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Oviedo-Solís CI, Monterrubio-Flores EA, Rodríguez-Ramírez S, Cediel G, Denova-Gutiérrez E, Barquera S. A Semi-quantitative Food Frequency Questionnaire Has Relative Validity to Identify Groups of NOVA Food Classification System Among Mexican Adults. Front Nutr 2022; 9:737432. [PMID: 35187027 PMCID: PMC8850985 DOI: 10.3389/fnut.2022.737432] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 01/05/2022] [Indexed: 01/19/2023] Open
Abstract
Background Ultra-processed foods are recognized as indicators of an unhealthy diet in epidemiological studies. In addition to ultra-processed foods, the NOVA food classification system identifies three other groups with less processing. Unprocessed foods that, together with minimally processed foods (MPF), make NOVA group 1, NOVA group 2 is processed culinary ingredients, and NOVA group 3 is processed foods. Objective To assess the relative validity of the semi-quantitative food frequency questionnaire (SFFQ) to estimate the energy intake for each group NOVA classification system by comparing it with two 24 h-dietary-recall (24DRs) Mexican adults. Methods We analyzed dietary information from 226 adults included <60 and ≥60 years with complete SFFQ and two 24DRs from the National Health and Nutrition Survey 2012. We reported mean differences, Spearman correlation coefficients, intra-class correlations coefficients, Bland–Altman plots, and weighted kappa between measures. Results The percentage energy intake from unprocessed and minimally processed foods group, Spearman correlation coefficients was 0.54 in adults <60 years and 0.42 in adults ≥60 years, while ultra-processed foods group was 0.67 and 0.48, respectively. The intra-class correlation coefficients in the unprocessed and minimally processed foods group was 0.51 in adults <60 years and 0.46 in adults ≥60 years, and for the ultra-processed foods group were 0.71 and 0.50, respectively. Bland–Altman plots indicated reasonably consistent agreement for unprocessed and minimally processed foods group and ultra-processed foods group in adults <60 years and adults in the ≥60 age group. Weighted kappa was 0.45 in the ultra-processed foods group to adults <60 years and was 0.36–≥60 years. Conclusion The SFFQ had acceptable validity to rank the percentage of energy intake from unprocessed and minimally processed foods group and ultra-processed foods group in Mexican adults, both in adults under 60 years and who were 60 years old or older.
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Affiliation(s)
| | | | - Sonia Rodríguez-Ramírez
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Gustavo Cediel
- School of Nutrition and Dietetics, University of Antioquia, Medellín, Colombia
| | - Edgar Denova-Gutiérrez
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
- *Correspondence: Edgar Denova-Gutiérrez
| | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
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Peres J, Barquera S, Moratorio X. NOVA in the definition of public policies in Latin America. CAD SAUDE PUBLICA 2022; 37Suppl 1:e00312620. [PMID: 35019049 DOI: 10.1590/0102-311x00312620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 05/31/2021] [Indexed: 11/21/2022] Open
Affiliation(s)
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, México
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Vargas-Meza J, Cervantes-Armenta MA, Campos-Nonato I, Nieto C, Marrón-Ponce JA, Barquera S, Flores-Aldana M, Rodríguez-Ramírez S. Dietary Sodium and Potassium Intake: Data from the Mexican National Health and Nutrition Survey 2016. Nutrients 2022; 14:281. [PMID: 35057461 PMCID: PMC8779568 DOI: 10.3390/nu14020281] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/01/2022] [Accepted: 01/04/2022] [Indexed: 01/03/2023] Open
Abstract
Population studies have demonstrated an association between sodium and potassium intake and blood pressure levels and lipids. The aim of this study was to describe the dietary intake and contribution of sodium and potassium to the Mexican diet, and to describe its association with nutrition status and clinical characteristics. We analyzed a national survey with 4219 participants. Dietary information was obtained with a 24-h recall. Foods and beverages were classified according to level of processing. The mean intake (mg/d) of Na was 1512 in preschool children, 2844 in school-age children, 3743 in adolescents, and 3132 in adults. The mean intake (mg/d) of K was 1616 in preschool children, 2256 in school-age children, 2967 in adolescents, and 3401 in adults. Processed and ultra-processed foods (UPF) contribute 49% of Na intake in preschool children, 50% in school-age children, 47% in adolescents, and 39% in adults. Adults with high Na intake had lower serum concentrations of cholesterol, HDL-c, and LDL-c. A significant proportion of the Mexican population has a high intake of Na (64-82%) and low K (58-73%). Strategies to reduce Na and increase K intake need to reduce the possibility of having high BP and serum lipid disturbances.
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Affiliation(s)
| | | | - Ismael Campos-Nonato
- Center for Nutrition and Health Research, National Institute of Public Health, Av. Universidad 655 Col Santa María Ahuacatitlán, Cuernavaca C.P. 62100, Morelos, Mexico; (J.V.-M.); (M.A.C.-A.); (C.N.); (J.A.M.-P.); (S.B.); (M.F.-A.); (S.R.-R.)
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Denova-Gutiérrez E, Lara-Castor L, Hernández-Alcaraz C, Hernández-Ávila M, Aguilar-Salinas C, Kershenobich D, Barquera S. Prevalence and predictors of elevated liver enzyme levels in Mexico: The Mexican National Health and Nutrition Survey, 2016. Ann Hepatol 2021; 26:100562. [PMID: 34653686 DOI: 10.1016/j.aohep.2021.100562] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/18/2021] [Accepted: 03/23/2021] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND OBJECTIVE To determine the prevalence of elevated liver enzyme levels and the fatty liver index according to specific sociodemographic, clinical, anthropometric, and metabolic risk factors in Mexican adult population. MATERIAL AND METHODS The present analysis was conducted using data from the Mexican National Health and Nutrition Survey 2016. For the present study, 3,490 adults with complete information on liver enzymes, sociodemographic, lifestyle, and metabolic factors were analyzed. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) levels were determined from blood samples. We computed the fatty liver Index (FLI), as a surrogate marker of non-alcoholic fatty liver disease. The associations are reported as adjusted odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS At the national level, the prevalence of high serum levels of ALT, AST, and GGT were 7.9%, 13.5, and 12.9 respectively. We observed that men had higher prevalences of altered ALT, GGT and FLI compared to women. Additionally, we observe that individuals with obesity, metabolic syndrome and insulin resistance are significantly more likely to present elevated concentrations of AST, ALT, GGT and FLI. Finally, we found that the subjects of the lowest socioeconomic level and indigenous population were more likely to present elevated levels of AST, ALT, GGT, and FLI. CONCLUSION In Mexico, non-alcoholic fatty liver disease affect people with obesity, diabetes, and metabolic syndrome as well as men, subjects of low socioeconomic status, subjects who live in rural areas and indigenous population. Interventions to reduce this condition should be a public health priority.
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Affiliation(s)
- Edgar Denova-Gutiérrez
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Mexico.
| | - Laura Lara-Castor
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Mexico; Friedman School of Nutrition Science and Policy, Tufts University, Boston, USA
| | - Cesar Hernández-Alcaraz
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | - Mauricio Hernández-Ávila
- Dirección de prestaciones económicas y sociales, Instituto Mexicano del Seguro Social (Mexican Institute of Social Security)
| | - Carlos Aguilar-Salinas
- National Institute of Medical Sciences and Nutrition, "Salvador Zubirán", Mexico City, Mexico
| | - David Kershenobich
- National Institute of Medical Sciences and Nutrition, "Salvador Zubirán", Mexico City, Mexico
| | - Simón Barquera
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Mexico.
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Medina C, Monge A, Romero M, López-Ridaura R, Barquera S, Romieu I, Denova-Gutiérrez E, Lajous M. Reliability and validity of the Mexican teachers' physical activity questionnaire (MTPAQ) in a subsample of female Mexican teachers. BMC Sports Sci Med Rehabil 2021; 13:143. [PMID: 34758874 PMCID: PMC8582186 DOI: 10.1186/s13102-021-00371-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 11/01/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Reliable and valid instruments are needed to estimate physical activity levels. The purposes of this study were to estimate the reliability and validity of the Physical Activity Questionnaire (MTPAQ) in a subsample of the Mexican Teachers Cohort study. METHODS We completed telephone interviews and clinical examinations of 82 teachers. Two MTPAQ, five International Physical Activity Questionnaire (IPAQ)-long form, and two accelerometer (AC) measures were used to determine physical activity levels throughout 24 months. Moderate and walking physical activity (MWPA min/week), vigorous physical activity (VPA min/week), and moderate-to-vigorous physical activity minutes per week (MVPA min/week) were estimated for each instrument. Pearson, Intra-class correlations and deattenuated adjustments were used to determine the reliability and validity of MTPAQ. RESULTS MWPA and MVPA min/week of MTPAQs were moderately correlated (r ≥ 0.54) to min/week of IPAQ-long form. MWPA and MVPA min/week average MTPAQ and MTPAQ1 and average AC, AC1 and AC2 were fairly correlated (r ≥ 0.20). A higher correlation was observed when correlation coefficients were attenuated (r ≥ 0.32). CONCLUSIONS MTPAQ1 is a reliable and valid tool to measure physical activity levels.
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Affiliation(s)
- C Medina
- Center for Nutrition and Health Research, Mexican National Institute of Public Health (INSP), Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - A Monge
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
| | - M Romero
- Center for Research in Evaluation and Surveys, National Institute of Public Health, Mexico City, Mexico
| | - R López-Ridaura
- National Center for Preventive Programs and Disease Control. Ministry of Health, Mexico City, Mexico
| | - S Barquera
- Center for Nutrition and Health Research, Mexican National Institute of Public Health (INSP), Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - I Romieu
- Section of Nutrition and Metabolism. International Agency for Research on Cancer, Lyon, France
| | - E Denova-Gutiérrez
- Center for Nutrition and Health Research, Mexican National Institute of Public Health (INSP), Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico.
| | - M Lajous
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
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Sánchez-Pájaro A, Pérez Ferrer C, Basto-Abreu A, Rivera-Dommarco J, Barquera S, Denova-Gutiérrez E, Barrientos-Gutiérrez T. Seroprevalencia de SARS-CoV-2 en adultos y adultos mayores en México y su asociación con enfermedades crónicas. Ensanut 2020 Covid-19. Salud Publica Mex 2021; 63:705-712. [PMID: 35099898 DOI: 10.21149/13163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 09/24/2021] [Indexed: 11/06/2022] Open
Abstract
Objetivo. Analizar la asociación entre seropositividad a SARS-CoV-2 y enfermedades crónicas en adultos y adultos mayores mexicanos. Material y métodos. Se utilizó la Encuesta Nacional de Salud y Nutrición 2020 sobre Covid-19 (Ensanut 2020 Covid-19) para evaluar la asociación de seropositividad a SARS-CoV-2 con hipertensión arterial sistémica, diabetes tipo 2, índice de masa corporal, LDL-c elevado, HDL-c bajo, colesterol total elevado e hipertrigliceridemia. Resultados. Se observó una mayor seropositividad en personas con mayor índice de masa corporal. La seroprevalencia fue 25% mayor entre los adultos que presentaban obesidad en comparación con aquellos de peso normal en modelos ajustados (RP: 1.25 IC95%: 1.08,1.46). No se observó asociación entre seropositividad y otras enfermedades crónicas en adultos o adultos mayores. Conclusiones. Las personas con obesidad podrían tener una mayor susceptibilidad a la infección por SARS-CoV-2. Este hallazgo debe ser confirmado con estudios longitudinales. No se encontró evidencia de asociación para otras enfermedades.
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Affiliation(s)
- Andrés Sánchez-Pájaro
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | | | - Ana Basto-Abreu
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Juan Rivera-Dommarco
- Dirección General, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Edgar Denova-Gutiérrez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
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Campos-Nonato I, Hernández-Barrera L, Oviedo-Solís C, Ramírez-Villalobos D, Hernández-Prado B, Barquera S. Epidemiología de la hipertensión arterial en adultos mexicanos: diagnóstico, control y tendencias. Ensanut 2020. Salud Publica Mex 2021; 63:692-704. [DOI: 10.21149/12851] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 08/25/2021] [Indexed: 11/06/2022] Open
Abstract
Objetivo. Describir la prevalencia de hipertensión arterial (HTA) en adultos mexicanos, la proporción que tiene tensión arterial (TA) controlada y la tendencia en el periodo 2018-2020. Material y métodos. Se midió la TA a 9 844 adultos en la Encuesta Nacional de Salud y Nutrición (Ensanut) 2020. Se consideró que tenían HTA o TA controlada cuando cumplían los criterios del Seventh Joint National Committee (JNC-7) o American Heart Association (AHA). Resultados. La prevalencia de HTA fue 49.4% (según JNC-7), de los cuales 70% desconocía su diagnóstico. Según la clasificación AHA, 30.2% de los adultos tenía HTA y 51.0% ignoraba su diagnóstico. Entre adultos con diagnóstico previo de HTA, 54.9% tuvo TA controlada. Entre el periodo 2018-2020 no se observaron cambios en las prevalencias. Conclusiones. Al menos un tercio de los adultos mexicanos tiene HTA y de ellos al menos la mitad no habían sido diagnosticados. Debe evaluarse la pertinencia de los actuales programas de diagnóstico de HTA porque el subdiagnóstico y mal control pueden ocasionar complicaciones y la muerte.
