Differential dietary intake and contribution of ultra-processed foods during pregnancy according to nutritional status.

Introduction: Frequent consumption of ultra-processed foods (UPFs) during pregnancy is linked to excess intake of added sugar, fat, and sodium and inadequacy of several micronutrients. Diet quality during pregnancy should be maximized as inadequate levels of key nutrients and excessive intake of energy and added sugar might influence mother-child health. We aimed to estimate the contribution (% of total calories) of ultra-processed products to the total energy intake by pre-gestational body mass index (BMI) categories and Hb status during pregnancy in participants from the MAS-Lactancia Cohort. Methods: Pre-gestational weight, hemoglobin levels, 24-h dietary intake recall interviews, and sociodemographic data were collected during the second and third trimesters of pregnancy. Reported consumed foods were categorized using the NOVA classification, and the contribution of calories from each NOVA category was estimated using the Mexican Food Database. We estimated medians and interquartile ranges (p25 and p75) for dietary intake and energy contributions. The comparison of intake between the second and third trimesters was done using the Wilcoxon test. In addition, a quantile regression model with an interaction between pre-gestational BMI and Hb levels status in tertiles over the percentage of energy from UPFs was adjusted by age and socioeconomic status. Results: The contribution to total energy intake from UPFs was 27.4% in the second trimester and 27% in the third trimester (with no statistical difference). The percentage of energy intake from UPFs was higher in women who started pregnancy with obesity and presented the lowest levels of Hb (1st tertile), 23.1, 35.8, and 44.7% for the 25th, 50th, and 75th percentiles, respectively, compared to those with normal BMI and the highest tertile of Hb levels: 18, 29.0, and 38.6% for the 25th, 50th, and 75th percentiles, respectively. Conclusion: In conclusion, UPF intake in pregnant women is similar to the general population and was higher for those with pre-gestational obesity and the lowest tertile of Hb levels. UPF contributes also to sugar, saturated fat, and sodium, which may adversely affect the health of mothers and their offspring.

Estado de nutrición de niñas y niños menores de cinco años en México. Ensanut 2022.

OBJETIVO: Actualizar las prevalencias de desnutrición infantil y de sobrepeso más obesidad en menores de cinco años de México, en el ámbito nacional y por grupos de edad y su distribución por variables sociodemográficas. Material y métodos. Se analizó la información de 1 684 menores de cinco años de la Encuesta Nacional de Salud y Nutrición 2022 (Ensanut 2022). Se estimaron prevalencias con IC95%, ajustadas por el diseño del estudio, de bajo peso, baja talla, emaciación y sobrepeso más obesidad y su distribución por variables sociodemográficas: tipo de localidad y región de residencia. RESULTADOS: Actualmente, 4.1% tienen bajo peso, 12.8% baja talla y 0.8% emaciación. El sobrepeso más obesidad es de 7.7%. En el Pacífico-Sur y la Península, la baja talla es de 20%. Conclusión. La baja talla es el principal problema de nutrición entre los preescolares, notablemente en los mayores de 24 meses y en los estados del sur. En 12 años se ha estancado la desnutrición crónica en México. La Ensanut 2022 contribuye con información actualizada que permite la focalización de las estrategias hacia las zonas y grupos más vulnerables en México.

Collaboration in public health research among institutions in Asia-Pacific and Latin America.

Not available.

Equitability of Individual and Population Interventions to Reduce Obesity: A Modeling Study in Mexico.

