Association Between Changes in Sleep, Nap Duration and Bone Mineral Density in Mexican Adults.

Studies have found associations between sleep, nap duration, and bone mineral density (BMD). However, the longitudinal relationship between sleep, nap duration, and BMD has not been explored. We evaluated the association between the change in sleep and nap duration and BMD in Mexican adults. Data come from 1,337 adult participants of the Health Workers Cohort Study (341 were men and 996 were women, including 450 women < 45 years old and 546 ≥ 45 years old), with two study waves. At each wave, sleep and nap duration was assessed using self-administered questionnaires and BMD in g/cm2 was determined by dual X-ray absorptiometry. We used fixed-effect regression models stratified by sex and adjusted for BMI, diet, physical activity, vitamin supplements, and hormone replacement therapy. Women who changed from < 7 to ≥ 7 h/day of sleep from baseline to follow-up were associated with increases in the total hip (ß = 0.012 g/cm2; 95% CI: 0.002, 0.022) and lumbar spine BMD (ß = 0.024 g/cm2; 95% CI: 0.009, 0.039). Furthermore, most of these associations were observed in women ≥ 45 years. For women, a changing from 0 to > 60 min/day of napping was associated with a significant increase in total hip BMD of 0.012 g/cm2 (95% CI: 0.004, 0.024) and lumbar spine BMD of 0.027 g/cm2 (95% CI: 0.009, 0.045). No significant associations were observed for men. Our results suggest that increased sleep and nap duration are associated with gains in BMD in Mexican women, emphasizing sleep's role in promoting bone health and supporting established recommendations.

Diet quality indices are associated with breast cancer by molecular subtypes in Mexican women.

BACKGROUND: Inconclusive epidemiological evidence suggests that diet quality indices may influence breast cancer (BC) risk; however, the evidence does not consider the molecular expression of this cancer. PURPOSE: We aimed to evaluate if diet quality is related to molecular subtypes of BC, in women residing in Northern Mexico. METHODS: This is a secondary analysis of 1,045 incident cases and 1,030 population controls from a previous case-control study, conducted between 2007 and 2011 in Northern Mexico. Information about the expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor 2 (HER2) was obtained from medical records to classify BC as luminal (ER + and/or PR+/HER2-), HER2+ (ER+/-and/or PR+/-/HER2+), or triple-negative (TN) (ER- and PR-/HER2-) cases. Food consumption was assessed with a semi-quantitative food frequency questionnaire. Diet quality was evaluated using the Mexican Diet Quality Index (MxDQI) and the Mexican Alternative Healthy Eating Index (MxAHEI). We used unconditional logistic regression models to estimate the association between Mexican diet quality indices and BC molecular subtypes. RESULTS: The MxDQI was related to lower odds of BC (ORT3vsT1=0.24; 95%CI: 0.18, 0.31). Similarly, MxAHEI was negatively associated with BC (ORT3vsT1=0.43; 95%CI: 0.34, 0.54). The associations of both indices remained significant in the ER + and ER- tumors, and in the BC luminal and HER2 + molecular subtypes, except in the TN molecular subtype for MxAHEI, which was not statistically significant. CONCLUSIONS: Our findings showed that MxDQI and MxAHEI were negatively associated with BC risk regardless of its molecular subtype.

Soft drink consumption and increased risk of nonalcoholic fatty liver disease: Results from the health workers cohort study.

INTRODUCTION AND OBJECTIVES: Nonalcoholic fatty liver disease (NAFLD) is a common clinical condition and an important public health problem. Some epidemiological studies have suggested that soft drinks (SD) intake is associated with NAFLD. However, the evidence is inconsistent. Our objective was to assess the association between SD consumption and the risk of NAFLD in a Mexican adult population. MATERIALS AND METHODS: A total of 1,759 participants from the Health Workers Cohort Study (HWCS) were included in the analyses. SD intake was measured using a validated food frequency questionnaire. We classified SD consumption as follows: a) less than 1 serving per week, b) 1 to less than 3.5 servings per week, and c) 3.5 or more servings per week. Hepatic steatosis index (HSI) was calculated based on sex, BMI, and blood transaminase levels, and was categorized as NAFLD ≥ 36. To assess the relation between SD and NAFLD, we followed two approaches: fixed effects logistic regression and generalized estimating equations. RESULTS: After adjusting for demographic characteristics, lifestyle factors, and dietary intake, the odds ratio (OR) and 95 % confidence interval (95 % CI) for NAFLD were 1.26 (95 % CI: 1.08, 1.48) for 1 to less than 3.5 servings per week and 1.42 (95 % CI: 1.19, 1.69) for ≥3.5 servings/week category in both sexes. When stratifying the analysis by sex, we observed that the association tended to be greater in men than in women. CONCLUSIONS: The results from our prospective study indicate that SD consumption is associated with an increased risk of NAFLD.

