Association of Dietary Patterns with Cardiovascular Disease Risk Factors in Mexican Adults: Insights from a Cross-Sectional Descriptive Study.

Dietary patterns (DPs) are an essential tool to analyze the relationship between diet and health as they have presented an association with the incidence of chronic non-communicable diseases. Therefore, the aim of this study was the identification and characterization of DPs and their association with cardiovascular risk factors. For this purpose, a cross-sectional descriptive study was carried out in 165 Mexican adults, including dietary intakes derived from a validated food frequency questionnaire, clinical history, anthropometry, and biochemical biomarkers using standardized procedures for glucose, total cholesterol, triglycerides, LDL-c, and HDL-c. DPs were identified through principal component analysis and ordinal logistic regression was used to examine associations between DPs and cardiovascular disease risk factors. Three DPs were identified: Mexican Fast-Food, Variety-Food, and Healthy-Economic, with a high prevalence of overweight and obesity (78%). Having a high adherence to a Mexican Fast-Food pattern (OR 1.71 CI 1.4-2.8), being sedentary (OR 4.85 2.32-10.15) and smoking (0R 6.4 CI 2.40-16.9) increased the risk of having a high scale of risk factors (four or more risk factors simultaneously). In conclusion, the Mexican Fast-Food pattern showed an increase in the risk of having multiple risk factors, while a sedentary lifestyle and overeating were largely responsible for the prevalence of overweight and obesity in this group of Mexican adults.

Metabolomic-Based Studies of the Intake of Virgin Olive Oil: A Comprehensive Review.

Virgin olive oil (VOO) is a high-value product from the Mediterranean diet. Some health and nutritional benefits have been associated with its consumption, not only because of its monounsaturated-rich triacylglycerols but also due to its minor bioactive components. The search for specific metabolites related to VOO consumption may provide valuable information to identify the specific bioactive components and to understand possible molecular and metabolic mechanisms implicated in those health effects. In this regard, metabolomics, considered a key analytical tool in nutritional studies, offers a better understanding of the regulatory functions of food components on human nutrition, well-being, and health. For that reason, the aim of the present review is to summarize the available scientific evidence related to the metabolic effects of VOO or its minor bioactive compounds in human, animal, and in vitro studies using metabolomics approaches.

Medición del ángulo vestíbulo-lingual en conductos mesiales de primeros molares inferiores utilizando tomografía de haz cónico / Measuring the vestibular-lingual angle in lower molar first mesial ducts using cone beam tomography

El objetivo del presente estudio fue medir la curvatura vestíbulo-lingual de los conductos de las raíces mesiales de primeros molares inferiores en personas adultas del estado de Chihuahua, por medio de la técnica de tomografía computarizada de haz cónico (CBCT, por sus siglas en inglés) y usando el software de análisis 3D EndoTM (Dentsply/Sirona USA). Se llevó a cabo la medición por dos observadoras, empleando dos métodos diferentes, Schneider y 3D EndoTM (Dentsply/Sirona USA). Los resultados obtenidos tuvieron valores mayores a los 100 grados con la técnica 3D EndoTM y a los 20 grados con la técnica de Schneider. No se detectó una diferencia estadística significativa al comparar los diferentes conductos entre sí (AU)

The objective of the present study was to measure the vestibule-lingual curvature of the ducts of the mesial roots of lower first molars, of adults from the state of Chihuahua. Using the cone beam computed tomography (CBCT) technique and using the 3D analysis software EndoTM (Dentsply/Sirona USA). The measurement was carried out by two observers using two different methods, Schneider and 3D EndoTM (Dentsply/Sirona USA). The results obtained had values greater than 100 degrees with the 3D EndoTM technique and at 20 degrees with the Schneider technique. No statistically significant difference was detected when comparing the different ducts with each other (AU)

A hyaluronan synthesis inhibitor delays the progression of diabetic kidney disease in a mouse experimental model.

