Association of cardiometabolic risk status with clinical activity and damage in systemic lupus erythematosus patients: A cross-sectional study.

Cardiometabolic status is a key factor in mortality by cardiovascular disease (CVD) in systemic lupus erythematosus (SLE). This study evaluated the association of cardiometabolic risk status with clinical activity and damage in SLE patients. A cross-sectional study was conducted in 158 SLE patients and 123 healthy subjects (HS). Anthropometry, glucose, hs-CRP, lipid profile, oxLDL, sCD36, anti-oxLDL antibodies, and cardiometabolic indexes were evaluated. SLE patients had dyslipidemia, higher sCD36, anti-oxLDL antibodies, hs-CRP, and risk (OR > 2) to present Castelli score ≥ 4.5, HDL-C < 40 mg/dL and LDL-C ≥ 100 mg/dL. Disease evolution time was correlated with glucose and BMI, damage with TG, and clinical activity with TG, TG/HDL-C ratio, and Kannel index. Active SLE patients had risk (OR > 2) to present a Castelli score ≥ 4.5, Kannel score ≥ 3, TG/HDL-C ratio ≥ 3 and HDL-C < 40 mg/dL. In conclusion, SLE patients have high cardiometabolic risk to CVD related to disease evolution time, and clinical activity.

Association of Vitamin D Metabolism Gene Polymorphisms with Autoimmunity: Evidence in Population Genetic Studies.

A high prevalence of vitamin D (calcidiol) serum deficiency has been described in several autoimmune diseases, including multiple sclerosis (MS), rheumatoid arthritis (AR), and systemic lupus erythematosus (SLE). Vitamin D is a potent immunonutrient that through its main metabolite calcitriol, regulates the immunomodulation of macrophages, dendritic cells, T and B lymphocytes, which express the vitamin D receptor (VDR), and they produce and respond to calcitriol. Genetic association studies have shown that up to 65% of vitamin D serum variance may be explained due to genetic background. The 90% of genetic variability takes place in the form of single nucleotide polymorphisms (SNPs), and SNPs in genes related to vitamin D metabolism have been linked to influence the calcidiol serum levels, such as in the vitamin D binding protein (VDBP; rs2282679 GC), 25-hydroxylase (rs10751657 CYP2R1), 1α-hydroxylase (rs10877012, CYP27B1) and the vitamin D receptor (FokI (rs2228570), BsmI (rs1544410), ApaI (rs7975232), and TaqI (rs731236) VDR). Therefore, the aim of this comprehensive literature review was to discuss the current findings of functional SNPs in GC, CYP2R1, CYP27B1, and VDR associated to genetic risk, and the most common clinical features of MS, RA, and SLE.

Anthropometric and Body Composition Profile of Young Professional Soccer Players.

Bernal-Orozco, MF, Posada-Falomir, M, Quiñónez-Gastélum, CM, Plascencia-Aguilera, LP, Arana-Nuño, JR, Badillo-Camacho, N, Márquez-Sandoval, F, Holway, FE, and Vizmanos-Lamotte, B. Anthropometric and body composition profile of young professional soccer players. J Strength Cond Res 34(7): 1911-1923, 2020-The purpose was to describe the anthropometric and body composition profile of young professional soccer players and to compare the players profiles between different competitive divisions and playing positions. A retrospective cross-sectional study was carried out with anthropometric data obtained from the records of soccer players of Club Deportivo Guadalajara, S.A. de C.V. (Mexico) in the under-17, under-20, second, third, and fourth division categories. Body mass, height, sitting-height, skinfolds, girths, and bone breadths were measured by certified anthropometrists from September 2011 to March 2015, following the procedures recommended by the International Society for the Advancement of Kinanthropometry. Body composition was determined using the 5-way fractionation method. Comparisons between playing positions in each division and between divisions were performed using analysis of variance, and Bonferroni's post-hoc analyses (SPSS version 22 for Windows, p < 0.05 considered as significant). Data from 755 subjects were analyzed. The mean age was 18.1 ± 1.7 years old (minimum 14.8, maximum 23.2). The under-20 division registered higher anthropometric and body composition values than all other competitive divisions. In addition, goalkeepers were taller, heavier, and obtained the highest values for adipose mass, whereas forwards presented higher percentages of muscle mass. These tables can be used during nutritional assessment and nutritional monitoring of players to establish body composition goals. In addition, the strength and conditioning practitioner may also use these data to design effective and specific training programs most suitable to the anthropometric and body composition profile of each player, taking into consideration his competitive division and playing position.

