Abstract INTRODUCTION Anemia is a public health problem worldwide and is most prevalent in preschool children, for whom it is the most frequent cause of nutritional deficits. In turn, iron deficiency is the main cause of anemia, affecting 43% of children globally. Previous studies in Cuba show rates of iron deficiency in preschool children between 38.6% and 57.6%, higher in infants (71.2% to 81.1%). WHO recommends using serum ferritin as an indicator of iron deficiency accompanied by acute (C-reactive protein) and chronic (α1-acid glycoprotein) inflammation biomarkers. OBJECTIVE Assess how inflammation affects measuring and reporting of iron-deficiency anemia rates in Cuban preschool children. METHODS Data were obtained from serum samples contained in the National Anemia and Iron Deficiency Survey, and included presumably healthy preschool Cuban children (aged 6–59 months). Serum samples were collected from 1375 children from randomly selected provinces in 4 regions of the country from 2014 through 2018. We examined the association between ferritin and two inflammatory biomarkers: C-reactive protein and α1-acid glycoprotein. Individual inflammation-adjusted ferritin concentrations were calculated using four approaches: 1) a higher ferritin cut-off point (<30 g/L); 2) exclusion of subjects showing inflammation (C-reactive protein >5 mg/L or α1-acid glycoprotein >1 g/L); 3) mathematical correction factor based on C-reactive protein or α1-acid glycoprotein; and 4) correction by regression with the method proposed by the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia Group. We estimated confidence intervals of differences between unadjusted prevalence and prevalence adjusted for inflammation by each method. RESULTS The proportion of children with inflammation according to C-reactive protein concentrations >5 mg/L was lower (11.1%, 153/1375) than the proportion measured according to the concentrations of α1-acid glycoprotein, at >1 g/L (30.8%, 424/1375). The percentage of children with high concentrations of at least one of the aforementioned biomarkers was 32.7% (450/1375). Thus, each correction method increased the observed prevalence of iron deficiency compared to unadjusted estimates (23%, 316/1375). This increase was more pronounced when using the internal regression correction method (based only on C-reactive protein) or the method based on a higher cut-off point. Adjustment using all four methods changed estimated iron deficiency prevalence, increasing it from 0.1% to 8.8%, compared to unadjusted values. CONCLUSION One-third of preschool children had biomarkers indicating elevated inflammation levels. Without adjusting for inflammation, iron deficiency prevalence was underestimated. The significant disparity between unadjusted and inflammation-adjusted ferritin when using some approaches highlights the importance of selecting the right approach for accurate, corrected measurement. The internal regression correction approach is appropriate for epidemiological studies because it takes into account inflammation severity. However, other models should be explored that account for inflammation and also provide better adjusted ferritin concentrations.

ABSTRACT Introduction: Zinc deficiency is considered a global health problem. There is scarce information on zinc’s nutritional state in Cuban childbearing-aged women. Objective: Identify zinc and serum copper deficiency in childbearing-aged women, based on related factors, such as anemia, inflammation, excess weight and abdominal adiposity. Methods: 104 seemingly healthy women from Havana, aged 18 to 40 were studied. A descriptive cross-sectional study was conducted. The determination of zinc, copper, hemoglobin, ferritin, C-reactive protein, alpha 1 glycoprotein, weight, size and minimum waist circumference was made, and the body mass index was calculated. International breakpoints were used for evaluation. Results: The prevalence of iron deficiency, estimated by serum ferritin, zinc and serum copper was 66.3%(67/101), 36.2% (34/94) and 19.1% (18/94), respectively. Of women, 23.5% (24/102) had anemia, and 8.8% had inflammation (9/102) and 13% (13/100) estimated by CRP and AGP. Women with overweight 52.9% (54/102) and abdominal adiposity 61.8% (60/97) predominated. Conclusions: The risk of zinc deficiency in the sample is high, the prevalence of decreased serum Zn exceeds 20%. There is no criterion for assessing the risk of copper deficiency as a public health problem. Zinc and copper deficiencies do not appear to be associated with anemia, inflammation and overall nutritional status. Additional tests are required to identify the magnitude of zinc and copper deficiencies and their possible causes.

