Sex and Body Mass Index differences after one-year follow-up of an eating disorders risk factors universal prevention intervention in university students in Mexico City / Diferencias por sexo e índice de masa corporal a un año de seguimiento de una intervención de prevención universal para disminuir factores de riesgo para los trastornos de la conducta alimentaria en estudiantes universitarios de la Ciudad de México

Abstract Introduction Interventions based on cognitive dissonance theory are the most effective for preventing eating disorders. Objective To identify the changes at one year follow-up of a universal prevention intervention in disordered eating behaviors (DEB), thin-ideal internalization (TII), and drive for muscularity (DM). Method A pre-experimental, pretest-posttest study was conducted on 602 university student subjects (76.1% women and 23.9% men) with an average age of 20.74 years at a public (30.6%) and a private university (69.4%) in Mexico City. A Split Plot ANOVA was performed with the intrasubject variable equal to each measurement (pretest, posttest, and follow-up), as well as the sex and body mass index (BMI) intersubject variables to analyze whether there was a significant interaction between these variables and the changes in dependent variables, as well as the changes through each measurement by group. Results In the intrasubject analyses, statistically significant differences were found for DEB through the various measurements, without taking the interactions into account. Statistically significant interactions were observed between each measurement and BMI, and between each measurement and sex and BMI for the DM variable. Discussion and conclusion Since a reduction of TII in women and DM in men was achieved, together with a decrease in DEB in women, the workshop can be said to have fully achieved its objectives for women and partly so for men.

Resumen Introducción Las intervenciones basadas en la teoría de la disonancia cognoscitiva son las más efectivas para la prevención de los trastornos de la conducta alimentaria. Objetivo Conocer los cambios a un año de seguimiento de una intervención de prevención universal en las conductas alimentarias de riesgo (CAR), interiorización del ideal estético de la delgadez (IED) y la motivación por la musculatura (MM). Método Se llevó a cabo un estudio pre-experimental pretest-postest en 602 (76.1% mujeres y 23.9% hombres) sujetos estudiantes universitarios con una edad promedio de 20.74 años en una universidad pública (30.6%) y una privada (69.4%) de la Ciudad de México. Se realizó un ANOVA split plot con la variable intrasujetos igual a cada medición (pretest, postest y seguimiento) así como el sexo y el índice de masa corporal (IMC) variables intersujetos, para analizar si existía una interacción significativa entre dichas variables y los cambios sobre las variables dependientes, así como los cambios a través de cada medición por grupo. Resultados en los análisis intrasujetos se encontraron diferencias estadísticamente significativas para las CAR a través de las distintas mediciones, sin tomar en cuenta las interacciones. Se observaron interacciones estadísticamente significativas entre cada medición y el IMC, y entre cada medición con el sexo y el IMC para la variable MM. Discusión y conclusión Se logró la reducción de la IED en las mujeres y de la MM en los hombres, así como la disminución de las CAR en las mujeres por lo que se considera que el taller logra sus objetivos para las mujeres y parcialmente para los varones.

Validation of a new screening questionnaire for disordered eating behaviors in men.

PURPOSE: The aim of this study was to develop an instrument to identify disordered eating behaviors (DEB) in college men (hereafter, DEBM-Q). METHODS: A two-stage project consisting of a diagnostic scale construction (n1 = 9 for interviews, n2 = 9 for cognitive laboratory) and a validation study with a cross-sectional sample (N = 570) was carried out. Both semi-structured interviews and a cognitive laboratory with nine participants were conducted to obtain DEBM-Q items. DEBM-Q was applied to 570 freshmen male in Mexico City. Psychometric characteristics and internal consistency (Cronbach's alpha) were analyzed. An item-total correlation value greater than 0.30 was determined, and factor loads greater than 0.40 were considered valid. Exploratory factor analysis (EFA, n1 = 297) and confirmatory factor analysis (CFA, n2 = 273) were performed. RESULTS: Two fixed factors explaining 55.08% of the total variance were extracted. Factor 1, "Drive for Thinness" (8 items), explained 30.84% of the variance, whereas factor 2, "Drive for Muscularity" (8 items), explained 24.23% of the variance. Cronbach's alpha for the whole questionnaire was 0.84. DEBM-Q was correlated with the Dutch Food Restriction Scale (RS) (r = 0.52, p < 0.001), Eating Disorder Examination-Questionnaire (EDE-Q) (r = 0.46, p < 0.001), Emotional Eating Scale (EES) (r = 0.18, p < 0.001), and Negative Affect Subscale (PANAS-X) (r = 0.11, p < 0.005). CONCLUSION: DEBM-Q is a valid and practical short screening tool (16 items) allowing early identification of disordered eating in young men, thereby facilitating clinical management. LEVEL OF EVIDENCE: Level V: Opinions of authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

Sensitivity, specificity, and cut-off points in the Brief Questionnaire for Measuring Disordered Eating Behaviors in Mexican Women.

