Obesity and its association with mental health among Mexican children and adolescents: systematic review.

CONTEXT: Obesity and mental health issues increasingly affect children and adolescents, but whether obesity is a risk factor for mental health issues is unclear. OBJECTIVE: To systematically review the association between obesity and mental health issues (ie, anxiety and/or depression) among Mexican children and adolescents. DATA SOURCING, EXTRACTION, AND SYNTHESIS: A literature search of 13 databases and 1 search engine was conducted. Population, exposure, comparison, outcomes, and study design data were extracted, analyzed, and narratively synthesized. The JBI critical appraisal tool was used to evaluate evidence quality. RESULTS: A total of 16 studies with 12 103 participants between 8 and 18 years old were included. Four studies focused on anxiety outcomes, 10 on depression, and 2 on both (ie, anxiety and depression). Evidence is unclear about the association of obesity with anxiety. However, most evidence shows that Mexican children and adolescents with overweight or obesity are more likely to have depression or report a higher number of depressive symptoms than normal-weight participants. Such likelihood is greater for females. CONCLUSION: Health promotion interventions to treat or prevent obesity could also consider mental health outcomes. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42019154132.

Cultural factors related to childhood and adolescent obesity in Mexico: A systematic review of qualitative studies.

Culture and culturally specific beliefs or practices may influence perceptions and decisions, potentially contributing to childhood obesity. The objective of this study is to identify the cultural factors (expressed through decisions, behaviors, individual experiences, perceptions, attitudes, or views) related to childhood and adolescent obesity in Mexico. Ten databases and one search engine were searched from 1995 onwards for qualitative studies. The Sunrise Enabler Model, described within the Cultural Care Theory, guided this review. Sample, the phenomenon of interest, study design, and evaluation data were extracted, and the Critical Appraisals Skills Programme tool was used to assess the quality of the included studies. Twenty-four studies were included. Of these, 12 studies included children or adolescents, 12 included parents, eight included schoolteachers, four included school staff (other than teachers), four included food vendors, and one included policymakers. Cultural values, beliefs, lifeways (especially food and food costumes), kinship, and social factors (particularly immediate and extended family) strongly influenced childhood and adolescent obesity-related lifestyles in Mexico. Most cultural factors related to childhood obesity in Mexico identified in this review may be modifiable and amenable to practical interventions.

Obesity and oral health in Mexican children and adolescents: systematic review and meta-analysis.

CONTEXT: A relationship between obesity and poor oral health has been reported. OBJECTIVE: To investigate the association between overweight/obesity and oral health in Mexican children and adolescents. DATA SOURCES: A literature search was conducted of 13 databases and 1 search engine for articles published from 1995 onward. DATA ANALYSIS: A total of 18 publications were included. Evidence was inconclusive and varied according to sociodemographic factors or outcome measuring tools. The Decayed, Missing, and Filled Teeth and Filled Teeth Surfaces indices and the decayed extracted filled teeth index outcomes were included in a random effects model meta-analysis. Pooled estimates showed no statistically significant oral health differences (measured via the decayed extracted filled teeth or the Decayed, Missing, and Filled Teeth Surfaces indexes) among body mass index (BMI) categories. However, pooled estimates of 6 studies showed that children with higher BMI had worse oral health in permanent teeth (measured via the Decayed Missing Filled Teeth Index) than children with lower BMI (overall mean difference, -0.42; 95%CI, -0.74, -0.11). CONCLUSION: Whether there is an association between poor oral health and high BMI is inconclusive; however, both co-exist among Mexican children. Therefore, health promotion and prevention efforts should address common risk factors and broader risk social determinants shared between noncommunicable diseases.

Interventions to Treat Obesity in Mexican Children and Adolescents: Systematic Review and Meta-Analysis.

