Evaluación de la exposición solar, ingesta y actividad física en relación con el estado sérico de vitamina D en niñas prepúberes españolas / Evaluation of solar exposure, intake and physical activity in relation with vitamin D serum status in Spanish prepubertal girls

Antecedentes: Los niveles adecuados de vitamina D y calcio en la infancia determinan el desarrollo adecuado de la masa ósea. En la actualidad se ha detectado déficit de vitamina D en determinadas poblaciones infantojuveniles, como en lactantes y adolescentes pero existe información insuficiente respecto al estado de la vitamina D en niños de otras edades. Objetivo: Determinar los niveles séricos de vitamina D en niñas prepuberales sanas de una ciudad del sur de Europa y estudiar el efecto de la exposición solar, la actividad física y la ingesta. Métodos: Se estudiaron 56 niñas caucasianas, sanas y prepúberes entre 7-10 años. Se recogieron datos sobre ingesta nutricional y actividad física. Las muestras de sangre se obtuvieron en diciembre. Resultados: La ingesta de vitamina D fue significativamente menor a las recomendaciones internacionales. Los niveles medios de calcidiol fueron de 40,07 ± 10,49 ng/ ml. Ninguna niña presentó un nivel inferior a 20 ng/ml; un 25% (14 niñas) tenían unos niveles entre 20-30 ng/ml, y un 75 % superiores a 30 ng/ml. No hemos encontrado diferencias en los niveles de vitamina D entre las niñas que realizaban actividad física, y las sedentarias. Conclusión: Los niveles de vitamina D en niñas prepúberes que viven al sur de España al inicio del invierno son adecuados. No obstante, se debe asegurar una ingesta adecuada de vitamina D, así como una exposición solar suficiente y realizar seguimiento en estas edades para evitar deficiencias (AU)

Background: Vitamin D and calcium play an important role in peak bone mass acquisition. Recent studies havesuggested that vitamin D deficiency in children is widespread, mainly during infancy and adolescent years. However, the vitamin D status at others ages is unsufficiently investigated. Objectives: To determine the vitamin D status in prepubertal, healthy South European girls, and to examine the relationship between serum vitamin D concentrations, sun exposure, physical activity and dietary intake. Methods: A cross-sectional observational study was conducted on 56 Caucasian; healthy and prepubertal girls aged 7-10 years. Dietary information, amount of sunlight exposure and activity were estimated. Blood samples were extracted in the first week of December. Results: Vitamin D intake was below the international recommended references. Mean serum vitamin D was 40.07 ± 10.49 ng/ml. No girl presented a level lower than 20 ng/ml; 25% had levels between 20-30 ng/ml and 75% above 30 ng/ml. We have not found differences in vitamin D levels from the girls who did sport and those who were sedentary. Conclusions: Vitamin D status is suitable for prepubertal girls living in the South of Spain at the beginning of winter. However, it is necessary to follow-up girls and check and adequate vitamin D intake, as well as sufficient sun exposure (AU)

[Evaluation of solar exposure, intake and physical activity in relation with vitamin D serum status in Spanish prepubertal girls]. / Evaluación de la exposición solar, ingesta y actividad física en relación con el estado sérico de vitamina D en niñas prepúberes Españolas.

BACKGROUND: Vitamin D and calcium play an important role in peak bone mass acquisition. Recent studies have suggested that vitamin D deficiency in children is widespread, mainly during infancy and adolescent years. However, the vitamin D status at others ages is unsufficiently investigated. OBJECTIVES: To determine the vitamin D status in prepubertal, healthy South European girls, and to examine the relationship between serum vitamin D concentrations, sun exposure, physical activity and dietary intake. METHODS: A cross-sectional observational study was conducted on 56 Caucasian; healthy and prepubertal girls aged 7-10 years. Dietary information, amount of sunlight exposure and activity were estimated. Blood samples were extracted in the first week of December. RESULTS: Vitamin D intake was below the international recommended references. Mean serum vitamin D was 40.07 ± 10.49 ng/ml. No girl presented a level lower than 20 ng/ml; 25% had levels between 20-30 ng/ml and 75% above 30 ng/ml. We have not found differences in vitamin D levels from the girls who did sport and those who were sedentary. CONCLUSIONS: Vitamin D status is suitable for prepubertal girls living in the South of Spain at the beginning of winter. However, it is necessary to follow-up girls and check and adequate vitamin D intake, as well as sufficient sun exposure.

Using of WHO guidelines for the management of severe malnutrition to cases of marasmus and kwashiorkor in a Colombia children's hospital.

