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Obesity affects an important part of Chilean society, particularly women from poorer sectors. However, physical exercise programs and devices to reduce overweight have been ineffective due to cultural factors, which are aggravated due to emotional problems. Sexual performance in this group is a decisive factor in the connivance of couples and is an important reason for divorce. The difficulty of giving and receiving pleasure due to overweight, deepens the problem and maintains the vicious circle of “depression-overeating-sedentary lifestyle-obesity-divorce”. On the other hand, sexual performance improves substantially with the strengthening of the pelvic wall, but the cultural factors of the group must be overcome, which prevent it; among them, archive results in the short term and with little effort, such as winning the lottery or being a successful footballer. In effect, these are some of the most valued ways to achieve success, where, in addition, soccer is a cultural reference and sexual symbol. This project, rooted in ethnography, proposes a change in the design strategy for wellness, through the emulation of a sexual relationship, so that the user receives immediate pleasure and exercises continuously, even as a collective activity.

El sobrepeso, la obesidad y el cáncer de mama constituyen tres patologías muy prevalentes en la actualidad y con gran impacto en la sociedad. Muchas investigaciones han intentado establecer una asociación entre esos procesos, circunstancias que aún se están estudiando. Objetivo de estudio: Verificar una asociación entre el sobrepeso y la obesidad de las mujeres con cáncer de mama y su relación con la edad de diagnóstico. Material y métodos: Se estudiaron 118 mujeres diagnosticadas de cáncer de mama con edades comprendidas entre 32 y 76 años. Todas diagnosticadas y tratadas de cáncer de mama entre los años 2009 y 2011 en el centro Oncológico de ISSEMyM de México. Se realizó un estudio observacional, descriptivo y transversal. Se seleccionó la muestra aleatoria n = 60 con mujeres divididas en dos grupos. El grupo 1 con diagnóstico de cáncer de mama y normopeso. El grupo 2 fueron mujeres diagnosticadas de cáncer de mama y presentaban sobrepeso y obesidad. Se utilizó en ambos grupos la EGS-GP (Evaluación Global Subjetiva Generada por el Paciente) y se determinó el IMC (peso y estatura) y la circunferencia de cintura. Resultados: Se estableció una relación estadísticamente significativa entre la edad de diagnóstico, dependiendo si la mujer presentaba normopeso, sobrepeso y obesidad (p < 0,05). Conclusiones: Los resultados obtenidos de este estudio muestran que el sobrepeso y la obesidad se encuentran íntimamente ligados con el cáncer de mama y la edad de diagnóstico. El diagnóstico se produce de una forma más temprana que en las mujeres con normopeso.Overweight, obesity, and breast cancer are three pathologies that are endemic in the world today and which have a great impact on society. Many research studies are currently trying to discover possible associations between these factors and to specify the links between them. Objective: To verify whether there is a direct connection between overweight/obesity in women with breast cancer and its relation to age of diagnosis. Materials and methods: The sample population in this study was composed of 118 women (32-76 years of age) who had been diagnosed and treated for breast cancer in 2009-2011 at the Centro Oncológico Estatal ISSEMyM [National Cancer Institute of Mexico]. An observational, descriptive, and transversal study was performed in which a random sample of n = 60 women was divided into two groups. The first group was composed of women with breast cancer, but who were of normal weight. The second group was composed of women with breast cancer, but who were either overweight or obese. In both groups, the Patient-Generated Subjective Global Assessment (PG-SGA) was applied, and the BMI (weight and height) was determined as well as waist circumference. Results: A statistically significant relation was found between age of diagnosis and weight (normal/overweight/obese) of the subjects (p < 0.05). Conclusions: The results obtained show that overweight and obesity are directly linked to breast cancer and age of diagnosis. Breast cancer was diagnosed earlier in women of normal weight.

La obesidad se ha convertido en un importante problema de salud pública en todos los países desarrollados. En las mujeres adquiere unas connotaciones ligeramente diferentes debido, además de a la mayor prevalencia, a que el bajo nivel socioeconómico es factor de riesgo sólo en la mujer. Además de ser factor de riesgo cardiovascular en la mujer se asocia a una aumento del riesgo de cáncer de mama y de endometrio y a poliquistosis ovárica e infertilidad. En las mujeres el control de peso tiene una fuerte motivación estética y presenta importantes componentes emocionales en relación con la comida. Por otra parte, la mujer es mayor consumidora de fármacos (anticonceptivos, analgésicos, antimigrañosos, ansiolíticos, antidepresivos), que parecen favorecer la obesidad. Queda por aclarar el papel que tienen en la patogénesis de la obesidad los cambios hormonales cíclicos, el embarazo, la ingesta de anticonceptivos orales y la menopausia. El efecto del tratamiento hormonal sustitutivo como causa de la ganancia de peso es dudoso.Obesity has become an important problem of public health in all developed countries. It has slightly different connotations in women because, apart from its greater prevalence, low socio-economic level is a risk factor solely for women. As well as a cardiovascular risk factor in women, it is associated with an increased risk of breast cancer, cancer of the endometrium, ovarian polycystosis and infertility. Weight control in women has a large aesthetic motivation and eating has considerable emotional components. On the other hand, women consume more drugs (contraceptives, painkillers, migraine treatments, anxiolytics, anti-depressants) which seem to favour obesity. The role played in the pathogenesis of obesity by cyclical hormonal changes, pregnancy, the consumption of oral contraceptives and the menopause remains to be clarified. The effect of replacement hormone therapy as a cause of weight gain is doubtful.

