Search

Apheresis allows the collection of specific blood components but changes serum calcium (Ca), magnesium (Mg), copper (Cu), zinc (Zn), and hormones involved in bone metabolism due to citrate infusion. We assessed the effect of oral supplementation of calcium, vitamin D, and minerals as pills or an enriched diet before plateletpheresis donation on levels of divalent cations, hormones, and bone turnover markers that may prevent metabolic changes. Methods: Non-randomized controlled study including 134 donors. Serum parathyroid hormone (PTH), Ca, Mg, Zn, Cu, osteocalcin (OC), vitamin D, and type-1 collagen C-terminal telopeptide (CTX-1) levels were measured at baseline and post-procedure. Donors were divided into four groups: supplemented with calcium carbonate and vitamin D (cal + vitd); those receiving calcium, minerals, and vitamin D (cal + vitd + min); those receiving a calcium-rich diet (diet) and a control group (control). Results: PTH levels increased >1-fold, whereas tCa, tMg, Zn, Cu, iCa, iMg, and vitamin D levels decreased immediately after apheresis amongst donors of any group; when these levels were measured two weeks later, donors in the calcium-vitd and cal + vitd + min groups returned to basal values; donors in the cal + vitd + min group were the only group that kept their levels of OC and CTX unchanged at the different study times. Conclusions: Bone turnover markers changes induced by plateletpheresis may be minimized with oral supplementation of calcium, minerals, and vitamin D two days before the procedures.

Pregnant adolescents’ diet and eating habits are inadequate; however, their association with gestational weight gain (GWG) is uncertain. We aimed to analyze whether there is an association between dietary and nutrient intake and eating habits with GWG among pregnant adolescents and their offspring’s birth weight. A longitudinal study was performed with 530 participants. We assessed GWG and applied several tools, such as a food frequency questionnaire and 24-h recall, to obtain dietary and nutrient intake and eating habits. The birth weight of adolescents’ offspring was registered. Later, we performed crude and adjusted Poisson models. The mean age was 15.8 ± 1.3 years. Of all food groups, the lowest frequency of adequate intake corresponded to vegetables (7%) and legumes (10.2%). Excessive (36.8%) and insufficient (40.9%) GWG were observed. Pregnant adolescents with inadequate legumes intake increased the probability of excessive GWG: (PR 1.86 95% CI 1.00–3.44). Cereals and grains were positively associated with GWG: (PR 1.65, 95% CI 1.18–2.29). Energy, macronutrient intake, and eating habits were not associated with GWG. Offspring’s small gestational age (SGA) increased when pregnant adolescents had inadequate sugar-sweetened beverages intake: PR (1.58, 95% CI 1.01–2.49) and when pregnant adolescent watched television (TV). In our sample of Mexican adolescents, dietary and nutrient intake and eating habits were inadequate. Excessive dietary intake from cereals, grains, and animal-sourced foods along with insufficient legumes were associated with excessive GWG. Watching TV while adolescents ate was associated with the birth weight of the offspring.

The Estrogen Metabolites (2-hydroxyestrogens: 16α-hydroxyestrone) Urine Ratio (EMUR) has been negatively associated with breast cancer; Mexican women have a lower EMUR than other populations. We evaluated the effectiveness of 3,3'-diindolylmethane (DIM) supplementation on increasing EMUR in premenopausal women. A randomized, double-blind clinical trial (NCT02525159 at ClinicalTrial.gov) was carried out on 60 women with an EMUR below 0.9. Patients were assigned randomly to receive a placebo or 75 mg of DIM a day (administered as 300 mg of DIM-BR®) for 30 day. Urine samples were obtained at baseline, at 30 day of supplementation, and 30 day after finishing supplementation. A Mann-Whitney U test was used to compare the EMUR; an ANOVA was used to analyze differences in body composition. EMUR was analyzed using ESTRAMET™ kits. While DIM-treated subjects did not increase their EMUR at 30 day of supplementation (

Gastrointestinal functional disorders are characterized by abnormalities in motility with visceral hypersensitivity, representing a global public health problem. We aimed to determine whether eating habits, lifestyle characteristics, and body mass index (BMI) are associated with gastrointestinal health risk. The Gastrointestinal Health (GIH) test of the World Gastroenterology Organization (WGO) and the Roma IV criteria were applied. We obtained information on food consumption habits and aerobic exercise, among other variables. Not exercising regularly, drinking water and eating vegetables less than recommended, having high body weight, and taking symptomatic medication were variables that explained 73% of the probabilities of not having good GIH (R2 = 0.734). According to Rome IV criteria, women had a 50% higher risk than men of having functional bowel disorder (RR 1.6, 95% CI: 1.04, 2.45). Among the men studied, eating few or no vegetables and drinking less than 1 L of water daily was more frequent; however, the women had significantly more intestinal symptoms. In addition, constipation was higher among women than men (p = 0.020). All of the above explains the prognostic value of eating habits and the importance of paying attention to body weight to reduce the risk of gastrointestinal disease.

Introducción: la calidad de vida (CV) es importante en profesionales de la salud, en especial en el personal de enfermería que labora en áreas críticas, ya que ésta depende no sólo de factores físicos, mentales y sociales, sino también laborales, que surgen del contacto diario con pacientes. Objetivo: determinar la CV de los profesionales de enfermería que laboran en áreas críticas en una institución de tercer nivel de atención. Material y métodos: estudio observacional transversal realizado en una institución de tercer nivel, con una n de 73 profesionales de enfermería. Se aplicaron dos cuestionarios internacionalmente validados: WHOQOL-BREF, que valora 4 dominios; y PROQOL-IV, evalúa 3 dominios. El análisis se realizó con las pruebas t-student y ANOVA para comparar los puntajes de la CV con las características sociodemográficas y laborales. Resultados: el 85% de los participantes fueron mujeres. El rango de edad más frecuente de 40-49 años (43%). El puntaje más alto en el WHOQOL-BREF el dominio de salud psicológica y el menor puntaje el de ambiente. En el PROQOL-IV, 40% de participantes tuvieron riesgo de padecer desgaste por empatía de los cuales 83% son mujeres, 15% no está satisfecho al realizar su trabajo y 19% tiene riesgo de padecer burnout. Conclusiones: la CV del personal de enfermería podría determinarse como buena, excepto el dominio desgaste por empatía (PROQOL-IV). Se sugiere continuar estudiando estas variables para poder realizar intervenciones que ayuden a mejorar su CV.

