Association between consumption of nonessential energy-dense food and body mass index among Mexican school-aged children: a prospective cohort study.

BACKGROUND/OBJECTIVES: Obesity prevalence in Mexican children has increased rapidly and is among the highest in the world. We aimed to estimate the longitudinal association between nonessential energy-dense food (NEDF) consumption and body mass index (BMI) in school-aged children 5 to 11 years, using a cohort study with 6 years of follow-up. SUBJECTS/METHODS: We studied the offspring of women in the Prenatal omega-3 fatty acid supplementation, child growth, and development (POSGRAD) cohort study. NEDF was classified into four main groups: chips and popcorn, sweet bakery products, non-cereal based sweets, and ready-to-eat cereals. We fitted fixed effects models to assess the association between change in NEDF consumption and changes in BMI. RESULTS: Between 5 and 11 years, children increased their consumption of NEDF by 225 kJ/day (53.9 kcal/day). In fully adjusted models, we found that change in total NEDF was not associated with change in children's BMI (0.033 kg/m2, [p = 0.246]). However, BMI increased 0.078 kg/m2 for every 418.6 kJ/day (100 kcal/day) of sweet bakery products (p = 0.035) in fully adjusted models. For chips and popcorn, BMI increased 0.208 kg/m2 (p = 0.035), yet, the association was attenuated after adjustment (p = 0.303). CONCLUSIONS: Changes in total NEDF consumption were not associated with changes in BMI in children. However, increases in the consumption of sweet bakery products were associated with BMI gain. NEDF are widely recognized as providing poor nutrition yet, their impact in Mexican children BMI seems to be heterogeneous.

Longitudinal patterns of breastfeeding and its association with adiposity and subjective indicators of satiety/appetite in the first 2 years of life.

Evidence about the association between breastfeeding and its duration with growth, appetite and satiety indicators, and adiposity in low and middle-income countries facing nutritional transition is scarce. The aim of this study was to evaluate the association between longitudinal patterns of breastfeeding (exclusive [EBF] and continued [CBF]) with adiposity and growth, and the mediating role of appetite and satiety indicators in these associations in Mexican children during the first 2 years of life. Information from 378 mother-child pairs from the MAS-Lactancia birth cohort was analysed. Information was collected at birth and at months 1, 3, 6, 9, 12, 18 and 24 of life. Duration of EBF and CBF was computed. Linear mixed models were used to assess the association of EBF and CBF with growth and adiposity. Path analysis was used for mediation analysis. Compared with the reference group (EBF duration <1 month), males with >3 to ≤6 months of EBF had less abdominal circumference (ß = -0.66, p = 0.05), Z-score weight-for-length (ß = -0.17, p = 0.19) and length-for-age (ß = -0.49, p < 0.01). Participants without CBF beyond 6 months had higher BMI Z-score (ß = 0.19, p < 0.01), abdominal circumference (ß = 0.62, p < 0.01) and skinfold sum (ß = 0.80, p = 0.09), and o difference in length-for-age. For EBF, mediation was confirmed for satiety responsiveness on the association with BMI Z-Score, for food fussiness for the association with abdominal circumference and length-for-age Z-score, and enjoyment of food on the association with length-for-age Z-score. For CBF, mediation was confirmed for food fussiness in the association with length-for-age. This study suggests that a longer exposure to EBF and CBF is associated with lower adiposity in children under 2 years of age, and that this association could be partially mediated by appetite and satiety indicators.

Prácticas de alimentación infantil antes y después de la pandemia por Covid-19, Ensanut 2012 a 2022.