Healthy lifestyle interventions within the curriculum in school-age children: systematic review and meta-analysis.

Childhood obesity is a major public health challenge. Previous research has identified the impact of school-based interventions for preventing and treating obesity; we hypothesized that when curricular changes are integrated, results could be exponentiated. This study aimed to systematically review and conduct a meta-analysis of the published literature analyzing information about school-based interventions inserted in the curriculum. The Cochrane Handbook methodology was followed. An electronic search was conducted in five databases, with a specific design strategy per database. Randomized controlled trials or quasi-experimental studies of children with nutrition and physical activity (PA) interventions inserted into the school curricula were included. The risk of bias was assessed with the Risk of Bias tool. The mean differences were pooled using a fixed-effects model for the meta-analysis. The certainty of the evidence was evaluated according to the guidelines of the Grading of the Recommendations, Assessment, Development, and Evaluations working group (Protocol ID: CRD42021270557). After the screening and selection process, 12 studies were included. The interventions identified, based on the school curricula, include classroom activities and homework, among others. A meta-analysis with five intervention groups presented an overall mean difference of -0.14 body mass index (BMI) Z-score (95% CI: -0.25, -0.03) after this intervention with high certainty of the evidence. This systematic review and meta-analysis suggest that nutrition and PA lessons inserted into the curricula and supported with additional activities (i.e. homework, workshops, etc.) could increase nutrition knowledge and improve attitudes toward fruit, vegetables, and water consumption, and BMI Z-score reduction.

Avocado consumption is associated with a reduction in hypertension incidence in Mexican women.

Avocado is a fruit rich in dietary fibre, potassium, Mg, mono and PUFA and bioactive phytochemicals, which are nutritional components that have been associated with cardiovascular health. Yet, despite the boom in avocado consumption, we lack evidence on its association with CVD risk in the general population. To estimate the prospective association between avocado consumption and incident hypertension in Mexican women, we estimated the association in participants from the Mexican Teachers' Cohort who were ≥ 25 years, free of hypertension, CVD and cancer at baseline (n 67 383). We assessed baseline avocado consumption with a semi-quantitative FFQ (never to six or more times per week). Incident hypertension cases were identified if participants self-reported a diagnosis and receiving treatment. To assess the relation between categories of avocado consumption (lowest as reference) and incident hypertension, we estimated incidence rate ratios (IRR) and 95 % CI using Poisson regression models and adjusting for confounding. We identified 4002 incident cases of hypertension during a total of 158 706 person-years for a median follow-up of 2·2 years. The incidence rate of hypertension was 25·1 cases per 1000 person-years. Median avocado consumption was 1·0 (interquartile range: 0·23, 1·0) serving per week (half an avocado). After adjustment for confounding, consuming 5 + servings per week of avocado was associated with a 17 % decrease in the rate of hypertension, compared with non- or low consumers (IRR = 0·83; 95 % CI: 0·70, 0·99; Ptrend = 0·01). Frequent consumption of avocado was associated with a lower incidence of hypertension.

Diagnostic accuracy of blood biomarkers and non-invasive scores for the diagnosis of NAFLD and NASH: Systematic review and meta-analysis.

