Prevalencias de estado de nutrición en recién nacidos mexicanos por peso y longitud al nacimiento: un análisis de los certificados de nacimiento del Sinac.

Objective: To describe the national by federal entity prevalence of the nutritional status of weight and length at birth. Materials and Methods: Cross-sectional descrip­tive study. Data from 1 907 341 alive newborns in 2017, registered in the Subsistema de Información sobre Nacimientos (Sinac), were analyzed. The percentiles for weight and length were estimated in the INTERGROWTH-21st platform. Results: The prevalence of small gestational age (SGA) and insufficient length (IL) was 7.4 and 4.8%, respectively. Differ­ences in the prevalence of IL, SGA and large for the gestational age (LGA) by sex were recorded (p <0.01). The entities with the highest prevalence of SGA were Estado de México and Yucatán (10.4%); Sonora (15.3%) and Baja California Sur (16.8%) of LGA. Conclusion: Sizing the nutritional status at birth allows the identification of entities that require targeted actions to reduce the risks associated with malnutrition.

Objetivo. Describir la prevalencia nacional por entidad federativa del estado de nutrición de peso y longitud al nacimiento. Material y métodos. Estudio transversal descriptivo. Se analizaron datos de 1 907 341 recién nacidos vivos en 2017, registrados en el Subsistema de Información sobre Nacimientos (Sinac). Los percentiles para peso y lon­gitud se estimaron en la plataforma INTERGROWTH-21st. Resultados. La prevalencia de pequeños para la edad ges­tacional (PEG) y longitud insuficiente (LI) fue de 7.4 y 4.8%, respectivamente. Se registraron diferencias por sexo en las prevalencias de LI, PEG y grandes para la edad gestacional (GEG) (p <0.01). Las entidades con mayores prevalencias de PEG (10.4%) fueron Estado de México y Yucatán. De GEG, fueron Sonora (16.8%) y Baja California Sur (15.3%). Conclu­sión. Dimensionar el estado de nutrición al nacer permite identificar entidades que requieren acciones focalizadas para disminuir los riesgos asociados con la malnutrición.

Slow gait speed is associated with dynapenic obesity in Mexican ambulatory older adults.

An increased risk of slow gait speed (GS) has been reported among older adults with decreased muscle strength, coupled with a concomitant increase in body fat known as dynapenic obesity (DO); however, these two conditions together have rarely been studied. The objective of this study was to determine the association between GS and DO in older Mexican ambulatory adults. A cross-sectional study was conducted; body fat percentage, and muscle strength and GS using EWGSOP criteria, were measured in 126 older ambulatory Mexican adults, with a mean age of 71 years old. The association was evaluated using controlled logistic regression models. Among ambulatory older adults with slow GS, the risk of DO was 3.4 times higher than among those without, controlling for age and sex (p<0.01). In conclusion, slow GS in ambulatory older adults can be a useful indicator for the early identification of DO.

Comorbidities associated with maternal mortality from COVID-19 in Mexico.

INTRODUCTION: In Mexico, there is a syndemic in pregnant women, where the epidemic of obesity and chronic diseases coexists with that of coronavirus disease 2019 (COVID-19), which has been associated with a higher risk of maternal mortality. OBJECTIVE: To evaluate the association of comorbidities during pregnancy with maternal mortality from COVID-19 in Mexico. MATERIAL AND METHODS: SISVER COVID-19 databases and epidemiological surveillance reports on maternal mortality were used. Multivariate logistic regression models were used to evaluate the association of comorbidities with maternal deaths from COVID-19. RESULTS: A total of 29,416 pregnant women were evaluated, out of which 39% were positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); the risk of maternal mortality was 3.24 times higher (p < 0.01) for positive in comparison with negative women. COVID-19 is the leading cause of maternal death since July 2020 and explains more than 50% of total deaths in 2021. Chronic kidney disease (odds ratio [OR]: 4.11; p < 0.01) and diabetes (OR: 2.53; p < 0.01) were the two main comorbidities that were positively associated with maternal death from COVID-19. CONCLUSION: Comorbidities during pregnancy that are possibly associated with an increase in the inflammatory response and an alteration of the immune response increase the risk of maternal death from COVID-19 in Mexican pregnant women.

