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The 2023 Mexican Healthy and Sustainable Dietary Guidelines (HSDG 2023) were developed to include all dimensions of sustainability. Here we compare the environmental impact and cost of diets based on the HSDG 2023, current diets and the Mexican-adapted EAT healthy reference diet. Diets following HSDG 2023 are 21% less expensive, require 30% less land to be produced and have 34% less carbon emissions than current diets-particularly in Mexico City and other urban areas with higher prevalence of Westernized diets. This is driven by reduced animal-source food, especially red meat, and ultra-processed foods. In south-rural areas, the water footprint and cost of diets following HSDG 2023 were higher than those of current diets owing to increased intake of nuts, fruits and vegetables not offset by lower meat consumption (which is already close to recommendations). Diet environmental impact and cost could be further reduced with the Mexican-adapted EAT healthy reference diet compared with the HSDG 2023.
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Política Nutricional , Humanos , México , Dieta/economia , Dieta Saudável/economia , Meio Ambiente , Carne/economia , Conservação dos Recursos Naturais/economia , VerdurasRESUMO
Introduction: Introduction: most studies that analyze the relationship between diet quality and obesity have a cross-sectional design; an alternative with repeated cross-sectional data is a pseudo-panel design. Objective: to estimate the association between trends in dietary patterns, defined by a diet quality index, and body mass index (BMI) of Mexican adults between 2006 and 2016. Methodology: a pseudo-panel analysis was performed using data from cross-sectional surveys: National Health and Nutrition Surveys of Mexico (ENSANUTs) 2006 and 2012 and the Midway National Health and Nutrition Survey 2016 (ENSANUTMC). Cohorts (n = 108) were constructed by grouping adults 20-59 years old by sex (men n = 6,081 and women n = 11,404), education level, and year of birth. The association between diet quality (defined with the Healthy Eating Index-2015) and BMI was estimated using a fixed effects model, adjusting for sociodemographic characteristics. Results: a one-point increase in the proportion of women with high diet quality was associated with 4.1 points lower BMI (p = 0.014) compared with women with low diet quality when excluding sub-reporters of energy, the same association is observed when physical activity is included in the model. No association was found between diet quality and BMI in men, possibly because of the existence of latent classes within sociodemographic strata, therefore diet qualiy is inversely associated with BMI only in some categories of sociodemographic strata. Conclusions: these results contribute to the evidence in the longitudinal analysis between diet and BMI, highlighting the importance of differentiating the population by sex and sociodemographic characteristics. These results are input for public policy creation that promotes improving the quality of the population's diet as part of multisectoral strategies to reduce overweight and obesity in Mexican adults.
Introducción: Introducción: muchos estudios que analizan la relación entre calidad de la dieta y obesidad son transversales; una alternativa con datos transversales repetidos es el diseño de pseudopanel. Objetivo: estimar la asociación entre patrones alimentarios definidos mediante un índice de calidad de la dieta y el índice de masa corporal (IMC) en adultos mexicanos entre 2006 y 2016. Metodología: se realizó un análisis de pseudopanel utilizando datos de las Encuestas Nacionales de Salud y Nutrición de México (ENSANUTs) de 2006 y 2012 y la Encuesta Nacional de Salud y Nutrición de medio camino de 2016 (ENSANUTMC). Se construyeron cohortes (n = 108) agrupando datos de adultos entre 20 y 59 años, por sexo (hombres n = 6,081, mujeres n = 11,404), nivel de escolaridad y año de nacimiento. La asociación entre calidad de la dieta (definida mediante el Índice de Calidad de la Dieta 2015) y el IMC se estimó con un modelo de efectos fijos, ajustado por características sociodemográficas. Resultados: un aumento de 1 punto en la proporción de mujeres con calidad de dieta alta se asoció con 4,1 puntos menos de IMC (p = 0,014) comparado con las mujeres con calidad de dieta baja; al excluir a las subreportadoras de energía, la misma asociación se observó incluyendo la actividad física al modelo. No se encontró asociación entre calidad de dieta e IMC en los hombres, posiblemente debido a la existencia de subgrupos dentro de los estratos sociodemográficos, lo cual hace que la calidad de la dieta esté inversamente asociada al IMC solo en algunas categorías de los estratos. Conclusiones: estos resultados contribuyen a la evidencia longitudinal entre dieta e IMC, destacando la importancia de estratificar por sexo y características sociodemográficas. Los resultados son un ínsumo para crear políticas públicas que promuevan mejorar la calidad de la dieta como parte de estrategias multisectoriales para disminuir el sobrepeso y la obesidad en los adultos mexicanos.