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Basto-Abreu AC, López-Olmedo N, Rojas-Martínez R, Aguilar-Salinas CA, De la Cruz-Góngora VV, Rivera-Dommarco J, Shamah-Levy T, Romero-Martínez M, Barquera S, Villalpando S, Barrientos-Gutiérrez T. Prevalence of diabetes and glycemic control in Mexico: national results from 2018 and 2020. Salud Publica Mex 2021; 63:725-733. [PMID: 35099912 DOI: 10.21149/12842] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/03/2021] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of diabetes (diagnosed and undiagnosed), glycemic control in Mexico, and its associated factors. MATERIALS AND METHODS We used data from Ensanut 2018 (n=12 648) and 2020 (n=2 309). We defined diabetes as fasting glucose ≥126 mg/dl or HbA1c≥6.5% or previously diagnosed; glycemic control was defined as HbA1c<7%. We fitted Poisson regression models to assess the association between diabetes, glycemic control, and potential associated factors. RESULTS The total prevalence of diabetes was 16.8% in 2018 and 15.7% in 2020. In 2018, 38% of adults with diabetes were unaware of their disease, while in 2020 this figure was 29%. Glycemic control was observed in 42% of participants in 2018 and 39% in 2020. Longer disease duration was associated with lower glycemic control, while older age, having a diet, and being affiliated to IMSS, Pemex, Sedena, or private healthcare were associated with better control. CONCLUSION Mexico is among the countries with the highest diabetes prevalence. A high proportion of adults with diabetes did not have a previous diagnosis, and the proportion with glycemic control is low. Strengthening screening to achieve a timely diagnosis, and improving glycemic control, should be key actions in the management of diabetes.
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Affiliation(s)
- Ana Cristina Basto-Abreu
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Nancy López-Olmedo
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Rosalba Rojas-Martínez
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Carlos A Aguilar-Salinas
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Mexico City, Mexico. / Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey. Monterrey, Mexico..
| | | | - Juan Rivera-Dommarco
- Dirección General, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico..
| | - Teresa Shamah-Levy
- Centro de Investigación en Evaluación y Encuestas. Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico..
| | - Martín Romero-Martínez
- Centro de Investigación en Evaluación y Encuestas. Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico..
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico..
| | - Salvador Villalpando
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico..
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Batis C, Marrón-Ponce JA, Stern D, Vandevijvere S, Barquera S, Rivera JA. Adoption of healthy and sustainable diets in Mexico does not imply higher expenditure on food. Nat Food 2021; 2:792-801. [PMID: 37117976 DOI: 10.1038/s43016-021-00359-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 07/28/2021] [Indexed: 04/30/2023]
Abstract
The relative cost of healthy and sustainable diets is key for their adoption in different countries. Using a newly developed modelling tool that generates different diet baskets, we compared the costs of diets following the EAT-Lancet healthy reference diet, the Mexican dietary guidelines and locals' current food intake. On average, the cost of the EAT-Lancet healthy reference diet baskets was 21% lower than that of the Mexican dietary guidelines baskets, and 40% lower than that of the current intake baskets (29% lower if the comparison was isocaloric). Findings were similar over time (2011-2018) and by geographic region. The higher cost associated with the larger amount of fruits, vegetables, legumes and nuts in healthy and sustainable diets was surpassed by the savings associated with their lower amount of animal protein sources, sugar-sweetened beverages and discretionary foods. We conclude that transitioning to better diets in Mexico is possible without a higher expenditure on food.
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Affiliation(s)
- Carolina Batis
- CONACYT - National Institute of Public Health, Cuernavaca, Mexico.
| | | | - Dalia Stern
- CONACYT - National Institute of Public Health, Cuernavaca, Mexico
| | | | | | - Juan A Rivera
- National Institute of Public Health, Cuernavaca, Mexico
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Tolentino-Mayo L, Sagaceta-Mejía J, Cruz-Casarrubias C, Ríos-Cortázar V, Jauregui A, Barquera S. [Understanding and use of the front-of-pack Guideline Daily Amounts nutritional labeling of industrialized food and beverages in Mexico.]. Salud Publica Mex 2021; 62:786-797. [PMID: 33620975 DOI: 10.21149/11568] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 08/06/2020] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Evaluate the use, subjective and objective under-standing of the GDA frontal labeling to assist the population towards making healthy decisions regarding the products they consume. MATERIALS AND METHODS The use of nu-tritional information contained in products ́ packages (GDA, nutritional information table, and list of ingredients), as well as the subjective and objective comprehension of the GDA. RESULTS A total of 43 157 people were interviewed. Amid the labels, the nutritional table was read more frequently (11.1%). 24.6% (IC95%: 23.9-25.3) and 41.2% (IC95%: 40.4-42.1) of the interviewees classified products correctly as not healthy and high in sodium, respectively. These outcomes were smaller between the elderly, lower socioeconomic levels, lower educational levels, and rural areas. CONCLUSIONS The results show that the GDA labeling is not useful to support the vulnerable population to make healthy decisions.
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Affiliation(s)
- Lizbeth Tolentino-Mayo
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Janine Sagaceta-Mejía
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Carlos Cruz-Casarrubias
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Víctor Ríos-Cortázar
- Coordinación de Primer Nivel y Salud Comunitaria, Universidad Autónoma Metropolitana-Unidad Xochimilco. Ciudad de México, México
| | - Alejandra Jauregui
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Simón Barquera
- Dirección del Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
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Barquera S, Hernández-Barrera L, Trejo-Valdivia B, Shamah T, Campos-Nonato I, Rivera-Dommarco J. [Obesity in Mexico, prevalence andtrends in adults. Ensanut 2018-19.]. Salud Publica Mex 2021; 62:682-692. [PMID: 33620965 DOI: 10.21149/11630] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 09/22/2020] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To describe the prevalence of obesity in Mexican adults stratifying by physical and sociodemographic conditions and to analyze trends. MATERIALS AND METHODS The data of 16 256 adults who participated in Ensanut 2018-19 was analyzed. Obesity (WHO), abdominal adiposity (IFD) and short stature (NOM-008-SSA3-2017) were classified. Logistic regression models were performed to analyze the association between obesity and risk factors. ENSA-2000 and Ensanut (2006, 2012, 2018-19) were used to assess trends. RESULTS The prevalence of overweight was 39.1%, obesity 36.1%, and abdominal adiposity 81.6%. Adults >40-50y and women had the highest prevalence. There was no difference by socio-economic level. Between 2000-2018, the prevalence of obesity increased 42.2% and morbid obesity 96.5%. Women with short stature had a higher risk (RM=1.84) of being obese than women without this condition, while in men the risk was lower (RM=0.79). CONCLUSIONS In Mexico the prevalence of obesity continues to increase regardless of socio-economic level, region or locality.
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Affiliation(s)
- Simón Barquera
- Centro de investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Lucía Hernández-Barrera
- Centro de investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Belem Trejo-Valdivia
- Centro de investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Teresa Shamah
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Ismael Campos-Nonato
- Centro de investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Juan Rivera-Dommarco
- Dirección General, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
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Théodore FL, López-Santiago M, Cruz-Casarrubias C, Mendoza-Pablo PA, Barquera S, Tolentino-Mayo L. Digital marketing of products with poor nutritional quality: a major threat for children and adolescents. Public Health 2021; 198:263-269. [PMID: 34492506 DOI: 10.1016/j.puhe.2021.07.040] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 07/08/2021] [Accepted: 07/24/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To identify general characteristics, the use of persuasive techniques, and the nutritional quality of Mexican digital marketing of food and beverages/brand with the greatest number of followers and views (Facebook, Twitter, and YouTube) with specific appeal to children/adolescents. STUDY DESIGN Cross sectional, quantitative, exploratory, and descriptive study. METHODS Multistep process to select a sample of 46 products with a Mexican website and major audiences on social networks. The energy and nutrient content of the foods and beverages were analyzed with the Pan American Health Organization Nutrient Profile Model. RESULTS Cola and soft drinks, sweetened juices were the products with the greatest number of followers on Facebook and Twitter (13,321,274 and 1,020,504). Companies used diverse persuasive techniques combining promotional characters (79.1%), incentives (65.1%), and digital techniques (78.3%). Products with excess critical nutrients were most frequently advertised regardless of the type of social network and the marketing techniques used. CONCLUSION Digital Marketing represents a major threat for children and adolescents in Mexico, and probably all over the world, because of its persuasive techniques, and it shall be regulated.
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Affiliation(s)
- F L Théodore
- National Institute of Public Health of Mexico, Nutrition and Health Research Center, Universidad No. 655, Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C. P. 62100, Cuernavaca, Morelos, México
| | - M López-Santiago
- National Institute of Public Health of Mexico, Nutrition and Health Research Center, Universidad No. 655, Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C. P. 62100, Cuernavaca, Morelos, México
| | - C Cruz-Casarrubias
- National Institute of Public Health of Mexico, Nutrition and Health Research Center, Universidad No. 655, Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C. P. 62100, Cuernavaca, Morelos, México
| | - P A Mendoza-Pablo
- School of Dietetics and Nutrition ISSSTE, Callejón Vía San Fernando No. 12, San Pedro Apóstol, 14070, CDMX, México
| | - S Barquera
- National Institute of Public Health of Mexico, Nutrition and Health Research Center, Universidad No. 655, Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C. P. 62100, Cuernavaca, Morelos, México
| | - L Tolentino-Mayo
- National Institute of Public Health of Mexico, Nutrition and Health Research Center, Universidad No. 655, Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C. P. 62100, Cuernavaca, Morelos, México.
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Cruz-Casarrubias C, Munguía A, Tolentino-Mayo L, Barquera S. Use of health and nutritional endorsements in unhealthy food and beverages in Mexico: opportunity to avoid misleading information. Salud Publica Mex 2021; 62:231-232. [PMID: 32520476 DOI: 10.21149/11234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Carlos Cruz-Casarrubias
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Ana Munguía
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Lizbeth Tolentino-Mayo
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
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Medina C, Jáuregui A, Hernández C, Shamah T, Barquera S. Physical inactivity and sitting time prevalence and trends in Mexican adults. Results from three national surveys. PLoS One 2021; 16:e0253137. [PMID: 34214109 PMCID: PMC8253416 DOI: 10.1371/journal.pone.0253137] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 06/01/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Physical inactivity and high sitting time are directly related to mortality and morbidity of non-communicable diseases (NCDs). Thus, improved understanding of the prevalence and trends of these behaviors could support the design of policies and interventions for NCDs prevention. OBJECTIVE To determine the current prevalence of physical inactivity and high sitting time, to analyze the trends, and to estimate the association of meeting/not meeting physical activity recommendations and low/high sitting time with sociodemographic characteristics and body mass index categories. METHODOLOGY Data from the 2018 National Health and Nutrition Survey were used. Moderate-to-vigorous physical activity (MVPA) and sitting minutes per week were calculated using the International Physical Activity Questionnaire short form (IPAQ). In total, 38,033 questionnaires of adults aged 20 to 69-year-old were analyzed. Adults were classified as physically inactive if they achieved less than 150 minutes per week of MVPA and as with high sitting time if they accumulated more than 420 minutes of sitting per day. Health and Nutrition National Surveys (ENSANUT) 2006, 2012 and 2018 were used to estimate the trends. RESULTS In total, 16.5% were classified as physically inactive and 11.3% within the high sitting time category. Both prevalences increased more than 40% during the 12-y period (2006-2018). In 2018, men, younger adults, those living in urban areas, and people within the highest socioeconomical status and educational levels were more likely to not achieve physical activity recommendations and to be classified in the highest sitting time category. CONCLUSION To stop current increased trends and achieve global targets, stronger and more concerted efforts to promote physical activity and reduce sitting time are required. Thus, continued surveillance of these behaviors is necessary.
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Affiliation(s)
- Catalina Medina
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Alejandra Jáuregui
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Cesar Hernández
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Teresa Shamah
- Center for Evaluation and Surveys Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Simón Barquera
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
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65
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Gutierrez JP, Agudelo-Botero M, Garcia-Saiso S, Zepeda-Tena C, Davila-Cervantes CA, Gonzalez-Robledo MC, Fullman N, Razo C, Hernández-Prado B, Martínez G, Barquera S, Lozano R. Advances and challenges on the path toward the SDGs: subnational inequalities in Mexico, 1990-2017. BMJ Glob Health 2021; 5:bmjgh-2020-002382. [PMID: 33122296 PMCID: PMC7597504 DOI: 10.1136/bmjgh-2020-002382] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 05/07/2020] [Accepted: 05/28/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The sustainable development goals (SDGs) have generated momentum for global health, aligning efforts from governments and international organisations toward a set of goals that are expected to reflect improvements in life conditions across the globe. Mexico has huge social inequalities that can affect access to quality care and health outcomes. The objective of this study is to analyse inequalities among Mexico's 32 states on the health-related SDG indicators (HRSDGIs) from 1990 to 2017. METHODS These analyses rely on the estimation of HRSDGIs as part of the Global Burden of Disease study 2017. We estimated the concentration index for 40+3 HRSDGI stratified by Socio-demographic Index and marginalisation index, and then for indicators where inequalities were identified, we ran decomposition analyses using structural variables such as gross domestic product per capita, poverty and health expenditure. FINDINGS Mexico has made progress on most HRSDGIs, but current trends in improvement do not appear to fast enough to meet 2030 targets. Out of 43 HRSDGIs, we identified evidence of inequality between Mexico's states for 30 indicators; of those, 23 HRSDGIs were unequal distributed affecting states with lower development and seven affecting states with higher development. The decomposition analysis indicates that social determinants of health are major drivers of HRSDGI inequalities in Mexico. INTERPRETATION Modifying current trends for HRSDGIs will require subnational-level and national-level policy action, of which should be informed by the latest available data and monitoring on the health-related SDGs. The SDGs' overarching objective of leaving no-one behind should be prioritised not only for individuals but also for communities and other subnational levels.
