RESUMO
RESUMEN La situación nutricional de los niños menores de 2 años de edad está relacionada principalmente con su alimentación, la cual incluye lactancia materna exclusiva hasta los 6 meses de edad y una alimentación complementaria adecuada y segura desde los 6 meses de edad, manteniendo la lactancia materna hasta los 2 años o más, por tal razón se caracterizó la alimentación en un grupo de niños y niñas de O a 24 meses de la ciudad de Bogotá. Estudio descriptivo longitudinal, donde se aplicó encuesta alimentaria en 5 momentos a 388 madres de niños participantes, estableciéndose frecuencias simples, con intervalos de confianza al 95% y pruebas de diferencia Chi2. La Lactancia Materna (LM) en la primera hora de vida fue 68,8%, a los 2 meses 96.1% y esta prevalencia disminuyó gradualmente a 43,3% a los 24 meses. La prevalencia de lactancia materna exclusiva hasta los 6 meses fue 22,9% y la duración media 2,9 meses. El suministro de leche artificial inició a los 0 meses, alcanzó el 60% a los 6 meses. El 50% de los niños y niñas había iniciado alimentación complementaria alrededor de los 2 meses de edad. En la mayoría de los niños, a los 24 meses no cumplían con el consumo establecido de frutas, verduras y carnes, así mismo, con la recomendación mundial de lactancia materna exclusiva debido al suministro temprano de leche artificial y otros alimentos.
ABSTRACT The nutritional status of children under 2 years of age is mainly related to their diet, which includes exclusive breastfeeding until 6 months of age and adequate and safe supplementary feeding from 6 months of age, maintaining breastfeeding for 2 or more years. For this reason, feeding was characterized in a group of children from 0 to 24 months of the city of Bogotá. We conducted a longitudinal descriptive study, where a food survey was completed on 5 occasions by 388 mothers of participating children, establishing simple frequencies, with 95% confidence intervals and Chi2 difference tests. Breastfeeding (BF) in the first hour of life was 68.8% and 96.1% at 2 months. This prevalence gradually decreased to 43.3% at 24 months. The prevalence of exclusive breastfeeding up to 6 months was 22.9% and the average duration was 2.9 months. The supply of artificial milk began at 0 months and was 60% at 6 months. 50% of children had started complementary feeding around 2 months of age. At 24 months, children's diets did not meet the established norms for consumption of fruits, vegetables and meats. Due to the early supply of artificial milk and other foods, the worldwide recommendation to exclusively breastfeed was also not met.
Assuntos
Humanos , Fenômenos Fisiológicos da Nutrição do Lactente , Aleitamento Materno , Lactente , Saúde da Criança , Substitutos do Leite HumanoRESUMO
Introducción. En Colombia, la práctica de lactancia exclusiva y total es inadecuada y de corta duración, especialmente en mujeres adolescentes. Teniendo en cuenta que las adolescentes constituyen un grupo social con sus propios estilos de vida, es necesario conocer cuáles son los significados que construyen alrededor de la lactancia y cuáles son las características de su experiencia de lactar para identificar aspectos que limitan o facilitan esta práctica, generando conocimientos para mejorar las estrategias de promoción de la lactancia. Objetivo. Caracterizar la experiencia de lactancia materna en adolescentes en período de lactancia, e identificar aspectos positivos, limitaciones y necesidades sentidas desde su propia perspectiva. Materiales y métodos. Se trata de un estudio cualitativo con enfoque fenomenológico. Se hicieron 24 entrevistas y se conformaron tres grupos de mujeres adolescentes en diferentes períodos posparto. La información se recolectó en Bogotá con mujeres que participaban en un programa de la Secretaría Distrital de Integración Social. El proceso de sistematización se desarrolló paralelamente con el proceso de análisis. Este proceso comprendió las relaciones entre categorías y las redes que se forman entre ellas. Resultados. Las adolescentes no alimentan sus hijos con lactancia materna exclusivamente y refieren varias dificultades en el acto de lactar. La alimentación complementaria incluye alimentos no naturales. La maternidad y la lactancia no son acordes con la percepción de ser adolescente. Conclusiones. Las adolescentes reconocen los beneficios que ofrece la lactancia materna para sus hijos y para ellas; sin embargo, su experiencia de lactancia materna difiere de las recomendaciones para lograr una lactancia materna exclusiva y una alimentación complementaria saludable. Entre las causas identificadas, sobresale la ausencia de acompañamiento acertado y oportuno.