INTRODUCTION: Modeling studies have estimated the potential impact and cost effectiveness of interventions to reduce obesity; few have focused on their equity across socioeconomic groups. This study aims to compare the equitability of individual- and population-level interventions to reduce obesity in Mexico. METHODS: Mathematical models were implemented to estimate the expected effect of 2 sugar-sweetened beverage tax scenarios (10% and 20%) and bariatric surgery, pharmacotherapy, and dietary advice as individual interventions to reduce body weight. Individual interventions were modeled using meta-analytical weight change, inclusion and exclusion criteria, and the probability of access to healthcare services. For the tax, investigators obtained the baseline consumption of sugar-sweetened beverages from the National Health Survey 2012 and applied the reduction in sales observed in 2016 to estimate the caloric change and weight reduction. Implementation costs and cost per person, per kilogram, and equity were calculated for all interventions over a 1-year timeframe. RESULTS: The 20% tax produced the largest estimated increase (4.50%) in normal BMI prevalence, was the most cost effective, and had the largest and most equitable decrease in obesity across socioeconomic categories. Pharmacotherapy and bariatric surgery produced sizable decreases in obesity prevalence (3.68% and 1.18%), particularly among the middle and high socioeconomic groups, whereas dietary advice had the lowest impact on normal and obese categories. CONCLUSIONS: Individual interventions were effective in reducing obesity; yet, they were more expensive and less equitable than population interventions. Obesity in Mexico affects all socioeconomic groups; available interventions need to be carefully analyzed to tailor a national strategy that is both effective and equitable.

Pro-Inflammatory Diet Is Associated with Adiposity during Childhood and with Adipokines and Inflammatory Markers at 11 Years in Mexican Children.

There is limited evidence about the inflammatory potential of diet in children. The aim of this study was to evaluate the association between the Children's Dietary Inflammatory Index (C-DII) from 5 to 11 years with adiposity and inflammatory biomarkers in Mexican children. We analyzed 726 children from a birth cohort study with complete dietary information and measurements to evaluate adiposity at 5, 7 and 11 y and 286 children with IL-6, hsCRP, leptin and adiponectin information at 11 y. C-DII trajectories were estimated using latent class linear mixed models. We used linear mixed models for adiposity and logistic and multinomial regression for biomarkers. In girls, each one-point increase in C-DII score was associated with greater adiposity (abdominal-circumference 0.41%, p = 0.03; skinfold-sum 1.76%, p = 0.01; and BMI Z-score 0.05, p = 0.01). At 11 y the C-DII was associated with greater leptin (34% ≥ 13.0 ng/mL, p = 0.03) and hsCRP concentrations (29% ≥ 3.00 mg/L, p = 0.06) and lower adiponectin/leptin ratio (75% < 2.45, p = 0.02). C-DII trajectory 3 in boys was associated with a 75.2% (p < 0.01) increase in leptin concentrations and a 37.9% decrease (p = 0.02) in the adiponectin/leptin ratio. This study suggests that the inflammatory potential of diet may influence adiposity in girls and the homeostasis of adipose tissue and chronic subclinical inflammation in 11-year-old children.

[Nutricia Code: nutrition and conflict of interest in academia]. / Código Nutricia: nutrición y conflicto de interés en la academia.

To combat malnutrition in all its forms, actions must be integrated from society as a whole. The main interest of the actors involved in these actions should be health. However, there are actors with conflict of interest that interfere in the design, planning, implementation and monitoring of public health nutrition policies. In order to mitigate the adverse effect that result from these conflicts, from evidence generation to the design and implementation of policies, this Code is proposed. It invites the nutrition and health community to adopt it, promote it and subscribe it, and to favor the advancement of actions and policies without industry interference to address the problem of malnutrition.

Para combatir la mala nutrición en todas sus formas es necesario integrar acciones desde la sociedad en su conjunto. El interés superior de los actores involucrados en generar estas acciones debe ser la salud. No obstante, existen actores con conflictos de interés que interfieren en el diseño, planeación, implementación y monitoreo de las políticas derivadas de dichas acciones. A fin de mitigar el efecto adverso que generan estos conflictos desde la etapa de generación de evidencia hasta el diseño e implementación de las políticas, se propone este código. Se invita a la comunidad de nutrición y salud a adoptarlo, promoverlo y sumarse al mismo, para favorecer el avance de las acciones y políticas necesarias sin interferencia de la industria y resolver el problema de la mala nutrición.

