Association between Maternal and Toddler Appetitive Traits in a Mexican Population.

The Child Eating Behaviour Questionnaire for toddlers (CEBQ-T-Mex) and the Adult Eating Behaviour Questionnaire (AEBQ-Esp) measure appetitive traits (ATs) in children and adults, respectively, both validated for use in Spanish. ATs are inherited variations in appetite, present from birth, that are reasonably stable throughout childhood and can explain why some infants over- or undereat in response to environmental exposures. "Food approach" traits predispose to overweight while "food avoidance" traits provide protection, but little is known about the relationships between parents' and their toddler's ATs. The aim was to examine the associations between maternal and toddler appetitive traits, using the AEBQ-Esp and CEBQ-T-Mex, and to examine the associations between ATs and Body Mass Index z-scores (BMIz). Sociodemographic data and the weights and heights of mothers and toddlers (aged 12-36 months) were collected from a teaching hospital in Guadalajara, Mexico. Mothers completed both the AEBQ-Esp and the CEBQ-T-Mex. Direct correlations were found between the ATs of toddlers and their mother (p < 0.005), except for "Slowness in Eating" (SE), and only an inverse correlation was found between the "Satiety Responsiveness" (SR) of toddlers and their BMIz (r = -0.147; p = 0.007). These results suggest that ATs could potentially run in families. These may be useful targets for family-wide interventions to support the development and maintenance of healthy eating behaviours in childhood.

Anthropometric Indicators and Dietary Intake in Toddlers Aged from 12 to 24 Months Who Attended Private Clinics in the Metropolitan Area of Guadalajara.

The objective was to evaluate the anthropometric indicators and dietary intake of toddlers attending private clinics in Guadalajara. In a cross-sectional study, 101 toddlers aged 12 to 24 months were included. They were born full term, had an adequate weight for gestational age, and attended private clinics in Guadalajara. Two 24 h dietary recalls were administered. Anthropometric measurements were taken, and anthropometric indices were estimated. Student's t test or the Mann-Whitney U test, chi-square test, and odds ratio were used for quantitative or qualitative variables. Males had lower Z scores for the weight/age index than females. During the week, energy intake was excessive in males [OR = 5.5 (95% CI 1.4, 20.8)], and cholesterol intake was insufficient in females [OR = 3.03 (95% CI 1.2, 7.1)]. On weekends, energy [OR = 2.5 (95% CI 1.1, 5.7)] and fiber intake [OR = 3.1 (95% CI 1.2, 7.8)] were insufficient in females. Most of the toddlers who attend the private clinics in the upper-middle socioeconomic stratum of the Guadalajara Metropolitan Area had excessive protein intake, excessive consumption of added sugars was frequent, and there was insufficient intake of vitamin D and calcium. Sex was shown to be a factor influencing nutrient intake in these toddlers aged 12-24 months. Males had a Z-score of weight/age lower than females, suggesting nutritional risk.

Adiposity and feeding practices in the first two years of life among toddlers in Guadalajara, Mexico.

BACKGROUND: Feeding practices in the first two years of life have a direct impact on nutritional status and adiposity. The purpose of this study was to identify the differences in feeding practices during the first two years of life by sex and type of feeding in the first semester of postnatal life and their relationships with adiposity in toddlers. METHODS: An analytical cross-sectional study that included 150 toddlers aged 12 to 24 months who were healthy, full-term, and had adequate weight for their gestational ages, was conducted at the New Civil Hospital and at a private practice in Guadalajara. Body compositions were obtained by bioelectrical impedance (BIA) measurements, and a modified questionnaire was used. Then, the parents completed two 24-h dietary recalls. In addition to the descriptive statistics, ANOVA, Kruskal-Wallis and Mann-Whitney U tests were used in the contrast analysis of the quantitative variables. To analyze the qualitative variables, we used X2 tests. Afterward, linear regression tests were conducted to identify the relationships between adiposity and feeding practices during the first two years. RESULTS: There were direct relationships between adiposity and duration of full breastfeeding (r = 0.610, p = 0.021), age of introduction of ultra-processed products (r = 0.311, p = 0.011), sugar (r = 0.186; p = 0.024) and age at which eggs were introduced (r = -0.202; p = 0.016). CONCLUSIONS: Adiposity was related to feeding practices in the first two years of life in toddlers.

