Anthropometric predictors for cardiovascular risk in Indigenous women in Mexico: an inexpensive alternative in rural clinical practice.

INTRODUCTION: Cardiovascular diseases are one of the leading causes of death in Mexico. Although the use of anthropometric indicators facilitates the diagnosis of cardiovascular risk (CVR), their use is limited in rural communities with limited resources. This article evaluated and demonstrated predictive capacity of three anthropometric indexes for CVR in Indigenous women in Mexico from Matlatzinca ethnic group. METHODS: A cross-sectional study of 93 Indigenous women was carried out. CVR was calculated with the Framingham risk score and used as the reference method by comparing it with waist circumference (WC), conicity index (CoI) and waist-height index (WHI). Receiver operating characteristic (ROC) curves were used to analyze the area under the curve (AUC), sensitivity and specificity for each anthropometric index. RESULTS: Cut-off points (and AUC) for each anthropometric index were WHI 0.63 (0.763), CoI 1.29 (0.756) and WC 91 (0.663). CONCLUSION: In this population, WHI presented the greatest discrimination power; it was considered the best predictor of CVR because of its high sensitivity. It was demonstrated that the anthropometric indexes WC, CoI and WHI could be used in clinical practice in rural areas without sufficient resources for serological tests.

Association Between Cardiovascular Risk Factors and Stress Hormones With Cognitive Performance in Mexican Adolescents.

Objective: The objective of this study was to determine whether cardiovascular disease (CVD) risk factors and stress hormones are associated with cognitive performance in Mexican adolescents. Methods: This was a cross-sectional study including 139 Mexican adolescents 10-14 years old. Participants were divided into three categories: 0, 1-2, and ≥3 CVD risk factors. These factors included: high-density lipoprotein-cholesterol (HDL-C) <40 mg/dl; waist circumference (WC) ≥90th percentile for age and sex, systolic or diastolic blood pressure ≥90th percentile for age, sex, and height; and triacylglycerols (TGs) ≥110 mg/dl. Low-density lipoprotein-cholesterol (LDL-C), very low-density lipoprotein-cholesterol (VLDL-C), total cholesterol, cortisol, and plasma catecholamines were measured as well. Furthermore, attention, memory, and executive functions were evaluated using a validated test for Spanish-speaking individuals (Neuropsi). Results: Adolescents in the three risk categories did not show significant differences in Neuropsi test performance tasks; however, they presented different lipid and plasma norepinephrine concentrations. TG and VLDL-C were inversely associated with memory (r = -0.19, **p < .01). Multivariate regression analysis showed consistently that TG/HDL-C ratio was inversely related to attention-memory general score (standardized ß = -0.99, t = -2.30, p = .023), memory (standardized ß = -0.83, t = -2.08, p = .039), and attention-executive functions (standardized ß = -1.02, t = -2.42, p = .017). Plasma epinephrine levels presented an inverse and weak relation to the attention-executive functions score (standardized ß = -0.18, t = -2.19, p = .030). Conclusions: Cognitive performance is not completely dependent on the accumulation of risk factors, but instead on the combination of strong predictors of CVD like waist to height ratio, TG/HDL-C, and VLDL-C. Plasma norepinephrine and epinephrine have a stronger association with cognition and CVD risk than dopamine and cortisol.

Soft drink consumption is positively associated with increased waist circumference and 10-year incidence of abdominal obesity in Spanish adults.

BACKGROUND: The accumulation of abdominal fat increases risk of metabolic disorders and premature death. There is a dearth of prospective data on the association between caloric beverage consumption and surrogate markers of abdominal adiposity. OBJECTIVE: The aim of this study was to assess the relation between consumption of nonalcoholic caloric beverages, including soft drinks, fruit juice, whole milk, and skim and low-fat milk, and changes in waist circumference (WC) and odds of 10-y incidence of abdominal obesity. METHODS: We conducted a prospective, population-based study of 2181 Spanish men and women aged 25-74 y who were followed from 2000 to 2009. We measured weight, height, and WC, and recorded data on diet and leisure-time physical activity (LTPA) with the use of validated questionnaires. We fit multivariable linear and logistic regression models. RESULTS: A 100 kcal increase in soft drink consumption was associated with a 1.1 cm increase in WC (P = 0.018) after 10 y of follow-up. Substitution of 100 kcal of soft drinks with 100 kcal of whole milk or 100 kcal of juice was associated with a 1.3 cm (95% CI: 0.3, 2.4) and 1.1 cm (95% CI: 0.03, 2.2) decrease in WC, respectively. Increasing consumption of soft drinks from baseline to follow-up led to WC gain compared with maintaining nonconsumption. Greater soft drink consumption was positively associated (P = 0.029) with increased odds of 10-y incidence of abdominal obesity. CONCLUSION: Adults' consumption of soft drinks was associated with increased WC and odds of 10-y incidence of abdominal obesity. This association was moderate but consistent in all statistical models.