Background: The development of obesity is complex and multifactorial, with genetic, biological, environmental and lifestyle of each individual etiology. The different changes in metabolism of women, amongst other factors, lead to disorganization in the distribution of lipids, which gathered in large quantities within the viscera, increases cardiovascular mortality and it is a major determinant factor of the metabolic syndrome., Objective: To homologate and to apply concepts of evidence-based clinical practice in diagnosis and treatment of obesity in women in reproductive age and climacterium., Method: The experts' consensus was done by specialized physicians properly endocrinologists, gynecologists, surgeons, psychologists, nutrition specialists, physical activity and public health, according to their expertise and clinical judgment. The recommendations were based in diagnostic criteria aside from the level of evidence of previously established treatment guidelines, controlled clinical trials and standardized guides for women in reproductive age and climacterium with obesity., Results: The establishment of a nutritional intervention amongst other aspects of lifestyle is the first-line in the treatment of obesity. Current pharmacological treatments offer modest results in efficiency and security in weight reduction so these must go along with real changes in lifestyle in order to obtain better results in the short and long term., Conclusion: The high prevalence of overweight and obesity in our country, especially in women in reproductive age, compels us to pose and work in prevention strategies as well as diverse therapeutic plans favoring safe weight loss and results in the long term.

Unlabelled: Overweight, obesity, and breast cancer are three pathologies that are endemic in the world today and which have a great impact on society. Many research studies are currently trying to discover possible associations between these factors and to specify the links between them., Objective: To verify whether there is a direct connection between overweight/obesity in women with breast cancer and its relation to age of diagnosis., Materials and Methods: The sample population in this study was composed of 118 women (32-76 years of age) who had been diagnosed and treated for breast cancer in 2009-2011 at the Centro Oncológico Estatal ISSEMyM [National Cancer Institute of Mexico]. An observational, descriptive, and transversal study was performed in which a random sample of n = 60 women was divided into two groups. The first group was composed of women with breast cancer, but who were of normal weight. The second group was composed of women with breast cancer, but who were either overweight or obese. In both groups, the Patient-Generated Subjective Global Assessment (PG-SGA) was applied, and the BMI (weight and height) was determined as well as waist circumference., Results: A statistically significant relation was found between age of diagnosis and weight (normal/overweight/obese) of the subjects (p < 0.05)., Conclusions: The results obtained show that overweight and obesity are directly linked to breast cancer and age of diagnosis. Breast cancer was diagnosed earlier in women of normal weight.

Obesity has become an important problem of public health in all developed countries. It has slightly different connotations in women because, apart from its greater prevalence, low socio-economic level is a risk factor solely for women. As well as a cardiovascular risk factor in women, it is associated with an increased risk of breast cancer, cancer of the endometrium, ovarian polycystosis and infertility. Weight control in women has a large aesthetic motivation and eating has considerable emotional components. On the other hand, women consume more drugs (contraceptives, painkillers, migraine treatments, anxiolytics, anti-depressants) which seem to favour obesity. The role played in the pathogenesis of obesity by cyclical hormonal changes, pregnancy, the consumption of oral contraceptives and the menopause remains to be clarified. The effect of replacement hormone therapy as a cause of weight gain is doubtful.

Introduction More than 600 thousand people in Chile live with morbid obesity. Effective, safe, cost-effective therapeutic interventions are critical for healthcare systems and insurance schemes. In 2022, two bundled payment codes for bariatric surgery (gastric bypass and gastric sleeve) were incorporated into the National Health Fund's free-choice modality fee scheme. The objective was to characterize the execution of this payment mechanism program associated with bariatric surgery diagnosis in its first year of implementation.More than six hundred thousand people in Chile are estimated to live with morbid obesity. Effective, safe, cost-effective therapeutic interventions are critical for health systems and insurance schemes. In 2022, FONASA incorporated two Bariatric Surgery codes into the Free Choice Modality: Gastric Bypass and Sleeve Gastrectomy. Our objective was to characterize the execution of the Bariatric Surgery Bundled Payment Program in its first year of implementation. Methods Descriptive and observational study of the pragmatic approach of the national execution of the payment associated with diagnosis in bariatric surgery. We examined sociodemographic variables (sex, age brackets, and National Health Fund tranches) and characterization of surgeries by code broken down by public or private provider, period of issue, unit cost, co-payment, and medical loans between March and December 2022. Results We recorded n = 13 118 surgeries (45.81% bypass versus 54.19% sleeve), of which n = 2424 (18.48%) used medical loans. A total of 85.01% (p = 0.01) of the procedures were in women, in people between 35 and 39 years of age (20.15%), and 45.12% in beneficiaries of tranche B. Private providers performed a total of 99.21% of the surgeries. Ten accounted for 50% of the activity (range n = 1200 to 426 surgeries per year; n = 4.8 to 1.7 surgeries per working day). Total program expenditure was $71 626 948 350 CLP, accounting for 5.04% of the total activity of the national Diagnosis Associated Payment Program. Conclusions The implementation of this bariatric surgery voucher benefited more than 13 thousand people living with obesity, mostly women of productive ages and with purchasing capacity. As an equity strategy, regardless of the access route through the voucher, it will be important to safeguard the activity in the public network.