Firmicutes, Bacteroidetes and Actinobacteria in Human Milk and Maternal Adiposity.

The main objective was to explore the relationship between the microbiota of human milk and adiposity in Mexican mothers during the first lactation stage. METHODS: Seventy lactating women were included. Adiposity by anthropometric measurements and by bioelectric impedance was obtained. The donation of human milk was requested, from which bacterial DNA was extracted and qPCR of the 16S region was performed. The Mann-Whitney U test, Spearman and Pearson correlations, and multiple linear regressions models were also calculated. RESULTS: The median percentage of Bacteroidetes had a direct and significant correlation with normal adiposity, current BMI, waist circumference, and body fat percentage. The correlation with current BMI became significantly inverse in women with BMI ≥ 25. In women with normal BMI, the percentage of Actinobacteria showed a direct and significant correlation with current BMI, waist circumference, and percentage of body fat. Multiple linear regressions showed that pre-pregnancy BMI was the variable with the highest predictive value with the Bacteroidetes phyla in normal BMI and in BMI ≥ 25. CONCLUSIONS: the adiposity of the woman before pregnancy and during lactation would have an important effect on the abundance of Bacteroidetes and Actinobacteria in human milk.

Volviéndonos mejores: necesidad de acción inmediata ante el reto de la obesidad. Una postura de profesionales de la salud.

La creciente epidemia de obesidad ha sido uno de los retos más importantes de salud pública en México durante los últimos años. Con apoyo de la Federación Mundial de Obesidad, en 2021 formamos un grupo de profesionales para identificar y resumir las acciones prioritarias en las que puede enfocarse nuestro país para hacer frente a esta epidemia. Al proceso de desarrollo y discusión de este grupo se sumaron más de 1 000 profesionales de la salud para retomar recomendaciones de documentos y guías de alto nivel previamente publicados. En conmemoración del Día Mundial de la Obesidad, en este 2022 se presenta esta postura como insumo para el desarrollo de acciones en el ámbito profesional y de los diferentes sectores, en la que se incluyen 10 recomendaciones de acción, desde la perspectiva poblacional hasta la atención individualizada, y se enfatiza en la importancia de la participación social, de las intervenciones integrales con visión centrada en la persona y de la sostenibilidad planetaria, además de mejorar la educación y las campañas de difusión, propiciar un ambiente promotor de entornos activos y blindar de conflictos de interés los esfuerzos de prevención y control. La postura hace un llamado para abordar la obesidad de manera seria, con base en la evidencia científica, oportuna e integral, con enfoque de curso de vida, de forma ética y sensible, y sin perpetuar las barreras del estigma de peso en la sociedad.

Volviéndonos mejores: necesidad de acción inmediata ante el reto de la obesidad. Una postura de profesionales de la salud / Becoming better: the need for immediate action to address obesity. A position statement from health professionals

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Abstract: In recent decades, the growing obesity epidemic in Mexico has become one of the most important public health challenges faced by the country. With support from the World Obesity Federation, we formed a working group in 2021 to identify and summarize priority actions that Mexico can take to face this epidemic. More than 1 000 health professionals joined the development and discussion process. Recommendations from previously published, high-level documents and guidelines were taken into account. In commemoration of World Obesity Day 2022, this statement is presented as input for health care professionals to develop actions to address obesity. The statement includes 10 recommendations that include population-level and individual-level actions. It emphasizes the importance of social participation, comprehensive interventions with a person- centered perspective, planetary sustainability, on improving education and communication campaigns, as well as fostering a built environment that promotes active living, and shielding prevention and control efforts from conflicts of interest. The statement calls for obesity to be treated seriously, based on scientific evidence, in a timely and comprehensive manner, employing a life-course and ethical approach that does not perpetuate weight stigma in society.

Intergenerational transmission of appetite: Associations between mother-child dyads in a Mexican population.