RESUMEN Introducción: La deficiencia de cinc se considera un problema de salud global. Existe escasa información sobre el estado nutricional del cinc en mujeres cubanas en edad reproductiva. Objetivo: Identificar deficiencia de cinc y cobre sérico en mujeres en edad reproductiva, según factores relacionados, como la anemia, inflamación, exceso de peso y adiposidad abdominal. Métodos: Se estudiaron 104 mujeres de 18 a 40 años de edad, de La Habana, aparentemente sanas. Se realizó un estudio transversal descriptivo. Se realizó la determinación de cinc, cobre, hemoglobina, ferritina, proteína C reactiva, alfa 1 glicoproteína, peso, talla y circunferencia mínima de la cintura, se calculó el índice de masa corporal. Se utilizaron puntos de corte internacionales para la evaluación. Resultados: La prevalencia de deficiencia de hierro, estimada por ferritina sérica, cinc y cobre sérico fueron 66,3 % (67/102), 36,2 % (34/94) y 19,1% (18/94), respectivamente. De las mujeres 23,5 % (24/102) tenían anemia e inflamación 8,8 % (9/102) y 13 % (13/102) estimada por CRP y AGP. Predominaron mujeres con exceso de peso 52,9 % (54/102) y adiposidad abdominal 61,8 % (60/97). Conclusiones: El riesgo de deficiencia de cinc en la muestra es elevado, la prevalencia del Zn sérico disminuido supera el 20 %. No existe criterio para evaluar el riesgo de deficiencia de cobre como problema de salud pública. Las deficiencias de cinc y cobre no parecen estar asociadas a la anemia, la inflamación y el estado nutricional general. Se requiere realizar pesquisas adicionales para identificar la magnitud de las deficiencias de cinc y cobre y sus posibles causas.

ABSTRACT Introduction: Zinc deficiency is considered a global health problem. There is scarce information on zinc’s nutritional state in Cuban childbearing-aged women. Objective: Identify zinc and serum copper deficiency in childbearing-aged women, based on related factors, such as anemia, inflammation, excess weight and abdominal adiposity. Methods: 104 seemingly healthy women from Havana, aged 18 to 40 were studied. A descriptive cross-sectional study was conducted. The determination of zinc, copper, hemoglobin, ferritin, C-reactive protein, alpha 1 glycoprotein, weight, size and minimum waist circumference was made, and the body mass index was calculated. International breakpoints were used for evaluation. Results: The prevalence of iron deficiency, estimated by serum ferritin, zinc and serum copper was 66.3%(67/101), 36.2% (34/94) and 19.1% (18/94), respectively. Of women, 23.5% (24/102) had anemia, and 8.8% had inflammation (9/102) and 13% (13/100) estimated by CRP and AGP. Women with overweight 52.9% (54/102) and abdominal adiposity 61.8% (60/97) predominated. Conclusions: The risk of zinc deficiency in the sample is high, the prevalence of decreased serum Zn exceeds 20%. There is no criterion for assessing the risk of copper deficiency as a public health problem. Zinc and copper deficiencies do not appear to be associated with anemia, inflammation and overall nutritional status. Additional tests are required to identify the magnitude of zinc and copper deficiencies and their possible causes.

RESUMEN Introducción: La deficiencia de cinc se considera un problema de salud global. Existe escasa información sobre el estado nutricional del cinc en mujeres cubanas en edad reproductiva. Objetivo: Identificar deficiencia de cinc y cobre sérico en mujeres en edad reproductiva, según factores relacionados, como la anemia, inflamación, exceso de peso y adiposidad abdominal. Métodos: Se estudiaron 104 mujeres de 18 a 40 años de edad, de La Habana, aparentemente sanas. Se realizó un estudio transversal descriptivo. Se realizó la determinación de cinc, cobre, hemoglobina, ferritina, proteína C reactiva, alfa 1 glicoproteína, peso, talla y circunferencia mínima de la cintura, se calculó el índice de masa corporal. Se utilizaron puntos de corte internacionales para la evaluación. Resultados: La prevalencia de deficiencia de hierro, estimada por ferritina sérica, cinc y cobre sérico fueron 66,3 % (67/102), 36,2 % (34/94) y 19,1% (18/94), respectivamente. De las mujeres 23,5 % (24/102) tenían anemia e inflamación 8,8 % (9/102) y 13 % (13/102) estimada por CRP y AGP. Predominaron mujeres con exceso de peso 52,9 % (54/102) y adiposidad abdominal 61,8 % (60/97). Conclusiones: El riesgo de deficiencia de cinc en la muestra es elevado, la prevalencia del Zn sérico disminuido supera el 20 %. No existe criterio para evaluar el riesgo de deficiencia de cobre como problema de salud pública. Las deficiencias de cinc y cobre no parecen estar asociadas a la anemia, la inflamación y el estado nutricional general. Se requiere realizar pesquisas adicionales para identificar la magnitud de las deficiencias de cinc y cobre y sus posibles causas.

