Effectiveness of 3,3'-Diindolylmethane Supplements on Favoring the Benign Estrogen Metabolism Pathway and Decreasing Body Fat in Premenopausal Women.

The Estrogen Metabolites (2-hydroxyestrogens: 16α-hydroxyestrone) Urine Ratio (EMUR) has been negatively associated with breast cancer; Mexican women have a lower EMUR than other populations. We evaluated the effectiveness of 3,3'-diindolylmethane (DIM) supplementation on increasing EMUR in premenopausal women. A randomized, double-blind clinical trial (NCT02525159 at ClinicalTrial.gov) was carried out on 60 women with an EMUR below 0.9. Patients were assigned randomly to receive a placebo or 75 mg of DIM a day (administered as 300 mg of DIM-BR®) for 30 day. Urine samples were obtained at baseline, at 30 day of supplementation, and 30 day after finishing supplementation. A Mann-Whitney U test was used to compare the EMUR; an ANOVA was used to analyze differences in body composition. EMUR was analyzed using ESTRAMET™ kits. While DIM-treated subjects did not increase their EMUR at 30 day of supplementation (p > 0.05), there was a non-significant positive trend 30 day once supplementation ended (p = 0.06). The DIM group saw a more significant decrease in body fat percentage than the placebo group (p = 0.04). In premenopausal Mexican women, 75 mg of the daily DIM supplement was ineffective in increasing EMUR; further studies are needed to evaluate the effective dosage, time frames, and effect on body fat.

Dietary and Nutrient Intake, Eating Habits, and Its Association with Maternal Gestational Weight Gain and Offspring's Birth Weight in Pregnant Adolescents.

Pregnant adolescents' diet and eating habits are inadequate; however, their association with gestational weight gain (GWG) is uncertain. We aimed to analyze whether there is an association between dietary and nutrient intake and eating habits with GWG among pregnant adolescents and their offspring's birth weight. A longitudinal study was performed with 530 participants. We assessed GWG and applied several tools, such as a food frequency questionnaire and 24-h recall, to obtain dietary and nutrient intake and eating habits. The birth weight of adolescents' offspring was registered. Later, we performed crude and adjusted Poisson models. The mean age was 15.8 ± 1.3 years. Of all food groups, the lowest frequency of adequate intake corresponded to vegetables (7%) and legumes (10.2%). Excessive (36.8%) and insufficient (40.9%) GWG were observed. Pregnant adolescents with inadequate legumes intake increased the probability of excessive GWG: (PR 1.86 95% CI 1.00-3.44). Cereals and grains were positively associated with GWG: (PR 1.65, 95% CI 1.18-2.29). Energy, macronutrient intake, and eating habits were not associated with GWG. Offspring's small gestational age (SGA) increased when pregnant adolescents had inadequate sugar-sweetened beverages intake: PR (1.58, 95% CI 1.01-2.49) and when pregnant adolescent watched television (TV). In our sample of Mexican adolescents, dietary and nutrient intake and eating habits were inadequate. Excessive dietary intake from cereals, grains, and animal-sourced foods along with insufficient legumes were associated with excessive GWG. Watching TV while adolescents ate was associated with the birth weight of the offspring.

Vitamin D Status and Its Determinants in Mexican Pregnant Women from a Rural and an Urban Area: A Comparative Study.

BACKGROUND: During pregnancy, vitamin D requirements are higher due to fetal growth and development. Vitamin D production occurs mainly through sunlight exposure, which is affected by geographic location and lifestyle factors. METHODS: This was a case-control study nested within two cohorts of adult pregnant women (n = 298): urban (Mexico City) and rural (Cuetzalan). To reduce confounding, pairs were selected by age, pregestational body mass index, and pregnancy trimester. Generalized linear models were used to assess the two groups according to their vitamin D status. RESULTS: A total of 298 adult women were studied: 149 from a rural area and 149 from an urban area. Vitamin D deficiency and insufficiency were observed in 28% and 38.2% of women, respectively. A trend for higher 25(OH)D concentrations was observed in women from the rural area (27.5 ng/mL vs. 25.8 ng/mL), probably related to the type of job, where women with partial jobs showing less probability of having vitamin D deficiency (OR = 0.26; CI = 0.06-1.16; p = 0.08) and vitamin D insufficiency (OR = 0.24; CI = 0.06-0.99; p = 0.05). Women whose Last Menstrual Period occurred in spring showed lower vitamin D concentration compared to those whose LMP occurred in winter (p < 0.01). CONCLUSIONS: A high prevalence of vitamin D deficiency was observed in both rural and urban areas. Women living in rural areas tended to have higher 25(OH)D concentrations, probably related to more sunlight exposure associated with their type of job.

