Interventions to prevent obesity in Latinx children birth to 6 years globally: a systematic review.

OBJECTIVE: To conduct a systematic review of obesity prevention interventions in Latinx children ages birth to 6 years published in any language from 2010-2020. DESIGN: We used PubMed, ERIC, PsycINFO, Scopus, Scientific Electronic Library Online (SciELO) and Google Scholar databases to conduct a search on May 1 2020, January 1 2021 and November 1 2022. We included randomised controlled trials, quasi-experimental studies and non-randomised interventions with a control or comparison group that reported measures of adiposity. SETTING: Interventions taking place in the United States, Latin America or the Caribbean. PARTICIPANTS: Latinx children ages birth to 6 years. RESULTS: Of 8601 unique records identified, forty manuscripts about thirty-nine unique studies describing thirty distinct interventions in the United States and nine interventions in Latin America and the Caribbean met our inclusion criteria. Interventions were primarily based in early care and education centres (n 13) or combined home settings, for example home and community (n 7). Randomised interventions taking place in community or home settings were more likely to report significant reductions in adiposity or weight-related outcomes compared to other settings. Using the Cochrane risk of bias tools for randomised and non-randomised studies, we judged thirty-eight randomised trials and nine non-randomised interventions to have a high or unclear risk of bias. CONCLUSIONS: The results highlight a need for more rigorous designs and more effective intervention strategies in Latinx children at risk for having overweight and obesity. Registered with the PROSPERO database for systematic reviews under registration number CRD42020161339.

Longitudinal changes in sleep patterns and circadian rhythm metrics in preschool-age children from Northern Mexico.

OBJECTIVES: To assess changes in sleep parameters and circadian rhythm metrics measured by actigraphy in preschool-aged children. DESIGN: Longitudinal analysis over 1 year. PARTICIPANTS: Ninety-four children living in Tijuana and Ensenada, Mexico. MEASUREMENTS: Children wore accelerometers on the right hip for one continuous week at baseline and 1-year follow-up. Parents recorded child bedtime, waketime, and naps in sleep diaries. We used cosinor and nonparametric approaches to calculate circadian rhythm metrics. RESULTS: At baseline, children had a mean age of 4.2 years, and 51.1% were girls. In multivariable models adjusted for age, gender, BMI category, parental education, household income and city, at follow-up children had significantly earlier waketimes (ß = -7.99 minutes, p < .001) compared to baseline. Children also had lower sleep onset latency (ß = -2.32 minutes, p = .057), and longer nighttime sleep (ß = 9.38 minutes, p = .079), but these changes were not significant at the α < 0.05 level. We found significant increases in log relative amplitude (ß = 0.017, p = .009), and decreases in log midline estimated statistic of rhythm (ß = -0.084, p = .017) and log of the least active 5-hour period (ß = -0.057, p = .010). When we adjusted for co-sleeping, we found significant decreases in the number of nighttime awakenings (ß = -1.29, p = .011) but otherwise similar results. There were no other changes in sleep parameters or circadian rhythm metrics. CONCLUSIONS: Mean increases in nighttime sleep and earlier wake times over one year were concomitant with decreases in overall activity levels and increases in circadian rhythm robustness. Co-sleeping was a predictor of sleep disturbances. This study provides longitudinal evidence regarding changes in sleep and circadian metrics in a sample of children from an under-researched sociodemographic group during an important, early life period.

Interventions to prevent obesity in Latinx children globally: protocol for a systematic review and meta-analysis.

BACKGROUND: Rates of childhood obesity have accelerated rapidly over the past decade in low- and middle-income countries and in Latin America in particular. At the same time, Latinx children in high-income countries have been disproportionately affected by obesity. Public health and medical experts have called for greater focus on multi-sector approaches to obesity prevention, including policy, systems, and environmental strategies, but current evidence for effective intervention strategies among Latinx children is lacking. Several systematic reviews have investigated obesity prevention interventions in Latinx children in the United States and in Latin America, including our own review, but these are now a decade old. Thus, an updated review of existing interventions is needed. To address this gap, we will conduct a systematic review and summary of interventions for obesity prevention among Latinx children published over the past 10 years. The objective of this paper is to outline the protocol for conducting the systematic review and possible meta-analysis. METHODS: We will conduct a literature search using PubMed, ERIC, PsycINFO, Scopus, Scientific Electronic Library Online, and Google Scholar databases for studies of interventions to prevent obesity in Latinx children ages birth to 18 years of age. To meet our definition of an intervention, we will include study designs that evaluate the either the efficacy or effectiveness of obesity prevention interventions, including randomized controlled trials, quasi-experimental studies, and non-randomized interventions with a control or comparison group. We will exclude interventions that aimed to treat rather than prevent overweight or obesity. Interventions may take place in any country or setting. The primary outcome of interest will be child overweight or obesity, measured as adiposity, body mass, or similar anthropometric measures. We will assess risk of bias of included studies using the Cochrane risk of bias tool for randomized and non-randomized studies, as appropriate. We may conduct meta-analyses if studies with comparable exposure and outcome variables are available. DISCUSSION: This protocol paper establishes a methodology for a future systemic review of obesity prevention interventions in Latinx children. A systematic review of this topic will provide an important update to the literature regarding interventions to prevent obesity in Latinx child populations globally over the past decade. Review results will be relevant to stakeholders across multiple sectors engaged in childhood obesity prevention among Latinx children. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020161339.