The Child Eating Behaviour Questionnaire (CEBQ) and the Adult Eating Behaviour Questionnaire (AEBQ) measure 'food approach' [Food responsiveness (FR); Emotional overeating (EOE); Enjoyment of food (EF); Desire to Drink] and 'food avoidant' [Satiety responsiveness (SR); Emotional undereating (EUE); Food fussiness (FF); Slowness in eating (SE)] appetitive traits (ATs) in children and adults, respectively. 'Food approach' traits predispose to overweight while 'food avoidance' traits provide protection, but little is known about the relationships between parents' and their offspring's ATs. The aim was to examine the associations between maternal and child appetitive traits, using the AEBQ-Esp and CEBQ-Mex adapted for use in Mexican populations. Sociodemographic data, weights and heights of mothers and their children (aged 3-13 years), who were recruited from a teaching hospital in Guadalajara, Mexico, were measured. Mothers completed both the AEBQ-Esp and the CEBQ-Mex. The CEBQ-Mex was developed, and its reliability was tested using Cronbach's alpha and Omega, and Confirmatory Factor Analysis (CFA) was used to assess its validity. Pearson's correlation coefficients were used to assess associations between mothers' and children's Ats. The sample included 842 mother-child dyads (mother's mean age = 34.8±SD6.9 years, BMI 29.7±6.1 kg/m2; children's mean age = 8.5 ±SD2.5 years, BMIz 1.5±1.6). Internal reliability was moderate to high [Cronbach alpha = .68-.86; Omega = .71-.87] for the CEBQ-Mex and validity was confirmed for an 8-factor model through CFA [RMSEA = 0.065; CFI = 0.840, NFI = 0.805; IFI = 0.842; and χ2(df = 532) = 2939.51, p < 0.001]. All but one of the children's appetitive traits showed small to moderate, significant correlations with their mother's counterpart [FR (r = .22; p<001); EOE (r = .30; p < .001); EF (r = .15; < .001); SR (r = .16; p < .001); EUE (r = .34; p < .001) and FF (r = .14; p < .001). Only SE was not significantly associated with maternal SE (r = .01; p>.05). ATs tend to run in families, signalling the intergenerational transmission of eating behaviours. These may be useful targets for family-wide interventions to support the development and maintenance of healthy eating behaviours in childhood.

Examining the validity and consistency of the Adult Eating Behaviour Questionnaire-Español (AEBQ-Esp) and its relationship to BMI in a Mexican population.

PURPOSE: Appetitive traits in adults and their associations with weight can be measured using the Adult Eating Behaviour Questionnaire (AEBQ). The aim of this study was to confirm the factor structure of the Spanish AEBQ (AEBQ-Esp) in a Mexican sample and explore associations between the eight traits with body mass index (BMI). METHOD: A sample of 1023 adults, mean age of 36.8 ± 12.8 years, was recruited from Guadalajara, Mexico. Researchers weighed and measured participants, and they completed the AEBQ-Esp either online or in paper format and reported sociodemographic data. To test two alternative factor structures (eight factors including Hunger; seven factors excluding Hunger), confirmatory factor analysis (CFA) was used. Internal reliability was assessed using Cronbach's alpha; test-retest reliability was assessed using intra-class correlation coefficients. Multivariate linear regressions were used to test for associations between the AEBQ subscales and BMI, adjusted for age, sex, format of AEBQ responses, education, marital and employment status. RESULTS: A seven-factor structure was the best model fit using CFA, excluding the Hunger subscale but similar to the original AEBQ. Internal reliability was good for all subscales (Cronbach's α = 0.70-0.86), and the intra-class correlation coefficient (0.70-0.91) reflected good test-retest reliability. In the fully adjusted models, Satiety Responsiveness [ß = - 0.61; (- 1.01, - 0.21)] and Slowness in Eating [ß = - 0.70; (- 1.01, - 0.39)] were negatively associated with BMI, and Emotional Over-Eating [ß = 0.94; (0.62, 1.27)] was positively associated with BMI. CONCLUSIONS: The AEBQ-Esp (excluding Hunger) appears to be a valid and reliable psychometric questionnaire for measuring appetitive traits in a Mexican Spanish-speaking population. Some traits appear to be associated with BMI in adulthood and warrant further exploration. LEVEL OF EVIDENCE: Level III evidence obtained from well-designed cohort or case-control analytic studies. Although this was just an observational study, it was well designed and provided new evidence.