Código Nutricia: nutrición y conflicto de interés en la academia / Nutricia Code: nutrition and conflict of interest in academia

Resumen: Para combatir la mala nutrición en todas sus formas es necesario integrar acciones desde la sociedad en su conjunto. El interés superior de los actores involucrados en generar estas acciones debe ser la salud. No obstante, existen actores con conflictos de interés que interfieren en el diseño, planeación, implementación y monitoreo de las políticas derivadas de dichas acciones. A fin de mitigar el efecto adverso que generan estos conflictos desde la etapa de generación de evidencia hasta el diseño e implementación de las políticas, se propone este código. Se invita a la comunidad de nutrición y salud a adoptarlo, promoverlo y sumarse al mismo, para favorecer el avance de las acciones y políticas necesarias sin interferencia de la industria y resolver el problema de la mala nutrición.

Abstract: To combat malnutrition in all its forms, actions must be integrated from society as a whole. The main interest of the actors involved in these actions should be health. However, there are actors with conflict of interest that interfere in the design, planning, implementation and monitoring of public health nutrition policies. In order to mitigate the adverse effect that result from these conflicts, from evidence generation to the design and implementation of policies, this Code is proposed. It invites the nutrition and health community to adopt it, promote it and subscribe it, and to favor the advancement of actions and policies without industry interference to address the problem of malnutrition.

A Brief History of Evidence-Informed Decision Making for Nutrition in Mexico.

The Progresa Conditional Cash Transfer program in Mexico began in 1997, with a strong evidence-based design. The program's ultimate objective was to foster the development of human capital through 3 components-education, health, and food. Rigorous impact evaluation generated evidence of impact on several outcomes, including child growth, but also aspects of program design and implementation challenges that may have limited impact. The objective of this supplement is to present research that led to the redesign of the health component, its implementation and evaluation at pilot scale, and its scale-up to national level, representing >15 y of collaboration among evaluators, program implementers, and funders. The studies used various methodologies, including process evaluation, cohort studies, ethnographic assessments, and a cluster-randomized trial, among others. The articles report previously unpublished results and citations of published literature. Article 1 uses an impact pathway to highlight gaps and bottlenecks that limited potential for greater impact, the original recognition of which was the impetus for this long collaboration. Article 2 explores the social and cultural factors that influence decisions to participate in programs and to adopt the actions proposed by them. Article 3 presents a cluster-randomized trial implemented to inform the choice of nutritional supplements for pregnant and lactating women and children 6-59 mo of age and how this and other evidence from the studies were used to redesign the health component of the program. Articles 4 and 5 present results of the development and pilot testing of the modified health component, the Integrated Strategy for Attention to Nutrition (abbreviated to EsIAN from its name in Spanish) (article 4), and the process and challenges of training and supervision in taking the EsIAN to scale (article 5). The final article provides reflections on the relevance of this body of work for implementation research in nutrition.

Closing the Nutrition Impact Gap Using Program Impact Pathway Analyses to Inform the Need for Program Modifications in Mexico's Conditional Cash Transfer Program.

