Sugar-sweetened beverage consumption and risk of hyperuricemia: a longitudinal analysis of the Health Workers Cohort Study participants in Mexico.

BACKGROUND: The elevated consumption of sugar-sweetened beverages (SSBs) in Mexico is an important public health concern. However, the association between SSB consumption and hyperuricemia has been scarcely studied and not well documented. OBJECTIVES: To prospectively evaluate the association between SSB consumption and risk of hyperuricemia in Mexican adults. METHODS: A longitudinal analysis was conducted using data from the Health Workers Cohort Study. Participants were followed from 2004 to 2018, with measurements every 6 y. The analysis sample consisted of 1300 adults, aged 18 to 85 y. SSB consumption during the previous year was evaluated through a semiquantitative FFQ. Hyperuricemia was defined as a concentration of uric acid ≥7.0 mg/dL in men and ≥5.7 mg/dL in women. We evaluated the association of interest using 2 methodologies: fixed-effects logistic regression and generalized estimating equations (GEEs). Potential confounders were included in both approaches. RESULTS: At baseline, median intake of SSBs was 472.1 mL/wk (IQR: 198.8-1416.4 mL/wk), and 233 participants had hyperuricemia. Uric acid was higher in participants with an SSB intake ≥7 servings/wk, compared with those with an intake <1 serving/wk (P < 0.001). Participants who changed from the lowest to the highest category of servings consumption experienced 2.6 increased odds of hyperuricemia (95% CI: 1.27, 5.26). Results from the GEE model indicated the odds of hyperuricemia increased by 44% (OR=1.44; 95% CI: 1.13, 1.84) in the 2-6 servings/wk group, and by 89% (OR=1.89; 95% CI: 1.39, 2.57) in the ≥7 servings/wk categories, compared with the <1 serving/wk category. Diet soft drinks were not associated with hyperuricemia. CONCLUSIONS: Our results suggest that the consumption of SSBs is associated with an increased risk of hyperuricemia in Mexican adults, but diet soft drink consumption is not, which supports the need to strengthen existing recommendations to reduce the intake of SSBs.The Health Workers Cohort Study (HWCS) has been approved by the Institutional Review Board of the Mexican Social Security Institute (12CEI 09 006 14), and the National Institute of Public Health of Mexico (13CEI 17 007 36).

Health workers cohort study: methods and study design / Cohorte de trabajadores de la salud: métodos y diseño del estudio

Abstract: Objective: To examine different health outcomes that are associated with specific lifestyle and genetic factors. Materials and methods: From March 2004 to April 2006, a sample of employees from three different health and academic institutions, as well as their family members, were enrolled in the study after providing informed consent. At baseline and follow-up (2010-2013), participants completed a self-administered questionnaire, a physical examination, and provided blood samples. Results: A total of 10 729 participants aged 6 to 94 years were recruited at baseline. Of these, 70% were females, and 50% were from the Mexican Social Security Institute. Nearly 42% of the adults in the sample were overweight, while 20% were obese. Conclusion: Our study can offer new insights into disease mechanisms and prevention through the analysis of risk factor information in a large sample of Mexicans.

Resumen: Objetivo: Examinar diferentes desenlaces en salud y su asociación con factores genéticos y del estilo de vida. Material y métodos: De marzo de 2004 a abril de 2006, una muestra de empleados de tres diferentes instituciones de salud y académicas, así como miembros de sus familias, fueron enrolados en el estudio, previa firma de consentimiento informado. Durante la medición basal y el seguimiento (2010-2013) los participantes completaron un cuestionario autoaplicado, exámenes físicos y proporcionaron muestras sanguíneas. Resultados: Fueron incluidos participantes (10 729) de entre 6 y 94 años en la medición basal. De estos, 70% fueron mujeres y 50% del Instituto Mexicano del Seguro Social. Aproximadamente 42% de los adultos tuvieron sobrepeso y 20% obesidad. Conclusión: Este estudio puede ofrecer conocimientos sobre los mecanismos de la enfermedad a través del análisis de factores de riesgo en una muestra de mexicanos.

Health workers cohort study: methods and study design.

OBJECTIVE:: To examine different health outcomes that are associated with specific lifestyle and genetic factors. MATERIALS AND METHODS:: From March 2004 to April 2006, a sample of employees from three different health and academic institutions, as well as their family members, were enrolled in the study after providing informed consent. At baseline and follow-up (2010-2013), participants completed a self-administered questionnaire, a physical examination, and provided blood samples. RESULTS:: A total of 10 729 participants aged 6 to 94 years were recruited at baseline. Of these, 70% were females, and 50% were from the Mexican Social Security Institute. Nearly 42% of the adults in the sample were overweight, while 20% were obese. CONCLUSION:: Our study can offer new insights into disease mechanisms and prevention through the analysis of risk factor information in a large sample of Mexicans.

