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Castro-Porras LV, Rojas-Martínez R, Romero-Martínez M, Aguilar-Salinas CA, Escamilla-Nuñez C. The Trend in the Prevalence of Diabetes Mellitus in the Mexican Indigenous Population From 2000 to 2018. AJPM FOCUS 2023; 2:100087. [PMID: 37790638 PMCID: PMC10546564 DOI: 10.1016/j.focus.2023.100087] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Introduction Diabetes is a worldwide public health problem. In Mexico, diabetes was the third leading cause of death in the total population in 2020. The indigenous people in Mexico are approximately 6%. This study aims to estimate the trends in diabetes prevalence from 2000 to 2018 in the group of Mexican indigenous language speakers and to analyze the main sociodemographic (e.g., age, educational and socioeconomic level, and the urbanicity of the area of residence) and clinical (e.g., age of diabetes onset, years with diabetes, and BMI) characteristics of this group. Methods This cross-sectional study included participants aged ≥20 years from 4 National Health Surveys, 2000-2018. We presented the analyses for indigenous and nonindigenous strata. Logistic models adjusted were used to estimate the trend of diabetes in the study period. Results We found a significant increase in the prevalence of diabetes in the indigenous group. This trend in the ORs was maintained when adjusting for age, sex, waist circumference, and area of residence. For the study period, the prevalence change in diagnosed diabetes in the indigenous group was greater than that in the nonindigenous group (OR=6.4, 95% CI=4.1, 8.8 and OR=3.3, 95% CI=2.5, 4.1, respectively). We also found a significant prevalence change in undiagnosed diabetes for the indigenous group (OR=7.7, 95% CI=1.3, 14.6). Conclusions In contrast to the results in nonindigenous populations, our main result reveals an increasing probability of being diabetic in the indigenous population from 2006 to 2018. It is necessary to clarify the origin of the accelerated change in diabetes prevalence among the indigenous population in Mexico.
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Affiliation(s)
- Lilia V. Castro-Porras
- Policies, Population and Health Research Center, Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Rosalba Rojas-Martínez
- Reproductive Health Department, Center for Population Health, Instituto Nacional de Salud Publica, Mexico City, Mexico
| | - Martín Romero-Martínez
- Center for Evaluation and Survey Research, Instituto Nacional de Salud Publica, Mexico City, Mexico
| | - Carlos A. Aguilar-Salinas
- Metabolic Diseases Research Unit, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
- Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutrición Salvador Zubiran, Mexico City, Mexico
- Tec Salud, Instituto Tecnológico y de Estudios Superiores de Monterrey, Monterrey, Mexico
| | - Consuelo Escamilla-Nuñez
- Environmental Health Department, Center for Population Health, Instituto Nacional de Salud Publica, Mexico City, Mexico
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Perez-Sastre MA, Ortiz-Hernandez L. Changes in blood pressure according to stature in Mexican adults. Rev Saude Publica 2021; 55:87. [PMID: 34878088 PMCID: PMC8647983 DOI: 10.11606/s1518-8787.20210550032531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 12/09/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE: To determine the possible existence of differences in blood pressure change over time according to stature in Mexican adults. METHODS: We analyzed the National Household Living Standards Survey databases following household members between 2005 and 2009. We selected participants who were between 20 and 40 years old (n = 7,130). We estimated multilevel models with random intercept to analyze differences in blood pressure changes according to stature. We adjusted the models for age, locality size, geographic region, per capita family income, waist-to-height ratio, physical activity, alcohol consumption, smoking, and use of antihypertensive drugs. RESULTS: In both sexes, baseline blood pressure tended to be lower as stature decreased. The differences were maintained in both the crude and adjusted models. In men, the increases in systolic pressure over time tended to be higher as stature increased. CONCLUSIONS: Contrary to what studies observed in high-income countries, in Mexico blood pressure was positively associated with stature.
