State-level prevalence of anemia in women of reproductive age. Ensanut 2006, 2012 and 2018-19.

OBJECTIVE: To compare the prevalence of anemia and iron deficiency, at state level in non-pregnant women between 20 and 49 years of age from the Encuesta Nacional de Salud y Nutrición (Ensanut, in Spanish) 2006, 2012 and 2018-19. MATERIALS AND METHODS: The Ensanut 2006, 2012 and 2018-19 have a probabilistic design. Hb in capillary blood was measured by HemoCue Hb201 and ferritin by venous sample. Anemia was diagnosed with Hb<120g/L and iron deficiency with Ferritin<15ng/mL. RESULTS: At the national level, anemia increased 6.1 (p<0.05) percentage points (pp) from 2006 to 2018-19. Baja California Norte, Campeche, Colima, Chiapas, Quintana Roo, Sinaloa and Sonora, went from low prevalence (5 to 19.9%) to moderate (20 to 39.9%); in Yucatán and Tamaulipas it went from low to severe (>40). In Guanajuato, State of Mexico and Querétaro it was reduced from 2006 to 2018-19 (p<0.05). CONCLUSIONS: Anemia continues to be a public health problem that requires actions at the state level, considering level of wellbeing index, food programs and affiliation to medical Services insurance.

Factores asociados con anemia y deficiencia de micronutrimentos en mujeres mexicanas. Ensanut Continua 2022.

OBJETIVO: Identificar los factores asociados con anemia, deficiencias de hierro (DH) y vitamina B12 (DVB12) en mujeres de 12 a 49 años, participantes en la Encuesta Nacional de Salud y Nutrición Continua 2022 (Ensanut Continua 2022). Material y métodos. La Ensanut es probabilística con representatividad nacional. Se recolectó sangre venosa de 1 141 mujeres para analizar hemoglobina, ferritina y vitamina B12, para estimar deficiencias según la Organización Mundial de la Salud. Se realizaron análisis descriptivos y modelos de regresión logística (módulo SVY/STATA). RESULTADOS: Las prevalencias de anemia, DH y DVB12 fueron 15.7, 41.9 y 17.2%, respectivamente. Se asoció (p<0.5) anemia con agua de garrafón/botella (razón de momios [RM]=2.27; IC95% 0.99,5.17) y DH con no tener agua entubada (RM=2.86; IC95% 1.31, 6.22) y pertenecer al estrato urbano (RM=1.56; IC95% 0.98, 2.45). Conclusión. La anemia, DH y DVB12 fueron altamente prevalentes, por lo tanto se requiere profundizar en el tema del agua para beber y en la derechohabiencia en mujeres con mayores desventajas socioeconómicas.

Estado de micronutrimentos en niños, niñas y mujeres mexicanas: análisis de la Ensanut Continua 2022.

OBJETIVO: Describir las deficiencias de micronutrientes en la población mexicana participante de la Encuesta Nacional de Salud y Nutrición 2022 (Ensanut 2022). Material y métodos. La Ensanut 2022 es probabilística y de representatividad nacional. Se recolectó sangre venosa en una submuestra de niños de 1-11 años (48%) y de mujeres de 12-49 años (37%). Se separó el suero in situ para analizar ferritina, vitamina B12, folato y 25[OH]D, definiendo deficiencias según criterios de la Organización Mundial de la Salud. Se realizaron análisis descriptivos en niños/as preescolares, escolares y mujeres (12-49 años), utilizando el diseño de la encuesta. RESULTADOS: Las prevalencias de deficiencia de hierro, niveles bajos de vitamina B12 y deficiencia de vitamina D fueron 30.6, 17.4 y 4.7% en preescolares; 17.2, 20 y 37.1% en escolares; y 39.7, 34.0 y 37.7% en mujeres, respectivamente. Conclusión. La deficiencia de hierro en preescolares y de micronutrientes en mujeres fueron altamente prevalentes. Es necesario un llamado a la acción para realizar intervenciones focalizadas en grupos con mayor desventaja social.

