Detection of risk for type 2 diabetes and its relationship with metabolic alterations in nurses. / Risco de desenvolvimento do diabetes tipo 2 em enfermeiras e sua relação com alterações metabólicas.

OBJECTIVE: to detect the risk of development of type 2 diabetes in nurses and its relationship with metabolic alterations. METHOD: cross-sectional study, with 155 nurses. The variables investigated were: sociodemographic, body mass index, waist circumference, waist-hip index, lipid profile, basal glycemia and oral glucose tolerance curve. The Finnish Diabetes Risk Score was used to collect data. RESULTS: 155 nurses were included, with an average age of 44 years and 85% were overweight or obese. 52% had a family history of diabetes and 21% had occasional hyperglycemia. With respect to the risk, 59% were identified with moderate and very high risk for type 2 diabetes. Glucose, insulin, glycosylated hemoglobin A1c and insulin resistance increased in parallel to the increased risk for type 2 diabetes, although lipids did not increase. 27% of the sample had impaired fasting glycemia. 15% had glucose intolerance and 5% had type 2 diabetes. CONCLUSION: there was a high detection rate of people at risk for type 2 diabetes (59%) and the high and very high risk score was associated with high levels of glycosylated hemoglobin A1c, glucose, insulin and insulin resistance, but not with lipids.

Burnout and Metabolic Syndrome in Female Nurses: An Observational Study.

Nurses are at risk of having burnout due to workload and job stress-studies have reported that chronic stress is associated with metabolic syndrome. This study aimed to assess the association between burnout and metabolic syndrome in a sample of female nurses. Data were collected from a cross-sectional study from 2016 to 2018 in a tertiary hospital in Mexico City. All nurses that work in the hospital were invited to participate. Information pertaining to sociodemographic (age, education level), work (labor seniority, service area, shift work), anthropometric (weight, waist circumference, blood pressure) and biochemical (glucose, serum lipids) variables were collected. Burnout was assessed using the Maslach Burnout Inventory test, and metabolic syndrome was defined according to the International Diabetes Federation criteria. A total of 168 nurses participated with a median age of 44 years. The prevalence of burnout and metabolic syndrome was 19.6% and 38.7%, respectively. There was no association between burnout and metabolic syndrome (p = 0.373). However, associations of emotional exhaustion (aOR: 14.95; 95% CI: 1.5-148.7), personal accomplishment (aOR: 0.13; 95% CI: 0.01-0.99), and night shift (aOR: 12.39; 95% CI: 1.02-150.5) with increased waist circumference were found. Strategies are needed to prevent burnout and metabolic syndrome in nurses, especially in those who work at night shift.

Characteristics of the Family Support Network of Pregnant Adolescents and Its Association with Gestational Weight Gain and Birth Weight of Newborns.

It has been proposed that, in the Mexican culture, family support can be a factor that contributes to protect the maternal and child health of pregnant adolescents. There may be complex associations between family support and the circumstances of a pregnancy during adolescence. The aim of the study was to analyze the association between the family support network (FSN) characteristic and the maternal and neonatal outcomes in Mexican adolescents. A cross-sectional study was conducted, and 352 pregnant adolescents participated; their FSN during pregnancy was assessed. The gestational weight gain and birth weight/length of newborns were registered. The size of the FSN was described and divided into quartiles; the main members for each quartile were identified. Then, sociodemographic and clinical variables were compared by FSN quartiles. Logistic regression models were performed to assess the association of FSN size and pregnancy and neonatal outcomes. Our results indicate that the mean age was 15 ± 1 year old. The primary support member in the FSN was the mother of the adolescent in each quartile, except for quartile 3, where the primary support was the mother-in-law. In quartile 3 there was a significantly lower gestational weight gain compared to quartile 4 (11.8 ± 5 vs. 13 ± 5 kg, p = 0.054). According to the regression model, a higher risk of small for gestational age (OR 2.99, CI 95% 1.25⁻7.15) newborns was found in quartile 3. We conclude that the maternal and neonatal outcomes did not differ between quartiles of FSN size, except for quartile 3. Small for gestational age newborns were observed when a non-blood relative was present in the FSN. The quality rather than the network size might be more important for improving pregnancy outcomes.

Sociodemographic Factors Associated with the Knowledge and Use of Birth Control Methods in Adolescents before and after Pregnancy.

