Longitudinal changes in sleep patterns and circadian rhythm metrics in preschool-age children from Northern Mexico.

OBJECTIVES: To assess changes in sleep parameters and circadian rhythm metrics measured by actigraphy in preschool-aged children. DESIGN: Longitudinal analysis over 1 year. PARTICIPANTS: Ninety-four children living in Tijuana and Ensenada, Mexico. MEASUREMENTS: Children wore accelerometers on the right hip for one continuous week at baseline and 1-year follow-up. Parents recorded child bedtime, waketime, and naps in sleep diaries. We used cosinor and nonparametric approaches to calculate circadian rhythm metrics. RESULTS: At baseline, children had a mean age of 4.2 years, and 51.1% were girls. In multivariable models adjusted for age, gender, BMI category, parental education, household income and city, at follow-up children had significantly earlier waketimes (ß = -7.99 minutes, p < .001) compared to baseline. Children also had lower sleep onset latency (ß = -2.32 minutes, p = .057), and longer nighttime sleep (ß = 9.38 minutes, p = .079), but these changes were not significant at the α < 0.05 level. We found significant increases in log relative amplitude (ß = 0.017, p = .009), and decreases in log midline estimated statistic of rhythm (ß = -0.084, p = .017) and log of the least active 5-hour period (ß = -0.057, p = .010). When we adjusted for co-sleeping, we found significant decreases in the number of nighttime awakenings (ß = -1.29, p = .011) but otherwise similar results. There were no other changes in sleep parameters or circadian rhythm metrics. CONCLUSIONS: Mean increases in nighttime sleep and earlier wake times over one year were concomitant with decreases in overall activity levels and increases in circadian rhythm robustness. Co-sleeping was a predictor of sleep disturbances. This study provides longitudinal evidence regarding changes in sleep and circadian metrics in a sample of children from an under-researched sociodemographic group during an important, early life period.

Association of Food Parenting Practices on Child BMI z Score and Waist Circumference in Mexican Preschool Children After 1 Year of Follow-Up.

OBJECTIVE: To evaluate the association between food parenting practices (FPPs) and weight status among preschoolers and the directionality of this association at 1-year follow-up. METHODS: A longitudinal exploratory study was conducted using linear regression and structural equation modeling to determine directional associations between FPPs and children's body mass index z score and waist circumference. The FPPs were estimated using Child Feeding Questionnaire subscales. RESULTS: A total of 91 parent-child dyads completed the study. In structural equation modeling analysis, when identifying the FPPs in a latent variable with its indicators of indulgent feeding, food as a reward and restriction predicted higher body mass index z score at follow-up. Higher baseline waist circumference was also negatively associated with the use of food as a reward. CONCLUSIONS AND IMPLICATIONS: Feeding-weight associations are likely bidirectional. Understanding them, as well as the pathways between them, is critical to developing effective prevention and treatment strategies.

Alimentos seleccionados por los padres para los refrigerios de sus hijos en etapa de educación básica en Reynosa, Tamaulipas / Lunch box contents of elementary school children in Reynosa, Tamaulipas

Resumen Los refrigerios que consumen los niños durante el recreo complementan su dieta diaria, y pueden representar un riesgo de obesidad si los padres los preparan con base en alimentos procesados, elevados en azúcar, sal y grasa. El objetivo de este estudio fue identificar el contenido de los refrigerios empacados en casa, así como el estado nutricio de escolares de Reynosa, Tamaulipas, México. Se realizó un estudio descriptivo y transversal. Se trabajó con 769 niños de 12 escuelas públicas de educación básica. Se tomaron peso y talla. Se registraron durante una semana los refrigerios por observación directa, mediante una lista de cotejo. El 44.7 % de los escolares presentó sobrepeso u obesidad. Los alimentos contenidos en los refrigerios fueron el sándwich (50.0 %), tacos (29.5 %) y tortas (14.5 %). Las bebidas azucaradas incluyeron jugo (44 %) y agua saborizada (38.2 %). El 18.8 % llevó frutas, 13.5 % verduras y 31.6 % agua. En promedio, el contenido de energía fue de 327 kcal, por lo tanto, sobrepasaron la recomendación de calorías, e incluían alimentos no saludables (alto contenido de azúcar y grasa en relación a su aportación nutrimental), siendo necesario realizar intervenciones de educación nutricional para promover el consumo de agua y alimentos saludables dentro del entorno escolar, para mejorar la calidad de los hábitos alimenticios, tanto en escuelas de medio tiempo, como de tiempo completo, las cuales, brindan el servicio de alimentación.