During pregnancy, adolescents experience physiological changes different from adults because they have not concluded their physical growth. Therefore, maternal and neonatal outcomes may not be the same. This paper aimed to analyze the association between pregestational BMI (pBMI) and gestational weight gain (GWG) with maternal and neonatal outcomes in adolescent and adult pregnant women. The authors performed an observational study that included 1112 women, where 52.6% (n = 585) were adolescents. Sociodemographic information, pBMI, GWG, neonatal anthropometric measures, and maternal and neonatal outcomes were obtained. Adolescent women had a mean lower (21.4 vs. 26.2, p ≤ 0.001) pBMI than adults and a higher gestational weight gain (12.3 vs. 10.7 kg, p ≤ 0.001). According to Poisson regression models, gestational diabetes is positively associated with insufficient GWG and with pregestational obesity. Furthermore, the probability of developing pregnancy-induced hypertension increased with pBMI of obesity compared to normal weight. Preeclampsia, anemia, and preterm birth were not associated with GWG. Insufficient GWG was a risk factor, and being overweight was a protective factor for low birth weight and small for gestational age. We conclude that pBMI, GWG, and age group were associated only with gestational diabetes and low birth weight.

Background: Vitamin D (VD) deficiency has been inversely associated with parathyroid hormone (PTH) levels in the adult population but not in children and adolescents. This study aimed to report VD concentration and its correlation with PTH levels in a sample of healthy Mexican children. Methods: We conducted a cross-sectional study with 275 healthy Mexican subjects aged 2 to 17 years to estimate the status of 25-(OH)-D and its correlation with PTH levels. The 25-(OH)-D levels were estimated by liquid chromatography-tandem mass spectrometry and PTH by radioimmunoassay. Results: Subjects were categorized as young children (2 to 5 years), school children (6 to 10 years), and adolescents (11 to 17 years). The median concentration of 25-(OH)-D in young children was 27.4 ng/ml; in school children, 25.6 ng/ml; and adolescents, 24.7 ng/ml. VD levels < 20 ng/ml were found in only 10.5% of the participants. Only 3% of the young children showed VD deficiency, in contrast to 10% of school children and 21% of adolescents (p ≤ 0.05). PTH was found within normal ranges in 95.6% ofthe studied population. VD levels < 20 mg/dl were found in 25.8% of children with overweight or obesity (p = 0.009).Conclusions: VD levels < 20 ng/ml were observed in 10% of the studied group, but this percentage increased with age:21% of the adolescents showed VD levels < 20 ng/ml. No correlation with PTH levels was found. The VD values reported inthis study are lower than those previously reported in Mexican children.

Disordered eating behaviors (DEBs) and adolescent pregnancy are public health problems. Among adolescents, there is little evidence concerning the relationship of DEB with gestational weight gain (GWG) and the birth weight and length of their offspring. We aimed to determine the association between DEB with GWG and the weight and length of adolescents’ offspring. We conducted a study with 379 participants. To evaluate DEB, we applied a validated scale. We identified three factors from DEB by factorial analysis: restrictive, compensatory, and binge–purge behaviors. The main events were GWG and offspring’s birth weight and length. We performed linear regression models. We found that 50% of adolescents have at least one DEB. Excessive and insufficient GWG were 37 and 34%, respectively. The median GWG was 13 kg, adolescents with restrictive behaviors had higher GWG (13 vs. 12 kg, p = 0.023). After adjusting for pregestational body mass index and other covariables, the restrictive (β = 0.67, p = 0.039), compensatory (β = 0.65, p = 0.044), and binge–purge behaviors (β = 0.54, p = 0.013) were associated with higher GWG. We did not find an association between the birth weight and length of newborns with DEB, and suggest that DEB is associated with GWG but not with the birth weight or length of the offspring.

University students, as young adults, are at risk for Body Dissatisfaction (BD) and Distorted Body Image (DBI), which are related to Disordered Eating Behaviors (DEBs). This study aimed to assess changes in the prevalence of these three conditions over six years; and the associations between them. Data was collected through an annual online survey from 2017 to 2022 at a private university in Mexico City. Students between 18–30 years old were invited to participate. Body image-related variables were assessed by the Stunkard’s Silhouettes and Body Mass Index, by self-reported height and weight. Disordered Eating Behaviors were measured by the Brief Disordered Eating Behaviors Questionnaire. A median of 250 students participated per year, with a median age of 21 years old. The prevalence was 63.5–71.7% for BD, 40.4–49.1% for DBI, and 25–38.3% for DEBs. DEBs and BD showed associations during the whole period (OR from 3.6 to 15.9, p ≤ 0.001); as well as DBI with DEBs (OR from 1.9 to 3.3, p < 0.05). Alterations in Body Image and eating behaviors are common conditions, mainly in women and in the young population. Therefore, it is important to promote screening for these conditions, as they usually remain undiagnosed, their prevalence is increasing worldwide, and their impact on physical and mental health has already been acknowledged.

