Binge drinking associated with mean temperature: a cross-sectional study among Mexican adults living in cities.

BACKGROUND: The association between environmental temperature and alcohol consumption has not been widely explored despite the potential that increasing temperatures could promote the consumption of alcoholic beverages and the alcohol-related burden of disease. We aimed to explore the association between temperature and binge drinking in Mexican adults from urban cities, overall, and by alcoholic beverage type. METHODS: Data on 10,552 adults ≥ 18 years was obtained from the 2016 National Survey on Drug, Alcohol, and Tobacco Consumption. The mean annual temperature at the municipality was obtained from the Mexican National Weather Service using monthly temperatures from 2015 to 2016. We analyzed binge drinking for all alcoholic beverages in the last year and by type of alcohol as beer, liquor, wine, and coolers. Associations between mean temperature over the past year and binge drinking over the past year among current drinkers were estimated using multilevel Poisson models with robust standard errors adjusted for age, sex, education level, marital status, and household socioeconomic status, with a fixed effect by region. RESULTS: We observed a non-significant increase in the prevalence of binge drinking for every difference of 1 °C between municipalities of the same region. By alcohol type, a 1 °C increase in mean annual temperature across municipalities of the same region increased the prevalence of beer binge drinking in the past year by 0.9% (PR = 1.009, 95%CI 1.005, 1.013) among beer consumers and the prevalence of coolers' binge drinking by 3.0% (PR = 1.030, 95%CI 1.003, 1.057) in coolers consumers. We observed non-significant results for liquor binge drinking (PR = 1.047, 95%CI 0.994, 1.102) and wine binge drinking (PR = 1.047, 95% 0.944, 1.161). CONCLUSION: People living in municipalities with higher temperatures reported a higher beer binge drinking in Mexican cities. This could account for 196,000 cases of beer binge drinking in 2016. The context of each country needs to be considered when generalizing these findings, and they need to be further explored with longitudinal data as there might be implications for climate change. If our findings are confirmed given the forecasted rising temperatures, we could expect an increase in binge drinking and therefore, in the alcohol burden of disease.

Consumo de tabaco y uso de cigarro electrónico en adolescentes y adultos mexicanos. Ensanut Continua 2022.

OBJETIVO: Estimar la prevalencia de consumo actual y previo de tabaco y uso de cigarro electrónico en la población adolescente y adulta mexicana en 2022. Material y métodos. Se utilizó la Encuesta Nacional de Salud y Nutrición Continua 2022 para estimar la prevalencia de consumo de tabaco fumado y uso de cigarro electrónico, considerando variables sociodemográficas. RESULTADOS: El 4.6% de los adolescentes reportó fumar actualmente y 3.7% reportó fumar en el pasado. De los adultos, 19.5% fuma actualmente y 17.8% fumó en el pasado. El consumo de tabaco fue mayor en las áreas urbanas y metropolitanas, en comparación con las rurales y se encontraron diferencias por nivel educativo y región. El 2.6% de adolescentes y 1.5% de adultos reportaron usar cigarros electrónicos. Conclusión. El tabaquismo continúa siendo un problema de salud pública en México. Es prioritario acelerar la implementación completa del Convenio Marco de la Organización Mundial de la Salud para el Control del Tabaco.

Association of sociodemographic and lifestyle factors with dietary patterns among men and women living in Mexico City: A cross-sectional study.