OBJETIVO: Describir la tendencia en las prácticas de alimentación infantil en México antes y después de la pandemia por Covid-19, usando datos de la Encuesta Nacional de Salud y Nutrición (Ensanut) 2012, 2018-19, 2021 y 2022. Material y métodos. Población: mujeres 12-59 años y sus hijos/as < 24 meses. Se calcularon los indicadores de alimentación infantil según la Organización Mundial de la Salud 2021. Se realizaron modelos de regresión logística para analizar tendencias entre encuestas ajustando por variables sociodemográficas, considerando el diseño muestral. Se muestran las tendencias de lactancia materna (LM) y fórmula comercial infantil (FCI) por área urbano/rural y ocupación de la madre. RESULTADOS: La prevalencia ajustada de LM exclusiva en niñas/os menores de seis meses aumentó (14.8% en 2012; 28.6% en 2018-19 y 33.6% en 2021-22; p<0.001). El consumo de FCI en niñas/os < 12 meses se redujo de 62.8 a 42.8% entre 2012 y 2018-19 y permaneció en 43.3% en 2021-22 (p<0.001). CONCLUSIONES: Las prácticas de alimentación infantil mejoraron principalmente entre 2012 y 2018-19, y la tendencia positiva se desaceleró en 2021-22.

Prácticas de lactancia materna y alimentación complementaria en menores de dos años de edad en México.

OBJETIVO: Estimar prevalencias de indicadores de prácticas de alimentación infantil en menores de 24 meses en México. Material y métodos. Análisis de la Encuesta Nacional de Salud y Nutrición Continua 2021 y 2022 (Ensanut Continua 2021 y 2022) en mujeres de 14-59 años y sus hijos/as menores de 24 meses (<24 meses). Se calcularon los indicadores ajustando por diseño muestral de las encuestas. RESULTADOS: El 33.6% de niñas/os <6 meses recibió lactancia materna exclusiva (LME). El 27.2% de niñas/os <24 meses no recibió LME durante los primeros tres días de vida y fue alimentado con fórmula comercial infantil (FCI) u otro líquido. El 42% de niñas/os de entre 6 y 23 meses consumió alimentos no saludables. CONCLUSIONES: Las prácticas de alimentación infantil en México deben ser protegidas mediante políticas que regulen la comercialización de FCI y promuevan un entorno laboral, social y político propicio para la lactancia materna y el cuidado infantil, para que madres, padres y cuidadores puedan adoptar prácticas de lactancia y alimentación complementaria adecuadas.

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.

Predictors of patterns of weight change 1 year after delivery in a cohort of Mexican women.

OBJECTIVE: To evaluate the associations of pregestational BMI, gestational weight gain (GWG) and breast-feeding at 1 month postpartum with four patterns of weight change during the first year after delivery: postpartum weight retention (PPWR), postpartum weight gain (PPWG), postpartum weight retention + gain (PPWR + WG) and return to pregestational weight. DESIGN: In this secondary analysis of a prospective study, we categorised postpartum weight change into four patterns using pregestational weight and weights at 1, 6 and 12 months postpartum. We evaluated their associations with pregestational BMI, GWG and breast-feeding using multinomial logistic regression. Results are presented as relative risk ratios (RRR) and 95 % CI. SETTING: Mexico City. PARTICIPANTS: Women participating in the Programming Research in Obesity, Growth, Environment and Social Stressors pregnancy cohort. RESULTS: Five hundred women were included (53 % of the cohort). Most women returned to their pregestational weight by 1 year postpartum (57 %); 8 % experienced PPWR, 14 % PPWG and 21 % PPWR + WG. Compared with normal weight, pregestational overweight (RRR 2·5, 95 % CI 1·3, 4·8) and obesity (RRR 2·2, 95 % CI 1·0, 4·7) were associated with a higher risk of PPWG. Exclusive breast-feeding, compared with no breast-feeding, was associated with a lower risk of PPWR (RRR 0·3, 95 % CI 0·1, 0·9). Excessive GWG, compared with adequate, was associated with a higher risk of PPWR (RRR 3·3, 95 % CI 1·6, 6·9) and PPWR + WG (RRR 2·4, 95 % CI 1·4, 4·2). CONCLUSIONS: Targeting women with pregestational overweight or obesity and excessive GWG, as well as promoting breast-feeding, may impact the pattern of weight change after delivery and long-term women's health.

Self-perception of dietary quality and adherence to food groups dietary recommendations among Mexican adults.