BACKGROUND: Evidence suggests that disordered eating behaviors can result in eating disorders, which is already a reality for the Mexican population, representing an increasingly complex public health problem. Early detection is therefore essential. AIM OF THE STUDY: To obtain the sensitivity, specificity, and cut-off points of the Brief Questionnaire for Measuring Disordered Eating Behaviors to identify eating disorders in Mexican women. METHODS: The Eating Disorders Examination-Questionnaire and the Brief Questionnaire for Disordered Eating Behaviors were applied to patients diagnosed with eating disorders at two public health institutions and university students. ROC analysis was performed to determine sensitivity, specificity, predictive values, and cut-off points. RESULTS: Three cut-off points were obtained: first: eight points (Sensitivity = 60.7%, Specificity = 92.2%), showing low risk; second: 11 points (sensitivity = 24.1%; specificity = 98.9%), detecting moderate risk; and, finally, 15 points and over (sensitivity = 4.46%; specificity = 100%), indicating high risk. CONCLUSIONS: The instrument adequately identifies those individuals who are not at risk for eating disorders, making it possible to channel prevention efforts towards those who do have DEB, thus optimizing resources. LEVEL OF EVIDENCE: Level III: case-control analytic study.

Dissonance-based Program for Eating Disorders Prevention in Mexican University Students / Un programa de prevención de los trastornos de la conducta alimentaria basado en la técnica de disonancia cognitiva en alumnos universitarios mexicanos

The purpose of this study was to identify changes in the risk of eating disorders after a one-year follow-up of a dissonance-based eating disorders prevention program. The Body Project was implemented in a sample of male and female university students: 133, 110, and 74 at baseline, post-test, and follow-up respectively, and we tested the change in disordered eating behaviors (DEB) over time, and by levels of variables that according to the theoretical model lie on the path between the intervention and DEB, with one-way MANOVA analyses of repeated measures for the associations between internalization of the esthetic thin ideal, depressive symptoms, and DEB. The average value of DEB was 5.23 at pre-test, 3.45 at post-test, and 2.80 at follow-up. The model with DEB at each time point, as dependent variables, and internalization of the esthetic thin ideal and depressive symptoms, as independent variables, showed a significant effect of internalization of the esthetic thin ideal, F(2, 136) = 7.66, p = .0011, while there was no significant effect of depressive symptoms, F(2, 136) = 0.45, p = .6191, indicating that the intervention exerted its effect on DEB via the former variable. The intervention proved to produce effects after a one-year follow-up. These findings support the implementation of universal prevention programs using dissonance-based techniques

El objetivo de este trabajo fue identificar los cambios en el riesgo de desarrollar trastornos de la conducta alimentaria después de un año de seguimiento de un programa de prevención basado en la técnica de la disonancia cognitiva para trastornos de la conducta alimentaria. El Body Project fue implementado en una muestra de estudiantes universitarios, hombres y mujeres: 133, 110 y 74 en el pre-test, post-test y seguimiento, respectivamente. Se comprueba el cambio en las conductas alimentarias de riesgo (CAR) a lo largo del tiempo y según las variables que, de acuerdo con el modelo teórico, se encuentran entre la intervención y las CAR, con un análisis MANOVA de medidas repetidas para las asociaciones entre interiorización del ideal estético de delgadez, los síntomas depresivos y las CAR. El valor promedio de las CAR en el pre-test fue 5.23, 3.45 en el post-test y 2.80 en el seguimiento. El modelo de las CAR como variable dependiente e interiorización del ideal estético de delgadez y los síntomas depresivos como variables independientes mostró un efecto significativo de la internalización del ideal estético de delgadez, F(2, 136) = 7.66, p = .0011, mientras que no hubo un efecto significativo de los síntomas depresivos, F(2, 136) = 0.45, p = .6191, lo que indica que la intervención tuvo un efecto en las CAR por vía de la variable antecedente. Se mostró que la intervención produce efectos después de un año de seguimiento. Este hallazgo sustenta la implementación de programas universales de prevención que utilicen la técnica de disonancia cognoscitiva

Effect of parental criticism on disordered eating behaviors in male and female university students in Mexico City.

