[Social inequalities in the progression of COVID-19 in the Mexican population]. / Inequidades sociales en la progresión de la COVID-19 en población mexicana.

OBJECTIVE: To determine if there are disparities associated with socioeconomic stratification, ethnicity, medical services, and geographic region in the progression of coronavirus disease (COVID-19) in Mexican adults infected with SARS-CoV-2. METHOD: We analyzed data registered by the General Direction of Epidemiology of the Ministry of Health of the Federal Government of Mexico regarding the confirmed cases of SARS-CoV-2 infection. The analysis was limited to data from adults 20 years and older recorded up to July 10, 2020 (n=234 870). Indicators of severity of COVID-19 were hospitalization, development of pneumonia, requirement for intubation or admission to the intensive care unit, and death. Differences were estimated according to the level of municipal marginalization, belonging to an indigenous group, geographic region, and service sector. Prevalence ratios (PR) were estimated using multilevel regression models. RESULTS: People who lived in municipalities with greater marginalization were at greater risk of presenting the four indicators of severe forms of COVID-19 (PR=1.05 or 1.06). Indigenous people were at greater risk of pneumonia (PR=1.22), hospitalization (PR=1.14) and death (PR=1.23). Among the cases treated in the private health sector, the risk of death was lower (PR=0.40), but the use of intubation or admission to the intensive care unit was higher (PR=4.45). CONCLUSIONS: The trends observed indicate that the effects of COVID-19 are not only related to the biological characteristics of SARS-CoV-2, but also to the resources (or lack thereof) to deal with it, which are distributed by social processes.

Clinical characteristics and severity of COVID-19 among Mexican adults.

INTRODUCTION: Obesity, diabetes, hypertension and age have been pointed at as factors that influence on the progression of COVID-19; however, evidence for other conditions is inconclusive. OBJECTIVE: To identify which clinical characteristics are related to COVID-19 severity and to determine whether age acts a modifier of the relationship between cardio-metabolic comorbidities (CMC) and COVID-19 progression. METHOD: Data on ≥ 20-year-old confirmed cases (n = 159,017) were analyzed. Hospitalization, development of pneumonia, intubation requirement, intensive care unit admission and death were the dependent variables in Poisson regression models estimation, whereas the interaction between age and different CMCs were the independent variables. RESULTS: Having CMCs, as well as other comorbidities, was directly related to COVID-19 progression, whereas chronic obstructive pulmonary disease was only related to an increase in the risk of dying. The risk for COVID-19 severity was lower as age was more advanced. Asthma and smoking were not risk factors for the progression of COVID-19. CONCLUSION: In the Mexican population, the risk of COVID-19 progression associated with comorbidities was higher in young adults.

INTRODUCCIÓN: Se ha señalado que factores como obesidad, diabetes, hipertensión y edad influyen en la progresión de COVID-19; sin embargo, la evidencia para otras condiciones no es concluyente. OBJETIVO: Identificar qué antecedentes clínicos están relacionados con la gravedad de COVID-19 y si la edad funge como un modificador de efecto de la relación entre comorbilidades cardiometabólicas (CCM) y progresión de COVID-19. MÉTODO: Se analizaron los datos de casos confirmados ≥ 20 años (n = 155 017). La hospitalización, el desarrollo de neumonía, el requerimiento de intubación, el ingreso a la unidad de cuidados intensivos y la muerte constituyeron las variables dependientes en la estimación de modelos de regresión de Poisson y la interacción entre edad y CCM, las independientes. RESULTADOS: Tener CCM, así como otras comorbilidades, se relacionó directamente con la progresión de COVID-19. El riesgo de gravedad de COVID-19 asociado a las CCM fue menor conforme la edad era mayor. El asma y el tabaquismo no fueron factores de riesgo para la progresión de COVID-19. CONCLUSIÓN: En la población mexicana, el riesgo de progresión de COVID-19 asociada a comorbilidades fue mayor en los adultos jóvenes.

