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BACKGROUND: The study of dietary patterns in older adults (OA) and their association with geriatric syndromes (GS) is scarce in Latin America. OBJECTIVE: To describe the association of dietary patterns with GS in the Mexican older adult population, using data from the 2018-19 National Health and Nutrition Survey. METHODS: Dietary data were collected from 3,511 adults (≥60 years of age, both sexes) using a semi-quantitative food frequency questionnaire. Dietary patterns were derived by principal component analysis based on the consumption of 162 foods from 24 food groups. The GS studied were: frailty, depressive symptoms (DS), low appendicular skeletal muscle mass (ASMM); additionally, we studied inflammation (serum CRP>5 mg/L). Logistic regression models were used. RESULTS: Four major dietary patterns were identified: a) "Western", b) "Prudent", c) "Soups", and d) "Traditional". The middle and higher tertiles of the "Prudent" pattern were associated with lower odds of DS (OR 0.71, p = 0.04; and OR 0.61, p = 0.008), respectively. The second tertile of the "Soups" pattern was associated with lower odds of low ASMM (OR 0.68, p = 0031) and inflammation (OR 0.58, p = 0.022). The highest tertile of the "Traditional" pattern was associated with low ASMM (OR 1.55, p = 0.008) and lower odds of inflammation (OR 0.69, p = 0.044). No association was found between the "Western" dietary pattern and GS. CONCLUSIONS: Three of four major dietary patterns were associated with GS in older Mexican adults. Further studies are needed to address strategies to improve diet quality in this age group and its association with health and functional outcomes.
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BACKGROUND: Despite the emergence of diverse programs in Mexico to address anemia and micronutrient deficiencies in disadvantaged groups, progress on reducing their prevalence has stagnated. In Mexico, anemia surveillance at the population level is conducted through the National Health and Nutrition Survey ENSANUT (for its acronym in Spanish). OBJECTIVE: To overview the trends in anemia and iron deficiency (ID) from 1999 to 2018-19 in the Mexican population before COVID-19 pandemic. METHODS: Data from five nationwide surveys in Mexico were used. Where available, data on anemia, ID, and ID anemia (IDA) were extracted from ENSANUTs 1999, 2006, 2012, 2016, and 2018-19 in participants from 1 to 99 years old. Blood sample collection methods were similar across surveys (1999-2018) where capillary drop blood was used to estimate Hb using a HemoCue and serum blood samples to measure ferritin and C-reactive protein concentration. RESULTS: The trend in anemia prevalence shows a U-shape from 1999 to 2018-19 in <60 years old. In older adults (≥60 years), an increasing trend was observed. Anemia declined progressively from 1999 to 2012 but increased from 2016 to 2018-19 in comparison with 2012. In contrast, ID declined from 2006 to 2018-19, mainly in children, while IDA did not change over this period. In older adults, ID prevalence remained constant over time. CONCLUSIONS: The shifting trend in anemia prevalence across ENSANUTs 1999 through 2018-19 did not mimic the decreasing trend of ID over the same period of time. Other noncausal factors seem to play an important role in the variability of hemoglobin measurements.
Plain language titleOverview of Trends in the Prevalence of Anemia and Iron Deficiency in the Mexican Population From 1999 to 2018-19Plain language summaryIn Mexico, anemia surveillance has been monitored through the National Health and Nutrition Survey since 1999. Nonetheless, progress on reducing their prevalence seems to be stagnated despite the emergence of diverse social programs in Mexico to tackle micronutrient deficiencies in children and women. The main cause of anemia in children and women is iron deficiency (ID). Any progress in tackling ID should be reflected in anemia prevalence. To investigate the prevalence trend, we used information about anemia (based on hemoglobin concentration) and ID (based on serum ferritin levels) where available, from 5 nationwide surveys in Mexico among participants from 1 to 99 years old, to discuss some of the potential factors behind anemia and ID trends. From 1999 to 2018-19, we observed an ¨U" shape in the prevalence of anemia in all age groups <60 years old, contrasting with the prevalence of ID, which trend is in decline. No major changes in terms of social programs can explain the trend in anemia. In fact, other nutritional indicators seem to have improved in Mexican children. A major difference in the measurement of anemia and ID is that hemoglobin was measured in situ using drop of capillary blood in HemoCue, a portable photometer, while ferritin was measured in venous blood in the central laboratory. While many external factors might influence the hemoglobin measurement in the field setting, it seems that the technique of finger prick capillary introduces more errors to the measurement of hemoglobin than other techniques (e.g., pool capillary or venous blood using HemoCue). This difference, in turn, affects anemia diagnosis. Since the drop of capillary blood has been widely acceptable, we did not perform any validation of hemoglobin measurement in those past surveys, so we cannot role out the contribution of other factors that affected hemoglobin measurement. Future studies should use venous blood to improve anemia classification; otherwise, validation studies should be carried out to improve hemoglobin measurement when using capillary blood.