PURPOSE: The aim of this study was to analyze the effect of parental criticism of their offspring's bodies in the development of disordered eating behaviors (DEBs) in university students in Mexico City. METHODS: A sample of 892 freshmen (502 women and 390 men) was included. The prevalence of the internalization of the aesthetic thin ideal, body dissatisfaction, self-esteem, depressive symptoms, and body mass index was estimated by sex. For each sex, the effect of parental criticism on DEBs, together with that of the other covariates, was measured through ordinal regression models. RESULTS: It was found that women received more criticism from their mothers than men. Among the participants, the likelihood of DEBs is increased in the presence of criticism from both parents (OR = 2.5), criticism from the mother alone (OR = 2.0), overweight (OR = 1.7), obesity (OR = 2.1), wanting a slimmer body (OR = 8.3), and depressive symptoms (OR = 3.3). Among men, this risk is increased in the presence of criticism from both parents (OR = 2.7), being obese (OR = 2.4), wanting a slimmer body (OR = 3.4), and depressive symptoms (OR = 2.8). CONCLUSIONS: It is essential to include issues linked to parental criticism of their bodies in interventions to prevent eating disorders in college students. Level of evidence V, cross-sectional descriptive study.

Validation of eating disorders examination questionnaire in Mexican women.

BACKGROUND: Efficient assessment of eating disorders (ED) is indispensable for research and clinical practice in Mexico. One of the most commonly used questionnaires, the EDE-Q, has a self-applicable questionnaire format with 28 questions and four subscales drawn from the Eating Disorder Examination (EDE), a semistructured interview developed to evaluate the specific symptomatology of eating disorders. OBJECTIVE: Obtain the factorial structure and construct validity of the EDE-Q questionnaire in Mexican women. METHOD: The language in the EDE-Q was adapted. It was applied to university students (N = 330) and a sample of patients with ED (N = 165) from two ED outpatient treatment services. The anthropometric data of the participants was obtained. Internal consistency was explored using the Cronbach's Alpha coefficient and a confirmatory factor analysis was conducted by group. RESULTS: Cronbach's alpha was 0.9 for the full scale in all groups, while the reliability of each of the subscales fluctuated between 0.8 and 0.9. Confirmatory factor analysis showed that the fit of the seven-item model in three factors was better than that of the original 22-item one and that of the eight-item model for one factor. CONCLUSIONS: This study provides information supporting the seven-item and three-factor version, rather than the original or eight-item versions of the EDE-Q. In the future, the adapted version of the EDE-Q will make it possible to draw comparisons between Mexican samples in other socio-cultural contexts. Future research is required to continue refining the instruments to achieve more representative results from the general ED population.

Variables associated with disordered eating behaviors among freshman students from Mexico City.

OBJECTIVE:: To estimate the prevalence of disordered eating behaviors (DEB) and identify their associations with demographic and psychological variables among freshman students at a public university in Mexico City. MATERIALS AND METHODS:: A sample of 892 subjects participated in the study. Bivariate and multinomial models were performed to determine associations between DEB and covariates. RESULTS:: Of those surveyed, 6.8% of the women and 4.1% of the men exhibited DEB (p<0.05). The variables increasing the risk of eating disorders (ED) for women were internalization of the aesthetic thin ideal (IATI), body mass index (BMI), self-esteem and physical activity, while for men they were IATI, drive for muscularity, and self-esteem. CONCLUSIONS:: The frequency of DEB among women and men and the internalization of the thin ideal in both sexes suggest the possibility of a change in the precursor conditions for eating disorders, particularly for men, who exhibit increased risk of such behaviors.

Variables associated with disordered eating behaviors among freshman students from Mexico City / Variables asociadas con conductas alimentarias de riesgo en estudiantes de la Ciudad de México

Abstract: Objective: To estimate the prevalence of disordered eating behaviors (DEB) and identify their associations with demographic and psychological variables among freshman students at a public university in Mexico City. Materials and methods: A sample of 892 subjects participated in the study. Bivariate and multinomial models were performed to determine associations between DEB and covariates. Results: Of those surveyed, 6.8% of the women and 4.1% of the men exhibited DEB (p<0.05). The variables increasing the risk of eating disorders (ED) for women were internalization of the aesthetic thin ideal (IATI), body mass index (BMI), self-esteem and physical activity, while for men they were IATI, drive for muscularity, and self-esteem. Conclusions: The frequency of DEB among women and men and the internalization of the thin ideal in both sexes suggest the possibility of a change in the precursor conditions for eating disorders, particularly for men, who exhibit increased risk of such behaviors.

