Individualized tailor-made dietetic intervention program at schools enhances eating behaviors and dietary habits in obese Hispanic children of low socioeconomic status.

UNLABELLED: Hispanic children and those from low-socioeconomic status are predisposed to unhealthy eating habits and obesity. AIM: to implement an individualized, face-to-face, parent supported, and school-partnership dietetic intervention to promote healthy eating habits and decrease body mass index. Prospective school year dietetic intervention of 101 obese, Hispanic, low-socioeconomic school-age children representative of Monterrey, Mexico, consisted of anthropometrics, dietetic assessment, energy-restriction tailor-made daily menus, and parental education every three weeks. Student's t-test was used for means comparison. A significant decrease was found in body mass index percentile (96.43 ± 3.32 to 93.42 ± 8.12/P = 0.00) and energy intake/day of -755.7 kcal/day (P = 0.00). Among other energy dense foods with significant decline in servings/day and servings/week were processed meats (3.13 ± 1.43 to 2.19 ± 1.04/P = 0.00 and 5.60 ± 1.75 to 4.37 ± 2.10/P = 0.00, resp.), saturated fat (1.47 ± 1.08 to 0.78 ± 0.79/P = 0.00 and 2.19 ± 2.18 to 1.1 ± 1.36/P = 0.00), sweetened beverages (2.79 ± 1.99 to 1.42 ± 1.21 and 6.21 ± 1.72 to 3.89 ± 2.80/P = 0.00), and desserts and refined-grain bakery (1.99 ± 1.54 to 1.32 ± 1.59 and 2.85 ± 2.54 to 1.57 ± 2.20/P = 0.00). There was a significant increase in servings/day and servings/week of water (2.98 ± 2.02 to 4.91 ± 2.37 and 6.62 ± 2.03 to 6.87 ± 0.91/P = 0.00, resp.) and nutrient dense foods such as fruits (1.31 ± 0.89 to 1.66 ± 0.96 and 3.34 ± 2.24 to 4.28 ± 2.43/P = 0.00) and fish and poultry (3.76 ± 2.15 to 4.54 ± 2.25/P = 0.00). This intervention created healthy eating habits and decreased body mass index in a high risk population. TRIAL REGISTRATION NUMBER: NCT01925976.

Association of ALT and the metabolic syndrome among Mexican children.

Nonalcoholic fatty liver disease (NAFLD) is emerging as a component of the metabolic syndrome (MetS); Hispanics being particularly predisposed. Alanine aminotransferase (ALT) is considered a marker of NAFLD. The aim of this study was to determine the prevalence and associations between ALT elevations and MetS in normal-weight, overweight and obese Mexican children and adolescents, since data in Mexico is scarce. Body mass index (BMI), waist circumference (WC), percentage body fat, blood pressure, glucose, lipid profiles, ALT and aspartate aminotransferase (AST) were measured in 236, 6-12yo normal-weight, overweight and obese Mexicans from eight public schools. The results showed that elevated ALT (>40 IU/L) was found in 17.7% of the obese and overweight population, with no gender difference. The prevalence of elevated ALT increased linearly across BMI categories (p = 0.001), from 0.0% for the normal-weight group (95%CI 0.0-€“8.0) to 22.4% for the obese one (95%CI 16.2-€“30.2). AST/ALT ratio <1 also increased linearly, as did the prevalence of MetS (p = 0.001), from 0.0% for the normal-weight group to 40.3% for the obese one. The prevalence of MetS was strongly associated with elevated ALT (p = 0.002), 50% in the elevated ALT group (95%CI 34.1-€“65.9) and 24.1% in the normal ALT one (95%CI 18.1-€“31.3). There was also a strong association between MetS and an AST/ALT ratio <1. WC was the best predictor of elevated ALT (AOR = 7.13). Pearson correlation showed that MetS components were significantly correlated with elevated ALT. Therefore elevated ALT levels were highly prevalent and strongly associated with MetS in Mexican children, it should be screened in overweight and obese children.

Clinical and epidemiological features of 2009 pandemic H1N1 influenza differ slightly according to seroprevalence status during the second wave in the general population in México.

BACKGROUND: Clinical features of pandemic H1N1 have been derived from lab-confirmed, hospitalized, or critically ill subjects. This report describes the clinical features of H1N1 and their prevalence from non-confirmed subjects according to seroprevalence status in México. The objective was to determine the prevalence of these clinical features from non-confirmed cases of pandemic H1N1 and to compare them according to seroprevalence status in northern Monterrey, México, during 2009, and to identify the predictive signs and symptoms; there have been no prior serologic studies in México. METHODS: During November-December 2009, 2,222 volunteers, ages 6-99 years, were categorized into 3 symptomatic groups: influenza-like illness, respiratory illness, and non-respiratory illness. Antibodies against influenza A/H1N1/2009 were determined by a virus-free enzyme-linked immunosorbent assay (ELISA) method. Demographics and clinical presentation were assessed through face-to-face questionnaire, and the association with seroprevalence status was determined and compared. RESULTS: Overall seroprevalence was 39%. Of the seropositive subjects, 67% were symptomatic and 33% were asymptomatic. Seventy-one percent of seropositive symptomatic subjects reported respiratory illness, 17% reported non-respiratory symptoms, and 12% reported influenza-like illness. The most common symptoms were rhinorrhea/nasal congestion (93%) and headache (83%). No significant difference was found between the symptom profiles of the seropositive group, compared to the seronegative one, nor of the median duration of symptoms. The seropositive group had a significantly elevated proportion of influenza-like illness (12%), compared to the seronegative group (8%). The proportion of subjects who took days off and who sought medical attention was significantly higher in the seropositive group. No single symptom was associated as a predictor of seropositiveness. CONCLUSIONS: One third of the seropositive subjects were asymptomatic, and few had an influenza-like illness. No difference was found in the symptom profiles of the seropositive and seronegative groups. No single symptom predicted seropositiveness. Large scale population studies are needed, especially in México, to characterize clinical syndromes.