Abstract School lunch supplements children's dailydiet and may pose a risk of obesity if they are prepared based on processed foods high in sugar, salt and fat. The aim of this study was to identify the content of lunch packs, as well as the nutritional status of scholars from Reynosa, Tamaulipas, Mexico. To that aim, a descriptive and transversal study was conducted. We worked with 769 children from 12 public elementary schools. Students' size and weight were taken. The contents of their lunch packs were recorded for one week by direct observation through a checklist. 44.7 % of school children were overweight or obese. The foods contained in the lunch packs were sandwich (50.0 %), tacos (29.5 %) and big sandwich (14.5 %). Sugary drinks included juice (44 %) and flavored water (38.2 %). They also contained fruits (18.8 %), vegetables (13.5 %) and water (31.6 %). On average, the energy content was 327 kcal. Therefore, they exceeded the calorie recommendation and included unhealthy foods (high content of sugar and fat in relation to their nutritional contribution). This suggests the need to implement nutrition education intervention programs to promote the consumption of drinking water and healthy foods within the school environment to improve the quality of eating habits.

Greenspace, physical activity, and BMI in children from two cities in northern Mexico.

Numerous previous studies have reported positive associations between exposure to greenspace and children's physical activity, but in high-income countries only. Prior studies have also examined greenspace and obesity in children, but these have yielded inconsistent results and focused mostly on older children. The purpose of this study was to assess associations between time children spent in greenspace as the primary exposure and our outcomes of interest, including 1) minutes of physical activity, and 2) body mass index (BMI) z-score. Our sample was 102 children ages 3 to 5 years living in Ensenada and Tijuana, Mexico. We fit linear mixed models to estimate associations between greenspace and children's physical activity and BMI z-score. After adjustment for potential confounders, greater time in greenspace was associated with decreased sedentary time (-0.08 min per hour for each additional 30 min in greenspace; 95% CI -0.13, -0.04; p = 0.002) and increased moderate-to-vigorous physical activity (MVPA) (0.06; 95% CI 0.03, 0.10; p < 0.001). Results were driven primarily by children in Tijuana (-0.22; 95% CI -0.38, -0.06; p = 0.008 for sedentary time and 0.15; 95% CI 0.06, 0.38; p = 0.007 for MVPA). Time in greenspace was not associated with BMI z-score in children in Ensenada (0.001; 95% CI -0.008, 0.01; p = 0.83) or Tijuana (-0.009; 95% CI -0.02, 0.004; p = 0.17). Greater time in greenspace was associated with physical activity but not BMI in our sample of children-more so in Tijuana compared to Ensenada. Given high rates of obesity, interventions should aim to increase physical activity in young children in Northern Mexico.

Long-term outcomes of metabolic and bariatric surgery in adolescents with severe obesity with a follow-up of at least 5 years: A systematic review.

The practice of metabolic and bariatric surgery for adolescents with severe obesity has been increasing, and evidence of the outcomes in the long term remains unclear. The aim of this study was to review and analyze the outcomes of this therapy in adolescents with a follow-up ≥5 years. MEDLINE, EMBASE, and Cochrane databases were systematically searched. Inclusion criteria were 10- to < 20-year-old adolescents, 5 years minimum of follow-up, and a retention rate ≥70% at 5 years of follow-up. Adiposity indicators outcomes, co-morbidity remission, and complications were analyzed. A total of 10 studies met the inclusion criteria. Surgeries performed included gastric bypass, gastric band, and sleeve gastrectomy. The age of the participants ranged from 13 to 17 years. The longest follow-up after intervention was 156 months. Mean body mass index at baseline and follow-up was 47 and 32.4 kg/m 2 , respectively. Most of the studies reported weight regain within 1 to 12 years of follow-up. Remission rate of co-morbidities was 75% for dyslipidemia, 78% for musculoskeletal problems, 85% for hypertension, and 85% for type 2 diabetes. Not all studies stated that they were looking for all complications. Iron deficiency and anemia were high, ranging from 30% to 70% and 16% to 50%, respectively. The review indicates that there is low to moderate evidence that metabolic and bariatric surgery in adolescents with severe obesity after 5 years of follow-up results in substantial reduction in body mass index, and very low to low evidence in the resolution of related co-morbidities. Although long-term complications were inadequately reported or nonreported, a high prevalence of iron deficiency and anemia was found. Because maternal anemia might be implicated in deleterious effects for offspring, monitoring female patients for anemia after metabolic and bariatric surgery is strongly recommended. Further high-quality studies with long-term follow-up are warranted to assess related co-morbidities and long-term complications.

Nutritional Intervention to Improve the Quality of Lunchboxes Among Mexican School Children.

