Risk Assessment of Dyslipidemias, Hyperglycemia, Hyperuricemia, and Hypertension Utilizing Self-Reported Body Silhouettes.

Objective: Self-reported body silhouette is an anthropometric instrument that has been utilized as a screening tool for underweight, overweight, obesity, and other abnormal anthropometric variables. Herein, we analyzed the risk associated with the self-reported body silhouette in the scope of dyslipidemias, hyperglycemia, hyperuricemia, and hypertension. Methods: Adult participants of the Health Workers Cohort Study enrolled between March 2004 and April 2006 were included. Then, risk analysis was performed considering dyslipidemias as serum triglycerides, high total cholesterol, high LDL-C, low HDL-C, hyperglycemia, hyperuricemia, and hypertension. Results: A total of 2,297 males and 5,003 females were analyzed. The median ages of the studied population was 39 (30-49) and 41 (31-50) years for males and females, respectively. Overall, there is a stepwise increase in the risk of presenting dyslipidemias, hyperglycemia, hyperuricemia, and hypertension as the self-reported body silhouette number increases, this tendency was observed in both males and females. Conclusion: Self-reported body silhouette is a useful risk assessment tool for dyslipidemias, hyperglycemia, hyperuricemia, and hypertension in Mexican adults. Applications of questioners containing this silhouette might be considered a valuable public health instrument due to their low cost, relative simplicity, and absence of specialized equipment, training, or respondent knowledge.

Sarcopenia, neuropatía periférica y enfermedad arterial periférica en pacientes con diabetes mellitus sometidos a hemodiálisis / Sarcopenia, peripheral neuropathy, and peripheral arterial disease in patients with diabetes mellitus under hemodialysis

Resumen Introducción: La sarcopenia se caracteriza por pérdida de fuerza y masa muscular. Los pacientes con diabetes mellitus que se encuentran bajo tratamiento en hemodiálisis tienen disminución de actividad física y cambios en su ingestión alimentaria, lo que propicia también la presencia de sarcopenia; por otro lado, la neuropatía periférica y enfermedad arterial periférica aparecen comúnmente como complicaciones crónicas de la diabetes mellitus. Material y métodos: Se realizó un estudio transversal, observacional, en pacientes con diabetes mellitus y hemodiálisis. Para la evaluación de la sarcopenia se midió fuerza muscular, rendimiento físico y cantidad de masa muscular. Se midió fuerza muscular con dinamómetro, mientras que el rendimiento físico se evaluó con el tiempo en segundos de marcha con cronómetro, la cantidad de músculo de obtuvo utilizando una báscula con bioimpedancia. Se consideró sarcopenia severa cuando existía baja fuerza y cantidad muscular además de bajo rendimiento físico. La neuropatía periférica se evaluó explorando la sensibilidad a la presión y el tacto con el monofilamento de Semmes-Weinstein y sensibilidad profunda con un diapasón de 128 Hz. El índice tobillo-brazo fue la medición tomada para la clasificación de enfermedad arterial periférica. Resultados: El análisis final se realizó con 33 pacientes. Con un tiempo en hemodiálisis de 3,57 ± 2,56 años. La prevalencia de sarcopenia severa y sarcopenia fue de 90,8% y la de pre-sarcopenia de 9% del total de los pacientes; por otro lado, se encontró al 78,1% los pacientes con pérdida de la sensibilidad profunda, mientras que el porcentaje de los pacientes con pérdida de la sensibilidad a la presión y al tacto fue de 54,5%. Se encontró correlación entre los parámetros de sarcopenia y el tiempo de evolución de la insuficiencia renal y la edad. Conclusión: La sarcopenia se presenta, en sus diferentes etapas, en prácticamente todos los pacientes con diabetes mellitus sometidos a hemodiálisis; existe relación con la edad del paciente y el tiempo de hemodiálisis.