BACKGROUND: Mexico's Prospera-Oportunidades-Progresa Conditional Cash Transfer Program (CCT-POP) included the distribution of fortified food supplements (FFS) for pregnant and lactating women and young children. Rigorous evaluations showed significant impacts on nutrition outcomes but also substantial gaps in addressing nutrition problems. OBJECTIVES: To highlight the program design-related and implementation-related gaps and challenges that motivated further research and the eventual design and roll-out of a modified nutrition component for CCT-POP. METHODS: We used a program impact pathway approach to highlight the extent and quality of implementation of CCT-POP, and its impact on nutrition outcomes. We drew on previously published and new primary data, organized into 3 sources: impact evaluations, studies to inform reformulation of the FFS, and a longitudinal follow-up study using qualitative and quantitative methods to document FFS use and the dietary intake of women and children. RESULTS: Despite positive impacts, a high prevalence of malnutrition persisted in the population. Coverage and use of health services improved, but quality of care was lacking. Consumption of FFS among lactating women was irregular. Micronutrient intake improved among children who consumed FFS, but the pattern of use limited frequency and quantity consumed. Substantial diversity in the prevalence of undernutrition was documented, as was an increased risk of overweight and obesity among women. CONCLUSIONS: Three key design and implementation challenges were identified. FFS, although well accepted for children, had limited potential to substantially modify the quality of children's diets because of the pattern of use in the home. The communications strategy was ineffective and ill-suited to its objective of motivating FFS use. Finally, the program with its common design across all regions of Mexico was not well adapted to the special needs of some subgroups, particularly indigenous populations. The studies reviewed in this paper motivated additional research and the eventual redesign of the nutrition component.

The Mexican National Health and Nutrition Survey as a Basis for Public Policy Planning: Overweight and Obesity.

Mexico has one of the highest overweight and obesity rates in the world. Our objective is to describe the tendency of overweight and obesity by sex, health service affiliation, and socioeconomic tertile (T1,2,3), and to give examples of public policies derived from the results of the Mexican National Health and Nutrition Surveys (ENSANUT). Data come from the 2006, 2012, and 2016 ENSANUTs, which are probabilistic surveys that allow us to make inferences at the national level, on urban and rural strata and regions; their coverage includes all the population age groups. We assessed overweight and obesity (OW + O) in all population groups. The prevalence of OW + O in preschool children was lower in T1 in all the surveys, and shows an increase by year of survey, according to the health service affiliation. In school-age women, prevalence increased over the 10 years of evaluation, in spite of the high prevalence in both genders in T3. Adolescent behavior is similar and, in adults, the prevalence of OW + O shows an increase by year of survey, gender, and affiliation, with the differences not explained by socioeconomic tertile. In conclusion, the ENSANUT series represents a surveillance system that allow us to observe the changes in overweight and obesity prevalence over the time, showing a high prevalence of OW + O in the population, and has contributed to public policy enhancement.

The Role of Public Nutrition Research Organizations in the Construction, Implementation and Evaluation of Evidence-Based Nutrition Policy: Two National Experiences in Mexico.

Malnutrition and poor diet are the largest risk factors responsible for the global burden of disease. Therefore, ending all forms of malnutrition by 2030 is a global priority. To achieve this goal, a key element is to design and implement nutrition policies based on the best available scientific evidence. The demand for evidence-based nutrition policies may originate directly from policymakers or through social actors. In both cases, the role of research institutions is to generate relevant evidence for public policy. The two key objects of analysis for the design of an effective policy are the nutrition conditions of the population and the policies and programs available, including the identification of delivery platforms and competencies required by personnel in charge of the provision of services (social response). In addition, systematic literature reviews about risk factors of malnutrition, as well as the efficacy and effectiveness of policy actions, lead to evidence-based policy recommendations. Given the multifactorial nature of malnutrition, the drivers and risk factors operate in several sectors (food and agriculture, health, education, and social development) and may be immediate, underlying or basic causes. This multilevel complexity should be considered when developing nutrition policy. In this article, we show two models for the evidence-based design of nutrition policies and programs that may be useful to academia and decision makers demonstrated by two examples of policy design, implementation and evaluation in Mexico.

Compliance with nutrition standards in Mexican schools and their effectiveness: a repeated cross-sectional study.

