Vitamin A Positively Correlates with Secretory Immunoglobulin A: A Cross-Sectional Study in Omicron COVID-19 Outpatients.

Background: Respiratory tract infections remain among the leading causes of mortality worldwide. The COVID-19 pandemic has highlighted the importance of mucosal immunity in defending against infectious agents. Vitamin A is known to influence the production of secretory immunoglobulin A (SIgA) predominantly in the gut, where it is a critical component of the first line of defense on mucosal surfaces. Methods: This cross-sectional study, conducted 14 days post-positive COVID-19 diagnosis, aimed to determine the relationship between the nutritional status of vitamin A and SIgA levels in COVID-19 outpatients. Serum and saliva samples were collected. Vitamin A nutritional status was determined based on the assessment of dietary intake and the analysis of retinol-binding protein 4 (RBP4). SIgA levels were analyzed from salivary samples. In addition, serum antibodies were analyzed. Results: Dietary vitamin A intake and RBP4 levels positively correlated with SIgA. Patients with higher vitamin A intake showed higher SIgA/IgG1 and SIgA/IgG3 ratios, while those with higher RBP4 levels showed higher SIgA/IgM, SIgA/IgG1, and SIgA/IgG2 ratios. Conclusions: These findings underscore a significant correlation between vitamin A nutritional status and SIgA levels in COVID-19 outpatients, which may suggest the potential importance of maintaining optimal vitamin A levels for the prevention of viral infections.

The Influence of Lifestyle on High-Density Lipoprotein Concentration among Mexican Emerging Adults.

Previous studies have highlighted the role of lifestyle on HDL-C concentrations in adults. To our knowledge, the health and nutritional status of emerging adults have been understudied. The present study aimed to explore the most important lifestyle factors, including micronutrient intake adequacy and the percentage of energy from food processing, according to HDL-C concentrations in emerging adults. In this context, a cross-sectional analysis was conducted on 261 Mexican emerging adults who were apparently healthy. Lifestyle factors were collected through a structured survey and the prevalence of micronutrient intake inadequacy was estimated using the estimated average requirement cut-point method. The percentage of energy from ultra-processed foods was assessed using the NOVA system. HDL-C was determined using the enzymatic colorimetric method. Statistical analyses were conducted in SPSS. The results revealed that lifestyle factors do not differ according to HDL-C status. The participants showed a poor nutritional diet that was energy-dense and micronutrient-inadequate. Nearly half of their energy came from processed and ultra-processed foods. Most participants did not meet the recommendations for key nutrients (ϖ3 fatty acids and phytosterols) that promote a healthy lipid status. In conclusion, regardless of their HDL-C levels, emerging adults exhibited lifestyle-related risk factors. The persistence of these findings over time could contribute to the development of metabolic disorders in the future. It is crucial to increase understanding and to develop effective nutritional interventions during this critical phase of life.

Food insecurity was negatively associated with adherence to the "fruits, vegetables, and foods rich in animal protein" dietary pattern among university students' households: the 2018 Mexican National Household Survey.

BACKGROUND: University students are often affected by food insecurity (FI) and this situation has been associated with low consumption of fruit/vegetables and high intake of added sugars and sweet drinks. However, there needs to be more evidence on the association between FI and dietary patterns (DPs), assessing the overall diet and allowing analysis of commonly consumed food combinations. We aimed to analyze the association between FI and DPs in university students' households. METHODS: We used data from 7659 university student households from the 2018 Mexican National Household Income and Expenditure Survey (ENIGH, for its acronym in Spanish). We obtained FI levels (mild, moderate, and severe) using the validated Mexican Food Security Scale (EMSA, Spanish acronym). Two DPs were identified by principal component analysis based on the weekly frequency of consumption of 12 food groups. Multivariate logistic regression adjusted by university student and household's characteristics was applied. RESULTS: Compared to food security, households with mild-FI (OR:0.34; 95%CI:0.30, 0.40), moderate-FI (OR:0.20; 95%CI:0.16, 0.24) or severe-FI (OR:0.14; 95%CI:0.11, 0.19) were less likely to adhere to the dietary pattern "Fruits, vegetables and foods rich in animal protein" (fruits, vegetables, meat, fish or seafood, dairy products, and starchy vegetables). In addition, people with severe-FI (OR:0.51; 95% CI:0.34, 0.76) were also less likely to adhere to the dietary pattern "Traditional-Westernized" (pulses, oils or fats, sugar, sweets, industrialized drinks, foods made from corn/maize, wheat, rice, oats or bran, coffee, tea and eggs). CONCLUSIONS: In these households FI impairs the ability to consume a healthy dietary pattern (fruits/vegetables and foods rich in animal protein). In addition, the intake of foods typical of the Mexican food culture reflecting the local Western dietary pattern is compromised in households with severe-FI.