INTRODUCTION AND OBJECTIVES: Fatty liver disease is an important public health problem. Early diagnosis is critical to lower its rate of progression to irreversible/terminal stages. This study aimed to evaluate the accuracy of non-invasive prediction scores for fatty liver disease (NAFLD and NASH) diagnosis in adults. MATERIALS AND METHODS: A search was conducted in 10 databases, a qualitative synthesis of 45 studies, and quantitative analysis of the six most common scores. There were 23 risk scores found for NAFLD diagnosis and 32 for NASH diagnosis. The most used were Fatty Liver Index (FLI), aspartate aminotransferase (AST) to Platelet Ratio Index, Fibrosis-4 Index (FIB-4), AST/alanine aminotransferase (ALT) ratio, BARD score, and NAFLD fibrosis score (NFS). RESULTS: The results from the meta-analysis for FLI: Area under the curve (AUC) of 0.76 (95% Confidence Interval [CI] 0.73, 0.80), sensitivity 0.67 (CI 95% 0.62, 0.72) and specificity 0.78 (CI 95% 0.74, 0.83). The AST to Platelet Ratio Index: AUC 0.83 (CI 95% 0.80, 0.86), sensitivity 0.45 (95% CI 0.29, 0.62), and specificity of 0.89 (95% CI 0.83, 0.92). The NFS: AUC of 0.82 (CI 95% 0.78, 0.85), sensitivity 0.30 (CI 95% 0.27, 0.33) and specificity 0.96 (CI 95% 0.95,0.96). CONCLUSIONS: The FLI for NAFLD and AST to Platelet Ratio Index for NASH were the risk scores with the highest prognostic value in the included studies. Further research is needed for the application of new diagnostic risk scores for NAFLD and NASH.

Modelling the impact of sodium intake on cardiovascular disease mortality in Mexico.

BACKGROUND: Cardiovascular diseases (CVD) represent the main cause of death in Mexico, while high blood pressure is suffered by about half of the adult population. Sodium intake is one of the main risk factors for these diseases. The Mexican adult population consumes about 3.1 g/day, an amount that exceeds what is recommended by the World Health Organization (WHO) < 2 g sodium/day. The objective of this study was to estimate the impact of reducing sodium intake on CVD mortality in Mexico using a scenario simulation model. METHODS: The Integrated Model of Preventable Risk (PRIME) was used to estimate the number of deaths prevented or postponed (DPP) due to CVD in the Mexican adult population following the following sodium intake reduction scenarios: (a) according to the WHO recommendations; (b) an "optimistic" reduction of 30%; and (c) an "intermediate" reduction of 10%. RESULTS: The results show that a total of 27,700 CVD deaths could be prevented or postponed for scenario A, 13,900 deaths for scenario B, and 5,800 for scenario C. For all scenarios, the highest percentages of DPP by type of CVD are related to ischemic heart disease, hypertensive disease, and stroke. CONCLUSIONS: The results show that if Mexico considers implementing policies with greater impact to reduce sodium/salt consumption, a significant number of deaths from CVD could be prevented or postponed.

Risk Prediction Score for Chronic Kidney Disease in Healthy Adults and Adults With Type 2 Diabetes: Systematic Review.

INTRODUCTION: Chronic kidney disease (CKD) is an important public health problem. In 2017, the global prevalence was estimated at 9.1%. Appropriate tools to predict the risk of developing CKD are necessary to prevent its progression. Type 2 diabetes is a leading cause of CKD; screening the population living with the disease is a cost-effective solution to prevent CKD. The aim of our study was to identify the existing prediction scores and their diagnostic accuracy for detecting CKD in apparently healthy populations and populations with type 2 diabetes. METHODS: We conducted an electronic search in databases, including Medline/PubMed, Embase, Health Evidence, and others. For the inclusion criteria we considered studies with a risk predictive score in healthy populations and populations with type 2 diabetes. We extracted information about the models, variables, and diagnostic accuracy, such as area under the receiver operating characteristic curve (AUC), C statistic, or sensitivity and specificity. RESULTS: We screened 2,359 records and included 13 studies for healthy population, 7 studies for patients with type 2 diabetes, and 1 for both populations. We identified 12 models for patients with type 2 diabetes; the range of C statistic was from 0.56 to 0.81, and the range of AUC was from 0.71 to 0.83. For healthy populations, we identified 36 models with the range of C statistics from 0.65 to 0.91, and the range of AUC from 0.63 to 0.91. CONCLUSION: This review identified models with good discriminatory performance and methodologic quality, but they need more validation in populations other than those studied. This review did not identify risk models with variables comparable between them to enable conducting a meta-analysis.

Espacios cardioprotegidos en México: acciones para prevenir la muerte súbita cardiaca. Una postura de profesionales de la salud.