Background: Diet is one of the leading risk factors for non-communicable diseases and is related to sociodemographic and lifestyle factors, including sex. These associations vary across populations. We aimed to investigate which factors are associated with dietary patterns among adults living in Mexico City by sex. Methods: We used data from the Mexico City Diabetes Representative Study, a cross-sectional, multistage, stratified, and cluster-sampled survey in Mexico City (n = 1,142; 413 men and 729 women). Dietary information was collected using a semi-quantitative food frequency questionnaire. Foods and beverages were categorized into 23 food groups to identify dietary patterns by cluster analysis. Sociodemographic and lifestyle variables included were self-reported through standardized questionnaires. We assessed the association of sociodemographic and lifestyle factors with dietary patterns through a multinomial logistic model stratified by sex. Results: We identified three dietary patterns: basic, prudent, and fast food. Among men and women, higher school attainment was associated with a lower relative probability of having a basic rather than prudent dietary pattern (women: RRR = 0.8, 95% CI: 0.8, 0.9; men: RRR = 0.8, 95% CI: 0.7, 0.9). Divorced or separated men (RRR = 3.8, 95% CI: 1.3, 11.2) and those living with a partner (RRR = 2.6, 95% CI: 1.1, 6.1) had a higher relative probability of consuming a fast food dietary pattern than the prudent one, compared to single men. Men living with a partner (RRR = 3.0, 95% CI: 1.1, 8.6) or working long shifts (RRR = 3.8, 95% CI: 1.3, 11.1) had a higher probability of consuming a basic pattern rather than a prudent one compared to peers. Among women, those with high SES had a lower probability of consuming the "basic" pattern rather than the "prudent" pattern compared to those with low SES. No lifestyle factors were associated to dietary patterns. Conclusions: Men living in Mexico City with lower education, age, non-single, and working long hours (i.e., more than the established by the law), and women with lower age, education, and socioeconomic level are prone to adhere to unhealthy diets. These associations are likely to be driven by gender roles.

Greenhouse Gas Emissions Associated With the Mexican Diet: Identifying Social Groups With the Largest Carbon Footprint.

Background: Most studies of the climate footprint of diets have been conducted in countries in the global north, but the majority of the world population lives in global south countries. We estimated total dietary greenhouse gas emissions (GHGE) in Mexico, examined the contribution of major food and beverage groups, and assessed variation across social groups. Methods: We linked individual-level dietary data from the Mexican National Health and Nutrition Survey 2018 to the SHARP Indicators Database, containing GHGE estimates for 182 primary food and beverages. Results: Mean dietary GHGE was 3.9 kg of carbon dioxide equivalent per person per day. Dietary GHGE is highest among those in young adulthood and middle age versus adolescents and older adults, and among males, those with higher educational attainment, higher socioeconomic status, that do not speak an indigenous language, and that live in urban areas. Conclusion: The Mexican diet has a much lower carbon footprint than diets in other Latin American countries for which such estimates are available. In contrast to patterns observed in Argentina and Brazil, dietary GHGE was lowest in those in lower socioeconomic and educational strata and in rural areas. A better understanding of the differences in diet sustainability between and within countries will be needed for developing global and local strategies that meet the environmental sustainability goals.

Cambios en los patrones de consumo de alcohol y tabaco antes y durante la pandemia de Covid-19. Ensanut 2018 y 2020.

OBJETIVO: Examinar los cambios en la prevalencia de con-sumo de alcohol y tabaco antes y durante la pandemia de Covid-19 en México. Material y métodos. Se utilizaron datos de las Ensanut 2018 y 2020 para adolescentes y adultos y se obtuvieron prevalencias de consumo actual y excesivo de alcohol y de fumadores actuales y exfumadores. Resul-tados. El consumo de alcohol en mujeres incrementó de 33.5% en 2018 a 42.5% en 2020, mientras que en los hom-bres no hubo cambios significativos. En el mismo periodo, la prevalencia de consumo excesivo de alcohol disminuyó de 11.1 a 5.5% en mujeres y de 36.7 a 18.3% en hombres. La prevalencia de mujeres fumadoras disminuyó de 9.5 a 7.2%. En adolescentes, no se encontraron diferencias significativas en la prevalencia de consumo de alcohol y tabaco. Conclusión. El consumo de alcohol y tabaco continúa siendo elevado en adolescentes y adultos mexicanos. Urge la implementación de las medidas SAFER y MPOWER para abatir sinérgicamente estas epidemias.