ABSTRACT INTRODUCTION Age-related cognitive disorders, including Alzheimer disease, are among the main causes of disability and dependence in older adults worldwide. High blood homocysteine levels (hyperhomocysteinemia) are a risk factor for diseases whose metabolism involves different B vitamins. Antioxidant vitamins provide a protective effect by mitigating oxidative stress generated by these diseases. Epidemiological studies have presented varying results on the relationships between blood levels of these vitamins and such cognitive disorders. OBJECTIVE Evaluate the association of vitamin and homocysteine levels with mild cognitive impairment and Alzheimer disease in a group of Cuban older adults. METHODS A cross-sectional study was conducted in Havana, Cuba, of 424 persons aged ≥65 years: 43 with Alzheimer disease, 131 with mild cognitive impairment, and 250 with no signs of cognitive impairment. Dementia was diagnosed using criteria of the International 10/66 Dementia Research Group and Diagnostic and Statistical Manual of Mental Disorders (DSM IV), and mild cognitive impairment was diagnosed using Petersen’s criteria. Blood levels of vitamins (thiamine, B-2, folate, B-12, C and A) and homocysteine were measured by standard procedures. Analysis of variance for continuous variables and percentage comparison tests for dichotomous variables were used to compare groups. RESULTS Persons with Alzheimer disease presented significantly lower levels of vitamins B-2, C and A than healthy participants (p <0.05). Homocysteine levels were significantly higher in those with Alzheimer disease and mild cognitive impairment than in participants with no cognitive impairment (p <0.05). Statistically, levels of thiamine, folic acid, and vitamin B-12 were not significantly different across groups. Compared with those without cognitive impairment, prevalence rates (PR) in the Alzheimer group were significantly higher for hyperhomocysteinemia (PR = 3.26; 1.84–5.80) and deficiency of all B vitamins: thiamine (PR = 1.89; 1.04–3.43), B-2 (PR = 2.85; 1.54–5.26), folate (PR = 3.02; 1.53–5.95), B-12 (PR = 2.21; 1.17–4.19), vitamin C (PR = 3.88; 2.12–7.10) and A (PR = 5.47; 3.26–9.17). In mild cognitive impairment, prevalence rates were significantly higher for hyperhomocysteinemia (PR = 1.42; 1.08–1.87), vitamin B-2 deficiency (PR = 1.70; 1.24–2.32) and vitamin A deficiency (PR =1.88; 1.05–3.38). CONCLUSIONS Hyperhomocysteinemia and various vitamin deficiencies are related to Alzheimer disease and mild cognitive impairment. Longitudinal studies are needed to further elucidate the relationship between different nutritional biomarkers and dementia. A better understanding of this relationship could provide a basis for therapeutic and preventive strategies.

ABSTRACT Introduction: Non-healthy food habits boost chronic diseases that represent the main death causes in Cuba. Objectives: To assess the effects of a nutritional intervention on the changes in the knowledge of diet-nutrition and food habits of adolescents. Methods: It was carried out a participative nutritional intervention with adolescents from 12 to 15 years from Habana Vieja municipality during their 3 middle school years. From 604 adolescents that started the study, 155 formed the ´´promoter groups´´ which leadered the activities implemented. There were applied knowledge surveys on food consumption and habits before and after the intervention. For comparing the scores, it was used t-Student test for paired samples. It was used the analysis of simple variance for comparing among schools and the percentages of right answers in the knowledge questions, intake of vegetables and sugar before and after of the test for the estimation of differences among proportions. It was defined p<0,05 as the threshold of statistical signification. Results: The promoter groups showed significative increase of knowledge (p<0,001). There were found differences among schools for promoter groups (p<0,001) and for the rest of the students (p<0,024). In the promoter groups decreased the intake of sugar added to soft drinks (p<0,001) and to milk for all the adolescents studied (p<0,002). There were no changes in breakfast habits, liking fried food, or the consumption of soft drinks, fritters, sweets and pizzas. Conclusions: Nutritional education interventions are needed to reach healthier diet patterns and in this way contributing to stop the epidemic of non-communicable diseases; in addition, they allow adolescents to have an approach to food-nutrition topic.

