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Introduction: Introduction: the combination of cesarean section delivery and limited exposure to full breastfeeding (FBF) in the first six months of life may increase the risk of obesity and diabetes mellitus. This study aimed to establish an association between type 2 diabetes mellitus (T2DM) in adulthood, cesarean section delivery and incomplete full breastfeeding (FBF) in individuals from the metropolitan area of Guadalajara, Mexico. Methodology: this analytical cross-sectional study included patients over 18 years of age with T2DM and normal weight, overweight or obesity, regardless of sex. Informed consent was obtained. Variables encompassed T2DM, type of delivery method, first-year diet, family history, demographic, socioeconomic, and educational characteristics, and anthropometric measurements. For statistical analysis, Student's t test, chi-square tests and odds ratios were employed. Results: the study evaluated 218 patients with an average age of 57.8 years (± 12.7) and an average age at T2DM diagnosis of 46.2 years (± 12.5). FBF (65.6 %) and partial breastfeeding (PBF) (23.8 %) prevailed in the first six months. The average age at T2DM diagnosis was 46.7 years (± 12.1) for vaginally born patients and 30.7 years (± 15.5) for cesarean-born patients (p = 0.001). Cesarean delivery increased obesity risk by nine times in patients with T2DM [OR = 8.9 (CI, 1.05, 75.2), p = 0.02]. Conclusion: prioritizing the limitation of nonmedically justified cesarean section deliveries is crucial to mitigate the risk of obesity and T2DM in adulthood. .

Background/objectives: Neck circumference (NC) has been proposed as a simple measurement to identify patients with overweight and obesity. It has been found that adipose tissue at the cervical level is associated with the presence of metabolic alterations. The aim of this study was to estimate the association between NC and indicators of Metabolic Syndrome (MS) to subsequently estimate its capacity to identify the risk of MS compared to waist circumference (WC) and Body Mass Index (BMI)., Methods: A cross-sectional study was carried out with a sample of 286 children 6-9 years old who attended six public primary schools in Jalisco, Mexico. Pearson's correlation coefficients along with sensitivity and specificity tests were performed to analyze the relationship between NC and MS indicators. Odds ratio (OR) and concordance analyses were performed considering the Kappa index., Results: NC showed statistically significant correlations with all MS indicators except for LDL cholesterol and total cholesterol. The cut-off points of NC to identify MS according to sex was >27.4 cm for girls and >29.8 cm for boys. The association of NC with values above the cutoff point and the presence of MS was OR: 21.6 (CI: 7.11-65.74)., Conclusions: NC represents a simple and cost-effective alternative to identify children at risk of MS when compared to BMI and WC.

Background: Neck circumference (NC) has been proposed as an indicator of upper trunk adiposity and a potential indicator of metabolic risk. The objective was to evaluate NC and its correlation with body fat percentage (BF%) and other indicators of adiposity in children with normal weight, overweight, and obesity., Methods: In a cross-sectional study, 112 children 5 to 10 years of age were included in the outpatient clinic from a public hospital. Measures of weight and height to calculate BMI (kg/m 2 ), NC, mid-upper arm circumference, waist circumference, and tricipital skinfold thickness. Body composition measurements were performed using an electrical bioimpedance device (BIA). The relationship between anthropometric variables and BF% obtained by BIA was determined using Spearman correlation tests. Multivariate models were constructed with BF% as the dependent variable and anthropometric parameters as independent., Results: In the entire group, there was a direct correlation between NC and BF% (r = 0.50, p < 0.001), but lost statistical significance in the case of normal weight. The relationship maintained its significance in subjects from the overweight and obesity groups. In multivariate models, BMI exhibited the highest correlation with BF%, followed by waist circumference and mid-upper arm circumference; for NC, the R 2 value was 0.30 ( p < 0.001)., Conclusions: Neck circumference is useful in the screening of population groups with the advantage of not requiring any specialized instruments for its measurement other than a tape measure. BMI and waist circumference were the best indicators of general and central adiposity, respectively.