BACKGROUND: Mexico approved mandatory nutrient-based standards for foods sold in schools in 2011. The aim of this study was to analyse the association between compliance with nutrition standards for foods sold in schools and children's school snacks. METHODS: Data came from three surveys representative of Mexican elementary schools in 13 states and their students (2012, 2013 and 2015); n = 645 children from N = 99 different schools. Information on foods sold in schools and snacks consumed by children was collected through direct observation. Compliance with the standards was defined as the proportion of foods sold in school which met nutrition criteria established by the standards. Snacks were classified as healthy if they contained at least one fruit or vegetable and had no sugar-sweetened beverages. Robust logistic regression models for cross-sectional and repeated surveys aggregated at the school-level were fitted to quantify the association between school compliance with standards and healthy snacks. RESULTS: On average across waves 27% of foods sold complied with nutrition standards; 18% of children consumed a healthy snack. For snacks purchased in school, a 10% increase in school compliance with the standards was associated with a 32% increase in the odds of a healthy snack (OR = 1.32; 95%CI 1.09,1.61); no association was observed for snacks brought from home. The odds of a healthy snack increased over time in schools where compliance with the standards improved (OR = 3.89; 95%CI 1.47,10.31) but not in those where compliance remained constant or decreased. CONCLUSIONS: Only a small proportion of children are eating healthy snacks in school. School compliance with standards increases the likelihood of a healthy snack if it is bought at school. Our findings support better implementation of the standards and additional strategies to enhance the policy to achieve its aim of reducing childhood obesity.

Tendencias de la mala nutrición en menores de cinco años en México, 1988-2016: análisis de cinco encuestas nacionales / Trends of malnutrition in Mexican children under five years from 1988 to 2016: Analysis of five national surveys

Resumen: Objetivo: Estudiar la magnitud, distribución y tendencias de la desnutrición y el peso excesivo en menores de cinco años entre 1988 y 2016. Material y métodos: Se calcularon prevalencias de bajo peso, emaciación, desnutrición crónica y sobrepeso, en el ámbito nacional, en cuatro regiones y localidades urbanas/rurales, en menores de cinco años obtenidas en encuestas nacionales probabilísticas en 1988, 1999, 2006, 2012 y 2016. Resultados: Actualmente 3.9% de la muestra tiene bajo peso, 1.9% emaciación y 10% desnutrición crónica. Hubo un descenso en la desnutrición crónica de 1988 a 2016 (26.9 vs 10.0%), en localidades rurales (43.1 vs 12.6%) y urbanas (22.5 vs 9.1%) y en el sur (38.6 vs 13.4%), centro (29.2 vs 8.4%) y Ciudad de México (13.6 vs 4.7%). En el Norte el descenso fue menor (13.3 vs 11.4%). El sobrepeso disminuyó de 9.7% a 5.8%, entre 2012-2016. Conclusiones: La desnutrición crónica continúa a la baja en México, pero persisten prevalencias elevadas en grupos vulnerables. El sobrepeso presentó una disminución inesperada entre 2012-2016.

Abstract: Objective: To study the magnitude, distribution and trends of undernutrition and overweight in Mexican children under five years between 1988 and 2016. Materials and methods: Underweight, wasting, stunting and overweight prevalences were calculated, at national, regional and rural/urban locality levels in children under five years from the 1988, 1999, 2006, 2012 and 2016 national probabilistic surveys. Results: Currently 3.9% suffer underweight, 1.9% wasting and 10% stunting. There was an decrease in stunting from 1988 to 2016 (26.9 vs 10.0%), in rural (43.1 vs 12.6%) and urban (22.5 vs 9.1%) localities and in South (38.6 vs 13.4%), Center (29.2 vs 8.4%) and Mexico City (13.6 vs 4.7%). In the North region the decrease was smaller (13.3 vs 11.4%). Overweight diminished from 9.7% to 5.8, mainly between 2012-2016. Conclusions: Stunting has continued its decline in Mexico, but high prevalences persist in some vulnerable groups. Overweight had an unexpected decline between 2012-2016.

[Trends of malnutrition in Mexican children under five years from 1988 to 2016: Analysis of five national surveys]. / Tendencias de la mala nutrición en menores de cinco años en México, 1988-2016: análisis de cinco encuestas nacionales.

