A systematic review of educational nutrition interventions based on behavioral theories in school adolescents.

The purpose of this study was to summarize the evidence from studies conducted on adolescents, evaluating educational nutrition interventions for the modification of food consumption through controlled trials based on behavior change theories or models and implemented in school settings. A systematic search was carried out through PubMed and ERIC databases between November and December 2020, and updated in February 2023; English-language keywords were used, and no publication date limits were applied. Two authors independently performed the search, data extraction, data synthesis and risk of bias assessment. Twelve studies meeting the inclusion criteria were included. The interventions were based on different theories; the most used was the Social Cognitive Theory. Eleven of the twelve studies showed favorable modifications in the consumption of at least two of the food groups. Most studies were at low risk of bias, and only one was classified as high risk. It is concluded that educational nutrition interventions based on behavior change theories/models and implemented in the school setting influence positive changes in adolescents eating behavior.

Severe COVID-19: Drugs and Clinical Trials.

By January of 2023, the COVID-19 pandemic had led to a reported total of 6,700,883 deaths and 662,631,114 cases worldwide. To date, there have been no effective therapies or standardized treatment schemes for this disease; therefore, the search for effective prophylactic and therapeutic strategies is a primary goal that must be addressed. This review aims to provide an analysis of the most efficient and promising therapies and drugs for the prevention and treatment of severe COVID-19, comparing their degree of success, scope, and limitations, with the aim of providing support to health professionals in choosing the best pharmacological approach. An investigation of the most promising and effective treatments against COVID-19 that are currently available was carried out by employing search terms including "Convalescent plasma therapy in COVID-19" or "Viral polymerase inhibitors" and "COVID-19" in the Clinicaltrials.gov and PubMed databases. From the current perspective and with the information available from the various clinical trials assessing the efficacy of different therapeutic options, we conclude that it is necessary to standardize certain variables-such as the viral clearance time, biomarkers associated with severity, hospital stay, requirement of invasive mechanical ventilation, and mortality rate-in order to facilitate verification of the efficacy of such treatments and to better assess the repeatability of the most effective and promising results.

Effect of flaxseed (Linum usitatissimum) supplementation on glycemic control and insulin resistance in prediabetes and type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Prediabetes and type 2 Diabetes Mellitus (T2DM) are characterized by increased blood sugar concentration and insulin resistance. Although there are only a few reports of potential benefits of flaxseed's consumption on different metabolic parameters, there is no evidence of its effect among people with these conditions. OBJECTIVES: The present systematic review and meta-analysis aimed to assess the effect of flaxseed supplementation on glycemic control variables and insulin resistance in prediabetes and T2DM. METHODS: A literature search was conducted through PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science, to identify Randomized Control Trials (RCTs) that evaluated the effect of milled or ground flaxseed supplementation on fasting blood glucose, HbA1c, insulin concentrations, or HOMA-IR. The data were analyzed using Comprehensive Meta-Analysis (CMA) software version 3.3 in a fixed-effect model. RESULTS: Seven studies were included in the systematic review and the meta-analysis, the results showed a significant reduction on fasting blood sugar (SMD: -0.392, 95% CI: -0.596, -0.187, p = <0.001, I2 = 64.81%) insulin concentrations, (SMD: -0.287, 95% CI: -0.534, -0.041, p = 0.022, I2 = 32.53%), HbA1c (SMD: -0.442, 95% CI: -0.770, -0.114, p = 0.008, I2 = 11.058%), and HOMA-IR (SMD: -0.284, 95% CI: -0.530, -0.038, p = 0.024, I2 = 0.00%) after flaxseed supplementation. CONCLUSIONS: Flaxseed supplementation seems to improve glycemic control variables and insulin resistance in prediabetes and T2DM; however, more RCTs are needed to have more decisive evidence about doses, method of supplementation, and the possible effect of synergy with the dietetic treatment.

The Reproducibility and Relative Validity of a Food Frequency Questionnaire for Identifying Iron-Related Dietary Patterns in Pregnant Women.