Cambios en los patrones de consumo de alcohol y tabaco antes y durante la pandemia de Covid-19. Ensanut 2018 y 2020 / Changes in alcohol and tobacco consumption patterns before and during the Covid-19 pandemic. Ensanut 2018 and 2020

Resumen: Objetivo: Examinar los cambios en la prevalencia de consumo de alcohol y tabaco antes y durante la pandemia de Covid-19 en México. Material y métodos: Se utilizaron datos de las Ensanut 2018 y 2020 para adolescentes y adultos y se obtuvieron prevalencias de consumo actual y excesivo de alcohol y de fumadores actuales y exfumadores. Resultados: El consumo de alcohol en mujeres incrementó de 33.5% en 2018 a 42.5% en 2020, mientras que en los hombres no hubo cambios significativos. En el mismo periodo, la prevalencia de consumo excesivo de alcohol disminuyó de 11.1 a 5.5% en mujeres y de 36.7 a 18.3% en hombres. La prevalencia de mujeres fumadoras disminuyó de 9.5 a 7.2%. En adolescentes, no se encontraron diferencias significativas en la prevalencia de consumo de alcohol y tabaco. Conclusión: El consumo de alcohol y tabaco continúa siendo elevado en adolescentes y adultos mexicanos. Urge la implementación de las medidas SAFER y MPOWER para abatir sinérgicamente estas epidemias.

Abstract: Objective: To examine the changes in alcohol and tobacco consumption prevalence before and during the Covid-19 pandemic in Mexico. Materials and methods: Data from the Ensanut 2018 and 2020 were used for adolescents and adults, obtaining prevalence of current and excessive alcohol consumption and current and former smokers. Results: Alcohol consumption in women increased from 33.5% in 2018 to 42.5% in 2020. In the same period, the prevalence of excessive alcohol consumption decreased from 11.1 to 5.5% in women and from 36.7 to 18.3% in men. The prevalence of female smokers decreased from 9.5 to 7.2%. In adolescents, we did not find differences in alcohol and tobacco consumption prevalence. Conclusion: Alcohol and tobacco use continues to be high in Mexican adolescents and adults. The implementation of SAFER and MPOWER measures is needed to address the alcohol and tobacco epidemics synergistically.

Prevalence of diabetes and glycemic control in Mexico: national results from 2018 and 2020 / Prevalencia de diabetes y control glucémico en México: resultados nacionales 2018 y 2020

Abstract: Objective: To estimate the prevalence of diabetes (diagnosed and undiagnosed), glycemic control in Mexico, and its associated factors. Materials and methods: We used data from Ensanut 2018 (n=12 648) and 2020 (n=2 309). We defined diabetes as fasting glucose ≥126 mg/dl or HbA1c≥6.5% or previously diagnosed; glycemic control was defined as HbA1c<7%. We fitted Poisson regression models to assess the association between diabetes, glycemic control, and potential associated factors. Results: The total prevalence of diabetes was 16.8% in 2018 and 15.7% in 2020. In 2018, 38% of adults with diabetes were unaware of their disease, while in 2020 this figure was 29%. Glycemic control was observed in 42% of participants in 2018 and 39% in 2020. Longer disease duration was associated with lower glycemic control, while older age, having a diet, and being affiliated to IMSS, Pemex, Sedena, or private healthcare were associated with better control. Conclusion: Mexico is among the countries with the highest diabetes prevalence. A high proportion of adults with diabetes did not have a previous diagnosis, and the proportion with glycemic control is low. Strengthening screening to achieve a timely diagnosis, and improving glycemic control, should be key actions in the management of diabetes.

Resumen: Objetivo: Estimar la prevalencia de diabetes total (diagnosticada y no diagnosticada), control glucémico en México y sus factores asociados. Material y métodos: Se analizó información de la Ensanut 2018 (n=12 648) y 2020 (n=2 309). Se definió diabetes como glucosa en ayunas ≥126 mg/dl o HbA1c≥6.5% o diagnóstico previo; se consideró control glucémico si HbA1c<7%. Usando modelos de regresión de Poisson, se estimaron los factores asociados con diabetes y control glucémico. Resultados: La prevalencia de diabetes fue de 16.8% en 2018 y 15.7% en 2020. En 2018, 38% de los adultos con diabetes desconocían su enfermedad, en 2020 fue 29%. El control glucémico se observó en 42% de los participantes en 2018 y en 39% en 2020. Mayor tiempo de diagnóstico se asoció con descontrol glucémico mientras que mayor edad, seguir una dieta y estar afiliado al IMSS, Pemex/Sedena o privados se asoció con control glucémico. Conclusión: México se encuentra entre los países con mayor prevalencia de diabetes. Una alta proporción de adultos con diabetes no tenía un diagnóstico previo y la proporción con control glucémico es baja. Fortalecer la detección, el diagnóstico oportuno y el control glucémico es clave para el manejo de la diabetes.