Validity of equations for estimating aerobic fitness in Mexican youth.

The purpose of this study was to evaluate the validity of prediction equations for estimating maximal oxygen uptake (VO2peak) based on the PACER test and different adiposity indicators in Mexican youth. A convenience sample of youth aged 9-18 years from schools in Mexico City was recruited. VO2peak was evaluated with a laboratory exercise test on a treadmill and using a gas analyser and with the 20-m PACER test guidelines. The sample was randomly divided to develop new equations (n = 220) and to evaluate their validity (n = 106). Prediction equations of VO2peak were developed using multiple linear regression models. The adiposity indicators were BMI, waist circumference and body fat. The validity of the new and previously published equations was evaluated based on linear regression models, intra-class coefficient, Akaike's information criterion, mean absolute percentage error and Bland-Altman graphs. Equations with waist circumference and body fat performed better than those with BMI and without any anthropometric indicator. The accuracy of the developed equations (R2 = 57.0%-59.50%) was higher than that of previously published equations (R2 = 24.1%-56.0%). The new equations had lower bias in estimating VO2peak. In Mexican youth, the estimation of VO2peak from the 20-m PACER test is more accurate after including waist circumference or body fat than with BMI.

[Contribution of NOVA food groups to energy and nutrient supply in Mexican households]. / Contribución de los grupos de alimentos NOVA a la disponibilidad de energía y nutrientes en los hogares mexicanos.

OBJECTIVE: To analyze the contribution of natural, processed and ultra-processed foods to energy and nutrient supply in Mexican households. MATERIALS AND METHODS: The database of the National Household Expenditure Survey 2013 was analyzed (n=58 001), which is a cross-sectional survey. Food supply (g/adult equivalent/day) and energy, macro- and micro-nutrient supplies were estimated. Foods were classified following the NOVA system. Households sociodemographic characteristics were analyzed as covariates. RESULTS: Natural foods (NF) contributed with more energy (55.0%) followed by ultra-processed foods (UPF, 21.2%). NF were the main source of most nutrients. Processed culinary ingredients (PCI) and processed foods (PF) had high content of energy, total fats, and saturated fats, but low content of certain micronu- trients. Sodium was mainly available in PF (34.6%) and UPF (31.4%). Sugar-sweetened beverages, fast foods, and biscuits and cookies were the main UPF in terms of energy supply. CONCLUSIONS: In Mexican households, the PCI, PF and UPF had low nutritional quality.

OBJETIVO: Analizar la contribución de los alimentos naturales, procesados y ultraprocesados a la disponibilidad de energía y nutrientes en los hogares mexicanos. MATERIAL Y MÉTODOS: Se analizó la base de datos de la Encuesta Nacional de Gasto de los Hogares 2013 (n = 58 001), la cual es una encuesta transversal. Se estimó la disponibilidad de alimentos (g/adulto equivalente/día), energía y nutrientes. Los alimentos fueron clasificados siguiendo el sistema NOVA. RESULTADOS: Los alimentos naturales (AN) y los ultraprocesados (AUP) contribuyeron con más energía. Los AN fueron la principal fuente de la mayoría de los nutrimentos. Los ingredientes culinarios procesados (ICP) y los alimentos procesados (AP) tenían alto contenido de energía, grasas totales y grasas saturadas pero bajo contenido de ciertos micronutrientes. El sodio estaba disponible principalmente en AP y AUP. Las bebidas azucaradas, comidas rápidas, galletas y panes fueron los principales AUP. CONCLUSIONES: En México, los ICP, AP y AUP tienen baja calidad nutricional.

Characterization of the School Neighborhood Food Environment in Three Mexican Cities.

Food resources in school neighborhoods can negatively influence diet; however, this environment is understudied. This study characterized the school neighborhood food environment in Guadalajara (n=11), Puerto Vallarta (n=7), and Mexico City (n=14). Convenience stores, table-service restaurants, and taco stands were highly available in all three cities. Grocery stores were highly available in Mexico City school neighborhoods, yet less frequently observed in Guadalajara and Puerto Vallarta. Socioeconomic differences in food cart and grocery store availability were observed in Guadalajara and Puerto Vallarta. Policy and intervention strategies are needed to address the saturation of food resources in Mexico school neighborhoods.

