Association between the risk of malnutrition and sarcopenia at 4.2 years of follow-up in community-dwelling older adults

Introduction

Currently, there is only scarce evidence of a causal association between risk of malnutrition (RM) by the mini-nutritional assessment (MNA) and the incidence of sarcopenia. This study was designed to assess such an association at 4.2 years of follow-up in community-dwelling subjects over 60 years old.

Methods

The data used were from the FraDySMex cohort study. The exposition variables were RM diagnosed by the long forma of the MNA (MNA-LF) and short form (MNA-SF). The last one included the body mass index and calf circumference at baseline, while sarcopenia was diagnosed by the EWGSOP2 at follow-up and taken as the response variable. Several covariates involved in the association were also considered. A multiple logistic regression analysis was performed to test the association.

Results

At baseline, 27.0 and 37.9% of subjects had RM by the MNA-LF and MNA-SF, respectively. The incidence of sarcopenia was 13.7%. The fat mass variable significantly modified the association, so it was tested in each stratum. Two independent models showed that subjects with RM by the MNA-LF in the normal fat mass stratum were at a higher risk for developing sarcopenia at follow-up than those without RM (OR 9.28; IC 95% 1.57-54.76) after adjusting for age, sex, and waist circumference. No association was found for the excess fat mass stratum subjects. Subjects with RM by the MNA-SF in the excess fat mass stratum were more likely to develop sarcopenia at follow-up than those without RM by the MNA-SF (OR 3.67; IC 95% 1.29-10.43). This association was not found in the subjects in the normal fat mass stratum.

Conclusion

The association was dependent on the variable fat mass. The two forms of the MNA should not be applied indistinctly with older adults. Based on these results, it is clear that the risk of malnutrition precedes the onset of sarcopenia.

Diagnosis of nutritional status, dyslipidemia and associated risk factors in indigenous Yaqui schoolchildren

BACKGROUND

Malnutrition is a global problem that affects schoolchildren and can increase the risk of diseases in adulthood. Adult members of the Yaqui Indigenous group have been shown to have serious health problems, and Yaqui schoolchildren could therefore find themselves in a similar situation.

OBJECTIVE

To evaluate the nutritional status, lipid profile and associated factors in a sample of Yaqui schoolchildren.

MATERIAL AND METHODS

A total of 109 Yaqui schoolchildren who lived in their localities of origin were recruited. Anthropometric measurements were carried out, a venous blood sample was extracted in fasting conditions, and several questionnaires were applied.

RESULTS

The prevalence of overweight/obesity was 38.5%, with no cases of chronic malnutrition being recorded; 38.6% of the children had dyslipidemia. Fiber consumption was a protective factor against overweight/obesity, while fat intake was a risk factor. The physical activity score was found to be a protective factor against dyslipidemia, and the risk factors were BMI-for-age Z-scores, waist circumference, family history of dyslipidemia, educational level, and permanent employment.

CONCLUSIONS

Yaqui schoolchildren equally suffer from a high proportion of overweight/obesity and dyslipidemia. The associated factors may be useful for the design of contextualized interventions for this population.

Incidence of the Risk of Malnutrition and Excess Fat Mass, and Gait Speed as Independent Associated Factors in Community-Dwelling Older Adults

BACKGROUND AND AIMS

Only one cohort study exists on the incidence of the risk of malnutrition (RM) in older adults, though numerous cross-sectional reports, identified several risk factors associated with the prevalence and incidence of this condition. However, alterations in body composition and impaired physical performance as exposition variables of RM have not been explored. This study assessed the incidence of RM and determined its association with excess fat mass, low total lean tissue, gait speed, and handgrip strength as exposition variables for RM in community-dwelling older adults.

METHODS

This is a secondary analysis of older adults (≥60 years) derived from the study "Frailty, dynapenia, and sarcopenia in Mexican adults (FraDySMex)", a prospective cohort project conducted from 2014 to 2019 in Mexico City. At baseline, volunteers underwent body composition analysis and physical performance tests. Several covariates were identified through comprehensive geriatric assessment. At baseline and follow-up, RM was assessed using the long form of the mini nutritional assessment (MNA-LF) scale. Associations between the exposition variables and RM were assessed by multiple logistic regression.

RESULTS

The cohort included 241 subjects. The average age was 75.6 ± 7.8 years, and 83.4% were women. The mean follow-up period was 4.1 years, during which 28.6% of subjects developed RM. This condition was less likely to occur in those with an excess fat mass, even after adjusting for several covariates. Regarding total lean tissue, the unadjusted model showed that RM was more likely to occur in men and women with a low TLT by the TLTI classification, compared to the normal group. However, after adjusting for several covariates (models 1 and 2), the association lost significance. Results on the association between gait speed and RM showed that this condition was also more likely to occur in subjects with low gait speed, according to both the unadjusted and adjusted models. Similar results were found for RM in relation to low handgrip strength; however, after adjusting for the associated covariates, models 1 and 2 no longer reached the level of significance.

CONCLUSIONS

RM diagnosed by MNA-LF was significantly less likely to occur among subjects with excess fat mass, and a significant association emerged between low gait speed and RM after 4.1 years of follow-up in these community-dwelling older adults. These results confirm the association between some alterations of body composition and impaired physical performance with the risk of malnutrition and highlight that excess fat mass and low gait speed precede the risk of malnutrition, not vice versa.

Predictive equations for fat mass in older Hispanic adults with excess adiposity using the 4-compartment model as a reference method

BACKGROUND

Predictive equations are the best option for assessing fat mass in clinical practice due to their low cost and practicality. However, several factors, such as age, excess adiposity, and ethnicity can compromise the accuracy of the equations reported to date in the literature.

OBJECTIVE

To develop and validate two predictive equations for estimating fat mass: one based exclusively on anthropometric variables, the other combining anthropometric and bioelectrical impedance variables using the 4C model as the reference method.

SUBJECTS/METHODS

This is a cross-sectional study that included 386 Hispanic subjects aged ≥60 with excess adiposity. Fat mass and fat-free mass were measured by the 4C model as predictive variables. Age, sex, and certain anthropometric and bioelectrical impedance data were considered as potential predictor variables. To develop and to validate the equations, the multiple linear regression analysis, and cross-validation protocol were applied.

RESULTS

Equation 1 included weight, sex, and BMI as predictor variables, while equation 2 considered sex, weight, height squared/resistance, and resistance as predictor variables. R2 and RMSE values were ≥0.79 and ≤3.45, respectively, in both equations. The differences in estimates of fat mass by equations 1 and 2 were 0.34 kg and -0.25 kg, respectively, compared to the 4C model. This bias was not significant (p < 0.05).