Mediterranean diet impact on changes in abdominal fat and 10-year incidence of abdominal obesity in a Spanish population.

Abdominal obesity is a strong predictor of metabolic disorders. Prospective data on the association between the Mediterranean diet and surrogate markers of abdominal adiposity are scarce. The present study evaluated the relationship between adherence to the Mediterranean diet and (1) changes in waist circumference (WC) and (2) 10-year incidence of abdominal obesity. We conducted a prospective, population-based study in 3058 male and female Spaniards aged 25-74 years, followed from 2000 to 2009. Dietary intake and leisure-time physical activity levels were recorded using validated questionnaires. Weight, height and WC were measured. Adherence to the Mediterranean diet, determined using the previously validated REGICOR-Mediterranean diet score (R-MDS), based on the distribution of population food intake and on the dietary recommendations (MDS-rec), was negatively associated with WC gain (P = 0.007 and 0.024, respectively) in fully adjusted models. In the multivariate logistic analysis, the odds of abdominal obesity incidence decreased across the tertiles of the R-MDS, but the association was not significant. In conclusion, adherence to the Mediterranean diet was associated with lower abdominal fat gain, but not with 10-year incidence of abdominal obesity.

[Association between adiposity, inflammation and cardiovascular risk factors in school-aged Mexican children]. / Asociación entre adiposidad, inflamación y factores de riesgo cardiovascular en un grupo de escolares mexicanos.

OBJECTIVE: To evaluate the differences in inflammation markers and cardiovascular risk factors in a group of school-aged children with and without excessive adiposity. To examine the relationship between adiposity, inflammation, and cardiovascular risk factors. METHODS: Cross-sectional study of 285 school children (8-12 years old). Adiposity (body mass index, BMI, total body fat, TBF, and waist circumference), inflammatory markers (C-reactive protein [CRP], interleukin 1ß [IL-1ß], interleukin 6 [IL-6], and tumor necrosis factor-a [TNF-α]) and cardiovascular risk factors were analyzed. Mean differences were calculated and multiple regression models were made. RESULTS: Obese children had higher concentrations of CRP and IL-1ß; children with abdominal obesity also had higher CRP levels. A higher BMI was associated with higher blood pressure, and higher total cholesterol, triglycerides-TAG, and insulin concentrations, and with lower HDL-cholesterol. The CRP and IL-1ß concentrations correlated significantly with the three adiposity indices. The IL-6 concentrations were associated with TAG, and IL-1ß with HDL-cholesterol concentration, after adjustment by BMI. DISCUSSION: In a group of school-aged Mexican children, obesity increases cardiovascular risk and inflammation. Both IL-6 and IL-1ß appear to be factors involved in lipid alterations in these children. More research is needed in order to explore the role of subclinical inflammation in the development of cardiovascular alterations that have already been described in Mexican children with obesity.

Validity of two short screeners for diet quality in time-limited settings.

OBJECTIVE: An urgent need in dietary assessment is the development of short tools that provide valid assessments of dietary quality for use in time-limited settings. The present study assessed concurrent and construct validity of the short Diet Quality Screener (sDQS) and brief Mediterranean Diet Screener (bMDSC) questionnaires. DESIGN: Relative validity was measured by comparing three dietary quality indices--the Diet Quality Index (DQI), the modified Mediterranean Diet Score (mMDS) and the Antioxidant Score (ANTOX-S)--derived from the two questionnaires with those from multiple 24 h recalls over 12 months. Construct validity was demonstrated by correlations between average nutrient intake recorded on multiple 24 h recalls and the DQI, mMDS and ANTOX-S derived by the short screeners. SETTING: Both short questionnaires were administered to 102 participants recruited from a population-based survey in Spain. RESULTS: DQI, mMDS and ANTOX-S correlated (P < 0·001) with the corresponding 24 h recall indices (r = 0·61, 0·40 and 0·45, respectively). Limits of agreement lay between 96 and 126%, 59 and 144% and 61 and 118% for the DQI, ANTOX-S and mMDS, respectively. Dietary intakes of fibre, vitamin C, vitamin E, Mg and K reported on the 24 h recalls were positively associated (P < 0·04) with the DQI, mMDS and ANTOX-S indices. CONCLUSIONS: The sDQS and bMDSC provide reasonable approximations to food-based dietary indices and accurately situate subjects within the indices constructed for the present validation study.