OBJECTIVE The objective of this study was to investigate the association between food assistance program participation and overweight/obesity according to poverty level. METHODS A cross-sectional analysis of data from 46,217 non-pregnant and non-lactating women in Lima, Peru was conducted; these data were obtained from nationally representative surveys from the years 2003, 2004, 2006, and 2008-2010. The dependent variable was overweight/obesity, and the independent variable was food assistance program participation. Poisson regression was used to stratify the data by family socioeconomic level, area of residence (Lima versus the rest of the country; urban versus rural), and survey year (2003-2006 versus 2008-2010). The models were adjusted for age, education level, urbanization, and survey year. RESULTS Food assistance program participation was associated with an increased risk of overweight/obesity in women living in homes without poverty indicators [prevalence ratio (PR) = 1.29; 95% confidence interval (CI) 1.06;1.57]. When stratified by area of residence, similar associations were observed for women living in Lima and urban areas; no associations were found between food assistance program participation and overweight/obesity among women living outside of Lima or in rural areas, regardless of the poverty status. CONCLUSIONS Food assistance program participation was associated with overweight/obesity in non-poor women. Additional studies are required in countries facing both aspects of malnutrition.

Gestational diabetes (GD) is a metabolic disorder characterized by maternal hyperglycemia that generates short-term and long-term maternal-fetal complications, both for the mother and the child. Early detection is essential to avoid these complications, being its diagnosis simple and accessible to the general population. The pregnant woman normally has fasting blood glucose levels lower than 85 mg / dl during the first trimester, so values above this level in this period of pregnancy are one of the risk factors associated with the development of GD. Lifestyle changes are essential to prevent this disease. Alertness among OB / GYN physicians is essential to carry out generalized screening of all pregnant women in weeks 24-28 or before this date if suspicion is high. The increasing increase in overweight and obesity in women of childbearing age together with excessive weight gain throughout pregnancy are risk factors for the development of this pathology. From the first trimester, it can be observed how these risk factors generate increases in the average of fasting blood glucose values. Furthermore, in these patients a greater predisposition to maternal hypertriglyceridemia is detected during the third trimester, which favors fetal macrosomia.

Adverse socioeconomic conditions in childhood can have lasting effects on health, but evidence is lacking from prospective studies concerning the effects of early poverty on abdominal obesity in adulthood. Cross-sectional studies in adults from middle and high-income countries show that current socioeconomic status is inversely related to obesity in women, but the pattern in men is not consistent. A systematic review was undertaken to assess the influence of early socioeconomic status on waist circumference, hip circumference, and waist-hip ratio in adulthood. Thirteen relevant articles were located (five cross-sectional and eight cohort), including only one from a middle-income country and the remainder from high-income settings. In all the studies, childhood poverty was associated with higher levels of abdominal obesity in women. In men, the associations were weaker, and no clear pattern emerged.Condições sócio-econômicas adversas na infância podem exercer efeitos duradouros sobre a saúde de adultos, mas são poucos os estudos longitudinais que avaliaram os efeitos sobre a obesidade abdominal. Estudos transversais em adultos de países de renda média e alta mostram uma associação inversa entre obesidade e posição sócio-econômica atual em mulheres, mas para os homens não se observa um padrão consistente. Entre homens e crianças de ambos os sexos não existe um padrão definido. Foi realizada uma revisão sistemática dos estudos que avaliaram a posição sócio-econômica precoce e o seu efeito na circunferência da cintura, a circunferência do quadril e/ou na razão cintura-quadril em adultos. Dos 13 trabalhos incluídos (cinco transversais e oito coortes), apenas um foi realizado em um país de renda média, sendo os demais provenientes de países de renda alta. Em todos os estudos, a pobreza na infância esteve associada com maiores níveis de obesidade abdominal em mulheres. Em homens, as associações foram de menor magnitude e não houve consistência entre os estudos em termos da direção do efeito da posição sócio-econômica.

Resumen: 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. Abstract: Objective: To analyze changes in blood glucose, insulin and triglyceride concentrations in relation to a moderate aerobic exercise in sedentary women of different body weight, exposed to either a high or low glycemic index carbohydrates diet. Diseño: Cross-over type. Site: Research was performed in the Exercise Physiology Laboratory at Facultad de Ciencias de la Cultura Física, Universidad Autónoma de Chihuahua, México. Participants: Twenty-six young sedentary women who did not exercise in the last year participated in the study. Four of adequate weight (AW) and 2 with obesity (OB) were excluded for not consuming the suggested carbohydrates (1 gr/kg of weight) nor completed the programed exercise. There were n = 10 in each group (AW/OB). Intervention: Two treatments of 55 minutes of aerobic exercise each were applied one day after consuming either high or low glycemic index carbohydrates. Main measurements: Plasmatic glucose, insulin, and triglycerides were determined before and after the scheduled exercise. Results: Glucose, insulin, and triglycerides were higher in OB than in AW at baseline. Glucose was normalized in OB from 5.8 ± 0.35 to 5.3 ± 0.23 mmol/L (P = .001), only by eating foods with low glycemic index; triglycerides increased from 139.5 ± 66.0 to 150.8 ± 67.2 mg/dl (P = .004) at the end of the exercise, after consumption of low glycemic index carbohydrates. Conclusion: Elevation of triglycerides secondary to exercise after consumption of low glycemic index seems to indicate an increase of lipid oxidation in OB. Palabras clave: Índice glucémico, Ejercicio aerobio, Obesidad, Mujeres jóvenes, Keywords: Glycemic index, Aerobic exercise, Obesity, Young women

The purpose of the study was to describe the composition and perception of body image in adult women. 300 women participated from 35 to 59 years of age. A convenience Sampling was used. Sociodemographic data was used, body mass index and body image perception questionnaire. The study showed that 36.3% on weight and 41.3% some type of obesity. Regarding perception, 16.7% was perceived in obesity, while 12% overestimated their condition in relation to the actual BMI, that is, 48% perceived to be overweight. 85% of the participants wanted to be placed in a normal BMI and only 22.3% presented this condition with respect to their actual BMI. For future studies it is recommended to include psychological variables to identify potential causes of overweight and obesity in women.