Association of Pregestational BMI and Gestational Weight Gain with Maternal and Neonatal Outcomes in Adolescents and Adults from Mexico City.

During pregnancy, adolescents experience physiological changes different from adults because they have not concluded their physical growth. Therefore, maternal and neonatal outcomes may not be the same. This paper aimed to analyze the association between pregestational BMI (pBMI) and gestational weight gain (GWG) with maternal and neonatal outcomes in adolescent and adult pregnant women. The authors performed an observational study that included 1112 women, where 52.6% (n = 585) were adolescents. Sociodemographic information, pBMI, GWG, neonatal anthropometric measures, and maternal and neonatal outcomes were obtained. Adolescent women had a mean lower (21.4 vs. 26.2, p ≤ 0.001) pBMI than adults and a higher gestational weight gain (12.3 vs. 10.7 kg, p ≤ 0.001). According to Poisson regression models, gestational diabetes is positively associated with insufficient GWG and with pregestational obesity. Furthermore, the probability of developing pregnancy-induced hypertension increased with pBMI of obesity compared to normal weight. Preeclampsia, anemia, and preterm birth were not associated with GWG. Insufficient GWG was a risk factor, and being overweight was a protective factor for low birth weight and small for gestational age. We conclude that pBMI, GWG, and age group were associated only with gestational diabetes and low birth weight.

Serum Concentration of Leptin in Pregnant Adolescents Correlated with Gestational Weight Gain, Postpartum Weight Retention and Newborn Weight/Length.

Introduction: Gestational weight gain is an important modifiable factor known to influence fetal outcomes including birth weight and adiposity. Leptin is normally correlated with adiposity and is also known to increase throughout pregnancy, as the placenta becomes a source of leptin synthesis. Several studies have reported positive correlations between cord blood leptin level and either birthweight or size for gestational age, as well as body mass index (BMI). Objective: To determine the correlation of prenatal leptin concentration in pregnant adolescents with their gestational weight gain, postpartum weight retention, and weight/length of their newborn. Methods: A cohort study was conducted on pregnant Mexican adolescents from Gestational Week 26-28 to three months postpartum (n = 168 mother-child dyads). An anthropometric assessment was made of each pregnant adolescent, and the serum level of leptin and the intake of energy were determined. The newborn was evaluated each month during postpartum. Clinical records were reviewed to obtain sociodemographic data. Bivariate correlations, tests for repeating measurements and logistic regression models were performed. Results: Leptin concentration gradually increased during the third trimester of pregnancy. At Gestation Week 36, leptin level correlated with gestational weight gain. When comparing adolescents that had the lowest and highest concentration of leptin, the former presented a mean of 6 kg less in gestational weight gain (inter-subject leptin concentration, p = 0.001; inter-subject energy intake, p = 0.497). Leptin concentration and gestational weight gain exerted an effect on the weight of the newborn (inter-subject leptin concentration for Week 32, p = 0.024; inter-subject gestational weight gain, p = 0.011). Newborn length was associated with leptin concentration at Week 28 (leptin effect, p = 0.003; effect of gestational weight gain, p = 0.722). Conclusions: Pregnant adolescents with leptin concentration over 20 ng/mL showed a greater gestational weight gain. Leptin concentration correlated with length and weight of the newborn.