A Novel Approach to Obtain Vaccine Effectiveness Continuous Profiles. Example Case: COVID-19 in Elderly Mexicans.

Population-wide vaccination is the most promising long-term COVID-19 disease management strategy. However, the protection offered by the currently available COVID-19 vaccines wanes over time, requiring boosters to be periodically given, which represents an unattainable challenge, especially if it is necessary to apply several doses per year. Therefore, it is essential to design strategies that contribute to maximizing the control of the pandemic with the available vaccines. Achieving this objective requires knowing, as precisely and accurately as possible, the changes in vaccine effectiveness over time in each population group, considering the eventual dependence on age, sex, etc. Thus, the present work proposes a novel approach to calculating realistic effectiveness profiles against symptomatic disease. In addition, this strategy can be adapted to estimate realistic effectiveness profiles against hospitalizations or deaths. All such time-dependent profiles allow the design of improved vaccination schedules, where each dose can be administrated to the population groups so that the fulfillment of the containment objectives is maximized. As a practical example for this analysis, vaccination against COVID-19 in Mexico was considered. However, this methodology can be applied to other countries' data or to characterize future vaccines with time-dependent effectiveness values. Since this strategy uses aggregated observational data collected from massive databases, assumptions about the data validity and the course of the studied epidemic could eventually be necessary.

Emotional Eating and Dietary Patterns: Reflecting Food Choices in People with and without Abdominal Obesity.

Emotional eating (EE) is food consumption in response to feelings rather than hunger. EE is related to unhealthy food intake and abdominal obesity (AO). However, little evidence exists about the association between EE and dietary patterns (DPs) and EE−AO interaction related to DPs. DPs allow describing food combinations that people usually eat. We analyzed the association of EE with DPs in adults (≥18 years) with AO (WC ≥ 80/90 cm in women/men, respectively; n = 494; 66.8% women;) or without AO (n = 269; 74.2% women) in a cross-sectional study. Principal component analysis allowed identifying four DPs from 40 food groups (validated with a semiquantitative food frequency questionnaire). Among the subjects presenting AO, being "emotional/very-emotional eater" (emotional eating questionnaire) was negatively associated with the "Healthy" DP (fruits, vegetables, olive oil, oilseeds, legumes, fish, seafood) (OR:0.53; 95% CI: 0.33, 0.88, p = 0.013) and positively with the "Snacks and fast food" DP (sweet bread, breakfast cereal, corn, potato, desserts, sweets, sugar, fast food) (OR:1.88; 95% CI: 1.17, 3.03, p = 0.010). Emotional eaters with AO have significantly lower fiber intake, folic acid, magnesium, potassium, vitamin B1, and vitamin C, while they had a higher intake of sodium, lipids, mono and polyunsaturated fatty acids, and saturated fats. In non-AO participants, EE was not associated with any DP (p > 0.05). In conclusion, EE is associated with unhealthy DPs in subjects with AO.

The Effect of Dietary Interventions on Hypertriglyceridemia: From Public Health to Molecular Nutrition Evidence.

