Proteína C reactiva, su relación con el estado nutricional y perfil lipídico en mujeres posmenopáusicas

Objetivo: En la mujer posmenopáusica se incrementa el riesgo de enfermedades cardiovasculares (ECV), asociado a un perfil lipídico aterogénico y a la elevación de la proteína C reactiva ultrasensible (PCRus), marcador proinflamatario considerado importante predictor para estas patologías. El objetivo del estudio fue determinar los niveles séricos de PCRus, su relación con el estado nutricional y perfil lipídico en mujeres posmenopáusicas venezolanas. Métodos: Se seleccionaron 61 mujeres, sanas, residenciadas en el Municipio Naguanagua, con edades comprendidas entre 45 y 60 años. Se clasificó estado nutricional según IMC (OMS). Se evaluó PCRus, perfil lipídico y estradiol. Resultados: Los valores promedios de los parámetros bioquímicos fueron: PCRus (3,16±2,0mg/L), colesterol total (249±58mg/dL), c-HDL (42± 10mg/dL), c-LDL (176±55mg/dL), triglicéridos(151±70mg/dL), índices aterogénicos CT/HDL (6,2±1,9) y LDL/HDL (4,5±1,8). El 60,7% de las mujeres presentaron sobrepeso/obesidad. Según PCRus 44,4% en alto riesgo. La relación de riesgo (OR), muestra que la probabilidad de que las mujeres con estado nutricional normal presenten valores del c-LDL en riesgo fue de 0,485 (CI 95%: 0,230-0,999), mientras que en aquellas con sobrepeso/obesidad fue de 1,547 (CI 95%: 1,025-2,335). Se obtuvo correlación entre PCR y CT/HDL (r=0,418; p=0,001). Conclusión: Las mujeres posmenopáusicas evaluadas presentaron alta frecuencia de sobrepeso/obesidad, perfil lipídico aterogénico y PCR en situación de riesgo para ECV.

Objective: In postmenopausal women increases the risk of cardiovascular disease (CVD) associated with an atherogenic lipid profile and elevated circulating levels of high-sensitivity C-reactive protein (hsCRP), considered important predictor proinflamatario marker for these diseases. The main purpose of this study was to evaluate the results of hsCRP and their relationship with nutritional state according to index of mass coporal (BMI) and lipid profile in postmenopausal women venezuelans Methods: 61 women were selected, healthy, residing in the municipality Naguanagua, aged between 45 and 60, apparently healthy. Nutritional status was classified according to BMI (WHO). We assessed hsCRP, lipid profile and estradiol. Results: Mean values of biochemical parameters were: hsCRP (3,16±2,0mg/L), total cholesterol (249±58mg/dL), HDL (42 ± 10mg/dL), LDL (176±55mg/dL), triglycerides (151±70mg/dL) and atherogenic index TC/HDL (6,2±1,9) y LDL/HDL (4,5±1,8). 60.7% category overweigh and obesity. 44.4% high risk according to hsCRP. The hazard ratio (OR), shows that the likelihood of women with normal nutritional status presented LDL-c values at risk was 0.485 (CI 95%: 0.230-0.999), while those who were overweight/obesity was 1.547 (CI 95%: 1.025-2.335). There was a significantly positive correlation between CRP and TC/HDL (r=0.418; p=0.001). Conclusions: Postmenopausal women presented a high prevalence of overweight/obesity, atherogenic lipid profile and CRP in risk for CVD.

Estado nutricional, indicadores antropométricos y homocisteína sérica en mujerees posmenopáusicas venezolanas / Nutritional status, anthropometric index and serum omocysteine in postmenopausal Venezuelan women

Menopause is associated with an increased body weight and changes in fat distribution, high levels of homocysteine and cardiovascular risk factors associated with estrogen deficiency. The objective was to evaluate body mass index (BMI), waist circumference (WC), waist/hip index (WHI), and serum homocysteine (Hct) levels in postmenopausal women (n 128). Nutritional status was diagnosed by BMI (WHO), WC (normal <88cm, at risk> 88cm), WHI (normal <0.8, at risk> 0.8), serum homocysteine (Hct) (ELISA) normal < 10 mmol/L, at risk >10-15mmol/L, high >15mmol/L and estradiol (ELISA) <65pg/mL (menopause). Sixty five point nine percent were overweight/obese, 47.3 percent and 82.2 percent showed cardio metabolic risk by WC and WHI. There was a significant difference for WHI, and a positive significant correlation between anthropometrics indexes. Ten percent showed risk and hyperhomocysteinaemia, but it was not correlated with the evaluated variables. The subjects had a high frequency of overweight, obesity and android fat distribution, showing a high risk for cardiometabolics diseases.

