Dietary intake of the Mexican population: comparing food group contribution to recommendations, 2012-2016 / Ingesta dietética de la población mexicana: contribución de grupos de alimentos vs. recomendaciones, 2012-2016

Abstract: Objective: To estimate energy contribution (EC) of food groups in 2016, to compare consumption against Mexican Dietary Guidelines, and to examine changes in EC from 2012 to 2016. Materials and methods: We analyzed 24-hour dietary recalls from the 2012 and 2016 National Health and Nutrition Surveys (Ensanut). Foods and beverages were classified into eight food groups: cereals, legumes, dairy, meats, fruit and vegetables, fats and oils, sugar-sweetened beverages, and high in saturated fat and added sugar (HSFAS) products. Results: Cereals had the highest EC (30.1%), followed by meats (15.9%), HSFAS products (15.5%), and SSBs (10.5%). Fruits and vegetables, and legumes had the lowest contribution with 6.4 and 3.8%, respectively. SSBs, meats, and HSFAS products were 250, 59 and 55% above the recommended intake, respectively. Conclusions: This analysis confirms the need to generate a food environment conducive to a healthier diet.

Resumen: Objetivo: Estimar la contribución energética (CE) de grupos de alimentos al compararla con las Guías Alimentarias y examinar los cambios de 2012 a 2016. Material y métodos: Se analizaron recordatorios de 24 horas de las Encuestas Nacionales de Salud y Nutrición de 2012 y 2016. Los alimentos y bebidas se clasificaron en ocho grupos: cereales, leguminosas, lácteos, carnes, frutas y verduras, grasas, bebidas azucaradas, y productos altos en grasa saturada y/o azúcares añadidos. Resultados: Los cereales tuvieron la CE más alta (30.1%), seguidos por carnes (15.9%), productos altos en grasa saturada y azúcares añadidos (15.5%) y bebidas azucaradas (10.5%). Frutas y verduras y leguminosas tuvieron la menor CE con 6.4 y 3.8%, respectivamente. Las bebidas azucaradas, carnes y productos altos en grasa saturada y azúcares añadidos superaron en 250, 59 y 55% la recomendación, respectivamente. Conclusión: Este análisis confirma la necesidad de generar un ambiente alimentario que propicie una dieta más saludable.

Volviéndonos mejores: necesidad de acción inmediata ante el reto de la obesidad. Una postura de profesionales de la salud / Becoming better: the need for immediate action to address obesity. A position statement from health professionals

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Abstract: In recent decades, the growing obesity epidemic in Mexico has become one of the most important public health challenges faced by the country. With support from the World Obesity Federation, we formed a working group in 2021 to identify and summarize priority actions that Mexico can take to face this epidemic. More than 1 000 health professionals joined the development and discussion process. Recommendations from previously published, high-level documents and guidelines were taken into account. In commemoration of World Obesity Day 2022, this statement is presented as input for health care professionals to develop actions to address obesity. The statement includes 10 recommendations that include population-level and individual-level actions. It emphasizes the importance of social participation, comprehensive interventions with a person- centered perspective, planetary sustainability, on improving education and communication campaigns, as well as fostering a built environment that promotes active living, and shielding prevention and control efforts from conflicts of interest. The statement calls for obesity to be treated seriously, based on scientific evidence, in a timely and comprehensive manner, employing a life-course and ethical approach that does not perpetuate weight stigma in society.

Soluciones relacionadas con el entorno alimentario para prevenir la obesidad infantil en América Latina y en la población latina que vive en Estados Unidos.

