Main Retailers In Which Mexican Households Acquire Their Food Supply.

OBJECTIVE: To describe the frequency of food and beverages purchased made by Mexican households at different types of grocery retailers. DESIGN: A national cross-sectional survey. SETTING: Mexico. PARTICIPANTS: A representative sample of Mexican households (n = 70,311). MAIN OUTCOME MEASURE(S): Household food and beverages purchases. ANALYSIS: The association between amounts of food and beverages supply bought in different food retailers (as outcome) and households' sociodemographic characteristics (as covariates) was assessed using logistic and linear regression models. RESULTS: Mexican households acquired their food and beverages primarily from abarrotes stores, followed by supermarkets and mercados and tianguis. Abarrotes stores and supermarkets were sources of unprocessed and processed foods. Specialized stores, mercados, and tianguis were primary sources of unprocessed foods. Households with low socioeconomic status and those in the central or southern regions acquired more foods from abarrotes stores, mercados and tianguis, and specialized stores. Households with high socioeconomic status and living in the northern region acquired more foods from supermarkets and convenience stores. CONCLUSIONS AND IMPLICATIONS: Abarrotes stores are the primary source of food and beverages for Mexican households; however, some interventions are needed to increase their supply of unprocessed foods. Public health interventions aiming at increasing access to unprocessed foods could be done through traditional retailers.

Latin dance and Qigong/Tai Chi effects on physical activity and body composition in breast cancer survivors: A pilot study.

BACKGROUND: Breast cancer survivors (BCS), particularly Latina BCS, experience weight gain and reduced physical activity (PA) post-treatment increasing the risk for recurrence. There is a lack of evidence on the intensity and type of PA needed to engage cultural subgroups and improve clinical outcomes. This study developed and piloted two non-traditional PA interventions among a diverse sample of BCS. METHODS: Twenty BCS (65% Latina; age 25-75) participated in a 2-arm parallel group-randomized pilot study to test the effects of an 8-week Latin dance and Qigong/Tai Chi intervention on PA and body composition. A seven-day pedometer protocol was used to measure steps/week and a bioelectric impedence scale was used to assess BMI and %body fat. T-tests were used to examine preliminary outcomes across both interventions and within intervention arms. RESULTS: There were no significant changes in steps/week, BMI, or %body fat across or in each separate intervention. A small effect size for increase in steps/day was found among participants in the Qigong/Tai Chi arm (0.10) and low-to-moderate effect sizes for reductions in % body fat overall (0.36), and separately for participants in Latin dance (0.26) and Qigong/Tai Chi (0.46). CONCLUSION: Latin dance and Qigong/Tai Chi are engaging and acceptable PA modalities that are promising for improving PA and body fat among diverse, high-risk BCS. Our findings highlight the need to continue to reach and engage high-risk BCS, including Latina survivors, using novel, culturally-sensitive PA interventions. Future studies should extend and more rigorously test these novel approaches to improving outcomes associated with recurrence.

Food, energy, and nutrient supply in Mexican households from 1984 to 2018.

INTRODUCTION: Introduction: information about changes in food and energy supply, macronutrient and micronutrient availability by processing level is required to understand the nutritional transition in Mexican society. Objective: to describe the food, energy, and nutrient supply in Mexican households from 1984 to 2018. Methods: five waves of a Mexican cross-sectional survey were analyzed to identify changes in food, energy, and nutrient supplies in households. Food groups were created using the NOVA classification. The content of energy and nutrients was estimated using Mexican and U.S. databases. The education and income interaction with energy and nutritional supply was analyzed. Results: in this period, the supply of fresh and processed fruits and vegetables, processed meat and dairy, fish and seafood, prepared food, and ultra-processed food and drinks increased, whereas unprocessed or minimally processed (UMP) cereals and tubers, legumes, meat, dairy, eggs, and all processed culinary ingredients decreased. These changes have implied a higher supply of protein, total fat, cholesterol, vitamins A and C, calcium and sodium. Total energy, energy density, carbohydrates, and magnesium and potassium density decreased. Across waves, UMP and processed cereals were the main supply for energy, carbohydrates, fiber, iron and potassium. Dairy was the main supply of saturated fat. UMP and processed cereals were the main source of sodium in 1984, whereas ultra-processed cereals were the main source of sodium in 2018. Conclusions: although UMP foods remain the main group in most Mexican households, their supply has decreased over the years, whereas the supply of ultra-processed foods has increased.