Objectives. To determine the prevalence of macrosomia and factors associated with it in Peru and to describe the occurrence of complications peri- and postpartum. Materials and Methods. Birth weights of children under the age of 5 years were analyzed using data from the 2013 Demographic and Family Health Survey (ENDES) carried out by the Instituto Nacional de Estadística e Informática. Children with a birth weight higher than 4000 g were considered macrosomic. A logistic regression analysis was used to establish the independent association of sociodemographic factors with macrosomia. Results. The sample comprised 6121 children. The prevalence of macrosomia was 5.3% (95% interval confidence: 4.8-5.9%). Being male, a higher birth order, maternal obesity, and greater maternal height were independently linked with macrosomia. Caesarean births were more common in macrosomic children than unaffected ones (43.9% vs 26.9%). Complications during birth and postpartum were common but not statistically linked with macrosomia. Conclusions. The prevalence of macrosomia in Peru is relatively low compared to other low-to-middle income countries. The factors associated with macrosomia were mainly unmodifiable, with the exception of maternal obesity. Macrosomic children were more frequently born by caesarean. Weight reduction and the prevention of obesity in women of childbearing age in Peru could potentially reduce macrosomia and caesarean rates.

Female obesity is one of the most worrying nutritional problems nowadays, with higher prevalence in women of low socioeconomic status. The social perception of the phenomenon of obesity has significantly changed throughout the ages. There is a contemporary subjection to culturally imposed and socially constructed physical standards, prevailing the aesthetic imperative that establishes thin and slender bodies as the standard to be achieved by all women. This becomes particularly perverse in low-income women because of the specific “food ethics” that guide their actions, according to which people should be educated to like everything, and to which the act of eating is valued more than the food itself. This article is justified by the importance of understanding the changes in the valued image of the female body, using studies of authors who address the problem of obesity in women of low socioeconomic status. The aim is to reflect on the contemporary subjection to culturally constructed physical standards and on how they affect low-income women. The findings reveal the suffering caused by body dissatisfaction that afflicts poor women, since the access to goods and services to transform the body is far from their financial possibilities. To deal with the frustration that inevitably sets in, the pleasure that is overly focused on food is exaggerated. It is the possibility that women find a way to express their frustration and at the same time ensure the enjoyment of immediate pleasure. DOI: 10.12957/demetra.2015.16117

Introduction: Retention of the weight gained during pregnancy or the weight gain postpartum has been associated with increased prevalence of obesity in women of childbearing age. Objective: To identify determinants of weight variation at 24 months postpartum in women from 2 towns in Bahia, Brazil. Methods: Dynamic cohort data of 325 adult women were collected for 24 months postpartum. Weight variation at 24 months postpartum was considered a response variable. Socioeconomic, demographic, reproductive, related with childbirth variables and lifestyle conditions were considered exposure variables. A linear mixed-effects regression model with a hierarchical approach was used for data analysis. Results: Suitable sanitary conditions in the household (2.175 kg; p = 0.001) and participation social programs for income transfer (1.300 kg; p = 0.018) contributed to weight gain in distal level of determinants, while at intermediate level, pre gestational overweight and surgical delivery had effects on postpartum weight, causing an average increase of 3.380 kg (p < 0.001) and loss of 2.451 kg (p < 0.001), respectively. At proximal level, a score point increase for breastfeeding yielded an average post-partum loss of 70 g (p = 0.002). Conclusion: Our results indicate the need to promote weight control during and after pregnancy, encourage extended breastfeeding, and improve living conditions through intersectoral interventions.

Background: Food availability and dietary intake are thought to contribute to rising obesity among women of low socioeconomic status in Latin America. In Costa Rica, few studies have investigated food availability, dietary intake, or how they vary by SES. Objectives: The purpose of this study in San José, Costa Rica was to (1) evaluate women’s perceptions of food availability and, (2) describe dietary intake in women from low- and high-SES areas of the city. Methods: Thirty non-pregnant, non-lactating women between 25 and 50 years were recruited in March 2013 from a low- and high-SES canton. Structured, qualitative interviews assessed perceptions of food availability in 17 of the 30 women. Quantitative 24-hour dietary recalls assessed dietary intake in all 30 women. Results: Many women from the low-SES canton reported that they would include more chicken and fish in their diet if cost were not a barrier. Protein intake as a proportion of total energy intake was significantly greater in women from the high- versus low-SES canton (17% SD=5 vs. 13 SD=3, p = 0.02). Protein intake from animal source foods was significantly greater in women from the high-SES canton (38 g SD=22 vs. 21 SD=11, p = 0.02). Conclusion: Protein intake was greater in high-SES women and this may be due to the perceived cost of animal source foods.

