Life Course Education, Health, and Ageing Well: A Short Inter-Academic Report.

After the first wave of the COVID-19 pandemic, during which the severity of the disease in certain countries was attributed to a lack of basic education of the inhabitants, the authors of this paper initiated a literature review of educational trajectories, health, and ageing well. The findings strongly demonstrate that alongside genetics, the affective and educational family environment, as well as the general environment, greatly interact starting from the very first days of life. Thus, epigenetics plays a major role in the determination of health and disease [DOHAD] in the first 1,000 days of life as well as in the characterization of gender. Other factors such as socio-economic level, parental education, schooling in urban or rural areas, also play a major role in the differential acquisition of health literacy. This determines adherence (or lack thereof) to healthy lifestyles, risky behaviours, substance abuse, but also compliance with hygiene rules, and adherence to vaccines and treatments. The combination of all these elements and lifestyle choices facilitates the emergence of metabolic disorders (obesity, diabetes), which promote cardiovascular and kidney damage, and neurodegenerative diseases, explaining that the less well educated have shorter survival and spend more years of life in disability. After having demonstrated the impact of the educational level on health and longevity, the members of this inter-academic group propose specific educational actions at three levels: (1) teachers and health professionals, (2) parents, (3) the public, emphasizing that these crucial actions can only be carried out with the unfailing support of state and academic authorities.

Identificación de factores protectores y de riesgo para trastornos de conductas alimentarias en una intervención educativa con adolescentes de la Ciudad de México / Identification of protective and risk factors for eating disorders in an educational intervention with adolescents from Mexico City

Fundamentos: Los trastornos de la conducta alimentaria (TCA) constituyen un grupo de trastornos mentalescaracterizados por una conducta alterada de la ingesta alimentaria y/o la aparición de comportamientosinadecuados encaminados a controlar el peso. El objetivo del presente estudio fue identificar los factoresprotectores y de riesgo para TCA en una muestra de adolescentes de la Ciudad de México.Métodos: Se realizó una intervención tipo ensayo controlado aleatorizado, se estimó el estado ponderal conlos percentiles de índice de masa corporal (IMC) propuestos por la OMS. Para la evaluación delcomportamiento alimentario se aplicaron cuestionarios dietéticos y para la identificación de trastornos deconductas alimentarias, ansiedad y depresión se aplicaron los cuestionarios para medir conductasalimentarias de riesgo (CAR) y el cuestionario HAD ansiedad y depresión de Hamilton.Resultados: Se encontró que la presencia de ansiedad incrementa 2,956 la probabilidad de aparición de unTCA (IC 95% = 1,919-4,513) y que el incremento en el IMC es un factor que aumenta la probabilidad depresentar un TCA 1,278 veces (IC 95% 1,220-1,339).Conclusiones: Factores como la ansiedad e IMC son determinantes para el desarrollo de TCA los cuales semanifiestan cada vez más en hombres que en mujeres. (AU)

Background: Eating disorders constitute a group of mental disorders characterized by altered eating behaviorand the appearance of inappropriate behaviors aimed at controlling weight. The aim of the present study wasto identify the protective and risk factors for eating disorders in a sample of adolescents from Mexico City.Methods: A randomized controlled trial intervention was performed, weight status was estimated with thepercentiles of body mass index (BMI) proposed by the WHO. For the evaluation of eating behavior, dietaryquestionnaires were applied and for the identification of eating behavior disorders, anxiety and depression,the questionnaires to measure risk eating behaviors and the Hamilton anxiety and depression questionnairewere applied.Results: It was found that the presence of anxiety increases 2.956 the probability of an eating disorders (95%CI = 1.919-4.513) and the increase in BMI is a factor that increases the probability of presenting an eatingdisorders 1.278 (95% CI 1.220-1.339).Conclusions: Factors such as anxiety and BMI are determinants for the development of eating disorders,which are increasingly manifested in men than in women. (AU)

Intervención educativa para disminuir la prevalencia de obesidad en adolescentes de la ciudad de México, México / Educational intervention to decrease the prevalence of obesity in adolescents of mexico city, mexico