La menopausia se asocia a un aumento del peso corporal y a cambios en la distribución de grasa, describiéndose también niveles elevados de homocisteína, factores de riesgo cardiovascular asociados al déficit de estrógenos. El objetivo de este estudio fue evaluar índice de masa corporal (IMC), la circunferencia de cintura (CCi), el índice cintura-cadera (ICC), la homocisteína sérica en mujeres posmenopáusicas (n: 128). El diagnóstico nutricional antropométrico se determinó según IMC (OMS); se determinaron la CCi (normal <88cm, en riesgo >88cm), ICC (normal <0,8, en riesgo >0,8), homocisteína sérica (tHci) (ELISA): normal < 10mmol/L, en riesgo >10-15mmol/L, alta: >15mmol/L y estradiol (ELISA): <65pg/mL (posmenopausia). 65,9 por ciento presentaron sobrepeso/ obesidad. 47,3 por ciento y 82,2 por ciento en riesgo cardiometabólico según CCi e ICC. Hubo diferencia significativa para ICC y correlación positiva significativa entre indicadores antropométricos. 10 por ciento presentó riesgo e hiperhomocisteinemia. Este aminoácido no correlacionó con las variables evaluadas. Las mujeres evaluadas presentaron una alta frecuencia de sobrepeso-obesidad y una distribución de grasa tipo androide, presentando un alto riesgo para enfermedades cardiometabólicas.

Relación entre lípidos séricos y estado de las vitaminas C y E como antioxidantes en adultos mayores venezolanos / Relationship between serum lipids and status of vitamin C and E as antioxidants in venezuelan elderly people

En el envejecimiento se observa tendencia a hiperlipidemias, cambios en la distribución de lipoproteínas y una declinación del sistema de defensa antioxidante del organismo. El objetivo de este estudio fue relacionar concentraciones séricas de colesterol total, fracciones, triglicéridos y Vitaminas C y E. Se evaluaron 61 adultos mayores de 60 años de edad, de enero-marzo, 2006. Se diagnosticó estado nutricional por IMC; se determinaron niveles séricos de triglicéridos (TG), colesterol total (CT) y fracciones (HDL-c y LDL-c), (método enzimático), Vitamina C (método colorimétrico) y Vitamina E (HPLC). Se utilizaron valores de ATPIII como referencia para riesgo de TG, CT, HDL, LDL-c; vitamina C: > 0,9 mg/dL (normal), < 0,9mg/dL (déficit); vitamina E: >1300 µg/dL (normal), =1300 µg/dL (déficit). Se calculó consumo dietario de vitaminas C y E por método de pesada directa tres días/semana. Según IMC, 19,7 por ciento presentó déficit nutricional, 39,3 por ciento sobrepeso y 11,5 por ciento obesidad. TG, CT, LDL-c en riesgo para el sexo femenino y HDL-c para ambos sexos. La prevalencia de riesgo para enfermedades cardiovasculares fue: TG (45,2 por ciento), HDL-c (51,1 por ciento), LDL-c (52,5 por ciento), deficientes de vitamina C (9,8 por ciento) y E (90,2 por ciento). El consumo y niveles séricos de vitamina E en déficit en ambos sexos. No hubo asociación entre las variables. Correlación significativa y positiva entre TG, CT, LDL-c, vitamina E sérica e IMC. El grupo femenino presentó sobrepeso, hipertrigliceridemia e hipercolesterolemia, HDL-c y LDL-c en riesgo y el grupo total estado de vitamina E deficiente, importantes factores de riesgo para enfermedad cardiovascular en este grupo etario.

