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OBJECTIVES: Mexico exhibits one of the highest prevalence rates of overweight and obesity globally, accompanied by a surge in non-communicable diseases, which in turn leads to elevated mortality rates. Existing efforts to address rising obesity rates have shown limited effectiveness. Maternal weight, diet, and physical activity (PA) during pregnancy affect the mother's and offspring's health. Despite the importance of establishing and engaging in healthy behaviors during pregnancy, little is known about which factors impact these behaviors among pregnant women in Mexico. This study explored perspectives on factors impacting healthy dietary behaviors and PA in pregnancy from pregnant women and health care professionals in Mexico. METHODS: We conducted semistructured interviews with 11 pregnant women and 12 health care professionals working in prenatal care. Data were analyzed using qualitative content analysis in a stepwise inductive approach. RESULTS: Classifying factors at the 1) individual level, 2) relational level, and 3) health care system level, three overall themes emerged. At the individual level, challenges with lack of time and competing priorities as well as knowledge of healthy dietary behaviors and PA were identified. At the relational level, influencing factors encompassed financial, social, and emotional support along with descriptive norms. At the health care system level, guidelines for PA during pregnancy and the quality of care were noted. CONCLUSIONS: This study identified factors impacting healthy dietary behaviors and PA in pregnancy in Mexico. Important considerations for future interventions include addressing sociocultural norms around healthy dietary behaviors and PA in pregnancy and involving pregnant women's families, closest social networks, and health care professionals working at the prenatal care unit.

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OBJECTIVES: Previous studies have suggested that acute exercise-induced cardiac and kidney damage following ultra-distance running is low in Mexican Tarahumara even though C-reactive protein (CRP) remained elevated 24 hours post-race. We aimed to study if the plasma biomarker, soluble urokinase-type plasminogen activator receptor (suPAR), could replace or complement CRP as a systemic inflammation biomarker in Tarahumara men and women following ultra-distance running. METHODS: Plasma samples were collected pre-race and at three to six different time points post-race in Mexican Tarahumara competing in three independent ultramarathons; men running 78 km (GroupI, n = 9), women running 52 km (GroupII, n = 3), and men running 63 km (GroupIII, n = 10). Baseline anthropometry, blood pressure, glycated hemoglobin, and hemoglobin were measured, aerobic fitness was estimated by submaximal step test, absolute and relative running intensity assessed using combined heart rate and accelerometry. Plasma was collected pre- and post-race to analyze concentrations of suPAR, and-for women only-a panel of inflammatory, cardiac and kidney plasma biomarkers. Mixed-effect models were used to evaluate the effect of ultramarathon running on plasma suPAR concentrations. RESULTS: Compared to pre-race values, suPAR was significantly elevated in plasma <5 minutes after the three ultramarathon races (70%-109% increase of the mean for the three groups). Furthermore, plasma suPAR remained significantly elevated up to 6 hours post-race for all three groups of runners independent of running intensity. CONCLUSIONS: The results suggest that suPAR can complement, but not replace CRP following ultra-distance running in Tarahumara men and women.

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OBJECTIVES: To study the association between physical activity energy expenditure (PAEE) and cardio-respiratory fitness (CRF) with key metabolic traits and anthropometric measures in the Tarahumara of Mexico. METHODS: A cross-sectional study was carried out in five rural communities in Chihuahua, México including 64 adult Tarahumara, mean (SD) age 40.7 (12.9) years. Using a combined accelerometer and heart rate sensor, PAEE was measured over three consecutive days and nights and a sub-maximal step test was carried out in order to (1) calibrate heart rate at the individual level and (2) to estimate CRF. Random blood glucose level and resting blood pressure (BP) were measured with standard anthropometrics. RESULTS: Mean (SD) PAEE was 71.2 (30.3) kJ kg(-1) day(-1) and CRF was 36.6 (6.5) mlO(2) min(-1) kg(-1) . Mean (SD) glucose was 127.9 (32.4) mg/dl, with 3.3% having diabetes. Mean (SD) systolic and diastolic BP was 122 (20.8) and 82 (14.8) mm Hg, respectively, with 28.1% having hypertension. Mean body mass index was 27.5 (4.2) kg m(-2) , with 71.9% being overweight. Following adjustment for age and sex, weak inverse associations were observed between PAEE and systolic BP (ß = -0.20, P = 0.27) and diastolic BP (ß = -0.16, P = 0.23); and between CRF and systolic BP (ß = -0.51, P = 0.14) and diastolic BP (ß = -0.53, P = 0.06). The inverse associations with glucose were also weak and not statistically significant for neither PAEE (ß = -0.01, P = 0.63) nor CRF (ß = -0.05, P = 0.27). CONCLUSIONS: This study suggests high levels of overweight and hypertension in the Tarahumara, and points to fitness and physical activity as potential intervention targets although findings should be confirmed in larger samples.

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