Parameters of lung inflammation in asthmatic as compared to healthy children in a contaminated city.

BACKGROUND: The impact of air pollution on the respiratory system has been estimated on the basis of respiratory symptoms and lung function. However; few studies have compared lung inflammation in healthy and asthmatics children exposed to high levels of air pollution. The aim of the study was to elucidate the modulatory effect of air pollution on Cysteinyl-leukotrienes (Cys-LTs) levels in exhaled breath condensate (EBC) among healthy and asthmatic children. METHODS: We performed a cross-sectional comparative study. Children between 7-12 years of age, asthmatics and non-asthmatics, residents of a city with high levels of PM10 were included. In all cases, forced spirometry, Cys-LTs levels in EBC, and the International Study of Asthma and Allergies in Childhood questionnaire were evaluated. We also obtained average of PM10, CO, SO2 and O3 levels during the period of the study by the State Institute of Ecology. RESULTS: We studied 103 children (51 asthmatics and 52 non-asthmatics). Cys-LTs levels were higher in asthmatics than in non-asthmatics (77.3 ± 21.6 versus 60.3 ± 26.8 pg/ml; p = 0.0005). Also, Cys-LTs levels in children with intermittent asthma were lower than in children with persistent asthma (60.4 ± 20.4 versus 84.7 ± 19.2 pg/ml; p = 0.0001). In the multiple regression model, factors associated with levels of Cys-LTs were passive smoking (ß = 13.1, p 0.04) and to be asthmatic (ß = 11.5, p 0.03). CONCLUSIONS: Cys-LTs levels are higher in asthmatic children than in healthy children in a contaminated city and its levels are also associated with passive smoking.

Breastfeeding and metabolic indicators in Mexican premature newborns.

BACKGROUND: Morbidity and mortality rates are higher among preterm infants due to physiological immaturity and greater growth demands. Nutritional intervention contributes to proper weight gain, which translates into better growth and neurological development, and prevents the onset of metabolic complications. The effect of breastfeeding duration was studied in the analytic profile at the end of the first six months of life. OBJECTIVE: To describe the nutritional and metabolic markers effect in preterm infants at the end of the first semester of life. MATERIAL AND METHODS: We performed an analytical, transversal and comparative study in 100 preterm infants, 30 to 36 weeks gestational age. Measures for weight, length and head circumference at birth were taken from the subjects' clinical files. A follow-up conducted at 6 to 9 months of age evaluated the same nutritional indicators (weight, length, head circumference) and compared them with values at birth and recommendations. Metabolic indicators (glucose, hemoglobin, cholesterol, triglycerides, insulin, urea, creatinine, gamma-glutamyl-transferase and alkaline phosphatase) were compared with the recommendations. Follow-up study in 100 preterm infants (30 to 36 weeks gestational age). Weight, length and head circumference were measured at birth and 6 to 9 months later. We measured analytic parameters related to metabolic syndrome (glucose, hemoglobin, cholesterol, triglycerides, insulin, urea, creatinine, gamma-glutamyl transferase and alkaline phosphatase). Confusing factors like income level and access to public services were also studied. RESULTS: The mean age at follow-up was 7.3 +/- 1.4 months. Levels of hemoglobin, creatinine and urea showed significant differences with regard to reference values (Wilcoxon ranks test, < 0.05). The average duration of breastfeeding was 4.3 months. The mean age at follow-up was 7.3 +/- 1.4 months. Risk factors for hypercholesterolemia, as well as levels of hemoglobin, creatinine and urea showed significant differences with regard to reference values (Wilcoxon ranks test, < 0.05). CONCLUSIONS: Premature infants showed deficiencies in weight gain. Biochemical parameters could reflect metabolic risk, therefore we recommend prolonging breastfeeding as well as extending the follow-up of these infants for monitoring their growth and development once out of the hospital.

Fluoride Concentration in Urine after Supplementation with Quelites in a Population of Adolescents.

Wild plants have detoxifying and protective properties. They reduce or neutralize the toxic effects caused by chemical agents and pollutants and have beneficial effects on the nutritional and health status. This research was conducted to complement a previous clinical intervention in which participants were exposed to high concentrations of arsenic and fluoride in drinking water to discover similarities or differences in the pattern of fluoride (F-) excretion after supplementation with partial areas of purslane and quelite cenizo (SP-Q). The study was 4 weeks long, and it was carried out on a sample of 27 adolescents in an age range of 11-12 years. Anthropometric and dietary evaluations were performed, and the concentrations of fluoride (F-) in urine and drinking water were quantified using the potentiometric method with an ion-selective electrode. The treated group increased urinary F- excretion after the first week (Baseline: 9.23 mg/g creatinine; Week 2: 0.73 mg/g creatinine), together with significant mobilization of F- and a recovery process at the end of the intervention (Week 4: 0.52 mg/g creatinine). The supplement may act by increasing the excretion of F- and the nutritional dietary conditions that contribute to mitigation and recovery in participants exposed to the contaminant while also managing access to drinking water.

Sensitivity and specificity of body mass index and main risk factors for cardiovascular disease in middle-income urban participants in Guanajuato, Mexico.