Satisfaction with Healthcare Services and Adherence to Antiretroviral Therapy among Patients with HIV Attending Two Public Institutions.

BACKGROUND: Discontinuation of antiretroviral therapy has adverse consequences in HIV patients and is a major public health problem. We analyzed the relationship between satisfaction with healthcare services and adherence to antiretroviral therapy among patients with HIV in Mexico City. MATERIAL AND METHODS: We conducted a cross-sectional study with patients with HIV (n = 557) who were treated in two public institutions. An ad hoc questionnaire was used to assess perceived satisfaction with healthcare services (i.e. physician/patient relationship, performance of services, and administrative aspects with focus on specific areas) and adherence to HIV treatment (i.e. failure to take antiretroviral therapy on previous day, week, and month). RESULTS: The higher prevalence of non-adherence to antiretroviral therapy was during the previous month (23.5%). Dissatisfied patients with the relationship with their physician were more likely to have low adherence during the previous month (OR: 1.90; p < 0.05). Those who were dissatisfied with the care provided in specific clinical areas had low adherence (OR: 1.67; p = 0.051), but the difference disappeared (OR: 1.26; p = 0.443) after adjusting for satisfaction with physician/patient relationship. CONCLUSIONS: The quality of the relationship between physician and patients is an aspect that impacts on adherence to antiretroviral therapy. It is necessary to promote effective communication between health personnel and patients with HIV.

[Food availability according to food security-insecurity among Mexican households]. / Disponibilidad de alimentos en los hogares mexicanos de acuerdo con el grado de inseguridad alimentaria.

OBJECTIVE: To know the differences in food availability according to food insecurity level among the Mexican households. MATERIALS AND METHODS: We analyzed the database of the National Survey of Household's Incomes and Expenditures (n=27 445 households). Households were classified according to the Latin American and Caribbean Inventory of Food Security. The availability of each food group was estimated as grams per day per equivalent adult. RESULTS: 50.0% of Mexican households experienced some degree of food insecurity. Among households with food insecurity there was high availability of corn, wheat, egg, and sugars; but there was low availability of fresh fruits and vegetables, lean meat, poultry, seafood, milk, cheeses, and sweetened beverages. CONCLUSION: Although in households with food insecurity there is lower availability of most food groups (both with high nutrient density and with high energy density); they have higher availability of cheap foods, which in some cases are only source of energy but do not provide nutrients.

Social capital as a moderator of the relationship between violent community environment and psychological distress.

OBJECTIVE: To evaluate the modifying effect of social capital on the relationship between living in violent communities and the presence of psychological distress in adolescents and youth in Mexico. METHOD: The analysis of the Social Cohesion Survey for the Prevention of Violence and Crime (ECOPRED, by its acronym in Spanish) was conducted. The analytic sample consisted of 39,639 participants aged 12 to 29 years. Community violence and social capital were measured at the census tract level using the average answers of a household's head sample. These environmental variables were independent of the experiences of the participants. Social capital variables included structural (social ties, recreational participation, collaborative participation, and social cohesion), and cognitive (trust in neighbors) dimensions. Multilevel structural equation models were used. RESULTS: Recreational participation, collaborative participation, and social cohesion modified the relationship between community environments and psychological distress. In females who lived in places with less recreational participation or less social cohesion, the higher the social disorder, the higher the psychological distress. A similar relationship between vandalism and psychological distress was identified, but only in males who lived in places with less collaborative participation, and in females with less social cohesion. CONCLUSIONS: Our results suggest that dimensions of the structural social capital (organization and interest in the community and its members) were the ones that had the buffering effect of the exposure to disordered community environments on psychological distress.

Beyond direct exposure to violence: effects of living in disordered and violent communities on psychological distress in young Mexican people.