Prevalencia de anemia en la población mexicana: análisis de la Ensanut Continua 2022.

OBJETIVO: Describir la magnitud de la prevalencia de anemia en la población mexicana participante en la Encuesta Nacional de Salud y Nutrición Continua 2022 (Ensanut Continua 2022). Material y métodos. La Ensanut 2022 es probabilística. Mediante sangre venosa y Hemocué (201+) se midió hemoglobina (Hb) y se ajustó por altitud. Se definió anemia según criterios de la Organización Mundial de la Salud (OMS). Considerando el diseño muestral de la encuesta, se obtuvieron prevalencias e IC95%. RESULTADOS: Las prevalencias de anemia fueron 6.8% en niños de 1-4 años, 3.8% en niños de 5-11 años, 10.1% en adolescentes (12-19 años), 15.8% en mujeres (20-49 años) y 10.3% en adultos mayores (≥60 años). CONCLUSIONES: La anemia afectó principalmente a las mujeres adultas. Resulta necesario identificar sus causas para focalizar acciones y evitar el ciclo intergeneracional del riesgo de anemia.

Vitamin D status in Mexican women at reproductive age, Ensanut 2018-19.

OBJECTIVE: To describe the prevalence of deficiency (VDD) and insufficiency (VDI) of vitamin D (VD), by sociodemo-graphic factors, obesity and physical activity in a probabilistic sample of Mexican women participating in Ensanut 2018-19. MATERIALS AND METHODS: In 1 262 women aged 20 to 49 years, the prevalence of VDD/IVD was estimated and the factors associated with it were evaluated with a multinomial regression model. RESULTS: The prevalence of VDI was 46.1% and of VDD was 31.6%. The probability of present-ing VDI and VDD was higher for residents of urban areas, in tertiles 2 and 3 of socioeconomic status, and with obesity, while was lower in women with moderate physical activ-ity. CONCLUSION: The prevalence of vitamin D in Mexican women continues to be a public health problem in Mexico despite the high availability of sunlight in the country. It is necessary to promote healthy sun exposure in the population and consider fortifying foods with vitamin D.

Prevalence of iron deficiency was stable and anemia increased during 12 years (2006-2018) in Mexican women 20-49 years of age.

OBJECTIVE: To compare the prevalence of women 20-49 years of age with iron deficiency anemia (IDA), iron deficiency with no anemia (IDNA), and non-ID anemia (NIDA) in com-parison during 2006, 2012 and 2018, and their association with sociodemographic characteristics and nutritional status. MATERIALS AND METHODS: Ensanut 2006, 2012 and 2018- 19 are comparable for measurements of anemia (hemoglobin) and Iron deficiency (ID, by ferritin). Both measurements combined were compared with year of surveys and other dependent variables using a multinomial regression. RESULTS: In 2006, the total prevalence of anemia was 14.9% and ID 29.0%, the prevalence of IDA was 8.35%, of IDNA 20.5%, and NIDA 6.6%; in 2012, the total prevalence of anemia was 13.3%, ID was 9.6%, IDA 8.6%, IDNA 21.0% y NIDA 4.7%; in 2018 total prevalence of anemia was 21.4%, of ID 25.7%, IDA 10.5%, IDNA 15.2% and NIDA 10.9%. CONCLUSIONS: The total prevalence of anemia increased 6.5 pp between 2006 and 2018, IDNA reduced, IDA had no significant changes, the mayor increase (4.3 pp) occurred in NIDA.

[Behavior and factors associated with anemia inMexican women of childbearing age. Ensanut 2018-19]. / Comportamiento y factores asociados con la anemia en mujeres mexicanas en edad fértil. Ensanut 2018-19.