Association of Food Parenting Practices on Child BMI z Score and Waist Circumference in Mexican Preschool Children After 1 Year of Follow-Up.

OBJECTIVE: To evaluate the association between food parenting practices (FPPs) and weight status among preschoolers and the directionality of this association at 1-year follow-up. METHODS: A longitudinal exploratory study was conducted using linear regression and structural equation modeling to determine directional associations between FPPs and children's body mass index z score and waist circumference. The FPPs were estimated using Child Feeding Questionnaire subscales. RESULTS: A total of 91 parent-child dyads completed the study. In structural equation modeling analysis, when identifying the FPPs in a latent variable with its indicators of indulgent feeding, food as a reward and restriction predicted higher body mass index z score at follow-up. Higher baseline waist circumference was also negatively associated with the use of food as a reward. CONCLUSIONS AND IMPLICATIONS: Feeding-weight associations are likely bidirectional. Understanding them, as well as the pathways between them, is critical to developing effective prevention and treatment strategies.

Alimentos seleccionados por los padres para los refrigerios de sus hijos en etapa de educación básica en Reynosa, Tamaulipas / Lunch box contents of elementary school children in Reynosa, Tamaulipas

Resumen Los refrigerios que consumen los niños durante el recreo complementan su dieta diaria, y pueden representar un riesgo de obesidad si los padres los preparan con base en alimentos procesados, elevados en azúcar, sal y grasa. El objetivo de este estudio fue identificar el contenido de los refrigerios empacados en casa, así como el estado nutricio de escolares de Reynosa, Tamaulipas, México. Se realizó un estudio descriptivo y transversal. Se trabajó con 769 niños de 12 escuelas públicas de educación básica. Se tomaron peso y talla. Se registraron durante una semana los refrigerios por observación directa, mediante una lista de cotejo. El 44.7 % de los escolares presentó sobrepeso u obesidad. Los alimentos contenidos en los refrigerios fueron el sándwich (50.0 %), tacos (29.5 %) y tortas (14.5 %). Las bebidas azucaradas incluyeron jugo (44 %) y agua saborizada (38.2 %). El 18.8 % llevó frutas, 13.5 % verduras y 31.6 % agua. En promedio, el contenido de energía fue de 327 kcal, por lo tanto, sobrepasaron la recomendación de calorías, e incluían alimentos no saludables (alto contenido de azúcar y grasa en relación a su aportación nutrimental), siendo necesario realizar intervenciones de educación nutricional para promover el consumo de agua y alimentos saludables dentro del entorno escolar, para mejorar la calidad de los hábitos alimenticios, tanto en escuelas de medio tiempo, como de tiempo completo, las cuales, brindan el servicio de alimentación.

Abstract School lunch supplements children's dailydiet and may pose a risk of obesity if they are prepared based on processed foods high in sugar, salt and fat. The aim of this study was to identify the content of lunch packs, as well as the nutritional status of scholars from Reynosa, Tamaulipas, Mexico. To that aim, a descriptive and transversal study was conducted. We worked with 769 children from 12 public elementary schools. Students' size and weight were taken. The contents of their lunch packs were recorded for one week by direct observation through a checklist. 44.7 % of school children were overweight or obese. The foods contained in the lunch packs were sandwich (50.0 %), tacos (29.5 %) and big sandwich (14.5 %). Sugary drinks included juice (44 %) and flavored water (38.2 %). They also contained fruits (18.8 %), vegetables (13.5 %) and water (31.6 %). On average, the energy content was 327 kcal. Therefore, they exceeded the calorie recommendation and included unhealthy foods (high content of sugar and fat in relation to their nutritional contribution). This suggests the need to implement nutrition education intervention programs to promote the consumption of drinking water and healthy foods within the school environment to improve the quality of eating habits.

Effect of water consumption on weight loss: a systematic review.

INTRODUCTION: Water intake has been proposed for weight loss; however, the evidence of its efficacy is limited. The aim of this study was to systematically review the randomized clinical trials that assessed the effect of water consumption on weight with a follow up ≥ 12 weeks. A systematic query-based search was performed on PubMed, EBSCO, and Cochrane Library to identify eligible records that quantitatively measured body weight change after interventions. This review included six RCTs that reported different strategies for weight loss achievement: increasing daily water intake, replacement of caloric beverages with water, and premeal waterload. All the studies showed a weight loss effect after follow-up, ranged from -0.4 kg to -8.8 kg with a mean percentage of weight loss of 5.15%. The most effective intervention among the studies was the replacement of caloric beverages with water. The quality of the evidence for the primary outcome of weight loss was rated low to moderate. The main limitation of these results is the short-term follow up-period. In conclusion, despite 5.15% of weight loss, the low to moderate quality of evidence and the short term of follow-up are limitations to support evidence-based recommendations of water consumption for weight loss.