Abstract Introduction: Sarcopenia is characterized by loss of strength and muscle mass. Patients with diabetes mellitus who are under hemodialysis treatment show decreased physical activity and changes in their food intake, which also leads to the presence of sarcopenia. On the other hand, peripheral neuropathy and peripheral arterial disease commonly appear as chronic complications of diabetes mellitus. Methods: A cross-sectional, observational study was carried out in diabetes mellitus patients on hemodialysis. For the assessment of sarcopenia, muscle strength, physical performance and muscle mass percentage were measured. Muscle strength was calculated with a dynamometer, while physical performance was evaluated in seconds by means of a walk test with a stopwatch; muscle mass percentage was obtained using a scale with bioelectrical impedance. Sarcopenia was considered severe when there was low muscle strength and percentage in addition to low physical performance. Peripheral neuropathy was assessed by exploring touch and pressure sensibility with the Semmes-Weinstein monofilament test and deep sensibility with a 128 Hz tuning fork. The ankle-brachial index was the measurement taken for the peripheral arterial disease classification. Results: The final analysis was performed with 33 patients, whose time on hemodialysis was 3.57 ± 2.56 years. The prevalence of severe sarcopenia and sarcopenia was 90.8% and that of pre-sarcopenia was 9% of all patients. On the other hand, 78.1% were found to be patients with loss of deep sensibility, while the percentage of patients with loss of sensibility to pressure and touch was 54.5%. A correlation was found between the sarcopenia parameters and the time of evolution of renal failure and age. Conclusion: Sarcopenia occurs, in its different stages, in practically all diabetes mellitus patients undergoing hemodialysis; there is a relationship with the patient's age and hemodialysis time.

Prescription of Physical Activity: How Does the Internist Perceive it?

OBJECTIVE: To assess the meaning of a physical activity prescription (PAP) from the physician's point of view and to examine current PAP-related clinical practices and stage of change, including the factors that influence them. METHODS: Mixed methodology was applied to obtain valid, high-quality data. During the qualitative phase, the "free-listing" technique was used to explore the "cultural domain" of a physician's perception of PAP, as well as the construction of culturally relevant items used during the last phase of the study. A survey was conducted to evaluate clinical practices, attitudes, and physician state of change regarding PAP. The convenience sample of 58 (qualitative phase) and 350 internists (quantitative phase) who attended the International Congress of Internal Medicine was interviewed. RESULTS: A majority of internist reported having adequate knowledge, positive attitude, being in the maintenance phase with no barriers to prescribe physical activity (PA). Prescription was associated with physician training, their workplace, and experience. However, physicians do not satisfactorily evaluate the level of patient's PA nor recommend an adequate level of PA, which is necessary to achieve health goals. CONCLUSIONS: Physicians had great acceptance of PAP. However, there were low levels of knowledge of current PA guidelines, although most physicians thought they had sufficient knowledge. Training seems to be an excellent way to improve PAP.

Health workers cohort study: methods and study design / Cohorte de trabajadores de la salud: métodos y diseño del estudio

Abstract: Objective: To examine different health outcomes that are associated with specific lifestyle and genetic factors. Materials and methods: From March 2004 to April 2006, a sample of employees from three different health and academic institutions, as well as their family members, were enrolled in the study after providing informed consent. At baseline and follow-up (2010-2013), participants completed a self-administered questionnaire, a physical examination, and provided blood samples. Results: A total of 10 729 participants aged 6 to 94 years were recruited at baseline. Of these, 70% were females, and 50% were from the Mexican Social Security Institute. Nearly 42% of the adults in the sample were overweight, while 20% were obese. Conclusion: Our study can offer new insights into disease mechanisms and prevention through the analysis of risk factor information in a large sample of Mexicans.

Resumen: Objetivo: Examinar diferentes desenlaces en salud y su asociación con factores genéticos y del estilo de vida. Material y métodos: De marzo de 2004 a abril de 2006, una muestra de empleados de tres diferentes instituciones de salud y académicas, así como miembros de sus familias, fueron enrolados en el estudio, previa firma de consentimiento informado. Durante la medición basal y el seguimiento (2010-2013) los participantes completaron un cuestionario autoaplicado, exámenes físicos y proporcionaron muestras sanguíneas. Resultados: Fueron incluidos participantes (10 729) de entre 6 y 94 años en la medición basal. De estos, 70% fueron mujeres y 50% del Instituto Mexicano del Seguro Social. Aproximadamente 42% de los adultos tuvieron sobrepeso y 20% obesidad. Conclusión: Este estudio puede ofrecer conocimientos sobre los mecanismos de la enfermedad a través del análisis de factores de riesgo en una muestra de mexicanos.

Levels of serum estradiol and lifestyle factors related with bone mineral density in premenopausal Mexican women: a cross-sectional analysis.