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Affiliation(s)
- Juan Pablo Gutierrez
- Center for Policy, Population & Health Research, Universidad Nacional Autónoma de México, Coyoacan, Mexico
| | - Marcela Agudelo-Botero
- Center for Policy, Population & Health Research, Universidad Nacional Autónoma de México, Coyoacan, Mexico
| | - Sebastian Garcia-Saiso
- Center for Policy, Population & Health Research, Universidad Nacional Autónoma de México, Coyoacan, Mexico
| | - Carolina Zepeda-Tena
- Center for Policy, Population & Health Research, Universidad Nacional Autónoma de México, Coyoacan, Mexico
| | | | | | - Nancy Fullman
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Christian Razo
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | | | - Gabriel Martínez
- Departamento Académico de Economía, ITAM, Alvaro Obregon, Mexico
| | | | - Rafael Lozano
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
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Soltero EG, Jáuregui A, Hernandez E, Barquera S, Jáuregui E, López-Taylor JR, Ortiz-Hernández L, Lévesque L, Lee RE. Associations between Screen-Based Activities, Physical Activity, and Dietary Habits in Mexican Schoolchildren. Int J Environ Res Public Health 2021; 18:ijerph18136788. [PMID: 34202680 PMCID: PMC8297222 DOI: 10.3390/ijerph18136788] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 11/16/2022]
Abstract
Screen-based activities are associated with increased risk of obesity and contribute to physical inactivity and poor dietary habits. The primary aim of this study was to examine the associations among screen-based activities, physical activity, and dietary habits in school-aged children in Guadalajara, Puerto Vallarta, and Mexico City, Mexico. The secondary aim was to examine these associations across sex. The School Physical Activity and Nutrition survey was used to assess screen-based activities (TV watching, video game use, computer use), physical activity, and dietary habits. Organized activity/sports participation, unhealthy dietary habits, and household income were correlated with screen-based activities. While TV watching was associated with decreased participation in organized activity/sports participation, computer and video game use was associated with increased organized activity/sports participation. Boys engaged in more TV watching and video game use compared to girls. All screen-based activities were associated with age among boys; whereas video game and computer use were associated with higher income among girls. These findings suggest a need for sex- and age-specific strategies that acknowledge the differential use of screen-based activities across sex and age. Future research should continue to identify underlying correlates linking screen-based activities with health behaviors to inform strategies to reduce screen-time in Mexican children.
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Affiliation(s)
- Erica G. Soltero
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030, USA;
- Correspondence:
| | - Alejandra Jáuregui
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, Cuernavaca 62100, Mexico; (A.J.); (S.B.)
| | - Edith Hernandez
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030, USA;
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, Cuernavaca 62100, Mexico; (A.J.); (S.B.)
| | - Edtna Jáuregui
- Instituto de Ciencias Aplicadas a la Actividad Física y Deporte, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Independencia Oriente, Guadalajara 44340, Mexico; (E.J.); (J.R.L.-T.)
- Departamento Medicina Preventiva, Secretaria de Salud, Dr. Baeza Alzaga #107, Colonia Centro, Mexico City 44100, Mexico
| | - Juan Ricardo López-Taylor
- Instituto de Ciencias Aplicadas a la Actividad Física y Deporte, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Independencia Oriente, Guadalajara 44340, Mexico; (E.J.); (J.R.L.-T.)
| | - Luis Ortiz-Hernández
- Departamento de Atención a la Salud, Universidad Autónoma Metropolitana Unidad, Calzada del Hueso 1100, Col. Villa Quietud, Delegación Coyoacán, Xochimilco, Distrito Federal 04960, Mexico;
| | - Lucie Lévesque
- School of Kinesiology & Health Studies, Queen’s University, 28 Division Street, Kingston, ON K7L3N6, Canada;
| | - Rebecca E. Lee
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 550 N. 3rd Street, Phoenix, AZ 77092, USA;
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Cruz-Casarrubias C, Tolentino-Mayo L, Vandevijvere S, Barquera S. Estimated effects of the implementation of the Mexican warning labels regulation on the use of health and nutrition claims on packaged foods. Int J Behav Nutr Phys Act 2021; 18:76. [PMID: 34112183 PMCID: PMC8194035 DOI: 10.1186/s12966-021-01148-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 06/02/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The use of health and nutrition claims on front-of-pack labels may impact consumers' food choices; therefore, many countries have established regulations to avoid misinformation. This study describes the prevalence of health and nutrition claims on the front-of-pack of food products in retail stores in Mexico and estimate the potential effects of the Official Mexican Standards 051 (new regulation that includes specifications for implementing warning labels and other packaging elements such as health and nutrition claims on less healthy foods) on the prevalence of these claims. METHODS This is a cross-sectional study in which health and nutrition claims, nutrition information panels, and the list of ingredients of all foods and beverages available in the main retail stores in Mexico City were collected. The products were grouped by level of processing according to the NOVA food system classification. Claims were classified using the internationally harmonized INFORMAS taxonomy. According to the criteria of the new Mexican front-of-pack labelling regulation, the effect on the reduction on the prevalence of health and nutrition claims was estimated by type of food and by energy and nutrients of concern thresholds. RESULTS Of 17,264 products, 33.8% displayed nutrition claims and 3.4% health claims. In total, 80.8% of all products in the Mexican market were classified as "less healthy"; 48.2% of products had excess calories, 44.6% had excess sodium, and 40.7% excess free sugars. The new regulation would prevent 39.4% of products with claims from displaying health and nutrition claims (P < 0.001); the largest reduction is observed for ultra-processed foods (51.1%, P < 0.001). The regulation thresholds that resulted in the largest reduction of claims were calories (OR 0.62, P < 0.001) and non-sugar sweeteners (OR 0.54, P < 0.001). CONCLUSIONS The new Mexican front-of-pack labelling regulation will prevent most processed and ultra-processed foods from displaying health and nutrition claims and will potentially improve information on packaging for consumers.
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Affiliation(s)
- Carlos Cruz-Casarrubias
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Universidad No. 655, Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera. C.P, Cuernavaca, Morelos, 62100, Mexico
| | - Lizbeth Tolentino-Mayo
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Universidad No. 655, Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera. C.P, Cuernavaca, Morelos, 62100, Mexico.
| | - Stefanie Vandevijvere
- Department of Epidemiology and Statistics, School of Population health, The University of Auckland, Auckland, New Zealand
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Universidad No. 655, Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera. C.P, Cuernavaca, Morelos, 62100, Mexico
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68
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Monterrubio-Flores E, Ramírez-Villalobos MD, Espinosa-Montero J, Hernandez B, Barquera S, Villalobos-Daniel VE, Campos-Nonato I. Characterizing a two-pronged epidemic in Mexico of non-communicable diseases and SARS-Cov-2: factors associated with increased case-fatality rates. Int J Epidemiol 2021; 50:430-445. [PMID: 33585901 PMCID: PMC7928870 DOI: 10.1093/ije/dyab008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 01/11/2021] [Indexed: 01/10/2023] Open
Abstract
Background People with a previous diagnosis of non-communicable diseases (NCDs) are more likely to develop serious forms of COVID-19 or die. Mexico is the country with the fourth highest fatality rate from SARS-Cov-2, with high mortality in younger adults. Objectives To describe and characterize the association of NCDs with the case-fatality rate (CFR) adjusted by age and sex in Mexican adults with a positive diagnosis for SARS-Cov-2. Methods We studied Mexican adults aged ≥20 years who tested positive for SARS-Cov-2 during the period from 28 February to 31 July 2020. The CFR was calculated and associations with history of NCDs (number of diseases and combinations), severity indicators and type of institution that treated the patient were explored. The relative risk (RR) of death was estimated using Poisson models and CFR was adjusted using logistic models. Results We analysed 406 966 SARS-Cov-2-positive adults. The CFR was 11.2% (13.7% in men and 8.4% in women). The CFR was positively associated with age and number of NCDs (p trend <0.001). The number of NCDs increased the risk of death in younger adults when they presented three or more NCDs compared with those who did not have any NCDs [RR, 46.6; 95% confidence interval (CI), 28.2, 76.9 for women; RR, 16.5; 95% CI, 9.9, 27.3 for men]. Lastly, there was great heterogeneity in the CFR by institution, from 4.6% in private institutions to 18.9% in public institutions. Conclusion In younger adults, higher CFRs were associated with the total number of NCDs and some combinations of type 2 diabetes, chronic kidney disease, chronic obstructive pulmonary disease and cardiovascular disease.
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Affiliation(s)
- Eric Monterrubio-Flores
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - María D Ramírez-Villalobos
- Instituto Nacional de Salud Pública, Centro de Investigación en Sistemas de Salud, Cuernavaca, Morelos, Mexico
| | - Juan Espinosa-Montero
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Bernardo Hernandez
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Victor E Villalobos-Daniel
- Centro Nacional de Prevención y Control de Enfermedades, México, Universidad de California, Berkeley, EUA
| | - Ismael Campos-Nonato
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
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69
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Nieto C, Castillo A, Alcalde-Rabanal J, Mena C, Carriedo Á, Barquera S. Perception of the use and understanding of nutrition labels among different socioeconomic groups in Mexico: a qualitative study. Salud Publica Mex 2021; 62:288-297. [PMID: 32520486 DOI: 10.21149/10793] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 01/20/2020] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To explore the perception of the use and comprehension of the nutrition labeling (GDA, NFT,NS) and claims in packaged foods among different socio economic-status (SES). MATERIALS AND METHODS This was a qualitative study, 12 focus groups were performed in four cities of Mexico. Participants were recruited outside the supermarkets, which were selected according to SES using Basic Geostatistical Areas. The focus groups had a total of 78 participants. RESULTS Participants perceived several barriers to the use and understanding of the GDA; like technicalities of the terms used, and the format (small font size and percentages). Claims are mistrusted in general. Participants from the high SES believed that the claims are just a marketing strategy. CONCLUSIONS This study shows the consumers' difficulties to understand the current nutrition labeling system regardless SES. These data might call attention in order to implement a simpler nutrition labeling system that is understood regardless of SES.
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Affiliation(s)
- Claudia Nieto
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico
| | - Alejandra Castillo
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico
| | - Jacqueline Alcalde-Rabanal
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico
| | - Carmen Mena
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico
| | - Ángela Carriedo
- London School of Hygiene and Tropical Medicine. London, United Kingdom
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico
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Medina C, Chavira J, Aburto T, Nieto C, Contreras-Manzano A, Segura L, Jáuregui A, Barquera S. Revisión rápida: evidencia de transmisión por Covid-19 e infecciones respiratorias agudas similares en espacios públicos abiertos. Salud Publica Mex 2021; 63:232-241. [PMID: 33989486 DOI: 10.21149/11827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 11/23/2020] [Indexed: 11/06/2022] Open
Abstract
Objetivo. Describir la evidencia disponible sobre la trans-misión por Covid-19 e infecciones respiratorias agudas simi-lares al Covid-19 en espacios públicos abiertos. Material y métodos. La búsqueda incluyó 4 926 artículos en inglés de los años 2000 a 2020. Seis investigadores revisaron el título y el resumen de los artículos de Embase y PubMed; dos inves-tigadores revisaron los de medRxiv. Todos los investigadores revisaron textos completos y otros resolvieron las discre-pancias. Resultados. De los 21 artículos seleccionados, se observó que la presencia de virus en superficies públicas, aguas residuales y áreas exteriores no fue indicativa de trans-misión. No obstante, se observó que el uso de cubrebocas, el lavado de manos, el distanciamiento social, no asistir a eventos masivos y la movilidad individual a espacios públicos podría ayudar a reducir el riesgo de transmisión. Conclusión. Esta información podría coadyuvar a generar recomendaciones en salud pública, sin embargo, es recomendable actualizar esta revisión conforme avance la evidencia científica.
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Affiliation(s)
- Catalina Medina
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México.
| | - Julissa Chavira
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México.
| | - Tania Aburto
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México.
| | - Claudia Nieto
- Centro de Investigación en Nutrición y Salud. Instituto Nacional de Salud Pública. Cuernavaca, Morelos México.
| | - Alejandra Contreras-Manzano
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México.
| | - Luis Segura
- Epidemiology Department, Columbia University Mailman School of Public Health. New York, New York, USA.
| | - Alejandra Jáuregui
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México.
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México.