RESUMEN Introducción: Los hábitos alimentarios no saludables potencian las enfermedades crónicas que constituyen las primeras causas de muerte en Cuba. Objetivos: Evaluar los efectos de una intervención nutricional sobre los cambios en los conocimientos de alimentación-nutrición y hábitos alimentarios en adolescentes. Métodos: Se realizó una intervención nutricional participativa con adolescentes de 12-15 años del municipio Habana Vieja, durante sus tres años curriculares. De los 604 adolescentes que comenzaron el estudio 155 formaron los “grupos promotores” que lideraron las actividades realizadas. Se aplicaron encuestas de conocimientos, consumo y hábitos alimentarios antes y después de la intervención. Para comparar la puntuación alcanzada se utilizó la prueba t de Student para muestras pareadas. Para la comparación entre escuelas se utilizó análisis de la varianza simple y para comparar los porcentajes de respuestas correctas de las preguntas de conocimientos, consumo de hortalizas y azúcar antes y después de la prueba de estimación de diferencias entre proporciones. Se definió como umbral de significación estadística p < 0,05. Resultados: Los grupos promotores mostraron aumentos significativos de los conocimientos (p < 0,001). Se encontraron diferencias entre escuelas para los grupos promotores (p < 0,001) y para el resto de los estudiantes (p = 0,024). Decreció el azúcar añadido a los refrescos para los grupos promotores (p < 0,001) y a la leche para todos los adolescentes (p = 0,002). No hubo cambios en el hábito de desayunar, en el gusto por alimentos fritos, ni en el consumo de refrescos, frituras, dulces y pizzas. Conclusiones: Las intervenciones de educación nutricional son necesarias para alcanzar patrones dietéticos más saludables y de esta manera contribuir a detener la epidemia de enfermedades no transmisibles, además permiten que los adolescentes tengan un acercamiento al tema alimentación-nutrición.

ABSTRACT Introduction: Non-healthy food habits boost chronic diseases that represent the main death causes in Cuba. Objectives: To assess the effects of a nutritional intervention on the changes in the knowledge of diet-nutrition and food habits of adolescents. Methods: It was carried out a participative nutritional intervention with adolescents from 12 to 15 years from Habana Vieja municipality during their 3 middle school years. From 604 adolescents that started the study, 155 formed the ´´promoter groups´´ which leadered the activities implemented. There were applied knowledge surveys on food consumption and habits before and after the intervention. For comparing the scores, it was used t-Student test for paired samples. It was used the analysis of simple variance for comparing among schools and the percentages of right answers in the knowledge questions, intake of vegetables and sugar before and after of the test for the estimation of differences among proportions. It was defined p<0,05 as the threshold of statistical signification. Results: The promoter groups showed significative increase of knowledge (p<0,001). There were found differences among schools for promoter groups (p<0,001) and for the rest of the students (p<0,024). In the promoter groups decreased the intake of sugar added to soft drinks (p<0,001) and to milk for all the adolescents studied (p<0,002). There were no changes in breakfast habits, liking fried food, or the consumption of soft drinks, fritters, sweets and pizzas. Conclusions: Nutritional education interventions are needed to reach healthier diet patterns and in this way contributing to stop the epidemic of non-communicable diseases; in addition, they allow adolescents to have an approach to food-nutrition topic.

RESUMEN Introducción: Los hábitos alimentarios no saludables potencian las enfermedades crónicas que constituyen las primeras causas de muerte en Cuba. Objetivos: Evaluar los efectos de una intervención nutricional sobre los cambios en los conocimientos de alimentación-nutrición y hábitos alimentarios en adolescentes. Métodos: Se realizó una intervención nutricional participativa con adolescentes de 12-15 años del municipio Habana Vieja, durante sus tres años curriculares. De los 604 adolescentes que comenzaron el estudio 155 formaron los “grupos promotores” que lideraron las actividades realizadas. Se aplicaron encuestas de conocimientos, consumo y hábitos alimentarios antes y después de la intervención. Para comparar la puntuación alcanzada se utilizó la prueba t de Student para muestras pareadas. Para la comparación entre escuelas se utilizó análisis de la varianza simple y para comparar los porcentajes de respuestas correctas de las preguntas de conocimientos, consumo de hortalizas y azúcar antes y después de la prueba de estimación de diferencias entre proporciones. Se definió como umbral de significación estadística p < 0,05. Resultados: Los grupos promotores mostraron aumentos significativos de los conocimientos (p < 0,001). Se encontraron diferencias entre escuelas para los grupos promotores (p < 0,001) y para el resto de los estudiantes (p = 0,024). Decreció el azúcar añadido a los refrescos para los grupos promotores (p < 0,001) y a la leche para todos los adolescentes (p = 0,002). No hubo cambios en el hábito de desayunar, en el gusto por alimentos fritos, ni en el consumo de refrescos, frituras, dulces y pizzas. Conclusiones: Las intervenciones de educación nutricional son necesarias para alcanzar patrones dietéticos más saludables y de esta manera contribuir a detener la epidemia de enfermedades no transmisibles, además permiten que los adolescentes tengan un acercamiento al tema alimentación-nutrición.