Validity and Reliability of the Baby and Child Eating Behavior Questionnaire, Toddler Version (BEBQ-Mex and CEBQ-T-Mex) in a Low Sociodemographic Sample Recruited in a Mexican Hospital.

The objective of this study was to validate and measure the internal reliability of the Baby and Child Eating Behavior Questionnaires for Toddlers (BEBQ-Mex and CEBQ-T-Mex), that evaluate appetitive trait (ATs). Mothers recruited from a public hospital in Guadalajara, Mexico, completed the BEBQ-Mex or CEBQ-T-Mex along with information on sociodemographic characteristics. Internal reliability of the BEBQ-Mex was sufficient for Food Responsiveness (FR) (Cronbach α = 0.82), while Enjoyment of Food (EF) and Satiety Responsiveness (SR) showed poor reliability (α = 0.56) and Slowness in Eating (SE) had unacceptable reliability (a = 0.36). All reliability values for the CEBQ-T-Mex were acceptable (>0.70), except for SE (α = 0.64). Confirmatory factor analysis (CFA) revealed an adequate model fit for the BEBQ-Mex, except the SE subscale. CFA for the CEBQ-T-Mex confirmed the six-factor structure. Mothers of a low sociodemographic background were unable to recognize their infants' ATs; the BEBQ-Mex partly met the criteria for validity and reliability. Mothers from similar sociodemographic characteristics were more able to recognize the ATs of their toddlers than their infants; the CEBQ-T-Mex was found to be a valid and reliable tool. Findings support the need to help mothers' ability to recognize their infants' ATs, which have been previously associated with weight and growth.

Influence of Breastfeeding Factors on Polyamine Content in Human Milk.

The polyamine content of human breast milk, which is the first exogenous source of polyamines for the newborn, can be affected by several factors associated with the mother, the infant, or breastfeeding itself. The aim of this study was to evaluate the influence of different breastfeeding factors on the polyamines found in human milk. For this study, a cohort of 83 mothers was considered for up to 4 months, and a subgroup of 33 mothers were followed during the first six months of breastfeeding. Two breast milk samples were collected at each sampling point (foremilk and hindmilk) and the polyamine content was determined by UHPLC-FL. Polyamine levels varied considerably between the mothers and tended to decrease over time. Putrescine was the minor polyamine, whereas spermidine and spermine contents were very similar. The concentrations of the three polyamines were significantly higher in hindmilk than foremilk (p < 0.001). Spermidine and spermine levels decreased significantly through the lactation progress (p < 0.05). Finally, slightly higher levels of polyamines were observed in the milk of mothers providing partial, rather than full, breastfeeding, although the differences were not significant. The polyamine content in human milk was found to change during a single feed (foremilk versus hindmilk) and as lactation progressed, mainly in response to the specific circumstances of the newborn.

Percentile Reference Values for the Neck Circumference of Mexican Children.

Neck circumference was studied for the first time in a pediatric population in 2010. Since then, various countries have proposed cutoff values to identify overweight, obesity, and metabolic syndrome. However, no reference values have been established for the Mexican child population. The aim of this study is to provide percentile reference values for the neck circumference of Mexican schoolchildren. Only normal-weight schoolchildren aged 6-11 years were included. Percentiles and growth charts were constructed based on the "Generalized Additive Model for Location, Scale and Shape" (GAMLSS). A total of 1059 schoolchildren (52.9% female) was evaluated. Weight, height, and BMI values were higher for males; however, this difference was not statistically significant. The 50th percentile for females was 24.6 cm at six years old and 28.25 cm at 11 years old, and for males, it was 25.75 cm and 28.76 cm, respectively. Both males and females displayed a pronounced increase in neck circumference between 10 and 11 years of age. The greatest variability was found in the 11-year-old group, with an increase of 5.5 cm for males and 5.4 cm for females. This study presents the first reference values for neck circumference for a Mexican child population.

Full Breastfeeding Modifies Anthropometric and Body Composition Indicators in Nursing Mothers.