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Índice de Massa Corporal , Dieta , Inquéritos Nutricionais , Obesidade , Humanos , Adulto , México , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Transversais , Adulto Jovem , Obesidade/epidemiologiaRESUMO
BACKGROUND: Avocado contains numerous vitamins, minerals, and phytochemicals that can contribute to reducing the risk of metabolic syndrome and diabetes. However, limited studies have examined the association between avocados and diabetes risk. OBJECTIVE: This study aimed to examine the association between avocado consumption and diabetes by sex in Mexican adults. DESIGN: This was a cross-sectional study. PARTICIPANTS/SETTING: Participants included a subsample of adults (aged 20 years and older) from the 2012, 2016, and 2018 Mexican National Health and Nutrition Survey. Avocado consumption was assessed using a 7-day, semiquantitative food frequency questionnaire, and participants were classified as avocado consumers (consuming any amount of avocado) or nonconsumers. MAIN OUTCOME MEASURES: Participants were considered to have diabetes if they answered "yes" to "Has a doctor ever told that you have diabetes or high blood sugar?" STATISTICAL ANALYSES PERFORMED: This analysis assessed the association between avocado intake and diabetes using multivariate logistic models by sex and adjusted for relevant covariates. RESULTS: Of 28 239 Mexican National Health and Nutrition Survey 2012, 2016, and 2018 participants, 25 640 met the criteria (ie, have diabetes outcome and plausible energy and avocado intakes) for this study. More than half of the participants were women, and approximately 45% were avocado consumers, with an average (SE) avocado consumption of 34.7 (0.9) among men and 29.8 (0.8) g/day among women. Avocado consumers had lower odds of diabetes in both unadjusted (odds ratio [OR] 0.762, 95% CI 0.639 to 0.907) and adjusted (OR 0.792, 95% CI 0.632 to 0.993) models among women but not men (OR 1.192, 95% CI: 0.907 to 1.566 and OR 0.914, 95% CI 0.675 to 1.239 for unadjusted and adjusted models, respectively). CONCLUSIONS: Avocado consumption was associated with a lower risk of diabetes, which remained significant even when adjusted for relevant covariates. However, this finding was observed in only women, not men, underscoring the importance of personalized nutrition in diabetes care and prevention.
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Diet diversity becomes especially relevant during adolescence to satisfy the adequate micronutrient intake. Diet diversity (DD) and micronutrient probability of adequacy (PA) were studied in 818 Costa Rican (CR) and 1202 Mexican (MX) adolescents aged 13-18 years. DD was compared using the Minimum Dietary Diversity (MDD) score. Receiver-operating characteristic (ROC) curves were employed to identify the optimal MDD for each sample from the respective countries. The mean MDD for the overall CR sample was 4.17 ± 1.43 points, and for the MX sample, the mean MDD was 4.68 ± 1.48 points. The proportion of adolescents with a DD was significantly higher in Costa Rica than in Mexico (66.5% vs. 55.6%; p < 0.0001). Also, DD was higher in rural Costa Rican adolescents, while no difference was found in the MX adolescents by area of residence. CR adolescents reported significantly higher PA than MX participants for 6 of the 11 micronutrients assessed. The calcium PA in MX adolescents was significantly higher than in the CR sample (MX: 0.84 vs. CR: 0.03; p < 0.0001), while low PA was obtained for iron in both countries (CR: 0.01 vs. MX: 0.07; p < 0.0001). In Costa Rica and Mexico, nutritional interventions and assessing the compliance of food-fortifying programs are needed to improve the PA of diverse micronutrients.
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OBJETIVO: Evaluar el consumo y porcentaje de adultos en apego a recomendaciones de la Organización Mundial de la Salud (OMS) e EAT-Lancet Commission on Food, Planet, Health sobre consumo de frutas, verduras y leguminosas, y sus cambios en el periodo de 2012-2022. Material y métodos. Se analizó información de 29 757 adultos >20 años, obtenida del cuestionario semicuantitativo de frecuencia de consumo de alimentos de las Encuestas Nacionales de Salud y Nutrición 2012-2022. Se estimó el consumo de frutas, verduras y leguminosas mediante modelos de regresión cuantílica y el porcentaje de población que cumplió las recomendaciones de consumo de la OMS y de una dieta de salud planetaria con modelos de regresión logit. Todos los modelos se ajustaron por covariables. RESULTADOS: De 2012 a 2020-2022, el consumo de frutas se mantuvo constante (113.5-131 g/día) y el de verduras incrementó (de 83 a 109 g/día), mientras que el consumo de leguminosas disminuyó (de 10 a 7.7 g/día). Se encontró bajo porcentaje de adultos (<40%) que cumplieron las recomendaciones, sobre todo de leguminosas (<1.5%), situación que se mantuvo constante a lo largo de los 10 años analizados. CONCLUSIONES: Existe una tendencia a la disminución en el consumo de leguminosas y el consumo de frutas y verduras sigue siendo bajo.