OBJECTIVE: To study the magnitude, distribution and trends of undernutrition and overweight in Mexican children un¬der five years between 1988 and 2016. MATERIALS AND METHODS: Underweight, wasting, stunting and overweight prevalences were calculated, at national, regional and rural/ urban locality levels in children under five years from the 1988, 1999, 2006, 2012 and 2016 national probabilistic surveys. RESULTS: Currently 3.9% suffer underweight, 1.9% wasting and 10% stunting. There was an decrease in stunting from 1988 to 2016 (26.9 vs 10.0%), in rural (43.1 vs 12.6%) and urban (22.5 vs 9.1%) localities and in South (38.6 vs 13.4%), Center (29.2 vs 8.4%) and Mexico City (13.6 vs 4.7%). In the North region the decrease was smaller (13.3 vs 11.4%). Overweight diminished from 9.7% to 5.8, mainly between 2012-2016. CONCLUSIONS: Stunting has continued its decline in Mexico, but high prevalences persist in some vulnerable groups. Overweight had an unexpected decline between 2012-2016.

OBJETIVO: Estudiar la magnitud, distribución y tendencias de la desnutrición y el peso excesivo en menores de cinco años entre 1988 y 2016. MATERIAL Y MÉTODOS: Se calcularon prevalencias de bajo peso, emaciación, desnutrición crónica y sobrepeso, en el ámbito nacional, en cuatro regiones y locali­dades urbanas/rurales, en menores de cinco años obtenidas en encuestas nacionales probabilísticas en 1988, 1999, 2006, 2012 y 2016. RESULTADOS: Actualmente 3.9% de la muestra tiene bajo peso, 1.9% emaciación y 10% desnutrición crónica. Hubo un descenso en la desnutrición crónica de 1988 a 2016 (26.9 vs 10.0%), en localidades rurales (43.1 vs 12.6%) y urbanas (22.5 vs 9.1%) y en el sur (38.6 vs 13.4%), centro (29.2 vs 8.4%) y Ciudad de México (13.6 vs 4.7%). En el Norte el descenso fue menor (13.3 vs 11.4%). El sobrepeso disminuyó de 9.7% a 5.8%, entre 2012-2016. CONCLUSIONES: La desnutrición crónica continúa a la baja en México, pero persisten preva­lencias elevadas en grupos vulnerables. El sobrepeso presentó una disminución inesperada entre 2012-2016.

Consumption of foods and beverages in elementary schools: Results of the implementation of the general guidelines for foods and beverages sales in elementary schools in Mexico, stages II and III.

The Mexican government developed the General Guidelines for the dispensing or distribution of foods and beverages at food sales in elementary schools (Guidelines). The objective is to evaluate the consumption of food and beverages during school hours, in two different stages of the implementation of the Guidelines: stages II (2011-2012) and stage III (2012-2013) in 565 elementary school students. We constructed three categories of consumption according to the origin of food: Home, food brought from home; School, food purchased at school and Both, food from home and food purchased at school. The main results showed that there are differences in both stages in energy intake according to the foods' origin; the category of School has the lowest energy and macronutrients consumption, as well as the closer compliance with de Guidelines recommendations in both stages, while the category of Both has a higher consumption and the less compliance with the Guidelines. This may be indicating an improvement in school guidelines and it is also reflecting the need to reinforce orientation for a healthy diet with respect to foods brought from home. It is necessary to continue with periodic evaluations to measure fulfillment with the Guidelines.

Energy, added sugar, and saturated fat contributions of taxed beverages and foods in Mexico.