INTRODUCCIÓN: En México existe una sindemia en las mujeres gestantes, donde coexiste la epidemia de obesidad y enfermedades crónicas con la de enfermedad por coronavirus 2019 (COVID-19), lo que se ha asociado con un mayor riesgo de mortalidad. OBJETIVO: Evaluar la asociación de las comorbilidades en la mortalidad materna por COVID-19 en México. MATERIAL Y MÉTODOS: Se utilizaron las bases de datos de COVID-19 del SISVER y los reportes de vigilancia epidemiológica de muertes maternas. Se utilizaron modelos de regresión logística multivariante para evaluar la asociación de las comorbilidades durante la gestación con mortalidad materna por COVID-19. RESULTADOS: Se evaluaron 29,416 mujeres embarazadas, el 39% fueron positivas para coronavirus 2 del síndrome respiratorio agudo grave, el riesgo de mortalidad materna fue 3.24 veces mayor (p < 0.01) para las mujeres positivas en comparación con las negativas. La COVID-19 es la primera causa de muerte materna desde julio del 2020 y explica más del 50% del total de muertes en el 2021. La enfermedad renal crónica (razón de momios [RM]: 4.11; p < 0.01) y la diabetes (RM: 2.53; p < 0.01) fueron las dos principales comorbilidades asociadas positivamente a la mortalidad materna por COVID-19. CONCLUSIÓN: Las comorbilidades durante el embarazo posiblemente asociadas con un incremento de la respuesta inflamatoria y alteración de la respuesta inmunitaria incrementan el riesgo de muerte materna por COVID-19 en mujeres gestantes mexicanas.

Effect of exposure to p,p´-DDE during the first half of pregnancy in the maternal thyroid profile of female residents in a Mexican floriculture area.

BACKGROUND: Dichlorodiphenyldichloroethene (p,p´-DDE), the main metabolite of dichlorodiphenyltrichloroethane (DDT), has been associated with changes in human thyroid hormone levels. Maternal thyroid hormones are essential for adequate fetal neurodevelopment during the first half of pregnancy. OBJECTIVE: To evaluate the association between maternal p,p´-DDE concentration and the maternal thyroid profile during the first half of pregnancy. MATERIALS AND METHODS: We analyzed the information of 430 pregnant women from a Mexican floriculture area, with a gestational age ≤16 weeks. By questionnaire, we obtained sociodemographic, reproductive, and life-style, information. Serum concentrations of thyroid stimulating hormone (TSH), and total and free T3 and T4 were determined by means of Enzyme-Linked ImmunoSorbent Assay (ELISA). p,p´-DDE was analyzed by Gas Chromatography. The association between p,p´-DDE and thyroid profile was assessed through linear and logistic regression models. RESULTS: Thirty eight percent of women had p,p´-DDE levels below the Limit of Detection and 12.3% below the Limit of Quantification. Within the quantifiable range, median was 53.03ng/g. TSH >2.5 mIU/L was present in 9.3% of women; 47.7% had isolated hypothyroxinemia; 3.5% had subclinical hypothyroidism, and 5.8% had overt hypothyroidism. We observed a significant positive association between quantifiable p,p´-DDE and total T3 serum levels in comparison with those with concentrations below the Limit of Detection (ß=0.19; 95% CI=0.06, 0.34). There were no significant associations with other hormones of the thyroid profile or with clinical diagnosis. CONCLUSIONS: Our findings suggest that p,p´-DDE exposure, even at low concentrations, could disrupt thyroid homeostasis during pregnancy.

Blood toxic metals and hemoglobin levels in Mexican children.

Metal toxicity can cause hematologic abnormalities and hemolysis. To evaluate the relationship of anemia with metal contamination in children, the following elements were quantified in dry blood: silicon, chromium, lead, titanium, vanadium, nickel, arsenic, manganese, and cadmium. A total of 88 samples of anemic children and 208 of non-anemic children aged 6-12 years were analyzed. Lead (35.1%), chromium (24.3%), vanadium (24.3%), nickel (45.6%), and silicon (48.6%) were identified in the samples, with titanium only detected in anemic children. The average level of arsenic was higher in anemic than non-anemic children (0.041 ± 0.11 wt% vs 0.014 ± 0.05 wt%, p < 0.05) and correlated with the concentration of hemoglobin (r = -0.441, p < 0.01). In conclusion, heavy metals, which confer a health risk, were detected in the dry blood of the children evaluated, and the levels of arsenic and titanium were found to be related to anemia.

Association between childhood obesity, cognitive development, physical fitness and social-emotional wellbeing in a transitional economy.

BACKGROUND: It has been suggested that obese children have lower cognitive function, demonstrate poorer physical performance and are more susceptible to social-emotional problems. AIMS: To describe associations between human physical growth, cognitive development, physical fitness and social-emotional characteristics of obese and non-obese children and to verify the predictors of intellectual coefficient by socioeconomic status (SES). SUBJECTS AND METHODS: A sample of 107 non-obese (N-Ob) children [-1 z-score body mass index (BMI) ≤1 z-score] and 108 obese (Ob) children [2 z-score ≤BMI ≤5 z-score] from a larger cohort was evaluated. Intellectual coefficient (IQ), social-emotional wellbeing (SEW), 6-minute walk test (6MWT) and SES (mid-low, low and very low) were assessed. RESULTS: Ob children were taller, heavier and present more height for age and BMI than N-Ob children (p < 0.001). A significant correlation between IQ and SEW (r = 0.14), 6MWT and BMI z-score (r = -0.18) and 6MWT and SEW (r = 0.15) was found. Multiple regression analysis revealed that BMI z-score had a negative impact on IQ in the mid-low SES sub-group and that SEW had a positive effect on IQ in the very-low SES sub-group. CONCLUSIONS: In Chilean pre-school children from low-income families cognitive ability varied according to SES.