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Anemia Ferropénica , Anemia , Encuestas Nutricionales , Humanos , México/epidemiología , Preescolar , Adulto , Anemia Ferropénica/epidemiología , Anemia Ferropénica/sangre , Persona de Mediana Edad , Adolescente , Niño , Lactante , Adulto Joven , Masculino , Femenino , Anciano , Prevalencia , Anciano de 80 o más Años , Anemia/epidemiología , Anemia/sangre , Deficiencias de Hierro , COVID-19/epidemiología , Ferritinas/sangreRESUMEN
BACKGROUND: Avocado contains numerous vitamins, minerals, and phytochemicals that can contribute to reducing the risk of metabolic syndrome and diabetes. However, limited studies have examined the association between avocados and diabetes risk. OBJECTIVE: This study aimed to examine the association between avocado consumption and diabetes by sex in Mexican adults. DESIGN: This was a cross-sectional study. PARTICIPANTS/SETTING: Participants included a subsample of adults (aged 20 years and older) from the 2012, 2016, and 2018 Mexican National Health and Nutrition Survey. Avocado consumption was assessed using a 7-day, semiquantitative food frequency questionnaire, and participants were classified as avocado consumers (consuming any amount of avocado) or nonconsumers. MAIN OUTCOME MEASURES: Participants were considered to have diabetes if they answered "yes" to "Has a doctor ever told that you have diabetes or high blood sugar?" STATISTICAL ANALYSES PERFORMED: This analysis assessed the association between avocado intake and diabetes using multivariate logistic models by sex and adjusted for relevant covariates. RESULTS: Of 28 239 Mexican National Health and Nutrition Survey 2012, 2016, and 2018 participants, 25 640 met the criteria (ie, have diabetes outcome and plausible energy and avocado intakes) for this study. More than half of the participants were women, and approximately 45% were avocado consumers, with an average (SE) avocado consumption of 34.7 (0.9) among men and 29.8 (0.8) g/day among women. Avocado consumers had lower odds of diabetes in both unadjusted (odds ratio [OR] 0.762, 95% CI 0.639 to 0.907) and adjusted (OR 0.792, 95% CI 0.632 to 0.993) models among women but not men (OR 1.192, 95% CI: 0.907 to 1.566 and OR 0.914, 95% CI 0.675 to 1.239 for unadjusted and adjusted models, respectively). CONCLUSIONS: Avocado consumption was associated with a lower risk of diabetes, which remained significant even when adjusted for relevant covariates. However, this finding was observed in only women, not men, underscoring the importance of personalized nutrition in diabetes care and prevention.