Pregnancy is a stage in a woman&rsquo, s life when she is more open to receiving health advice, especially related to diet. However, women are often caught between receiving scientifically unfounded myths and concrete empirical knowledge. Culturally perpetuated myths may be acted upon more than knowledge, but research on these concepts, especially in the Americas, is scarce. This cross-sectional study aimed to describe the frequency of diet and nutrition myths and knowledge and describe the associated factors in pregnant mothers receiving care in Mexico City. A total of 695 pregnant adults and 322 pregnant adolescents participated in this study, in which they responded to a questionnaire on nutrition and diet myths, knowledge, and practice during pregnancy and breastfeeding. The myths were examined individually, but for the purposes of statistical analysis, a score was obtained. We compared means of variables that could be associated to myth and knowledge scores, then calculated linear and logistical regressions. Forty-six percent of participants had below the mean myth scores. Ninety-two percent of participants had a knowledge score below the mean. Age (&beta, = 0.025, SE 0.007, 95% CI 0.011&ndash, 0.040, p = 0.001) and years of education (&beta, = 0.166, SE 0.024, 95% CI 0.119&ndash, 0.213, p = 0.001) explained the myth&rsquo, s score, while age explained the knowledge score (&beta, = 0.011, SE 0.020, 95% CI &minus, 0.032&ndash, &minus, 0.008, p = 0.002). We found that although most women reported not believing in the myths, they acted on them. The probability of practicing such myths as &ldquo, You must eat for two during pregnancy&rdquo, was associated with being an adolescent (OR 1.76, p = 0.001) and being married (OR 1.47, p = 0.007), &ldquo, Not satisfying cravings leave a mark on the infant&rsquo, s body&rdquo, with being adolescent (OR 1.59, p = 0.003) and low socioeconomic level (OR 1.41, p = 0.038), &ldquo, A frightened or angry mother should not nurse her baby&rdquo, with being adult (OR 2.61, p = 0.004), and &ldquo, Drinking atole or beer enhances breast milk production&rdquo, with being single (OR 2.07, p = 0.001). The probability of not acting on some knowledge was associated with being an adolescent (p &le, 0.003) and having a high school education or below (p &le, 0.046). Almost all of our participants held at least one myth about nutrition and diet during pregnancy and breastfeeding, younger participants showed a higher frequency of holding myths. Years of schooling and age were associated with acting on myths and not acting on correct knowledge.

Objetivo: identificar o risco de desenvolvimento de diabetes tipo 2 em enfermeiras e sua relação com as alterações metabólicas. Método: estudo transversal, com 155 enfermeiras. As variáveis investigadas foram: sociodemográficas, índice de massa corporal, a circunferência da cintura, índice cintura-quadril, perfil lipídico, a glicemia basal e a curva oral de tolerância à glicose. Para a coleta de dados utilizou-se o Finnish Diabetes Risk Score. Resultados: Das 155 (100%) enfermeiras, a média de idade foi de 44 anos e 85% apresentavam sobrepeso ou obesidade; 52% tinham história familiar de diabetes e 21%, hiperglicemia ocasional. Em relação ao risco, 59% foram identificados com risco moderado e muito alto de diabetes tipo 2. A glicose, a insulina, a hemoglobina glicosilada A1c e a resistência à insulina aumentaram paralelamente ao aumento do risco de diabetes tipo 2, embora os lipídios não tenham aumentado. 27% das participantes apresentaram glicemia em jejum alterada, 15%, intolerância à glicose e 5%, diabetes tipo 2. Conclusão: houve uma elevada taxa de detecção de risco de diabetes tipo 2 (59%) e a pontuação de risco alto e muito alto foi associado com níveis elevados de hemoglobina glicosilada A1c, glicose, insulina e resistência à insulina, mas não com lipídios. Objective: to detect the risk of development of type 2 diabetes in nurses and its relationship with metabolic alterations. Method: cross-sectional study, with 155 nurses. The variables investigated were: sociodemographic, body mass index, waist circumference, waist-hip index, lipid profile, basal glycemia and oral glucose tolerance curve. The Finnish Diabetes Risk Score was used to collect data. Results: 155 nurses were included, with an average age of 44 years and 85% were overweight or obese. 52% had a family history of diabetes and 21% had occasional hyperglycemia. With respect to the risk, 59% were identified with moderate and very high risk for type 2 diabetes. Glucose, insulin, glycosylated hemoglobin A1c and insulin resistance increased in parallel to the increased risk for type 2 diabetes, although lipids did not increase. 27% of the sample had impaired fasting glycemia. 15% had glucose intolerance and 5% had type 2 diabetes. Conclusion: there was a high detection rate of people at risk for type 2 diabetes (59%) and the high and very high risk score was associated with high levels of glycosylated hemoglobin A1c, glucose, insulin and insulin resistance, but not with lipids. Objetivo: identificar el riesgo de desarrollo de diabetes tipo 2 en enfermeras y su relación con alteraciones metabólicas. Método: estudio transversal, con 155 enfermeras. Las variables investigadas fueron: sociodemográficas, el índice de masa corporal, circunferencia de cintura, índice cintura-cadera, perfil de lípidos, glucemia basal y curva de tolerancia oral a la glucosa. Para la recolección de datos se utilizó el Finnish Diabetes Risk Score. Resultados: De las 155 enfermeras, la edad promedio fue 44 años y 85% tenía sobrepeso u obesidad. El 52% tenía antecedentes familiares de diabetes de primera línea, el 21% hiperglucemia ocasional. Con relación al riesgo, se identificaron 59% con riesgo de diabetes tipo 2 moderado y muy alto. Glucosa, insulina, hemoglobina glucosa A1c y la resistencia a la insulina incrementaron paralelos al aumento del riesgo de diabetes tipo 2, aunque los lípidos no. El 27% de las enfermeras presentó glucemia basal alterada. El 15% tuvo intolerancia a la glucosa y 5% diabetes tipo 2. Conclusión: la detección de riesgo de diabetes tipo 2 fue elevada (59%) y el puntaje de riesgo alto y muy alto se relacionó con valores mayores de hemoglobina glucosa A1c, glucosa, insulina y resistencia a la insulina pero no con lípidos.