La inseguridad alimentaria y factores asociados en hogares mexicanos con casos de Covid-19 / Food insecurity and associated factors in Mexican households with Covid-19 cases

Resumen: Objetivo: Analizar la asociación entre la presencia de anticuerpos contra SARS-CoV-2, con la inseguridad alimentaria (IA) y otras características del hogar, en una muestra nacional de hogares mexicanos. Material y métodos: Se obtuvo información a nivel de hogar en una muestra nacional representativa sobre seguridad alimentaria (SA), factores sociodemográficos, cambios en la economía y consumo de alimentos. Se estimó mediante regresión logística ordinal la relación entre IA y características de los hogares y modelos de regresión logística multinomial para estudiar los cambios autorreportados en el consumo de alimentos e IA, ante la presencia de seropositividad contra SARS-CoV-2 en el hogar. Resultados: Los hogares con casos de seropositividad presentaron menor consumo de carnes. En hogares que tuvieron una reducción de sueldo y la presencia de una persona con anticuerpos contra SARS-CoV-2 en el hogar, se presentó un aumento en la prevalencia de niveles más altos de IA (RM=1.225; IC95%: 1.04, 1.44) Conclusiones: La IA en hogares durante la pandemia se agravó por diversos factores, por lo cual se requieren acciones de política pública integrales.

Abstract: Objective: To analyze the association between the presence of anti SARS-CoV-2 antibodies and other household characteristics and the food insecurity in a national sample of Mexican households. Materials and methods: Information at household level about food security (FS), sociodemographic factors, changes in family economy and food consumption was obtained in a national and representative sample. The relation between food insecurity (FI) and household characteristics was established through ordinal logistic regression, multinomial regression models were used to study the self-reported changes in food consumption and FI in the presence of antibodies against SARS-CoV-2 in at least one inhabitant of the household. Results: Households with seropositive cases shown a lower meat consumption. In those households which suffered an income reduction and had at least one individual positive for anti SARS-CoV-2 antibodies, the FI -in its higher levels- worsened (OR=1.225; CI95%: 1.04, 1.44). Conclusions: The food insecurity in households during pandemic worsened due to many factors, in this sense integral actions of public policies are required.

Aislamiento ante síntomas sugestivos de Covid-19 o contacto con un caso: cumplimiento, prevalencia y factores asociados. Ensanut 2020 Covid-19 / Isolation in the fase of symptoms suggestive of Covid-19 or contact with a case: compliance, prevalence, and associated factors. Ensanut 2020 Covid-19

Resumen: Objetivo: Investigar el cumplimiento de las recomendaciones de aislamiento ante síntomas de Covid-19 o contacto con un caso. Material y métodos: Estudio transversal basado en la Encuesta Nacional de Salud y Nutrición 2020 sobre Covid-19. Se describió la prevalencia de aislamiento y su asociación con factores del nivel individual, hogar y contexto utilizando modelos de regresión log-binomial. Resultados: El 48.1% de la población >10 años reportó quedarse en casa ante síntomas o contacto con un caso. La prevalencia de aislamiento fue menor entre población ocupada vs. no-ocupada (RP 0.81; IC95% 0.73-0.89), mayor entre personas con alto nivel socioeconómico vs. bajo (RP 1.22; IC95% 1.08-1.38) y menor entre personas viviendo en estados sin un mensaje específico sobre aislamiento vs. estados con mensaje específico (RP 0.76; IC95% 0.63-0.91). Conclusiones: El cumplimiento de las recomendaciones de aislamiento durante la pandemia de Covid-19 estuvo asociado con factores socioeconómicos individuales y con la calidad de los mensajes de salud pública de los estados.