El entorno alimentario es un factor importante que contribuye a las dietas poco saludables en la niñez y, por tanto, a las crecientes tasas de obesidad. Los países de Latinoamérica han recibido el reconocimiento internacional por su liderazgo en la implementación de políticas dirigidas a distintos aspectos del entorno alimentario. Sin embargo, los datos sobre la naturaleza y la gravedad de la exposición de los niños a entornos alimentarios poco saludables en la región latinoamericana y entre los latinos que viven en Estados Unidos son aún insuficientes. El objetivo de esta revisión es utilizar el marco conceptual de la Red Internacional para la Investigación, Monitoreo y Apoyo a la Acción para la Alimentación, Obesidad y Enfermedades No Transmisibles (INFORMAS, por sus siglas en inglés) para crear un entorno alimentario saludable con el que (i) comparar los elementos clave de los entornos alimentarios en relación con la obesidad en Latinoamérica y entre los latinos que viven en Estados Unidos; (ii) describir la evidencia sobre soluciones que podrían contribuir a mejorar los entornos alimentarios relacionados con la obesidad infantil; y (iii) establecer prioridades de investigación que permitan identificar estrategias de lucha contra la obesidad en estas poblaciones. Hemos detectado la necesidad de un amplio conjunto integrado de evidencias que sirva de respaldo para establecer un conjunto adecuado de políticas que mejoren el entorno alimentario al que están expuestos los niños de Latinoamérica y los niños latinos que viven en Estados Unidos y para traducir de forma más eficiente las soluciones políticas, de manera que contribuyan a reducir los crecientes niveles de obesidad infantil en estos países.

Exploration of Machine Learning and Statistical Techniques in Development of a Low-Cost Screening Method Featuring the Global Diet Quality Score for Detecting Prediabetes in Rural India.

BACKGROUND: The prevalence of type 2 diabetes has increased substantially in India over the past 3 decades. Undiagnosed diabetes presents a public health challenge, especially in rural areas, where access to laboratory testing for diagnosis may not be readily available. OBJECTIVES: The present work explores the use of several machine learning and statistical methods in the development of a predictive tool to screen for prediabetes using survey data from an FFQ to compute the Global Diet Quality Score (GDQS). METHODS: The outcome variable prediabetes status (yes/no) used throughout this study was determined based upon a fasting blood glucose measurement ≥100 mg/dL. The algorithms utilized included the generalized linear model (GLM), random forest, least absolute shrinkage and selection operator (LASSO), elastic net (EN), and generalized linear mixed model (GLMM) with family unit as a (cluster) random (intercept) effect to account for intrafamily correlation. Model performance was assessed on held-out test data, and comparisons made with respect to area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. RESULTS: The GLMM, GLM, LASSO, and random forest modeling techniques each performed quite well (AUCs >0.70) and included the GDQS food groups and age, among other predictors. The fully adjusted GLMM, which included a random intercept for family unit, achieved slightly superior results (AUC of 0.72) in classifying the prediabetes outcome in these cluster-correlated data. CONCLUSIONS: The models presented in the current work show promise in identifying individuals at risk of developing diabetes, although further studies are necessary to assess other potentially impactful predictors, as well as the consistency and generalizability of model performance. In addition, future studies to examine the utility of the GDQS in screening for other noncommunicable diseases are recommended.

Malnutrition in all its forms by wealth, education and ethnicity in Latin America: who are more affected?

OBJECTIVE: To summarise the findings from this supplemental issue on the distribution of malnutrition (stunting/short stature, anaemia and overweight) by wealth, education and ethnicity within and between ten Latin American countries. DESIGN: We retrieved information from each country's article and estimated the average difference in the prevalence of malnutrition between groups. We estimated the associations between countries' malnutrition prevalence and GDP, percentage of women with high education and percentage of non-indigenous ethnicity. SETTING: Nationally representative surveys from ten Latin American countries conducted between 2005 and 2017. PARTICIPANTS: Children (<5 years), adolescent women (11-19 years) and adult women (20-49 years). RESULTS: Socially disadvantaged groups (low wealth, low education and indigenous ethnicity) had on average 15-21 (range across indicators and age groups) percentage points (pp) higher prevalence of stunting/short stature and 3-11 pp higher prevalence of anaemia. For overweight or obesity, adult women with low education had a 17 pp higher prevalence; differences were small among children <5 years, and results varied by country for adolescents by education, and for adults and adolescents by wealth and ethnicity. A moderate and strong correlation (-0·58 and -0·71) was only found between stunting/short stature prevalence and countries' GDP per capita and percentage of non-indigenous households. CONCLUSIONS: Overweight was equally distributed among children; findings were mixed for ethnicity and wealth, whereas education was a protective factor among adult women. There is an urgent need to address the deep inequalities in undernutrition and prevent the emerging inequalities in excess weight from developing further.