Introduction: Background: infants receiving full breastfeeding (FBF) regulate their appetites differently from those receiving human milk substitutes (HMS). In addition, early exposure to the dietary cholesterol in human milk could lead to better cholesterol regulation in later stages of life. Therefore, the purpose was to compare lipid profiles in 4-month-old infants and to correlate lipid profile with anthropometric indicators and appetite-regulating hormones according to the type of feeding. Methods: this was a cross-sectional and correlational study, which included 145 mother-infant dyads according to the type of feeding; 64 received FBF, 47 partial breastfeeding (PBF), and 34 HMS. The complete lipid profile, total ghrelin, leptin, peptide YY, and glucagon-like peptide type 1 were measured. Z-scores for weight/age, length/age, weight/length, triceps (TSF) and subscapular folds (SSF) and body mass index for age were also obtained. Results: there were significant differences in triglycerides and LDL cholesterol according to the type of feeding. In the HMS group, an inverse relationship was observed between ghrelin and triglycerides (p = 0.038), ghrelin and total cholesterol (TC) (p = 0.026), and peptide YY and HDL cholesterol (p = 0.017). In the PBF group, a direct relationship was observed between length/age (z) and triglycerides (p = 0.001) and between subscapular folds and TC (p = 0.049). In infants receiving HMS, a direct correlation was observed between weight/age (z) and TC (p = 0.045) and between length/age (z) and LDL cholesterol (p = 0.010). Conclusion: these findings show a relationship between growth, energy reserve, lipid profile, and modulation of appetite-regulating hormones according to the type of feeding they received.

Objective: To review the available evidence on the early introduction of allergenic foods and the possible protection in the development of food allergy in later stages., Methods: An exploratory review of randomized clinical trials whose study population included infants less than 6 months of age at enrollment with or without a diagnosis of food allergy was conducted. For the purposes of this review, eggs, peanuts, and wheat were included as potentially allergenic foods. The following databases were consulted: Medline, EBSCO, OVID, Science Direct and JSTOR (Journal Storage), Scielo, LILACS, Redalyc and Imbiomed from August to December 2021., Results: 429 articles were identified, 412 were excluded, and the final analysis included 9 studies that met the inclusion criteria. Six trials correspond to allergy to eggs, two to peanuts and one to wheat. The age of introduction differs in all trials. The earliest exposure was at 3.5 months and the latest at 5.5 months. The reduction in the risk of developing food allergy occurred in children at risk of allergy. Adverse reactions were common, particularly with the introduction of egg., Conclusions: We found no evidence that early introduction (< 6 months of age) of allergenic foods reduces the risk of developing food allergy in infants without risk factors.

Objective: To assess whether automated office blood pressure (BP) (AOBP) measurement is a better method for measuring BP in the office than conventional techniques and an alternative to out-of-office BP measurements: home-self BP (HSBP) or ambulatory BP monitoring (ABPM)., Methods: We conducted a cross-sectional study of 74 patients and compared AOBP with the conventional technique using a mercury sphygmomanometer and with both out-to-office BP measurements: HSBP of 7 days (three measurements in the morning, afternoon, and night) and daytime ABPM. In addition, we compared BP values obtained using HSBP and ABPM to determine their level of agreement. We used ANOVA to compare means, Bland-Altman, and intraclass correlation coefficients (ICC) for concordance., Results: BP values obtained by the two office methods were similar: conventional 147.2/85.0 mmHg and AOBP 146.0/85.5 mmHg ( P > 0.05) with good agreement (ICC 0.85). The mean SBP differences between AOBP and HSBP ( P < 0.001) and between AOBP and ABPM ( P < 0.001) were 8.6/13.0 mmHg with limits of agreement of -21.2 to 38.5 and -18.4 to 44.3 mmHg, respectively. The average SBP values obtained by HSBP were 4.3 mmHg higher than those obtained by ABPM ( P < 0.01)., Conclusion: Our study showed good agreement and concordance between the two office methods as well between the two out-to-office methods, although there was a significant difference in the mean SBP between the HSBP and ABPM. Moreover, AOBP was not comparable to either HSBP or ABPM; therefore, the estimation of out-to-office BP using AOBP is not supported., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Background: There is a possibility that excess body fat affects bone mass gain and may compromise skeletal health in obese children. The purpose of the study was to identify the relationship between bone mineral density (BMD) and body composition in normal weight, overweight and obese children., Methods: This was a cross-sectional study of 6- to 11-year-old children who attended the hospital's outpatient clinic. They were apparently healthy and had no history of prematurity, low birth weight, or chronic diseases. Body mass index (BMI) was used to identify subjects as normal weight, overweight or obese. BMD and body composition were assessed by dual energy X-ray absorptiometry. The BMD values (total and lumbar spine) were compared between normal weight, overweight and obese children. Correlation coefficients were calculated, and multivariate models were performed., Results: Forty-nine children were included: 16 with normal weight, 15 that were overweight and 18 with obesity; the mean age was 8.4 ± 1.7 years. All the participants had a normal BMD (> - 2 SD). BMD was higher in obese children and had a positive correlation with total and trunk lean mass in the three study groups (p < 0.001). In obese children, an inverse correlation of lumbar spine BMD (Z score) with total and trunk fat mass (p < 0.05) was identified. In the multivariate models (with the whole group), the total lean mass was the only significant variable that explained BMD variability., Conclusions: BMD in obese children was higher than that in normal weight children, which is explained by their greater lean mass and not by excess body fat. In obese children, a higher fat mass was related to a lower lumbar spine BMD. Lean mass had a direct correlation with BMD in the three study groups and was the most important predictor of BMD, reflecting the importance of strengthening the muscular system through performing physical activity and practicing a healthy lifestyle., (© 2022. The Author(s).)