The association between community violence and mental health has been studied by reports of individual experiences, particularly in adolescents and youths, but little is known about the effect of living in disordered and violent communities. This study aims to determine the possible relation between living in disordered and violent community environments and psychological distress in Mexican adolescents and youths regardless of their individual experience of victimization and to assess the potential modifying effect of sex and age on this association. Data come from a cross-sectional survey with a representative sample of adolescents and youths living in Mexican municipalities, including 39,639 participants aged from 12 to 29 years. Disordered and violent community environments were assessed using reports from a secondary sample of adults who lived in the same communities as participants. Using exploratory factor analysis, three contextual variables related to disordered and violent community environment were created: social disorder, vandalism, and criminality. Multilevel linear regression models with random intercept were estimated. Adolescents and youths who lived in environments with higher social disorder had more psychological distress. Men in environments with greater vandalism had a higher level of psychological distress. Unexpectedly, women from communities with higher levels of crime had fewer symptoms. It is necessary to address the violence that exists in these communities, creating strategies that reduce not only crime, but also the social disorder and vandalism that could contribute to developing negative effects on mental health.

Association between maternal cardiometabolic markers and fetal growth in non-complicated pregnancies: a secondary analysis of the PRINCESA cohort.

The objective of this study was to evaluate the association of maternal cardiometabolic markers trajectories (glucose, triglycerides (TG), total cholesterol, systolic blood pressure (SBP) and diastolic blood pressure (DBP)) with estimated fetal weight trajectories and birth weight in Mexican pregnant women without medical complications. Cardiometabolic marker trajectories were characterized using group-based trajectory models. Mixed-effect and linear regression models were estimated to assess the association of maternal trajectories with estimated fetal weight and birth weight. The final sample comprised 606 mother-child dyads. Two trajectory groups of maternal cardiometabolic risk indicators during pregnancy were identified (high and low). Fetuses from women with higher values of TG had higher weight gain during pregnancy ( ß ^ = 24.00 g; 95%CI: 12.9, 35.3), were heavier at the sixth month ( ß ^ =48.24 g; 95%CI: 7.2, 89.7) and had higher birth weight ( ß ^ = 89.08 g; 95%CI: 20.8, 157.4) than fetuses in the low values trajectory. Fetuses from mothers with high SBP and DBP had less weight in the sixth month of pregnancy ( ß ^ = - 42.4 g; 95%CI: - 82.7, - 2.1 and ß ^ = - 50.35 g; 95%CI: - 94.2, - 6.4), and a higher DBP trajectory was associated with lower birth weight ( ß ^ = - 101.48 g; 95%CI: - 176.5, - 26.4). In conclusion, a longitudinal exposition to high values of TG and BP was associated with potentially adverse effects on fetal growth. These findings support the potential modulation of children's phenotype by maternal cardiometabolic conditions in pregnancies without medical complications.

Differences in Body Weight According to Skin Color and Sex in Mexican Adults.

OBJECTIVES: 1) To analyze the differences in body weight according to skin color in Mexican adults. 2) Identify mediator variables that could explain possible differences in body weight according to skin color. METHODS: A nationally representative survey of Mexican adults was analyzed (n = 12,021). People with obesity were identified (body mass index, BMI > 30) based on self-reported weight and height. Skin color was measured by self-report using a chromatic scale. The mediator variables were socioeconomic level, height, neighborhood public services, public safety, and discrimination based on skin color. RESULTS: Compared to white-skinned women, brown-skinned women had higher BMI and a higher probability of being obese. These differences in weight by skin color are related to the lower level of education and more discrimination experiences of brown-skinned women. In men, there were no differences in weight according to skin color. CONCLUSIONS: In Mexican women (but not in men), darker skin color was associated with a higher probability of being obese, and the examined social factors partially explained this disparity.

Energy Expenditure in Free-Living Physical Activities and Sedentary Behaviors in Mexican Schoolchildren.