Background: It has been observed that breastfeeding mobilizes the deposits of fat that accumulate during pregnancy and promotes weight loss through energy expenditure. The purpose of this study was to demonstrate that full breastfeeding (FBF) reduces anthropometric and body composition indicators in women between the 8th and the 16th week postpartum. Methods: In a nonrandom cohort study, 170 mothers at the Hospital Civil de Guadalajara, Guadalajara, México, were enrolled: FBF 74, partial breastfeeding (PBF) 57, and human milk substitutes (HMS) 39. Anthropometric indicators and body composition were measured at the 8th and 16th week postpartum. We performed analysis of variance to compare body composition according to the type of feeding and paired Student's t-test to compare the changes from the 8th to 16th week postpartum. Results: We found that FBF mothers had a trend to lower arm fat area and triceps skinfold than PBF and HMS mothers at 8 and 16 weeks postpartum. We observed a decrease in weight (p = 0.004), weight/age index (p = 0.003), body mass index (p = 0.003), hip circumference (p = 0.037), and lean mass (p = 0.003) from 8 to 16 weeks postpartum in mothers who offered FBF. The mid-upper arm circumference, the arm total area, and their z-score increased in the three feeding groups. Conclusions: Our results show that FBF mothers had some lower adiposity from 8 to 16 weeks postpartum compared with the result observed among PBF mothers and those who utilized HMS.

Lactobacillus reuteri DSM 17938 and Agave Inulin in Children with Cerebral Palsy and Chronic Constipation: A Double-Blind Randomized Placebo Controlled Clinical Trial.

The main objective was to assess the efficacy of a probiotic (Lactobacillus reuteri DSM 17938), a prebiotic (agave inulin), and a synbiotic on the stool characteristics in children with cerebral palsy and chronic constipation. Thirty-seven children with cerebral palsy and chronic constipation were included. The probiotic group received 1 × 108 colony forming unit (cfu) of L. reuteri DSM 17938 plus placebo, the prebiotic group received 4 g of agave inulin plus placebo, the synbiotic group received L. reuteri DSM 17938 plus agave inulin, and the placebo group received two placebos for 28 days. The probiotic group showed a significant decrease in stool pH (p = 0.014). Stool consistency improved in the prebiotic group (p = 0.008). The probiotic, prebiotic, and synbiotic groups showed a significant improvement in the history of excessive stool retention, the presence of fecal mass in the rectum, and the history of painful defecation. L. reuteri concentration in feces was higher in the probiotic group than in the placebo group (p = 0.001) and showed an inverse correlation with stool pH in the probiotic group (r = -0.762, p = 0.028). This study showed that the use of L. reuteri DSM 17938 and/or agave inulin improved the stool characteristics such as the history of painful defecation and the presence of fecal mass in the rectum against placebo in children with cerebral palsy and chronic constipation.

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

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

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

Appetitive traits in children aged 6 to 12 years: association with obesity and differences by gender.

Background: Overweight and obesity in schoolchildren are a major public health problem in Mexico. The objective of this study was to demonstrate the association of appetitive traits with the presence of obesity and identify gender differences in children attending a university hospital. Methods: A cross-sectional study was conducted on 176 children with obesity and 175 children with normal weight in the outpatient clinic of the Nuevo Hospital Civil de Guadalajara. The body mass index (BMI) of the participants was calculated. The parents completed the Children's Eating Behaviour Questionnaire to measure eight appetitive traits. The mean appetitive trait scores were compared between children with obesity and normal weight, and between genders. Statistical analysis was performed using Student's t-tests for independent samples and regression analysis between appetite traits and BMI Z-scores. Results: The mean food responsiveness score (or food onset appetitive trait) was higher in children with obesity (p < 0.001), while the mean satiety responsiveness (or food offset trait) was higher in children with normal weight (p < 0.001). Normal weight males showed higher scores for Food responsiveness, Emotional over-eating, and Desire to drink (p < 0.05). Conclusions: Children with obesity show appetitive traits that could lead to higher food consumption. Normal weight males showed appetitive traits that could represent a risk of developing obesity.