INTRODUCCIÓN: Introducción: se requiere información sobre los cambios de la disponibilidad de alimentos, energía y nutrientes, por nivel de procesamiento, para entender la transición nutricional en México. Objetivo: describir la disponibilidad de alimentos, energía y nutrientes en los hogares mexicanos de 1984 a 2018. Métodos: se crearon grupos usando la clasificación NOVA. El contenido de energía y nutrientes se estimó usando bases de datos mexicanas y estadounidenses. Se analizó la interacción de la educación y el ingreso con la disponibilidad de energía y nutrientes. Resultados: en este periodo aumentó la disponibilidad de verduras naturales y procesadas, carnes y lácteos procesados, pescados y mariscos, comida preparada y comida y bebida ultraprocesada, mientras que los cereales sin procesar o mínimamente procesados (SPMP), las leguminosas, las carnes, los lácteos, los huevos y los ingredientes culinarios procesados disminuyeron. Estos cambios implican una mayor disponibilidad de proteína, grasa total, colesterol, vitamina A y C, calcio y sodio. La energía total, la densidad energética, los carbohidratos y la densidad de magnesio y potasio disminuyeron. A lo largo el tiempo, los cereales SPMP y procesados fueron la principal fuente de energía, carbohidratos, fibra, hierro y potasio. Los lácteos fueron la principal fuente de grasas saturadas. Los cereales SPMP y procesados fueron la principal fuente de sodio en 1984, mientras que los cereales ultraprocesados lo fueron en el 2018. Conclusiones: aunque los alimentos SPMP siguen siendo el grupo más disponible en los hogares, su disponibilidad ha disminuido a lo largo de los años, mientras que la de los ultraprocesados ha aumentado.

Development and Interrater Reliability of a Street Food Stand Assessment Tool.

OBJECTIVE: To design and test the interrater reliability of a Street Food Stand Assessment Tool (SFSAT). DESIGN: Variables were adapted from validated assessment tools, field observations, and the Mexican Dietary Guidelines. Two researchers tested the SFSAT by observing street food stands (SFS) in 3 middle- to high-income neighborhoods. SETTING: Mexico City. PARTICIPANTS: Fifty-two SFS. VARIABLES MEASURED: The SFSAT contains 14 items for SFS characteristics and 44 items for food and beverages. ANALYSIS: Percent agreement and kappa interrater reliability scores were calculated for each variable. RESULTS: Almost perfect kappa interrater reliability scores (0.81-1.00) were reported for 62.7% of SFS characteristic items. Interrater reliability scores for food and beverage availability and variety ranged from 0.00-1.00, whereas the percent agreement for these items ranged from 59.6%-100.0%. CONCLUSIONS AND IMPLICATIONS: The SFSAT is a reliable assessment tool to measure the availability and variety of street foods and beverages in Mexico City. Future research can update and adapt the SFSAT to the street food environment of other cities-in Mexico and abroad.

Availability, variety and distribution of healthy and unhealthy foods and beverages sold at street food stands in Mexico City.

OBJECTIVE: To examine differences in the availability, variety and distribution of foods and beverages sold at street food stands (SFS) across neighbourhood income levels in Mexico City. DESIGN: Cross-sectional. SETTING: Twenty neighbourhoods representing low-, middle- and high-income levels in Mexico City. PARTICIPANTS: Direct observations of SFS (n 391). RESULTS: The availability of healthy foods such as fruits/vegetables was high in middle- and high-income neighbourhoods, whereas the availability of unhealthy foods such as processed snacks was higher in low-income neighbourhoods. However, statistically significant differences in food availability across neighbourhoods were only observed for dairy and processed snack items (P < 0·05). Similarly, differences in variety were only observed for cereal and processed snacks (P < 0·05). No statistically significant differences were seen for variety of fruits/vegetable across neighbourhood income levels (P > 0·05). No statistically significant differences across neighbourhood income levels were observed for beverage availability and variety (P > 0·05). Although street foods and beverages were often distributed near homes, public transportation centres and worksites, no differences were observed across neighbourhood income levels (P > 0·05). CONCLUSIONS: Findings suggest that SFS can be a source of both unhealthy foods and healthy foods for communities across neighbourhoods in Mexico City. Additional studies are needed to assess the relationship between street food and beverage availability, and consumption.