BACKGROUND: The role of hyaluronan (HA) in the development and progression of diabetic kidney disease (DKD), as well as the precise mechanisms and consequences of HA involvement in this pathology are still to be clarified. METHODS: In this study, we assayed the effects of the HA synthesis inhibitor 4-methylumbelliferone (4-MU) on the development of DKD. Diabetic type 2 model mice (eNOS-/- C57BLKS/Jdb) were fed artificial diets containing 5% 4-MU or not for 9 weeks. Plasma glucose, glomerular filtration rate (GFR), albumin to creatinine ratio (ACR), and biomarkers of kidney function and systemic inflammation were measured at baseline and after treatment. Diabetic nephropathy was further characterized in treated and control mice by histopathology. RESULTS: Treated animals consumed a daily dose of approximately 6.2 g of 4-MU per kg of body weight. At the end of the experimental period, the 4-MU supplemented diet resulted in a significant decrease in non-fasting plasma glucose (516 [interquartile range 378-1170] vs. 1149 [875.8-1287] mg/dL, P=0.050) and a trend toward lower HA kidney content (5.6 ± 1.5 vs. 8.8 ± 3.1 ng/mg of kidney weight, P=0.070) compared to the control diet, respectively. Diabetic animals treated with 4-MU showed significantly higher GFR and lower urine ACR and plasma cystatin C levels than diabetic controls. Independent histological assessment of DKD also demonstrated a significant decrease in mesangial expansion score and glomerular injury index in 4-MU-treated mice compared to controls. Plasma glucose showed a strong correlation with kidney HA levels (r=0.66, P=0.0098). Both total hyaluronan (r=0.76, P=0.0071) and low-molecular-weight hyaluronan content (r=0.64, P=0.036) in the kidneys correlated with urine ACR in mice. CONCLUSION: These results show that the hyaluronan synthesis inhibitor 4-MU effectively slowed the progression of DKD and constitutes a potential new therapeutic approach to treat DKD.

Consumo de agua, bebidas azucaradas y uso de bebederos en secundarias del Programa Nacional de Bebederos Escolares de la Ciudad de México / Plain water and sugar sweetened beverages intake and use of school drinking fountains in secondary schools of the National School Drinking Fountains Program in Mexico City

Resumen: Objetivo: Describir prácticas de consumo de bebidas y uso de bebederos escolares en estudiantes de secundarias del Programa Nacional de Bebederos Escolares (PNBE). Material y métodos: Estudio transversal descriptivo, con enfoque mixto en secundarias públicas (turnos matutino y vespertino). Se indagó el consumo de agua y bebidas azucaradas, utilización de bebederos escolares y barreras-facilitadores para el consumo de agua. Resultados. Se entrevistaron 617 estudiantes (11 a 16 años); 51.5% fueron hombres. El consumo promedio de agua (568.9 ml; IC95%: 470.7-667.1) y bebidas azucaradas (143.4 ml; IC95%:124.0-162.7) fue similar entre hombres y mujeres. En el turno matutino las mujeres presentaron una menor probabilidad de hacer uso de los bebederos en comparación con los hombres (p=0.032). Hombres y mujeres desconfían del agua de los bebederos. Conclusiones: Se requieren acciones integrales para favorecer el consumo de agua y el uso de los bebederos en las secundarias del PNBE.

Abstract: Objective: To describe beverages consumption practices, and school drinking fountains utilization among secondary school's students from National School Drinking Fountains Program (PNBE, Spanish acronym). Materials and methods: Descriptive cross-sectional study with mixed methods in public secondary schools (morning and afternoon shifts). We estimated plain water and sugar sweetened beverages consumption, school drinking fountains utilization, and barriers-facilitators for plain water consumption. Results: We interviewed 617 students (11 to 16 y); 51.5% were men. The mean of plain water intake (568.9 ml; CI95%: 470.7-667.1), and sugar sweetened beverages (143.4 ml; CI95%:124.0-162.7) was similar among women and men. In the morning shift women had a lower probability of utilizing the school drinking fountains in comparison with men (p=0.032). Men and women have mistrust water that comes from school drinking fountains. Conclusions: Integral actions are necessary to favor plain water consumption, and utilization of school drinking fountains at PNBE secondary schools.

Self-perception of dietary quality and adherence to food groups dietary recommendations among Mexican adults.