INTRODUCCIÓN: El consumo de agua se ha propuesto como medida para la pérdida de peso; sin embargo, la evidencia de su eficacia es limitada. El objetivo de este estudio fue revisar sistemáticamente los ensayos clínicos aleatorizados que han evaluado el efecto del consumo de agua en el peso corporal con un periodo de seguimiento ≥ 12 semanas. Se realizó una búsqueda sistemática en cadena en PubMed, EBSCO y Cochrane Library para identificar estudios elegibles que midieran cuantitativamente el cambio de peso corporal después de sus intervenciones. Esta revisión incluye seis ECA que reportan diferentes estrategias para alcanzar la pérdida de peso: incremento del consumo diario de agua, reemplazo de bebidas calóricas por agua y sobrecarga con agua previa a las comidas. Todos los estudios mostraron un efecto de pérdida de peso después del seguimiento, con un rango de -0.4 kg a -8.8 kg y con un porcentaje promedio de pérdida de peso del 5.15%. La intervención más efectiva entre los estudios fue el reemplazo de bebidas calóricas por agua. La calidad de la evidencia para el resultado primario de pérdida de peso fue calificada de baja a moderada. La principal limitación de estos resultados es el corto periodo de seguimiento. En conclusión, a pesar de encontrarse una pérdida de peso del 5.15%, la calidad de la evidencia baja a moderada y el corto periodo de seguimiento son limitaciones para sustentar una recomendación basada en la evidencia sobre el consumo de agua para la pérdida de peso.

Greenspace, physical activity, and BMI in children from two cities in northern Mexico.

Numerous previous studies have reported positive associations between exposure to greenspace and children's physical activity, but in high-income countries only. Prior studies have also examined greenspace and obesity in children, but these have yielded inconsistent results and focused mostly on older children. The purpose of this study was to assess associations between time children spent in greenspace as the primary exposure and our outcomes of interest, including 1) minutes of physical activity, and 2) body mass index (BMI) z-score. Our sample was 102 children ages 3 to 5 years living in Ensenada and Tijuana, Mexico. We fit linear mixed models to estimate associations between greenspace and children's physical activity and BMI z-score. After adjustment for potential confounders, greater time in greenspace was associated with decreased sedentary time (-0.08 min per hour for each additional 30 min in greenspace; 95% CI -0.13, -0.04; p = 0.002) and increased moderate-to-vigorous physical activity (MVPA) (0.06; 95% CI 0.03, 0.10; p < 0.001). Results were driven primarily by children in Tijuana (-0.22; 95% CI -0.38, -0.06; p = 0.008 for sedentary time and 0.15; 95% CI 0.06, 0.38; p = 0.007 for MVPA). Time in greenspace was not associated with BMI z-score in children in Ensenada (0.001; 95% CI -0.008, 0.01; p = 0.83) or Tijuana (-0.009; 95% CI -0.02, 0.004; p = 0.17). Greater time in greenspace was associated with physical activity but not BMI in our sample of children-more so in Tijuana compared to Ensenada. Given high rates of obesity, interventions should aim to increase physical activity in young children in Northern Mexico.

Long-term outcomes of metabolic and bariatric surgery in adolescents with severe obesity with a follow-up of at least 5 years: A systematic review.

The practice of metabolic and bariatric surgery for adolescents with severe obesity has been increasing, and evidence of the outcomes in the long term remains unclear. The aim of this study was to review and analyze the outcomes of this therapy in adolescents with a follow-up ≥5 years. MEDLINE, EMBASE, and Cochrane databases were systematically searched. Inclusion criteria were 10- to < 20-year-old adolescents, 5 years minimum of follow-up, and a retention rate ≥70% at 5 years of follow-up. Adiposity indicators outcomes, co-morbidity remission, and complications were analyzed. A total of 10 studies met the inclusion criteria. Surgeries performed included gastric bypass, gastric band, and sleeve gastrectomy. The age of the participants ranged from 13 to 17 years. The longest follow-up after intervention was 156 months. Mean body mass index at baseline and follow-up was 47 and 32.4 kg/m 2 , respectively. Most of the studies reported weight regain within 1 to 12 years of follow-up. Remission rate of co-morbidities was 75% for dyslipidemia, 78% for musculoskeletal problems, 85% for hypertension, and 85% for type 2 diabetes. Not all studies stated that they were looking for all complications. Iron deficiency and anemia were high, ranging from 30% to 70% and 16% to 50%, respectively. The review indicates that there is low to moderate evidence that metabolic and bariatric surgery in adolescents with severe obesity after 5 years of follow-up results in substantial reduction in body mass index, and very low to low evidence in the resolution of related co-morbidities. Although long-term complications were inadequately reported or nonreported, a high prevalence of iron deficiency and anemia was found. Because maternal anemia might be implicated in deleterious effects for offspring, monitoring female patients for anemia after metabolic and bariatric surgery is strongly recommended. Further high-quality studies with long-term follow-up are warranted to assess related co-morbidities and long-term complications.