Resumen: Objetivo: Estimar la prevalencia de conductas alimentarias de riesgo (CAR) e identificar asociaciones con variables sociodemográficas y psicológicas en estudiantes de nuevo ingreso de una universidad pública de la Ciudad de México. Material y métodos: Se aplicó una encuesta a 892 estudiantes de ambos sexos. Para analizar asociaciones entre CAR y sus covariables se emplearon modelos bivariados y multivariados. Resultados: Se estimó que 6.8% de las mujeres y 4.1% de los hombres presentaron CAR (p>0.05). Entre las mujeres las variables que aumentaron el riesgo de CAR fueron interiorización del ideal estético de la delgadez (IIED), índice de masa corporal (IMC), autoestima y actividad física. Entre los hombres, las variables que sobresalieron fueron IIED, deseo por un cuerpo musculoso y autoestima. Conclusiones: La frecuencia de CAR entre mujeres y hombres, así como la IIED en ambos sexos sugiere un cambio en las condiciones de riesgo, especialmente entre los varones.

Conductas alimentarias de riesgo y correlatos psicosociales en estudiantes universitarios de primer ingreso con sobrepeso y obesidad / Disordered eating behaviors and psychological correlates among overweight and obese freshmen College students

Resumen: INTRODUCCIÓN: El comienzo de los estudios universitarios es un estresor importante para los jóvenes que se asocia con un incremento en la incidencia de depresión, ansiedad, abuso de alcohol y CAR. OBJETIVO: Analizar la relación entre CAR e IMC, su asociación con variables demográficas y psicológicas y la interacción con el IMC. MÉTODO: En una muestra de 892 estudiantes universitarios de nuevo ingreso (502 mujeres y 390 hombres) (Xedad=19.7; DE=2.9) se midió peso y estatura y se utilizaron cuestionarios validados. RESULTADOS: La prevalencia de CAR fue de 6.1% en mujeres y de 4.1% en hombres. La prevalencia de sobrepeso y obesidad en mujeres fue de 22.6% y de 7.4%, y en hombres fue de 26.6% y de 9.3%, respectivamente. Las mujeres y los hombres con obesidad 10.8% y 11.1% presentaron CAR de frecuencia alta, y las mujeres y hombres con sobrepeso 13.2% y 3.8%, respectivamente. En las mujeres el IMC aumenta el riesgo de CAR 1.6 veces (p < 0.05) y en los hombres 1.4 veces (p > 0.05). No se encontró interacción del IMC en la asociación de CAR con el resto de las variables. DISCUSIÓN Y CONCLUSIÓN: En ambos sexos, las variables relacionadas con la imagen corporal aumentan el riesgo de CAR significativamente (p < 0.05). Los síntomas depresivos, la baja autoestima y el IMC aumentan el riesgo entre las mujeres, y el deseo por la musculatura, nivel socioeconómico y el área de estudio entre los hombres. Se recomienda llevar a cabo una investigación específica sobre CAR en varones, para evitar el subregistro de casos.

Abstract: INTRODUCTION: The beginning of college studies involves important stress, which is related to an increase in the incidence of depression, anxiety, alcohol abuse and DEB. OBJECTIVE: To analyze the relationship between DEB and nutritional status measured with BMI, its association with demographic and psychological variables, and the interaction with BMI. METHOD: A sample of 892 college students in their freshman year (502 females and 390 males) (Xage=19.7; SD=2.9) was studied. Weight and height were measured, and validated questionnaires were used. RESULTS: The prevalence of DEB was 6.1% in females and 4.1% in males. The prevalence of overweight and obesity in females was 22.6%, and 7.4% and 26.6% and 9.3% in males, respectively. Among women and men with obesity 10.8% and 11.1% showed high-DEB, whilst among overweight women and men 13.2% and 3.8% showed high-DEB, respectively. BMI increases the risk for DEB 1.6 times among women (p < 0.05), 1.4 times among men (p > 0.05). There was no interaction found between BMI and the other variables. DISCUSSION AND CONCLUSION: The variables related with body image increase the risk of DEB significantly (p < 0.05) in both sexes. Depressive symptoms, low self-steem increase the risk among women, and socioeconomic status and study area increase the risk of DEB among men. The specific research of DEB among males is highly recommended to avoid the under registration of cases.