Approximately 25-50% of the population worldwide exhibits serum triglycerides (TG) (≥150 mg/dL) which are associated with an increased level of highly atherogenic remnant-like particles, non-alcoholic fatty liver disease, and pancreatitis risk. High serum TG levels could be related to cardiovascular disease, which is the most prevalent cause of mortality in Western countries. The etiology of hypertriglyceridemia (HTG) is multifactorial and can be classified as primary and secondary causes. Among the primary causes are genetic disorders. On the other hand, secondary causes of HTG comprise lifestyle factors, medical conditions, and drugs. Among lifestyle changes, adequate diets and nutrition are the initial steps to treat and prevent serum lipid alterations. Dietary intervention for HTG is recommended in order to modify the amount of macronutrients. Macronutrient distribution changes such as fat or protein, low-carbohydrate diets, and caloric restriction seem to be effective strategies in reducing TG levels. Particularly, the Mediterranean diet is the dietary pattern with the most consistent evidence for efficacy in HTG while the use of omega-3 supplements consumption is the dietary component with the highest number of randomized clinical trials (RCT) carried out with effective results on reducing TG. The aim of this review was to provide a better comprehension between human nutrition and lipid metabolism.

Functional Food and Bioactive Compounds on the Modulation of the Functionality of HDL-C: A Narrative Review.

Cardiovascular diseases (CVD) remain a serious public health problem and are the primary cause of death worldwide. High-density lipoprotein cholesterol (HDL-C) has been identified as one of the most important molecules in the prevention of CVD due to its multiple anti-inflammatories, anti-atherogenic, and antioxidant properties. Currently, it has been observed that maintaining healthy levels of HDL-C does not seem to be sufficient if the functionality of this particle is not adequate. Modifications in the structure and composition of HDL-C lead to a pro-inflammatory, pro-oxidant, and dysfunctional version of the molecule. Various assays have evaluated some HDL-C functions on risk populations, but they were not the main objective in some of these. Functional foods and dietary compounds such as extra virgin olive oil, nuts, whole grains, legumes, fresh fish, quercetin, curcumin, ginger, resveratrol, and other polyphenols could increase HDL functionality by improving the cholesterol efflux capacity (CEC), paraoxonase 1 (PON1), and cholesteryl ester transfer protein (CETP) activity. Nevertheless, additional rigorous research basic and applied is required in order to better understand the association between diet and HDL functionality. This will enable the development of nutritional precision management guidelines for healthy HDL to reduce cardiovascular risk in adults. The aim of the study was to increase the understanding of dietary compounds (functional foods and bioactive components) on the functionality of HDL.

Dietary Antioxidants in the Treatment of Male Infertility: Counteracting Oxidative Stress.

Infertility affects about 15% of the population and male factors only are responsible for ~25-30% of cases of infertility. Currently, the etiology of suboptimal semen quality is poorly understood, and many environmental and genetic factors, including oxidative stress, have been implicated. Oxidative stress is an imbalance between the production of free radicals, or reactive oxygen species (ROS), and the capacity of the body to counteract their harmful effects through neutralization by antioxidants. The purpose of this review, by employing the joint expertise of international researchers specialized in nutrition and male fertility areas, is to update the knowledge about the reproductive consequences of excessive ROS concentrations and oxidative stress on the semen quality and Assisted Reproduction Techniques (ART) clinical outcomes, to discuss the role of antioxidants in fertility outcomes, and finally to discuss why foods and dietary patterns are more innocuous long term solution for ameliorating oxidative stress and therefore semen quality results and ART fertility outcomes. Since this is a narrative review and not a systematic/meta-analysis, the summarized information in the present study should be considered cautiously.

Second Version of a Mini-Survey to Evaluate Food Intake Quality (Mini-ECCA v.2): Reproducibility and Ability to Identify Dietary Patterns in University Students.