La muerte súbita cardiaca es un problema de salud pública a nivel mundial. Aunque su incidencia no es conocida, se estima que causa hasta 50% de la mortalidad de origen cardíaco y hasta 20% de la mortalidad total en los adultos. En México, estimaciones previas sugieren que causa en promedio 33 000 muertes al año; sin embargo, los datos no son precisos. La  mitad de los eventos por muerte súbita cardiaca se deben a un paro cardiaco súbito extrahospitalario que, de no ser atendido oportunamente, deriva en una muerte súbita cardiaca. Por tanto, la capacidad de responder pronta y adecuadamente a estos eventos con las maniobras y equipos necesarios mejora la sobrevida de las víctimas. Para atender este problema, en algunos estados del país se han creado espacios cardioprotegidos que permiten realizar maniobras de reanimación cardiopulmonar y desfibrilación cardiaca de acceso público oportunamente. Como objetivo, los profesionales de la salud establecen la importancia de implementar espacios cardioprotegidos y crear políticas públicas al respecto en todo el país.

Dietary inflammatory index and bone mineral density in Mexican population.

Dietary inflammatory index has been associated with bone loss. In this longitudinal study, we reported that changes in dietary inflammatory index were associated with a reduction in bone mineral density of the total hip and femoral neck in males and females ≥ 45 years, but not in individuals < 45 years. PURPOSE: Previous studies have suggested that an inflammatory environment can affect bone mineral density (BMD). However, most of the studies have been done in postmenopausal women. Thus, longitudinal studies in different age groups and sex are necessary to evaluate the longitudinal association between dietary inflammatory index (DII) and BMD in Mexican adults. METHODS: A total of 1,486 participants of the Health Workers Cohort Study were included in this study. The DII was estimated with data retrieved through a semi-quantitative food frequency questionnaire. Total hip, femoral neck, and lumbar spine BMD were measured by dual-energy X-ray absorptiometry. Linear regression models for cross-sectional associations and fixed effects linear regression models for longitudinal association were estimated, and both models were stratified by sex and age groups (< 45 and ≥ 45 years). RESULTS: We did not observe cross-sectional associations between DII and the different BMD sites at baseline. In contrast, women and men ≥ 45 years in the 25th quartile of changes in DII were associated with a gain of 0.067 g/cm2 and 0.062 g/cm2 of total hip BMD, while those in the 75th quartile of DII was associated with a reduction of - 0.108 g/cm2 and - 0.100 g/cm2, respectively. These results were similar for femoral neck BMD in women. In contrast, we did not observe association with femoral neck BMD in men. We did not observe statistically significant changes for lumbar spine BMD. CONCLUSION: Our data suggest that changes in the DII score are associated with changes in total hip and femoral neck BMD among Mexican population.

Muscle Strength Reference Values and Correlation with Appendicular Muscle Mass in Mexican Children and Adolescents.

Strength and muscle mass are important determinants of health status, and reference values for pediatric populations from every country or geographic region are needed. The aim of this study was to develop age- and sex-specific reference values of muscle strength and evaluate the correlation between muscle strength and appendicular lean mass in Mexican children and adolescents. A cross-sectional study was conducted in 1111 healthy subjects ages 5 to 19 years of age participating in the "Body Composition Reference Values in Mexican Children and Adolescents" study. Smoothed reference values for the 1, 3, 5, 15, 25, 50, 75, 85, 95, 97, and 99 percentiles of muscle strength for upper and lower limbs were developed based on age and sex using Jamar® and Microfet2® dynamometers. Mean values were derived using the Generalized Additive Models for Location, Scale and Shape (GAMLSS), and lean mass was determined using dual-energy X-ray absorptiometry. Highly positive correlations of muscle strength with lean mass in upper limbs were found r-values 0.87-0.92 for boys and r = 0.80-0.86 for girls. High and moderate positive correlations for lower limbs were also noted for upper limbs: r = 0.74-0.86 for boys and r = 0.67-0.82 for girls. The reference values for appendicular muscle strength established in this study demonstrated a high and positive correlation between appendicular mass and muscle strength. These data will be useful when evaluating conditions and diseases affecting muscle or sports.

Association between physical activity and physical and functional performance in non-institutionalized Mexican older adults: a cohort study.