CONTEXT: Prevalence of overweight and obesity has been rising in the past 3 decades among Mexican children and adolescents. OBJECTIVE: To systematically review experimental studies evaluating interventions to treat obesity in Mexican children and adolescents (≤18 years old). DATA SOURCES: For this study, 13 databases and 1 search engine were searched. DATA ANALYSIS: A total of 29 studies met the inclusion criteria. Overall, 2302 participants (age range, 8-16 years) from 11 states in Mexico were included. Most of the studies (n = 17 of 29) were provided in a clinical setting. A random-effect meta-analysis of 4 randomized controlled trials was conducted and a significant effect was found on body mass index reduction that favored the intervention group (-1.52; 95%CI, -2.15 to -0.89) for short-term (≤6 mo) interventions. CONCLUSIONS: A multicomponent, multidisciplinary, and individualized intervention that includes dietary modifications, physical activity practice, behavioral strategies, and active parental involvement might help treat childhood obesity in Mexico. However, long-term results need to be produced to identify effectiveness pointers that might help establish an integrated, long-lasting care model to treat obesity.

Interventions to Prevent Obesity in Mexican Children and Adolescents: Systematic Review.

The prevalence of overweight and obesity has been rising among Mexican children and adolescents in the last decades. To systematically review obesity prevention interventions delivered to Mexican children and adolescents. Thirteen databases and one search engine were searched for evidence from 1995 to 2021. Searches were done in English and Spanish to capture relevant information. Studies with experimental designs, delivered in any setting (e.g., schools or clinics) or digital domains (e.g., social media campaigns) targeting Mexican children or adolescents (≤ 18 years) and reporting weight outcomes, were included in this review. In addition, the risk of bias was appraised with the Effective Public Health Practice Project Quality Assessment Tool. Twenty-nine studies with 19,136 participants (3-17 years old) were included. The prevalence of overweight and obesity at baseline ranged from 21 to 69%. Most of the studies (89.6%) were delivered in school settings. The duration ranged from 2 days to 3 school years, and the number of sessions also varied from 2 to 200 sessions at different intensities. Overall, anthropometric changes varied across studies. Thus, the efficacy of the included studies is heterogeneous and inconclusive among studies. Current evidence is heterogeneous and inconclusive about the efficacy of interventions to prevent obesity in Mexican children and adolescents. Interventions should not be limited to educational activities and should include different components, such as multi-settings delivery, family inclusion, and longer-term implementations. Mixed-method evaluations (including robust quantitative and qualitative approaches) could provide a deeper understanding of the effectiveness and best practices.

Involvement of the food industry in nutrition conferences in Latin America and the Caribbean.

OBJECTIVE: Identify and characterise the food industry's involvement in nutrition and dietetics national and regional events in Latin America and the Caribbean. DESIGN: Between February and April 2020, we conducted desk-based searches for nutrition and dietetics events held in the region between January 2018 and December 2019. Online freely accessible, publicly available information was collected on the involvement of the food industry through: sponsorship of events; sponsorship of sessions; speakers from the food industry; scholarships, fellowship, grants, awards and other prizes and; exhibition space/booths. SETTING: Nutrition and dietetics events in Latin America and the Caribbean. RESULTS: Thirty-one events held in twenty countries of the region had information publicly available online at the period of data collection. There was a lack of transparency on the involvement of industry actors in these events. When information was publicly available, we found that a total of ninety-two food industry actors sponsored 88 % of these events. CONCLUSIONS: There is a mostly unreported, but likely extensive, involvement of food industry actors in nutrition and dietetics events in Latin America and the Caribbean.

Involvement of the food industry in nutrition conferences in Latin America and the Caribbean

Objective: Identify and characterise the food industry's involvement in nutrition and dietetics national and regional events in Latin America and the Caribbean. Design: Between February and April 2020, we conducted desk-based searches for nutrition and dietetics events held in the region between January 2018 and December 2019. Online freely accessible, publicly available information was collected on the involvement of the food industry through: sponsorship of events; sponsorship of sessions; speakers from the food industry; scholarships, fellowship, grants, awards and other prizes and; exhibition space/booths. Setting: Nutrition and dietetics events in Latin America and the Caribbean. Results: Thirty-one events held in twenty countries of the region had information publicly available online at the period of data collection. There was a lack of transparency on the involvement of industry actors in these events. When information was publicly available, we found that a total of ninety-two food industry actors sponsored 88 % of these events. Conclusions: There is a mostly unreported, but likely extensive, involvement of food industry actors in nutrition and dietetics events in Latin America and the Caribbean.(AU)

[Association between birth weight and cardiometabolic risk factors in children of Bucaramanga, Colombia>]. / Asociación entre peso al nacer y factores de riesgo cardiometabólicos en niños de Bucaramanga, Colombia.

