Unusually high prevalence rates of obesity in four Mexican rural communities

Intervention during the first 1000 days in Mexico

Health systems and society are facing the growing problem of obesity and its accompanying comorbidities. New approaches to reduce these problems must be oriented to population groups in which long-lasting effects of interventions may occur. Biological processes occurring during the first 1000 days of life, which may be modulated by environmental modifications and result in phenotypes with differential risk for noncommunicable chronic disease, constitute an opportunity for interventions. The nutritional and general health conditions of pregnant women and the fetus, as well as toddlers, can be improved with interventions during the first 1000 days, offering pregnancy care, promoting breastfeeding, instructing on the use of complementary foods, and educating on the adequacy of the family dietary patterns for children. Evidence that interventions during this period result in promotion of children's growth and development, influencing the risk for development of obesity in infancy, is available. In this article, an ongoing program in Mexico City directed to offer continuum of care during the first 1000 days is described.

An intervention to promote physical activity in Mexican elementary school students: building public policy to prevent noncommunicable diseases

Physical activity is an important component of strategies for health promotion and prevention of noncommunicable diseases. It is also associated with decreased risk for cardiovascular disease in overweight and obese adults and children. This article addresses the initial description of a physical activity intervention for children attending public elementary schools in Mexico. The objective was to develop a replicable model based on a strategic public, private, academic, and social partnership that would have a short-term impact on the metabolic health of children and be useful for building effective public policy. Forty-nine schools (20 000 students) participated, and 5 schools were selected for evaluation. The intervention included a 30-minute supervised middle-effort interchangeable routine, 5 days a week for a complete school year, adapted for different school conditions and students of different ages. Evaluation included anthropometric measurements and biochemical markers. Actual prevalence of combined overweight and obesity in these children was 31.9%. The intervention was successfully implemented in all schools. No change in body mass index, waist circumference, or other anthropometric indicators was found. However, changes in biochemical markers showed a significant decrease in blood glucose, total cholesterol, and cholesterol-low-density lipoproteins, reflecting a positive effect on cardiovascular health indicators.

Altitude effects on growth of indigenous children in Oaxaca, Southern Mexico

The effect of altitude of residence on the growth status of 11,454 indigenous school children 6-14 years of age in Oaxaca, southern Mexico, was examined. Indicators of living conditions (human development index [HDI], index of community nutritional risk [INR], index of marginalization [IM], index of relative isolation [II]) were regressed on z-scores for height, weight and BMI, and the residuals were regressed on altitude of residence (km). Independent of other environmental conditions, altitude negatively affected height by approximately -0.07 z-scores per kilometer altitude above sea level. The estimated average decrease in stature was 0.92 cm per kilometer elevation. BMI was significantly increased, 1.2 units per kilometer elevation, consistent with earlier studies of growth status and altitude. In contrast, weight was not affected by altitude of residence. Approximately 36% of the reduction in height and 54% of the increase in BMI were due to altitude effects; the remaining changes in height and BMI were associated with environmental factors reflected in the indices of community well-being considered.

Nutritional quality of foods and beverages on child-care centre menus in Mexico

OBJECTIVE

The purpose of the present study was to assess the nutritional quality of foods and beverages listed on menus serving children in government-sponsored child-care centres throughout Mexico.

DESIGN

For this cross-sectional menu assessment, we compared (i) food groups and portion sizes of foods and beverages on the menus with MyPlate recommendations and (ii) macronutrients, sugar and fibre with Daily Reference Intake standards.

SETTING

Menus reflected foods and beverages served to children attending one of 142 government-sponsored child-care centres throughout Mexico.

SUBJECTS

There were fifty-four distinct menus for children aged 4–6 months, 7–9 months, 10–12 months, 13–23 months, 24–47 months and 48–72 months.

