Volviéndonos mejores: necesidad de acción inmediata ante el reto de la obesidad. Una postura de profesionales de la salud / Becoming better: the need for immediate action to address obesity. A position statement from health professionals

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Abstract: In recent decades, the growing obesity epidemic in Mexico has become one of the most important public health challenges faced by the country. With support from the World Obesity Federation, we formed a working group in 2021 to identify and summarize priority actions that Mexico can take to face this epidemic. More than 1 000 health professionals joined the development and discussion process. Recommendations from previously published, high-level documents and guidelines were taken into account. In commemoration of World Obesity Day 2022, this statement is presented as input for health care professionals to develop actions to address obesity. The statement includes 10 recommendations that include population-level and individual-level actions. It emphasizes the importance of social participation, comprehensive interventions with a person- centered perspective, planetary sustainability, on improving education and communication campaigns, as well as fostering a built environment that promotes active living, and shielding prevention and control efforts from conflicts of interest. The statement calls for obesity to be treated seriously, based on scientific evidence, in a timely and comprehensive manner, employing a life-course and ethical approach that does not perpetuate weight stigma in society.

Consumo frecuente de alimentos industrializados y su percepción en adolescentes indígenas Mayas con sobrepeso y obesidad / Frequent consumption of industrialized food and its perception among overweight and obese indigenous Mayan adolescents

Resumen Se planteó como objetivo identificar cuáles y de qué tipo son los alimentos industrializados modernos que los adolescentes con sobrepeso y obesidad consumen y la percepción que tienen de ellos. El estudio fue de tipo cuali-cuantitativo, descriptivo e interpretativo; se llevó a cabo con estudiantes adolescentes de cuatro secundarias del municipio de Abalá, Yucatán, México. Constó de tres etapas, en la primera se realizaron mediciones antropométricas a 292 estudiantes de las secundarias para obtener el Índice de Masa Corporal, en la segunda se seleccionaron al azar 58 estudiantes que presentaron sobrepeso y obesidad; a los cuales se les aplicó un cuestionario de frecuencia de consumo de alimentos. En la tercera etapa se realizaron cuatro grupos focales para conocer la percepción respecto al consumo de alimentos. Se observó una ingesta alta de alimentos industrializados modernos en el desayuno, receso escolar y cena; en el tiempo de la comida aún se consumen preparaciones tradicionales. Existe una transculturación de la alimentación en los adolescentes.

Abstract The scope of this paper was to identify what kind and which type of modern industrialized foods that overweight and obese adolescents consume and the perception they have of them. The study was of the qualitative-quantitative, descriptive and interpretative type and was conducted with adolescent students from four high schools in the municipality of Abalá, Yucatán, Mexico. It consisted of three stages, the first of which involved recording anthropometric measurements of 292 high school students to obtain their Body Mass Index. In the second stage, 58 students who were overweight and obese were randomly selected and a food consumption frequency questionnaire was applied. In the third stage, four focus groups were held to ascertain the perception with respect to food consumption. A high intake of modern industrialized foods was observed at breakfast, school break and dinner, though traditional dishes are still consumed at mealtimes. The conclusion drawn is that there is a transculturation of food among adolescents.

Comparación entre la percepción corporal y el índice de masa corporal en estudiantes de secundaria de dos municipios de Yucatán / Comparison between body perception and body mass index in secondary students from two municipalities of Yucatan / Comparação entre percepção corporal e índice de massa corporal em estudantes do ensino médio de dois municipios de Yucatán / Comparaison entre la perception corporelle et l'indice de masse corporelle chez des élèves du secondaire de deux municipalités du Yucatán