Concurrent and construct validity of Mediterranean diet scores as assessed by an FFQ.

OBJECTIVE: The aim of the present study was to assess the concurrent and construct validity of two diet-quality indices, a modified Mediterranean diet score (mMDS) and a Mediterranean-like diet score (MLDS) additionally incorporating unhealthy food choices, as determined by an FFQ. DESIGN: A validation study assessing FFQ intake estimates compared with ten or more unannounced 24 h recalls. Pearson's correlation coefficients, intraclass correlation coefficients (ICC), Bland-Altman plots and the limits of agreement method were used to assess the between-method agreement of scores. Construct validity was shown using associations between nutrient intakes derived from multiple 24 h recalls and the mMDS and MLDS derived from the FFQ. SETTING: Gerona, Spain. SUBJECTS: A total of 107 consecutively selected participants from a population-based cross-sectional survey. RESULTS: Pearson's correlations for the energy-adjusted mMDS and MLDS compared with multiple recalls were 0·48 and 0·62, respectively. The average FFQ energy-adjusted mMDS and MLDS were 102 % and 98 % of the recall-based mMDS and MLDS estimates, respectively. The FFQ under- and overestimated dietary recall estimates of the energy-adjusted MLDS by 28 % and 25 %, respectively, with slightly wider boundaries for the mMDS (31 % and 34 %). The ICC, which assesses absolute agreement, was similar to Pearson's correlations (mMDS = 0·48 and MLDS = 0·61). The mean differences between methods were similar across the range of average ratings for both scores, indicating the absence of bias. The FFQ-derived mMDS and MLDS correlated in the anticipated directions with intakes of eleven (73·3 %) and thirteen of fifteen nutrients (86·7 %), respectively. CONCLUSIONS: The FFQ provides valid estimates of diet quality as assessed by the mMDS and MLDS.

The effect of exercise on cardiovascular risk markers in Mexican school-aged children: comparison between two structured group routines.

OBJECTIVE: To assess the effects of two groups of exercise routines on cardiovascular disease risk markers. MATERIAL AND METHODS: An intervention study was conducted with 319 Mexican school-aged children in which routines were implemented Monday through Friday for 12 weeks. Routine A was the reference group, with 20 min of less intense activity and routine B was the new group with 40 min of aerobic exercises. Body mass index (BMI), waist circumference, fat mass percentage (FM%), systolic and diastolic blood pressure, lipids, lipoproteins, glucose and insulin were measured before and after the intervention. RESULTS: Routine A had an effect on diastolic pressure, while routine B had an effect on BMI, FM%, blood pressure and triglycerides. Routine B had a greater effect on blood pressure than routine A. The prevalence of obesity, high blood pressure and hypertriglyceridemia decreased in both groups. CONCLUSION: Aerobic exercise is an effective health promotion strategy to reduce some cardiovascular disease risk markers.

Visceral Adiposity Index in Breast Cancer Survivors: A Case-Control Study.

BACKGROUND: Breast cancer (BC) is the first cause of cancer morbidity and mortality in women. This disease has been linked to obesity; however, it is not clear how fat accumulation affects women who survive breast cancer. Although the visceral adiposity index (VAI) is a marker of cardiometabolic risk and adipose tissue dysfunction, it is not clear how it changes in breast cancer survivors. The aim of this investigation was to compare VAI in women with and without breast cancer. METHODS: A case-control cross-sectional study was conducted on women who were BC survivors and women without the history of BC (control group). Body composition was assessed using electrical bioimpedance while VAI by means of waist circumference (WC), body mass index (BMI), triacylglycerols (TG), and high-density lipoprotein cholesterol (HDL-C). RESULTS: 49 women in the BC survivor group and 50 in the control group. WC was wider in the survivor group as regards control (93.65 ± 10.48 vs. 88.52 ± 9.61 cm) (p=0.025); at once, TG and VAI were significantly higher for the survivor group (243.55 ± 199.84 vs. 159.84 ± 75.77) (p=0.007) and (11.03 ± 11.15 vs. 6.41 ± 3.66) (p < 0.005), respectively. Body composition parameters were similar in both groups. CONCLUSIONS: VAI is higher in women who are BC survivors in comparison with controls matched by age and bodyweight.