RESULTS

Menus included a variety of foods meeting minimum MyPlate recommendations for each food category except whole grains for children aged 48–72 months. Menus listed excessive amounts of high-energy beverages, including full-fat milk, fruit juice and sugar-sweetened beverages for children of all ages. The mean daily energy content of menu items yielded an average of 2?76 MJ for infants, 4.77 MJ for children aged 13–23 months, 5.36 MJ for children aged 24–47 months and 5.87 MJ for children aged 48–72 months. Foods and beverages on menus provided sufficient grams of carbohydrate and fat, but excessive protein.

CONCLUSIONS

Menus provided a variety of foods but excessive energy. Whole grains were limited, and high-energy beverages were prevalent. Both may be appropriate targets for nutrition intervention. Future studies should move beyond menus and assess what children actually consume in child care.

The High Prevalence of Overweight and Obesity in Mexican Children

OBJECTIVE

To establish the prevalence of overweight and obesity in Mexican children 10 to 17 years of age according to the percentiles from both the Centers of Disease Control and Prevention (CDC) and the International Obesity Task Force (IOTF).

RESEARCH METHODS AND PROCEDURES

Heights and weights were measured in children from nationally representative, randomly chosen households in the Mexican National Health Survey 2000. The study population consisted of 7862 boys and 8947 girls, 10 to 17 years of age. Measurements used were the percentage of children in the corresponding BMI categories for overweight and obesity specified by the CDC and the IOTF BMI percentiles.

RESULTS

The children were short, with mean Z scores for height by age varying from - 0.62 +/- 1.26 to -1.12 +/- 1.06 in boys and from -0.45 +/- 1.25 to -1.19 +/- 1.12 in girls. CDC-based overweight prevalences varied by age from 10.8% to 16.1% in boys and 14.3% to 19.1% in girls, with obesity prevalences from 9.2% to 14.7% in boys and 6.8% to 10.6% in girls; these prevalences did not relate to stunting. IOTF-based excess weight prevalences were similar, with higher overweight rates (boys, 15.4% to 18.8%; girls, 18.4% to 22.3%) but lower obesity rates (boys, 6.1% to 9%; girls, 5.9% to 8.2%).

DISCUSSION

Mexican children have one-half the overweight/obesity prevalences of U.S. Mexican-American children; however, there are higher rates in Northern Mexico, which is closer to the U.S. These escalating rates of excess weight demand new prevention, as well as management, policies.

Global gender disparities in obesity: a review

There is a global obesity pandemic. However, the prevalence of overweight and obesity among men and women varies greatly within and between countries, and overall, more women are obese than men. These gender disparities in overweight and obesity are exacerbated among women in developing countries, particularly in the Middle East and North Africa. Yet, in developed countries, more men are overweight than women. Current knowledge suggests that myriad sociocultural dynamics throughout the world exacerbate gender disparities in excess weight gain. Different contextual factors drive gender differences in food consumption, and women often report consuming healthier foods, yet may consume more sugar-laden foods, than men. Acculturation, through complex sociocultural pathways, affects weight gain among both men and women. The nutrition transition taking place in many developing countries has also affected excess weight gain among both genders, but has had an even greater impact on the physical activity levels of women. Furthermore, in some countries, cultural values favor larger body size among women or men as a sign of fertility, healthfulness, or prosperity. As the global obesity pandemic continues, more research on gender disparities in overweight and obesity will improve the understanding of this pandemic.

Synthesis and antifungal properties of papulacandin derivatives

Derivatives of an antifungal agent that targets the β-(1,3)-D-glucan synthase, papulacandin D, were synthesized and tested for activity. The papulacandin D structure contains a challenging benzannulated spiroketal unit, which is introduced in a palladium-catalyzed cross-coupling reaction of a glycal silanolate and an aryl iodide followed by an oxidative spiroketalization. Four different variants were made, differing in the nature of the acyl side chain with respect to the length, and in the number and stereochemistry of the double bonds. Moderate biological activity was observed for the derivatives with a side chain based on palmitic acid and linoleic acid.