Antecedentes: La obesidad en mujeres en edad reproductiva es cada vez más frecuente y complica el embarazo aumentando el riesgo de enfermedades como la diabetes mellitus gestacional (DMG). Objetivo: Determinar el riesgo de presentar DMG e intolerancia a la glucosa (ITG) de acuerdo con el índice de masa corporal pregestacional (IMCPG). Método: Muestra de 489 pacientes, se clasificaron por IMCPG y se les realizó una curva de tolerancia oral a la glucosa (CTOG) de 100 g de 120 minutos. Se definió DMG con dos valores alterados en la CTOG e ITG con un solo valor alterado. Se aplicó prueba de chi cuadrada para determinar diferencia entre grupos y se obtuvo un Odds Ratio (OR), con intervalo de confianza del 95%. Resultados: 9 pacientes con bajo peso, 194 con peso normal, 158 con sobrepeso y 128 con obesidad, edad gestacional promedio 31,3 ± 5,6 semanas. El 13% de las pacientes presentaron DMG, el 10,6% ITG. Las mujeres con sobrepeso presentaron un OR de 3,81 para desarrollar ITG (IC95% 1,62-8,95) y un OR de 3,7 para DMG (IC95% 1,65-8,38), mientas que las pacientes con obesidad pregestacional presentaron un OR de 6,6 para desarrollar ITG (IC95% 2,83-15,66) y un OR de 8,8 para DMG (IC95% 4,05-19,51), comparadas con mujeres con peso pregestacional normal. Conclusión: La población mexicana tiene mayor riesgo de DMG que otras poblaciones y mayor prevalencia de sobrepeso y obesidad, por lo que se debe realizar un diagnóstico y tratamiento oportuno de DMG, previniendo complicaciones y diabetes mellitus tipo 2.Background: Obesity in women in reproductive age is becoming more frequent and it self complicates preg-nancy increasing the risk of diseases such as gestational diabetes mellitus (GDM). Aims: To determine the risk of gestational diabetes mellitus (GDM) and impaired glucose tolerance (IGT) according to the pregestational body mass index (PGBMI). Methods: Sample of 489 patients, they were classified by PGBMI and underwent an oral glucose tolerance test (OGTT) with 100 g of glucose during 120 minutes. GDM was defined with two altered valúes in the OGTT and IGT with a single altered value. A chi-square test was applied to determine difference between groups, and we obtained an Odds Ratio (OR), with a confidence level of 95%. Results: 9 patients were low weight, 194 normal weight, 158 overweight and 128 obese, average gestational age 31.3 ± 5.6 weeks. 13% of the patients had GDM, 10.6% had IGT. Overweight women had an OR of 3.81 of developing IGT (95% Cl 1.62-8.95) and an OR of 3.7 of developing GDM (95% Cl 1.65-8.38), while women with prepregnancy obesity showed an OR of 6.6 of developing ITG (95% Cl 2.83-15.66) and an OR of 8.8 of developing GDM (95% Cl 4.05-19.51), all compared to women with prepregnancy normal weight. Conclusions: Mexican population has a higher risk of GDM than other populations and also a higher prevalence of overweight and obesity, so that every pregnant woman should be screening for GDM, has a diagnosis and receive treatment, preventing complications and Type 2 Diabetes.

Aim: We aim was to compare the sagittal abdominal diameter (SAD) with waist circumference (WC) as a predictor of central obesity among adults and to identify the sensitivity and specificity of the best cut-off point for SAD. Methods: A cross-sectional study of 266 Brazilians adults (euthrophic and overweight), aged 31-84 years old, of which 89 men and 177 women, was carried out. Anthropometric measurements such as SAD, weight, height, waist and hip circumferences, waist and hip ratio, body mass index, body fat percentage were performed. Receiver Operating Characteristics (ROC) curve was used to identify the sensitivity and specificity of the best cut off point for SAD as a predictor of central obesity. Statistical analysis were considered significant with a value of p < 0.05. Results: The SAD measurement was positively correlated with WC for both genders, although stronger among overweight and obesity women (r = 0.71; p < 0.001 and r = 0.79; p < 0.001, respectively) than men. ROC curves identified the best cut-off points for SAD of 23.1 cm and 20.1 cm for men and women (96% and 85% sensitivity, 86% and 84% specificity, respectively). Conclusion: SAD measurement may be used as an anthropometric tool to identify central obesity among women for presenting adequate sensitivity and specificity.Objetivo: Nuestro objetivo es comparar el diámetro abdominal sagital (DAS) con la circunferencia de la cintura (CC) como predictor de la obesidad central entre los adultos y para determinar la sensibilidad y la especificidad de la mejor punto de corte para el DAS. Métodos: Estudio transversal de 266 adultos brasileños (eutróficos y con sobrepeso), de entre 31-84 años de edad, de los cuales 89 hombres y 177 mujeres, se llevó a cabo. Las medidas antropométricas como la DAS, peso, talla, circunferencia de la cintura y cadera, relación cintura-cadera, índice de masa corporal, porcentaje de grasa corporal se llevaron a cabo. Receiver Operating Characteristics (ROC) curva se utilizó para determinar la sensibilidad y la especificidad del mejor punto de corte para el DAS como predictor de la obesidad central. El análisis estadístico se consideró significativo un valor de p < 0,05. Resultados: La medición del DAS se correlacionó positivamente con CC para ambos sexos, aunque más fuerte entre las mujeres con sobrepeso y obesidad (r = 0,71, p < 0,001, r = 0,79, p < 0,001, respectivamente) que los hombres. De curvas ROC identificado las mejores puntos de corte para el DAS de 23.1 cm y 20.1 cm para los hombres y mujeres (96% y el 85% de sensibilidad, 86% y el 84% de especificidad, respectivamente). Conclusión: La medición DAS puede ser utilizada como una herramienta antropométrica para identificar la obesidad central entre las mujeres para la presentación de la sensibilidad y especificidad adecuadas.

