Dietary intake of the Mexican population: comparing food group contribution to recommendations, 2012-2016.

OBJECTIVE: To estimate energy contribution (EC) of food groups in 2016, to compare consumption against Mexican Dietary Guidelines, and to examine changes in EC from 2012 to 2016. MATERIALS AND METHODS: We analyzed 24-hour dietary recalls from the 2012 and 2016 National Health and Nutrition Surveys (Ensanut). Foods and beverages were clas-sified into eight food groups: cereals, legumes, dairy, meats, fruit and vegetables, fats and oils, sugar-sweetened beverages, and high in saturated fat and added sugar (HSFAS) products. RESULTS: Cereals had the highest EC (30.1%), followed by meats (15.9%), HSFAS products (15.5%), and SSBs (10.5%). Fruits and vegetables, and legumes had the lowest contribu-tion with 6.4 and 3.8%, respectively. SSBs, meats, and HSFAS products were 250, 59 and 55% above the recommended intake, respectively. CONCLUSIONS: This analysis confirms the need to generate a food environment conducive to a healthier diet.

Dietary intake of the Mexican population: comparing food group contribution to recommendations, 2012-2016 / Ingesta dietética de la población mexicana: contribución de grupos de alimentos vs. recomendaciones, 2012-2016

Abstract: Objective: To estimate energy contribution (EC) of food groups in 2016, to compare consumption against Mexican Dietary Guidelines, and to examine changes in EC from 2012 to 2016. Materials and methods: We analyzed 24-hour dietary recalls from the 2012 and 2016 National Health and Nutrition Surveys (Ensanut). Foods and beverages were classified into eight food groups: cereals, legumes, dairy, meats, fruit and vegetables, fats and oils, sugar-sweetened beverages, and high in saturated fat and added sugar (HSFAS) products. Results: Cereals had the highest EC (30.1%), followed by meats (15.9%), HSFAS products (15.5%), and SSBs (10.5%). Fruits and vegetables, and legumes had the lowest contribution with 6.4 and 3.8%, respectively. SSBs, meats, and HSFAS products were 250, 59 and 55% above the recommended intake, respectively. Conclusions: This analysis confirms the need to generate a food environment conducive to a healthier diet.

Resumen: Objetivo: Estimar la contribución energética (CE) de grupos de alimentos al compararla con las Guías Alimentarias y examinar los cambios de 2012 a 2016. Material y métodos: Se analizaron recordatorios de 24 horas de las Encuestas Nacionales de Salud y Nutrición de 2012 y 2016. Los alimentos y bebidas se clasificaron en ocho grupos: cereales, leguminosas, lácteos, carnes, frutas y verduras, grasas, bebidas azucaradas, y productos altos en grasa saturada y/o azúcares añadidos. Resultados: Los cereales tuvieron la CE más alta (30.1%), seguidos por carnes (15.9%), productos altos en grasa saturada y azúcares añadidos (15.5%) y bebidas azucaradas (10.5%). Frutas y verduras y leguminosas tuvieron la menor CE con 6.4 y 3.8%, respectivamente. Las bebidas azucaradas, carnes y productos altos en grasa saturada y azúcares añadidos superaron en 250, 59 y 55% la recomendación, respectivamente. Conclusión: Este análisis confirma la necesidad de generar un ambiente alimentario que propicie una dieta más saludable.

Tax awareness and perceived cost of sugar-sweetened beverages in four countries between 2017 and 2019: findings from the international food policy study.