Correlates of physical activity and inactivity in urban Mexican youth

OBJECTIVES

To evaluate correlates of physical activity in Mexico City school youth.

METHODS

A cross-sectional survey was conducted with 1,004 school youth (490 males and 514 females), 9-18 years of age resident in Mexico City. Age, height, body mass index (BMI), socioeconomic status (SES), time viewing television and playing video games (physical inactivity), and perceived sport/physical activity status of mother and father were evaluated as potential correlates of physical activity [Physical Activity Questionnaire (PAQ)]. Multiple linear regression analyses (backward elimination) by age group and sex were used.

RESULTS

Physical activity declined in older adolescents, while differences between the two younger age groups were minimal. Television time showed a similar tendency. Overall, fathers were perceived as being active in sport/physical activity more frequently than mothers. Significant predictors of activity differed by age group and sex. For the total sample, age (negative) and perceived sport/activity status of the mother (positive) were significant predictors of the PAQ in boys, and age and the BMI (negative) and height and perceived sport/activity status of both parents (positive) were significant predictors for girls. Age (negative) was the main predictor for inactivity in both males and females.

CONCLUSIONS

Potential correlates of physical activity and inactivity considered in this analysis were limited and accounted for relatively little of the variance in physical activity. The role of perceived sport/activity of the parents, especially among younger boys and girls, is particularly of interest and merits more detailed study. Nevertheless, many other variables also need to be considered.

Metabolic imprinting by maternal protein malnourishment impairs vagal activity in adult rats

Protein restriction during lactation has been suggested to diminish parasympathetic activity, whereas sympathetic activity is enhanced in adult rats. The present study analyses whether dysfunction of the autonomic nervous system is involved in the impairment of insulin secretion from perinatally undernourished rats. Male neonates were reared by mothers fed a low- (4%) protein (LP group) or normal- (23%) protein diet (NP group). At 81 days of age, LP rats showed less body mass than NP rats (318 ± 4 g versus 370 ± 5 g) (P < 0.001). Fat tissue accumulation decreased in LP [0.8 ± 0.03 g/100 g body weight (BW)] compared to NP rats (1.1 ± 0.04 g/100 g BW) (P < 0.001). LP were glucose-intolerant as registered by the area under the curve of an i.v. glucose tolerance test (37 ± 3) compared to NP rats (29 ± 2) (P < 0.05); however, LP animals showed fasting normoglycaemia (LP, 5.0 ± 0.1; NP, 4.9 ± 0.03 mm) and hypoinsulinaemia (LP, 0.10 ± 0.02 ng/ml; NP, 0.17 ± 0.02 ng/ml). LP also showed glucose tissue uptake 60% higher than NP rats (P < 0.05). Vagus firing rate from LP was lower (7.1 ± 0.8 spikes/5 s) than that in NP rats (12.3 ± 0.7 spikes/5 s) (P < 0.001); however, there was no difference in sympathetic nervous activity. The cholinergic insulinotrophic effect was lower in pancreatic islets from LP (0.07 ± 0.01 ng/min/islet) than in NP rats (0.3 ± 0.06 ng/min/islet), whereas the levels of adrenaline-mediated inhibition of glucose-induced insulin release were similar. Perinatal protein restriction inhibited the activity of the vagus nerve, thus reducing the insulinotrophic effect of parasympathetic pathways on pancreatic β-cells, which inhibit insulin secretion.

Maternal perceptions of early childhood ideal body weight differ among Mexican-origin mothers residing in Mexico compared to California

OBJECTIVE

To assess maternal perceptions of children's current and ideal body sizes, and the meaning of and factors contributing to overweight in infancy and early childhood among Mexican-origin mothers living in Mexico and in California.

DESIGN

A quali-quantitative study combining focus groups and a self-administered questionnaire.

SUBJECTS/SETTING

A purposive sample of 84 low-income, Mexican-origin mothers of 4- to 6-year-old children recruited between March 2006 and January 2008 from rural and urban communities in Mexico and California.