In Mexico, the type of foods included in the lunchboxes of school children are unhealthy. The aim of this study was to evaluate the effects of an intervention program to improve the quality of the foods in the lunchboxes. Two schools were randomly selected as the intervention group (IG) and two more as the control group (CG). The evaluation was performed by comparing a food list from 3 days before and 6 months after the intervention. The components of the intervention included: exposure to posters inside and outside the classrooms and the distribution of pamphlets to parents, the pamphlets provided recipes and information about healthy foods. A lunchbox was considered adequate (AL) if it had less than 276 cal, fruits or vegetables, and an item prepared at home; a healthy lunchbox (HL) consisted of fruits or vegetables, water, and it did not have unhealthy foods. At the beginning of the study there were no significant differences in the compliance of AL and HL in both groups. By the end of the study, 19 % of the children in the IG and 10 % of the children in the CG met the criteria of a HL (p = 0.002). The results of this study demonstrate that a simple, 6 month intervention targeting parents improved the quality of the foods in the lunchboxes of second and sixth graders.

Estudio prospectivo sobre el efecto del consumo de bebidas azucaradas sobre la obesidad en un periodo de 12 meses en mexicanos de 15 a 19 años.

Antecedentes: se ha reportado una asociación entre el aumento del consumo de bebidas azucaradas y varias enfermedades metabólicas. Objetivo: evaluar el efecto del consumo de bebidas azucaradas sobre la obesidad en un periodo de 12 meses en mexicanos de 15 a 19 años. Métodos: el diseño del estudio fue prospectivo, con 12 meses de seguimiento. Se midieron el peso, la talla y la circunferencia de cintura (CC), y se calculó el puntaje z de índice de masa corporal (IMC). Se aplicó un cuestionario sobre consumo de 19 bebidas. Para evaluar la predicción del aumento de IMC y de CC como resultado del consumo de bebidas, se utilizó análisis de regresión logística binomial. Resultados: al final del estudio se evaluó al 89% (1.344). El promedio de edad fue de 15 años, 55% fueron mujeres. La prevalencia de sobre- peso y obesidad al final del estudio fue del 33%. Al final del estudio, un 25% de los participantes consumían más de 50 g de azúcar proveniente de las bebidas. Quienes consumieron 50 g de azúcar o más al día presentaron mayor riesgo de aumentar la CC ≥ 2 cm (RR = 1,19, IC 95%, 1,03-1,39, p = 0,02). Quienes mantuvieron el consumo de bebidas azucaradas durante 12 meses, al compararlo con los que disminuyeron el consumo a 10 g/día, presentaron 71% más probabilidades de aumentar a un puntaje de IMC ≥ 2 (RR = 1,71, IC 95%, 1,03-2,86, p = 0,039). Conclusión: el alto consumo de bebidas azucaradas aumentó las probabilidades de aumentar de peso y de circunferencia de cintura.

FAT PHOBIA IN MEXICAN NUTRITION STUDENTS.

Nutritionists play a major role in the prevention and treatment of obesity. Currently, fat phobia among nutrition students and health workers is resulting in health and social consequences. The aim of this study was to assess the fat phobia among nutrition college students of two schools from different regions in Mexico. Six hundred and thirty 18 to 25 yo nutrition students participated in the study. Fat phobia was assessed using the F-scale, containing 14 pairs of adjectives that described people with obesity. Participants achieved a mean F-scale score of 3.45, which could be considered a moderate amount of fat phobia. Only twelve per cent showed neutral or positive attitudes towards obesity (≤ 2.5), while negative attitude (≥ 2.5) was observed among 88% of all students showing a high prevalence of fat phobia towards obesity.

Los nutricionistas juegan un papel importante en la prevencion y el tratamiento de la obesidad, y la fobia hacia personas con obesidad entre estudiantes de nutricion y los trabajadores de la salud tiene consecuencias sanitarias y sociales. El proposito del estudio fue valorar la fobia hacia la obesidad, entre estudiantes de nutricion de dos escuelas de diferentes regiones de Mexico. Seiscientos treinta estudiantes de 18 a 25 anos participaron en el estudio. La fobia hacia la obesidad se evaluo mediante la escala F, que contiene 14 pares de adjetivos que describen a las personas con obesidad. Los participantes obtuvieron una media de calificacion en la escala F de 3,45, lo que se considera una cantidad moderada de fobia hacia la obesidad. Solamente el 12% presentaron actitudes neutrales positivas (≤ 2,5), mientras que el 88% de los estudiantes presentaron actitudes negativas (≥ 2.5). Se observo una alta prevalencia de fobia hacia la obesidad.

[DO WEIGHT LOSS INCREASE LIFE EXPECTANCY?: SYSTEMATIC REVIEW]. / ¿PERDER PESO AUMENTA LA ESPERANZA DE VIDA? REVISIÓN SISTEMÁTICA.

