Anthropometric predictors of body fat as measured by hydrostatic weighing in Guatemalan adults.

BACKGROUND: Most predictive equations currently used to assess percentage body fat (%BF) were derived from persons in industrialized Western societies. OBJECTIVE: We developed equations to predict %BF from anthropometric measurements in rural and urban Guatemalan adults. DESIGN: Body density was measured in 123 women and 114 men by using hydrostatic weighing and simultaneous measurement of residual lung volume. Anthropometric measures included weight (in kg), height (in cm), 4 skinfold thicknesses [(STs) in mm], and 6 circumferences (in cm). Sex-specific multiple linear regression models were developed with %BF as the dependent variable and age, residence (rural or urban), and all anthropometric measures as independent variables (the "full" model). A "simplified" model was developed by using age, residence, weight, height, and arm, abdominal, and calf circumferences as independent variables. RESULTS: The preferred full models were %BF = -80.261 - (weight x 0.623) + (height x 0.214) + (tricipital ST x 0.379) + (abdominal ST x 0.202) + (abdominal circumference x 0.940) + (thigh circumference x 0.316); root mean square error (RMSE) = 3.0; and pure error (PE) = 3.4 for men and %BF = -15.471 + (tricipital ST x 0.332) + (subscapular ST x 0.154) + (abdominal ST x 0.119) + (hip circumference x 0.356); RMSE = 2.4; and PE = 2.9 for women. The preferred simplified models were %BF = -48.472 - (weight x 0.257) + (abdominal circumference x 0.989); RMSE = 3.8; and PE = 3.7 for men and %BF = 19.420 + (weight x 0.385) - (height x 0.215) + (abdominal circumference x 0.265); RMSE = 3.5; and PE = 3.5 for women. CONCLUSION: These equations performed better in this developing-country population than did previously published equations.

Energy requirements of children and adolescents.

Total energy expenditure (TEE) was calculated at 1-18 years of age from measurements with doubly labelled water (DLW) in 483 boys and 646 girls, and heart rate monitoring (HRM) in 318 boys and 162 girls. Studies on obese, underweight and stunted groups were not included. TEE of populations with different lifestyles was estimated by factorial calculations in 42 studies on time allocation involving 1982 boys and 1969 girls in developed industrialised countries, and 1236 boys and 1116 girls in developing countries. Quadratic polynomial models were best to predict TEE in boys (TEE(MJ day(-1)) = 1.298 + 0.265 kg - 0.0011 kg2, r = 0.982, SEE = 0.518) and girls (TEE(MJ day(-1)) = 1.102 + 0.273 kg - 0.0019 kg2, r = 0.955, SEE = 0.650). TEE at 1-2 years was reduced by 7% based on DLW measurements and TEE estimates of infants. Energy requirements (ER) were calculated adding 8.6 kJ (2 kcal) for each gram of weight gained during growth. Compared with the 1985 FAO/WHO/UNU values, ER were 18-20% lower from 1 to 7 years of age, 12% lower for boys and 5% lower for girls at 7-10 years, and 12% higher for either gender from 12 years onwards. Differences between industrialised and developing countries, the variance in DLW and HRM studies, and the standard error of the estimate (SEE) of the quadratic predictive equations, suggested that ER should be adjusted after 5 years of age by +/-15% in populations with more or less physical activity than an average lifestyle. Physical activity recommendations must accompany dietary recommendations in order to maintain optimal health and reduce the risk of diseases associated with sedentary lifestyles.

Validation of a semi-quantitative food-frequency questionnaire for use among adults in Guatemala.

OBJECTIVE: The purpose of the study was to assess the validity of a 52-item semi-quantitative food-frequency questionnaire (FFQ) by comparing it with multiple 24-hour dietary recalls. DESIGN: Three non-consecutive 24-hour dietary recalls and one FFQ were administered over a one-month period. SETTING: Four communities of El Progreso, Guatemala. SUBJECTS: Seventy-three individuals aged 22-55 years. RESULTS: : Intakes of energy and other nutrients as measured by the FFQ were higher than intakes measured by 24-hour recalls. Energy was overestimated by 361 kcal, and nutrient overestimates were particularly great for vitamin C and iron. Pearson correlation coefficients for crude energy and nutrients intakes ranged from 0.64 for energy to 0.12 for vitamin C. Exact agreement for both methods (measured by the concordance correlation coefficient) ranged from 0.59 (fat) to 0.06 (vitamin C). Pearson correlation coefficients for energy-adjusted nutrients ranged from 0.59 (carbohydrates) to 0.11 (thiamin). Pearson correlation coefficients for the proportion of total energy derived from specific foods ranged from 0.59 (tortillas) to 0.01 (sugared beverages). Cross-classification of quartiles of crude nutrient intakes for both methods indicated that <11% were grossly misclassified; after adjusting for energy intake, <13% were grossly misclassified. CONCLUSIONS: This FFQ provides good measures of energy and macronutrient intakes and a reasonably reliable measure of micronutrient intake, indicating its suitability for comparing exposures within a study population in reference to heath-related endpoints. Our results highlight the need to adapt any FFQ to specific cultural needs - in this case, the Guatemalan 'core foods' (tortilla, bread and beans), for which inter-individual variability in intake is high.