During aging there is a tendency towards hyperlipidemia and changes in the distribution of lipoproteins. A decline in the functioning of the body’s antioxidant defense system is also observed at this time. The objective of this study was to establish the relationship between serum concentrations of total cholesterol and fractions, triglycerides, and Vitamins C and E. 61 adults over 60 years of age were evaluated from January to March, 2006. Nutritional status was diagnosed by BMI (WHO); serum levels of triglycerides (TG), total cholesterol (TC) and fractions (HDL-c and LDL-c) were determined by enzyme method; Vitamin C (colorimetric method) and Vitamin E by HPLC. ATPIII values were used as a reference for risk of TG, TC, HDL, LDL-c, vitamin C:> 0.9 mg/dL (normal), <0.9 mg/dL (deficit); vitamin E: =1300 µg/dL (normal), 1300 = µg /dL (deficit). Consumption of vitamins C and E were estimated by the direct weighing method 3 days per week. According to BMI, 19.7 percent had nutritional deficit, 39.3 percent overweight, and 11.5 percent obesity. TG, TC, LDL-c levels were at risk in females, and HDL-c in both genders. Prevalence of risk for heart disease was: TG (45.2 percent), HDL-c (51.1 percent), and LDL-c (52.5 percent). Consumption and serum levels of vitamin E were low in both genders. There was no association between variables. A significant and positive correlation between TG, TC, LDL-C, serum vitamin E, and BMI was observed. The female group showed overweight, hypertriglyceridemia and hypercholesterolemia, HDL-c and LDL-c at risk, and vitamin E deficiency, all of which are important risk factors for cardiovascular disease in this age group.

Prácticas inadecuadas de alimentación entre el 4º y 6º mes de vida y su asociación con el déficit nutricional en un grupo de lactantes venezolanos / Inadequate feeding practices between month 4 and 6 and its association with nutritional deficit in a group of venezuelan lactating infants

Las adecuadas prácticas de alimentación son fundamentales para la salud, la nutrición y el crecimiento infantil. A fin de detectar asociaciones entre la práctica inadecuada de la lactancia materna en los primeros 4 y 6 meses de vida y las deficiencias en el crecimiento y malnutrición, se evaluaron 240 lactantes menores de 24 meses, en una zona urbana de bajos recursos socioeconómicos de la ciudad de Valencia, Venezuela (2006). Para la práctica de la lactancia materna se identificaron dos grupos; lactantes que recibieron sólo lactancia materna exclusiva (LME) en dicho periodo de tiempo y aquellos que no la recibieron con exclusividad; lactancia predominante/complementaria (No LME). Se calcularon puntajes Z para los indicadores Peso/Talla (P/T) y Talla/Edad (T/E), según la referencia del CDC. Se consideró déficit a todo valor por debajo de -2 Z; normalidad entre -2 Z y + 2 Z y el exceso; > +2 Z. Para las asociaciones se utilizó la prueba no paramétrica de Mann Whitney y un Odds ratio (95 por ciento de intervalo de confianza). Un 27 por ciento de los niños recibieron LME. En la muestra total, el déficit para P/T y T/E fue del 11,3 por ciento y 5,4 por ciento respectivamente. El grupo con No LME presentó un riesgo 5,25 veces mayor de estar en déficit nutricional. A pesar de que en el presente trabajo no se evaluó el efecto de variables sociodemográficas sobre la causalidad del déficit nutricional, se puede inferir que la LME entre el 4° y 6° mes de vida, atenuó los efectos adversos de dichas variables sobre el estado nutricional.

Adequate practices in food consumption are fundamental for child health, nutrition and growth. In order to detect associations between the inadequate practice of exclusive breastfeeding (EBF), predominant and/or complimentary in the first 4 to 6 months of life, and deficiencies in growth and malnutrition, 240 lactating infants younger than 24 months were evaluated in a low income urban area in the city of Valencia, Venezuela (2006). For the practice of breastfeeding, two groups were identified: children who received EBF in that period of time, and those who did not receive it (No EBF). Z scores were calculated for the indicators of Weight for Height (W/H) and Height for Age (H/A), using the CDC reference. Any value under -2 Z was considered deficient, normal between -2 Z y +2 Z, and excess >+2 Z. The non-parametrical Mann-Whitney test and Odd ratio (95 percent confidence interval) were used for associations. 27 percent of the children received EBF. The deficit for W/H and H/A was of 11,3 percent and 5,4 percent, respectively. Risk of nutritional deficit was 5,25 for those with No EBF. Even though the effect of other socio-demographic variables on the causes of nutritional deficit was not evaluated in the present investigation, it is to be suggested that the EBF between the first 4 to 6 months of life diminished the adverse effects of these variables on the nutritional state.

[Relationship between serum lipids and status of vitamin C and E as antioxidants in Venezuelan elderly people]. / Relación entre lípidos séricos y estado de las vitaminas C y E como antioxidantes en adultos mayores venezolanos.