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Introduction: Introduction: most studies that analyze the relationship between diet quality and obesity have a cross-sectional design; an alternative with repeated cross-sectional data is a pseudo-panel design. Objective: to estimate the association between trends in dietary patterns, defined by a diet quality index, and body mass index (BMI) of Mexican adults between 2006 and 2016. Methodology: a pseudo-panel analysis was performed using data from cross-sectional surveys: National Health and Nutrition Surveys of Mexico (ENSANUTs) 2006 and 2012 and the Midway National Health and Nutrition Survey 2016 (ENSANUTMC). Cohorts (n = 108) were constructed by grouping adults 20-59 years old by sex (men n = 6,081 and women n = 11,404), education level, and year of birth. The association between diet quality (defined with the Healthy Eating Index-2015) and BMI was estimated using a fixed effects model, adjusting for sociodemographic characteristics. Results: a one-point increase in the proportion of women with high diet quality was associated with 4.1 points lower BMI (p = 0.014) compared with women with low diet quality when excluding sub-reporters of energy, the same association is observed when physical activity is included in the model. No association was found between diet quality and BMI in men, possibly because of the existence of latent classes within sociodemographic strata, therefore diet qualiy is inversely associated with BMI only in some categories of sociodemographic strata. Conclusions: these results contribute to the evidence in the longitudinal analysis between diet and BMI, highlighting the importance of differentiating the population by sex and sociodemographic characteristics. These results are input for public policy creation that promotes improving the quality of the population's diet as part of multisectoral strategies to reduce overweight and obesity in Mexican adults.
Introducción: Introducción: muchos estudios que analizan la relación entre calidad de la dieta y obesidad son transversales; una alternativa con datos transversales repetidos es el diseño de pseudopanel. Objetivo: estimar la asociación entre patrones alimentarios definidos mediante un índice de calidad de la dieta y el índice de masa corporal (IMC) en adultos mexicanos entre 2006 y 2016. Metodología: se realizó un análisis de pseudopanel utilizando datos de las Encuestas Nacionales de Salud y Nutrición de México (ENSANUTs) de 2006 y 2012 y la Encuesta Nacional de Salud y Nutrición de medio camino de 2016 (ENSANUTMC). Se construyeron cohortes (n = 108) agrupando datos de adultos entre 20 y 59 años, por sexo (hombres n = 6,081, mujeres n = 11,404), nivel de escolaridad y año de nacimiento. La asociación entre calidad de la dieta (definida mediante el Índice de Calidad de la Dieta 2015) y el IMC se estimó con un modelo de efectos fijos, ajustado por características sociodemográficas. Resultados: un aumento de 1 punto en la proporción de mujeres con calidad de dieta alta se asoció con 4,1 puntos menos de IMC (p = 0,014) comparado con las mujeres con calidad de dieta baja; al excluir a las subreportadoras de energía, la misma asociación se observó incluyendo la actividad física al modelo. No se encontró asociación entre calidad de dieta e IMC en los hombres, posiblemente debido a la existencia de subgrupos dentro de los estratos sociodemográficos, lo cual hace que la calidad de la dieta esté inversamente asociada al IMC solo en algunas categorías de los estratos. Conclusiones: estos resultados contribuyen a la evidencia longitudinal entre dieta e IMC, destacando la importancia de estratificar por sexo y características sociodemográficas. Los resultados son un ínsumo para crear políticas públicas que promuevan mejorar la calidad de la dieta como parte de estrategias multisectoriales para disminuir el sobrepeso y la obesidad en los adultos mexicanos.
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Índice de Masa Corporal , Dieta , Encuestas Nutricionales , Obesidad , Humanos , Adulto , México , Masculino , Femenino , Persona de Mediana Edad , Estudios Transversales , Adulto Joven , Obesidad/epidemiologíaRESUMEN
Introduction: Acute leukemias (AL) are the main types of cancer in children worldwide. In Mexico, they represent one of the main causes of death in children under 20 years of age. Most of the studies on the incidence of AL in Mexico have been developed in the urban context of Greater Mexico City and no previous studies have been conducted in the central-south of the country through a population-based study. The aim of the present work was to identify the general and specific incidence rates of pediatric AL in three states of the south-central region of Mexico considered as some of the marginalized populations of Mexico (Puebla, Tlaxcala, and Oaxaca). Methods: A population-based study was conducted. Children aged less than 20 years, resident in these states, and newly diagnosed with AL in public/private hospitals during the period 2021-2022 were identified. Crude incidence rates (cIR), standardized incidence rates (ASIRw), and incidence rates by state subregions (ASIRsr) were calculated. Rates were calculated using the direct and indirect method and reported per million children under 20 years of age. In addition, specific rates were calculated by age group, sex, leukemia subtype, and immunophenotype. Results: A total of 388 cases with AL were registered. In the three states, the ASIRw for AL was 51.5 cases per million (0-14 years); in Puebla, it was 53.2, Tlaxcala 54.7, and Oaxaca de 47.7. In the age group between 0-19 years, the ASIRw were 44.3, 46.4, 48.2, and 49.6, in Puebla, Tlaxcala, and Oaxaca, respectively. B-cell acute lymphoblastic leukemia was the most common subtype across the three states. Conclusion: The incidence of childhood AL in the central-south region of Mexico is within the range of rates reported in other populations of Latin American origin. Two incidence peaks were identified for lymphoblastic and myeloid leukemias. In addition, differences in the incidence of the disease were observed among state subregions which could be attributed to social factors linked to the ethnic origin of the inhabitants. Nonetheless, this hypothesis requires further investigation.