STATISTICAL ANALYSES

Bivariate, multivariate, and qualitative analyses of maternal perceptions of children's actual and ideal body size supplemented by qualitative analyses of meaning of and factors contributing to childhood overweight/obesity.

RESULTS

Ideal child body size was considerably lower among Mexican-origin mothers living in California (3.86+/-0.56) than it was among mothers living in Mexico (4.32+/-0.83), and this difference was significant (P=0.001) after adjusting for sociodemographic covariates. Among mothers of overweight children, 82% of mothers in California were dissatisfied with their child's weight compared with 29% of mothers in Mexico (P=0.003). Focus-group results suggest that these differences in the perception of children's ideal body size can be attributable to differences in body size norms among mothers and awareness of the negative effects of obesity that occur after migration to California.

CONCLUSIONS

Maternal perceptions of early childhood overweight appear to differ among Mexican-origin women living in Mexico and California. Recognition of the negative health consequences of obesity and identification of barriers to achieving weight control are important first steps toward childhood obesity prevention. Interventions directed at Mexican-origin mothers should focus on culturally acceptable ways of transmitting weight-control information.

Anthropometry and body composition of school children in Bahrain

BACKGROUND AND OBJECTIVES

This study was conducted because of the lack of a comprehensive nationwide assessment of data on the anthropometric status and related health problems in Bahraini school children aged 6 to 18 years.

SUBJECTS AND METHODS

A cross-sectional survey was conducted on the anthropometric status of school children enrolled in the primary, intermediate and secondary government schools in all populated regions of Bahrain. The sample size included 2594 students (1326 girls and 1268 boys) representing 2.5% of the total student population. For sample selection, a multi-stage sampling design was chosen that combined multi-cluster and simple random sampling methods. Anthropometric measurements included height, weight, mid-arm circumference and skin fold thickness at two sites (triceps and subscapular). Anthropometric indices derived were body mass index (BMI) and arm muscle area. The WHO reference standards (2007) and the National Health and Nutrition Examination Survey (NHANES) II data were used for comparison.

RESULTS

Compared to WHO reference standards, the median height of Bahraini children and adolescents in the age range of 6 to 18 years was close to the 25th percentile or lower, while the median BMI during adolescent years was comparable in boys, but higher than WHO standards in girls, reaching the 75th percentile. The cutoff values of BMI for overweight/obesity status (85th and 95th percentile) were higher by 3-6 kg/m(2) compared to WHO standards. While skin fold thicknesses were also higher in Bahraini adolescents compared to their American counterparts (NHANES II), arm muscularity was substantially lower.

CONCLUSIONS

Current study findings for BMI as well as skin fold thicknesses suggest an increased trend toward adiposity among Bahraini adolescents, especially in girls, which puts this age group at a high risk of adult obesity and its consequences. A need for urgent intervention programs is emphasized.

Fatores associados à resistência à insulina em populações rurais

O objetivo deste estudo foi avaliar a associação dos indicadores antropométricos, de composição corporal, bioquímicos e hemodinâmicos com a resistência à insulina em duas comunidades rurais. A amostra foi constituída por indivíduos com idade maior ou igual a 18 anos de ambos os sexos. Foram excluídos os diabéticos e as mulheres grávidas. A coleta de dados incluiu variáveis demográficas, de estilo de vida, hemodinâmicas, antropométricas e bioquímicas. Dos 567 participantes, 50,4% eram homens e 49,6%, mulheres. A maioria das pessoas tinha a cor de pele não-branca (75,7%), vivia com seus cônjuges (69,3%) e possuía baixo nível educacional. Neste trabalho, 17,4% das pessoas apresentavam sobrepeso e 5,5%, obesidade. Pela análise multivariada observou-se que, nos indivíduos adultos, não-diabéticos, com baixo nível socioeconômico e educacional, os fatores associados à resistência à insulina foram o sobrepeso e a obesidade, o aumento da razão cintura/quadril, a proteína C-reativa e a cor de pele.