BACKGROUND: prospective trials that assess the effect of weight loss on all-cause mortality have shown controversial results. We conducted a systematic review of prospective studies, with a follow up ≥10y, assessing the association of weight loss and weight cycling with all cause- mortality. METHODS: we searched Pubmed of prospective studies with a follow up of ≥10y, published from January 1st 2004 to December 31th 2014. RESULTS: nine studies met the inclusion criteria. Five studies assessed the association between weight loss and mortality, two of the studies examined weight cycling and mortality, and two other weight loss and weight cycling with mortality. Weight loss increased all-cause mortality in those that assessed weight loss and mortality. In the two studies evaluating the association between weight cycling and mortality, weight cycling made no difference on mortality. In the two studies assessing weight loss and weight cycling, results showed weight cycling increased mortality in both of them, and weight loss increased mortality in one study. CONCLUSION: six out of seven (≥10 y of follow up) prospective studies showed that weight loss was associated with increased mortality; the results from studies assessing weight cycling were inconsistent. None of the studies found evidence showing that weight loss improved life expectancy.

Antecedentes: existe controversia sobre el efecto de la pérdida de peso sobre la mortalidad. Se realizó una revisión sistemática de estudios prospectivos, con un seguimiento ≥10 años, que evaluó el efecto de la pérdida de peso y los cambios de peso cíclicos con todas las causas de mortalidad. Métodos: se efectuó una búsqueda en PubMed, de artículos prospectivos, con un seguimiento > 10 años, publicados del 1 de enero de 2004 al 31 de diciembre de 2014. Resultados: nueve estudios cumplieron con los criterios de inclusión: cinco evaluaron la relación de la pérdida de peso exclusiva sobre la mortalidad, dos los cambios en el peso cíclicos y la mortalidad, y dos la pérdida de peso y los cambios en el peso cíclicos y la mortalidad. En los cinco que evaluaron la pérdida de peso, la mortalidad aumentó; en los dos que evaluaron cambios cíclicos en el peso, no se observó aumento en el riesgo de mortalidad, y en los dos que evaluaron pérdida de peso y cambios cíclicos en el peso, los cambios en el peso aumentaron el riesgo de mortalidad en ambos estudios, mientras que la pérdida de peso aumento el riesgo de mortalidad en un estudio. Conclusión: seis de los siete estudios(≥10 años de seguimiento) prospectivos mostraron que la pérdida de peso se asoció con aumento de la mortalidad; los resultados de los estudios que evaluaron cambios cíclicos de peso fueron inconsistentes. No se observaron evidencias de que la pérdida de peso aumente la esperanza de vida.

[EFFECT OF LOW CARBOHYDRATE DIETS ON WEIGHT LOSS AND GLYCOSILATED HEMOGLOBIN IN PEOPLE WITH TYPE 2 DIABETES: SYSTEMATIC REVIEW]. / EFECTO DE LAS DIETAS BAJAS EN CARBOHIDRATOS SOBRE LA PÉRDIDA DE PESO Y HEMOGLOBINA GLUCOSILADA EN PERSONAS CON DIABETES TIPO 2: REVISIÓN SISTEMÁTICA.

INTRODUCTION: some experts have suggested out that low carbohydrate diets (LCD) are more effective for weight loss and glycemic control. However, long term results are controversial. OBJETIVE: to review and analyze randomized control studies that evaluate the effect of LCD on weight and metabolic control in individuals with type 2 diabetes for a period equal to or greater than 10 months. METHODS: a systematic review was conducted on randomized trials registered in PubMed, EBSCOhost and Scielo to May 15th 2015, published in English and Spanish, with the following search data: "diabetes mellitus" AND "carbohydrate restricted diet" OR "restricted carbohydrate diet" OR "low carbohydrate diet" AND "weight loss". RESULTS: four studies met the inclusion criteria. There were 444 participants between 18-70yo. Follow-up time ranged between 10 to 24 months. Three out of the four studies reported weight reduction with LCD. However, when LCD were compared with other diets no significant differences in weight loss or A1C levels were observed. CONCLUSIONS: this review showed that three of four studies on the LCD were effective for weight loss over a period of 10 to 24 months. However, there was no evidence showing better results than those observed with other diets. Nor, difference in A1C.