Avaliou-se a ingestão alimentar de 24 horas de um dia típico, mediu-se a massa corporal e a estatura e estimou-se o gasto energético em uma amostra probabilística de adultos de Niterói, Rio de Janeiro, Brasil. Os resultados mostraram que a ingestão energética média foi de 1.570,9 (24,1) e 2.188,8 (46,1) kcal.dia-1 para mulheres e homens, respectivamente. O gasto energético foi maior nos obesos do que nos indivíduos com massa corporal normal. O balanço energético medido (ingestão energética - gasto energético) diminuiu com o aumento do índice de massa corporal, sendo negativo (-3,2; 131 kcal.dia-1) nos homens obesos. Concluiu-se que a ingestão alimentar da população adulta de Niterói encontra-se dentro do recomendado, apesar da prevalência de pré-obesidade e obesidade ser alta. Ao se estratificar a ingestão energética pelo estado nutricional nota-se menor ingestão para os indivíduos com maior massa corporal, fato mais evidente nas mulheres (possível subestimativa da ingestão energética), o que pode ser explicado, em parte, pela superestimativa no cálculo do gasto energético ou pela omissão da ingestão energética por parte dos indivíduos.This study aimed to assess typical daily dietary intake and energy expenditure in a probabilistic sample of adults in the city of Niterói, Rio de Janeiro State, Brazil. Dietary intake was measured by 24-hour dietary recall, body mass and height were measured in the household, and energy expenditure was estimated by the Flex-heart rate method. The results showed mean energy intake of 1,570.9 (24.1) and 2,188.8 (46.1) kcal.day-1 for women and men, respectively. Energy expenditure was higher in obese women and men (1,511.5±19.5 and 2,222.3±68.8 kcal.day-1, respectively) due to their higher body mass. Measured energy balance (intake - expenditure) decreased with increasing body mass index (BMI) in both women and men and was negative (-3.2; 131 kcal.day-1) in obese men. In conclusion, energy intake among adults in Niterói falls within the recommended values, despite high prevalence of overweight and obesity in women and men. Energy intake decreased with increasing body mass, indicating possible overestimation of energy expenditure. It is important to develop better estimates of energy expenditure in this population.

O objetivo desta pesquisa foi verificar a freqüência de obesidade central e generalizada e sua associação com perfil lipídico e hábitos de vida em idosos hipertensos, cadastrados no Sistema HiperDia em Campina Grande, Paraíba, Brasil. Trata-se de um estudo transversal, comparativo e associativo realizado em uma população de 131 sujeitos (60 a 92 anos), os quais foram divididos em grupos, por sexo; masculino (n=34) e feminino (n=97), e por idade; 60 a 69 (n=59), 70 a 79 (n=58) e = 80 (n=14). Foram realizadas avaliações bioquímicas e antropométricas e entrevista contendo informações sobre diagnóstico médico, dados sócio-econômicos, demográficos e hábitos de vida. Utilizou-se estatística descritiva e na análise comparativa, Teste t de Student ou ANOVA One-Way. Para associação utilizou-se o Teste Exato de Fisher ou Qui-quadrado. Dos entrevistados, 75,8% eram sedentários. Entre os homens, a freqüência de sobrepeso foi de 14,7% e de obesidade de 11,8%, já entre as mulheres, de 24,7% e 21,6%, respectivamente. Na análise da Relação-Cintura-Quadril - RCQ observou-se que 76,3% das mulheres e 26,5% dos homens apresentaram valores acima dos recomendados. Para a Circunferência da Cintura - CC, 95,9% das mulheres e 52,9% homens mostraram risco elevado. A Circunferência Abdominal - CA de 95,9% das mulheres e 38,2% dos homens apresentou valores de indicativos de risco. Somente os homens apresentaram associação estatisticamente significativa da RCQ e CA com Índice de Massa Corpórea (= 30 Kg/m2), indicando obesidade centralizada (p=0.0480) e (p=0.0040), respectivamente. Os resultados apontam uma alta freqüência de sobrepeso e obesidade centralizada associada com sedentarismo.The objective of this study was to verify the frequency of central and generalized obesity and its association with lipid profile and lifestyle in hypertensive elders enrolled in HiperDia System in Campina Grande, Paraíba, Brazil. This cross-sectional comparative and associative study was performed on a sample of 131 hypertensive elders (range: 60 to 92 years). They were divided into groups by sex (masculine) n=34 and (feminine) n=97, and by age (60 to 69) n=59, (70 to 79) n=58 and (= 80) n=14. Anthropometric and biochemical assessments and interviews containing information about medical diagnosis and socioeconomic, demographic, and lifestyle characteristics were performed. A descriptive statistics analysis was used and in the comparative analysis we used Student´s t test or One-way Anova. To the association we used Fisher´s Exact test or Chi-square test. Seventy-five point eight percent of who were interviewed were sedentarians. Men showed frequencies of 14.7% of overweight and 11.8% of obesity, and women showed frequencies of 24.7% and 21.6%, respectively. In the Waist-to-hip ratio - WHR analysis it was observed that 76.3% of women and 26.5% of men showed inadequate values. Considering the Waistline measurement - WM, 95.9% of women and 52.9% of men showed high risk. Considering the Abdominal circumference - AC, 95.9% of women and 38.2% of men showed values that indicated risk. Only men showed significative association between WHR, AC and Body Mass Index = 30 Kg/m2, that indicated central obesity, (p=0.0480) and (p=0.0040), respectively. Results point to a high frequency of overweight and central obesity associated with sedentarism.

