Liver diseases in Mexico and their associated mortality trends from 2000 to 2007: A retrospective study of the nation and the federal states.

INTRODUCTION: Liver disease is a major health issue in Mexico. Although several studies have been performed to analyze the impact of liver diseases on the Mexican population, none has compared the prevalence and impact of liver disease between states within Mexico. AIM: To analyze trends in mortality associated with liver diseases from 2000 to 2007 at the national and state levels. METHODS: Data was obtained from the Ministry of Health (number of deaths) and the National Population Council (CONAPO) (population at risk) and mortality rates were analyzed using statistical software. RESULTS: Mortality due to viral hepatitis, liver tumors, and cirrhosis increased over the study period. Alcohol-related mortality decreased but was still the main cause of liver-related deaths. Viral hepatitis infection occurred predominantly in the northern states and liver tumors occurred predominantly in the central region. Alcohol-related deaths were elevated along the Pacific shoreline and deaths associated with cirrhosis occurred mainly in the central and southern states. CONCLUSION: Incidence of liver-related mortality has increased and will continue to do so in the future.

The relationship of overweight and obesity to high mortality rates from liver cirrhosis in Mexico.

BACKGROUND & AIM: Liver cirrhosis continues to be an important cause of death in Mexico. Some data suggest that being overweight is a risk factor for chronic liver disease. The aim of this study was to assess the link between the incidences of being overweight or obese and mortality from liver cirrhosis in Mexico during the period 1990-2001. METHODS: We designed and conducted an ecological study of trends with multiple comparisons of regions of Mexico (North, Central, Mexico City, and South). We built the time trends according to the mortality rates of liver cirrhosis reported by the System of Vital Statistics (Health Ministry) in each state for each year from 1990 to 2001. The information on prevalences of overweight (body mass index (BMI) = 25-29.9) and obesity (BMI >/= 30) was from two national surveys (1993 and 2000). RESULTS: The analysis of mortality trends in liver cirrhosis by region showed an increase in the risk of death across time. This risk was considerably higher for the South Region (beta = 1.03, p <0.0001). The mortality rates remained higher than 30 per 100,000 inhabitants. When we selected the three states with the highest mortality rates for each region, the most significant changes in the trends were in the North and South regions (beta = 0.75, p <0.0001 and beta = 1.29, p <0.0001, respectively). In addition, the prevalence of overweight in the four regions increased from 1993 to 2000 (percentage change, 10.2-48.2). Obesity was most prevalent in the North and South regions in 1993. CONCLUSION: Our observations support the hypothesis that obesity might play an important role in the risk of developing liver cirrhosis.

Questinnaire assessment of antioxidants and retinol intakes in mexican women

Background. In order to assess intake of antioxidants and retinol, we evaluated the valid ity and reproducibility of a semiquantitative food frequency questionnaire. Methods. Data were collected from 110 women, aged 15-54 years, who resided in the southern part of Mexico City. Study participants were asked to complete the food frequency questionnaire before and after completing four series of 4 days of 24-h diet recalls. We obtained the 24-h recalls at 3-month intervals designed to account for seasonal variability. In addition, we measured serum blood levels of retinol and various carotenoids at 3 and 9 months baseline. Results. Intraclass correlation coefficients for intake of energy-adjusted daily nutrients, assessed by the questionnaires 1 year apart ranged from 0.23 for lutein/zaezanthin to 0.50 for total carotenes. Correlation coefficients between energy-adjusted nutrient intakes were measured by means of the sixteen 24-h dietary recalls, and the second questionnaire ranged from 0.09 for lutein/zexanthin to 0.45 for total carotenes. The correlations were higher after adjusting for day-to-day variations in diets ranging from 0.11 for lutein/zeaxanthin to 0.49 for vitamin C. Correlation coefficients between intake and biochemical measures were 0.32 for alpha-carotene, 0.34 for beta-carotene, and 0.40 for total carotene after adjustinf for age, body mass index, cholesterol and triglyceride plasma levels, smoking status, and caloric intake. Conclusions. These data support the ability of our food frequency questionnaire to provide valid information on the relative antake of these nutrients and to confirm its usefulness in epidemiological studies of diet-disease relations. However, its application outside Mexico City or in different age or gender populations will require additional modifications and validation efforts

Consumption of dietary fiber in rural Mexico.

The average per capita intake of dietary fibre and the relative contribution of different foods to its intake in the Mexican rural population was studied. Food consumption data were obtained from the National Nutrition Surveys of 1979 (21,248 families in 219 rural Mexican communities), and from a similar survey of the same communities in 1989 (20,759 families). Average per capita intake of total dietary fibre (TDF) ranged from 19.8 to 34.0 g/d (average 27.2 ± 3.3) in 1979 and from 17.5 to 27.1 g/d (average 22.5 ± 2.2) in 1989. About 13% of TDF in both surveys was contributed by soluble dietary fibre. Of the 19 regions of the country, 18 exhibited a significant reduction in TDF intake from 1979 to 1989 (p < 0.001). With the exception of two regions on the northern border, maize was the major single source of TDF (from 31 to 74% of TDF). The implication of these observations on disease patterns needs to be studied.

Vigilancia del crecimiento de los niños / Surveillance of growth in children

En este trabajo se plantea III necesidad de organizar un Sistema de Vigilancia Epidemiológica de la Nutrición (SMN) y se discute su implementación a través de un Programa Integrado para la Atención Nutricional Regional, cuyo principal antecedente es el Paquete de Detección- Atención. Este Paquete consiste de un conjunto de elementos de diagnóstico, medidas preventivas y acciones correctivas sencillas y de bajo costo que inciden en el corto plazo, enla Ireducción de los morbi-mortalidad por desnutrición y, en el largo plazo, en Ia mejoría de los patrones de crecimiento. Las medidas propuestas son el resultado de la experiencia acumulada del INNS:Z. en Chiapas y han demostrado su efectividad en la práctica. Estas acciones, dirigidas al núcleo familiar, dan prioridad a los grupos más vulnerables (mujeres embarazadas y lactantes, y preescolares). Se recomiendan también sistemas de apoyo que aseguren el éxito de los programas, como la capacitación del personal, y el uso de sistemas de información, registro y mecanismos de evaluación.