BACKGROUND: Mexicans' adherence to food group's dietary recommendations is low and an inaccurate self-perception of dietary quality might perpetuate this low adherence. Our aim was to compare the intake and the adherence to the dietary recommendations for several food groups, subgroups, and to an overall Mexican Diet Quality Index (MxDQI), among those that perceived their diet as healthy vs. those that did not. METHODS: We analyzed data from 989 subjects 20-59 y old from the nationally representative Mexican National Health and Nutrition Survey 2016. Dietary intake was collected with one 24-h recall and a repeated recall in 82 subjects. Self-perception of dietary quality was evaluated with the following question "Do you consider that your diet is healthy? (yes/no)". We used the National Cancer Institute method to estimate the usual intake. We compared the mean intake adjusted by sociodemographic variables and the percentage of adherence according to the self-perception of dietary quality among the whole sample and in sociodemographic subpopulations. RESULTS: Sixty percent perceived their diet as healthy, and their adherence to recommendations was low [20% for fruits and vegetables, < 8% for legumes, seafood and SSBs, and ~ 50% for processed meats and high in saturated fat and/or added sugar (HSFAS) products]. The mean number of recommendations they met was 2.8 (out of 7) vs. 2.6 among the rest of the population (p > 0.05), and the MxDQI score was 40 vs. 37 (out of 100 points). The only food groups and subgroups with a statistically significant difference between those that perceived their diet as healthy vs. unhealthy were fruits [38 g/d (95% CI 3, 73)], fruit juices [27 g/d (95% CI 2, 52)], industrialized SSBs [- 35 kcal/d (- 70, - 1)] and salty snacks [- 40 kcal/d (- 79, - 1)]. Other differences were small or inconsistent across subgroups of the population. CONCLUSIONS: Those that perceived their diet as healthy only had a slightly healthier diet than the rest of the population, moreover, their adherence to recommendations was very low. Hence, it is necessary to improve their nutrition knowledge.

Impact of ABVD chemotherapy on ovarian reserve after fertility preservation in reproductive-aged women with Hodgkin lymphoma.

RESEARCH QUESTION: How is ovarian reserve affected by chemotherapy in patients with Hodgkin lymphoma (HL) who undergo fertility preservation (FP)? METHODS: A retrospective study was conducted by reviewing medical records of 105 HL patients referred to the FP unit before starting adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) chemotherapy. Ovarian reserve was evaluated before chemotherapy and at the last follow-up using anti-Müllerian hormone (AMH) and antral follicle count (AFC) measurements. The decrease in AMH was compared with that expected from normograms. AMH was compared between patients who underwent cryopreservation of ovarian tissue and those who underwent cryopreservation of mature oocytes. RESULTS: After ABVD, 15% of patients required hematopoietic stem cell transplantation. At a median follow-up of 33 months, the median decrease in AMH was 0.88 ng/mL, which was significantly greater than that of the general population of this age group (p < 0.001). Of the 82 women who only had ABVD, 38 underwent FP by cryopreservation of mature oocytes and 44 underwent cryopreservation of the ovarian cortex. There was no significant difference in AMH or AFC at the last follow-up between FP techniques. CONCLUSION: Although ABVD is considered to be of low gonadotoxic risk, the decrease in AMH was greater than expected for patients' age, and 15% of patients needed more aggressive therapy during follow-up. Type of FP was not associated with decline in ovarian reserve. Reproductive-aged women with HL should have the opportunity for FP counseling before starting treatment.

Design of an educational strategy based on Intervention Mapping for nutritional health promotion in Child Care Centers.

Early childhood is a critical period for instilling healthy habits to prevent overweight and obesity. This paper describes the development of an educational intervention for the promotion of healthy eating and physical activity among two-to-four-year-old children in public child care centers (CCCs) in Mexico City. Following the Intervention Mapping (IM) protocol, we developed the Bright Futures multidisciplinary intervention. First, a formative research process to identify the personal and environmental determinants of childhood overweight and obesity, behavioral outcomes and performance objectives was conducted. Then, a matrix of change objectives by intersecting the performance objectives with the determinants was integrated. Bright Futures lasted six months and included 24 weekly sessions, each composed of five phases: warm-up, theory, active movements, relaxation, and hydration. Ad hoc interactive teaching materials focused on recreational activities, and formulated plans for the adoption, implementation and process/impact evaluation of the intervention was developed. IM successfully guided the design of a theory-driven and evidence-based intervention for children in CCCs within a socio-ecological and participatory planning framework. This is one of the first studies in Mexico to use IM in the context of CCCs.