Impact of memory bias in the dietary estimation of older adults measured through a food frequency questionnaire and weighed food records: A cross-sectional study in older adults and primary caregivers.

Introduction: Introduction: changes in cognitive performance and memory of older adults (OA) can interfere in their reporting their diet. Objective: to evaluate the impact of memory bias in dietary estimation between OA and their primary caregivers (PC) through the food frequency questionnaire (FFQ) for Mexican OA and weighed food records (WFR). Methods: the present analysis uses the estimated dietary information based on the response provided by 51 older adults (OA) and their primary caregivers (PC) from the validation study of the FFQ for Mexicans OA was conducted during lockdowns for COVID-19. The personnel who applied FFQ and WFR were trained with standardized instruments and procedures. The Wilcoxon test was used to compare the intake per day of the foods and food groups, the Spearman correlation coefficient was used to evaluate the grams of intake per day of the food groups, and kappa coefficient was used to compare the level of food items and food groups between OA and PC. Results: in 11 of 14 food groups, no significant differences were observed between the amounts of intake reported by OA and PC. In the groups of dairy products, fruits, vegetables, and legumes, moderate agreement was observed (κ = 0.63 to 0.79), and in the rest of the groups was strong to perfect (κ ≥ 0.80). Correlation of the amount of intake between OA and PC was high in all food groups (r ≥ 0.87). Conclusion: the high correlation and high agreement between the amounts and frequencies of the food groups consumed as reported by the older adults and primary caregivers indicate that the information from both respondents is reliable.

Introducción: Introducción: los cambios cognitivos y la memoria que presentan los adultos mayores (AM) pueden interferir al momento de reportar los alimentos de su dieta. Objetivo: evaluar el impacto del sesgo de memoria en la estimación de la dieta entre AM y sus cuidadores principales (CP) a través del cuestionario de frecuencia de alimentos (CFA) para AM mexicanos y el registro de peso de alimentos (RPA). Métodos: el presente análisis utiliza la información dietética estimada con base en la respuesta proporcionada por 51 adultos mayores (AM) y sus cuidadores principales (CP) del estudio de validación del CFA para AM mexicanos que se realizó durante el confinamiento por COVID-19. El personal que aplicó CFA y RPA fue capacitado con instrumentos y procedimientos estandarizados. Se utilizó prueba de Wilcoxon para comparar la ingesta por día de los alimentos y grupos de alimentos, el coeficiente de correlación de Spearman para evaluar los gramos de ingesta por día de los grupos de alimentos y el coeficiente kappa para comparar el nivel de alimentos y grupos de alimentos entre AM y CP. Resultados: en 11 de 14 grupos de alimentos no se observaron diferencias significativas entre las cantidades de ingesta reportadas por AM y CP. En los grupos de lácteos, frutas, verduras y legumbres se observó concordancia moderada (κ = 0,63 a 0,79), y en el resto de los grupos fue de fuerte a perfecta (κ ≥ 0,80). La correlación de la cantidad de ingesta entre AM y CP fue alta en todos los grupos de alimentos (r ≥ 0,87). Conclusión: La alta correlación y la alta concordancia entre las cantidades y frecuencias de los grupos de alimentos consumidos según lo informado por los adultos mayores y los cuidadores principales indican que la información de ambos encuestados es confiable.

Determinants of cognitive development of low SES children in Chile: a post-transitional country with rising childhood obesity rates.

Studies conducted in developing countries have noted associations between concurrent stunting, social-emotional problems and poor cognitive ability in young children. However, the relative contribution of these variables in Latin America is likely changing as undernutrition rates decline and prevalence of childhood obesity rises. We conducted a cross-sectional study of 106 normal-weight and 109 obese preschool children to compare the relative contribution of early nutrition, sociodemographic factors and psychosocial variables on cognitive development in normal-weight and obese preschool children in Chile. The study variables were categorized as: (1) socio-demographic (age, sex, birth order and socioeconomic) (2) early nutrition (maternal height, birth weight, birth length and height at 5 years) (3) psychosocial factors (maternal depression, social-emotional wellbeing and home space sufficiency). In order to assess determinants of cognitive development at 4-5 years we measured intelligence quotient (IQ); variability in normal children was mostly explained by socio-demographic characteristics (r(2) = 0.26), while in obese children early nutritional factors had a significant effect (r(2) = 0.12) beyond socio-demographic factors (r(2) = 0.19). Normal-weight children, who were first born, of slightly better SES and height Z score >1, had an IQ ≥ 6 points greater than their counterparts (p < 0.05). Obese children who were first born with birth weight >4,000 g and low risk of socio-emotional problems had on average ≥5 IQ points greater than their peers (p < 0.05). We conclude that in Chile, a post-transitional country, IQ variability of normal children was mostly explained by socio-demographic characteristics; while in obese children, early nutrition also played a significant role.