Resumen Objetivo Comparar la relación de la Percepción de la Imagen Corporal y el Índice de Masa Corporal en estudiantes de secundaria de dos municipios de Yucatán. Material y Métodos Estudio cuantitativo y transversal, en 462 estudiantes de 11 a 17 años pertenecientes a escuelas de los municipios de Abalá y Chacsinkín, Yucatán. Se tomó el peso corporal y la talla, se calculó el Índice de Masa Corporal (IMC)/edad, de acuerdo a los patrones de la Organización Mundial de la Salud (OMS) para adolescentes. Se determinó la percepción de la imagen corporal mediante el instrumento Análisis de la Percepción de la Imagen Corporal (APC), propuesta por Stunkard y Stellard, modificado por Collins. Para el análisis estadístico inferencial se utilizó la prueba Chi-cuadrara con un valor de significancia estadística de 5%. Resultados 62.9% de los adolescentes, tienen un Índice de Masa Corporal normal, mientras que 35.6% presentan una prevalencia combinada de obesidad y sobrepeso. En cuanto a Percepción de la Imagen Corporal, 28.8 % de los adolescentes se percibieron de acuerdo con su IMC real; 25.3% se percibieron con IMC mayor al real y 45.9% se percibieron con IMC menor al que tienen en realidad Conclusiones En el municipio de Abala, los adolescentes presentaron mayor prevalencia de normo peso y exceso de peso; frecuencia mayor de concordancia entre la percepción corporal y el IMC real y sobre estimación de su IMC, a diferencia de la mayor frecuencia de subestimación que se presentó en los adolescentes del municipio de Chacsinkín Los adolescentes de ambos municipios con exceso de peso, subestimaron su IMC y no lo identifican como un problema de salud, lo que representa un área de oportunidad para el trabajo del equipo multidisciplinario de salud.

Abstract Objective To compare the relationship between the Perception of the Body Image and the Body Mass Index in secondary school students of two municipalities of Yucatán. Material and Methods Quantitative and cross-sectional study, with a population of 462 students aged from 11 to 17 belonging to schools in the municipalities of Abalá and Chacsinkin, Yucatán. Body weight and height were taken; Body Mass Index (BMI) by age was calculated according to the patterns of the World Health Organization (WHO) for adolescents. Body image perception was determined by means of the Body Image Perception Analysis (BPI) instrument proposed by Stunkard and Stellard and modified by Collins. For the inferential statistical analysis, the Chi-square test with a statistical significance value of 5% was used. Results 62.9% of adolescents have a normal Body Mass Index; while 35.6% have a combined prevalence of obesity and overweight. Regarding Perception of Body Image, 28.8% of adolescents were perceived according to their real BMI; 25.3% were perceived with BMI greater than the real and 45.9% were perceived with BMI lower than they actually have Conclusions In the municipality of Abalá, adolescents presented a higher prevalence of normal weight and excess weight; higher frequency of concordance between body perception and real BMI and overestimation of their BMI, unlike the higher frequency of underestimation that occurred in adolescents in the municipality of Chacsinkin Adolescents in both municipalities with excess weight underestimated their BMI and they did not identify it as a health problem, which represents an area of opportunity for the work of the multidisciplinary health team.

Sumário Objetivo Comparar a relação entre a percep9áo da imagem corporal e o índice de massa corporal em estudantes do ensino médio de dois municipios de Yucatán. Material e Métodos Estudo quantitativo e transversal, em 462 alunos de 11 a 17 anos pertencentes a escolas dos municipios de Abalá e Chacsinkin, Yucatán. O peso corporal e a altura foram medidos, calculado o Índice de Massa Corporal (IMC) / idade, de acordo com os padrões da Organização Mundial da Saúde (OMS) para adolescentes. A percepção da imagem corporal foi determinada utilizando o instrumento Body Image Perception Analysis (APC), proposto por Stunkard e Stellard, modificado por Collins. O teste do qui-quadrado com valor de significância estatística de 5% foi utilizado para a análise estatística inferencial. Resultados 62,9% dos adolescentes têm um Índice de Massa Corporal normal, enquanto 35,6% têm uma prevalência combinada de obesidade e sobrepeso. Em relação a percepção da imagem corporal, 28,8% dos adolescentes foram percebidos de acordo com o IMC real; 25,3% foram percebidos com IMC maior que o real e 45,9% foram percebidos com IMC menor do que realmente Conclusões No municipio de Abala, os adolescentes apresentaram maior prevalência de peso normal e excesso de peso; maior frequência de concordância entre a percepção corporal e o IMC real e superestimação do IMC, diferentemente da maior frequência de subestimação que ocorreu em adolescentes no município de Chacsinkín. Os adolescentes dos dois municípios com excesso de peso subestimaram seu IMC e não o identificam como um problema de saúde, o que representa uma área de oportunidade para o trabalho da equipe multiprofissional de saúde.