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Márquez I, Tolentino-Mayo L, Barquera S. Regulación de la publicidad de alimentos y bebidas dirigida a la población infantil: el derecho a la información. Salud Publica Mex 2020; 63:92-99. [PMID: 33984216 DOI: 10.21149/11194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 10/01/2020] [Indexed: 11/06/2022] Open
Abstract
Objetivo. Documentar la evolución de los marcos reguladores de la publicidad de alimentos y bebidas no alcohólicas (PABNA) dirigida a la población infantil (PI) en México. Material y métodos. Revisión documental de las leyes, reglamentos y lineamientos encargados de regular la PABNA publicados en el Diario Oficial de la Federación (DOF) desde 1926 hasta 2016. Resultados. Se revisaron 18 documentos del DOF, se identificaron ventajas y limitaciones que tienen los marcos reguladores respecto a la PABNA dirigida a la PI y cómo se ha adecuado la regulación a los cambios en los medios de comunicación. Conclusiones. Es necesario implementar una regulación estricta sobre la PABNA dirigida a la PI, la cual evite mensajes que promuevan el consumo de productos de baja calidad nutrimental, relacionados con el incremento de prevalencias de sobrepeso, obesidad y enfermedades crónicas.
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Affiliation(s)
- Irving Márquez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México.
| | - Lizbeth Tolentino-Mayo
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México.
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México.
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Morris SS, Barquera S, Sutrisna A, Izwardy D, Kupka R. Perspective: Interventions to improve the diets of children and adolescents. Global Food Security 2020. [DOI: 10.1016/j.gfs.2020.100379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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73
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Loyola-Leyva A, Loyola-Rodríguez JP, Terán-Figueroa Y, Camacho-Lopez S, González FJ, Barquera S. Application of atomic force microscopy to assess erythrocytes morphology in early stages of diabetes. A pilot study. Micron 2020; 141:102982. [PMID: 33227627 DOI: 10.1016/j.micron.2020.102982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 10/23/2022]
Abstract
The study aim was to assess the application of atomic force microscopy (AFM) to evaluate erythrocyte morphology in early stages of type 2 diabetes mellitus, and the association with biochemical, anthropometric, diet, and physical activity indicators. This was a pilot cross-sectional study with four groups: healthy individuals, people with prediabetes (PDG), metabolic syndrome (MSG), and diabetes mellitus group (DMG). Blood samples were obtained to assess the erythrocyte morphology and biochemical parameters. Anthropometrical measurements were taken. Besides, a diet and a physical activity questionnaire were applied. The evaluation of the erythrocyte morphology through the AFM showed quantitative and qualitative alterations in the cell's form and size. Compared to the healthy group, the PDG had a reduction in height (-0.80 μm, p < 0.05), and an increase in axial ratio (-0.09 μm, p < 0.05); the MSG had lower concave depth (-0.19 μm, p < 0.05); and the DMG had a decreased height (-0.46 μm, p < 0.05) and concave depth (-0.29 μm, p < 0.05), and higher axial ratio (+0.08 μm) and thickness (+0.32 μm, p < 0.05). The PDG vs. DMG had a statistically significant difference in concave depth (+0.23 μm, p < 0.05) and thickness (-0.26 μm, p < 0.05). The MSG was different than the DMG in variables like axial ratio (-0.05 μm) and thickness (-0.25 μm). Besides, higher values of age, HbA1c, triglycerides, body mass index, waist-to-hip ratio, and physical inactivity were associated with altered erythrocyte morphology. AFM is a promising instrument to assess early but subtle changes in erythrocyte morphology (height, axial ratio, concave depth, thickness) before significant pathological conditions, such as type 2 diabetes mellitus. HbA1c might have a major effect in altered morphology, vs. metabolic parameters like high triglycerides, body mass index, waist, and physical inactivity.
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Affiliation(s)
- Alejandra Loyola-Leyva
- Coordination for Innovation and Application of Science and Technology (Coordinación para la Innovación y Aplicación de la Ciencia y Tecnología, CIACyT), Avenida Sierra Leona 550, Lomas 2ª sección, 78210, San Luis Potosí, S.L.P, Mexico.
| | - Juan Pablo Loyola-Rodríguez
- Faculty of Dentistry, Popular Autonomous University of the State of Puebla, 21 sur 1103, Barrio de Santiago, 72410, Puebla, Puebla, Mexico.
| | - Yolanda Terán-Figueroa
- Faculty of Nursing and Nutrition, Autonomous University of San Luis Potosí (Universidad Autónoma de San Luis Potosí), Lateral Av. Salvador Nava, Lomas, 78290, San Luis Potosí, S.L.P, Mexico.
| | - Santiago Camacho-Lopez
- Department of Optics, Center for Scientific Research and Higher Education of Ensenada (Centro de Investigación Científica y de Educación Superior de Ensenada, CICESE), Carretera Ensenada-Tijuana 3918. Zona Playitas, Ensenada, Baja California, Mexico.
| | - Francisco Javier González
- Coordination for Innovation and Application of Science and Technology (Coordinación para la Innovación y Aplicación de la Ciencia y Tecnología, CIACyT), Avenida Sierra Leona 550, Lomas 2ª sección, 78210, San Luis Potosí, S.L.P, Mexico.
| | - Simón Barquera
- Center for Nutrition and Health Research. National Institute of Public Health. Address: Av. Universidad No.655 Col Sta. Ma. Ahuacatitlán. Cuernavaca, Morelos, Mexico.
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Hernández-Alcaraz C, Shamah-Levy T, Romero-Martínez M, Sepúlveda-Amor J, Aguilar-Salinas CA, Rivera-Dommarco J, Kershenobich-Stalnikowitz D, Hernández-Ávila M, Barquera S. [Subsample for the analysis of chronic diseases with biomarkers, National Survey of Health and Nutrition 2016]. Salud Publica Mex 2020; 62:504-510. [PMID: 33027861 DOI: 10.21149/11306] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 07/07/2020] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To describe the adult subsample for the analysis of biomarkers of chronic diseases, as well as the sample sizes (n) and representativity of the Encuesta Nacional de Salud y Nutrición (Ensanut) 2016. MATERIALS AND METHODS An adult subsample with national representativity was calculated to obtain blood, serum and urine samples. The prevalence of variables of interest was compared for each subsample. RESULTS The n for at least one serum biomarker and urine samples were 4 000 and 3 782, respectively. The n varied depending on the grouping of biomarkers and fasting time selection. No differences were observed in the distribution of variables between the whole sample, urine and blood biomarkers samples. CONCLUSIONS The weighted subsamples of urine, serum and blood biomarkers are comparable to the weighted sample of adults in the survey. The data of the subsample will allow to monitor the distribution of chronic diseases in Mexico, including altered function of liver and kidney, and sodium intake.
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Affiliation(s)
- César Hernández-Alcaraz
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Teresa Shamah-Levy
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Martín Romero-Martínez
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Jaime Sepúlveda-Amor
- UCSF School of Medicine, Department of Epidemiology and Biostatistics. San Francisco CA, USA.,UCSF Institute for Global Health Sciences. San Francisco CA, USA
| | - Carlos A Aguilar-Salinas
- División de Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Ciudad de México, México
| | | | | | - Mauricio Hernández-Ávila
- Dirección de Prestaciones Económicas y Sociales, Instituto Mexicano del Seguro Social. Ciudad de México
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
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75
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Denova‐Gutiérrez E, Lopez‐Gatell H, Alomia‐Zegarra JL, López‐Ridaura R, Zaragoza‐Jimenez CA, Dyer‐Leal DD, Cortés‐Alcala R, Villa‐Reyes T, Gutiérrez‐Vargas R, Rodríguez‐González K, Escondrillas‐Maya C, Barrientos‐Gutiérrez T, Rivera JA, Barquera S. The Association of Obesity, Type 2 Diabetes, and Hypertension with Severe Coronavirus Disease 2019 on Admission Among Mexican Patients. Obesity (Silver Spring) 2020; 28:1826-1832. [PMID: 32610364 PMCID: PMC7361939 DOI: 10.1002/oby.22946] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/24/2020] [Accepted: 06/27/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE This study's aim was to explore the association of obesity, type 2 diabetes, and hypertension with severe coronavirus disease 2019 (COVID-19) on admission. METHODS In the present study, a total of 23,593 patient samples were evaluated by a laboratory from the Mexican Institute of Epidemiological Diagnosis and Reference. Of these, 18,443 were negative for COVID-19, 3,844 were positive for COVID-19, and 1,306 were positive for other respiratory viruses. Severe types of respiratory disease were defined by the presence of pneumonia and other organ failure that requires intensive care. Multivariable logistic regression models were used to explore factors associated with severe COVID-19 on admission. RESULTS Patients who tested positive for COVID-19 had a higher proportion of obesity (17.4%), diabetes (14.5%), and hypertension (18.9%) compared with those without a confirmed diagnosis. Compared with patients without obesity, those with obesity showed a 1.43-fold higher odds of developing severe COVID-19 on admission, whereas subjects with diabetes and hypertension showed a 1.87-fold and 1.77-fold higher odds of developing severe COVID-19 on admission, respectively. CONCLUSIONS Obesity, diabetes, and hypertension were significantly associated with severe COVID-19 on admission and the association of obesity was stronger in patients < 50 years of age.
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Affiliation(s)
- Edgar Denova‐Gutiérrez
- Centro de Investigación en Nutrición y SaludInstituto Nacional de Salud PúblicaCuernavacaMorelosMexico
| | - Hugo Lopez‐Gatell
- Subsecretario de Prevención y Promoción de la SaludSecretaria de SaludMexico CityMexico
| | | | - Ruy López‐Ridaura
- Dirección General del Centro Nacional de Programas Preventivos y Control de EnfermedadesSecretaria de SaludMexico CityMexico
| | | | - Dwigth D. Dyer‐Leal
- Dirección General de Promoción de La SaludSecretaria de SaludMexico CityMexico
| | | | - Tania Villa‐Reyes
- Dirección General de EpidemiologiaSecretaria de SaludMexico CityMexico
| | | | | | | | | | - Juan A. Rivera
- Centro de Investigación en Nutrición y SaludInstituto Nacional de Salud PúblicaCuernavacaMorelosMexico
| | - Simón Barquera
- Centro de Investigación en Nutrición y SaludInstituto Nacional de Salud PúblicaCuernavacaMorelosMexico
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76
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Barquera S, Rivera JA. Obesity in Mexico: rapid epidemiological transition and food industry interference in health policies. Lancet Diabetes Endocrinol 2020; 8:746-747. [PMID: 32822599 PMCID: PMC7434327 DOI: 10.1016/s2213-8587(20)30269-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 07/16/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Simón Barquera
- Instituto Nacional de Salud Pública, Av. Universidad No. 655. Col. Sta. Ma. Ahuacatitlan, Cuernavaca, Morelos, CP. 62100, Mexico.
| | - Juan A Rivera
- Instituto Nacional de Salud Pública, Av. Universidad No. 655. Col. Sta. Ma. Ahuacatitlan, Cuernavaca, Morelos, CP. 62100, Mexico
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77
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Mendoza-Herrera K, Valero-Morales I, Ocampo-Granados ME, Reyes-Morales H, Arce-Amaré F, Barquera S. An Overview of Social Media Use in the Field of Public Health Nutrition: Benefits, Scope, Limitations, and a Latin American Experience. Prev Chronic Dis 2020; 17:E76. [PMID: 32762809 PMCID: PMC7417023 DOI: 10.5888/pcd17.200047] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Social media platforms are low-cost tools that can be used to address issues in public health nutrition, especially in countries where health-related institutions experience economic limitations. We aimed to emphasize the benefits of using social media to promote health that have been documented to date. To show social media’s positive impact on population health literacy, we briefly describe an inexpensive systematic communication strategy implemented in our research center through 2 social media platforms, the lessons learned, and the strategy’s short-term results. Because social media use in public health is a new field of study, this perspective also focuses on the current limitations and gaps in evidence that need to be addressed to translate the best practices into policy recommendations. In conclusion, the perspective highlights the role that health actors and governments should take to maximize the benefits of social media use.
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Affiliation(s)
- Kenny Mendoza-Herrera
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, México
| | - Isabel Valero-Morales
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, México
| | | | - Hortensia Reyes-Morales
- Center for Information on Public Health Decisions, National Institute of Public Health, Cuernavaca, Morelos, México
| | | | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, México.,Instituto Nacional de Salud Pública, Avenida Universidad 655, Santa María Ahuacatitlán, Cuernavaca, Morelos, México 62100.
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78
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Rodríguez LA, Barquera S, Aguilar-Salinas CA, Sepúlveda-Amor J, Sánchez-Romero LM, Denova-Gutiérrez E, Balderas N, Moreno-Loaeza L, Handley MA, Basu S, López-Arellano O, Gallardo-Hernández A, Schillinger D. Design of a cluster-randomized trial of the effectiveness and cost-effectiveness of metformin on prevention of type 2 diabetes among prediabetic Mexican adults (the PRuDENTE initiative of Mexico City). Contemp Clin Trials 2020; 95:106067. [PMID: 32580032 PMCID: PMC7484103 DOI: 10.1016/j.cct.2020.106067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Type 2 diabetes (T2D) is a global epidemic, and nations are struggling to implement effective healthcare strategies to reduce the burden. While efficacy studies demonstrate that metformin can reduce incident T2D by half among younger, obese adults with prediabetes, its real-world effectiveness are understudied, and its use for T2D prevention in primary care is low. We describe the design of a pragmatic trial to evaluate the incremental effectiveness of metformin, as an adjunct to a simple lifestyle counseling. METHODS The "Prevención de la Diabetes con Ejercicio, Nutrición y Tratamiento" [Diabetes Prevention with Exercise, Nutrition and Treatment; PRuDENTE, (Spanish acronym)] is a cluster-randomized trial in Mexico City's public primary healthcare system. The study randomly assigns 51 clinics to deliver one of two interventions for 36 months: 1) lifestyle only; 2) lifestyle plus metformin, to 3060 patients ages 30-65 with impaired fasting glucose and obesity. The primary endpoint is incident T2D (fasting glucose ≥126 mg/dL, or HbA1c ≥6.5%). We will also measure a range of implementation-related process outcomes at the clinic-, clinician- and patient-levels to inform interpretations of effectiveness and enable efforts to refine, adapt, adopt and disseminate the model. We will also estimate the cost-effectiveness of metformin as an adjunct to lifestyle counseling in Mexico. DISCUSSION Findings from this pragmatic trial will generate new translational knowledge in Mexico and beyond, both with respect to metformin's real-world effectiveness among an 'at-risk' population, and uncovering facilitators and barriers to the reach, adoption and implementation of metformin preventive therapy in public primary care settings. TRIAL REGISTRATION This trial is registered at Clinicaltrials.gov (NCT03194009).