Frequency and Risk Factors of Kidney Alterations in Children and Adolescents who Are Overweight and Obese in a Primary Health-care Setting.

OBJECTIVE: Obesity is clearly associated to kidney disease in adult population; however, there is scarce evidence in children and adolescents. The aim was to compare frequency of renal damage according to the presence of overweight-obesity in children and adolescents, as well as to compare nutritional and biochemical risk factors, according to the presence of kidney alterations. METHODS: Cross-sectional study; 172 children and adolescents, 6-16 years old, without malnutrition, diabetes mellitus, hypertension and independent comorbid conditions associated to obesity or kidney disease, as well as transitory causes of microalbuminuria (MA) from a Primary Health-Care Unit were included. Clinical, biochemical, anthropometric and dietetic evaluations were measured in all subjects; subsequently they were classified as normal weight, overweight and obesity groups according to sex- and age-adjusted body mass index (BMI). Glomerular filtration rate (GFR, estimated by Schwartz equation) and albuminuria (albumin/creatinine ratio) were determined. Presence of kidney alterations was measured as decreased GFR (<90 mL/min/1.73m2), hyperfiltration (>170 mL/min/1.73m2) and MA (30-300 mg/g). RESULTS: Compared with controls, subjects with overweight-obesity had significantly (P<.05) abdominal obesity (0 vs 69%), hypertension (19 vs 26%), hypertriglyceridemia (11 vs 47%), high low-density lipoprotein cholesterol (2 vs 8%) and low high-density lipoprotein cholesterol (HDL-cholesterol; 2 vs 28%), hyperuricemia (11 vs 28%) and hyperinsulinemia (8 vs 70%). Hyperfiltration and MA were present in 5 and 4 subjects with overweight/obesity, respectively, whereas decreased GFR was present in only 1 subject with obesity. Normal weight subjects had no kidney alterations. In multivariate analysis, kidney alterations were significantly predicted by higher BMI and lower HDL-cholesterol. CONCLUSIONS: Kidney alterations were observed only in subjects with overweight (3.6%) and obesity (9.9%), who additionally, displayed cardiometabolic and kidney disease risk factors more frequently than normal weight subjects.

Effect of a symbiotic gel (Lactobacillus acidophilus + Bifidobacterium lactis + inulin) on presence and severity of gastrointestinal symptoms in hemodialysis patients.

OBJECTIVE: The study aimed to assess the effect of a symbiotic gel on presence and severity of gastrointestinal symptoms (GIS) in hemodialysis patients. DESIGN: A double-blinded, placebo-controlled, randomized, clinical trial was designed. The study was conducted at 2 public hospitals in Guadalajara, Mexico. SUBJECTS AND INTERVENTION: Twenty-two patients were randomized to the intervention group (nutritional counseling + symbiotic gel) and 20 patients were randomized to the control group (nutritional counseling + placebo), during 2 months of follow-up. MAIN OUTCOME MEASURE: Presence and monthly episodes of GIS were assessed by direct interview and severity by using the self-administered GIS questionnaire. Additionally, biochemical parameters, inflammatory markers, and nutritional status (dietary intake, subjective global assessment, anthropometry, and body composition) were evaluated. RESULTS: After a 2-month treatment, intervention group had a significant reduction in prevalence and monthly episodes of vomit, heartburn, and stomachache, as well as a significant decrease in GIS severity compared with control group. Moreover, intervention group had a greater yet not significant decrease in the prevalence of malnutrition and a trend to reduce their C-reactive protein and tumor necrosis factor α levels compared with control group. No symbiotic-related adverse side effects were shown in these patients. Clinical studies with longer follow-up and sample size are needed to confirm these results. CONCLUSIONS: We concluded that administration of a symbiotic gel is a safe and simple way to improve common GIS in dialysis patients.