Combined dietary-exercise intervention for gestational weight gain and birthweight: a meta-analysis.

BACKGROUND AND OBJECTIVES: Excessive gestational weight gain has been associated with higher risk for large for gestational age newborns. This systematic review and meta-analysis aims to assess whether an intensive diet and exercise intervention has an effect in reducing gestational weight gain and large for gestational age newborns. METHODS AND STUDY DESIGN: The search was conducted on PubMed and Cochrane database. Through PRISMA flow diagram, clinical trials which met the inclusion criteria were selected. Risk of bias, sensitivity analysis, and quality of evidence assessment were conducted using adequate statistical tests, and the quality of evidence was performed by GRADE method. A random-effect model was used to estimate the statistical significance of the meta- analysis. RESULTS: Ten clinical trials met the inclusion criteria. Using the random-effect model and a sensitivity analysis, it was found that an intensive patient-centered intervention reduced gestational weight gain when compared with standard prenatal care (Z=6.21 (p<0.00001); Tau²=0.00; Chi²=3.90, df=4 (p=0.42); I²=0%), and the quality of evidence was moderate. An intensive diet and exercise intervention decreased the number of large for gestational age newborns (Z=2.20 (p=0.03); Tau²=0.14; Chi²=7.84, df=4 (p=0.10); I²=49%), and the quality of evidence using the GRADE approach was moderate. CONCLUSION: The present review and meta-analysis indicates that an intensive diet and exercise intervention reduced gestational weight gain and large for gestational age newborns.

Body-image dissatisfaction in children and adolescents: a systematic review / Insatisfacción con la imagen corporal en niños y adolescentes: revisión sistemática

Background: The difference in the perception between the perceived silhouette and the desired silhouette has been defined as body image dissatisfaction (BID). Objective: To review the type of methods for measuring BID, the frequency of BID among children and adolescents. Method: We searched studies through electronic databases (PubMed, Scielo and EBSCOhost), from cross-sectional studies published in English or Spanish. Eligible studies assessing BID in children and adolescents published in Spanish and English, from April 2010 to April 2015. Age, sex, weight and method or scale used to evaluate the BID and the self- perception of body weight were assessed. Results: Sixteen studies met the inclusion criteria, and included children and adolescents aged 5 to 19 years. Nine types of measurement methods of BID were found. In most of the studies, temporal stability and validity test were performed. In BID studies where frequency was reported, ranged from 44% to 83% for overweight or obese and 1.7% a 37% for underweight. In some studies, BID was associated with age and was more frequent among girls. BID was also present in thin boys. Conclusion: BID was more frequent among girls and was positively associated with BMI. Despite the variety of methods used, the results are consistent.

Introducción: la diferencia de la percepción entre la silueta percibida y la deseada se ha definido como insatisfacción con la imagen corporal (IMCO). Objetivo: evaluar los métodos utilizados para medir la IMCO y la frecuencia de la IMCO en niños y adolescentes. Metodología: se buscaron artículos registrados en las bases de datos de PubMed, EBSCOhost y Scielo, de estudios transversales en inglés y español, que valoraran la IMCO en niños y adolescentes publicados de abril de 2010 al mes de abril de 2015. Se registraron, edad, sexo, tamaño muestral, estado de peso, tipo de método para valorar la IMCO y estimación de la IMCO. Resultados: cumplieron con los criterios de inclusión 16 estudios que valoraron la IMCO en niños y adolescentes de 5 a 19 años de edad. De los artículos analizados se encontraron 9 métodos de valoración de la IMCO. En la mayoría se realizaron pruebas de estabilidad temporal y validez. La frecuencia de IMCO por tener sobrepeso u obesidad, osciló de 44% a 83% y por bajo peso, de 1,7% a 37%. La IMCO aumentó de acuerdo al IMC, y en algunos estudios se asoció con la edad. Fue más frecuente en las mujeres, y en algunos casos se presenta IMCO en los niños delgados. Conclusión: la IMCO se presenta con mayor frecuencia en el sexo femenino y se asocia positivamente con el IMC. A pesar de la variedad de métodos utilizados para evaluar la IMCO, los resultados son consistentes.

Nutritional Intervention to Improve the Quality of Lunchboxes Among Mexican School Children.

In Mexico, the type of foods included in the lunchboxes of school children are unhealthy. The aim of this study was to evaluate the effects of an intervention program to improve the quality of the foods in the lunchboxes. Two schools were randomly selected as the intervention group (IG) and two more as the control group (CG). The evaluation was performed by comparing a food list from 3 days before and 6 months after the intervention. The components of the intervention included: exposure to posters inside and outside the classrooms and the distribution of pamphlets to parents, the pamphlets provided recipes and information about healthy foods. A lunchbox was considered adequate (AL) if it had less than 276 cal, fruits or vegetables, and an item prepared at home; a healthy lunchbox (HL) consisted of fruits or vegetables, water, and it did not have unhealthy foods. At the beginning of the study there were no significant differences in the compliance of AL and HL in both groups. By the end of the study, 19 % of the children in the IG and 10 % of the children in the CG met the criteria of a HL (p = 0.002). The results of this study demonstrate that a simple, 6 month intervention targeting parents improved the quality of the foods in the lunchboxes of second and sixth graders.