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.

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

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

The Relationship Between Feasting Periods and Weight Gain: a Systematic Scoping Review.

PURPOSE OF REVIEW: Whilst evidence indicates that weight gain occurs over holidays, the contribution of specific festive periods and celebrations to eating behaviour and weight gain is unclear. We aimed to synthesise literature on how festive periods and celebrations contribute to population weight gain and weight-related outcomes. RECENT FINDINGS: Thirty-nine studies examining (i) body weight changes, (ii) determinants of eating behaviour or (iii) weight-gain prevention interventions during festive periods were systematically reviewed. Of the 23 observational studies examining changes in body weight during festive periods, 70% found significant increases (mean 0.7 kg). Only four studies investigated exposure to food cues and overeating during these periods, with heterogeneous results. All six intervention studies found that weight gain can be mitigated by self-weighing/self-monitoring and intermittent fasting. Interventions targeting festive periods could have a significant impact on population weight gain. The scalability and sustainability of such interventions require further investigation, as do the broader socioecological factors driving unhealthy eating during festive periods.

Determinantes del consumo de alimentos no básicos de alta densidad energética en población mexicana (Ensanut 2012) / Determinants of non-essential energy-dense food consumption in Mexican population (Ensanut 2012)

Resumen: Objetivo: Caracterizar el perfil sociodemográfico que se asocia con las probabilidades de consumo de alimentos no básicos de alta densidad energética (ANBADE), gravados desde 2014. Material y métodos: Se utilizó la Encuesta Nacional de Salud y Nutrición (Ensanut) 2012. Se identificó el grupo de ANBADE y se estimaron modelos probit sobre las probabilidades de consumo (PC) y de alto consumo después de ajustar por energía total (PAC), en función de características sociodemográficas. Resultados: Los escolares tienen 10.7 puntos porcentuales (pp) más PAC frente a los preescolares. Pertenecer a hogares con el mayor gasto o escolaridad del jefe se asocia con una PC 3.3 y 3.2 pp mayor en comparación con los hogares de menor gasto o escolaridad del jefe, respectivamente. Vivir en localidades metropolitanas se asocia con una PAC 5.2 pp mayor frente a localidades rurales. Conclusiones: El estudio identificó las condiciones sociodemográficas que se asocian con las mayores PC o PAC de ANBADE, que podrán considerarse en el diseño y evaluación de la política alimentaria.

Abstract: Objective: To characterize the sociodemographic profile associated with the probabilities of consumption of nonessential energy-dense foods (ANBADE), taxed since 2014. Materials and methods: We used the National Health and Nutrition Survey (Ensanut) 2012. ANBADE group was identified and probit models were estimated for the probabilities of consumption (PC) and of belonging to the high quintile of consumption after adjusting for total energy intake (PAC), as a function of sociodemographic characteristics. Results: School-aged children have a PAC 10.7 percentage points (pp) higher vs. preschool-aged. Belonging to households with the highest expenditures or education of the head of the household are associated with a PC 3.3 or 3.2 pp higher vs. households with lower expenditures or education of the head, respectively. Living in metropolitan areas is associated with a PAC 5.2 pp higher vs. rural areas. Conclusions: The study identified the sociodemographic conditions associated with the largest PC or PAC of ANBADE, which may be considered in the design and evaluation of food policy.