Adolescent pregnancy rates are high worldwide. However, insufficient information exists regarding the frequency of birth control methods used before the first pregnancy and postpartum. In the current study, we analyzed the association of sociodemographic factors with the knowledge of birth control methods and their use before and after pregnancy in a sample of adolescents in Mexico City. A cohort study was conducted on 600 pregnant adolescents in Mexico City, from 2013 to 2017, at a health care institution providing prenatal care. Participants were assessed during the second trimester and four months postpartum. The questionnaire explored the knowledge of birth control methods, their use, and other associated factors. Two logistic regression models were implemented to identify potential variables associated with the lack of birth control method use before and after pregnancy. The mean age of participants was 15.4 + 1 years, of which, 48% and 65.2% used a birth control method before pregnancy and postpartum, respectively. We found that the main factors associated with increased risk of not using any birth control method before pregnancy included being under the age of 15 years, school dropout, having an educational lag, initiation of sexual life before the age of 15, and having a mother who did not inform their child about contraceptives. By contrast, variables associated with a higher risk of not using any contraceptive methods after pregnancy included educational lag, lower level of education, and the fact that the adolescent had not used any birth control prior to the pregnancy.

Risco de desenvolvimento do diabetes tipo 2 em enfermeiras e sua relação com alterações metabólicas / Detection of risk for type 2 diabetes and its relationship with metabolic alterations in nurses / Detección de riesgo de diabetes tipo 2 y su relación con alteraciones metabólicas en enfermeras

Objetivo: identificar o risco de desenvolvimento de diabetes tipo 2 em enfermeiras e sua relação com as alterações metabólicas. Método: estudo transversal, com 155 enfermeiras. As variáveis investigadas foram: sociodemográficas, índice de massa corporal, a circunferência da cintura, índice cintura-quadril, perfil lipídico, a glicemia basal e a curva oral de tolerância à glicose. Para a coleta de dados utilizou-se o Finnish Diabetes Risk Score. Resultados: Das 155 (100%) enfermeiras, a média de idade foi de 44 anos e 85% apresentavam sobrepeso ou obesidade; 52% tinham história familiar de diabetes e 21%, hiperglicemia ocasional. Em relação ao risco, 59% foram identificados com risco moderado e muito alto de diabetes tipo 2. A glicose, a insulina, a hemoglobina glicosilada A1c e a resistência à insulina aumentaram paralelamente ao aumento do risco de diabetes tipo 2, embora os lipídios não tenham aumentado. 27% das participantes apresentaram glicemia em jejum alterada, 15%, intolerância à glicose e 5%, diabetes tipo 2. Conclusão: houve uma elevada taxa de detecção de risco de diabetes tipo 2 (59%) e a pontuação de risco alto e muito alto foi associado com níveis elevados de hemoglobina glicosilada A1c, glicose, insulina e resistência à insulina, mas não com lipídios.

Objective: to detect the risk of development of type 2 diabetes in nurses and its relationship with metabolic alterations. Method: cross-sectional study, with 155 nurses. The variables investigated were: sociodemographic, body mass index, waist circumference, waist-hip index, lipid profile, basal glycemia and oral glucose tolerance curve. The Finnish Diabetes Risk Score was used to collect data. Results: 155 nurses were included, with an average age of 44 years and 85% were overweight or obese. 52% had a family history of diabetes and 21% had occasional hyperglycemia. With respect to the risk, 59% were identified with moderate and very high risk for type 2 diabetes. Glucose, insulin, glycosylated hemoglobin A1c and insulin resistance increased in parallel to the increased risk for type 2 diabetes, although lipids did not increase. 27% of the sample had impaired fasting glycemia. 15% had glucose intolerance and 5% had type 2 diabetes. Conclusion: there was a high detection rate of people at risk for type 2 diabetes (59%) and the high and very high risk score was associated with high levels of glycosylated hemoglobin A1c, glucose, insulin and insulin resistance, but not with lipids.