Evaluation of food intake quality using validated tools makes it possible to give individuals or populations recommendations for improving their diet. This study's objective was to evaluate the reproducibility and ability to identify dietary patterns of the second version of the Mini Food Intake Quality Survey (Mini-ECCA v.2). The survey was administered using a remote voting system on two occasions with four-week intervals between administrations to 276 health science students (average age = 20.1 ± 3.1 years; 68% women). We then performed a per-question weighted kappa calculation, a cluster analysis, an ANOVA test by questionnaire item and between identified clusters, and a discriminant analysis. Moderate to excellent agreement was observed (weighted κ = 0.422-0.662). The cluster analysis identified three groups, and the discriminant analysis obtained three classification functions (85.9% of cases were correctly classified): group 1 (19.9%) was characterized by higher intake of water, vegetables, fruit, fats, oilseeds/avocado, meat and legumes (healthy food intake); group 2 (47.1%) frequently consumed both fish and unhealthy fats (habits in need of improvement); group 3 (33%) frequently consumed sweetened beverages, foods not prepared at home, processed foods, refined cereals and alcohol (unhealthy food intake). In conclusion, the Mini-ECCA v.2 has moderate to excellent agreement, and it is able to identify dietary patterns in university students.

Anthropometric and Body Composition Profile of Young Professional Soccer Players.

Bernal-Orozco, MF, Posada-Falomir, M, Quiñónez-Gastélum, CM, Plascencia-Aguilera, LP, Arana-Nuño, JR, Badillo-Camacho, N, Márquez-Sandoval, F, Holway, FE, and Vizmanos-Lamotte, B. Anthropometric and body composition profile of young professional soccer players. J Strength Cond Res 34(7): 1911-1923, 2020-The purpose was to describe the anthropometric and body composition profile of young professional soccer players and to compare the players profiles between different competitive divisions and playing positions. A retrospective cross-sectional study was carried out with anthropometric data obtained from the records of soccer players of Club Deportivo Guadalajara, S.A. de C.V. (Mexico) in the under-17, under-20, second, third, and fourth division categories. Body mass, height, sitting-height, skinfolds, girths, and bone breadths were measured by certified anthropometrists from September 2011 to March 2015, following the procedures recommended by the International Society for the Advancement of Kinanthropometry. Body composition was determined using the 5-way fractionation method. Comparisons between playing positions in each division and between divisions were performed using analysis of variance, and Bonferroni's post-hoc analyses (SPSS version 22 for Windows, p < 0.05 considered as significant). Data from 755 subjects were analyzed. The mean age was 18.1 ± 1.7 years old (minimum 14.8, maximum 23.2). The under-20 division registered higher anthropometric and body composition values than all other competitive divisions. In addition, goalkeepers were taller, heavier, and obtained the highest values for adipose mass, whereas forwards presented higher percentages of muscle mass. These tables can be used during nutritional assessment and nutritional monitoring of players to establish body composition goals. In addition, the strength and conditioning practitioner may also use these data to design effective and specific training programs most suitable to the anthropometric and body composition profile of each player, taking into consideration his competitive division and playing position.

Heats of combustion of the main carbohydrates contained in plant-source foods.

In a previous review, the experiments of American chemist W.O. Atwater were critically examined, with the findings demonstrating certain weaknesses that could compromise the validity of the values currently used for metabolizable energy. An examination of published works on the heat of combustion of carbohydrates reveals 2 types of weaknesses: the inaccuracy and imprecision of the calorimetric data used, and the averaging procedure employed to estimate such representative values. The present review focuses on the first type of weakness, namely the inaccuracy and imprecision of the calorimetric data used in previous studies. An exhaustive bibliographic search yielded almost 100 heat of combustion values for some of the 6 main carbohydrates contained in plant-source foods (glucose, fructose, sucrose, maltose, starch, and cellulose). These heats of combustion were subjected to rigorous statistical analysis to propose the following for each carbohydrate: (1) an interval (termed a bibliographic interval) that very likely includes the actual heat of combustion value and (2) a "representative value" (calculated to produce the minimum level of inaccuracy). In addition, an estimation of the maximum level of inaccuracy that could be expected when using such a representative value is reported.

Metabolic Syndrome Among Young Health Professionals in the Multicenter Latin America Metabolic Syndrome Study.