Introducción: El sobrepeso y la obesidad en niños de edad escolar se consideran un problema de salud pública en México. El objetivo de este estudio fue demostrar la asociación entre los rasgos del apetito y la presencia de obesidad, e identificar diferencias por sexo en niños que acuden a un hospital universitario. Métodos: Se realizó un estudio de diseño transversal en 176 niños con obesidad y 175 niños con normopeso, pacientes del Nuevo Hospital Civil de Guadalajara y se calculó el índice de masa corporal (IMC) de los participantes. Se aplicó el Cuestionario de Conductas Alimentarias del Niño a los padres para evaluar ocho rasgos del apetito y se comparó el promedio de la puntuación de los rasgos del apetito entre niños con obesidad y normopeso, y entre sexos. Se utilizó la prueba t de Student para muestras independientes y análisis de regresión con los rasgos del apetito y el puntaje Z del IMC. Resultados: El promedio de la puntuación de los rasgos del apetito que muestran inclinaciones positivas hacia los alimentos (proingesta) fue mayor en niños con obesidad (p < 0.001), mientras que el promedio de los que muestran inclinaciones negativas hacia los alimentos (antiingesta) fue mayor en niños con normopeso (p < 0.001). Los participantes de sexo masculino con normopeso presentaron mayor puntaje en los rasgos del apetito Respuesta a los alimentos, Sobrealimentación emocional y Deseo de beber (p < 0.05). Conclusiones: Los niños con obesidad muestran rasgos del apetito que pueden llevar a un mayor consumo de alimentos. Los participantes de sexo masculino con normopeso mostraron rasgos del apetito que podrían representar un riesgo de desarrollo de obesidad.

Rasgos del apetito en niños de 6 a 12 años: asociación con la obesidad y diferencias por sexo / Appetitive traits in children aged 6 to 12 years: association with obesity and differences by gender

Resumen Introducción: El sobrepeso y la obesidad en niños de edad escolar se consideran un problema de salud pública en México. El objetivo de este estudio fue demostrar la asociación entre los rasgos del apetito y la presencia de obesidad, e identificar diferencias por sexo en niños que acuden a un hospital universitario. Métodos: Se realizó un estudio de diseño transversal en 176 niños con obesidad y 175 niños con normopeso, pacientes del Nuevo Hospital Civil de Guadalajara y se calculó el índice de masa corporal (IMC) de los participantes. Se aplicó el Cuestionario de Conductas Alimentarias del Niño a los padres para evaluar ocho rasgos del apetito y se comparó el promedio de la puntuación de los rasgos del apetito entre niños con obesidad y normopeso, y entre sexos. Se utilizó la prueba t de Student para muestras independientes y análisis de regresión con los rasgos del apetito y el puntaje Z del IMC. Resultados: El promedio de la puntuación de los rasgos del apetito que muestran inclinaciones positivas hacia los alimentos (proingesta) fue mayor en niños con obesidad (p < 0.001), mientras que el promedio de los que muestran inclinaciones negativas hacia los alimentos (antiingesta) fue mayor en niños con normopeso (p < 0.001). Los participantes de sexo masculino con normopeso presentaron mayor puntaje en los rasgos del apetito Respuesta a los alimentos, Sobrealimentación emocional y Deseo de beber (p < 0.05). Conclusiones: Los niños con obesidad muestran rasgos del apetito que pueden llevar a un mayor consumo de alimentos. Los participantes de sexo masculino con normopeso mostraron rasgos del apetito que podrían representar un riesgo de desarrollo de obesidad.

Abstract Background: Overweight and obesity in schoolchildren are a major public health problem in Mexico. The objective of this study was to demonstrate the association of appetitive traits with the presence of obesity and identify gender differences in children attending a university hospital. Methods: A cross-sectional study was conducted on 176 children with obesity and 175 children with normal weight in the outpatient clinic of the Nuevo Hospital Civil de Guadalajara. The body mass index (BMI) of the participants was calculated. The parents completed the Children’s Eating Behaviour Questionnaire to measure eight appetitive traits. The mean appetitive trait scores were compared between children with obesity and normal weight, and between genders. Statistical analysis was performed using Student’s t-tests for independent samples and regression analysis between appetite traits and BMI Z-scores. Results: The mean food responsiveness score (or food onset appetitive trait) was higher in children with obesity (p < 0.001), while the mean satiety responsiveness (or food offset trait) was higher in children with normal weight (p < 0.001). Normal weight males showed higher scores for Food responsiveness, Emotional over-eating, and Desire to drink (p < 0.05). Conclusions: Children with obesity show appetitive traits that could lead to higher food consumption. Normal weight males showed appetitive traits that could represent a risk of developing obesity.