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Affiliation(s)
- Luis A Rodríguez
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
| | - Simón Barquera
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | - Carlos A Aguilar-Salinas
- Division of Nutrition, Salvador Zubiran National Institute of Medical Sciences and Nutrition, Mexico City, Mexico
| | - Jaime Sepúlveda-Amor
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA; Institute for Global Health Sciences, University of California, San Francisco, San Francisco, CA, USA
| | | | - Edgar Denova-Gutiérrez
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | - Nydia Balderas
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | - Lizbeth Moreno-Loaeza
- Research Unit on Metabolic Diseases, Salvador Zubiran National Institute of Medical Sciences and Nutrition, Mexico City, Mexico; Medical, Dental and Health Sciences, National Autonomous University of Mexico, Mexico City, Mexico
| | - Margaret A Handley
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA; Division of General Internal Medicine at San Francisco General Hospital, University of California, San Francisco, San Francisco, CA, USA; UCSF Center for Vulnerable Populations, San Francisco General Hospital, San Francisco, CA, USA
| | - Sanjay Basu
- Department of Medicine, Stanford University, Palo Alto, CA, USA
| | | | | | - Dean Schillinger
- Division of General Internal Medicine at San Francisco General Hospital, University of California, San Francisco, San Francisco, CA, USA; UCSF Center for Vulnerable Populations, San Francisco General Hospital, San Francisco, CA, USA
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79
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Hernández-Barrera L, Trejo Valdivia B, Téllez-Rojo MM, Barquera S, Muñoz-Manrique C. Validity assessment of self-reported weight and its correction process among Mexican adult women of reproductive age. PLoS One 2020; 15:e0235967. [PMID: 32726317 PMCID: PMC7390308 DOI: 10.1371/journal.pone.0235967] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 06/25/2020] [Indexed: 11/18/2022] Open
Abstract
Objective We aimed to evaluate the agreement between self-reported weight (SRW) and measured weight (MW) in adult women of reproductive age, identify characteristics associated with the difference between SRW and MW (DW), and develop a correction procedure for SRW. Methods We used data from 3,452 non-pregnant or non-lactating adult women who participated in the Mexican Family Life Survey. Standardized personnel asked women about their weight before measuring weight and height. We conducted a Bland-Altman analysis for agreement and adjusted linear regression models for sociodemographic characteristics. Results Mean DW was -0.59±3.21 kg. Difference varied according to Body Mass Index (BMI) and region of residence (p< 0.05). Correction model for log-MW, included the log-SRW, age group (18–34 and 35–49 years), interaction term (age × SRW), log-height, Southern region, and living with a partner. Based on self-reported weight, we observed an overestimation of underweight/normal weight prevalence and an underestimation of overweight or obesity prevalence. Conclusion SRW has limitations to be considered as an alternative to MW among women of reproductive age with specific characteristics. Our proposed correction equation may decrease SRW imprecision improving the estimation of overweight and obesity. We suggest that studies consider and adjust the possible bias associated with weight misreporting on health outcomes.
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Affiliation(s)
- Lucia Hernández-Barrera
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Morelos, México
| | - Belem Trejo Valdivia
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Morelos, México
| | - Martha Maria Téllez-Rojo
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Morelos, México
| | - Simón Barquera
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Morelos, México
| | - Cinthya Muñoz-Manrique
- Department of Nutrition and Bioprogramming, National Institute of Perinatology, Mexico City, Mexico
- * E-mail:
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80
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Basto-Abreu A, Barrientos-Gutiérrez T, Rojas-Martínez R, Aguilar-Salinas CA, López-Olmedo N, De la Cruz-Góngora V, Rivera-Dommarco J, Shamah-Levy T, Romero-Martínez M, Barquera S, López-Ridaura R, Hernández-Ávila M, Villalpando S. [Prevalence of diabetes and poor glycemic control in Mexico: results from Ensanut 2016.]. Salud Publica Mex 2020; 62:50-59. [PMID: 31869561 DOI: 10.21149/10752] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 08/30/2019] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of total, diagnosed and undiagnosed diabetes, and the prevalence of poor glycemic control in Mexico, and its associated factors. MATERIALS AND METHODS Data from 3 700 adult participants were analysed in the 2016 National Health and Nutrition Survey. Diabetes prevalences were estimated with population weights, and the factors associated with total diabetes and poor glycemic control with Poisson regression models. RESULTS The total prevalence of diabetes was 13.7% (9.5% diagnosed, 4.1% undiagnosed); 68.2% of people with diagnosed diabetes presented poor glycemic control. Longer disease duration, living in the centre or south of the country and being treated in pharmacies were associated with poor glycemic control. Being treated in a social security system was associated with better glycemic control. CONCLUSIONS Multisectoral efforts are needed to strengthen screening, timely diagnosis and disease control, considering differences by region and type of health service.
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Affiliation(s)
- Ana Basto-Abreu
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | | | - Rosalba Rojas-Martínez
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Carlos A Aguilar-Salinas
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Cuernavaca, Morelos, México
| | - Nancy López-Olmedo
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Vanessa De la Cruz-Góngora
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Juan Rivera-Dommarco
- Dirección General, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Teresa Shamah-Levy
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Martín Romero-Martínez
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Ruy López-Ridaura
- Centro Nacional de Programas Preventivos y Control de Enfermedades. Ciudad de México, México
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81
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Campos-Nonato I, Hernández-Barrera L, Flores-Coria A, Gómez-Álvarez E, Barquera S. [Prevalence, diagnosis and control of hypertension in Mexican adults with vulnerable condition. Results of the Ensanut 100k]. Salud Publica Mex 2020; 61:888-897. [PMID: 31869552 DOI: 10.21149/10574] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 08/22/2019] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To describe the prevalence of hypertension (HBP) in adults with vulnerability, the percentage of them with previous diagnosis and the proportion that had adequate control. MATERIALS AND METHODS Blood pressure was measured in 7 838 adults who participated in the Ensanut 100k. Those who self-reported the diagnosis of HBP or had systolic blood pressure (SBP) ≥130mmHg or diastolic blood pressure (DBP) ≥80mmHg were classified as hypertensive. Controlled blood pressure was considered when SBP was <130mmHg and TAD <80mmHg. RESULTS The prevalence of hypertension in adults with a vulnerability condition was 49.2%, of which 54.7% did not know had hypertension. Of the hypertensive patients who received pharmacological treatment (69.0%), 66.8% of them had blood pressure under control. CONCLUSIONS Almost half of Mexican adults in vulnerable condition have HBP and of these more than half do not know that they have this disease. One third of hypertensive adults have inadequate control.
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Affiliation(s)
- Ismael Campos-Nonato
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Lucía Hernández-Barrera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Alejandra Flores-Coria
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Enrique Gómez-Álvarez
- Jefatura del Servicio de Cardiología, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado. Ciudad de México, México
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
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Basto-Abreu A, Torres-Alvarez R, Reyes-Sánchez F, González-Morales R, Canto-Osorio F, Colchero MA, Barquera S, Rivera JA, Barrientos-Gutierrez T. Predicting obesity reduction after implementing warning labels in Mexico: A modeling study. PLoS Med 2020; 17:e1003221. [PMID: 32722682 PMCID: PMC7386611 DOI: 10.1371/journal.pmed.1003221] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 06/24/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND In October 2019, Mexico approved a law to establish that nonalcoholic beverages and packaged foods that exceed a threshold for added calories, sugars, fats, trans fat, or sodium should have an "excess of" warning label. We aimed to estimate the expected reduction in the obesity prevalence and obesity costs in Mexico by introducing warning labels, over 5 years, among adults under 60 years of age. METHODS AND FINDINGS Baseline intakes of beverages and snacks were obtained from the 2016 Mexican National Health and Nutrition Survey. The expected impact of labels on caloric intake was obtained from an experimental study, with a 10.5% caloric reduction for beverages and 3.0% caloric reduction for snacks. The caloric reduction was introduced into a dynamic model to estimate weight change. The model output was then used to estimate the expected changes in the prevalence of obesity and overweight. To predict obesity costs, we used the Health Ministry report of the impact of overweight and obesity in Mexico 1999-2023. We estimated a mean caloric reduction of 36.8 kcal/day/person (23.2 kcal/day from beverages and 13.6 kcal/day from snacks). Five years after implementation, this caloric reduction could reduce 1.68 kg and 4.98 percentage points (pp) in obesity (14.7%, with respect to baseline), which translates into a reduction of 1.3 million cases of obesity and a reduction of US$1.8 billion in direct and indirect costs. Our estimate is based on experimental evidence derived from warning labels as proposed in Canada, which include a single label and less restrictive limits to sugar, sodium, and saturated fats. Our estimates depend on various assumptions, such as the transportability of effect estimates from the experimental study to the Mexican population and that other factors that could influence weight and food and beverage consumption remain unchanged. Our results will need to be corroborated by future observational studies through the analysis of changes in sales, consumption, and body weight. CONCLUSIONS In this study, we estimated that warning labels may effectively reduce obesity and obesity-related costs. Mexico is following Chile, Peru, and Uruguay in implementing warning labels to processed foods, but other countries could benefit from this intervention.
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Affiliation(s)
- Ana Basto-Abreu
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Rossana Torres-Alvarez
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Francisco Reyes-Sánchez
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Romina González-Morales
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Francisco Canto-Osorio
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - M. Arantxa Colchero
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
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Contreras-Manzano A, Jáuregui A, Nieto C, Hall MG, Vargas-Meza J, Thrasher JF, Illescas-Zárate D, Barquera S, Hammond D. The impact of a cartoon character on adults perceptions of Children's breakfast cereals: a randomized experiment. Nutr J 2020; 19:43. [PMID: 32418538 PMCID: PMC7232833 DOI: 10.1186/s12937-020-00565-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 05/11/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Cartoon characters on processed food packaging increase the perception of product preference among children, but their effect among adults has rarely been examined. We evaluated the effect of a cartoon character on breakfast cereals on beliefs about buying them for children, as well as whether demographic characteristics modified this effect. METHODS An experimental study was conducted with adults from online consumer panels in Mexico (n = 3755). Participants were randomly assigned to a "cartoon" condition (n = 1789), in which they viewed a breakfast cereal box with a Minion character on the front of the package, or the "control" condition (n = 1966), in which the same cereal box was displayed with no character on the package. Participants were asked: "Is this a good cereal to buy children?" with the response options "Yes", "No", or "Don't know". Multinomial adjusted logistic models regressed responses to this question (Yes = 0, No = 1, 2 = Don't know) on experimental condition. Differences in the effect of the cartoon character across demographic characteristics were tested by introducing multiplicative interaction terms. RESULTS The adjusted model showed that participants in the "cartoon character" condition were 1.67 (1.45-1.94) times more likely to consider the cereal as being "Not good to buy for children" than those in the control condition (p < 0.001). This effect was smaller among parents (RRR = 1.39, 1.13-1.72) compared to those without children (RRR = 2.01, 1.63-2.47). No differences were observed in the proportion of participants answering "Don't know" across experimental groups. CONCLUSION Among this sample of Mexican adults, a cereal with a cartoon character on the packaging was more often perceived as "not good to buy for children" compared to a cereal without it. This effect was smaller among parents, potentially due to children influences of parental decisions during food purchasing.