During aging there is a tendency towards hyperlipidemia and changes in the distribution of lipoproteins. A decline in the functioning of the body's antioxidant defense system is also observed at this time. The objective of this study was to establish the relationship between serum concentrations of total cholesterol and fractions, triglycerides, and Vitamins C and E. 61 adults over 60 years of age were evaluated from January to March, 2006. Nutritional status was diagnosed by BMI (WHO); serum levels of triglycerides (TG), total cholesterol (TC) and fractions (HDL-c and LDL-c) were determined by enzyme method; Vitamin C (colorimetric method) and Vitamin E by HPLC. ATPIII values were used as a reference for risk of TG, TC, HDL, LDL-c, vitamin C: > 0.9 mg/dL (normal), < 0.9 mg/dL (deficit); vitamin E: = 1300 microg/dL (normal), 1300 = microg /dL (deficit). Consumption of vitamins C and E were estimated by the direct weighing method 3 days per week. According to BMI, 19.7% had nutritional deficit, 39.3% overweight, and 11.5% obesity. TG, TC, LDL-c levels were at risk in females, and HDL-c in both genders. Prevalence of risk for heart disease was: TG (45.2%), HDL-c (51.1%), and LDL-c (52.5%). Consumption and serum levels of vitamin E were low in both genders. There was no association between variables. A significant and positive correlation between TG, TC, LDL-C, serum vitamin E, and BMI was observed. The female group showed overweight, hypertriglyceridemia and hypercholesterolemia, HDL-c and LDL-c at risk, and vitamin E deficiency, all of which are important risk factors for cardiovascular disease in this age group.

[Inadequate feeding practices between month 4 and 6 and its association with nutritional deficit in a group of Venezuelan lactating infants]. / Prácticas inadecuadas de alimentación entre el 4o- y 6o- mes de vida y su asociación con el déficit nutricional en un grupo de lactantes venezolanos.

Adequate practices in food consumption are fundamental for child health, nutrition and growth. In order to detect associations between the inadequate practice of exclusive breastfeeding (EBF), predominant and/or complimentary in the first 4 to 6 months of life, and deficiencies in growth and malnutrition, 240 lactating infants younger than 24 months were evaluated in a low income urban area in the city of Valencia, Venezuela (2006). For the practice of breastfeeding, two groups were identified: children who received EBF in that period of time, and those who did not receive it (No EBF). Z scores were calculated for the indicators of Weight for Height (W/H) and Height for Age (H/A), using the CDC reference. Any value under -2 Z was considered deficient, normal between -2 Z y +2 Z, and excess >+2 Z. The non-parametrical Mann-Whitney test and Odd ratio (95% confidence interval) were used for associations. 27% of the children received EBF. The deficit for W/H and H/A was of 11,3% and 5,4%, respectively. Risk of nutritional deficit was 5,25 for those with No EBF. Even though the effect of other socio-demographic variables on the causes of nutritional deficit was not evaluated in the present investigation, it is to be suggested that the EBF between the first 4 to 6 months of life diminished the adverse effects of these variables on the nutritional state.

Estado de vitamina A y su relación con antecedentes infecciosos en escolares venezolanos / Vitamin A status and the relationship with morbidity in venezuelan school children

La vitamina A (VA) cumple una función importante sobre el sistema inmunológico demostrándose una relación sinérgica entre estado corporal de VA, y procesos infecciosos. El objetivo fue evaluar la relación entre niveles séricos de retinol y la Citología de Impresión Conjuntival (CIC) con el estado nutricional antropométrico y antecedentes infecciosos en escolares de bajos recursos económicos de una zona urbana de Valencia. Se evaluaron 445 niños (4-13 años de edad), de ambos géneros. Se determinó: retinol sérico (HPLC-r), proteína C reactiva (nefelometría), CIC (ICEPO), los indicadores antropométricos peso-talla (PT) y talla-edad (TE) según referencia nacional y el registro de enfermedades infecciosas (diarrea, enfermedades respiratorias, sarampión y parasitosis) dos meses previos al estudio. El 92,3 por ciento estaban en situación de pobreza, 7 por ciento presentó déficit nutricional (PT ≤ p10), 10,8 por ciento exceso (PT > p90) y 1,5 por ciento talla baja (TE = p3); 18 por ciento de los niños presentó al menos un episodio de diarrea, 39,8 por ciento infección respiratoria superior, 28,1 por ciento inferior y 32,8 por ciento parasitosis. El 10,3 por ciento mostró niveles altos de PCR (> 10 mg/L), el valor promedio de retinol fue 35,7 ± 9,2 μg/dL con una prevalencia de valores bajos (< 20 μg/dL) de 0,7 por ciento, niveles marginales (20-30 μg/dL) de 27,4 por ciento y 9,5 por ciento déficit de VA según CIC. Se encontró correlación significativa entre retinol sérico y CIC y asociación significativa entre retinol sérico y las enfermedades respiratorias superiores únicamente. No se encontró asociación entre los indicadores antropométricos con el estado de vitamina A ni con la morbilidad. No fue posible demostrar la relación entre el estado de vitamina A y los antecedentes infecciosos como diarrea, enfermedades del tracto respiratorio inferior y sarampión, sin embargo, la alta prevalencia de morbilidad y de niveles marginales de VA, hacen que el grupo estudiado...