Efecto de la deficiencia de hierro sobre el desarrollo neuropsicológico en lactantes / Effect of iron deficiency on neuropsychological development in infants

Resumen La deficiencia de hierro (DFe) es la patología nutrimental infantil de mayor prevalencia en el mundo y afecta la maduración cerebral y el consiguiente desarrollo cognitivo, lingüístico, motor y comportamental de quienes la padecen. El informe que se presenta tuvo como objetivo estudiar, en profundidad, literatura acerca del efecto de la DFe sobre el desarrollo neuropsicológico en lactantes. Para ello, se analizaron 51 estudios originales realizados en humanos, 49 de los cuales fueron obtenidos a través de Pubmed y 2, de Scielo. Cabe resaltar que, con el fin de discutir los hallazgos de estos artículos, se incluyeron investigaciones sobre el efecto de la DFe que utilizan modelo animal, así como estudios en humanos con desarrollo típico. Esta búsqueda se realizó a conveniencia. El reconocimiento de sus implicaciones facilitaría el trabajo terapéutico, así como la inclusión de programas de estimulación temprana junto con el manejo de la deficiencia nutrimental.

Abstract Iron is involved in various aspects related to brain function, including oxygen transport, neurotransmitters metabolism, DNA synthesis, ATP production, dendritic growth, axonal development and transport, myelin production, glial development, in plasticity markers such as the brain-derived growth factor, and in synaptic plasticity. Human development (biological, cognitive, social) is associated with a bidirectional and dynamic interaction between gene activity, neural activity and environment. An environmental variable is nutrition, and it is known that the central nervous system is extremely vulnerable to nutritional deficiencies during pregnancy and in the first two years of life, period in which an accelerated maturational dynamism occurs. Therefore, a disturbance of these by an iron deficiency would result in neuropsychological alterations, with varied expressions depending on the age at which it occurs and the severity and duration of the nutritional disease. Iron deficiency is defined as the depletion of iron reserves in the body by various factors (nutritional, physiological, pathological, etc.). Three stages of the illness have been established: iron depletion, iron deficiency without anemia and iron deficiency anemia. The first is associated with a decrease in iron reserves without reaching the deficiency; it may be due to a reduction in iron intake and or absorption, excessive loss or an increase in iron requirements. At this stage, there are no functional consequences in the organism. The second stage, is characterized by biochemical changes that reflect a pathologically reduced concentration of serum ferritin with a normal hemoglobin concentration. Finally, iron deficiency anemia is defined by the combination of low concentration of serum ferritin and hemoglobin. Given that iron deficiency is the most prevalent childhood nutritional disorder in the world (affecting 43 % of children aged 6-59 months) and that it impacts brain maturation and the consequent cognitive, linguistic, motor and behavioral development of those who suffer from it, in this paper, the literature on the effect of iron deficiency on neuropsychological development in infants is analyzed in depth. The review was performed considering the short, medium and long lasting effects of iron deficiency without anemia, iron deficiency anemia, chronic iron deficiency during the first two years of life and the presence of treatment. To contextualize, the analysis of the relationship between iron and brain functioning is included and the variables that modulate the expression of its effect are addressed. To carry out the search of literature regarding the effect of iron deficiency on neuropsychological development in infants, Pubmed and SciELO were consulted. No date or language restriction was established. Different combinations of terms were used: "iron deficiency infant", "iron deficiency fetal", "iron deficiency neonatal", "iron deficiency long lasting". The analyzed reports fulfilled the following inclusion criteria: a) primary sources, b) establish a value of hemoglobin and at least one of iron (i.e, serum ferritin, mean corpuscular volume, free erythrocyte, protoporphyrin, transferrin saturation) to define the children of each group, c) human sample, d) description of the measures used for the evaluation, e) studies examined after this stage, had to determine that the sample evaluated presented iron deficiency during the first two years of life. In this paper, 51 original articles conducted in humans were analyzed, of which 49 were obtained through Pubmed and 2 from SciELO. It should be noted that, in order to discuss the findings of these reports, literature was included on the effect of iron deficiency using animal models, as well as studies in humans with typical development. The search for these was done at convenience. The recognition of its implications would facilitate the therapeutic work, as well as the inclusion of early stimulation programs together with the management of nutritional deficiency.