Estudio prospectivo sobre el efecto del consumo de bebidas azucaradas sobre la obesidad en un periodo de 12 meses en mexicanos de 15 a 19 años.

Antecedentes: se ha reportado una asociación entre el aumento del consumo de bebidas azucaradas y varias enfermedades metabólicas. Objetivo: evaluar el efecto del consumo de bebidas azucaradas sobre la obesidad en un periodo de 12 meses en mexicanos de 15 a 19 años. Métodos: el diseño del estudio fue prospectivo, con 12 meses de seguimiento. Se midieron el peso, la talla y la circunferencia de cintura (CC), y se calculó el puntaje z de índice de masa corporal (IMC). Se aplicó un cuestionario sobre consumo de 19 bebidas. Para evaluar la predicción del aumento de IMC y de CC como resultado del consumo de bebidas, se utilizó análisis de regresión logística binomial. Resultados: al final del estudio se evaluó al 89% (1.344). El promedio de edad fue de 15 años, 55% fueron mujeres. La prevalencia de sobre- peso y obesidad al final del estudio fue del 33%. Al final del estudio, un 25% de los participantes consumían más de 50 g de azúcar proveniente de las bebidas. Quienes consumieron 50 g de azúcar o más al día presentaron mayor riesgo de aumentar la CC ≥ 2 cm (RR = 1,19, IC 95%, 1,03-1,39, p = 0,02). Quienes mantuvieron el consumo de bebidas azucaradas durante 12 meses, al compararlo con los que disminuyeron el consumo a 10 g/día, presentaron 71% más probabilidades de aumentar a un puntaje de IMC ≥ 2 (RR = 1,71, IC 95%, 1,03-2,86, p = 0,039). Conclusión: el alto consumo de bebidas azucaradas aumentó las probabilidades de aumentar de peso y de circunferencia de cintura.

[EFFICACY OF SELF-MONITORING IN WEIGHT LOSS: A SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED STUDIES]. / EFICACIA DE LA AUTOMONITORIZACIÓN SOBRE LA PÉRDIDA DE PESO: REVISIÓN SISTEMÁTICA DE ESTUDIOS ALEATORIZADOS.

INTRODUCTION: different studies have shown a strong relationship between self-monitoring and weight loss. The objective of this review was to analyze randomized clinical trials using self-monitoring as a strategy for weight loss. METHODS: a search was conducted in PubMed database of randomized controlled trials using self-monitoring for weight loss in adults, published in English and Spanish, from January 1st, 2009 to April 30th, 2015. The sample size, age, weight loss, BMI, intervention strategy, duration, and retention rate, were recorded. RESULTS: six studies met the selection criteria. The intervention and the follow-up ranged from 3 to 12 months. The study population ranged from 18-74 years of age and included subjects from 50-329. Weight loss ranged from 1.14 to 2.1 kg in the control group and -1.27 to -6.1 kg in the intervention group. The six studies determined a greater weight loss in the self-monitoring group with moderate to high evaluation evidence. CONCLUSION: greater weight loss was consistently found in the self-monitoring group. These results suggest the need to use self-monitoring as a strategy for weight loss.

Introducción: los resultados de diferentes estudios sugieren que existe una asociación entre la automonitorización y la pérdida de peso. El objetivo de esta revisión es analizar de manera sistemática estudios aleatorizados que han utilizado la automonitorización como estrategia para la pérdida de peso. Metodología: se realizó una búsqueda de artículos en la base de datos de Pubmed, de estudios aleatorizados en inglés y español, que utilizaran la automonitorización del ejercicio y la dieta sobre la pérdida de peso en población adulta, publicados entre el uno de enero de 2009 y el 30 de abril de 2015. Se registró el tamaño de la población, la edad, la pérdida de peso y el IMC, la estrategia de intervención, el porcentaje de retención, y la duración de la intervención, y se evaluó la calidad siguiendo el método GRADE. Resultados: cumplieron los criterios de selección seis estudios, que tuvieron un periodo de seguimiento de tres a 12 meses. La población de estudio incluyó desde 50 hasta 329 sujetos. El rango de edad al inicio del seguimiento fue de 18 a 74 años, y la media de seguimiento fue de 8 meses. La pérdida de peso osciló entre 1,14 y -2,1 kg en el grupo control, y de -1,27 a -6,1 kg en el grupo de intervención. En los seis estudios se observó una mayor pérdida de peso en el grupo con automonitorización. La evaluación de la evidencia fue moderada a alta. Conclusión: en esta revisión se observó que los grupos que utilizaron la automonitorización presentaron mayor pérdida de peso y que el grado de evidencia fue de moderada a alta.

FAT PHOBIA IN MEXICAN NUTRITION STUDENTS.