Introduction: Introduction: several studies have questioned body mass index (BMI) as an accurate diagnostic tool for obesity and therefore a predictor of cardiovascular risk. But BMI is widely used currently. Objective: we analyzed the sensitivity and specificity of BMI and compared cardiovascular risk factors in middle-income urban participants in Guanajuato, Mexico, at different ages. Design: an analytical and cross-sectional study was carried out in 385 apparently healthy subjects, stratified by age ranges (20 to 59 years old). A high global CVD risk was obtained with the Framingham risk score (Framingham Risk Score > 20 %). The odds ratio was used to assess the association between high global CVD risk and the dietetic and anthropometric variables. Sensitivity, specificity, and correlation statistical analyses were carried out between BMI and other anthropometric variables with high cardiovascular risk, and this was integrated to derive recommendations to improve risk factor detection (p < 0.05 and power of 80 %). Results: a high global CVD risk was found in 4 % of the sample. BMI ≥ 30 kg/m2 had a sensitivity of 77 % for the detection of high cardiovascular risk; waist circumference ≥ 90 cm (men) or ≥ 80 cm (women) and body fat percentage ≥ 2 5% (men) or ≥ 35 % (women) had a sensitivity of 100 %. BMI showed a significant association with high global CVD risk (OR = 6.1; 95 % CI, 1.6-22.6, p < 0.01), but was not able to predict high global CVD risk in at least 30 % of the cases. There was not significative difference by age group for waist circumference, body fat percentage, total cholesterol, and low-density lipoprotein. Regarding the comparison of dietary intake of the stratified population by age group, intake of cholesterol, added sugars, fiber, sodium were highest in the 20 years group. Conclusions: a higher intake of cholesterol, simple sugars, and sodium was observed in the 20-year-old age group. The use of BMI with waist circumference and percentage of body fat used together allow a better assessment of cardiovascular risk. We need to integrate this new recommendation to increase early detection of main risk factors for cardiovascular disease.

Introducción: Introducción: diversos estudios han cuestionado el índice de masa corporal (IMC) como herramienta diagnóstica certera de la obesidad y por tanto predictor de riesgo cardiovascular. Pero el IMC es ampliamente utilizado actualmente. Objetivo: se analizó la sensibilidad y especificidad del IMC y se compararon factores de riesgo cardiovascular en participantes de diferentes edades de zonas urbanas de ingresos medios en Guanajuato, México. Diseño: se realizó un estudio analítico y transversal en 385 participantes, aparentemente sanos, estratificados por rangos de edad (20 a 59 años). El riesgo de CVD global alto se obtuvo con la puntuación de riesgo de Framingham (puntuación de riesgo de Framingham > 20 %). Se calculó la odds ratio para evaluar la asociación entre el alto riesgo global de ECV y las variables dietéticas y antropométricas. Se realizó un análisis estadístico de sensibilidad, especificidad y correlación entre el IMC y otras variables antropométricas con el alto riesgo cardiovascular, y se integró para derivar recomendaciones para mejorar la detección de factores de riesgo (p < 0,05 y potencia del 80 %). Resultados: se encontró un alto riesgo global de ECV en el 4 % de la muestra. El IMC ≥ 30 kg/m2 tuvo una sensibilidad del 77 % para la detección del alto riesgo cardiovascular; la circunferencia de la cintura ≥ 90 cm (hombre) o ≥ 80 cm (mujer) y el porcentaje de grasa corporal ≥ 25 % (hombre) o ≥ 35 % (mujer) tuvo una sensibilidad del 100 %. El IMC mostró una asociación significativa con un alto riesgo global de ECV (OR = 6,1; IC 95 % 1,6-22,6; p < 0,01) pero no fue capaz de predecir un alto riesgo global de ECV en al menos el 30 % de los casos. No hubo diferencia significativa por grupo de edad para circunferencia de cintura, porcentaje de grasa corporal, colesterol total y lipoproteínas de baja densidad. Con respecto a la comparación de la ingesta dietética de la población estratificada por grupos de edad, la ingesta de colesterol, azúcares añadidos y sodio fue mayor en el grupo de 20 años. Conclusiones: se observó una mayor ingesta de colesterol, azúcares simples y sodio en el grupo de edad de 20 años. El uso del IMC con la circunferencia de la cintura y el porcentaje de grasa corporal utilizados conjuntamente permiten lograr una mejor evaluación del riesgo cardiovascular. Necesitamos contar con herramientas para aumentar la detección temprana de los principales factores de riesgo de enfermedad cardiovascular.

Weight gain and metabolic complications in preterm infants with nutritional support.

OBJECTIVE: To analyze the weight gain and to describe the metabolic complications in preterm newborns with nutritional support (NS) and to describe nutritional practices in the first month of hospitalization for 52 preterm newborns. MATERIAL AND METHODS: Descriptive and prospective study of preterm infants (30-36 gestational weeks), with birth weight > 1 kg, hospital stay > 12 days, without respiratory support or complications, conducted at a public hospital in Leon, Guanajuato, Mexico from January to November 2006. Weight, serum glucose, insulin, cholesterol, triglycerides, gamma-glutamyltransferase, creatinine, urea nitrogen, type of NS (parenteral PN, enteral EN, mixed MN), energy content, and macronutrient intake were measured weekly. To obtain representative data, nutritional practices were not altered by the study protocol. One way ANOVA and Wilcoxon tests were used in data analyses. RESULTS: Overall, 52 newborns were included, averaging 33 gestational weeks and 1,590 g of weight. The NS was started by the fourth day on average. Parenteral nutrition was the most frequent NS during the first 2 weeks (75%). Energy and macronutrient supply was 50% less than the recommended. Weight gain ranged from -100 to 130 g/week. Parenteral nutrition showed better weekly weight gain, followed by EN. The metabolic complication rate per person-day was greater for MN (0.56), than for EN (0.16) or PN (0.09). Routine surveillance of weight and metabolic complications was deficient. CONCLUSIONS: Late onset of NS, insufficient energy supply, and deficient surveillance were obstacles to weight gain and to prevent the metabolic complications in these newborns.