Analyzing pregnant women's iron intake using dietary patterns would provide information that considers dietary relationships with other nutrients and their sources. The objective of this study was to evaluate the reproducibility and relative validity of a Qualitative Food Frequency Questionnaire to identify iron-related dietary patterns (FeP-FFQ) among Mexican pregnant women. A convenience sample of pregnant women (n = 110) completed two FeP-FFQ (FeP-FFQ1 and FeP-FFQ2) and a 3-day diet record (3DDR). Foods appearing in the 3DDR were classified into the same food groupings as the FeP-FFQ, and most consumed foods were identified. Exploratory factor analysis was used to determine dietary patterns. Scores were compared (FeP-FFQ for reproducibility and FeP-FFQ1 vs. 3DDR for validity) through intraclass correlation coefficients (ICC), cross-classification, Bland−Altman analysis, and weighed Cohen kappa (κw), using dietary patterns scores tertiles. Two dietary patterns were identified: "healthy" and "processed foods and dairy". ICCs (p < 0.01) for "healthy" pattern and "processed foods and dairy" pattern were 0.76 for and 0.71 for reproducibility, and 0.36 and 0.37 for validity, respectively. Cross-classification and Bland−Altman analysis showed good agreement for reproducibility and validity; κw values showed moderate agreement for reproducibility and low agreement for validity. In conclusion, the FeP-FFQ showed good indicators of reproducibility and validity to identify dietary patterns related to iron intake among pregnant women.

Breastfeeding training in Mexican health students may not be enough: A case analysis.

BACKGROUND: Breastfeeding education is key to undergraduate nursing, nutrition, and medicine students' study programs. All students should be prepared to support and inform mothers about the best infant feeding methods. However, students may not be receiving adequate training to provide this support during their preparation. OBJECTIVES: The objective of this study was to explore if the Learning Units of the study programs of the bachelor's degrees in medicine, nursing, and nutrition, incorporate theoretical/practical content regarding breastfeeding and to evaluate whether these contents cover requirements related to knowledge and skills in breastfeeding recommended by international organizations for student's health area. DESIGN: Descriptive. METHODS: In the study programs of the bachelor's degrees, we identified the Learning Units that described theoretical/practical contents related to the subject of breastfeeding, to later contrast this training with the objectives in knowledge and skills in breastfeeding that the students in the health area should receive during their academic education, according to international recommendations. RESULTS: The three study programs offer content on breastfeeding. The degrees in nursing and medicine manage to review a more significant number of training contents, unlike nutrition. However, the knowledge and skills targeted and identified do not seem to approach the knowledge and skills recommended by international institutions. CONCLUSIONS: Several knowledge and skills need to be addressed during the training of health students. Thematic content and educational strategies must be improved and implemented to improve their breastfeeding training.

A Local Health Situation Room for COVID-19: Recommendations for Decision-Making From a Higher Education Institution in Mexico.

Introduction: The Situation Room is a physical or virtual space where experts systematically analyze information to characterize a health situation, especially during emergencies. Decision-making processes are made toward solving health needs and promoting collaboration among institutions and social sectors. This paper presents the context and circumstances that led the University of Guadalajara (UdeG) to install a local health situation room (HSR) to address the COVID-19 pandemic at this institution based in the state of Jalisco, Mexico, a narrative is also made of its working processes and some of its results. Methods: The design of this situation room for COVID-19 was based on the methodology established by the Pan American Health Organization (PAHO)/WHO. This local-type situation room was installed on February 12, 2020. The health problem was characterized, and strategic lines, objectives, and goals were established; the first analysis was derived from an action plan deployed at the UdeG. The strategic lines were situational diagnosis, preventive actions, and containment strategies. Results: The situation room influenced the activities of the UdeG before the epidemic cases started in the state. One of the actions with the greatest impact was developing a mathematical model for predicting COVID-19 cases. Subsequently, new models have been developed according to the epidemiological evolution of the disease, helping manage the epidemic in the state. Another important result was the early closing of face-to-face university activities, reducing contagion risks and the mobility of more than 310,000 students, faculty, and administrative personnel throughout Jalisco. Conclusions: A consequence of the closure was that the confinement generated by the pandemic was the change to virtual meetings from April 2020 to date; but at the same time, this working format was a strength, since it influenced the decision of the university board to change all the academic activities to virtual format before other educational, economic, and social activities in the state did. By April 2020, the situation room transcended its institutional boundaries and was invited to participate at the Jalisco State's Health Committee. Its recommendations have helped to maintain the state with one of Mexico's lowest COVID-19 incidence and mortality rates.

