Effectiveness of a Lifestyle Change Program on Insulin Resistance in Yaquis Indigenous Populations in Sonora, Mexico: PREVISY.

To evaluate the effectiveness of the healthy lifestyle promotion program for Yaquis (PREVISY) on insulin resistance in the short- and medium-term periods in adults who are overweight/obese and have an increased risk for diabetes. Using a translational research design, an intervention program was implemented in a sample of 93 Yaqui adult subjects. The effectiveness of PREVISY was evaluated by comparing the levels of Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and the Triglycerides-Glucose Index (TyG index) at 6 and 12 months using a paired t-test. Results: In the subjects who completed the program, a decrease in the HOMA-IR index (∆ = -0.91 and ∆ = -1.29, p ≤ 0.05) and the TyG index (∆ = -0.24 y ∆ = -0.20, p ≤ 0.05) was observed in the short- and medium-term period, respectively. Subjects with body weight loss ≥ 10% showed decreased levels of HOMA-IR (∆ = -3.32 and ∆ = -4.89, p ≤ 0.05) and the TyG index (∆ = -0.80 and ∆ = -0.60, p ≤ 0.05) at 6 and 12 months, respectively. A stronger benefit of the program was found in subjects with obesity (vs. overweight) and with high and very high risk of diabetes (vs. moderate risk) in IR markers (p ≤ 0.05). The PREVISY program demonstrated its effectiveness in the improvement of some markers of insulin resistance in Yaqui adults at risk of diabetes.

Reproducibility and validity of a food frequency questionnaire to assess cardiovascular health-related food intake among Mexican adolescents.

There is a lack of region-adapted tools to evaluate diet as a risk factor for cardiovascular disease (CVD) in adolescents. The study aim was to evaluate the reproducibility and validity of a paper-based and region-adapted food frequency questionnaire (FFQ) designed to assess CVD-related food and nutrient intakes of adolescents from Northwest México. The study design was cross-sectional. The FFQ was developed in a two-step process: prototype designing and a pilot test, with re-tested in a 3-month period, along with two administrations of 24 h-recall (24 hR). Pearson's and intra-class correlation coefficients (PCC and ICC) were assessed. Bland-Altman plots, limits of agreement and quintile classifications were carried out. Participants (n 221) were 53·8 % male, 18·5 ± 0·4 years old. Reproducibility had a median PCC = 0·66 for processed meats, ranging from 0·40 (saturated fat) to 0·74 (fish & shellfish), P = 0·001. ICC ranged from 0·53 (saturated fat) to 0·80 (sodium; and nuts, seeds and legumes), P = 0·001. Validity comparing FFQ1 v. 24 hR mean, PCCs ranged from 0·12 (P = 0·06) to 0·95 (P = 0·001), and ICC from 0·20 (P = 0·048) to 0·88 (P = 0·001); comparing FFQ2 v. 24 hR mean, PCCs ranged from 0·07 (P = 0·25) to 0·46 (P = 0·001), and ICC from 0·15 (P = 0·106) to 0·58 (P = 0·001). The FFQ overestimated the intake of all food groups and nutrients (P < 0·05), while Cohen's κ showed coefficients lower than 0·20. The proposed FFQ represents a moderately validated tool to estimate CVD-related food and nutrient intakes as a risk factor, which can be used in combination with multiple administrations of 24 hRs, as a critical mean in future interventions intended to reduce cardiometabolic risk in adolescents.

Prevalence of overweight, obesity and central obesity and factors associated with BMI in indigenous yaqui people: a probabilistic cross-sectional survey.

BACKGROUND: The Yaquis are an Indigenous group who inhabit in the state of Sonora in northwestern Mexico. This group has experienced changes in their lifestyle, moving from a traditional lifestyle to a more modern one, resulting in an increase of obesity and its comorbidities. However, few studies have been done in this group. The aim of this study was to determine the prevalence of overweight, obesity and central obesity and to identify the factors associated with body mass index (BMI) in a representative sample of Indigenous Yaqui people from Sonora, Mexico. METHODS: A cross-sectional survey with multistage sampling was conducted among adults (N = 351) with residence in Yaqui traditional villages (Vícam, Pótam, Loma de Guamúchil, Loma de Bácum, Tórim, Ráhum, Huiribis or Belem). Anthropometric measurements were taken to diagnose overweight, obesity and central obesity. Food frequency and physical activity (PA) questionnaires designed for the Yaqui population were applied, as well as sociodemographic and clinical history questionnaires. The factors associated with BMI were assessed using multiple linear regression considering the complex design of the sampling. RESULTS: The prevalence of overweight, obesity and central obesity in the population were 36.5%, 35.0% and 76.0%, respectively. Having higher values of the modernization index (ß = 0.20, p = 0.049) was associated with a higher BMI, while having a higher consumption of a "prudent" dietary pattern (traditional dishes, fruits, vegetables and low-fat dairy) (ß = -0.58, p = 0.009) and performing a greater number of hours per week of vigorous PA (ß = -0.14, p = 0.017) were associated with a lower BMI. CONCLUSIONS: The prevalence of the studied abnormalities is high. The evidence presented in this study suggests that interventions are needed and more research is required to determine the appropriate components of such interventions, in order to meet the needs of the Yaqui people.