BACKGROUND: Aging is an independent risk factor for deterioration in functional capacity. Some studies have reported that physical activity (PA) improves functional capacity and physical performance among older adults (OA). Thus the objective of the present study was to assess the longitudinal association between PA and functional and physical performance in non-institutionalized OA. METHODS: A longitudinal analysis using data from the Frailty, Dynapenia and Sarcopenia in Mexican adults (FRADYSMEX, by its Spanish acronym) cohort study was conducted. PA was assessed through the Community Healthy Activities Model Program for Seniors (CHAMPS) instrument. Functionality was measured with the Barthel index and the Lawton and Brody scale, while physical performance was measured with the Short Physical Performance Battery (SPPB). To evaluate the association between the level of PA and physical and functional performance as a continuous variable, a linear regression of mixed effects was performed. To assess PA and dependence in basic activities of the daily life (BADL), instrumental activities of the daily life (IADL), and low physical performance (PP), generalized estimation equation models [to compute odds ratios (OR) and 95% confidence intervals (95%CI)] were computed. RESULTS: Older people who performed moderate to vigorous-intensity PA had a lower risk of dependence in IADL (OR = 0.17; 95%CI: 0.10, 0.80) and lower risk of low PP (OR = 0.18; 95%CI: 0.11, 0.58) compared to those in lower categories of PA. CONCLUSIONS: Older adults living in the community who perform PA of moderate to vigorous intensity have a lower risk of dependence in BADL and IADL and have a lower risk of low PP.

Validity and reliability of the International Physical Activity Questionnaire (IPAQ) long-form in a subsample of female Mexican teachers.

OBJECTIVE: To evaluate the test-retest reliability and validity of the long-form International Physical Activity Questionnaire (IPAQ-long form). MATERIALS AND METHODS: A subsample of 86 teachers underwent telephone interviews and clinic visits in Mexico City. Through 22 months, physical activity (PA) levels were obtained from accelerometers (months 6 and 22) and IPAQ long-form (months 1, 3, 6, 9 and 12). Minutes per week of moderate (MPA), walking (WPA), vigorous (VPA) and moderate-to-vigorous physical activity (MVPA) were calculated for each intensity and domain. Variables were loga-rithmically transformed. Intra-class and Pearson correlations were used to determine the relationship between instru-ments. RESULTS: Test-retest reliability of the average IPAQs long-form varied across intensities and domains (ranged from r= 0.24 to r= 0.65). Minutes per week of VPA and MVPA ac-celerometer 1 (AC1) were fairly associated to International Physical Activity Questionnaire-long form 3 (IPAQ3) (r= 0.60 and r= 0.31, respectively) one week apart. CONCLUSIONS: IPAQ long-form is fairly reliable for MVPA and valid for as-sessing MVPA and VPA in a subsample of Mexican teachers.

The Mexican Consortium of Epidemiological Studies for the Prevention, Diagnosis, and Treatment of Chronic Kidney Disease: a review of collaborating studies.

OBJECTIVE: To harmonize participants' information from five epidemiological studies. MATERIALS AND METHODS: The Mexican Consortium of Epidemiological Studies for the Prevention, Diagnosis, and Treatment of Chronic Kidney Disease (RenMex, by its Spanish acronym) was established in 2018. RenMex is a consortium of five studies: The Mexican Teachers Cohort Study; the Mexico City Diabetes Study; the Health Workers Cohort Study; the Comitán Study; and the Salt Consumption in Mexico Study, which assessed baseline serum creatinine, albumin, and C-reactive protein, all performed with standardized techniques. RESULTS: RenMex includes 3 133 participants, with a mean age of 44.8 years, 68.8% women, 10.8% with a previous medical diagnosis of type 2 diabetes, and 24.1% living with obesity. CONCLUSIONS: In the future, RenMex will work on more detailed analyses with each cohort allowed to opt in or out for each topic according to their individual data.

Volviéndonos mejores: necesidad de acción inmediata ante el reto de la obesidad. Una postura de profesionales de la salud.