OBJECTIVE: To study the behavior of anemia in 2006, 2012 and 2018-19, its severity and associated factors in Mexican women between 20 and 49 years of age. MATERIALS AND METHODS: The Ensanut 2006, 2012 and 2018-19 has a methodological design that allows comparisons between them. Capillary hemoglobin (Hb) classified anemia with Hb values <12dL. Pregnant women were excluded. Anemia was associated with individual and sociodemographic factors using a logit regression model. RESULTS: The reduction in anemia from 2006 to 2012 was significant, but not the increase for 2018-19. Anemia was associated with a higher number of pregnancies, and being 35 to 49 years of age. A BMI≥30 (k/m2), tertile 3 of wellness condition, not being indigenous and living in the Center and Mexico City were protective of anemia. CONCLUSIONS: Anemia continues to be a public health problem, especially in women 35 to 49 years of age with more than four pregnancies.

OBJETIVO: Estudiar el comportamiento de la anemia en los años 2006, 2012 y 2018-19, su severidad y factores asociados en mujeres mexicanas de 20 a 49 años de edad. MATERIAL Y MÉTODOS: Las Ensanut 2006, 2012 y 2018-19 tienen un diseño metodológico que permite comparaciones entre ellas. Mediante hemoglobina capilar <12dL se clasificó anemia. Se excluyó a quienes estuvieron embarazadas. Se asoció anemia con factores sociodemográficos mediante regresión logística. RESULTADOS: La reducción de anemia de 2006 a 2012 fue significativa, pero no el incremento para 2018-19. Se asoció anemia con un mayor número de embarazos, y tener de 35 a 49 años de edad. Fueron factores protectores de anemia un IMC≥30(k/m2), tercil 3 de CB, no ser indígena y vivir en Cen-tro y Ciudad de México. CONCLUSIONES: La anemia continúa siendo un problema de salud pública, sobre todo en mujeres de 35 a 49 años de edad con más de cuatro embarazos.

Closing the Nutrition Impact Gap Using Program Impact Pathway Analyses to Inform the Need for Program Modifications in Mexico's Conditional Cash Transfer Program.

BACKGROUND: Mexico's Prospera-Oportunidades-Progresa Conditional Cash Transfer Program (CCT-POP) included the distribution of fortified food supplements (FFS) for pregnant and lactating women and young children. Rigorous evaluations showed significant impacts on nutrition outcomes but also substantial gaps in addressing nutrition problems. OBJECTIVES: To highlight the program design-related and implementation-related gaps and challenges that motivated further research and the eventual design and roll-out of a modified nutrition component for CCT-POP. METHODS: We used a program impact pathway approach to highlight the extent and quality of implementation of CCT-POP, and its impact on nutrition outcomes. We drew on previously published and new primary data, organized into 3 sources: impact evaluations, studies to inform reformulation of the FFS, and a longitudinal follow-up study using qualitative and quantitative methods to document FFS use and the dietary intake of women and children. RESULTS: Despite positive impacts, a high prevalence of malnutrition persisted in the population. Coverage and use of health services improved, but quality of care was lacking. Consumption of FFS among lactating women was irregular. Micronutrient intake improved among children who consumed FFS, but the pattern of use limited frequency and quantity consumed. Substantial diversity in the prevalence of undernutrition was documented, as was an increased risk of overweight and obesity among women. CONCLUSIONS: Three key design and implementation challenges were identified. FFS, although well accepted for children, had limited potential to substantially modify the quality of children's diets because of the pattern of use in the home. The communications strategy was ineffective and ill-suited to its objective of motivating FFS use. Finally, the program with its common design across all regions of Mexico was not well adapted to the special needs of some subgroups, particularly indigenous populations. The studies reviewed in this paper motivated additional research and the eventual redesign of the nutrition component.

[High prevalence of anemia in Mexican women in poverty, Ensanut 100k]. / Alta prevalencia de anemia en mujeres mexicanas en pobreza, Ensanut 100k.

OBJECTIVE: To estimate the prevalence and distribution of anemia in Mexican women and their association with sociodemographic factors and diet diversity. MATERIALS AND METHODS: We analyzed information of women in childbearing age. The Ensanut 100k is a probabilistic survey that overrepresents households with less economic capacity. Anemia was estimated using hemoglobin concentration. We collected sociodemographic and health information, food insecurity, and dietary diversity. RESULTS: 34.3% of the women presented anemia, belong to tertile 3 of welfare status is a protective factor for anemia (OR= 0.26, 95%CI 0.16-0.61), and living in a household with food security, as well as high diversity of the diet in rural women (OR= 0.57, 95%CI 0.36-0.92). CONCLUSIONS: It is necessary to implement actions of detection and early attention of the anemia in women in childbearing age, identification of its underlying causes, strengthening and reformulation of strategies to prevent it.