Skipping breakfast might have an impact on cognitive functions, such as interference, which is a basic capacity of executive functions that denotes the possibility of controlling an automated response. This study aimed to analyze the association between nutritional quality of breakfast and cognitive interference in a sample of university students. A cross-sectional study was conducted, a total of 422 students between 18 and 25 years participated. Cognitive interference was assessed with the Stroop Test. Breakfast was assessed with a questionnaire assigning a score for each serving of each food group that was consumed. Logistic regression models were performed. The performance in cognitive tasks was slower in those who had a poor breakfast (32.9 &plusmn, 6 vs 29.3 &plusmn, 6 s, p &lt, 0.050). Poor cognitive interference was greater in students with poor breakfast (53% versus 23%, p = 0.001). A slower word reading was associated with skipping vegetables (OR: 2.78, 95% CI: 0.09&ndash, 2.13), and cereals (OR: 1.70, 95% CI: 1.03&ndash, 2.81). Wrong color identification was associated with skipping fruits (OR: 1.55, 95% CI: 1.43&ndash, 1.99) and animal protein sources (OR: 1.63, 95% CI: 1.07&ndash, 2.49). Skipping fat-rich cereals was a protector factor (OR: 0.55, 95% CI: 0.36&ndash, 0.85). Difficulty in the ability to inhibit interference was associated with skipping vegetables (OR: 2.72, 95% CI: 1.25&ndash, 4.80) and cereals (OR: 2.65, 95% CI: 1.28&ndash, 4.68). The nutritional quality of breakfast was associated with the time spent answering the Stroop test, but not with cognitive interference.

Adolescent pregnancy rates are high worldwide. However, insufficient information exists regarding the frequency of birth control methods used before the first pregnancy and postpartum. In the current study, we analyzed the association of sociodemographic factors with the knowledge of birth control methods and their use before and after pregnancy in a sample of adolescents in Mexico City. A cohort study was conducted on 600 pregnant adolescents in Mexico City, from 2013 to 2017, at a health care institution providing prenatal care. Participants were assessed during the second trimester and four months postpartum. The questionnaire explored the knowledge of birth control methods, their use, and other associated factors. Two logistic regression models were implemented to identify potential variables associated with the lack of birth control method use before and after pregnancy. The mean age of participants was 15.4 + 1 years, of which, 48% and 65.2% used a birth control method before pregnancy and postpartum, respectively. We found that the main factors associated with increased risk of not using any birth control method before pregnancy included being under the age of 15 years, school dropout, having an educational lag, initiation of sexual life before the age of 15, and having a mother who did not inform their child about contraceptives. By contrast, variables associated with a higher risk of not using any contraceptive methods after pregnancy included educational lag, lower level of education, and the fact that the adolescent had not used any birth control prior to the pregnancy.

It has been proposed that, in the Mexican culture, family support can be a factor that contributes to protect the maternal and child health of pregnant adolescents. There may be complex associations between family support and the circumstances of a pregnancy during adolescence. The aim of the study was to analyze the association between the family support network (FSN) characteristic and the maternal and neonatal outcomes in Mexican adolescents. A cross-sectional study was conducted, and 352 pregnant adolescents participated, their FSN during pregnancy was assessed. The gestational weight gain and birth weight/length of newborns were registered. The size of the FSN was described and divided into quartiles, the main members for each quartile were identified. Then, sociodemographic and clinical variables were compared by FSN quartiles. Logistic regression models were performed to assess the association of FSN size and pregnancy and neonatal outcomes. Our results indicate that the mean age was 15 &plusmn, 1 year old. The primary support member in the FSN was the mother of the adolescent in each quartile, except for quartile 3, where the primary support was the mother-in-law. In quartile 3 there was a significantly lower gestational weight gain compared to quartile 4 (11.8 &plusmn, 5 vs. 13 &plusmn, 5 kg, p = 0.054). According to the regression model, a higher risk of small for gestational age (OR 2.99, CI 95% 1.25&ndash, 7.15) newborns was found in quartile 3. We conclude that the maternal and neonatal outcomes did not differ between quartiles of FSN size, except for quartile 3. Small for gestational age newborns were observed when a non-blood relative was present in the FSN. The quality rather than the network size might be more important for improving pregnancy outcomes.

Introduction: Institute of Medicine gestational weight gain recommendations are based on body mass index (BMI) status using adult cut-off points for women of all ages, even though adolescents have specific criteria, like WHO and CDC, so adolescents can receive inadequate weight gain recommendations. Objectives: To estimate the proportion of classification disparity between the three criteria (WHO, CDC and IOM) of pre-pregnancy BMI status; and to analyze neonatal outcomes according to weight gain recommendation based on pre-pregnancy BMI using the three criteria. Methods: Follow-up study in pregnant adolescents 12–19 years. Sociodemographic, anthropometric and pregnancy data were obtained. Percentage of pre-pregnancy BMI classification disparity was calculated between three criteria. Gestational weight gain was categorized in adequate, low and high according to IOM. Regression models were used to analyze negative neonatal outcomes. Results: 601 pregnant adolescents were included, mean age was 16±1.4 years. For pre-pregnancy BMI classification, 28.5% had classification disparity using IOM vs WHO, and 14% when comparing IOM vs CDC. Greater classification disparity was observed as BMI increased. When using WHO categories, a high weight gain was associated with increased risk of having a low birth weight baby (OR: 1.91, CI95%: 1.03–3.53). For CDC criteria, a low weight gain was associated with increased risk of having a preterm baby (OR: 2.65; CI95%: 1.16–6.08) and a high weight gain was associated with low birth weight (OR: 2.10; CI95%: 1.10–4.01). For IOM criteria, a weight gain either low or high were associated with increased risk of low birth weight and preterm birth. Conclusion: There is pre-pregnancy BMI classification disparity using criteria for adolescents compared to adult criteria. Nevertheless, with WHO and CDC only a high gestational weight gain was a risk for negative neonatal outcome. It is important to have a BMI classification system for adolescents that better predicts neonatal outcomes.