Introducción: algunos expertos señalan que las dietas bajas en carbohidratos (DBC) son más efectivas para la reducción de peso y el control glucémico. Sin embargo, los resultados a largo plazo son controversiales. Objetivo: realizar una revisión y análisis de estudios aleatorizados que estudien el efecto de la DBC sobre el control metabólico en individuos con diabetes tipo 2 en un periodo igual o superior a 10 meses. Métodos: se realizó una revisión de estudios aleatorizados controlados publicados en PubMed, EBSCOhost y Scielo hasta el 15 de mayo del 2015. Se buscaron estudios publicados en inglés y español, utilizando los términos de búsqueda: "diabetes mellitus" AND "carbohydrate restricted diet" OR "restricted carbohydrate diet" OR "low carbohydrate diet" AND "weight loss". Resultados: cuatro estudios cumplieron con los criterios de inclusión. El número de participantes fue de 444 individuos, el rango de edad fue de 18 a 70 años. El tiempo de seguimiento osciló entre los 10 y 24 meses. Tres de los cuatro estudios reportaron una reducción de peso con la DBC. Al compararlos con otras dietas no se observaron diferencias significativas en la pérdida de peso ni en los niveles de A1C. Conclusiones: esta revisión muestra que en tres de los cuatro estudios las DBC son efectivas para la pérdida de peso en un período de 10 a 24 meses. Sin embargo, no existen evidencias que demuestren mayor efectividad para la pérdida de peso o la reducción de AIC, cuando se comparan con otras dietas.

Association of eating behaviors and BMI among elementary school students from Mexico.

The aim of this study was to analyze the association of cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE) with body max index (BMI) among elementary schools children in Mexico. 5th and 6th grade students were recruited from two schools. Weight, height, and waist circumference were measured and BMI was calculated. Overweight and obese children were classified according to the World Health Organization's (WHO) BMI z-score. The TFEQ-R18 questionnaire was applied to assess behavioral patterns. Gender differences of UE and EE were observed. Private school children had higher scores of CR and UE. Children with CR were three times more likely to have abdominal obesity (AO) and children with OW or O were more likely to have UE. Children attending the private school and those with AO had higher CR scores; private school children, those with overweight or obesity and with AO had higher UE scores.

El objetivo de este estudio fue analizar la asociación de la restricción cognitiva (CR), el consumo incontrolado (UE) y el consumo emocional (EE) con el índice de masa corporal (IMC) entre alumnos de primaria en México. Se reclutaron estudiantes de quinto y sexto grado de dos escuelas. Se midieron el peso, la estatura y la circunferencia de cintura y se calculó el IMC. El sobrepeso (SP) y la Obesidad (OB) se clasificó de acuerdo al puntaje Z de IMC de la OMS. Se aplicó el cuestionario TFEQ -R18 para valorar los patrones de conducta. Se observaron diferencias de UE y de EE. Los niños de las escuelas privadas presentaron mayores puntajes de CR y UE. Los niños con CR presentaron tres veces más probabilidades de tener obesidad abdominal (OA) y los niños con SP u OB tenían más posibilidades de tener UE. Los niños que atendían escuelas privadas y los que tenían OB tenían mayores puntajes de CR; los niños de escuelas privadas, los que tenían OW u OB y OA tenían más puntaje en UE.

Modifiable environmental obesity risk factors among elementary school children in a Mexico-us border city.

BACKGROUND: The increasing overweight (OW) and obesity (OB) prevalence in Mexican children warrant the assessment of the environmental risk factors. OBJECTIVE: To assess whether there is an association between food availability in children's environments and their food consumption with BMI z-score and waist circumference (WC). METHODS: Six hundred and eighty four children, 264 parents, 22 teachers and cafeteria staff in the schools and street vendors participated in the study. Weight, height, and WC of 5(th) grade children were assessed. Food frequency, physical activity (PA) and eating habits questionnaires were applied to parents, children and teachers. A food inventory questionnaire was applied to parents, cafeteria staff in the schools, street vendors and stores near the schools. RESULTS: The children's mean age was 10.5. Twenty eight per cent of the children were overweight, 26% obese and 25% had abdominal obesity. A positive correlation was found between energy-dense foods (EDF), fruit and vegetable availability at home and their weekly consumption. Also a correlation between consumption of soft drinks and other EDF was found. The largest contributors to food consumption were the availability at home and at school (R2 = 0.11, p = 0.0001). Children's TV viewing was positively correlated with parents TV viewing time. For each hour of increase (from cero to seven) in daily TV viewing children were more likely to be overweight or obese (OR=1.22 95% CI 1.02-1.45, p=0.026). CONCLUSION: EDF, fruit and vegetable availability in and near home and school along with hours of TV viewing were positively associated with obesity.

