Social determinants for overweight and obesity in a highly marginalized population from Comitán, Chiapas, Mexico.

OBJECTIVE: We assessed the prevalence of overweight and obesity and its association with some social determinants in a highly marginalized population in Mexico. MATERIALS AND METHODS: Cross-sectional study conducted in Comitán, Chiapas, from 2010 to 2012, comprising 1 858 subjects aged ≥20 years. We evaluated proximal, intermediate, and structuralsocial determinants. RESULTS: The prevalence of overweight and obesity was 37.9 and 16.5%, respectively. The probability of overweight and obesity was higher in participants with ≥primary school, self-reported non-indigenous origin, and medium level of marginalization compared with those with

OBJETIVO: Estimar la prevalencia de sobrepeso y obesidad y su asociación con determinantes sociales en población con alto grado de marginación. MATERIAL Y MÉTODOS: Estudio transversal realizado en Comitán, Chiapas, de 2010 a 2012, que incluyó 1 858 sujetos ≥20 años de edad. Se evaluaron determinantes sociales proximales, intermedios y estructurales. RESULTADOS: La prevalencia de sobrepeso y obesidad fue de 37.9 y 16.5%, respectivamente. La probabilidad de sobrepeso y obesidad fue mayor en sujetos con escolaridad ≥primaria, en sujetos que se autodefinieron como no indígenas y en sujetos con un grado de marginación medio comparado con individuos con escolaridad

Dietary patterns, overweight and obesity from 1961 to 2011 in the socioeconomic and political context of Argentina.

To analyse the changes in eating patterns in Argentina from 1961 to 2011, and to assess changes in overweight and obesity in their socioeconomic and political context, we performed a hierarchical cluster analysis. We used the information from Food Balance Sheets of the United Nations Food and Agriculture Organisation to identify dietary patterns of apparent consumption. Years were grouped into five patterns. The food group with the highest apparent consumption was cereals (30% of total kcal/person/day) although this decreased slightly. Meats were second and their contribution decreased by 12%. The following foods contribution increased during the period: Sugar and milk by 2% and vegetable oils by 6%. The changes observed in the number of kcal/person/day were in line with changes in real wage, and coincided with economic and political crises that Argentina experienced during that period. Changes in eating patterns allow us to interpret that they relate to the increase in overweight and obesity.

[Construction and validation of an instrument to assess primary care level patient satisfaction]. / Construcción y validación de un instrumento para medir la satisfacción de los pacientes del primer nivel de atención médica en la Ciudad de México.

OBJECTIVE: To develop an instrument to assess the satisfaction of patients using health services at the first care level of the city of Mexico (SSA), adapted to the socio-cultural characteristics of the population, and to examine its reliability and validity. METHODS: The instrument reagents were designed using the natural semantic networks technique. The dimensions used have been determined from the literature. Participants included 230 adults with type 2 diabetes attending eight SSA health centers. Subsequently, intelligibility was determined by conducting a pilot, then the construct validity of the instrument by means of exploratory factor analysis was evaluated and its internal consistency was determined by calculating Cronbach's alpha. RESULTS: The questionnaire is composed of six factors with a Likert-type scale. Its consistency showed a Crombach´s alpha of 0.94. The factor structure included 29 reagents that correlated with the six dimensions with factorial loads>0.581 that explained 66.8% of the total variance. CONCLUSIONS: The patient satisfaction questionnaire incorporates the sociocultural characteristics of the target population and has an adequate level of validity and reliability and is quick and easy in application.

[Type 2 Diabetes and Dietary Patterns 1961 to 2009: Some Social Determinants in Mexico]. / Diabetes tipo 2 y patrones de alimentación de 1961 a 2009: algunos de sus determinantes sociales en México.

In order to analyze whether the increase in mortality from diabetes in Mexico is related to changes in eating patterns over the period 1961 to 2009, and if they in turn could be explained in the Mexican socioeconomic context, we conducted an ecological study with information from the Food Balance Sheets FAO. A cluster analysis was performed to shape eating patterns (three) and some socioeconomic variables were analyzed. It was observed that the energy derived from cereals and legumes (beans) was significantly reduced, and simultaneously, energy from sugars, animal foods, and vegetable fats had a significant increase. Various socioeconomic conditions may have favored changes in diet and increased mortality from diabetes. These conditions are: trade liberalization, low growth, rising inequality and informal work, declining agriculture, falling real wages in relation to the value of what is called the "basic food and non-food baskets", increasing prices of healthy food,low cost of processed foods and beverages, and the lack of control in the food market.