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OBJETIVO: Estimar cambios en el consumo de frutas, verduras y leguminosas y su cumplimiento según recomendaciones internacionales en población menor de 20 años de México. Material y métodos. En 31 083 menores de 20 años con información de frecuencia de consumo de alimentos de las Encuestas Nacionales de Salud y Nutrición 2012, 2016, 2018 y 2020-2022, se estimó el cambio en el consumo de frutas, verduras y leguminosas ajustados mediante modelos de regresión cuantílica y la probabilidad de cumplimiento de las recomendaciones de ingesta de EAT-Lancet y la Organización Mundial de la Salud mediante modelos de regresión logit. RESULTADOS: Entre 2012 y 2020-2022 se observó un incremento en la mediana de consumo de 15% en frutas y 23.5% en verduras. La probabilidad de cumplimiento de recomendaciones de EAT-Lancet fue de 42.6% para frutas y 13.6% para verduras en 2020-2022. El consumo de leguminosas disminuyó 17.4% en 10 años. Conclusión. La población mexicana menor de 20 años se encuentra muy lejos de alcanzar las recomendaciones de consumo para la salud planetaria, a pesar de los incrementos modestos en el consumo de frutas y verduras. Se debe poner especial atención en el consumo de leguminosas por su disminución alarmante en estos grupos de edad. Es esencial realizar más investigación en este tema.
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OBJETIVO: Analizar la asociación de la contribución de los azúcares con sobrepeso y obesidad (Sp+Ob) en población escolar y adolescente. Material y métodos. En una muestra de 2 844 escolares y adolescentes de 5 a 19 años se determinó el estado de Sp+Ob según los patrones de crecimiento de la Organización Mundial de la Salud, así como el consumo de azúcares totales, añadidos e intrínsecos (%kcal/día) con información de un cuestionario de frecuencia de consumo de alimentos. Se estimó la probabilidad ajustada de presentar Sp+Ob mediante modelos de regresión logística con interacción entre el consumo de azúcares y la condición de bienestar. RESULTADOS: La prevalencia de Sp+Ob fue del 41% en la población de 5 a 19 años y más de 60% excedió el límite recomendado de consumo de azúcares añadidos del 10% de energía; las bebidas endulzadas fueron el grupo que más contribuyó a este consumo elevado. La probabilidad de presentar Sp+Ob a mayores consumos de azúcar añadido fue significativamente mayor en el tercil alto de condición de bienestar (0.59) vs. el bajo (0.30). CONCLUSIONES: El Sp+Ob y el consumo de azúcares añadidos son elevados en la población de 5 a 19 años en México. Se requiere fortalecer, focalizar y diversificar las estrategias de atención a estos problemas considerando las diferencias sociodemográficas de la población.
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OBJETIVO: Actualizar las estimaciones del porcentaje de población mexicana que consume grupos de alimentos recomendables y no recomendables de manera habitual. Material y métodos. Con información derivada del cuestionario semicuantitativo de frecuencia de consumo de alimentos de diferentes grupos de edad de la población participante en la Encuesta Nacional de Salud y Nutrición Continua de 2020 a 2022, se estimó el porcentaje de consumidores de trece grupos de alimentos de relevancia para la salud. RESULTADOS: Los grupos de alimentos mayormente consumidos en toda la población fueron el agua sola (>83%) y las bebidas endulzadas (>76%). Cerca de la mitad de la población menor de 20 años consumieron botanas, dulces y postres, cifra que es similar al porcentaje de consumidores de frutas y mayor al de consumidores de verduras (<30%). En todos los grupos de edad los consumidores de leguminosas no superan el 26%. Conclusión. La fracción de la población mexicana que consume bebidas endulzadas es muy alta en todos los grupos de edad, mientras que para alimentos saludables es baja. Se necesita profundizar en el análisis de las causas de estas diferencias y diseñar acciones encaminadas a aumentar la calidad de la dieta en la población mexicana.