BACKGROUND: The public health benefits of sugar-sweetened beverage (SSB) taxes often rely on, among other things, changes to consumer purchases. Thus, perceived cost of SSBs and signalling effects-via awareness of the tax-may impact the effectiveness of SSB taxes on consumer purchases. OBJECTIVE: The study sought to examine perceived cost of SSBs, tax awareness, and changes in beverage purchasing over time and across four countries with and without SSB taxes. METHODS: The study used data from the 2017, 2018 and 2019 waves of the International Food Policy Study. Annual cross-sectional online surveys were conducted in Australia, Mexico, UK and US, which captured perceived cost of SSBs relative to non-SSBs in all countries (with Australia as a no-tax comparator), and measures of tax awareness and participants' reported changes in beverage purchasing in response to SSB taxes in Mexico (tax implemented in 2014), UK (tax implemented in 2018) and US (subnational taxes since 2015). Logistic regression models evaluated the measures across years and socio-demographic groups. RESULTS: Perceived cost of SSBs relative to non-SSBs was higher in Mexico (all three years) and the UK (2018 and 2019 following tax implementation) than Australia and the US. Tax awareness was higher in UK than Mexico, and decreased over time among Mexican respondents. Patterns of reported beverage purchasing changes in response to the tax were similar across Mexico, UK and US, with the largest changes reported by Mexican respondents. Respondents with characteristics corresponding to lower socioeconomic status were less likely to be aware of an SSB tax, but more likely to perceive SSBs to cost more than non-SSBs and report changes in purchasing in response to the tax, where there was one. CONCLUSIONS: This study suggests that in countries where a national SSB tax was present (Mexico, UK), perceived cost of SSBs and tax awareness were higher compared to countries with no SSB tax (Australia) or subnational SSB taxes (US), respectively, and suggests that perceived cost and tax awareness represent distinct constructs. Improving the 'signalling effect' of existing SSB taxes may be warranted, particularly in tax settings where consumer behaviour change is a policy objective.

Mexican households' food shopping patterns in 2015: analysis following nonessential food and sugary beverage taxes.

OBJECTIVE: To examine patterns of taxed and untaxed food and beverage shopping across store types after Mexico's sugary drink and non-essential food taxes, the nutritional quality of these patterns and the socio-economic characteristics associated with them. DESIGN: We performed k-means cluster analyses using households' percentage of food and beverage purchases from each store type (i.e. convenience stores, traditional shops (e.g. bodegas, tiendas, mom-and-pop shops), supermarkets, wholesalers and others). We calculated adjusted mean proportions of taxed and untaxed products (ml or g/capita per d) purchased in each pattern. We studied the associations between households' SES and shopping patterns using multinomial logistic regressions. Within shopping patterns, we obtained mean volumes and proportions of taxed and untaxed food and beverage subgroups and calculated the proportion of products purchased at each store type. SETTING: Mexico. PARTICIPANTS: Urban Mexican households (n 5493) from the Nielsen Mexico Consumer Panel Survey 2015. RESULTS: We found four beverage shopping patterns and three food shopping patterns, driven by the store type where most purchases were made. For beverages, 48 % of households were clustered in the Traditional pattern and purchased the highest proportion of taxed beverages. Low-SES households had the highest probability of clustering in the Traditional beverage shopping pattern. For foods, 35 % of households were clustered into the Supermarket pattern. High-SES households had the highest probability of clustering in the Supermarket food shopping pattern. CONCLUSIONS: The combination of store types where Mexican households purchase packaged foods and beverages varies. However, households in all shopping patterns and SES purchase taxed beverages mainly at traditional stores. Store-level strategies should be developed to intervene on traditional stores to improve the healthfulness of purchases.

[Food contribution to total daily energy intake in the Mexican population older than five years]. / Contribución de los alimentos a la ingesta total de energía en la dieta de los mexicanos mayores de cinco años.

OBJECTIVE: To identifiy the energy contribution (EC) of the food consumed in those older than five years and by sociodemographic characteristics in Mexican population. MATERIALS AND METHODS: We analyzed data from 24-hour recalls from 7 983 subjects ≥5 years included in the Encuesta Nacional de Salud y Nutrición 2012 (Ensanut 2012). The EC to total daily energy intake of 50 foods allocated to eight food groups at national level and stratified by age, area of residence, region and socioeconomic level was estimated. RESULTS: Seven foods contributed 50% of total energy intake: tortilla and corn products (20.6%), sweet bread (6.6%), vegetable oils (4.9%), white bread and wheat products (4.9%), carbonated sugary drinks (4.6%), red meat (4.0%) and whole milk (4.0%). Other foods, which its consumption is recommended to increase due to its positive effects on health, showed minor contributions (less than 1.0%), with the exception of beans (3.3%). Great heterogeneity in intakes was observed between subgroups of the population. CONCLUSIONS: The identification of individual foods and their EC for both, food groups whose consumption should be increased as well as those that should be reduced can be useful for the design of regulatory actions and educational strategies aimed at reducing the diet related burden of disease.