CONCLUSIONS

The new predictive equations are reliable for estimating body composition and are interchangeable with the 4C model. Thus, they can be used in epidemiological and clinical studies, as well as in clinical practice, to estimate body composition in older Hispanic adults with excess adiposity.

Determination of Fat-Free Mass Density and its Components in Older Hispanic Adults by In Vivo Methods

The densitometry method estimates body composition based on cadaver reference values, mainly the fat-free mass density value of 1.100 g/cm³. However, several changes in fat-free mass components by aging, ethnicity, and excess adiposity could influence their density and affect body composition estimations. The present study aimed to compare the mean fat-free mass component values in older Hispanic adults to cadaver reference values. This cross-sectional study included a sample of 420 subjects aged ≥60 yr from northern Mexico. Fat-free mass was determined by the four-compartment model using air displacement plethysmography, the deuterium dilution technique, and dual-energy X-ray absorptiometry for body density, aqueous and mineral fractions of body weight, respectively. A 1-sample t test was used to compare the fat-free mass density and aqueous, mineral, and residue fractions of fat-free mass from subjects in the study to the assumed cadaver reference values. The mean fat-free mass density value for the total sample of older Hispanic adults (1.096 ± 0.011 g/cm³) was significantly (p < 0.001) lower than the assumed value of 1.100 g/cm³, except in obese older men. The mean aqueous fraction of fat-free mass (74.8 ± 3.3%) was higher than the assumed value of 73.8%, and the mean residue fraction of fat-free mass value was lower (18.3 ± 3.4%) than the reference value of 19.4%. Indeed, only the mean mineral fraction of fat-free mass value (6.8 ± 0.8%) was similar to the reference value. In the total sample, all characteristic mean fat-free mass values in these older Hispanic adults differed from cadaver reference values, except the mineral fraction of fat-free mass value.

External validation of BIA equations to estimate appendicular skeletal muscle mass in older adults: Importance of the bias analysis and derivation of correction factors to achieve agreement

There are several equations based on bioelectrical impedance analysis (BIA) to estimate with high precision appendicular skeletal muscle mass (ASM). However, most of the external validation studies have reported that these equations are inaccurate or biased when applied to different populations. Furthermore, none of the published studies has derived correction factors (CFs) in samples of community-dwelling older adults, and none of the published studies have assessed the influence of the dual-energy X-ray absorptiometry (DXA) model on the validation process. This study assessed the agreement between six BIA equations and DXA to estimate ASM in non-Caucasian older adults considering the DXA model and proposed a CF for three of them. This analysis included 547 non-institutionalized subjects over 60 years old from the northwest of Mexico who were physically independent and without cognitive impairment: 192 subjects were measured using DXA Hologic, while 355 were measured by DXA Lunar. The agreement between each of the equations and DXA was tested considering the DXA model used as a reference method for the design of each equation, using the Bland and Altman procedure, a paired t test, and simple linear regression as objective tests. This process was supported by the differences reported in the literature and confirmed in a subsample of 70 subjects measured with both models. Only six published BIA equations were included. The results showed that four equations overestimated ASM_DXA, and two underestimated it (p < 0.001, 95% CI for Kim's equation:−5.86-−5.45, Toselli's:−0.51-−0.15, Kyle's: 1.43–1.84, Rangel-Peniche's: 0.32–0.74, Sergi's: 0.83–1.23, and Yoshida's: 4.16–4.63 kg). However, Toselli's, Kyle's and Rangel-Peniche's equations were the only ones that complied with having a homogeneous bias. This finding allowed the derivation of CFs, which consisted of subtracting or adding the mean of the differences from the original equation. After estimating ASM applying the respective CF, the new ASM estimations showed no significant bias and its distribution remained homogeneously distributed. Therefore, agreement with DXA in the sample of non-Caucasian was achieved. Adding valid CFs to some BIA equations allowed to reduce the bias of some equations, making them valid to estimate the mean values of ASM at group level.

Prevalence of overweight, obesity and central obesity and factors associated with BMI in indigenous yaqui people: a probabilistic cross-sectional survey

BACKGROUND

The Yaquis are an Indigenous group who inhabit in the state of Sonora in northwestern Mexico. This group has experienced changes in their lifestyle, moving from a traditional lifestyle to a more modern one, resulting in an increase of obesity and its comorbidities. However, few studies have been done in this group. The aim of this study was to determine the prevalence of overweight, obesity and central obesity and to identify the factors associated with body mass index (BMI) in a representative sample of Indigenous Yaqui people from Sonora, Mexico.

METHODS

A cross-sectional survey with multistage sampling was conducted among adults (N = 351) with residence in Yaqui traditional villages (Vícam, Pótam, Loma de Guamúchil, Loma de Bácum, Tórim, Ráhum, Huiribis or Belem). Anthropometric measurements were taken to diagnose overweight, obesity and central obesity. Food frequency and physical activity (PA) questionnaires designed for the Yaqui population were applied, as well as sociodemographic and clinical history questionnaires. The factors associated with BMI were assessed using multiple linear regression considering the complex design of the sampling.

RESULTS

The prevalence of overweight, obesity and central obesity in the population were 36.5%, 35.0% and 76.0%, respectively. Having higher values of the modernization index (β = 0.20, p = 0.049) was associated with a higher BMI, while having a higher consumption of a "prudent" dietary pattern (traditional dishes, fruits, vegetables and low-fat dairy) (β = -0.58, p = 0.009) and performing a greater number of hours per week of vigorous PA (β = -0.14, p = 0.017) were associated with a lower BMI.

CONCLUSIONS

The prevalence of the studied abnormalities is high. The evidence presented in this study suggests that interventions are needed and more research is required to determine the appropriate components of such interventions, in order to meet the needs of the Yaqui people.