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BACKGROUND: Waist-to-height ratio (WHtR) is one of the anthropometric measures associated with cardiovascular risk (CVR). However, WHtR cut-off points may vary depending according to population characteristics, including sex and height. OBJECTIVE: To identify optimal WHtR cut-off points to predict CVR factors by sex in Mexican adults according to height. MATERIAL AND METHODS: Information from adults >20 years (n = 3550) from the 2016 National Health and Nutrition Survey were analyzed. Prevalence of high WHtR, CVR factors (glucose and insulin, lipid profile (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides) and blood pressure were estimated by sex and height (short height <1.60 and <1.50 m in men and women, respectively). The maximum proximity procedure was used to establish the point of maximum simultaneous sensitivity and specificity using the operating characteristic curve of the receiver. The estimates were stratified by sex and height condition. RESULTS: The WHtR cut-off points identified to predict CVR were higher than those suggested for international use (≥0.5), being significantly higher (p <0.0001) for women (0.61) than for men (0.56). Also, the WHtR cut-off points were higher for short stature (men 0.58 and 0.56, women 0.63 and 0.58, with short and normal stature, respectively). CONCLUSIONS: The WHtR cut-off points for predicting CVR in the Mexican population were higher than 0.5 in both sexes and it was higher for individuals with short stature. The identified cut-off points may be an additional tool in screening the adult population in Mexico to predict CVR.
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Doenças Cardiovasculares , Obesidade , Masculino , Humanos , Adulto , Feminino , Obesidade/epidemiologia , Fatores de Risco , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/complicações , México/epidemiologia , Índice de Massa Corporal , Fatores de Risco de Doenças Cardíacas , Circunferência da Cintura , Curva ROCRESUMO
BACKGROUND: Currently, 30% of the total energy intake in the Mexican diet comes from ultra-processed foods. Although its consumption is associated with high intakes of added sugar and saturated fats and low intakes of dietary fibre, there is no evidence regarding its association with dietary diversity and micronutrient intake. The present study evaluated the association between ultra-processed foods consumption with dietary diversity and micronutrient intake in Mexico. METHODS: Ultra-processed foods items were identified in a 24-h recall from a sample of 10,087 participants aged ≥ 1 year. The minimum dietary diversity (MDD) was established by using the Food and Agriculture Organization 10 food group indicators with unprocessed, minimally processed and processed foods. The study conducted multiple linear regression models to evaluate the association between quintiles of energy contribution of ultra-processed foods with dietary diversity and micronutrient intake. RESULTS: A high consumption of ultra-processed foods was associated with a low dietary diversity and micronutrients intake. The association between ultra-processed foods and MDD was not linear (47.1%, 57.1%, 52.5%, 45.0% and 28.0% of participants achieved the MDD). On the other hand, the association was linear and negatively associated with: niacin, pantothenic acid, pyridoxine, folate, vitamin B12 , vitamin C, vitamin E, zinc, calcium, magnesium, potassium and phosphorus (p < 0.05). CONCLUSIONS: These findings are relevant in the context of the double burden of malnutrition currently faced in Mexico. Increasing dietary diversity and micronutrient intake is essential by discouraging ultra-processed foods consumption. However, other strategies are also needed to promote the dietary diversity and increase the consumption of unprocessed and minimally processed foods.
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Fast Foods , Alimento Processado , Humanos , México , Dieta , Ingestão de Energia , Ingestão de AlimentosRESUMO
Introduction: The prevalence of overweight and obesity in Mexican adults is very high. To identify the dietary characteristics related with this disorder is necessary to design intervention. The objective was to analyze the association between dietary patterns and obesity in Mexican adults. Materials and Methods: This is a cross-sectional study carried out in Mexican adults (20-59 years old) participating in the Halfway National Health and Nutrition Survey 2016. Participants (n = 5,735) were classified as having normal weight, overweight-obesity and by their abdominal circumference as having abdominal obesity or not. With information from a 7-day food frequency questionnaire, we used a K-means cluster analysis to derive dietary patterns and calculated a healthy diet indicator to evaluate quality. The association between dietary patterns and overweight-obesity and abdominal obesity was assessed with Poisson regression models adjusted by some characteristics. Results: We identified a Rural pattern characterized by tortilla, legumes and egg consumption; a Diverse pattern, characterized by fruits, meat and poultry, vegetables, and dairy beverages, and desserts; and a Westernized pattern, characterized by sweetened non-dairy beverages, fast food, bakery and cookies, candies and salty snacks. In men, Westernized pattern was associated with overweight-obesity (PR = 1.11, 95% CI 0.97-1.27), and abdominal obesity (PR = 1.15, 95% CI 1.00-1.33), the Diverse pattern was associated with overweight-obesity (PR = 1.18, 95% CI 1.00-1.38), and abdominal obesity (PR = 1.27, 95% CI 1.07-1.50), compared with the Rural pattern. In women, these dietary patterns were not associated with obesity. Discussion: Westernized and Diverse patterns are associated with overweight and obesity and abdominal obesity in men. Gender-specific recommendations and surveillance are necessary in the Mexican adult population.