ABSTRACT INTRODUCTION Iron deficiency is the main cause of anemia, but infections, inflammation and other factors also play a role. Anemia in women of childbearing age is a risk for pregnancy, childbirth and childhood development during the first two years of life. In Cuba, per WHO definition, anemia is a moderate public health problem in the third trimester of pregnancy and in preschoolers, with a prevalence of 21.6%, in both cases. OBJECTIVE Estimate prevalence of anemia and iron deficiency in women of childbearing age and assess its relation to inflammation, overweight, central adiposity, H. pylori infection and ingestion of iron-rich foods and enhancers of iron absorption. METHODS A cross-sectional, analytical study was performed in 391 women aged 18–40 years in four municipalities of Havana, Cuba, from February through June 2014. Variables (indicators in parentheses) were anemia (hemoglobin), iron deficiency (ferritin), nutritional status (body mass index and waist circumference), inflammation (C-reactive protein, acid alpha 1-glycoprotein and interleukin 6), H. pylori infection and ingestion of iron-rich foods. SPSS 20.0 and Epi Info 7.1.2.0 were used for statistical analysis. RESULTS Anemia prevalence was 24.6% (96/391); iron deficiency, 68% (266/391); H. pylori infection, 47.1% (184/391); inflammation detected by C-reactive protein, 8.4 % (33/391) and by alpha-1-gly-coprotein, 19.9% (78/391). Limited results are included for interleukin 6, which was determined in fewer cases (96). Excess body weight was found in 38.7% (150/388) and increased central adiposity in 26.7% (101/378). Iron deficiency was the main cause of anemia (OR 2.68). Central adiposity, excess body weight, and iron deficiency were positively associated with inflammation (OR of 1.77, 1.23 and 1.72, respectively), whereas H. pylori infection was negatively associated with iron deficiency and anemia (OR 0.75 and 0.94, respectively). Low consumption of meat (OR 1.17) and vegetables (OR 1.36) showed discrete limited positive associations with iron deficiency, as well as low consumption of eggs (OR 1.69) and vegetables (OR 1.56) with anemia. CONCLUSIONS Anemia is a moderate public health problem in the studied group, but with iron deficiency present in two thirds of the population and associated with anemia. Risk factors for anemia and iron deficiency, such as menorrhagia and bacterial or viral infections, should be assessed in women of childbearing age, to support interventions needed to reduce risks in pregnancy and childbirth.

Anemia in children less than five years of age is the main nutritional problem in Cuba. The aim of this study was to assess the intake of iron-rich foods (IRF) and of enhancers of iron absorption (EIA) in children living in the five eastern provinces of Cuba and its association with anemia in 2005, 2008 and 2011. A food frequency questionnaire of 6 months and hemoglobin determination were used. Intake increased in red meat and poultry (44.2% to 60.4%), eggs (38.7% to 58.6%) and vegetables (47.6% to 56.2%); decreased in fruit (73.2% to 55.8%) and legumes (87.7% to 57.7%). The prevalence of anemia in children 6 to 11 months old showed a decrease (62.1% to 44.3%). A reduction in the prevalence of anemia in infants 12-23 months old was found in 2008 compared with 2005 and reversed slightly in 2011, a similar finding was observed in children 2-5 years old. There was a consistent association of anemia with low intake of eggs, vegetables and fruits, but and not with low intake of legumes. Children who attended daycare center ate more iron-rich foods and enhancers of iron absorption than those who did not. The group of children younger than 24 months old remains the most vulnerable group for anemia.