Background: Metabolic syndrome (MS) and its components increase the risk of a number of chronic diseases. Evidence regarding its prevalence among health professionals, particularly in Latin America, is limited. The purpose of this study was to assess the overall prevalence of MS and its components among health professionals and students from five Latin American countries. Methods: A cross-sectional multicenter study entitled LATIN America METabolic Syndrome (LATINMETS) was conducted on five groups of apparently healthy volunteer subjects. Sociodemographic factors, lifestyle variables (smoking and physical activity), anthropometric measurements (weight, height, and waist circumference), standard biochemical analyses [triglycerides, glucose, and high-density lipoprotein cholesterol (HDL-C)], and blood pressure measurements were assessed. MS was diagnosed based on internationally harmonized criteria. Associations between MS components and sociodemographic, lifestyle, and anthropometric variables were analyzed using multivariate logistic regression. Results: A total of 1,032 volunteers (n = 316-Mexico, n = 285-Colombia, n = 223-Brazil, n = 132-Paraguay, and n = 76-Argentina) were recruited. The majority of them were women (71.9%), students (55.4%), and younger than 28 years (67.2%). The overall prevalence of age-standardized MS was 15.5% (23.1% men and 12.2% women). The majority (59.3%) presented at least one MS component, mainly abdominal obesity (29.7%) and low HDL-C levels (27.5%). After adjusting for age and sex, MS and its components were positively associated with being overweight or obese. Conclusions: MS prevalence in this study was similar to that generally found among young populations in Latin-American countries. More than half of the sample had at least one MS component, suggesting that preventive measures and treatments aimed at achieving low-risk health status are essential in this population.

Unhealthy dietary patterns among healthcare professionals and students in Mexico.

BACKGROUND: While dietary patterns (DPs) enable the combination of foods that make up a person's habitual diet to be known, little is known about the DPs of health sector professionals. The objective of this study was to describe the DPs of healthcare students and professionals and assess their association with sociodemographic, lifestyle, anthropometric and biochemical characteristics. METHODS: Cross-sectional design. A sample (n = 319) of healthcare students and professionals in apparent good health who studied or worked at the University of Guadalajara (Mexico) was selected. A semiquantitative food intake frequency questionnaire validated on a Mexican population was administered. Questions covering sociodemographic factors, smoking habits and physical activity were asked. Weight, height, waist circumference, blood pressure, triglycerides, glucose, HDL-cholesterol, LDL-cholesterol and total cholesterol were also measured. DPs were generated from a principal components analysis of 25 food groups, and associations were analyzed using logistic regression adjusted for age and sex. RESULTS: The majority of participants were younger than 29 years (84%), women (71.2%) and students (59.6%). Three DPs were identified: "Traditional Westernized", "Healthy" and "Animal protein and alcoholic beverages". After adjustment, the "Traditional Westernized" DP was positively associated with being younger than 22 years (OR: 2.15; 95%CI: 1.1-4.1); the "Healthy" DP was positively associated with having a daily energy expenditure from physical activity greater than 605 kcal (OR: 4.19; 95%CI: 2.3-7.5), and it was negatively associated with being younger than 22 years (OR: 0.48; 95%CI: 0.2-0.9); and the "Animal protein and alcoholic beverages" DP was positively associated with being male (OR: 3.07; 95%CI: 1.8-5.1) and a smoker (OR: 2.77; 95%CI: 1.2-6.3). No association was found between DPs and anthropometric and biochemical characteristics. CONCLUSIONS: Among the participants evaluated, healthy DP was associated with being physically active while unhealthy DPs were associated with being younger than 22 years, male and a smoker. These data suggest that being knowledgeable about health does not ensure that individuals will engage in healthy behaviors. As is the case among the general population, training and individual efforts aimed at achieving healthy behaviors must be reinforced by initiatives undertaken by social groups, social institutions, the community at large as well as political and business leaders.

Metabolic syndrome components in young health professionals; LATIN America METabolic Syndrome (LATINMETS) Mexico study.