Biomarcadores óseos y su relación con la densidad mineral ósea en adultas jóvenes y adolescentes en su primer año posparto / Bone biomarkers and its relation with bone mineral density in adults and adolescents during the first year postpartum

La información sobre biomarcadores óseos en adolescentes y adultas durante el periodo posparto es incierta, por lo que el objetivo de este artículo fue analizar el patrón de biomarcadores óseos en adolescentes y adultas a 15, 90, 180 y 365 días posparto (dpp) y su asociación con la densidad mineral ósea (DMO) y lactancia materna. Se realizó un estudio de cohorte en 32 madres adolescentes ≤17 años y 41 adultas de 18 a 29 años de edad en el primer año posparto. Se realizaron medidas antropométricas, DMO y biomarcadores óseos y así como datos del tipo y la duración de lactancia. Como resultados se encontró asociación entre la concentración basal de N-telopéptidos ≤24 μg/L y mayor aumento de DMO. Las adolescentes tuvieron mayor concentración de N-telopéptidos (p≤0.004) y menor concentración de osteocalcina (5±3 vs13±4, p <0.001) que las adultas. La lactancia no afectó el cambio de DMO (p>0.050), ni de biomarcadores óseos. La osteocalcina se asoció con el cambio en DMO (p<0.040). La prolactina fue mayor entre las que practicaron lactancia materna exclusiva (p<0.001). A menor edad menores concentraciones de osteocalcina (p<0.001) y mayores concentraciones de N-telopéptidos (p<0.001). Se concluyó que a menor concentración de N-telopéptidos y mayor de osteocalcina hubo un mayor aumento de DMO, lo cual implica menor aumento de ésta en el grupo de adolescentes. La lactancia no afectó la DMO.

The objective of this study was to describe the trend of bone biomarkers in adults and adolescents women at 15, 90, 180 and 365 postpartum days (ppd) and its relation with bone mineral density (BMD). It was a prospective cohort of 32 teenager’s ≤17 and 41 women from 18 to 29 years old. We evaluated diet, anthropometry, BMD, bone biomarkers and hormonal profile. In all, the concentration of N-telopeptide was higher at 15 days postpartum decreasing during first year postpartum, but adolescents had the highest concentration. The lowest N-telopeptide concentration was associated with highest increasing of the BMD. Osteocalcin concentration was lower in adolescents than in adults women (5 ± 3 vs 13 ± 4 ng/mL, p<0.001) during first year postpartum. Exclusive breastfeeding did not affect the BMD (p>0.050) or bone biomarkers. Osteocalcin concentration was positively associated with bone BMD (p<0.040), breastfeeding did not affect osteocalcin concentrations. Prolactin was higher among women who breastfed exclusively (p<0.001). Age and breastfeeding inversely correlated with bone biomarkers (p<0.001) N-telopeptide and PTHi respectively. We concluded that a lower N-telopeptide concentration and a higher osteocalcin concentration were associated with a higher increasing of BMD, so then, adolescents showed the lowest recovery of the BMD. Breastfeeding does not affect the BMD.

[Body image satisfaction in Mexican adolescents and adults and its relation with body selfperception and real body mass index]. / Satisfacción de la imagen corporal en adolescentes y adultos mexicanos y su relación con la autopercepción corporal y el índice de masa corporal real.

INTRODUCTION: Body Image (BI) perception could determine the nutritional care search, even though there is not always concordance between the real BMI and the self-perceived one. OBJETIVE: To determine the correlation between self-perceived and real BMI, and their relation with body image (BI) satisfaction in a sample of Mexican adolescents and adults. SUBJECTS AND METHODS: An cross-sectional and analytical study, conformed by 556 participants; of which 330 were adolescents and 217 were adults with anthropometric, self-perception and BI satisfaction assessment. RESULTS: The BMI was higher 23±6 vs 29.3±5 p<0.001 in adults, which doubled the level of overweight and obesity present in the adolescents 79% vs 43%. About 50% of participants had concordance between their real BMI and their perceived one (p<0.001). Of all adults with overweight and obesity 68% had satisfaction with their BI, whereas the prevalence of satisfaction with the BI in adolescents was 80%. The predictive variables of BI insatisfaction were being an adult, being a woman and having overweight/obesity (p=0.013). Those ones who referred a positive judgment about their BI, they also reported being satisfied with their BI and presented a real normal or overweight BMI. CONCLUSIONS: Half of the participants had concordance of their perceived BI with their real BMI. The satisfaction with BI was more frequent between the lower real and perceived BMI, but subjects with overweight and obesity also reported satisfaction with their BI even though it is considered a risk condition.