OBJETIVO: Estimar la prevalencia y distribución de anemia en mujeres mexicanas y su asociación con factores sociodemográficos y la diversidad de la dieta. MATERIAL Y MÉTODOS: Se incluyeron mujeres en edad fértil de la encuesta probabilística Ensanut 100k, que representa a los hogares con menos capacidades económicas. Se estimó la prevalencia de anemia mediante concentración de hemoglobina, con información sociodemográfica, de salud, inseguridad alimentaria y diversidad de la dieta. RESULTADOS: El 34.3% de las mujeres presentó anemia; los factores protectores para anemia fueron pertenecer al tercil 3 de condición de bienestar (OR=0.26, IC95% 0.16-0.61), alta diversidad de la dieta en áreas rurales (OR=0.57, IC95%0.36-0.92), así como vivir en un hogar con seguridad alimentaria. CONCLUSIONES: Es necesario implementar acciones de detección y atención temprana de la anemia en las mujeres de edad fértil, así como identificar las causas subyacentes y fortalecer y reformular estrategias para prevenirla.

Fortified food supplementation in children with reduced dietary energy and micronutrients intake in Southern Mexico.

BACKGROUND: Nutritional supplements are an important source of complementary food for young children, since they may either complement or substitute nutrients obtained from other food sources. Assessing how the introduction of different types of supplements modifies the consumption of other food sources may help in designing supplementation programs that aim to improve the nutrition of vulnerable populations. The objetive is to quantify dietary energy and nutrient intake among children aged 6-12 months who received one of three nutritional supplements. METHODS: A cluster-randomized trial was conducted from 2005 to 2007. Urban communities were randomly allocated to one of three intervention groups receiving one of the following: a milk-based fortified food, micronutrient powders, or syrup. Each supplement was fortified with equal amounts of micronutrients. Dietary intake was estimated using a food frequency questionnaire (FFQ) to reflect the average consumption over the month prior to the interview. Children between 6 and 12 months of age were recruited. Median regression was performed with adjusted standard errors for clustered data, and the linear predictors for the median included the study group, study stage and their interaction. Adjusted medians by study group and study stage were obtained as post-estimations. RESULTS: No statistically significant differences between study groups were observed at baseline. After four months of supplementation, the children in the fortified food group had a smaller increase in median dietary energy (183.7 kcal, CI95%: 59.9, 307.5) and dietary protein (6.6 g, CI95%: 2.6, 10.6) intake from their home diet than those in the syrup group (p < 0.05). These differences remained significant after adjusting for group differences at baseline. Regarding covariate-adjusted median changes from baseline to follow-up at 10 months, the children in the fortified food group had a smaller median increase in dietary energy intake than those in the syrup group (698 vs 915 kcal), with a difference of 217.9 kcal (CI95%: 20.4, 415.4). CONCLUSION: Children in the fortified food group consumed less dietary energy, protein, and micronutrients than those in the micronutrient powder and syrup groups. It is possible that absolute nutrient intake may be overestimated by the FFQ, but this possibility does not compromise the ability to compare study groups. Given the observed differences in dietary energy consumption among the three supplemented groups, it can be concluded that supplementation with micronutrient powders is an adequate option for urban children who have met their minimum energy and protein requirements.

Dietary intake and adequacy of energy and nutrients in Mexican adolescents: Results from Ensanut 2012.