[The nutrition transition and the double burden of malnutrition: changes in dietary patterns 1961-2009 in the Mexican socioeconomic context]. / La transición alimentaria y la doble carga de malnutrición: cambios en los patrones alimentarios de 1961 a 2009 en el contexto socioeconómico mexicano.

The purpose of this study was to identify whether there were changes in the composition of dietary patterns from 1961 to 2009, if food patterns by income level and the increase in the price of certain basic foods of the diet in the socioeconomic Mexican context, could explain the nutrition transition and the double burden of malnutrition. We conducted an ecological study with data from FAO balance sheets. To construct eating patterns cluster analysis was performed. Engel curves were developed with data from the 2012 INEGI ENGH survey and evolution of the relative price of some foods was calculated. The diet was defined in three dietary patterns. The increase in the total availability of energy increased from 2316 kcal/person/day in 1961 to 3146 in 2009. Dietary pattern modifications are in line with the nutrition transition and the double burden of malnutrition. It was observed that the energy derived from cereals and from legume (common beans) was significantly reduced, and simultaneously, the energy from sugars, animal foods and vegetable fats had a dramatic increase. Spending on food was differential according to income level. Malnutritionis mediated by the unequal distribution of income, the relatively low cost of energy-dense foods, the increased cost of nutritious foods, and limited support to agriculture.

[Teaching performance assessment in Public Health employing three different strategies]. / Evaluación del desempeño docente en Salud Pública mediante tres estrategias.

INTRODUCTION: The educational system depends upon the quality and performance of their faculty and should therefore be process of continuous improvement. OBJECTIVE: To assess the teaching performance of the Public Health professors, at the Faculty of Medicine, UNAM through three strategies. METHODS: Justification study. The evaluation was conducted under a mediational model through three strategies: students' opinion assessment, self-assessment and students' academic achievement. We applied descriptive statistics, Student t test, ANOVA and Pearson correlation. RESULTS: Twenty professors were evaluated from the Public Health department, representing 57% of all them who teach the subject. The professor's performance was highly valued self-assessment compared with assessment of student opinion, was confirmed by statistical analysis the difference was significant. The difference amongst the three evaluation strategies became more evident between self-assessment and the scores obtained by students in their academic achievement. CONCLUSIONS: The integration of these three strategies offers a more complete view of the teacher's performance quality. Academic achievement appears to be a more objective strategy for teaching performance assessment than students' opinion and self-assessment.

A Healthy Diet Is Not More Expensive than Less Healthy Options: Cost-Analysis of Different Dietary Patterns in Mexican Children and Adolescents.

Unhealthy diets are recognized as a major risk factor for many diseases. The decrease in costs of industrialized products, as well as the possible misinformation about a healthy diet, has led to new behaviors in the dietary patterns of the pediatric population. The costs of dietary patterns have not been estimated in our population, so the objective of this study was to determine the cost associated with dietary patterns in Mexican children and adolescents, hypothesizing that a healthy diet is not necessarily more economically expensive. This study analyzed data from a population-based cross-sectional study of healthy children and adolescents in Mexico City. Data were collected from a food frequency questionnaire and the meal cost of habitual food shopping. Eating patterns were obtained by using principal component analysis. A micro-costing technique was performed to obtain the direct costs of each pattern. When comparing the healthy pattern with the transition and non-healthy patterns, it was observed that there were no statistically significant differences between the dietary patterns (p = 0.8293). The cost of the healthy pattern only takes up 16.6% of the total biweekly income of a salaried Mexican. In this study, no differences were observed between the costs of a healthy and a less healthy diet.

[Disease, body and corporeity: an anthropological perspective]. / Enfermedad, cuerpo y corporeidad: una mirada antropológica.

The aim of this article is to present a reflection on the perception of disease, taking the body and its relation to the world as a crucial point of departure. We develop some key notions of body and corporeity that throughout history involve different symbolic conceptions of the diseased body from an anthropological perspective. We highlight the polysemic nature of bodily performance that involves nature and culture as well as the mind-body dual condition. Thus, the notion of embodiment involves our body consciousness, not just the experience of what we feel through it, but the set of meanings from it that we give the world.