Purpose: Metabolic equivalents for youth (METy) are derived using the estimated basal metabolic rate (BMR). However, is unknown whether this METy can be different when measured resting energy expenditure (REE) is used. The purposes of this article are to: (a) To determine whether there is equivalence between METy values calculated using measured REE (METy-mea) and METy using predicted BMR (METy-est). (b) To determine whether METy values of different activities are dependent on age, sex, and body composition. Methods: A cross-sectional study with a sample of 122 Mexican children (5-11 years old) was conducted. With indirect calorimetry, energy expenditure was measured at rest and during 16 sedentary- to vigorous-intensity physical activities. METy were obtained in two forms: METy-mea and METy-est. Equivalence testing was used to compare METy-mea and METy-est. To examine the individual-level agreement, Bland-Altman plots were graphed, and intra-class correlation coefficients (ICC) were calculated. Linear regression models were estimated having METy as the outcome. Results: For 15 activities, there was equivalence between METy-mea and METy-est (t > 2.05, p < 0.050). However, at the individual-level, for 7 activities the agreement between METy-eREE and METy-mREE was inadequate (ICC<0.75). In the Bland-Altman plots was evident that in 8 activities METy-est was biased compared to METy-mea, METy-est had more correlations with body mass index and body fat. Conclusions: In conclusion, at group-level, for most activities METy-mea and METy-est were equivalent. However, at the individual level, METy-est of many activities is not a valid estimate of METy-mea. METy-est of many physical activities were dependent on adiposity, which could be an artifact introduced when BMR is predicted.

[Evaluation of a program led by community workers to promote cardiometabolic health in adults in a highly marginalized Mexican municipality]. / Evaluación de un programa dirigido por trabajadores comunitarios para promover la salud cardiometabólica en adultos de un municipio mexicano de alta marginación.

Introduction: Objective: to evaluate the impact of a group program of nutrition education implemented by community workers on food consumption, physical activity and cardiometabolic risk. Material and methods: a randomized trial by conglomerates was performed. The intervention group (n = 246) participated in a program of nine group sessions of nutrition education delivered by community workers and focused on giving healthy habits options and evocation of motivations. The control group (n = 183) received printed information on healthy eating and physical activity. At the beginning of the study and after one year of follow-up, anthropometric measurements of blood pressure, heart rate, lipid profile and glucose were assessed. A questionnaire was applied to collect sociodemographic data, food consumption and physical activity. Results: in multilevel regression models it was observed that the intervention group reported an increase in the frequency of consumption of fruits, vegetables and legumes, increased body mass index and its probability of increasing recreational physical activity was higher; in addition, it reduced its consumption of sweetened cereals, and decreased the probability of hyperglycemia compared to the control group. Resting heart rate increased in both groups, but the increase was lower in the intervention group. Conclusions: nutrition education guided by community workers can have positive effects on cardiometabolic risk, so it would be an alternative to traditional education focused on providing information.

Introducción: Objetivo: evaluar el impacto de un programa grupal de orientación alimentaria implementado por trabajadores comunitarios sobre el consumo de alimentos, actividad física y riesgo cardiometabólico. Material y métodos: se realizó un ensayo aleatorizado por conglomerados. El grupo de intervención (n = 246) participó en un programa de nueve sesiones grupales de orientación alimentaria impartido por trabajadores comunitarios y centrado en dar opciones de hábitos saludables y en la evocación de motivaciones. El grupo control (n = 183) recibió información impresa sobre alimentación saludable y actividad física. Al inicio del estudio y después de un año de seguimiento se realizaron mediciones antropométricas, de presión arterial, frecuencia cardiaca, perfil de lípidos y glucosa; además se aplicó un cuestionario que recabó información sociodemográfica, consumo de alimentos y actividad física. Resultados: en modelos de regresión multinivel se observó que el grupo de intervención reportó aumento en la frecuencia de consumo de frutas, verduras y leguminosas, aumentó el índice de masa corporal y su probabilidad de incrementar la actividad física recreativa fue mayor; además, redujo su consumo de cereales altos en azúcar y grasa, y disminuyó la probabilidad de hiperglucemia comparado con el grupo control. La frecuencia cardiaca aumentó en ambos grupos, pero el aumento fue menor en el grupo de intervención. Conclusiones: la orientación alimentaria guiada por trabajadores comunitarios puede tener efectos positivos en el riesgo cardiometabólico, por lo cual sería una alternativa a la educación en salud enfocada a dar información.