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Affiliation(s)
- Alejandra Contreras-Manzano
- Nutrition and Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col, Santa María Ahuacatitlán, 62100, Cuernavaca, Mexico
| | - Alejandra Jáuregui
- Nutrition and Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col, Santa María Ahuacatitlán, 62100, Cuernavaca, Mexico.
| | - Claudia Nieto
- Nutrition and Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col, Santa María Ahuacatitlán, 62100, Cuernavaca, Mexico
| | - Marissa G Hall
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Jorge Vargas-Meza
- Nutrition and Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col, Santa María Ahuacatitlán, 62100, Cuernavaca, Mexico
| | - James F Thrasher
- Population Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, 62100, Cuernavaca, Mexico
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, 921 Assembly St, Columbia, SC, 29208, USA
| | - Daniel Illescas-Zárate
- Nutrition and Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col, Santa María Ahuacatitlán, 62100, Cuernavaca, Mexico
| | - Simón Barquera
- Nutrition and Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col, Santa María Ahuacatitlán, 62100, Cuernavaca, Mexico
| | - David Hammond
- School of Demography, ANU College of Arts and Social Sciences, The Australian National University, 9 Fellows Road Acton ACT, Canberra, 260, Australia
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84
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Jáuregui A, Vargas-Meza J, Nieto C, Contreras-Manzano A, Alejandro NZ, Tolentino-Mayo L, Hall MG, Barquera S. Impact of front-of-pack nutrition labels on consumer purchasing intentions: a randomized experiment in low- and middle-income Mexican adults. BMC Public Health 2020; 20:463. [PMID: 32252716 PMCID: PMC7137298 DOI: 10.1186/s12889-020-08549-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 03/18/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Front-of-pack (FOP) nutrition labeling is a cost-effective strategy to help consumers make informed and healthier food choices. We aimed to investigate the effect of the FOP labels used in the Latin American region on consumers' shopping intentions when prompted to make their choices with specific nutrients-to-limit in mind among low- and middle-income Mexican adults (> 18 y). METHODS In this experimental study of an online simulated shopping situation participants (n = 2194) were randomly assigned to one of three labeling conditions: Guideline Daily Amounts (GDA), Multiple Traffic Lights (MTL), or red Warning Labels (WL). Participants were required to view a video explaining how to correctly interpret the assigned label. Primary outcomes were the overall nutritional quality (estimated using the Nutrient Profiling Scoring Criterion [NPSC] and NPSC baseline score) and mean energy and nutrient content of purchases. Secondary outcomes included shopping time variables. We also evaluated the impact of the labels across food categories (ready-made foods, dairy beverages, non-dairy beverages, salty snacks, and breakfast cereals) and sociodemographic subgroups. RESULTS The MTL and the WL led to a better overall nutritional quality of the shopping cart compared to the GDA (p < 0.05). According to the NPSC score, the WL led to a better nutritional quality across breakfast cereals and salty snacks compared to the GDA (p < 0.05); a similar effect was observed for the MTL among non-dairy beverages (p < 0.05). The MTL and the WL required shorter shopping times compared to GDA (p < 0.05). Across all labeling conditions, the nutritional quality of the shopping cart tended to be lower among those with low income, education and nutrition knowledge levels. CONCLUSION WL and MTL may foster healthier food choices in a faster way among low- and middle-income groups in Mexico. To produce an equitable impact among consumers of all socioeconomic strata, efforts beyond simply the inclusion of a communication campaign on how to use and interpret FOP labels will be required. TRIAL REGISTRATION clinicaltrials.gov. NCT04308408 Retrospectively registered March 16, 2020.
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Affiliation(s)
- Alejandra Jáuregui
- Nutrition and Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, CP. 62100 Cuernavaca, Morelos Mexico
| | - Jorge Vargas-Meza
- Nutrition and Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, CP. 62100 Cuernavaca, Morelos Mexico
| | - Claudia Nieto
- Nutrition and Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, CP. 62100 Cuernavaca, Morelos Mexico
| | - Alejandra Contreras-Manzano
- Nutrition and Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, CP. 62100 Cuernavaca, Morelos Mexico
| | - Nelson Zacarías Alejandro
- School of Public Health, Mexican National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, CP. 62100 Cuernavaca, Mexico
| | - Lizbeth Tolentino-Mayo
- Nutrition and Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, CP. 62100 Cuernavaca, Morelos Mexico
| | - Marissa G. Hall
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, USA
| | - Simón Barquera
- Nutrition and Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, CP. 62100 Cuernavaca, Morelos Mexico
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85
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Hernández-Alcaraz C, Aguilar-Salinas CA, Mendoza-Herrera K, Pedroza-Tobías A, Villalpando S, Shamah-Levy T, Rivera-Dommarco J, Hernández-Ávila M, Barquera S. Dyslipidemia prevalence, awareness, treatment and control in Mexico: results of the Ensanut 2012. Salud Publica Mex 2020; 62:137-146. [PMID: 32237556 DOI: 10.21149/10520] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 08/30/2019] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To describe in a national sample 1) the prevalence, awareness, treatment and control of dyslipidemias 2) the prevalence of dyslipidemias through previous national surveys. MATERIALS AND METHODS We analyzed data of the National Health and Nutrition Survey 2012, a representative cross-sectional study. Serum samples of 9 566 adults ≥20 years old with fasting ≥8 hours were analyzed for lipid fractions. Age-adjusted prevalences were calculated, by sociodemographic variables. Prevalence of awareness, treatment and control was estimated. A description of the dyslipidemia prevalence reported in previous surveys is reported. RESULTS Hypoalphalipoproteinemia and elevated LDL-C are the most prevalent dyslipidemias in Mexican adults. One in four adults had hypercholesterolemia at the moment of the interview without previous diagnosis. Awareness, treatment and control of dyslipidemia were 12.6, 3.7 and 3.1%, respec- tively. CONCLUSIONS Dyslipidemias are the most prevalent risk factor for cardiovascular diseases in Mexico. Public policies to increase awareness, access to therapy and sustained control are urgently needed.
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Affiliation(s)
- César Hernández-Alcaraz
- Centro de Investigación en Salud y Nutrición, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico
| | - Carlos A Aguilar-Salinas
- Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Mexico City, Mexico
| | - Kenny Mendoza-Herrera
- Centro de Investigación en Salud y Nutrición, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico
| | - Andrea Pedroza-Tobías
- Centro de Investigación en Salud y Nutrición, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico.,Institute for Global Health Sciences, University of California. San Francisco, United States
| | - Salvador Villalpando
- Centro de Investigación en Salud y Nutrición, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico
| | - Teresa Shamah-Levy
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico
| | | | - Mauricio Hernández-Ávila
- Dirección de Prestaciones Económicas y Sociales, Instituto Mexicano del Seguro Social. Mexico City, Mexico
| | - Simón Barquera
- Centro de Investigación en Salud y Nutrición, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico
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86
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Denova-Gutiérrez E, Vargas-Chanes D, Hernández S, Muñoz-Aguirre P, Napier D, Barquera S. Linking socioeconomic inequalities and type 2 diabetes through obesity and lifestyle factors among Mexican adults: a structural equations modeling approach. ACTA ACUST UNITED AC 2020; 62:192-202. [DOI: 10.21149/10819] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 11/19/2019] [Indexed: 11/06/2022]
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87
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Vargas-Meza J, Jáuregui A, Contreras-Manzano A, Nieto C, Barquera S. Acceptability and understanding of front-of-pack nutritional labels: an experimental study in Mexican consumers. BMC Public Health 2019; 19:1751. [PMID: 31888575 PMCID: PMC6938009 DOI: 10.1186/s12889-019-8108-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 12/18/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Front-of-package labelling is a cost-effective strategy to help consumers make healthier choices and informed food purchases. The effect of labels is mediated by consumer understanding and acceptability of the label. We compared the acceptability and understanding of labels used in Latin-America among low- and middle-income Mexican adults. METHODS Participants (n = 2105) were randomly assigned to one of three labels: Mexican Guideline Daily Allowances (GDA), Ecuador's Multiple Traffic Lights (MTL), or Chile's Warning Labels (WL) in red. Label acceptability was evaluated through items regarding likeability, attractiveness and perceived cognitive workload. Objective understanding was evaluated by asking participants to select the product with the lowest nutritional quality among three products. We measured the time participants took to choose the product. Differences in label acceptability, understanding and time required to choose a product across labels were tested. RESULTS Compared to the GDA, a higher proportion of participants liked the MTL and WL, considered them attractive, and with a lower perceived cognitive workload (p < 0.05). Participants had 4.00 (2.86-5.59) times the odds of correctly identifying the product with the lowest nutritional quality when using the MTL label and 4.52 (3.24-6.29) times the odds when using the WL, in comparison to the GDA. Time required to choose the product was lower for the MTL (Median: 11.25 s; IQR = 8.00-16.09) and the WL (Median = 11.94 s, IQR = 8.56-16.52) compared to the GDA (Median: 15.31 s; IQR = 10.81-20.21; p < 0.05). No differences were observed between the MTL and the WL. CONCLUSIONS GDA had the lowest acceptability and understanding among the labels tested. The MTL and the WL were more accepted and understood, and allowed low- and middle-income consumers to make nutrition-quality related decisions more quickly. WL or MTL may foster healthier food choices in the most vulnerable groups in Mexico compared to the current labelling format.
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Affiliation(s)
- Jorge Vargas-Meza
- Center for Nutrition and Health Research, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Alejandra Jáuregui
- Center for Nutrition and Health Research, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | | | - Claudia Nieto
- Center for Nutrition and Health Research, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, 62100 Cuernavaca, Mexico
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Shamah-Levy T, Campos-Nonato I, Cuevas-Nasu L, Hernández-Barrera L, Morales-Ruán MDC, Rivera-Dommarco J, Barquera S. Sobrepeso y obesidad en población mexicana en condición de vulnerabilidad. Resultados de la Ensanut 100k. ACTA ACUST UNITED AC 2019; 61:852-865. [DOI: 10.21149/10585] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 09/30/2019] [Indexed: 11/06/2022]
Abstract
Objetivo. Describir las prevalencias y tendencias de sobrepeso y obesidad en población con mayor vulnerabilidad social, residente en localidades con menos de 100 000 habitantes. Material y métodos. En preescolares, escolares, adolescentes y adultos de la Ensanut 100k y Ensanut 2012 se analizó la información sociodemográfica y de antropometría para calcular prevalencias y tendencias de sobrepeso+obesidad (SP+O), obesidad y obesidad abdominal. Resultados. La prevalencia de SP+O fue 6% en preescolares. La prevalencia de obesidad fue 15.3% en escolares, 14.2% en adolescentes y 33.6% en adultos. En comparación con el año 2012, el SP+O disminuyó 35% en 2018 entre los preescolares con inseguridad alimentaria severa. En escolares, la obesidad aumentó 97% entre 2012 y 2018 en quienes no tenían ayuda alimentaria. En adolescentes sin programas de ayuda alimentaria, la obesidad aumentó 60% entre 2012 y 2018. En adultos, entre 2012-2018 incrementó 10% la obesidad abdominal en quienes tenían inseguridad alimentaria moderada. Conclusiones. Existe una alta prevalencia de obesidad en la población mexicana con vulnerabilidad social y parece alcanzar al resto de la población de forma rápida pero con importantes desventajas estructurales.
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89
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Vargas-Meza J, Jáuregui A, Pacheco-Miranda S, Contreras-Manzano A, Barquera S. Front-of-pack nutritional labels: Understanding by low- and middle-income Mexican consumers. PLoS One 2019; 14:e0225268. [PMID: 31738782 PMCID: PMC6860442 DOI: 10.1371/journal.pone.0225268] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 10/31/2019] [Indexed: 12/01/2022] Open
Abstract
Front-of-pack labeling is a cost-effective strategy to decrease population consumption of sodium, sugar, saturated fat, total fat, and trans-fatty acids, considered critical nutrients for chronic disease. Our main objective was to explore the subjective understanding of labels that are currently used internationally among low- and middle-income Mexican consumers. We performed two phases of 10 focus groups with adolescents (13–15 y), young adults (21–23 y), mothers of children 3–12 y, fathers of children 3–12 y and older adults (55–70 y). Seven FOPL were evaluated: Guideline Daily Amounts, Multiple Traffic Light, Chilean Warning labels, Warning labels in Red, 5-Color Nutrition Label, Health Star Rating, and Healthy Choice label. Data was analyzed with a triangulation of researchers using a content analysis, based on three codes: 1) awareness and use of the Guideline Daily Amounts, 2) acceptability, and 3) subjective understanding of labels. Most participants were aware of the Guideline Daily Amounts, however they rarely used it because interpreting the information displayed on the label was too complicated. Health Star Rating, Warning labels, Multiple Traffic Light and the Healthy Choice logo labels were the most understandable, however the acceptability of the The Healthy Choice logo decreased as it did not provide information on specific ingredients. The Warning labels was the only label able to warn about critical nutrients that could represent a health risk. The Warning labels in red was more accepted compared to Warning labels in black. Results show that directive and semi-directive labels, such as Warning labels, Health Star Rating or Multiple Traffic Light, may be better at helping population of low- and middle income make healthier food choices, than non-directive FOPL such as the Guideline Daily Amounts implemented in México. The study results highlight the potential of Warning labels to support decreases in the consumption of critical ingredients in low- and middle-income Mexican consumers.