BACKGROUND: Many factors, such as heredity, ethnicity, nutrition and other lifestyle factors, have been related to bone mineral density in postmenopausal women. Additionally, bone mass has been significantly associated with decreased estrogen levels. However, fewstudies have been conducted on premenopausal women. The present study was designed to estimate the relationship between low bone mineral density and levels of serum estradiol and lifestyle factors in premenopausal Mexican women. METHODS: A cross-sectional study was conducted in 270 women between 40 and 48 years of age who participate in the Health Workers Cohort Study. Information on socio-demographic and lifestyle factors were obtained through a self-administered questionnaire. Body mass index and serum estradiol were measured with standard procedures; bone mineral density was assessed using dual-energy X-ray absorptiometry. Multiple linear and logistic regression models were computed to evaluate the relationship between low bone mineral density and levels of serum estradiol and lifestyle factors. RESULTS: In linear regression analysis levels of estradiol, body mass index, physical activity, and vitamin D intake were positively related to bone mineral density. Age, cigarette smoking and caffeine were inversely associated with BMD. Finally, the odds of low bone mineral density increase significantly when the premenopausal women had low levels of serum estradiol (OR = 4.93, 95 % CI: 2.14, 11.37). CONCLUSION: These data support that low serum estradiol, advancing age, lower physical activity, lower vitamin D intake, cigarette smoking, and higher amount of caffeine intake are linked to low bone mineral density in premenopausal Mexican women.

Health workers cohort study: methods and study design.

OBJECTIVE:: To examine different health outcomes that are associated with specific lifestyle and genetic factors. MATERIALS AND METHODS:: From March 2004 to April 2006, a sample of employees from three different health and academic institutions, as well as their family members, were enrolled in the study after providing informed consent. At baseline and follow-up (2010-2013), participants completed a self-administered questionnaire, a physical examination, and provided blood samples. RESULTS:: A total of 10 729 participants aged 6 to 94 years were recruited at baseline. Of these, 70% were females, and 50% were from the Mexican Social Security Institute. Nearly 42% of the adults in the sample were overweight, while 20% were obese. CONCLUSION:: Our study can offer new insights into disease mechanisms and prevention through the analysis of risk factor information in a large sample of Mexicans.

Thyroid function is associated with insulin resistance markers in healthy adolescents with risk factors to develop diabetes.

INTRODUCTION: The prevalence of obesity and Type 2 diabetes mellitus (T2DM) among children and adolescents is rising. Thyroid function has been associated with insulin resistance. There is scarce information about how thyroid function could be related with cardiovascular risk or glucose homeostasis in adolescent. AIM: To analyze how thyroid function is associated with insulin resistance and another cardiovascular risk factors in healthy adolescents with risk factors to develop diabetes. METHODS: A prospective cross-sectional analysis was carried out on euthyroid, adolescents. considered at high risk to develop Type 2 diabetes. Fasting blood samples were obtained. Thyroid function test and another cardiometabolic parameters were assessed. A 75 grams oral glucose tolerance test was performed to calculate insulin resistance. RESULTS: One hundred adolescents were evaluated. The mean age was 15.9 ± 0.8 years, There is a negative correlation between Fasting insulin, post glucose load insulin and HOMA IR. There were no correlation with Matsuda index. We could not found any correlation with TSH values. CONCLUSIONS: We found a correlation between fasting insulin, HOMA IR and serum thyroid hormones, we did not find any relation with serum TSH. In euthyroid adolescents with risk factors to develop diabetes.

Osteoporotic fracture risk evaluation. Options when central densitometry is not available.

BACKGROUND: Osteoporosis-related fractures represent a major health problem. Although spine and hip bone densitometry is the gold standard to assess bone density, this test is not always accesible. The purpose of this study was to describe two options to assess the risk of fracture due to osteoporosis in post-menopausal women assigned to a primary care unit where bone densitometry is not available. METHODS: A cross-sectional study was conducted in 332 post-menopausal women without diagnosis or treatment for osteoporosis, attending regularly to a primary care unit. A heel bone peripheral densitometry, physical exam and medical history were performed. The assessment of fracture risk was carried out using the FRAX™ method. RESULTS: Mean age was 60 ± 8.7 years and body mass index was 28.68 ± 4.24. According to the heel bone peripheral densitometry, 19 (5.7 %) women had osteoporosis (T-score less than or equal to -2.5), 171 (51.8 %) had osteopenia (T-score between -2.5 and less than or equal to -1) and 141 (42.5 %) had normal bone mineral density. According to the FRAX method, 13 (3.9 %) had an increased risk of osteoporotic fracture in a 10-year period and 40 (12 %) of hip fracture. CONCLUSIONS: There was low concordance in the 10-year risk for major osteoporotic fracture and hip fracture assessed with both the FRAX™ and the peripheral bone densitometry methods.