BACKGROUND: Mexicans' adherence to food group's dietary recommendations is low and an inaccurate self-perception of dietary quality might perpetuate this low adherence. Our aim was to compare the intake and the adherence to the dietary recommendations for several food groups, subgroups, and to an overall Mexican Diet Quality Index (MxDQI), among those that perceived their diet as healthy vs. those that did not. METHODS: We analyzed data from 989 subjects 20-59 y old from the nationally representative Mexican National Health and Nutrition Survey 2016. Dietary intake was collected with one 24-h recall and a repeated recall in 82 subjects. Self-perception of dietary quality was evaluated with the following question "Do you consider that your diet is healthy? (yes/no)". We used the National Cancer Institute method to estimate the usual intake. We compared the mean intake adjusted by sociodemographic variables and the percentage of adherence according to the self-perception of dietary quality among the whole sample and in sociodemographic subpopulations. RESULTS: Sixty percent perceived their diet as healthy, and their adherence to recommendations was low [20% for fruits and vegetables, < 8% for legumes, seafood and SSBs, and ~ 50% for processed meats and high in saturated fat and/or added sugar (HSFAS) products]. The mean number of recommendations they met was 2.8 (out of 7) vs. 2.6 among the rest of the population (p > 0.05), and the MxDQI score was 40 vs. 37 (out of 100 points). The only food groups and subgroups with a statistically significant difference between those that perceived their diet as healthy vs. unhealthy were fruits [38 g/d (95% CI 3, 73)], fruit juices [27 g/d (95% CI 2, 52)], industrialized SSBs [- 35 kcal/d (- 70, - 1)] and salty snacks [- 40 kcal/d (- 79, - 1)]. Other differences were small or inconsistent across subgroups of the population. CONCLUSIONS: Those that perceived their diet as healthy only had a slightly healthier diet than the rest of the population, moreover, their adherence to recommendations was very low. Hence, it is necessary to improve their nutrition knowledge.

Prevalence of inadequate intake of vitamins and minerals in the Mexican population correcting by nutrient retention factors, Ensanut 2016.

OBJECTIVE: To estimate the usual intake and the prevalence of inadequacy of selected nutrients in the Mexican population and the potential effect that the nutrient retention factors (NRF) could have on these estimates. Likewise, document the methodology used in the analysis of the 24 hours of the mid-way National Health and Nutrition Survey 2016 (Ensanut MC 2016). MATERIALS AND METHODS: Dietary information from the Ensanut MC 2016 was analyzed with and without the use of NRFs. RESULTS: Results. Most nutrients evaluated showed a relevant inadequacy prevalence above 10% in all age groups. Likewise, we documented that, when NRFs were not applied, estimated intakes and prevalence were significantly under-estimated in a range of 2% to 55.5%. CONCLUSIONS: We documented the relevance of the application of NRFs for adequate estimation of the prevalence of inadequate intake of selected nutrients in population studies.

OBJETIVO: Estimar la ingesta habitual y la prevalencia de inadecuación de nutrimentos selectos en la población mexicana y el efecto potencial de los factores de retención de nutrimentos (FRN). Asimismo, describir la metodología utilizada en el procesamiento del recordatorio de 24 horas de la Encuesta Nacional de Salud y Nutrición de Medio Camino 2016 (Ensanut MC 2016). MATERIAL Y MÉTODOS: Se analizó la información dietética de Ensanut MC 2016 con y sin utilización de FRN. RESULTADOS: En los nutrimentos evaluados, las prevalencias de inadecuación fueron superiores al 10% en todos los grupos de estudio. La no consideración de los FRN causó la subestimación en las prevalencias de inadecuación en un rango de 2% a 55.5%. CONCLUSIONES: . Se documenta la relevancia de la aplicación de FRN para la adecuada estimación de las prevalencias de inadecuación en estudios poblacionales.

[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.

[Food groups consumption and its associationwith sociodemographic characteristics in Mexicanpopulation. Ensanut 2018-19]. / Consumo de grupos de alimentos y su asociación con características sociodemográficas en población mexicana. Ensanut 2018-19.