Efecto de una intervención en línea de cambio en el estilo de vida sobre el puntaje zIMC de escolares mexicanos: protocolo de ensayo controlado aleatorizado piloto cegado a evaluadores durante la pandemia por COVID-19

RESUMEN Introducción:  El cierre de escuelas por la pandemia de COVID-19, representa un factor de riesgo para el desarrollo de obesidad en los niños, debido al aumento de conductas no saludables. Las intervenciones de cambio de estilo de vida en línea en escolares podrían ayudar a mitigar este problema. Sin embargo, en nuestro conocimiento no se han realizado ensayos controlados aleatorizados para prevenir obesidad en escolares durante COVID-19. El objetivo del presente estudio es evaluar el efecto de una intervención en línea de cambio de estilo de vida sobre el puntaje Z de IMC de escolares mexicanos a 4 meses durante la pandemia por COVID-19 en un grupo intervención en comparación a un control. Material y Métodos: Protocolo de un ensayo controlado aleatorizado piloto cegado a los evaluadores. Se invitará a participar a escolares de una primaria pública de Hermosillo, Sonora, México. Los participantes serán aleatorizados a un grupo de intervención o a un grupo control. La intervención incluirá 3 sesiones semanales en línea de educación nutricional y actividad física (60 minutos por sesión, 30 minutos de educación nutricional y 30 minutos para la actividad física) e información para padres de familia. El grupo control recibirá un folleto digital con recomendaciones de una dieta saludable al inicio del estudio y acceso a los materiales del programa al finalizar. Las mediciones del estudio se realizarán al inicio y a los 4 meses. La variable primaria será el puntaje Z de IMC. Las variables secundarias serán circunferencia de cintura, porcentaje de grasa, conocimientos en nutrición, parámetros de estilo de vida, retención, aceptación y participación en la intervención.  Los cambios de las variables se analizarán mediante pruebas de comparación de medias por intención de tratamiento. El protocolo fue aprobado por el Comité de Ética en Investigación del Departamento de Enfermería de la Universidad de Sonora y registrado en la plataforma Clinical Trials. Conclusión: En nuestro conocimiento, el estudio aportará la primera evidencia de la evaluación de intervenciones en línea para la prevención de obesidad en escolares derivada de un ensayo controlado aleatorizado, lo cual podría ser útil en el combate de la obesidad infantil.

Occurrence of Intestinal Parasites in Fruits and Vegetables from Markets of Northwest Mexico

Background: Fruits and vegetables are potential vehicle of transmission of intestinal parasites. The main aim of this study was to determine prevalence of intestinal parasitic contamination in fruits and vegetables sampled from Caborca region, Northwest Mexico. Methods: A total of 400 fruit and vegetable samples were collected from unregulated open-air markets and closed (i.e., regulated) markets in Caborca region of Northwest Mexico; including melon, peach, asparagus, and grapes. Faust, Kinyoun, and Enzyme- Linked Immunosorbent Assay (ELISA) techniques were used to detect and identify the genus and species of all parasites found in the examined samples. Data were statistically analyzed using STATA/SE (version 12.0). Results: An overall prevalence (45%) of parasitic contamination was found in the 400 fruit and vegetable samples. Endolimax nana (27.5%) and Entamoeba coli (17.5%) were the most common nonpathogenic parasites, while the most prevalent parasitic pathogens were Cryptosporidium spp. (11.7%), Cyclospora spp., (11.0%), and Blastocystis hominis (9.2%). Asparagus (31%) and grapes (38.9%) had significantly (p<0.05) higher percent- ages of overall and multiple parasitic contamination than melon (10.6%) and peaches (19.4%). The fresh produce from the open-air markets had significantly (p<0.05) higher overall parasitic contamination (53.5%) than those of the closed establishments (36.5%). Conclusion: The parasitic contamination in the fresh produce sold in the Northwest region of Mexico is a serious public health concern.

Agreement between laboratory methods and the 4-compartment model in assessing fat mass in obese older Hispanic-American adults

BACKGROUND/OBJECTIVES

Densitometry (Siri's and Brožek's equations), hydrometry (by the deuterium dilution technique), and dual-energy X-ray absorptiometry (DXA) are three methods for estimating body composition. However, because they are all based on certain assumptions, they may not be applicable to aged and obese subjects due to changes in their body composition. Hence, the validity of these "laboratory methods" could be affected in obese older people. The main aim was to assess the agreement between densitometry, hydrometry, and DXA with the 4-compartment (4C) model to estimate fat mass (FM) in obese older Hispanic-American adults. As secondary goals, we explored whether the bias in densitometry and hydrometry results could be improved by modifying the assumptions regarding fat-free mass (FFM) density and hydration factor (HF) values, respectively. In the case of DXA, we explored the factors that contribute to bias.

SUBJECTS/METHODS

This is a cross-sectional study based on a sample of 171 obese subjects aged ≥60 years from 3 regions of northern Mexico. Body composition was assessed by the 4C model as the reference method and by all three laboratory methods. Agreement of the latter with the 4C model was probed by Bland and Altman analysis, a paired sample t-test, and simple linear regression analyses. In addition, the mean FFM density estimated in this sample, and HF values (published previously) of 0.737 and 0.753 for obese older Hispanic-American men and women, respectively, were considered as ethnic- and gender-specific values. These values were used to modify the densitometric and hydrometric equations in order to improve their bias. Finally, we tested whether the hydration status and indirect markers of adiposity are contributing factors to the bias of DXA using multiple linear regression analysis.

RESULTS

Siri's equation overestimated FM by 0.57 kg (p < 0.01), while Brožek's equation, hydrometry, and DXA underestimated it by 1.24 kg, 0.89 kg, and 0.79 kg (p < 0.01), respectively, compared to the 4C model. The bias in the densitometry and hydrometry results was eliminated by substituting the ethnic- and gender-specific values into the equations. Finally, we found that hip circumference contributes to the bias in DXA.

CONCLUSION

The densitometry, hydrometry, and DXA methods are not interchangeable with the 4C model for assessing fat mass in obese, older Hispanic-American adults. The lack of agreement could indicate that the assumptions of each method do not apply to this population.

Prevalence and factors associated with type 2 diabetes mellitus in the indigenous population of Mexico: systematic review

Currently, diabetes represents a serious health problem, due to the complications it entails and because of its high mortality rate. Type 2 diabetes mellitus (T2DM) is the most prevalent and it is characterized by insulin resistance. The objective was to analyze the available scientific literature on prevalence and factors associated to T2DM in indigenous population of Mexico. Searches for articles published between 1990 and 2019 in English and Spanish were carried out in 13 electronic databases. Combinations of eight keywords were used according to the MeSH vocabulary. To select the studies, it was used the JBI’s Critical Appraisal Tools guide in Spanish for analytical prevalence studies. Out of 478, 12 cross-sectional studies reported T2DM prevalences from 12 indigenous groups located in Mexico: Huichol (0%), Mexican (0%), Tepehuano (0 and 0.83%), Mazateco (2.01%), Otomí (4.4%), Tojolabal (4.7%), Mixe (6.9%), Pima (6.9 and 9.0%), Zapoteco (8.7%), Maya (10.6%), Yaqui (18.3 and 14.8%) and Mixteco (19.0 and 26.2%). Factors associated with T2DM reported were being older, being female, less education level, presence of family history of T2DM, obesity, high blood pressure and increased waist-hip circumference. There is little evidence of the prevalence of T2DM in indigenous groups in Mexico. Studies found suggest a diversity of prevalences, ranging from lower to greater prevalences. Considering the risk factors associated with T2DM is essential to generate prevention strategies according to the context of each ethnic group, in order to improve the epidemiological landscape of diabetes in indigenous groups of Mexico.