Introduction: In Colombia, breastfeeding is inadequate and -especially in teenage girls- short. Given that adolescents are a social group with their own lifestyles, we need to know what meanings they have regarding breastfeeding, and also what the characteristics of their breastfeeding experience are, in order to identify issues that limit or facilitate this practice, which will produce the knowledge to improve breastfeeding promotion strategies. Objective: To characterize the experience of breastfeeding in nursing adolescents and identify strengths, limitations and perceived needs from their own perspective. Materials and methods: This was a phenomenological qualitative study. We conducted 24 interviews and had three focal groups with female adolescents in different postpartum periods. Data collection was carried out in Bogotá, with women participating in a program of the Secretaría Distrital de Integración Social. The systematic process was developed in parallel with the analysis process. It involved the relationships between categories and the networks that form among them. Results: Teenagers do not breastfeed exclusively, identifying several difficulties in the act of breastfeeding. Complementary feeding includes unnatural foods. Maternity and breastfeeding are not consistent with the perception of being a teenager. Conclusions: Adolescents recognize the benefits of breastfeeding for their children and for them; however, their breastfeeding experience differs from the recommendations to achieve exclusive breastfeeding and a healthy complementary feeding. Among the identified causes, we highlight the lack of accurate backing and timely support.
Assuntos
Adolescente , Feminino , Humanos , Aleitamento Materno/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Colômbia , Mães , População UrbanaRESUMO
Introducción. El síndrome metabólico se caracteriza por la aparición simultánea o secuencial de diversas alteraciones metabólicas e inflamatorias a nivel molecular, celular o hemodinámico, asociadas a resistencia a la insulina y adiposidad de predominio visceral. Diferentes grupos de expertos, como la International Diabetes Federation (IDF) y el National Cholesterol Education Program (NCEP), han tratado de elaborar criterios para su diagnóstico. Objetivo. Establecer los niveles de concordancia de los criterios de diagnóstico para el síndrome metabólico. Material y métodos. El estudio incluyó 357 individuos. Se hizo el análisis descriptivo de variables cualitativas y de resultados de laboratorio y medición antropométrica para la determinación de la prevalencia de síndrome metabólico, según las definiciones de los dos grupos mencionados. Se utilizaron concordancia kappa y regresión logística, para la comparación de las metodologías. Resultados. Las prevalencia del síndrome metabólico, según la International Diabetes Federation, es de 19,9 % y por el Adult Treatment Panel (ATP) III fue de 10,4 %. La estimación de concordancia entre los criterios diagnósticos de la Federación y los del Panel fue escasa (fair agreement) κ=0,3997; IC95%: 0,28-0,52). Conclusiones. En la población trabajadora que participó en este estudio, la prevalencia del síndrome metabólico se presentó en mayor porcentaje utilizando la definición de la International DiabetesFederation y fue más alta en los hombres que en las mujeres. Los criterios diagnósticos para el síndrome metabólico deben usarse teniendo en cuenta la población en estudio, así como el sexo y la edad.
