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Exploration of cardiometabolic alterations in the pre-adolescent stage is necessary to characterize possible patterns for matabolic syndrome (MetS) in the earliest stages of the life. However, defining specific cutoff points for metabolic and vascular markers represents a complex task in pre-adolescent populations. This study aimed to estimate the prevalence of MetS and its components in children aged 5-9 years old by using the MetS definition for adolescents with the lowest cut-off points, and evaluate its relationship with overweight and socio-demographic determinants. A total of 494 children were evaluated. Multivariate models with filtered variables in preliminary univarite analyses were built to find predictive factors of MetS and its components. The prevalence of MetS was 8.7% in the studied children. Multivariate models showed that age, overweight and low socioeconomic stratum were associated with MetS; low high-density lipoprotein cholesterol was not significantly associated with any variable; high triglycerides were positively associated with age, overweight and inversely associated with kilocalories/day; female gender was the only variable significantly associated with high fasting glucose (inverse association); and age, gender and overweight were significant factors for increased waist circumference. In the case of high blood pressure, no variable was classified to the multivariate analysis. This study showed disturbing figures regarding cardiometabolic risk in the children based on comparisons with studies in adolescents. Further studies are needed to confirm the utility of the de Ferranti Mets definition in children.

Scope Very few studies have evaluated serum hepcidin in patients with type 2 diabetes and they have reported conflicting results. In addition, the effect of antidiabetic drugs on circulating hepcidin has not been explored so far. The aims of the study were to evaluate hepcidin concentrations and hepcidin/ferritin ratio in type 2 diabetes subjects and healthy non-diabetic controls and to evaluate the effect of metformin on hepcidin concentrations. Methods and results Study 1: Cross-sectional multivariate study of 239 non-diabetic individuals and 65 people with type 2 diabetes. The multivariate analysis included covariates of chronic inflammation, BMI, pharmacological treatment, menopausal status and insulin resistance. Study 2: Randomized, double-blinded, placebo-controlled 4-month trial metformin compared to placebo among 36 type 2 diabetic patients. In both groups diet was controlled by maintaining a hypocaloric intake across the trial. Hepcidin levels were significantly lower in patients with type 2 diabetes than in non-diabetic individuals either in crude or adjusted regression models (P

Epidemiological studies have led scientists to postulate the developmental origins of health and disease hypothesis for noncommunicable diseases such as diabetes, cardiovascular diseases, hypertension, and obesity. However, the cellular and molecular mechanisms involved in the development of these diseases are not well understood. In various animal models, it has been observed that oxidative stress during pregnancy is associated with the early development of endothelial dysfunction in offspring. This phenomenon suggests that endothelial dysfunction may initiate in the uterus and could lead to increased risk of cardiovascular disease later in life. Currently, it is known that many of the fetal adaptive responses to environmental factors are mediated by epigenetic changes in the genome, especially by the degree of methylation in cytosines in the promoter regions of genes. These findings suggest that the establishment of a particular epigenetic pattern in the genome may be generated by oxidative stress.

Background: Today, scientific evidence has supported the popular belief that physical activity is associated with biological health in pregnant women. A randomized controlled trial was used to assess the benefits of physical exercise during pregnancy on maternal lipids in low-income Latina women. Methods: The study included 67 nulliparous low-income Latina women in gestational weeks 16–20, randomly assigned into one of two groups: 1) The exercise group, which took part in aerobic and resistance exercise for 60min, three times a week for 12 weeks, 2) The control group, which undertook their usual physical activity and prenatal care. The primary outcomes were changes in maternal blood lipids after intervention. Obstetrical and neonatal outcomes measured were type of delivery, postpartum hemorrhage, newborn and/or maternal complications’, gestational age, weight gain, birth weight, foetal growth, and Apgar score. Results: Fifty women completed the study. At the end of the intervention, there were differences between groups in low-density lipoprotein levels (mean change: −8 mg/dL, 95%CI -3 to −29; P < 0.001) and triglycerides (mean change: −6 mg/dL, 95%CI -1 to −11; P = 0.03). Also, compared with women who remained in the control group, active women showed lower complications during delivery (moderate postpartum haemorrhage) (58% compared with 75%; P < 0.05) and lower complications in newborns (e.g. cyanosis or respiratory distress) (21% compared with 46%; P < 0.001). Conclusions: An exercise programme during the second and third trimester favours less gain in low-density lipoprotein cholesterol and triglycerides fewer delivery and neonatal complications. The authors would like to acknowledge Universidad del Valle for the financial support to the Nutrition Group (Grant N. CI 1575) and Instituto Colombiano para el Desarrollo de la Ciencia y la Tecnología “Francisco José de Caldas” (Grant N. 656,640,820,391). Robinson Ramírez-Velez received a grant from Instituto Colombiano para el Desarrollo de la Ciencia y la Tecnología “Francisco José de Caldas” to do a doctorate and received a grant from American College Sport Medicine to the Fellow in CDC Atlanta (RAFA-PANA Scholarship).