Objetivo: identificar el riesgo de desarrollo de diabetes tipo 2 en enfermeras y su relación con alteraciones metabólicas. Método: estudio transversal, con 155 enfermeras. Las variables investigadas fueron: sociodemográficas, el índice de masa corporal, circunferencia de cintura, índice cintura-cadera, perfil de lípidos, glucemia basal y curva de tolerancia oral a la glucosa. Para la recolección de datos se utilizó el Finnish Diabetes Risk Score. Resultados: De las 155 enfermeras, la edad promedio fue 44 años y 85% tenía sobrepeso u obesidad. El 52% tenía antecedentes familiares de diabetes de primera línea, el 21% hiperglucemia ocasional. Con relación al riesgo, se identificaron 59% con riesgo de diabetes tipo 2 moderado y muy alto. Glucosa, insulina, hemoglobina glucosa A1c y la resistencia a la insulina incrementaron paralelos al aumento del riesgo de diabetes tipo 2, aunque los lípidos no. El 27% de las enfermeras presentó glucemia basal alterada. El 15% tuvo intolerancia a la glucosa y 5% diabetes tipo 2. Conclusión: la detección de riesgo de diabetes tipo 2 fue elevada (59%) y el puntaje de riesgo alto y muy alto se relacionó con valores mayores de hemoglobina glucosa A1c, glucosa, insulina y resistencia a la insulina pero no con lípidos.

"Sacbe", a Comprehensive Intervention to Decrease Body Mass Index in Children with Adiposity: A Pilot Study.

Interventions in children with adiposity decrease less than 0.2 the body mass index (BMI) z-score less than 0.2 and only in 21⁻23% of cases. Experts recommend focusing on the habits of a healthy lifestyle (HLS) but considering the sociocultural context of children and their parents. Our objective was to achieve a higher percentage of success in lowering the BMI z-score in children with adiposity and their parents through a pilot program "Sacbe" based on HLS, sensitive to the sociocultural context previously explored and with the active participation of parents. This is a pilot study in children aged 8 to 18 years with adiposity according to the BMI z-score. The program consisted of two workshops on HLS and nutrition given by the pediatric endocrinologist in group sessions with 3⁻5 families and reinforcements in each visit by registered dietitians. We recorded lifestyle habits and anthropometric characteristics of children and their parents at the baseline visit and every month for 3⁻4 months. Forty-nine families, 55 children and 64 parents participated, 60% of the children were female, the average age was 13.95 ± 3.3 years, 72.7% and 86.7% lowered the z score of the BMI due to intention to treat and protocol analysis (p < 0.001), respectively; BMI z-score decreased by 0.22 ± 0.21, from 2.13 ± 0.57 to 1.91 ± 0.58 (p < 0.001). In total, 83% of the parents involved were mothers, the average age was 45.8 ± 9.4 years, 77% lost weight and body fat (p < 0.001), the frequency of unhealthy habits decreased. The results of "Sacbe" exceeded expectations by combining the active participation of parents, sessions in groups, and the education on various components of an HLS inside sociocultural context. The main challenge will be to standardize and reproduce this type of complex interventions, as well as to assure long-term success.

Pre-pregnancy body mass index classification and gestational weight gain on neonatal outcomes in adolescent mothers: A follow-up study.

INTRODUCTION: Institute of Medicine gestational weight gain recommendations are based on body mass index (BMI) status using adult cut-off points for women of all ages, even though adolescents have specific criteria, like WHO and CDC, so adolescents can receive inadequate weight gain recommendations. OBJECTIVES: To estimate the proportion of classification disparity between the three criteria (WHO, CDC and IOM) of pre-pregnancy BMI status; and to analyze neonatal outcomes according to weight gain recommendation based on pre-pregnancy BMI using the three criteria. METHODS: Follow-up study in pregnant adolescents 12-19 years. Sociodemographic, anthropometric and pregnancy data were obtained. Percentage of pre-pregnancy BMI classification disparity was calculated between three criteria. Gestational weight gain was categorized in adequate, low and high according to IOM. Regression models were used to analyze negative neonatal outcomes. RESULTS: 601 pregnant adolescents were included, mean age was 16±1.4 years. For pre-pregnancy BMI classification, 28.5% had classification disparity using IOM vs WHO, and 14% when comparing IOM vs CDC. Greater classification disparity was observed as BMI increased. When using WHO categories, a high weight gain was associated with increased risk of having a low birth weight baby (OR: 1.91, CI95%: 1.03-3.53). For CDC criteria, a low weight gain was associated with increased risk of having a preterm baby (OR: 2.65; CI95%: 1.16-6.08) and a high weight gain was associated with low birth weight (OR: 2.10; CI95%: 1.10-4.01). For IOM criteria, a weight gain either low or high were associated with increased risk of low birth weight and preterm birth. CONCLUSION: There is pre-pregnancy BMI classification disparity using criteria for adolescents compared to adult criteria. Nevertheless, with WHO and CDC only a high gestational weight gain was a risk for negative neonatal outcome. It is important to have a BMI classification system for adolescents that better predicts neonatal outcomes.