INTRODUCTION: metabolic syndrome (MS) components are independent risk factors for the development of cardiovascular disease and type 2 diabetes, major causes of mortality in the world. OBJECTIVE: to evaluate the frequency of MS components and its association with sociodemographic variables and physical activity among young health professionals at the University of Guadalajara. METHODS: a cross-sectional study entitled LATIN America METabolic Syndrome Mexico (LATINMETS-Mex) was conducted. Weight, height, waist circumference, blood pressure, triglycerides, glucose and HDL cholesterol were measured. Socio-demographic and physical activity data were surveyed. MS components were diagnosed based on the revised criteria of Alberti et al. (2009). Associations were assessed using logistic regression adjusted for age and sex. RESULTS: a total of 316 volunteer subjects were analyzed (70.9% women, 83.8% ≤ 29 years). The frequency of MS was 7.0% and 55.5% of subjects presented one or more MS components (27.2% abdominal obesity, 26.6% low HDL cholesterol). After adjustment, abdominal obesity, high blood pressure and hypertriglyceridemia were positively associated with BMI ≥ 25 kg/m2. High blood pressure and hypertriglyceridemia were negatively associated with being female while low HDL cholesterol was positively associated with this gender after adjustment. Abdominal obesity was the only component negatively associated with physical activity (300 to 600 minutes per week) after adjusting for age and sex. No association between MS and sociodemographic variables or physical activity was found. CONCLUSIONS: half of the participants presented one or more metabolic syndrome components. Actions are required to reduce cardiometabolic risk in the study population considering the sociodemographic and lifestyle variables associated.

Metabolic syndrome components in young health professionals; latin america metabolic syndrome (latinmets) mexico study / Componentes del síndrome metabólico en profesionales de la salud jóvenes; LATIN America METabolic Syndrome (LATINMETS) México

Introduction: metabolic syndrome (MS) components are independent risk factors for the development of cardiovascular disease and type 2 diabetes, major causes of mortality in the world. Objective: to evaluate the frequency of MS components and its association with sociodemographic variables and physical activity among young health professionals at the University of Guadalajara. Methods: a cross-sectional study entitled LATIN America METabolic Syndrome Mexico (LATINMETS-Mex) was conducted. Weight, height, waist circumference, blood pressure, triglycerides, glucose and HDL cholesterol were measured. Socio-demographic and physical activity data were surveyed. MS components were diagnosed based on the revised criteria of Alberti et al. (2009). Associations were assessed using logistic regression adjusted for age and sex. Results: a total of 316 volunteer subjects were analyzed (70.9% women, 83.8% ≤ 29 years). The frequency of MS was 7.0% and 55.5% of subjects presented one or more MS components (27.2% abdominal obesity, 26.6% low HDL cholesterol). After adjustment, abdominal obesity, high blood pressure and hypertriglyceridemia were positively associated with BMI ≥ 25 kg/m2. High blood pressure and hypertriglyceridemia were negatively associated with being female while low HDL cholesterol was positively associated with this gender after adjustment. Abdominal obesity was the only component negatively associated with physical activity (300 to 600 minutes per week) after adjusting for age and sex. No association between MS and sociodemographic variables or physical activity was found. Conclusions: half of the participants presented one or more metabolic syndrome components. Actions are required to reduce cardiometabolic risk in the study population considering the sociodemographic and lifestyle variables associated

Introducción: los componentes del síndrome metabólico (SM) son factores de riesgo independientes para desarrollar enfermedades cardiovasculares y metabólicas, principales causas de mortalidad en el mundo. Objetivo: evaluar la frecuencia de componentes del SM y su asociación con variables sociodemográficas y actividad física en profesionales de la salud jóvenes de la Universidad de Guadalajara. Métodos: diseño transversal derivado del estudio multicéntrico LATIN America METabolic Syndrome (LATINMETS). Se midieron peso, talla, cintura, presión arterial y concentración sanguínea de triglicéridos, glucosa y colesterol HDL. Se preguntaron datos sociodemográficos y actividad física. Los componentes del SM se diagnosticaron con los criterios de Alberti y cols. (2009). Las asociaciones se evaluaron con regresión logística ajustada por edad y sexo. Resultados: se analizaron 316 voluntarios (70,9% mujeres, 83,8% ≤ 29 años). La frecuencia de SM fue del 7,0% y el 55,5% presentó uno o más componentes (27,2% obesidad abdominal, 26,6% hipocolesterolemia HDL). Después del ajuste, la obesidad abdominal, la presión arterial elevada y la hipertrigliceridemia se asociaron positivamente con un IMC ≥ 25 kg/m2. Ser mujer se asoció negativamente con presión arterial elevada e hipertrigliceridemia y se asoció positivamente con hipocolesterolemia HDL después del ajuste. La obesidad abdominal se asoció negativamente con actividad física (300 a 600 minutos por semana) después de ajustar por edad y sexo. El SM no se asoció con variables sociodemográficas ni de actividad física. Conclusiones: la mitad de los participantes presentaron uno o más componentes del SM. Se requieren acciones para reducir el riesgo cardiometabólico en la población estudiada considerando las variables sociodemográficas y de estilo de vida asociadas