Introduction and objectives To examine the relationships between of four measures of adiposity, namely waist circumference (WC), body mass index (BMI), and subscapular and abdominal skinfolds, with different cardiovascular risk factors in prepubertal children. Methods Four hundred and ninety-four prepubertal children aged 6–10 years participated in this cross-sectional study. The subscapular and abdominal skinfolds, WC, and BMI were measured to assess adiposity, and cardiovascular risk factors (CVRFs) were assessed by measuring systolic (SBP) and diastolic blood pressures (DBP), glucose, triglycerides (TG), and high density (HDL-C) and low density lipoprotein cholesterol (LDL-C). Dichotomous variables were created based on whether or not the subjects were in the upper quartile (Q4) for the WC, BMI, and skinfold variables. Results No CVRF was found in 52.8% of children, 33.4% had one factor, and 10.9% and 2.8% had 2 and 3 factors respectively. An adjusted logistic regression analysis showed that being in Q4 of anthropometric variables and CVRFs was associated to TG levels ≥ 100 mg/dL. Glucose levels ≥96 mg/dL were associated to Q4 and abdominal fold. Presence of 2 or more CVRFs was significantly associated to Q4 in all anthropometric variables despite adjustment for age, gender, and calorie intake. The subscapular skinfold was the adiposity marker associated to the highest risk. Conclusions Children with a more unfavorable adiposity profile tend to have a greater cardiovascular risk in the prepubertal stage.

Objetivo Determinar los valores por edad y sexo de los lipidos sericos colesterol total (CT), trigliceridos (TG), y colesterol de lipoproteinas de alta densidad (c-HDL) de ninos y adolescentes de 10 a 17 anos de Colombia. Material y metodos Estudio descriptivo de corte transversal en 1.773 ninos y adolescentes. A cada participante se le realizo una medicion en ayunas para cuantificar los niveles de CT, c-HDL y TG utilizando metodos enzimatico-colorimetricos. Se calcularon centiles a partir de la regresion LMS por edad y sexo p5, p25, p50, p75, p90 y p95 con el metodo de los Least Mean squares (LMS, ‘minimos cuadrados’) por curvas centiles que representan la asimetria, la mediana y la variabilidad utilizando el paquete estadistico Growth Analyzer. Resultados En general, los hombres presentan menores valores de CT y TG sericos que las mujeres. El p95 de los TG y CT en los hombres de las edades de 10 a 14 anos fue mayor que en las mujeres, mientras que los niveles de c-HDL fueron similares en ambos sexos y edades. Conclusiones La obtencion de valores centiles ayudara a clasificar los ninos y adolescentes con respecto a otras poblaciones en funcion de este indicador de salud.

Copper and calcium are essential for human growth and development. The present study was conducted to evaluate the relationship between calcium and copper levels, as well as their relationship to age and anthropometry in 180 preschool children ages 2-5 years old. Serum copper levels were inversely correlated with age (r = -0.184, P = 0.032) and height (r = -0.175, P = 0.043) in the whole group and with height for age Z score only in male children (r = -0.291, P = 0.016). The correlation with age is not maintained when it is analyzed for gender. Serum calcium values in the total group were inversely correlated with weight (r = -0.153, P = 0.044) and weight for height Z score (r = -0.246, P = 0.001). No differences were found for gender in the levels of both metals. A negative relationship between serum calcium and copper was found only in male children (r = -0.339, P = 0.005). Studies are required in other populations and experimental designs that can explain an inverse relationship between serum calcium and copper levels.