OBJECTIVE: To describe the consumption of recommended and non-recommended food groups for daily consumption, and their association with sociodemographic characteristics in Mexican population. MATERIALS AND METHODS: Infor-mation from the 2018-19 National Health and Nutrition Survey from Mexico, using a 7-day food consumption fre-quency questionnaire, in children and adults. We estimated consumption of seven food groups in quartiles by age group. We analyzed the association of locality of residence, region and tertil of well-being index (WBI). RESULTS: Living in urban locality, north region, or medium or high WBI were associated with higher possibility of being in higher quartiles of egg and dairy, legumes, processed meat and snacks, candies and desserts consumption. CONCLUSIONS: In the southern Mexico more fruits are consumed, but less legumes, eggs and dairy products, while in urban locations more snacks, sweets and desserts are consumed.

OBJETIVO: Describir el consumo de grupos de alimentos recomendables y no recomendables para consumo cotidiano y su asociación con características sociodemográficas en población mexicana. MATERIAL Y MÉTODOS: tomada de la Encuesta Nacional de Salud y Nutrición 2018-19, utilizando un cuestionario de frecuencia de consumo de ali-mentos. Se estimaron cuartiles de consumo de siete grupos de alimentos por grupo poblacional. Se analizó la asociación del consumo con tipo de localidad, región y terciles de condición de bienestar (ICB). RESULTADOS: Pertenecer a localidades urbanas, región norte e ICB medio y alto se asoció con mayor posibilidad de estar en los cuartiles más altos de consumo de huevo y lácteos y carnes procesadas, mientras que la región sur se asoció con mayor consumo de leguminosas y bebidas endulzadas. CONCLUSIONES: En el sur de México se consume más frutas, pero menos leguminosas, huevo y lácteos, mientras que en localidades urbanas se consume más carnes procesa-das, botanas, dulces y postres.

Relative Weight Gain Through Age 4 Years Is Associated with Increased Adiposity, and Higher Blood Pressure and Insulinemia at 4-5 Years of Age in Mexican Children.

Background: Rapid early weight gain has been associated with increased risk of obesity and cardiometabolic alterations, but evidence in low and middle-income countries is inconclusive. Objective: We evaluated the relation between relative weight gain from 1 to 48 mo with adiposity and cardiometabolic risk factors at 4-5 y of age, and determined if adiposity is a mediator for cardiometabolic alterations. Methods: We studied 428 Mexican children with anthropometric and blood pressure (BP) information from birth to 5 y of age from POSGRAD (Prenatal Omega-3 fatty acid Supplementation and child GRowth And Development), of whom 334 provided measures of adiposity and cardiometabolic risk markers at 4 y. We estimated relative weight gain by means of conditional weight-for-height z scores for the age intervals 1-6, 6-12, 12-24, and 24-48 mo. Associations between relative weight gain and adiposity and cardiometabolic risk markers (lipid profile, triglycerides, insulin, glucose, and BP) were analyzed by multivariate multiple linear models and path analysis. Results: A 1-unit increase in conditional weight-for-height z score within each age interval was positively associated with adiposity at 5 y, with coefficients of 0.43-0.89 for body mass index (BMI) z score, 1.08-3.65 mm for sum of skinfolds, and 1.21-3.87 cm for abdominal circumference (all P < 0.01). Positive associations were documented from ages 6 to 48 mo with systolic BP (coefficient ranges: 1.19-1.78 mm Hg; all P < 0.05) and from ages 12 to 48 mo with diastolic BP (1.28-0.94 mm Hg; P < 0.05) at 5 y. Conditional weight-for-height z scores at 12-24 and 24-48 mo of age were more strongly associated with adiposity and BP relative to younger ages. A unit increase in conditional weight-for-height z scores from 12 to 24 mo was associated with 14% higher insulin levels (P < 0.05) at 4 y. Path analyses documented that the associations of conditional weight gain with BP were mediated by BMI and sum of skinfolds. Conclusion: Relative weight gain at most periods during the first 4 y of life was associated with greater adiposity and higher systolic and diastolic BP at 5 y. These associations with BP were mediated by adiposity. Relative weight gain from 12 to 24 mo was associated with increased serum insulin concentrations at 4 y, but there were no associations with lipid profiles or glucose concentration.

Usual Intake of Added Sugars and Saturated Fats Is High while Dietary Fiber Is Low in the Mexican Population.