Inhibition of tumor cell proliferation in human uterine leiomyomas by vitamin D via Wnt/ß-catenin pathway.

OBJECTIVE: To assess the effect of vitamin D (VitD) on human uterine leiomyomas through Wnt/ß-catenin pathway inhibition, apoptosis induction, and cell growth arrest. DESIGN: A prospective study comparing leiomyoma vs. myometrium tissues. Paired design study comparing human uterine leiomyoma primary (HULP) cells treated with or without VitD. SETTING: University hospital. PATIENT(S): Human uterine leiomyoma and myometrium were collected from women (aged 35-52 years) without hormonal treatment. INTERVENTION(S): Samples were collected from women undergoing surgery due to symptomatic uterine leiomyoma pathology. MAIN OUTCOME MEASURE(S): Uterine leiomyoma and myometrium tissues were analyzed by western blot (WB) to determine proliferation, Wnt/ß-catenin, and apoptosis pathways. HULP cells were used to study VitD effect in cell proliferation (WB), cell cycle (flow cytometry), Wnt/ß-catenin and apoptosis genes (polymerase chain reaction arrays), Wnt-related proteins (protein array), and apoptosis (terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling [TUNEL] assay). RESULTS: Human leiomyoma tissues compared with matched myometrium showed higher proliferation (fold change = 8.16; P=.0006) and altered Wnt/ß-catenin pathway (fold change = 5.5; P<.0001), whereas no differences in apoptosis were observed. VitD induced cell growth arrest and decreased proliferation in HULP cells (fold change = 0.74; P=.007). Moreover, VitD decreased Wnt-pathway expression in HULP cells at gene (activity score = -0.775; P<.001) and protein levels. However, VitD did not induce apoptosis expression. CONCLUSION: Increased proliferation and Wnt/ß-catenin pathway deregulation play a role in the development and growth of leiomyomas, whereas apoptosis appears not to contribute. VitD exerts an antiproliferative action on HULP cells through cell growth arrest and Wnt/ß-catenin pathway inhibition, but not through apoptosis regulation, suggesting VitD as an effective therapy to stabilize leiomyoma size and prevent its growth.

Percepción del peso corporal y de la probabilidad de desarrollar obesidad en adultos mexicanos / Perception of body weight and of the probability of developing obesity in Mexican adults

Resumen: Objetivo: Documentar la percepción del peso corporal, las variables que se asocian con una percepción correcta de éste y la percepción de la probabilidad de desarrollar obesidad a corto plazo en población adulta mexicana. Material y métodos: Se utilizaron datos de los cuestionarios de percepción de obesidad, comportamiento alimentario y actividad física (POCAA), y de hogar y antropometría obtenidos en la Ensanut MC, durante mayo y octubre de 2016. Resultados: Más de 90% de la población tiende a subestimar su peso. El 32% de la población refirió que sería muy probable que desarrollara obesidad; más de 90% consideró que padecer obesidad es grave. El tener una percepción correcta del peso corporal y tener sobrepeso u obesidad por IMC se relacionaron con la percepción de desarrollar obesidad a corto plazo. Conclusión: Resulta cada vez más relevante que los individuos, independientemente del estado de su peso, tengan una percepción precisa de su cuerpo y las consecuencias del sobrepeso en su salud.

Abstract: Objective: To document the perception of body weight, the variables that are associated with a correct perception of it and with the perception about the probability of developing obesity at short-term in Mexican adult population. Materials and methods: We used data from the Perception of obsesity, eating behavior and physical activity questionnaire (POCAA, by its Spanish acronym), as well as household and anthropometric measurements obtained at Ensanut MC during May and October of 2016. Results: More than 90% of the population tend to underestimate their weight; 32% of the population said that they would be very likely to develop obesity at short-term; more than 90% considered that suffering from obesity is very serious. Having a correct perception of body weight and being overweight or obese by BMI, were positively related to the perception of developing obesity at short-term. Conclusion: It is very relevant that individuals, regardless of the state of their weight, have an accurate perception of their body and the consequences to their health.