Background: It has been pointed out that ghrelin and obestatin could have an impact on the genesis of obesity, since they estimulate and inhibit apetite and, therefore, food consumption., Objective: To compare the metabolic profile, lipid profile and the concentrations of ghrelin and obestatin in children with normal weight or obesity., Material and Methods: Cross-sectional design with 97 normal weight or obese children, 6 to 18 years of age, who did not present systemic diseases. The serum concentrations of glucose, insulin, total cholesterol, triglycerides, high (HDL), low (LDL) and very low density (VLDL) lipoproteins, aspartate aminotransferase (AST), alanine aminotransferase (ALT), ghrelin and obestatin were determined. Descriptive statistics were performed. Student's t test was used to compare groups, and correlation coefficients of ghrelin and obestatin values with biochemical and anthropometric variables. A p value of ≤ 0.05 was significant., Results: 55 children with normal weight and 42 with obesity were included; mean age was 10.7 years. Triglycerides, LDL, VLDL, ALT and insulin were higher, and HDL lower in obese children (p < 0.05). Ghrelin values were higher in normal weight children (p < 0.05), and there was no difference in obestatin values., Conclusions: The lower concentration of ghrelin in obese children may indicate a negative feedback to regulate energy consumption. Children and adolescents with obesity show metabolic and lipid profile alterations that place them at risk of early development of cardiovascular risk factors., (© 2022 Revista Medica del Instituto Mexicano del Seguro Social.)

The Child Eating Behaviour Questionnaire (CEBQ) and the Adult Eating Behaviour Questionnaire (AEBQ) measure 'food approach' [Food responsiveness (FR); Emotional overeating (EOE); Enjoyment of food (EF); Desire to Drink] and 'food avoidant' [Satiety responsiveness (SR); Emotional undereating (EUE); Food fussiness (FF); Slowness in eating (SE)] appetitive traits (ATs) in children and adults, respectively. 'Food approach' traits predispose to overweight while 'food avoidance' traits provide protection, but little is known about the relationships between parents' and their offspring's ATs. The aim was to examine the associations between maternal and child appetitive traits, using the AEBQ-Esp and CEBQ-Mex adapted for use in Mexican populations. Sociodemographic data, weights and heights of mothers and their children (aged 3-13 years), who were recruited from a teaching hospital in Guadalajara, Mexico, were measured. Mothers completed both the AEBQ-Esp and the CEBQ-Mex. The CEBQ-Mex was developed, and its reliability was tested using Cronbach's alpha and Omega, and Confirmatory Factor Analysis (CFA) was used to assess its validity. Pearson's correlation coefficients were used to assess associations between mothers' and children's Ats. The sample included 842 mother-child dyads (mother's mean age = 34.8±SD6.9 years, BMI 29.7±6.1 kg/m2; children's mean age = 8.5 ±SD2.5 years, BMIz 1.5±1.6). Internal reliability was moderate to high [Cronbach alpha = .68-.86; Omega = .71-.87] for the CEBQ-Mex and validity was confirmed for an 8-factor model through CFA [RMSEA = 0.065; CFI = 0.840, NFI = 0.805; IFI = 0.842; and χ2(df = 532) = 2939.51, p < 0.001]. All but one of the children's appetitive traits showed small to moderate, significant correlations with their mother's counterpart [FR (r = .22; p<001); EOE (r = .30; p < .001); EF (r = .15; < .001); SR (r = .16; p < .001); EUE (r = .34; p < .001) and FF (r = .14; p < .001). Only SE was not significantly associated with maternal SE (r = .01; p>.05). ATs tend to run in families, signalling the intergenerational transmission of eating behaviours. These may be useful targets for family-wide interventions to support the development and maintenance of healthy eating behaviours in childhood., Competing Interests: The authors declare that they have no competing interests.