Design and Reproducibility of a Mini-Survey to Evaluate the Quality of Food Intake (Mini-ECCA) in a Mexican Population.

Evaluating food intake quality may contribute to the development of nutrition programs. In Mexico, there are no screening tools that can be administered quickly for the evaluation of this variable. The aim was to determine the reproducibility of a mini-survey designed to evaluate the quality of food intake (Mini-ECCA) in a Mexican population. Mini-ECCA consists of 12 questions that are based on Mexican and international recommendations for food and non-alcoholic beverage intake, with the support of photographs for food quantity estimation. Each question scores as 0 (unhealthy) or 1 (healthy), and the final score undergoes a classification procedure. Through the framework of a nutritional study, 152 employees of the municipal water company in Guadalajara, Mexico (April⁻August 2016), were invited to participate. The survey was administered in two rounds (test and retest) with a 15-day interval between them. We calculated the Spearman correlation coefficient, the intra-class correlation coefficient (ICC), and weighted kappa for score classification agreement (SPSS versus 14 p < 0.05 was considered statistically significant). The survey obtained a “good” reproducibility (ρ = 0.713, p < 0.001), and an excellent concordance (ICC = 0.841 Confidence Interval 95% 0.779, 0.885). It can thus be said that the Mini-ECCA displayed acceptable reproducibility and is suitable for the purpose of dietary assessment and guidance.

Calculating the metabolizable energy of macronutrients: a critical review of Atwater's results.

The current values for metabolizable energy of macronutrients were proposed in 1910. Since then, however, efforts to revise these values have been practically absent, creating a crucial need to carry out a critical analysis of the experimental methodology and results that form the basis of these values. Presented here is an exhaustive analysis of Atwater's work on this topic, showing evidence of considerable weaknesses that compromise the validity of his results. These weaknesses include the following: (1) the doubtful representativeness of Atwater's subjects, their activity patterns, and their diets; (2) the extremely short duration of the experiments; (3) the uncertainty about which fecal and urinary excretions contain the residues of each ingested food; (4) the uncertainty about whether or not the required nitrogen balance in individuals was reached during experiments; (5) the numerous experiments carried out without valid preliminary experiments; (6) the imprecision affecting Atwater's experimental measurements; and (7) the numerous assumptions and approximations, along with the lack of information, characterizing Atwater's studies. This review presents specific guidelines for establishing new experimental procedures to estimate more precise and/or more accurate values for the metabolizable energy of macronutrients. The importance of estimating these values in light of their possible dependence on certain nutritional parameters and/or physical activity patterns of individuals is emphasized. The use of more precise values would allow better management of the current overweight and obesity epidemic.

The Reproducibility and Relative Validity of a Mexican Diet Quality Index (ICDMx) for the Assessment of the Habitual Diet of Adults.