[Food insecurity and its association with obesity and cardiometabolic risks in Mexican women]. / Inseguridad alimentaria y su asociación con la obesidad y los riesgos cardiometabólicos en mujeres mexicanas.

INTRODUCTION: Objective: we conducted a systematic review of the main scientific evidence that associates food insecurity with a higher frequency of obesity and cardiometabolic risks in Mexican women. Design: a systematic review. Data sources: MEDLINE, Embase, CINAHL Plus, Web of Science, CAB Abstracts and PAIS Index. Selection criteria: articles that met the journal quality criteria and integrated food status with health insecurity, in which the situation of vulnerability in the current statistics for cardiometabolic diseases and risks that are associated with food insecurity was shown in women and their homes. Data analysis: relevance and quality of the results regarding food security, the presence of overweight and obesity, and socio-environmental indicators in women. Results: households headed by women who are at higher risk of having some degree of food insecurity or food assistance associated with the presence of obesity and overweight (RR = 1.28 to 2.97; 95 % CI: 1.08-1.44 to 1.52-6.14) as well as the development of cardiometabolic diseases such as diabetes mellitus (with a history of pregnancy as risk factor for developing diabetes and hypertension) presenting premature labor, shorter stature in the adult stage, a deficiency in micronutrients such as iron and antioxidant vitamins. Conclusion: the evidence found shows an association of food insecurity as found in women and their homes with a greater risk of being overweight and obese, as well as the development of a cardiometabolic disease (diabetes, hypertension), in addition to anemia and vitamin deficiency.

INTRODUCCIÓN: Objetivo: realizar una revisión de la principal evidencia científica que asocie la inseguridad alimentaria con una mayor frecuencia de obesidad y riesgos cardiometabólicos en mujeres mexicanas. Diseño: revisión sistemática. Fuentes de datos: MEDLINE, Embase, CINAHL Plus, Web of Science, CAB Abstracts y PAIS Index. Selección de estudios: artículos que reunieran los criterios de calidad de las revistas e integraran la situación de inseguridad alimentaria y salud, en los que se viera la situación de vulnerabilidad en las estadísticas actuales de enfermedades y riesgos cardiometabólicos asociados con la situación de inseguridad alimentaria en mujeres y sus hogares. Extracción de datos: relevancia y calidad de los resultados respecto a la seguridad alimentaria, la presencia de sobrepeso y obesidad, e indicadores socioambientales en las mujeres. Resultados: los hogares encabezados por mujeres presentaron mayor riesgo de tener algún grado de inseguridad alimentaria o carencia alimentaria, asociándose esta con la presencia de obesidad y sobrepeso (RR = 1,28 a 2,97; IC 95 %: 1,08-1,44 a 1,52-6,14) así como con el desarrollo de enfermedades cardiometabólicas como la diabetes mellitus (siendo el embarazo, como antecedente, un factor de riesgo para desarrollar diabetes e hipertensión), presentar partos prematuros, tener menor estatura en la etapa adulta, una deficiencia de micronutrimentos como el hierro y de vitaminas antioxidantes. Conclusiones: la evidencia encontrada muestra una asociación de la inseguridad alimentaria encontrada en las mujeres y sus hogares con una mayor probabilidad de presentar sobrepeso y obesidad, así como el desarrollo de una enfermedad de índole cardiometabólica (diabetes, hipertensión), además de anemia y deficiencia de vitaminas.

[Comparison between five growth curves used in a public hospital]. / Comparación de cinco curvas de crecimiento de uso habitual para prematuros en un hospital público.

OBJECTIVE: To compare five curves routinely used for growth evaluation in preterm newborns in a public hospital in Leon, Guanajuato, and to identify those with similar diagnosis according to the reference curve (Williams) in order to determine their usefulness in the clinical practice. METHODS: Analytical, prospective, comparative and cross sectional study in 100 preterm infants, of both sexes, 30 to 36 weeks of gestation without congenital malformations. We obtained the weight and length for their interpretation and to compare the nutritional diagnosis, between five curves routinely used for growth evaluation in preterm newborns: Babson-Benda, Fenton, Jurado-Garcia, Battaglia-Lubchenco and Williams, subsequently, four of the curves were compared against the reference curve (Williams). To analyse the proportions, the chi2 statistic was used. RESULTS: The average age of the preterm infants was 34 +/- 2 gestation weeks, with birth weight 1932 +/- 699 g. When the combination between them were, it was noted that Babson and Benda-Fenton showed similar distribution for the diagnosis of small for gestional age by 50%. Small for gestational age was diagnosed with the Jurado-Garcia, Williams, Battaglia-Lubchenco curves in 43, 38 and 29% respectively. The comparison showed that the curves of Jurado-Garcia and Battaglia-Lubchenco rendered a similar diagnosis, respect to the curve of Williams. CONCLUSIONS: According to this study, the curves of Jurado-Garcia and Battaglia- Lubchenco are recommended for evaluating the extra uterine and intrauterine growth of preterm infants.

Repurposing Individualized Nutritional Intervention as a Therapeutic Component to Prevent the Adverse Effects of Radiotherapy in Patients With Cervical Cancer.