Introduction: Metabolic syndrome is characterized by the simultaneous or sequential appearance of various metabolic and inflammatory changes at molecular, cellular or hemodynamic level associated with the presence of insulin resistance and dominant visceral adiposity. Different expert groups, including the International Diabetes Federation and the National Cholesterol Education Program, have tried to develop criteria for its diagnosis. Objective: To establish diagnostic criteria concordance levels for metabolic syndrome.. Materials and methods: A total of 357 people were part of the study. We performed a descriptive analysis of qualitative variables, and laboratory and anthropometric measurement results to determine the prevalence of metabolic syndrome according to the International Diabetes Federation and National Cholesterol Education Program - ATP III definitions. We used kappa concordance and logistic regression for the comparison of methodologies.. Results: The prevalence of metabolic syndrome was 19.9% according to the International Diabetes Federation, and 10.4% using the National Cholesterol Education Program - ATP III. The estimate of agreement between the two diagnostic criteria of the International Diabetes Federation and the National Cholesterol Education Program - ATP III was fair (low) (κ=0.3997, CI 95% 0.28-0.52).. Conclusions: In the working population who participated in this study, the obtained prevalence of metabolic syndrome occurred at a higher rate using the International Diabetes Federation definition, being higher in men than in women. The use of diagnostic criteria for metabolic syndrome must take into account the study population as well as sex and age.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Síndrome Metabólica/diagnóstico , Estudos Transversais , Técnicas e Procedimentos Diagnósticos , Síndrome Metabólica/complicaçõesRESUMO
INTRODUCTION: Metabolic syndrome is characterized by the simultaneous or sequential appearance of various metabolic and inflammatory changes at molecular, cellular or hemodynamic level associated with the presence of insulin resistance and dominant visceral adiposity. Different expert groups, including the International Diabetes Federation and the National Cholesterol Education Program, have tried to develop criteria for its diagnosis. OBJECTIVE: To establish diagnostic criteria concordance levels for metabolic syndrome. MATERIALS AND METHODS: A total of 357 people were part of the study. We performed a descriptive analysis of qualitative variables, and laboratory and anthropometric measurement results to determine the prevalence of metabolic syndrome according to the International Diabetes Federation and National Cholesterol Education Program - ATP III definitions. We used kappa concordance and logistic regression for the comparison of methodologies. RESULTS: The prevalence of metabolic syndrome was 19.9% according to the International Diabetes Federation, and 10.4% using the National Cholesterol Education Program - ATP III. The estimate of agreement between the two diagnostic criteria of the International Diabetes Federation and the National Cholesterol Education Program - ATP III was fair (low) (κ=0.3997, CI 95% 0.28-0.52). CONCLUSIONS: In the working population who participated in this study, the obtained prevalence of metabolic syndrome occurred at a higher rate using the International Diabetes Federation definition, being higher in men than in women. The use of diagnostic criteria for metabolic syndrome must take into account the study population as well as sex and age.
Assuntos
Síndrome Metabólica/diagnóstico , Adulto , Estudos Transversais , Técnicas e Procedimentos Diagnósticos , Feminino , Humanos , Masculino , Síndrome Metabólica/complicações , Pessoa de Meia-Idade , Adulto JovemRESUMO
INTRODUCTION: In Colombia, breastfeeding is inadequate and -especially in teenage girls- short. Given that adolescents are a social group with their own lifestyles, we need to know what meanings they have regarding breastfeeding, and also what the characteristics of their breastfeeding experience are, in order to identify issues that limit or facilitate this practice, which will produce the knowledge to improve breastfeeding promotion strategies. OBJECTIVE: To characterize the experience of breastfeeding in nursing adolescents and identify strengths, limitations and perceived needs from their own perspective. MATERIALS AND METHODS: This was a phenomenological qualitative study. We conducted 24 interviews and had three focal groups with female adolescents in different postpartum periods. Data collection was carried out in Bogotá, with women participating in a program of the Secretaría Distrital de Integración Social. The systematic process was developed in parallel with the analysis process. It involved the relationships between categories and the networks that form among them. RESULTS: Teenagers do not breastfeed exclusively, identifying several difficulties in the act of breastfeeding. Complementary feeding includes unnatural foods. Maternity and breastfeeding are not consistent with the perception of being a teenager. CONCLUSIONS: Adolescents recognize the benefits of breastfeeding for their children and for them; however, their breastfeeding experience differs from the recommendations to achieve exclusive breastfeeding and a healthy complementary feeding. Among the identified causes, we highlight the lack of accurate backing and timely support.