OBJECTIVE: To estimate energy and nutrient intakes and adequacies in Mexican adolescents. MATERIALS AND METHODS: Dietary intake was assessed in 1 961 adolescents who participated in the National Health and Nutrition Survey 2012 (Ensanut 2012), by a food frequency questionnaire. Medians of intakes and adequacies were estimated for energy, macroand micronutrients and are presented by residence area, region and household wealth index (HWI). Consumption by food groups was estimated. RESULTS: Median daily energy intake was 2 000 Kcal in males and 1 800 Kcal in females. High prevalences of inadequacy were observed for fiber, PUFAs, iron, zinc and calcium. These inadequacies were higher among individuals of low HWI. Moreover, excessive intakes of total and saturated fat were higher among adolescents of higher HWI. CONCLUSIONS: The diet of Mexican adolescents is deficient in essential nutrients for good health and high in saturated fat. Actions are needed to promote a healthy diet.

[Trend in the prevalence of anemia in Mexican women of childbearing age from 2006-2016. Ensanut MC 2016]. / Tendencia en la prevalencia de anemia entre mujeres mexicanas en edad reproductiva 2006-2016. Ensanut MC 2016.

OBJECTIVE: To describe the anemia prevalence among women from 20 to 49 years from 2016-Halfway National Health and Nutrition Survey (Ensanut MC 2016) and compare the trends in 2006, 2012 and 2016 surveys, as well as its association with dietary iron and sociodemographic factors. MATERIALS AND METHODS: The methodological design of Ensanut MC is fully comparable with Ensanut 2006 and 2012. Capillary hemoglobin (Hb) was obtained and those values <120 g/L were classified as anemic. Pregnant women were excluded from the analysis. RESULTS: Anemia prevalence is higher in Ensanut MC 2016 when compared with Ensanut 2012 (p<0.001), differences can be found by age-groups, locality (urban-rural) and country region (North, Center, Mexico City and South). Logistic model showed an increase in anemia prevalence in 2016. CONCLUSIONS: Anemia decreas from 2006 to 2012 was followed by an increas in 2016. It is necessary to identify potential risk factors that could be promoting anemia prevalence rising as well as estimate the iron-rich foods intake whit 24 hours recall.

OBJETIVO: Describir la prevalencia de anemia en mujeres de 20 a 49 años de edad, según la Encuesta Nacional de Salud y Nutrición de Medio Camino 2016 (Ensanut MC 2016), y comparar su tendencia con la registrada en las Encuestas Nacionales de Salud (Ensanut) 2006 y 2012, así como su asociación con la presencia de hierro en la dieta y factores sociodemográficos. MATERIAL Y MÉTODOS: La Ensanut MC 2016 tiene un diseño metodológico comparable con el de las Ensanut 2006 y 2012. Se obtuvo hemoglobina (Hb) capilar y se clasificó anemia con valores de Hb <120g/L. Se excluyó a las embarazadas. RESULTADOS: La prevalencia de anemia resultó mayor en la Ensanut MC 2016 que en la Ensanut 2012 (p<0.001) y difirió por grupos de edad, área (urbano-rural) y región (Norte, Centro, Ciudad de México y Sur). El modelo logístico mostró un incremento de la prevalencia de anemia en 2016. CONCLUSIONES: La reducción de anemia, de 2006 a 2012, fue seguida de un incremento en 2016. Es necesario identificar otros factores de riesgo que estén favoreciendo en el aumento de la prevalencia de anemia y evaluar la ingesta de alimentos ricos en hierro, mediante un cuestionario de recordatorio de 24 horas.

Dissonant health transition in the states of Mexico, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