La anemia en niños menores de 5 años constituye el principal problema nutricional en Cuba. El objetivo de este estudio fue estimar el consumo de alimentos ricos en hierro y potenciadores de su absorción en niños residentes en las cinco provincias orientales de Cuba y la asociación con la anemia en los años 2005, 2008 y 2011. La evaluación se realizó mediante una encuesta de frecuencia de consumo de alimentos en el período de 6 meses anterior a la fecha del estudio y determinación de hemoglobina mediante HemoCue. El consumo frecuente entre 2005 a 2011 incrementó en cárnicos (44.2% a 60.4%), huevos (38.7% a 58.6%) y vegetales (47.6% a 56.2%); con un descenso en frutas (73.2% a 55.8%) y leguminosas (87.7% a 57.7%). La prevalencia de anemia disminuyó en niños de 6 a 11 meses de 2005 a 2011 (62.1% a 44.3%). Se observó disminución de la anemia en el grupo de 12 a 23 meses en 2008 que revierte ligeramente el 2011, de manera similar ocurrió en el grupo de 24 a 59 meses. Se encontró asociación de la anemia con el bajo consumo de huevo, vegetales y frutas; no con el consumo de leguminosas. Los niños que asisten a guardería consumían alimentos ricos en hierro y potenciadores de su absorción con mayor frecuencia que los que no asistían, por lo que la asistencia a guardería constituye un factor protector para la anemia en esta población. El grupo de niños menores de 24 meses se mantiene como el grupo de mayor vulnerabilidad para la anemia.

Anemia is a global health problem affecting both developed and developing countries. The causes of anemia may be multifactorial, and several of them are often present at the same time. The main cause of anemia is the low intake of foods with adequate sources of iron both in quantity and quality. Work is being done in Cuba since the year 1987 aimed at developing intervention programs for the prevention of iron deficiency anemia in the population, but despite the great effort, the expected impact has not been achieved, due to the combined influence of various factors. National scientific evidence shows that the low incidence of breastfeeding, the low intake of fruits and vegetables, as well as vitamin deficiency, have an influence on the prevalence of anemia in Cuba. Neither intestinal parasitism nor infection with H. pylori are associated with the prevalence of anemia in the country. Obesity and chronic inflammation would require epidemiological studies describing the potential relationships between these factors.

La anemia es un problema de salud mundial que afecta tanto a los países desarrollados como a aquellos en desarrollo. Sus causas pueden ser multifactoriales y frecuentemente pueden coexisitir varias de ellas; la principal es la baja ingestión de alimentos con fuentes adecuadas de hierro, tanto en cantidad como en calidad. En Cuba se está trabajando desde el año 1987 en el desarrollo de programas de intervención para la prevención de la anemia por deficiencia de hierro en la población, pero a pesar de todo el esfuerzo, no se han obtenido los impactos esperados, y existen diversos factores que pueden estar incidiendo en ello y que pueden sinergizarse. Evidencias científicas nacionales muestran que la baja prevalencia de lactancia materna, el escaso consumo de frutas y vegetales y la deficiencia vitamínica, ejercen influencia en la prevalencia de la anemia en Cuba. El parasitismo intestinal y la infección con H. pylori no están asociados con la prevalencia de anemia en el país. La obesidad e inflamación crónica a bajo tenor requerirían de estudios epidemiológicos que describan las posibles asociaciones entre estos factores.

INTRODUCTION: The aim of this research was the carrying out of a nutrition assessment of a group of children aged from 10 to 14 months, in Ciudad de la Habana. METHODS: Variables analyzed included decimal age, weight, supine length and energy and macronutrients consumption. Anthropometric rates for age-weight, age-height and height-weight were compared with reference national and international values. Dietetic surveys were analyzed in CERES program. RESULTS: Most of subjects were normal for the three anthropometric rates, and although girls had a slight trend to obesity, there were not significant differences between both sexes. The 87,5% showed an excessive consumption of proteins and contribution of macronutrients to energy was unstable. CONCLUSIONS: Was proved that most of children are normal from the anthropometric point of view, and that there is an inappropriate dietetic pattern.