[Perception of body weight and of the probability of developing obesity in Mexican adults]. / Percepción del peso corporal y la probabilidad de desarrollar obesidad en adultos mexicanos.

OBJECTIVE: To document the perception of body weight, the variables that are associated with a correct perception of it and with the perception about the probability of developing obesity at short-term in Mexican adult population. MATERIALS AND METHODS: We used data from the Perception of obsesity, eating behavior and physical activity questionnaire (POCAA, by its Spanish acronym), as well as household and anthropometric measurements obtained at Ensanut MC during May and October of 2016. RESULTS: More than 90% of the population tend to underestimate their weight; 32% of the population said that they would be very likely to develop obesity at short-term; more than 90% considered that suffering from obesity is very serious. Having a correct perception of body weight and being overweight or obese by BMI, were positively related to the perception of developing obesity at short-term. CONCLUSIONS: It is very relevant that individuals, regardless of the state of their weight, have an accurate perception of their body and the consequences to their health.

OBJETIVO: Documentar la percepción del peso corporal, las variables que se asocian con una percepción correcta de éste y la percepción de la probabilidad de desarrollar obesidad a corto plazo en población adulta mexicana. MATERIAL Y MÉTODOS: Se utilizaron datos de los cuestionarios de percepción de obesidad, comportamiento alimentario y actividad física (POCAA), y de hogar y antropometría obtenidos en la Ensanut MC, durante mayo y octubre de 2016. RESULTADOS: Más de 90% de la población tiende a subestimar su peso. El 32% de la población refirió que sería muy probable que desarrollara obesidad; más de 90% consideró que padecer obesidad es grave. El tener una percepción correcta del peso corporal y tener sobrepeso u obesidad por IMC se relacionaron con la percepción de desarrollar obesidad a corto plazo. CONCLUSIONES: Resulta cada vez más relevante que los individuos, independientemente del estado de su peso, tengan una percepción precisa de su cuerpo y las consecuencias del sobrepeso en su salud.

S-nitrosylation of VASP at cysteine 64 mediates the inflammation-stimulated increase in microvascular permeability.

We tested the hypothesis that platelet-activating factor (PAF) induces S-nitrosylation of vasodilator-stimulated phosphoprotein (VASP) as a mechanism to reduce microvascular endothelial barrier integrity and stimulate hyperpermeability. PAF elevated S-nitrosylation of VASP above baseline levels in different endothelial cells and caused hyperpermeability. To ascertain the importance of endothelial nitric oxide synthase (eNOS) subcellular location in this process, we used ECV-304 cells transfected with cytosolic eNOS (GFPeNOSG2A) and plasma membrane eNOS (GFPeNOSCAAX). PAF induced S-nitrosylation of VASP in cells with cytosolic eNOS but not in cells wherein eNOS is anchored to the cell membrane. Reconstitution of VASP knockout myocardial endothelial cells with cysteine mutants of VASP demonstrated that S-nitrosylation of cysteine 64 is associated with PAF-induced hyperpermeability. We propose that regulation of VASP contributes to endothelial cell barrier integrity and to the onset of hyperpermeability. S-nitrosylation of VASP inhibits its function in barrier integrity and leads to endothelial monolayer hyperpermeability in response to PAF, a representative proinflammatory agonist.NEW & NOTEWORTHY Here, we demonstrate that S-nitrosylation of vasodilator-stimulated phosphoprotein (VASP) on C64 is a mechanism for the onset of platelet-activating factor-induced hyperpermeability. Our results reveal a dual role of VASP in endothelial permeability. In addition to its well-documented function in barrier integrity, we show that S-nitrosylation of VASP contributes to the onset of endothelial permeability.