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Affiliation(s)
- Miguel A Perez-Sastre
- Universidad Nacional Autónoma de México. Programa de Maestría y Doctorado en Ciencias Médicas y Odontológicas y de la Salud. Ciudad de México, México
| | - Luis Ortiz-Hernandez
- Universidad Autónoma Metropolitana unidad Xochimilco. Departamento de Atención a la Salud. Ciudad de México, México
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3
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Garcia-Oropesa EM, Martinez-Lopez YE, Ruiz-Cejudo SM, Martínez-Ezquerro JD, Diaz-Badillo A, Ramirez-Pfeiffer C, Bustamante-Fuentes A, Lopez-Sosa EB, Moctezuma-Chavez OO, Nava-Gonzalez EJ, Perales-Torres AL, Perez-Navarro LM, Rosas-Diaz M, Carter K, Tapia B, Lopez-Alvarenga JC. Looking for Crumbs in the Obesity Forest: Anti-obesity Interventions and Obesity-Associated Cardiometabolic Traits in the Mexican Population. History and Systematic Review With Meta-Analyses. Front Med (Lausanne) 2021; 8:665023. [PMID: 34805192 PMCID: PMC8595206 DOI: 10.3389/fmed.2021.665023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 09/24/2021] [Indexed: 11/30/2022] Open
Abstract
Mexicans and Mexican Americans share culture, genetic background, and predisposition for chronic complications associated with obesity and diabetes making imperative efficacious treatments and prevention. Obesity has been treated for centuries focused-on weight loss while other treatments on associated conditions like gout, diabetes (T2D), and hypertriglyceridemia. To date, there is no systematic review that synthesizes the origin of obesity clinics in Mexico and the efforts to investigate treatments for obesity tested by randomized clinical trials (RCT). We conducted systematic searches in Pubmed, Scopus, and Web of Science to retrieve anti-obesity RCT through 2019 and without an inferior temporal limit. The systematic review included RCT of anti-obesity treatments in the Mexican adult population, covering alternative medicine, pharmacological, nutritional, behavioral, and surgical interventions reporting metabolism-associated traits such as BMI, weight, waist circumference, triglycerides, glucose, among others. Only the studies with at least 3 months of treatment were included in the meta-analyses in order to reduce placebo effects. We found 634 entries, after removal of duplicates and screening the studies based on eligibility criteria, we analyzed 43 national, and 2 multinational-collaborative studies. Most of the national studies had small sample sizes, and the implemented strategies do not have replications in the population. The nutrition/behavioral interventions were difficult to blind, and most studies have medium-to-high risk of bias. Nutritional/behavioral interventions and medications showed effects on BMI, waist circumference, and blood pressure. Simple measures like pure water instead of sweet beverages decrease triglycerides and systolic blood pressure. Dark chocolate showed the highest effect for BMI and high blood pressure, and treatment with insulin increased weight in those with T2D. The study of obesity in Mexico has been on-going for more than four decades, the interest on RCT just increased until this millennium, but with small sample sizes and lack of replication. The interventions affect different cardiometabolic associated traits, which should be analyzed in detail in the population living near the Mexico-U.S. border; therefore, bi-national collaboration is desirable to disentangle the cultural effects on this population's treatment response. Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020221436, identifier: CRD42020221436.