Worldwide, cervical cancer was the fourth leading cause of cancer death among women, while in Mexico was the second cause (5.28%). Cancer patients receiving chemotherapy and radiotherapy have a high risk of malnutrition secondary to the disease and treatment, affects the patient's overall, with adverse effects on gastrointestinal symptoms. These use affects the medical therapy. The aim of the present study was to evaluate the benefits on individualized nutritional therapy on decrease weight loss and gastrointestinal adverse effects and to consider these outcomes in pharmacology research, especially in repurposing drugs. We conducted a longitudinal design with two comparation groups with medical diagnosis of cervical cancer and received radiotherapy weekly, 1) the intervention group (nutritional intervention and counseling -INC-) with 20 participants and 2) control group (retrospective cohort -CG-) with 9 participants. Weekly body composition, dietary intake, adverse effects (gastrointestinal symptoms), glucose, hemoglobin, and blood pressure were analyzed during 4 to 5 weeks. Both groups had weight loss weekly (p = 0.013 and p = 0.043 respectively) but the CG vs INC presented loss fat-free mass ≥500g in 67 and of 37% respectively. By the end of the intervention a 25% of the INC group had <10 g/dL of hemoglobin vs 60% for the CG. To compare the dietary intake of vitamins (A and folic acid), fiber (p = 0.006), iron (p = 0.03) and energy (mainly carbohydrates) (p = 0.04) were according to the recommendations in INC group (p>0.05). The number needed to treat was 4 (95% CI, 2 to 13). The nutritional intervention and counseling weekly during radiotherapy in cervical cancer to maintain/improve muscle mass, hemoglobin, and dietary intake above 70% of the recommendations for INC group compared to the evidence. Adequate nutritional status was maintained and decrease the rate of complications, mainly gastrointestinal symptoms, in INC group. The efficacy of drug repurposing can improve through individualized nutritional therapy for preventing adverse effects of radiotherapy in patients with cervical cancer.

5'UTR methylation in different genes from workers exposed to volatile organic compounds: A new insight for considering an epigenetic mark as a functional correlate.

Gene-specific methylation has been related with transcriptional/translational consequences in different cells; also, this epigenetic modification is affected by environmental exposures. In previous studies, CYP2E1 activity in toluene-exposed workers was decreased compared to controls, however, CYP2E1 promoter methylation levels did not show significant differences. Here, we compared gene-specific methylation levels at the 5'UTR region, in a subset of workers whom already participated in two former studies, compared to controls. METHODS: DNA was obtained from whole blood in five different groups: occupationally exposed to a mixture of volatile organic compounds (VOC): high levels (n = 19); low levels (n = 19) and very low levels (n = 17), toluene-exposed workers (n = 19) and control group (n = 19). We performed PCR-pyrosequencing at the 5'UTR region from four genes: CYP2E1, IL-6, SOD1 and TNF-α. RESULTS: In participants exposed to high levels of a VOC mixture, we found significant differences: lower methylation levels for IL-6, and higher methylation levels for TNF-α compared to controls. In toluene-exposed workers, we found significant, lower methylation levels for CYP2E1 compared to controls. CONCLUSION: Lower methylation levels at the 5'UTR region from CYP2E1 in toluene exposed-workers, suggests that this epigenetic modification could represent a functional correlate regarding enzymatic activity, as a response to toluene biotransformation.

Cancer prevention programmes in Mexico: are we doing enough?

Cancer has increased in all the countries of the world and Mexico is no exception. The recognised risk factors for the main types of cancer are reviewed and searched through the Mexican government web pages and cancer prevention programmes to tackle the risk factors in the population. The Mexican government, a member of the World Health Organization, shows that the main approach is an early diagnosis rather than prevention, forgetting that an ounce of prevention is better than a pound of cure. Effective public programmes should be promoted to reduce preventable risk factors in the population (smoking, nutrition, obesity, diet, environmental toxicity, sedentary lifestyle) and control the non-preventable factors (genetics) if we really want to control the incidence of different types of cancer.

Arsenic in Mexican children exposed to contaminated well water.

This cross-sectional study measures the arsenic level in school children exposed to contaminated well water in a rural area in México. Arsenic was measured in hair by hydride generation atomic absorption spectrophotometry. Overall, 110 children were included (average 10 years-old). Among 55 exposed children, mean arsenic level on hair was 1.3 mg/kg (range <0.006-5.9). All unexposed children had undetectable arsenic levels. The high level of arsenic in water was associated to the level in hair. However, exposed children drank less well water at school or at home than unexposed children, suggesting that the use of contaminated water to cook beans, broths or soups may be the source of arsenic exposure.

Association between food insecurity and perinatal risk factors with hearing problems in preterm birth.