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Background: Little is known about the current intake of sustainable diets globally and specifically in middle-income countries, considering nutritional, environmental and economic factors. Objective: To assess and characterize the sustainability of Mexican diets and their association with sociodemographic factors. Design: Dietary data of 2,438 adults within the National Health and Nutrition Survey 2012 by integrating diet quality measured by the Healthy Eating Index (HEI-2015), diet cost, and four environmental indicators were analyzed: land use (LU), biodiversity loss (BDL), carbon footprint (CFP), and blue water footprint (BWFP). We defined healthier more sustainable diets (MSD) as those with HEI-2015 above the overall median, and diet cost and environmental indicators below the median. Logistic regression was used to evaluate the association of sociodemographic factors with MSD. Results: MSD were consumed by 10.2% of adults (4% of urban and 22% of rural), who had lower intake of animal-source foods, unhealthy foods (refined grains, added sugar and fats, mixed processed dishes and sweetened beverages), fruits, and vegetables, and higher intake of whole grains than non-MSD subjects. Characteristics of MSD vs. non-MSD (urban; rural) were: HEI-2015 (62.6 vs. 51.9; 66.8 vs. 57.6), diet-cost (1.9 vs. 2.8; 1.9 vs. 2.5 USD), LU (3.3 vs. 6.6; 3.2 vs. 5.9 m2), BDL (105 vs. 780; 87 vs. 586 species × 10-10), BWFP (244 vs. 403; 244 vs. 391 L), and CFP (1.6 vs. 4.4; 1.6 vs. 3.7 kg CO2eq). Adults from rural vs. urban (OR 2.7; 95% CI: 1.7, 4.1), or from the South (OR 2.1; 95% CI: 1.1, 3.9), Center (OR 2.3; 95% CI: 1.3, 4.4) vs. the North were more likely to consume MSD, while adults with high vs. low socioeconomic status were less likely (OR 0.17; 95% CI: 0.09, 0.3). Conclusions: The MSD is a realistic diet pattern mainly found in disadvantaged populations, but diet quality is still sub-optimal. Increased consumption of legumes, fruits, and vegetables, and a reduction in unhealthy foods, is required to improve nutritional quality of diets while ensuring their environmental sustainability.
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BACKGROUND: Ultra-processed foods are recognized as indicators of an unhealthy diet in epidemiological studies. In addition to ultra-processed foods, the NOVA food classification system identifies three other groups with less processing. Unprocessed foods that, together with minimally processed foods (MPF), make NOVA group 1, NOVA group 2 is processed culinary ingredients, and NOVA group 3 is processed foods. OBJECTIVE: To assess the relative validity of the semi-quantitative food frequency questionnaire (SFFQ) to estimate the energy intake for each group NOVA classification system by comparing it with two 24 h-dietary-recall (24DRs) Mexican adults. METHODS: We analyzed dietary information from 226 adults included <60 and ≥60 years with complete SFFQ and two 24DRs from the National Health and Nutrition Survey 2012. We reported mean differences, Spearman correlation coefficients, intra-class correlations coefficients, Bland-Altman plots, and weighted kappa between measures. RESULTS: The percentage energy intake from unprocessed and minimally processed foods group, Spearman correlation coefficients was 0.54 in adults <60 years and 0.42 in adults ≥60 years, while ultra-processed foods group was 0.67 and 0.48, respectively. The intra-class correlation coefficients in the unprocessed and minimally processed foods group was 0.51 in adults <60 years and 0.46 in adults ≥60 years, and for the ultra-processed foods group were 0.71 and 0.50, respectively. Bland-Altman plots indicated reasonably consistent agreement for unprocessed and minimally processed foods group and ultra-processed foods group in adults <60 years and adults in the ≥60 age group. Weighted kappa was 0.45 in the ultra-processed foods group to adults <60 years and was 0.36-≥60 years. CONCLUSION: The SFFQ had acceptable validity to rank the percentage of energy intake from unprocessed and minimally processed foods group and ultra-processed foods group in Mexican adults, both in adults under 60 years and who were 60 years old or older.