Association between UCP polymorphisms and adipokines with obesity in Mexican adolescents.

BACKGROUND: It has been reported that the uncoupling proteins (UCPs) can contribute to energy metabolism, and are thus involved in the pathogenesis of obesity. The objective of the study was to analyze the association between UCP polymorphisms, clinical parameters and leptin and adiponectin plasma levels in an adolescent population with overweight and obesity. METHODS: We analyzed the UCP1 -3826 C/T, UCP2-866 G/A, Ala55Val and UCP3 -55 C/T polymorphisms and the levels of adipokines in adolescents with normal weight and with overweight or obesity. The study included 270 students aged between 12 and 18 years categorized according to the percentiles from Mexico City. Adipokines levels were measured by immunoassay methods and the UCP polymorphisms were determined using Taqman real-time polymerase chain reaction (RT-PCR). RESULTS: No significant differences were found in the UCP polymorphisms in seven inheritance models studied. Most of the significant differences in the clinical parameters were found under a recessive model, the UCP2 -866 polymorphism was associated with diastolic blood pressure (p=0.008), triglycerides (p=0.045), low-density lipoprotein-cholesterol (LDL-C) (p=0.003), high-density lipoprotein-cholesterol (HDL-C) (p=0.050) and plasma levels of leptin (p<0.001). Also, the obese group was found to have higher leptin levels and lower adiponectin levels in GA+AA vs. GG (recessive model). CONCLUSIONS: This study demonstrated a direct relationship between the clinical characteristics and UCP2-866 in a recessive model, associated with high levels of leptin and decreased levels of adiponectin in an obese or overweight Mexican adolescent population.

Demographics and Psychological Factors Associated with Adiposity in Nurses.

Adiposity-based chronic disease (ABCD), overweight-Ow- or obesity-Ob-) in health personnel is as frequent as in the general population, even though they understand well the importance of maintaining a healthy weight. Thus, it is highly likely that certain demographic and psychological conditions, independently of knowledge, are contributing to develop ABCD. The aim of this study was to examine the association between these factors and ABCD in nurses. Data were collected from a cross-sectional study conducted in a tertiary level institute in Mexico City from 2012 to 2013. All the nurses of the institute of any age, shift, service area and seniority were invited to participate and 55% (265) accepted. We found that ABCD was present in 79.6%, and low self-esteem and emotional distress in 26% and 10%, respectively. Working in the night shift (p = 0.031), labor seniority ≥15 years (p = 0.006), having 1 or more children (p = 0.021) and sessions of physical activity <30 min (p = 0.03) were associated with ABCD. Low self-esteem (OR = 2, 95% CI 1.150–3.07, p = 0.023) and emotional distress (OR = 4, 95% CI 1.472–13.078, p = 0.012) were associated with unhealthy lifestyle (less of 3 days per week and/or less of 30 min per session of physical activity and poor dietary habits). Therefore, strategies to prevent and treat ABCD must consider each context among nurses and psychological disorders need be identified to avoid an unhealthy lifestyle.

Family context and individual situation of teens before, during and after pregnancy in Mexico City.

BACKGROUND: In the last 20 years, adolescent pregnancy has become one of the most critical problems affecting women in Latin America and the Caribbean. METHODS: This qualitative study was based on in-depth interviews with 29 teen mothers. All of the pregnant teens were from low- to lower-middle-class social strata in the Mexico City metropolitan area. The family (living with the girl) and the individual context of pregnant teens were analysed on the basis of data from at least three interviews: during pregnancy and at approximately 6 and 24 months following delivery. Additionally, six mothers, four fathers, and four partners of the pregnant girls of the group were interviewed. The information on the individual and family situation before, during and after the pregnancy was recorded and transcribed, then analysed in three phases, comprising pre-analysis, exploration and interpretation. RESULTS: The pregnant teens had a family background of teen pregnancy. The girls disclosed feelings of repression, loneliness and indifference to their parents, leading them to unprotected sexual relations without fear of pregnancy. After the pregnancy, communication improved between the girls and their parents, but became worse with their partner. Consequently, these teens returned to feeling as they did before getting pregnant. They stated that they would make their situation work for the sake of their child, and regretted dropping out of school and getting pregnant so young. Almost all said they were seeking love outside the family, which revealed a scenario of limited communication and unsatisfactory relations within the family. CONCLUSIONS: Understanding how communication works between parents and children is necessary to avoid teenage pregnancy, as well as early marriage or cohabitation, resulting in dropping out of school and financial constraints, which lead to great frustrations between the couple and affects the child. In addition, it is vitally important that adolescents be motivated in the family setting in order for them to continue their studies. There is also an urgent need to implement measures that compensate for educational inequality, as well as to strengthen strategies aimed at adolescent mothers and pregnant teens that encourage their school performance through the support of scholarship programs and day care centres. Many of the problems inherent in adolescence are related to the lack of affection and support, and in many cases are a reaction to authoritarian rules or limits established unilaterally by parents with little or no dialogue involved.