OBJETIVO: Identificar la contribución a la ingesta de energía (CIE) de alimentos consumidos en mayores de cinco años y por características sociodemográficas, en la población mexicana. MATERIAL Y MÉTODOS: Se analizó información del recordatorio de 24 horas de 7 983 sujetos ≥5 años incluidos en la Encuesta Nacional de Salud y Nutrición 2012 (Ensanut 2012). Se estimó la CIE de 50 alimentos clasificados en ocho grupos de alimentos en el ámbito nacional, estratificando por edad, área de residencia, región y nivel socioeconómico. RESULTADOS: Siete alimentos contribuyeron con 50% de la ingesta energética total: tortilla y productos de maíz (20.6%), pan dulce (6.6%), aceites vegetales (4.9%), pan blanco y derivados de trigo (4.9%), bebidas azucaradas carbonatadas (4.6%), carnes rojas (4.0%) y leche entera (4.0%). Otros alimentos, cuyo consumo es recomendable aumentar por sus efectos positivos en salud, mostraron contribuciones menores a 1.0%, con excepción del frijol (3.3%). Se observó gran heterogeneidad en el consumo entre subgrupos de población. CONCLUSIONES: La identificación de los alimentos individuales y su CIE, tanto en grupos de alimentos cuyo consumo se recomienda aumentar, como en aquéllos que se recomienda reducir, puede ser de utilidad para el diseño de acciones regulatorias y estrategias educativas dirigidas a disminuir la carga de enfermedad relacionada con la dieta.

Contribución de los alimentos a la ingesta total de energía en la dieta de los mexicanos mayores de cinco años / Food contribution to total daily energy intake in the Mexican population older than five years

Resumen: Objetivo: Identificar la contribución a la ingesta de energía (CIE) de alimentos consumidos en mayores de cinco años y por características sociodemográficas, en la población mexicana. Material y métodos: Se analizó información del recordatorio de 24 horas de 7 983 sujetos ≥5 años incluidos en la Encuesta Nacional de Salud y Nutrición 2012 (Ensanut 2012). Se estimó la CIE de 50 alimentos clasificados en ocho grupos de alimentos en el ámbito nacional, estratificando por edad, área de residencia, región y nivel socioeconómico. Resultados: Siete alimentos contribuyeron con 50% de la ingesta energética total: tortilla y productos de maíz (20.6%), pan dulce (6.6%), aceites vegetales (4.9%), pan blanco y derivados de trigo (4.9%), bebidas azucaradas carbonatadas (4.6%), carnes rojas (4.0%) y leche entera (4.0%). Otros alimentos, cuyo consumo es recomendable aumentar por sus efectos positivos en salud, mostraron contribuciones menores a 1.0%, con excepción del frijol (3.3%). Se observó gran heterogeneidad en el consumo entre subgrupos de población. Conclusión: La identificación de los alimentos individuales y su CIE, tanto en grupos de alimentos cuyo consumo se recomienda aumentar, como en aquéllos que se recomienda reducir, puede ser de utilidad para el diseño de acciones regulatorias y estrategias educativas dirigidas a disminuir la carga de enfermedad relacionada con la dieta.

Abstract: Objetive: To identifiy the energy contribution (EC) of the food consumed in those older than five years and by sociodemographic characteristics in Mexican population. Materials and methods: We analyzed data from 24-hour recalls from 7 983 subjects ≥5 years included in the Encuesta Nacional de Salud y Nutrición2012 (Ensanut 2012). The EC to total daily energy intake of 50 foods allocated to eight food groups at national level and stratified by age, area of residence, region and socioeconomic level was estimated. Results: Seven foods contributed 50% of total energy intake: tortilla and corn products (20.6%), sweet bread (6.6%), vegetable oils (4.9%), white bread and wheat products (4.9%), carbonated sugary drinks (4.6%), red meat (4.0%) and whole milk (4.0%). Other foods, which its consumption is recommended to increase due to its positive effects on health, showed minor contributions (less than 1.0%), with the exception of beans (3.3%). Great heterogeneity in intakes was observed between subgroups of the population. Conclusions: The identification of individual foods and their EC for both, food groups whose consumption should be increased as well as those that should be reduced can be useful for the design of regulatory actions and educational strategies aimed at reducing the diet related burden of disease.