Validity of a food frequency questionnaire to assess food intake in Mexican adolescent and adult population / Validación de un cuestionario de frecuencia de alimentos para evaluar la ingesta alimentaria en adolescentes y adultos de México

Abstract: Objective: To assess the validity of a 140-item semiquantitative food frequency questionnaire (SFFQ), in Mexican adolescents and adults. Materials and methods: Dietary intakes using a SFFQ and two 24-hour dietary recalls (24DRs), in nonconsecutive days during the same week were measured from 178 adolescents and 230 adults participating in the Mexican National Health and Nutrition Survey-2012.Validity was evaluated using correlation coefficients (CC),deattenuated CC, linear regression models, cross-classification analysis, and the Bland-Altman method. Results: In adults, deattenuated correlation coefficients between the SFFQ and the 24DRs ranged from 0.30 for folate to 0.61 for saturated fat. In addition, 63% adults and 62% adolescents were classified in the same and adjacent quartile of nutrient intake when comparing data from SFFQ and 24DRs. Conclusions: The SFFQ had moderate validity for energy, macronutrients and micronutrients. It also had good validity to rank individuals according to their dietary intake of different nutrients.

Resumen: Objetivo: Evaluar la validez de un cuestionario de frecuencia de consumo de alimentos semicuantitativo (CFA), en adolescentes y adultos mexicanos. Material y métodos: Se evaluó la ingesta de alimentos de 178 adolescentes y 230 adultos que participaron en la Encuesta Nacional de Salud y Nutrición-2012, de México, mediante un CFA y el promedio de dos recordatorios de 24-horas (24DRs). La validez se evaluó utilizando coeficientes de correlación, coeficientes de correlación corregidos (CCC) y análisis de clasificación. Resultados: En adultos, los CCC entre el CFA y el promedio de los 24DRs estuvieron entre 0.30 para folatos y 0.61 para grasas saturadas. Adicionalmente, 63% de los adultos y 62% de los adolescentes fueron clasificados en el mismo o adyacente cuartil cuando fueron comparados los datos del CFA y el 24DR. Conclusión: El CFA mostró una validez moderada para energía, macronutrimentos y micronutrimentos. Además, mostró buena validez para clasificar a los individuos de acuerdo con su ingesta dietética.

Methodology for estimating dietary data from the semi-quantitative food frequency questionnaire of the Mexican National Health and Nutrition Survey 2012 / Metodología para la estimación de información dietética del cuestionario semicuantitativo de frecuencia de consumo de alimentos de la Encuesta Nacional de Salud y Nutrición 2012

Abstract: Objective: To describe the methodology used to clean up and estimate dietary intake (DI) data from the Semi-Quantitative Food Frequency Questionnaire (SFFQ) of the Mexican National Health and Nutrition Survey 2012. Materials and methods: DI was collected through a shortterm SFFQ regarding 140 foods (from October 2011 to May 2012). Energy and nutrient intake was calculated according to a nutrient database constructed specifically for the SFFQ. Results: A total of 133 nutrients including energy and fiber were generated from SFFQ data. Between 4.8 and 9.6% of the survey sample was excluded as a result of the cleaning process.Valid DI data were obtained regarding energy and nutrients consumed by 1 212 pre-school children, 1 323 school children, 1 961 adolescents, 2 027 adults and 526 older adults. Conclusions: We documented the methodology used to clean up and estimate DI from the SFFQ used in national dietary assessments in Mexico.

Resumen: Objetivo: Describir la metodología para la estimación y limpieza de datos sobre ingestión dietética (ID) derivados del cuestionario semicuantitativo de frecuencias de consumo de alimentos (CFCAS) de la Encuesta Nacional de Salud y Nutrición 2012. Material y métodos: La información de ID fue recolectada a través de un CFCAS de siete días que obtuvo información sobre la ingesta de 140 alimentos (de octubre de 2011 a mayo de 2012). La ingesta de energía y nutrientes fue calculada utilizando una base de datos de nutrientes construida para el procesamiento del CFCAS. Resultados: Se obtuvieron 133 nutrimentos (incluidos energía y fibra). Entre 4.8 y 9.6% de la muestra fue excluido, con lo que se obtuvo información válida sobre la ingesta de energía y nutrimentos para 1 212 preescolares, 1 323 escolares, 1 961 adolescentes, 2 027 adultos y 526 adultos mayores. Conclusiones: Se documentó la metodología para la estimación de la ID y los criterios de limpieza para CFCAS usados para la evaluación dietética nacional.