Individual, Family, and Social Factors Associated with Gestational Weight Gain in Adolescents: A Scoping Review.

About 56% to 84% of pregnant adolescents have inappropriate (insufficient or excessive) gestational weight gain (GWG); however, the factors associated with GWG in this age group have not been systematically identified. This scoping review aimed to synthesize the available scientific evidence on the association of individual, family, and social factors with inappropriate gestational weight gain in pregnant adolescents. To carry out this review, the MEDLINE, Scopus, Web of Science, and Google Scholar databases were searched for articles from recent years. The evidence was organized according to individual, family, and social factors. The analyzed studies included 1571 adolescents from six retrospective cohorts, 568 from three prospective cohorts, 165 from a case-control study, 395 from a cross-sectional study, and 78,001 from two national representative samples in the USA. At the individual level, in approximately half of the studies, the pre-pregnancy body mass index (pBMI) was positively associated with the GWG recommended by the Institute of Medicine of the USA (IOM). The evidence was insufficient for the other factors (maternal age, number of deliveries, and family support) to determine an association. According to the review, we concluded that pBMI was positively associated with the GWG. More quality studies are needed to assess the association between GWG and individual, family, and social factors.

Food, energy, and nutrient supply in Mexican households from 1984 to 2018.

INTRODUCTION: Introduction: information about changes in food and energy supply, macronutrient and micronutrient availability by processing level is required to understand the nutritional transition in Mexican society. Objective: to describe the food, energy, and nutrient supply in Mexican households from 1984 to 2018. Methods: five waves of a Mexican cross-sectional survey were analyzed to identify changes in food, energy, and nutrient supplies in households. Food groups were created using the NOVA classification. The content of energy and nutrients was estimated using Mexican and U.S. databases. The education and income interaction with energy and nutritional supply was analyzed. Results: in this period, the supply of fresh and processed fruits and vegetables, processed meat and dairy, fish and seafood, prepared food, and ultra-processed food and drinks increased, whereas unprocessed or minimally processed (UMP) cereals and tubers, legumes, meat, dairy, eggs, and all processed culinary ingredients decreased. These changes have implied a higher supply of protein, total fat, cholesterol, vitamins A and C, calcium and sodium. Total energy, energy density, carbohydrates, and magnesium and potassium density decreased. Across waves, UMP and processed cereals were the main supply for energy, carbohydrates, fiber, iron and potassium. Dairy was the main supply of saturated fat. UMP and processed cereals were the main source of sodium in 1984, whereas ultra-processed cereals were the main source of sodium in 2018. Conclusions: although UMP foods remain the main group in most Mexican households, their supply has decreased over the years, whereas the supply of ultra-processed foods has increased.