Vitamin A (VA) is an essential micronutrient for the immune system and several researchs have shown a synergic relationship between vitamin A status and morbidity. The aim was to show the relationship between serum retinol level, Conjunctival Impression Cytology (CIC), anthropometric status, and morbidity in low income school children. 445 children (both genders) between 4 and 13 years old were assessed. Serum retinol levels (HPLC-r), C-reactive protein (nefelometry) and CIC (ICEPO), anthropometric indicators (Weight-height (WH), height-age (HA)according to national references values), morbidity (diarrhea, respiratory tract infections, measles, and parasitosis) two months prior to the evaluation, were determined. The poverty was 92.3%, wasting (WH ≤ p10) 7%, overweight (WH > p90) 10.8%, and stunting (HA = p3) 1.5%. 18% had one or more diarrhea episodes, 39.8% upper respiratory tract infections, 28.1% lower respiratory tract infections, and 32.8% intestinal parasitosis; 10.3% showed ahigh level of C-reactive protein (CRP > 10 mg/L). The average retinol level was 35.7 ± 9.2 μg/dL, with 0.7% low level(< 20 μg/dL), 27.4% of the children at risk of vitamin A deficiency (20-30 μg/dL), and 9.5% deficient according CIC. There was a significant correlation between serum retinol and CIC, and a significant association between serum retinol and upper respiratory tract infections, but not between morbidity and CIC. There was not a significant association between anthropometric indicators and vitamin A status and morbidity. In this study it was not possible to demonstrate the relationship between vitamin A status and diarrhea, measles, lower respiratory tract infections and parasitosis but the high prevalence of marginal serum retinol levels and morbidity in this group makes it susceptible to nutritional surveillance.

[Serum homocysteine, folate and vitamin B12 in venezuelan elderly]. / Homocisteína, ácido fólico y vitamina B12 en adultos mayores venezolanos.

The anatomical and physiological changes of aging make elderly people a vulnerable group to malnutrition and specific deficiencies of nutrients such as vitamin B12 and folate. This study was aimed to establish relationships among serum vitamin B12, folate, homocysteine concentrations and dietary intake and adequacy. Fifty five male and female elderly (60 and more years), free-living, were assessed. Measurements were: serum vitamin B12 and folate by radioimmunoanalysis (RIA), homocysteine by polarized fluorescence immunoassay, nutrient intake by three 24 hours recalls and food frequency questionnaire. Nutritional status was determined by Body Mass Index (BMI). Serum vitamin B12 and folate were at normal range (423,3+/-227,6 pmol/l and 6,4 +/- 4,5 mg/ml), but 17,5% of elderly had B12 deficiency and 12% had folate deficiency. Serum homocysteine was higher than reference values (15,8+/-4,4 mmol/l), but 47,5% showed concentrations above 15 mmol/L, male population showed higher mean value (p: 0,01). Nutrient intake was inadequate by deficiency. BMI indicated 11,8% of undernutrition, 29,4% of overweight and 20,6% of obesity A negative and inverse correlation between homocysteine and serum folate was found. Results suggest a biochemical deficiency of B12 and folate that is expressed as elevated homocysteine levels. These finding represent a high cardiovascular risk factor for this elderly group.