Effects of a symbiotic on gut microbiota in Mexican patients with end-stage renal disease.

OBJECTIVES: Gut microbiota provides beneficial effects under physiological conditions, but is able to contribute to inflammatory diseases in susceptible individuals. Thus, we designed this study to test whether additional intake of symbiotic gel affects specific modifications of gut microbiota in patients with end-stage renal disease (ESRD). METHODS: Eighteen patients with ESRD diagnosis with renal replacement therapy (hemodialysis) were included in this study. They were randomly assigned to 2 treatment groups: (1) test group (nutritional counseling + symbiotic) and (2) control group (nutritional counseling + placebo). Clinical history and the evaluation of Gastrointestinal Symptom Rating Scale were performed. Gut microbiota composition was analyzed by real-time polymerase chain reaction from fecal samples. All subjects were followed for 2 months. RESULTS: Bifidobacterial counts were higher in the second samples (mean: 5.5 ± 1.72 log10 cells/g) than in first samples (4.2 ± 0.88 log 10 cells/g) in the patients of the test group (P = .0344). Also, lactobacilli counts had a little decrease in the test group (2.3 ± 0.75 to 2.0 ± 0.88 log 10 cells/g) and the control group (2.2 ± 0.90 to 1.8 ± 1.33 log 10 cells/g), between the first and the second samples. Gastrointestinal symptoms scores (scale 8-40) were reduced in the test group (start 12 [10-14] and end 9 [8-10]) compared with control group (start 11 [8-21] and end 11 [9-15]). CONCLUSIONS: Short-term symbiotic treatment in patients with ESRD can lead to the increase of Bifidobacterium counts, maintaining the intestinal microbial balance.

Clustering Health Behaviors in Mexican Adolescents: The HELENA-MEX Study.

Purpose: The prevalence of excess weight within the adolescent population is rapidly increasing in Mexico, especially in areas with lower socioeconomic status. The present study aimed to identify lifestyle clustered patterns in adolescents and analyze the associations among these clusters and body composition. Method: A final sample of n=259 participants (13 to 17 years old, 58.7% girls), residents in rural and urban areas, were included. Hierarchical and k-means clusters analyses included moderate to vigorous physical activity (MVPA), cardiorespiratory fitness (CRF), handgrip strength, screen time, sleep time, and diet. The associations between cluster membership and body composition were analyzed through general linear models (ANCOVA), including sex, age, place of residence, and socioeconomic status as covariates. Results: Three different clusters were identified: Cluster 1, [Unhealthy] (low values in all lifestyle patterns), Cluster 2, [Low Physical Fitness] (low values in CRF and handgrip strength) and Cluster 3, [High Physical Activity and CRF] (highest values in CRF, handgrip strength and MVPA). Clusters 2 and 3 showed high values in screen time and industrialized food consumption. There were no differences in sleep between the 3 Clusters. ANCOVA analysis revealed that participants belonging to Cluster 3 showed significantly lower adiposity and a higher Fat Free Mass compared with the other two clusters (p < 0.05). Conclusion: Our findings suggest that a lifestyle characterized by high levels of physical activity and physical fitness and low consumption of industrialized food may be protective against the problem of obesity, which could be helpful to develop interventions to reduce excess weight in Mexican adolescents.

Validation of a Mexican food photograph album as a tool to visually estimate food amounts in adolescents.