Changing prevalence of obesity in a rural community between 1977 and 2003: a multiple cross-sectional study

OBJECTIVE

To determine the changes in the prevalence of obesity in a rural community between 1977 and 2003.

STUDY DESIGN

A multiple cross-sectional study.

METHODS

The analysis was based on data from four cross-sectional surveys of adults aged 25-59 years, conducted in the town of Humboldt, Saskatchewan in 1977, 1983, 1993 and 2003. People with a body mass index (BMI) > or =30 kg/m(2) were considered to be obese.

RESULTS

Average body weight increased by 8 kg for both men and women during the study period. The increase in BMI was greater in adults aged 25-39 years compared with older age groups. The prevalence of obesity increased from 24% in 1977 to 38% in 2003 for men, and from 16% to 32% for women. The change was more pronounced from 1993 to 2003 than from 1977 to 1993, especially among younger adults. Standardized to the 2003 study population by sex, age and smoking status, the prevalence of obesity was 16.8% in 1977, 22.7% in 1983, 24.7% in 1993 and 34.5% in 2003, and was much higher than the Canadian national average (16% in 2003).

CONCLUSION

There was a dramatic increase in the prevalence of obesity in rural adults, and this was greater in younger adults. Changes in cigarette smoking did not explain the increase. There is an urgent need to identify and implement effective interventions to slow if not reverse the trend, particularly in rural populations.

Overweight and obesity doubled over a 6-year period in young women living in poverty in Mexico

OBJECTIVE

To document the changes in BMI and the prevalence of overweight and obesity in young women living in poverty in a semi-urban community in Mexico.

METHODS AND PROCEDURES

Women who had previously participated in a longitudinal research study (1997-2000) were re-assessed in 2005. Anthropometric measurements were obtained using standard procedures, and socio-demographic questionnaires were administered. Total and annual rate of change in BMI and change in the prevalence of overweight and obesity (BMI > or = 25.0 and > or =30.0) were estimated.

RESULTS

Mean age in 2005 was 30.0 +/- 5.7 years (n = 683) and time between recruitment and follow-up was 6.4 +/- 1.0 years. Mean change in BMI was +3.6 +/- 2.7 (range -8.2 to +14.6). In 2005, 500 (73.2%) women were overweight, up from 263 (38.5%) in the original assessment. The prevalence of obesity tripled over the follow-up period (from 9.8% to 30.3%). The mean annual rate of change in BMI was +0.6 (+/-0.4). After adjustment for age and parity at baseline, an annual rate of change of BMI above the sample median (>0.5) was associated with lower levels of formal education.

DISCUSSION

The annual increase in the prevalence of overweight and obesity in this sample is double that which was reported at a national level in Mexico. An understanding of the determinants of this rapid increase among the women living in poverty in Mexico is urgently needed.

Overweight and obesity in a rural Amerindian population in Oaxaca, Southern Mexico, 1968-2000

The purpose of this study was to evaluate secular change in the prevalence of overweight and obesity in a rural Zapotec Indian community in southern Mexico between 1968 and 2000. Cross-sectional surveys of children 6-13 years, adolescents 13-17 years, and adults 19 years of age and older resident in a rural community in Oaxaca were conducted in 1968/1971, 1978, and 2000. Individuals present in the 1968, 1978, and 2000 surveys provided a small longitudinal component. Height and weight were measured; the BMI was calculated. International criteria for overweight and obesity were used. Overweight and obesity were virtually absent in school children 6-13 years in 1968 and 1978 and in adolescents in 1978. Small proportions of children (boys, 5%; girls, 8%) and adolescents (boys, 3%; girls, 15%) were overweight in 2000; two children (1%) and no adolescents were obese. Among adults, 7% of males and 19% of females were overweight and <1% of males and 4% of females were obese in 1971/1978, but 46% of males and 47% of females were overweight; and 5% of males and 14% of females were obese in 2000. The trends for children, adolescents, and adults were confirmed in the longitudinal subsamples. In conclusion, overweight and obesity are not presently a major problem in children and adolescents in this rural Zapotec community. Overweight, in particular, and to a lesser extent obesity have increased in prevalence among adults since the late 1970s. The results suggest adulthood as a critical period for onset of overweight and obesity in this sample.