PPARG-LYPLAL1 Multi-Allelic Combination Associated with Obesity and Overweight in Mexican Adolescent Females.

OBJECTIVE: We studied multi-loci variants to identify the contribution of six candidate genes (ADIPOQ, CDH13, LYPLAL1, MC4R, PPARG and PGC1A) in the development of obesity and overweight. DESIGN: We genotyped 404 chromosomes with eleven SNPs in Mexican female adolescents, who were subdivided into two groups (obesity-overweight and normal-weight) using the World Health Organization parameters. Genomic (800 chromosomes) and ancestral (208 chromosomes) controls were included to reduce the population bias. Anthropometric measurements, biochemical parameters, and caloric intake were obtained only in the groups of Mexican female adolescents. RESULTS: A positive genotype-phenotype association was found that involves the multi-allelic combination of three risk alleles (one in PPARG and two in LYPLAL1) with obesity and overweight (OR=3.1, P=.010). This combination also exhibited a significant association with waist circumference (P=.030) and triglycerides levels (P=.030). These associations were supported by a logistic regression analysis adjusted for several confounding variables. CONCLUSIONS: Our data suggest the joint participation of PPARG-LYPLAL1 genes in metabolic disorders development. Hence, these genes could act as potential biomarkers in obesity and overweight. Our findings underscore the complexity of metabolic disorders and provide evidence about the importance of multi-loci analysis to study complex diseases.

Satisfacción de la imagen corporal en adolescentes y adultos mexicanos y su relación con la autopercepción corporal y el índice de masa corporal real / Body image satisfaction in Mexican adolescents and adults and its relation with body selfperception and real body mass index

Introducción: La percepción que se tengan de la imagen corporal (IC) podría determinar la búsqueda de atención nutricia, aunque no siempre hay concordancia del índice de masa corporal (IMC) autopercibido con el real. Objetivo: Correlacionar el IMC autopercibido con el real y su relación con la satisfacción de la IC en una muestra de adolescentes y adultos mexicanos. Métodos: Estudio transversal analítico, con 556 participantes: 330 adolescentes y 217 adultos, con las siguientes evaluaciones: de autopercepción y de la satisfacción de la IC; asimismo, antropométrica. Resultados: El IMC fue mayor entre adultos 23±6 vs 29.3±5 p<0.001, quienes duplicaron la cifra de sobrepeso y obesidad de los adolescentes 79% vs 43%. La mitad de todos los participantes tuvo concordancia de su IMC percibido con el real (p<0.001). De los adultos con sobrepeso u obesidad 68% estuvieron satisfechos con su IC, mientras que en los adolescentes esto correspondió a más del 80%. Las variables predictoras de insatisfacción de la IC fueron ser adulto, ser mujer y tener sobrepeso/obesidad (p=0.013). Los que refirieron que su figura corporal les inspiraba un juicio positivo reportaron estar satisfechos con su IC y la mayoría presentaron un IMC real de normal o sobrepeso. Conclusiones: En la mitad de los participantes hubo concordancia entre la IC autopercibida y el IMC real. La satisfacción con la IC fue más frecuente entre los de menor IMC real y autopercibido, pero una gran proporción de los de sobrepeso y obesidad también refirieron satisfacción con su IC, aunque sea una condición de riesgo (AU)