Abstract: Objective: To examine compliance to isolation and quarantine recommendations during the early phase of the Covid-19 epidemic in Mexico. Materials and methods: Cross-sectional population-based study (National Health and Nutrition Survey 2020 Covid-19). We estimated the prevalence of compliance with recommendations and assessed its association with individual, household and context level variables using log-binomial models. Results: 48.1% of the population over 10 years old reported staying at home when faced with symptoms or a potential contact with a case. The prevalence was lower in employed vs unemployed population (PR 0.81; 95%IC 0.73-0.89), higher among higher socioeconomic position groups vs lower (RP 1.22; 95%IC 1.08-1.38), and lower among people living in states with an unspecific public health message regarding isolation and quarantine (RP 0.76; 95%IC 0.63-0.91). Conclusions: Compliance to isolation and quarantine recommendations was associated with socioeconomic factors and the quality of public health messages during the Covid-19 pandemic in Mexico.

Prevalence of Covid-19 sequelae in the National Health and Nutrition Survey 2020 / Secuelas de Covid-19: Encuesta Nacional de Salud y Nutrición 2020

Abstract: Objective: To estimate the prevalence of Covid-19 sequelae and its association with sociodemographic and medical care characteristics. Materials and methods: Mexican adults that experienced Covid-19 symptoms and were seropositive to the N-protein of Sars-CoV-2 in the Ensanut 2020 responded to a question regarding sequelae. Associations were estimated using Poisson regression. Results: The prevalence of sequelae was 15.7%, being higher for people with higher education and who were hospitalized or treated at an emergency room during the acute Covid-19 phase. Conclusions: Self-reported sequelae associated to Covid-19 was frequent. Covid-19 sequelae could represent an important challenge for the health system and the Mexican society.

Resumen: Objetivo: Estimar la prevalencia de secuelas para Covid-19 y su asociación con características sociodemográficas y de atención médica. Material y métodos: Adultos mexicanos que experimentaron síntomas de Covid-19 y fueron seropositivos a la proteina N del SARS-CoV-2 respondieron una pregunta sobre secuelas. Se estimaron las asociaciones mediante regresión Poisson. Resultados: La prevalencia de secuelas fue de 15.7%, siendo mayor en personas con alto nivel educativo y que recibieron atención hospitalaria o de urgencia durante la fase aguda de Covid-19. Conclusiones: El autorreporte de secuelas asociadas con Covid-19 fue frecuente. Las secuelas por Covid-19 podrían representar un reto importante para el sistema de salud y la sociedad mexicana.

Family and household characteristics associated with seropositive cases to SARS-CoV-2 across Mexican households / Características de la estructura familiar y de la vivienda asociadas con casos seropositivos a SARS-CoV-2 en hogares mexicanos

Abstract: Objective: To assess the association of family and housing characteristics with the number of seropositive cases to SARS-CoV-2 in households. Materials and methods: We analyzed 874 households from Encuesta Nacional de Salud y Nutrición (Ensanut) 2020 Covid-19 using Poisson regression models. Results: The number of seropositive family members was higher among families composed of children/adolescents, adults and older adults, households with more than two members per bedroom, and among households with closed windows. No association was found for bathroom availability and piped water. Conclusions: Family composition and housing characteristics can impose significant structural barriers to safe home confinement.

Resumen: Objetivo: Determinar la asociación de la estructura familiar y de las características de la vivienda con el número de casos positivos a SARS-CoV-2 a nivel hogar. Material y métodos: Se analizaron 874 hogares de la Encuesta Nacional de Salud y Nutrición (Ensanut) 2020 Covid-19 utilizando modelos de regresión de Poisson. Resultados: El número de miembros seropositivos fue mayor en los hogares compuestos por niños/adolescentes, adultos y adultos mayores, donde más de dos miembros ocupaban la misma habitación y en los hogares donde se observaron ventanas cerradas. No se encontró asociación con la disponibilidad de baño y de agua entubada. Conclusiones: La composición familiar y las características de la vivienda pueden representar barreras importantes para el confinamiento seguro en casa.