Nurses are at risk of having burnout due to workload and job stress&mdash, studies have reported that chronic stress is associated with metabolic syndrome. This study aimed to assess the association between burnout and metabolic syndrome in a sample of female nurses. Data were collected from a cross-sectional study from 2016 to 2018 in a tertiary hospital in Mexico City. All nurses that work in the hospital were invited to participate. Information pertaining to sociodemographic (age, education level), work (labor seniority, service area, shift work), anthropometric (weight, waist circumference, blood pressure) and biochemical (glucose, serum lipids) variables were collected. Burnout was assessed using the Maslach Burnout Inventory test, and metabolic syndrome was defined according to the International Diabetes Federation criteria. A total of 168 nurses participated with a median age of 44 years. The prevalence of burnout and metabolic syndrome was 19.6% and 38.7%, respectively. There was no association between burnout and metabolic syndrome (p = 0.373). However, associations of emotional exhaustion (aOR: 14.95, 95% CI: 1.5&ndash, 148.7), personal accomplishment (aOR: 0.13, 95% CI: 0.01&ndash, 0.99), and night shift (aOR: 12.39, 95% CI: 1.02&ndash, 150.5) with increased waist circumference were found. Strategies are needed to prevent burnout and metabolic syndrome in nurses, especially in those who work at night shift.

Nutrition research has traditionally promoted a nutrient-based approach; however, to evaluate population compliance with dietary recommendations, researchers have increasingly used dietary pattern analysis.To assess the relationship between dietary patterns and vitamin D and calcium intake in an adult Mexican population.We characterized the dietary patterns of 8,456 men and women aged 20-80 years who were participating in the Health Workers Cohort Study. Information on participants' sociodemographic conditions and physical activity was collected via self-administered questionnaires. A food frequency questionnaire was used to assess diet. In a cross-sectional analysis, we examined dietary patterns in relation to vitamin D and calcium consumption.Factor analysis revealed 3 major dietary patterns. Pattern 1, labeled as "prudent pattern", was characterized by high positive loads for the consumption of fresh vegetables, fresh fruits, whole grains, oils, and legumes. The second dietary pattern, named as "dairy and fish pattern", was positively correlated with intake of dairy foods, fish and other seafood, milk and whole grains. Finally, dietary pattern 3 was associated with higher intake of red meat, soft drinks, fats, eggs, white meat and alcoholic beverages. Of these, the "dairy and fish pattern" was positively and significantly associated with vitamin D and calcium consumption (r = 0.42, p0.001; and r = 0.20, p0.001 respectively). Conversely, the third dietary pattern was negatively associated with vitamin D and calcium intake (r = -0.28, p0.001; and r = -0.41, p0.001, respectively).In summary, our findings show that dietary patterns represented by high consumption of milk, dairy products, whole grains, fish are associated with higher consumption of vitamin D and calcium in Mexican adult population. Additionally, our results highlight the importance of following an appropriate dietary pattern to achieve adequate consumption of nutrients.

Introduction: Nutrition research has traditionally promoted a nutrient-based approach; however, to evaluate population compliance with dietary recommendations, researchers have increasingly used dietary pattern analysis. Objective: To assess the relationship between dietary patterns and vitamin D and calcium intake in an adult Mexican population. Methods: We characterized the dietary patterns of 8,456 men and women aged 20-80 years who were participating in the Health Workers Cohort Study. Information on participants' sociodemographic conditions and physical activity was collected via self-administered questionnaires. A food frequency questionnaire was used to assess diet. In a cross-sectional analysis, we examined dietary patterns in relation to vitamin D and calcium consumption. Results: Factor analysis revealed 3 major dietary patterns. Pattern 1, labeled as "prudent pattern", was characterized by high positive loads for the consumption of fresh vegetables, fresh fruits, whole grains, oils, and legumes. The second dietary pattern, named as "dairy and fish pattern", was positively correlated with intake of dairy foods, fish and other seafood, milk and whole grains. Finally, dietary pattern 3 was associated with higher intake of red meat, soft drinks, fats, eggs, white meat and alcoholic beverages. Of these, the "dairy and fish pattern" was positively and significantly associated with vitamin D and calcium consumption (r = 0.42, p < 0.001; and r = 0.20, p < 0.001 respectively). Conversely, the third dietary pattern was negatively associated with vitamin D and calcium intake (r = -0.28, p < 0.001; and r = -0.41, p < 0.001, respectively). Conclusions: In summary, our findings show that dietary patterns represented by high consumption of milk, dairy products, whole grains, fish are associated with higher consumption of vitamin D and calcium in Mexican adult population. Additionally, our results highlight the importance of following an appropriate dietary pattern to achieve adequate consumption of nutrients. Introducción: tradicionalmente, la investigación en nutrición ha promovido un abordaje basado en el análisis de nutrimentos; sin embargo, más recientemente el análisis de patrones dietarios ha sido ampliamente utilizado para evaluar el apego de la población a las recomendaciones dietéticas. Objetivo: evaluar la asociación entre los patrones dietarios y el consumo de calcio y vitamina D en población adulta mexicana. Métodos: se derivaron patrones dietarios de 8.456 hombres y mujeres de 20-80 años de edad participantes de la Cohorte de Trabajadores de la Salud. La información sociodemográfica y de actividad física fue recolectada mediante cuestionarios autoadministrados. Para evaluar la información dietética, se utilizó un cuestionario de frecuencia de consumo de alimentos. Resultados: mediante análisis factorial se derivaron tres patrones dietarios. El patrón 1, etiquetado como "patrón prudente", estuvo caracterizado por alto consumo de verduras frescas, frutas frescas, granos integrales, aceites y leguminosas. El segundo patrón, denominado "patrón de lácteos y pescado", fue positivamente correlacionado con ingesta de productos lácteos, pescado, leche y granos integrales. Finalmente, el tercer patrón dietario se asoció con alta ingesta de carnes rojas, bebidas azucaradas, grasas, huevos, pan blanco y bebidas alcohólicas. El patrón de lácteos y pescado se asoció positivamente con el consumo de vitamina D y calcio (r = 0,42, p < 0,001; r = 0,20, p < 0,001, respectivamente). Por último, el tercer patrón se asoció inversamente con el consumo de vitamina D y calcio (r = -0,28, p < 0,001; r = -0,41, p < 0,001 respectivamente). Conclusión: nuestros hallazgos muestran que el patrón representado por un alto consumo de leche, productos lácteos, granos enteros y pescado está asociado con un mayor consumo de vitamina D y calcio en población adulta mexicana. Adicionalmente, nuestros resultados resaltan la importancia de seguir un patrón dietario apropiado para lograr un adecuado consumo de nutrientes.