COVID-19 Screening by Anti-SARS-CoV-2 Antibody Seropositivity: Clinical and Epidemiological Characteristics, Comorbidities, and Food Intake Quality.

Developing countries have reported lower molecular diagnostic testing levels due to a lack of resources. Therefore, antibody tests represent an alternative to detect exposure to SARS-CoV-2 and analyze possible risk factors. We aimed to describe and compare the clinical-epidemiological characteristics and the quality of food intake in Mexican individuals with a positive or negative test to antibodies against SARS-CoV-2. We carried out antibody tests and applied a survey to 1799 individuals; 42% were positive, and diabetes was more prevalent in these cases (p < 0.01). No differences were identified in the blood type nor influenza vaccination between groups. Coughing, respiratory distress, muscle pain, joint pain, and anosmia were the most prevalent symptoms among seropositive cases (p < 0.0001). Food intake quality was similar in both groups, except for the most consumed type of fat (p = 0.006). In conclusion, this study supports the association of diabetes as a principal risk factor for SARS-CoV-2 infection in the Mexican population. The results do not support previous associations between blood group or influenza vaccination as protective factors against SARS-CoV-2 infection. However, frequent consumption of polyunsaturated fats is highlighted as a new possible associated factor with COVID-19, which more studies should corroborate as with all novel findings.

RT-qPCR Assays for Rapid Detection of the N501Y, 69-70del, K417N, and E484K SARS-CoV-2 Mutations: A Screening Strategy to Identify Variants With Clinical Impact.

Background: Several variants of the SARS-CoV-2 have been documented globally during the current COVID-19 pandemic. The N501Y, 69-70del, K417N, and E484K SARS-CoV-2 mutations have been documented among the most relevant due to their potential pathogenic biological effects. This study aimed to design, validate, and propose a fast real-time RT-qPCR assay to detect SARS-CoV-2 mutations with possible clinical and epidemiological relevance in the Mexican population. Methods: Targeting spike (S) gene mutations of SARS-CoV-2 (N501Y, 69-70del, K417N, and E484K), specific primers, and probes for three specific quantitative reverse transcription PCR (RT-qPCR) assays were designed, and validated using Sanger sequencing. These assays were applied in clinical samples of 1060 COVID-19 patients from Jalisco Mexico. Results: In silico analyzes showed high specificity of the three assays. Amplicons of samples were confirmed through sequencing. The screening of samples of COVID-19 patients allowed the identification of the E484K mutation in nine individuals and the identification of P.2 Brazilian variant in Mexico. Conclusion: This work provides low-cost RT-qPCR assays for rapid screening and molecular surveillance of mutations with potential clinical impact. This strategy allowed the detection of E484K mutation and P.2 variant for the first time in samples from the Mexican population.

Vitamin D Levels in COVID-19 Outpatients from Western Mexico: Clinical Correlation and Effect of Its Supplementation.

BACKGROUND: The immunomodulatory effects of vitamin D are known to be beneficial in viral infections; it is also known that its deficiency is associated with a prognosis more critical of Coronavirus Disease 2019. This study aimed to determine baseline vitamin D serum concentrations and the effects of its supplementation in asymptomatic or mildly symptomatic Coronavirus Disease 2019 outpatients. METHODS: 42 outpatients were included, 22 of which received a supplement of 10,000 IU of vitamin D3 for 14 days; the remaining 20 outpatients were designated as a control group. Serum levels of transferrin, ferritin, vitamin D, and D-dimer were measured at baseline in both groups. After 14 days, serum levels of total vitamin D were determined in the supplemented group. RESULTS: At baseline, only 19% of infected outpatients had vitamin D levels corresponding to sufficiency. All outpatients with vitamin D insufficiency had at least one symptom associated with the disease, while only 75% of patients with symptoms presented sufficiency. On the seventh and fourteenth day of follow-up, the supplemented group presented fewer symptoms with respect to those non-supplemented. A vitamin D3 dose of 10,000 IU/daily for 14 days was sufficient to raise vitamin D serum concentrations. CONCLUSIONS: Immunomodulatory effects of vitamin D appear to be linked to the development of symptoms in positive outpatients. Vitamin D supplementation could have significant benefits in the Western Mexican population.

Validation of the Spanish-Mexican Version of the Australian Breastfeeding Attitude Questionnaire in Higher Education Health Students.