The aim of the present study was to validate a food photograph album (FPA) as a tool to visually estimate food amounts, and to compare this estimation with that attained through the use of measuring cups (MC) and food models (FM). We tested 163 foods over fifteen sessions (thirty subjects/session; 10-12 foods presented in two portion sizes, 20-24 plates/session). In each session, subjects estimated food amounts with the assistance of FPA, MC and FM. We compared (by portion and method) the mean estimated weight and the mean real weight. We also compared the percentage error estimation for each portion, and the mean food percentage error estimation between methods. In addition, we determined the percentage error estimation of each method. We included 463 adolescents from three public high schools (mean age 17·1 (sd 1·2) years, 61·8 % females). All foods were assessed using FPA, 53·4 % of foods were assessed using MC, and FM was used for 18·4 % of foods. The mean estimated weight with all methods was statistically different compared with the mean real weight for almost all foods. However, a lower percentage error estimation was observed using FPA (2·3 v. 56·9 % for MC and 325 % for FM, P< 0·001). Also, when analysing error rate ranges between methods, there were more observations (P< 0·001) with estimation errors higher than 40 % with the MC (56·1 %), than with the FPA (27·5 %) and FM (44·9 %). In conclusion, although differences between estimated and real weight were statistically significant for almost all foods, comparisons between methods showed FPA to be the most accurate tool for estimating food amounts.

[Calcium intake and adiposity in adolescents aged 12-16 years in Guadalajara, Mexico]. / Ingestión de calcio y adiposidad en adolescentes de 12 a 16 años en Guadalajara, México.

The purpose was to evaluate the association between calcium (Ca) intake and adiposity in adolescents. A cross-sectional study of 125 adolescents 12 to 16 years. Ca intake was evaluated by 24-hour recall dietary surveys and food frequency consumption. Adiposity was measured by anthropometric methods and bioelectrical impedance (BIA). The association between Ca intake and adiposity was identified by simple correlation and multivariate models adjusted to energy consumption, age, sex and menarche. Mean age of adolescents was 13.5 +/- 0.8 years. A negative correlation was identified between Ca intake and anthropometric indicators weight, skinfolds, body mass index, fat mass and percentage of fat (the latter two by BIA and only in women). Multivariate analysis, including energy consumption showed no association between Ca intake and adiposity. In conclusion, Ca consumption does not associate with adiposity in adolescents; multivariate models showed that energy intake and menarche are the variables that show a higher association with adiposity at this stage of life.

CRP Serum Levels Are Associated with High Cardiometabolic Risk and Clinical Disease Activity in Systemic Lupus Erythematosus Patients.

Systemic lupus erythematosus (SLE) patients have a higher frequency of cardiovascular risk factors such as high C-reactive protein (CRP) levels than the general population. CRP is considered a cardiovascular disease marker that could be related to SLE clinical disease activity. This study aimed to assess the association between CRP with cardiometabolic risk and clinical disease activity in SLE patients. A comparative cross-sectional study was conducted in 176 female SLE patients and 175 control subjects (CS) with median ages of 38 and 33 years, respectively; SLE patients were classified by the 1997 SLE-ACR criteria, and the clinical disease activity by the Mexican-SLEDAI (Mex-SLEDAI). CRP and lipid profile (triglycerides, cholesterol, HDL-C, and LDL-C) were quantified by turbidimetry and colorimetric-enzymatic assays, respectively. SLE patients had higher CRP levels than CS (SLE: 5 mg/L vs. CS = 1.1 mg/L; p < 0.001). In SLE patients, CRP levels ≥ 3 mg/L were associated with a higher risk of cardiometabolic risk status assessed by LAP index (OR = 3.01; IC: 1.04−8.7; p = 0.04), triglycerides/HDL-C index (OR = 5.2; IC: 2.1−12.8; p < 0.001), Kannel index (OR = 3.1; IC: 1.1−8.1; p = 0.03), Castelli index (OR = 6.6; IC: 2.5−17.8; p < 0.001), and high clinical disease activity (OR = 2.5: IC: 1.03−6.2; p = 0.04; and ß coefficient = 5.8; IC: 2.5−9.4; R2 = 0.15; p = 0.001). In conclusion, high CRP levels were associated with high cardiometabolic risk and clinical disease activity in SLE patients.

[Continuum of risky eating behaviors in Mexican adolescents]. / Continuo de conductas alimentarias de riesgo en adolescentes de México.