The study of diet quality in a population provides information for the development of programs to improve nutritional status through better directed actions. The aim of this study was to assess the reproducibility and relative validity of a Mexican Diet Quality Index (ICDMx) for the assessment of the habitual diet of adults. The ICDMx was designed to assess the characteristics of a healthy diet using a validated semi-quantitative food frequency questionnaire (FFQ-Mx). Reproducibility was determined by comparing 2 ICDMx based on FFQs (one-year interval). Relative validity was assessed by comparing the ICDMx (2nd FFQ) with that estimated based on the intake averages from dietary records (nine days). The questionnaires were answered by 97 adults (mean age in years = 27.5, SD = 12.6). Pearson (r) and intraclass correlations (ICC) were calculated; Bland-Altman plots, Cohen's κ coefficients and blood lipid determinations complemented the analysis. Additional analysis compared ICDMx scores with nutrients derived from dietary records, using a Pearson correlation. These nutrient intakes were transformed logarithmically to improve normality (log10) and adjusted according to energy, prior to analyses. The ICDMx obtained ICC reproducibility values ranged from 0.33 to 0.87 (23/24 items with significant correlations; mean = 0.63), while relative validity ranged from 0.26 to 0.79 (mean = 0.45). Bland-Altman plots showed a high level of agreement between methods. ICDMx scores were inversely correlated (p < 0.05) with total blood cholesterol (r = -0.33) and triglycerides (r = -0.22). ICDMx (as calculated from FFQs and DRs) obtained positive correlations with fiber, magnesium, potassium, retinol, thiamin, riboflavin, pyridoxine, and folate. The ICDMx obtained acceptable levels of reproducibility and relative validity in this population. It can be useful for population nutritional surveillance and to assess the changes resulting from the implementation of nutritional interventions.

Effect of a symbiotic gel (Lactobacillus acidophilus + Bifidobacterium lactis + inulin) on presence and severity of gastrointestinal symptoms in hemodialysis patients.

OBJECTIVE: The study aimed to assess the effect of a symbiotic gel on presence and severity of gastrointestinal symptoms (GIS) in hemodialysis patients. DESIGN: A double-blinded, placebo-controlled, randomized, clinical trial was designed. The study was conducted at 2 public hospitals in Guadalajara, Mexico. SUBJECTS AND INTERVENTION: Twenty-two patients were randomized to the intervention group (nutritional counseling + symbiotic gel) and 20 patients were randomized to the control group (nutritional counseling + placebo), during 2 months of follow-up. MAIN OUTCOME MEASURE: Presence and monthly episodes of GIS were assessed by direct interview and severity by using the self-administered GIS questionnaire. Additionally, biochemical parameters, inflammatory markers, and nutritional status (dietary intake, subjective global assessment, anthropometry, and body composition) were evaluated. RESULTS: After a 2-month treatment, intervention group had a significant reduction in prevalence and monthly episodes of vomit, heartburn, and stomachache, as well as a significant decrease in GIS severity compared with control group. Moreover, intervention group had a greater yet not significant decrease in the prevalence of malnutrition and a trend to reduce their C-reactive protein and tumor necrosis factor α levels compared with control group. No symbiotic-related adverse side effects were shown in these patients. Clinical studies with longer follow-up and sample size are needed to confirm these results. CONCLUSIONS: We concluded that administration of a symbiotic gel is a safe and simple way to improve common GIS in dialysis patients.

Validation of a Mexican food photograph album as a tool to visually estimate food amounts in adolescents.

The aim of the present study was to validate a food photograph album (FPA) as a tool to visually estimate food amounts, and to compare this estimation with that attained through the use of measuring cups (MC) and food models (FM). We tested 163 foods over fifteen sessions (thirty subjects/session; 10-12 foods presented in two portion sizes, 20-24 plates/session). In each session, subjects estimated food amounts with the assistance of FPA, MC and FM. We compared (by portion and method) the mean estimated weight and the mean real weight. We also compared the percentage error estimation for each portion, and the mean food percentage error estimation between methods. In addition, we determined the percentage error estimation of each method. We included 463 adolescents from three public high schools (mean age 17·1 (sd 1·2) years, 61·8 % females). All foods were assessed using FPA, 53·4 % of foods were assessed using MC, and FM was used for 18·4 % of foods. The mean estimated weight with all methods was statistically different compared with the mean real weight for almost all foods. However, a lower percentage error estimation was observed using FPA (2·3 v. 56·9 % for MC and 325 % for FM, P< 0·001). Also, when analysing error rate ranges between methods, there were more observations (P< 0·001) with estimation errors higher than 40 % with the MC (56·1 %), than with the FPA (27·5 %) and FM (44·9 %). In conclusion, although differences between estimated and real weight were statistically significant for almost all foods, comparisons between methods showed FPA to be the most accurate tool for estimating food amounts.