Trends in frequency of type 2 diabetes in Mexico and its relationship to dietary patterns and contextual factors.

OBJECTIVE: To analyse the evolution of the frequency of type 2 diabetes (T2D) and its relationship to eating patterns in Mexico from 1961 to 2013, and the Gini coefficient, Human Development Index (HDI) and Gross Domestic Product (GDP). Mexico ranked sixth in world prevalence of diabetes in 2015 with an estimated 11.4 million Mexicans affected. METHOD: Using data from the Balance Sheets Food published by the Food and Agriculture Organization of the United Nations (FAO), the means of apparent food consumption (kcal/person/day) were grouped by decades. Data for mortality rate for diabetes were obtained from 1990 until 2015. Spearman's correlation coefficient was calculated between the diabetes mellitus mortality rate and all food groups. Pearson's correlation explored the relationship between socio economic indicators and the prevalence of T2D diabetes. RESULTS: The mortality rate for T2D has increased over the last decades. An increase of 647.9kcal/person/day in apparent food consumption was observed. Cereal and legume consumption decreased, while apparent sugar, animal food and animal fat and vegetable oil consumption increased substantially. HDI and GDP showed a directly proportional relationship to diabetes. Spearman's correlation coefficient was statistically significant only for sugar. The Gini coefficient suggests that in lower inequalities there is an increased frequency of diabetes. CONCLUSIONS: The increase in the mortality rate of type 2 diabetes was constant during the study period, which coincides with the increase in energy density of Mexican eating patterns from 1961 to 2013. The higher the Gini coefficient, HDI and GDP, the higher the mortality observed for diabetes.

Area-level disadvantage and alcohol use disorder in northern Mexico.

BACKGROUND: In Mexico, the Northern States are highly impacted by alcohol consumption and associated problems. Little is known about the association between contextual social disadvantage and alcohol use disorder in this region. METHODS: Information from 1265 current drinkers surveyed in the U.S.-Mexico Study on Alcohol and Related Conditions (UMSARC) was combined with official data on neighborhood disadvantage (index of urban marginalization, a composite of ten indicators of area-level social disadvantage) for 302 neighborhoods. Using statistical marginal models, we estimated the association of neighborhood disadvantage with alcohol use disorder (AUD; based on DSM-5 criteria), alone and with adjustment for individual and contextual covariates. We also tested for moderation of neighborhood disadvantage effects by sex, education, internal migration and border area. RESULTS: There was a statistically significant increase in the odds of AUD of 59% (AOR=1.59; 95%CI=1.03, 2.46) for every one-point increase on the neighborhood disadvantage scale, after adjustment for covariates. A significant interaction between sex and neighborhood disadvantage was indicated by two measures of additive interaction (AP=0.55; p<0.001 and S=2.55; p<0.001), with higher neighborhood disadvantage related to higher prevalence of AUD for men but not for women. No moderation effects were observed for education, internal migration or border area. CONCLUSIONS: Neighborhood disadvantage is a risk factor for AUD independent of other variables, specifically in men. Studies of contextual variables offer the possibility for understanding the role of collective circumstances on individuals in society. Future studies of alcohol use in this geographic area should consider effects of contextual determinants such as disadvantage.

Are there changes in the nutritional status of children of Oportunidades families in rural Chiapas, Mexico? A cohort prospective study.

BACKGROUND: In Mexico, despite that the fact that several social programs have been implemented, chronic undernutrition is still a public health problem affecting 1.5 million children of <5 years. Chiapas ranks first in underweight and stunting at national level with a stunting prevalence of 31.4 % whereas for its rural population is 44.2 %. The purpose of this paper is to determine if the nutritional status of a cohort of children living in poor rural communities under Oportunidades has changed. We were interested in assessing the nutrition evolution of the children who were initially diagnosed as stunted and of those who were diagnosed as normal. Oportunidades is an anti-poverty program of the Mexican government consisting mainly in monetary transfers to the families living in alimentary poverty. METHODS: A 9-year cohort prospective study was conducted with nutritional evaluations of 222 children. Anthropometric indices were constructed from measurements of weight, height, and age of the children whose nutritional status was classified following WHO standards. RESULTS: The results showed that although these children were Oportunidades beneficiaries for 9 years and their families improved their living conditions, children still had a high prevalence of stunting (40.1 %) and 69.6 % had not recovered yet. Children who were initially diagnosed with normal nutritional status and became stunted 2 years later had a higher risk (relative risk (RR) 5.69, 2.95-10.96) of continuing stunted at school age and adolescence. CONCLUSIONS: Oportunidades has not impacted, as expected, the nutritional status of the study population. These findings pose the question: Why has not the nutritional status of children improved, although the living conditions of their families have significantly improved? This might be the result of an adaptation process achieved through a decrease of growth velocity. It is important to make efforts to watch the growth of the children during their first 3 years of age, to focus on improving the diet of women at fertile age and pay special attention to environmental conditions to break the vicious cycle of malnutrition.