OBJECTIVE: Determine the relationship between the variables of self-esteem (SE), body dissatisfaction (BD), and body mass index (BMI) in a continuum of risky eating behaviors (REB) that ranges from normal behavior to the risk of eating disorders (ED), thus facilitating early detection of adolescents with ED symptomatology and the degree to which such variables have an influence. METHODS: A total of 1 982 young women aged 15-19 were selected through stratified random sampling. Self-esteem (Pope, McHale, and Craighead scale), body dissatisfaction (Stunkard's Figure Rating Scale), and body mass index were measured. A brief REB questionnaire was administered. Three categories of REB were defined: no risk, moderate risk, and high risk. A multiple regression analysis was performed. RESULTS: A direct relationship was found between risk of REB and BD, with significant differences between the groups (P < 0.001): no risk (83.6% of sample), 54.1% had BD; moderate risk (11.9% of sample), 84.8% had BD; and high risk (4.5% of sample), 89.9% had BD. There were significant differences in SE and BMI only between the group with no risk and each of the risk groups. Self-esteem played a role in predicting REB in all the regression models evaluated, whereas BMI did not. CONCLUSIONS: It is essential to identify adolescents at moderate risk of REB who have prodromic features of ED such as low SE and BD. When these features occur simultaneously, they can mediate a negative effect of BMI on REB.

[Sexual and reproductive health among adolescents in high school in Guadalajara, México]. / Salud sexual y reproductiva en adolescentes de escuela secundaria en Guadalajara, Mexico.

BACKGROUND: Some authors define adolescence as the period of transition between childhood and adulthood, a stage characterized by the succession of major physiological, psychological and social human beings. OBJECTIVE: To determine the extent of information about preventing sexually transmitted diseases, knowledge and use of contraceptive methods, and to determine the percentage of high school teenagers who have initiated sex and age of onset. MATERIAL AND METHOD: We have realized a transverse descriptive study in 754 students from public junior high school number 54 in the city of Guadalajara, during the 2005-2006 school year. We have applied a survey that included questions about sexual health, and aspects as knowledge and use of contraceptive methods and concepts on the prevention of sexually transmitted diseases. Data were captured in a database in Excel, and then analyzed using SPSS. RESULTS: It included 641 students who agreed to complete the questionnaire by signed consent. The source of information on sex education is the most important school. The 84.5% of students surveyed know at least one contraceptive method, of which the condom is the best known (73.3%). The 84% of teenagers know how to prevent sexually transmitted diseases. Of all students, only 46 (7.2%) have initiated sexual activity of which 100% of males used contraception while only 63.3% of women did. CONCLUSIONS: It is necessary to establish or strengthen information programs on sexual health for adolescents, not only in schools if not in the media.

Body Dissatisfaction and Its Association with Health-Related Factors in Rural and Urban Mexican Adolescents from the State of Jalisco.

BACKGROUND: To better understand Mexican adolescent's body self-perception, this study aimed to analyze their body dissatisfaction (BD) levels according to sex and place of residence. We also aimed to explore differences in body composition (BC), physical fitness (PF), and physical activity (PA) between satisfied and dissatisfied adolescents and to find the associations between BD and these parameters. METHODS: Cross-sectional, observational study carried out in Jalisco (Mexico) in which 451 adolescents (43.68% males, 43.90% rural) aged 13-17 years were evaluated. BD and self-perceived PF and PA were assessed with validated questionnaires, while objectively measured PF (strength, explosive strength, speed-agility, and cardiovascular fitness) was assessed using field tests. To evaluate BC, anthropometric measures and bioelectric impedance analysis were carried out. Regression analysis was used to ascertain the associations between health-related factors and body dissatisfaction. RESULTS: Girls obtained higher scores on the BD questionnaire than boys (11.12 ± 3.13 vs. 10.33 ± 2.73; p < 0.05), whereas no geographical differences between rural and urban adolescents were found. BD was positively associated with higher fat mass (ß = 0.15; p < 0.001), and negatively associated with muscle mass and PF (ß = -0.24 and ß = -0.23; p < 0.001). However, PA was not associated with any of the measured parameters. CONCLUSIONS: selected parameters of BC, PF, and sex have an impact on the Mexican adolescent's body satisfaction levels and should be considered when designing future health policies.