Estado nutricional en niños preescolares que asisten a un jardín de infancia público en Valencia, Venezuela / Nutritional status in preschoolers attending a public day-care center in Valencia, Venezuela

A fin de evaluar el estado nutricional en un grupo de preescolares que asisten a un jardín de infancia público en Valencia, Venezuela (2002), se indagó el estrato social, las variables antropométricas; peso, talla y circunferencia del brazo, la hemoglobina, el retinol sérico, la presencia de parasitosis y el consumo de alimentos, así como el nivel educativo materno. Se utilizó el programa SPSS versión 11.0 y las pruebas t de Student, ANOVA de una vía, Post Hoc de Bonferroni y Fisher (p < 0,05). Se presentó un predominio del sexo femenino (52%). Según el estrato social 23,3% se ubicó en clase media y 76,8% en algún nivel de pobreza. El 60% de las madres de clase media habían terminado su educación secundaria y sólo el 9,8% de las madres en pobreza alcanzaron este nivel. Se observó según valores Z (T/E, P/T y CMB/T) altos porcentajes por debajo de -1,00 (27,3%, 25,6% y 24,5% respectivamente). El P/T y la CMB/T de los hijos de madres universitarias presentaron diferencias al compararlos con los hijos de madres con nivel de educación primaria. Se presentó un 25,9% de anemia y hubo diferencias entre los grupos anémicos y no anémicos para T/E y CMB/T. Se observaron protozoarios en 61,0%, helmintos en 16,9% y la presencia de ambos en 22,1%. Se encontró 2,6 veces mayor riesgo de presentar déficit nutricional para CMB/T en el grupo parasitado. Se encontró un consumo adecuado de energía y hierro, con consumo excesivo de proteínas y vitamina A. Se concluye que existe riesgo nutricional evaluado a través de los parámetros hematológicos, la presencia de parasitosis y el estrato social.

Nutritional status in preschoolers attending a public day-care center in Valencia, Venezuela. With the purpose of evaluating nutritional status in a group of preschoolers attending a public day care center in Valencia, Venezuela (2002), a research was made for social stratus, anthropometric variables; weight, height and arm circumference, hemoglobin, seric retinol, presence of parasitosis and food consumption, as well as the mother’s educational level. The program SPSS 11.0 and the t Student, ANOVA Post Hoc from Bonferroni and Fisher (p<0,05) were used. A predominance of the female sex was presented (52%). According to the social stratus, 23.3% was located in the middleclass, and 76.8% on some level of poverty. 60% of the middleclass mothers had finished their high school education, while only 9.8% of the mothers in poverty had reached that level. According to the Z values (H/A, W/H and AC/H), high percentages under -1.00 were observed (27.3%, 25.6% and 24.5%, respectively). The W/H and AC/H of children of mothers studying in a university presented discrepancies when compared with children of mothers with a primary educational level. A 25.9% of anemia was presented, and there were differences between anemic and non-anemic groups for H/A and AC/H. Protozoaries were observed in 61.0%, helmintos in 16.9% and both in 22.1%. There was a 2.6 times higher risk of presenting nutritional deficiency for AC/H in the group found with parasites. An adequate consumption of energy and iron was found, with an excessive consumption of proteins and vitamin A. It is concluded that there exists a nutritional risk evaluated through hematologic parameters, the presence of parasitosis and social stratus.

[Nutritional status in preschoolers attending a public day-care center in Valencia, Venezuela]. / Estado nutricional en niñios preescolares que asisten a un jardín de infancia público en Valencia, Venezuela.

With the purpose of evaluating nutritional status in a group of preschoolers attending a public day care center in Valencia, Venezuela (2002), a research was made for social stratus, anthropometric variables; weight, height and arm circumference, hemoglobin, seric retinol, presence of parasitosis and food consumption, as well as the mother's educational level. The program SPSS 11.0 and the t Student, ANOVA Post Hoc from Bonferroni and Fisher (p < 0.05) were used. A predominance of the female sex was presented (52%). According to the social stratus, 23.3% was located in the middleclass, and 76.8% on some level of poverty. 60% of the middleclass mothers had finished their high school education, while only 9.8% of the mothers in poverty had reached that level. According to the Z values (H/A, W/H and AC/H), high percentages under -1.00 were observed (27.3%, 25.6% and 24.5%, respectively). The W/H and AC/H of children of mothers studying in a university presented discrepancies when compared with children of mothers with a primary educational level. A 25.9% of anemia was presented, and there were differences between anemic and non-anemic groups for H/A and AC/H. Protozoaries were observed in 61.0%, helmintos in 16.9% and both in 22.1%. There was a 2.6 times higher risk of presenting nutritional deficiency for AC/H in the group found with parasites. An adequate consumption of energy and iron was found, with an excessive consumption of proteins and vitamin A. It is concluded that there exists a nutritional risk evaluated through hematologic parameters, the presence of parasitosis and social stratus.