[Nutritional status of two generations of brothers and sisters <5 years of age beneficiaries from opportunities living in marginalized rural communities in Chiapas, Mexico]. / ESTADO NUTRICIO DE DOS GENERACIONES DE HERMANOS(AS) < DE 5 AÑOS DE EDAD BENEFICIARIOS(AS) DE OPORTUNIDADES, EN COMUNIDADES RURALES MARGINADAS DE CHIAPAS, MÉXICO.

UNLABELLED: Mexico, in recent decades, has developed several programs to eradicate the problem of infant malnutrition <5 years, primarily among those living in rural and indigenous areas. However, there is insufficient evidence on these programs' impact on child health and nutrition. OBJECTIVE: To describe the nutritional changes of two generations of brothers and sisters living in rural communities of Chiapas and who are Oportunidades beneficiaries. METHODS: Cross-sectional study. It was determined: underweight, stunting, wasting and overweight plus obesity. Older brothers and sisters were evaluated in 2002-2003, for 2010-2011 younger brothers and sisters were evaluated, both groups were <5 years of age at the time of data collection. RESULTS: Malnutrition, in its three types is a problem. 43.4% of brothers and sisters evaluated in 2010-2011 showed stunting, underweight prevalence declined from 18% to 13.2%, wasting (low weight for height) increased from 8.1% to 10.4%. Overweight and obesity increased significantly by 12 percentage points among brothers and sisters, from 24.8% in 2002-2003 to 36.8% in 2010-2011. Malnutrition among male children is lower than their brothers and sisters from the 2002-2003 generation (stunting p=<0.05), overweight and obesity was 10.9 percentage points higher than their brothers and sisters (26.4% to 37.3%). CONCLUSION: Children beneficiaries from Opportunities have not yet overcome chronic malnutrition problems. This study shows that there is not a clear impact in improving the nutritional status of the study population.

En México, en las últimas décadas se han desarrollado varios programas para erradicar el problema de la desnutrición en infantes < de 5 años, principalmente de aquellos que viven en áreas indígenas y rurales. No obstante, no existe suficiente evidencia sobre su impacto en la salud y la nutrición infantil. Objetivo: describir los cambios nutricionales de dos generaciones de hermanos(as) que han sido beneficiados por el programa Oportunidades en comunidades rurales de Chiapas. Métodos: estudio transversal. Se determinó: bajo peso, baja talla, emaciación y SP + O (Sobrepeso más Obesidad). Los hermanos(as) mayores fueron evaluados en los años 2002-2003, para el 2010-2011 se evaluaron a los hermanos( as) menores, ambos grupos eran < de 5 años de edad en el momento de conseguir la información. Resultados: la desnutrición en sus tres formas es un problema, 43,4% de los hermanos(as) evaluados(as) en 2010-2011 presentaron baja talla, la prevalencia de bajo peso disminuyó de 18% a 13,2%, la emaciación (peso bajo para la talla) aumentó de 8,1% a 10.4%. El SP + O aumentó significativamente 12 puntos porcentuales entre los hermanos(as) de 24,8% en 2002-2003 a 36,8% en 2010-2011. La desnutrición en los niños (varones) es menor que la de sus hermanos de la generación de 2002- 2003 (baja talla p =.

Social determinants for overweight and obesity in a highly marginalized population from Comitán, Chiapas, Mexico / Determinantes sociales relacionados con el sobrepeso y obesidad en una población con alto grado de marginación de Comitán, Chiapas, México

Abstract Objective: We assessed the prevalence of overweight and obesity and its association with some social determinants in a highly marginalized population in Mexico. Materials and methods: Cross-sectional study conducted in Comitán, Chiapas, from 2010 to 2012, comprising 1 858 subjects aged ≥20 years. We evaluated proximal, intermediate, and structural social determinants. Results: The prevalence of overweight and obesity was 37.9 and 16.5%, respectively. The probability of overweight and obesity was higher in participants with ≥primary school, self-reported non-indigenous origin, and medium level of marginalization compared with those with <primary school, self-reported indigenous origin, and high/very high level of marginalization. Conclusion: The probability of overweight and obesity was higher in population with more favorable social conditions, which may be partially explained by changes in the traditional lifestyle with greater access to high energy foods and physical inactivity.