BACKGROUND: Child and maternal health outcomes have notably improved in Mexico since 1990, whereas rising adult mortality rates defy traditional epidemiological transition models in which decreased death rates occur across all ages. These trends suggest Mexico is experiencing a more complex, dissonant health transition than historically observed. Enduring inequalities between states further emphasise the need for more detailed health assessments over time. The Global Burden of Diseases, Injuries, and Risk Factors Study 2013 (GBD 2013) provides the comprehensive, comparable framework through which such national and subnational analyses can occur. This study offers a state-level quantification of disease burden and risk factor attribution in Mexico for the first time. METHODS: We extracted data from GBD 2013 to assess mortality, causes of death, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) in Mexico and its 32 states, along with eight comparator countries in the Americas. States were grouped by Marginalisation Index scores to compare subnational burden along a socioeconomic dimension. We split extracted data by state and applied GBD methods to generate estimates of burden, and attributable burden due to behavioural, metabolic, and environmental or occupational risks. We present results for 306 causes, 2337 sequelae, and 79 risk factors. FINDINGS: From 1990 to 2013, life expectancy from birth in Mexico increased by 3·4 years (95% uncertainty interval 3·1-3·8), from 72·1 years (71·8-72·3) to 75·5 years (75·3-75·7), and these gains were more pronounced in states with high marginalisation. Nationally, age-standardised death rates fell 13·3% (11·9-14·6%) since 1990, but state-level reductions for all-cause mortality varied and gaps between life expectancy and years lived in full health, as measured by HALE, widened in several states. Progress in women's life expectancy exceeded that of men, in whom negligible improvements were observed since 2000. For many states, this trend corresponded with rising YLL rates from interpersonal violence and chronic kidney disease. Nationally, age-standardised YLL rates for diarrhoeal diseases and protein-energy malnutrition markedly decreased, ranking Mexico well above comparator countries. However, amid Mexico's progress against communicable diseases, chronic kidney disease burden rapidly climbed, with age-standardised YLL and DALY rates increasing more than 130% by 2013. For women, DALY rates from breast cancer also increased since 1990, rising 12·1% (4·6-23·1%). In 2013, the leading five causes of DALYs were diabetes, ischaemic heart disease, chronic kidney disease, low back and neck pain, and depressive disorders; the latter three were not among the leading five causes in 1990, further underscoring Mexico's rapid epidemiological transition. Leading risk factors for disease burden in 1990, such as undernutrition, were replaced by high fasting plasma glucose and high body-mass index by 2013. Attributable burden due to dietary risks also increased, accounting for more than 10% of DALYs in 2013. INTERPRETATION: Mexico achieved sizeable reductions in burden due to several causes, such as diarrhoeal diseases, and risks factors, such as undernutrition and poor sanitation, which were mainly associated with maternal and child health interventions. Yet rising adult mortality rates from chronic kidney disease, diabetes, cirrhosis, and, since 2000, interpersonal violence drove deteriorating health outcomes, particularly in men. Although state inequalities from communicable diseases narrowed over time, non-communicable diseases and injury burdens varied markedly at local levels. The dissonance with which Mexico and its 32 states are experiencing epidemiological transitions might strain health-system responsiveness and performance, which stresses the importance of timely, evidence-informed health policies and programmes linked to the health needs of each state. FUNDING: Bill & Melinda Gates Foundation, Instituto Nacional de Salud Pública.

The Associations of Maternal Weight Change with Breastfeeding, Diet and Physical Activity During the Postpartum Period.

OBJECTIVE: To determine the association between breastfeeding practices, diet and physical activity and maternal postpartum weight. METHODS: This was a secondary data analysis of a randomized community trial on beneficiaries of the Programa de Desarrollo Humano Oportunidades, recently renamed Prospera (n = 314 pregnant women), without any diseases that could affect body weight. Generalized estimating equations were used to determine the association between postpartum weight change and changes in diet, physical activity and type of breastfeeding. RESULTS: The mean postpartum weight change from the first to the third month was 0.6 ± 2.2 kg. Women who breastfed exclusively for 3 months had a 4.1 (SE = 1.9) kg weight reduction in comparison with women who did not provide exclusive breastfeeding or who discontinued breastfeeding before 3 months (p = 0.04). There was no association between postpartum weight change and physical activity (p = 0.24) or energy intake (p = 0.06). CONCLUSIONS: Exclusive breastfeeding was associated with maternal postpartum weight reduction. These results reinforce the World Health Organization recommendation of exclusive breastfeeding during the first 6 months of life in order to reduce the risk of weight retention or weight gain in postpartum women. It has been well established that exclusive breastfeeding is beneficial for both infants and mothers, but promoting breastfeeding as a strategy to promote postpartum weight loss is of paramount importance, especially in countries like Mexico where excessive weight in women of reproductive age is a public health problem.