Street Food Stand Availability, Density, and Distribution Across Income Levels in Mexico City.

Street food stands (SFS) are an understudied element of the food environment. Previous SFS studies have not used a rigorous approach to document the availability, density, and distribution of SFS across neighborhood income levels and points of access in Mexico City. A random sample (n = 761) of street segments representing 20 low-, middle-, and high-income neighborhoods were assessed using geographic information system (GIS) and ground-truthing methods. All three income levels contained SFS. However, SFS availability and density were higher in middle-income neighborhoods. The distribution of SFS showed that SFS were most often found near homes, transportation centers, and worksites. SFS availability near schools may have been limited by local school policies. Additional studies are needed to further document relationships between SFS availability, density, and distribution, and current structures and processes.

Relationship between different levels of the Mexican food environment and dietary intake: a qualitative systematic review.

OBJECTIVE: To investigate the possible associations between the food environment and dietary intake in the Mexican population. DESIGN: Four databases (PubMed, PsychInfo, Web of Science and SCIelo) were used to retrieve relevant articles using an open timeframe. Articles were reviewed if they contained a systematic measure (i.e. food checklist) of the food environment (e.g. food availability) and dietary intake. SETTING: Urban and rural communities in Mexico. PARTICIPANTS: Population-based studies of Mexican communities. RESULTS: Twenty studies that assessed at least one food environment level, and at least one dietary outcome, were reviewed. Findings from these studies showed that changes in the Mexican food environment seem to be associated with higher availability of energy-dense foods. Energy-dense foods can be linked to a high consumption in household, environment and community food environments. When both nutrient-dense and energy-dense foods were present, individuals were more likely to consume foods with added sugars, fats and salt options than nutrient-dense items. CONCLUSIONS: The various levels of the food environment (i.e. household, school, community) exposed participants to energy-dense foods. Although nutrient-dense foods were present in all three levels, individuals were more likely to consume energy-dense food items. Not all three levels of the food environment are well represented in the urban and rural settings. Most studies on the community food environment were done in rural areas, whereas most studies on the school food environment were done in urban settings. Additional rigorously designed studies are needed to document the relationship between the food environment and dietary intake in the Mexican population.

Applying the RE-AIM conceptual framework for the promotion of physical activity in low- and middle-income countries / Aplicando o modelo RE-AIM para a promoção da atividade física em países de baixa e média renda / Aplicando el marco conceptual RE-AIM para la promoción de la actividad física en países de ingreso bajo y médio

ABSTRACT Objective: the RE-AIM framework has been widely used to evaluate internal and external validity of interventions aimed to promote physical activity, helping to provide comprehensive evaluation of the reach, efficacy, adoption, implementation and maintenance of research and programming. Despite this progress, the RE-AIM framework has not been used widely in Latin America. The purpose of this manuscript is to describe the RE-AIM framework, the process and materials developed for a one-day workshop in Guadalajara, and the acceptability and satisfaction of participants that attended the workshop. Methods: lecture, interactive examples and an agenda were developed for a one-day RE-AIM workshop over a three month period. Results: thirty two health care practitioners (M age = 30.6, SD=9.9 years) attended the workshop. Most (100%) rated the workshop as credible, useful (100%) and intended to apply it in current or future research (95%). Conclusion: results suggest intuitive appeal of the RE-AIM framework, and provide a strategy for introducing the utility and practical application of the framework in practice settings in Mexico and Latin America.