Association of High Calcitriol Serum Levels and Its Hydroxylation Efficiency Ratio with Disease Risk in SLE Patients with Vitamin D Deficiency.

Vitamin D (calcidiol) deficiency in systemic lupus erythematosus (SLE) is more frequent than in healthy subjects (HS); it is associated with clinical activity and damage in SLE. Although calcidiol is considered the best indicator of the vitamin D serum status, its deficiency could not reflect its hydroxylation efficiency ratio and calcitriol serum status. This study was aimed at assessing the association of calcidiol and calcitriol serum levels and its hydroxylation efficiency ratio with the risk to clinical and renal disease activities in SLE patients. A cross-sectional study was conducted in 308 SLE and HS women; calcidiol and calcitriol serum levels were evaluated by immunoassays. SLE patients showed lower calcidiol serum levels vs. HS (21.2 vs. 24.2 ng/mL; p < 0.001). Active SLE patients presented higher calcidiol/calcitriol ratio scores vs. inactive SLE patients (2.78 vs. 1.92 pg/ng; p = 0.02), and SLE patients with renal disease activity showed a pattern of calcidiol-deficient levels (19.5 vs. 25.3 ng/mL; p < 0.04) with higher calcitriol levels (47 pg/mL vs. 41.5 pg/mL; p = 0.02) and calcidiol/calcitriol ratio scores (2.13 vs. 1.54 pg/ng; p < 0.02) compared to SLE patients without renal disease activity. Calcidiol levels were negatively correlated with calcitriol levels (r = -0.26; p = 0.001) and urine proteins (mg/dL) (r = -0.39; p < 0.01). Regarding calcitriol levels, it was positively correlated with the blood lymphocyte count (r = 0.30; p < 0.001) and negatively correlated with the glomerular filtration rate (r = -0.28; p = 0.001). Moreover, the calcitriol/calcidiol ratio was positively correlated with urine proteins (r = 0.38; p < 0.01). The calcidiol deficiency (OR = 2.27; 95% CI = 1.15-4.49; p < 0.01), high calcitriol levels (T3rd, OR = 4.19, 95% CI = 2.23-7.90; p < 0.001), and a high calcitriol/calcidiol ratio score (T3rd, OR = 5.93, 95% CI: 3.08-11.5; p < 0.001) were associated with the risk for SLE. In conclusion, a pattern of calcidiol deficiency with high calcitriol serum levels and a high vitamin D hydroxylation efficiency ratio was associated with disease risk in SLE patients.

Healthy Obese Subjects Differ in Chronotype, Sleep Habits, and Adipose Tissue Fatty Acid Composition from Their Non-Healthy Counterparts.

Obesity is not the same in all individuals and two different phenotypes have been described: metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO). The aim of this study was to identify factors that explain metabolic health status in a rigorously matched Spanish population. Subcutaneous and visceral fat, adipocyte size and fatty acid composition, cardiometabolic markers in serum, and lifestyle habits were assessed. Higher physical activity in the mornings (Odds Ratio (95% Confidence Interval) (OR (95% CI) = 1.54 (1.09-2.18), p = 0.01)), earlier bedtimes (8:30-10:30 pm) (OR = 2.11 (1.02-4.36), p = 0.04), a complete breakfast (OR = 1.59 (1.07-2.36), p = 0.02), and a greater number of meals per day (4.10 ± 0.05 vs. 3.93 ± 0.05, p < 0.01), were associated with the MHO phenotype. Concentrations of 20:5 n-3 eicosapentaenoic acid (0.26 ± 0.46 vs. 0.10% ± 0.11%, p = 0.04) and 18:3 n-6 gamma-linolenic acid (0.37 ± 0.24 vs. 0.23% ± 0.22%, p = 0.04) in subcutaneous adipocytes were higher and omental adipocyte size (187 094 ± 224 059 µm3 vs. 490 953 ± 229 049 µm3, p = 0.02) was lower in MHO subjects than in those with MUO. Visceral fat area differed between MHO and MUO subjects (135 ± 60 cm2 vs. 178 ± 85 cm2, p = 0.04, respectively). The study highlights specific lifestyle habits that could form part of obesity therapies, not only involving healthier eating habits but also earlier sleeping and exercise patterns.

