ABSTRACT
@#Caborca is one of the most productive asparagus-growing regions in the state of Sonora in northwest Mexico, an area where some fresh fruits and vegetables are sold at unregulated open-air street markets. This is a cross-sectional study in which fifty bundles of asparagus for exportation, 50 bundles of sub-standard asparagus, and 50 bundles of asparagus from open-air markets were selected randomly and then subjected to Faust, Kinyoun and ELISA testing to detect intestinal parasites. Pearson’s chi-square (χ2) and Student-Newman- Keuls tests were used to estimate differences among the sampling site groups (P < 0.05). The pathogens Cryptosporidium spp. (29%) G. intestinalis (5%) and Cyclospora spp. (3%) were found in the asparagus sold in the region. The prevalence of Cryptosporidium spp. was higher in both the sub-standard asparagus and the product sampled from the open-air markets than in the samples for exportation (P < 0.05). This is the first study to demonstrate contamination by intestinal parasites in asparagus sold in different markets in northwest Mexico.
ABSTRACT
El objetivo del estudio fue evaluar el efecto de un programa intensivo de cambio en el estilo de vida para el control de peso sobre la sensibilidad a la insulina en niños y adolescentes en el primer nivel de atención. El estudio incluyó a 42 niños y adolescentes de 9 a17 años (n=23 grupo intensivo, n=19 grupo control) que participaron en un estudio clínico aleatorizado para el tratamiento de obesidad. El programa intensivo de cambio en el estilo de vida incluyó consultas mensuales con el médico del primer nivel de atención, asesoría dietética con el nutriólogo (semanal los primeros 3 meses y luego mensual) y 12 sesiones grupales en un protocolo de cambio de conducta. El grupo control incluyó solamente las consultas médicas mensuales. La sensibilidad a la insulina se estimó por el índice de sensibilidad a la insulina (ISI(0,120)) al inicio y a los 6 meses de intervención. Los niños y adolescentes del programa intensivo mostraron un mayor efecto en la sensibilidad a la insulina a los 6 meses en comparación al grupo control ([media ± DE], + 46.8 ± 56 vs. + 5.6 ± 47, diferencia 41.2 [IC 95%, 8.5, 73.9], p= 0.01) y 65% lograron aumentar la sensibilidad a la insulina >9 unidades vs. 32% en el grupo control (p=0.03). Este estudio muestra evidencia preliminar que un programa intensivo de cambio en el estilo de vida puede ser un modelo alternativo para mejorar la sensibilidad a la insulina en los niños y adolescentes con obesidad en el primer nivel de atención.
Improvement of insulin sensitivity after an intensive lifestyle program for youth´s weight management in the primary care. The aim of this study was to evaluate an intensive lifestyle intervention for weight management among youth in a primary care setting on insulin sensibility, compared to a control group. The study included 42 youths 9-17 years old (n=23 intensive lifestyle intervention, n=19 control group) who completed a randomized trial for weight management in a primary care setting which included an oral glucose tolerance test. The intensive lifestyle intervention included monthly consultations with the primary care physician, nutrition counseling with a registered dietitian (weekly first 3 months and then monthly) and 12 group sessions in a behavioral change protocol. The control group attended monthly consultations with the primary care physician. Insulin sensitivity was estimated by the Insulin Sensitivity Index ISI(0,120) at baseline and 6 months posttreatment. At 6 months, the mean ± DE, increase in insulin sensitivity was greater in the intensive lifestyle intervention than the control group (+46.8 ± 56 vs. +5.6 ± 47, betweengroup difference 41.2 [CI 95%, 8.5, 73.9], p= 0.01). Sixty five percent of youths on the intensive lifestyle intervention increased insulin sensitivity over 9 units vs. 32% in the control group (p=0.03). This study shows preliminary evidence that an intensive lifestyle intervention program can be an alternative model to improve insulin sensitivity among youths in the primary care setting.