INTRODUCCIÓN: las fracturas relacionadas con la osteoporosis son un problema de salud. Aunque la densitometría ósea de columna y cadera es el estándar para evaluar la densidad ósea, no siempre es accesible. El objetivo de este estudio fue describir dos alternativas a la densitometría ósea para evaluar el riesgo de fractura por osteoporosis en mujeres posmenopáusicas. MÉTODOS: estudio transversal de 332 mujeres posmenopáusicas sin diagnóstico o tratamiento de osteoporosis, que asistían regularmente a una unidad de primer nivel. Se realizó densitometría periférica de talón, examen físico e historia médica. La evaluación del riesgo de fractura se llevó a cabo mediante FRAXTM. RESULTADOS: la edad media fue de 60 ± 8.7 años y el índice de masa corporal de 28.68 ± 4.24. Según la densitometría periférica de talón, mujeres 19 (5.7 %) tenían osteoporosis (T-score menor de ­2.5), 171 (51.8 %) osteopenia (T-score entre ­2.5 y menos de ­1) y 141 (42.5 %) densidad mineral ósea normal. Según el método FRAX, 13 (3.9 %) tenían riesgo aumentado de fractura osteoporótica en un periodo de 10 años y 40 (12 %) de fractura de cadera. CONCLUSIONES: la prevalencia de riesgo para osteoporosis es diferente de acuerdo con el método que se utilice para medirlo. La concordancia entre los dos métodos fue baja.

Sweetened beverage consumption and the risk of hyperuricemia in Mexican adults: a cross-sectional study.

BACKGROUND: The prevalence of hyperuricemia has doubled worldwide during the last few decades. The substantial increase in sweetened beverage (SB) consumption has also coincided with the secular trend of hyperuricemia. Recent studies do show that the consumption of SB can induce hyperuricemia. However, the association between SB and hyperuricemia remains unclear. The aim of this study was to evaluate the association between SB consumption and levels of uric acid in Mexican adults. METHODS: We performed a cross-sectional analysis of data from selected adults participating in the baseline assessment of the Health Workers Cohort Study. A total of 6,705 participants of both sexes between ages 18 and 70 years were included. SB intake was estimated using a validated semi-quantitative food frequency questionnaire. Biochemical and anthropometric information was collected using standard procedures. Hyperuricemia was defined as uric acid levels ≥ 7.0 mg/dL in men and ≥ 5.8 mg/dL in women. The association of interest was assessed by multiple logistic regression models. RESULTS: The odds ratios (OR) for hyperuricemia in men who consume 0.5-1 SB/day was 1.59 (95% CI; 1.05-2.40) and 2.29 (95% CI; 1.55-3.38) for those who consume ≥3 SB/day when compared to men who consume less than half a SB/day. In women, the OR for hyperuricemia for those who consume >1.0- < 3.0 SB/day was 1.33 (95% CI; 1.04-1.70) and 1.35 (95% CI; 1.04-1.75) for those who consume ≥3 SB/day when compared to women who consume less than half a SB/day, independent of other covariables. Men and women with high SB consumption and a body mass index (BMI) ≥ 25 Kg/m2 had greater risk for hyperuricemia than men and women with low SB consumption and normal BMI < 25 Kg/m2. CONCLUSIONS: Our findings suggest that the consumption of SB is associated with an increased risk of hyperuricemia in Mexican adults. However, longitudinal research is needed to confirm the association between SB intake and hyperuricemia.

Predictors of hyperlipidemia during the first half of pregnancy in Mexican women.