INTRODUCTION: Background: hearing disorders in the premature newborns impact on their development and language and therefore, on their quality of life. Several risk factors have been associated to these conditions, but little is known about socioeconomic, nutrition factors and food security. Objective: to analyze the association between food security and prenatal risk factors in newborns with hearing disorders. Material and methods: study of 35 cases and 105 controls in premature newborns from 30 to 37 weeks of gestation (WG) in a public hospital. The working tool was a questionnaire to collect data about the maternal medical record and the anthropometry of the newborn, as well as the risk factors for the auditory function, sociodemographic aspects, and food security with its respective classification and food habits. Results: the principal perinatal risk factor associated to hearing impairment was the use of gentamycin (ototoxic drug) in 18.1% of the total (OR: 5.61 [1.29-24.50]). Severe food insecurity was associated with auditory disfunctions in 27.2% of cases and in 2.8% of controls (OR: 12.75 [2.89-56.16]). There were differences between the groups regarding the education level (cases: 50% of the mothers finished or interrupted primary education level vs controls with 19%; Ji2 = 0.008). The anthropomorphic variables showed differences in weight, length and cephalic perimeter for the newborns (p < 0.000). Conclusion: severe food insecurity, exposure to gentamycin and low education level of the mother had a significant association with auditory impairments in preterm children. For these newborns, variables like weight, length and cephalic perimeter at the moment of birth were lower than in controls. These initial findings point to the important role that environmental risks, like food insecurity, have in auditory impairments in addition to those previously described.

INTRODUCCIÓN: Introducción: las alteraciones auditivas en el recién nacido prematuro impactan en su desarrollo y lenguaje y por ende a la calidad de vida. Se conocen varios factores de riesgo asociados a estas alteraciones, pero poco sobre los aspectos socioeconómicos, nutricionales y de inseguridad alimentaria. Objetivo: analizar la asociación con la inseguridad alimentaria y los factores de riesgo prenatales en prematuros con problemas de audición. Material y métodos: estudio de 35 casos y 105 controles, en prematuros de 30 a 37 SDG de un hospital público, realizado a través de una encuesta donde se recopilaron datos del expediente materno y del recién nacido (antropometría), así como factores de riesgo para alteración auditiva, aspectos sociodemográficos, seguridad alimentaria con sus respectivas clasificaciones y tipo de alimentación. Resultados: el principal factor de riego perinatal asociado a las alteraciones auditivas fue la administración de gentamicina (antibiótico ototóxico) en 18,1% de los casos (OR: 5,61 [IC = 1,29-24,50]). La inseguridad alimentaria severa se asoció con las alteraciones auditivas, en 27,2% de casos y en 2,8% de controles (OR: 12,75 [IC = 2,89-56,16]). Además, se encontraron diferencias entre los grupos para el nivel de escolaridad (casos: 50% de las madres tuvieron primaria terminada o incompleta vs. controles con 19%; Ji2 = 0,008) y Las variables antropométricas presentaron diferencias en peso, longitud y perímetro cefálico (p < 0,000). Conclusión: la inseguridad alimentaria severa, exposición a gentamicina, el nivel de escolaridad de la madre, tuvieron una asociación significativa con las alteraciones auditivas en el prematuro. Variables como el peso, longitud y perímetro cefálico al nacimiento presentaron valores inferiores en el grupo casos. Estos primeros hallazgos, reflejan riesgos ambientales como la inseguridad alimentaria en las alteraciones auditivas además de las ya conocidas.

Effect of a Supplementation with Two Quelites on Urinary Excretion of Arsenic in Adolescents Exposed to Water Contaminated with the Metalloid in a Community in the State of Guanajuato, Mexico.

Quelites are Mexican wild plants, reported as excellent sources of nutritional compounds such as amino acids (serine, glycine, and cysteine), minerals (Mg, Fe, and Zn), and phytochemicals, as phenolic acids (chlorogenic acid) and flavonoids (phloridzin and naringenin); on the other hand, high biological activity has been shown in these compounds. This work aimed to evaluate the effect of a supplementation with two endemic quelites of Mexico (Chenopodium berlandieri L. and Portulaca Oleracea L.); in addition to supplementation, a nutritional intervention was performed; the biomarkers of hemoglobin (Hb), urinary malondialdehyde (UMDA), and urinary arsenic (UAs) were measured in adolescents exposed to arsenic. A clinical intervention study was conducted in 27 adolescents ages 11 to 12 years for 4 weeks. Weekly anthropometric and dietary evaluations were carried out, as well as the concentration of Hb; the UMDA and UAs were performed by plate-based colorimetric measurement and atomic absorption spectrophotometry with the hydrides generation system, respectively. The results showed that UMDA concentrations had a significant improvement in the supplemented group (SG) vs. control group (CG) (SG = 1.59 ± 0.89 µM/g creatinine vs. CG = 2.90 ± 0.56 µM/g creatinine) in the second week of intervention; on the other hand, the supplemented group showed an increase in Hb levels (15.12 ± 0.99 g/dL) in the same week; finally after the second week, an increase in UAs levels was observed significantly compared to the baseline value (Baseline: 56.85; Week 2: 2.02 µg/g creatinine). Therefore, the results show that the mixture of quelites (a rich source of phytochemicals and nutrients) improved hemoglobin and UMDA levels, and urinary arsenic excretion from the second week in the exposed population.

[Threats, challenges and opportunities for paediatric environmental health in Europe, Latin America and the Caribbean]. / Amenazas, desafíos y oportunidades para la salud medioambiental pediátrica en Europa, América Latina y el Caribe.

In a world that is increasingly technological and interconnected, but also more violent, overexploited and polluted, Paediatric Environmental Health (PEH) is one of the best contributions to improve global health. Few areas of the planet have a high affinity with common values and interests, such as the European Union (EU), Latin America and the Caribbean (LAC). The investments and actions of the PEH in pre- and postnatal periods during the first two decades of life will generate countless benefits in the health and well-being during the human life span. Detecting, reducing, or eliminating physical, chemical, biological and social pollutants is one of the main missions and actions of the PEH. In this special article, an update review is presented on the threats, challenges and cooperation opportunities in PEH among bio-health professionals and other social sectors involved, from the EU and LAC. New professional profiles, knowledge structures and architectures for engagement emerge. Courageous leaderships, new substantial resources, broad social changes, and the necessary collaboration between the two regions will be required to improve the health of present and future generations.