Background and objective Reference data for anthropometric parameters are not available for adolescents in Cali (Colombia). This study aimed to develop representative age- and sexspecific percentiles for anthropometric indicators [fat percentage, body mass index (BMI), and waist circumference] in urban adolescents aged 10–16 years in Cali. Methods The sample (n = 1,773) consisted of 865 boys and 908 girls from the descriptive, cross-sectional population-based IFRECNTEC study (Identification of Risk Factors for Noncommunicable Chronic Diseases in Adulthood in a Population aged 6 to 18 years old attending School in the Municipality of Cali, Colombia). Data on anthropometric variables were recorded. Smoothed age- and sex- specific 5th, 25th, 50th, 75th, 90th and 95th centiles were derived using the least mean squares (LMS) regression method. Results In most ages, anthropometric indicators were higher for girls than for boys. The BMI p50 ranged from 16.8 to 19.9 kg/m2 in boys and from 16.7 to 21.1 kg/m2 in girls. Fat percentage in boys in the p50 varied from ≈12% at the ages of 10 and 11 years to ≈13% at the age of 16 years; for girls, these percentages varied from ≈13% in the earliest ages to ≈16% in older ages. Waist circumference was lower in girls than in boys in most ages. Conclusion The results of this study could be used to identify adolescents with an elevated risk of developing obesity, dyslipidemia, hypertension and cardiovascular disorders in adulthood, to plan and implement preventive policies, and to study temporal trends. The introduction of centile values will help to classify adolescents from Cali and compare their anthropometric indicators with those of a reference population.

Question Does supervised aerobic exercise during pregnancy improve health-related quality of life in nulliparous women? Design Analysis of secondary outcomes of a randomised trial with concealed allocation, blinded assessors, and intention-to-treat analysis. Participants 64 nulliparous, pregnant women attending for prenatal care at one of three tertiary hospitals. Intervention The experimental group completed a 3-month supervised exercise program, commencing at 16 to 20 weeks of gestation. Each session included walking (10 min), aerobic exercise (30 min), stretching (10 min), and relaxation (10 min). The control group continued usual activities and performed no specific exercise. Outcome measures The primary outcome was health-related quality of life assessed by the Colombian version of the Medical Outcome Study Short-Form Health Survey at baseline and immediately after the 3-month intervention. Results Fifty women completed the study. After the 3-month intervention, the experimental group had improved their health-related quality of life more than the control group in the physical component summary of the questionnaire by 6 points (95% CI 2 to 11), the physical function domain (7 points, 95% CI 0 to 14), the bodily pain domain (7 points, 95% CI 1 to 13) and the general health domain (5 points, 95% CI 1 to 10). Conclusions A supervised 3-month program of primarily aerobic exercise during pregnancy improves health-related quality of life. Trial registration NCT00741312.

Very few large studies in Latin America have evaluated the association between waist:height ratio (W-HtR) and cardiometabolic risk in children and adolescents. Further, multivariable analyses verifying the independence of located subcutaneous fat have not been conducted so far. The aim of this study was to evaluate the associations of W-HtR and waist circumference (WC) with metabolic syndrome abnormalities and high LDL-cholesterol levels in schooled adolescents before and after adjusting for trunk skinfolds and BMI. The sample consisted of 831 boys and 841 girls aged 10–17 years. Biochemical, blood pressure and anthropometrical variables were measured. Age- and sex-specific quartiles of W-HtR and WC were used in Poisson regression models to evaluate the associations. High WC values (highest quartilev. quartiles 1–3) were associated with high TAG levels in both sexes (prevalence ratio, boys: 2·57 (95 % CI 1·91, 3·44); girls: 1·92 (95 % CI 1·49, 2·47);PPPP>0·05). High W-HtR (highest quartilev. quartiles 1–3) was only independently associated with high TAG in female adolescents (1·99 (95 % CI 1·55, 2·56);P