INTRODUCCIÓN. El objetivo de la investigación fue realizar la evaluación nutricional de un grupo de niños con edades entre 10 y 14 meses, residentes en Ciudad de La Habana. MÉTODOS. Las variables analizadas fueron la edad decimal, peso, longitud supina e ingestión de energía y macronutrientes. Los índices antropométricos peso para la edad, talla para la edad y peso para la talla se compararon con los valores nacionales e internacionales de referencia. Las encuestas dietéticas fueron analizadas en el programa CERES. RESULTADOS. La mayoría de los individuos fueron normales para los tres índices antropométricos, y aunque las niñas presentaron una ligera tendencia a la obesidad, no existieron diferencias significativas entre hembras y varones. El 87,5 % presentó ingestión excesiva de proteínas y la contribución de los macronutrientes a la energía fue desequilibrada. CONCLUSIONES. Se comprobó que la mayoría de los niños son normales desde el punto de vista antropométrico y que existe un patrón dietético inadecuado.

INTRODUCTION. Vitamins and minerals are essential nutrients in the formation of tissues, the defense of the organism and the regulation of metabolic processes. They are specially necessary in the first 12 months of life, when the growth speed is high and the neurological and behavioral development is complex. The objective of this paper was to evaluate the contribution of vitamins and minerals to the diet of children aged 10-14 months old living in Havana City. METHODS. A cross-sectional study was conducted from June to September 2005 in health areas of Centro Habana, Marianao and Plaza de la Revolución municipalities. 80 children aged 10-14 months old were evaluated with the previous authorization of their parents. They were selected at random and no symptoms of disease were present at the moment of the study. The data were collected in dietetic surveys for 3 days in a row and they were processed in the CERES automated system. RESULTS. Levels of vitamin A, vitamin C, thiamine, pyridoxine, folic acid, calcium and zinc adjusted to the nutritional recommendations for children at this age were found. The iron intake in food was deficient. CONCLUSIONS. Generally, the main food consumed by children proved to be good sources of vitamins and minerals, although the deficient iron intake shows the need to study the frequency of appearance of iron-deficiency anemia in infants of Havana City and to use this research as a baseline for the implementation of new strategies to enrich the food for children at these ages.

INTRODUCCIÓN. Las vitaminas y los minerales son nutrientes esenciales en la formación de tejidos, la defensa del organismo y la regulación de procesos metabólicos. Son especialmente necesarios en los primeros 12 meses de edad, cuando la velocidad de crecimiento es alta y el desarrollo neurológico y conductual es complejo. El objetivo de este trabajo fue evaluar el aporte de vitaminas y minerales en la dieta de niños de 10 a 14 meses de edad, residentes en Ciudad de La Habana. MÉTODOS. Se realizó un estudio transversal en los meses de junio a septiembre del 2005, en áreas de salud de los municipios Centro Habana, Marianao y Plaza de la Revolución. Con la autorización previa de los padres, se evaluaron 80 niños de 10 a 14 meses de edad, escogidos al azar, que no presentaran síntomas de enfermedad en el momento del estudio. Los datos se recogieron en encuestas dietéticas durante 3 días consecutivos y se procesaron en el sistema automatizado CERES. RESULTADOS. Se encontraron niveles de vitamina A, vitamina C, tiamina, piridoxina, ácido fólico, calcio y cinc que se ajustan a las recomendaciones nutricionales para niños de esta edad. El aporte de hierro en los alimentos fue deficiente. CONCLUSIONES. De manera general los principales alimentos consumidos por los niños resultaron buenas fuentes de vitaminas y minerales, aunque el deficiente aporte de hierro demuestra la necesidad de estudiar la frecuencia de aparición de la anemia por deficiencia de hierro en los lactantes de Ciudad de La Habana y emplear esta investigación como punto de referencia para la implementación de nuevas estrategias de fortificación de alimentos dirigidas a niños de estas edades.

The possible association between the deficient serum levels of vitamins E, C and A with the presence of myocardial infarction and smoking habit is evaluated. A sample composed of 34 patients with a first myocardial infarction was selected. The controls, 61 in all, were taken at random in the last month of every quarter. The serum levels of vitamins E, C and A were determined and a lipid profile was performed. The smoking habit was evaluated as a factor in the influence of vitamin concentrations and the history of arterial hypertension. 93.3 % of the cases and 59.3 % of the controls smoked once in their lives. The means of the plasmatic vitamin C values were significantly higher in the control compared with the cases (p< 0,001). It was not so with the values of vitamin A (retinol) and E (α tocoferol) found. The association of the myocardial infarction with the vitamin C deficiency was marked with OR =5.95 and CI =1.27 - 36.84. It was not observed a significant association with the deficiency of α tocoferol OR =1.89 CI=0.72 - 5.05. The analysis of the association between the vitamin C deficiency and the smoking habit was remarkable with p= 0.009, but the association of the α tocoferol deficiency with the smoking habit was not significant (p=0.691). No vitamin A deficiencies were detected.

