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BACKGROUND: Lead can affect early childhood development (ECD) differentially due to nutritional deficiencies that lead to stunted growth, defined as being at least two standard deviations below the average height-for-age. These deficiencies are more frequent among children living in rural locations or with lower socioeconomic status (SES); however, studies at a population level are scarce worldwide. Early childhood development plays a crucial role in influencing a child's health and wellbeing throughout life. Therefore, the aim of this study was to analyze how stunted growth can modify the association between lead exposure and ECD in children from disadvantaged communities. METHODS: Data were analyzed from the 2018 National Health and Nutrition Survey in localities with fewer than 100,000 inhabitants in Mexico (ENSANUT-100K). Capillary blood lead (BPb) levels were measured using a LeadCare II device and dichotomized as detectable (cutoff point ≥ 3.3 µg/dL) and non-detectable. As a measure of ECD, language development was assessed in n = 1394 children, representing 2,415,000 children aged 12-59 months. To assess the association between lead exposure and language z-scores, a linear model was generated adjusted by age, sex, stunted growth, maternal education, socioeconomic status, area, region (north, center, south), and family care characteristics; afterwards, the model was stratified by stunted growth. RESULTS: Fifty percent of children had detectable BPb and 15.3% had stunted growth. BPb showed a marginal inverse association with language z-scores (ß: -0.08, 95% CI: -0.53, 0.36). Children with detectable BPb and stunted growth had significantly lower language z-scores (ß: -0.40, 95% CI: -0.71, -0.10) than those without stunted growth (ß: -0.15, 95% CI: -0.36, 0.06). CONCLUSIONS: Children with stunted growth are more vulnerable to the adverse effects of lead exposure. These results add to previous research calling for action to reduce lead exposure, particularly in children with chronic undernutrition.

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OBJECTIVE: To evaluate the association between life-course leisure-time physical activity (PA) and prostate cancer (PC) among males living in Mexico City. Materials and meth-ods. Information from 394 incident PC cases and 794 popula-tion controls matched by age (± 5 years), was analyzed. Using leisure-time PA information at different life stages, life-course PA patterns were constructed. The association between PA and PC was estimated using an unconditional logistic regres-sion model. RESULTS: Three life-course PA patterns were identified: low PA (71.0%), moderate PA (22.0%), and high PA (7.0%); this last pattern was characterized by higher levels and consistent PA practice. Compared with inactive males, those in the high PA pattern (OR: 0.50; 95%CI: 0.26-0.93) had significantly lower PC odds. CONCLUSION: Intense and regular PA could reduce the possibility of PC. These results are in accordance with PA World Health Organization rec-ommendations.

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Abstract: Objective: To evaluate the association between life-course leisure-time physical activity (PA) and prostate cancer (PC) among males living in Mexico City. Materials and methods: Information from 394 incident PC cases and 794 population controls matched by age (± 5 years), was analyzed. Using leisure-time PA information at different life stages, life-course PA patterns were constructed. The association between PA and PC was estimated using an unconditional logistic regression model. Results: Three life-course PA patterns were identified: low PA (71.0%), moderate PA (22.0%), and high PA (7.0%); this last pattern was characterized by higher levels and consistent PA practice. Compared with inactive males, those in the high PA pattern (OR: 0.50; 95%CI: 0.26-0.93) had significantly lower PC odds. Conclusion: Intense and regular PA could reduce the possibility of PC. These results are in accordance with PA World Health Organization recommendations.

Resumen: Objetivo: Evaluar la asociación entre la actividad física (AF) en la vida y el cáncer de próstata (CP) en hombres. Material y métodos: Se analizó la AF de 394 casos incidentes de CP y 794 controles poblacionales pareados por edad (± 5 años). Se utilizó la información de AF en diferentes etapas para generar los patrones de AF a lo largo de la vida. La asociación entre AF y CP se estimó mediante regresión logística no condicionada. Resultados: Se identificaron tres patrones de AF: baja (71.0%), moderada (22.0%) y alta (7.0%); este último patrón se caracterizó por una AF consistentemente mayor a lo largo de la vida. Comparado con los hombres inactivos, aquéllos en el patrón de alta AF (RM= 0.50; IC95% = 0.26-0.93) presentaron menos posibilidades de tener CP. Conclusión: El papel protector de la AF parece estar en función de la intensidad y regularidad de su práctica y apoyan las recomendaciones de la OMS.