BACKGROUND: Birth weight could be a medium-term risk factor in the development of overweight and obesity and a long-term risk factor of cardio-metabolic diseases. OBJECTIVE: To evaluate the association between birth weight and cardio-metabolic risk factors in children from Bucaramanga, Colombia. METHODS: This cross-sectional study included 1,282 children between five and eleven years of age in Bucaramanga. Dependent variables: arterial hypertension, arterial prehypertension, overweight/obesity, glucose intolerance, insulin resistance, dyslipidemia. The main independent variable: birth weight (grams). The association between the independent and dependent variables was evaluated through logistic and multiple linear regression. Data analysis was performed using Stata v. 12.0 software. RESULTS: The overweight prevalence (overweight or obesity) was 22.93% (95% CI 20.64%-25.33%), while the low birth weight prevalence was 3.70% (95% CI 2.65%-5.00%). The most prevalent cardiovascular risk factor was overweight, followed by high LDL-cholesterol levels (17.24%, 95% CI 15.20-19.41%). Following an adjustment by age, sex, socioeconomic level and physical activity and obstetric maternal history, overweight, BMI Z-scores for age and systolic blood pressure had a statistically significant association with birth weight (OR: 1.44; 95% CI 1.10-1.89; p = 0.006, ß= 0.23, 95% CI: 0.10-0.36, p = 0.001 and ß= 1.18, CI 95%: 0.24-2.12, p = 0.013, respectively). CONCLUSIONS: Children with higher birth weight showed more likely to develop overweight or obesity during childhood.

Asociación entre peso al nacer y factores de riesgo cardiometabólicos en niños de Bucaramanga, Colombia / Association between birth weight and cardiometabolic risk factors in children of Bucaramanga, Colombia

Introducción: el peso a nacer puede ser un factor de riesgo a mediano plazo en el desarrollo de sobrepeso y obesidad, y a largo plazo como determinante de enfermedades cardiovasculares. Objetivo: evaluar la asociación entre peso al nacer y factores de riesgo cardiometabólicos en niños de Bucaramanga, Colombia. Métodos: estudio de corte transversal analítico en niños de cinco a once años (n = 1.282). Variables dependientes: hipertensión arterial, prehipertensión arterial, sobrepeso/obesidad, glucosa alterada, resistencia a la insulina, dislipidemia. Principal variable independiente: peso al nacer (g). Se emplearon modelos de regresión logística y lineal múltiple. Los datos fueron analizados en el programa estadístico Stata 12.0. Resultados: la prevalencia de exceso de peso (sobrepeso u obesidad) fue del 22,93% (IC 95%: 20,64-25,33%), mientras que la de bajo peso al nacer fue del 3,70% (IC 95%: 2,65-5,00%). De los factores de riesgo, el más prevalente fue el exceso de peso seguido del colesterol LDL elevado (17,24%, IC 95%: 15,20-19,41%). El exceso de peso, el puntaje Z del índice de masa corporal (IMC) para la edad y la presión arterial sistólica se asociaron de manera significativa con el peso al nacer (OR: 1,44; IC 95%: 1,10-1,89, p = 0,006; β = 0,23, IC 95%: 0,10-0,36, p = 0,001, y β = 1,18, IC 95%: 0,24-2,12, p = 0,013, respectivamente), después de ajustar por edad, sexo, nivel socioeconómico, actividad física y antecedentes ginecoobstétricos maternos. Conclusiones: los niños con mayor peso al nacer presentaron mayor probabilidad de desarrollar sobrepeso u obesidad y mayores niveles de presión arterial sistólica durante la etapa de su niñez (AU)