RESUMO Objetivo: o modelo RE-AIM tem sido amplamente utilizado para avaliar a validade interna e externa de intervenções que objetivam promover atividade física, auxiliando a fornecer uma avaliação abrangente do alcance, eficácia, adoção, implementação e manutenção de pesquisas e programas. Apesar deste progresso, o modelo RE-AIM não tem sido amplamente utilizado na América Latina. O objetivo deste artigo é descrever o modelo RE-AIM, o processo e os materiais desenvolvidos para uma oficina de um dia de duração em Guadalajara e a aceitabilidade e satisfação dos participantes que compareceram na oficina. Métodos: durante o período de três meses, palestras e exercícios interativos foram desenvolvidos para uma oficina de um dia sobre o modelo RE-AIM. Resultados: trinta e dois profissionais de saúde (Média de idade=30,6±9,9 anos) participaram da oficina. A maioria dos participantes classificou a oficina como credível (100%), útil (100%) e pretende aplicar o que foi aprendido em investigações atuais ou futuras (95%). Conclusão: os resultados sugerem que o modelo RE-AIM é um recurso intuitivo e fornecem uma estratégia para a apresentação da utilidade e aplicação prática do modelo em cenários práticos no México e na América Latina.

RESUMEN Objetivo: el marco RE-AIM ha sido ampliamente utilizado para evaluar la validez interna y externa de intervenciones destinadas a promover la actividad física, ayudando a proporcionar una evaluación exhaustiva de la cobertura, eficacia/efectividad, adopción, implementación y mantenimiento de programas sobre actividad física. A pesar de este progreso, el marco RE-AIM no se ha utilizado ampliamente en América Latina. El objetivo de este artículo es presentar el marco conceptual RE-AIM, describir el proceso y los materiales desarrollados para un taller en Guadalajara; y reportar la aceptabilidad y satisfacción de los participantes que acudieron al taller. Métodos: durante un período de tres meses, se desarrolló un taller sobre el marco RE-AIM. El taller duró un día e incluyó una conferencia y ejercicios interactivos. Resultados: treinta y dos profesionales de la salud (edad media = 30.6 [±9.9 años]) participaron en el taller. La mayoría calificó el taller como creíble, útil (100%) y manifestó la intención de aplicar lo aprendido en investigaciones actuales o futuras (95%). Conclusión: los resultados sugieren que el marco RE-AIM es intuitivamente atractivo y que el curso es una estrategia adecuada para introducir la utilidad y aplicación práctica del marco en espacios de práctica en América Latina.

Are physical activity studies in Hispanics meeting reporting guidelines for continuous monitoring technology? A systematic review.

BACKGROUND: Continuous monitoring technologies such as accelerometers and pedometers are the gold standard for physical activity (PA) measurement. However, inconsistencies in use, analysis, and reporting limit the understanding of dose-response relationships involving PA and the ability to make comparisons across studies and population subgroups. These issues are particularly detrimental to the study of PA across different ethnicities with different PA habits. This systematic review examined the inclusion of published guidelines involving data collection, processing, and reporting among articles using accelerometers or pedometers in Hispanic or Latino populations. METHODS: English (PubMed; EbscoHost) and Spanish (SCIELO; Biblioteca Virtual en Salud) articles published between 2000 and 2013 using accelerometers or pedometers to measure PA among Hispanics or Latinos were identified through systematic literature searches. Of the 253 abstracts which were initially reviewed, 57 met eligibility criteria (44 accelerometer, 13 pedometer). Articles were coded and reviewed to evaluate compliance with recommended guidelines (N = 20), and the percentage of accelerometer and pedometer articles following each guideline were computed and reported. RESULTS: On average, 57.1 % of accelerometer and 62.2 % of pedometer articles reported each recommended guideline for data collection. Device manufacturer and model were reported most frequently, and provision of instructions for device wear in Spanish was reported least frequently. On average, 29.6 % of accelerometer articles reported each guideline for data processing. Definitions of an acceptable day for inclusion in analyses were reported most frequently, and definitions of an acceptable hour for inclusion in analyses were reported least frequently. On average, 18.8 % of accelerometer and 85.7 % of pedometer articles included each guideline for data reporting. Accelerometer articles most frequently included average number of valid days and least frequently included percentage of wear time. DISCUSSION: Inclusion of standard collection and reporting procedures in studies using continuous monitoring devices in Hispanic or Latino population is generally low. CONCLUSIONS: Lack of reporting consistency in continuous monitoring studies limits researchers' ability to compare studies or draw meaningful conclusions concerning amounts, quality, and benefits of PA among Hispanic or Latino populations. Reporting data collection, computation, and decision-making standards should be required. Improved interpretability would allow practitioners and researchers to apply scientific findings to promote PA.