Nutritionists play a major role in the prevention and treatment of obesity. Currently, fat phobia among nutrition students and health workers is resulting in health and social consequences. The aim of this study was to assess the fat phobia among nutrition college students of two schools from different regions in Mexico. Six hundred and thirty 18 to 25 yo nutrition students participated in the study. Fat phobia was assessed using the F-scale, containing 14 pairs of adjectives that described people with obesity. Participants achieved a mean F-scale score of 3.45, which could be considered a moderate amount of fat phobia. Only twelve per cent showed neutral or positive attitudes towards obesity (≤ 2.5), while negative attitude (≥ 2.5) was observed among 88% of all students showing a high prevalence of fat phobia towards obesity.

Los nutricionistas juegan un papel importante en la prevencion y el tratamiento de la obesidad, y la fobia hacia personas con obesidad entre estudiantes de nutricion y los trabajadores de la salud tiene consecuencias sanitarias y sociales. El proposito del estudio fue valorar la fobia hacia la obesidad, entre estudiantes de nutricion de dos escuelas de diferentes regiones de Mexico. Seiscientos treinta estudiantes de 18 a 25 anos participaron en el estudio. La fobia hacia la obesidad se evaluo mediante la escala F, que contiene 14 pares de adjetivos que describen a las personas con obesidad. Los participantes obtuvieron una media de calificacion en la escala F de 3,45, lo que se considera una cantidad moderada de fobia hacia la obesidad. Solamente el 12% presentaron actitudes neutrales positivas (≤ 2,5), mientras que el 88% de los estudiantes presentaron actitudes negativas (≥ 2.5). Se observo una alta prevalencia de fobia hacia la obesidad.

[DO WEIGHT LOSS INCREASE LIFE EXPECTANCY?: SYSTEMATIC REVIEW]. / ¿PERDER PESO AUMENTA LA ESPERANZA DE VIDA? REVISIÓN SISTEMÁTICA.

BACKGROUND: prospective trials that assess the effect of weight loss on all-cause mortality have shown controversial results. We conducted a systematic review of prospective studies, with a follow up ≥10y, assessing the association of weight loss and weight cycling with all cause- mortality. METHODS: we searched Pubmed of prospective studies with a follow up of ≥10y, published from January 1st 2004 to December 31th 2014. RESULTS: nine studies met the inclusion criteria. Five studies assessed the association between weight loss and mortality, two of the studies examined weight cycling and mortality, and two other weight loss and weight cycling with mortality. Weight loss increased all-cause mortality in those that assessed weight loss and mortality. In the two studies evaluating the association between weight cycling and mortality, weight cycling made no difference on mortality. In the two studies assessing weight loss and weight cycling, results showed weight cycling increased mortality in both of them, and weight loss increased mortality in one study. CONCLUSION: six out of seven (≥10 y of follow up) prospective studies showed that weight loss was associated with increased mortality; the results from studies assessing weight cycling were inconsistent. None of the studies found evidence showing that weight loss improved life expectancy.

Antecedentes: existe controversia sobre el efecto de la pérdida de peso sobre la mortalidad. Se realizó una revisión sistemática de estudios prospectivos, con un seguimiento ≥10 años, que evaluó el efecto de la pérdida de peso y los cambios de peso cíclicos con todas las causas de mortalidad. Métodos: se efectuó una búsqueda en PubMed, de artículos prospectivos, con un seguimiento > 10 años, publicados del 1 de enero de 2004 al 31 de diciembre de 2014. Resultados: nueve estudios cumplieron con los criterios de inclusión: cinco evaluaron la relación de la pérdida de peso exclusiva sobre la mortalidad, dos los cambios en el peso cíclicos y la mortalidad, y dos la pérdida de peso y los cambios en el peso cíclicos y la mortalidad. En los cinco que evaluaron la pérdida de peso, la mortalidad aumentó; en los dos que evaluaron cambios cíclicos en el peso, no se observó aumento en el riesgo de mortalidad, y en los dos que evaluaron pérdida de peso y cambios cíclicos en el peso, los cambios en el peso aumentaron el riesgo de mortalidad en ambos estudios, mientras que la pérdida de peso aumento el riesgo de mortalidad en un estudio. Conclusión: seis de los siete estudios(≥10 años de seguimiento) prospectivos mostraron que la pérdida de peso se asoció con aumento de la mortalidad; los resultados de los estudios que evaluaron cambios cíclicos de peso fueron inconsistentes. No se observaron evidencias de que la pérdida de peso aumente la esperanza de vida.

[EFFECT OF LOW CARBOHYDRATE DIETS ON WEIGHT LOSS AND GLYCOSILATED HEMOGLOBIN IN PEOPLE WITH TYPE 2 DIABETES: SYSTEMATIC REVIEW]. / EFECTO DE LAS DIETAS BAJAS EN CARBOHIDRATOS SOBRE LA PÉRDIDA DE PESO Y HEMOGLOBINA GLUCOSILADA EN PERSONAS CON DIABETES TIPO 2: REVISIÓN SISTEMÁTICA.

