A one-year follow-up study in anorexia nervosa. Dietary pattern and anthropometrical evolution.

OBJECTIVE: To find out the modifications and the interrelationships between the energy and macronutrient intakes and anthropometric measurements of a group of anorexia nervosa patients (ANP), with homogenous diagnosis, age and treatment, during a 1 y follow-up. DESIGN: Longitudinal study design. SUBJECTS: Fourteen restricting-type ANP in the adolescent age (11-21 y) were recruited for the study and evaluated at four time intervals during 1 y of multidisciplinary treatment: (a) on admission (AN0); (b) after 1 month (AN1); (c) after 6 months (AN6); (d) after 1 y (AN12). MEASURES: Energy and macronutrient composition of the diet (48 h recall) and anthropometric measurements including skinfold thickness. RESULTS: Mean weight and BMI were under the 3rd percentile in AN0. All anthropometrical parameters increased significantly in AN1 compared to AN0 and did not change in AN6 and AN12. Energy and macronutrient intakes increased significantly in AN1. The dietary changes were not maintained in the subsequent time intervals and there was an overall tendency to turn back to AN0 results. Energy intake adequacy to Spanish Recommended Intakes (RI) showed only an acceptable ratio in AN1 (94% RI); however, a preserved protein intake was found throughout the study (mean intakes between 128.5% and 230.0% RI). Negative correlations were found at AN12 between size of arm's subcutaneous fat stores and energy and macronutrient intakes. CONCLUSION: In this 1 y follow-up study the decrease in the intake of energy and macronutrients after discharge seems to be related to anthropometric evolution, so that a return to restrictive eating behaviour had occurred in those subjects who had reached the highest values in their subcutaneous fat stores, probably related to dissatisfaction with self-body image.

[The Fuenlabrada study: relationship between anthropometric variables and cardiovascular risk factors]. / Estudio de Fuenlabrada: relación de las variables antropométricas con los factores de riesgo cardiovascular.

Anthropometric variables were studied in 2,153 healthy children, 1,115 males and 1,038 females, aged 0 to 18 years, of the Fuenlabrada population, Madrid. Height was measured by an anthropometer and weight by a weighting scale. Tricipital and subscapular skinfold thickness were measured by Holtain caliper. Body mass index (kg/m2) and ponderal index (kg/m3) were calculated from weight and height. In the total population skinfold thickness had the highest correlation with total body fat. But, when only obese children (greater than 95 p) were analyzed, other variables like body mass index and ponderal index had also high correlation. Different fatness trends were observed between sexes, although females always were the fattest. In our population the correlation of skinfold thickness, body mass index and ponderal index with lipids, blood pressure, glycemia and uric acid were significant. Obese children and adolescents had nearly a twofold increase in relative risk of arterial hypertension, hypertriglyceridemia, hyperuricemia and low C-HDL.

[Fuenlabrada study: lipid and lipoprotein levels in children and adolescents associated with ischemic cardiopathy prevalence among their relatives]. / Estudio de Fuenlabrada: asociación entre los niveles de lípidos y lipoproteínas en niños y adolescentes con la prevalencia de cardiopatía isquémica en sus familiares.

The prevalence of coronary heart disease (CHD) was studied in parents and grandparents of 2,419 children surveyed for lipid levels. Children and their families were divided into 3 groups depending on the level of each lipid and lipoprotein studied in children: high greater than or equal to 95 percentile (p), medium 5-95 p, and low less than 5 p. Total cholesterol (Chol) and triglycerides (TG) were determined by enzymatic techniques in autoanalyzer. C-HDL was determined by precipitation method. C-LDL and C-VLDL were obtained by Friedewald-Fredrickson's equation. The prevalence of CHD in parents and grandparents was ascertained from clinical history. Fathers of children in the high groups of Chol, TG, C-LDL/C-HDL, and low group of C-HDL had increased prevalence of CHD compared with those of the low groups of Chol, TG, C-LDL, C-LDL/C-HDL and high group of C-HDL. The strongest association was with C-HDL. Maternal and paternal grandfathers of children in the high groups of Chol had also increased prevalence of CHD compared with those of low group of Chol. There was no association with any other variable. The association was not significant neither in mothers nor in maternal and paternal grandmothers. Childhood lipid and lipoprotein levels could identify families at elevated risk for CHD.

[The Fuenlabrada study: arterial pressure in children and adolescents]. / Estudio de Fuenlabrada: tensión arterial en niños y adolescentes.