Introduction: Body Image (BI) perception could determine the nutritional care search, even though there is not always concordance between the real BMI and the self-perceived one. Objetive: To determine the correlation between self-perceived and real BMI, and their relation with body image (BI) satisfaction in a sample of Mexican adolescents and adults. Subjects and methods: An cross-sectional and analytical study, conformed by 556 participants; of which 330were adolescents and 217 were adults with anthropometric, self-perception and BI satisfaction assessment. Results: The BMI was higher 23±6 vs 29.3±5 p<0.001in adults, which doubled the level of overweight and obesity present in the adolescents 79% vs 43%. About 50%of participants had concordance between their real BMI and their perceived one (p<0.001). Of all adults with overweight and obesity 68% had satisfaction with their BI, whereas the prevalence of satisfaction with the BI in adolescents was 80%. The predictive variables of BI insatisfaction were being an adult, being a woman and having overweight/obesity (p=0.013). Those ones who referred a positive judgment about their BI, they also reported being satisfied with their BI and presented a real normal or overweight BMI. Conclusions: Half of the participants had concordance of their perceived BI with their real BMI. The satisfaction with BI was more frequent between the lower real and perceived BMI, but subjects with overweight and obesity also reported satisfaction with their BI even though it is considered a risk condition (AU)

Determinación de la relación 2-hidroxiestrona/16x-hidroxiestrona en la orina de mujeres mexicanas como indicador de riesgo a cáncer de mama y su relación con otros factores de riesgo / Determination of 2-hydroxyestrone/16x-hydroxyestrone ratio in urine of Mexican women as a risk indicator for breast cancer and its relationship with other risk factors

La relación 2-hidroxiestrona/16α-hidroxiestrona urinaria (RMEO), se ha propuesto en diversas poblaciones del mundo como indicador de riesgo a cáncer de mama (CM), sin embargo, en la población mexicana, nunca se ha determinado. Objetivo: Determinar la RMEO en mujeres mexicanas y establecer su relación con factores de riesgo para CM. Material y Métodos: Estudio transversal analítico de 142 mujeres premenopáusicas y 42 posmenopáusicas. Se determinó la RMEO con el estuche ESTRAMETTM y se relacionó con factores de riesgo para CM. Se realizaron correlaciones y regresiones lineales. Resultados: La mediana de la RMEO fue 0.90 (RIC: 0.64-1.18). El índice de masa corporal (IMC) y la menarca temprana contribuyeron en 5.4% de su variabilidad (F=5.17; p<0.000). IMC participó en 6.1% de la variabilidad de 2-hidroxiestrona en mujeres premenopáusicas (F=4.40; p<0.000) y 18.1% en posmenopáusicas (F=8.85; p<0.000). Conclusión: La RMEO fue ≈50% menor que lo reportado para otras poblaciones e inversamente proporcional al IMC (AU)

The urinary ratio 2-hydroxyoestrone/16α-hydroxyoestrone (URME), has been proposed in various populations on the world as a risk indicator for breast cancer (BC), however in the Mexican population has never been determined. Objective: To determine URME Mexican women and establish its relationship with risk factors for BC. Material and Methods: Cross-sectional study of 142 premenopausal and 42 posmenopausal women. The URME was determined with the kit ESTRAMETTM and was related to risk factors for BC. Correlations and linear regressions were performed. Results: The median URME was 0.90 (RIQ 0.64-1.18). The body mass index (BMI) and early menarche contribute 5.4% of their variability (F=5.17; p<0.000). IMC participated in 6.1% of the variability of 2-hydroxyoestrone in premenopausal (F=4.40; p<0.000) and 18.1% in posmenopausal women (F=8.85; p<0.000). Conclusion: The URME was ≈50% lower than reported for other populations and inversely proportional to BMI (AU)

Barriers to lose weight from the perspective of children with overweight/obesity and their parents: a sociocultural approach.

INTRODUCTION: There are not enough studies about the barriers to lose weight from the perspective of children and their parents. METHODS: Children and adolescents diagnosed with overweight/obesity in the Department of Endocrinology and their parents were invited to participate in a series of focus group discussions (FGD). Twenty-nine children 10-16 years old and 22 parents participated in 7 focus groups; 2 mothers and 2 adolescents participated in depth interviews. All interviews were recorded, transcribed, and analyzed through grounded theory. RESULTS: Parents went to the hospital only when their children presented any obesity complication; for them, overweight was not a health problem. Parents referred to lack of time to supervise about a healthy diet and exercise; besides, the same parents, relatives, friends, and the mass media encourage the consumption of junk food. Children accepted eating a lot, not doing exercise, skipping meals, and not understanding overweight consequences. Both, parents and children, demanded support to do the time recommended for exercise inside the schools. They also suggested getting information from schools and mass media (TV) about overweight consequences, exercise, and healthy food by health workers; they recommended prohibiting announcements about junk food and its sale. CONCLUSIONS: The barriers detected were lack of perception of being overweight, its identification as a disease and its consequences, lack of time to supervise a healthy lifestyle, and a big social influence to eat junk food.