Is there gender discrimination in full breastfeeding in Mexico?

INTRODUCTION: Objective: differences have been shown between males and females in terms of the prevalence of malnutrition in different parts of the world, which point to discrimination against females, including with respect to full breastfeeding. Therefore, the objective was to show that exclusive breastfeeding is less common for females in a population of medium-low and low socioeconomic strata. Methods: this was a cross-sectional analysis of a sample of 170 mother-infant dyads according to type of feeding (74 full breastfeeding, 57 partial breastfeeding and 39 human milk substitutes) at the Nuevo Hospital Civil de Guadalajara. Dependent variables according to type of feeding: full breastfeeding (exclusive and/or predominant), partial breastfeeding, and human milk substitutes. Independent variables: demographic data, schooling, occupation of mothers and/or parents, and family income. Kruskal-Wallis, Mann-Whitney U and Chi-square tests and odds ratio were used. Results: the probability of full breastfeeding was 3.8 times lower in females than in males. In a non-significant way, the likelihood of full breastfeeding was lower than that of partial breastfeeding, and full breastfeeding was lower than the combination of partial breastfeeding and human milk substitutes in females. Full breastfeeding and partial breastfeeding were lower than human milk substitutes, and partial breastfeeding was lower than human milk substitutes in females. Conclusion: there is a differentiated character in the privilege of full breastfeeding; it is four times lower in females than in males.

INTRODUCCIÓN: Objetivo: se han observado diferencias entre niñas y varones en la prevalencia de desnutrición en diferentes partes del mundo, lo que apunta a la discriminación contra las niñas, incluso con respecto a la lactancia materna completa. El objetivo fue mostrar que la lactancia completa es menos común en las niñas en una población de estratos socioeconómicos medio-bajo y bajo. Métodos: se realizó un análisis transversal de una muestra de 170 díadas madre-lactante según el tipo de alimentación (74 de lactancia completa, 57 de lactancia parcial y 39 sucedáneos de la leche humana) en el Nuevo Hospital Civil de Guadalajara. Variables dependientes según el tipo de alimentación: lactancia completa (exclusiva y/o predominante), lactancia parcial y sucedáneos de leche humana. Variables independientes: datos demográficos, escolaridad, ocupación de madres y/o padres e ingresos familiares. Se utilizaron pruebas de Kruskal-Wallis, Mann-Whitney U y Chi-cuadrado y razón de momios. Resultados: la probabilidad de lactancia materna completa fue 3,8 veces menor en niñas que en varones. De manera no significativa, la probabilidad de lactancia completa fue menor que la de lactancia parcial y la frecuencia de lactancia completa fue menor que la combinación de lactancia parcial y sucedáneos de leche humana en niñas. La frecuencia de lactancia completa y lactancia parcial fue menor que los sucedáneos de leche humana y la lactancia parcial fue menos frecuente que los sucedáneos de leche humana en niñas. Conclusión: hay un carácter diferenciado en el privilegio de ofrecer lactancia materna completa. Es cuatro veces menor en las niñas que en varones.

Neck circumference as an indicator of elevated central adiposity in children.

OBJECTIVE: We aimed to study the correlation between neck circumference (NC) and anthropometric adiposity indicators, and to determine cut-off points of NC for both sexes to identify elevated central adiposity in schoolchildren in western Mexico. DESIGN: Cross-sectional study. SETTING: Rural settings in western México.ParticipantsChildren from a convenience sample of six schools in Acatlán, Jalisco, Mexico (n 1802). RESULTS: NC showed a strong positive correlation with all anthropometric adiposity indicators in both sexes, which were notably higher in boys regardless of age. Noteworthy, waist circumference displayed the highest significant correlation when analysed by both age and sex. As age increased, NC cut-off points to identify elevated central adiposity ranged from 25·7 to 30·1 cm for girls and from 27·5 to 31·7 cm for boys. CONCLUSIONS: NC could be used as a simple, inexpensive and non-invasive indicator for central obesity assessment in Mexican schoolchildren.