Resumen Objetivo: Estimar la prevalencia de sobrepeso y obesidad y su asociación con determinantes sociales en población con alto grado de marginación. Material y métodos: Estudio transversal realizado en Comitán, Chiapas, de 2010 a 2012, que incluyó 1 858 sujetos ≥20 años de edad. Se evaluaron determinantes sociales proximales, intermedios y estructurales. Resultados: La prevalencia de sobrepeso y obesidad fue de 37.9 y 16.5%, respectivamente. La probabilidad de sobrepeso y obesidad fue mayor en sujetos con escolaridad ≥primaria, en sujetos que se autodefinieron como no indígenas y en sujetos con un grado de marginación medio comparado con individuos con escolaridad <primaria, con autodefinirse como indígena y tener un grado de marginación alto/muy alto. Conclusión: La probabilidad de sobrepeso y obesidad fue mayor en población con condiciones sociales más favorables, parcialmente explicada por cambios en el estilo de vida con mayor acceso a alimentos con alta energía e inactividad física.

[GLUTAMINE AS AN AID IN THE RECOVERY OF MUSCLE STRENGTH: SYSTEMATIC REVIEW OF LITERATURE]. / GLUTAMINA COMO COADYUVANTE EN LA RECUPERACIÓN DE LA FUERZA MUSCULAR: REVISIÓN SISTEMÁTICA DE LA LITERATURA.

BACKGROUND: after a traumatic injury or post surgical orthopedic, the loss of skeletal muscle strength is common. In addition to strength training schemes and/or resistance to treatment, it has been proposed as an additional treatment, the use of some amino acids such as glutamine (Gln) in isolation or combination with other nutrients. However, the information on the effectiveness of oral Gln supplementation during exercise strength schemes and / or endurance in adults with strength deficit is inconsistent. OBJECTIVE: to evaluate the strength of the evidence at hand about the effect of oral supplementation on muscle strength Gln set to strength training schemes and / or resistance in adult muscle strength deficit. METHODS: a systematic search was conducted in different databases, in clinical trials reported from the year 1980-2014, both in English and Spanish, about oral Gln supplementation alone or in combination with other nutrients, with a control group, in adults with strength deficits under exercise schemes of strength and / or endurance, tracking under a year and muscle power as the primary outcome. RESULTS: of 661 articles, six relevant studies were identified. The study participants in Gln isolation evaluation did not suggest changes between the groups, only an improvement in the perception of muscle weakness. Studies evaluating Gln with other nutrients, have reported results in favor of it. No meta-analysis was possible. CONCLUSIONS: nowadays there are insufficient data on the effects related to the Gln on the deficit of muscular force during exercise schemes in adults. It is required more research in this topic to respond more accurately about this fact.

Antecedentes: la pérdida de fuerza del músculo esquelético es frecuente tras una lesión traumática o en el postquirúrgico ortopédico. Además de los esquemas de ejercicio de fuerza y/o resistencia para su tratamiento, ha sido propuesto como auxiliar el uso de algunos aminoácidos como la glutamina (Gln), de manera aislada o combinada con otros nutrimentos. Sin embargo, la información sobre la eficacia de la suplementación oral con Gln durante los esquemas de ejercicio de fuerza y/o resistencia en adultos con déficit de fuerza es inconsistente. Objetivo: evaluar la solidez de la evidencia disponible del efecto de la suplementación oral con Gln sobre la fuerza muscular, junto con esquemas de ejercicio de fuerza y/o resistencia en adultos con déficit de fuerza muscular. Métodos: se realizó una búsqueda sistemática en diferentes bases de datos, de ensayos clínicos reportados desde el año 1980 a 2014, en idioma inglés y español, sobre suplementación oral con Gln aislada o combinada con otros nutrimentos, con grupo control, en adultos con déficit de fuerza, bajo esquemas de ejercicio de fuerza y/o resistencia, seguimiento menor a un año y fuerza muscular como desenlace primario. Resultados: de 661 artículos, se identificaron seis estudios relevantes. El estudio con más participantes que evaluó la Gln aislada no sugiere cambios entre los grupos, solo una mejoría en la percepción de la debilidad muscular. Los estudios que evaluaron la Gln con otros nutrimentos reportan resultados a favor de esta. No fue posible realizar un metanálisis. Conclusiones: actualmente no se dispone de suficientes datos de los efectos relacionados con la Gln sobre el déficit de fuerza muscular durante esquemas de ejercicio en adultos. Se requiere mayor investigación al respecto para responder con mayor solidez sobre este hecho.