Dexamethasone Causes Hypertension in Rats Even Under Chemical Blockade of Peripheral Sympathetic Nerves.

Synthetic glucocorticoids (GCs) are widely used to treat inflammatory conditions. However, chronic use of GCs can lead to hypertension. The cause of this undesired side effect remains unclear. Previously, we developed an in vivo rat model to study the mechanisms underlying hypertension induced by the chronic administration of the potent synthetic GC, dexamethasone (DEX) and found that the catecholamine biosynthetic pathway plays an important role. In the current study, we used this model to investigate the role of the adrenal medulla, renal nerves, and other peripheral sympathetic nerves in DEX-induced hypertension. After 5 days of baseline telemetric recording of mean arterial pressure (MAP) and heart rate (HR), rats were subjected to one of the following treatments: renal denervation (RDNX), adrenal medullectomy (ADMX), 6-hydroxydopamine (6-OHDA, 20 mg/kg, i.p.) to induce chemical sympathectomy, or a combination of ADMX and 6-OHDA. On day 11, the animals received vehicle (VEH) or DEX in drinking water for 7 days, with the latter causing an increase in MAP in control animals. ADMX and RDNX by themselves exacerbated the pressor effect of DEX. In the chemical sympathectomy group, DEX still caused a rise in MAP but the response was lower (ΔMAP of 6-OHDA/DEX < VEH/DEX, p = 0.039). However, when ΔMAP was normalized to day 10, 6-OHDA + DEX did not show any difference from VEH + DEX, certainly not an increase as observed in DEX + ADMX or RDNX groups. This indicates that sympathetic nerves do not modulate the pressor effect of DEX. TH mRNA levels increased in the adrenal medulla in both VEH/DEX (p = 0.009) and 6-OHDA/DEX (p = 0.031) groups. In the 6-OHDA group, DEX also increased plasma levels of norepinephrine (NE) (p = 0.016). Our results suggest that the activation of catecholamine synthetic pathway could be involved in the pressor response to DEX in animals even under chemical sympathectomy with 6-OHDA.

Inulin Supplementation Reduces Systolic Blood Pressure in Women with Breast Cancer Undergoing Neoadjuvant Chemotherapy.

INTRODUCTION: Breast cancer is the most frequently diagnosed malignancy in women, and comorbidities like hypertension and obesity diminish their quality of life and negatively affect their response to chemotherapy. Furthermore, inulin supplementation is associated with the reduction of cardiovascular diseases (CVD) risk. OBJECTIVE: To determine whether inulin supplementation prevents the elevation of blood pressure in women with breast cancer undergoing neoadjuvant therapy with cyclophosphamide and doxorubicin. METHODS: This was a randomized, double-blind placebo controlled trial which included women with early-stage breast cancer undergoing neoadjuvant therapy (n=38). Patients were randomly assigned to participate in two different groups to receive either 15 g of inulin or 15 g of placebo (maltodextrin) for 21 days. Body composition and blood pressure were evaluated before and after the supplementation period. RESULTS: Women in the inulin group showed a lower systolic blood pressure (SBP) after the supplementation (-4.21 mmHg, p<0.001). However, SBP increased in the placebo supplemented group. Diastolic blood pressure (DBP) nonsignificantly decreased in the inulin group. Inulin supplementation also increased BMI (p<0.001) but reduced BFP (p=0.288). Furthermore, confounding variables, such as BMI, baseline fasting glucose, age, menopause status, vomiting, constipation, and chronic medication did not have a statistical influence over the inulin effect on SBP. CONCLUSION: Inulin supplementation reduces SBP and prevents increases in DBP in women with breast cancer. This could be an innovative nutraceutical approach to prevent hypertension present in women with this type of cancer at an early stage and may improve the quality of life of the patients and their prognostic development through chemotherapy. TRIAL REGISTRATION NUMBER: This trial is registered with ACTRN12616001532493.

