Sweetened beverages intake, hyperuricemia and metabolic syndrome: the Mexico City Diabetes Study.

OBJECTIVE. To determine prevalence of hyperuricemia and its relation with intake of sweetened beverages (SB) and metabolic syndrome (MS) in low income urban Mexican population. MATERIALS AND METHODS. A cross-sectional analysis of The Mexico City Diabetes Study, a prospective population-based investigation (1 173 participants) was performed. We used logistic regression, adjusted by pertinent variables. We determined prevalence of hyperuricemia and explored associations of uric acid levels with MS and intake of SB. RESULTS. Prevalence of hyperuricemia was 26.5 and 19.8% in males and females respectively. In an adjusted multivariate model, body mass index, waist circumference, and triglyceride were higher as uric acid quartiles increased (p<0.005-0.001). The odds ratio for MS was 1.48 for 3rd uric acid quartile and 2.03 for 4th quartile. Higher consumption of SB was associated with higher uric acid levels (p<0.001). CONCLUSION. Prevalence of hyperuricemia is high. Potential association with intake of SB, resulting in metabolic alterations should be considered.

Dietary intakes of polyunsaturated fatty acids among pregnant Mexican women.

Nutritional demands for docosahexaenoic acid (DHA) are high during pregnancy. Diets low in DHA and long-chain polyunsaturated fatty-acids (LC-PUFA) in pregnancy are associated with poorer DHA status and slower reestablishment of maternal stores. To assess intakes of LC-PUFA among urban pregnant women in Central Mexico, we conducted a cross-sectional survey in Prenatal Clinic at the General Hospital No. 1 of the Mexican Society Security Institute, Cuernavaca, Morelos, Mexico. We ascertained intakes over past three months of 110 food items using a food frequency questionnaire developed for this population. Among 1364 pregnant women 18-35 years of age (mean age 26.2 ± 4.7 years) who were interviewed at 18-22 weeks gestation, median (inter-quartile range) daily intakes of linoleic acid, alpha-linolenic acid (LA), arachidonic acid, eicosapentaenoic acid and DHA were 17.6 (13.6; 22.2) g, 1.4 (1.0; 2.0) g, 137 (102; 174) mg, 18 (10; 38) mg, and 55 (37; 99) mg respectively. The median ratio of n-6 to n-3 PUFA was 11.8:1. The main dietary contributions to DHA intake were eggs, chicken, and fresh canned fish. Intakes of PUFAs were higher among women who had completed high school (p<0.01). We conclude that intakes of DHA were much lower than recommended values; the high n-6 to n-3 ratio suggests a suboptimal balance of these PUFAs. Very few sources of DHA are commonly eaten.

An international trial of antioxidants in the prevention of preeclampsia (INTAPP).

OBJECTIVE: We sought to investigate whether prenatal vitamin C and E supplementation reduces the incidence of gestational hypertension (GH) and its adverse conditions among high- and low-risk women. STUDY DESIGN: In a multicenter randomized controlled trial, women were stratified by the risk status and assigned to daily treatment (1 g vitamin C and 400 IU vitamin E) or placebo. The primary outcome was GH and its adverse conditions. RESULTS: Of the 2647 women randomized, 2363 were included in the analysis. There was no difference in the risk of GH and its adverse conditions between groups (relative risk, 0.99; 95% confidence interval, 0.78-1.26). However, vitamins C and E increased the risk of fetal loss or perinatal death (nonprespecified) as well as preterm prelabor rupture of membranes. CONCLUSION: Vitamin C and E supplementation did not reduce the rate of preeclampsia or GH, but increased the risk of fetal loss or perinatal death and preterm prelabor rupture of membranes.

Effects of docosahexaenoic acid supplementation during pregnancy on gestational age and size at birth: randomized, double-blind, placebo-controlled trial in Mexico.