Cardiovascular disease risk factors are related to adult adiposity but not birth weight in young guatemalan adults.

Fetal undernutrition has been hypothesized to program inappropriate metabolic responses to nutritional abundance in later life. Most studies have been conducted in industrialized countries. We studied the relationship between birth weight and risk factors for cardiovascular disease (CVD) among 187 men and 198 women age 20-29 y (mean age 24 y) who had participated in a longitudinal study conducted in Guatemala between 1969 and 1977. In women, birth weight was positively associated with adult body mass index (BMI; P < 0.01), systolic (P < 0.001) and diastolic blood pressure (P < 0.05), but not with glucose or any lipid measure. In men, birth weight was not associated with adult BMI, blood pressure or glucose, and was weakly and inversely related to total cholesterol and LDL cholesterol (test for trend: P = 0.06 and P = 0.09, respectively). Adult BMI was associated with increased prevalence of CVD risk factors in both men and women. Our data offer no support for the fetal programming of cardiovascular disease risk hypothesis in young adult women, and weak support in young adult men. Overweight in adults is a strong determinant of variance in CVD risk factor prevalence.

Rural-to-urban migration and cardiovascular disease risk factors in young Guatemalan adults.

BACKGROUND: Migration to cities may increase cardiovascular disease risk factors in developing countries. We examined rural and urban individuals who were born in the same villages and shared similar childhood experiences. METHODS: Blood lipids and glucose, blood pressure, anthropometry, body composition, physical activity, and food, tobacco and alcohol consumption were examined in 161 men and 193 women, 19-29 years old, living in their village of birth (76 commuted to work in Guatemala City), and in 76 men and 43 women living in the city. RESULTS: Rural and urban women had similar prevalence of overweight (28%), elevated body fat (29.8 +/- 6.1%) and low physical activity (83%). Compared to rural men, more urban men were sedentary (79 versus 27%), and they had higher body fat (15.3 +/- 5.3% versus 13.3 +/- 5.7%), serum cholesterol (4.27 +/- 0.75 versus 3.90 +/- 0.70 mmol/l [165 +/- 29 versus 151 +/- 27 mg/dl]), low density lipoprotein [LDL]-cholesterol (2.66 +/- 0.72 versus 2.30 +/- 0.62 mmol/l [103 +/- 28 versus 89 +/- 24 mg/dl]) and total cholesterol/high density lipoprotein [HDL]-cholesterol ratio (4.6 +/- 1.0 versus 4.1 +/- 0.9). Commuters showed intermediate values. Women had higher serum cholesterol (4.43 +/- 0.80 mmol/l [171 +/- 31 mg/dl]) than men in rural and urban areas. Urban residents ate/drank more saturated fats, red meat and sweetened beverages, and less legumes. CONCLUSIONS: High proportions of young Guatemalan women were overweight and sedentary. Migration to a city increased sedentarism and undesirable eating habits among men and women; men became fatter and their lipid profile worsened. Public health actions must address the prevention of emerging chronic diseases in countries still burdened by undernutrition and infections.

Prácticas alimentarias en los primeros cinco años de edad / Feeding practices from birth 5 years

Las recomendaciones de un grupo de especialistas latinoamericanos hechas en 1993 para la alimentación y nutrición del niño siguen vigentes. Se basan en el grado de maduración fisiológica, los requerimientos nutricionales, los hábitos alimentarios deseables, las características y disponibilidad de los alimentos, y el patrón de cultural y económico de la familia. La lactancia materna exclusiva por 4-6 meses es ideal para todo niño. Después se debe agregar otros alimentos para llenar las necesidades nutricionales del niño y exponerlo a diversas texturas, consistencias y sabores. Cuando un niño no puede ser amamantado, se le debe alimentar, en orden de preferencia, con; 1) Leche de una nodriza; 2) Fórmulas lácteas acordes con la madurez gastrointestinal y renal; 3) Leche de vaca, diluida, reconstruida y hervida adecuadamente o; 4) fórmulas basadas en productos vegetales. Estos alimentos deben ser fortificados o complementados con algunas vitaminas, minerales y ácidos grasos esenciales. Los primeros alimentos semisólidos deben ser cereales sin gluten, tubérculos y frutas con bajo potencial antigéno. Agregar otros alimentos animales y vegetales después de los seis meses, proponiendo aquellos con mayor riesgo alergénico hasta después de los 8 ó 12 meses. En el segundo año se debe introducir gradualmente todos los alimentos del hogar, cuidando que aporten anergía y nutrientes en cantidades adecuadas. Es importante el manejo higiénico de los alimentos, la frecuencia de su administración en relación a la edad del niño, y la actitud de los adultos durante las comidas para evitar rechazos o inducir una sobrealimentación