Effectiveness of the Healthy Lifestyle Promotion Program for Yaquis with Obesity and Risk of Diabetes in the Short and Medium Term: A Translational Study

Type 2 diabetes (T2D) is a public health problem worldwide, and the main risk factor for its development is obesity. The Yaqui ethnic group of Sonora has serious obesity problems, resulting in an increased risk of T2D in its inhabitants. The objective of this study was to evaluate the effectiveness of a health promotion program on obesity parameters and cardiovascular risk factors in short- (6 months) and medium-term periods (12 months) in indigenous Yaquis of Sonora. The design is a translational clinical study of a single cohort with prepost intervention measurements in a sample of 93 subjects. The effectiveness of the program was evaluated by comparing obesity parameters, metabolic markers, and physical activity 6 and 12 months with those measured under basal conditions using a paired t-test or Wilcoxon rank-sum test. The short-term retention percentage was 58.0%. There was a decrease in body weight (Δ = -3.9 kg, p ≤ 0.05) and other obesity parameters, and an increase in physical activity and improvements in metabolic markers (p ≤ 0.05) was observed. Similar findings were obtained for the medium-term period; body weight loss was also -3.9 kg (p ≤ 0.05). The short and medium-term results of the program showed improvements in the obesity parameters and other cardiovascular risk factors of the participants. These results support the effectiveness of the program and its translation in this ethnic group.

Effect of multi-component school-based program on body mass index, cardiovascular and diabetes risks in a multi-ethnic study

Background

Mexico occupies one of the first places worldwide in childhood obesity. Its Mestizo and Indigenous communities present different levels of westernization which have triggered different epidemiological diseases. We assessed the effects of a multi-component school-based intervention program on obesity, cardiovascular and diabetes risk factors.

Methods

A physical activity, health education and parent involvement (PAHEPI) program was developed and applied in six urban (Mestizo ethnic group) and indigenous (Seri and Yaqui ethnic groups) primary schools for 12 weeks. A total of 320 children aged 4–12 years participated in intervention program; 203 under Treatment 1 (PAHEPI program) and 117, only from Mestizo groups, under Treatment 2 (PAHEPI+ school meals). For Body Mass Index (BMI), cardiovascular and diabetes factors, pairwise comparisons of values at baseline and after treatments were done using Wilcoxon signed rank test. Generalized linear models were applied to assess the intervention effect by age, sex and nutritional status in relation to ethnicity and treatment.

Results

We observed improvements on BMI in children with overweight-obesity and in triglycerides in the three ethnic groups. The Mestizo ethnic group showed the largest improvements under Treatment 2. While Seris showed improvements only in cardiovascular risk factors, Yaquis also showed improvements in diabetes risk factors, though not in BMI.

Conclusions

This study showed that the same intervention may have positive but different effects in different ethnic groups depending on their lifestyle and their emerging epidemiological disease. Including this type of intervention as part of the school curriculum would allow to adapt to ethnic group in order to contribute more efficiently to child welfare.

Trial registration

This study was retrospectively registered under the identifier NCT03768245.

Effectiveness of the Diabetes Prevention Program for Obesity Treatment in Real World Clinical Practice in a Middle-Income Country in Latin America

The Diabetes Prevention Program (DPP) is effective for the prevention of type 2 diabetes by weight loss with diet and physical activity. However, there is little evidence as to whether this program could be translated into real-world clinical practice in Latin American countries. The objective of this work was to evaluate the effectiveness of the DPP for the management of overweightness and obesity at 6 and 12 months in clinical practice in Mexico. This was a non-controlled intervention study implemented in five public clinics in northern Mexico. Two hundred and thirty-seven adults aged 45.7 ± 9.9 years with a Body Mass Index (BMI) of 34.4 ± 5.4 kg/m² received group sessions with an adaptation of the DPP, in addition to nutrition counseling. One hundred and thirty-three (56%) participants concluded the 6 month phase. They showed a significant weight loss, ranging from 2.76 ± 4.76 to 7.92 ± 6.85 kg (p ≤ 0.01) in the clinics. The intention-to-treat analysis showed a more conservative weight loss. Participant retention at the end of 12 months was low (40%). The implementation of the DPP in different public clinics in Mexico was effective in the management of obesity in the short term, but better strategies are required to improve participant retention in the long term.

Human intestinal protozoa in fresh asparagus from different types of markets in northwest Mexico

Caborca is one of the most productive asparagus-growing regions in the state of Sonora in northwest Mexico, an area where some fresh fruits and vegetables are sold at unregulated open-air street markets. This is a cross-sectional study in which fifty bundles of asparagus for exportation, 50 bundles of sub-standard asparagus, and 50 bundles of asparagus from open-air markets were selected randomly and then subjected to Faust, Kinyoun and ELISA testing to detect intestinal parasites. Pearson's chi-square (χ2) and Student-NewmanKeuls tests were used to estimate differences among the sampling site groups (P < 0.05). The pathogens Cryptosporidium spp. (29%) G. intestinalis (5%) and Cyclospora spp. (3%) were found in the asparagus sold in the region. The prevalence of Cryptosporidium spp. was higher in both the sub-standard asparagus and the product sampled from the open-air markets than in the samples for exportation (P < 0.05). This is the first study to demonstrate contamination by intestinal parasites in asparagus sold in different markets in northwest Mexico.