BACKGROUND: The need for omega-3 fatty acids, especially docosahexaenoic acid (DHA), during pregnancy has received much attention, but evidence of effects on birth outcomes is limited. OBJECTIVE: To evaluate whether prenatal DHA supplementation increases gestational age and birth size. METHODS: We conducted a double-blind, randomized, placebo-controlled trial in Cuernavaca, Mexico. We randomly assigned 1,094 pregnant women (18 to 35 years of age; median DHA dietary intake, 55 mg/day) to 400 mg/day of algal DHA or placebo from 18 to 22 weeks of gestation through delivery. Birth outcomes (968 live births and 5 stillbirths) were ascertained from hospital records within 24 hours of delivery. RESULTS: Intention-to-treat analysis showed no differences between the control and DHA group (all p > .05) in mean gestational age (39.1 + 1.7 and 39.0 +/- 1.9 weeks, respectively), weight (3.20 + 0.47 and 3.21 +/- 0.45 kg, respectively), length (50.3 +/- 2.7 and 50.3 +/- 2.3 cm, respectively) and head circumference (34.3 +/- 1.8 and 34.3 +/- 1.5 cm, respectively) at birth. Offspring of supplemented primigravidae (n = 370) were heavier (difference, 99.4 g; 95% CI, 5.5 to 193.4) and had larger head circumferences (difference, 0.5 cm; 95% CI, 0.1 to 0.9) than controls; the differences in multigravidae (n = 603) were -53.3 g (95% CI, -126.8 to 20.2) and -0.2 cm (95% CI, -0.4 to 0.1), respectively (p < .05 for heterogeneity). CONCLUSIONS: Prenatal DHA supplementation of primigravid women may result in increased birth size in a population where dietary DHA intakes are very low. Benefits of the intervention on infant health and neurodevelopment are under study.

Household food insecurity and its association with anaemia in Mexican children: National Health and Nutrition Survey 2012.

OBJECTIVES: To assess the association between household food insecurity (FI) and the presence of anaemia among Mexican children who were between 12 and 59 months old, and to determine whether this association differs by geographical regions. METHODS: We analysed 7468 children of ages between 12 and 59 months, based on data from the 2012 National Health and Nutrition Survey (ENSANUT 2012). Haemoglobin was measured in capillary blood. Household FI levels were defined according to the Latin American and Caribbean Food Security Scale. An ordinal logistic regression model was developed to assess the relationship between FI and anaemia. The interaction between geographical regions and FI was determined. RESULTS: The highest proportion of anaemia occurred in children with severe household FI (24.3%), compared to those from households with food security (21.2%). Children from severe FI households have a higher adjusted prevalence of anaemia than those from households with food security. FI and anaemia were associated mainly among children residing in the southern region of Mexico. CONCLUSIONS: Our findings can contribute to a better understanding of FI and anaemia in children and to strengthen interventions to address these problems.

Maternal dietary omega fatty acid intake and auditory brainstem-evoked potentials in Mexican infants born at term: cluster analysis.

OBJECTIVE: To identify biological and socioeconomic factors associated with the neurological development of Mexican infants born at term, as measured by brainstem auditory-evoked potentials (BAEPs). SUBJECTS AND METHODS: We conducted a cohort study among 76 women with low risk pregnancies recruited in their third trimester of pregnancy and followed their infants until 12 months of age. BAEP tests were conducted on the infants before 3 months of age during physiologic sleep, using 100 msec bipolar clicks. Maternal dietary intake was evaluated by food frequency questionnaire. Two BAEP groups (short latency, long latency) were identified by cluster analysis. The association between BAEP group and maternal PUFAs was estimated using logistic regression models adjusted for socioeconomic and biological factors. RESULTS: Short latency BAEPs were associated with a maternal diet rich in arachidonic acid (OR=3.63, 95% CI 1.23-10.67) after adjusting for age (in days) sex, head circumference and gestational age but was not significantly associated to a maternal diet rich in docosahexaenoic acid (DHA). CONCLUSIONS: Our results suggest the importance of arachidonic acid intake during pregnancy for short latency BAEPs and adequate fetal myelination.

Prenatal docosahexaenoic acid supplementation and infant morbidity: randomized controlled trial.