Fundamentos: La prevalencia de obesidad se ha elevado considerablemente entre los niños y adolescentes, representando uno de los principales problemas para la salud pública. El objetivo fue evaluar el impacto de una intervención focalizada en los estilos de vida y los factores asociados a la alimentación, la actividad física, así como aspectos psicológicos y conductuales en adolescentes de escuelas secundariasde Ciudad de México. Métodos: Se realizó una intervención tipo ensayo controlado aleatorizado diseñada con base a la metodología EPODE (Ensemble Prévenons l’Obésité Des Enfants). Se estimó el estado ponderal con los percentiles de IMC propuestos por la Organización Mundial de la Salud y para la evaluación del comportamiento alimentario y la determinación de factoresrelacionados con la obesidad se aplicaron cuestionarios dietéticos y cuestionarios para detectar el riesgo de trastornos de conducta alimentaria, ansiedad y depresión. Resultados: Los factores del modelo en este estudio quepresentan probabilidades de ser protectores para la aparición de la obesidad en adolescentes de escuelas secundarias de la Ciudad de México son el número de pasos a la semana (OR =0,872 IC 95%: 1,212-1,761), el aumento de la actividad física vigorosa (OR = 0,903 IC 95%: 0,843-0,967) y el consumo de fruta (OR = 0,927 IC 95%: 0,861-0,999). Conclusiones: De acuerdo a las condiciones de los adolescentes de escuelas secundarias de la Ciudad de México la realización de actividad física fue un factor importante, tanto por ser un factor protector para la aparición de la obesidad, como por su relación con la disminución del IMC. (AU)

Background: The prevalence of obesity has risen considerably among children and adolescents, representing one of the mai public health problems. The objective was to evaluate theimpact of a focused intervention on lifestyle and factors associated with diet, physical activity as well as psychological and behavioral aspects in adolescents from high schools inMexico City. Methods: A randomized controlled trial interventiondesigned based on EPODE (Ensemble Prévenons l'Obésité Des Enfants) methodology was conducted. Weight status was estimated using the BMI percentiles proposed by the WorldHealth Organization, and dietary questionnaires and questionnaires to detect the risk of eating disorders, anxiety and depression were used for the assessment of eating behaviour and the determination of factors related to obesity. Results: The model factors in this study that presents probabilities of being protective for the appearance of obesity in adolescents from high schools in Mexico City are the number of steps per week (OR = 0.872 95% CI: 1.212-1.761), the increase in vigorous physical activity (OR = 0.903 95% CI:0.843-0.967) and fruit consumption (OR = 0.927 95% CI: 0.861-0.999).Conclusions: According to the conditions of adolescents from high schools in Mexico City, physical activity was an important factor, because it was a protective factor for the appearance of obesity, and because of its relationship with the decrease of the BMI. (AU)

Evaluation of Medical Care for Diabetic and Hypertensive Patients in Primary Care in Mexico: Observational Retrospective Study.

INTRODUCTION: The present study evaluated the quality of medical care for patients diagnosed with diabetes mellitus (DM), hypertension (HBP), and both pathologies (DM+HBP) within a public health system in Mexico. METHODS: 45,498 patients were included from 2012 to 2015. All information was taken from the electronic medical record database. Each patient record was compared against the standard to test the quality of medical care. RESULTS: Glycemia with hypertension goals reached 29.6% in DM+HBP, 48.6% in DM, and 53.2% in HBP. The goals of serum lipids were reached by 3% in DM+HBP, 5% in DM, and 0.2% in HBP. Glycemia, hypertension, and LDL cholesterol reached 0.04%. 15% of patients had an undiagnosed disease. Clinical follow-up examinations reached 20% for foot examination and clinical eye examination. Specialty referrals reached 1% in angiology or cardiology. CONCLUSION: Goals for glycemic and hypertension reached 50% in the overall population, while serum lipids, clinical follow-up examinations, and referral to a specialist were deficient. Patients who had both diseases had more consultations, better control for hypertension and lipids, but inferior glycemic control. Overall, quality care for DM and/or HBP has not been met according to the standards.

[Obesity and metabolic syndrome. A challenge for the Mexican Institutes of Health]. / La obesidad y el síndrome metabólico. Un reto para los Institutos Nacionales de Saluda.

Numerous efforts for the development of basic and clinical research in obesity are being made by the National Institutes of Health and Federal Reference Hospitals in Mexico. However, greater interaction among researchers and stronger efforts towards the dissemination of the results are needed. The document outlines the general ideas and proposals of the Academic Group for the Study, Prevention and Treatment of Obesity and Metabolic Syndrome of the Coordinating Committee of the National Institutes of Health and High Specialty Hospitals (CCINSHAE). This is the first step in developing common objectives, with the aim of understanding the effect of these entities in public health and to establish guidelines to limit and eventually overcome them. We discuss the appropriateness of analyzing obesity and the metabolic syndrome together, and the current management of these entities at the National Institutes of Health in Mexico. The problems that arise in clinical practice lead to the need to generate a new model of medical care, including a new health worker and a new patient. It is imperative to establish permanent lines of communication and education with health personnel and with patients. The group proposes an integrated approach for research in these areas. Finally, a master plan that links the National Institutes of Health, particularly in the areas of research and programs within the institutions, is required as a first step in seeking answers useful in solving the problem. The second step would be linking the first and second levels of care through concrete actions needed to limit and reduce obesity and metabolic syndrome in the population.