[Influence of an individualized diet to control gestational diabetes mellitus]. / Influencia de una dieta individualizada en el control de la diabetes mellitus gestacional.

BACKGROUND: Dietetic control is part of an integral therapy to gestational diabetes mellitus. OBJECTIVE: To evaluate the effect of an individualized diet with 52% of complex carbohydrates of low and moderate glycemic index to control gestational diabetes mellitus. MATERIAL AND METHODS: Analytic and longitudinal study in 31 patients with gestational diabetes mellitus in a third level hospital in Leon, Guanajuato, from August 2005 to December 2006. During 4 months, starting on 24 to 26 weeks of pregnancy, patients followed a 1,700 to 2,000 kcal/day diet, with 52% of complex carbohydrates of low and moderate glycemic index, 30% of fat and 18% of proteins. Total diet intake, weight gain, percentage of weight for gestational age, and glucose were measured monthly; glycosylated hemoglobin was measured at the beginning and at the end of the study. The weight of the newborn was registered. RESULTS: Overall, 76% of patients were obese and 24% had overweight. Final weight gain at the end of third trimester was 3 kg. There were significant differences in month-to-month and final comparisons of glucose (146 +/- 37 vs 90 +/- 5 mg/dL), caloric intake (2,800 +/- 1,030 vs 1,740 +/- 109 kcal/day) and macronutrients, as well as in glycosylated hemoglobin (7.1 +/- 1.2 vs 5.3 +/- 0.5%). At the end of the study diet of 65% of patients was recommendable, in comparison with 14% at the beginning. Adherence to diet plan improved in final months. Average newborn weight was 3,347 +/- 385 g. CONCLUSION: An individualized diet here prescribed leads to control of gestational diabetes and to the birth of normal size babies. There were significant differences in the month-to-month comparisons of glucose, weight, caloric intake and macronutrients, as well as in the initial and final glycosylated hemoglobin (7.1 +/- 1.2 and 5.0 +/- 0.7%). Our results suggest that an individual diet of 52% of complex carbohydrates allowed a satisfactory control of gestational diabetes mellitus, with normal levels of glucose, glycosylated hemoglobin, and weight gain.

Saberes, tradiciones y prácticas de alimentación materno-infantil en localidades del Carso Huasteco hidalguense / Knowledge, traditions, and practices of maternal and child feeding in localities of the Huasteco hidalguense Carso

Resumen La alimentación durante los primeros 1000 días de vida (desde el vientre materno hasta los dos años) son fundamentales para la salud futura de una persona. Este artículo tiene por objetivo analizar los saberes y prácticas alimentarias materno-infantiles en localidades rurales del Estado de Hidalgo en México. Estudio de corte transversal, descriptivo, observacional desde una perspectiva fenomenológica combinando técnicas cuantitativas y cualitativas en 56 participantes y 7 informantes a quienes se entrevistó. El 48% de las mujeres entrevistadas ofrecieron leche materna exclusivamente durante 4 a 6 meses, el 57% destetó después del año. La familia fue la principal fuente de información de las mujeres (91%), por encima del personal de salud (80%), quien frecuentemente da opiniones contradictorias. El 71% prefirió el uso de conocimientos de herbolaria provenientes de parteras, hijas de parteras o adultas mayores. Los saberes, tradiciones y prácticas alimentarias de las madres de menores de dos años en el Carso Huasteco hidalguense, se basan en conocimientos tradicionales permeados por el discurso del personal de salud y los medios de comunicación, así como el acceso físico y económico a los alimentos procesados y frescos.

Abstract Nutrition during the first 1000 days of life (from the womb to two years of age) is fundamental for the future health of a person. The objective of this article is to analyze maternal and child feeding knowledge and practices in rural localities of the state of Hidalgo in Mexico. A cross-sectional, descriptive, observational study was carried out from a phenomenological perspective combining quantitative and qualitative techniques in 56 participants and 7 informants who were interviewed. 48% of the women interviewed offered breast milk exclusively for 4 to 6 months, 57% weaned after one year. The family was the main source of information for the women (91%), above the health personnel (80%), who frequently gave contradictory opinions. Seventy-one percent preferred the use of herbal knowledge from midwives, daughters of midwives, or older women. The knowledge, traditions, and food practices of mothers of children under two years of age in the Carso Huasteco hidalguense are based on traditional knowledge permeated by the discourse of health personnel and the media, as well as physical and economic access to processed and fresh foods.

[Effect of a four-week vitamin and mineral supplementation on the nutritional status and urinary excretion of arsenic in adolescents]. / Efecto de una suplementación de vitaminas y minerales de cuatro semanas sobre el estado nutricio y excreción urinaria de arsénico en adolescentes.