Positive attitudes towards breastfeeding in health professionals/students have been associated with increasing their confidence to provide support and accompaniment to mothers. In Mexico, there is no valid/reliable tool to assess attitudes towards breastfeeding in this population. The Australian Breastfeeding Attitudes (and Knowledge) Questionnaire (ABAQ) measures attitudes in the Australian population. We aimed to adapt and validate the ABAQ in Mexican health students. We included 264 health students (nursing, nutrition, and medicine) from the University of Guadalajara. Bilingual translators carried out the Spanish adaptation with a reverse translation into English. Experts evaluated the content validity. Reliability was evaluated through an internal consistency analysis (Cronbach's alpha) and construct validity through convergent-divergent validation, item-total correlation, exploratory factor analysis (by principal components), and confirmatory factor analysis. According to the exploratory factor analysis, only one component was identified. Seven items were removed (low correlation between items ≤0.2 and low factor load ≤0.3). The Cronbach's alpha was 0.78. According to the confirmatory factor analysis, the one-factor solution of the ABAQ-13Mx showed a good model fit (X2 = 98.41, G = 62, p = 0.02, CFI = 0.940, and RMSEA = 0.048). The ABAQ-13Mx is a reliable and valid instrument for evaluating attitudes towards breastfeeding in Mexican health degree students.

Potential immunomodulatory effects of vitamin D in the prevention of severe coronavirus disease 2019: An ally for Latin America (Review).

Currently, the world is under a pandemic of severe acute respiratory syndrome coronavirus 2 (SARS­CoV­2), responsible for coronavirus disease 2019 (COVID­19). This disease is characterized by a respiratory syndrome that can progress to an acute respiratory distress syndrome. To date, limited effective therapies are available for the prevention or treatment of COVID­19; therefore, it is necessary to propose novel treatment options with immunomodulatory effects. Vitamin D serves functions in bone health and has been recently reported to exert protective effects against respiratory infections. Observational studies have demonstrated an association between vitamin D deficiency and a poor prognosis of COVID­19; this is alarming as vitamin D deficiency is a global health problem. In Latin America, the prevalence of vitamin D deficiency is unknown, and currently, this region is in the top 10 according to the number of confirmed COVID­19 cases. Supplementation with vitamin D may be a useful adjunctive treatment for the prevention of COVID­19 complications. The present review provides an overview of the current knowledge of the potential immunomodulatory effects of vitamin D in the prevention of COVID­19 and sets out vitamin D recommendations for the Latin American population.

Metabolic syndrome in rheumatoid arthritis patients: Relationship among its clinical components.

BACKGROUND: Metabolic syndrome (MetS) prevalence in rheumatoid arthritis (RA) patients is known to vary considerably across the world. This study aimed to determine the prevalence of MetS in RA patients from western Mexico and to analyze the interrelation of the MetS components with the clinical variables of RA. METHODS: This case-control study included 216 RA patients and 260 control subjects (CS). MetS prevalence was determined according to the NCEP/ATP III and the Latin American Consensus of the Latin American Diabetes Association (ALAD) criteria. RESULTS: MetS was observed in 30.6% RA patients and 33.3% of controls (p > 0.05) according to NCEP/ATP III and 28.7% in RA patients and 31.1% for controls using ALAD criteria. Total cholesterol, LDL-C, and Castelli's I-II indexes were lower in RA (p < 0.001) than in CS. The RA patients with MetS had more swollen joints than those without MetS (p = 0.018). In RA patients with MetS, DAS-28 score correlated with smoking index (rho = 0.4601, p = 0.0004) and VLDL-C (rho = 0.3108, p = 0.0056); similarly, rheumatoid factor (RF) correlated with age (rho = 0.2031, p = 0.0027), smoking index (rho = 0.3404, p < 0.0001), triglycerides (rho = 0.1958, p = 0.0039), and VLDL-C (rho = 0.1761, p = 0.0162). CONCLUSIONS: The MetS prevalence in RA patients from western Mexico is not higher than controls; however, in RA patients with MetS, some inflammatory markers are associated with MetS components; thus, the control of MetS in RA could be beneficial to regulate disease activity.

Validation of semiquantitative FFQ administered to adults: a systematic review.