BACKGROUND: The Mexican National Health and Nutrition Survey (ENSANUT) was carried out in 2012. Information from the survey is used to design and evaluate food and nutrition policies in Mexico. OBJECTIVE: The objective of this study was to estimate the usual intake of energy and macronutrients in the Mexican population by using the ENSANUT 2012. METHODS: Twenty-four-hour recall interviews were administered to a nationally representative subsample of 10,096 individuals aged ≥1 y from the ENSANUT 2012. Usual intake distributions and the prevalence of inadequate intakes were estimated by using the Iowa State University method. Student's t tests and tests on the equality of proportions were used to compare usual intakes and prevalence of inadequacy across socioeconomic status, area (rural or urban), and region of residence (North, Center, or South). RESULTS: Energy and macronutrient intakes and indicators of dietary adequacy are presented for children (ages 1-4 y and 5-11 y), adolescents (12-19 y), and adults (≥20 y). At the national level, the estimated mean fiber intake was below the Adequate Intake for all population subgroups, suggesting inadequacies. The estimated proportion with a usual added sugars intake of >10% of total energy intake was >64% in all age groups. The proportion with a usual saturated fat intake of >10% of total energy intake was estimated to be >78% in children, >66% in adolescents, and >50% in adults. Overall, fiber intake was lower and intakes of saturated fat and added sugars were higher in urban compared with rural areas, in the North compared with South regions, and among those with high compared with low socioeconomic status (P < 0.05). CONCLUSIONS: Fiber intake is lower and added sugar and saturated fat intakes are higher than recommended for >50% of the Mexican population aged ≥1 y. These results highlight the importance of improving the diets of the overall population to reduce the risk of noncommunicable chronic diseases.

Usual Vitamin Intakes by Mexican Populations.

BACKGROUND: In the past several years, the consumption of high-energy, nutrient-poor foods has increased globally. Dietary intake data collected by the National Health and Nutrition Survey (ENSANUT) 2012 provide information to assess the quality of the Mexican diet and to guide food and nutrition policy. OBJECTIVE: The aim was to describe the usual intake and the prevalence of inadequate intakes of vitamins for the overall Mexican population and by subgroups defined by sex, age, region, urban or rural areas, and socioeconomic status (SES). METHODS: ENSANUT 2012 is a cross-sectional probabilistic survey representative of the Mexican population. Dietary information was collected by using the 24-h recall automated multiple-pass method (n = 10,096) with a repeated measurement on a subsample (n = 889) to permit adjustment for intraindividual variability with the use of the Iowa State University method. Mean usual intakes and the prevalence of inadequate intakes of thiamin, riboflavin, niacin, folate, and vitamins A, D, E, C, B-6, and B-12 were calculated for children aged 1-4 y (CH1-4y), children aged 5-11 y (CH5-11y), adolescents aged 12-19 y, and adults aged ≥20 y. RESULTS: In all of the age groups, prevalences of inadequate intakes of vitamins D and E were the highest (77-99% of adults and adolescents and 53-95% of CH5-11y and CH1-4y) and those of folate and vitamin A were intermediate (47-70% of adults and adolescents, 15-23% of CH5-11y and 8-13% of CH1-4y), whereas those of thiamin, riboflavin, niacin, and vitamins B-6, B-12, and C were the lowest (0-37% of adults, 1-27% of adolescents, and 0-2.4% of CH5-11y and CH1-4y). With few exceptions, the highest prevalences of inadequate intakes for vitamins were observed in the poorest populations (rural South region and the lowest tertile of SES). CONCLUSIONS: The intake of vitamins among Mexicans is inadequate overall. Information collected by ENSANUT can help target food assistance programs and develop strategies to prevent vitamin deficiencies.

Methodology for estimating dietary data from the semi-quantitative food frequency questionnaire of the Mexican National Health and Nutrition Survey 2012.