Using a lactation room at the workplace is associated with longer breastfeeding duration in working mothers.

INTRODUCTION: IIntroduction: maternal employment after childbirth is associated with abandonment of breastfeeding; however, lactation rooms in the workplace increase the practice of breastfeeding. Objective: to compare the frequency and duration of breastfeeding among working mothers based on the presence of lactation rooms in their workplaces. Methods: we included mothers from different institutions whose infants were between 6 and 35 months (n = 158), and an ad hoc questionnaire was applied to assess breastfeeding, exclusive breastfeeding (EBF), partial breastfeeding (PBF), and use of human milk substitutes (HMS). Two groups were compared: working mothers with a lactation room at their workplace (n = 76) versus working mothers without this resource (n = 82). Results: breastfeeding duration (7.5 vs. 5.0 months, p < 0.001) and EBF (3.0 vs. 1.2 months, p = 0.005) were higher in mothers who had a lactation room. HMS use was shorter in mothers who had a lactation room (2.5 vs. 10.0 months, p = 0.001). There were more working mothers who breastfed for more than six months (75.0 % vs. 48.8 %) [OR = 3.15 (95 % CI, 1.60-6.19), p = 0.001] and 12 months (31.6 % vs. 14.6 %) [OR = 2.69 (95 % CI, 1.23-5.87), p = 0.014] when lactation rooms were available in their workplaces. Conclusion: the presence of a lactation room in the workplace was associated with a higher frequency and duration of breastfeeding.

INTRODUCCIÓN: RESUMEN Introducción: el empleo materno después del parto se asocia con el abandono de la lactancia materna, mientras que las salas de lactancia en el lugar de trabajo aumentan la práctica de la lactancia. Objetivo: comparar la frecuencia y duración de la lactancia materna entre madres trabajadoras en función de la presencia o no de salas de lactancia en sus lugares de trabajo. Métodos: incluimos madres de diferentes instituciones cuyos bebés tenían entre 6 y 35 meses (n = 158) y se aplicó un cuestionario ad hoc para evaluar la lactancia materna, la lactancia materna exclusiva (LME), la lactancia materna parcial (LMP) y el uso de sucedáneos de la leche humana (SLH). Se compararon dos grupos: madres trabajadoras con una sala de lactancia en su lugar de trabajo (n = 76) y madres trabajadoras sin este recurso (n = 82). Resultados: la duración de la lactancia (7,5 vs. 5,0 meses, p < 0,001) y LME (3,0 vs. 1,2 meses, p = 0,005) fueron mayores en las madres que tenían sala de lactancia. El uso de SLH fue más corto en las madres que tenían sala de lactancia (2,5 vs. 10,0 meses, p = 0,001). Hubo más madres trabajadoras que amamantaron más de seis meses (75,0 % vs. 48,8 %) [OR = 3,15 (IC 95 %: 1,60-6,19), p = 0,001] y 12 meses (31,6 % vs. 14,6 %) [OR = 2,69 (IC 95 %: 1,23-5,87), p = 0,014] cuando había salas de lactancia disponibles en sus lugares de trabajo. Conclusión: la presencia de una sala de lactancia en el lugar de trabajo se asoció a una mayor frecuencia y duración de la lactancia materna.

Health-Related Factors in Rural and Urban Mexican Adolescents from the State of Jalisco: The HELENA-MEX Study.

Mexico shows a high prevalence of obesity in children and adolescents. Geographical location and cultural environment could play a role in the promotion of healthy lifestyles in terms of physical activity (PA), sedentary behavior (SB) and nutrition. The purpose of this study was to assess rural and urban differences in body composition (BC), physical fitness (PF), PA and nutritional status of adolescents from the state of Jalisco (Mexico). The study involved 469 students aged 13-17 years (55.0% girls) from eight high schools. BC was analyzed by bioimpedance and PF by standardized field tests. Objective measurements of PA and SB were taken in a subsample (n = 240). Energy intake (EI) was calculated from two 24h recalls. Rural residents presented a higher prevalence of overweight, waist circumference, trunk fat mass, regional fat free mass and muscle handgrip strength (all p < 0.05, η2p < 0.06). Cardiorespiratory fitness was similar among participants, whereas urban adolescents showed higher muscle power, speed-agility and flexibility scores (all p < 0.05, η2p < 0.07). Overall lifestyle behavior in urban adolescents was more sedentary (p < 0.05, η2p = 0.11). EI was similar in both locations. In conclusion, rural Mexican adolescents presented a generally lower sedentary behavior and a lower fitness and fatness profile than their urban peers.