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Introduction: The prevalence of obesity in the Mexican school-age (5-11 years old) population increased from 8.9 to 18.1% between 1999 and 2022. Although overweight and obesity (OW + Ob) is a complex and multifactorial phenomenon, alongside its increasing trend, changes in eating patterns as a result of obesogenic environments that promote higher energy intake have been documented. The objective of the present study was to detect possible associations between schools and their proximity to and density of convenience stores in Monterrey, Mexico from 2015 to 2018. Materials and methods: Anthropometric data were obtained from a subset of measurements of the National Registry of Weight and Height (RNPT) performed in the Monterrey Mexico metropolitan area in 2015 and 2018, and obesity prevalence was computed and classified into quintiles at the school level. Convenience store data were obtained from the National Directory of Economic Units (DNUE). The analyses consisted of densities within 400-800 m buffers, distance to the nearest stores, and cartographic visualization of the store's kernel density versus OW + Ob hotspots for both periods. Results: A total of 175,804 children in 2015 and 175,964 in 2018 belonging to 1,552 elementary schools were included in the study; during this period, OW + Ob prevalence increased from 38.7 to 39.3%, and a directly proportional relationship was found between the quintiles with the higher OW + Ob prevalence and the number of stores for both radii. Hotspots of OW + Ob ranged from 63 to 91 between 2015 and 2018, and it was visually confirmed that such spots were associated with areas with a higher density of convenience stores regardless of socioeconomic conditions. Conclusion: Although some relationships between the store's proximity/density and OW + Ob could be identified, more research is needed to gather evidence about this. However, due to the trends and the magnitude of the problem, guidelines aimed at limiting or reducing the availability of junk food and sweetened beverages on the school's periphery must be implemented to control the obesogenic environment.
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OBJECTIVE: To assess trends in the dietary quality of Mexican adolescents from 2006 to 2018, both overall and by sociodemographic indicators, using adaptations of the EAT-Lancet Planetary Health (PH) recommendations, optimal intake estimated by the Global Burden of Disease (GBD) and 2015 Mexican Dietary Guidelines (MDG) in nationally representative samples. DESIGN: Using dietary data from a semi-quantitative FFQ, dietary quality indexes were constructed as adaptations of three dietary intake recommendations. Trends in adherence to recommendations were evaluated with multivariate quantile regression models with survey year as the main independent variable and adjusted for age, sex, energy intake, dwelling area, geographical region, household assets condition, and student/non-student status. P values and CI were Bonferroni-corrected. SETTING: Mexico. PARTICIPANTS: Non-pregnant or lactating adolescents aged 12-19 years (n 16 520). RESULTS: Adherence to the PH index was about 40 %, GBD was nearly 35 % and MDG was about 37 %. The lowest adherences were for added sugars, sugar-sweetened beverages, nuts and seeds, red meats, processed meats, and legumes (<28 %). No 2006-2018 trends in total adherence were found in any index. Nevertheless, negative adherence trends were identified for poultry (ß = -2·4), and saturated fats (ß = -0·93), and positive for unsaturated oils (ß = 1·23), in the PH. In MDG, relevant trends were found for plain water (ß = 1·63) and foods rich in fats (ß = -1·24). CONCLUSIONS: Mexican adolescents have demonstrated poor dietary quality by these three approaches. Therefore, this population has a high-risk profile for diet-associated chronic diseases. Further research and appropriate public policies are needed.