OBJECTIVE: To determine the predictors of hypercholesterolemia and of hypertriglyceridemia during the first half of pregnancy in Mexican women. METHODS: Cross-sectional comparative study of pregnant women with less than 21 weeks of gestational age. MEASUREMENTS: Demographic information, obstetric history, prepregnancy body mass index, cholesterol and triglycerides. Cross tabulations and multiple logistic regression were used for statistical analysis. RESULTS: 230 participants; 61 women with normal prepregnancy body mass index, 108 with overweight, and 61 with obesity. Dyslipidemia was defined as elevated cholesterol (>180 mg/dL) or triglycerides (>170 mg/dL). After adjusting by potential confounders, independent predictors of hypercholesterolemia included being overweight (OR=2.8, 95% CI 1.4-5.9), being obese (OR=3.7 95% CI 1.6-8.4) or being on the second trimester of pregnancy. The same predictors were found for hypertriglyceridemia, respectively OR=2.8, 95% CI 1.4-5.6, OR=2.9, 95% CI 1.3-6.5, OR=2.6, 95% CI 1.4-4.7. CONCLUSION: Mexican women with prepregnancy overweight or obesity have greater risk of suffering hypercholesterolemia and hypertriglyceridemia during pregnancy. Women in the second trimester had higher levels of both lipids as compared to the first one. This is the first Mexican study that confirms the increase of lipids as gestational age progresses.

Objetivo: Determinar los predictores de hipercolesterolemia y de hipertrigliceridemia durante la primera mitad del embarazo en mujeres Mexicanas. Métodos: Estudio transversal comparativo de mujeres embarazadas con menos de 21 semanas de edad gestacional. Mediciones: información demográfica, historia obstétrica, índice de masa corporal pregestacional, niveles sanguíneos de colesterol y triglicéridos. Se usaron tabulaciones cruzadas y regresión logística múltiple en el análisis estadístico. Resultados: 230 participantes; 61 mujeres con índice de masa corporal pregestacional normal, 108 con sobrepeso, y 61 con obesidad. Dislipidemia se definió como elevación de colesterol (>180 mg/dL) ó triglicéridos (>170 mg/dL). Después de ajustar con potenciales variables de confusión, los predictores independientes de hipercolesterolemia incluyeron sobrepeso (OR=2.8, 95% CI 1.4-5.9), obesidad (OR=3.7 95% CI 1.6-8.4) o estar en el segundo trimestre del embarazo. Los mismos predictores se encontraron para hipertrigliceridemia, respectivamente: OR=2.8, 95% CI 1.4-5.6, OR=2.9, 95% CI 1.3-6.5, OR=2.6, 95% CI 1.4-4.7. Conclusión: Mujeres Mexicanas con sobrepeso u obesidad pregestacional tienen mayor riesgo de presentar hipercolesterolemia e hipertrigliceridemia durante el embarazo. Mujeres en el segundo trimestre tuvieron niveles más altos de ambos lípidos comparando con el primer trimestre. Este es el primer estudio Mexicano que confirma el incremento de lípidos conforme la edad gestacional progresa.

Association of inflammatory and oxidative stress biomarkers in subjects with cardiovascular risk.

Cardiovascular disease is originated in the vascular endothelium, which controls the homeostasis and the filtration and diffusion of molecules from blood to the tissues. The classical cardiovascular risk factors (CRFs) act directly on the endothelium through an increase in the production of reactive oxygen species, promoting an endothelial activation mediated by the expression of adhesion and proinflammatory molecules, which lead to endothelial dysfunction, the progression of the atherosclerotic plaque, and the onset of cardiovascular disease. The objective of this study was to analyze the association of superoxide dismutase, catalase, gluthatione peroxidase, and lipoperoxidation with fibrinogen, interleukin (IL)-6, tumor necrosis factor-α, and vascular cell adhesion molecule (VCAM)-1 in subjects with cardiovascular risk (CVR) and CRF. This was a cross-sectional study of 114 individuals; oxidative stress (superoxide dismutase, catalase, gluthatione peroxidase, and lipoperoxidation) and inflammatory (fibrinogen, IL-6, tumor necrosis factor-α, and VCAM-1) biomarkers were measured; a CVR score (Framingham) and its CRF were taken into consideration to classify the participants. Twenty-nine subjects out of a total of 114 had high CVR. Smokers and subjects with diabetes (43 subjects) were excluded from the low CVR group. Significant decreases in lipoperoxidation, IL-6, and VCAM-1 and an increase in SOD were found in the high CVR group (P ≤ 0.05). Individual analysis of each CRF in the 114 subjects revealed a different pattern in the biomarkers' statistical differences. Concluding that the biomarkers show statistical differences in each CRF, especially IL-6, VCAM-1, and SOD; therefore, these are highly recommended to be used as biomarkers of the oxidative stress and inflammatory status in CVR.