[Factors associated with nutritional status of iodine in Mexican preschool children]. / Factores asociados al estado nutricional de yodo en preescolares del estado de Hidalgo, México.

BACKGROUND: Iodine deficiency is a public health problem in many developing countries where pregnant women and children are the more susceptible populations. OBJECTIVE: To evaluate the association of iodine nutritional status with the weather, availability of iodine in salt, and degree of social exclusion in preschool children of the state of Hidalgo, Mexico. METHODS: Cross-sectional study in 1,333 children < 5 years; in these, urinary iodine and iodine in the salt was measured, and annual average of humidity, type of location and degree of social marginalization in the localities where they lived was recorded. RESULTS: 24.5% of children evaluated had < 100 µg/l of urinary iodine excretion, and 28.6% of salt samples contained < 20 ppm of iodine; iodine urine average of wet weather children was lower (209.09 ± 6.8 µg/l) than in dry climates (274.7 ± 5.86 µg/l; p < 0.05); the iodine content of salt in children living communities with high levels of marginalization was less than with low marginalization (23.5 ± 1.2 and 32.9 ± 2.7 ppm, respectively; p < 0.01). CONCLUSIONS: The humidity and the degree of social marginalization of the locations were associated with lower iodine content of salt and urinary iodine in children evaluated.

Perceptions of food environments in the school and at home during Covid-19: An online cross-sectional study of parents, teachers and experts from Latin America.

BACKGROUND: The high prevalence of overweight and obesity in children from Latin America (LA) have been related to obesogenic food environments. Besides, the negative effects of the Covid-19 pandemic should also be considered. The objective of this research was to describe and compare the perceptions of parents, teachers, and experts in LA of food environments at home and school that favor healthy habits in schoolchildren in pre Covid-19 stage and during the pandemic. METHODS: This study used a survey self-reporting regarding conditions at home and the school favoring healthy habits, for three profiles: parents, primary school teachers, and experts. A fisher exact test was used to establish the difference between the response categories between countries and profiles. Logistic regression models were used to determine the probability of response in the levels of importance adjusted for sex and nationality. RESULTS: Information from 954 questionnaires was reported: 48.4% experts, 32.0% teachers, and 19.6% parents. There were differences in the perception of food environments at school between profiles (p<0.001). In multivariate logistic regression models, experts and teachers were 20% more likely to give greater importance to elements of the food environment at school compared to parents (p<0.001). CONCLUSIONS: Our findings showed that parents were less likely to perceive important elements of the school food environment compared to experts and teachers. Interventions are required to improve healthy eating environments that consider children's interpersonal mediators.

Iodine nutritional status in urban and rural Mexican schoolchildren. / Estado nutricional de yodo en niños escolares mexicanos de zonas urbanas y rurales.

INTRODUCTION: Deficient or excess iodine intake has effects on human health. Assessment of the prevalence and risk factors in children can therefore support effective prevention or treatment. METHOD: A cross-sectional probabilistic study in 631 children aged 5 to 12 years in whom iodine levels were measured in urine and salt samples. Results are reported by type of location and indigenous condition. Association of these variables to urinary iodine levels was assessed using a binary logistic regression. RESULTS: Median urinary iodine level was 278.4µg/L (177.3-360.9, IQR), 13.2% of children assessed had iodine levels <100µg/L, and 41.8% had values ≥300µg/L. Indigenous schoolchildren had the greatest risk of urinary iodine levels <100µg/L (ß = 2.29, CI 1.1-4.6, p <.05), while children from urban and non-indigenous localities had a high risk of iodine levels >300µg/L (ß = 2.2, CI 1.3 -3.9, p <.01, and ß = 3.8, CI 2.2-6.5, p <.01 respectively). Median iodine level in salt was 35.9ppm (29.1-42.4 IQR), and there were no differences in iodine levels in salt by type of location or ethnicity. CONCLUSIONS: In Mexican schoolchildren living in rural and indigenous areas, iodine levels <100µg/L have not been eradicated. There was high prevalence of urinary iodine levels ≥300µg/L in schoolchildren living in urban areas which was associated to high sodium intake from processed food.

Common polymorphisms in MC4R and FTO genes are associated with BMI and metabolic indicators in Mexican children: Differences by sex and genetic ancestry.