Cardiovascular risk factors in the Mexican population

Chronic degenerative disorders have become a major health problem in Mexico. Cardiovascular diseases represent the first cause of death in our country. Diabetes mellitus (DM) has emerged as the main health problem in Mexico. Its prevalence doubled from < 3% in the 1960s to 6% in the 1980s. Between 1993 and 2000, diabetes mellitus increased from 6.7% to 8.2%, a 22% growth over a seven-year period. In 1995, the cost of the treatment of DM represented 15.48% of the health budget and 0.79% of the GDP. The prevalence of hypertension (HTN) increased from 10% in 1933 to 20% in 1990 and from 23.8% to 30.7% between 1993 and 2000. The expenditures from HTN in 1999 corresponded to 13.9% of the health budget, and 0.71% of GDP. Dyslipidemias are very common. Close to 40% of the population has levels of HDL cholesterol < 35 mg/dL, 24.3% has fasting triglycerides > 200 mg/dL, and 10% has hypercholesterolemia. The prevalence of obesity increased from 21.4% in 1993, to 23.7% in the year 2000. Eight percent of the population has a glomerular filtration rate < 60 mL/min, and 9.1% has proteinuria. Twenty-four percent uses tobacco regularly, and 13% had the habit in the past. Smoking is more frequent among diabetics (34%).In conclusion, cardiovascular risks factors are highly common among the Mexican population and increasing at alarming rates. Preventive programs targeted to decrease their prevalence are urgently needed in Mexico and should become a national priority.

Mexican anthropometric percentiles for ages 10–18

OBJECTIVE

To elaborate Mexican growth charts based on international methodology.

DESIGN

Data were obtained from the Mexican National Health Survey. The survey was stratified and probabilistic representative of all the country.

SETTING

Nationwide open population living in urban and rural areas.

SUBJECTS

Boys (8545) and girls (9983) from 10 to 18 years participating in the survey.

METHODS

Age, weight and height were recorded. Empirical percentiles were calculated and smoothed. Smoothed curves were approximated using least-mean square estimation.

RESULTS

Tables and figures for percentile values of weight, height and body mass index (BMI) for age, as well as percentile values of weight and BMI for height for both genders are presented. Regarding 50th BMI for age percentiles, Mexicans had higher levels than the Americans in the Centers for Disease Control and Prevention growth charts; Mexicans were lower but had similar weights than the Americans. Owing to the high BMI, the percentile corresponding to an overweight level (25 kg/m(2)) at 18 years was 74.5 in boys and 72.5 in girls, whereas obesity level (30 kg/m(2)) at 18 years was 97.3 and 97.4 in boys and girls, respectively.

CONCLUSIONS

The present growth charts are snapshots of a Mexican population. Because of the high median BMI compared to US and World Health Organization standards, we must be cautious in establishing an upper normal cutoff for clinical normality, not merely selecting the 85th and 95th percentiles as equivalents of overweight and obesity, respectively. Therefore, we proposed percentiles 74.5 in boys and 72.5 in girls as the action points of overweight as they are the percentiles corresponding to BMI 25 kg/m(2) at 18 years.

SPONSORSHIP

The survey was supported by the Mexican Minister of Health. Statistical analyses were sponsored by Dr Del-Rio-Navarro.

Prevalence and determinants of stunting and overweight in 3-year-old black South African children residing in the Central Region of Limpopo Province, South Africa

Objectives

To determine the prevalence of stunting, wasting and overweight and their determinants in 3-year-old children in the Central Region of Limpopo Province, South Africa.

Design

Prospective cohort study.

Setting

Rural villages in the Central Region of the Limpopo Province, South Africa.