Effects of a physical activity program on markers of endothelial dysfunction, oxidative stress, and metabolic status in adolescents with metabolic syndrome.

The metabolic syndrome (MetS) is a precursor of diabetes. Physical activity (PA) improves endothelial dysfunction and may benefit patients with MetS. Aims. To evaluate the effect of a physical activity (PA) program on markers of endothelial dysfunction and oxidative stress in adolescents with (MetS). Methods. We carried out a cohort study of 38 adolescents with and without MetS (18 females and 20 males). All participants completed a 3-month PA program. All variables of the MetS as well as markers of endothelial dysfunction and oxidative stress tests were evaluated. Results. Females with and without MetS showed significant differences for almost all components of the MetS, whereas males were significantly different in half of the components. After the PA program, components of the MetS were not different from baseline values except for HDL-C levels. Some baseline endothelial dysfunction markers were significantly different among adolescents with and without MetS; however, after the PA program, most of these markers significantly improved in subjects with and without MetS. Conclusion. PA improves the markers of endothelial dysfunction in adolescents with MetS although other changes in the components of the MetS were not observed. Perhaps the benefits of PA on all components of MetS would appear after a PA program with a longer duration.

Dificultades en la clasificación del síndrome metabólico: El ejemplode los adolescentes en México / Difficulties in the classification of metabolic syndrome: The example of adolescents in Mexico

OBJETIVO. Determinar la diferencia entre las definiciones del National Cholesterol Education Program Adult Treatment Panel (ATPIII) y de la International Diabetes Federation (IDF) para síndrome metabólico (SM) en adolescentes mexicanos. MATERIAL Y MÉTODOS. Estudio transversal en 575 adolescentes de 14 a 16 años. Se utilizaron pruebas t de Student, ji cuadrada y correlación de Spearman. RESULTADOS. La prevalencia de SM fue mayor por ATPIII (18.6 por ciento) versus IDF (8.2 por ciento) (p<0.001), con 41.1 por ciento de concordancia. CONCLUSIONES. Existe una diferencia estadística de la prevalencia del SM en adolescentes mexicanos entre las dos definiciones.

OBJECTIVE. Determine the difference between the National Cholesterol Education Program Adult Treatment Panel (ATPIII) definition of the diagnosis of metabolic syndrome (MS) in Mexican adolescents and that by the International Diabetes Federation (IDF). MATERIAL AND METHODS. We conducted a cross-sectional study of 575 adolescents aged 14 to 16 years using the student's t test, chi square and Spearman correlation. RESULTS. The prevalence of MS was higher by ATPIII (18.6 percent) than by IDF (8.2 percent) (p <0.001) and there was a concordance of 41.1 percent. CONCLUSIONS. There is a statistical difference in the prevalence of MS depending on the definition.

Dietary glycemic index, dietary glycemic load, blood lipids, and coronary heart disease.

Objective. To examine the associations of dietary glycemic index (GI) and dietary glycemic load (GL) with blood lipid concentrations and coronary heart disease (CHD) in nondiabetic participants in the Health Worker Cohort Study (HWCS). Materials and Methods. A cross-sectional analysis was performed, using data from adults who participated in the HWCS baseline assessment. We collected information on participants' socio-demographic conditions, dietary patterns and physical activity via self-administered questionnaires. Dietary GI and dietary GL were measured using a validated food frequency questionnaire. Anthropometric and clinical measurements were assessed with standardized procedures. CHD risk was estimated according to the sex-specific Framingham prediction algorithms. Results. IIn the 5,830 individuals aged 20 to 70 who were evaluated, dietary GI and GL were significantly associated with HDL-C, LDL-C, LDL-C/HDL-C ratio, and triglycerides serum levels. Subjects with high dietary GI have a relative risk of 1.56 (CI 95%; 1.13-2.14), and those with high dietary GL have a relative risk of 2.64 (CI 95%; 1.15-6.58) of having an elevated CHD risk than those who had low dietary GI and GL. Conclusions. Our results suggest that high dietary GI and dietary GL could have an unfavorable effect on serum lipid levels, which are in turn associated with a higher CHD risk.