Validez del índice energía/proteína en la identificación de la malnutrición por exceso en preescolares venezolanos de bajo estrato socioeconómico / Validity of the energy/protein index in the detection of overweight in low income Venezuelan preschoolers

Se evaluó la validez del índice energía-proteína (IEP) en la identificación de la malnutrición por exceso en 163 niños entre 4 y 6 años, de bajo estrato socioeconómico en la ciudad de Valencia, Estado Carabobo, Venezuela. Se tomó peso, talla, brazo y pliegues subcutáneos. Se calculó el Peso para la Talla (P/T), área grasa (AG) e IEP. Se consideró en déficit a todo sujeto con P/T £ p10, normalidad P/T >p10 y £ p90 y en exceso aquel con P/T y AG >p90. Se calculó la distribución percentilar del IEP por edad y género, considerando bajo la norma £ p10, normal >p10 y £ p90 y sobre la norma >p90. Su validez se analizó a través de la sensibilidad, especificidad y razón de verosimilitud positiva (RV+) y negativa (RV-). Las pruebas de t de Student y ANOVA se utilizaron para comparaciones de grupos (p< 0,05). Según el diagnóstico nutricional, un 27,60 por ciento de los niños presentaron déficit, 66,88 por ciento normalidad y 5,52 por ciento exceso. El IEP reportó un 7,36 por ciento en bajo la norma, 82,20 por ciento normal y 10,44 por ciento sobre la norma. El IEP disminuyó con la edad en los varones y presenta diferencias por género en el grupo de 6 años, siendo significativamente mayor en las niñas. Para identificar el exceso, la sensibilidad fue del 77 por ciento y la especificidad del 93 por ciento, con una RV+ de 11. Finalmente, un IEP sobre la norma fue 11 veces más probable en un sujeto con exceso que en otro en normalidad. Para el déficit, las pruebas no cumplieron los requisitos de utilidad. Palabras clave:Indice energía-proteína, preescolares, composición corporal

[Validity of the energy/protein index in the detection of overweight in low income Venezuelan preschoolers]. / Validez del índice energía/proteína en la identificación de la malnutrición por exceso en preescolares venezolanos de bajo estrato socioeconómico.

The validity of the energy/protein index (EPI) in the detection of overweight was assessed in 163 low income children (four to six years old) from Valencia, Venezuela. Weight, height, arm circumference, and skinfolds were taken. Weight for height (W/H), limb fat area (LFA), and EPI were calculated. All subjects with W/H < or =p10 were considered deficient, with W/H between >p10 and < or =p90 normal, and with W/H and LFA >p90 in excess. Percentile distribution of EPI for age and gender was calculated, regarding below the norm all subjects < or =p10, normal those > p10 and p90, and above the norm those >p90. Validity was assessed through sensibility, specificity, and likelihood ratio. Student's t test and ANOVA were used for group comparisons (p < 0.05). According to the nutritional diagnosis, 27.60% of the children were deficient, 66.88% normal, and 15.52% in excess. According to the EPI, 7.36% of the sample was considered below the norm, 82.20% normal, and 10.44% above the norm. The EPI decreased with age in boys, and in the 6 years old group was significantly higher for girls. Lastly, an EPI above the norm is eleven times more likely to occur in a subject considered in excess than in subjects considered normal. For deficiency, the tests did not meet the expected values.

[Nutritional characterization by anthropometrics of institutionalized and non-institutionalized elderly Venezuelan]. / Caracterización nutricional antropométrica de ancianos institucionalizados y no institucionalizados.

In order to evaluate nutritional status by anthropometry, a group of elderly (60 to 83 years old) was studied: 63 institutionalized and 37 non-institutionalized elderly from Valencia city, Venezuela. Weight, height, triceps skinfold and mid-arm circumference were measured and the body mass index (weight/height2) was calculated. The average age for the institutionalized group was 77.3 +/- 7.5 years old and 69.5 +/- 7.6 years old for the free-living elderly group. Tricipital skinfold (TSF) and mid-arm circumference (MAC) means were within the normal reference range for both groups, without significant differences by sex. Body mass index (BMI) was higher in the institutionalized group. Lower BMI and MAC were found in older elderly (> or =80 y). According to the nutritional classification by BMI, 16% of nutritional deficit, 45% of normal status and 39.7% with of excess weight were found in institutionalized elderly; while in free-living elderly, prevalences were 8%, 62% and 29.7% respectively. Even though normal nutritional status was highly prevalent, institutionalized elderly showed higher prevalences of nutritional alterations (underweight and overweight).