Subjects

One hundred and sixty-two children who were followed from birth were included in the study. Anthropometric measurements and sociodemographic characteristics of the children were recorded.

Results

Height-for-age Z-scores were low, with a high prevalence of stunting (48%). The children also exhibited a high prevalence of overweight (22%) and obesity (24%). Thirty-one (19%) children were both stuntedandoverweight. Gaining more weight within the first year of life increased the risk of being overweight at 3 years by 2.39 times (95% confidence interval (CI) 1.96–4.18) while having a greater length at 1 year was protective against stunting (odds ratio (OR) 0.41; 95% CI 0.17–0.97). Having a mother as a student increased the risk for stunting at 3 years by 18.21 times (95% CI 9.46–34.74) while having a working mother increased the risk for overweight by 17.87 times (95% CI 8.24–38.78). All these factors also appeared as risks or as being protective in children who were both overweight and stunted, as did living in a household having nine or more persons (OR 5.72; 95% CI 2.7–12.10).

Conclusion

The results of this study highlight the importance of evaluating anthropometric status in terms of both stunting and overweight. Furthermore, it is important to realise the importance of normal length and weight being attained at 1 year of age, since these in turn predict nutritional status at 3 years of age.

Uneven dietary development: linking the policies and processes of globalization with the nutrition transition, obesity and diet-related chronic diseases

In a "nutrition transition", the consumption of foods high in fats and sweeteners is increasing throughout the developing world. The transition, implicated in the rapid rise of obesity and diet-related chronic diseases worldwide, is rooted in the processes of globalization. Globalization affects the nature of agri-food systems, thereby altering the quantity, type, cost and desirability of foods available for consumption. Understanding the links between globalization and the nutrition transition is therefore necessary to help policy makers develop policies, including food policies, for addressing the global burden of chronic disease. While the subject has been much discussed, tracing the specific pathways between globalization and dietary change remains a challenge. To help address this challenge, this paper explores how one of the central mechanisms of globalization, the integration of the global marketplace, is affecting the specific diet patterns. Focusing on middle-income countries, it highlights the importance of three major processes of market integration: (I) production and trade of agricultural goods; (II) foreign direct investment in food processing and retailing; and (III) global food advertising and promotion. The paper reveals how specific policies implemented to advance the globalization agenda account in part for some recent trends in the global diet. Agricultural production and trade policies have enabled more vegetable oil consumption; policies on foreign direct investment have facilitated higher consumption of highly-processed foods, as has global food marketing. These dietary outcomes also reflect the socioeconomic and cultural context in which these policies are operating. An important finding is that the dynamic, competitive forces unleashed as a result of global market integration facilitates not only convergence in consumption habits (as is commonly assumed in the "Coca-Colonization" hypothesis), but adaptation to products targeted at different niche markets. This convergence-divergence duality raises the policy concern that globalization will exacerbate uneven dietary development between rich and poor. As high-income groups in developing countries accrue the benefits of a more dynamic marketplace, lower-income groups may well experience convergence towards poor quality obseogenic diets, as observed in western countries. Global economic policies concerning agriculture, trade, investment and marketing affect what the world eats. They are therefore also global food and health policies. Health policy makers should pay greater attention to these policies in order to address some of the structural causes of obesity and diet-related chronic diseases worldwide, especially among the groups of low socioeconomic status.

Overweight and stunting in migrant Hispanic children in the USA

In order to evaluate the need for preventive interventions to improve nutrition, the BMI/sex/age percentile, height/sex/age percentile, prevalence of stunting, at-risk-for-overweight and overweight in a group of migrant Hispanic children, aged 2-18, in southern New Jersey, USA, was assessed using anthropometric measurements of height, weight and skinfold thickness with reference to the NHANES 1999-2000. Results showed that the frequency of overweight in this sample--20%--exceeds that of the general U.S. pediatric population and equals or exceeds (in 2-5-year olds) that of settled Mexican-Americans. Being born in the U.S. significantly diminished the prevalence of stunting, especially in boys. The children of migrant Hispanic agricultural workers belong to a marginalized, poor and insecure population who are not included in the National Health and Nutrition Examination studies, because of their transience. This is the first anthropometric study to evaluate growth in this population in over 20 years.