Lifestyle intervention for obesity: a call to transform the clinical care delivery system in Mexico

Obesity and its comorbidities have become the most important public health problems for Latin America. In Mexico obesity has increased dramatically to the point where the government has declared it an epidemiological emergency. The most recent national data showed overweight and obesity affects 72.5% of adults, or around 56 million Mexicans. Most Mexican adults with obesity are undiagnosed. According to data derived from a national representative survey, only 20% of adults with BMI >30 kg/m² were diagnosed with obesity by a health provider. Likewise, only 8% of individuals with obesity had received treatment for obesity. Interventions offered in the Mexican health care delivery system generally consist of traditional consultations with recommendations on diet and exercise, visits are monthly to quarterly, and validated behavior change protocols are not used. Evidence from clinical trials has shown that weight loss with this type of treatment is generally less than 1 kg per year. In contrast, intensive lifestyle interventions - protocols focusing on achieving changes in diet, physical activity, and moderate weight loss using behavioral strategies with weekly or bi-weekly sessions for the first 3 to 6 months, and a maintenance phase with trained interventionists - as implemented in the Diabetes Prevention Program and the Look AHEAD studies achieved weight loss of 7-9% at one year. Additionally, translation studies of these interventions to the community and to real-world clinical practice have achieved weight loss of around 4%. Adaptations of intensive lifestyle interventions have been implemented in the United States, both in clinical practice and in the community, and this type of intervention represents a potential model to combat obesity in Mexico and other Latin American countries. It is essential that primary care providers in Mexico implement clinical practice guidelines based on the best evidence available as discussed here to effectively treat obesity. The authors make recommendations to improve the treatment of obesity in the clinical care delivery system in Mexico using intensive lifestyle interventions.

[Moderate exercise and intake of either high or low glycemic index carbohydrates in sedentary women]

Objetivo

Analizar los cambios en las concentraciones de glucosa, insulina y triglicéridos sanguíneos en relación con un ejercicio aerobio moderado en mujeres sedentarias de distinto peso corporal, expuestas a una dieta rica en hidratos de carbono de alto o bajo índice glucémico.

Diseño

Tipo cruzado.

Emplazamiento

Se realizó en el Laboratorio de Fisiología del Ejercicio de la Facultad de Ciencias de la Cultura Física de la Universidad Autónoma de Chihuahua, México.

Participantes

Participaron 26 mujeres jóvenes sedentarias que no realizaron ejercicio en el último año. Se excluyeron 4 de peso adecuado (PA) y 2 con obesidad (OB) por no consumir los hidratos de carbono indicados (1 g/kg de peso) ni completar el ejercicio programado. Quedaron n = 10 en cada grupo (PA/OB).

Intervención

Se aplicaron 2 tratamientos de 55 min de ejercicio aerobio cada uno, un día después de consumir hidratos de carbono de alto o de bajo índice glucémico.

Mediciones principales

Se determinaron glucosa, insulina y triglicéridos plasmáticos, antes y después del ejercicio programado.

Resultados

Glucosa, insulina y triglicéridos fueron más altos en OB que en PA al inicio del estudio. La glucosa se normalizó en OB de 5,8 ± 0,35 a 5,3 ± 0,23 mmol/L (p = 0,001), solo por ingerir alimentos de bajo índice glucémico; los triglicéridos incrementaron de 139,5 ± 66 a 150,8 ± 67,2 mg/dl (p = 0,004), al término del ejercicio, habiendo consumido alimentos de bajo índice glucémico.

Conclusión

La elevación de triglicéridos secundaria al ejercicio posterior al consumo de bajo índice glucémico parece indicar aumento de oxidación lipídica en OB.

Mechanistic Pathways Underlying the Antihypertensive Effect of Fermented Milk with Lactococcus lactis NRRL B-50571 in Spontaneously Hypertensive Rats

It has been reported that fermented milk (FM) with Lactococcus lactis NRRL B-50571 had an antihypertensive effect in spontaneously hypertensive rats (SHR) and prehypertensive subjects. Therefore, the objective of the present study was to evaluate the possible mechanisms involved (angiotensin converting enzyme inhibition (ACEI), enhancement of nitric oxide production, antioxidant activity and opioid effect), in the antihypertensive effect of FM with SHR. First, twenty one SHR were randomized into three groups to either receive in a single-oral dose of purified water (negative control), FM, or naloxone (opioid receptor antagonist) + FM. In a parallel study, twenty seven SHR were randomized into three groups to either receive ad libitum purified water (negative control), Captopril or FM. After six weeks of treatment ACEI activity, enhancement of nitric oxide production, and antioxidant activity were evaluated in plasma. Results indicated that opioid receptors were not involved in the hypotensive effect of FM. However, ACEI activity (94 U/L), the oxidative stress index (malondialdehyde/catalase + glutathione peroxidase) 0.9, and nitric oxide in plasma (4.4 ± 1.3 U/L), were significantly different from the negative control, and not significantly different from the Captopril group. Thus, these results suggested that these mechanisms are involved in the hypotensive effect of FM.

The fat mass index, not the fat-free mass index, is associated with impaired physical performance in older adult subjects: Evidence from a cross-sectional study

BACKGROUND

Impaired physical performance (IPP) and physical disability (PD) are two serious public health problems in older adult populations worldwide. While studies show that changes in body composition are important risk factors for developing these conditions, there is little evidence that the fat-free mass (FFM) and fat mass (FM) indices (FFMI and FMI, respectively) are associated with IPP in older men and women. This study assessed the association among FFMI, FMI, and IPP using Short Physical Performance Battery (SPPB) in Mexican men and women aged over 60 years.

METHODS

This cross-sectional study included 217 older people (men 34.6%, women 65.4%; 60-92 years). FFM and FM were assessed by dual X-ray absorptiometry, assuming a two-compartment model. FFM and FM were adjusted by height squared and the indices were obtained. After assessment of physical performance by SPPB, subjects with scores ≤6 were classified as having IPP. Associations were tested by multiple logistic regression analysis in separated models.

RESULTS

IPP prevalence was 14.3%. Women were affected more than men. Regression analysis showed no significant association between FFMI and IPP, but FMI was strongly-associated, as for each unit increase in FMI, the risk of IPP rose significantly (OR: 1.14), and this result remained significant after adjusting for age, comorbidity, polypharmacy, and the appendicular skeletal muscle mass index (OR: 1.23; p ≤ 0.001). These results emphasize the importance of preventing increases in FM and avoiding overweight and obesity in older men and women.

Randomized double-blind controlled clinical trial of the blood pressure-lowering effect of fermented milk with Lactococcus lactis: A pilot study

The blood pressure-lowering effect of fermented milk with Lactococcus lactis NRRL B-50571 was evaluated in a double-blind randomized controlled clinical trial with prehypertensive subjects. Participants were randomized into 2 groups (n = 18 each group): one group treated with fermented milk with Lactococcus lactis NRRL B-50571 and a control group treated with artificially acidified milk. Results revealed that during daily consumption of fermented milk for 5 wk, systolic [(116.55 ± 12.26 mmHg vs. 124.77 ± 11.04 mmHg) and diastolic blood pressure (80.7 ± 9 vs. 84.5 ± 8.5 mmHg)] from the fermented milk group was lower than the control group. Additionally, triglyceride, total cholesterol, and low-density lipoprotein in blood serum were lower in the fermented milk group than in the control group. Results demonstrated that daily consumption of fermented milk with Lactococcus lactis (NRRL B-50571) had a blood pressure-lowering effect on prehypertensive subjects. Regular consumption of this product may be used as a potential functional food.