OBJECTIVE: To conduct a systematic review of studies for the validation of semiquantitative FFQ (SFFQ) that assess food intake in adults. DESIGN: The authors conducted a systematic search in PubMed for articles published as late as January 2020 in Spanish, English, French and Portuguese. Individual searches (twelve in total) paired three hyphenated and non-hyphenated variations of 'semiquantitative food frequency questionnaire' with both 'validity' and 'validation' using the 'all fields' and the 'title/abstract' retrieval categories. Independent extraction of articles was performed by four authors using predefined data fields. SETTING: We searched for original SFFQ validation studies that analysed general diet composition (nutrients with or without food groups or energy analysis) in healthy adults, in any setting, and that also reported correlation coefficients. PARTICIPANTS: Healthy adults. RESULTS: Sixty articles were included. The preferred comparison standard for validation was food records (n 37). The main correlation coefficients used were Pearson's (n 41), and validity coefficients varied from -0·45 to 1. Most correlation coefficients were adjusted by energy (twelve studies presented only crude values). The elements mentioned most frequently were energy, macronutrients, cholesterol, SFA, PUFA, fibre, vitamin C, Ca and Fe. CONCLUSIONS: Although all these SFFQ are reported as validated, coefficients may vary across groups of foods and nutrients. Based on our findings, we suggest researchers to consult our revision before choosing a SFFQ and to review important issues about them, such as their validation, number of items, number of participants, etc. Systematic Review Registration: PROSPERO number CRD42017064716. Available at: http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42017064716.

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.

Validation of a Spanish-Language Questionnaire on Adolescent Eating Behavior Based on Social Cognitive Theory.

OBJECTIVE: To validate a Spanish-language questionnaire on adolescent eating behavior based on Social Cognitive Theory. DESIGN: The validity (reliability and construct validity) of a self-administered questionnaire containing 28 questions with Likert scale-type response options was evaluated. SETTING: School located in Tonala, Jalisco, Mexico (a peri-urban area) with approximately 1,400 students enrolled. PARTICIPANTS: One hundred fifty-two adolescents enrolled in the second year of a middle school in Tonalá, Jalisco, Mexico (mean age, 13.7 years; SD, 0.5 years; 64% female). The retest was completed by 70 adolescents chosen at random. OUTCOME MEASURES AND ANALYSIS: The questionnaire's reliability was measured through internal consistency (Cronbach α) and reproducibility (intraclass correlation coefficient [ICC]). Construct validity was assessed using exploratory factor analysis. RESULTS: Five questions were eliminated from the questionnaire because of a lack of temporal stability (ICC ≤0.4). The exploratory factor analysis was satisfactory for 3 factors (41.89% of variance): environmental facilitators and social support, self-efficacy and self-regulation, and outcome expectations and outcome expectations value. The questionnaire had good internal consistency (α = 0.824) and excellent temporal stability (ICC = 0.849). CONCLUSIONS AND IMPLICATIONS: The results substantiate the reliability and construct validity of this questionnaire. The questionnaire has the potential to use the assessment of Social Cognitive Theory constructs in clinical practice or in nutrition interventions aimed at modifying the eating habits of Spanish-speaking adolescents.

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.

Diseño y validación de la Guía de Salud Integral como una representación gráfica alternativa para las guías alimentarias mexicanas

bjetivo: diseñar y validar una Representación Gráfica (RG) de guía alimentaria mexicana, como alternativa al Plato del Bien Comer" (PBC).Métodos: la nueva RG se diseñó considerando: la revisión de RG internacionales; el análisis, en el ámbito internacional y en México, de la situación epidemiológica y las recomendaciones nutricionales; la identificación de las áreas de oportunidad del PBC. Validación en dos fases: 1) Análisis de contenido sobre la apreciación de los mensajes transmitidos por la Guía de Salud Integral (GSI) entre 19 alumnos universitarios y 41 pacientes de consulta externa. 2) Comparativo de la percepción de los mensajes transmitidos entre GSI y PBC en 28 padres de familia de alumnos de primaria.Resultados: se generó una RG denominada GSI incluyó cuatro grupos dentro del círculo: frutas, verduras, cereales integrales y proteínas saludables. Además, incorporó grasas saludables, agua natural, actividad física y convivencia familiar. La validación muestra que 59,3 % (fase 1) y 60 % (fase 2), identifica que la GSI representa alimentos saludables; 25,4 % (fase 1) y 40 % (fase 2) percibe que la GSI incluye estilos de vida saludables, datos independientes del tipo de población. La GSI obtuvo datos similares al PBC e incluso más favorables en la inclusión de frutas, grasas y agua natural al elaborar un menú ejemplo.Conclusión: la GSI puede ser utilizada como una RG alternativa para facilitar el proceso educativo, la adopción de hábitos alimentarios saludables y de estilo de vida. Puede ser empleada por profesionales de la salud para impactar de manera positiva en la población.

