Effectiveness of a Lifestyle Change Program on Insulin Resistance in Yaquis Indigenous Populations in Sonora, Mexico: PREVISY.

To evaluate the effectiveness of the healthy lifestyle promotion program for Yaquis (PREVISY) on insulin resistance in the short- and medium-term periods in adults who are overweight/obese and have an increased risk for diabetes. Using a translational research design, an intervention program was implemented in a sample of 93 Yaqui adult subjects. The effectiveness of PREVISY was evaluated by comparing the levels of Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and the Triglycerides-Glucose Index (TyG index) at 6 and 12 months using a paired t-test. Results: In the subjects who completed the program, a decrease in the HOMA-IR index (∆ = -0.91 and ∆ = -1.29, p ≤ 0.05) and the TyG index (∆ = -0.24 y ∆ = -0.20, p ≤ 0.05) was observed in the short- and medium-term period, respectively. Subjects with body weight loss ≥ 10% showed decreased levels of HOMA-IR (∆ = -3.32 and ∆ = -4.89, p ≤ 0.05) and the TyG index (∆ = -0.80 and ∆ = -0.60, p ≤ 0.05) at 6 and 12 months, respectively. A stronger benefit of the program was found in subjects with obesity (vs. overweight) and with high and very high risk of diabetes (vs. moderate risk) in IR markers (p ≤ 0.05). The PREVISY program demonstrated its effectiveness in the improvement of some markers of insulin resistance in Yaqui adults at risk of diabetes.

Effectiveness of multicomponent lifestyle intervention programs on adiposity indicators in schoolchildren from vulnerable groups: a review article / · Efectividad de los programas multicomponentes de intervención de estilo de vida sobre indicadores de adiposidad en escolares de grupos vulnerables: artículo de revisión

Vulnerable groups are those who, due to their age, sex, race/ethnicity, health status, income level, etc., are at higher risk of poor health. Vulnerable school populations are distinguished by having predisposing factors to overweight and obesity, which results in a greater risk of suffering from the disease and its ravages. Additionally, the effects of the COVID-19 contingency can worsen the situation. Previous reviews of prevention, treatment and control of the disease have focused on schoolchildren from high- and middle-income countries. The objective of this review was to gather the evidence from the studies that evaluate the effectiveness of multicomponent lifestyle intervention programs (MLIP) on adiposity indicators in vulnerable populations. Five electronic databases were searched: PubMed, MEDLINE, Cochrane Library, EMBASE, and Google Scholar. The eligibility criteria were schoolchildren (5 to 12 years old), inhabitants of rural area, with low socioeconomic level and/or belonging to an indigenous community. Randomized and quasi-experimental controlled trials were included. Interventions that included two or more of the following components were considered: physical activity, nutrition, psychology, school meals and/or family/community involvement. Of the 11 interventions included 73 % had significant improvements in at least one variable related to adiposity. The most successful interventions had components of nutrition, physical activity and family/community involvement, the majority (80 %) had a duration of ≥ 6 months and were provided, in 80 % of the cases, by previously trained teachers. In conclusion, there is evidence that MLIPs are effective in improving indicators of adiposity in vulnerable schoolchildren. (AU)

Los grupos vulnerables son aquellos que, debido a sus condiciones de edad, sexo, raza/etnia, estado de salud, ingresos, etc., tienen un riesgo mayor de presentar una salud deficiente. Las poblaciones escolares vulnerables se distinguen por tener factores predisponentes de sobrepeso y obesidad, lo que redunda en mayor riesgo de padecer la enfermedad y sus complicaciones. Adicionalmente, los efectos de la contingencia por COVID-19 podrían agravar la situación. Revisiones previas sobre la prevención, tratamiento y control de la enfermedad se han enfocado en escolares de países de altos y medianos ingresos. Esta revisión tuvo como objetivo reunir la evidencia que evalúa la efectividad de los programas multicomponentes de intervención de estilo de vida (PMIEV) sobre los indicadores de adiposidad en poblaciones vulnerables. Se exploraron cinco bases de datos electrónicas: PubMed, MEDLINE, Cochrane Library, EMBASE y Google Scholar. Los criterios de elegibilidad fueron escolares (5-12 años), habitantes rurales, con bajo nivel socioeconómico y/o pertenecientes a comunidades indígenas. Se incluyeron ensayos controlados aleatorizados y cuasi-experimentales. Se consideraron intervenciones con dos o más de los siguientes componentes: actividad física, nutrición, psicología, comidas escolares y/o participación familiar/comunitaria. De las 11 intervenciones incluidas, el 73 % obtuvieron mejoras en al menos una variable relacionada con la adiposidad. Las intervenciones más exitosas incluyeron componentes de nutrición, actividad física y participación familiar/comunitaria, la mayoría (80 %) tuvo una duración ≥ 6 meses y las llevaron a cabo en un 80 % de los casos profesores entrenados. En conclusión, la evidencia indica que los PMIEV son efectivos para mejorar los indicadores de adiposidad en los escolares vulnerables. (AU)