OBJECTIVE:: To describe the methodology used to clean up and estimate dietary intake (DI) data from the Semi-Quantitative Food Frequency Questionnaire (SFFQ) of the Mexican National Health and Nutrition Survey 2012. MATERIALS AND METHODS:: DI was collected through a shortterm SFFQ regarding 140 foods (from October 2011 to May 2012). Energy and nutrient intake was calculated according to a nutrient database constructed specifically for the SFFQ. RESULTS:: A total of 133 nutrients including energy and fiber were generated from SFFQ data. Between 4.8 and 9.6% of the survey sample was excluded as a result of the cleaning process.Valid DI data were obtained regarding energy and nutrients consumed by 1 212 pre-school children, 1 323 school children, 1 961 adolescents, 2 027 adults and 526 older adults. CONCLUSIONS:: We documented the methodology used to clean up and estimate DI from the SFFQ used in national dietary assessments in Mexico.

Validity of a food frequency questionnaire to assess food intake in Mexican adolescent and adult population.

OBJECTIVE:: To assess the validity of a 140-item semiquantitative food frequency questionnaire (SFFQ), in Mexican adolescents and adults. MATERIALS AND METHODS:: Dietary intakes using a SFFQ and two 24-hour dietary recalls (24DRs), in nonconsecutive days during the same week were measured from 178 adolescents and 230 adults participating in the Mexican National Health and Nutrition Survey-2012.Validity was evaluated using correlation coefficients (CC),deattenuated CC, linear regression models, cross-classification analysis, and the Bland-Altman method. RESULTS:: In adults, deattenuated correlation coefficients between the SFFQ and the 24DRs ranged from 0.30 for folate to 0.61 for saturated fat. In addition, 63% adults and 62% adolescents were classified in the same and adjacent quartile of nutrient intake when comparing data from SFFQ and 24DRs. CONCLUSIONS:: The SFFQ had moderate validity for energy, macronutrients and micronutrients. It also had good validity to rank individuals according to their dietary intake of different nutrients.

Breastfeeding status at age 3 months is associated with adiposity and cardiometabolic markers at age 4 years in Mexican children.

BACKGROUND: The effect of breastfeeding (BF) on cardiometabolic risk factors is not well characterized. OBJECTIVE: The objective was to assess the association of BF status at 3 mo and duration with adiposity and cardiometabolic markers at 4 y. METHODS: We studied 727 children with prospectively collected BF information and anthropometric measurements at 4 y, of whom 524 provided a nonfasting blood sample. BF status at 3 mo was classified as exclusive or predominant (EBF-PreBF), partial (PaBF), or nonbreastfeeding (NBF). Total duration of any BF was classified as <3 mo, 3- 6 mo, >6 to 12 mo, and >12 mo. We modeled associations of BF with body mass index (BMI; in kg/m(2)), serum total cholesterol and low-density lipoprotein (LDL) cholesterol, triglycerides (TGs), and insulin at 4 y. RESULTS: Children who were NBF or PaBF at 3 mo had higher BMI [0.46 (95% CI: 0.16, 0.76) and 0.31 (95% CI: 0.07, 0.54), respectively] than the EBF-PreBF group (P < 0.01). NBF children had higher total cholesterol (8.02 mg/dL; 95% CI: 1.39, 14.64; P = 0.02) than children who were EBF-PreBF. LDL cholesterol (5.04 mg/dL; 95% CI: -0.72, 10.81) and TGs (12% change; 95% CI: -0.01, 0.24) showed similar patterns. An inverse association between EBF-PreBF and insulin, mediated through abdominal circumference, was documented (P < 0.05). Children breastfed <3 mo had higher BMI (0.44; 95% CI: 0.11, 0.77) at 4 y than children breastfed for >12 mo. CONCLUSION: EBF and PreBF at 3 mo were associated with lower adiposity and serum total cholesterol in children at 4 y. In addition, BF >12 mo was associated with lower adiposity. These data confirm the importance of exclusive BF and prolonged BF for later cardiometabolic health.

Addressing Infant and Young Child Feeding Recommendations From a Planetary Health Perspective.