OBJECTIVE: To estimate the dietary contribution of taxed beverages and foods. MATERIALS AND METHODS: Using 24-hour diet recall data from the Ensanut 2012 (n=10 096), we estimated the contribution of the items which were taxed in 2014 to the total energy, added sugar, and saturated fat intakes in the entire sample and by sociodemographic characteristics. RESULTS: The contributions for energy, added sugar, and saturated fat were found to be 5.5, 38.1, and 0.4%, respectively, for the taxed beverages, and 14.4, 23.8, and 21.4%, respectively, for the taxed foods. Children and adolescents (vs. adults), medium and high socioeconomic status (vs. low), urban area (vs. rural), and North and Center region (vs. South) had higher energy contribution of taxed beverages and foods. The energy contribution was similar between males and females. CONCLUSIONS: These taxes covered an important proportion of Mexicans' diet and therefore have the potential to improve it meaningfully.

Energy, added sugar, and saturated fat contributions of taxed beverages and foods in Mexico / Contribución de energía, azúcar añadido y grasa saturada de las bebidas y alimentos con impuesto en México

Abstract: Objective: To estimate the dietary contribution of taxed beverages and foods. Materials and methods: Using 24-hour diet recall data from the Ensanut 2012 (n=10 096), we estimated the contribution of the items which were taxed in 2014 to the total energy, added sugar, and saturated fat intakes in the entire sample and by sociodemographic characteristics. Results: The contributions for energy, added sugar, and saturated fat were found to be 5.5, 38.1, and 0.4%, respectively, for the taxed beverages, and 14.4, 23.8, and 21.4%, respectively, for the taxed foods. Children and adolescents (vs. adults), medium and high socioeconomic status (vs. low), urban area (vs. rural), and North and Center region (vs. South) had higher energy contribution of taxed beverages and foods. The energy contribution was similar between males and females. Conclusions: These taxes covered an important proportion of Mexicans' diet and therefore have the potential to improve it meaningfully.

Resumen: Objetivo: Estimar la contribución dietética de las bebidas y alimentos con impuesto. Material y métodos: Con el recordatorio de 24-horas de la Ensanut 2012 (n=10 096), estimamos la contribución de los productos con impuesto en 2014 al consumo total de energía, azúcar añadido y grasa saturada en toda la muestra y por sociodemográficos. Resultados: La contribución de energía, azúcar añadido y grasa saturada fue 5.5, 38.1 y 0.4%, respectivamente, para bebidas con impuesto y 14.4, 23.8 y 21.4%, respectivamente, para alimentos con impuesto. Los niños y adolescentes (vs. adultos), nivel socioeconómico medio y alto (vs. bajo), área urbana (vs. rural), y región Norte y Centro (vs. Sur) tuvieron una contribución de energía mayor de bebidas y alimentos con impuesto. La contribución fue similar entre hombres y mujeres. Conclusión: Estos impuestos cubren una proporción importante de la dieta mexicana y por lo tanto tienen el potencial de mejorarla de manera relevante.

[Changes in prices of taxed sugar-sweetened beverages and nonessential energy dense food in rural and semi-rural areas in Mexico]. / Cambios en los precios de bebidas y alimentos con impuesto en áreas rurales y semirrurales de México.

OBJECTIVE:: To estimate changes in prices associated with the implementation of the tax to sugar sweetened beverages (SSB) and to nonessential energy dense food in 2014. MATERIALS AND METHODS:: Price data were collected in rural and semi-rural areas in December 2013, and April and December 2014. Fixed effects models were used to estimate changes in prices of beverages and nonessential energy dense food, stratified by region, retailer and package size. RESULTS:: The SSB tax did not pass completely through prices: prices increased on average 0.73 pesos per liter. For nonessential energy dense food, the tax passed completely or was overshifted for cookies, cereal bars and cereal boxes. CONCLUSION:: The potential effect of the taxes on consumption could be attenuated in rural areas as the pass through prices was incomplete.