Translational study of obesity management using the Diabetes Prevention Program "Group Lifestyle Balance" in primary care clinics and public hospitals from Mexico: study protocol

Introducción: La obesidad es el principal factor de riesgo para el desarrollo de enfermedades crónicas en México. Varios ensayos clínicos controlados han mostrado que los programas intensivos de cambio de estilo de vida son eficaces para el manejo de obesidad. Estos programas incluyen sesiones frecuentes (14 o más los primeros 6 meses), centradas en hacer mejoras en la dieta y actividad física utilizando un protocolo de cambio de comportamiento. Sin embargo, la mayoría de clínicas de primer nivel y los hospitales públicos aplican tratamientos tradicionales para el manejo de obesidad que tienen resultados limitados. El propósito del estudio es evaluar la efectividad del Programa de Prevención de Diabetes “Grupo de Equilibrio de Estilo de Vida” sobre la pérdida de peso en adultos con sobrepeso y obesidad del inicio a 6 meses y del inicio a 12 meses del seguimiento en clínicas de primer nivel y hospitales públicos de Sonora, México.Material y Métodos: Este es un estudio clínico multicéntrico traslacional, no controlado con diseño pre y post-prueba a 6 y 12 meses. Los proveedores de salud de dos clínicas de primer nivel, dos hospitales públicos y una clínica universitaria serán entrenados con el protocolo del Programa de Prevención de Diabetes, para implementarlo en sus pacientes adultos con sobrepeso y obesidad. Se medirá el peso corporal, índice de masa corporal, circunferencia de cintura, presión sistólica y diastólica, así como escalas de depresión, calidad de vida y estrés, al inicio, 6 y 12 meses. Los parámetros bioquímicos se medirán al inicio y a los 12 meses. La variable de desenlace primaria será el cambio de peso a 6 y 12 meses.Discusión: Este estudio proveerá evidencia científica de la efectividad del protocolo del Programa de Prevención de Diabetes como un modelo para el manejo de obesidad en adultos mexicanos en condiciones de la práctica clínica del mundo real.

Effect of the Holiday Season on Weight Gain: A Narrative Review

Several studies suggest that the holiday season, starting from the last week of November to the first or second week of January, could be critical to gaining weight. This study aims to review the literature to determine the effects of the holidays on body weight. In studies of adults, a significant weight gain was consistently observed during this period (0.4 to 0.9 kg, p < 0.05). The only study in college students found an effect on body fat but not on weight (0.1 kg, p = 0.71). The only study found in children did not show an effect on BMI percentile (-0.4%, p > 0.05) during this period. Among individuals with obesity who attempt to lose weight, an increase in weight was observed (0.3 to 0.9 kg, significant in some but not in all studies), as well as increase in weight in motivated self-monitoring people (0.4 to 0.6%, p < 0.001). Programs focused on self-monitoring during the holidays (phone calls and daily mailing) appeared to prevent weight gain, but information is limited. The holiday season seems to increase body weight in adults, even in participants seeking to lose weight and in motivated self-monitoring people, whereas in children, adolescents, and college students, very few studies were found to make accurate conclusions.

Antineoplastic treatment effect on bone mineral density in Mexican breast cancer patients

BACKGROUND

Breast cancer is the most deadly malignancy in Mexican women. Although treatment has improved, it may significantly affect bone mineral status in those who receive it. The aim of this study was to assess the impact of cancer treatment on bone mineral density (BMD) and bone mineral content (BMC), in patients with breast cancer and explore the interaction of menopausal status and clinical stage with cancer treatment on such changes.

METHODS

A quasi-experimental design was applied with measurements before and after a chemotherapy treatment in 40 patients with primary diagnosis of invasive breast cancer. BMD and body composition measurements were taken by dual X-ray absorptiometry (DXA) and changes in these variables due to therapy were analyzed using mixed regression for repeated measurements.

RESULTS

Significant loss was found in femoral neck and L2-L4 BMD (p < 0.001). Patients diagnosed with osteopenia or osteoporosis received calcium + vitamin D supplementation (600 mg/200 IU day). It showed a protective effect in the decrease of femoral neck BMD and total BMC. BMD loss in both femoral neck and L2-L4 BMD was higher in premenopausal women: 0.023 g/cm² in femoral neck and 0.063 g/cm² in L2-L4 (p < 0.001), while in postmenopausal women BMD loss was 0.015 g/cm² in femoral neck and 0.035 g/cm² in L2-L4 (p = 0.021 and p = 0.001 respectively). Change in lumbar spine BMD was prominent in premenopausal women with advanced clinical stage (IIB, IIIA, IIIB): 0.066 g/cm² (p = 0.003).

CONCLUSION

The antineoplastic breast cancer treatment with chemotherapy had a negative impact on BMD, in premenopausal women overall, although a differential effect was found according to clinical stage and calcium supplementation status.

Vitamin A-fortified milk increases total body vitamin A stores in Mexican preschoolers

Vitamin A (VA) deficiency (VAD) continues to be a major nutritional problem in developing countries, including Central America. In Mexico, milk is a well-accepted vehicle for the administration of micronutrients, including VA, to preschoolers. Thus, we conducted a randomized, controlled, clinical trial to investigate the efficacy of daily consumption of 250 mL of VA-fortified milk (which provided 196 retinol equivalents/d) for 3 mo on VA stores in mildly to moderately VAD (serum retinol concentration 0.35-0.7 μmol/L) preschoolers who were not enrolled in a food assistance program. Twenty-seven mildly to moderately VAD children were randomly assigned based on screening measurements to either the intervention (n = 14) or control group (n = 13) (children in the control group did not receive placebo). All children in the control group and 79% (n = 11) of the children in the intervention group completed the study. The total body VA (TBVA) pool size was estimated using the deuterated retinol dilution technique before and after the intervention. After 3 mo, median changes in the serum retinol concentration for the intervention and control groups were 0.13 and -0.21 μmol/L, respectively (P = 0.009). Median changes in the TBVA stores were 0.06 and 0.01 mmol, respectively (P = 0.006) and estimated median changes in the liver VA concentration were 0.09 and 0.01 μmol/g, respectively (P = 0.002). The VA-fortified milk was well accepted among preschoolers and significantly increased TBVA stores, liver VA stores, and serum retinol concentration, indicating that it may be an effective means to ameliorate VAD in young Mexican children.