Sweetened beverage consumption and increased risk of metabolic syndrome in Mexican adults.

OBJECTIVE: To examine the relationship between sweetened beverage consumption and components of the metabolic syndrome in a Mexican population. DESIGN: We performed a cross-sectional analysis of data from selected adults participating in the baseline assessment of the Health Workers Cohort Study. Information on participants' sociodemographic characteristics, dietary patterns and physical activity were collected via self-administered questionnaires. Sweetened beverage consumption was evaluated through a validated semi-quantitative FFQ. Anthropometric and clinical measures were assessed with standardized procedures. The definition of metabolic syndrome was determined using criteria from the National Cholesterol Education Program Adult Treatment Panel III. The associations of interest were evaluated by means of linear and logistic regression models. SETTING: The Mexican states of Morelos and Mexico. SUBJECTS: A total of 5240 individuals aged 20 to 70 years (mean 39.4 (sd 11.5) years) were evaluated. RESULTS: Overweight/obesity prevalence was 56.6 %. The prevalence of metabolic syndrome in this sample was 26.6 %. We found that for each additional daily sweetened beverage serving consumed, participants experienced an average increase of 0.49 mmol/l in TAG and a decrease in HDL cholesterol of 0.31 mmol/l. Subjects consuming more than two servings of sweetened beverages daily were at 2.0 times greater risk of metabolic syndrome than those who did not consume sweetened beverages. We also observed that higher sweetened beverage consumption increased the risk of all components of the metabolic syndrome. CONCLUSIONS: Our data support the hypothesis that sweetened beverage consumption increases the risk of metabolic syndrome in Mexican adults, possibly by providing excess energy and large amounts of rapidly absorbable sugars.

[Difficulties in the classification of metabolic syndrome. The example of adolescents in Mexico]. / Dificultades en la clasificación del síndrome metabólico. El ejemplode los adolescentes en México.

OBJECTIVE: Determine the difference between the National Cholesterol Education Program Adult Treatment Panel (ATPIII) definition of the diagnosis of metabolic syndrome (MS) in Mexican adolescents and that by the International Diabetes Federation (IDF). MATERIAL AND METHODS: We conducted a cross-sectional study of 575 adolescents aged 14 to 16 years using the student's t test, chi square and Spearman correlation. RESULTS: The prevalence of MS was higher by ATPIII (18.6%) than by IDF (8.2%) (p <0.001) and there was a concordance of 41.1%. CONCLUSIONS: There is a statistical difference in the prevalence of MS depending on the definition.

Body mass index and the prevalence of metabolic syndrome among children and adolescents in two Mexican populations.

PURPOSE: To report the prevalence of metabolic syndrome (MS) among children and adolescents living in central Mexico, and its association with body mass index (BMI). METHODS: In a sample of 1366 subjects from 7 to 24-years-old, a self-administered questionnaire was used to determined demographic characteristics. The definition of pediatric MS was determined using analogous criteria to Adult Treatment Panel III (ATPIII) as > or = 3 of the following: concentration of triglycerides > or = 100 mg/dL, HDL cholesterol < 45 mg/dL for males and < 50 mg/dL for females, waist circumference > or = 75th percentile (sex specific), glucose concentration > or = 110 to < 126 mg/dL, and systolic or diastolic blood pressure > or = 90th percentile (age, height, and sex specific). RESULTS: Most of the sample was in the 10-14- (32.4%) and the 15-19-year (35.4%) age groups, mostly females (57%), and 31% of this young sample was overweight (mean BMI = 21.6 kg/m2). About 1 in every 5 participants had full criteria for MS (19.2%, 95% confidence interval [CI]: 16.4-22.1 among females, and 20.2%, 95% CI: 17.1-23.7 among males), and only 1 in every 10 was free of any MS component. The most common component was a low HDL level, observed in 85.4% of the sample. Unfavorable fat distribution, as indicated by a large waist circumference, was present in 27.9% of the sample. About 66% of those 10-14-year-olds with a large BMI were positive for MS. CONCLUSIONS: MS and overweight are major problems for youth in Mexico. Immediate and comprehensive actions at home and schools are needed if Mexico wants to avoid the heavy burden that this disorder will have for its population in the near future.