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Affiliation(s)
- Esperanza M Garcia-Oropesa
- Laboratorio de Biología Molecular, Unidad Académica Multidisciplinaria Reynosa Aztlán (UAMRA), Universidad Autónoma de Tamaulipas, Reynosa, Mexico
| | - Yoscelina E Martinez-Lopez
- Programa de Doctorado en Ciencias Médicas y de la Salud, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - Sonia María Ruiz-Cejudo
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Área Envejecimiento (UIESSAE), Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico.,Programa de Maestría y Doctorado en Música, Cognición Musical, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - José Darío Martínez-Ezquerro
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Área Envejecimiento (UIESSAE), Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico.,Centro de Ciencias de la Complejidad (C3), Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - Alvaro Diaz-Badillo
- Department of Human Genetics, School of Medicine, The University of Texas Rio Grande Valley, Edinburg, TX, United States.,Programa de Maestría en Salud Pública, Universidad México-Americana del Norte (UMAN), Reynosa, Mexico
| | - Carlos Ramirez-Pfeiffer
- Programa de Maestría en Salud Pública, Universidad México-Americana del Norte (UMAN), Reynosa, Mexico
| | | | | | | | - Edna J Nava-Gonzalez
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Adriana L Perales-Torres
- Laboratorio de Bromatología, Unidad Académica Multidisciplinaria Reynosa Aztlán (UAMRA), Universidad Autónoma de Tamaulipas Reynosa-Aztlán, Reynosa, Mexico
| | - Lucia M Perez-Navarro
- Servicio de Nefrología, Dirección de Investigación, Hospital General de México Dr. Eduardo Liceaga, Mexico City, Mexico
| | - Marisol Rosas-Diaz
- Laboratorio de Biología Molecular, Unidad Académica Multidisciplinaria Reynosa Aztlán (UAMRA), Universidad Autónoma de Tamaulipas, Reynosa, Mexico
| | - Kathleen Carter
- Research and Education Library of the School of Medicine, Education & Academic Affairs, University of Texas Rio Grande Valley, Edinburg, TX, United States
| | - Beatriz Tapia
- Office of Faculty Affairs and Department of Pediatrics, School of Medicine, The University of Texas Rio Grande Valley, Harlingen, TX, United States
| | - Juan C Lopez-Alvarenga
- Department of Human Genetics, School of Medicine, The University of Texas Rio Grande Valley, Edinburg, TX, United States.,Programa de Maestría en Salud Pública, Universidad México-Americana del Norte (UMAN), Reynosa, Mexico
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Ancira-Moreno M, Monterrubio-Flores E, Hernández-Cordero S, Omaña-Guzmán I, Soloaga I, Torres F, Reyes M, Burrola-Mendez Y, Morales-López A. Incidence of low birth weight in Mexico: A descriptive retrospective study from 2008-2017. PLoS One 2021; 16:e0256518. [PMID: 34506506 PMCID: PMC8432805 DOI: 10.1371/journal.pone.0256518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 08/09/2021] [Indexed: 11/18/2022] Open
Abstract
According to the WHO, low birth weight (LBW) affects 15-20% of newborns worldwide. In Mexico, there are no national, state, nor municipal estimates that inform the country's situation over time. The purpose of this study was to estimate the incidence of LBW at the national, state, and municipal levels from 2008 to 2017, and to estimate the LBW incidence based on maternal sociodemographic characteristics, prenatal care and marginalization indexes at the national level using open national data. We used spatial data analysis to georeferenced LBW incidence at the three levels of geographical disaggregation studied. At the national level, the incidence of LBW increased progressively from 6.2% (2008) to 7.1% (2017), and the country's capital represented the area with the highest incidence. Southeastern and central states reported the highest LBW regional incidence. At the municipal level, the number of municipalities with an incidence of LBW ≥8% increased in both male and female newborns. The incidence of LBW was higher as the marginalization indexes increases. The results from this study may assist in the identification of vulnerable groups and the development of public health programs and policies with an intersectoral approach that improves maternal and child nutrition.