Introducción: La percepción que se tengan de la imagen corporal (IC) podría determinar la búsqueda de atención nutricia, aunque no siempre hay concordancia del índice de masa corporal (IMC) autopercibido con el real. Objetivo: Correlacionar el IMC autopercibido con el real y su relación con la satisfacción de la IC en una muestra de adolescentes y adultos mexicanos. Métodos: Estudio transversal analítico, con 556 participantes: 330 adolescentes y 217 adultos, con las siguientes evaluaciones: de autopercepción y de la satisfacción de la IC; asimismo, antropométrica. Resultados: El IMC fue mayor entre adultos 23±6 vs 29.3±5 p.

[Determination of 2-hydroxyestrone /16α-hydroxyestrone ratio in urine of Mexican women as a risk indicator for breast cancer and its relationship with other risk factors]. / Determinación de la relación 2-hidroxiestrona/16α-hidroxiestrona en la orina de mujeres mexicanas como indicador de riesgo a cáncer de mama y su relación con otros factores de riesgo.

UNLABELLED: The urinary ratio 2-hydroxyoestrone/16-hydroxyoestrone (URME), has been proposed in various populations on the world as a risk indicator for breast cancer (BC), however in the Mexican population has never been determined. OBJECTIVE: To determine URME Mexican women and establish its relationship with risk factors for BC. MATERIAL AND METHODS: Cross-sectional study of 142 premenopausal and 42 posmenopausal women. The URME was determined with the kit ESTRAMETTM and was related to risk factors for BC. Correlations and linear regressions were performed. RESULTS: The median URME was 0.90 (RIQ 0.64-1.18). The body mass index (BMI) and early menarche contribute 5.4% of their variability (F=5.17; p.

La relacion 2-hidroxiestrona/16-hidroxiestrona urinaria (RMEO), se ha propuesto en diversas poblaciones del mundo como indicador de riesgo a cancer de mama (CM), sin embargo, en la poblacion mexicana, nunca se ha determinado. Objetivo: Determinar la RMEO en mujeres mexicanas y establecer su relacion con factores de riesgo para CM. Material y Métodos: Estudio transversal analitico de 142 mujeres premenopausicas y 42 posmenopausicas. Se determino la RMEO con el estuche ESTRAMETTM y se relaciono con factores de riesgo para CM. Se realizaron correlaciones y regresiones lineales. Resultados: La mediana de la RMEO fue 0.90 (RIC: 0.64-1.18). El indice de masa corporal (IMC) y la menarca temprana contribuyeron en 5.4% de su variabilidad (F=5.17; p.

[Bone biomarkers and its relation with bone mineral density in adults and adolescents during the first year postpartum]. / Biomarcadores óseos y su relación con la densidad mineral ósea en adultas jóvenes y adolescents en su primer año posparto.

The objective of this study was to describe the trend of bone biomarkers in adults and adolescents women at 15, 90, 180 and 365 postpartum days (ppd) and its relation with bone mineral density (BMD). It was a prospective cohort of 32 teenager's ≤17 and 41 women from 18 to 29 years old. We evaluated diet, anthropometry, BMD, bone biomarkers and hormonal profile. In all, the concentration of N-telopeptide was higher at 15 days postpartum decreasing during first year postpartum, but adolescents had the highest concentration. The lowest N-telopeptide concentration was associated with highest increasing of the BMD. Osteocalcin concentration was lower in adolescents than in adults women (5 ± 3 vs 13 ± 4 ng/mL, p<0.001) during first year postpartum. Exclusive breastfeeding did not affect the BMD (p>0.050) or bone biomarkers. Osteocalcin concentration was positively associated with bone BMD (p<0.040), breastfeeding did not affect osteocalcin concentrations. Prolactin was higher among women who breastfed exclusively (p<0.001). Age and breastfeeding inversely correlated with bone biomarkers (p<0.001) N-telopeptide and PTHi respectively. We concluded that a lower N-telopeptide concentration and a higher osteocalcin concentration were associated with a higher increasing of BMD, so then, adolescents showed the lowest recovery of the BMD. Breastfeeding does not affect the BMD.

[Association of consumption of carbonated beverages and decalcification in woman on reproductive and non-reproductive age of Mexico City]. / Asociación del consumo de bebidas carbonatadas y descalcificación en mujeres en edad reproductiva y no reproductiva de la Ciudad de México.