INTRODUCTION: adequate nutrition in adolescence is important for growth and development. There are environmental factors that cannot be avoided, such as exposure to heavy metals through natural sources such as water. Arsenic is a metalloid that can cause damage to health (alterations in nutritional status, diabetes, cancer) and it has been found in concentrations higher than those allowed in drinking water. OBJECTIVE: to measure the effect of vitamin and mineral supplementation on the nutritional status and urinary excretion of arsenic in adolescents exposed to this metal through drinking water. MATERIAL AND METHODS: an observational, follow-up study of a cohort was conducted to assess the efficacy of vitamin and mineral supplementation on supplementation in 45 adolescents exposed to arsenic in drinking water, who were given a daily multivitamin supplement for four weeks. Weekly nutritional status and arsenic levels in urine and drinking water were evaluated. RESULTS: the basal nutritional intake was low for proteins, fiber, folic acid, vitamin B2, B6, B12, E, C, selenium and iron, increasing their consumption through the supplement during the intervention and with an increase of approximately 1 g/dl of hemoglobin in all participants. At the end of the intervention, there was an increase in fat-free mass and a decrease in the percentage of body fat. In relation to the urinary excretion of arsenic, the biggest elimination of this metalloid was observed from the first week of intervention (35.91 µg/g Cr [IC 95% = 23.2-74.8 µg/g Cr]), which was statistically significant compared to basal levels of urinary arsenic (43.2 µg/g Cr [IC 95% = 30.8-117.6 µg/g Cr]) (p < 0.05), with an average water consumption with As of 96.2 ± 7.5 µg/l. CONCLUSION: four weeks of supplementation with vitamins and minerals in the adolescent population studied improved nutritional status and increased metalloid excretion significantly in the first and second week after intervention.

Introducción: la adecuada nutrición en la adolescencia es de importancia para el crecimiento y desarrollo. Existen factores ambientales que no pueden evitarse, como la exposición a metales pesados a través de fuentes naturales como el agua. El arsénico es un metaloide que puede causar un daño a la salud (alteraciones del estado nutricio, diabetes, cáncer) y ha sido encontrado en concentraciones superiores a las permitidas en el agua de consumo.Objetivo: medir el efecto de una suplementación de vitaminas y minerales sobre el estado nutricio y la excreción urinaria de arsénico en adolescentes expuestos a este metal a través de agua de consumo.Material y métodos: se realizó un estudio de intervención y longitudinal para la valorar la eficacia de la suplementación de vitaminas y minerales sobre la suplementación en 45 adolescentes, expuestos a arsénico en agua de consumo, a quienes se dio un suplemento multivitamínico diariamente durante cuatro semanas. De forma semanal se evaluaron el estado nutricio y los niveles de arsénico en orina y en agua de consumo.Resultados: en la población de estudio se observó que el consumo nutrimental basal fue bajo para proteínas, fibra, ácido fólico, vitamina B2, B6, B12, E, C, selenio y hierro, incrementando su consumo a través del suplemento durante la intervención y con un aumento de aproximadamente 1 g/dl de hemoglobina en todos los participantes. Al final de la intervención presentaron incremento de masa libre de grasa y disminución en el porcentaje de grasa corporal. Por otro lado, en cuanto a la excreción urinaria de arsénico, se observó mayor eliminación de este metal (35,91 µg/g Cr [IC 95% = 23,2-74,8 µg/g Cr]) desde la primera semana de intervención, la cual fue estadísticamente significativa en comparación con los niveles basales de arsénico urinario (43,2 µg/g Cr [IC 95% = 30,8-117,6 µg/g Cr]) (p < 0,05), con un consumo promedio de agua con As de 96,2 ± 7,5 µg/l.Conclusión: la suplementación con vitaminas y minerales de cuatro semanas en la población de adolescentes estudiada mejoró el estado nutricio y aumentó la excreción del metaloide de manera significativa en la primera y segunda semana postintervención.

The effect of probiotics in the treatment and prevention of metabolic syndrome: a systematic review / El efecto de los probióticos en el tratamiento y prevención del síndrome metabólico: revisión sistemática

Abstract There is consistent clinical evidence, but not yet conclusive, that the consumption of foods or supplements based on probiotics modifies the microbiota and the microenvironment, with beneficial effects that are manifested in the clinical, anthropometric, and biochemical components of metabolic syndrome (MS) in the adult population. The objective of this systematic review was to analyze the effects of probiotic supplementation on the prevention and treatment of MS and its components in the adult population. A systematic review was carried out in the databases: Pubmed-Medline, Scopus, Web of Science, LILACS, Cochrane, SIGN, NICE and Scielo, with articles in Spanish and English from 2010 to 2020, with controlled intervention designs where have compared probiotic supplementation (regardless of dose, strains, route of administration, or duration of use). Sixteen articles were selected (10 randomized clinical trials (RCTs), which included 610 participants). The meta-analysis carried out indicated that no statistically significant differences were found on insulin resistance (HOMA-IR), obesity (body mass index -BMI-), atherogenic dyslipidemia or on blood pressure. These findings conclude the lack of evidence found to recommend the consumption of probiotics as a strategy to reduce the prevalence of MS. The methodological limitations found among the reviewed studies imply the need for future lines of research on its relevance as a potential nutritional therapy and for the moment it is recommended to integrate variables such as nutritional treatment or diet control.