Posicionamiento sobre los impuestos a alimentos no básicos densamente energéticos y bebidas azucaradas / Position paper on taxes to non-basic energy-dense foods and sugar-sweetened beverages

Resumen: En 2014, el gobierno mexicano implementó una política fiscal para disminuir el consumo de bebidas azucaradas y alimentos no básicos con alta densidad energética. Este documento resume y analiza los estudios que han evaluado el impacto observado y esperado de los impuestos a alimentos y bebidas no saludables en México. La implementación de impuestos ha logrado disminuir las compras de bebidas azucaradas en 7.6% y alimentos no básicos con alta densidad energética en 7.4%. La reducción de consumo de bebidas azucaradas podría reducir la obesidad en 2.5%, prevenir 20 000 casos de enfermedad cardiovascular y 189 000 casos de diabetes al año 2022, así como prevenir 2 000 muertes. Además, se espera que estos impuestos ayuden a reducir en 1 173 millones de dólares los costos de atención a la salud. Los impuestos a alimentos no saludables deben fortalecerse y permanecer como parte integral de la estrategia nacional dirigida a reducir la obesidad y las enfermedades crónicas en México.

Abstract: In 2014 the Mexican government implemented taxes to reduce the consumption of sugar-sweetened beverages and nonessential energy-dense foods. In this manuscript, we analyze the scientific evidence linking the consumption of these products to chronic diseases, and summarize the studies that have evaluated the observed and expected impact of food taxes in Mexico. The implementation of taxes to unhealthy foods has reduced purchases of sugar-sweetened beverages in 7.6% and nonessential energy-dense foods in 7.4%. A reduction in consumption could decrease obesity prevalence by 2.5%; prevent 20 000 cardiovascular disease events; 189 000 diabetes cases; and 20 000 cardiovascular deaths. Additionally, this impact could save nearly 1 173 million dollars from healthcare costs. Taxes to unhealthy foods should be strengthened up and remain as an integral part of the national strategy to reduce obesity and chronic diseases in Mexico.

Energy, added sugar, and saturated fat contributions of taxed beverages and foods in Mexico / Contribución de energía, azúcar añadido y grasa saturada de las bebidas y alimentos con impuesto en México

Abstract: Objective: To estimate the dietary contribution of taxed beverages and foods. Materials and methods: Using 24-hour diet recall data from the Ensanut 2012 (n=10 096), we estimated the contribution of the items which were taxed in 2014 to the total energy, added sugar, and saturated fat intakes in the entire sample and by sociodemographic characteristics. Results: The contributions for energy, added sugar, and saturated fat were found to be 5.5, 38.1, and 0.4%, respectively, for the taxed beverages, and 14.4, 23.8, and 21.4%, respectively, for the taxed foods. Children and adolescents (vs. adults), medium and high socioeconomic status (vs. low), urban area (vs. rural), and North and Center region (vs. South) had higher energy contribution of taxed beverages and foods. The energy contribution was similar between males and females. Conclusions: These taxes covered an important proportion of Mexicans' diet and therefore have the potential to improve it meaningfully.

Resumen: Objetivo: Estimar la contribución dietética de las bebidas y alimentos con impuesto. Material y métodos: Con el recordatorio de 24-horas de la Ensanut 2012 (n=10 096), estimamos la contribución de los productos con impuesto en 2014 al consumo total de energía, azúcar añadido y grasa saturada en toda la muestra y por sociodemográficos. Resultados: La contribución de energía, azúcar añadido y grasa saturada fue 5.5, 38.1 y 0.4%, respectivamente, para bebidas con impuesto y 14.4, 23.8 y 21.4%, respectivamente, para alimentos con impuesto. Los niños y adolescentes (vs. adultos), nivel socioeconómico medio y alto (vs. bajo), área urbana (vs. rural), y región Norte y Centro (vs. Sur) tuvieron una contribución de energía mayor de bebidas y alimentos con impuesto. La contribución fue similar entre hombres y mujeres. Conclusión: Estos impuestos cubren una proporción importante de la dieta mexicana y por lo tanto tienen el potencial de mejorarla de manera relevante.