La creciente epidemia de obesidad ha sido uno de los retos más importantes de salud pública en México durante los últimos años. Con apoyo de la Federación Mundial de Obesidad, en 2021 formamos un grupo de profesionales para identificar y resumir las acciones prioritarias en las que puede enfocarse nuestro país para hacer frente a esta epidemia. Al proceso de desarrollo y discusión de este grupo se sumaron más de 1 000 profesionales de la salud para retomar recomendaciones de documentos y guías de alto nivel previamente publicados. En conmemoración del Día Mundial de la Obesidad, en este 2022 se presenta esta postura como insumo para el desarrollo de acciones en el ámbito profesional y de los diferentes sectores, en la que se incluyen 10 recomendaciones de acción, desde la perspectiva poblacional hasta la atención individualizada, y se enfatiza en la importancia de la participación social, de las intervenciones integrales con visión centrada en la persona y de la sostenibilidad planetaria, además de mejorar la educación y las campañas de difusión, propiciar un ambiente promotor de entornos activos y blindar de conflictos de interés los esfuerzos de prevención y control. La postura hace un llamado para abordar la obesidad de manera seria, con base en la evidencia científica, oportuna e integral, con enfoque de curso de vida, de forma ética y sensible, y sin perpetuar las barreras del estigma de peso en la sociedad.

Diet Modulates the Effects of Genetic Variants on the Vitamin D Metabolic Pathway and Bone Mineral Density in Mexican Postmenopausal Women.

BACKGROUND: Macro- and micronutrients, such as proteins, vitamin D, and calcium (Ca), are important dietary factors that can modify bone mineral density (BMD). Genetic factors can interact with diet, affecting an individual's predisposition to osteoporosis. OBJECTIVES: This study aimed to evaluate the associations between macro- and micronutrient intakes and BMD in Mexican postmenopausal women, and their interactions with genetic polymorphisms involved in the vitamin D metabolic pathway. METHODS: We analyzed data from 317 postmenopausal women from the Health Workers Cohort Study, a longitudinal cohort studied in Cuernavaca, Mexico. Postmenopausal women participated in 2 data collection waves (2004-2006 and 2010-2011), with a mean time of 6.4 years. Dietary intake was assessed with a semi-quantitative FFQ. BMD (femoral neck, hip, and lumbar spine) was measured by DXA. Hybrid mixed-effects regression models were used to assess the associations of dietary macro- and micronutrients on BMD, after adjusting for confounding factors and for diet and single nucleotide polymorphism interactions. RESULTS: At baseline, the median age was 57 years (IQR, 50-64). Mean femoral neck, hip, and lumbar spine BMDs decreased over time. We observed statistically significant longitudinal associations for diet (Ca, vitamin D, magnesium, phosphorus, and protein intake) and BMD. Increases of vitamin D, Ca, and protein intakes by 1 SD were associated with mean increases in the femoral neck BMD (0.083 SD, 0.064 SD, and 0.130 SD, respectively). Multiple significant interactions were identified between several loci (CYP2R1, CYP24A1, CYP27B1, VDR, and DHCR7/NADSYN1) and diet for BMDs (femoral neck, hip, and lumbar spine), mainly for protein intake. CONCLUSIONS: Our data support associations of vitamin D, Ca, protein, phosphorous, and magnesium consumption with BMD in Mexican postmenopausal women and suggest possible gene-diet interactions. These results could facilitate future personalized nutrition recommendations to help prevent low BMD.

Dietary Patterns and Breast Cancer Risk in Women from Northern Mexico.

We evaluated the association between dietary patterns and breast cancer (BC) subtypes among women from Northern Mexico. From a study of incident cases and population controls that was carried out from 2007 to 2011, a subsample of 509 cases matched 1:1 by age with 509 controls was selected. Information about expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor 2 (HER2) was available from medical records to classify BC on luminal (ER + and/or PR+/HER2-), HER2+ (ER+/- and/or PR+/-/HER2+), or triple negative (ER- and PR-/HER2-). Dietary information was gathered using a semiquantitative food frequency questionnaire and a factor analysis was used to obtain dietary patterns. The association between each dietary pattern and BC molecular subtypes was assessed through conditional logistic regression models. Two dietary patterns were identified. The first (mainly characterized by meat, high fat, and sugary cereals) was positively associated with BC (odds ratio, OR = 12.62; 95% CI: 7.42, 21.45); the second (consisting of corn, legumes, and other vegetables) was inversely associated with BC (OR = 0.50; 95% CI: 0.40, 0.62). Both associations remained significant by BC molecular subtypes. These findings could contribute to the development of public health strategies for BC prevention.

Prevalence and predictors of elevated liver enzyme levels in Mexico: The Mexican National Health and Nutrition Survey, 2016.