Revisión rápida: probabilidad de contagio por infecciones respiratorias agudas en el transporte público colectivo / Quick review: probability of infection by acute respiratory infections on public transportation

Resumen: Objetivo: Determinar el nivel de evidencia sobre la probabilidad de transmisión de enfermedades respiratorias agudas en el transporte público colectivo. Material y métodos: Se utilizó la metodología de revisiones rápidas de Cochrane. La estrategia de búsqueda abarcó una base de datos académica hasta el 10 de diciembre de 2020. Resultados: Se identificaron 16 manuscritos que cumplieron los criterios de selección. En estudios de cohorte agrupados se encontró que el momio de seroconversión por influenza A o B fue 54% mayor en personas con uso frecuente de transporte público colectivo en comparación con las personas con un uso poco frecuente (razón de momios: 1.54; IC95%:1.06-2.01). Conclusión: La probabilidad de contagio por enfermedades respiratorias agudas puede incrementar con el uso del transporte público colectivo. Algunas recomendaciones para reducir la probabilidad de contagio en el transporte público colectivo son el uso de cubrebocas y reducir el número de pasajeros y tiempo de traslado.

Abstract: Objective: To determine the level of evidence on the probability of transmission of acute respiratory diseases on collective public transport. Materials and methods: We followed the Cochrane rapid review methodology. The search strategy encompasses one academic database until December 10, 2020. Results: 16 manuscripts met the inclusion criteria. Pooling of cohort studies showed that the odd of seroconversion to influenza A or B was 54% greater in people with frequent use of public transport compared to people with infrequent use (odds ratio: 1.54; 95%CI: 1.06-2.01). Conclusions: The probability of contagion from acute respiratory diseases may increase with the use of public transport. Some recommendations to reduce the probability of contagion in collective public transport include the use of face masks, to avoid speaking or singing, and to reduce the number of passengers and the travel time.

Ciclos de trabajo-confinamiento para reducir la transmisión de Covid-19: evidencia y recomendaciones en el contexto de México / Cyclic schedules for working population to reduce Covid-19 transmission: evidence and recommendations for Mexico

Resumen: Este artículo propone intervenciones estructurales dirigidas a la reorganización del trabajo para evitar un repunte de casos de Covid-19, permitiendo la continuidad de la actividad económica. Se resume la evidencia disponible acerca de los ciclos de trabajo-confinamiento y la posible aplicación de ciclos de cuatro días de trabajo por tres de confinamiento (4x3) en el contexto mexicano. También se discuten otras intervenciones como la continuación del teletrabajo en algunos sectores y el escalonamiento de las jornadas de trabajo como medidas complementarias a los ciclos de trabajo-confinamiento. Esta discusión se da en el contexto de alta informalidad y escasos recursos para absorber una pérdida importante de la productividad por las empresas medianas y pequeñas en México. Se considera la necesidad de implementar apoyos para que personas y empresas puedan mitigar pérdidas en salarios y ganancias tanto del sector formal como informal.

Abstract: This paper proposes structural interventions to organize the working population which could be implemented to avoid a new wave of Covid-19 cases without halting economic activity. We summarize the evidence regarding cyclic schedules of work days followed by days in lockdown. We discuss the possible application of cycles of four days of work followed by three in lockdown for the Mexican context. We also discuss two complimentary interventions for these cycles: continuing to work from home for the sectors for which this is possible and staggered work shifts. This discussion takes into account the high informality context and the scarcity of resources to absorb productivity losses in middle and small companies. We consider the need to implement financial help for people and companies to mitigate lost earnings both in the formal and in the informal work sectors.