INTRODUCTION: some experts have suggested out that low carbohydrate diets (LCD) are more effective for weight loss and glycemic control. However, long term results are controversial. OBJETIVE: to review and analyze randomized control studies that evaluate the effect of LCD on weight and metabolic control in individuals with type 2 diabetes for a period equal to or greater than 10 months. METHODS: a systematic review was conducted on randomized trials registered in PubMed, EBSCOhost and Scielo to May 15th 2015, published in English and Spanish, with the following search data: "diabetes mellitus" AND "carbohydrate restricted diet" OR "restricted carbohydrate diet" OR "low carbohydrate diet" AND "weight loss". RESULTS: four studies met the inclusion criteria. There were 444 participants between 18-70yo. Follow-up time ranged between 10 to 24 months. Three out of the four studies reported weight reduction with LCD. However, when LCD were compared with other diets no significant differences in weight loss or A1C levels were observed. CONCLUSIONS: this review showed that three of four studies on the LCD were effective for weight loss over a period of 10 to 24 months. However, there was no evidence showing better results than those observed with other diets. Nor, difference in A1C.

Introducción: algunos expertos señalan que las dietas bajas en carbohidratos (DBC) son más efectivas para la reducción de peso y el control glucémico. Sin embargo, los resultados a largo plazo son controversiales. Objetivo: realizar una revisión y análisis de estudios aleatorizados que estudien el efecto de la DBC sobre el control metabólico en individuos con diabetes tipo 2 en un periodo igual o superior a 10 meses. Métodos: se realizó una revisión de estudios aleatorizados controlados publicados en PubMed, EBSCOhost y Scielo hasta el 15 de mayo del 2015. Se buscaron estudios publicados en inglés y español, utilizando los términos de búsqueda: "diabetes mellitus" AND "carbohydrate restricted diet" OR "restricted carbohydrate diet" OR "low carbohydrate diet" AND "weight loss". Resultados: cuatro estudios cumplieron con los criterios de inclusión. El número de participantes fue de 444 individuos, el rango de edad fue de 18 a 70 años. El tiempo de seguimiento osciló entre los 10 y 24 meses. Tres de los cuatro estudios reportaron una reducción de peso con la DBC. Al compararlos con otras dietas no se observaron diferencias significativas en la pérdida de peso ni en los niveles de A1C. Conclusiones: esta revisión muestra que en tres de los cuatro estudios las DBC son efectivas para la pérdida de peso en un período de 10 a 24 meses. Sin embargo, no existen evidencias que demuestren mayor efectividad para la pérdida de peso o la reducción de AIC, cuando se comparan con otras dietas.

Association of eating behaviors and BMI among elementary school students from Mexico.

The aim of this study was to analyze the association of cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE) with body max index (BMI) among elementary schools children in Mexico. 5th and 6th grade students were recruited from two schools. Weight, height, and waist circumference were measured and BMI was calculated. Overweight and obese children were classified according to the World Health Organization's (WHO) BMI z-score. The TFEQ-R18 questionnaire was applied to assess behavioral patterns. Gender differences of UE and EE were observed. Private school children had higher scores of CR and UE. Children with CR were three times more likely to have abdominal obesity (AO) and children with OW or O were more likely to have UE. Children attending the private school and those with AO had higher CR scores; private school children, those with overweight or obesity and with AO had higher UE scores.

El objetivo de este estudio fue analizar la asociación de la restricción cognitiva (CR), el consumo incontrolado (UE) y el consumo emocional (EE) con el índice de masa corporal (IMC) entre alumnos de primaria en México. Se reclutaron estudiantes de quinto y sexto grado de dos escuelas. Se midieron el peso, la estatura y la circunferencia de cintura y se calculó el IMC. El sobrepeso (SP) y la Obesidad (OB) se clasificó de acuerdo al puntaje Z de IMC de la OMS. Se aplicó el cuestionario TFEQ -R18 para valorar los patrones de conducta. Se observaron diferencias de UE y de EE. Los niños de las escuelas privadas presentaron mayores puntajes de CR y UE. Los niños con CR presentaron tres veces más probabilidades de tener obesidad abdominal (OA) y los niños con SP u OB tenían más posibilidades de tener UE. Los niños que atendían escuelas privadas y los que tenían OB tenían mayores puntajes de CR; los niños de escuelas privadas, los que tenían OW u OB y OA tenían más puntaje en UE.

Tv food advertising geared to children in Latin-American countries and Hispanics in the USA: a review.

INTRODUCTION: Obesity is a pandemic disease in Latin America. The purpose of this review was to analyze the studies exploring food advertising in TV conducted in Latin-American countries and in the USA geared to Hispanics. METHODS: An electronic literature search was conducted in the MEDLINE/PubMed, EMBASE, SCIELO, and CINAHL, databases and open access internet, of food advertising directed to children in TV in Latin American countries and Hispanics living in the USA, published from 1985 to January, 2015 RESULTS: Twenty three studies were found, six were conducted in Chile, five in Mexico, four in Brazil, three among Hispanics in the USA, and one in each of the following countries: Argentina, Peru, Colombia, Honduras and Venezuela. A high exposure of TV food advertised is geared toward children and their family. This exposure has been shown to be associated with the preference and purchase of those foods by adults and children with a high BMI, overweight and obesity. CONCLUSION: An alarming high exposure of the TV food advertised directed toward children was reported, which warrants effective regulations, supervision and accountability.