Cambios en los precios de bebidas y alimentos con impuesto en áreas rurales y semirrurales de México / Changes in prices of taxed sugar-sweetened beverages and nonessential energy dense food in rural and semi-rural areas in Mexico

Resumen: Objetivo: Analizar cambios en precios asociados con la implementación de los impuestos a bebidas azucaradas y alimentos no básicos con alta densidad energética implementados en 2014. Material y métodos: Se recolectaron precios en áreas rurales y semiurbanas en diciembre de 2013, y abril y diciembre de 2014. Se analizaron cambios en precios por tipo de bebidas y alimento con impuesto usando modelos de efectos fijos y estratificando por región, tipo de establecimiento y tamaño de presentación. Resultados: El impuesto a bebidas azucaradas no pasó por completo a los precios; en promedio, los precios aumentaron 0.73 pesos por litro. Para alimentos con alta densidad energética, el impuesto pasó igual o mayor al monto del impuesto para galletas, barras de cereal y cereales de caja. Conclusión: El potencial efecto de los impuestos en consumo podría ser menor al esperado en áreas rurales dado que los impuestos no pasaron por completo a los precios.

Abstract: Objective: To estimate changes in prices associated with the implementation of the tax to sugar sweetened beverages (SSB) and to nonessential energy dense food in 2014. Materials and methods: Price data were collected in rural and semi-rural areas in December 2013, and April and December 2014. Fixed effects models were used to estimate changes in prices of beverages and nonessential energy dense food, stratified by region, retailer and package size. Results: The SSB tax did not pass completely through prices: prices increased on average 0.73 pesos per liter. For nonessential energy dense food, the tax passed completely or was overshifted for cookies, cereal bars and cereal boxes. Conclusion: The potential effect of the taxes on consumption could be attenuated in rural areas as the pass through prices was incomplete.

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.

Adherence to Dietary Recommendations for Food Group Intakes Is Low in the Mexican Population.

BACKGROUND: Given the high prevalence of obesity and noncommunicable diseases in Mexico and the key role of dietary quality in these conditions, it is important to determine Mexicans' adherence to dietary recommendations. OBJECTIVE: Our aim was to estimate the percentage of the Mexican population who adhere to dietary recommendations for key food groups. METHODS: We analyzed 7983 participants aged ≥5 y from the nationally representative Mexican National Health and Nutrition Survey 2012. Dietary intake data were collected by using one 24-h recall and a repeated 24-h recall in 9% of the sample. We used the National Cancer Institute method for episodically consumed foods, which uses a 2-part (probability and amount) mixed regression model to estimate the usual intake distribution and its association with sociodemographic variables. RESULTS: For the food groups that are encouraged, only 1-4% of the population (range across sex and age groups) reached the recommended intake of legumes, 4-8% for seafood, 7-16% for fruit and vegetables, and 9-23% for dairy. For food groups that are discouraged, only 10-22% did not exceed the recommended upper limit for sugar-sweetened beverages, 14-42% for high saturated fat and/or added sugar (HSFAS) products, and 9-50% for processed meats, whereas the majority (77-93%) did not exceed the limit for red meat. A lower proportion of adolescents than children and adults adhered to recommendations for several food groups. Participants with higher socioeconomic status (SES) and living in urban areas consumed more (probability of consuming and/or amount consumed) fruit and vegetables, dairy, and HSFAS products, but they consumed fewer legumes than those of lower SES and living in rural areas. CONCLUSIONS: These results reveal the poor dietary quality of the Mexican population and the urgent need to shift these habits. If current intakes continue, the burden of disease due to obesity and noncommunicable chronic diseases will likely remain elevated in the Mexican population.