Association of diet quality and body mass index in Mexican adults: a pseudo-panel analysis.

Introduction: Introduction: most studies that analyze the relationship between diet quality and obesity have a cross-sectional design; an alternative with repeated cross-sectional data is a pseudo-panel design. Objective: to estimate the association between trends in dietary patterns, defined by a diet quality index, and body mass index (BMI) of Mexican adults between 2006 and 2016. Methodology: a pseudo-panel analysis was performed using data from cross-sectional surveys: National Health and Nutrition Surveys of Mexico (ENSANUTs) 2006 and 2012 and the Midway National Health and Nutrition Survey 2016 (ENSANUTMC). Cohorts (n = 108) were constructed by grouping adults 20-59 years old by sex (men n = 6,081 and women n = 11,404), education level, and year of birth. The association between diet quality (defined with the Healthy Eating Index-2015) and BMI was estimated using a fixed effects model, adjusting for sociodemographic characteristics. Results: a one-point increase in the proportion of women with high diet quality was associated with 4.1 points lower BMI (p = 0.014) compared with women with low diet quality when excluding sub-reporters of energy, the same association is observed when physical activity is included in the model. No association was found between diet quality and BMI in men, possibly because of the existence of latent classes within sociodemographic strata, therefore diet qualiy is inversely associated with BMI only in some categories of sociodemographic strata. Conclusions: these results contribute to the evidence in the longitudinal analysis between diet and BMI, highlighting the importance of differentiating the population by sex and sociodemographic characteristics. These results are input for public policy creation that promotes improving the quality of the population's diet as part of multisectoral strategies to reduce overweight and obesity in Mexican adults.

Introducción: Introducción: muchos estudios que analizan la relación entre calidad de la dieta y obesidad son transversales; una alternativa con datos transversales repetidos es el diseño de pseudopanel. Objetivo: estimar la asociación entre patrones alimentarios definidos mediante un índice de calidad de la dieta y el índice de masa corporal (IMC) en adultos mexicanos entre 2006 y 2016. Metodología: se realizó un análisis de pseudopanel utilizando datos de las Encuestas Nacionales de Salud y Nutrición de México (ENSANUTs) de 2006 y 2012 y la Encuesta Nacional de Salud y Nutrición de medio camino de 2016 (ENSANUTMC). Se construyeron cohortes (n = 108) agrupando datos de adultos entre 20 y 59 años, por sexo (hombres n = 6,081, mujeres n = 11,404), nivel de escolaridad y año de nacimiento. La asociación entre calidad de la dieta (definida mediante el Índice de Calidad de la Dieta 2015) y el IMC se estimó con un modelo de efectos fijos, ajustado por características sociodemográficas. Resultados: un aumento de 1 punto en la proporción de mujeres con calidad de dieta alta se asoció con 4,1 puntos menos de IMC (p = 0,014) comparado con las mujeres con calidad de dieta baja; al excluir a las subreportadoras de energía, la misma asociación se observó incluyendo la actividad física al modelo. No se encontró asociación entre calidad de dieta e IMC en los hombres, posiblemente debido a la existencia de subgrupos dentro de los estratos sociodemográficos, lo cual hace que la calidad de la dieta esté inversamente asociada al IMC solo en algunas categorías de los estratos. Conclusiones: estos resultados contribuyen a la evidencia longitudinal entre dieta e IMC, destacando la importancia de estratificar por sexo y características sociodemográficas. Los resultados son un ínsumo para crear políticas públicas que promuevan mejorar la calidad de la dieta como parte de estrategias multisectoriales para disminuir el sobrepeso y la obesidad en los adultos mexicanos.

Association Between Avocado Consumption and Diabetes in Mexican Adults: Results From the 2012, 2016, and 2018 Mexican National Health and Nutrition Surveys.

BACKGROUND: Avocado contains numerous vitamins, minerals, and phytochemicals that can contribute to reducing the risk of metabolic syndrome and diabetes. However, limited studies have examined the association between avocados and diabetes risk. OBJECTIVE: This study aimed to examine the association between avocado consumption and diabetes by sex in Mexican adults. DESIGN: This was a cross-sectional study. PARTICIPANTS/SETTING: Participants included a subsample of adults (aged 20 years and older) from the 2012, 2016, and 2018 Mexican National Health and Nutrition Survey. Avocado consumption was assessed using a 7-day, semiquantitative food frequency questionnaire, and participants were classified as avocado consumers (consuming any amount of avocado) or nonconsumers. MAIN OUTCOME MEASURES: Participants were considered to have diabetes if they answered "yes" to "Has a doctor ever told that you have diabetes or high blood sugar?" STATISTICAL ANALYSES PERFORMED: This analysis assessed the association between avocado intake and diabetes using multivariate logistic models by sex and adjusted for relevant covariates. RESULTS: Of 28 239 Mexican National Health and Nutrition Survey 2012, 2016, and 2018 participants, 25 640 met the criteria (ie, have diabetes outcome and plausible energy and avocado intakes) for this study. More than half of the participants were women, and approximately 45% were avocado consumers, with an average (SE) avocado consumption of 34.7 (0.9) among men and 29.8 (0.8) g/day among women. Avocado consumers had lower odds of diabetes in both unadjusted (odds ratio [OR] 0.762, 95% CI 0.639 to 0.907) and adjusted (OR 0.792, 95% CI 0.632 to 0.993) models among women but not men (OR 1.192, 95% CI: 0.907 to 1.566 and OR 0.914, 95% CI 0.675 to 1.239 for unadjusted and adjusted models, respectively). CONCLUSIONS: Avocado consumption was associated with a lower risk of diabetes, which remained significant even when adjusted for relevant covariates. However, this finding was observed in only women, not men, underscoring the importance of personalized nutrition in diabetes care and prevention.

Trends in the dietary patterns of Mexican adults by sociodemographic characteristics.

BACKGROUND: Sociodemographic characteristics are associated with the dietary patterns of populations. However, the direction of the association is not consistent among countries: it is contingent on the nutritional transition phase, level of economic development, cultural contexts and both the social and health policies prevailing in each country. The objective of this study was to identify the trends in dietary patterns observed in 2006, 2012 and 2016 among Mexican adults by sociodemographic characteristic. METHODS: To determine and compare dietary patterns, we performed a secondary analysis of dietary and sociodemographic data for adults 20-59 years old. Data were drawn from the 2006 and 2012 National Health and Nutrition Surveys (ENSANUTs) together with the 2016 Half-Way National Health and Nutrition Survey (ENSANUTMC). To estimate the dietary patterns, we used an adapted version of the Healthy Eating Index-2015 (HEI-2015) and a quantile-based regression model to compare the HEI medians by sociodemographic characteristic. RESULTS: From 2006 to 2016, the quality of the diet of Mexican adults scored under 50 points on a scale of 0 to 100, markedly below the maximum scores for the majority of HEI-2015 components. Diet quality varied according to age, sex, socioeconomic status (SES), area (urban/rural) and region of residence, with the highest quality observed among older individuals (within the 40-59 age group), women, people of lower SES and residents of rural areas, particularly in southern Mexico. Although this trend remained constant overall throughout 2006, 2012 and 2016, specific HEI-2015 components showed an opposite trend by sociodemographic strata. CONCLUSION: The diet quality of Mexican adults was suboptimal from 2006 to 2016, with notorious disparities persisting over time among sociodemographic strata. Our results can serve as a basis for formulating recommendations on ways to improve the population diet, where those components diverging the most from adequate scores could be highlighted in public-health messages.