Objective To determine the effects of combined aerobic and resistance exercise training during the second half of pregnancy on endothelial NOS expression (eNOS), nitric oxide (NO) production and oxygen metabolism in human placenta. Methods The study included 20 nulliparous in gestational week 16–20, attending prenatal care at three tertiary hospitals in Colombia who were randomly assigned into one of two groups: The exercise group (n?=?10) took part in an exercise session three times a week for 12 weeks which consisted of: aerobic exercise at an intensity of 55–75% of their maximum heart rate for 60 min and 25 mins. Resistance exercise included 5 exercise groups circuit training (50 repetitions of each) using barbells (1–3 kg/exercise) and low-to-medium resistance bands. The control group (n?=?10) undertook their usual physical activity. Mitochondrial and cytosol fractions were isolated from human placental tissue by differential centrifugation. A spectrophotometric assay was used to measure NO production in cytosolic samples from placental tissue and Western Blot technique to determine eNOS expression. Mitochondrial superoxide levels and hydrogen peroxide were measured to determine oxygen metabolism. Results Combined aerobic and resistance exercise training during pregnancy leads to a 2-fold increase in eNOS expression and 4-fold increase in NO production in placental cytosol (p?=?0.05). Mitochondrial superoxide levels and hydrogen peroxide production rate were decreased by 8% and 37% respectively in the placental mitochondria of exercising women (p?=?0.05). Conclusion Regular exercise training during the second half of pregnancy increases eNOS expression and NO production and decreases reactive oxygen species generation in human placenta. Collectively, these data demonstrate that chronic exercise increases eNOS/NO production, presumably by increasing endothelial shear stress. This adaptation may contribute to the beneficial effects of exercise on the vascular and antioxidant system and in turn reduce the risk of preeclampsia, diabetes or hypertension during pregnancy.

To evaluate the relationship of copper and zinc dietary intakes with metabolic syndrome (MetS) in adolescents.The sample consisted of 1,311 adolescents aged 11-16 years, and MetS definition by de Ferranti et al. was used. Nutritional intakes, anthropometrical and biochemical markers were measured.In males, highest quartile of zinc intake was inversely associated with MetS without and with adjustment by covariables. Without adjustment, highest quartile of copper intake was inversely associated (marginal significance) with MetS, but with adjustment, the relationship was not maintained. Likewise in male gender, elevated waist circumference was the only MetS component inversely associated with highest quartiles of zinc (without and with adjustment) and copper (significant in crude analysis and marginal significant in adjustment by covariables) intakes. In the girls, only waist circumference was significant and inversely associated with highest quartiles of zinc and copper intakes but the association did not remain significant after adjustments.In the adolescents of this study, zinc intake could be more associated to a clustering of anthropometric, vascular, and metabolic alterations than to these alterations separately, and also it is inversely related to this clustering (MetS). However, studies in other populations are necessary to confirm and explain the finding of exclusive association zinc intake-MetS in male gender adolescents. Further research is required to explore biomarkers of physiological processes (antioxidant function, blood flow regulation, and epigenetic modulation dependent of zinc) in relation to zinc intake and MetS in pediatric and adult populations.

Objective The aim of this study was to evaluate the relationship of tricipital (TS), abdominal (AS), subscapular (SS), and suprailiac (SIS) skinfolds, Body Mass Index (BMI), and Waist Circumference (WC) with 1) variables related to cardiovascular risk (CVR) and 2) the clustering of cardiovascular risk factors (CVRF) – referenced pediatric cut-off points – in a multivariate analysis. Materials/Methods The sample was 1672 adolescents. Glucose, lipid profile, blood pressure and anthropometric variables were measured. Results Adjusting for age, gender, and caloric intake, the highest quartile (Q4) of adiposity markers was associated to Q4 of biochemical and blood pressure variables. However, the association was not found for WC, SS and TS with glucose, and for diastolic blood pressure (DBP) with TS, SS, and SIS. Triglycerides Q4 was related to Q4 of SS, AS, and SIS after further adjustments, as well as HDL cholesterol (HDL-C) Q1 with Q4 of SS and AS. Glucose Q4 was associated to BMI, AS (Not adjusting for BMI and SIS), and SIS Q4 (Not adjusting for BMI and TS). LDL-Cholesterol (LDL-C) Q4 was associated to TS and SS Q4. The associations of LDL-C Q4 and HDL-C Q1 with WC Q4 were not significant after further adjustments. All the adiposity markers, except WC and TS, were associated to CVRF clustering in all the adjustments. Conclusions In the adolescents, subcutaneous fat from the trunk (SS, AS, SIS) was better and independently associated to CVR variables and with CVRF clustering than visceral fat (WC). Further research is required to explain the specificity in the described associations.