Foi realizado um estudo transversal de base populacional com uma amostra representativa de 981 mulheres de 20 a 60 anosresidentes no sul do Brasil para investigar o efeito de fatores socioeconômicos, demográficos e do estilo de vida na ocorrência deobesidade abdominal. Adiposidade abdominal foi avaliada através da circunferência da cintura (CC) em centímetros (cm). Para descrevera amostra CC foi agrupada em três categorias: adequada (CC < 80 cm), adiposidade abdominal nível I (circunferência da cintura: 80 = CC = 87,9 cm) e adiposidade abdominal nível II (circunferência da cintura: CC = 88 cm) - considerada como obesidade abdominal. Para as outras análises, CC foi tratada como dicotômica: ausência ou presença de obesidade abdominal, respectivamente, CC < 88 cm e CC = 88 cm. A análise multivariada foi realizada com Regressão de Poisson. As prevalências de adiposidade abdominal foram 23% (IC95%: 20,5-25,8) e 23,3% (IC95%: 20,7-26,0), respectivamente, nível I e nivel II. Ter baixa escolaridade, não estar trabalhando, idade superior a 40 anos, história de obesidade familiar e estar casada/união foram fatores de risco para obesidade abdominal. Houve maior risco também para a presença de hipertensão arterial (Prevalence Ratio - PR=2,06; CI95%: 1,58-2,69) e mulheres com maior número de filhos (PR=1,17; CI95% 1,00 - 1,37). Menarca tardia, aos 12-13 anos e aos 14 anos, foi fator protetor para obesidade abdominal comparada com mulheresque tiveram menarca entre 8 e 11 anos de idade, respectivamente,proteções de 31% e 46%. A compreensão de como a obesidade abdominal se distribui na população permite o planejamento de ações mais efetivas para a redução deste relevante problema de nutrição e saúde públicaThe objective of this study was to investigate the risk factors associated with abdominal obesity in women. A cross-sectional population based study was carried out on 981 women aged 20 to 60 years living in Southern Brazil. Abdominal adiposity was assessed by waist circumference (WC) = 88 cm. Poisson regression models were used to obtain prevalence ratios (PR) and their confidence intervals. The abdominal obesity prevalence was 23,3% (IC95%: 20,7-26,0). The main factors associated with the outcome were: having low education level, being unemployed, being more than 40 years old, having family obesity history, and being married. Adjusted analyses showed increased obesity prevalence in hypertensive women (Prevalence Ratio - PR=2,06; CI95%: 1,58 - 2,69) and those having higher number of children (PR=1,17; CI95% 1,00 - 1,37). Later menarche, at 12-13 years and at 14 years of age, protected against obesity comparing to women with earlier menarche at 8-11 years, respectively, 31% and 46% of protection. The understanding of how the abdominal obesity is distributed among the population allows effective planning and action implementation towards the reduction rates of this nutritional and public health problem.

A household survey was conducted to assess the nutritional status of the adult population in Niterói, Rio de Janeiro, Brazil. In the selected households, all adults (³ 20 years) had their body mass and stature measured. Body mass index (BMI) was used to determine the nutritional status according to the World Health Organization classification. The population estimates showed low prevalence of underweight (BMI < 18.5kg/m²), while 45.8% of women and 49.6% of men were overweight/obese (BMI ³ 25kg/m²). Obesity prevalence varied from 5.6% to 19.3% in men and from 9.6% to 21.3% in women, according to age. The prevalence of overweight/obesity was not associated with income (in either men and women) or schooling (in men), but there was an inverse relationship between schooling and overweight/obesity in women. The prevalence of underweight decreased with increasing mean income in the census enumeration area. The authors conclude that overweight/obesity is the most prevalent nutritional disorder in both men and women in Niterói. This pattern resembles recent results for the adult population in Southeast Brazil as a whole, where Niterói is located.A avaliação do estado nutricional antropométrico, através do índice de massa corporal (IMC), foi realizada a partir de inquérito domiciliar com amostra probabilística da população adulta de Niterói, Rio de Janeiro, Brasil. Nos domicílios selecionados, moradores com idade ³ 20 anos tiveram a massa corporal e a estatura medidas no próprio domicílio. As estimativas para a população mostraram baixa prevalência de baixo peso (IMC < 18,5kg/m²) enquanto 45,8% das mulheres e 49,6% dos homens tinham excesso de massa corporal (IMC ³ 25kg/m²). Houve tendência a um gradiente na prevalência de baixo peso dos setores censitários de menor para os de maior renda. A prevalência do excesso de massa corporal não apresentou tendência evidente em função da renda ou escolaridade nos homens, mas houve relação inversa com a escolaridade entre as mulheres. A prevalência de obesidade (IMC ³ 30kg/m²) variou de 5,6 a 19,3% entre os homens e de 9,6 a 21,3% entre as mulheres em função da faixa etária. Conclui-se que o excesso de massa corporal é o agravo nutricional mais prevalente na população de Niterói.