Revisión rápida del uso de cubrebocas quirúrgicos en ámbito comunitario e infecciones respiratorias agudas / Rapid review of the community-wide use of surgical masks and acute respiratory infections

Resumen: Objetivo: Evaluar la efectividad del uso de cubrebocas quirúrgico en ámbitos comunitarios para reducir la probabilidad de contagio por SARS-CoV-2 u otra infección respiratoria aguda viral, en comparación con no usar cubrebocas. Material y métodos: Se utilizó la metodología de revisiones rápidas de Cochrane. La estrategia de búsqueda abarcó una base de datos académica y pre-prints hasta el 1 de abril de 2020. Los títulos y resúmenes fueron revisados por un investigador. La revisión de textos completos fue dividida entre tres investigadores. Los resultados fueron sintetizados de forma narrativa. Resultados: Se identificaron 713 manuscritos, de los cuales 21 cumplieron los criterios de inclusión. De seis revisiones sistemáticas, cuatro no encontraron reducciones en la probabilidad de contagio y seis estudios experimentales en hogares no encontraron diferencias en la probabilidad de contagio asociado con el uso de cubrebocas. Únicamente un estudio de modelaje estimó una reducción de 20% en la incidencia de enfermedad respiratoria, asumiendo que 10 a 50% de la población hace uso correcto de cubrebocas quirúrgicos. Conclusiones: La evidencia científica no es concluyente para recomendar o desalentar el uso de cubrebocas a nivel poblacional. Considerando los potenciales efectos negativos, las recomendaciones gubernamentales deberían esperar a los resultados de los experimentos naturales en países que han recomendado la utilización poblacional de cubrebocas.

Abstract: Objective: To assess the effectiveness of using surgical masks in community settings to reduce the probability of infection by SARS-CoV-2 or other acute viral respiratory infection, compared to not using surgical masks. Materials and methods: We followed the Cochrane rapid review methodology. The search strategy encompasses one academic database and pre-prints until April 1, 2020. Titles and abstracts were reviewed by one investigator. The full text review was divided among three researchers. The results were synthesized in a narrative way. Result: 713 manuscripts were identified, of which 21 met the inclusion criteria. Of six systematic reviews, four found no reduction in the probability of transmission. Experimental home studies found no differences in the probability of contagion associated with the use of mouth masks. Only one modeling study estimated a 20% reduction in the incidence of acute respiratory disease, assuming that 10 to 50% of the population use the surgical masks correctly. Conclusions: The scientific evidence is inconclusive to recommend or discourage the use of surgical masks at the population level. Considering the potential negative effects, official recommendations should await for the results of natural experiments currently occurring in countries that have recommended the use of face masks at the population level.

Prevalencia de diabetes y descontrol glucémico en México: resultados de la Ensanut 2016 / Prevalence of diabetes and poor glycemic control in Mexico: results from Ensanut 2016

Resumen: Objetivo: Estimar la prevalencia de diabetes (total, diagnosticada y no diagnosticada), de descontrol glucémico en México y sus factores asociados. Material y métodos: Se analizaron 3 700 adultos participantes en la Encuesta Nacional de Salud y Nutrición de 2016. Se estimaron las prevalencias con ponderadores poblacionales y los factores asociados con diabetes total y descontrol glucémico con modelos de regresión de Poisson. Resultados: La prevalencia total de diabetes fue de 13.7% (9.5% diagnosticada, 4.1% no diagnosticada); 68.2% de los diagnosticados presentó descontrol glucémico. Mayor tiempo de diagnóstico, vivir en el centro/sur del país y ser atendido en farmacias se asoció con descontrol glucémico, mientras que ser atendido en los servicios de seguridad social se asoció con mejor control glucémico. Conclusión: Se requieren esfuerzos multisectoriales para fortalecer el tamizaje, diagnóstico oportuno y control de la enfermedad, considerando las diferencias por región y tipo de servicio de salud.

Abstract: Objective: To estimate the prevalence of total, diagnosed and undiagnosed diabetes, and the prevalence of poor glycemic control in Mexico, and its associated factors. Materials and methods: Data from 3 700 adult participants were analysed in the 2016 National Health and Nutrition Survey. Diabetes prevalences were estimated with population weights, and the factors associated with total diabetes and poor glycemic control with Poisson regression models. Results: The total prevalence of diabetes was 13.7% (9.5% diagnosed, 4.1% undiagnosed); 68.2% of people with diagnosed diabetes presented poor glycemic control. Longer disease duration, living in the centre or south of the country and being treated in pharmacies were associated with poor glycemic control. Being treated in a social security system was associated with better glycemic control. Conclusion: Multisectoral efforts are needed to strengthen screening, timely diagnosis and disease control, considering differences by region and type of health service.

