas de sobrepeso (24,7%). Las proporciones de delgadez (8,3%) y sobrepeso (13,4%) fueron más bajas en niños indígenas que en los no indígenas (14.3% y 37.5%, respectivamente). La referencia de la OMS del IMC para la edad produjo las prevalencias más altas de delgadez y sobrepeso en comparación con los estándares de CDC y IOTF. Dado que la delgadez como indicador de desnutrición en niños es de uso reciente, las diferencias encontradas entre indígenas y mestizos pueden justificar el contar con mejores herramientas de tamizaje en estudios de crecimiento(AU)

Factors affecting on obesity and underweight with outcome among people living in the vicinity of Marzipura, Faisalabad

Due to transformation in nutritional status, along with epidemiological and socio demographic changes in developing countries like Pakistan, obesity and underweight coexist in our community. Date about coexistence of obesity [body mass index, BMI >/= 30kg/m[2]] and underweight [BMI >/= 18.5 kg/m[2]] and related factors are lacking in this region of our province. This study will help us to relate different sociodemographic factors with obesity and underweight. To know the prevalence of obesity and underweight by body mass index [BMI] and to investigate the association of obesity and underweight with selected health conditions and socioeconomic differences in this group.Observational retrospective crosssectional study. The record of 1656 individual presented in medical OPD or Independent University Hospital Marzi Pura Faisalabad, during the period of 4 months Mar 2013 to June 2013 was analysed. Age, Sex, Body Weight and height were enter in a structure format sheet. Date was analysed by SPSS Version17. Mean BMI was 24.0 kg/m[2] [SD = 6.2], and was higher for women and decreased with age. Prevalence of obesity was 19.6% and was positively associated with female gender, family income, hypertension, and diabetes and inversely related to physical activity. Underweight affected 15.6% of participants mainly of age group < 25 years and in elderly people, and was higher among women and low-income families. It was negatively associated with hypertension and diabetes and directly associated with Mycobacterium tuberculosis infection and >/= 2 hospitalizations in the previous 12 months. Both obesity and underweight were associated with increased morbidity. The association of underweight with Mycobacterium tuberculosis infection, increased hospitalization, and low family income may reflect illness-related weight loss in all age groups especially

Crescimento e deficiências de micronutrientes: perfil das crianças assistidas no núcleo de creches do governo da Paraíba, Brasil / Growth and micronutrient deficiencies: profile of children attendied at the day care center for the government of Paraiba, Brazil

O objetivo deste artigo é avaliar o perfil de crescimento das crianças assistidas no Núcleo de Creches do Governo da Paraíba e a contribuição relativa das deficiências de vitamina A, ferro e zinco. Estudo transversal em 240 crianças pré-escolares. Foram consideradas as categorias de diagnóstico nutricional: déficit ponderal, déficit de estatura e sobrepeso. As concentrações séricas de retinol, zinco e de hemoglobina foram determinadas para avaliar a deficiência de vitamina A (< 0,70 µmol/L), deficiência de zinco (< 65 Μmol/L) e anemia (< 110 g/L), respectivamente. A prevalência de déficit de estatura foi de 5,8%, a de sobrepeso de 3,8%, e a de déficit de peso de 0,4%. A média de Escore-Z para o índice P/E foi menor e estatisticamente significante quando a mãe da criança foi diagnosticada com baixa estatura ou com baixo peso e nas crianças de 12-36 meses de idade. Para o índice E/I, a média de Escore-Z foi menor e estatisticamente significante quando a criança nasceu com baixo peso e quando a mãe da criança apresentou baixa estatura. Crianças de 12-36 meses e sem o beneficio do Programa Bolsa Família tiveram média de hemoglobina menor. Verificou-se ausência de associação significante entre as deficiências de vitamina A, ferro e zinco e os índices antropométricos estudados.

This article seeks to evaluate the growth of children attending public day care centers of the Government of the State of Paraiba and the relative significance of vitamin A, iron and zinc deficiencies. It involved a cross-sectional study of 240 preschool children. The following categories of nutritional status were considered: underweight (W/H < -2 z-scores), stunting (H/A < -2 z-scores) and overweight (W/H > +2 z-scores). Serum concentrations of retinol, zinc and hemoglobin were established to assess vitamin A deficiency (< 0.70 mmol/L), zinc deficiency (< 65 mmol/L) and anemia (< 110 g/L), respectively. The prevalence of stunting was 5.8%, that of overweight 3.8%, and that of underweight 0.4%. W/H z-scores were lower and statistically significant in children aged 12-36 months. An association was also found between W/H z-scores and maternal height. This association was also observed regarding body mass index. H/A z-scores were lower and statistically significant in low birth weight children. Lower hemoglobin concentrations were detected in children aged 12-36 months who were not receiving the financial support of the Bolsa Familia (Family Allowance) program. There was no significant association between vitamin A, iron and zinc deficiencies and the anthropometric indices studied.