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We aimed to identify patterns of cognitive differences and characterize subgroups of Mexican children and adolescents with three neurodevelopmental disorders (NDD): intellectual disability (ID), autism spectrum disorders (ASD) and attention deficit/hyperactivity disorder (ADHD). The sample included 74 children and adolescents 6-15 years; 34% had ID, ASD or ADHD, 47% had ID in comorbidity with ASD, ADHD or both, 11% had ASD + ADHD, 8% were children without NDD. We applied WISC-IV, Autism Diagnostic Interview-Revised, Mini-International Neuropsychiatric Structured Interview, Child Behavior Checklist, and UNICEF Child Functioning Module. We evaluated the normality of the WISC-IV sub-scales using the Shapiro-Francia test, then conducted a latent class analysis and assessed inter-class differences in terms of household, parent and child characteristics. The following four-class solution best fit the data: "Lower Cognitive Profile" (LCP), "Lower Working Memory" (LWM), "Higher Working Memory" (HWM), "Higher Cognitive Profile" (HCP). LCP included most of the children with ID, who had a low Working Memory (WM) index score. LWM included mainly children with ASD or ID + ADHD; their Perceptual Reasoning (PR) and Processing Speed (PS) index scores were much higher than those for Verbal Comprehension (VC) and WM. HWM included children with ASD or ADHD; their scores for PR, PS and VC were high with lower WM (although higher than for LWM). HCP included children without NDD and with ASD or ADHD or both and had the highest scores on all indices. Children with NDD show cognitive heterogeneity and thus require individualized treatment plans.

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Resumen: Objetivo: Evaluar la asociación entre embarazo en la adolescencia y desarrollo del lenguaje (DL), en niños(as) residentes en zonas económicamente vulnerables de México. Material y métodos: Estimación y comparación del puntaje estandarizado de lenguaje de niños(as) de 12-59 meses participantes en la Ensanut 100k e hijos(as) de madres que al nacimiento fueron adolescentes (12-19 años) o adultas (>20 años). La asociación se estimó mediante regresión lineal multivariada y probamos una interacción entre condición materna y lugar de residencia. Resultados: Los hijos(as) de adolescentes que residen en áreas urbanas tuvieron un DL menor que los hijos(as) de madres adultas, (ß= -0.33 IC95%: -0.65 a -0.01; p interacción <0.01). Sin embargo, la disponibilidad de libros o apoyo materno al aprendizaje redujeron esta diferencia. Conclusiones: La presión sociocultural hacia las adolescentes en zonas urbanas podría explicar los resultados observados; no obstante, esta población podría ser susceptible de estrategias dirigidas a mejorar la relación madre-hijo y el apoyo al aprendizaje.

Abstract: Objetive: To evaluate the association between adolescent pregnancy and language development, in children living in socio-economic vulnerable areas of Mexico. Materials and methods: We estimated the standardized language score of children age 12-59 months who participated in the Ensanut 100k. Teenage mothers (TM) were those who at delivery was between 12-19 years old. The association was estimated using multivariate linear regression; moreover, we evaluated an interaction between type of mother and place of residence. Results: Children of TM who lived in urban areas had lower standardized language score than those children of adult mothers (ß= -0.33 95%CI: -0.65 a -0.01; p for interaction<0.01). However, book availability and/or mother's support for learning significantly reduce this difference. Conclusions: Sociocultural pressures towards TM in urban areas could explain the results; nevertheless, this population could be susceptible to strategies aimed to improve the mother-child relationship and support for learning.

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Flavonoids are a broad group of bioactive compounds with anticarcinogenic effects on the prostate that have been scarcely evaluated in Latin American populations. Our objective was to evaluate the association between dietary patterns of flavonoid intake and prostate cancer (PC) in a population-based case-control study carried out in Mexico City. Based on a semi-quantitative FFQ with a frame reference of 3 years before diagnosis or interview, we used an updated database for estimating the daily intake (mg/d) of flavones, flavonols and flavanols for 395 confirmed incident PC cases and 797 population controls matched by age (± 5 years). Histological PC differentiation was evaluated using the Gleason score at diagnosis. Flavonoid dietary intake patterns (FDIP) were determined through principal component analysis, and their association with PC was estimated using logistic regression models. Three FDIP were identified: gallate pattern (GP) characterised by (-)-epicatechin-3-O-gallate, (-)-epigallocatechin-3-O-gallate and (+)-gallocatechin; luteolin pattern (LP) characterised by luteolin and (-)-epigallocatechin-3-O-gallate; and a mixed pattern (MP) that included (+)-catechin, (-)-epicatechin and quercetin. A higher GP (ORT3 v.T1 = 0·47; 95 % CI 0·33, 0·66) and LP intake (ORT3 v. T1 = 0·39; 95 % CI 0·27, 0·59) were associated with a decreased PC likelihood. In contrast, a higher MP intake (ORT3 v. T1 = 2·32; 95 % CI 1·67, 3·23) increased PC likelihood. The possible differential and synergistic anticarcinogenic role of flavonoid compounds in PC deserves further study.

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Objective: To evaluate the association between adolescent pregnancy and language development in children living in socioeconomically vulnerable areas of Mexico. Materials and methods: We estimated the standardized language score of children aged 12-59 months who participated in the Ensanut 100k. Teenage mothers (TM) were those who at delivery was between 12-19 years old. The association was estimated using multivariate linear regression; moreover, we evaluated an interaction between type of mother and place of residence. Results: Children of TM who lived in urban areas had lower standardized language scores than those of adult mothers (ß= -0.33 95%CI: -0.65 a -0.01; p for interaction<0.01). However, book availability and/or mother's support for learning significantly reduce this difference. Conclusions: Sociocultural pressures towards TM in urban areas could explain the results; nevertheless, this population could be susceptible to strategies aimed to improve the mother-child relationship and support for learning.

