[Breastfeeding duration, mixed feeding and health risk in Costa Rican children and adolescents]. / Duración de la lactancia materna, alimentación combinada y riesgo para la salud en jóvenes costarricenses.

OBJECTIVE: to analyze the associations between breastfeeding duration and mixed feeding (breast milk and formula) with obesity, cardiometabolic risk (WHtR), body fat, and dietary and physical activity risk behaviors in children and adolescents. SUBJECTS AND METHOD: cross-sectional study carried out with 1,467 students in Costa Rica. An interview was conducted with parents and children to gather information on socioeconomic status, education, dietary and physical activity risk behaviors of the youth, including breastfeeding duration and mixed feeding. Body mass index, waist circumference, and body fat were assessed by bioelectrical impedance analysis and cardiometabolic risk was mea sured with the waist-to-height ratio (WHtR ≥ 0.5) by trained personnel. Descriptive statistics and logistic regression models were applied. RESULTS: the average age was 11.4 ± 2.6 years and 50.9% were male. 55.5% of the population was middle class; 60% were sedentary, and 16% presented obesity. Around 20% were breastfed without the introduction of formula before 6 months, 13% were never breastfed, and more than 60% were breastfed for ≥ 6 months. Those children who were fed only with breast milk or in combination with formula for ≥ 6 months presented a lower percentage of obesity than those who received formula feeding only (60.8 vs 39.2; p < 0.005). Children with cardiometa bolic risk (WHtR ≥ 0.50), unhealthy diet, sedentary lifestyle, and who were fed only with formula are at higher risk of developing obesity (OR = 18.8, 95% CI 13.2-26.0). CONCLUSIONS: these results are consistent with other studies and reinforce the evident protection of breastfeeding against the development of obesity.

Percepción del peso corporal y estrategias utilizadas para controlarlo, en adultos costarricenses / Body weight perception and strategies used to control body weight among Costa Rican adults

Justificación: La obesidad se considera un problema de salud pública. La encuesta directa es el método más utilizado para generar información al respecto, pero su alto costo económico limita obtener datos periódicos. Se han experimentado otros métodos de recolección de información; entre ellos la encuesta telefónica se concibe como una opción válida de costo menor. Objetivo: Explorar la percepción del peso corporal de adultos costarricenses y las estrategias utilizadas para controlarlo, mediante el análisis de la información obtenida en la primera Encuesta Telefónica de Salud del IDESPO. Métodos: Estudio descriptivo, transversal. Se elaboraron preguntas abiertas sobre conocimiento, percepción y estrategias sobre peso corporal, que se incorporaron en la primera Encuesta Telefónica de Salud del IDESPO. Resultados: El 50,3 por ciento y 42 por ciento de los sujetos se percibieron con peso normal y peso alto o muy alto, respectivamente. Las principales estrategias para perder el peso: hacer ejercicio, 29,4 por ciento, cambios en la alimentación; 42 por ciento de los hombres y 44 por ciento de las mujeres reportaron "no hacer nada". Al contrastar la percepción del peso con el IMC estimado, más del 25 por ciento de mujeres y 34 por ciento de hombres que se percibieron con peso normal presentaron sobrepeso. Conclusiones: La metodología de encuesta telefónica introduce una subestimación en la percepción del exceso de peso conforme avanza la edad. La encuesta telefónica no sustituye las encuestas directas, pero se visualiza como alternativa para generar información sobre factores de riesgo cardiovascular. El reto próximo será validarla en nuestro contexto.

Rationale: Obesity is considered a public-health problem. A direct survey is the method most-frequently used to generate relevant information but its high economic cost doesn´t allow obtaining periodic data. Other methods of collecting information have been tried and, among these, the telephone survey is seen as a valid option at lower cost.Objective: To explore the perception of body-weight among Costa Rican adults as well as the strategies used to control this variable by analyzing information obtained in the First Telephone Health Survey conducted by IDESPO (The Institute for Social Studies in Populations.) Methods: a cross-sectional, descriptive study was carried out. Open questions were developed having to do with knowledge, perception and strategies to deal with body-weight. These were incorporated into the Health Survey mentioned above.Results: 50.3 % and 42% of the subjects, respectively, had a self-perception of normal weight or of high - very high weight. The main weight-loss strategies were: doing exercise (29.4%), changes in diet and no special strategy (the latter as admitted by 42% of men and 44% of women). When comparison of self-perception of weight with estimated BMI was done, more than 25% of females and more than 34% of males of those thinking they had normal weight were actually overweight. Conclusions: a telephone-survey methodology introduces an underestimate in the self-perception of overweight according to age. While telephone surveys do not substitute direct surveys, they can be seen an an alternative to generate information about cardiovascular risk factors. The next challenge will to validate these surveys in Costa Rica.