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Dieta , Lactancia , Femenino , Humanos , Adolescente , México/epidemiología , Ingestión de Energía , Encuestas Nutricionales , VerdurasRESUMEN
INTRODUCTION: risk factors associated with obesity such as poor dietary quality, low physical activity (PA), screen time (ST), and poor sleep duration (SD) were affected during confinement resulting from the SARS-CoV-2 pandemic. OBJECTIVE: the aim of our study was to evaluate the association between PA, ST and SD with the consumption of non-recommended food groups (N-RFG) in children during the COVID-19 pandemic, using data from ENSARS-CoV-2 Girls and Boys. METHODS: data were gathered through a self-administered electronic survey carried out in four regions of Mexico during September and October 2020. Dietary patterns were established using k-means cluster analysis. Linear regression models were used to study the effect of food consumption patterns and PA on hours of ST per week. RESULTS: in all, 2,405 children aged 2 to 11 were studied. Three food group consumption patterns were identified. Group 1 or "high consumption of added sugars group" and Group 2 or "high consumption of N-RFG group" children reported more hours of ST than those in Group 3 or "low consumption of N-RFG group" (p < 0.001 and p < 0.001, respectively). Group 2 reported more hours per week of ST but also more days of PA vs Group 3. CONCLUSION: confronted by the pandemic, it is essential to redouble efforts to reverse the harmful effects of lifestyles during the COVID-19 pandemic to improve the health of Mexican children in the years to come.
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OBJETIVO: Identificar la viabilidad de la Escala de Experiencias de Inseguridad del Agua en el Hogar (Household Water Insecurity Experiences Scale, HWISE, por sus siglas en inglés) como herramienta para evaluar las experiencias de hogares mexicanos en relación con la inseguridad en el acceso al agua. Material y métodos. La escala fue integrada en la Encuesta Nacional de Salud y Nutrición Continua 2021 (Ensanut Continua 2021) y se utilizaron tres criterios para evaluar su viabilidad: 1) Consistencia interna: Se aplicó la prueba Alfa de Cronbach para estimar la correlación entre los ítems de la escala. Se consideró un punto de corte de al menos 0.80 como criterio de confiabilidad; 2) Equivalencia de los ítems para distintos indicadores sociodemográficos; y 3) Variables asociadas con inseguridad del agua. RESULTADOS: La escala HWISE mostró: 1) Buena confiabilidad o consistencia interna (Alfa de Cronbach de 0.928); 2) comportamiento equivalente de los ítems en los contextos urbano y rural, en nueve regiones del país y por terciles de condiciones de bienestar; y 3) asociación significativa con variables predictoras de inseguridad del agua. CONCLUSIONES: La escala HWIS, adaptada para México, es apropiada para su uso en evaluar la condición de inseguridad del agua en hogares mexicanos.
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OBJECTIVE: To compare the prevalence of anemia and iron deficiency, at state level in non-pregnant women between 20 and 49 years of age from the Encuesta Nacional de Salud y Nutrición (Ensanut, in Spanish) 2006, 2012 and 2018-19. MATERIALS AND METHODS: The Ensanut 2006, 2012 and 2018-19 have a probabilistic design. Hb in capillary blood was measured by HemoCue Hb201 and ferritin by venous sample. Anemia was diagnosed with Hb<120g/L and iron deficiency with Ferritin<15ng/mL. RESULTS: At the national level, anemia increased 6.1 (p<0.05) percentage points (pp) from 2006 to 2018-19. Baja California Norte, Campeche, Colima, Chiapas, Quintana Roo, Sinaloa and Sonora, went from low prevalence (5 to 19.9%) to moderate (20 to 39.9%); in Yucatán and Tamaulipas it went from low to severe (>40). In Guanajuato, State of Mexico and Querétaro it was reduced from 2006 to 2018-19 (p<0.05). CONCLUSIONS: Anemia continues to be a public health problem that requires actions at the state level, considering level of wellbeing index, food programs and affiliation to medical Services insurance.