Effectiveness of multicomponent lifestyle intervention programs on adiposity indicators in schoolchildren from vulnerable groups: a review article.

Introduction: Vulnerable groups are those who, due to their age, sex, race/ethnicity, health status, income level, etc., are at higher risk of poor health. Vulnerable school populations are distinguished by having predisposing factors to overweight and obesity, which results in a greater risk of suffering from the disease and its ravages. Additionally, the effects of the COVID-19 contingency can worsen the situation. Previous reviews of prevention, treatment and control of the disease have focused on schoolchildren from high- and middle-income countries. The objective of this review was to gather the evidence from the studies that evaluate the effectiveness of multicomponent lifestyle intervention programs (MLIP) on adiposity indicators in vulnerable populations. Five electronic databases were searched: PubMed, MEDLINE, Cochrane Library, EMBASE, and Google Scholar. The eligibility criteria were schoolchildren (5 to 12 years old), inhabitants of rural area, with low socioeconomic level and/or belonging to an indigenous community. Randomized and quasi-experimental controlled trials were included. Interventions that included two or more of the following components were considered: physical activity, nutrition, psychology, school meals and/or family/community involvement. Of the 11 interventions included 73 % had significant improvements in at least one variable related to adiposity. The most successful interventions had components of nutrition, physical activity and family/community involvement, the majority (80 %) had a duration of ≥ 6 months and were provided, in 80 % of the cases, by previously trained teachers. In conclusion, there is evidence that MLIPs are effective in improving indicators of adiposity in vulnerable schoolchildren.

Introducción: Los grupos vulnerables son aquellos que, debido a sus condiciones de edad, sexo, raza/etnia, estado de salud, ingresos, etc., tienen un riesgo mayor de presentar una salud deficiente. Las poblaciones escolares vulnerables se distinguen por tener factores predisponentes de sobrepeso y obesidad, lo que redunda en mayor riesgo de padecer la enfermedad y sus complicaciones. Adicionalmente, los efectos de la contingencia por COVID-19 podrían agravar la situación. Revisiones previas sonre la prevención, tratamiento y control de la enfermedad se han enfocado en escolares de países de altos y medianos ingresos. Esta revisión tuvo como objetivo reunir la evidencia que evalúa la efectividad de los programas multicomponentes de intervención de estilo de vida (PMIEV) sobre los indicadores de adiposidad en poblaciones vulnerables. Se exploraron cinco bases de datos electrónicas: PubMed, MEDLINE, Cochrane Library, EMBASE y Google Scholar. Los criterios de elegibilidad fueron escolares (5-12 años), habitantes rurales, con bajo nivel socioeconómico y/o pertenecientes a comunidades indígenas. Se incluyeron ensayos controlados aleatorizados y cuasi-experimentales. Se consideraron intervenciones con dos o más de los siguientes componentes: actividad física, nutrición, psicología, comidas escolares y/o participación familiar/comunitaria. De las 11 intervenciones incluidas, el 73 % obtuvieron mejoras en al menos una variable relacionada con la adiposidad. Las intervenciones más exitosas incluyeron componentes de nutrición, actividad física y participación familiar/comunitaria, la mayoría (80 %) tuvo una duración ≥ 6 meses y las llevaron a cabo en un 80 % de los casos profesores entrenados. En conclusión, la evidencia indica que los PMIEV son efectivos para mejorar los indicadores de adiposidad en los escolares vulnerables.

Effectiveness of the Healthy Lifestyle Promotion Program for Yaquis with Obesity and Risk of Diabetes in the Short and Medium Term: A Translational Study.