Current international infant and young child (IYC) feeding recommendations consider nutrition and health but not environmental impacts. Only a handful of countries have dietary guidelines that provide quantitative recommendations for food groups of environmental concern. This study aimed to perform a narrative review of the environmental impacts of commercial milk formula compared with breastfeeding and to analyze the degree to which current country-specific IYC feeding recommendations are aligned with sustainable dietary targets. A mixed-methods review was conducted, including the following: 1) a narrative review of the environmental impact of commercial milk formula compared with breastfeeding and 2) a comparison of recommended intake of meats and dairy for children IYC based on country-specific dietary guidelines compared with the EAT-Lancet Commission dietary targets (ELCT) for children 24 mo or older and adults and if the ELCT should be adjusted for the energy needs of IYC. Formula feeding has a greater environmental impact (∼48% higher carbon footprint) than exclusive breastfeeding. Available country-specific dietary guidelines for meat and dairy products in children IYC are, in general, at or below the upper limits of the ELCT recommended ranges for older children and adults but are in most cases above the upper limit when adjusting for the energy needs of IYC. Exclusive breastfeeding should be protected and promoted not only as the healthier but also as the most sustainable alternative. Available complementary dietary feeding recommendations of nonprocessed meat and dairy fall below current ELCT for older children and adults. Given that IYC require a more nutrient-dense diet than older children and adults and considering the small quantities they consume, we recommend using the unadjusted ELCT as reference for IYC feeding while specific international consumption recommendations are developed for this age group.

Dietary Zinc Intake and the Association of Insulin Level and HOMA-IR with Telomere Shortening in Mexican Children.

PURPOSE: The relationship between dietary zinc (Zn) intake, metabolic diseases, and telomere length has been little explored in the children population. This observational cross-sectional study assesses the association between obesity (OB), cardiometabolic traits, telomere length, and dietary Zn intake in children with normal weight (NW) and OB from Mexico City. METHODS: Anthropometric data, blood pressure, biochemical measurements, the homeostatic model assessment of insulin resistance (HOMA-IR) and leucocyte telomere length (determined by quantitative-PCR) were analyzed in 171 children with NW and 172 with OB. Furthermore, dietary Zn intake was evaluated in 117 children NW and 120 with OB. RESULTS: Telomere shortening was associated with fasting plasma insulin (FPI) and HOMA-IR in NW (beta coefficient [ß]FPI = -0.022 ± 0.008, p = 0.009; ßHOMA-IR = -0.096 ± 0.040, p = 0.020) and OB (ßFPI = -0.007 ± 0.002, p = 0.003; ßHOMA-IR = -0.034 ± 0.012, p = 0.005) children. Dietary Zn intake resulted negatively associated with FPI (ß = -2.418 ± 0.764, p = 0.002) and HOMA-IR (ß = -0.399 ± 0.014, p = 0.009) in children with OB. Then, in children with OB, the association between FPI, HOMA-IR, and telomere shortening was evaluated separately in groups of low, medium, and high dietary Zn intake (according to tertiles). The association between FPI, HOMA-IR, and telomere shortening was not significant in the high Zn intake group (PFPI = 0.633; PHOMA-IR = 0.567). CONCLUSION: Our results suggest that a high Zn intake may ameliorate the telomere shortening related to high FPI and HOMA-IR.

Differential dietary intake and contribution of ultra-processed foods during pregnancy according to nutritional status.

Introduction: Frequent consumption of ultra-processed foods (UPFs) during pregnancy is linked to excess intake of added sugar, fat, and sodium and inadequacy of several micronutrients. Diet quality during pregnancy should be maximized as inadequate levels of key nutrients and excessive intake of energy and added sugar might influence mother-child health. We aimed to estimate the contribution (% of total calories) of ultra-processed products to the total energy intake by pre-gestational body mass index (BMI) categories and Hb status during pregnancy in participants from the MAS-Lactancia Cohort. Methods: Pre-gestational weight, hemoglobin levels, 24-h dietary intake recall interviews, and sociodemographic data were collected during the second and third trimesters of pregnancy. Reported consumed foods were categorized using the NOVA classification, and the contribution of calories from each NOVA category was estimated using the Mexican Food Database. We estimated medians and interquartile ranges (p25 and p75) for dietary intake and energy contributions. The comparison of intake between the second and third trimesters was done using the Wilcoxon test. In addition, a quantile regression model with an interaction between pre-gestational BMI and Hb levels status in tertiles over the percentage of energy from UPFs was adjusted by age and socioeconomic status. Results: The contribution to total energy intake from UPFs was 27.4% in the second trimester and 27% in the third trimester (with no statistical difference). The percentage of energy intake from UPFs was higher in women who started pregnancy with obesity and presented the lowest levels of Hb (1st tertile), 23.1, 35.8, and 44.7% for the 25th, 50th, and 75th percentiles, respectively, compared to those with normal BMI and the highest tertile of Hb levels: 18, 29.0, and 38.6% for the 25th, 50th, and 75th percentiles, respectively. Conclusion: In conclusion, UPF intake in pregnant women is similar to the general population and was higher for those with pre-gestational obesity and the lowest tertile of Hb levels. UPF contributes also to sugar, saturated fat, and sodium, which may adversely affect the health of mothers and their offspring.