BACKGROUND: In 2007, the Hospital Infantil Los Ángeles (HILA) in Colombia implemented a slightly-modified version of the WHO guidelines for the diagnosis and management of malnutrition during childhood. OBJECTIVE: To evaluate the efficacy of the WHO-HILA protocol in children hospitalized with severe, chronic marasmus and kwashiorkor malnutrition (MS-KWK) in 2007 and 2008. MATERIAL AND METHODS: In this descriptive retrospective study the records of 100 children hospitalized with MSKWK were initially evaluated. Of these, 30 fulfilled the inclusion criteria: children of both sexes with a primary diagnosis of MS-KWK. Patients with any chronic disease liable to cause malnutrition were excluded. Anthropometric parameters, clinical signs and biochemical indicators of malnutrition were assessed upon admission and again at discharge following application of the WHO guidelines. Univariate analysis was performed for each study variable; serum hemoglobin and albumin levels on admission and at discharge were compared, and data were subjected to bivariate analysis. RESULTS: Marasmus was diagnosed in 23.3% of children, kwashiorkor in 73.3% and marasmic kwashiorkor in 3.3%. The major clinical findings were: edema (70%), emaciation (40%), "flag sign" hair (42.86%), low serum albumin (93%) and anemia (80%). Thirteen children following the WHO-HILA protocol showed a significant nutritional status improvement (p<0.05), whereas no improvement was noted in the 17 children not treated according to the protocol. CONCLUSIONS: Application of the WHO-HILA protocol was associated with reduced morbimortality in children with marasmus-kwashiorkor malnutrition. Implementation of this protocol should therefore be considered in all children´s hospitals in countries where this disease is prevalent.

Using of WHO guidelines for the management of severe malnutrition to cases of marasmus and kwashiorkor in a Colombia children's hospital / Aplicación del protocolo de la OMS de malnutrición marasmo-kwashiorkor en un hospital de Colombia

Background: In 2007, the Hospital Infantil Los Ángeles (HILA) in Colombia implemented a slightly-modified version of the WHO guidelines for the diagnosis and management of malnutrition during childhood. Objective: To evaluate the efficacy of the WHO-HILA protocol in children hospitalized with severe, chronic marasmus and kwashiorkor malnutrition (MS-KWK) in 2007 and 2008. Material and methods: In this descriptive retrospective study the records of 100 children hospitalized with MSKWK were initially evaluated. Of these, 30 fulfilled the inclusion criteria: children of both sexes with a primary diagnosis of MS-KWK. Patients with any chronic disease liable to cause malnutrition were excluded. Anthropometric parameters, clinical signs and biochemical indicators of malnutrition were assessed upon admission and again at discharge following application of the WHO guidelines. Univariate analysis was performed for each study variable; serum hemoglobin and albumin levels on admission and at discharge were compared, and data were subjected to bivariate analysis. Results: Marasmus was diagnosed in 23.3% of children, kwashiorkor in 73.3% and marasmic kwashiorkor in 3.3%. The major clinical findings were: edema (70%), emaciation (40%), "flag sign" hair (42.86%), low serum albumin (93%) and anemia (80%). Thirteen children following the WHO-HILA protocol showed a significant nutritional status improvement (p < 0.05), whereas no improvement was noted in the 17 children not treated according to the protocol.Conclusions: Application of the WHO-HILA protocol was associated with reduced morbimortality in children with marasmus-kwashiorkor malnutrition. Implementation of this protocol should therefore be considered in all children´s hospitals in countries where this disease is prevalent (AU)

Introducción: En 2007, el Hospital Infantil de Los Ángeles (HILA) en Colombia implementó una versión del protocolo-OMS para el diagnóstico y tratamiento de la malnutrición en la infancia. Objetivo: Evaluar la aplicación del protocolo de la OMS-HILA en niños hospitalizados con marasmo y/o kwashiorkor (MS-KWK) durante 2007-2008. Material y métodos: En este estudio retrospectivo, se evaluaron 100 niños hospitalizados con MS-KWK; 30 cumplieron los criterios de inclusión: niños de ambos sexos con MS-KWK primario. Los pacientes con enfermedades crónicas que pudieran causar desnutrición fueron excluidos. Se evaluaron determinados parámetros antropométricos, y signos clínicos y bioquímicos de desnutrición según el protocolo de la OMS, al ingreso y al alta. Se realizó un análisis univariante; los niveles de hemoglobina y albúmina séricas fueron comparados al ingreso y al alta, y los datos fueron sometidos a análisis de dos variables. Resultados: Se diagnosticaron de marasmo al 23,3% de los niños, de kwashiorkor al 73,3% y de kwashiorkor marásmico al 3,3%. Los hallazgos clínicos más importantes fueron: edema (70%), emaciación (40%), "signo de bandera" (42,86%), albúmina baja (93%) y anemia (80%). Trece niños mostraron mejoría significativa del estado nutricional tras aplicar el protocolo OMS-HILA (p < 0,05), mientras que no ocurrió en 17 niños no tratados según el protocolo. Conclusiones: La aplicación del protocolo de la OMSHILA se asoció con una reducción de la morbimortalidad en los niños con desnutrición marasmo-kwashiorkor. La aplicación completa y continuada de este protocolo debe ser considerada en los hospitales infantiles de todos los países donde esta enfermedad es prevalente (AU)