Type 2 diabetes (T2D) is a public health problem worldwide, and the main risk factor for its development is obesity. The Yaqui ethnic group of Sonora has serious obesity problems, resulting in an increased risk of T2D in its inhabitants. The objective of this study was to evaluate the effectiveness of a health promotion program on obesity parameters and cardiovascular risk factors in short- (6 months) and medium-term periods (12 months) in indigenous Yaquis of Sonora. The design is a translational clinical study of a single cohort with prepost intervention measurements in a sample of 93 subjects. The effectiveness of the program was evaluated by comparing obesity parameters, metabolic markers, and physical activity 6 and 12 months with those measured under basal conditions using a paired t-test or Wilcoxon rank-sum test. The short-term retention percentage was 58.0%. There was a decrease in body weight (Δ = -3.9 kg, p ≤ 0.05) and other obesity parameters, and an increase in physical activity and improvements in metabolic markers (p ≤ 0.05) was observed. Similar findings were obtained for the medium-term period; body weight loss was also -3.9 kg (p ≤ 0.05). The short and medium-term results of the program showed improvements in the obesity parameters and other cardiovascular risk factors of the participants. These results support the effectiveness of the program and its translation in this ethnic group.

Prevalence and factors associated with type 2 diabetes mellitus in the indigenous population of Mexico: systematic review. / Prevalencia y factores asociados a diabetes mellitus tipo 2 en población indígena de México: revisión sistemática.

Currently, diabetes represents a serious health problem, due to the complications it entails and because of its high mortality rate. Type 2 diabetes mellitus (T2DM) is the most prevalent and it is characterized by insulin resistance. The objective was to analyze the available scientific literature on prevalence and factors associated to T2DM in indigenous population of Mexico. Searches for articles published between 1990 and 2019 in English and Spanish were carried out in 13 electronic databases. Combinations of eight keywords were used according to the MeSH vocabulary. To select the studies, it was used the JBI's Critical Appraisal Tools guide in Spanish for analytical prevalence studies. Out of 478, 12 cross-sectional studies reported T2DM prevalences from 12 indigenous groups located in Mexico: Huichol (0%), Mexican (0%), Tepehuano (0 and 0.83%), Mazateco (2.01%), Otomí (4.4%), Tojolabal (4.7%), Mixe (6.9%), Pima (6.9 and 9.0%), Zapoteco (8.7%), Maya (10.6%), Yaqui (18.3 and 14.8%) and Mixteco (19.0 and 26.2%). Factors associated with T2DM reported were being older, being female, less education level, presence of family history of T2DM, obesity, high blood pressure and increased waist-hip circumference. There is little evidence of the prevalence of T2DM in indigenous groups in Mexico. Studies found suggest a diversity of prevalences, ranging from lower to greater prevalences. Considering the risk factors associated with T2DM is essential to generate prevention strategies according to the context of each ethnic group, in order to improve the epidemiological landscape of diabetes in indigenous groups of Mexico.

Actualmente la diabetes representa un grave problema de salud por las complicaciones que conlleva y por su elevada tasa de mortalidad. La diabetes mellitus tipo 2 (DM2) es la más prevalente y se caracteriza por la resistencia a la insulina. El objetivo fue analizar la literatura científica disponible sobre la prevalencia y los factores asociados a DM2 en población indígena de México. Se buscaron artículos publicados entre 1990 y 2019 en inglés y español en 13 bases de datos electrónicas. Se utilizaron combinaciones de ocho palabras clave según el vocabulario MeSH. Para seleccionar los estudios se siguió la guía JBI's Critical Appraisal tools en español para estudios de prevalencia analíticos. De 478, 12 investigaciones con diseño trasversal mostraron prevalencias de DM2 de 12 grupos indígenas de México: huichol (0%), mexicanero (0%), tepehuano (0 y 0.83%), mazateco (2.01%), otomí (4.4%), tojolabal (4.7%), mixe (6.9%), pima (6.9 y 9.0%), zapoteco (8.7%), maya (10.6%), yaqui (18.3 y 14.8%) y mixteco (19.0 y 26.2%). Los factores asociados a DM2 fueron mayor edad, ser mujer, menor escolaridad, presencia de antecedentes familiares de diabetes, presentar obesidad, hipertensión arterial y una mayor circunferencia de cintura-cadera. Hay poca evidencia de la prevalencia de DM2 en grupos indígenas de México. Los estudios encontrados sugieren heterogeneidad en las prevalencias, desde muy bajas a muy altas. Considerar los factores de riesgo asociados a la DM2 es imprescindible para generar estrategias de prevención según el contexto de cada etnia, a fin de mejorar el panorama epidemiológico de la diabetes en grupos indígenas de México.