BACKGROUND: Mexico is experiencing an epidemic of childhood obesity and overweight, the factors that determine type 2 diabetes and cardiovascular diseases. Even though variants in genes such as MC4R, LEP, LEPR, and FTO have been associated with the risk of obesity, in Mexico the level of miscegenation is heterogeneous, so this risk must be measured as genetic ancestry. This study aimed at evaluating the association between common SNPs in FTO and MC4R genes in Mexican children with Amerindian, mestizo and predominance European ancestry. METHODS: Anthropometric data and fasting blood samples were collected from 718 unrelated Mexican school children aged 4-13 years old. Variants in the FTO, MC4R, LEP, LEPR genes and 15 ancestry informative markers (AIMs), were genotyped using allelic discrimination assays. RESULTS: High triglycerides and low cholesterol HDL were the most frequent metabolic alterations. The prevalence of minor allele frequency of polymorphism rs8050136, rs9939609, and rs3751812 in the FTO gene; and rs17782313 of MC4R gene were found to be significantly higher among Mexican children with a predominance of European ancestry (EA) compared to native Mexican children (Amerindian predominance), X2 test, p < 0.05. The FTO (rs8050136, rs9939609) and MC4R (rs17782313) genotypes also were significantly associated with obesity (BMI > 2Z) in boys (OR=1.89, P=0.04, OR=3.3, P=0.006 OR=3.11, p=0.04, respectively). Children with AA genotype (minor) of rs8050136 and rs9939609 SNPs have higher triglycerides in relation to native ancestral genotypes. CONCLUSION: Risk variants in the FTO and MC4R genes had a higher frequency in children with EA compared with Amerindian predominance children, showing that miscegenation is associated with the frequency of obesity-related genotypes.

Valor diagnóstico del índice de masa corporal en comparación con impedancia bioeléctrica para identificar sobrepeso u obesidad en jóvenes adultos mexicanos / Diagnostic value of body mass index versus bioelectrical impedance analysisfor detection of overweight and obesity among Mexican young adults

Introducción: El índice de masa corporal (IMC) es am-pliamente utilizado para diagnosticar estado de nutrición;pero tiene limitaciones porque no evalúa la grasa corporal. Objetivo: Determinar el valor diagnóstico del IMC en com-paración con impedancia bioeléctrica para identificar sobre-peso y obesidad (SpyOb) en adultos jóvenes mexicanos.Material y métodos: Estudio de validación en adultos jó-venes mexicanos. Se midió talla con estadímetro SECA 215,peso y composición corporal con InBody 270 por personal en-trenado. Se realizaron comparaciones por sexo con U deMann Whitney y Chi2; y correlaciones de Spearman para IMCy porcentaje de grasa corporal total (%GCT). Se calculó sen-sibilidad (s) y especificidad (e) con curvas ROC comparandoIMC y %GCT para diagnosticar SpyOb. Análisis se realizó conStata 14 y valores p<0.05 fueron considerados significativos. Resultados: Se evaluaron 351 universitarios con medianade edad de 19 años. El 42.4% fue diagnosticado con SpyObde acuerdo al IMC, y 48.1% fue identificado en esa mismacondición mediante %GCT; con diferencias significativas porsexo sólo en el diagnóstico por %GCT. La correlación entre IMC y %GCT fue alta para la muestra en general (r=0.68) ymuy alta por sexo (r=0.85 hombres y r=0.81 mujeres). ElAUC para diagnosticar obesidad en mujeres fue de 0.90, conalta sensibilidad (100%) y alta especificidad (80.4%), y paradiagnosticar sobrepeso el AUC fue de 0.52 con baja sensibili-dad (31.5%) y especificidad regular (73.1%). El AUC paradiagnosticar obesidad en hombres fue de 0.84, con alta sen-sibilidad (80%) y alta especificidad (88.9%), y para diagnos-ticar sobrepeso el AUC fue de 0.63, con baja sensibilidad(32.5%) y alta especificidad (94.3%).Conclusiones: Se encontró alta y muy alta correlaciónentre IMC y %GCT, tanto en hombres como en mujeres. ElIMC es un indicador útil y confiable para diagnosticar obesi-dad, pero no para diagnosticar sobrepeso en jóvenes adultos mexicanos.(AU)

Background:The Body Mass Index (BMI) is widely usedfor nutritional status assessment; nevertheless, it has limita-tions due to the fact that it doesn’t evaluate the body fat.Objective: Identify the diagnostic value of the BMI versusBioelectrical Impedance to determinate overweight and obe-sity in young Mexican adults.(AU)

Prevalencias de estado de nutrición en recién nacidos mexicanos por peso y longitud al nacimiento: un análisis de los certificados de nacimiento del Sinac / Prevalence of nutritional status in Mexican newborns by weight and leght at birth: an analysis of Sinac birth certificates