INTRODUCTION AND OBJECTIVE: There is not enough information about carbonated beverages (CB) consumption in Mexican women and its association with bone mineral density (BMD). The objective was to identify the association of CB consumption with BMD in two groups of Mexican women. METHODS: Transversal study with 328 women in reproductive age (WRA) and not reproductive (WNRA) with diet and anthropometric evaluation and BMD. RESULTS: Mean age of 18.7 years in WRA and 47 in WNRA. Energy adequacy percentage was lower in WNRA (98 ± 28% vs 144 ± 55) (p = 0.001), calcium intake was < 700 mg/day in women with osteopenia of both groups and median consumption of CB was higher in WRA, with 200 mL/day (0-462) vs 0 (0-250) in WNRA (p = 0.001), WRA with osteopenia drank 500 mL/day (253-750) of CB vs 100 (0-200) in who had not (p = 0.001). Anthropometric parameters were higher in WNRA (p =?0.002) and femoral neck BMD was lower (1.031 ± 0.14 vs 1.107 ± 0.10) (p = 0.001) and higher in L2-L4 (1.114 ± 0.13 vs 1.003 ± 0.09) (p = 0.001) in WRA. Variables associated with risk of osteopenia: drink CB (OR 11.186, p = 0.001), consuming < 700 mg of calcium (OR 5.774, p = 0.001) and dinner no milk (OR 1.942, p = 0.042). CONCLUSIONS: To drink CB increases risk of osteopenia in both groups, WRA drink more CB than WNRA and they will have high probability of fractures younger.

Introducción y objetivo: No hay información suficiente sobre el consumo de bebidas carbonatadas (BC) y su asociación con la densidad mineral ósea (DMO) en mexicanas. El objetivo fue identificar la asociación del consumo de BC con la DMO en dos grupos de mujeres mexicanas. Métodos: Estudio transversal con 328 mujeres en edad reproductiva (MER) y no reproductiva (MENR), con evaluación dietética, antropométrica y DMO. Resultados: Edad promedio de 18,7 años en MER y 47 años en MENR. El porcentaje de adecuación del consumo de energía fue inferior en MENR (98 ± 28% vs 144 ± 55) (p = 0,001), el consumo de calcio fue < 700 mg/día en mujeres con osteopenia de ambos grupos y la mediana del consumo de BC fue mayor en MER, con 200 mL/día (0- 462) vs 0 (0-250) en MENR (p = 0,001), las MER con osteo penia bebían 500 mL/día (253-750 mL/día) de BC/día vs 100 (0-200 mL/día) en las que no la presentaron (p = 0,001). Los parámetros antropométricos fueron superiores en MENR (p =?0.002) y la DMO en cuello de fémur fue inferior 1,031 ± 0,14 vs 1,107 ± 0,10 (p = 0,001), en MER fue mayor en L2-L4: 1,114 ± 0,13 vs 1,003 ± 0,09 (p = 0,001). Variables asociadas al riesgo de osteopenia: beber BC (OR 11,186; p = 0,001), consumir < 700 mg de calcio (OR 5,774; p = 0,001) y no cenar leche (OR 1,942; p = 0,042). Conclusiones: Beber BC aumenta el riesgo de osteopenia en ambos grupos, las MER consumen más BC que las MENR y tienen aún más probabilidad de fracturas a edades más tempranas.

Effects of breastfeeding on weight loss and recovery of pregestational weight in adolescent and adult mothers.

BACKGROUND: Exclusive breastfeeding (EBF) in adolescent mothers has been associated with greater postpartum maternal weight loss. OBJECTIVE: To assess the associations between EBF and weight loss in adolescent and adult mothers and between EBF and weight and length gain of their children. METHODS: A cohort of 68 adolescent mothers (15 to 19 years), 64 adult mothers (20 to 29 years), and their infants were studied. Anthropometric measurements were performed at 15, 90, 180, and 365 days postpartum in the mothers and children. EBF was defined as consumption of human milk without supplementation of any type (water, juice, nonhuman milk, or food) for 4 months. RESULTS: Sixty-five percent of mothers sustained EBF for 4 months. There were no significant differences in the weight or length of the infants of adolescent and adult mothers at 365 days postpartum. Among infants of adult mothers, there was a significant difference between the weight gain of those were exclusively breastfed and those who were not exclusively breastfed (6,498 +/- 1,060 vs 6,096 +/- 1,035 g, p < .050) at 365 days postpartum, according to the parameters for weight gain and length established by the World Health Organization (WHO). Among both adult and adolescent mothers, those who practiced EBF lost more weight than those who did not practice EBF (-2.9 kg, 95% interquartile range, -5.7 to 0.8 kg, vs -1.8 kg 95% interquartile range -2.8 to 2.2 kg; p = .004). Gestational weight gain, duration of EBF, and recovery menstruation explained 21% of the variance (F = 28.184, p = .001) in change in postpartum maternal weight (in kilograms) from 0 to 365 days postpartum in all mothers. Pregestational weight, duration of EBF, and maternal age were factors that explained 14% (F = 22.759, p = .001) of the change in the weight and length of the infants from 0 to 365 days of life. CONCLUSIONS: EBF in adolescent and adult mothers influences postpartum weight loss and provides adequate infant growth in accordance with the WHO 2006 standards.