A sample of 585 healthy subjects 14 years and older was studied to estimate the status of 25-hydroxyvitamin D (25(OH)D) and its correlation with parathyroid hormone in healthy Mexicans. In 43.6 % of the sample, levels of vitamin D were below 20 ng/mL and showed an inverse relationship with parathyroid hormone (PTH; p 0.01).The purpose of the present study was to estimate the status of 25-hydroxyvitamin D (25(OH)D) and its correlation with parathyroid hormone in healthy Mexicans.A cross-sectional study of 585 healthy subjects 14 years and older was carried out. A questionnaire including all relevant demographics, medical history, and lifestyle factors was applied by trained interviewers. Morning fasting blood was collected in all subjects for estimation of 25(OH)D using liquid chromatography-tandem mass spectrometry and PTH hormone-intact molecule by RIA.Of the group of 585 subjects, 54.1 % were women; the sample was divided in three age groups (14-29, 30-50, and51). Only 9.6 % of the total sample had levels of 25(OH)D above 30 ng/mL; 46.8 % were between 20 and 29 ng/mL, and 43.6 % were below 20 ng/mL. Regarding PTH, a three-phase model was identified using regression smoothing scatterplot (LOESS), with two thresholds of 25(OH)D of 19 and 29 ng/mL. Phase 1 (25(OH)D19 ng/mL) showed an inverse relationship with PTH (p 0.01); phases 2 and 3 showed no significant relationship.Our results show that 43.6 % of the Mexicans in this study have deficient concentration levels of vitamin D. The cutoff point of 20 ng/mL of 25(OH)D established by the Institute of Medicine has a biological and statistically significant relationship with PTH levels in the Mexican population, independently of principal confounding factors. Like many other countries, Mexico could be included in the global epidemic of hypovitaminosis D.

Different sources were used to estimate the 2010 health care costs of managing low bone density (osteopenia/osteoporosis) plus caring fragility fractures in Mexico at 411 million USD. Figures are projected to rise 42 % by 2020. Preventive and timely interventions are required to decrease the financial burden of these entities.Osteopenia, osteoporosis, and fragility fractures (FF) are a public health concern. The study purpose was to estimate the health care costs of these conditions in Mexico during 2010 and project them to 2015 and 2020.Prevalence of osteopenia and osteoporosis was derived from international data. The Mexican version of FRAX® algorithm was used to assess risk for a major FF (hip, clinical spine, forearm, and proximal humerus) in osteopenic and osteoporotic population aged over 40 years. The estimates were applied to national demographic projections. Only direct medical costs composed by routine non-pharmacological management of osteopenia/osteoporosis besides the costs owing to medical care of major FF were considered into the analysis. Resource use for managing osteopenia/osteoporosis was defined from local sources (clinical practice guidelines, published literature, and expert opinion); unit costs were gathered from official lists. Costs for medical care of FF were based on diagnosis-related groups.In population aged ≥40 years, prevalence of osteopenia and osteoporosis in 2010 was 32.8 and 8 %, respectively. A total of 75,763 FF occurred that year. Costs of managing osteopenia and osteoporosis were 154.9 million USD, whereas medical costs due to FF reached 256.2 million USD. Therefore, the annual health care costs of these entities in 2010 were 411 million USD. Total costs will be 19.2 % higher in 2015, and by 2020, the figures will have increased by 41.7 %.Low bone density entails substantial epidemiological and financial burden in Mexico, and their impact will grow considerably during the next years.