Caracterización nutricional antropométrica de ancianos institucionalizados y no institucionalizados / Nutritional characterization by anthropometrics of institutionalized and non-institutionalized elderly Venezuelan

A fin de caracterizar el estado nutricional antropométrico de un grupo de ancianos se estudiaron 63 adultos mayores institucionalizados y 38 no institucionalizados de la ciudad de Valencia, Venezuela. El rango de edades del grupo estudiado fue de 60 a 83 años. Se midió peso, talla, pliegue tricipital, circunferencia del brazo izquierdo y se calculó índice de masa corporal (peso/talla²). La edad promedio fue para los institucionalizados 77,3 ± 7,4 años y de 69,5 ± 7,6 años en los no institucionalizados. Los promedios de pliegue tricipital (PT) y circunferencia del brazo (CB) estuvieron dentro del rango normal en ambos grupos, siendo mayores para los no institucionalizados. El PT de los hombres institucionalizados estuvo en el rango de déficit (9,3 ± 1,6) siendo significativa la diferencia con los no institucionalizados. El IMC estuvo en el rango del sobrepeso para los hombres residenciados en sus hogares (25,2 ± 1,2) y para las mujeres institucionalizadas (26,8 ± 1,2). Al clasificar el estado nutricional según IMC, en los ancianos institucionalizados se encontró 16 por ciento de déficit, 45 por ciento de normalidad y 33,3 por ciento de sobrepeso, siendo respectivamente las prevalencias de 8 por ciento, 62 por ciento y 29,7 por ciento en los no institucionalizados. El estado nutricional con mayor prevalencia fue el de normalidad según antropometría, sin embargo, en los ancianos institucionalizados se observó mayor prevalencia de malnutrición tanto en déficit como en exceso

[Nutritional status by social stratification in Venezuelan school children]. / Situación nutricional por estrato social en niños escolarizados venezolanos.

UNLABELLED: This study assessed nutritional status of 590 children from Naguanagua, Valencia, attending school, aged between 4 and 14 years and its relation to social stratification, age and gender. Body dimension indicators were used for nutritional diagnosis. NCHS/OMS and Frisancho references were used for height/age (HA) weight/height (WH) cut-off points, and body mass index (BMI). Graffar modified by Mendez was used to establish socioeconomic status. Statistical analyses included descriptives, x2 and student-test. RESULTS: 91% of the children were in poverty, (71% relative and 20% critical). For HA, 6.4% classified as short, 27.6% in risk, and 4.9% tall for age without significative differences between sex. For WH, 0.6% were in nutritional deficit, 10.2% in risk and 22.1% in excess. For BMI, 12.9% had nutritional deficit, 7.3% excess but no significative differences for sex. Stunting and deficit were present in all age groups, but more significantly in those older than 10 years (12%; 23.9% respectively). Social stratification was associated with WH and BMI being deficit more prevalent in III and V class, predominating excess in IV class. The high prevalence of obesity makes this group as a high risk one for chronic degenerative diseases.

Situacion nutricional por estrato social en niños escolarizados venezolanos / Nutricional status by social stratification in venezuelan school children

Se evaluó el estado nutricional de 590 niños escolarizados de Naguanagua, Valencia, entre 4 y 14 años de edad y su relación con estrato social, edad y sexo. El diagnóstico nutricional se realizó por indicadores de dimensión corporal. Para peso para la talla (P/T) y talla para la edad (T/E) se utilizaron puntos de corte OMS/NCHS y para Indice de Masa Corporal (IMC), Frisancho y para estratificación social, Graffar-Méndez Castellano. Se realizaron descriptivos, chi 2 y t-student. RESULTADOS: 91 % de los niños estaban en situación de pobreza, (71 % relativa y 20 % crítica). Según T/E 6,4 % talla baja, 27,6 % riesgo y 4,9 % talla alta, sin diferencias significativas por sexo. Según P/T, 0,6 % presentó déficit, 10,2 % riesgo y 22,1 % exceso. Según IMC, 12,9 % presentó déficit y 7,3 % exceso sin diferencia significativa por sexo. La talla baja y el déficit nutricional fueron significativamente más frecuentes en los mayores de 10 años (12 % y 23,9 % respectivamente). El P/T e IMC estuvo asociado con el estrato socioeconómico. Hubo mayor prevalencia de déficit en estratos III y V y predominio de exceso en el estrato IV. La alta prevalencia de obesidad hace a este grupo de alto riesgo para las enfermedades crónicas degenerativas.