Résumé Objectif Comparer la relation entre la Perception de l'Image Corporelle et l'Indice de Masse Corporelle chez des élèves du secondaire de deux municipalités du Yucatan. Matériel et méthodes Étude quantitative et transversale, avec une population de 462 élèves, de 11 a 17 ans, inscrits dans des écoles des municipalités d'Abalá et de Chacsinkin, Yucatán. Le poids et la taille ont été relevés, et l'Indice de Masse Corporelle en fonction de l'âge (IMC-pour-l'âge) a été calculé selon les normes de l'Organisation Mondiale de la Santé (OMS) pour adolescents. La Perception de l'Image Corporelle a été déterminée a l'aide de l'instrument Analyse de la Perception de l'Image Corporelle (BPA) proposé par Stunkard et Stellard et modifié par Collins. Le test du Khi-deux avec une valeur de signification statistique de 5 % a été utilisé pour l'analyse statistique inférentielle. Résultats 62,9 % des adolescents ont un Indice de Masse Corporelle normal alors qu'il existe une prévalence combinée d'obésité et de surpoids de 35,6 %. La Perception de l'Image Corporelle a été en accord à l'IMC réel dans 28,8 % des cas. 25,3 % se sont per9us comme ayant un IMC supérieur à leur IMC réel et 45,9 % comme ayant un IMC inférieur à leur IMC réel. Conclusions Dans la municipalité d'Abala, les adolescents ont présenté une prévalence plus élevée de poids normal et de surpoids, une fréquence plus élevée de concordance entre leur perception corporelle et l'IMC réel et une surestimation de leur IMC, en comparaison avec la fréquence plus élevée de sous-estimation chez les adolescents de la municipalité de Chacsinkin. Les adolescents des deux municipalités ayant un excès de poids ont sous-estimé leur IMC et ne l'ont pas identifié comme un problème de santé, ce qui constitue un champs d'opportunités pour le travail de l'équipe de santé multidisciplinaire.

Riesgo de enfermedades cardiovasculares y su percepción en adolescentes con sobrepeso y obesidad de comunidades mayas de Yucatán / Risk of cardiovascular diseases and their perception in adolescents with overweight and obesity in Mayan communities of Yucatan

Las investigaciones realizadas en adolescentes del área rural y su percepción de salud son escasas, lo que representa un área de oportunidad para prevenir enfermedades de tipo cardiovascular en la vida adulta. El objetivo fue determinar el riesgo de enfermedades cardiovasculares y su percepción en adolescentes con sobrepeso y obesidad de comunidades mayas. Se llevó a cabo en dos etapas: cuantitativatransversal y cualitativa. En el Municipio de Abalá, Yucatán, con estudiantes de secundarias (n = 292). Se registró el peso, talla, edad, circunferencia de cintura, tensión arterial y se calcularon los indicadores Talla/Edad, Índice de Masa Corporal/Edad, Cintura Cadera/Talla y Tensión Arterial sistólica/Talla. Se realizaron grupos focales con adolescentes con sobrepeso u obesidad según Índice de Masa Corporal (IMC) para explorar creencias acerca del sobrepeso/obesidad, alimentos que lo provocan y enfermedades ocasionadas. Se utilizó estadística descriptiva y prueba de Chi-cuadrado. El 96,9% de los adolescentes tuvo talla normal; según IMC, 54,1% peso Normal, 28,4% sobrepeso y 17,1% obesidad. El 30,5% presentó riesgo cardiovascular según Cintura Cadera/Talla y el 8,9% de los adolescentes registró prehipertensión/hipertensión, más frecuente en hombres que en mujeres. Respecto a la percepción del sobrepeso/obesidad, los adolescentes señalaron que no es buena para la salud; los alimentos que ocasionan sobrepeso/obesidad son ricos en hidratos de carbono, grasas, con alto contenido calórico y las enfermedades derivadas del sobrepeso/obesidad son diabetes, anemia, anorexia y desnutrición. Se encontró riesgo cardiovascular en adolescentes, mayor en los hombres. Perciben que no llevan una buena alimentación, lo que podría ocasionarles sobrepeso/obesidad y desarrollar enfermedades cardiovasculares(AU)