bjective: To design and validate a Graphic Representation (RG) of mexican food guide, as an alternative to "Healthy eating plate" (PBC).Methods: The new RG was designed considering: the revision of international RG; the analysis, at the international level and in Mexico, of the epidemiological status and nutritional recommendations; the identification of the aspects to improve the PBC. Validation in two phases: 1) Content analysis on the evaluation of the messages transmitted by the Full Health Guide (GSI) among 19 university students and 41 outpatients. 2) Comparison of the perception of messages transmitted between GSI and in 28 parents of elementary school students.Results: An RG denominated , was generated; included four groups within the circle: fruits, vegetables, whole grains and healthy proteins. In addition, it incorporated healthy fats, natural water, physical activity and share time with family. Validation shows that 59.3% (phase 1), and 60% (phase 2), identifies GSI as healthy food; 25.4% (phase 1) and 40% (phase 2) perceived that the GSI included healthy lifestyles, data independent of population type. The GSI obtained data similar to the PBC, and even more favorable, in the inclusion of fruits, fats and natural water when elaborating an example menu.Conclusion: GSI can be used as an alternative RG to facilitate the educational process, adoption of healthy eating habits, and lifestyle. It can be used, by health professionals, to positively influence the population.

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.

Validación de un cuestionario autocompletado de hábitos alimentarios para adolescentes, en Jalisco, México / Validation of a questionnaire self-completed of food habits for adolescents, in Jalisco, México

Fundamentos: La evaluación de la calidad de la alimentación en la adolescencia es imprescindible. Existen diferentes métodos, sin embargo, la mayoría son útiles en la práctica clínica y se complica su uso en poblaciones. El objetivo de este estudio fue validar un cuestionario autocompletado de hábitos alimentarios para adolescentes, mediante su aplicación en una población de Jalisco, México. Métodos: El cuestionario fue autocompletado en dos ocasiones por 64 adolescentes de educación secundaria. Se realizó un análisis factorial exploratorio; se evalúo consistencia interna con coeficiente Alfa de Cronbach; se midió la concordancia entre las puntuaciones test-retest por medio de coeficiente de Pearson y coeficiente de Correlación Intraclase; la concordancia entre la clasificación de los hábitos test-retest se evalúo con coeficiente de Spearman y Kappa. Resultados: Todas las variables presentaron carga factorial significativa en sus respectivos componentes. La consistencia interna fue buena para la mayoría de las secciones. Se obtuvieron correlaciones de Pearson razonables y los valores del CCI fueron en su mayoría excelentes. La correlación de Spearman fue moderada y el coeficiente kappa aceptable. Conclusiones: La validación del cuestionario fue satisfactoria. Su utilización en adolescentes permitirá obtener resultados validos y evaluar poblaciones grandes sin invertir excesivos recursos humanos y temporales (AU)

Background: The evaluation of the quality of feeding in adolescence is essential. There are different methods, however, are most useful in clinical practice and use in populations is complicated. The objective of this study was to validate a food habits self-completion questionnaire for adolescents, through its application in a population of Jalisco, Mexico. Methods: The questionnaire was self-completed twice for 64 high school adolescents. Exploratory factor analysis was performed; internal consistency was assessed with Cronbach's Alpha coefficient; the correlation between test-retest scores by Pearson coefficient and intraclass correlation coefficient was measured; the correlation between the classifications of the test-retest habits was assessed with Spearman and Kappa coefficient. Results: All variables presented significant factor loadings in their respective components. Internal consistency was good for most sections. Pearson correlations were obtained fair and ICC values were mostly almost perfect. Spearman correlation was moderate and kappa coefficient was substantial. Conclusions: Validation of the questionnaire was satisfactory. Its use in adolescents will allow obtain valid results and evaluate large populations without investing excessive human and time resources (AU)