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Population studies have demonstrated an association between sodium and potassium intake and blood pressure levels and lipids. The aim of this study was to describe the dietary intake and contribution of sodium and potassium to the Mexican diet, and to describe its association with nutrition status and clinical characteristics. We analyzed a national survey with 4219 participants. Dietary information was obtained with a 24-h recall. Foods and beverages were classified according to level of processing. The mean intake (mg/d) of Na was 1512 in preschool children, 2844 in school-age children, 3743 in adolescents, and 3132 in adults. The mean intake (mg/d) of K was 1616 in preschool children, 2256 in school-age children, 2967 in adolescents, and 3401 in adults. Processed and ultra-processed foods (UPF) contribute 49% of Na intake in preschool children, 50% in school-age children, 47% in adolescents, and 39% in adults. Adults with high Na intake had lower serum concentrations of cholesterol, HDL-c, and LDL-c. A significant proportion of the Mexican population has a high intake of Na (64-82%) and low K (58-73%). Strategies to reduce Na and increase K intake need to reduce the possibility of having high BP and serum lipid disturbances.
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Dieta/estatística & dados numéricos , Potássio na Dieta/análise , Sódio na Dieta/análise , Adolescente , Adulto , Pressão Sanguínea , Criança , Pré-Escolar , Colesterol/sangue , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Dieta/efeitos adversos , Dislipidemias/epidemiologia , Dislipidemias/etiologia , Ingestão de Alimentos , Feminino , Humanos , Hipertensão/epidemiologia , Hipertensão/etiologia , Lipídeos/sangue , Masculino , México/epidemiologia , Inquéritos Nutricionais , Estado Nutricional , Adulto JovemRESUMO
OBJECTIVE: To establish the cutoff point for a Minimum Dietary Diversity (MDD) that most accurately predicts the Mean Probability Adequacy (MPA) of 11 micronutrients in the Mexican population, and estimate the population prevalence above it. SUBJECTS AND METHODS: We analyzed a 24 h-recall collected in a sample of 10,087 participants (≥1-year-old) from the 2012 Mexican National Health and Nutrition Survey. Foods were classified into ten food group indicators (FGIs) of the Food Agriculture Organization (FAO). The cutoff points of MDD were established as follows: (1) sum of the number of FGIs in the participant's diet; (2) micronutrient intake adequacy estimated by the probability approach method of the FAO; (3) Receiver operating characteristic curves generated by age groups to assess the performance of the number FGIs consumed in predicting the MPA. RESULTS: The cutoff points of MMD established by age groups were: ≥4 FGIs in preschool-aged children (75.94% of sensitivity and 72.55% of specificity); ≥5 FGIs in school-aged children (60.51% of sensitivity and 72.82% of specificity) and adolescents (70.01% of sensitivity and 59.38% of specificity); and six in adults (62.26% of sensitivity and 70.33% of specificity) and elders (66.67% of sensitivity and 73.33% of specificity). Based on these cutoff points, we observed that 75% of the preschool-aged children, ~60% of school-aged children and adolescents, and less than 40% of adults and elders were above the MDD. CONCLUSION: This study provides novel insight into the specific MDD cutoff point to predict micronutrient adequacy in the Mexican population.
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Micronutrientes , Avaliação Nutricional , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Dieta , Ingestão de Alimentos , Humanos , Lactente , MéxicoRESUMO
OBJECTIVE: To assess the association between diet cost and quality by place of residence. DESIGN: We analysed cross-sectional data of the National Health and Nutrition Survey-2012. Diet cost was estimated by linking dietary data, obtained from a 7-d SFFQ, with municipality food prices, which were derived from a national expenditure survey. Diet quality was assessed using the Healthy Eating Index-2015 (HEI-2015). Association between quintiles of diet cost and HEI-2015 was assessed using linear regression analysis. SETTINGS: Mexico. PARTICIPANTS: 2438 adults (18-59 years). RESULTS: Diet cost was positively associated with diet quality (HEI-2015) in urban but not in rural areas. Compared with quintile (Q1) of cost, the increment in diet quality score was 1·17 (95 % CI -0·06, 4·33) for Q2, 2·14 (95 % CI -0·06, 4·33) for Q3, 4·70 (95 % CI 2·62, 6·79) for Q4 and 6·34 (95 % CI 4·20, 8·49) for Q5 (P-trend < 0·001). Individuals in rural v. urban areas on average have higher quality diets at lower cost with higher intakes of whole grains and beans and lower intakes of Na, added sugars and saturated fats. Living in the South, being indigenous and having low socio-economic status were also associated with higher quality diets. CONCLUSIONS: Diet cost was positively associated with diet quality, but only in urban areas. Further studies are needed to understand the relation between diet cost and quality in rural areas. To improve overall diet quality in Mexico, strategies that aim to reduce the cost of high-quality diets should consider the heterogeneity by place of residence.