Background: Birth weight could be a medium-term risk factor in the development of overweight and obesity and a long-term risk factor of cardio-metabolic diseases. Objective: To evaluate the association between birth weight and cardio-metabolic risk factors in children from Bucaramanga, Colombia. Methods: This cross-sectional study included 1,282 children between five and eleven years of age in Bucaramanga. Dependent variables: arterial hypertension, arterial prehypertension, overweight/obesity, glucose intolerance, insulin resistance, dyslipidemia. The main independent variable: birth weight (grams). The association between the independent and dependent variables was evaluated through logistic and multiple linear regression. Data analysis was performed using Stata v. 12.0 software. Results: The overweight prevalence (overweight or obesity) was 22.93% (95% CI 20.64%-25.33%), while the low birth weight prevalence was 3.70% (95% CI 2.65%-5.00%). The most prevalent cardiovascular risk factor was overweight, followed by high LDL-cholesterol levels (17.24%, 95% CI 15.20-19.41%). Following an adjustment by age, sex, socioeconomic level and physical activity and obstetric maternal history, overweight, BMI Z-scores for age and systolic blood pressure had a statistically significant association with birth weight (OR: 1.44; 95% CI 1.10-1.89; p = 0.006, β = 0.23, 95% CI: 0.10-0.36, p = 0.001 and β = 1.18, CI 95%: 0.24-2.12, p = 0.013, respectively). Conclusions: Children with higher birth weight showed more likely to develop overweight or obesity during childhood (AU)

Prenatal Docosahexaenoic Acid Supplementation Does Not Affect Nonfasting Serum Lipid and Glucose Concentrations of Offspring at 4 Years of Age in a Follow-Up of a Randomized Controlled Clinical Trial in Mexico.

BACKGROUND: Docosahexaenoic acid (DHA) has regulatory effects on lipid and glucose metabolism. Differences in DHA availability during specific developmental windows may program metabolic changes. OBJECTIVE: We investigated the effects of maternal DHA supplementation during pregnancy on the nonfasting serum lipid and glucose concentrations of offspring at 4 y of age. METHODS: We used data from the Prenatal Omega-3 Fatty Acid Supplementation, Growth, and Development trial, a double-blind randomized controlled trial conducted in Mexico. Pregnant women were supplemented daily with 400 mg DHA or placebo from 18-22 wk of gestation to delivery. The primary outcomes of the trial were offspring growth and neurological development. Nonfasting blood samples were obtained from the offspring at 4 y of age. We analyzed serum total, HDL, non-HDL, and LDL cholesterol; the total-to-HDL cholesterol ratio; apolipoprotein B (apoB); triglycerides; glucose; and insulin as secondary outcomes and compared their concentrations between treatment groups. RESULTS: Data from 524 offspring were available. The women were compliant with the intervention based on pill counts and changes in cord blood and breast milk DHA concentrations. None of the between-group differences (DHA compared with placebo), adjusted for maternal height and time since last food intake, were significant (P range 0.27-0.83). Means (95% CIs) were as follows: total cholesterol (TC), 1.73 mg/dL (-2.63, 6.09 mg/dL); HDL cholesterol, 0.66 mg/dL (-1.07, 2.39 mg/dL); non-HDL cholesterol, 1.77 mg/dL (-1.83, 5.37 mg/dL); LDL cholesterol, 1.62 mg/dL (-2.21, 5.45 mg/dL); TC:HDL ratio, 0.01 (-0.09, 0.11); apoB, -0.15 mg/dL (-2.78, 2.48 mg/dL); triglycerides, 0.21 mg/dL (-10.93, 10.52 mg/dL); glucose, -0.67 mg/dL (-2.46, 1.11 mg/dL); and insulin, 0.62 µU/mL (-0.88, 2.11 µU/mL). CONCLUSION: Prenatal DHA supplementation does not affect nonfasting serum lipid and glucose concentrations of offspring at 4 y of age. This trial was registered at clinicaltrials.gov as NCT00646360.