[Food insecurity at the household level and nutritional status of older people in México]. / Inseguridad alimentaria en el hogar y estado de nutrición en personas adultas mayores de México.

OBJECTIVE: To estimate the prevalence of food insecurity (FI) in households with members aged 60-and-over, analyzing the association between household FI and the nutritional status of older members. MATERIALS AND METHODS: Data on 6790 adults aged 60-and-over distributed in 6591 households were analyzed. FI was measured using the harmonized version for Mexico of the Latin American and Caribbean Food Security Scale (ELCSA). Households were classified according to the level of FI. Prevalences of FI were analyzed by associated variables. RESULTS: The overall prevalence of FI at the household level was 67.0%. FI was higher in native language-speaking households (85.9%), households in rural areas (82.2%) and those benefiting from food-related programs (>79.0%). Positive associations between household FI and low weight in the older person were found. CONCLUSIONS: Further analysis on the individual expressions of FI is required to improve food and nutrition interventions during old age.

Inseguridad alimentaria en el hogar y estado de nutrición en personas adultas mayores de México / Food insecurity at the household level and nutritional status of older people in México

Objetivo. Estimar prevalencias de inseguridad alimentaria (IA) en hogares con personas de 60 años o más y su asociación con el estado de nutrición. Material y métodos. Con información de 6 790 adultos mayores distribuidos en 6 591 hogares se midió la IA utilizando la versión armonizada para México de la Escala Latinoamericana y Caribeña de Seguridad Alimentaria (ELCSA). Los hogares se clasificaron según nivel de IA; se analizaron prevalencias de IA según variables asociadas. Resultados. 67.0% de los hogares reportó alguna forma de IA. Las prevalencias más altas se registraron en hogares indígenas (85.9%), rurales (82.2%) y beneficiarios de programas con componente alimentario (>79.0%). Se encontraron asociaciones positivas entre IA en el hogar y bajo peso de los ancianos. Conclusiones. Se requiere complementar el análisis de IA en el hogar con indicadores individuales para una toma de decisiones más cercana a la realidad nutricional de las personas mayores.

Objective. To estimate the prevalence of food insecurity (FI) in households with members aged 60-and-over, analyzing the association between household FI and the nutritional status of older members. Materials and methods. Data on 6790 adults aged 60-and-over distributed in 6591 households were analyzed. FI was measured using the harmonized version for Mexico of the Latin American and Caribbean Food Security Scale (ELCSA). Households were classified according to the level of FI. Prevalences of FI were analyzed by associated variables. Results. The overall prevalence of FI at the household level was 67.0%. FI was higher in native language-speaking households (85.9%), households in rural areas (82.2%) and those benefiting from food-related programs (>79.0%). Positive associations between household FI and low weight in the older person were found. Conclusions. Further analysis on the individual expressions of FI is required to improve food and nutrition interventions during old age.

[Impact of risk factors for osteoporosis on bone mineral density in perimenopausal women of the City of Querétaro, México]. / Impacto de los factores de riesgo en osteoporosis sobre la densidad mineral osea en mujeres perimenopáusicas de la Ciudad de Querétaro, México.

It is essential to evaluate osteoporosis risk factors, mainly the modifiable, like the lifestyle, in Mexican women in order to prevent it, since it is a serious public health problem. We studied 805 women (35-55 years old) in the City of Queretaro, México. We obtained: personal data, family history, habits, such as smoking, alcohol, caffeine (coffee and soft drink of cola) and physical activity. Participants complete the questionnaire on 19 risk factors for osteoporosis (International Osteoporosis Foundation) one of them with risk. We evaluated: body mass index (BMI), cardiovascular risk and corporal complexion. Bone densitometry was performed in two diagnostic regions: lumbar spine and total hip and participants were classified as normal bone mass density (BMD), low BMD and osteoporosis. The prevalence of osteoporosis was 7% and of low BMD was 34%, predominantly in the lumbar region and in those with menopause. In osteoporotic women, the age was higher (51 years) and 85% menopausal women, also lower values of weight, height, BMI, waist circumference and hip than women with normal bone mass density. The significantly modifiable risk factors were: low weight, smoking and consumption of soft drink of cola with 6,5, 1,2 and 1,4 (odds ratio), respectively (p < 0.05). The significantly non-modifiable risk factors were: menopause (surgical), history of fracture and risk. It is concluded that within the modifiable risk factors for the prevention ofosteoporosis, those with the greatest impact were low weight, cigarette and soft drink of cola.