Effectiveness of the Healthy Lifestyle Promotion Program for Yaquis with Obesity and Risk of Diabetes in the Short and Medium Term: A Translational Study.

Type 2 diabetes (T2D) is a public health problem worldwide, and the main risk factor for its development is obesity. The Yaqui ethnic group of Sonora has serious obesity problems, resulting in an increased risk of T2D in its inhabitants. The objective of this study was to evaluate the effectiveness of a health promotion program on obesity parameters and cardiovascular risk factors in short- (6 months) and medium-term periods (12 months) in indigenous Yaquis of Sonora. The design is a translational clinical study of a single cohort with prepost intervention measurements in a sample of 93 subjects. The effectiveness of the program was evaluated by comparing obesity parameters, metabolic markers, and physical activity 6 and 12 months with those measured under basal conditions using a paired t-test or Wilcoxon rank-sum test. The short-term retention percentage was 58.0%. There was a decrease in body weight (Δ = -3.9 kg, p ≤ 0.05) and other obesity parameters, and an increase in physical activity and improvements in metabolic markers (p ≤ 0.05) was observed. Similar findings were obtained for the medium-term period; body weight loss was also -3.9 kg (p ≤ 0.05). The short and medium-term results of the program showed improvements in the obesity parameters and other cardiovascular risk factors of the participants. These results support the effectiveness of the program and its translation in this ethnic group.

Prevalence of previous diagnosis of hypertension and associated factors in the Yaqui indigenous of Sonora / Prevalencia de diagnóstico previo de hipertensión arterial y factores asociados en indígenas Yaquis de Sonora

Abstract: Introduction: The hypertension (HT) is a public health problem worldwide. This disease is a risk factor for heart diseases and, cerebrovascular and renal failure, which are considered the main causes of mortality. Objective: This study aimed to describe factors associated with a previous diagnosis of HT in a group of Yaqui adults from Sonora, Mexico. Material and methods: We conducted a cross-sectional epidemiological study in which 108 individuals ≥ 18 years of age were included. HT was considered as prior diagnosis. In addition, anthropometric assessment, medical history and sociodemographic questionnaires were also applied. The sex- and age adjusted prevalence was estimated using the direct method of standardization using the studied sample as the standard population. The factors associated with previous diagnosis of HT were determined using multiple logistic regression analysis. Results: The sex- and age-adjusted prevalence of a previous diagnosis of HT was 12.0% (95% CI: 6.3-17.6) in the overall population. The age-adjusted prevalence in men was 7.1%, and it was 14.0% in women with no significant difference between genders. The independent factors associated with HT were increased waist circumference (cm) (OR: 1.07, 95% CI: 1.01-1.14) and a previous diagnosis of diabetes (OR: 4.14, 95% CI: 1.03-16.61). Conclusions: The prevalence of a previous diagnosis of HT was high, and it could be higher after confirmation of new diagnosis cases in the population. The identification of factors associated with HT may be useful for creating programs to prevent chronic diseases in this ethnic group.(AU)

Resumen: Introducción: La hipertensión arterial (HTA) es un problema de salud pública a nivel mundial. Esta enfermedad es un factor de riesgo para enfermedades del corazón, cerebrovasculares y falla renal, las cuales son consideradas entre las principales causas de mortalidad. Objetivo: Describir factores asociados con el diagnóstico previo de HTA en un grupo de adultos Yaquis de Sonora, México. Material y métodos: Llevamos a cabo un estudio epidemiológico con diseño transversal donde fueron estudiados 108 individuos ≥ 18 años de edad. La HTA fue considerada como diagnóstico previo, se hizo una evaluación antropométrica y se aplicaron cuestionarios de historial clínico y sociodemográficos. La prevalencia de HTA ajustada por edad y sexo se estimó por el método directo de estandarización utilizando la población estudiada como población estándar. Los factores asociados con el diagnóstico previo de HTA fueron obtenidos mediante análisis de regresión logística múltiple. Resultados: La prevalencia de diagnóstico previo de HTA fue 12.0% (IC 95%, 6.3-17.6) en la población total. La prevalencia ajustada por edad en hombres fue 7.1 y 14.0% en mujeres; sin diferencias significativas entre sexo. Los factores asociados de manera independiente con HTA fueron una mayor circunferencia de cintura (cm) (RM: 1.07; IC 95%, 1.01-1.14) y el diagnóstico previo de diabetes (RM: 4.14; IC 95%, 1.03-16.61). Conclusiones: La prevalencia de diagnóstico previo de HTA fue alta y podría incrementar con la confirmación de diagnóstico de casos nuevos en la población. La identificación de factores asociados con HTA puede servir para crear programas de prevención de enfermedades crónicas en este grupo étnico.(AU)