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Affiliation(s)
- Jorge Vargas-Meza
- Center Health and Nutrition Research, National Institute of Public Health, Cuernavaca, México
| | - Alejandra Jáuregui
- Center Health and Nutrition Research, National Institute of Public Health, Cuernavaca, México
- * E-mail:
| | - Selene Pacheco-Miranda
- Center Health and Nutrition Research, National Institute of Public Health, Cuernavaca, México
| | | | - Simón Barquera
- Center Health and Nutrition Research, National Institute of Public Health, Cuernavaca, México
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90
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Nieto C, Rodríguez E, Sánchez-Bazán K, Tolentino-Mayo L, Carriedo-Lutzenkirchen A, Vandevijvere S, Barquera S. The INFORMAS healthy food environment policy index (Food-EPI) in Mexico: An assessment of implementation gaps and priority recommendations. Obes Rev 2019; 20 Suppl 2:67-77. [PMID: 30618143 DOI: 10.1111/obr.12814] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 10/09/2018] [Accepted: 10/26/2018] [Indexed: 11/28/2022]
Abstract
Mexico is one of the countries with the highest prevalence of obesity and recently declared a national epidemic of diabetes. Healthy food environments have the potential to improve the diet of the population and decrease the burden of disease. The aim of the study was to assess the efforts of the Mexican Government towards creating healthier food environments using the Healthy Food Environment Policy Index (Food-EPI). The tool was developed by the International Network for Food and Obesity/Non-communicable Diseases Research, Monitoring and Action Support (INFORMAS). Then, it was adapted to the Latin-American context and assessed the components of policy and infrastructure support. Actors from academia, civil society, government, and food industry assessed the level of implementation of food policies compared with international best practices. Actors were classified as (1) independents from academia and civil society (n = 36), (2) government (n = 28), and (3) industry (n = 6). The indicators with the highest percentage of implementation were those related to monitoring and intelligence. Those related to food retail were rated lowest. When stratified by type of actor, the government officials rated several indicators at a higher percentage of implementation compared with independent actors. None of the indicators were rated at high implementation. Government officials and independent actors agreed upon nine priority actions to improve the food environment in Mexico. These actions have the potential to improve government commitment and advocacy efforts to create healthier food environments.
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Affiliation(s)
- Claudia Nieto
- Centro de Investigación en Nutrición y Salud, Instituto Nacional De Salud Pública, Cuernavaca, Morelos, Mexico
| | - Estefania Rodríguez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional De Salud Pública, Cuernavaca, Morelos, Mexico
| | - Karina Sánchez-Bazán
- Centro de Investigación en Nutrición y Salud, Instituto Nacional De Salud Pública, Cuernavaca, Morelos, Mexico
| | - Lizbeth Tolentino-Mayo
- Centro de Investigación en Nutrición y Salud, Instituto Nacional De Salud Pública, Cuernavaca, Morelos, Mexico
| | - Angela Carriedo-Lutzenkirchen
- Faculty of Public Health and Policy, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional De Salud Pública, Cuernavaca, Morelos, Mexico
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91
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Vargas-Meza J, Pedroza-Tobías A, Campos-Nonato I, Nilson E, Jauregui A, Barquera S. [Challenges of frontal food labeling to reduce sodium consumption (salt)]. Salud Publica Mex 2019; 61:555. [PMID: 31661728 DOI: 10.21149/10593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
[No disponible]
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Affiliation(s)
- Jorge Vargas-Meza
- Centro de Investigación de Nutrición y Salud, Instituto Nacional de Salud Pública.Cuernavaca, Morelos, México
| | - Andrea Pedroza-Tobías
- Centro de Investigación de Nutrición y Salud, Instituto Nacional de Salud Pública.Cuernavaca, Morelos, México
| | - Ismael Campos-Nonato
- Centro de Investigación de Nutrición y Salud, Instituto Nacional de Salud Pública.Cuernavaca, Morelos, México
| | - Eduardo Nilson
- Coordinación General de Alimentación y Nutrición, Ministerio de Salud. Brasilia, Brasil
| | - Alejandra Jauregui
- Centro de Investigación de Nutrición y Salud, Instituto Nacional de Salud Pública.Cuernavaca, Morelos, México
| | - Simón Barquera
- Centro de Investigación de Nutrición y Salud, Instituto Nacional de Salud Pública.Cuernavaca, Morelos, México
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Mendoza-Herrera K, Pedroza-Tobías A, Hernández-Alcaraz C, Ávila-Burgos L, Aguilar-Salinas CA, Barquera S. Attributable Burden and Expenditure of Cardiovascular Diseases and Associated Risk Factors in Mexico and other Selected Mega-Countries. Int J Environ Res Public Health 2019; 16:E4041. [PMID: 31652519 PMCID: PMC6843962 DOI: 10.3390/ijerph16204041] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 09/13/2019] [Accepted: 10/17/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND This paper describes the health and economic burden of cardiovascular diseases (CVD) in Mexico and other mega-countries through a review of literature and datasets. METHODS Mega-countries with a low (Nigeria), middle (India), high (China/Brazil/Mexico), and very high (the U.S.A./Japan) human development index were included. The review was focused on prevalence of dyslipidemias and CVD economic impact and conducted according to the PRISMA statement. Public datasets of CVD indicators were explored. RESULTS Heterogeneity in economic data and limited information on dyslipidemias were found. Hypertriglyceridemia and hypercholesterolemia were higher in Mexico compared with other countries. Higher contribution of dietary risk factors for cardiovascular mortality and greater probability of dying prematurely from CVD were observed in developing countries. From 1990-2016, a greater decrease in cardiovascular mortality in developed countries was registered. In 2015, a CVD expense equivalent to 4% of total health expenditure was reported in Mexico. CVD ranked first in health expenditures in almost all these nations and the economic burden will remain significant for decades to come. CONCLUSIONS Resources should be assured to optimize CVD risk monitoring. Educational and medical models must be improved to enhance CVD diagnosis and the prescription and adherence to treatments. Long-term benefits could be attained by modifying the food system.
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Affiliation(s)
- Kenny Mendoza-Herrera
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos 62100, Mexico.
| | - Andrea Pedroza-Tobías
- Institute for Global Health Sciences, University of California, San Francisco, CA 94158, USA.
| | - César Hernández-Alcaraz
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos 62100, Mexico.
| | - Leticia Ávila-Burgos
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Morelos 62100, Mexico.
| | - Carlos A Aguilar-Salinas
- Unidad de Investigación de Enfermedades Metabolicas, Mexico City 14080, Mexico.
- Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran, Mexico City 14080, Mexico.
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey 64710, N.L., Mexico.
| | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos 62100, Mexico.
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93
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Nieto C, Jáuregui A, Contreras-Manzano A, Arillo-Santillan E, Barquera S, White CM, Hammond D, Thrasher JF. Understanding and use of food labeling systems among Whites and Latinos in the United States and among Mexicans: Results from the International Food Policy Study, 2017. Int J Behav Nutr Phys Act 2019; 16:87. [PMID: 31623663 PMCID: PMC6798377 DOI: 10.1186/s12966-019-0842-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 08/16/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Obesity and chronic diseases could be prevented through improved diet. Most governments require at least one type of food labeling system on packaged foods to communicate nutrition information and promote healthy eating. This study evaluated adult consumer understanding and use of nutrition labeling systems in the US and Mexico, the most obese countries in the world. METHODS Adults from online consumer panels in the US (Whites n = 2959; Latinos n = 667) and in Mexico (n = 3533) were shown five food labeling systems: 1. Nutrition Facts Table (NFT) that shows nutrients of concern per serving; 2. Guideline Daily Amounts (GDA) that shows levels of nutrients of concern; 3. Multiple Traffic-Light (MTL) that color codes each GDA nutrient (green = healthy; yellow = moderately unhealthy; red = unhealthy); 4. Health Star Rating System (HSR) that rates foods on a single dimension of healthiness; 5. Warning Label (WL) with a stop sign for nutrients present in unhealthy levels. Participants rated each label on understanding ("easy"/"very easy to understand" vs "difficult"/"very difficult to understand"), and, for NFTs and GDAs, frequency of use ("sometimes"/"often" vs "never"). Mixed logistic models regressed understanding and frequency of use on indicators of labeling systems (NFT = ref), testing for interactions by ethnicity (US Latinos, US Whites, Mexicans), while controlling for sociodemographic and obesity-related factors. RESULTS Compared to the NFT, participants reported greater understanding of the WL (OR = 4.8; 95% CI = 4.4-5.3) and lower understanding of the HSR (OR = 0.34, 95% CI = 0.31-0.37) and the MTL (OR = 0.56, 95% CI = 0.52-0.61), with similar patterns across ethnic subgroups. Participants used GDAs less often than NFTs (OR = 0.48; 95%CI = 0.41-0.55), with the greatest difference among US Whites (OR = 0.10; 95%CI = 0.07-0.14). CONCLUSIONS Understanding and use of the GDA was similar to that of the NFT. Whites, Latinos, and Mexicans consistently reported the best understanding for WLs, a FOPL that highlights unhealthfulness of a product. Therefore, a FOPL summary indicator, such as WLs, may be more effective in both the US and Mexico for guiding consumers towards informed food choices.
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Affiliation(s)
- Claudia Nieto
- Nutrition and Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col, Santa María Ahuacatitlán, 62100 Cuernavaca, Mexico
| | - Alejandra Jáuregui
- Nutrition and Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col, Santa María Ahuacatitlán, 62100 Cuernavaca, Mexico
| | - Alejandra Contreras-Manzano
- Nutrition and Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col, Santa María Ahuacatitlán, 62100 Cuernavaca, Mexico
| | - Edna Arillo-Santillan
- Population Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, 62100 Cuernavaca, Mexico
- School of Demography, ANU College of Arts and Social Sciences, The Australian National University, 9 Fellows Road Acton ACT 260, Canberra, Australia
| | - Simón Barquera
- Nutrition and Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col, Santa María Ahuacatitlán, 62100 Cuernavaca, Mexico
| | - Christine M. White
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1 Canada
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1 Canada
| | - James F. Thrasher
- Population Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, 62100 Cuernavaca, Mexico
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, 921 Assembly St, Columbia, SC 29208 USA
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94
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Nieto C, Tolentino-Mayo L, Monterrubio-Flores E, Medina C, Patiño SRG, Aguirre-Hernández R, Barquera S. Nutrition Label Use Is Related to Chronic Conditions among Mexicans: Data from the Mexican National Health and Nutrition Survey 2016. J Acad Nutr Diet 2019; 120:804-814. [PMID: 31585829 DOI: 10.1016/j.jand.2019.07.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 07/22/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Non-communicable diseases, such as obesity, diabetes, and hypertension, can be prevented and treated through a balanced nutrient-rich diet. Nutrition labels have been recognized as crucial to preventing obesity and non-communicable diseases through a healthier diet. OBJECTIVE Our aim was to examine the association between nutrition label use and chronic conditions (overweight, obesity, previously diagnosed diabetes, and hypertension) among an adult Mexican population. DESIGN This was a cross-sectional study that used data from the Mexican National Health and Nutrition Survey of 2016 (ENSANUT MC 2016). PARTICIPANTS/SETTING The participants were 5,013 adults aged 20 to 70 years old. Older adults (>70 years), illiterate participants, pregnant women, and participants with implausible blood pressure data were excluded from the sample. The survey was conducted from May to August 2016 in the participants' households. MAIN OUTCOME MEASURES We measured chronic conditions (overweight, obesity, previously diagnosed diabetes, and hypertension). STATISTICAL ANALYSES PERFORMED Pearson χ2 test was used to examine the associations among the use of nutrition labels and sociodemographic characteristics and chronic conditions. Multiple logistic regression was used to determine the association between nutrition label use and chronic conditions adjusting for the effect of confounding variables like sex, age, body mass index, education level, marital status, ethnicity, residence area, region, and socioeconomic status. RESULTS From the total sample, 40.9% (95% CI 38.4% to 43.8%) reported using nutrition labeling. Respondents with overweight or obesity were less likely to use nutrition labels (odds ratio 0.74; P<0.05). Participants who self-reported diabetes had significantly lower odds of nutrition label use than participants who did not report to have diabetes (odds ratio 0.66; P<0.05). Participants having 3 chronic conditions had lower odds of nutrition label use (odds ratio 0.34; P<0.01) relative to having zero chronic conditions. CONCLUSIONS This study suggests an association between nutrition label use and chronic conditions (obesity and diabetes). These findings demonstrate that people with obesity, diabetes, and a combination of chronic conditions were less likely to use nutrition labels than people without these conditions.
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95
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Kaufer-Horwitz M, Tolentino-Mayo L, Jáuregui A, Sánchez-Bazán K, Bourges H, Martínez S, Perichart O, Rojas-Russell M, Moreno L, Hunot C, Nava E, Ríos-Cortázar V, Palos-Lucio G, González L, González-de Cossio T, Pérez M, Borja Aburto VH, González A, Apolinar E, Pale LE, Colín E, Barriguete A, López O, López S, Aguilar-Salinas CA, Hernández-Ávila M, Martínez-Duncker D, de León F, Kershenobich D, Rivera J, Barquera S. [A front-of-pack labelling system for food and beverages for Mexico: a strategy of healthy decision-making.]. Salud Publica Mex 2019; 60:479-486. [PMID: 30137950 DOI: 10.21149/9615] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 05/29/2018] [Indexed: 11/06/2022] Open
Abstract
The Mexican Ministry of Health requested the National Institute of Public Health to constitute a group of independent, free of conflict-of-interest academic experts on front-of-pack labelling (FOP). This group was instructed to created a positioning paper to contribute to the development of a FOP system for industrialized products that offers useful information for purchase decision making. This position paper uses the best available scientific evidence, and recommendations from experts of international organizations. The FOP proposal focuses on the contents of energy, nutrients, ingredients and components that if consumed in excess on the diet, can be harmful to people's health, such as added sugars, sodium, total fat, saturated fat and energy. The academic expert group recommends the implementation of a FOP that provides an easy way to quickly assess the quality of a product. It is essential that this FOP provides direct, simple, visible and easily understandable information.
