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      Malnutrición infantil en Río Chico (Tucumán, Argentina). Evolución y manifestaciones actuales en el contexto de la transición nutricional

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          Abstract

          Resumen Argentina se encuentra en un estadio avanzado de transición nutricional donde el sobrepeso y la obesidad adquieren relevancia. Sin embargo, en algunas regiones del país, especialmente en la provincia de Tucumán, la desnutrición sigue siendo un problema no resuelto y la coexistencia de ambos extremos de la malnutrición implica un desafío sanitario. Desde perspectivas teóricas y metodológicas del campo de la Geografía, la Antropología Biológica y la Nutrición, este trabajo aborda la problemática nutricional infantil en el departamento de Río Chico (Tucumán, Argentina), un escenario histórico de pobreza. Los objetivos fueron: 1) describir el patrón de morbimortalidad de la malnutrición por déficit durante el periodo 1994-2014 y sus comorbilidades en niños y niñas menores de 5 años y 2) determinar las prevalencias actuales de malnutrición por déficit y exceso en niños y niñas de 5 y 6 años. Se definieron dos estrategias metodológicas diferentes, que incluyeron el análisis de fuentes de información secundaria (estadísticas vitales de mortalidad, de egresos hospitalarios y de nacimientos) y de datos antropométricos relevados durante el año 2018. Los resultados indicaron que, entre los menores de 5 años si bien la mortalidad por desnutrición infantil ha disminuido a valores mínimos, las tasas de egresos hospitalarios por desnutrición siguen siendo importantes. Por otra parte, entre los niños y las niñas de 5 y 6 años el sobrepeso y la obesidad presentan elevadas prevalencias.

          Translated abstract

          Abstract Argentina is in an advanced stage of nutritional transition where overweight and obesity are gaining importance. However, in some regions of the country, especially in the province of Tucumán, undernutrition is still an unsolved problem and the coexistence of both extremes of malnutrition implies a health challenge. From theoretical and methodological perspectives from the fields of Geography, Biological Anthropology and Nutrition, this paper addresses children’s nutritional problems in the department of Río Chico (Tucuman, Argentina), a historical scenario of poverty. The objectives were: 1) to describe the morbi-mortality pattern of undernutrition and its comorbidities in children under 5 years of age during the period 1994-2014, and 2) to determine the current prevalence of malnutrition of deficit and excess in children aged 5 and 6 years. Two different methodological strategies were defined and included the analysis of secondary information sources (vital statistics on mortality, hospital discharges and births) and anthropometric data collected during 2018.The results showed that among children under 5 years, although mortality from infant undernutrition has decreased to minimum values, hospital discharge rates due to undernutrition are still significant. On the other hand, among children aged 5 and 6 years, overweight and obesity are highly prevalent.

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          Most cited references53

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          Development of a WHO growth reference for school-aged children and adolescents

          OBJECTIVE: To construct growth curves for school-aged children and adolescents that accord with the WHO Child Growth Standards for preschool children and the body mass index (BMI) cut-offs for adults. METHODS: Data from the 1977 National Center for Health Statistics (NCHS)/WHO growth reference (1-24 years) were merged with data from the under-fives growth standards' cross-sectional sample (18-71 months) to smooth the transition between the two samples. State-of-the-art statistical methods used to construct the WHO Child Growth Standards (0-5 years), i.e. the Box-Cox power exponential (BCPE) method with appropriate diagnostic tools for the selection of best models, were applied to this combined sample. FINDINGS: The merged data sets resulted in a smooth transition at 5 years for height-for-age, weight-for-age and BMI-for-age. For BMI-for-age across all centiles the magnitude of the difference between the two curves at age 5 years is mostly 0.0 kg/m² to 0.1 kg/m². At 19 years, the new BMI values at +1 standard deviation (SD) are 25.4 kg/m² for boys and 25.0 kg/m² for girls. These values are equivalent to the overweight cut-off for adults (> 25.0 kg/m²). Similarly, the +2 SD value (29.7 kg/m² for both sexes) compares closely with the cut-off for obesity (> 30.0 kg/m²). CONCLUSION: The new curves are closely aligned with the WHO Child Growth Standards at 5 years, and the recommended adult cut-offs for overweight and obesity at 19 years. They fill the gap in growth curves and provide an appropriate reference for the 5 to 19 years age group.
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            The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report

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              The origins of the developmental origins theory.

              D Barker (2007)
              Current orthodoxy states that coronary heart disease results from the unhealthy lifestyles of westernized adults together with a contribution from genetic inheritance. This does not provide a secure basis for prevention of the disease. Geographical studies gave the first clue that the disease originates during intra-uterine development. Variations in mortality from the disease across England and Wales were shown to correlate closely with past differences in death rates among newborn babies. In the past most deaths among newborns were attributed to low birthweight. This led to the hypothesis that undernutrition in utero permanently changes the body's structure, function and metabolism in ways that lead to coronary heart disease in later life. The association between low birthweight and coronary heart disease has been confirmed in longitudinal studies of men and women around the world. The developmental model of the origins of the disease offers a new way forward.
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                Author and article information

                Journal
                reuge
                Revista Universitaria de Geografía
                Rev. Univ. geogr.
                Departamento de Geografía y Turismo. Universidad Nacional del Sur. (Bahia Blanca, Buenos Aires, Argentina )
                1852-4265
                June 2022
                : 31
                : 1
                : 1-3
                Affiliations
                [1] orgnameConsejo Nacional de Investigaciones Científicas y Técnicas (CONICET) - Instiututo Superior de Estudios Sociales (ISES) - Universidad Nacional de Santiago del Estero Argentina
                [2] orgnameConsejo Nacional de Investigaciones Científicas y Técnicas (CONICET) - Instituto Superior de Estudios Sociales (ISES, Tucumán) Argentina
                [3] orgnameConsejo Nacional de Investigaciones Científicas y Técnicas (CONICET) - Laboratorio de Investigaciones en Ontogenia y Adaptación (LINOA), Universidad Nacional de La Plata Argentina
                Article
                S1852-42652022000100001 S1852-4265(22)03100100001
                cd5f1022-9fcd-43c3-b4ea-b8a7edd8a854

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 27 August 2021
                : 15 April 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 53, Pages: 3
                Product

                SciELO Argentina

                Categories
                Artículos

                Transición nutricional,Infancia,Obesidad,Desnutrición,Argentina,Nutrition transition,Childhood,Obesity,Undernutrition

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