Validation of a Spanish-Language Questionnaire on Adolescent Eating Behavior Based on Social Cognitive Theory.

OBJECTIVE: To validate a Spanish-language questionnaire on adolescent eating behavior based on Social Cognitive Theory. DESIGN: The validity (reliability and construct validity) of a self-administered questionnaire containing 28 questions with Likert scale-type response options was evaluated. SETTING: School located in Tonala, Jalisco, Mexico (a peri-urban area) with approximately 1,400 students enrolled. PARTICIPANTS: One hundred fifty-two adolescents enrolled in the second year of a middle school in Tonalá, Jalisco, Mexico (mean age, 13.7 years; SD, 0.5 years; 64% female). The retest was completed by 70 adolescents chosen at random. OUTCOME MEASURES AND ANALYSIS: The questionnaire's reliability was measured through internal consistency (Cronbach α) and reproducibility (intraclass correlation coefficient [ICC]). Construct validity was assessed using exploratory factor analysis. RESULTS: Five questions were eliminated from the questionnaire because of a lack of temporal stability (ICC ≤0.4). The exploratory factor analysis was satisfactory for 3 factors (41.89% of variance): environmental facilitators and social support, self-efficacy and self-regulation, and outcome expectations and outcome expectations value. The questionnaire had good internal consistency (α = 0.824) and excellent temporal stability (ICC = 0.849). CONCLUSIONS AND IMPLICATIONS: The results substantiate the reliability and construct validity of this questionnaire. The questionnaire has the potential to use the assessment of Social Cognitive Theory constructs in clinical practice or in nutrition interventions aimed at modifying the eating habits of Spanish-speaking adolescents.

Relationship of Excess Weight with Clinical Activity and Dietary Intake Deficiencies in Systemic Lupus Erythematosus Patients.

Obesity and nutrients intake deficiencies may contribute to the clinical manifestations and inflammatory processes in systemic lupus erythematosus (SLE). The aim of this study was to assess the relationship between nutritional status and dietary intake with clinical variables in Mexican-mestizo SLE patients. A cross-sectional study was conducted in 130 female SLE patients, classified by the 1997 SLE American College of Rheumatology (ACR) criteria; the clinical activity was evaluated by the Mexican-Systemic Lupus Erythematosus-Disease Activity Index (Mex-SLEDAI); body mass index (BMI) by the World Health Organization (WHO) criteria; the energy calculation and nutritional intake were performed by Nutritionist Pro Diet software. SLE patients with excess weight (BMI > 25 kg/m2) showed a higher score of clinical activity (Mex-SLEDAI = 2; p = 0.003), higher clinical activity prevalence (40.9%; p = 0.039) and a significant association for high clinical activity (odds ratio (OR) = 2.52; 95% confidence interval (CI) = 1.08-5.9; p = 0.033), in comparison with patients without excess weight (BMI < 25 kg/m2). In particular, the excess weight increased the Mex-SLEDAI score (ß coefficient = 1.82; R2 = 0.05; p = 0.005). Also, the SLE patients presented a high prevalence (%) of deficient consumption (cut-off point: <67% of dietary adequacy) of vitamin E (100%), iodine (96%), omega 3 (93.44%), biotin (78%), vitamin K (73.33%), iron (67%), vitamin D (63.3%), potassium (59%), folic acid (56.67%), pantothenic acid (43.3%), vitamin A (41.67%) and zinc (32%). In conclusion, in SLE patients the excess weight was associated with increased clinical activity and to the presence of deficiencies in some essential nutrients ingested.