Plain water consumption is associated with lower intake of caloric beverage: cross-sectional study in Mexican adults with low socioeconomic status.

BACKGROUND: Plain water (PW) should be the main beverage consumed by the population. However, consumption of caloric beverages (CB) has increased considerably worldwide. The purpose of this paper is to analyze the association between CB and PW intake in Mexican adults with a low socioeconomic status (SES). METHODS: In a cross-sectional design, beverage consumption was evaluated with a 24-h beverages recall using the five-step multiple-pass method recommended by the U.S. Department of Agriculture. Physical activity, anthropometric and sociodemographic information were obtained. CB was defined as those beverages that provide energy, with the exception of low-fat milk and beverages with noncaloric sweeteners. Participants were classified into five groups according to their PW consumption (nondrinkers and four quartiles). Differences between groups were evaluated with ANOVA and Bonferroni tests for multiple comparisons among quartiles. A two-stage Heckman regression model was designed with robust standard errors, adjusting for potential confounders. RESULTS: A total of 1108 adults between 21 and 59 years of age were evaluated. A negative association was noted between PW intake and CB consumption (p <0.001) with the exception of natural juice, which was positive (p <0.01) and sodas that no differences were found between quartiles. Specifically, for every milliliter of PW, the intake of CB was 3.4, 1.3, 0.68 and 0.38 mL in each quartile, respectively (p <0.001). In Heckman's model, PW consumers were 0.5 times less likely to consume CB (p = 0.029). This probability increased to 0.9 for low-fat milk, skim milk and beverages without added sugar (LFM-BWAS) consumers (p <0.001). Also, for every 100 mL of PW consumption, CB intake diminished by 20 mL (p <0.001). In turn, for every 100 mL of LFM-BWAS consumption, a reduction of 47 mL in CB was observed (p <0.001). CONCLUSIONS: Higher PW consumption was associated with lower CB consumption. This association suggests that future studies are warranted to determine if increasing PW intake in a low SES Mexican population can reduce intake of CB.

México: comportamiento reproductivo y marginación social 1970-1990. Elementos para un diagnóstico geográfico en salud reproductiva / Mexico: reproductive behavior and social deprivation: 1970-1990. elements for a geographical diagnosis in reproductive health

La falta de conocimiento relativamente claro acerca de las características del comportamineto reproductivo regional, dificulta la evaluación de las metas propuestas por la Ley General de Población y hace improductivo cualquier esfuerzo por relacionar la población con el desarrollo regional. Este trabajo está ubicado en la perspectiva de la superación de esta situación. Se estimaron tasas específicas de fecundidad y tasas globales de fecundidad (TFG) a nivel estatal a través de técnicas indirectas. Se utilizó información censal y estadísticas vitales para las entidades federativas en el periodo 1970-1990. Para contextualizarlo, el comportamiento reproductivo se relacionó con los índices de marginación social elaborados por el Programa Nacional de Solidaridad y el Consejo Nacional de Población para esos mismos años. Se encontró una correlación alta y estadísticamente significativa (p< 0.01) entre los niveles de marginación y fecundidad en todo el periodo. Igualmente, se encontró una relación inversa estadísticamente signiicativa (p< 0.01) entre los niveles de marginación estatales y las velocidades de descenso en las TGF para las décadas en estudio. Se concluye que en las TGF hubo un descenso generalizado aunque no uniforme al interior del país. En este trabajo se plantea la necesidad de profundizar el análisis en el sentido de que las diferencias en los niveles de fecundidad y sus velocidades de descenso podrían estar sobredeterminadas por los distintos niveles de marginación, más que por la efectividad y generalización de los programas de planificación familiar. El mapeo de estos resultados se puede utilizar como un elemento de diagnóstico del comportamiento reproductivo de la población, a la vez que brinda la información necesaria para elaborar una respuesta social organizada en materia de salud reproductiva

The lack of a definite knowledge on regional reproductive behavior characteristics hinders the evaluation of the goals stated in the General Population Law (Ley General de Población) and counteracts any efforts towards equating population growth with regional development. The present work aims at overcoming this problem. Indirect specific fertility rates and global fertility rates (GFR) were obtained by state, using census and vital statistics data for the states of Mexico during the 1970-1990 period. Reproductive behavior was related to social deprivation indexes used by PRONASOL and CONAPO for those years. A high statistically significant correlation (p< 0.01) between state social deprivation levels and the downward trends of GFR for the same decades was found. Findings evidence a general downward trend of GFR during the period of study. However, this trend was not uniform across the country. Further studies are needed to determine whether these differences are due to the various social deprivation levels rather than to the effectiveness and extension of family planning programs. Mapping these results could be useful as diagnostic elements of the reproductive behavior of the population and also generates information necessary to support social organized responses in reproductive health.