Resumen Existe evidencia clínica consistente, pero no concluyentes aún, que el consumo de alimentos o suplementos a base de probióticos modifica la microbiota y el microambiente, con efectos benéficos que se manifiestan en los componentes clínicos, antropométricos y bioquímicos del síndrome metabólico (MS) en población adulta. El objetivo de la presente revisión sistemática fue analizar los efectos de la suplementación con probióticos sobre la prevención y tratamiento del MS y sus componentes en población adulta. Se realizó una revisión sistemática en las bases de datos: Pubmed-Medline, Scopus, Web of Science, LILACS, Cochrane, SIGN, NICE y Scielo, con artículos en idioma español e inglés de 2010 a 2020, con diseños de intervención controlados donde se haya comparado la suplementación con probióticos (independientemente de la dosis, las cepas, la vía de administración o la duración del consumo). Fueron seleccionados 16 artículos (10 ensayos clínicos aleatorizados (ECA), que incluyeron 610 participantes). El metaanálisis ejecutado indicó que no se encontraron diferencias estadísticamente significativas sobre la resistencia a la insulina (HOMA-IR), la obesidad (índice de masa corporal -IMC-), la dislipidemia aterogénica o sobre la presión arterial. Estos hallazgos concluyen la falta de evidencia encontrada para recomendar el consumo de probióticos como una estrategia en la disminución de la prevalencia del MS. Las limitantes metodológicas encontradas entre los estudios revisados implican la necesidad de futuras líneas de investigación sobre su relevancia como una potencial terapia nutricional y por el momento se recomienda integrar variables como el tratamiento nutricio o el control de la dieta.

[Does cranberry juice have bacteriostatic activity?]. / Es bacteriostático el jugo de arándano?

BACKGROUND: Cranberry juice is used to prevent urinary infections but it is not known if it inhibits bacterial growth in urine or in bacteriologic broth. OBJECTIVE: Determining if cranberry juice has bacteriostatic properties. METHODS: The urine of 20 female university students was studied before and after drinking cranberry juice. Both specimens were submitted to pH determination and inoculated with a control strain of Escherichia coli. After 1 and 2 hours of incubation with the inoculum, the urine specimens were plated on agar to determine their bacterial counts. Additionally, the growth of 10 E. coli strains were studied in broths with serial dilutions of juice. RESULTS: No inhibitory effect on bacterial growth was observed in urine after drinking cranberry juice. After 1 and two hours of incubation with the E. coli inoculum, control urine grew an average 132.2 and 153 x 10(3) colony-forming units/mL, respectively. After 1 and two hours of incubation with the inoculum, post-intervention urine grew an average 141.4 and 170.6 x 10(3) CFU/mL, respectively (p > 0.05). Against expectations, an increment was observed in urinary pH after drinking the juice (average pH in controls, 5.8 vs. 6.2 in post-intervention specimens; p = 0.043). In vitro analysis did not find a negative trend of E. coli growth in broths with higher concentrations of juice. CONCLUSIONS: Cranberry juice was not associated with bacteriostatic properties and its ingestion was not followed by a drop in urinary pH, which suggests that these are not its potential beneficial effects for the management and the prevention of urinary tract infections.

Importancia nutricional y actividad biológica de los compuestos bioactivos de quelites consumidos en México / Nutritional importance and biological activity of bioactive compounds from quelites consumed in Mexico

Sólo un 30% de los hogares en México, presentan seguridad alimentaria, es decir, un gran porcentaje de los hogares y por ende de la población no satisfacen las necesidades básicas diarias de macro y micronutrimentos. Los quelites, que se definen como plantas silvestres comestibles (hojas, tallos y flores) son una fuente accesible, continua, económica y adecuada de nutrimentos. Sin embargo, su consumo ha disminuido por modificaciones en las preferencias alimentarias, derivadas de los cambios en estilos de vida. El objetivo del presente trabajo fue valorizar a los quelites como fuente de alimento. Los quelites, aportan proteínas, aminoácidos, minerales (Ca, Mg, Zn), vitaminas (E, C) y fibra. Además, son una excelente fuente de compuestos bioactivos, como ácidos fenólicos (ácido cafeico, ferúlico) y flavonoides (quercetina, kaempferol, espinacetina), carotenoides, ácido α-linolénico y betalainas, que presentan elevada actividad antioxidante. Su consumo habitual se ha relacionado con beneficios a la salud, tales como efectos antitumorales, antihiperlipidémicos y antidiabéticos. Los quelites, además de estar disponibles en forma silvestre, forman parte de las tradiciones culinarias de México, incorporados de forma cruda y cocida en los platillos regionales. Por lo tanto, la revalorización y reincorporación de los quelites en la dieta, puede coadyuvar a cubrir las necesidades nutrimentales, en poblaciones con poco acceso o inseguridad alimentaria, además de contribuir a proporcionar efectos adicionales a través de sus compuestos bioactivos.

Only 30% of households in Mexico present food security, which means a large percentage of households and the population does not meet their needs in terms of macro and micronutrients. Thus, quelites, which are defined as wild edible plants, are an accessible, continuous, economical and adequate source of nutrients. However, quelite consumption in Mexico has been decreasing in response to changes in food preferences and lifestyles, including increased exposure to hypercaloric foods. Therefore, the aim of this work was to discuss the value of quelites as a food source rich in nutrients, proteins, amino acids, minerals (Ca, Mg, Zn), vitamins (E, C) and fiber. We also discuss how quelites are good source of bioactive compounds, such as phenolic acids (caffeic acid, ferulic acid) and flavonoids (quercetin, kaempferol, spinacetin), carotenoids, α-linolenic acid and betalaines. There use have been mainly related to the anti-tumor, antihyperlipidemic and antidiabetic benefits. We further discuss topics related to the culinary traditions of Mexico and the incorporation of quelites in the raw and cooked form in regional markets. The revaluation and the reincorporation of quelites in the diet can help meet nutritional needs, in addition to possibly providing additional health benefits.