Central Obesity (CO) might arise among individuals with normal body mass index (BMI). We aim to estimate the prevalence of Normal Weight CO (NWCO), using different definitions, and to compare its association with cardiometabolic risk factors in the adult population of Panama. Data from two population-based studies conducted in Panama in 2010 and 2019 were used. Using standard definitions, normal weight was defined as a BMI between 18·5 and 24·9 while CO was defined as a Waist-to-Height Ratio (WHtR) ≥ 0·5 in both sexes or a Waist Circumference (WC) ≥ 90, ≥94, or ≥102 cm for men, and 80 or 88 cm for women. Unconditional logistic regression models were used to estimate the association between each CO definition and dyslipidemia, high blood pressure (HBP), diabetes, and clusters of cardiovascular risk factors. Recent CO prevalence ranged between 3·9% (WC ≥ 102 cm for men and WC ≥ 88 cm for women) and 43·9% (WHtR ≥ 0·5) among individuals classify as normal weigh according to the BMI. Different cardiovascular risk factors were present in this normal weight population but among men the threshold of WC ≥ 102 cm screened less than 1·0%. NWCO was associated with cardiovascular risk factors, particularly with elevated concentration of triglycerides. CO evaluation at the primary health care level may be a useful technique to identify normal weight people with metabolically obese characteristics. Gorgas Memorial Institute for Health studies via Ministry of Economy and Finance of Panama and Inter-American Development Bank.

Diabetes mellitus (DM) represents an important global burden of disease. In Panama, DM was investigated in 1 study utilizing questionnaires and in another using biomarkers, but at subnational level. Using data from a recent cross-sectional country-wide population-based study that included biomarkers, we estimated the prevalence of DM, its awareness, and control; evaluating possible risk factors. We used data from 4400 participants aged 18 years or older from the National Health Study of Panama (ENSPA) study conducted in 2019 at a national level. Weighted prevalence and 95% confidence intervals for DM, awareness, and control were estimated by sociodemographic factors, family history of DM, tobacco and alcohol use, nutritional status, and hypertension. Odds ratios (ORs) and 95% confidence intervals were calculated using logistic regression models to assess the possible risk factors associated with DM prevalence and awareness. We generated OR estimates by pooling ENSPA data with a previous regional study, prevalence of cardiovascular risk factors. The prevalence of DM was estimated to be 12.4% (10.9%–14.05%). In both men and women, age, family history of diabetes (OR in men: 4.0 ([2.4–6.7]; OR in women 3.5 [2.5–4.8]), and obesity (OR in men: 2.6 [1.4–5.1]; OR in women: 2.0 [0.9–4.5]) were associated with DM. Diagnosed and controlled hypertension was associated with DM only in women (OR: 2.1 [1.2–3.6]). DM awareness was estimated to be 62.6% (56.3%–68.9%). In both men and women, DM awareness was associated with age and a family history of diabetes (OR in men: 6.6 [2.4–18.4]; OR in women 1.9 ([1.1–3.6]). In women, having secondary education (OR: 1.9 [0.9–3.9]) and being diagnosed with uncontrolled hypertension (OR: 3.3 [1.2–9.5]) was also associated to DM awareness. Men in the ENSPA study were less likely to be aware of DM than those in the prevalence of cardiovascular risk factors (OR: 0.2 [0.0–0.7]). Less than half of the individuals diagnosed with DM had their condition controlled (39.6% [31.4%–47.8%]). This study revealed that the prevalence, awareness, and control of DM were similar to recent estimates reported in other Latin American countries. It also provides a baseline regarding DM and associated risk factors in Panama at a country-level knowledge that is essential for health policy development and useful in clinical practice.

Physical inactivity (PI) has been described as an independent risk factor for a large number of major non-communicable diseases and is associated with an increased risk of premature death. Additionally, sedentary behaviour has been associated with increased overall mortality. We estimated the national prevalence of PI and sedentary behaviour using the Global Physical Activity Questionnaire version 2. Using unconditional logistic regressions, the possible risk factors for PI were assessed. Over half of the people included in this study (54.9%; 95% CI: 54.1–57.3%) were physically inactive, with the median time spent engaged in sedentary behaviour being 120 min per day. Statistically significant associations with PI were observed with regard to sex, living area, and alcohol consumption. PI prevalence in Panama was elevated and showed a sex difference (women: 64.7%, 95% CI: 63.7–66.7%; men: 43.4%, 95% CI: 41.5–47.5%). According to our analysis of three-domain-related physical activities, the main contribution to the total estimated energy expenditure of physical activity/week came from the transport domain, followed by the work/household domain, and the least significant contributor was consistently the domain of exercise- and sports-related physical activities.