The caloric and sugar content of beverages purchased at different store-types changed after the sugary drinks taxation in Mexico.

BACKGROUND: Following the 2014 sugary drinks tax implementation in Mexico, promising reduction in the volume of purchases of taxed beverages were observed overall and at different store-types. However, the tax's effects on purchasing patterns of calories and sugar remain unclear. METHODS: Using longitudinal data from Mexican households (n = 7038), we examined changes in volume, calories and total sugar of packaged beverages purchased from 2012 to 2016 overall and by store-type. We used fixed effects models to estimate means for volume, calories, and sugar of households. To address the potential selectivity from households shopping at different stores, we calculated inverse probability weights to model the purchases changes over time by store-type. RESULTS: For taxed beverages, the volume of purchases declined by - 49 ml and -30 ml in the first year and second year post tax (2014 and 2015, respectively), while purchases leveled off in the third year of the tax (2016). Calories and sugar from taxed beverage purchases decreased over time, with the majority of the declines occurring in the first two years post-tax implementation. The volume of untaxed beverage purchases increased, whereas changes in calories and total sugar of untaxed beverages were minimal. Store level purchases of taxed beverages significantly decreased in the first two years post taxation (2014 and to 2015) only in supermarkets and traditional stores. The steepest declines in purchases of taxed beverages in 2014 were observed at supermarkets (- 40 ml or - 45%). The volume of purchases of untaxed beverages increased over time in almost all store-types, while calories and sugar minimally decreased over time. CONCLUSION: Although the Mexican tax on SSBs has lowered the purchases of sugary drinks 3 years after the tax implementation, the tax should be strengthened and store-specific interventions should be implemented to further reduce SSBs purchases in the Mexican population.

Improvements in the nutritional quality of US young adults based on food sources and socioeconomic status between 1989-1991 and 2011-2014.

BACKGROUND: Fast food and other away from home food sources are linked with poorer diet quality and adverse health outcomes. The diet quality of young adults, major consumers of fast food, is understudied in terms of long-term shifts based on food sources for key subpopulation disparities. METHODS: The study included young adults ages 18-39 (n = 8012) from the Continuing Survey of Food Intakes by Individuals 1989-1991 (n = 4217) and the National Health and Nutrition Examination Survey 2011-2012 and 2013-2014 (n = 3795). We stratified individuals based on their combination of food sources, race/ethnicity, and socioeconomic status. Using 24-h dietary recall data, we measured diet quality with the Healthy Eating Index-2015 (HEI-2015). Differences in diet quality were determined using 95% confidence intervals. RESULTS: Overall, diet quality increased across all food sources between the 1989-1991 and 2011-2014 surveys. The restaurant category overtook the at home category as the healthiest food source, while the fast food category remained the unhealthiest on days it was consumed. Vegetable intake decreased, while added sugar intake increased across all sources. Non-Hispanic whites and non-Hispanic blacks experienced similar increases in HEI-2015 scores across all food sources except restaurants, while Mexican American diet quality remained unchanged. Although all income levels experienced an increase in diet quality, the disparity between low- and high-income groups increased considerably. CONCLUSIONS: US young adults consume healthier foods from all food sources, however, fast food consumers have significantly lower quality in the remainder of their diets. Additionally, Mexican Americans and low-income individuals emerge as high-risk groups for poor diet quality.

Mexican Households' Purchases of Foods and Beverages Vary by Store-Type, Taxation Status, and SES.