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Dieta Saudável , Dieta , Adulto , Estudos Transversais , Humanos , México , Inquéritos NutricionaisRESUMO
INTRODUCTION: Background: adherence to Dietary Approach to Stop Hypertension (DASH) has demonstrated to be effective in lowering blood pressure and other cardiovascular risk markers in different populations, but has never been evaluated in the Mexican population. Objective: to assess adherence to the DASH dietary pattern by using an adapted DASH adequacy index (DASH-AI), and to evaluate its association with cardiovascular risk markers in an adult Mexican population. Methods: we conducted a cross-sectional analysis of data of 1,490 adults aged 20-50 years. Diet was assessed with a Food Frequency Questionnaire and sodium intake by 24-hour urinary sodium excretion; the DASH-AI score was calculated based on the DASH nutrient targets. Multivariable linear and logistic regression analyses were performed to estimate the association between the DASH-AI score and cardiovascular risk markers (body mass index [BMI], waist circumferences, systolic (SBP) and diastolic blood pressure (DBP), glucose, triglycerides, total cholesterol, and high- and low-density lipoproteins). Results: we observed an association of the DASH-AI score with BMI, WC and DBP in the linear (BMI, ï¢: -0.55, 95 % CI: -0.77, -0.33; WC, ï¢: -1.66, 95 % CI: -2.19, -1.13; DBP, ï¢: -0.65, 95 % CI: -1.07, -0.24), and logistic (BMI > 25 kg/m2, OR: 0.82, 95 % CI: 0.74, 0.93; elevated WC, OR: 0.72, 95 % CI: 0.64, 0.81; DBP, OR: 0.83, 95 % CI: 0.72, 0 .95) models. Conclusion: compliance to the DASH-style diet was inversely associated with BMI, WC and DBP in this Mexican population. Promoting adherence to this dietary pattern in the context of Mexican diet is needed to improve cardiovascular health in this population.
INTRODUCCIÓN: Antecedentes: la adherencia al patrón de alimentación DASH ha mostrado ser eficaz para reducir la presión arterial y los marcadores de riesgo cardiovascular en diferentes poblaciones, pero nunca en la mexicana. Objetivo: evaluar la adherencia al patrón de alimentación DASH mediante un índice adapatado a los lineamientos DASH (DASH-AI) y evaluar su asociación con marcadores de riesgo. Métodos: análisis transversal de datos de 1490 adultos de entre 20 y 50 años de edad. La ingesta dietética se evaluó utilizando un cuestionario de frecuencia de consumo de alimentos y el sodio a través de la excresión urinaria en 24 horas; la puntuación DASH-AI se calculó de acuerdo con la adherencia a las recomendaciones DASH. Se realizaron modelos logísticos y lineales para estimar la asociación entre el puntaje DASH-AI y los marcadores de riesgo cardiovascular (índice de masa corporal [IMC], circunferencia de cintura (CC), presión arterial sistólica (PAS) y diastólica (PAD), glucosa, triglicéridos, colesterol total, lipoproteínas de alta y baja densidad). Resultados: observamos una asociación del DASH-AI con el IMC, la CC y la PAD en los modelos lineales (IMC ï¢: -0,55, IC del 95 %: -0,77, -0,33; CC ï¢: -1,66, IC del 95 %: -2,19, -1,33; PAD, ï¢: -0,65, IC del 95 %: -1,07, -0,24) y logístico (IMC > 25 kg/m2, OR: 0,82, IC del 95 %: 0,74, 0,93; CC elevado, OR: 0,72; IC del 95 %: 0,64, 0,81; PAD, OR: 0,83, IC del 95 %: 0,72, 0,95). Conclusión: la adherencia a la dieta DASH se asoció inversamente con el IMC, la CC y la PAD en la población estudiada. Es necesario promover la adherencia a este patrón dietético para mejorar la salud cardiovascular.
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Abordagens Dietéticas para Conter a Hipertensão , Hipertensão , Adulto , Pressão Sanguínea , Estudos Transversais , Dieta , Humanos , Hipertensão/epidemiologia , Pessoa de Meia-Idade , Adulto JovemRESUMO
OBJECTIVE: To estimate the effects of the social inclusion programme PROSPERA on food insecurity (FI) in Mexican households during 2012 and 2016. DESIGN: Quasi-experimental study using cross-sectional data from 2012 to 2016 National Household Income and Expenditure Survey - Socioeconomic Conditions Module (in Spanish, ENIGH-MCS). SETTING: Data were used from a 2012 sample of 56 888 Mexican households (representative of 31 206 819 households) and a 2016 sample of 70 263 Mexican households (representative of 33 445 353 households). Severity of FI was estimated with the Mexican Food Security Scale (in Spanish, EMSA). The statistical analysis estimated a differences in differences (DD) model weighted by propensity score to compare program beneficiary and non-beneficiary households in 2012 than in 2016. We estimated the effect on households with and without children (< 18 years of age). We also compared this model to a DD model without propensity score weighting. PARTICIPANTS: Mexican households. RESULTS: FI among all beneficiary households decreased 8·0pp as compared to non-beneficiary households over the study period. In beneficiary households with children, this decrease was 6·0pp and for beneficiary households without children, this decrease was 12·9pp (for all, P-value < 0·001). CONCLUSIONS: The PROSPERA program had a positive effect on FI reduction at the household level through increasing food access, which usually improves nutritional outcomes in vulnerable Mexican populations.