The research carried out in adolescents in rural areas and their perception of health is scarce, which represents an area of opportunity to prevent cardiovascular diseases in adulthood, since at this stage increases the degree of autonomy. The objective was to determine the risk of cardiovascular diseases and their perception in adolescents with overweight and obesity in Mayan communities. It was carried out in two stages: quantitative-transversal and qualitative; In the municipality of Abalá, Yucatán with secondary students (n = 292). The weight, height, age, waist circumference, blood pressure was recorded and height/age indicators, Body mass index/age, waist circumference/age and systolic/height were calculated. Focal groups were conducted with overweight or obese adolescents according to Body Mass Index (BMI) to explore beliefs about overweight/obesity, foods that cause obesity and illness. Descriptive statistics and Chisquare test were used. Height was adequate in 96.9% of adolescents, according to BMI, 54% had normal weight 28.4% were overweight and 17.1% were obese. 30.5% showed cardiovascular risk, according to waist circumference/height and 8.9% of adolescents had prehypertension/hypertension, being more frequent in males than females. About the perception of overweight/obesity, adolescents feel that it is not good for health; the foods that cause these problems are rich in carbohydrates, fats, with high caloric value; diseases resulting from overweight/obesity are diabetes, anaemia, anorexia and malnutrition. However, adolescents present cardiovascular risk, being higher in males. Adolescents perceive that they are not eating well, which can lead to overweight/obesity and the development of cardiovascular disease(AU)

Replacing sugar with S. rebaudiana extracts on the physicochemical and sensory properties of strawberry ice cream / Substituição do açúcar com extratos de S. rebaudiana sobre as propriedades físico-químicas e sensoriais de sorvete de morango

ABSTRACT: Ice cream is a product whose formulation requires considerable amounts of sugar. In addition to providing flavor, sugar contributes to the physicochemical characteristics of ice cream but its consumption in large quantities is related to chronic diseases such as diabetes and obesity. For this reason, the food industry seeks to formulate products with sweeteners that preserve the physicochemical and sensory characteristics of the original product. Stevia rebaudiana is a plant that naturally contains glycosides with no calories and high sweetening capacity and it is considered safe for consumption. Therefore the aim of this research was to evaluate the effect of replacing sugar with different levels of extracts of S. rebaudiana Morita II and Criolla, on the physicochemical and sensory properties of strawberry ice cream. Using a 2x2 factorial experimental design, a total of 4 formulations were prepared with two levels of concentration of the aqueous extract of Stevia rebaudiana (5 or 8%) and the variety of S. rebaudiana (Morita II or Criolla). Proximate composition, physicochemical properties and sensory evaluation were determined in processed products. The proximate analysis of strawberry ice cream varied significantly (P<0.05) depending of variety and level used on the formulation. The viscosities of all ice cream mixes were decreasing as the shear rate was increased, indicating a pseudoplastic behavior. The sensory analysis showed differences (P<0.05) among the formulations tested, however the score of all products were above the indifference point, suggesting that all of these formulations may have a commercial potential.

RESUMO: Sorvete é um produto cuja formulação requer quantidades consideráveis de açúcar. Além de proporcionar o sabor, o açúcar contribui para as propriedades físico-químicas do sorvete, mas o seu consumo em grandes quantidades está relacionada com as doenças crônicas, como diabetes e obesidade. Por essa razão, a indústria alimentícia buscou formular produtos com adoçantes para manter as propriedades físico-químicas e sensoriais do produto original. Stevia rebaudiana é uma planta que contém naturalmente glicosídeos sem calorias com alta capacidade adoçante, cujo consumo é considerado seguro. Portanto, o objetivo deste estudo foi avaliar o efeito da substituição do açúcar por diferentes níveis de extratos de S. rebaudiana Morita II e Criolla, sobre as propriedades físico-químicas e sensoriais do sorvete de morango. Usando um modelo experimental de fator 2x2, um total de 4 formulações foram preparadas com 2 níveis de concentração de extrato aquoso de Stevia rebaudiana (5 ou 8%) e a variedade de Stevia (Morita II ou Criolla). Os produtos processados foram submetidos a análises proximais e físico-químicas, e avaliação sensorial foi realizada para três deles. A análise do sorvete de morango teve uma variação estatisticamente significativa (P<0,05), dependendo da variedade e do nível utilizado na formulação. A viscosidade da mistura de sorvete diminuía com o aumento da velocidade de corte, indicando um comportamento pseudoplástico. A análise sensorial mostrou que não houve diferenças significativas (P>0,05) entre as formulações avaliadas e a pontuação de todos os produtos estava acima do ponto de indiferença, indicando que todos eles podem ter um potencial comercial.