[Improvement of insulin sensitivity after an intensive lifestyle program for youth's weight management in the primary care]

The aim of this study was to evaluate an intensive lifestyle intervention for weight management among youth in a primary care setting on insulin sensibility, compared to a control group. The study included 42 youths 9-17 years old (n=23 intensive lifestyle intervention, n=19 control group) who completed a randomized trial for weight management in a primary care setting which included an oral glucose tolerance test. The intensive lifestyle intervention included monthly consultations with the primary care physician, nutrition counseling with a registered dietitian (weekly first 3 months and then monthly) and 12 group sessions in a behavioral change protocol. The control group attended monthly consultations with the primary care physician. Insulin sensitivity was estimated by the Insulin Sensitivity Index ISI(0,120) at baseline and 6 months posttreatment. At 6 months, the mean +/- DE, increase in insulin sensitivity was greater in the intensive lifestyle intervention than the control group (+46.8 +/- 56 vs. +5.6 +/- 47, between-group difference 41.2 [CI 95%, 8.5, 73.9], p = 0.01): Sixty five percent of youths on the intensive lifestyle intervention increased insulin sensitivity over 9 units vs. 32% in the control group (p=0.03). This study shows preliminary evidence that an intensive lifestyle intervention program can be an alternative model to improve insulin sensitivity among youths in the primary care setting.

Physiological effects beyond the significant gain in muscle mass in sarcopenic elderly men: evidence from a randomized clinical trial using a protein-rich food

BACKGROUND

Sarcopenia is strongly associated with an inadequate intake of dietary protein. Dietary protein supplementation boosts muscle-protein synthesis and increases muscle mass in the elderly. This study tested whether adding a protein-rich food, ricotta cheese, to the habitual diet increased total appendicular skeletal muscle mass and strength in elderly people.

METHODS

Participants (n = 40), were sarcopenic elderly men and women over 60 years of age. Two comparison groups were formed at random and followed for 3 months: the intervention group received 210 g/day of ricotta cheese plus the habitual diet, while the control group followed the habitual diet with no additional intervention. Total appendicular skeletal muscle (TASM) was assessed by dual-energy X-ray absorptiometry, while strength was measured using a handheld dynamometer at baseline and after the intervention period. The primary outcomes were the percentage of relative change in TASM and strength.

RESULTS

The percentage of relative change in TASM was not significant between the groups after the intervention period. Muscle strength improved in the intervention group, but showed only a tendency towards significance (P = 0.06). Secondary analysis showed that the men in the intervention group gained 270 g in TASM compared to those in the control group, and improved their fasting insulin levels (P = 0.05), muscle strength, lean body mass in the arms, and body weight variables.

CONCLUSION

The results of this study indicate that a nutritional intervention using a high-quality protein food, specifically ricotta cheese, in order to increase the amount of protein intake might not be regarded as fully promising in elderly men and women with sarcopenia. However, the gender effects on muscle strength, lean tissue in the arms, homeostatic assessment of insulin resistance, and body weight detected in this study suggest that additional research is needed on elderly male subjects with sarcopenia.

Prediction of fat-free mass by bioelectrical impedance analysis in older adults from developing countries: a cross-validation study using the deuterium dilution method

OBJECTIVE

Several limitations of published bioelectrical impedance analysis (BIA) equations have been reported. The aims were to develop in a multiethnic, elderly population a new prediction equation and cross-validate it along with some published BIA equations for estimating fat-free mass using deuterium oxide dilution as the reference method.

DESIGN AND SETTING

Cross-sectional study of elderly from five developing countries.

METHODS

Total body water (TBW) measured by deuterium dilution was used to determine fat-free mass (FFM) in 383 subjects. Anthropometric and BIA variables were also measured. Only 377 subjects were included for the analysis, randomly divided into development and cross-validation groups after stratified by gender. Stepwise model selection was used to generate the model and Bland Altman analysis was used to test agreement.

RESULTS

FFM = 2.95 - 3.89 (Gender) + 0.514 (Ht2/Z) + 0.090 (Waist) + 0.156 (Body weight). The model fit parameters were an R2, total F-Ratio, and the SEE of 0.88, 314.3, and 3.3, respectively. None of the published BIA equations met the criteria for agreement. The new BIA equation underestimated FFM by just 0.3 kg in the cross-validation sample. The mean of the difference between FFM by TBW and the new BIA equation were not significantly different; 95% of the differences were between the limits of agreement of -6.3 to 6.9 kg of FFM. There was no significant association between the mean of the differences and their averages (r= 0.008 and p= 0.2).

CONCLUSIONS

This new BIA equation offers a valid option compared with some of the current published BIA equations to estimate FFM in elderly subjects from five developing countries.

Prevalence of malnutrition and associated metabolic risk factors for cardiovascular disease in older adults from Northwest Mexico

This cross-sectional study assessed the prevalence of malnutrition and several metabolic risk factors for cardiovascular disease in 287 apparently healthy older adults from Northwest Mexico. Also, the impact of overweight and obesity on metabolic risk factors was assessed. Nutritional status was determined using serum albumin levels and anthropometry. Vitamin status was also assessed. Metabolic risk factors for cardiovascular disease were evaluated. The prevalence of undernutrition was 15.3%. Also, vitamin E deficiency was common (18%). On the contrary, 44.9% of men and women were in overweight and 24% were obese. A 50.9% of the older adults had hypertension, 52.6% hypercholesterolemia (HC), 38.3% hypertriglyceridemia (HTG), 26.1% impaired fasting glucose and 26.1% impaired glucose tolerance (IGT). HC and low-density-lipoprotein-cholesterol (LDL-C) were significantly more prevalent in women than in men. Mean adjusted values of fasting glucose, high-density-lipoprotein-cholesterol (HDL-C), total cholesterol (TC)/HDL-C ratio > or = 5, triglycerides (TG) and diastolic blood pressure (DBP) were significantly higher in subjects with body mass index (BMI) > or = 25.0 kg/m(2). Undernutrition, obesity and vitamin E deficiency, as well as several metabolic risk factors for cardiovascular disease coexisted in this studied group. Overweight and obesity were the most prevalent findings. BMI > or = 25 kg/m(2) was the common factor explaining most of the metabolic abnormalities. However, due to the sample size and the design of the study, the results must be seen with caution and cannot be generalized.