Cross-sectional association between diet quality and cardiometabolic risk by education level in Mexican adults.

OBJECTIVE: Understanding the association between diet quality and cardiometabolic risk by education level is important for preventing increased cardiometabolic risk in the Mexican population, especially considering pre-existing disparities in diet quality. The present study examined the cross-sectional association of overall diet quality with cardiometabolic risk, overall and by education level, among Mexican men and women. DESIGN: Cardiometabolic risk was defined by using biomarkers and diet quality by the Mexican Diet Quality Index. We computed sex-specific multivariable logistic regression models. SETTING: Mexico. PARTICIPANTS: Mexican men (n 634) and women (n 875) participating in the Mexican National Health and Nutrition Survey 2012. RESULTS: We did not find associations of diet quality with cardiometabolic risk factors in the total sample or in men by education level. However, we observed that for each 10-unit increase in the dietary quality score, the odds of diabetes risk in women with no reading/writing skills was 0·47 (95 % CI 0·26, 0·85) relative to the odds in women with ≥10 years of school (referent). Similarly, for each 10-unit increase of the dietary quality score, the odds of having three v. no lipid biomarker level beyond the risk threshold in lower-educated women was 0·27 (95 % CI 0·12, 0·63) relative to the odds in higher-educated women. CONCLUSIONS: Diet quality has a stronger protective association with some cardiometabolic disease risk factors for lower- than higher-educated Mexican women, but no association with cardiometabolic disease risk factors among men. Future research will be needed to understand what diet factors could be influencing the cardiometabolic disease risk disparities in this population.

The association of overall diet quality with BMI and waist circumference by education level in Mexican men and women.

OBJECTIVE: The present study evaluated the association of two measures of diet quality with BMI and waist circumference (WC), overall and by education level, among Mexican men and women. DESIGN: We constructed two a priori indices of diet quality, the Mexican Diet Quality Index (MxDQI) and the Mexican Alternate Healthy Eating Index (MxAHEI), which we examined relative to BMI and WC. We computed sex-specific multivariable linear regression models for the total sample and by education level. SETTING: Mexico. PARTICIPANTS: Mexican men (n 954) and women (n 1356) participating in the Mexican National Health and Nutrition Survey 2012. RESULTS: Total dietary scores were not associated with BMI in men and women, but total MxDQI was inversely associated with WC in men (-0·10, 95 % CI -0·20, -0·004 cm). We also found that some results differed by education level in men. For men with the lowest education level, a one-unit increase in total MxDQI and MxAHEI score was associated with a mean reduction in BMI of 0·11 (95 % CI -0·18, 0·04) and 0·18 (95 % CI -0·25, -0·10) kg/m2, respectively. Likewise, a one-unit increase in total MxDQI and MxAHEI score was associated with a mean change in WC of -0·30 (95 % CI -0·49, -0·11) and -0·53 (95 % CI -0·75, -0·30) cm, respectively, in men with the lowest level of education. In women, the association of diet quality scores with BMI and WC was not different by education level. CONCLUSIONS: Our findings suggest that a higher diet quality in men with low but not high education is associated with lower BMI and WC.

Lessons learned and insights from the implementation of a food and physical activity policy to prevent obesity in Mexican schools: An analysis of nationally representative survey results.

Obesity is a serious problem among children in Mexico. In 2010, the government implemented a national food and physical activity policy in elementary schools, to prevent obesity. The goal of this study is to assess the implementation of this policy, using the logic model from a descriptive survey with national representativeness at the elementary school level and based on a stratified cluster design. We used a systematic random sampling of schools (n = 122), stratified into public and private. We administered questionnaires to 116 principals, 165 members of the Food and Physical Activity Committees, 132 food school food vendors, 119 teachers, 348 parents. This study evidences a significant deviation in implementation from what had been planned. Our lessons learned are the importance to: base the design/implementation of the policy on a theoretical framework, make programs appealing to stakeholders, select concrete and measurable objective or goals, and support stakeholders during the implementation process.