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Affiliation(s)
- Mónica Ancira-Moreno
- Departamento de Salud, Universidad Iberoamericana, Ciudad de México, México
- Observatorio Materno Infantil (OMI), Universidad Iberoamericana, Ciudad de México, México
| | - Eric Monterrubio-Flores
- Observatorio Materno Infantil (OMI), Universidad Iberoamericana, Ciudad de México, México
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Sonia Hernández-Cordero
- Departamento de Salud, Universidad Iberoamericana, Ciudad de México, México
- Observatorio Materno Infantil (OMI), Universidad Iberoamericana, Ciudad de México, México
- Departamento de Salud, Universidad Iberoamericana, Ciudad de México, México
| | - Isabel Omaña-Guzmán
- Observatorio Materno Infantil (OMI), Universidad Iberoamericana, Ciudad de México, México
- Doctorado en Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Mexico City, México
| | - Isidro Soloaga
- Observatorio Materno Infantil (OMI), Universidad Iberoamericana, Ciudad de México, México
- Departamento de Economía y GEOLab-IBERO, Universidad Iberoamericana, Ciudad de México, México
| | - Fabián Torres
- Observatorio Materno Infantil (OMI), Universidad Iberoamericana, Ciudad de México, México
- Centro de Estudios en Computación Avanzada, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Moisés Reyes
- Observatorio Materno Infantil (OMI), Universidad Iberoamericana, Ciudad de México, México
- Departamento de Economía y GEOLab-IBERO, Universidad Iberoamericana, Ciudad de México, México
- GEOLab-IBERO, Universidad Iberoamericana, Ciudad de México, México
| | - Yohali Burrola-Mendez
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
- CHU Sainte-Justine Research Center, Montréal, Québec, Canada
| | - Ariana Morales-López
- Maestría en Nutrición Aplicada, Universidad Iberoamericana, Ciudad de México, México
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Abstract
Background Globally, the prevalence of child stunting has been decreasing over the past decades. However, in low- and middle-income countries such as Mexico, stunting is still the most prevalent form of undernutrition affecting a large number of children in the most vulnerable conditions. Breastfeeding has been identified as one of the key affordable and modifiable maternal health behaviors protecting against child stunting. Objective To examine the association between breastfeeding (defined as never breastfed, any breastfeeding for <6 months, and any breastfeeding for ≥6 months) and other individual-, household-, and area-level factors with child stunting (defined as length/height-for-age-z-score for sex under -2 standard deviations of the World Health Organization child growth standards' median) in Mexico. Methods Secondary data analysis using the 2012 Mexican Health and Nutrition Survey, which allowed representativeness of rural and urban areas at national level and among 4 regions in Mexico. Our subset included data on 2,089 singleton Mexican children aged 6-35 months with information on previously identified risk and protective factors for stunting. We conducted fixed- and mixed-effects logistic regression models sequentially controlling for each level of factors. Findings Overall, 12.3% of children were stunted and 71.1% were breastfed for ≥6 months. Any breastfeeding and being female were consistent protective factors against child stunting across all models. In contrast, child low birthweight, maternal short stature, higher number of children aged <5 years per household, and moderate to severe food insecurity were consistent risk factors for child stunting across all models. Conclusions According to our findings, efforts to reduce child stunting in Mexico should include prenatal strategies aiming to prevent low birthweight offspring particularly among short-stature women, moderate to severe food insecure households, families with a higher number of children aged <5 years, and indigenous communities. Postnatal components should include multilevel strategies to support breastfeeding.
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Vilar-Compte M, Teruel G, Flores D, García-Appendini IC, Ochoa-Lagunas A. A longitudinal study of height gaps among Mexican children: Disparities and social inequity. Soc Sci Med 2020; 264:113388. [PMID: 33011458 PMCID: PMC8343967 DOI: 10.1016/j.socscimed.2020.113388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/04/2020] [Accepted: 09/20/2020] [Indexed: 10/23/2022]
Abstract
RATIONALE Health outcomes such as height are important determinants of social inequities. OBJECTIVE We assess height gaps in Mexico among boys and girls from distinct subpopulation groups over time. METHOD We use longitudinal data from the first three waves of the Mexican Family Life Survey (MxFLS) to analyze children's height differentials by gender and by indigenous and poverty status over 7-10 years. We control for children's characteristics, household factors, and mother's height and use the Blinder-Oaxaca Decomposition method to explain disparities in children's height across the three waves of the MxFLS. RESULTS The main findings suggest that height inequalities among indigenous and extremely poor boys and girls, compared with their non-indigenous and less socioeconomically disadvantaged counterparts, are persistent. The results also reveal that height disparities among girls are consistently greater than those among boys in similar population groups and that height gaps increase over time for girls. CONCLUSIONS These findings indicate the relevance of social and economic determinants on children's growth potential and the need to examine the association of social determinants on health outcomes. They also underscore the necessity to design and implement public policies that consider a gender perspective.