[Validity of an equation based on anthropometry to estimate body fat in older adults]

A prediction equation to estimate body fat mass from skinfold thickness for healthy elderly was developed using a four compartmental (4C) model as criterion method. This study included 202 subjects = 60 y old. The measurements of total body water, bone mineral content and body density were included in the 4C model equation. Total sample was randomly partitioned. Sub-sample one was used to design the equations, which were applied in sub-sample two. Its accuracy and precision was evaluated by lineal regression analysis and the bias by Bland and Altman analysis and simple lineal regression. The best model included body mass, sex and the calf and triceps skinfolds thicknesses, with an R2, standard error of the estimate and Cp of 0.85, 3.2 and 3.2, respectively. When the equation was applied in sub-sample two, it was accurate and precise, it showed no significant deviation from the line of identity (the intercept was no significantly different from zero, P>0.05), and slope was different from cero (or similar to 1) (P<0.05). Fat mass by the equation accounted for 86% of the variability of the mean fat mass estimated by the 4C model, having a low standard error of the estimate (3.2 kg) and low pure error (3.1 kg). The new equation was accurate and precise as well as free of significant bias in men and women together and for separately. This equation can be a good option to estimate fat mass in elderly men and women with similar physical characteristics to subjects of this study, and it can be used in clinical and epidemiological studies in this growing group.

Body fat measurement by bioelectrical impedance and air displacement plethysmography: a cross-validation study to design bioelectrical impedance equations in Mexican adults

BACKGROUND

The study of body composition in specific populations by techniques such as bio-impedance analysis (BIA) requires validation based on standard reference methods. The aim of this study was to develop and cross-validate a predictive equation for bioelectrical impedance using air displacement plethysmography (ADP) as standard method to measure body composition in Mexican adult men and women.

METHODS

This study included 155 male and female subjects from northern Mexico, 20-50 years of age, from low, middle, and upper income levels. Body composition was measured by ADP. Body weight (BW, kg) and height (Ht, cm) were obtained by standard anthropometric techniques. Resistance, R (ohms) and reactance, Xc (ohms) were also measured. A random-split method was used to obtain two samples: one was used to derive the equation by the "all possible regressions" procedure and was cross-validated in the other sample to test predicted versus measured values of fat-free mass (FFM).

RESULTS AND DISCUSSION

The final model was: FFM (kg) = 0.7374 * (Ht2 /R) + 0.1763 * (BW) - 0.1773 * (Age) + 0.1198 * (Xc) - 2.4658. R2 was 0.97; the square root of the mean square error (SRMSE) was 1.99 kg, and the pure error (PE) was 2.96. There was no difference between FFM predicted by the new equation (48.57 +/- 10.9 kg) and that measured by ADP (48.43 +/- 11.3 kg). The new equation did not differ from the line of identity, had a high R2 and a low SRMSE, and showed no significant bias (0.87 +/- 2.84 kg).

CONCLUSION

The new bioelectrical impedance equation based on the two-compartment model (2C) was accurate, precise, and free of bias. This equation can be used to assess body composition and nutritional status in populations similar in anthropometric and physical characteristics to this sample.

Body composition by the four-compartment model: validity of the BOD POD for assessing body fat in mexican elderly

OBJECTIVE

The aims of this study were to validate BOD POD in a wide sample of healthy and independent Mexican elderly men and women subjects using the 4 compartment (4C) model as the reference method, and to evaluate the assumptions of the densitometric two-compartment (2C) model.

DESIGN

Cross-sectional study designed to assess body composition and validation of a method based on 2C model (BOD POD).

SETTING

Urban and rural regions of Sonora, Mexico.

SUBJECTS

Two hundred and two free-living subjects >or=60 years old were completed in this study.

METHODS

Body density and body fat were measured by the BOD POD, total body water by deuterium dilution and total body bone ash by dual energy X-ray absorptiometry. Body composition was determined using Baumgartner's equation.

RESULTS

Percent body fat by the 4C model was 31.2 and 42.5% in men and women, respectively (P<0.001). Group mean accuracy of body fat by BOD POD against that of the 4C model showed an effect of sex (P<0.001), but not the method (P=0.27). Results of individual accuracy showed no significant difference with the identity line and the slope was significantly different from zero or a slope similar to one. Precision assessed by model R (2) was high for all subjects and for men and women by separate. The standard error of the estimate was low for all and for men and women by separate. Bland and Altman analysis showed no significant bias.

CONCLUSION

The BOD POD technique is a valid and reliable method compared to the 4C model and it could be applied in subjects with similar physical and anthropometric characteristics to subjects of this study.

[Vitamin B12 and folate in non-institutionalized urban older people]

Vitamin B12 and folate deficiencies are the main nutritional determinants of hyperhomocysteinemia, which is an independent risk factor for cardiovascular diseases. There is scarce information about nutritional status on vitamin B12 and serum levels of folate in Mexican older people. The objective was to evaluate the nutritional status of vitamin B12 and folic acid concentration in non-institutionalized, urban elderly men and women subjects. One hundred volunteers over 60 years were included in this cross-sectional study. Serum levels of vitamin B12 and folate were measured. In addition some biochemical and anthropometric indicators were also evaluated. Considering serum values of vitamin, 30% had vitamin B12 deficiency, 52% normal status and 18% with high levels. None subjects had folic acid deficiency, by the contrary, a high proportion (62%) showed elevated levels in serum. There was an effect of sex on vitamin B12 status. Elderly men showed significantly lower levels of vitamin B12, and it was according with significant higher prevalence of vitamin B12 deficiency in this group as compared with the women group. The high proportion of vitamin B12 deficiency found in this study underline a possible public health problem and guarantee further survey-studies about vitamin B12 status and to explore causes and consequences of the deficiency. Finally, due the sample size and the design of the study, the results must be seen with caution and not try to generalize.

[Anthropometry and body composition in persons over 60. The importance of physical activity]

OBJECTIVE

To measure anthropometric indicators of body composition by electric bioimpedence, as well as physical activity, blood glucose and arterial pressure in rural people over 60 years of age.

MATERIAL AND METHODS

A total of 54 subjects over 60 years old were selected by intentional non-probabilistic sampling. They were subjected to a standardized protocol to measure anthropometric indicators, body composition by electric bioimpedance (EBI), and physical activity was determined by an activity questionnaire. Arterial pressure and glucose tolerance levels were also measured. Analysis included Student's t test to detect differences by sex and the association of physical activity, body composition and other variables by simple linear regression and Pearson's correlation coefficient.

RESULTS

Physical activity correlated negatively with percent fat (r = -0.36; p = 0.007) and diastolic (r = -0.36; p = 0.006) and systolic blood pressure (r = -0.32; p = 0.018), and body mass index with post dose glucose (r = 0.31; p = 0.024).

CONCLUSIONS

Physical activity in this age group may have a favorable impact with respect to the mentioned health indicators.