Biomarcadores óseos y su relación con la densidad mineral ósea en adultas jóvenes y adolescentes en su primer año posparto / Bone biomarkers and its relation with bone mineral density in adults and adolescents during the first year postpartum

La información sobre biomarcadores óseos en adolescentes y adultas durante el periodo posparto es incierta, por lo que el objetivo de este artículo fue analizar el patrón de biomarcadores óseos en adolescentes y adultas a 15, 90, 180 y 365 días posparto (dpp) y su asociación con la densidad mineral ósea (DMO) y lactancia materna. Se realizó un estudio de cohorte en 32 madres adolescentes ≤17 años y 41 adultas de 18 a 29 años de edad en el primer año posparto. Se realizaron medidas antropométricas, DMO y biomarcadores óseos y así como datos del tipo y la duración de lactancia. Como resultados se encontró asociación entre la concentración basal de N-telopéptidos ≤24 μg/L y mayor aumento de DMO. Las adolescentes tuvieron mayor concentración de N-telopéptidos (p≤0.004) y menor concentración de osteocalcina (5±3 vs13±4, p <0.001) que las adultas. La lactancia no afectó el cambio de DMO (p>0.050), ni de biomarcadores óseos. La osteocalcina se asoció con el cambio en DMO (p<0.040). La prolactina fue mayor entre las que practicaron lactancia materna exclusiva (p<0.001). A menor edad menores concentraciones de osteocalcina (p<0.001) y mayores concentraciones de N-telopéptidos (p<0.001). Se concluyó que a menor concentración de N-telopéptidos y mayor de osteocalcina hubo un mayor aumento de DMO, lo cual implica menor aumento de ésta en el grupo de adolescentes. La lactancia no afectó la DMO.

The objective of this study was to describe the trend of bone biomarkers in adults and adolescents women at 15, 90, 180 and 365 postpartum days (ppd) and its relation with bone mineral density (BMD). It was a prospective cohort of 32 teenager’s ≤17 and 41 women from 18 to 29 years old. We evaluated diet, anthropometry, BMD, bone biomarkers and hormonal profile. In all, the concentration of N-telopeptide was higher at 15 days postpartum decreasing during first year postpartum, but adolescents had the highest concentration. The lowest N-telopeptide concentration was associated with highest increasing of the BMD. Osteocalcin concentration was lower in adolescents than in adults women (5 ± 3 vs 13 ± 4 ng/mL, p<0.001) during first year postpartum. Exclusive breastfeeding did not affect the BMD (p>0.050) or bone biomarkers. Osteocalcin concentration was positively associated with bone BMD (p<0.040), breastfeeding did not affect osteocalcin concentrations. Prolactin was higher among women who breastfed exclusively (p<0.001). Age and breastfeeding inversely correlated with bone biomarkers (p<0.001) N-telopeptide and PTHi respectively. We concluded that a lower N-telopeptide concentration and a higher osteocalcin concentration were associated with a higher increasing of BMD, so then, adolescents showed the lowest recovery of the BMD. Breastfeeding does not affect the BMD.

[Determination of 2-hydroxyestrone /16α-hydroxyestrone ratio in urine of Mexican women as a risk indicator for breast cancer and its relationship with other risk factors]. / Determinación de la relación 2-hidroxiestrona/16α-hidroxiestrona en la orina de mujeres mexicanas como indicador de riesgo a cáncer de mama y su relación con otros factores de riesgo.

UNLABELLED: The urinary ratio 2-hydroxyoestrone/16-hydroxyoestrone (URME), has been proposed in various populations on the world as a risk indicator for breast cancer (BC), however in the Mexican population has never been determined. OBJECTIVE: To determine URME Mexican women and establish its relationship with risk factors for BC. MATERIAL AND METHODS: Cross-sectional study of 142 premenopausal and 42 posmenopausal women. The URME was determined with the kit ESTRAMETTM and was related to risk factors for BC. Correlations and linear regressions were performed. RESULTS: The median URME was 0.90 (RIQ 0.64-1.18). The body mass index (BMI) and early menarche contribute 5.4% of their variability (F=5.17; p.