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Anemia Ferropénica , Anemia , Deficiencias de Hierro , Humanos , Femenino , Prevalencia , México/epidemiología , Anemia/epidemiología , Ferritinas , Anemia Ferropénica/epidemiologíaRESUMEN
OBJECTIVE: To estimate vaccine uptake and assess sociodemographic conditions associated with vaccination barriers and refusal and to explore the effect of a monetary incentive to overcome them. MATERIALS AND METHODS: We used data from adults from the 2021 National Continuous Health and Nutrition Survey conducted during August-October 2021. We evaluated if an hypothetical monetary incentive between 50-650 MXN (~2.5-31 USD) would overcome barriers or refusal. RESULTS: 73.9% were vaccinated with at least one dose, 7.5% refused, 4.8% reported barriers and 13.8% were ineligible at the time of the survey. Refusal and barriers were more frequent in men, older age, lower education and socioeconomic status, unemployed and informal workers. In people with barriers and refusal, the hypothetical incentive increased the acceptance in 57.6% (95%CI 50.7,64.4%) and 17.4% (95%CI 13.2,21.7%) in people with barriers and refusal, respectively. CONCLUSION: Understanding the reasons for barriers and refusal is crucial for future Covid-19 vaccination campaigns or epidemics. A monetary incentive might increase vaccination uptake, although, cost-effectiveness analyses are needed.
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Vacunas contra la COVID-19 , COVID-19 , Masculino , Adulto , Humanos , Motivación , COVID-19/epidemiología , COVID-19/prevención & control , Vacunación , Encuestas y CuestionariosRESUMEN
OBJETIVO: Presentar la metodología de la Encuesta Nacional de Salud y Nutrición 2023 (Ensanut 2023) y describir los procedimientos de inferencia para conjuntar la información colectada por la Ensanut Continua 2020-2024. Material y métodos. La Ensanut 2023 es la cuarta encuesta de la serie Ensanut Continua. Se describe el alcance de la Ensanut 2023 junto con sus procedimientos de muestreo, estimación, medición y organización logística. Además, se discute el procedimiento básico de estimación para analizar la integración de las encuestas Ensanut Continua 2020-2024. RESULTADOS: La Ensanut 2023 obtendrá a nivel nacional al menos 11 720 entrevistas completas de hogar y 13 378 cuestionarios completos de adulto. La unión de las Ensanut Continua 2020-2023 permitirá, en general, estimar a nivel estatal prevalencias p≥5% en adultos, con confiabilidad tolerable según las recomendaciones del Instituto Nacional de Estadística y Geografía. CONCLUSIONES: El análisis de la unión de la Ensanut Continua 2020-2023 permitirá iniciar la generación de estimaciones nacionales y estatales sobre el estado de salud y nutrición de la población mexicana.
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OBJETIVO: Describir la asociación entre inseguridad alimentaria (IA) con mala nutrición en mujeres adultas habitantes de zonas rurales de México en 2018 y 2020. Material y métodos. Datos de mujeres rurales recabados por la Encuesta Nacional de Salud y Nutrición de 2018 y 2020 (Ensanut 2018-2020). Se obtuvieron medidas de peso y talla y se calculó el índice de masa corporal. El nivel de IA del hogar se midió con la Escala Latinoamericana y Caribeña de Seguridad Alimentaria (ELCSA). Se estimó un modelo de regresión logística ordinal múltiple. RESULTADOS: La prevalencia de sobrepeso y obesidad (SyO) en mujeres fue de 76%. Se encontró una asociación significativa entre el SyO y la IA moderada (RM 1.35, p=0.001). CONCLUSIONES: La IA se asocia con SyO en mujeres adultas rurales, situación originada por factores estructurales e individuales. Se requieren acciones inmediatas para su atención a nivel nacional.