Prevalence of iron, folate, and vitamin B12 deficiencies in 20 to 49 years old women: Ensanut 2012.

OBJECTIVE: To describe the prevalence of iron, folate, and B12 deficiencies in Mexican women of reproductive age from the National Health and Nutrition Survey (Ensanut) 2012. MATERIALS AND METHODS: Data came from a national probabilistic survey, representative from rural and urban areas, and different age groups. Blood samples were obtained from 4 263, 20 to 49 years old women for serum ferritin, vitamin B12 and serum folate concentrations. The prevalence of deficiencies, was assessed using adjusted logistic regression models. RESULTS: The deficiency of folate was 1.9% (95%CI 1.3-2.8), B12 deficiency was 8.5% (95%CI 6.7-10.1) and iron deficiency was 29.4% (95%CI 26.5-32.2). No differences were found when compared with 2006, 24.8% (95%CI 22.3-27.2). CONCLUSIONS: The vitamin B12 deficiency is still a problem for women of reproductive age and their offspring in Mexico, while folate deficiency disappeared as a problem. Iron deficiency needs prevention and fortification strategies.

Validation of a food frequency questionnaire for retrospective estimation of diet during the first 2 years of life.

This study aims to validate a Food Frequency Questionnaire (FFQ), specifically designed to retrospectively estimate dietary intake and supplement consumption during the first 2 years of life in children from resource poor households in semi-rural Mexico. The FFQ querying about diet during the first 2 years of life was administered to mothers of children (N = 84), who participated in a prospective study 3-5 years earlier, in which complementary feeding practice questionnaires and 24-h recall (24hrR) were collected at several time points during the first 2 years of life to evaluate dietary and vitamin supplement intake. The resulting FFQ data were compared to intake data collected during the original study using Spearman correlations, deattenuated correlations and Wilcoxon signed-rank tests. Total energy intake, as estimated by the retrospective and original instruments, did not differ in the second year (Yr2); correlations between the measures were significant (r = 0.40, p < 0.001). The 24hrR and FFQ-Yr2 were significantly correlated for dietary intake of vitamins B6, B12 (p < 0.001) and folate (p < 0.01); however, after including vitamin supplement intake, the two dietary instruments were correlated only for vitamins A and B12 (p < 0.05). The FFQ provides a reasonable estimate of a child's dietary intake of energy and key micronutrients during the second year of life, and permits accurate ranking of intake 3-5 years after birth.

Consumption of fruits and vegetables and health status of Mexican children from the National Health and Nutrition Survey 2012.

OBJECTIVE: To characterize the current consumption of fruits and vegetables based on the international recommendations, as well as its relationship to certain variables of interest in Mexican children aged 6 to 12 years. MATERIALS AND METHODS: Adherence to the international recommendations for the consumption of fruits and vegetables was estimated based on data from the 2012 National Health and Nutrition Survey (Ensanut 2012). Logistic regression models were developed. RESULTS: Only 34.4% of children met the recommendations. Their age (years) (OR:074; p< 0.01) and the fact that they lived in the Central (OR:2.48; p< 0.01) or Southern (OR:2.66; p< 0.01) regions of Mexico or in Mexico City (OR:2.37; p< 0.01) versus the Northern region were significantly associated with adherence. An interaction was observed between the educational level of the head of the family and his or her kinship with the child. CONCLUSIONS: Only 3 out of every 10 Mexican children meet the recommendations; therefore, the implementation of a public policy with the appropriate legislation, financing and regulation is required.

Iron, zinc, copper and magnesium deficiencies in Mexican adults from the National Health and Nutrition Survey 2006.