The Prevalence of Obesity and its Relationship with Lifestyle Factors in Jamaica

We surveyed the prevalence of obesity in the general population in Jamaica, and examined the relationship between it and lifestyle. The survey population consisted of 1,935 inhabitants in Jamaica, whose body weight, height, marital status, educational history, employment status and other obesity-associated lifestyle factors were surveyed. Six major findings emerged. The first finding is that the proportion of obesity in women was very high, and there was a big gender difference. Secondly, a lower prevalence towards obesity was associated with cohabitation of the subjects in both genders, and higher educational levels in female subjects. Thirdly, the proportion of the subjects who considered their weight to be quite acceptable was higher in the obese/overweight groups in both genders. Fourthly, exercise frequency showed a negative correlation with the body mass index (BMI) in men, and the frequency of exercising was apparently lower in women than in men. Fifthly, as for dietary factors, in both genders vegetables showed a negative correlation with the BMI. Sixthly, non-smokers were also associated with a lower obesity prevalence in men. In conclusions, these findings suggest that social and lifestyle factors such as the educational level, marital status and dietary habits of the general population influence Jamaican obesity.

Obesity and hunger among Mexican-Indian migrant children on the US-Mexico border

BACKGROUND

Although Mexican-Indian migrant workers live under precarious conditions in both Mexico and the USA, they have more access to food than they did in their original communities. The nutritional status and food security among the children of these workers have not been reported.

OBJECTIVE

The purpose of this study was to assess the prevalence of overweight, obesity, undernutrition and hunger among migrant children in a city on the US-Mexico border.

DESIGN

During 2001-2002, a total of 1767 children from six schools from the Tijuana Indian school system was measured to assess anthropometric status. Third and fifth grade children were also interviewed for their perception of hunger experience and dietary intake by 24-h recall method.

RESULTS

The overall prevalence of overweight and obesity was 38%. Abdominal obesity was found in 26% of subjects, while 43% had both obesity and abdominal obesity. The prevalence of undernutrition according to weight-for-age was 1.2%, and by height-for-age it was 4.8%. The prevalence of hunger was 2.5%, and at risk of hunger was 44%. Daily intake of food groups in servings was: 8.7 grains, 1.2 fruit, 1.0 vegetable, 2.1 milk and 2.6 meat. Only one child (0.07%) consumed The Apple of Health recommended portions.

CONCLUSIONS

This study confirmed the coexistence of obesity, hunger, undernutrition and limited food group consumption among Indian children living in a prosperous and the largest US-Mexico border city.

Biocultural aspects of obesity in young Mexican schoolchildren

Obesity related to over-nutrition is investigated in a sample of 219 Mexican children from affluent families, ages 6-12 years. Defined as weight-for-age at or above the 95(th) percentile, obesity rates in middle childhood are very high in this population, being 24.2% of children (29.4% of boys and 19.1% of girls). Binary logistic regression shows that children are more likely to be obese if they are boys, from small households with few or no other children, and have more permissive, less authoritarian parents. Diet at school and activity patterns, including television viewing, are not different for boys and girls and so do not explain this gender variation. The value placed on children, especially sons, in smaller middle-class families, can result in indulgent feeding because food treats are a cultural index of parental caring. Parents also value child fatness as a sign of health. These obese Mexican children have no greater social problems (peer rejection or stigma) or psychological problems (anxiety, depression, or low self esteem) than their non-obese peers. More study specifically focused on feeding practices in the home environment is required to explain very high rates of child obesity. The differences in obesity risk related to specific aspects of children's developmental microniche emphasize the importance of including a focus on gender as a socio-ecological construct in human biological studies of child growth, development, and nutrition.