Introducción: El propósito de esta revisión fue analizar los estudios sobre anuncios de alimentos en la TV en Latinoamérica y en los EEUU dirigidos a Hispanos. Métodos: Se realizó una búsqueda electrónica de trabajos publicados de 1986 a 2015, en las bases de datos de MEDLINE/PubMed, EMBASE, SCIELO, y CINAHL, en internet de acceso abierto, sobre anuncios de alimentos en la televisión dirigidos a niños en países latinoamericanos y a Hispanos que viven en los Estados Unidos. Resultados: La búsqueda dio como resultado veinticuatro estudios, seis realizados en Chile, cinco en México, cuatro en Brasil, tres en Hispanos de EEUU, y uno en cada uno de los siguientes países: Argentina, Perú, Colombia, Honduras y Venezuela. Una gran proporción de anuncios sobre alimentos en la TV están dirigidos a los niños y a sus familias. Esta exposición ha sido asociada a la preferencia y solicitud de compra de estos alimentos por los niños y con un aumento del IMC, sobrepeso y obesidad en niños y adultos. Conclusión: Se observa una alarmante alta exposición de anuncios de alimentos en la TV dirigida a niños, lo que demanda políticas regulatorias, supervisión, y rendimiento de cuentas eficaces.

Modifiable environmental obesity risk factors among elementary school children in a Mexico-us border city.

BACKGROUND: The increasing overweight (OW) and obesity (OB) prevalence in Mexican children warrant the assessment of the environmental risk factors. OBJECTIVE: To assess whether there is an association between food availability in children's environments and their food consumption with BMI z-score and waist circumference (WC). METHODS: Six hundred and eighty four children, 264 parents, 22 teachers and cafeteria staff in the schools and street vendors participated in the study. Weight, height, and WC of 5(th) grade children were assessed. Food frequency, physical activity (PA) and eating habits questionnaires were applied to parents, children and teachers. A food inventory questionnaire was applied to parents, cafeteria staff in the schools, street vendors and stores near the schools. RESULTS: The children's mean age was 10.5. Twenty eight per cent of the children were overweight, 26% obese and 25% had abdominal obesity. A positive correlation was found between energy-dense foods (EDF), fruit and vegetable availability at home and their weekly consumption. Also a correlation between consumption of soft drinks and other EDF was found. The largest contributors to food consumption were the availability at home and at school (R2 = 0.11, p = 0.0001). Children's TV viewing was positively correlated with parents TV viewing time. For each hour of increase (from cero to seven) in daily TV viewing children were more likely to be overweight or obese (OR=1.22 95% CI 1.02-1.45, p=0.026). CONCLUSION: EDF, fruit and vegetable availability in and near home and school along with hours of TV viewing were positively associated with obesity.

Antecedentes: El aumento de la prevalencia de sobrepeso (SP) y la obesidad (OB) en niños mexicanos, hace necesario la valoración de los factores de riesgo ambientales. Objetivo: Valorar si existe asociación entre la disponibilidad de alimentos en el entorno de los niños y el consume de alimentos con el puntaje Z de IMC y la circunferencia de cintura (CC). Métodos: Participaron en el estudio 684, 264 padres, 22 maestros, el personal de cafetería de las escuelas, y vendedores ambulantes. Se valoró el peso, la estatura la CC, de niños de quinto año de educación básica. Se aplicaron a los padres, niños y maestros un cuestionario de frecuencia de consumo de alimentos, uno de actividad física y uno de hábitos alimentarios. Un inventario de alimentos se aplicó a los padres, al personal de la cafetería de la escuela, a los vendedores y a las tiendas cercanas a las escuelas. Resultados: La media de edad de los niños fue 10.5 años. 28% de los niños tenían SP, 26% OB, y 25% obesidad abdominal (OA). Se observó una correlación positiva entre el consumo de alimentos densamente energéticos (ADE), frutas, y verduras con la disponibilidad en casa y con el consumo semanal. También se observó una correlación entre el consumo de refrescos y otras ADE. El factor que más contribuía al consumo de alimentos fue la disponibilidad en casa y en la escuela (R2 = 0.11, p = 0.0001). Se observó una asociación positiva entre el tiempo que los niños ven televisión con el de sus padres. Por cada hora de aumento (de 0 a 7) de ver televisión al día, los niños tenían más posibilidades de tener SP o OB (OR=1.22 95% CI 1.02-1.45, p=0.026). Conclusión: La disponibilidad de ADE, de frutas y verduras en o fuera de casa o de la escuela, además de las horas de ver televisión estuvieron positivamente asociadas con la obesidad.