OBJECTIVE: To describe the prevalence of serum iron and zinc deficiencies and low serum concentrations (LSC) of copper and magnesium in Mexican adults. MATERIALS AND METHODS: Blood samples from subjects (≥20 years, both genders) participating in the 2006 National Health and Nutrition Survey were used to measure the serum concentrations of s-ferritin, soluble- transferrin-receptor (s-TfR), zinc, copper, and magnesium. RESULTS: The prevalence of s-ferritin≤12 ug/L was 18.1 and 3.6% while s-TfR>6 mg/L was 9.5 and 4.4%, for females and males, respectively. The prevalence of zinc deficiency was 33.8% females and 42.6% males; LSC of copper were 16.8 and 18.2%, and 36.3 and 31.0% for magnesium, for females and males, respectively. CONCLUSIONS: The prevalence of deficiencies in iron (in females), and zinc are still high in the adult population. LSC of copper and magnesium are published for the first time and show significant prevalence of deficiencies. Corrective actions are necessary in order to diminish these nutritional deficits in the Mexican population.

[Prevalence of anemia in reproductive-age Mexican women]. / Prevalencia de anemia en mujeres mexicanas en edad reproductiva, 1999-2012.

OBJECTIVE: To update the prevalence of anemia and its trend in Mexican women of childbearing age over the past 13 years using information from the National Health and Nutrition Survey 2012 and 2006 (ENSANUT 2012 and ENSANUT 2006, respectively) and from the National Nutrition Survey 1999 (ENN 99). MATERIALS AND METHODS: Data came from three national probabilistic surveys, representative at regional and rural / urban level. Hemoglobin (Hb) in women was measured using a HemoCue photometer and classified as anemia according to the WHO criteria. Frequencies and CI95% were estimated for each survey (ENSANUT 2012, ENSANUT 2006 and ENN 99) as well as percentage changes in anemia prevalence among pregnant and non-pregnant women in this survey sequence. RESULTS: The national prevalence of anemia in 2012 in non-pregnant women was 11.6% and in pregnant women was 17.9%. Between 1999 and 2012, a 10 percentage point (pp) decreasing in anemia prevalence was observed in the first ones and a 13.5 pp in the second ones. CONCLUSIONS: Although it has declined in the past 13 years, anemia in women of childbearing age remains as a serious public health problem. It is considered necessary to design strategies to prevent iron deficiency and for the early detection of anemia in women.

Anaemia in adolescent women: A priority for the nutrition agenda in Mexico. A comparison of data from the ENSANUT 2012 and 2018-2019 surveys.

The risk of anaemia in adolescence increases due to accelerated growth. This study aims to: (1) estimate the prevalence of anaemia in 2012 and 2018-2019 (Encuesta Nacional de Salud y Nutricion - ENSANUT [n = 5841 in 2012 and n = 2380 in 2018-2019]) in non-pregnant, Mexican adolescent women aged 12-19 years, and the changes in prevalence over this period according to sociodemographic, health and nutrition characteristics; (2) estimate the associations between anaemia and sociodemographic, health and nutrition characteristics in each year and overall, in non-pregnant Mexican adolescent women. Anaemia was defined as capillary haemoglobin <12 g/dL. The distribution of characteristics and their changes between 2012 and 2018-2019 were described. The covariate-adjusted prevalence of anaemia in 2012 and 2018-2019 and the changes over that period were estimated from a multiple log-binomial regression model and the factors associated with anaemia were assessed in each survey year and in both years combined. The prevalence of anaemia was 7.7% in 2012 and 13.1% in 2018-2019 (69% increase, Prevalence Ratio: PR = 1.69; 95%CI: 1.35, 2.13). The covariate-adjusted prevalence of anaemia increased from 6.9% to 10.5% in the overall population (PR = 1.53, 95%CI: 1.19, 1.96), and increased considerably in the age group 12-14 years (PR = 1.94, 95%CI: 1.36, 2.75), and in the northern region (PR = 3.68, 95%CI: 2.55, 5.32). Those receiving iron supplements or school breakfasts did not register a significant increase. A higher household wellbeing status and older age were associated with a lower prevalence of anaemia. Anaemia in non-pregnant adolescent women continues to be a public health problem. To improve the development and health of adolescent women in Mexico and to pave the way to a healthy pregnancy for the next generation, the causes of anaemia should be identified.