OBJECTIVE: Long-chain polyunsaturated fatty acids such as docosahexaenoic acid (DHA) influence immune function and inflammation; however, the influence of maternal DHA supplementation on infant morbidity is unknown. We investigated the effects of prenatal DHA supplementation on infant morbidity. METHODS: In a double-blind randomized controlled trial conducted in Mexico, pregnant women received daily supplementation with 400 mg of DHA or placebo from 18 to 22 weeks' gestation through parturition. In infants aged 1, 3, and 6 months, caregivers reported the occurrence of common illness symptoms in the preceding 15 days. RESULTS: Data were available at 1, 3, and 6 months for 849, 834, and 834 infants, respectively. The occurrence of specific illness symptoms did not differ between groups; however, the occurrence of a combined measure of cold symptoms was lower in the DHA group at 1 month (OR: 0.76; 95% CI: 0.58-1.00). At 1 month, the DHA group experienced 26%, 15%, and 30% shorter duration of cough, phlegm, and wheezing, respectively, but 22% longer duration of rash (all P ≤ .01). At 3 months, infants in the DHA group spent 14% less time ill (P < .0001). At 6 months, infants in the DHA group experienced 20%, 13%, 54%, 23%, and 25% shorter duration of fever, nasal secretion, difficulty breathing, rash, and "other illness," respectively, but 74% longer duration of vomiting (all P < .05). CONCLUSIONS: DHA supplementation during pregnancy decreased the occurrence of colds in children at 1 month and influenced illness symptom duration at 1, 3, and 6 months.

Sweetened beverages intake, hyperuricemia and metabolic syndrome: the Mexico City Diabetes Study / Ingesta de bebidas endulzadas, hiperuricemia y síndrome metabólico: estudio de la Diabetes en la Ciudad de México

Objective. To determine prevalence of hyperuricemia and its relation with intake of sweetened beverages (SB) and metabolic syndrome (MS) in low income urban Mexican population. Materials and methods. A cross-sectional analysis of The Mexico City Diabetes Study, a prospective population-based investigation (1 173 participants) was performed. We used logistic regression, adjusted by pertinent variables. We determined prevalence of hyperuricemia and explored associations of uric acid levels with MS and intake of SB. Results. Prevalence of hyperuricemia was 26.5 and 19.8% in males and females respectively. In an adjusted multivariate model, body mass index, waist circumference, and triglyceride were higher as uric acid quartiles increased (p<0.005-0.001). The odds ratio for MS was 1.48 for 3rd uric acid quartile and 2.03 for 4th quartile. Higher consumption of SB was associated with higher uric acid levels (p<0.001). Conclusion. Prevalence of hyperuricemia is high. Potential association with intake of SB, resulting in metabolic alterations should be considered.

Objetivo. Determinar prevalencia de hiperuricemia en población mexicana urbana de bajos ingresos, relación con ingesta de bebidas endulzadas y síndrome metabólico. Material y métodos. Análisis transversal del Estudio de la Diabetes en la Ciudad de México (1 173 participantes), utilizando regresión logística, ajustada por variables pertinentes. Se determinó prevalencia de hiperuricemia, se exploraron asociaciones de niveles de ácido úrico con síndrome metabólico y bebidas endulzadas. Resultados. La prevalencia de hiperuricemia fue 26.5 y 19.8%, hombres y mujeres, respectivamente. El índice de masa corporal, circunferencia de cintura y triglicéridos fueron más altos con cada cuartil de ácido úrico (p<0.005 - 0.001). La razón de momios para síndrome metabólico fue 1.48 para el tercer cuartil y 2.03 para el cuarto. Se encontró mayor consumo de bebidas endulzadas a mayores niveles de acido úrico (p<0.001). Conclusión. La prevalencia de hiperuricemia es alta. La asociación con bebidas endulzadas y las alteraciones metabólicas resultantes deben considerarse.

Modelos alternativos para el análisis epidemiológico de la obesidad como problema de salud pública / Alternative models for the epidemiological analysis of obesity as a public health problem

Los problemas de salud pública han sido estudiados desde muy diversas perspectivas y utilizando diferentes modelos teóricos y metodológicos. Dos modelos que han sido frecuentemente utilizados son el modelo epidemiológico clásico y el modelo epidemiológico social. Estos modelos emplean distintos criterios conceptuales, metodológicos e ideológicos. Se objetivó hacer una contrastación entre estos modelos de acuerdo a los criterios mencionados, utilizando el estudio de la obesidad como ejemplo de la utilización de estos modelos. Esta contrastación muestra que el conocimiento generado por cada modelo es muy distinto. Se discuten posibles áreas de complementariedad entre ambos modelos y la utilización de las ciencias sociales como estrategia para ampliar nuestro conocimiento sobre problemas de salud pública, en especial el problema de la obesidad