To examine trends in the rate of stillbirths at or after 21 weeks' gestation in Mexico from 2000 to 2013, identify factors associated with stillbirths and estimate subnational variability in stillbirth rates and the proportion of deaths occurring intrapartum.This population-based, ecological study involved data from a national database on 263 475 stillbirths in 29 Mexican states and maternal sociodemographic factors. Subnational variability in the stillbirth rate in 2012 was investigated and stillbirths in 2013 were categorized as intrapartum or antepartum according to the fetus' skin condition.The national stillbirth rate declined from 9.2 to 7.2 per 1000 births between 2000 and 2013 (i.e. -1.9% per year). The prevalence of stillbirths varied 3.9-fold between states. Stillbirths were associated, in particular, with: residence in Mexico City (odds ratio, OR: 1.71; 95% confidence interval, CI: 1.68-1.73) or central Mexico (OR: 1.36; 95% CI: 1.34-1.38); maternal education of 9 years or less (OR:1.10; 95% CI: 1.08-1.11) or 10 to 12 years (OR: 1.16; 95% CI: 1.14-1.18); mothers younger than 15 years (OR: 1.64; 95% CI: 1.55-1.72) or older than 34 years (OR: 1.68; 95% CI: 1.66-1.70); and male fetal sex (OR: 1.20; 95% CI: 1.19-1.21). Overall, 51% (7348/14 344) of fetal deaths occurred intrapartum.In Mexico, the total stillbirth rate declined between 2000 and 2013, however geographical variations were observed. Stillbirths were associated with sociodemographic factors. The proportion of intrapartum stillbirths was relatively high, suggesting that health system performance could be improved, especially at places of delivery.Examiner les tendances relatives au taux de mortinatalité à 21 semaines de grossesse ou plus au Mexique de 2000 à 2013, identifier les facteurs associés à la mortinatalité et estimer la variabilité infranationale du taux de mortinatalité ainsi que la proportion de décès survenus per-partum.Cette étude écologique en population a utilisé des données issues d'une base de données nationale qui recensait 263 475 mortinaissances survenues dans 29 États mexicains ainsi que les facteurs sociodémographiques des mères. Nous avons analysé la variabilité infranationale du taux de mortinatalité en 2012 et classé les mortinaissances de 2013 en mortinaissances survenues per-partum ou ante-partum suivant l'état de la peau du fœtus.Le taux de mortinatalité national est passé de 9,2 à 7,2 pour 1000 naissances entre 2000 et 2013 (soit -1,9% par an). La prévalence des mortinaissances variait de l'ordre de 1 à 3,9 selon les États. La mortinatalité était notamment associée au fait de vivre dans la ville de Mexico (rapport des cotes, RC: 1,71; intervalle de confiance (IC) de 95%: 1,68-1,73) ou dans le centre du Mexique (RC: 1,36; IC 95%: 1,34–1,38), à une durée d'instruction des mères de 9 années ou moins (RC: 1,10; IC 95%: 1,08–1,11) ou de 10 à 12 années (RC: 1,16; IC 95%: 1,14-1,18), à l’âge des mères, de moins de 15 ans (RC: 1,64; IC 95%: 1,55-1,72) ou de plus de 34 ans (RC: 1,68; IC 95%: 1,66–1,70) et au sexe masculin du fœtus (RC: 1,20; IC 95%: 1,19-1,21). Sur l'ensemble des morts fœtales, 51% (7348/14 344) étaient survenues per-partum.Au Mexique, le taux de mortinatalité total a baissé entre 2000 et 2013, cependant, des variations géographiques ont été observées. La mortinatalité était associée à des facteurs sociodémographiques. La proportion de mortinaissances survenues per-partum était relativement élevée, ce qui laisse penser que les performances du système de santé pourraient être améliorées, en particulier dans les lieux d'accouchement.Examinar las tendencias de las tasas de mortalidad fetal a partir de las 21 semanas de gestación en México desde 2000 hasta 2013, identificar los factores relacionados con las muertes fetales y calcular la variabilidad subnacional de las tasas de mortalidad fetal, así como el porcentaje de muertes fetales durante el parto.Este estudio ecológico basado en la población incluyó información de una base de datos nacional de 263 475 muertes fetales de 29 estados mexicanos y factores maternos sociodemográficos. Se investigó la variabilidad subnacional de la tasa de mortalidad fetal en 2012, y en 2013 se categorizó a las muertes fetales según si el feto había fallecido durante el parto o antes del parto, de acuerdo a las características de la piel del feto.La tasa de mortalidad fetal nacional descendió de un 9,2 a un 7,2 por cada 1 000 nacimientos entre 2000 y 2013 (es decir, -1,9% anual). La prevalencia de muertes fetales varió hasta 3,9 veces entre los estados. En concreto, las muertes fetales se relacionaron con: residencia en la Ciudad de México (razón de momios RM: 1,71; intervalo de confianza, IC, del 95%: 1,68–1,73) o centro de México (RM: 1,36; IC del 95%: 1,34–1,38); educación de la madre de 9 años o menos (RM: 1,10; IC del 95%: 1,08–1,11) o de entre 10 y 12 años (RM: 1,16; IC del 95%: 1,14–1,18); madres menores de 15 años (RM: 1,64; IC del 95%: 1,55–1,72) o mayores de 34 años (RM: 1,68; IC del 95%: 1,66–1,70); y fetos de sexo masculino (RM: 1,20; IC del 95%: 1,19–1,21). En términos generales, el 51% (7 348/14 344) de muertes fetales tuvieron lugar durante el parto.En México, la tasa total de mortalidad fetal descendió entre 2000 y 2013, aunque se observaron variaciones geográficas. Las muertes fetales se relacionaron con factores sociodemográficos. El porcentaje de muertes fetales durante el parto fue relativamente alto, lo que sugiere que es necesario mejorar el rendimiento del sistema sanitario, especialmente en las salas de parto.