Se evaluó la posible asociación entre niveles séricos deficientes de vitamina E, C y A con la presencia de infarto de miocardio y el hábito de fumar. Se seleccionó una muestra compuesta por 34 casos con un primer infarto de miocardio. Los controles se tomaron al azar en el último mes de cada trimestre con un total de 61 personas. Se determinaron los niveles séricos de vitamina E, C y A y lipidograma. Se evaluó el hábito de fumar como factor en la influencia de las concentraciones de vitaminas y los antecedentes de hipertensión arterial. De los casos, 93,3 %, y de los controles, 59,3 %, fumaron alguna vez durante su vida. Las medias de los valores de vitamina C plasmáticos fueron significativamente superiores en los controles en relación con los casos (p< 0,001), no así los valores encontrados de vitamina A (retinol) y E (α tocoferol). La asociación del infarto de miocardio y la deficiencia de vitamina C fue significativa con RD=5,95 e IC=1,27 - 36,84; se encontró asociación no significativa con la deficiencia de α tocoferol RD=1,89 IC=0,72 - 5,05. El análisis de asociación entre las deficiencias de vitamina C y el hábito de fumar fue significativo con p= 0,009, pero no la deficiencia de α tocoferol con el hábito de fumar (p=0,691). No se encontraron deficiencias de vitamina A.

A cross-sectional study was conducted in the second semester of the year 2003 to diagnose the prevalence of iron deficiency anemia in children aged 6 to 24 months and in school children aged 6 to 12 years, who live in the City of Guantánamo. The sample was made up of 200 children. Hemoglobin concentration and serum ferritin were determined by cyanometahemoglobin method and enzyme immunoassay respectively. Anemia prevalence was 35.8% in up to 2 years olds and 22% in school children. No child in any group had hemoglobin values indicative of serious anemia. A significant difference was found between hemoglobin values and the teaching system (p=0,01). Of the total number of anemic children, 86.4% attended the school as day students. According to serum ferritin concentrations, the prevalence of iron deficiency was 57.6%. In the first group, 74.2% of children were exclusively breast-fed up to the 4th month of life. 62.5% of the mothers of these children were already anemic when they got pregnant, and 59.2% suffered anemia in some trimester of their pregnancies. With respect to the school children group, the consumption of hem iron- and non-hem iron-carrying food was infrequent. To effectively face these deficiencies, it is necessary to fortify more those foodstuffs aimed at the above-mentioned age groups, to carry out nutritional education activities and to improve the patterns of iron-rich food intake

Se realizó un estudio transversal en el segundo semestre del año 2003 con el objetivo de diagnosticar la prevalencia de anemia por deficiencia de hierro en niños de 6 a 24 meses y en escolares de 6 a 12 años de edad residentes en la ciudad de Guantánamo. La muestra estuvo compuesta por 220 niños. La concentración de hemoglobina se determinó por el método de la cianometahemoglobina, y la ferritina sérica por enzimoinmunoensayo. La prevalencia de anemia en los niños hasta 2 años de edad fue del 35,8 % y en los escolares del 22 %. Ningún niño de ambos grupos de estudio presentó valores de hemoglobina indicativo de anemia grave. En los escolares se encontró diferencia significativa entre los valores de hemoglobina y el régimen docente (p = 0,01). Del total de anémicos, el 86,4 % pertenece a los niños que asisten a la escuela con un régimen externo. Según las concentraciones de ferritina sérica la prevalencia de la deficiencia de hierro fue del 57,6 %. El 74,2 % de los niños del primer grupo recibió lactancia materna exclusiva hasta el 4to mes. El 62,5 % de las madres de estos niños iniciaron la gestación con anemia y el 59,2 % tuvieron anemia en algún trimestre del embarazo. Para el grupo de escolares el consumo de alimentos portadores de hierro hem y no hem fue poco frecuente. Para combatir con efectividad estas deficiencias se hace necesario incrementar la fortificación de alimentos dirigidos a estos grupos de edades, actividades de educación nutricional, así como mejorar los patrones de ingestión de alimentos ricos en hierro