Trends in frequency of type 2 diabetes in Mexico and its relationship to dietary patterns and contextual factors / Tendencia en la frecuencia de diabetes tipo 2 en México y su relación con patrones alimentarios y factores contextuales

Objective: To analyse the evolution of the frequency of type 2 diabetes (T2D) and its relationship to eating patterns in Mexico from 1961 to 2013, and the Gini coefficient, Human Development Index (HDI) and Gross Domestic Product (GDP). Mexico ranked sixth in world prevalence of diabetes in 2015 with an estimated 11.4 million Mexicans affected. Method: Using data from the Balance Sheets Food published by the Food and Agriculture Organization of the United Nations (FAO), the means of apparent food consumption (kcal/person/day) were grouped by decades. Data for mortality rate for diabetes were obtained from 1990 until 2015. Spearman's correlation coefficient was calculated between the diabetes mellitus mortality rate and all food groups. Pearson's correlation explored the relationship between socio economic indicators and the prevalence of T2D diabetes. Results: The mortality rate for T2D has increased over the last decades. An increase of 647.9kcal/person/day in apparent food consumption was observed. Cereal and legume consumption decreased, while apparent sugar, animal food and animal fat and vegetable oil consumption increased substantially. HDI and GDP showed a directly proportional relationship to diabetes. Spearman's correlation coefficient was statistically significant only for sugar. The Gini coefficient suggests that in lower inequalities there is an increased frequency of diabetes. Conclusions: The increase in the mortality rate of type 2 diabetes was constant during the study period, which coincides with the increase in energy density of Mexican eating patterns from 1961 to 2013. The higher the Gini coefficient, HDI and GDP, the higher the mortality observed for diabetes

Objetivo: Analizar la evolución de la frecuencia de la diabetes tipo 2 y su relación con los patrones alimentarios en México de 1961 a 2013, así como el coeficiente de Gini, el índice de desarrollo humano (IDH) y el producto interno bruto (PIB). México ocupó el sexto lugar en la prevalencia mundial de diabetes en 2015, con una estimación de 11,4 millones de mexicanos afectados. Método: Utilizando los datos del balance de alimentos de la Organización de las Naciones Unidas para la Agricultura y la Alimentación (FAO) se agruparon por décadas las medias de consumo aparentes de alimentos (kcal/persona/día. Se analizaron datos sobre la diabetes de 1990 hasta 2015. Se realizó una correlación de Spearman entre la tasa de mortalidad por diabetes y el consumo de los distintos grupos de alimentos. La correlación de Pearson exploró la relación entre los indicadores socioeconómicos y la prevalencia de diabetes. Resultados: La tasa de mortalidad por diabetes tipo 2 aumentó consistentemente. Se observó un incremento de 647,9kcal/persona/día en el consumo aparente de alimentos. Los cereales y las legumbres disminuyeron, mientras que los azúcares, los alimentos y las grasas animales, y los aceites vegetales, aumentaron. La correlación de Spearman fue estadísticamente significativa solo para el azúcar. A mayores IDH y PIB, mayor fue la prevalencia de diabetes. El coeficiente de Gini sugirió que, a menor desigualdad, mayor frecuencia de diabetes. Conclusiones: El aumento en la tasa de mortalidad de la diabetes tipo 2 fue constante durante el periodo de estudio, lo cual coincide con el aumento de la densidad energética de los patrones de alimentación en México de 1961 a 2013. A mejor coeficiente de Gini, IDH y PIB, se observó una mayor mortalidad por diabetes

Panorama epidemiológico de México, principales causas de morbilidad y mortalidad / Epidemiological overview of Mexico's leading causes of morbidity and mortality