Impact of memory bias in the dietary estimation of older adults measured through a food frequency questionnaire and weighed food records: A cross-sectional study in older adults and primary caregivers.

Introduction: Introduction: changes in cognitive performance and memory of older adults (OA) can interfere in their reporting their diet. Objective: to evaluate the impact of memory bias in dietary estimation between OA and their primary caregivers (PC) through the food frequency questionnaire (FFQ) for Mexican OA and weighed food records (WFR). Methods: the present analysis uses the estimated dietary information based on the response provided by 51 older adults (OA) and their primary caregivers (PC) from the validation study of the FFQ for Mexicans OA was conducted during lockdowns for COVID-19. The personnel who applied FFQ and WFR were trained with standardized instruments and procedures. The Wilcoxon test was used to compare the intake per day of the foods and food groups, the Spearman correlation coefficient was used to evaluate the grams of intake per day of the food groups, and kappa coefficient was used to compare the level of food items and food groups between OA and PC. Results: in 11 of 14 food groups, no significant differences were observed between the amounts of intake reported by OA and PC. In the groups of dairy products, fruits, vegetables, and legumes, moderate agreement was observed (κ = 0.63 to 0.79), and in the rest of the groups was strong to perfect (κ ≥ 0.80). Correlation of the amount of intake between OA and PC was high in all food groups (r ≥ 0.87). Conclusion: the high correlation and high agreement between the amounts and frequencies of the food groups consumed as reported by the older adults and primary caregivers indicate that the information from both respondents is reliable.

Introducción: Introducción: los cambios cognitivos y la memoria que presentan los adultos mayores (AM) pueden interferir al momento de reportar los alimentos de su dieta. Objetivo: evaluar el impacto del sesgo de memoria en la estimación de la dieta entre AM y sus cuidadores principales (CP) a través del cuestionario de frecuencia de alimentos (CFA) para AM mexicanos y el registro de peso de alimentos (RPA). Métodos: el presente análisis utiliza la información dietética estimada con base en la respuesta proporcionada por 51 adultos mayores (AM) y sus cuidadores principales (CP) del estudio de validación del CFA para AM mexicanos que se realizó durante el confinamiento por COVID-19. El personal que aplicó CFA y RPA fue capacitado con instrumentos y procedimientos estandarizados. Se utilizó prueba de Wilcoxon para comparar la ingesta por día de los alimentos y grupos de alimentos, el coeficiente de correlación de Spearman para evaluar los gramos de ingesta por día de los grupos de alimentos y el coeficiente kappa para comparar el nivel de alimentos y grupos de alimentos entre AM y CP. Resultados: en 11 de 14 grupos de alimentos no se observaron diferencias significativas entre las cantidades de ingesta reportadas por AM y CP. En los grupos de lácteos, frutas, verduras y legumbres se observó concordancia moderada (κ = 0,63 a 0,79), y en el resto de los grupos fue de fuerte a perfecta (κ ≥ 0,80). La correlación de la cantidad de ingesta entre AM y CP fue alta en todos los grupos de alimentos (r ≥ 0,87). Conclusión: La alta correlación y la alta concordancia entre las cantidades y frecuencias de los grupos de alimentos consumidos según lo informado por los adultos mayores y los cuidadores principales indican que la información de ambos encuestados es confiable.