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OBJETIVO: Analizar la asociación entre la inseguridad del agua (IA) y la presencia de sintomatología depresiva (SD) en población mexicana de 20 años o más. Material y métodos. Se analizó información de 11 806 adultos participantes en la Encuesta Nacional de Salud y Nutrición 2022 (Ensanut 2022). La IA se evaluó con la escala de las experiencias de inseguridad del agua (HWISE) en los hogares y la SD con la Escala de Depresión del Centro de Estudios Epidemiológicos (CESD-7). Se realizaron modelos de regresión logística multinomial ajustando por variables confusoras. RESULTADOS: La IA se asocia con la presencia de SD en los adultos mexicanos (razón de momios [RM]=1.5; p<0.001). La prevalencia ajustada de SD fue 6.1 puntos porcentuales mayor en personas con IA. Otros factores asociados a SD en presencia de la IA fueron: mujer (RM=2.0; p<0.001), separada(o) o divorciada(o) (RM=1.5; p=0.001), sin escolaridad (RM=2.9; p<0.001), tercil bajo de condiciones de bienestar (RM=1.3; p=0.005) y 60 años o más de edad (RM=3.5; p<0.001). Conclusión. Los problemas con el agua afectan la salud mental de la población. Es relevante su monitoreo en proyectos donde el agua tiene un papel clave como en disminución de la pobreza, desarrollo económico y mitigación del cambio climático.
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OBJETIVO: Evaluar el consumo y porcentaje de adultos en apego a recomendaciones de la Organización Mundial de la Salud (OMS) e EAT-Lancet Commission on Food, Planet, Health sobre consumo de frutas, verduras y leguminosas, y sus cambios en el periodo de 2012-2022. Material y métodos. Se analizó información de 29 757 adultos >20 años, obtenida del cuestionario semicuantitativo de frecuencia de consumo de alimentos de las Encuestas Nacionales de Salud y Nutrición 2012-2022. Se estimó el consumo de frutas, verduras y leguminosas mediante modelos de regresión cuantílica y el porcentaje de población que cumplió las recomendaciones de consumo de la OMS y de una dieta de salud planetaria con modelos de regresión logit. Todos los modelos se ajustaron por covariables. RESULTADOS: De 2012 a 2020-2022, el consumo de frutas se mantuvo constante (113.5-131 g/día) y el de verduras incrementó (de 83 a 109 g/día), mientras que el consumo de leguminosas disminuyó (de 10 a 7.7 g/día). Se encontró bajo porcentaje de adultos (<40%) que cumplieron las recomendaciones, sobre todo de leguminosas (<1.5%), situación que se mantuvo constante a lo largo de los 10 años analizados. CONCLUSIONES: Existe una tendencia a la disminución en el consumo de leguminosas y el consumo de frutas y verduras sigue siendo bajo.
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OBJETIVO: Identificar los factores asociados con anemia, deficiencias de hierro (DH) y vitamina B12 (DVB12) en mujeres de 12 a 49 años, participantes en la Encuesta Nacional de Salud y Nutrición Continua 2022 (Ensanut Continua 2022). Material y métodos. La Ensanut es probabilística con representatividad nacional. Se recolectó sangre venosa de 1 141 mujeres para analizar hemoglobina, ferritina y vitamina B12, para estimar deficiencias según la Organización Mundial de la Salud. Se realizaron análisis descriptivos y modelos de regresión logística (módulo SVY/STATA). RESULTADOS: Las prevalencias de anemia, DH y DVB12 fueron 15.7, 41.9 y 17.2%, respectivamente. Se asoció (p<0.5) anemia con agua de garrafón/botella (razón de momios [RM]=2.27; IC95% 0.99,5.17) y DH con no tener agua entubada (RM=2.86; IC95% 1.31, 6.22) y pertenecer al estrato urbano (RM=1.56; IC95% 0.98, 2.45). Conclusión. La anemia, DH y DVB12 fueron altamente prevalentes, por lo tanto se requiere profundizar en el tema del agua para beber y en la derechohabiencia en mujeres con mayores desventajas socioeconómicas.