Estado nutricional de preescolares asistentes a la junta nacional de jardines infantiles de Chile: evaluación de la concordancia entre indicadores antropométricos de obesidad y obesidad central / Nutritional status of preschool children attending the Chilean national nursery schools council programs (JUNJI): assessment of the agreement among anthropometric indicators of obesity and central obesity

Históricamente, el monitoreo nutricional de los programas de ayuda nutricional infantil ha utilizado indicadores de peso-edad y talla-edad para detectar deficiencias nutricionales. Recientemente, dado el aumento de la obesidad infantil se ha recomendado también incorporar mediciones de peso-talla y de circunferencia de cintura. Sin embargo, en preescolares no está claro cuál es el grado de concordancia existente entre estos indicadores. Los objetivos de este artículo son: reportar el estado nutricional de niños beneficiarios de la Junta Nacional de Jardines Infantiles de Chile y evaluar la concordancia entre medidas antropométricas de obesidad general y obesidad central en este grupo. En 574 niñas y 580 niños entre 3,0 y 5,9 años de edad se midió peso, talla, circunferencia de cintura y de cadera y 5 pliegues. Los puntajes Z se estimaron según los estándares de crecimiento OMS 2006. Se definió obesidad general como Z P/T ó Z IMC/E ≥+ 2DE y obesidad central como circunferencia de cintura ≥ percentil 90 para el sexo y la edad según NHANES III. La prevalencia de obesidad fue cercana al 16 por ciento con ambos indicadores, mientras que la de obesidad central fue 15 por ciento. La concordancia entre indicadores antropométricos de obesidad general y central fue buena (Kappa entre 0,6 y 0,7). En conclusión, en niños beneficiarios de un programa de ayuda social chileno se encontró una alta prevalencia de obesidad y obesidad central. En este grupo, existe una buena concordancia entre indicadores antropométricos de obesidad general y obesidad central, lo que sugiere que no se justificaría la incorporación de mediciones de circunferencia de cintura al monitoreo nutricional del programa.

Historically, the anthropometric assessment of nutritional welfare programs has been targeted to assess nutritional deficiencies based on weight-to-age and height-to-age indicators. Recently, given the increase on childhood obesity, it has been also recommended the measurement of indicators of obesity (i.e. weight-to-height) and central obesity (i.e. waist circumference). However, the agreement of these indicators in preschool children is unclear. The aims of this study were: 1) assess the nutritional status of children attending the Chilean National Nursery Schools Council Program (JUNJI); 2) assess the agreement between general and central obesity anthropometric measurements in these children. In 574 girls and 580 boys, 3.0 to 5.9 years old, we measured: weight, height, waist and hip circumference, and five skinfolds. We used the WHO 2006 growth standards to estimate Z-scores. We defined general obesity as WHZ or BAZ= 2, and central obesity as waist circumference ≥ 90 percentile of NHANES III. The participants were on average slightly shorter but considerably heavier and obese than the reference populations. Prevalence of general obesity was close to 16 percent with both indicators while prevalence of central obesity reached 15 percent. There was good agreement among general obesity indicators and central obesity indicators (Kappa = 0.6-0.7). In summary, we found a high prevalence of obesity and central obesity among Chilean preschool children beneficiaries of a welfare program. At this age, there was a good agreement among general obesity indicators and central obesity indicators. These results suggest that waist circumferences measurements should not be incorporated to the program.