Where people shop for food is often linked to the healthiness of food purchases. In Mexico, no research has examined the connection between where people shop, what they buy, and their socioeconomic status (SES). Mexico's sugary beverage and junk food taxes have made households decrease purchases of taxed products. However, whether households have changed where they shop is unknown. To address this gap, we use a repeated cross-sectional analysis of household packaged food and beverage purchases from the Nielsen Mexico Consumer Panel Survey from 2012 to 2015 (n > 5500 households). We examine changes in the volume of the purchase of taxed and untaxed products from different store-types (i.e., convenience stores, supermarkets, traditional retailers, wholesalers, home water-delivery, and others) by SES using multivariate linear regression models. Results show that high-SES households purchased more foods and beverages at all store-types except for low-SES who purchased the most foods and taxed beverages at traditional retailers. Purchases of taxed foods and beverages from traditional retailers significantly decreased for low-SES and middle-SES households and from supermarkets for middle-SES and high-SES households. Purchases of untaxed beverages from wholesalers significantly increased for middle-SES households and from convenience stores for high-SES households. Our findings suggest that consumers choose different stores to purchase beverages than to purchase foods and that taxes may have differentially affected each store-type.

Energy, added sugar, and saturated fat contributions of taxed beverages and foods in Mexico.

OBJECTIVE: To estimate the dietary contribution of taxed beverages and foods. MATERIALS AND METHODS: Using 24-hour diet recall data from the Ensanut 2012 (n=10 096), we estimated the contribution of the items which were taxed in 2014 to the total energy, added sugar, and saturated fat intakes in the entire sample and by sociodemographic characteristics. RESULTS: The contributions for energy, added sugar, and saturated fat were found to be 5.5, 38.1, and 0.4%, respectively, for the taxed beverages, and 14.4, 23.8, and 21.4%, respectively, for the taxed foods. Children and adolescents (vs. adults), medium and high socioeconomic status (vs. low), urban area (vs. rural), and North and Center region (vs. South) had higher energy contribution of taxed beverages and foods. The energy contribution was similar between males and females. CONCLUSIONS: These taxes covered an important proportion of Mexicans' diet and therefore have the potential to improve it meaningfully.

Energy, added sugar, and saturated fat contributions of taxed beverages and foods in Mexico / Contribución de energía, azúcar añadido y grasa saturada de las bebidas y alimentos con impuesto en México

Abstract: Objective: To estimate the dietary contribution of taxed beverages and foods. Materials and methods: Using 24-hour diet recall data from the Ensanut 2012 (n=10 096), we estimated the contribution of the items which were taxed in 2014 to the total energy, added sugar, and saturated fat intakes in the entire sample and by sociodemographic characteristics. Results: The contributions for energy, added sugar, and saturated fat were found to be 5.5, 38.1, and 0.4%, respectively, for the taxed beverages, and 14.4, 23.8, and 21.4%, respectively, for the taxed foods. Children and adolescents (vs. adults), medium and high socioeconomic status (vs. low), urban area (vs. rural), and North and Center region (vs. South) had higher energy contribution of taxed beverages and foods. The energy contribution was similar between males and females. Conclusions: These taxes covered an important proportion of Mexicans' diet and therefore have the potential to improve it meaningfully.

Resumen: Objetivo: Estimar la contribución dietética de las bebidas y alimentos con impuesto. Material y métodos: Con el recordatorio de 24-horas de la Ensanut 2012 (n=10 096), estimamos la contribución de los productos con impuesto en 2014 al consumo total de energía, azúcar añadido y grasa saturada en toda la muestra y por sociodemográficos. Resultados: La contribución de energía, azúcar añadido y grasa saturada fue 5.5, 38.1 y 0.4%, respectivamente, para bebidas con impuesto y 14.4, 23.8 y 21.4%, respectivamente, para alimentos con impuesto. Los niños y adolescentes (vs. adultos), nivel socioeconómico medio y alto (vs. bajo), área urbana (vs. rural), y región Norte y Centro (vs. Sur) tuvieron una contribución de energía mayor de bebidas y alimentos con impuesto. La contribución fue similar entre hombres y mujeres. Conclusión: Estos impuestos cubren una proporción importante de la dieta mexicana y por lo tanto tienen el potencial de mejorarla de manera relevante.

Adapting the standardised computer- and interview-based 24 h dietary recall method (GloboDiet) for dietary monitoring in Latin America.