Cambios en los precios de bebidas y alimentos con impuesto en áreas rurales y semirrurales de México / Changes in prices of taxed sugar-sweetened beverages and nonessential energy dense food in rural and semi-rural areas in Mexico

Resumen: Objetivo: Analizar cambios en precios asociados con la implementación de los impuestos a bebidas azucaradas y alimentos no básicos con alta densidad energética implementados en 2014. Material y métodos: Se recolectaron precios en áreas rurales y semiurbanas en diciembre de 2013, y abril y diciembre de 2014. Se analizaron cambios en precios por tipo de bebidas y alimento con impuesto usando modelos de efectos fijos y estratificando por región, tipo de establecimiento y tamaño de presentación. Resultados: El impuesto a bebidas azucaradas no pasó por completo a los precios; en promedio, los precios aumentaron 0.73 pesos por litro. Para alimentos con alta densidad energética, el impuesto pasó igual o mayor al monto del impuesto para galletas, barras de cereal y cereales de caja. Conclusión: El potencial efecto de los impuestos en consumo podría ser menor al esperado en áreas rurales dado que los impuestos no pasaron por completo a los precios.

Abstract: Objective: To estimate changes in prices associated with the implementation of the tax to sugar sweetened beverages (SSB) and to nonessential energy dense food in 2014. Materials and methods: Price data were collected in rural and semi-rural areas in December 2013, and April and December 2014. Fixed effects models were used to estimate changes in prices of beverages and nonessential energy dense food, stratified by region, retailer and package size. Results: The SSB tax did not pass completely through prices: prices increased on average 0.73 pesos per liter. For nonessential energy dense food, the tax passed completely or was overshifted for cookies, cereal bars and cereal boxes. Conclusion: The potential effect of the taxes on consumption could be attenuated in rural areas as the pass through prices was incomplete.

Validity of a food frequency questionnaire to assess food intake in Mexican adolescent and adult population / Validación de un cuestionario de frecuencia de alimentos para evaluar la ingesta alimentaria en adolescentes y adultos de México

Abstract: Objective: To assess the validity of a 140-item semiquantitative food frequency questionnaire (SFFQ), in Mexican adolescents and adults. Materials and methods: Dietary intakes using a SFFQ and two 24-hour dietary recalls (24DRs), in nonconsecutive days during the same week were measured from 178 adolescents and 230 adults participating in the Mexican National Health and Nutrition Survey-2012.Validity was evaluated using correlation coefficients (CC),deattenuated CC, linear regression models, cross-classification analysis, and the Bland-Altman method. Results: In adults, deattenuated correlation coefficients between the SFFQ and the 24DRs ranged from 0.30 for folate to 0.61 for saturated fat. In addition, 63% adults and 62% adolescents were classified in the same and adjacent quartile of nutrient intake when comparing data from SFFQ and 24DRs. Conclusions: The SFFQ had moderate validity for energy, macronutrients and micronutrients. It also had good validity to rank individuals according to their dietary intake of different nutrients.

Resumen: Objetivo: Evaluar la validez de un cuestionario de frecuencia de consumo de alimentos semicuantitativo (CFA), en adolescentes y adultos mexicanos. Material y métodos: Se evaluó la ingesta de alimentos de 178 adolescentes y 230 adultos que participaron en la Encuesta Nacional de Salud y Nutrición-2012, de México, mediante un CFA y el promedio de dos recordatorios de 24-horas (24DRs). La validez se evaluó utilizando coeficientes de correlación, coeficientes de correlación corregidos (CCC) y análisis de clasificación. Resultados: En adultos, los CCC entre el CFA y el promedio de los 24DRs estuvieron entre 0.30 para folatos y 0.61 para grasas saturadas. Adicionalmente, 63% de los adultos y 62% de los adolescentes fueron clasificados en el mismo o adyacente cuartil cuando fueron comparados los datos del CFA y el 24DR. Conclusión: El CFA mostró una validez moderada para energía, macronutrimentos y micronutrimentos. Además, mostró buena validez para clasificar a los individuos de acuerdo con su ingesta dietética.