دراسة النزعات السائدة في معدل وفيات الرضّع المبكرة في عمر 21 أسبوعًا من الحمل أو بعده في المكسيك في الفترة من عام 2000 إلى عام 2013، وتحديد العوامل المرتبطة بوفيات الرضّع المبكرة وتقدير التغيرات الثانوية في معدلات وفيات الرضّع المبكرة ونسبة الوفيات التي تحدث أثناء الولادة.تضمنت الدراسة البيئية القائمة على السكان بيانات واردة من قاعدة البيانات الوطنية بشأن 263475 حالة وفاة مبكرة للرضّع في 29 ولاية مكسيكية والعوامل الاجتماعية والديموغرافية للأمهات. وتم التحري عن التغيرات الثانوية في معدل وفيات الرضّع المبكرة في عام 2012 كما تم تصنيف وفيات الرضّع المبكرة في عام 2013 لوفيات تحدث أثناء الولادة أو في الفترة السابقة للولادة وفقًا لحالة جلد الجنين.انخفض المعدل الوطني لوفيات الرضّع المبكرة من 9.2 إلى 7.2 لكل 1000 حالة ولادة في الفترة بين عامي 2000 و2013 (أي 1.9‏% سنويًا). وتباين معدل انتشار وفيات الرضّع المبكرة أضعاف ذلك بنسبة 3.9 ما بين الولايات. ارتبطت وفيات الرضّع المبكرة خاصة بما يلي: الإقامة في مدينة مكسيكو سيتي (نسبة الاحتمال: 1.71؛ بنسبة أرجحية مقدارها ‏95‏%: 1.68–1.73) أو منتصف المكسيك (نسبة الاحتمال: 1.36؛ ونسبة أرجحية مقدارها ‏‏95‏%: 1.34–1.38)؛ وتثقيف الأمهات لمدة 9 سنوات أو أقل (نسبة الاحتمال: 1.10؛ ونسبة أرجحية مقدارها 95‏%: 1.08–1.11) أو 10 إلى 12 سنة (نسبة الاحتمال: 1.16؛ ونسبة أرجحية مقدارها ‏‏95‏%: 1.14–1.18)؛ الأمهات الأصغر من 15 سنة (نسبة الاحتمال: 1.64؛ ونسبة أرجحية مقدارها ‏‏95‏%: 1.55–1.72) أو أكبر من 34 سنة (نسبة الاحتمال: 1.68؛ ونسبة أرجحية مقدارها ‏‏95‏%: 1.66–1.70)؛ وجنس الجنين الذكر (نسبة الاحتمال: 1.20؛ ونسبة أرجحية مقدارها ‏95‏‏%: 1.19–1.21). وبوجه عام، حدثت وفيات الأجنة بنسبة ‏51% (7348/14344) أثناء الولادة.انخفض المعدل الإجمالي لوفيات الرضّع المبكرة في المكسيك في الفترة بين عامي 2000 و2013 ولكن لوحظت اختلافات جغرافية. ارتبطت وفيات الرضّع المبكرة بالعوامل الاجتماعية والديموغرافية. كانت نسبة وفيات الرضّع المبكرة أثناء الولادة مرتفعة نسبيًا، مما يوحي بأنه من الممكن تحسين أداء النظام الصحي وخاصة في أماكن إنجاب الأطفال调查墨西哥 2000 年至 2013 年从第怀孕 21 周起出现死产率的趋势，确定与死产相关的因素并评估死产率的分区差异性以及胎儿产间死亡的比例。.这项基于人口的生态学研究包括来自国家数据库中 29 个墨西哥行政区 263 475 例死产数据以及产妇的社会人口因素。调查了 2012 年死产的地方性差异，并且根据胎儿的皮肤状况，将 2013 年的死产以产间或产前进行分类。.2000 年到 2013 年，全国每 1000 例出生死产率从 9.2 下降到了 7.2（即，每年 1.9%）。死产的普遍性在各州之间的差异是 3.9 倍。死产尤其与以下因素相关：居住在墨西哥城（比值比，OR: 1.71；95% 置信区间，CI: 1.68–1.73）或墨西哥中部 (OR: 1.36; 95% CI: 1.34–1.38)；母亲接受 9 年或少于 9 年的教育 (OR: 1.10; 95% CI: 1.08–1.11) 或 10 到 12 年的教育 (OR: 1.16; 95% CI: 1.14–1.18)；母亲小于 15 岁 (OR: 1.64; 95% CI: 1.55–1.72) 或大于34岁(OR: 1.68; 95% CI: 1.66–1.70)；男胎 (OR: 1.20; 95% CI: 1.19–1.21)。总体来说，胎儿产间死亡的比例为 51% (7348/14 344)。.2000 年至 2013 年，墨西哥的总死产率有所下降，然而地区性差异仍然值得注意。 死产与社会人口因素有关。产时死胎的比例相对较高，这表明卫生系统绩效有待改进，特别是在分娩的地方。.Проанализировать тенденции изменений коэффициента мертворождаемости на 21 неделе гестации (или позднее) в Мексике за период с 2000 по 2013 год, определить факторы, обуславливающие мертворождения, и измерить вариацию коэффициентов мертворождаемости на субнациональном уровне и долю интранатальных смертей.В ходе этого популяционного экологического исследования использовались данные из национальной базы данных по 263 475 случаям мертворождения, произошедшим в 29 мексиканских штатах, и социально-демографическим факторам, определяющим состояние здоровья матерей. Была изучена вариация коэффициента мертворождаемости на субнациональном уровне в 2012 году, а мертворождения в 2013 году были отнесены к категории интранатальных или антенатальных мертворождений в зависимости от состояния кожи плода.Национальный коэффициент мертворождаемости снизился с 9,2 до 7,2 на 1000 рождений за период между 2000 и 2013 годами (т. е. −1,9% в год). Между штатами было выявлено 3,9-кратное различие в доле мертворождений. В частности, было установлено, что вероятность мертворождения была выше, если мать проживала в городе Мехико (отношение шансов, ОШ: 1,71; 95%-й доверительный интервал, ДИ: 1,68–1,73) или в центральной части Мексики (ОШ: 1,36; 95%-й ДИ: 1,34–1,38), если продолжительность ее обучения не превышала 9 лет (ОШ: 1,10; 95%-й ДИ: 1,08–1,11) или составляла 10–12 лет (ОШ: 1,16; 95%-й ДИ: 1,14–1,18), если возраст матери был младше 15 лет (ОШ: 1,64; 95%-й ДИ: 1,55–1,72) или старше 34 лет (ОШ: 1,68; 95%-й ДИ: 1,66–1,70) и если плод был мужского пола (ОШ: 1,20; 95%-й ДИ: 1,19–1,21). В целом в 51% (7348 из 14 344) случаев гибель плода происходила интранатально.В Мексике общий коэффициент мертворождаемости снизился за период с 2000 по 2013 год, однако это снижение различалось в зависимости от географического расположения. Мертворождения были обусловлены социально-демографическими факторами. Доля интранатальных мертворождений была относительно высокой, из чего можно заключить, что эффективность системы здравоохранения может быть увеличена, особенно в местах проведения родов.

Background. The Latin American region is undergoing a demographic and epidemiological transition, which is leading to an increase in chronic and degenerative diseases. Osteoporosis (OP) and fragility fractures (FF) are emerging as main causes of disease burden with great impact on health institutions. Purpose. This review article provides an updated overview of trends in the epidemiology and economic impact of OP and FF, as well as in diagnosis and available treatments in Latin America, including calcium, vitamin D and prevention programs. Methods. Expert panel. Conclusions. According to this review, there is a lack of epidemiological and economic information in the region. It is desirable to obtain information regarding quality of life in OP and FF as well as to highlight prevention as a tool to reduce FF.