Blood pressure was studied in 2,153 healthy children of both sexes, from 0 to 18 years of age; 1,115 were males and 1,038 females. Systolic and diastolic blood pressures were measured in the sitting position by the auscultatory method on the right arm with a mercury sphygmomanometer using an appropriate cuff size. Systolic blood pressure was measured on the first sound and diastolic blood pressure in the fourth phase of Korotkoff. In children younger than 3 years blood pressure was measured in the decubitus supine position using the Doppler technique. There were no significant differences in mean systolic and diastolic blood pressure in both sexes. But the percentage of systolic blood pressure greater than or equal to 130 mmHg was higher in males than females (p less than or equal to 0.01). 8.4% of the total population had systolic blood pressure greater than or equal to 130 mmHg, and 1.3% had diastolic blood pressure greater than or equal to 90 mmHg. The annual increase rates of systolic and diastolic blood pressure were 2.31/0.94 mmHg in males and 2/0.97 mmHg in females. Children with blood pressure greater than or equal to the 95th percentile had a higher prevalence of hypertriglyceridemia and obesity. 54% of the variation in systolic blood pressure was explained by the association of weight, subscapular skinfold, body mass index and C-HDL. 30% of the variation in diastolic blood pressure was explained by the association of weight, obesity index, subscapular skinfold and C-HDL.

[The Fuenlabrada study: a familial aggregation of ischemic cardiopathy and cardiovascular risk factors]. / Estudio de Fuenlabrada: agregación familiar de la cardiopatía isquémica y de los factores de riesgo cardiovascular.

UNLABELLED: Familial aggregation of coronary heart disease (CHD) and coronary risk factors (CRF) were evaluated by clinical history in adult relatives of children surveyed for CRF. Population was divided into two groups: Group I included 2,153 children without parental history of CHD. Group II included 266 children of 112 families with parental history of early CHD (before 56 years). In 105 cases the patients were the fathers and in 7 cases the mothers. All the patients were admitted to a coronary care unit. Familial aggregation of CHD was 9.7 times more frequent in paternal families of group II (p less than or equal to 0.0001) than in group I; there was no differences in maternal families. Higher prevalence of hyperlipidaemia, blood pressure hypertension, smoking habits, diabetes and obesity in fathers of group II was observed. Children in group II showed increased levels of C-LDL and decreased levels of C-HDL compared with those of group I. The prevalence of CRF was also significantly higher in children of group II, although in the 33% of the children of group II no CRF was detected. CONCLUSION: a substantial proportion, but not all cases, of familial aggregation of CHD could be explained by known CRF.

[The Fuenlabrada study: lipids and lipoproteins in children and adolescents]. / Estudio de Fuenlabrada: lípidos y lipoproteínas en niños y adolescentes.

Lipids and lipoproteins were studied in 2,153 healthy children, of both sexes, aged 0 to 18 years old, of Fuenlabrada, Madrid, population. We determined: Total Cholesterol (TC) and Triglycerides (TG) by automatized enzymatic techniques. C-HDL by precipitation method. C-LDL and C-VLDL were calculated by Friedewald-Fredrickson equation. Our laboratory have previously standardized the techniques of obtention of TC, TG and C-HDL using serums of reference. Mean values were: TC = 166 +/- 36 mg/dl, TG = 63 +/- 39 mg/dl, C-HDL = 53 +/- 13 mg/dl, C-LDL = 102 +/- 34 mg/dl, C-VLDL = 13 +/- 6 mg/dl. In our population 14% had TC greater than or equal to 200 mg/dl, 2.6% TG greater than or equal to 140 mg/dl and 15% C-HDL less than or equal to 40 mg/dl. During adolescence a significant change in the lipid and lipoprotein pattern in both sexes was observed. At the end of the adolescence, males had C-HDL lower and TG, C-LDL and C-VLDL higher than females. Correlations and associations of lipids and lipoproteins were similar in our population than in adult population. The mean finding of this study is the actual high level of TC in our children population.

[Cardiovascular risk factors in children and adolescents in Fuenlabrada: objectives, features of the population, design, participation, equipment, laboratory technics, and quality control]. / Estudio de los factores de riesgo cardiovascular en niños y adolescentes de Fuenlabrada: objetivos, características de la población, diseño, participación, equipo, técnicas de laboratorio y controles de calidad.

Fuenlabrada is at the present time the most industrialized town placed at the south are of Madrid. This population has some peculiar attractive characteristics from the epidemiologic point of view. Perhaps the most important is that the majority of its inhabitants are immigrant from other depressed rural areas of the country, with a low socio-economic and cultural level. The new conditions of life could have changed the life expectation and the causes of morbidity and mortality of this population. Between 1981 and 1984 we have studied the prevalence of cardiovascular risk factors in children and adolescents of its population, the relationships with cardiovascular risk factors and cardiovascular disease of the family and type of lactancy of the newborn. The variables studied were: height, weight, skin fold, blood pressure, lipids, lipoproteins, glycemia, uric acid and tobacco habit. The laboratory technics were standardized with serums of reference. The index of participation in the study of the required population was approximately of 80%.