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Affiliation(s)
- Martha Kaufer-Horwitz
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Ciudad de México, México.,Miembros del Sistema Nacional de Investigadores
| | | | - Alejandra Jáuregui
- Instituto Nacional de Salud Pública. Morelos, México.,Miembros del Sistema Nacional de Investigadores
| | | | - Héctor Bourges
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Ciudad de México, México.,Miembros del Sistema Nacional de Investigadores.,Miembros de la Academia Nacional de Medicina de México
| | - Sophia Martínez
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Ciudad de México, México
| | - Otilia Perichart
- Instituto Nacional de Perinatología. Ciudad de México, México.,Miembros del Sistema Nacional de Investigadores
| | - Mario Rojas-Russell
- Universidad Nacional Autónoma de México. Ciudad de México, México.,Miembros del Sistema Nacional de Investigadores
| | - Laura Moreno
- Universidad Nacional Autónoma de México. Ciudad de México, México.,Miembros del Sistema Nacional de Investigadores
| | - Claudia Hunot
- Universidad de Guadalajara. Guadalajara, México.,Miembros del Sistema Nacional de Investigadores
| | - Edna Nava
- Colegio Mexicano de Nutriólogos AC. Ciudad de México.,Miembros del Sistema Nacional de Investigadores
| | | | | | - Lorena González
- Universidad Autónoma de Aguascalientes. Aguascalientes, México
| | - Teresita González-de Cossio
- Universidad Iberoamericana. Ciudad de México.,Miembros del Sistema Nacional de Investigadores.,Miembros de la Academia Nacional de Medicina de México
| | - Marcela Pérez
- Instituto Mexicano del Seguro Social. Ciudad de México
| | - Víctor Hugo Borja Aburto
- Instituto Mexicano del Seguro Social. Ciudad de México.,Miembros del Sistema Nacional de Investigadores.,Miembros de la Academia Nacional de Medicina de México
| | - Antonio González
- Hospital General de México. Ciudad de México, México.,Miembros del Sistema Nacional de Investigadores.,Miembros de la Academia Nacional de Medicina de México
| | - Evelia Apolinar
- Hospital Regional de Alta Especialidad del Bajío. León, Guanajuato
| | - Luz Elena Pale
- Escuela de Dietética y Nutrición del Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado. Ciudad de México
| | - Eloisa Colín
- Cátedra Conacyt. Instituto Nacional de Cardiología Ignacio Chávez. Ciudad de México, México
| | - Armando Barriguete
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Ciudad de México, México
| | - Oliva López
- Universidad Autónoma Metropolitana. Unidad Xochimilco, Ciudad de México, México.,Miembros del Sistema Nacional de Investigadores
| | - Sergio López
- Universidad Autónoma Metropolitana. Unidad Xochimilco,Ciudad de México, México.,Miembros del Sistema Nacional de Investigadores
| | - Carlos A Aguilar-Salinas
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Ciudad de México, México.,Miembros del Sistema Nacional de Investigadores.,Miembros de la Academia Nacional de Medicina de México
| | - Mauricio Hernández-Ávila
- Universidad de Guadalajara. Guadalajara, México.,Miembros del Sistema Nacional de Investigadores.,Miembros de la Academia Nacional de Medicina de México
| | | | - Fernando de León
- Universidad Autónoma Metropolitana. Unidad Xochimilco,Ciudad de México, México.,Miembros del Sistema Nacional de Investigadores
| | - David Kershenobich
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Ciudad de México, México.,Miembros del Sistema Nacional de Investigadores.,Miembros de la Academia Nacional de Medicina de México
| | - Juan Rivera
- Instituto Nacional de Salud Pública. Morelos, México.,Miembros del Sistema Nacional de Investigadores.,Miembros de la Academia Nacional de Medicina de México
| | - Simón Barquera
- Instituto Nacional de Salud Pública. Morelos, México.,Miembros del Sistema Nacional de Investigadores.,Miembros de la Academia Nacional de Medicina de México
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96
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Campos-Nonato I, Hernández-Barrera L, Pedroza-Tobías A, Medina C, Barquera S. [Hypertension in Mexican adults: prevalence, diagnosis and type of treatment. Ensanut MC 2016.]. Salud Publica Mex 2019; 60:233-243. [PMID: 29746740 DOI: 10.21149/8813] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 03/07/2018] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To describe the prevalence, awareness and proportion of adults with an adequate control of hypertension. MATERIALS AND METHODS Blood pressure was measured at 8 352 adults who participated in the Ensanut MC 2016. The adults who reported having diagnosis of hypertension or had systolic blood pressure values (TAS) ≥140mmHg or diastolic blood pressure (TAD) ≥90mmHg were classified as hypertensive. Hypertension was considered controlled when blood pressure was TAS <140mmHg and TAD <90mmHg. RESULTS The prevalence of hypertension was 25.5%. Of these, 40.0% were unaware of having high blood pressure. Of the hypertensive adults who had previous diagnosis of hypertension and receiving drug treatment (79.3%), 45.6% had blood pressure under control. CONCLUSIONS A high percentage of adults are unaware of having hypertension and nearly half have inadequate control. The relevance of current programmes for diagnosing hypertension should be assessed, as well as the effectiveness of their control strategies.
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Affiliation(s)
- Ismael Campos-Nonato
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Lucía Hernández-Barrera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Andrea Pedroza-Tobías
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Catalina Medina
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
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97
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Medina C, Jáuregui A, Campos-Nonato I, Barquera S. [Prevalence and trends of physical activity in children and adolescents: results of the Ensanut 2012 and Ensanut MC 2016]. Salud Publica Mex 2019; 60:263-271. [PMID: 29746743 DOI: 10.21149/8819] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 04/09/2018] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To describe the prevalence and trends of physical activity (PA) in children and adolescents from Ensanut 2012 and Ensanut MC 2016. MATERIALS AND METHODS Physical activity levels were obtained from the Health Behaviour in School-aged Children (HBSC) and the International Physical Activity (IPAQ) questionnaires for children and adolescents respectively. RESULTS More than 80% of the children and 35% of the adolescents in Mexico do not meet the PA recom¬mendations. From 2012-2016, girls and schoolchildren in the rural area showed an increase in participation in organized activities and sports. CONCLUSIONS The prevalence of PA is low in children and adolescents and the trend has not improved in the last six years.
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98
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Barquera S, García-Chávez CG, Navarro-Rosenblatt D, Uauy R, Pérez-Escamilla R, Martorell R, Ramírez-Zea M, Sánchez-Bazán K. Postura de la Sociedad Latinoamericana de Nutrición (SLAN) sobre el manejo de conflicto de intereses. ACTA ACUST UNITED AC 2018; 60:592-597. [DOI: 10.21149/9657] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 08/29/2018] [Indexed: 01/26/2023]
Abstract
Existe evidencia sólida de la existencia de relaciones entre la industria de alimentos y bebidas y la academia. Ésta sugiere que la investigación patrocinada por la industria es susceptible de conferir sesgos a su favor en los resultados. En América Latina, se han documentado ejemplos de estas situaciones en México, Brasil, Chile, Perú, Colombia y Ecuador, por citar a algunos países. Ante la necesidad urgente de estudiar y gestionar las relaciones entre la industria de alimentos y bebidas y el campo de investigación en salud y nutrición, en 2017 el Presidente de la Sociedad Latinoamericana de Nutrición (SLAN) designó a un Comité de Conflicto de Intereses (CCI). El CCI tuvo la encomienda de hacer una propuesta de postura sobre manejo de conflicto de intereses (CDI) de la SLAN. El presente artículo refleja los trabajos del CCI y la postura que adoptó la SLAN.
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99
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Barquera S, Schillinger D, Aguilar-Salinas CA, Schenker M, Rodríguez LA, Hernández-Alcaraz C, Sepúlveda-Amor J. Collaborative research and actions on both sides of the US-Mexico border to counteract type 2 diabetes in people of Mexican origin. Global Health 2018; 14:84. [PMID: 30134925 PMCID: PMC6104005 DOI: 10.1186/s12992-018-0390-5] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 06/29/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Type 2 Diabetes (T2D) is now a massive epidemic in both California and Mexico, with serious consequences for social and economic well-being. A large proportion of these populations share common ethnic backgrounds. Yet diverse environmental and social conditions across regions create unique opportunities to explore the ways that T2D risk, incidence, management and outcomes manifest. MAIN TEXT An action-oriented research consortium headed up by the University of California and Universidad Nacional Autónoma de Mexico was constituted to set priorities for bi-national translational research, in an attempt to implement and evaluate clinical, public health and policy actions to decrease the burden of T2D for people of Mexican origin. In this paper, we describe the epidemiology of T2D in Mexico and California, review current efforts to combat the epidemic, highlight gaps in knowledge and identify urgent areas of opportunity for collaboration. The group has developed a common research agenda and funding has been obtained to evaluate biological samples from the 2016 Mexican Health Survey, collaborate in a telemedicine-based retinopathy project, implement interventions in food banks, promote a communications campaign, and design a large-scale diabetes prevention effectiveness trial. CONCLUSIONS T2D has caused a state of emergency in Mexico and is a major health problem among Mexican populations on both sides of the border. Understanding the commonalities and differences between California and Mexico for those of Mexican origin with respect to T2D, when combined with a sharing of knowledge and advances, can produce a bi-national translational research agenda to inform relevant policy and practice. Amidst economic and political uncertainty and limited healthcare budgets, this collaboration can contribute to the development of scientific evidence to inform policies and interventions. This may provide a promising collaborative model that could be expanded to other health conditions and regions of the world.
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Affiliation(s)
- Simón Barquera
- Instituto Nacional de Salud Pública, Avenida Universidad 655, Santa María Ahuacatitlán, 62100 Cuernavaca, Mexico
| | - Dean Schillinger
- UCSF Division of General Internal Medicine at San Francisco General Hospital, 1545 Divisadero St., First and Second Floors, San Francisco, CA 94115 USA
- UCSF Center for Vulnerable Populations, School of Medicine, Department of Medicine, 1001 Potrero Ave, San Francisco, CA 94110 USA
| | - Carlos A. Aguilar-Salinas
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Avenida Vasco de Quiroga No.15, Colonia Belisario Domínguez Sección XVI, Delegación Tlalpan C.P, 14080 Ciudad de Mexico, Mexico
| | - Marc Schenker
- UC Davis School of Medicine, Department of Public Health Sciences, University of California Davis Medical Sciences 1-C, One Shields Avenue, Davis, CA 95616 USA
| | - Luis A. Rodríguez
- UCSF School of Medicine, Department of Epidemiology & Biostatistics, 550 16th St, San Francisco, CA 94158 USA
| | - Cesar Hernández-Alcaraz
- Instituto Nacional de Salud Pública, Avenida Universidad 655, Santa María Ahuacatitlán, 62100 Cuernavaca, Mexico
| | - Jaime Sepúlveda-Amor
- Instituto Nacional de Salud Pública, Avenida Universidad 655, Santa María Ahuacatitlán, 62100 Cuernavaca, Mexico
- UCSF School of Medicine, Department of Epidemiology & Biostatistics, 550 16th St, San Francisco, CA 94158 USA
- UCSF Institute for Global Health Sciences, Mission Hall, Box 1224, 550 16th Street, Third Floor, San Francisco, CA 94158 USA
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100
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Contreras-Manzano A, Jáuregui A, Velasco-Bernal A, Vargas-Meza J, Rivera JA, Tolentino-Mayo L, Barquera S. Comparative Analysis of the Classification of Food Products in the Mexican Market According to Seven Different Nutrient Profiling Systems. Nutrients 2018; 10:E737. [PMID: 29880737 PMCID: PMC6024607 DOI: 10.3390/nu10060737] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 05/31/2018] [Accepted: 06/04/2018] [Indexed: 01/08/2023] Open
Abstract
Nutrient profiling systems (NPS) are used around the world. In some countries, the food industry participates in the design of these systems. We aimed to compare the ability of various NPS to identify processed and ultra-processed Mexican products containing excessive amounts of critical nutrients. A sample of 2544 foods and beverages available in the Mexican market were classified as compliant and non-compliant according to seven NPS: the Pan American Health Organization (PAHO) model, which served as our reference, the Nutrient Profiling Scoring Criterion (NPSC), the Mexican Committee of Nutrition Experts (MCNE), the Health Star Rating (HSR), the Mexican Nutritional Seal (MNS), the Chilean Warning Octagons (CWO) 2016, 2018 and 2019 criteria, and Ecuador's Multiple Traffic Light (MTL). Overall, the proportion of foods classified as compliant by the HSR, MTL and MCNE models was similar to the PAHO model. In contrast, the NPSC, the MNS and the CWO-2016 classified a higher amount of foods as compliant. Larger differences between NPS classification were observed across food categories. Results support the notion that models developed with the involvement of food manufacturers are more permissive than those based on scientific evidence. Results highlight the importance of thoroughly evaluating the underlying criteria of a model.
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Affiliation(s)
- Alejandra Contreras-Manzano
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca 62100, Mexico;. (A.C.-M.).
| | - Alejandra Jáuregui
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca 62100, Mexico;. (A.C.-M.).
| | - Anabel Velasco-Bernal
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca 62100, Mexico;. (A.C.-M.).
| | - Jorge Vargas-Meza
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca 62100, Mexico;. (A.C.-M.).
| | - Juan A Rivera
- National Institute of Public Health, Cuernavaca 62100, Mexico.
| | - Lizbeth Tolentino-Mayo
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca 62100, Mexico;. (A.C.-M.).
| | - Simón Barquera
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca 62100, Mexico;. (A.C.-M.).
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