Intake of dehydrated nopal (Opuntia ficus indica) improves bone mineral density and calciuria in adult Mexican women.

BACKGROUND: The intake of dehydrated nopal (DN) at a high stage of maturity along with high calcium content could improve bone mineral density (BMD) and calciuria and thus prevent osteoporosis. OBJECTIVE: To evaluate the effect of calcium intake from a vegetable source (DN) on BMD and calciuria covering a 2-year period in menopausal and non-menopausal women with low bone mass (LBM). METHODS: The study was quasi-experimental, blinded, and randomized, and included 131 Mexican women aged 35-55. Urinary calcium/creatinine index (CCI) was determined; BMD was analyzed on lumbar spine and total hip regions. Four groups were studied: Control group (CG), women with normocalciuria and a minimum dose of DN; experimental group 1 (EG1), women with hypercalciuria and a minimum dose of DN; experimental group 2 (EG2), women with hypercalciuria, and a maximum dose of DN; and normal group (NG) for reference in BMD. RESULTS: After the first semester of treatment, calciuria levels in women from both experimental groups returned to normal, remaining constant for the rest of the treatment. The percentage difference in BMD increased in the total hip region in the CG (pre 4.5% and post 2.1%) and EG2 (pre 1.8% and post 2.5%) groups significantly in comparison to NG and EG1, which exhibited a significant decrease in their BMD. BMD increased only for the lumbar region in the EG2 group (premenopausal). CONCLUSION: The use of a vegetable calcium source such as nopal improves BMD in women with LBM in the total hip and lumbar spine regions principally in the premenopausal women, maintaining constant and normal calciuria levels.

Impacto de los factores de riesgo en osteoporosis sobre la densidad mineral ósea en mujeres perimenopáusicas de la Ciudad de Querétaro, México / Impact of risk factors for osteoporosis on bone mineral density in perimenopausal women of the City of Querétaro, México.

Es indispensable evaluar los factores de riesgo en osteoporosis, principalmente los modificables, como: los estilos de vida, para prevenirla, ya que es un grave problema de salud pública. Se estudiaron 805 mujeres (35-55 años) de la ciudad de Querétaro, México. Se obtuvieron datos personales, historia familiar, hábitos como: fumar, actividad física, consumo de alcohol y de cafeína (refresco de cola y café). Las participantes completaron el cuestionario de riesgo de osteoporosis (19 factores, con uno, existe riesgo) (International Osteoporosis Foundation). Se evaluó: Índice de Masa Corporal (IMC), riesgo cardiovascular y complexión corporal (Talla/Circunferencia de muñeca). Se realizó una densitometría ósea (DXA) en dos regiones diagnósticas: columna lumbar y cadera total y las participantes se clasificaron en: densidad mineral ósea (DMO) normal, DMO baja y osteoporosis. La prevalencia de osteoporosis fue de 7% y de DMO baja fue de 34%, predominantemente en región lumbar y en aquellas con menopausia. La edad fue mayor en mujeres osteoporóticas (51 años) y el 85% menopáusicas, con valores menores de: peso, talla, IMC, circunferencia de cintura y cadera, que las normales. Los factores de riesgo modificables que aumentaron el riesgo fueron: bajo peso, fumar y consumo de refresco de cola con 6,5, 1,2 y 1,4 (razón de momios) respectivamente (p<0,05). Factores no modificables significativos: menopausia (quirúrgica), historia de fractura y riesgo de osteoporosis. Se concluye que dentro de los factores de riesgo modificables para la prevención de osteoporosis de mayor impacto en esta muestra son: bajo peso, cigarrillo y el refresco de cola.