OBJECTIVE: The present study describes the procedure and approaches needed to adapt and harmonise the GloboDiet methodology, a computer- and interview-based 24 h dietary recall, for use in two Latin American pilot countries, Brazil and Mexico. DESIGN: About seventy common and country-specific databases on foods, recipes, dietary supplements, quantification methods and coefficients were customised and translated following standardised guidelines, starting from existing Spanish and Portuguese versions. SETTING: Brazil and Mexico. SUBJECTS: Not applicable. RESULTS: New subgroups were added into the existing common food classification together with new descriptors required to better classify and describe specific Brazilian and Mexican foods. Quantification methods were critically evaluated and adapted considering types and quantities of food consumed in these two countries, using data available from previous surveys. Furthermore, the photos to be used for quantification purposes were identified for compilation in country-specific but standardised picture booklets. CONCLUSIONS: The completion of the customisation of the GloboDiet Latin America versions in these two pilot countries provides new insights into the adaptability of this dietary international tool to the Latin American context. The ultimate purpose is to enable dietary intake comparisons within and between Latin American countries, support building capacities and foster regional and international collaborations. The development of the GloboDiet methodology could represent a major benefit for Latin America in terms of standardised dietary methodologies for multiple surveillance, research and prevention purposes.

Discretionary Foods Have a High Contribution and Fruit, Vegetables, and Legumes Have a Low Contribution to the Total Energy Intake of the Mexican Population.

BACKGROUND: Overweight and obesity prevalences in Mexico are among the highest in the world, with dietary factors being the third-leading category of risk contributing to the burden of disease. Consequently, studying the compliance of the Mexican population to food-based dietary recommendations is essential for informing nutritional policies. OBJECTIVES: We described the energy contribution of food groups to total dietary energy intake of the Mexican population and by sociodemographic subgroups and compared these results with Mexican dietary recommendations. METHODS: Twenty-four-hour dietary recalls for participants aged ≥5 y (n = 7983) from the 2012 Mexican National Health and Nutrition Survey were used. Foods and beverages were classified into 8 groups (the first 6 were called "basic foods" and the last 2 "discretionary foods"), as follows: 1) cereals, 2) legumes, 3) milk and dairy, 4) meat and animal products, 5) fruit and vegetables, 6) fats and oils, 7) sugar-sweetened beverages (SSBs), and 8) products high in saturated fat and/or added sugar (HSFAS). Recommendations were based on the Mexican Dietary Guidelines (MDG). Energy contributions from the food groups by age, sex, region, residence (rural or urban), and socioeconomic status (SES) were estimated. RESULTS: The highest contribution to total energy intake came from cereals (33%) followed by HSFAS (16%), meat and animal products (14%), and SSBs (9.8%). Fruit and vegetables (5.7%) and legumes (3.8%) had the lowest contribution. Energy contribution of several food groups differed significantly between population subgroups. Overall, discretionary foods contributed more than one-quarter of total energy intake (26%) and were 13 percentage points above the maximum allowed by the recommendations, whereas the intakes of legumes and fruit and vegetables were much lower than recommended. CONCLUSIONS: Our results show the need to generate a food environment conducive to a healthier diet in the Mexican population.

Overview of the Dietary Intakes of the Mexican Population: Results from the National Health and Nutrition Survey 2012.

BACKGROUND: Mexico is facing the double burden of malnutrition: stunting and micronutrient deficiencies in young children, iron deficiency in pregnant women, and widespread obesity across age groups. OBJECTIVE: The aim was to summarize and discuss findings published in this supplement on dietary intakes and the eating habits of the Mexican population. METHODS: A 24-h recall questionnaire that used the multiple-pass method with a repeated measure in a fraction of the sample was applied in a nationally representative sample. We estimated mean intakes and percentages of inadequacy for macronutrients and micronutrients; mean intakes and percentages of the population who adhere to dietary recommendations for food groups; sources of added sugars; intakes of discretionary foods by mealtime, place, and activity; and mean dietary intakes in children <2 y old. RESULTS: Infant formula was consumed by almost half of infants aged <6 mo and sugar-sweetened beverages were consumed by two-thirds of children aged 12-23 mo. In the different age groups, a high proportion of the population had excessive intakes of added sugars (58-85%) and saturated fats (54-92%), whereas a high prevalence of insufficient intakes was found for fiber (65-87%), vitamin A (8-70%), folates (13-69%), calcium (26-88%), and iron (46-89%). Discretionary foods (nonbasic foods high in saturated fats and/or added sugars) contributed 26% of the population's total energy intake, whereas only 1-23% met recommendations for legumes, seafood, fruit, vegetables, and dairy foods. CONCLUSIONS: High proportions of Mexicans consume diets that do not meet recommendations. Breastfeeding and complementary feeding diverged from recommendations, intakes of discretionary foods were high, and the prevalence of nutrient inadequacies and age groups not meeting intake recommendations of basic food groups were also high. The results are consistent with the high prevalence of the double burden of malnutrition and are useful to design food and nutrition policies.

