Overweight and obesity in Mexican children and adolescents during the last 25 years.

This corrects the article DOI: 10.1038/nutd.2016.52.

Overweight and obesity in Mexican children and adolescents during the last 25 years.

BACKGROUND/OBJECTIVE: The objective of the study was to provide current estimates of the prevalence and trends of overweight and obesity (OW+OB) in Mexican children and adolescents. SUBJECTS/METHODS: Body mass index objectively measured was analyzed for 37 147 children and adolescents aged 0-19 years obtained in 2012 as part of the National Health and Nutrition Survey (ENSANUT-2012), a nationally representative sample of the Mexican population. In addition, data from previous National Nutrition Surveys obtained in 1988, 1999 and 2006 were compared with analyze trends over a 24-year period (1988-2012) for children <5 years of age and adolescents and over a 13-year period (1999-2012) for school-age children. World Health Organization Child Growth Standard was used to define OW+OB. RESULTS: In 2012, 33.5% of children <5 years of age (both sexes) were at risk of overweight or were overweight (OW); 32% and 36.9% of girls and boys 5-11 years of age were OW+OB, respectively, and 35.8% and 34.1% of female and male adolescents were OW+OB, respectively. Statistically significant trends were documented for all age groups during the study period. Overall change in the combined prevalence in preschool children was 6.3±1.0 percentage points (pp; P<0.001; 0.26 pp per year) in the last 24 years, showing the highest increase between 1988 and 1999, whereas for school-age girls (from 1999 to 2012) and adolescent females (from 1988 to 2012), OW+OB increased across all periods at a declining trend, with an overall change of 0.5 and 1.0 pp per year, respectively. Changes in the prevalence of OW+OB were highest among children and adolescents in the lowest quintile of the household living condition index. CONCLUSIONS: Prevalence of OW+OB among children and adolescents increased significantly during the last 13-24 years. The rate of increase has declined in the last 6 years in all age groups. Changes in prevalence of OW+OB presented here suggest that, in Mexico, the burden of obesity is shifting toward the groups with lower socioeconomic level.

Price elasticity of the demand for sugar sweetened beverages and soft drinks in Mexico.

A large and growing body of scientific evidence demonstrates that sugar drinks are harmful to health. Intake of sugar-sweetened beverages (SSB) is a risk factor for obesity and type 2 diabetes. Mexico has one of the largest per capita consumption of soft drinks worldwide and high rates of obesity and diabetes. Fiscal approaches such as taxation have been recommended as a public health policy to reduce SSB consumption. We estimated an almost ideal demand system with linear approximation for beverages and high-energy food by simultaneous equations and derived the own and cross price elasticities for soft drinks and for all SSB (soft drinks, fruit juices, fruit drinks, flavored water and energy drinks). Models were stratified by income quintile and marginality index at the municipality level. Price elasticity for soft drinks was -1.06 and -1.16 for SSB, i.e., a 10% price increase was associated with a decrease in quantity consumed of soft drinks by 10.6% and 11.6% for SSB. A price increase in soft drinks is associated with larger quantity consumed of water, milk, snacks and sugar and a decrease in the consumption of other SSB, candies and traditional snacks. The same was found for SSB except that an increase in price of SSB was associated with a decrease in snacks. Higher elasticities were found among households living in rural areas (for soft drinks), in more marginalized areas and with lower income. Implementation of a tax to soft drinks or to SSB could decrease consumption particularly among the poor. Substitutions and complementarities with other food and beverages should be evaluated to assess the potential impact on total calories consumed.

Coexistence of maternal central adiposity and child stunting in Mexico.

OBJECTIVE: To assess the coexistence of maternal adiposity and child stunting (CS) in Mexico, estimate its national prevalence and identify the associated socio-demographic factors. METHODS: A secondary analysis from the Mexican Nutrition Survey 1999, a nationally representative survey, was conducted. Mother and children subsamples were matched and a total of 6225 mother/child pairs were obtained. Stunting was defined as height-for-age z-scores <-2.0. Maternal body mass index (BMI) was classified according to World Health Organization recommended cutoff points. Waist-to-hip ratio (WHR) was calculated by dividing waist by hip circumferences. Logistic regression models were fitted to explore the coexistence of CS and maternal central adiposity (MCA) (WHR> or =0.85) while controlling for biological and socio-demographic factors. RESULTS: A total of 5974 pairs had complete information. MCA coexisted with CS in 6.2% of the mother/child pairs. The phenomenon was more prevalent in rural locations, in the south region and among indigenous families (14.5, 12.5 and 23.9%). After controlling for child age and maternal BMI, a 78% increase in the likelihood of CS was related to maternal WHR > or =0.85 (odds ratio (OR)=1.78, 95% confidence interval (CI)=1.53, 2.10). After controlling for maternal height, the magnitude of the OR decreased (OR=1.33, 95%CI=1.13, 1.57), but remained significant. Therefore, it is suggested that women with a WHR approximately 1 have had twice the probability of having a stunted child as those with a WHR of 0.65. CONCLUSION: Although MCA and CS are two conditions frequently regarded as result of opposite determinants, our observation suggests that this is not necessarily the case, particularly in populations undergoing the nutrition transition. MCA was associated not only to chronic diseases, but also to child stunting.