Dietary patterns, central obesity and serum lipids concentration in Mexican adults.

INTRODUCTION: Introduction: dietary patterns (DP) analyse the relationship between consumption of foods or nutrients and disease or health outcomes. High prevalence of obesity in adults in Mexico is associated with factors such as high consumption of certain food groups and nutrients. However, few studies have been conducted to explore associations between dietary patterns and obesity in apparently healthy adults. Objective: to identify major dietary patterns (DP) associated with central-obesity (CO) and lipid concentrations in healthy adults. Methods: longitudinal study including usual dietary intakes derived from multiple 24-hour-recalls. Waist-circumference (WC) and biochemical measurements were obtained by standardized procedures and DP by principal component analysis. Adjusted-logistic regression was used to examine associations between DP, CO and serum-lipid concentrations. Results: three DP were identified: healthy-DP, risky-DP and empty-DP. Participants in the healthy-DP were more likely to have lower risk for central-obesity according to WC criteria (OR = 0.31, CI = 0.12, 0.82), p = 0.017, but also had the highest risk for elevated LDL-cholesterol (OR = 2.98, CI = 1.16, 7.66), p = 0.030. There was no significant association between risky and empty DP with obesity or overweight by body mass index (BMI), central-obesity by WC or serum lipid abnormalities. Conclusions: the healthy-DP is associated with lower risk for CO, with higher risk for elevated LDL-cholesterol. It is necessary to develop longitudinal studies of foods and nutritional analysis of the diet to clarify these associations, to promote the reduction of modifiable risk factors.

INTRODUCCIÓN: Introducción: los patrones de dieta (PD) analizan la relación entre el consumo de alimentos o nutrimentos con la salud y el desarrollo de enfermedades en poblaciones. La elevada prevalencia de obesidad en adultos mexicanos se asocia con factores como el elevado consumo de ciertos grupos de alimentos y nutrimentos. Sin embargo, pocos estudios han explorado la asociación entre los patrones dietéticos y la obesidad en adultos aparentemente sanos. Objetivo: identificar los patrones dietéticos (PD) asociados con la obesidad central (OC) y las concentraciones séricas de lípidos en adultos. Métodos: estudio longitudinal del consumo dietético obtenido de múltiples recordatorios de consumo de 24 horas. La circunferencia de cintura (CC) y las mediciones bioquímicas se obtuvieron mediante procedimientos estandarizados; los PD, por análisis del componente principal. Mediante regresión logística se identificaron las asociaciones entre PD, OC y las concentraciones séricas de lípidos. Resultados: se identificaron tres PD: PD saludable, PD de riesgo y PD vacío. Los participantes del PD saludable presentaron menor riesgo de OC de acuerdo con los criterios de la CC (OR = 0.31, CI = 0.12, 0.82), p = 0.017, pero también fueron los que presentaron mayor riesgo de cifras elevadas de colesterol-LDL (OR = 2.98. CI = 1.16, 7.66), p = 0.030. No hubo asociación estadísticamente significativa entre el PD de riesgo y el PD vacío con obesidad o sobrepeso por IMC, OC por CC o con la presencia de dislipidemias. Conclusiones: el PD saludable se asocia con un menor riesgo para OC pero con mayor riesgo de elevación del colesterol-LDL. Se necesitan estudios longitudinales para esclarecer estas asociaciones para promover la reducción de factores de riesgo modificables.

Modest validity and fair reproducibility of dietary patterns derived by cluster analysis.

Cluster analysis is widely used to analyze dietary patterns. We aimed to analyze the validity and reproducibility of the dietary patterns defined by cluster analysis derived from a food frequency questionnaire (FFQ). We hypothesized that the dietary patterns derived by cluster analysis have fair to modest reproducibility and validity. Dietary data were collected from 107 individuals from population-based survey, by an FFQ at baseline (FFQ1) and after 1 year (FFQ2), and by twelve 24-hour dietary recalls (24-HDR). Repeatability and validity were measured by comparing clusters obtained by the FFQ1 and FFQ2 and by the FFQ2 and 24-HDR (reference method), respectively. Cluster analysis identified a "fruits & vegetables" and a "meat" pattern in each dietary data source. Cluster membership was concordant for 66.7% of participants in FFQ1 and FFQ2 (reproducibility), and for 67.0% in FFQ2 and 24-HDR (validity). Spearman correlation analysis showed reasonable reproducibility, especially in the "fruits & vegetables" pattern, and lower validity also especially in the "fruits & vegetables" pattern. κ statistic revealed a fair validity and reproducibility of clusters. Our findings indicate a reasonable reproducibility and fair to modest validity of dietary patterns derived by cluster analysis.