To evaluate the relationship between nutrients intake in the first trimester of pregnancy and blood levels of lead and cadmium during the first and third trimesters of gestation.A total of 381 pregnant women were enrolled. Blood lead and cadmium were measured using electrothermal atomic absorption spectrometry, and dietary intake was assessed using 24-h recall questionnaire.Lead levels in the first trimester were negatively correlated with cadmium levels in the two trimesters, and levels of both metals correlated positively in the third trimester. Zinc and calcium intakes were negatively associated with blood lead during third trimester. Thiamine and folic acid intakes were negatively and positively associated (respectively) with blood lead at third trimester with marginal significance. Fat, niacin, and vitamin B12 intakes were significantly and positively associated with blood cadmium at first trimester. Folic acid and zinc intakes showed positive and marginally significant associations with blood cadmium without adjustments. At third trimester, blood cadmium was negatively associated to ascorbic acid intake, and positively associated with iron intake with a marginal significance.Possible acute and late effects of nutrients intake in blood lead and cadmium levels could be related with associations exclusively observed in the first and third trimester. This study represents the first exploration of relationships among a wide range of nutrients intake in the first trimester of pregnancy with blood lead and cadmium in first and third trimester of gestation. Further studies are required to confirm the findings mentioned herein.

To evaluate the effect of regular aerobic exercise on the endothelial function and cardiorespiratory fitness in pregnant women.This was a randomized, double-blinded, controlled clinical trial of 64 healthy primigravid women between 16 and 20 weeks' gestation. The experimental group took part in aerobic exercise at an intensity of 50-65% of their maximum heart rate for 60 min, three times a week for 16 weeks. The control group undertook their usual physical activity. The outcomes were the endothelial function evaluated by flow-mediated dilatation and cardiorespiratory fitness evaluated by the maximum indirect oxygen consumption (VO2max) in a 6-min walk test.Initially, no differences were found between the groups in any of the variables. At the end of the intervention, the participants that performed exercise showed a higher cardiorespiratory fitness, measured by the walked distance in the 6-min walk test (P = 0.014) and by the VO2max (P = 0.014). Also, the exercise group showed a lower heart rate at rest and a higher flow-mediated dilatation than the control group (P = 0.02).Regular aerobic exercise improves endothelium-dependent vasodilation in pregnancy. This intervention may be an early and effective alternative to strengthen the prevention of disorders associated to endothelial dysfunction.

Postprandial lipemia has been associated with atherogenesis and other non infectious chronic diseases. A descriptive, non aleatory study of 51 healthy young adults (23.8 +/- 4 years) of different ethnic background was carried out to identify possible personal or life style factors associated with the response of plasma lipids after a mixed carbohydrate and lipid load. Personal, family, life styles including use of drugs and activity and ethnic background were recorded. Anthropometrical measurements, a short insulin and postprandial lipemia tests were done. From these observations body mass index (BMI) and area under the curve (AUC) for lipids and glucose were calculated. High mean values were observed in AUC for glucose, triacylglycerol and nonesterified fatty acids (NEFA). Postprandial glucose with differences by age (p=0.05 Bonferroni) but no ethnic, gender, BMI or insulin sensitivity related significant differences were found. Mestizos (40%) showed two, and Negroes three (27%) postprandial triglyceridemia peaks. Noteworthy, subjects presenting four peaks had elevated BMI. Higher triglyceridemia values were found in white and mestizos (p0.05), in subjects older than 29 and in males (p0.05). Statistical correlation (r2=0.70) between BMI and triglyceridemia and change in postprandial trigliceridemia was found in white and black subjects. NEFA declined up to the second hour, but at 6-7 hours they reached levels higher than base values. Higher than reported values for UCA and BMI and an abnormal response to fat intake with an early release of NEFA was found. The high correlation between BMI and postprandial trigliceridemia suggests that body mass index could be a good predictor of postprandial trigliceridemia.