Validez y reproducibilidad de un cuestionario de actividad e inactividad física para escolares de la ciudad de México / Validity and reproducibility of a physical activity and inactivity questionnaire for Mexico Cityïs schoolchildren

Objetivo. Evaluar la validez y reproducibilidad de un cuestionario autoaplicado de actividad e inactividad física en escolares de 10 a 14 años de la ciudad de México. Material y métodos. Se desarrolló un cuestionario autoaplicado sobre la actividad e inactividad física que se aplicó dos veces a una muestra de 114 estudiantes, de 10 a 14 años de edad, en una población de bajos y medianos ingresos de la ciudad de México, entre mayo y diciembre de 1996. Las madres de los estudiantes llenaron el mismo cuestionario, mientras que aquéllos completaron dos recordatorios de actividad física de 24 horas, que se usaron como criterio de comparación. Se calcularon medidas de tendencia central y de dispersión y se estimó correlación de Pearson. Resultados. Las correlaciones entre las horas al día dedicadas a la actividad e inactividad física del cuestionario de los estudiantes y las de los recordatorios de 24 horas ajustadas por edad, sexo, zona de residencia y enfermedad anterior a la administración del cuestionario fueron de 0.03 para la actividad moderada, de 0.15 para la actividad vigorosa y de 0.51 (p=0.001) para el tiempo dedicado a ver televisión. Al comparar con los recordatorios de 24 horas, el cuestionario sobrestimó el tiempo de ver televisión, leer o participar en actividades vigorosas, y subestimó el tiempo de actividad moderada. Se observaron coeficientes de reproducibilidad en seis meses aceptables para el tiempo de ver televisión (r=0.53), dormir (r=0.40), actividad moderada (r=0.38) y actividad vigorosa (r=0.55) (p<0.05). Conclusiones. Entre los estudiantes de 10 a 14 años de la ciudad de México, el cuestionario mostró validez aceptable para estimar el tiempo de ver televisión, y una reproducibilidad aceptable de las medidas del tiempo de ver televisión, de la actividad moderada y de la vigorosa.

Fibra dietética y tumores gastrointestinales, implicaciones para la población mexicana / Dietary fiber and gastro-intestinal cancer, implication for the mexican population

Algunos nutrimentos ejercen influencias particulares en el desarrollo o bien en la protección contra las enfermedades crónicas y/o degenerativas. Entre otros problemas dietéticos implicados en este contexto, se ha observado que la ingestión abundante de fibra dietética actúa como un factor protector contra las neoplasias del aparato digestivo. Numerosos artículos científicos ha sugerido mecanismos por medio de los cuales la fibra dietética ejerce un efecto protector importante contra el cáncer de colon y en menor grado cánceres del estómago y del recto. En México para 1990, los tumores malignos constituyeron la segunda causa de mortalidad general en la población de 65 años y más. De acuerdo a los registros sobre el cáncer en la República Mexicana, los tumores del tubo digestivo fueron la tercera causa de importancia y el carcinoma gástrico se reportó más frecuentemente, seguido por el colon y recto. No se sabe hasta que punto la migración urbana y las modificaciones concomitantes en la dieta de la población, actúen como confactores en el incremento de éste tipo de neoplasia. En la década de los setentas, diversas investigaciones realizadas en población mexicana mostraron un alto consumo de fibra a partir de una dieta basada principalmente en la tortilla y el frijol. Hoy en día los patrones de alimentación se han modificado. El creciente consumo de alimentos concentrados en energía y de bajo valor nutriológico, se asocia con un bajo aporte de fibra. El presente documento tiene como objetivo, comentar sobre los riesgos a los que se expone la población para desarrollar algún tipo de neoplasia gástrica intestinal debido a la incorporación de patrones dietéticos inadecuados, que se caracterizen por incluir entre otros factores, el desplazamiento de la fibra dietética en la alimentación