Interculturalidad alimentario-nutricional en la etnia Wixarika de México / Eating-nutritional interculturality in the Wixarika ethnic group of Mexico

Fundamento: La alta prevalencia de problemas alimentario- nutricionales y el bajo impacto de los programas alimentarios, principalmente porque se ha ignorado la cosmovisión de este pueblo, justifica la recuperación de la cultura de consumo alimentario-nutrimental de la etnia Wixarika en México. La investigación tiene el objetivo de identificar elementos para construir un modelo de alimentación y nutrición sustentable, intercultural y participativo que articule modernidad y tradiciones ancestrales. Métodos: Se utiliza la metodología de investigación acción participativa sustentada en la epistemología sociocrítica con las técnicas de entrevista en profundidad y etnografía participante. La investigación se realizó en la comunidad Wixarika de Santa Catarina Cuexcomatitlan, en el municipio de Mezquitic, Jalisco, México. Resultados: El consumo alimentario del pueblo Wixarika tiene un sentido religioso, en el que el maíz es el articulador principal de la cosmovisión alimentaria. La base de la producción y el consumo alimentario está formada por la tríada: maíz, frijol y calabaza, con agregados de jitomate y chile, así como de la recolección de alimentos del entorno ecológico como hongos, quelites y nopales, alimentos que al producirse y consumirse en cantidades suficientes y combinados adecuadamente pueden permitir una alimentación correcta para esta etnia. Conclusiones: La alimentación constituye un elemento central en la construcción de la cosmovisión del pueblo Wixarika, representaciones y significados que deben integrarse para la construcción de un modelo que garantice la seguridad alimentario-nutrimental de esta etnia (AU)

Background: The high prevalence of eating-nutritional problems and the low degree of impact the food programs have, mainly because the cosmovision of this people has been overlooked warrants the recovery of the eating-nutritional culture of the Wixarika ethnic group in Mexico. This research is aimed at providing elements for constructing a sustainable, intercultural, participation- based eating and nutrition model bringing together modernity and this people's ancestral traditions. Methods: The participative action based on the Sociocritical epistemology was employed as the research methodology with the in-depth survey and participating ethnography techniques. This rese- arch was conducted in the Wixarika of Santa Catarina Cuexcomatitlan community in the municipality of Mezquitic, Jalisco, Mexico. Results: The foods eaten by the Wixarika people have a religious meaning, in which corn is the main connecting force of their food- related cosmovision. As most Mesoamerican cultures, the basis of food production and consumption is comprised by the «three sisters»: corn, beans and squash, to which «jitomate» and «chile» have been added, as well as the gathering of foods from the surrounding environment such as fungus, chelites and nopal, foods which, on being produced and eaten in sufficient quantities and properly combined may provide for this ethnic group being properly fed. Conclusions: Food comprises a central aspect in the way in which the cosmovision of the Wixarika people is set out, these being representations and meanings which must be integrated in order to a model which will ensure the eating-nutritional soundness of this ethnic group (AU)

[Eating-nutritional interculturality in the Wixarika ethnic group of Mexico]. / Interculturalidad alimentario-nutricional en la etnia Wixarika de Mexico.

BACKGROUND: The high prevalence of eating-nutritional problems and the low degree of impact the food programs have, mainly because the cosmovision of this people has been overlooked warrants the recovery of the eating-nutritional culture of the Wixarika ethnic group in Mexico. This research is aimed at providing elements for constructing a sustainable, intercultaral, participation-based eating and nutrition model bringing together modernity and this people's ancestral taditions. METHODS: The participative action based on the Sociocritical epistemology was employed as the research methodology with the in-depth survey and participating ethnography techniques. This research was conducted in the Wixarika of Santa Catarina Cuexcomatitlan community in the municipality of Mezquitic, Jalisco, Mexico. RESULTS: The foods eaten by the Wixarika people have a religious meaning, in which corn is the main connecting force of their food-related cosmovision. As most Mesoamerican cultures, the basis of food production and consumption is comprised by the "three sisters: corn, beans and squash, to which jitomate and chile have been added, as well as the gathering of foods from the surrounding environment such as fungus, chelites and nopal, foods which, on being produced and eaten in sufficient quantities and properly combined may provide for this ethic group being properly fed. CONCLUSIONS: Food comprises a central aspect in the way in which the cosmovision of the Wixarika people is set out, these being representations and meanings which must be integrated in order to model which will ensure the eating-nutritional soundness of this ethnic group.