Background Many studies have suggested a relationship between metabolic abnormalities and impaired fetal growth with the development of non-transmissible chronic diseases in the adulthood. Moreover, it has been proposed that maternal factors such as endothelial function and oxidative stress are key mechanisms of both fetal metabolic alterations and subsequent development of non-transmissible chronic diseases. The objective of this project is to evaluate the effect of micronutrient supplementation and regular aerobic exercise on endothelium-dependent vasodilation maternal and stress oxidative of the newborn. Methods and design 320 pregnant women attending to usual prenatal care in Cali, Colombia will be included in a factorial randomized controlled trial. Women will be assigned to the following intervention groups: 1. Control group: usual prenatal care (PC) and placebo (maltodextrine). 2. Exercise group: PC, placebo and aerobic physical exercise. 3. Micronutrients group: PC and a micronutrients capsule consisting of zinc (30 mg), selenium (70 μg), vitamin A (400 μg), alphatocopherol (30 mg), vitamin C (200 mg), and niacin (100 mg). 4. Combined interventions Group: PC, supplementation of micronutrients, and aerobic physical exercise. Anthropometric measures will be taken at the start and at the end of the interventions. Discussion Since in previous studies has been showed that the maternal endothelial function and oxidative stress are related to oxidative stress of the newborn, this study proposes that complementation with micronutrients during pregnancy and/or regular physical exercise can be an early and innovative alternative to strengthen the prevention of chronic diseases in the population. Trial registration NCT00872365.

Introduction: The metabolic syndrome, a set of metabolic anomalies that include insulin resistance, central obesity, dyslipidemia, hypertension and inflammation, is an important tool to explore factors associated to cardiometabolic disease. Objective: The aim of this study was to evaluate the relationship of the levels of self-reported physical activity and the International Physical Activity Questionnaire items and the metabolic syndrome and the variables related to cardiovascular risk in 89 women. Materials and methods: The short version of International Physical Activity Questionnaire was applied to classify participating subjects into three categories: insufficient, sufficient and very active physical activity. The metabolic syndrome was assessed according to the International Diabetes Federation criteria. Biochemical and anthropometrical parameters were measured. Results: Twenty-two participants (23%) presented metabolic syndrome and 66 women (74.2%) were classified in the insufficient physical activity category. No association was found between insufficient physical activity and metabolic syndrome. Inverse correlations were found among the days and minutes per week of physical activity of moderate-intensity, waist circumference (?=-0.327, and ?=-0.313, p less than 0.005, respectively), and body mass index (?=-0.262, and ?=-0.218, p less than 0.05, respectively). Conclusion: A high prevalence of insufficient physical activity was found in the study participants, but this was not associated with metabolic syndrome. Moderate but not vigorous physical activity items from the International Physical Activity Questionnaire correlated inversely with anthropometrical markers related to cardiovascular risk.

Atherosclerosis is an asymptomatic chronic disease, which begins at early age and is difficult to detect during this stage. Prospective studies suggest a causal relationship between total serum cholesterol levels during childhood and early adolescence and the development of cardiovascular diseases in adulthood.The aim of this study was to evaluate the prevalence of early atherosclerotic lesions in the aorta artery of children and its relationship with post-mortem serum cholesterol levels.Post-mortem samples of blood and aorta were taken from 43 subjects aged less than 17 years old. Histopathological analysis (intimal thickening and inflammatory infiltrates) of the thoracic aorta and measurement of total serum cholesterol were performed.The analysis showed thickening of the intima and lymphocyte infiltrates in 93% of children, and macrophage infiltrates in 79.1% of cases. A relationship between the highest terciles of total serum cholesterol levels and the presence of multiple lesions in the aorta wall was found ( P0.05).This group of children had a high prevalence of early inflammatory atherosclerotic lesions positively related with serum cholesterol levels. To our knowledge this study represents the first report of a relationship between post-mortem total serum cholesterol levels and pathological findings of macrophages and lymphocytes infiltrates in the aorta wall.