Efecto de una intervención basada en guarderías para reducir conductas de riesgo de obesidad en niños preescolares / Effect of an intervention based on child-care centers to reduce risk behaviors for obesity in preschool children

Resumen: Introducción: La edad preescolar es una etapa crítica para la promoción de la salud y la prevención de la obesidad, que es un problema emergente de salud pública en la niñez. El objetivo de este trabajo fue diseñar y evaluar el efecto de una intervención multifacética basada en la atención en guarderías para reducir conductas de riesgo de obesidad en niños preescolares. Métodos: Se realizó un ensayo comunitario, aleatorizado por conglomerados, en 16 guarderías del Instituto Mexicano del Seguro Social de la Ciudad de México. El estudio duró 12 meses. Participaron niños entre 2 y 4 años de edad que asistían a las guarderías. La intervención consistió en 12 sesiones educativas semanales interactivas para los niños y seis talleres familiares. Se determinaron cambios de alimentación y actividad física, disponibilidad en el hogar por tipo de alimentos y estilos maternos de alimentación a 6 y 12 meses. Se comparó el cambio por etapa en cada grupo y entre ambos grupos en cada etapa con la prueba χ2. Resultados: Se observó la reducción de disponibilidad en el hogar de algunos alimentos no recomendados y una mayor actividad física en el grupo de intervención. Conclusiones: La mejora en actividad física puede tener efecto en el largo plazo; se requieren estrategias innovadoras que modifiquen las conductas alimentarias de riesgo para obesidad en las familias.

Abstract: Background: Preschool age is a critical stage for health promotion and prevention of obesity, which is an emerging public health problem in children. The aim of this study was to design and evaluate the effect of a multifaceted intervention based on child-care centers to reduce risk behaviors for obesity among preschool children. Methods: A 12-month cluster-randomized community trial was conducted in 16 Mexican Institute of Social Security child-care centers in Mexico City. Children between 2 and 4 years of age enrolled in the selected child-care centers participated in the study. Intervention comprised 12 weekly curriculum sessions for the children, and six family workshops. Changes in children's dietary and physical activity, food availability at home, and maternal feeding styles were determined after 6 and 12 months. Changes within groups among stages, and between groups by stage were analyzed through χ2 test. Results: The intervention showed decrease of home availability for some non-recommended foods and increase in physical activity in the intervention group compared to the usual care group. Conclusions: Improvement in physical activity can be effective in the long term; innovative strategies aimed to modify family dietary risk behaviors are required.

[Effect of an intervention based on child-care centers to reduce risk behaviors for obesity in preschool children]. / Efecto de una intervención basada en guarderías para reducir conductas de riesgo de obesidad en niños preescolares.

BACKGROUND: Preschool age is a critical stage for health promotion and prevention of obesity, which is an emerging public health problem in children. The aim of this study was to design and evaluate the effect of a multifaceted intervention based on child-care centers to reduce risk behaviors for obesity among preschool children. METHODS: A 12-month cluster-randomized community trial was conducted in 16 Mexican Institute of Social Security child-care centers in Mexico City. Children between 2 and 4 years of age enrolled in the selected child-care centers participated in the study. Intervention comprised 12 weekly curriculum sessions for the children, and six family workshops. Changes in children's dietary and physical activity, food availability at home, and maternal feeding styles were determined after 6 and 12 months. Changes within groups among stages, and between groups by stage were analyzed through χ2 test. RESULTS: The intervention showed decrease of home availability for some non-recommended foods and increase in physical activity in the intervention group compared to the usual care group. CONCLUSIONS: Improvement in physical activity can be effective in the long term; innovative strategies aimed to modify family dietary risk behaviors are required.

Development of an educational intervention to promote healthy eating and physical activity in Mexican school-age children.