Assuntos
Aleitamento Materno/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Adolescente , Colômbia , Feminino , Humanos , Mães , População UrbanaRESUMO
OBJECTIVE: The present study aimed to evaluate the nutritional status of pregnant women in Colombia and the associations between gestational BMI and sociodemographic and gestational characteristics. DESIGN: Cross-sectional study. A secondary analysis was made of data from the 2005 Demographic and Health Survey of Colombia. SETTING: Bogotá, Colombia. SUBJECTS: Pregnant adolescents aged 13-19 years (n 430) and pregnant women aged 20-49 years (n 1272). RESULTS: The gestational BMI and sociodemographic characteristics of the adolescents differed from those of the pregnant adult women. Thirty-one per cent of the adolescents were underweight for gestational age, compared with 14·5 % of the adult women. Eighteen per cent of adolescents were overweight for gestational age, in contrast to 37·3 % of adult women. The overall prevalence of anaemia was 44·7 % and the prevalence of low serum ferritin was 38·8 %. Women within the high quintiles of the wealth index (prevalence odds ratio (POR) = 0·56; 95 % CI 0·34, 0·91, P < 0·02) had lower odds of being underweight. Women who received prenatal care (POR = 2·17; 95 % CI 1·48, 3·09, P < 0·001) and were multiparous (POR = 2·10; 95 % CI 1·43, 3·15, P < 0·0 0 1) had higher odds of being overweight. Women in extended families (POR = 0·63; 95 % CI 0·50, 0·95, P < 0·025) had lower odds of being overweight. CONCLUSIONS: Underweight in pregnant adolescents and overweight in adult women coexist as a double burden in Colombia. Factors associated with malnutrition among pregnant women and adolescents should be considered for future interventions in countries experiencing nutritional transition.
Assuntos
Anemia Ferropriva/epidemiologia , Anemia/epidemiologia , Estado Nutricional , Sobrepeso/epidemiologia , Complicações na Gravidez/epidemiologia , Magreza/epidemiologia , Adolescente , Adulto , Fatores Etários , Anemia Ferropriva/sangue , Índice de Massa Corporal , Colômbia/epidemiologia , Feminino , Ferritinas/sangue , Humanos , Desnutrição/epidemiologia , Pessoa de Meia-Idade , Razão de Chances , Paridade , Gravidez , Cuidado Pré-Natal , Fatores Socioeconômicos , Adulto JovemRESUMO
Poor physical fitness is associated with increased health-related risks in children. The association of nutritional status indicators and physical fitness in children residing in developing countries is not well characterised. We conducted a cross-sectional study among 1945 children of age 5-12 years in Bogotá, Colombia, to assess whether anthropometric and micronutrient status indicators were associated with performance in the shuttle run and standing long jump tests. Stunted children scored significantly lower in the run (0·4 s; P = 0·0002) and jump (6 cm; boys only; P = 0·003) tests than non-stunted children, after adjustment for age and other factors. Children who were thin, overweight or obese ran slower than normal-weight children (P < 0·01). Lower jump scores were associated with overweight or obesity and greater arm fat area in boys only (P < 0·0001). Girls with low ferritin concentrations ran 0·6 s slower than girls with normal ferritin concentrations (P = 0·02). Erythrocyte folate concentrations were linearly related to higher run (P < 0·0001) and long jump scores (P = 0·0001). Boys with marginal or low vitamin B12 status had 4 cm lower long jump scores than children with normal status (P = 0·01). Suboptimal anthropometric and micronutrient status are related to poorer performance in fitness tests. The effects of improving nutritional status on physical fitness of children warrant investigation.
Assuntos
Antropometria/métodos , Composição Corporal/fisiologia , Micronutrientes/sangue , Aptidão Física/fisiologia , Criança , Pré-Escolar , Colômbia , Estudos Transversais , Feminino , Ferritinas/sangue , Ácido Fólico/sangue , Humanos , Modelos Lineares , Masculino , Obesidade/fisiopatologia , Sobrepeso/fisiopatologia , Instituições Acadêmicas , Magreza , Vitamina B 12/sangueRESUMO
While Giardia duodenalis infection has been consistently associated with nutrient malabsorption and stunting in children, the effects of other protozoans on nutritional status or gastrointestinal morbidity are less clear. We sought to determine whether infection with common intestinal protozoans including Giardia duodenalis, Entamoeba coli and Blastocystis hominis was associated with anthropometric and micronutrient status, gastrointestinal symptoms, visits to the doctor or school absenteeism in children 5-12 years of age from Bogotá, Colombia. We obtained stool samples from 442 children enrolled in primary schools in 2006 and examined the presence of intestinal protozoans in relation to height, body mass index, plasma concentrations of vitamins A and B12, ferritin and zinc and erythrocyte folate. In addition, we examined the associations between protozoan infections and the incidence of common gastrointestinal symptoms, which were registered prospectively in morbidity diaries. The prevalence rates of G. duodenalis, E. coli and B. hominis infection were 6.3, 23.1 and 22.4%, respectively. Giardia infection was associated with lower height-for-age z-score (p = 0.04), whereas E. coli infection was associated with low erythrocyte folate (p = 0.04), and B. hominis infection was related to higher vitamin A levels (p = 0.05). Infection with E. coli was also associated with a significantly higher incidence of fever but fewer visits to the doctor, while B. hominis infection was associated with significantly less diarrhea, diarrhea with vomiting, doctor visits and school absenteeism. In conclusion, G. duodenalis and E. coli infections were associated with indicators of poor nutritional status in this population, while B. hominis was related to apparently decreased morbidity.