Resumen: Objetivo: Describir la prevalencia nacional por entidad federativa del estado de nutrición de peso y longitud al nacimiento. Material y métodos: Estudio transversal descriptivo. Se analizaron datos de 1 907 341 recién nacidos vivos en 2017, registrados en el Subsistema de Información sobre Nacimientos (Sinac). Los percentiles para peso y longitud se estimaron en la plataforma INTERGROWTH-21st. Resultados: La prevalencia de pequeños para la edad gestacional (PEG) y longitud insuficiente (LI) fue de 7.4 y 4.8%, respectivamente. Se registraron diferencias por sexo en las prevalencias de LI, PEG y grandes para la edad gestacional (GEG) (p <0.01). Las entidades con mayores prevalencias de PEG (10.4%) fueron Estado de México y Yucatán. De GEG, fueron Sonora (16.8%) y Baja California Sur (15.3%). Conclusión: Dimensionar el estado de nutrición al nacer permite identificar entidades que requieren acciones focalizadas para disminuir los riesgos asociados con la malnutrición.

Abstract: Objective: To describe the national by federal entity prevalence of the nutritional status of weight and length at birth. Materials and methods: Cross-sectional descriptive study. Data from 1 907 341 alive newborns in 2017, registered in the Subsistema de Información sobre Nacimientos (Sinac), were analyzed. The percentiles for weight and length were estimated in the INTERGROWTH-21stplatform. Results: The prevalence of small gestational age (SGA) and insufficient length (IL) was 7.4 and 4.8%, respectively. Differences in the prevalence of IL, SGA and large for the gestational age (LGA) by sex were recorded (p <0.01). The entities with the highest prevalence of SGA were Estado de México and Yucatán (10.4%); Sonora (15.3%) and Baja California Sur (16.8%) of LGA. Conclusion: Sizing the nutritional status at birth allows the identification of entities that require targeted actions to reduce the risks associated with malnutrition.

Design and evaluation of a campaign to promote the consumption of vegetables and fruits in Mexican school-age children.

INTRODUCTION: In Mexican school-age children the consumption of vegetables and fruits (V&F) is less than 25% of the amount recommended by the World Health Organization. OBJECTIVES: Evaluate the effectiveness of a promotion campaign about the consumption of V&F in urban school children from Hidalgo, Mexico. METHODS: A non controlled community trial in 226 school-age children from private and public schools was conducted, we designed and distributed printed material for promoting the consumption of V&F among the school population, access to V&F was provided through planning and sales at school stores, and consumption was supervised by the teachers. RESULTS: At the end of the intervention vegetable consumption increased by 50 g and plain water in 100 mL (T-test, p < 0.05); the proportion of school-age children who identified the health benefits of the consumption of V&F increased significantly (68% initial, 87% final) and greater support from parents (61% initial, 92 final%) was achieved. CONCLUSIONS: A promotion campaign and improved access to vegetables, fruits and water in the school environment which is supported by parents and teachers can encourage healthier eating at school.

Relación de la vulnerabilidad alimentaria con el estado de nutrición y fragilidad en adultos mayores mexicanos / Relationship of food vulnerability with nutritional status and fragility in elderly Mexicans

Introducción: Envejecer implica cambios físicos, biológicos, psicosociales y económicos que predisponen al adulto mayor (AM) a vulnerabilidad alimentaria (VA) influyendo en su estado de nutrición y fragilidad, trayendo como consecuencia un alto riesgo de discapacidad, hospitalización y mortalidad. Objetivo: Determinar la relación de la vulnerabilidad alimentaria con el estado de nutrición y fragilidad en una población de adultos mayores mexicanos. Métodos: Se realizó un estudio observacional analítico en adultos de 60 años o más de ambos sexos que se encontraban institucionalizados en el Centro Gerontológico Integral de Pachuca, México; los cuales dieron su consentimiento para realizar la Escala de Vulnerabilidad Alimentaria Nutricional, el cuestionario Mini Nutritional Assessment MNA(R) y el cuestionario Frail de cribado para identificar personas frágiles. Resultados: Se incluyeron 80 AM de 60-64 años (n=19), 65-74 años (n=37) y ≥ 75 (n=24) años; encontrando proporciones de VA leve de 92.5% y VA moderada de 7.5%; y el 50% de AM se encontró con riesgo de malnutrición de acuerdo con MNA(R), y 65% se encontró con riesgo de fragilidad de acuerdo con la escala Frail. Se encontró correlación negativa entre el puntaje obtenido en MNA y puntaje de VA (r= -0.56, p <0.001), y no se encontró asociación entre VA y fragilidad (CHI2, p =0.062). Conclusión: Una mayor vulnerabilidad alimentaria se asoció con incrementó del riesgo de malnutrición en los adultos mayores, pero no se encontró relación entre vulnerabilidad alimentaria con la fragilidad. Una alta proporción de adultos mayores presentó algún indicador de fragilidad, lo que en el corto plazo podría afectar su calidad de vida

