Bone mineral density changes in lactating adolescent mothers during the first postpartum year.

OBJECTIVES: This study aimed to compare changes in whole body bone mineral density (wbBMD) during the first postpartum year in adolescent mothers with those of nulliparous adolescents. METHODS: The study included 21 adolescent mothers and 16 nulliparous adolescent non-indigenous Mexican women (State of Sonora) from a low income level. All mothers were assessed at 15 days (0.5 months), 3 months, and 6 months postpartum; 16 were measured at 12 months postpartum. Nulliparous adolescents were assessed in the same periods. Multiple regression models was used to assess adjusted associations of changes in wbBMD (by DPX-MD+ densitometer) with dietary calcium and physical activity assessments (estimated using pre-tested questionnaires), post menarche years, and number of breast feedings. RESULTS: At baseline, no differences were observed between nulliparous and adolescent mothers regarding age, post-menarche years, or BMD values. Changes in wbBMD of -0.56% and 0.77% were observed in mothers and nulliparous adolescents, respectively, after the first 3 months (P = 0.006). Changes in wbBMD in mothers were associated with number of breast feedings and changes in BMI. At 12 months postpartum, the BMD of adolescent mothers was similar to that of nulliparous adolescents. CONCLUSIONS: At 1 year postpartum, adolescent mothers exhibited BMD similar to those of nulliparous adolescents. This result is likely attributable to the breastfeeding practices adopted by mothers during late adolescence.

Could giardiasis be a risk factor for low zinc status in schoolchildren from northwestern Mexico? A cross-sectional study with longitudinal follow-up.

BACKGROUND: Both giardiasis and zinc deficiency are serious health problems worldwide. In Mexico, the prevalence of G. intestinalis was estimated at 32% in 1994. It remains a health problem in northwestern Mexico. Recent surveys (1987, 1995, and 1999) reported zinc deficiency in the Mexican population. The association of giardiasis and malabsorption of micronutrients has been well documented, although the association with zinc remains controversial. This study investigated the association between giardiasis and zinc deficiency in schoolchildren from northwestern Mexico. METHODS: We combined a cross-sectional design with a longitudinal follow-up six months after parasite treatment. The baseline sample consisted of 114 schoolchildren (mean age 8.8 yr) from seven suburban public schools, grouped as Giardia-free (n = 65, 57%) and Giardia-infected (n = 49, 43%). Three stool analyses per child were done using Faust's method. Children with giardiasis received secnidazole. Serum zinc was determined by atomic absorption spectrophotometry. Height and weight were measured. Socioeconomic information was obtained in an oral questionnaire, and daily zinc intake was assessed using 24 hour-recalls. Pearson's correlation and ANCOVA and paired t-test analyses were used to determine the association between giardiasis and zinc status. RESULTS: Longitudinal analysis demonstrated a significant increase of the mean serum zinc levels in the Giardia-infected group six months after treatment (13.78 vs. 19.24 mumol/L mumol/L; p = 0.001), although no difference was found between the Giardia-free and the Giardia-infected groups (p = 0.86) in the baseline analysis. Z scores for W/A and H/A were lower in the Giardia-infected than in the Giardia-free group (p < 0.05). No difference was observed in the socioeconomic characteristics and mean daily intakes of zinc between the groups (p > 0.05). CONCLUSIONS: Giardiasis may be a risk factor for zinc deficiency in schoolchildren from northwestern Mexico.

Dietary behavior and type 2 diabetes care.

OBJECTIVE: To explore risk factors modification, as well as barriers and facilitators for behavioral change in Mexican type 2 diabetics and their families. METHODS: Risk assessment and impact evaluation included measurements on anthropometrics, diet, physical activity, nutrition knowledge, and HbA(1c.) The intervention included discussion groups and promoted behavioral change on dietary risk, physical exercise, and basic diabetic knowledge of 48 urban diabetic patients and 38 relatives. The educational method consisted of cognitive reframing and situational problem solving during five meetings over an 8-month period. RESULTS: Diabetics were older and less educated than their participating relatives (55.8+/-11 and 34.7+/-13.7 years old, and 4.5+/-3.4 and 7.8+/-3.7 years of schooling, respectively). Factors such as diet, degree of obesity, physical activity and HbA(1c), reflected that 92% of diabetic patients and 83% of their relatives were at high health risk. After the intervention, nutritional knowledge and diet-health awareness increased (p=.013 and .001 respectively); however, no significant health-risks reduction was observed. DISCUSSION: Focus group analysis suggested that lack of support from family and health services, low income, neighborhood insecurity and misleading "popular knowledge" and advice are key barriers to behavioral change. PRACTICE IMPLICATIONS: The study supports the understanding of constrains to health promotion campaigns and better health provider-patient interactions in Mexican population. Additionally, the study contributes to the general knowledge of ethnic socio-cultural environment influences over health care issues, primarily to diet modifications.