Background: Malnutrition has important short- and long-term consequences in children under age five. Malnutrition encompasses undernutrition, overnutrition, and the coexistence of both of them, known as the double burden of malnutrition (DBM). Objective: The aim of this study was to estimate the prevalence of undernutrition, overnutrition, and the DBM among these children at the national level and by living area in Panama. Methods: Data from the National Health Survey of Panama (ENSPA, Spanish acronym), a population-based, cross-sectional study carried out in 2019 were used. Stunting, wasting, overweight, and obesity were defined according to the cut-off points of the World Health Organization Growth Standards. Undernutrition was defined as being stunted only, wasted only or both; overnutrition was defined as being overweight only or obese only; and the DBM was defined as the co-occurence of stunting and overweight/obesity in the same child. Prevalence and general characteristics at the national level and by living area were weighted. Findings: The prevalence of undernutrition was 15.3% (95% confidence interval (CI) 13.4–17.3) at the national level and 36.6% (CI: 30.1–43.5) in indigenous areas. The prevalence of overnutrition was 10.2% (8.2–12.6) at the national level and 11.9% (CI: 8.5–16.3), 8.4% (CI: 6.5–10.7) and 8.7% (CI: 5.2–14.3) in urban, rural and indigenous areas, respectively. The DBM prevalence was 1.4% (CI: 1.0–2.1) at the national level and 2.7% (CI: 1.4–5.1) in indigenous areas. Conclusions: Undernutrition is still the most prevalent malnutrition condition in our country. Panama has the highest prevalence of overnutrition in Central America. The highest prevalence of undernutrition and DBM was found among children living in indigenous areas.

To assess secular trends in learning about dangers of tobacco products use at school (LADTAS) using the Panama Global Youth Tobacco Surveys 2002, 2008, 2012, 2017 and 2023.- We analysed nationally representative data from the Global Youth Tobacco Survey (GYTS) cross-sectional studies conducted in Panama in 2002, 2008, 2012, 2017, and 2023 among students aged 13–15 years. The key indicator was self-reported learning about dangers of tobacco products use at school in the past 12 months. Weighted proportions and logistic regression models were used to examine trends and correlates, adjusting for age, sex, and tobacco use status. The proportion of students reporting LADTAS declined from 64.6 % in 2002 to 55.0 % in 2023. Compared with 2002–2008, students surveyed from 2012 onwards had higher odds of not receiving tobacco education (adjusted OR 1.44; 95 % CI 1.31–1.59). No significant differences were observed by sex or age. Former tobacco users were less likely than never-users to report receiving instruction (adjusted OR 1.40; 95 % CI 1.23–1.59). Despite Panama's comprehensive tobacco control policies, classroom education on tobacco risks has declined over the past two decades. Reinvestment in systematic, multi-year, and up-to-date curricula—including coverage of emerging products—is needed to complement structural measures and sustain progress toward a tobacco-free generation.

Background The co-occurrence of different forms of malnutrition has implications for human capital development, as the physiological effects of both anaemia and obesity have been associated with national economic and productivity indicators. This study aims to estimate the prevalence of the double burden of malnutrition including its component conditions, and to identify sociodemographic factors and inflammatory factors associated with the co-occurrence of overweight/obesity and anaemia among non-pregnant women of reproductive age in Panama. Methods Using data derived from the 2019 National Health Survey of Panama, we estimated the prevalence of overweight/obesity without anaemia, anaemia without overweight/obesity and the double burden of malnutrition, defined as the co-occurrence of overweight/obesity and anaemia, among non-pregnant women aged 15–49 years. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using multinomial logistic regression to assess the association between sociodemographic factors and the double burden of malnutrition. Results The weighted prevalence of double burden of malnutrition was 18.6% (95% CI: 15.9%−21.7%). In multivariate adjusted models, compared with women with neither OW/OB nor anaemia, lower vs. higher education (OR= 2.84; 95% CI: 1.24–6.53), ever-having given birth vs. never (OR= 3.01; 95% CI: 1.11–8.15), higher vs. lower inflammation (OR= 9.39; 95% CI: 4.85–18.19) and age 40–49 vs. younger age (OR= 5.99; 95% CI: 1.80–19.95) were associated with double burden of malnutrition. Low education and inflammation were associated with anaemia without overweight/obesity, while older age, indigenous areas, low education, and inflammation were associated with overweight/obesity. Conclusion Double burden of malnutrition affected almost one in five women of reproductive age in Panama. While living in indigenous area was associated with overweight/obesity without anaemia, low education and inflammation emerged as potential shared factors for the individual and combined forms of the double burden of malnutrition.