Introduction: Aging implies physical, biological, psychosocial and economic changes that predispose the elderly (AM) to food vulnerability (VA) influencing their nutritional status and fragility, resulting in a high risk of disability, hospitalization and mortality. Objective: To determine the relationship of food vulnerability with the state of nutrition and frailty in an elderly Mexican population. Methods: An analytical observational study was conducted in adults of 60 years or older of both sexes who were institutionalized in the Comprehensive Gerontological Center of Pachuca, Mexico; who gave their consent to carry out the Nutritional Food Vulnerability Scale, the Mini Nutritional Assessment MNA(R) questionnaire and the Frail screening questionnaire to identify frail people.Results: 80 AM of 60-64 years (n = 19), 65-74 years (n = 37) and ≥75 (n = 24) years were included; finding proportions of mild VA of 92.5% and moderate VA of 7.5%; and 50% of AM was at risk of malnutrition according to MNA(R), and 65% was found to be at risk of frailty according to the Frail scale. A negative correlation was found between the score obtained in MNA and the VA score (r = -0.56, p <0.001), and no association was found between VA and fragility (CHI2, p = 0.062). Conclusion: Greater food vulnerability was associated with increased risk of malnutrition in older adults, but no relationship was found between food vulnerability and frailty. A high proportion of older adults presented some indicator of frailty, which in the short term could affect their quality of life

Indicadores de síndrome metabólico en escolares mexicanos con talla baja, sobrepeso u obesidad / Components of the metabolic syndrome in Mexican school-children stunted, normal weight and overweight

En niños mexicanos la obesidad, talla baja y anemia son problemas que coexisten principalmente en poblaciones rurales que comparten el mismo territorio geográfico, esto les otorga riesgos diferenciados. El objetivo de esta investigación fue determinar la asociación y magnitud del riesgo de indicadores de síndrome metabólico en niños escolares. Se realizó un estudio transversal analítico en una muestra probabilística de 746 escolares (5-13 años) del estado de Hidalgo, México; en quienes se determinó la seguridad alimentaria, el puntaje Z de IMC, T-E y la adiposidad central; se midió la presión arterial y se cuantificó hemoglobina para diagnosticar anemia. Se cuantificó en suero glucosa, triglicéridos, colesterol total, colesterol HDL e insulina; y se calculó el índice HOMA. La prevalencia de síndrome metabólico en los niños sanos fue de 3.4 %, en talla baja de 6.4 %, en sobrepeso de 15.7 % y en obesidad de 38.4 %. En el grupo de niños con anemia se registraron los OR de insulina (0.39, IC=0.18-0.87) y HOMA (0.21, IC=0.05-0.87) más bajos y en niños con obesidad (5.42, IC=3.07-9.54 y 4.12, IC=2.05-8.29) los más altos. Se concluye que en la anemia existe un menor riesgo metabólico y que el sobrepeso y la obesidad se asocian con dislipidemias y alteración en la secreción de insulina(AU)

Components of the metabolic syndrome in Mexican school children stunted, normal weight and overweight. Obesity, stunting and anemia are problems that coexist among Mexican children in rural populations that share the same geographical territory; this grants them differentiated risks. The objective of this research was to determine the magnitude of risk and the association of metabolic syndrome indicators among school children. A transversal analytic study was performed for a probabilistic sample of 746 school children from the State of Hidalgo, Mexico, for whom alimentary security, the Z score of BMI, HA and central adiposity were determined; blood pressure was measured and hemoglobin was quantified in order to detect anemia. It was quantified in serum: glucose, triglycerides, total cholesterol, HDL cholesterol and insulin; HOMA index was calculated. The prevalence of metabolic syndrome in children of normal weight and height was of 3.4 %, 6.4 % in short stature, 15.7 % in over weight and 38.4 % in obesity. In the group of children with anemia, the lowest OR insulin were recorded (0.39, IC=0.18- 0.87) and HOMA (0.21, IC=0.05-0.87); as for children with obesity these scores were the highest (5.42, IC=3.07-9.54 and 4.12, IC=2.05-8.29). It is concluded that there is a lower metabolic risk in anemia and that overweight and obesity are associated with dyslipidemia and impaired insulin secretion(AU)

Design and evaluation of a campaign to promote the consumption of vegetables and fruits in Mexican school-age children / Diseño y evaluación de una campaña de promoción del consumo de verduras y frutas en escolares mexicanos

Introduction: In Mexican school-age children the consumption of vegetables and fruits (V&F) is less than 25% of the amount recommended by the World Health Organization. Objectives: Evaluate the effectiveness of a promotion campaign about the consumption of V&F in urban school children from Hidalgo, Mexico. Methods: A non controlled community trial in 226 school-age children from private and public schools was conducted, we designed and distributed printed material for promoting the consumption of V&F among the school population, access to V&F was provided through planning and sales at school stores, and consumption was supervised by the teachers. Results: At the end of the intervention vegetable consumption increased by 50 g and plain water in 100 mL (T-test, p < 0.05); the proportion of school-age children who identified the health benefits of the consumption of V&F increased significantly (68% initial, 87% final) and greater support from parents (61% initial, 92 final%) was achieved. Conclusions: A promotion campaign and improved access to vegetables, fruits and water in the school environment which is supported by parents and teachers can encourage healthier eating at school (AU)