Antecedentes: El aumento de la prevalencia de sobrepeso (SP) y la obesidad (OB) en niños mexicanos, hace necesario la valoración de los factores de riesgo ambientales. Objetivo: Valorar si existe asociación entre la disponibilidad de alimentos en el entorno de los niños y el consume de alimentos con el puntaje Z de IMC y la circunferencia de cintura (CC). Métodos: Participaron en el estudio 684, 264 padres, 22 maestros, el personal de cafetería de las escuelas, y vendedores ambulantes. Se valoró el peso, la estatura la CC, de niños de quinto año de educación básica. Se aplicaron a los padres, niños y maestros un cuestionario de frecuencia de consumo de alimentos, uno de actividad física y uno de hábitos alimentarios. Un inventario de alimentos se aplicó a los padres, al personal de la cafetería de la escuela, a los vendedores y a las tiendas cercanas a las escuelas. Resultados: La media de edad de los niños fue 10.5 años. 28% de los niños tenían SP, 26% OB, y 25% obesidad abdominal (OA). Se observó una correlación positiva entre el consumo de alimentos densamente energéticos (ADE), frutas, y verduras con la disponibilidad en casa y con el consumo semanal. También se observó una correlación entre el consumo de refrescos y otras ADE. El factor que más contribuía al consumo de alimentos fue la disponibilidad en casa y en la escuela (R2 = 0.11, p = 0.0001). Se observó una asociación positiva entre el tiempo que los niños ven televisión con el de sus padres. Por cada hora de aumento (de 0 a 7) de ver televisión al día, los niños tenían más posibilidades de tener SP o OB (OR=1.22 95% CI 1.02-1.45, p=0.026). Conclusión: La disponibilidad de ADE, de frutas y verduras en o fuera de casa o de la escuela, además de las horas de ver televisión estuvieron positivamente asociadas con la obesidad.

[Obesity and high health risk due to beberages consumption and obesity among high school students in méxico]. / ALTO RIESGO PARA LA SALUD DEBIDO AL CONSUMO DE BEBIDAS Y OBESIDAD ENTRE BACHILLERES DE MÉXICO.

The purpose of this study was to identify the consumption of beverages among high school Mexican students and to determine obesity (OB) and abdominal obesity (AB). Differences in range and calorie beverage consumption between gender and BMI categories were calculated with the Mann-Whitney test. We assessed 1,677 students 15 to 17 yo. The prevalence of OB and AO was 15% and 53% in men and 12% and 47% in women. The consumption of energy, sugary drinks, and alcohol in milliliters and kilocalories per week, was higher in men (p = 0.001). More than 70% of students consumed per day more than 25 g/day of sugar from beverages, and more than 38% consumed more than 50 g/day of sugar. This high risk food consumption warrants immediate intervention.

El propósito del estudio fue identificar el consumo de bebidas y determinar la obesidad (O) y la obesidad abdominal (OA) en mexicanos de bachillerato. Se calcularon diferencias en rangos de consumo de bebidas entre sexo en categorías del IMC con la prueba de Mann-Whitney. Se evaluaron 1677 estudiantes entre 15 y 17 años. La prevalencia de O y OA fue en hombres y mujeres de 15% y 53% y de 12% y 43%, respectivamente. El consumo semanal de bebidas energéticas, alcohólicas, lácteas y azucaradas en mililitros y kilocalorías por semana fue mayor en hombres (p=0.001). Más del 70% de estudiantes consumen más de 25 g de azúcar al día proveniente de bebidas y más del 38% consumen más de 50 g de azúcar al día. Este consumo de alto riesgo requiere de intervenciones inmediatas.

[Consumption of sweetened, energy and alcoholic beverages among college students in the México-US border]. / consumo de bebidas energéticas, alcohólicas y azucaradas en jóvenes universitarios de la frontera México-USA.

BACKGROUND: The consumption of sugary, energy and alcoholic drinks among college students might be a health risk factor. OBJECTIVE: To assess the consumption of sugary, energy and alcoholic drinks and to determine their associations with body mass index (BMI) status among college students. METHODS: Second and third year college students enrolled in five different majors at the Universidad Autónoma de Baja California were evaluated. Weight, height and waist circumference were measured and BMI was calculated. A frequency questionnaire of 19 drinks was administered. RESULTS: A total of 1138 students participated in the study. The prevalence of obesity and abdominal obesity was 12 and 33% with 14 and 17% in women and men respectively. Fifty-five per cent of women and 68% of men consumed more than 25g of sugar drinks per day; 12% consumed more than 100g of sugar daily. The daily caloric intake from beverages was greater than 450kcal with 350kcal in men and women respectively. Ten per cent of women and 15% of men consumed more than 30g of alcohol daily. The sugary drinks more frequently consumed were fruit juices (90%), whole milk (69%), regular soft drinks (83%), beer (37%), liquor (27%) and energy drinks (12%). CONCLUSIONS: Consumption of sugary, energy, and alcoholic drinks is very high, which may be a health risk in this population.