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Assistência Alimentar , Abastecimento de Alimentos , Criança , Estudos Transversais , Características da Família , Insegurança Alimentar , HumanosRESUMO
Resumen: Objetivo: Estudiar la asociación de la inseguridad alimentaria con los cambios percibidos en la alimentación durante el confinamiento por Covid-19 en México. Material y métodos: El nivel de inseguridad alimentaria se obtuvo utilizando la Escala Latinoamericana y Caribeña de Seguridad Alimentaria (ELCSA) en 9 933 hogares de la Encuesta Nacional de Salud y Nutrición Continua 2020 Covid-19 (Ensanut -Continua- 2020 Covid-19). Los cambios en el consumo de grupos de alimentos durante el confinamiento se clasificaron en negativos, positivos o sin cambios durante el confinamiento. La asociación entre cambios en la alimentación e inseguridad alimentaria se analizó con modelos multinomiales ajustados por características sociodemográficas del hogar. Resultados: Los hogares con reducción en el gasto en alimentos e inseguridad alimentaria severa mostraron mayor probabilidad de tener cambios negativos en su alimentación (0.43, IC95%: 0.40-0.46). Conclusiones: La inseguridad alimentaria severa se asocia con cambios negativos en la alimentación durante el confinamiento por Covid-19, en hogares con reducción del gasto en alimentos.
Abstract: Objective: To study the association of food insecurity with changes in diet perceived during lockdown by Covid-19 in Mexico. Materials and methods: The level of food insecurity was identified using the Latin American and Caribbean Scale of Food Security in 9 933 households of the 2020 National Health and Nutrition Survey Covid-19. Changes in the food group consumption were classified in negative or positive changes, or unchanged during lockdown. The association of changes in diet with the level of food insecurity was analyzed with multinomial models adjusted for sociodemographic characteristics of the household. Results: Households that reported reduced spending on food and with severe food insecurity showed a greater probability of having negative changes (0.43, 95%CI: 0.40-0.46). Conclusions: Severe food insecurity is associate with negative food changes during lockdown by Covid-19, in households with reduced spending on food in Mexico.
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BACKGROUND: The Global Diet Quality Score (GDQS) is intended as a simple global diet quality metric feasible in low- and middle-income countries facing the double burden of malnutrition. OBJECTIVE: The aim of this study was to evaluate the performance of the GDQS with markers of nutrient adequacy and chronic disease in nonpregnant nonlactating (NPNL) Mexican women of reproductive age and to compare it with the Alternate Healthy Eating Index-2010 (AHEI-2010) and the Minimum Dietary Diversity for Women (MDD-W). METHODS: We included NPNL women aged 15 to 49 y from the Mexican National Health and Nutrition Surveys (2012 and 2016) with 24-h recall (n = 2542) or a FFQ (n = 4975) (separate samples). We evaluated the correlation of the GDQS with the energy-adjusted intake of several nutrients and evaluated its association with health parameters using covariate-adjusted linear regression models. RESULTS: The GDQS was positively correlated with the intake of calcium, folate, iron, vitamin A, vitamin B-12, zinc, fiber, protein, and total fat (rho = 0.09 to 0.38, P < 0.05) and was inversely correlated with the intake of added sugar (rho = -0.37 and -0.38, P < 0.05) using both instruments, and with total fat, SFA, and MUFA only with 24-h recall data (rho = -0.06 to -0.16, P < 0.05). The GDQS was inversely associated with serum ferritin, BMI, waist circumference, and serum total and LDL cholesterol using FFQ data (P < 0.05), and was positively associated with serum folate using 24-h recall data (P < 0.05). Similar correlations and associations were observed with the MDD-W (only with micronutrients) and the AHEI-2010 (only with chronic disease-related nutrients and health markers). CONCLUSIONS: In comparison to other diet metrics, the GDQS can capture both dimensions of nutrient adequacy and health markers related to the risk of chronic disease. The performance of the GDQS was satisfactory with either 24-h recall or FFQ.