Adherence to Dietary Recommendations for Food Group Intakes Is Low in the Mexican Population.

BACKGROUND: Given the high prevalence of obesity and noncommunicable diseases in Mexico and the key role of dietary quality in these conditions, it is important to determine Mexicans' adherence to dietary recommendations. OBJECTIVE: Our aim was to estimate the percentage of the Mexican population who adhere to dietary recommendations for key food groups. METHODS: We analyzed 7983 participants aged ≥5 y from the nationally representative Mexican National Health and Nutrition Survey 2012. Dietary intake data were collected by using one 24-h recall and a repeated 24-h recall in 9% of the sample. We used the National Cancer Institute method for episodically consumed foods, which uses a 2-part (probability and amount) mixed regression model to estimate the usual intake distribution and its association with sociodemographic variables. RESULTS: For the food groups that are encouraged, only 1-4% of the population (range across sex and age groups) reached the recommended intake of legumes, 4-8% for seafood, 7-16% for fruit and vegetables, and 9-23% for dairy. For food groups that are discouraged, only 10-22% did not exceed the recommended upper limit for sugar-sweetened beverages, 14-42% for high saturated fat and/or added sugar (HSFAS) products, and 9-50% for processed meats, whereas the majority (77-93%) did not exceed the limit for red meat. A lower proportion of adolescents than children and adults adhered to recommendations for several food groups. Participants with higher socioeconomic status (SES) and living in urban areas consumed more (probability of consuming and/or amount consumed) fruit and vegetables, dairy, and HSFAS products, but they consumed fewer legumes than those of lower SES and living in rural areas. CONCLUSIONS: These results reveal the poor dietary quality of the Mexican population and the urgent need to shift these habits. If current intakes continue, the burden of disease due to obesity and noncommunicable chronic diseases will likely remain elevated in the Mexican population.

The double burden of undernutrition and excess body weight in Mexico.

BACKGROUND: In Mexico, stunting and anemia have declined but are still high in some regions and subpopulations, whereas overweight and obesity have increased at alarming rates in all age and socioeconomic groups. OBJECTIVE: The objective was to describe the coexistence of stunting, anemia, and overweight and obesity at the national, household, and individual levels. DESIGN: We estimated national prevalences of and trends for stunting, anemia, and overweight and obesity in children aged <5 y and in school-aged children (5-11 y old) and anemia and overweight and obesity in women aged 20-49 y by using the National Health and Nutrition Surveys conducted in 1988, 1999, 2006, and 2012. With the use of the most recent data (2012), the double burden of malnutrition at the household level was estimated and defined as the coexistence of stunting in children aged <5 y and overweight or obesity in the mother. At the individual level, double burden was defined as concurrent stunting and overweight and obesity in children aged 5-11 y and concurrent anemia and overweight or obesity in children aged 5-11 y and in women. We also tested if the coexistence of the conditions corresponded to expected values, under the assumption of independent distributions of each condition. RESULTS: At the household level, the prevalence of concurrent stunting in children aged <5 y and overweight and obesity in mothers was 8.4%; at the individual level, prevalences were 1% for stunting and overweight or obesity and 2.9% for anemia and overweight or obesity in children aged 5-11 y and 7.6% for anemia and overweight or obesity in women. At the household and individual levels in children aged 5-11 y, prevalences of double burden were significantly lower than expected, whereas anemia and the prevalence of overweight or obesity in women were not different from that expected. CONCLUSIONS: Although some prevalences of double burden were lower than expected, assuming independent distributions of the 2 conditions, the coexistence of stunting, overweight or obesity, and anemia at the national, household, and intraindividual levels in Mexico calls for policies and programs to prevent the 3 conditions.