Assuntos
Disenteria Amebiana/complicações , Giardíase/complicações , Micronutrientes/sangue , Estado Nutricional , Absenteísmo , Blastocystis hominis/isolamento & purificação , Índice de Massa Corporal , Criança , Pré-Escolar , Colômbia/epidemiologia , Disenteria Amebiana/epidemiologia , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/complicações , Infecções por Escherichia coli/epidemiologia , Fezes/parasitologia , Feminino , Trato Gastrointestinal/fisiopatologia , Giardia/isolamento & purificação , Giardíase/epidemiologia , Humanos , Incidência , Masculino , Morbidade , Prevalência , Estudos Prospectivos , Instituições Acadêmicas , Fatores SocioeconômicosRESUMO
Anemia is a common complication of human malaria. Since micronutrient deficiencies are highly prevalent in malaria-endemic areas and appear to contribute to anemia etiology, we conducted a cross-sectional study in Tumaco, Colombia, to examine the associations between plasma vitamin B12 or erythrocyte folate concentrations and hemoglobin (Hb) among 96 adults with predominantly Plasmodium falciparum malaria. Prevalence of folate and vitamin B12 deficiencies was 26.0 and 26.6%, respectively. There was an inverse, linear relation between folate and Hb concentrations. Adjusted difference in Hb between lowest and highest folate quartiles was 1g/dL (p=0.04; p, test for trend=0.01). Vitamin B12 was not associated with Hb concentrations and did not modify the associations between folate and Hb. Incidentally, body mass index (BMI) was inversely associated with parasitemia and risk of clinical malaria. Future longitudinal studies are warranted to determine the potential pathophysiological role of folate in malaria-related anemia.
Assuntos
Anemia/epidemiologia , Ácido Fólico/análise , Hemoglobinas/análise , Malária Falciparum/complicações , Malária Falciparum/patologia , Parasitemia , Vitamina B 12/análise , Adolescente , Adulto , Animais , Colômbia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Plasmodium falciparum/isolamento & purificação , Adulto JovemRESUMO
BACKGROUND: In Latin America, the burden of vitamin A and iron deficiencies has been documented primarily in preschool-age children. There are few recent reports on the vitamin A and iron status of school-age children. OBJECTIVE: We aimed to determine the prevalence and predictors of vitamin A and iron deficiencies in Colombian schoolchildren. METHODS: We examined plasma retinol and ferritin concentrations in relation to socioeconomic and anthropometric factors in a representative sample of 2811 low- and middle-income children 5 to 12 years of age in Bogotá, Colombia. RESULTS: The prevalence rates of deficiencies of vitamin A (plasma retinol < 0.70 micromol/L) and iron (plasma ferritin <15 microg/L) were 14% and 3%, respectively. In multivariate analysis, plasma retinol concentrations were positively associated with child's age and household's socioeconomic stratum, whereas ferritin concentrations were positively related to child's age, number of home assets, and having a nonsingle mother. Ferritin concentrations were much lower among girls than boys in the 11- and 12-year-old age group, whereas there were only small positive differences between girls and boys in younger children (p for interaction < .0001). Both vitamin A and iron deficiencies were independently associated with lower z-scores for body-mass-index-for-age, after adjustment for sociodemographic factors and C-reactive protein concentrations. Neither vitamin A nor iron status was related to height-for-age. CONCLUSIONS: The prevalence rates of vitamin A and iron deficiencies among schoolchildren from Bogotd, Colombia, are not negligible. Both vitamin A and iron status are positively associated with socioeconomic status and anthropometric indices. The effect of improving vitamin A and iron status on physical growth and other functional outcomes needs to be further examined in this age group.