Vitamins and type 2 diabetes mellitus.

The present review evaluates the relationship between type 2 diabetes mellitus and individual or combined vitamins. Antioxidant vitamins A, C and E are found decreased in diabetic subjects, possibly due to an increased need to control the excessive oxidative stress produced by abnormalities in glucose metabolism. On the other hand, retinol binding protein exerts a modulating effect, as it has adipokine functions. With respect to the B group vitamins, thiamin, pyridoxine and biotin have been found decreased but the mechanisms are not clear, however supplementation has shown some improvement of the metabolic control in diabetic patients. The absorption of folic acid and vitamin B12 is importantly decreased by the prolongued use of metformin, which is the first choice drug in uncomplicated diabetes, thus these two nutrients have been found deficient in the disease and most probably need to be supplemented regularly. On the other hand, vitamin D is considered a risk factor for the development of diabetes as well as its complications, particularly cardiovascular ones. Although some studies have found an association of vitamin K intake with glucose metabolism further research is needed. Studies on the use of multivitamin supplements have shown unconclusive results. After reviewing the evidence, no real recommendation on the use of vitamin supplements in type 2 diabetes mellitus can be issued, however patients using metformin during prolongued periods may need folic acid and vitamin B12.

Effect of energy under-reporting on secular trends of dietary patterns in a mediterranean population.

BACKGROUND: Diet is an important factor in the prevention of chronic diseases. Analysis of secular trends of dietary patterns can be biased by energy under-reporting. Therefore, the objective of the present study was to analyse the impact of energy under-reporting on dietary patterns and secular trends in dietary patterns defined by cluster analysis. DESIGN AND METHODS: Two cross-sectional population-based surveys were conducted in Spain, in 2000 and 2005, with 3058 and 6352 participants, respectively, aged 25 to 74 years. Validated questionnaire was used to collect dietary data. Cluster analysis was run separately for all participants, plausible energy reporters (PER), and energy under-reporters (EUR) to define dietary patterns. RESULTS: Three clusters, "healthy", "mixed" and "western", were identified for both surveys. The "mixed" cluster was the predominant cluster in both surveys. Excluding EUR reduced the proportion of the "mixed" cluster up to 6.40% in the 2000 survey; this caused secular trend increase in the prevalence of the "mixed" pattern. Cross-classification analysis of all participants and PER' data showed substantial agreement in cluster assignments: 68.7% in 2000 and 84.4% in 2005. Excluding EUR did not cause meaningful (≥ 15%) changes in the "healthy" pattern. It provoked changes in consumption of some food groups in the "mixed" and "western" patterns: mainly decreases of unhealthy foods within the 2000 and increases of unhealthy foods within the 2005 surveys. Secular trend effects of EUR were similar to those within the 2005 survey. Excluding EUR reversed the direction of secular trends in consumption of several food groups in PER in the "mixed" and "western" patterns. CONCLUSIONS: EUR affected distribution of participants between dietary patterns within and between surveys, secular trends in food group consumption and amount of food consumed in all, but not in the "healthy" pattern. Our findings emphasize threats from energy under-reporting in dietary data analysis.

Dietary patterns, central obesity and serum lipids concentration in Mexican adults / Patrones de dieta, obesidad central y concentración de lípidos séricos en adultos mexicanos