INTRODUCCIÓN: Introducción: se requiere información sobre los cambios de la disponibilidad de alimentos, energía y nutrientes, por nivel de procesamiento, para entender la transición nutricional en México. Objetivo: describir la disponibilidad de alimentos, energía y nutrientes en los hogares mexicanos de 1984 a 2018. Métodos: se crearon grupos usando la clasificación NOVA. El contenido de energía y nutrientes se estimó usando bases de datos mexicanas y estadounidenses. Se analizó la interacción de la educación y el ingreso con la disponibilidad de energía y nutrientes. Resultados: en este periodo aumentó la disponibilidad de verduras naturales y procesadas, carnes y lácteos procesados, pescados y mariscos, comida preparada y comida y bebida ultraprocesada, mientras que los cereales sin procesar o mínimamente procesados (SPMP), las leguminosas, las carnes, los lácteos, los huevos y los ingredientes culinarios procesados disminuyeron. Estos cambios implican una mayor disponibilidad de proteína, grasa total, colesterol, vitamina A y C, calcio y sodio. La energía total, la densidad energética, los carbohidratos y la densidad de magnesio y potasio disminuyeron. A lo largo el tiempo, los cereales SPMP y procesados fueron la principal fuente de energía, carbohidratos, fibra, hierro y potasio. Los lácteos fueron la principal fuente de grasas saturadas. Los cereales SPMP y procesados fueron la principal fuente de sodio en 1984, mientras que los cereales ultraprocesados lo fueron en el 2018. Conclusiones: aunque los alimentos SPMP siguen siendo el grupo más disponible en los hogares, su disponibilidad ha disminuido a lo largo de los años, mientras que la de los ultraprocesados ha aumentado.

Main Retailers In Which Mexican Households Acquire Their Food Supply.

OBJECTIVE: To describe the frequency of food and beverages purchased made by Mexican households at different types of grocery retailers. DESIGN: A national cross-sectional survey. SETTING: Mexico. PARTICIPANTS: A representative sample of Mexican households (n = 70,311). MAIN OUTCOME MEASURE(S): Household food and beverages purchases. ANALYSIS: The association between amounts of food and beverages supply bought in different food retailers (as outcome) and households' sociodemographic characteristics (as covariates) was assessed using logistic and linear regression models. RESULTS: Mexican households acquired their food and beverages primarily from abarrotes stores, followed by supermarkets and mercados and tianguis. Abarrotes stores and supermarkets were sources of unprocessed and processed foods. Specialized stores, mercados, and tianguis were primary sources of unprocessed foods. Households with low socioeconomic status and those in the central or southern regions acquired more foods from abarrotes stores, mercados and tianguis, and specialized stores. Households with high socioeconomic status and living in the northern region acquired more foods from supermarkets and convenience stores. CONCLUSIONS AND IMPLICATIONS: Abarrotes stores are the primary source of food and beverages for Mexican households; however, some interventions are needed to increase their supply of unprocessed foods. Public health interventions aiming at increasing access to unprocessed foods could be done through traditional retailers.

Dietary and Nutrient Intake, Eating Habits, and Its Association with Maternal Gestational Weight Gain and Offspring's Birth Weight in Pregnant Adolescents.

Pregnant adolescents' diet and eating habits are inadequate; however, their association with gestational weight gain (GWG) is uncertain. We aimed to analyze whether there is an association between dietary and nutrient intake and eating habits with GWG among pregnant adolescents and their offspring's birth weight. A longitudinal study was performed with 530 participants. We assessed GWG and applied several tools, such as a food frequency questionnaire and 24-h recall, to obtain dietary and nutrient intake and eating habits. The birth weight of adolescents' offspring was registered. Later, we performed crude and adjusted Poisson models. The mean age was 15.8 ± 1.3 years. Of all food groups, the lowest frequency of adequate intake corresponded to vegetables (7%) and legumes (10.2%). Excessive (36.8%) and insufficient (40.9%) GWG were observed. Pregnant adolescents with inadequate legumes intake increased the probability of excessive GWG: (PR 1.86 95% CI 1.00-3.44). Cereals and grains were positively associated with GWG: (PR 1.65, 95% CI 1.18-2.29). Energy, macronutrient intake, and eating habits were not associated with GWG. Offspring's small gestational age (SGA) increased when pregnant adolescents had inadequate sugar-sweetened beverages intake: PR (1.58, 95% CI 1.01-2.49) and when pregnant adolescent watched television (TV). In our sample of Mexican adolescents, dietary and nutrient intake and eating habits were inadequate. Excessive dietary intake from cereals, grains, and animal-sourced foods along with insufficient legumes were associated with excessive GWG. Watching TV while adolescents ate was associated with the birth weight of the offspring.

External validation of a prediction model for estimating fat mass in children and adolescents in 19 countries: individual participant data meta-analysis.