Mexico has the highest and most alarming rates of childhood obesity worldwide. A study conducted in the State of Mexico revealed that one of every three children presents overweight or obesity. The objective of this paper is to provide a step-by-step description of the design and implementation of an educational intervention to promote healthy eating and physical activity called "Healthy Recess". The educational intervention was designed using the six stages of the Health Communication Process. This methodological model allowed identifying the needs of school-age children on information and participation in activities. In order to improve the strategy, adjustments were made to the print and audiovisual materials as well as to assessment tools. Typography was modified as well as the color of the images in student's workbook and facilitator's; special effects of the videos were increased; the narration of the radio spots was improved and common words and phrases were included. The Health Communication Process is an effective tool for program planners to design interventions aimed at managing prevalent health problems such as overweight and obesity in school-age children.

Diversidad de la dieta y consumo de nutrimentos en niños de 24 a 59 meses de edad y su asociación con inseguridad alimentaria / Dietary diversity and nutrient intake in children 24 to 59 months old and their association with food insecurity

Objetivo. Evaluar la diversidad dietética (DD) y adecuaciones en el consumo de energía y nutrimentos de niños mexicanos de dos a cuatro años de edad de acuerdo con el nivel de inseguridad alimentaria (IA) en su hogar. Material y métodos. Se incluyó información obtenida en la Ensanut 2012 de 955 niños y sus hogares. Los datos dietéticos se obtuvieron con un cuestionario de frecuencia de consumo de alimentos. Se construyó un índice de DD y se estimaron adecuaciones de energía y nutrimentos. Se calcularon prevalencias ajustadas de las categorías de DD, de acuerdo con la clasificación de IA en el hogar, usando la Escala Latinoamericana y Caribeña de Seguridad Alimentaria. Resultados. Los niños que viven en IA severa (IS) tuvieron la mayor proporción de baja DD (53.6%) en comparación con los que viven en SA. Los niños con IA moderada y severa no cubren con la ingestión recomendada de energía. Conclusión. La DD y el consumo de energía tienen relación con la IA en el hogar. Es importante mejorar el acceso a alimentos que aportan una mayor diversidad a la dieta y los cuales son difíciles de obtener debido a su costo.

Objective. To assess dietary diversity (DD) and adequacies of energy and nutrients intake of Mexican children two to four years old according to the level of food insecurity (FI) at household. Materials and methods. Information of 955 Mexican children aged 24-29 months and their households from Ensanut 2012 were included. Dietary data were obtained with a food frequency questionnaire. An index of DD and adequacies of energy and nutrients were estimated. Adjusted prevalences of DD were estimated according to the classification of FI at home using the Latin American and Caribbean Food Safety Scale. Results. Children living in severe FI had the highest proportion of low DD (53.6%) compared to those living in food security. Children with moderate and severe insecurity did not reach the recommended energy intake. Conclusion. The DD, energy and nutrients intake in Mexican children are associated to FI. It is important to improve access to foods that provide more diversity to the diet and which are difficult to obtain due to their cost.

Consumption of fruits and vegetables and health status of Mexican children from the National Health and Nutrition Survey 2012 / Consumo de frutas y verduras y estado de salud de niños mexicanos a partir de la Encuesta Nacional de Salud y Nutrición 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.

Objetivo. Caracterizar el consumo actual de frutas y verduras tomando como referencia las recomendaciones internacionales y su relación con algunas variables de interés en niños mexicanos de 6 a 12 años de edad. Material y métodos. Con datos de la Ensanut 2012 se estimó el apego hacia las recomendaciones internacionales del consumo de frutas y verduras. Se desarrollaron modelos de regresión logística. Resultados. El 34.4% de los niños cumplió con las recomendaciones. La edad (años) (RM:0.74; p< 0.01) y vivir en las regiones centro (RM:2.48; p< 0.01), Ciudad de México (RM:2.37; p< 0.01) y sur (RM:2.66; p< 0.01), con respecto a vivir en la región norte, se asociaron significativamente con el cumplimiento. Se observó una interacción entre el nivel educativo del jefe de familia y su parentesco con el niño. Conclusiones. Sólo 3 de 10 niños mexicanos cumplen con las recomendaciones, por lo que se requiere de la implementación de una política pública con legislación, financiamiento y regulación adecuados.