Introduction: dietary patterns (DP) analyse the relationship between consumption of foods or nutrients and disease or health outcomes. High prevalence of obesity in adults in Mexico is associated with factors such as high consumption of certain food groups and nutrients. However, few studies have been conducted to explore associations between dietary patterns and obesity in apparently healthy adults. Objective: to identify major dietary patterns (DP) associated with central-obesity (CO) and lipid concentrations in healthy adults. Methods: longitudinal study including usual dietary intakes derived from multiple 24-hour-recalls. Waist-circumference (WC) and biochemical measurements were obtained by standardized procedures and DP by principal component analysis. Adjusted-logistic regression was used to examine associations between DP, CO and serum-lipid concentrations. Results: three DP were identifi ed: healthy-DP, risky-DP and empty-DP. Participants in the healthy-DP were more likely to have lower risk for central-obesity according to WC criteria (OR = 0.31, CI = 0.12, 0.82), p = 0.017, but also had the highest risk for elevated LDL-cholesterol (OR = 2.98, CI = 1.16, 7.66), p = 0.030. There was no significant association between risky and empty DP with obesity or overweight by body mass index (BMI), central-obesity by WC or serum lipid abnormalities. Conclusions: the healthy-DP is associated with lower risk for CO, with higher risk for elevated LDL-cholesterol. It is necessary to develop longitudinal studies of foods and nutritional analysis of the diet to clarify these associations, to promote the reduction of modifi able risk factors

Introducción: los patrones de dieta (PD) analizan la relación entre el consumo de alimentos o nutrimentos con la salud y el desarrollo de enfermedades en poblaciones. La elevada prevalencia de obesidad en adultos mexicanos se asocia con factores como el elevado consumo de ciertos grupos de alimentos y nutrimentos. Sin embargo, pocos estudios han explorado la asociación entre los patrones dietéticos y la obesidad en adultos aparentemente sanos. Objetivo: identificar los patrones dietéticos (PD) asociados con la obesidad central (OC) y las concentraciones séricas de lípidos en adultos. Métodos: estudio longitudinal del consumo dietético obtenido de múltiples recordatorios de consumo de 24 horas. La circunferencia de cintura (CC) y las mediciones bioquímicas se obtuvieron mediante procedimientos estandarizados; los PD, por análisis del componente principal. Mediante regresión logística se identificaron las asociaciones entre PD, OC y las concentraciones séricas de lípidos. Resultados: se identificaron tres PD: PD saludable, PD de riesgo y PD vacío. Los participantes del PD saludable presentaron menor riesgo de OC de acuerdo con los criterios de la CC (OR = 0.31, CI = 0.12, 0.82), p = 0.017, pero también fueron los que presentaron mayor riesgo de cifras elevadas de colesterol-LDL (OR = 2.98. CI = 1.16, 7.66), p = 0.030. No hubo asociación estadísticamente signifi cativa entre el PD de riesgo y el PD vacío con obesidad o sobrepeso por IMC, OC por CC o con la presencia de dislipidemias. Conclusiones: el PD saludable se asocia con un menor riesgo para OC pero con mayor riesgo de elevación del colesterol-LDL. Se necesitan estudios longitudinales para esclarecer estas asociaciones para promover la reducción de factores de riesgo modificables

Olive oil consumption, BMI, and risk of obesity in Spanish adults.

BACKGROUND: Olive oil is an energy-dense food frequently consumed in south European countries with increasingly high obesity prevalence. Evidence of the impact of olive oil consumption on BMI and the risk of obesity is limited. We analyzed this association taking into consideration the problem of energy underreporting. METHODS: Cross-sectional data on 6,352 Spanish adults were analyzed. Dietary intake was assessed using a validated food frequency questionnaire. Height and weight were measured. RESULTS: Higher olive oil consumption was not associated with energy compensation in the overall diet. Olive oil consumption was positively associated (p < 0.004) with BMI in non-energy-adjusted multivariate linear regression models. Statistical significance of this association disappeared after controlling for energy intake in plausible energy intake reporters. The obesity risk increased for olive oil consumption of more than 2 tablespoons/day in both plausible energy intake reporters (odds ratio 1.30 (95% CI 1.01-1.70)) and energy intake underreporters (odds ratio 3.06 (95% CI 2.15-4.35)). This association was not significant after additional adjustment for energy intake (odds ratio 1.19 (95% CI 0.91-1.56)) in plausible energy intake reporters. CONCLUSION: Olive oil intake did not affect BMI and the risk of obesity after adjustment for total energy intake in plausible energy intake reporters. The lack of energy intake compensation for olive oil consumption might explain the positive associations in models not adjusted for energy.

Are immunoglobulin concentrations associated with the body composition of adolescents?