Resumen Introducción: En este trabajo se presenta a grandes rasgos el panorama epidemiológico de México. A través de esta revisión se discute la mortalidad y morbilidad general por grupos específicos, los egresos hospitalarios y recursos humanos disponibles para la atención de la salud. Propósito: Analizar las transformaciones en el panorama epidemiológico actual del país en el marco de algunas variaciones demográficas y acordes al crecimiento económico y la evolución del salario mínimo. Metodología: Se revisó la información oficial que emite el Instituto Nacional de Estadística y Geografía (INEGI), el Consejo Nacional de Población (CONAPO) y la Secretaría de Salud (SS). Resultados: Se muestran las transformaciones en estructura de la población y esperanza de vida que permiten entender los cambios en el perfil de riesgos y las modificaciones de la mortalidad y morbilidad general, así como sus principales causas. Conclusiones: Los datos mostrados evidencian que existe un reto importante para el país, ya que por una parte se debe seguir atendiendo las enfermedades infecciosas o transmisibles para abatir la tasa de morbilidad y, por otra parte, es fundamental implementar acciones encaminadas a disminuir las tasas de mortalidad por enfermedades no transmisibles.

Abstract Introduction: We present an overview of the epidemiologic profile of Mexico. Throughout this review, we discuss the general mortality and morbidity by specific groups, hospital discharges and the human resources available for health care. Purpose: To analyze the transformations of the current epidemiological situation in the country within the framework of certain demographic variations and according to the economic growth and the evolution of the minimum wage. Methodology: Official information issued by the Instituto Nacional de Estadística y Geografía [National Institute of Statistics and Geography] (INEGI), Consejo Nacional de Población [National Population Council] (CONAPO) and the Secretaría de Salud [Ministry of Health] was revised. Results: This information shows the structure of the population and life expectancy changes that leads to a better understanding of the changes of the risk profile and the modifications on the general mortality and morbidity, as well as their main causes. Conclusions: The data shows that there is a major challenge for the country. On one hand, the infectious or transmittable diseases should continually being addressed in order to bring down the morbidity rate. And on the other hand, it is essential to implement actions focused in reducing the mortality rates of the non-transmittable diseases.

Glutamina como coadyuvante en la recuperación de la fuerza muscular: revisión sistemática de la literatura / Glutamine as an aid in the recovery of muscle strength: systematic review of literature

Antecedentes: la pérdida de fuerza del músculo esquelético es frecuente tras una lesión traumática o en el postquirúrgico ortopédico. Además de los esquemas de ejercicio de fuerza y/o resistencia para su tratamiento, ha sido propuesto como auxiliar el uso de algunos aminoácidos como la glutamina (Gln), de manera aislada o combinada con otros nutrimentos. Sin embargo, la información sobre la eficacia de la suplementación oral con Gln durante los esquemas de ejercicio de fuerza y/o resistencia en adultos con déficit de fuerza es inconsistente. Objetivo: evaluar la solidez de la evidencia disponible del efecto de la suplementación oral con Gln sobre la fuerza muscular, junto con esquemas de ejercicio de fuerza y/o resistencia en adultos con déficit de fuerza muscular. Métodos: se realizó una búsqueda sistemática en diferentes bases de datos, de ensayos clínicos reportados desde el año 1980 a 2014, en idioma inglés y español, sobre suplementación oral con Gln aislada o combinada con otros nutrimentos, con grupo control, en adultos con déficit de fuerza, bajo esquemas de ejercicio de fuerza y/o resistencia, seguimiento menor a un año y fuerza muscular como desenlace primario. Resultados: de 661 artículos, se identificaron seis estudios relevantes. El estudio con más participantes que evaluó la Gln aislada no sugiere cambios entre los grupos, solo una mejoría en la percepción de la debilidad muscular. Los estudios que evaluaron la Gln con otros nutrimentos reportan resultados a favor de esta. No fue posible realizar un metanálisis. Conclusiones: actualmente no se dispone de suficientes datos de los efectos relacionados con la Gln sobre el déficit de fuerza muscular durante esquemas de ejercicio en adultos. Se requiere mayor investigación al respecto para responder con mayor solidez sobre este hecho (AU)