It is essential to evaluate osteoporosis risk factors, mainly the modifiable, like the lifestyle, in Mexican women in order to prevent it, since it is a serious public health problem.We studied 805 women (35-55 years old) in the City of Queretaro, México. We obtained: personal data, family history, habits, such as smoking, alcohol, caffeine (coffee and soft drink of cola) and physical activity. Participants complete the questionnaire on 19 risk factors for osteoporosis (International Osteoporosis Foundation) one of them with risk. We evaluated: body mass index (BMI), cardiovascular risk and corporal complexion. Bone densitometry was performed in two diagnostic regions: lumbar spine and total hip and participants were classified as normal bone mass density (BMD), low BMD and osteoporosis. The prevalence of osteoporosis was 7% and of low BMD was 34%, predominantly in the lumbar region and in those with menopause. In osteoporotic women, the age was higher (51 years) and 85% menopausal women, also lower values of weight, height, BMI, waist circumference and hip than women with normal bone mass density. The significantly modifiable risk factors were: low weight, smoking and consumption of soft drink of cola with 6,5, 1,2 and 1,4 (odds ratio), respectively (p <0,05). The significantly non-modifiable risk factors were: menopause (surgical), history of fracture and risk. It is concluded that within the modifiable risk factors for the prevention of osteoporosis, those with the greatest impact were low weight, cigarette and soft drink of cola.

[A qualitative approach to drug supply in Mexico: evaluation in the services for population with no medical insurance]. / Análisis cualitativo del abasto de medicamentos en México: evaluación en los servicios a población no asegurada.

OBJECTIVE: To identify the main problems that the drug supply chain (DSCh) faces in the state health systems (SHS); establishing how they relate to the degree of outsourcing. MATERIAL AND METHODS: Officials of the SHS hospitals and health centers were interviewed in a sample of 12 entities during the first half of 2008. Transcripts of the interviews were processed through the qualitative analysis program Atlas.ti 5.0; the analysis was aimed at reconstructing the phases of DSCh for identifying problems narrated by informants using the phenomenological approach to discourse analysis. RESULTS: There is a marked tendency to replace the conventional model by one that is characterized by greater involvement of private providers; all the models show specific problems that might be derived from the degree of outsourcing. CONCLUSION: The supply of drugs in the studied SHS differ from the pattern implemented according to the modality adopted; outsourcing is not exempt of problems and does not seem to fully resolve the difficulties encountered in conventional ways.

Análisis cualitativo del abasto de medicamentos en México: evaluación en los servicios a población no asegurada / A qualitative approach to drug supply in Mexico: evaluation in the services for population with no medical insurance

OBJETIVO. Identificar las principales problemáticas que muestra la cadena de abasto de medicamentos (CAM) en los Sistemas Estatales de Salud (SESA), estableciendo la relación que guardan con la tercerización. MATERIAL Y MÉTODOS. Se entrevistó a funcionarios de los SESA y de hospitales y centros de salud de una muestra de 12 entidades durante la primera mitad de 2008. Las transcripciones de las entrevistas se procesaron en el programa de análisis cualitativo Atlas.ti 5.0; el análisis se orientó a reconstruir las fases de la CAM e identificar las problemáticas narradas por los informantes mediante el enfoque fenomenológicodeanálisisdel discurso. RESULTADOS. Existe una marcada tendencia a sustituir el modelo convencional por otro caracterizado por una mayor participación de proveedores privados; los modelos muestran problemáticas particulares que no parecen derivarse del grado de tercerización. CONCLUSIÓN. El abasto de medicamentos en los SESA estudiados difiere según la modalidad adoptada; la tercerización no está exenta de problemáticas y no parece resolver totalmente las dificultades identificadas en las formas convencionales.

OBJECTIVE. To identify the main problems that the drug supply chain (DSCh) faces in the state health systems (SHS); establishing how they relate to the degree of outsourcing. MATERIAL AND METHODS. Officials of the SHS hospitals and health centers were interviewed in a sample of 12 entities during the first half of 2008. Transcripts of the interviews were processed through the qualitative analysis program Atlas.ti 5.0; the analysis was aimed at reconstructing the phases of DSCh for identifying problems narrated by informants using the phenomenological approach to discourse analysis. RESULTS. There is a marked tendency to replace the conventional model by one that is characterized by greater involvement of private providers; all the models show specific problems that might be derived from the degree of outsourcing. CONCLUSION. The supply of drugs in the studied SHS differ from the pattern implemented according to the modality adopted; outsourcing is not exempt of problems and does not seem to fully resolve the difficulties encountered in conventional ways.

[Food advertising in Mexican television: are children more exposed?]. / Publicidad de alimentos en la programación de la televisión mexicana: ¿los niños están más expuestos?