Introducción: en escolares mexicanos el consumo de verduras y frutas y (VyF) es menor del 25% de la cantidad recomendada por la Organización Mundial de la Salud. Objetivos: evaluar la efectividad de una campaña de promoción del consumo de VyF en niños de escuelas urbanas de Hidalgo, México. Métodos: se realizó un ensayo comunitario no contralado en 226 escolares de una escuela privada y una pública; se diseñó y distribuyó material impreso de promoción del consumo de VyF entre la población escolar; se facilitó el acceso a VyF mediante una planificación y venta en establecimientos de consumo escolar, y se supervisó el consumo por los profesores. Resultados: al finalizar la intervención, se incrementó el consumo de verduras en 50 g y el de agua simple en 100 ml (T-test, p < 0,05); se aumentó significativamente la proporción de escolares que identificaban los beneficios en su salud del consumo de VyF (68% inicial, 87% final) y se logró mayor apoyo de los padres de familia (61% inicial, 92% final). Conclusiones: una campaña de promoción y mejoramiento del acceso a verduras, frutas y agua en el contexto escolar, que cuente con el apoyo de padres de familia y profesores, puede favorecer una alimentación más saludable en la escuela (AU)

Estado nutricional de yodo en niños escolares mexicanos de zonas urbanas y rurales / Iodine nutritional status in urban and rural Mexican schoolchildren

INTRODUCCIÓN: El déficit o consumo excesivo de yodo en humanos tiene efectos en la salud, por lo que determinar las prevalencias y los factores de riesgo en los niños ayuda a reorientar las acciones de prevención o tratamiento. MÉTODO: Estudio transversal probabilístico realizado en 631 infantes de 5-12 años a quienes se les cuantificó yodo en una muestra de orina y de sal; se presentan resultados por tipo de localidad y condición de indigenismo, la asociación de estas variables con intervalos de yoduria fue evaluada con una regresión logística binaria. RESULTADOS: La mediana de la concentración de yodo en orina (yoduria) fue de 278,4 μ,g/L (177,3-360,9, RIC), el 13,2% de los infantes evaluados presentaron yodurias < 100 μ,g/L y el 41,8% registraron cifras ≥ 300 μ,g/L. Los escolares indígenas fueron los que registraron mayor riesgo para yodurias < 100 μ,g/L ((ß = 2,29, 1,1-4,6 IC, p < 0,05) e infantes de localidades urbanas y no indígenas riesgos altos para cifras ≥ 300 μ,g/L (ß = 2,2, 1,3-3,9 IC, p < 0,01 y ß = 3,8, 2,2-6,5 IC, p < 0,01; respectivamente). La mediana de la concentración de yodo en sal fue de 35,9 ppm (29,1-42,4, RIC), no se presentaron diferencias en las concentraciones de yodo en sal por tipo de localidad o etnicidad. CONCLUSIONES: En escolares mexicanos de zonas rurales e indígenas las cifras de yodurias < 100 μ,g/L no han sido erradicadas. Se registraron altas prevalencias de cifras elevadas de yoduria en escolares que habitan en localidades urbanas, esto se asoció al consumo de sodio de alimentos procesados

INTRODUCTION: Deficient or excess iodine intake has effects on human health. Assessment of the prevalence and risk factors in children can therefore support effective prevention or treatment. METHOD: A cross-sectional probabilistic study in 631 children aged 5 to 12 years in whom iodine levels were measured in urine and salt samples. Results are reported by type of location and indigenous condition. Association of these variables to urinary iodine levels was assessed using a binary logistic regression. RESULTS: Median urinary iodine level was 278.4 μ,g/L (177.3-360.9, IQR), 13.2% of children assessed had iodine levels < 100 μ,g/L, and 41.8% had values ≥ 300 μ,g/L. Indigenous schoolchildren had the greatest risk of urinary iodine levels < 100 μ,g/L (ß = 2.29, CI 1.1-4.6, p <.05), while children from urban and non-indigenous localities had a high risk of iodine levels > 300 μ,g/L (ß = 2.2, CI 1.3 -3.9, p <.01, and (ß = 3.8, CI 2.2-6.5, p <.01 respectively). Median iodine level in salt was 35.9 ppm (29.1-42.4 IQR), and there were no differences in iodine levels in salt by type of location or ethnicity. CONCLUSIONS: In Mexican schoolchildren living in rural and indigenous areas, iodine levels < 100 μ,g/L have not been eradicated. There was high prevalence of urinary iodine levels ≥ 300 μ,g/L in schoolchildren living in urban areas which was associated to high sodium intake from processed food