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OBJECTIVE: To validate hemoglobin (Hb) concentration in venous blood (VB) using the HemoCue 201+ in a subsample of children and women from the Mexican National Health and Nutrition Survey 2022. MATERIALS AND METHODS: Prior to field work 50 HemoCue 201+ devices were verified using venous blood. During the field work 57 children (aged 1-11) and 62 women (aged 12-49) donated 3 mL of VB each. Hb was measured in each device of HemoCue 201+ and in a hematologic autoanalyzer for the validation. RESULTS: No significant bias was found in most of the devices. An adjustment criterion was used for 22 devices. Hb mean difference results were -0.049±0.578 g/dL in children and -0.098±0.628 g/dL in women. CONCLUSIONS: The HemoCue 201+ is a valid tool for estimating Hb concentration to produce reliable estimates of anemia prevalence when using venous blood.
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OBJETIVO: Estimar cambios en el consumo de frutas, verduras y leguminosas y su cumplimiento según recomendaciones internacionales en población menor de 20 años de México. Material y métodos. En 31 083 menores de 20 años con información de frecuencia de consumo de alimentos de las Encuestas Nacionales de Salud y Nutrición 2012, 2016, 2018 y 2020-2022, se estimó el cambio en el consumo de frutas, verduras y leguminosas ajustados mediante modelos de regresión cuantílica y la probabilidad de cumplimiento de las recomendaciones de ingesta de EAT-Lancet y la Organización Mundial de la Salud mediante modelos de regresión logit. RESULTADOS: Entre 2012 y 2020-2022 se observó un incremento en la mediana de consumo de 15% en frutas y 23.5% en verduras. La probabilidad de cumplimiento de recomendaciones de EAT-Lancet fue de 42.6% para frutas y 13.6% para verduras en 2020-2022. El consumo de leguminosas disminuyó 17.4% en 10 años. Conclusión. La población mexicana menor de 20 años se encuentra muy lejos de alcanzar las recomendaciones de consumo para la salud planetaria, a pesar de los incrementos modestos en el consumo de frutas y verduras. Se debe poner especial atención en el consumo de leguminosas por su disminución alarmante en estos grupos de edad. Es esencial realizar más investigación en este tema.
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OBJETIVO: Analizar la asociación de la contribución de los azúcares con sobrepeso y obesidad (Sp+Ob) en población escolar y adolescente. Material y métodos. En una muestra de 2 844 escolares y adolescentes de 5 a 19 años se determinó el estado de Sp+Ob según los patrones de crecimiento de la Organización Mundial de la Salud, así como el consumo de azúcares totales, añadidos e intrínsecos (%kcal/día) con información de un cuestionario de frecuencia de consumo de alimentos. Se estimó la probabilidad ajustada de presentar Sp+Ob mediante modelos de regresión logística con interacción entre el consumo de azúcares y la condición de bienestar. RESULTADOS: La prevalencia de Sp+Ob fue del 41% en la población de 5 a 19 años y más de 60% excedió el límite recomendado de consumo de azúcares añadidos del 10% de energía; las bebidas endulzadas fueron el grupo que más contribuyó a este consumo elevado. La probabilidad de presentar Sp+Ob a mayores consumos de azúcar añadido fue significativamente mayor en el tercil alto de condición de bienestar (0.59) vs. el bajo (0.30). CONCLUSIONES: El Sp+Ob y el consumo de azúcares añadidos son elevados en la población de 5 a 19 años en México. Se requiere fortalecer, focalizar y diversificar las estrategias de atención a estos problemas considerando las diferencias sociodemográficas de la población.
RESUMEN
El 21 de julio de 2023, en un seminario interno de los Institutos Nacionales de Salud y Hospitales de Alta Especialidad, se presentaron los resultados de la Encuesta Nacional de Salud y Nutrición Continua 2022 (Ensanut Continua 2022). Junto con expertos del más alto nivel, se plantearon recomendaciones con el fin de apoyar la salud de la población mexicana. Dichas recomendaciones giran en torno a las temáticas incluidas en la Ensanut Continua 2022, como vacunación, salud de niños y adolescentes, salud mental y dificultades de funcionamiento y estado de nutrición y enfermedades crónicas en adultos, entre otras. Los logros de este esfuerzo realizado para obtener información de manera continua son cruciales para saber cómo hacer frente a los factores que afectan a nuestra salud y poder tomar mejores decisiones de política pública en esta materia, bajo la premisa de que los problemas públicos requieren ser medidos y monitoreados permanentemente.