OBJECTIVE: To evaluate the performance of a UK based prediction model for estimating fat-free mass (and indirectly fat mass) in children and adolescents in non-UK settings. DESIGN: Individual participant data meta-analysis. SETTING: 19 countries. PARTICIPANTS: 5693 children and adolescents (49.7% boys) aged 4 to 15 years with complete data on the predictors included in the UK based model (weight, height, age, sex, and ethnicity) and on the independently assessed outcome measure (fat-free mass determined by deuterium dilution assessment). MAIN OUTCOME MEASURES: The outcome of the UK based prediction model was natural log transformed fat-free mass (lnFFM). Predictive performance statistics of R2, calibration slope, calibration-in-the-large, and root mean square error were assessed in each of the 19 countries and then pooled through random effects meta-analysis. Calibration plots were also derived for each country, including flexible calibration curves. RESULTS: The model showed good predictive ability in non-UK populations of children and adolescents, providing R2 values of >75% in all countries and >90% in 11 of the 19 countries, and with good calibration (ie, agreement) of observed and predicted values. Root mean square error values (on fat-free mass scale) were <4 kg in 17 of the 19 settings. Pooled values (95% confidence intervals) of R2, calibration slope, and calibration-in-the-large were 88.7% (85.9% to 91.4%), 0.98 (0.97 to 1.00), and 0.01 (-0.02 to 0.04), respectively. Heterogeneity was evident in the R2 and calibration-in-the-large values across settings, but not in the calibration slope. Model performance did not vary markedly between boys and girls, age, ethnicity, and national income groups. To further improve the accuracy of the predictions, the model equation was recalibrated for the intercept in each setting so that country specific equations are available for future use. CONCLUSION: The UK based prediction model, which is based on readily available measures, provides predictions of childhood fat-free mass, and hence fat mass, in a range of non-UK settings that explain a large proportion of the variability in observed fat-free mass, and exhibit good calibration performance, especially after recalibration of the intercept for each population. The model demonstrates good generalisability in both low-middle income and high income populations of healthy children and adolescents aged 4-15 years.

Racism and mental health among university students in Mexico City.

OBJECTIVE: To assess whether differences exist in experiences of discrimination, perceptions of physical attractiveness, socioeconomic position, and mental health according to student's skin color. MATERIALS AND METHODS: The population included students from a public university in Mexico City. The following three groups were created based on skin color: white, light brown, and brown. By means of regression models, we evaluated whether differences in mental health according to skin color could be due to experiences of discrimination, perceptions of physical attractiveness, and/or socioeconomic position. RESULTS: Students with brown skin had lower levels of self-esteem and vitality and higher levels of fatigue and alcohol consumption. These differences were explained by more frequent experiences of discrimination and because students with brown skin perceived themselves as less attractive. CONCLUSIONS: This is one of the first studies to document the possible effects of racism on mental health among the urban population. Verification of these findings in representative samples is required.

Does food insecurity compromise maternal dietary zinc or energy intake in favor of her child, in rural poor Mexican households?

OBJECTIVE: To analyze quantitative indicators of food insecurity (FI), and estimate if FI modifies the association between maternal and child Zinc and energy intake as evidence for maternal dietary compromise in favor of her child. MATERIAL AND METHODS: Cross-sectional study (n=2 563), data derived from baseline impact evaluation of the Mexican Programa de Apoyo Alimentario. Quantitative indicators of FI were:Household food storage, maize and/or bean production, food expenditure, and spatial access to food markets. We evaluated percentage adequacy of energy (PAE) and Zinc (PAZn) intake. Multiple linear regression model was fitted to estimate the association between maternal and child PAE and PAZn. RESULTS: Child PAE and PAZn were positively associated with those of their mothers. None of the FI indicators modified the association between maternal and child PAE and PAZn. CONCLUSIONS: No evidence of maternal dietary compromise in favor of her child was observed using four quantitative indicators of FI in central-southern rural Mexican househods.