Programa MINSAL-FONASA para tratamiento de la obesidad infanto-juvenil / MINSAL-FONASA pilot study in obese children and adolescents
Rev. chil. pediatr
;
82(1): 21-28, feb. 2011. ilus
Article
in Spanish
| LILACS
| ID: lil-597606
ABSTRACT
Reducing the prevalence of childhood obesity is a sanitary goal for the decade. Objective:
To evaluate a short time intervention model in childhood obesity on its anthropometric and metabolic impact.Methods:
Prospective evaluation of obese children and adolescents, 6 to 19 years of age. A pilot treatment program from the Public Health System and FONASA was conducted as a multidisciplinary, non-pharmacologic intervention, during a 4-month follow-up period. Body Mass Index (BM1), waist circumference, lipid profile, plasma glucose and HOMA index were evaluated. In a subset of the subjects the blood profile was repeated on the 4th month.Results:
402 patients entered the program, 56,5 percent females, age 12,2 years (range 6,3-18,2). Baseline mean BMl z score was 2,92 (1,7 to 7,7), mean waist circumference was 92,3 +/-11,1 cm. A total cholesterol (TC) >170 mg/dL was founded in 39,1 percent of patients; LDL >110 mg/dL, 26,5 percent; HDL < 40 mg/dL, 30,9 percent, and TG > 110 mg/dL in 37 percent of patients. The median HOMA was 2,45 (0,37 to 17,79). The program was completed by 66,9 percent of patients, 68,4 percent of these reduced z score BMl at the 4-month evaluation (3,13 baseline vs 2,74, p < 0.05), without correlation with age, gender, or baseline BMl z score. The group who completed the program showed a BMl z score at baseline significantly higher than their counterparts (3,1 vs 2,74, p < 0,05). 118 subjects were reevaluated, 59 percent of them showed a decrease in HOMA index. From the group of patients with high TC levels at baseline, 54 percent reduced the TC and 66 percent TG, without relation to weight, waist circumference or HOMA reduction.Conclusion:
a high percentage of children succeeded in completing the program, showing better adherence those who were more overweight at the entrance of the program. The program showed an improvement in the nutritional state and in metabolic factors.RESUMEN
La disminución de la obesidad es un objetivo sanitario para la década. Objetivo:
Evaluar respuesta antropométrica, metabólica y adherencia a corto plazo, a un modelo de intervención en obesidad infantil. Sujetos yMétodo:
Niños(as) obesos, 6-19 años, ingresados a un programa piloto; intervención multidisciplinaria, de 4 meses de duración. Se evaluó al ingreso y 4 meses 1MC, perímetro de cintura (PC), lípidos plasmáticos, glice-mia e insulinemia.Resultados:
Ingresaron 402 pacientes, 12,2 años (6,3 a 18,2 años); 56,5 por ciento mujeres, zIMC al ingreso 2,92 (1,7 a 7,7); PC 92,3 +/- 11,1cm; HOMA 2,45 (0,37 a 17,79). El 39,1 por ciento presentaba un CT > 170 mg/dL; 26,5 por ciento; LDL > 110 mg/dL; 30,9 por ciento HDL < 40 mg/dL y 37 por ciento; TG > 110 mg/dl. El 66,9 por ciento completó el programa, 68,4 por ciento de éstos bajó el zIMC (3,13 ingreso vs 2,77 cuarto mes, p < 0,05) sin relación con edad, sexo, ni zIMC inicial. El grupo que completó el programa tenía un zIMC al ingreso significativamente mayor (3,1 ví 2,74, p < 0,05). Del grupo con exámenes alterados al ingreso y repitieron al cuarto mes, 54 por ciento disminuyeron HOMA, 59 por ciento bajaron el CT y 66 por ciento los TG, sin relación con descenso ponderal, disminución de PC, ni HOMA.Conclusión:
Un alto porcentaje de los niños(as) completa el programa, presentando mayor adherencia quienes tienen zIMC más alto al ingreso. El programa logra mejoría en estado nutricional y variables metabólicas a corto plazo, y justificaría su aplicación en atención primaria de salud.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Anthropometry
/
National Health Programs
/
Obesity
Type of study:
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adolescent
/
Child
/
Female
/
Humans
/
Male
Country/Region as subject:
South America
/
Chile
Language:
Spanish
Journal:
Rev. chil. pediatr
Journal subject:
Pediatrics
Year:
2011
Type:
Article
Affiliation country:
Chile
Institution/Affiliation country:
Ministerio de Salud/CL
/
Pontificia Universidad Católica de Chile/CL
/
Universidad de Chile/CL
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