Avaliação e tratamento da perda de peso involuntária e significativa / Evaluation and treatment of significant and unintentionalweight loss

A queixa de perda de peso possui incidência de 13% em pacientes ambulatoriais e 65% em pacientes institucionalizados. Considera-se significativa a perda de 5% ou mais do peso corporal em seis a 12 meses. Associa-se a diversas condições clínicas agudas e crônicas, ao uso de medicamentos e a fatores psicossociais. Constitui fator de risco independente para aumento na morbidade e mortalidade, sendo de particular relevância em indivíduos acima de 40 anos. A familiaridade com o processo de investigação clínica e laboratorial de pacientes com essa queixa pode auxiliar na abordagem e cuidado aos mesmos. Faz-se, aqui, revisão detalhada sobre o tema, incluindo-se comentários sobre os seus principais estudos clínicos disponíveis.

The complaint of weight loss has an incidence of 13% in outpatients and 65% in institutionalized patients. It is considered significant the loss of 5% or more of the body weight within 6 to 12 months. It is associated with several acute or chronic clinical conditions, the use of medication and psychosocial factors. It is an independent risk factor for morbidity and mortality increase, particularly relevant in individuals over 40 years old. Familiarity with the process of clinical and laboratory investigation of patients with this complaint can assist in their evaluation and care. This is a detailed review on the subject, including comments on its main clinical studies available.

Investigation of nutritional status in elementary school students of south khorasan province: East of Iran

Children have greater nutritional needs than adults in order to maintain their growth. It has been determined that about 70% of all malnourished children in the world live in Asia. This study evaluates nutritional status of elementary students in south khorasan province and some effective factors on it. The height and weight of 1303 elementary school students ages between 7 to 12 years old which were selected by multistage random sampling from urban and rural areas of the South Khorasan province were measured. Data for this study was collected for a period of six months from September 2006 to February 2007. Nutritional habits of these students and its relation to demographic factors were evaluated using Gomes [weight-for-age], Maclaren-ride [weight to height for age] and Waterlow [height-for-age] criteria. Based on the finding of this study, 69.8% of the students were underweight, 30.9% were wasted and 43.6% were stunted. The effects of malnutrition in this group were mild and severe cases of malnutrition effects were rare. The adverse effects of malnutrition were more widespread with the increase in the age of the students. These adverse effects were also more persistence with increased level of illiteracy among the parents of these students. The number of underweight students was significantly larger in the rural areas than in the urban areas. Heights of the students were directly correlated to the order of their birth. The higher the birth orders the higher the prevalence of being shorter Being stunted was more widespread among female students with less educated mothers. In order to improve high prevalence of malnutrition in elementary school students of South Khorasan province, we recommend improvement of the level of literacy, nutritional education of mothers, and students. We also suggest improvement of quality of students' free meal in schools

Patología del adulto mayor / Pathology of the elderly

El envejecimiento es un proceso fisiológico; inevitable; de comienzo insidioso; de evolución lentamente progresiva, de carácter degenerativo, sistémico e irreversible, que va reduciendo gradualmente la capacidad funcional del organismo y cuyas manifestaciones clínicas son múltiples y variadas. Se discute si es un proceso fisiológico regresivo que va reduciendo gradual e inexorablemente la capacidad funcional de todos los órganos o si se trata de un proceso patológico sistémico. Lo más probable es que sea un proceso mixto con una parte fisiológica y una patológica debida a trastornos sobreagregados susceptibles de corrección. Las principales manifestaciones clínicas de los senescentes son: neuropsiquiátricas, cardio y cerebrovasculares, osteo-articulares y musculares, urogenitales, tumorales, infecciosas, iatrogénicas que corresponden a reacciones adversas frente a drogas administradas en número y dosis excesivas. Para terminar, consideramos importante establecer o proponer algunos conceptos en relación a lo que podría considerarse una vejez satisfactoria: 1) salud física que permita una vida autovalente, 2) estado mental alerta compatible con una correcta orientación témporoespacial y una fluida comunicación interpersonal y colectiva, 3) existencia de una red de apoyo afectivo (familiares y amigos) que evite la soledad y el aislamiento, 4) disponibilidad de una situación económica mínima suficiente y estable jubilación, pensión, renta y recursos propios) que impida la indigencia y la dependencia obligada, 5) posibilidad de desarrollar algún tipo de actividad, rentada o no, que proporcione una real sensación de utilidad, 6) capacidad de elaborar proyectos futuros y no vivir sólo de recuerdos del pasado