The aim of this study was to analyze the association between serum concentrations of immunoglobulins (Ig) A, G, and M and body composition of adolescents from Mexico. Informed consent was obtained from parents and assent was obtained from the adolescents for the evaluation of 125 adolescents from the Capital city of Toluca and the adjacent semiurban county of Lerma de Villada. Height, weight, waist, and hip circumference were measured by trained personnel. Body mass index and waist:hip ratio were calculated from these measurements, whereas body fat (BF) was calculated from tricipital and subscapular skinfolds and measured by bioelectrical impedance. Serum concentrations of Ig were determined by nephelometry. Data were analyzed by independent samples t test and Pearson correlations. Subjects were mainly females (71.2%), with a mean age of 16.8 years (+/-0.8). No differences were reported in all indicators by weight or BF between gender. Female participants had higher Ig concentrations than males (IgG t = 2.24, p = 0.027; IgA t = 2.05, p = 0.043; IgM t = 4.49, p < 0.001). Positive correlations were reported for IgA and IgM with tricipital skinfold (r = 0.192, p = 0.041; and r = 0.221, p = 0.018, respectively) and for total BF by bioimpedance (r = 0.243, p = 0.009). Ig concentrations do not seem to be affected by overweight, obesity, or excessive or central BF in adolescents.

Nutrition and immunity in cancer.

The purpose of this article is to give a general overview of the effects of nutrition on the development of cancer as well as part of a therapeutic approach. There is much evidence that diet and lifestyle can alter the risk of cancer development as is the case for many other chronic diseases. This may be through a direct action on the immune system, either by enhancing or suppressing it, as well as on the development of the tumour itself, by modulating gene expression or by antioxidant activity. Protective effects can be achieved by adequate intakes of vitamins A and C, beta-carotene, selenium and n-3 fatty acids among others, while negative effects are found mainly with high intakes of n-6 and saturated fatty acids. Weight gain, obesity and lack of regular physical activity have also been associated with an increased risk of cancer. The protective effects are best observed when adequate diet and lifestyle are present together. With respect to the therapeutic role of nutrition in cancer, it has been observed that the use of pre- or post-operative enteral or parenteral nutrition may improve patients' survival rates and quality of life; however, more research is needed in this particular area. Breast, colon, rectum, prostate, stomach and lung are the types of cancer most commonly associated with diet or dietary components.

The effect of exercise on cardiovascular risk markers in Mexican school-aged children: comparison between two structured group routines / Efecto del ejercicio sobre marcadores de riesgo cardiovascular en escolares mexicanos: comparación entre dos rutinas grupales

Objective. To assess the effects of two groups of exercise routines on cardiovascular disease risk markers. Material and Methods. An intervention study was conducted with 319 Mexican school-aged children in which routines were implemented Monday through Friday for 12 weeks. Routine A was the reference group, with 20 min of less intense activity and routine B was the new group with 40 min of aerobic exercises. Body mass index (BMI), waist circumference, fat mass percentage (FM percent), systolic and diastolic blood pressure, lipids, lipoproteins, glucose and insulin were measured before and after the intervention. Results. Routine A had an effect on diastolic pressure, while routine B had an effect on BMI, FM percent, blood pressure and triglycerides. Routine B had a greater effect on blood pressure than routine A. The prevalence of obesity, high blood pressure and hypertriglyceridemia decreased in both groups. Conclusion. Aerobic exercise is an effective health promotion strategy to reduce some cardiovascular disease risk markers.

Objetivo. Evaluar el efecto de dos rutinas grupales de ejercicio sobre marcadores de riesgo cardiovascular. Material y métodos. Intervención en 319 escolares mexicanos. Las rutinas fueron implementadas por 12 semanas (rutina A (referencia): 20 min con ejercicios menos intensos vs rutina B (nueva): 40 min con ejercicios aeróbicos). Se midieron al inicio y al final el índice de masa corporal (IMC), masa grasa ( por cientoMG), presión arterial sistólica y diastólica, lípidos, lipoproteínas, glucosa e insulina. Resultados. La rutina A tuvo efecto sobre la presión diastólica; la B tuvo efecto sobre el IMC, por cientoMG, presión arterial y triglicéridos. La rutina B tuvo mayores efectos en la presión arterial que la rutina A. Las prevalencias de obesidad, hipertensión arterial e hipertrigliceridemia disminuyeron en ambos grupos. Conclusiones. El ejercicio aeróbico es una estrategia de promoción exitosa para reducir algunos marcadores de riesgo cardiovascular.