Introducción: El consumo de bebidas azucaradas, energéticas y alcohólicas en universitarios puede ser un riesgo para la salud. Objetivo: Determinar el consumo de bebidas azucaradas, energéticas, y alcohólicas y compararlo con el estado del IMC en universitarios. Metodología: Se evaluaron estudiantes de segundo y tercer año de la UABC. Se midieron el peso, la talla y la circunferencia de cintura, y se calculó el IMC. Se aplicó un cuestionario sobre consumo de 19 bebidas. Resultados: Participaron 1138 estudiantes. La prevalencia de obesidad y obesidad abdominal fue de 12 y 33% y de 14 y 17% en mujeres y hombres respectivamente. El 55% de las mujeres y el 68% de los hombres consumían más de 25g de azúcar de bebidas al día; 12% consumían más de 100g de azúcar al día. El consumo calórico diario proveniente de bebidas fue mayor de 450 kcal en hombres y de 350kcal en mujeres. Diez por ciento de mujeres y 15% de hombres consumen más de 30g de alcohol diarios. Las bebidas que contienen carbohidratos y que se consumen con mayor frecuencia son los zumos de frutas (90%), la leche entera (69%), los refrescos regulares (83%), las cervezas (37%), los licores (27%) y las bebidas energéticas (12%). Conclusiones: El consumo de bebidas azucaradas, alcohólicas y energéticas es muy alto, lo que podría ser un riesgo para la salud en esta población.

Association of obesity and eating in the absence of hunger among college students in a Mexican-USA border city.

Few studies have examined disinhibited eating behaviors in Mexico. However eating in the absence of hunger (EAH), defined as eating in response to the presence of palatable foods in the absence of physiological hunger, is one of the more frequently examined behaviors. The purpose of this study was to assess the association between obesity and EAH among college students in a large Mexican-USA border city. Two-hundred and one sophomore college students completed the EAH questionnaire (EAH-C). Weight and height were measured. To assess reproducibility a test-retest was conducted in a subset sample (n = 20). Test-retest correlations ranged from ρ = 0.44 to 0.86, p < 0.01. Data obtained from the EAH-C were subjected to a principal components analysis with a varimax rotation. The mean age of participants was 21.0 ± 2.0 years, 52 % were female. The prevalence of overweight and obesity was 29 and 14 % respectively. The internal validity was assessed by Cronbach's alph. Internal consistency for all subscales was: external eating (α = 0.83), negative affect (α = 0.92) and fatigue/boredom (α = 0.86). Principal component analysis generated four subscales for the EAH-C: external eating, negative affect, fatigue and boredom. Comparing normal weight students versus obese students, normal weight students (57.1%) had higher scores on boredom subscale than obese students (p < 0.008). Female students had higher scores in the negative affect subscale than the males (p < 0.001). We conclude that the EAH-C had internal consistent subscales with good convergent validity. In this study population we found no association between EAH and obesity.

Efficacy of social support on metabolic syndrome among low income rural women in Chiapas, México.

INTRODUCTION: The purpose of this study was to assess a social support intervention among rural women from Chiapas and its ability to change lifestyles, self-concept, and Metabolic Syndrome (MS). METHODS: A convenience sample was conducted among older than 16 yo women from a marginalized rural community from central Chiapas. Two questionnaires were used, a self-concept questionnaire and a healthy lifestyle profile. Criteria for components of MS used were those of the International Diabetes Federation. The intervention was conducted over a three month period and divided into 13 sessions that concentrated on social support and were complemented by nutrition education modules. RESULTS: Five hundred eighty six participants met inclusion criteria for the study. At basal time 47% had MS; abdominal obesity, 69%; high levels of glucose, 27%; triglycerides, 56%; systolic blood pressure, 17%; diastolic blood pressure, 15%; and low levels of HDL-cholesterol, 55%. After the intervention, 38% had MS and significant differences were observed in all of the components of MS. The pre and post-intervention dimension scores on the self-concept form 5 (AF5), or self-concept questionnaire, and the Pender Health Promotion and Lifestyle Questionnaire (PETS-1) also yielded significant differences. CONCLUSIONS: After a three month social support and nutrition education intervention, significant changes were observed in several dimensions of the AF5 and PETS-1, as well as in MS and its components.

Introducción: El propósito de este estudio fue valorar una intervención de soporte social entre mujeres rurales de Chiapas, sobre los cambios en el estilo de vida, el autoconcepto, y el síndrome metabólico (MS). Métodos: Se realizó una muestra de conveniencia entre todas la mayores de 16 años de una población rural marginada del centro de Chiapas. Se utilizaron dos cuestionarios. Uno sobre el auto-concepto de salud y el otro sobre el perfil de estilos saludables. Los componentes del MS se valoraron de acuerdo a los criterios de la Federación Internacional de Diabetes. La intervención se realizó durante un período de tres meses y se dividió en 13 sesiones que incluían soporte social (SS) y educación nutricional (EN). Resultados: Cumplieron con los criterios de inclusión, 586 mujeres. Al inicio del estudio 47% tenían MS; obesidad abdominal, 69%; altos niveles de glucosa, 27%; de triglicéridos, 56%; de presión arterial sistólica, 17%; de presión arterial diastólica, 15%; y bajos niveles de colesterol- HDL, 55%. Después de la intervención 38% presentaron MS y se observó una reducción de todos los componentes del MS. Al final del estudio se observaron cambios significativos en AF5, PETS-1 y algunos componentes del SM. Conclusiones: Después de una intervención de SS y EN, se observaron cambios significativos en varias dimensiones del AF5 y del PETS-1, así como en SM y todos los componentes del SM.