INTRODUCTION AND OBJECTIVE: To determine the prevalence of elevated liver enzyme levels and the fatty liver index according to specific sociodemographic, clinical, anthropometric, and metabolic risk factors in Mexican adult population. MATERIAL AND METHODS: The present analysis was conducted using data from the Mexican National Health and Nutrition Survey 2016. For the present study, 3,490 adults with complete information on liver enzymes, sociodemographic, lifestyle, and metabolic factors were analyzed. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) levels were determined from blood samples. We computed the fatty liver Index (FLI), as a surrogate marker of non-alcoholic fatty liver disease. The associations are reported as adjusted odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: At the national level, the prevalence of high serum levels of ALT, AST, and GGT were 7.9%, 13.5, and 12.9 respectively. We observed that men had higher prevalences of altered ALT, GGT and FLI compared to women. Additionally, we observe that individuals with obesity, metabolic syndrome and insulin resistance are significantly more likely to present elevated concentrations of AST, ALT, GGT and FLI. Finally, we found that the subjects of the lowest socioeconomic level and indigenous population were more likely to present elevated levels of AST, ALT, GGT, and FLI. CONCLUSION: In Mexico, non-alcoholic fatty liver disease affect people with obesity, diabetes, and metabolic syndrome as well as men, subjects of low socioeconomic status, subjects who live in rural areas and indigenous population. Interventions to reduce this condition should be a public health priority.

Seroprevalencia de SARS-CoV-2 en adultos y adultos mayores en México y su asociación con enfermedades crónicas. Ensanut 2020 Covid-19.

Objetivo. Analizar la asociación entre seropositividad a SARS-CoV-2 y enfermedades crónicas en adultos y adultos mayores mexicanos. Material y métodos. Se utilizó la Encuesta Nacional de Salud y Nutrición 2020 sobre Covid-19 (Ensanut 2020 Covid-19) para evaluar la asociación de seropositividad a SARS-CoV-2 con hipertensión arterial sistémica, diabetes tipo 2, índice de masa corporal, LDL-c elevado, HDL-c bajo, colesterol total elevado e hipertrigliceridemia. Resultados. Se observó una mayor seropositividad en personas con mayor índice de masa corporal. La seroprevalencia fue 25% mayor entre los adultos que presentaban obesidad en comparación con aquellos de peso normal en modelos ajustados (RP: 1.25 IC95%: 1.08,1.46). No se observó asociación entre seropositividad y otras enfermedades crónicas en adultos o adultos mayores. Conclusiones. Las personas con obesidad podrían tener una mayor susceptibilidad a la infección por SARS-CoV-2. Este hallazgo debe ser confirmado con estudios longitudinales. No se encontró evidencia de asociación para otras enfermedades.

Malnutrition prevalence among children and women of reproductive age in Mexico by wealth, education level, urban/rural area and indigenous ethnicity.

OBJECTIVE: To compare the prevalence of malnutrition (undernutrition and excess weight) by wealth, education level, ethnicity and urban/rural areas in Mexican children and women of reproductive age. DESIGN: We compared the prevalence of overweight, obesity, wasting/underweight, stunting/short stature and anaemia by socioeconomic and ethnic indicators. For each indicator, we estimated prevalence ratios (PR) adjusted by all other socioeconomic and ethnic indicators. We analysed if results differed by urban/rural areas. SETTING: Mexican National Health and Nutrition Survey 2012. PARTICIPANTS: Children <5 years, non-pregnant women 11-19 years and non-pregnant women 20-49 years (n 33 244). RESULTS: In most age groups, belonging to non-indigenous households, with high wealth, high education and in urban areas were inversely associated with stunting or short stature (PR ranging from 0·40 to 0·83), and wealth and education were inversely associated with anaemia (PR ranging from 0·53 to 0·78). The prevalence of overweight was similar across subgroups among children <5 years; however, among women 11-19 years, wealth, non-indigenous household and urban areas were positively associated (PR ranging from 1·16 to 1·33); and among women 20-49 years, education was inversely associated (PR 0·83). CONCLUSIONS: Socially disadvantaged populations have a higher prevalence of undernutrition, whereas the prevalence of excess weight is either equal (children <5 years), slightly lower (women 11-19 years) or even higher (women 20-49 years) with lower education. These results highlight the need for specific actions to address social inequalities in malnutrition in the Mexican population.