OBJECTIVE: To evaluate food advertisements on broadcast television channels in Mexico City. MATERIAL AND METHODS: Between July and October, 2007 programming by the 11 broadcast channels (N=11) in Mexico City was recorded during one weekday and one weekend day. The length of advertisements (N = 9178), types of products, and nutritional content of foods advertised were analyzed. RESULTS: The time devoted to food products advertising was greater during children's television than during programming targeted to the general audience (25.8 vs. 15.4%). The foods more frequently advertised were sweetened beverages, sweets and cereals with added sugar. Calorie, carbohydrate and fat contents were higher in foods advertised during children's shows. The two most common marketing strategies were to offer some kind of gift and to link the item to positive emotions. CONCLUSION: The findings of this research indicate the need for an effective system to regulate advertising directed towards children and adolescents.

Publicidad de alimentos en la programación de la televisión mexicana: ¿los niños están más expuestos? / Food advertising in Mexican television: are children more exposed?

OBJETIVOS: Evaluar la publicidad relacionada con alimentos transmitida en los canales gratuitos de televisión de la Ciudad de México. MATERIAL Y MÉTODOS: Se grabó la transmisión, un día entre semana y uno en fin de semana, de los 11 canales gratuitos de televisión de la Ciudad de México, entre julio y octubre de 2007. Se analizó la duración de los comerciales (N= 9178), los productos anunciados, el valor nutrimental de los alimentos anunciados, así como las estrategias publicitarias utilizadas. RESULTADOS: La publicidad de alimentos fue mayor durante los programas infantiles que durante la programación dirigida a la audiencia general (25.8 vs. 15.4 por ciento). Los alimentos anunciados con mayor frecuencia fueron bebidas con azúcar añadida y dulces, así como cereales con azúcar añadida. Los alimentos anunciados en programas infantiles tuvieron mayor contenido de calorías, grasa y carbohidratos. Las estrategias publicitarias más utilizadas fueron las promociones y asociar productos con emociones positivas. CONCLUSIÓN: Esta investigación ofrece evidencia sobre la necesidad de contar con un sistema de regulación efectiva de la publicidad dirigida a niños y adolescentes.

OBJECTIVE: To evaluate food advertisements on broadcast television channels in Mexico City. MATERIAL AND METHODS: Between July and October, 2007 programming by the 11 broadcast channels (N=11) in Mexico City was recorded during one weekday and one weekend day. The length of advertisements (N = 9178), types of products, and nutritional content of foods advertised were analyzed. RESULTS: The time devoted to food products advertising was greater during children's television than during programming targeted to the general audience (25.8 vs. 15.4 percent). The foods more frequently advertised were sweetened beverages, sweets and cereals with added sugar. Calorie, carbohydrate and fat contents were higher in foods advertised during children's shows. The two most common marketing strategies were to offer some kind of gift and to link the item to positive emotions. CONCLUSION: The findings of this research indicate the need for an effective system to regulate advertising directed towards children and adolescents.

Características de la morbilidad en población mexicana de edad avanzada: un análisis de la Escuela Nacional de Salud 1988 / Morbidity characteristics among elderly Mexicans: An analysis of the 1988 National Health Survey

Objetivo. Obtener una aproximación al panorama epidemiológico de la población mexicana envejecida a partir de la base de datos de la Encuesta Nacional de Salud 1988. Material y métodos. Se analizan las prevalencias de la morbilidad referida por la encuesta para algunos de los principales problemas sanitarios en el grupo de personas de 60 años y más y se mide la asociación entre las causas seleccionadas, algunas variables sociodemográficas e impedimentos para realizar las actividades de la vida diaria a través de dos análisis estratificados por edad. Resultados. Muestran que: a) el perfil de la morbilidad en este grupo de edad es producto de la combinación de eventos de distinta causa; b) existen patrones diferenciados de morbilidad al definir subgrupos con base en características sociales; y c) la morbilidad seleccionada y los impedimentos para realizar las actividades de la vida diaria se relacionan estrechamente. Conclusiones. Esta aproximación puede ser útil para avanzar en la investigación sobre condiciones de vida y salud de la población de edad avanzada en México

Based on the 1988 National Health Survey data base, a preliminary approach to an epidemiologic profile of the Mexican elderly is proposed. Material and methods. This paper analyzes both reported prevalences of some of the principal health problems in Mexicans over 60 years of age and the relationship between selected morbidity, socio-demographic variables and impairment of daily living activities, stratified by age. Results. Results show that: a) the panorama of reported morbidity among the Mexican elderly is a combination of multiple causes, b) socially defined groups present heterogeneous disease patterns, c) selected morbidity is strongly related to daily living activity impairments. Conclusions. This approach may be used to improve research on living and health conditions of the Mexican elderly .