A obesidade mórbida tem sido amplamente estudada em função de sua incidência e por suas conseqüências à saúde. Estudos têm destacado como variáveis relevantes os estilos alimentares e a qualidade de vida. Objetiva-se investigar os estilos alimentares e a qualidade de vida de mulheres com obesidade mórbida, pacientes do Ambulatório de Distúrbios de Conduta Alimentar do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo. Foram sujeitos 60 mulheres, sendo 30 obesas (Índice de Massa Corporal - IMC>40 kg/m²) e 30 não-obesas (IMC entre 20 e 25 kg/m²). Procedeu-se à aplicação de uma entrevista semi-estruturada, do Questionário Holandês de Comportamento Alimentar e do Exame de Saúde após tradução para a língua portuguesa e adaptação dos mesmos. Os dados foram cotados e quantificados, procedendo-se à comparação dos grupos através do Teste de Mann-Whitney. Os grupos diferiram significativamente quanto às subescalas alimentação restrita (pMorbid obesity in women - Eating style end quality of life. Morbid obesity has been widely studied due to its high incidence and its bad consequences to health. Studies about obesity have been emphasived some important aspects such as eating styles and quality of life. This study aim to investigate the eating styles and the quality of life of women with morbid obesity, patients in treatment at the Ambulatory of Eating Disorders, University Hospital of the Faculty of Medicine of Ribeirão Preto, University of São Paulo. Sixty women were assessed, 30 obese (Body Mass Index - BMI > 40 kg/m²) and 30 nonobese (BMI 20 to 25 kg/m²). A semi-structured interview, the Dutch Eating Behaviour Questionnaire and the Short-form Health Survey: Medical Outcomes Study were used for the assessment, after translate to portuguese and adapted. The data were rated and quantified and the groups were statistically analyzed through the Tests of Mann-Whitney. The groups differed significantly as for restrained (p

OBJECTIVE To estimate the degree of educational inequality in the occurrence of abdominal obesity in a population of non-faculty civil servants at university campi.METHODS In this cross-sectional study, we used data from 3,117 subjects of both genders aged 24 to 65-years old, regarding the baseline ofPró-Saúde Study, 1999-2001. Abdominal obesity was defined according to abdominal circumference thresholds of 88 cm for women and 102 cm for men. A multi-dimensional, self-administered questionnaire was used to evaluate education levels and demographic variables. Slope and relative indices of inequality, and Chi-squared test for linear trend were used in the data analysis. All analyses were stratified by genders, and the indices of inequality were standardized by age.RESULTS Abdominal obesity was the most prevalent among women (43.5%; 95%CI 41.2;45.9), as compared to men (24.3%; 95%CI 22.1;26.7), in all educational strata and age ranges. The association between education levels and abdominal obesity was an inverse one among women (p < 0.001); it was not statistically significant among men (p = 0.436). The educational inequality regarding abdominal obesity in the female population, in absolute terms (slope index of inequality), was 24.0% (95%CI 15.5;32.6). In relative terms (relative index of inequality), it was 2.8 (95%CI 1.9;4.1), after the age adjustment.CONCLUSIONS Gender inequality in the prevalence of abdominal obesity increases with older age and lower education. The slope and relative indices of inequality summarize the strictly monotonous trend between education levels and abdominal obesity, and it described educational inequality regarding abdominal obesity among women. Such indices provide relevant quantitative estimates for monitoring abdominal obesity and dealing with health inequalities.

La obesidad es un problema de salud que afecta a individuos en cualquier edad y se ha identificado como un factor de riesgo común a muchas enfermedades crónicas. La última encuesta de nutrición realizada en Costa Rica señala que en el grupo de mujeres de 20 a 44 años de edad la prevalencia de obesidad fue del 45,9%, un 11,3% más que en 1982; y en el grupo de 45 a 59 años, la prevalencia fue del 75%¹. En la encuesta de Damas en Desamparados, el sobrepeso u obesidad en mujeres de 19 a 44 años fue del 56,4% y el 58,8%, en hombres de 19 a 59 años; la encuesta CARMEN sobre factores de riesgo encontró un 59,4% de la población adulta entre 20 y 64 años, con problemas de sobrepeso u obesidad. (Ministerio de Salud. Encuesta basal de factores de riesgo para enfermedades no transmisibles. Cartago 2001. San José, Costa Rica: Ministerio de Salud, 2003. Serie de documentos técnicos #4 documento no convencional.Obesity is a health problem that effects individuals of any given age group, and it has been identified as risk factor, common to many chronic diseases. The lastest nutrition poll carried in Costa Rica shows that the prevalence of obesity in women 20 to 44 years old was 45.9%, 11.3% higher than in 1982 and in the group of 45 to 59 years, the prevalence was 75%1. According to the findings of the Damas/Desamparados poll overweight in women 19 to 44 years was 56.4%, and in men 19 to 59 years was 58.8%, the Carmen poll regarding risk factors found that 59.4% of the adult population (20-64 years) had overweight or obesity.