Purpose: Appetitive traits in adults and their associations with weight can be measured using the Adult Eating Behaviour Questionnaire (AEBQ). The aim of this study was to confirm the factor structure of the Spanish AEBQ (AEBQ-Esp) in a Mexican sample and explore associations between the eight traits with body mass index (BMI)., Method: A sample of 1023 adults, mean age of 36.8 ± 12.8 years, was recruited from Guadalajara, Mexico. Researchers weighed and measured participants, and they completed the AEBQ-Esp either online or in paper format and reported sociodemographic data. To test two alternative factor structures (eight factors including Hunger; seven factors excluding Hunger), confirmatory factor analysis (CFA) was used. Internal reliability was assessed using Cronbach's alpha; test-retest reliability was assessed using intra-class correlation coefficients. Multivariate linear regressions were used to test for associations between the AEBQ subscales and BMI, adjusted for age, sex, format of AEBQ responses, education, marital and employment status., Results: A seven-factor structure was the best model fit using CFA, excluding the Hunger subscale but similar to the original AEBQ. Internal reliability was good for all subscales (Cronbach's α = 0.70-0.86), and the intra-class correlation coefficient (0.70-0.91) reflected good test-retest reliability. In the fully adjusted models, Satiety Responsiveness [β = - 0.61; (- 1.01, - 0.21)] and Slowness in Eating [β = - 0.70; (- 1.01, - 0.39)] were negatively associated with BMI, and Emotional Over-Eating [β = 0.94; (0.62, 1.27)] was positively associated with BMI., Conclusions: The AEBQ-Esp (excluding Hunger) appears to be a valid and reliable psychometric questionnaire for measuring appetitive traits in a Mexican Spanish-speaking population. Some traits appear to be associated with BMI in adulthood and warrant further exploration., Level of Evidence: Level III evidence obtained from well-designed cohort or case-control analytic studies. Although this was just an observational study, it was well designed and provided new evidence., (© 2021. The Author(s).)

La creciente epidemia de obesidad ha sido uno de los retos más importantes de salud pública en México durante los últimos años. Con apoyo de la Federación Mundial de Obesidad, en 2021 formamos un grupo de profesionales para identificar y resumir las acciones prioritarias en las que puede enfocarse nuestro país para hacer frente a esta epidemia. Al proceso de desarrollo y discusión de este grupo se sumaron más de 1 000 profesionales de la salud para retomar recomendaciones de documentos y guías de alto nivel previamente publicados. En conmemoración del Día Mundial de la Obesidad, en este 2022 se presenta esta postura como insumo para el desarrollo de acciones en el ámbito profesional y de los diferentes sectores, en la que se incluyen 10 recomendaciones de acción, desde la perspectiva poblacional hasta la atención individualizada, y se enfatiza en la importancia de la participación social, de las intervenciones integrales con visión centrada en la persona y de la sostenibilidad planetaria, además de mejorar la educación y las campañas de difusión, propiciar un ambiente promotor de entornos activos y blindar de conflictos de interés los esfuerzos de prevención y control. La postura hace un llamado para abordar la obesidad de manera seria, con base en la evidencia científica, oportuna e integral, con enfoque de curso de vida, de forma ética y sensible, y sin perpetuar las barreras del estigma de peso en la sociedad.