La relacion 2-hidroxiestrona/16-hidroxiestrona urinaria (RMEO), se ha propuesto en diversas poblaciones del mundo como indicador de riesgo a cancer de mama (CM), sin embargo, en la poblacion mexicana, nunca se ha determinado. Objetivo: Determinar la RMEO en mujeres mexicanas y establecer su relacion con factores de riesgo para CM. Material y Métodos: Estudio transversal analitico de 142 mujeres premenopausicas y 42 posmenopausicas. Se determino la RMEO con el estuche ESTRAMETTM y se relaciono con factores de riesgo para CM. Se realizaron correlaciones y regresiones lineales. Resultados: La mediana de la RMEO fue 0.90 (RIC: 0.64-1.18). El indice de masa corporal (IMC) y la menarca temprana contribuyeron en 5.4% de su variabilidad (F=5.17; p.

[Body image satisfaction in Mexican adolescents and adults and its relation with body selfperception and real body mass index]. / Satisfacción de la imagen corporal en adolescentes y adultos mexicanos y su relación con la autopercepción corporal y el índice de masa corporal real.

INTRODUCTION: Body Image (BI) perception could determine the nutritional care search, even though there is not always concordance between the real BMI and the self-perceived one. OBJETIVE: To determine the correlation between self-perceived and real BMI, and their relation with body image (BI) satisfaction in a sample of Mexican adolescents and adults. SUBJECTS AND METHODS: An cross-sectional and analytical study, conformed by 556 participants; of which 330 were adolescents and 217 were adults with anthropometric, self-perception and BI satisfaction assessment. RESULTS: The BMI was higher 23±6 vs 29.3±5 p<0.001 in adults, which doubled the level of overweight and obesity present in the adolescents 79% vs 43%. About 50% of participants had concordance between their real BMI and their perceived one (p<0.001). Of all adults with overweight and obesity 68% had satisfaction with their BI, whereas the prevalence of satisfaction with the BI in adolescents was 80%. The predictive variables of BI insatisfaction were being an adult, being a woman and having overweight/obesity (p=0.013). Those ones who referred a positive judgment about their BI, they also reported being satisfied with their BI and presented a real normal or overweight BMI. CONCLUSIONS: Half of the participants had concordance of their perceived BI with their real BMI. The satisfaction with BI was more frequent between the lower real and perceived BMI, but subjects with overweight and obesity also reported satisfaction with their BI even though it is considered a risk condition.

Introducción: La percepción que se tengan de la imagen corporal (IC) podría determinar la búsqueda de atención nutricia, aunque no siempre hay concordancia del índice de masa corporal (IMC) autopercibido con el real. Objetivo: Correlacionar el IMC autopercibido con el real y su relación con la satisfacción de la IC en una muestra de adolescentes y adultos mexicanos. Métodos: Estudio transversal analítico, con 556 participantes: 330 adolescentes y 217 adultos, con las siguientes evaluaciones: de autopercepción y de la satisfacción de la IC; asimismo, antropométrica. Resultados: El IMC fue mayor entre adultos 23±6 vs 29.3±5 p.

[Bone biomarkers and its relation with bone mineral density in adults and adolescents during the first year postpartum]. / Biomarcadores óseos y su relación con la densidad mineral ósea en adultas jóvenes y adolescents en su primer año posparto.

The objective of this study was to describe the trend of bone biomarkers in adults and adolescents women at 15, 90, 180 and 365 postpartum days (ppd) and its relation with bone mineral density (BMD). It was a prospective cohort of 32 teenager's ≤17 and 41 women from 18 to 29 years old. We evaluated diet, anthropometry, BMD, bone biomarkers and hormonal profile. In all, the concentration of N-telopeptide was higher at 15 days postpartum decreasing during first year postpartum, but adolescents had the highest concentration. The lowest N-telopeptide concentration was associated with highest increasing of the BMD. Osteocalcin concentration was lower in adolescents than in adults women (5 ± 3 vs 13 ± 4 ng/mL, p<0.001) during first year postpartum. Exclusive breastfeeding did not affect the BMD (p>0.050) or bone biomarkers. Osteocalcin concentration was positively associated with bone BMD (p<0.040), breastfeeding did not affect osteocalcin concentrations. Prolactin was higher among women who breastfed exclusively (p<0.001). Age and breastfeeding inversely correlated with bone biomarkers (p<0.001) N-telopeptide and PTHi respectively. We concluded that a lower N-telopeptide concentration and a higher osteocalcin concentration were associated with a higher increasing of BMD, so then, adolescents showed the lowest recovery of the BMD. Breastfeeding does not affect the BMD.