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Affiliation(s)
- Mireya Vilar-Compte
- EQUIDE Research Institute for Equitable Development, Universidad Iberoamericana, Prolongación Paseo de la Reforma 880, Lomas de Santa Fe, Mexico City, 01219, Mexico.
| | - Graciela Teruel
- EQUIDE Research Institute for Equitable Development, Universidad Iberoamericana, Prolongación Paseo de la Reforma 880, Lomas de Santa Fe, Mexico City, 01219, Mexico
| | - Diana Flores
- EQUIDE Research Institute for Equitable Development, Universidad Iberoamericana, Prolongación Paseo de la Reforma 880, Lomas de Santa Fe, Mexico City, 01219, Mexico
| | - Ida C García-Appendini
- EQUIDE Research Institute for Equitable Development, Universidad Iberoamericana, Prolongación Paseo de la Reforma 880, Lomas de Santa Fe, Mexico City, 01219, Mexico
| | - Adriana Ochoa-Lagunas
- EQUIDE Research Institute for Equitable Development, Universidad Iberoamericana, Prolongación Paseo de la Reforma 880, Lomas de Santa Fe, Mexico City, 01219, Mexico
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Roldán E, Grajeda LM, Pérez W. Maternal height associated with cesarean section. A cross-sectional study using the 2014-2015 national maternal-child health survey in Guatemala. Int J Equity Health 2020; 19:95. [PMID: 32731894 PMCID: PMC7393904 DOI: 10.1186/s12939-020-01182-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 04/29/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Socioeconomic status is associated with cesarean section (CS). Maternal height, however, may be another related factor to CS. In Guatemala, a quarter of women between 15 and 49 years of age are shorter than 145 cm. Therefore, this study aims to examine the association of maternal height with cesarean section in Guatemala. METHODS We carried out a secondary analysis study using data from the 2014-15 Guatemalan national maternal and child health survey-9542 mothers aged 15-49 and 12,426 live births were analyzed. We obtained the prevalence ratio of the association between maternal height and CS based on three Poisson regression models. One model included all live births, another the first live birth, and a third model the last live birth. For each model, we accounted for covariates and sampling design. RESULTS The national prevalence of CS was 26.3% (95%CI: 25.0, 27.7). The adjusted prevalence ratio of CS, including all live births, was 1.63 (95%CI: 1.37, 1.94) more likely in mothers shorter than 145 cm compared with those equal or greater than 170 cm. This figure was 1.45 (95%CI: 1.19, 1.76) in the model with the first live birth. In the model with the last birth, maternal height was not associated with CS after accounting for previous CS as one of the covariates. CONCLUSIONS Prevalence of CS in this setting was high and above international recommendations. Further, very short mothers were more likely to experience CS compared to taller mothers after accounting for covariates, except when a previous CS was present. Maternal height should be included in clinical assessments during prenatal care.
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Affiliation(s)
- Evelyn Roldán
- Universidad del Valle de Guatemala, 18 Avenida 11-95 Zona 15 Vista Hermosa III, 01015 Guatemala, Guatemala
| | - Laura M Grajeda
- Universidad del Valle de Guatemala, 18 Avenida 11-95 Zona 15 Vista Hermosa III, 01015 Guatemala, Guatemala
| | - Wilton Pérez
- Universidad del Valle de Guatemala, 18 Avenida 11-95 Zona 15 Vista Hermosa III, 01015 Guatemala, Guatemala
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