[Policies and programs of food and nutrition in Mexico]. / Políticas y programas de alimentación y nutrición en México.

Mexico has a long-standing history of programs and policies oriented to improve the nutrition of vulnerable groups. However, malnutrition represents one of the main public health challenges in Mexico. This article provides a historic perspective of the main strategies, programs and policies that have been carried out in Mexico, as well as a detailed analysis of their design, implementation, and selected results. Finally, some critical issues related to food policies implemented in Mexico are identified.

Feeding patterns of Mexican infants recorded in the 1988 National Nutrition Survey.

Infant feeding patterns in Mexico were analyzed using data from the 1988 National Nutrition Survey. The prevalence of breast-feeding among infants declined from 86% at birth to approximately 40% after three months of age. The hazard rate of terminating breast-feeding increased by 38% at the national level and by 87% in the northern region with each increment in household living conditions, decreased 50% in rural municipalities in the south and decreased by 20% in all regions for each month that the introduction of other milks was delayed. The rate of other milk introduction increased by between 16% and 20% at the national level and within the central and southern regions with each household living condition increment but decreased by between 20 to 30% within indigenous or rural. Finally, the probability of solid food introduction increased by between 8 and 15% with each household living condition increment.

PIP: Infant feeding patterns are important determinants of child health and survival. This paper reports findings from an analysis of infant feeding patterns in Mexico using data from the 1988 National Nutrition Survey. Information was obtained on 7426 children younger than five years of age and 19,278 women aged 12-49 years from 13,236 surveyed households. 1518 children under one year old were included in the analysis, 52% of whom were male. At the national level, the prevalence of breastfeeding among infants declined from 86% at birth to approximately 40% after three months of age. The hazard rate of terminating breastfeeding increased by 38% at the national level and by 87% in the northern region with each increment in household living conditions, decreased by 50% in rural municipalities in the south, and decreased by 20% in all regions for each month that the introduction of other milks was delayed. The rate of other milk introduction increased by 16-20% at the national level and within the central and southern regions with each household living condition increment, but decreased by 20-30% within indigenous or rural areas. The probability of solid food introduction increased by 8-15% with each household living condition increment.

[Anemia in women of reproductive age. The results of a national probability survey]. / Anemia en mujeres de edad reproductiva. Resultados de una encuesta probabilística nacional.

Iron deficiency is one of the most prevalent forms of malnutrition which is clinically known as anemia. Functional consequences of anemia include impairment of cardiovascular performance, limitation in productivity, higher incidence of low birth weight and premature delivery, and increased maternal mortality. This paper presents a descriptive analysis of anemia in women of reproductive age in Mexico. Data were collected by the Ministry of Health through a National Nutrition Survey in 1988, which draw a representative sample from four regions: North, Center, South and Federal District. Anemia was more prevalent in pregnant (18.17%) than in non-pregnant women (15.38%). Those women living in predominantly indigenous communities had higher prevalence of anemia (24.02%) than non-indigenous women (14.67%). Anemia was more prevalent in urban areas (15.54%) than in rural (13.56%). Mean +/- standard deviation values for hemoglobin were lower in pregnant women (12.5 +/- 1.6 g/dL) than in non-pregnant ones (13.7 +/- 1.6 g/dL). Consistently, the Northern and Southern regions were worse off than the Center and the Federal District. These data indicate that anemia is a public health problem in Mexico. The functional consequences of this deficiency justify interventions to treat and prevent it.

[Stunting and emaciation in children under 5 in distinct regions and strata in Mexico]. / Déficit de talla y emaciación en menores de cinco años en distintas regiones y estratos en México.

Data from a National Nutrition Survey conducted in 1988 in a probability sample of 13,236 households and 17,426 children under five, representative at the national level and for four regions (North, Center, South, and Mexico City), were analyzed. Risks for wasting and stunting and odds ratios were obtained by region, by district according to proportion of indigenous population and by level of urbanization, by level of education of both parents, by gender, and by various combinations of the former strata. A high risk of stunting and a low risk of wasting were found. The risk of stunting is greater in predominantly indigenous and rural districts, in the South and Center, and in families of mothers with low education and poor housing conditions. The results can be used for food and nutrition policy planning and for targeting nutrition intervention programs.