Background: after a traumatic injury or post surgical orthopedic, the loss of skeletal muscle strength is common. In addition to strength training schemes and/or resistance to treatment, it has been proposed as an additional treatment, the use of some amino acids such as glutamine (Gln) in isolation or combination with other nutrients. However, the information on the effectiveness of oral Gln supplementation during exercise strength schemes and / or endurance in adults with strength deficit is inconsistent. Objective: to evaluate the strength of the evidence at hand about the effect of oral supplementation on muscle strength Gln set to strength training schemes and / or resistance in adult muscle strength deficit. Methods: a systematic search was conducted in different databases, in clinical trials reported from the year 1980-2014, both in English and Spanish, about oral Gln supplementation alone or in combination with other nutrients, with a control group, in adults with strength deficits under exercise schemes of strength and / or endurance, tracking under a year and muscle power as the primary outcome. Results: of 661 articles, six relevant studies were identified. The study participants in Gln isolation evaluation did not suggest changes between the groups, only an improvement in the perception of muscle weakness. Studies evaluating Gln with other nutrients, have reported results in favor of it. No meta-analysis was posible. Conclusions: nowadays there are insufficient data on the effects related to the Gln on the deficit of muscular force during exercise schemes in adults. It is required more research in this topic to respond more accurately about this fact (AU)

Estado nutricio de dos generaciones de hermanos(as) < de 5 años de edad beneficiarios(as) de Oportunidades, en comunidades rurales marginadas de Chiapas, México / Nutritional status of two generations of brothers and sisters < 5 years of age beneficiaries from opportunities living in marginalized rural communities in Chiapas, Mexico

En México, en las últimas décadas se han desarrollado varios programas para erradicar el problema de la desnutrición en infantes < de 5 años, principalmente de aquellos que viven en áreas indígenas y rurales. No obstante, no existe suficiente evidencia sobre su impacto en la salud y la nutrición infantil. Objetivo: describir los cambios nutricionales de dos generaciones de hermanos(as) que han sido beneficiados por el programa Oportunidades en comunidades rurales de Chiapas. Métodos: estudio transversal. Se determinó: bajo peso, baja talla, emaciación y SP + O (Sobrepeso más Obesidad). Los hermanos(as) mayores fueron evaluados en los años 2002-2003, para el 2010-2011 se evaluaron a los hermanos(as) menores, ambos grupos eran < de 5 años de edad en el momento de conseguir la información. Resultados: la desnutrición en sus tres formas es un problema, 43,4% de los hermanos(as) evaluados(as) en 2010-2011 presentaron baja talla, la prevalencia de bajo peso disminuyó de 18% a 13,2%, la emaciación (peso bajo para la talla) aumentó de 8,1% a 10.4%. El SP + O aumentó significativamente 12 puntos porcentuales entre los hermanos(as) de 24,8% en 2002-2003 a 36,8% en 2010-2011. La desnutrición en los niños (varones) es menor que la de sus hermanos de la generación de 2002- 2003 (baja talla p = < 0.05), el SP + O fue de 10,9 puntos porcentuales más que el de sus hermanos (26,4% a 37,3%). Conclusión: los niños(as) beneficiarios(as) de Oportunidades aún no han superado los problemas de desnutrición crónica. No se muestra un impacto claro en la mejora del estado nutricional de la población en estudio (AU)

Mexico, in recent decades, has developed several programs to eradicate the problem of infant malnutrition < 5 years, primarily among those living in rural and indigenous areas. However, there is insufficient evidence on these programs’ impact on child health and nutrition. Objective: to describe the nutritional changes of two generations of brothers and sisters living in rural communities of Chiapas and who are Oportunidades beneficiaries. Methods: cross-sectional study. It was determined: underweight, stunting, wasting and overweight plus obesity. Older brothers and sisters were evaluated in 2002-2003, for 2010-2011 younger brothers and sisters were evaluated, both groups were 5 years of age at the time of data collection. Results: malnutrition, in its three types is a problem. 43.4% of brothers and sisters evaluated in 2010-2011 showed stunting, underweight prevalence declined from 18% to 13.2%, wasting (low weight for height) increased from 8.1% to 10.4%. Overweight and obesity increased significantly by 12 percentage points among brothers and sisters, from 24.8% in 2002-2003 to 36.8% in 2010- 2011. Malnutrition among male children is lower than their brothers and sisters from the 2002-2003 generation (stunting p=< 0.05), overweight and obesity was 10.9 percentage points higher than their brothers and sisters (26.4% to 37.3%). Conclusion: children beneficiaries from Opportunities have not yet overcome chronic malnutrition problems. This study shows that there is not a clear impact in improving the nutritional status of the study population (AU)