Prevalence of obesity and abdominal obesity from four to 16 years old children living in the Mexico-USA border.

The prevalence of obesity among Mexicans is alarming in both the child and adult populations. The objective of this study was to determine the levels of overweight, obesity and abdominal obesity in pre-school (PS), elementary (ES), and middle high (MHS) public school children from Tijuana. From February to April of 2011, a bietapic random sample was selected by cluster method of 30 PS, 30 ES, and 30 MHS children. And a sample of 30 groups for each level was chosen. Twenty elementary teachers and eight graduate students were trained at one central location on how to take anthropometric measurements using a portable scale, a stadiometer, and a measuring tape to determine weight, height, and waist circumference. Body Mass Index values were computed and compared to age/gender BMI percentiles according to WHO criteria. Waist circumference for-age at the 90th percentile from NHANES III (Mexican-American) was used to define abdominal obesity. The sample was composed of 646 PS children, 961 ES children, and 1,095 MHS children. Their ages ranged from 4- 16 years. Results showed an overall prevalence of overweight and obesity in younger than 5y preschool children (> 2 SD) of 23.1%, in ≥ 5 y PS (> 1 SD) of 33.8%, in ES children of 46.3%, and in MHS children of 41.9%. Abdominal obesity in PS children was 18%, in ES children was 16.7%, and in MHS children was 15.2%. These results warrant immediate and comprehensive actions to prevent a critical public health problem in Mexico.

En población infantil y adulta, la prevalencia de obesidad entre mexicanos es alarmante. Los objetivos de este estudio fueron determinar los niveles de sobrepeso, obesidad y obesidad abdominal, en pre-escolares (PE), primaria (P), y secundaria (S) de Tijuana. De febrero a abril de 2011, se realizó una muestra aleatoria bietápica por el método de conglomerados, que incluyeron 30 escuelas de PE, 30 de P, y 30 de S. Posteriormente se seleccionó una muestra de 30 grupos de cada nivel educativo. Veinte maestros, y ochos estudiantes de postgrado participaron como encuestadores. Se les entrenó en un lugar central para homogeneizar las mediciones antropométricas para valorar el peso, la estatura, la circunferencia de cintura. Se calculó el IMC y se comparó con las tablas de la OMS para edad y sexo. Como punto de corte para valorar la obesidad abdominal se utilizó la percentile 90 para edad y sexo, del NHANES III para México-americanos. La muestra comprendió 646 niños PE, 961 de P, y 1.095 de S. Las edades oscilaron de 4 a 16 AÑOs. Se observó un prevalencia total de sobrepeso y obesidad en menores de 5 AÑOs, con DE > 2 de 23,1%, en PE = 5 AÑOs, con DE > 1 de 33,8%, en niños de P, de 46,3%, y en niños de S de 41,9%. La obesidad abdominal en niños PE fue de 18%, en niños de P de 16,7%, y en los de S fue de 15,2%. Estos resultados requieren acciones integrales para prevenir un problema crítico de salud pública.

Unhealthy and healthy food consumption inside and outside of the school by pre-school and elementary school Mexican children in Tijuana, Mexico.

Food from lunch packs (LP) or food available inside and outside of school can play an important role in the development of obesity. The purpose of this study was to evaluate the LP of elementary school (ES) and preschool children (PS) in Tijuana, and the foods available to them inside and outside of school. Eight public schools participated in the study. A random sample of all the groups from a school district was conducted. A questionnaire was administered to children in first through sixth grade (ES) and to the parents of PS. LP and food available inside and outside of the school were classified as healthy, unhealthy, and adequate according to the guidelines set forth by the Secretariat of Health. A total of 2,716 questionnaires were administered and the content of 648 LP was assessed. It was observed that 99% of PS had LP prepared at home, a higher percentage than ES. None of the LP of the ES was classified as healthy, and 1% was classified as adequate. Among PS, 21% of the LP were classified as healthy and 6% as adequate. More than half of the children recognized the brand name of foods high in fat, salt, and added sugar available inside and outside of school grounds. Most of the LP of ES and PS and the foods available inside and outside of school were unhealthy and inadequate. A strategy to prevent the availability of unhealthy and inadequate food in LP and foods available inside and outside schools is recommended.