Control prenatal y zinc sérico: su repercusión en el recién nacido de madres adolescentes / Prenatal control and serum zinc: impact on the newborn to adolescent mothers

Introducción: Las adolescentes embarazadas son un grupo vulnerable nutricionalmente porque deben cumplir con sus propias necesidades de crecimiento y las del embarazo. El control prenatal es importante para un consumo de nutrimentos y una resolución del embarazo adecuado. Objetivo: Asociar el trimestre de inicio de control prenatal y el zinc sérico consumido con algunas características neonatales. Material y métodos: Estudio de cohorte, analítico y prospectivo con adolescentes embarazadas que se atendieron en el Instituto Nacional de Perinatología con las siguientes evaluaciones, en el último trimestre gestacional: consumo de zinc (frecuencia de consumo de alimentos), zinc sérico (espectrofotometría), antropométrica (peso, estatura) y revisión del expediente clínico (inicio del control prenatal y datos del neonato). Análisis estadístico: prueba t de Student, χ² de Pearson y regresión lineal. Aprobado por los comités de ética e investigación. Resultados: El 59% de las participantes inició el control prenatal en el primer trimestre gestacional; de ellas, el 56% tuvo parto vaginal, 92% de neonatos fueron a término, 85% con peso adecuado y mayor consumo de zinc. Las concentraciones séricas de zinc a la semana 28 y 32 de gestación explicaron 35% el peso al nacer R² = 0.358, β 2837 IC 1761, 3914, p = 0.001, 16% del perímetro cefálico (R² = 0.163 β = 35 EE = 1.9, IC 31.2, 39, p = 0.001), 25% de la edad gestacional (p = 0.003) y el 43% la longitud al nacer R² = 0.431, β 55.5 IC 49.62, p = 0.001). Conclusiones: El control prenatal en el primer trimestre se asoció a un mayor consumo de zinc. Las concentraciones de zinc sérico normales se asociaron con más frecuencia a neonatos a término y con mayor longitud, peso y perímetro cefálico.

Introduction: Adolescents pregnant are a vulnerable group in the nutritional area because they have their self growth requirements and for the child. Prenatal care is important to achieve healthy nutrition and better pregnant outcomes. Aims: To associate the gestational trimester beginning prenatal care, zinc (Zn) serum concentrations and its intake with neonatal characteristics. Methods: This is a cohort study with pregnant adolescents assisted by Perinatology National Institute. In the last trimester of gestation, we determine anthropometry characteristics, zinc intake (food frequency), serum zinc (espectrofotometry) and clinical records in order to get newborn somatometry. Statistic analysis: T Student, χ² de Pearson and lineal regression. The study was approved by INPer's Research and Ethic Committee. Results: More than 50% adolescents pregnant began their prenatal care at the first gestational trimester, 56% had eutocic part, 92% were at term, and 85% had newborn's normal weight and normal zinc intake. Normal zinc serum concentrations explained 35% of NB weight (R² = 0.358, IC 1761, 3914, p = 0.001), 16% of head circumference (R² = 0.163, IC 31.2, 39, p = 0.001), 25% of gestational age at term (p = 0.003), and 43% of newborn height (R² = 0.431, IC 49.62, p = 0.001). Conclusions: Prenatal care in the first trimester was associated with a higher zinc intake. Zinc normal serum concentration was associated with normal gestational age at term, higher weight, head circumference and height stature.