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OBJECTIVE: The methods that were carried out for the inclusion of the early childhood development module in the Ensanut 100k are presented. MATERIALS AND METHODS: With this module and the questionnaire for children under five years-old, indicators of the state of health, development and well-being of children in the first five years of life are obtained. From November to December 2017, the sample design, instruments and manuals were defined and a test was carried out. Field staff were trained and standardized. The information was collected between January and June 2018. RESULTS: 3 892 children from 0 to 59 months of age were studied in the DIT Module of the Survey. CONCLUSIONS: Training and standardization of field personnel, by trained and standardized personnel, minimizes information biases.

OBJETIVO: Presentar los métodos realizados para la inclu-sión del módulo de Desarrollo Infantil Temprano (DIT) en la Ensanut 100k. MATERIAL Y MÉTODOS: Con dicho módulo y el cuestionario de menores de cinco años, se obtuvieron indicadores del estado de salud, desarrollo y bienestar de niñas/os en los primeros cinco años de vida.De noviembre a diciembre de 2017, se definió el diseño de la muestra, instrumentos y manuales, y se realizó una prueba piloto. Se capacitó y estandarizó al personal de campo. El levantamiento de información se realizó entre enero y junio de 2018. RESULTADOS: Se estudió en el módulo DIT de la encuesta a 3 892 niños/as de 0 a 59 meses de edad. CONCLUSIONES: La capacitación y estandarización del personal de campo, por parte de personal capacitado y estandarizado, minimiza los sesgos de información.

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Resumen Objetivo: Presentar los métodos realizados para la inclusión del módulo de Desarrollo Infantil Temprano (DIT) en la Ensanut 100k. Material y métodos: Con dicho módulo y el cuestionario de menores de cinco años, se obtuvieron indicadores del estado de salud, desarrollo y bienestar de niñas/os en los primeros cinco años de vida. De noviembre a diciembre de 2017, se definió el diseño de la muestra, instrumentos y manuales, y se realizó una prueba piloto. Se capacitó y estandarizó al personal de campo. El levantamiento de información se realizó entre enero y junio de 2018. Resultados: Se estudió en el módulo DIT de la encuesta a 3 892 niños/as de 0 a 59 meses de edad. Conclusiones: La capacitación y estandarización del personal de campo, por parte de personal capacitado y estandarizado, minimiza los sesgos de información.

Abstract Objective: The methods that were carried out for the inclusion of the early childhood development module in the Ensanut 100k are presented. Materials and methods: With this module and the questionnaire for children under five years-old, indicators of the state of health, development and well-being of children in the first five years of life are obtained. From November to December 2017, the sample design, instruments and manuals were defined and a test was carried out. Field staff were trained and standardized. The information was collected between January and June 2018. Results: 3 892 children from 0 to 59 months of age were studied in the DIT Module of the Survey. Conclusions: Training and standardization of field personnel, by trained and standardized personnel, minimizes information biases.

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Prostate cancer (PC) is a polygenic disease with broad differences across ethnicities. BRCA1/2 and VDR have exhibited a featured genetic contribution to PC development in European populations. Nonetheless, its contribution in Latino populations specifically among Mexican men, where 70% of PC cases are detected in advanced stages, is still unknown. The contribution of seven polymorphisms in BRCA1/2 and VDR genes to PC susceptibility was evaluated in 370 incident PC cases and 759 age-matched (±5 years) controls belonging to the Mexican population. Based on Gleason score at diagnosis, PC cases were classified as well-differentiated PC (Gleason <7) and moderate or poorly differentiated PC (Gleason ≥7). Age at diagnosis was used to divided PC cases in earlier (<60 years) and late-onset PC (≥60 years). Prostate and breast cancer family histories were obtained through interview. Our results provided evidences about the contribution of BRCA1-rs1799966 (ORCC genotype = 2.30; 95% confidence interval [CI] = 1.36-3.91) to the moderate or poorly differentiated PC risk, independently of the family history of prostate, breast or ovary cancer. Further, VDR-rs2238135-G allele was associated with early-onset PC (ORG allele = 2.05; 95% CI = 1.06-3.95), and marginally with moderate or poorly differentiated PC risk. The present study revealed the crucial role of BRCA1 in PC aggressiveness risk, outstanding the gender imbalance regarding the breast cancer risk in women.

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OBJECTIVE: To evaluate early childhood development (ECD) and its determinants in 12 to 59 months old children residents of communities <100 000 inhabitants. MATERIALS AND METHODS: The Encuesta Nacional de Salud y Nutrición of communities <100 000 inhabitants (Ensanut 100k) evaluated language level, access to ECD care services and standardized indicators of the eight quality of the development environment. We report indicator prevalence and standardized language scores according to variables of interest. RESULTS: 20.7% of children attended eight wellchild care visits within the first year of life, 13.0% received an ECD assessment, 75.0% receive support for learning, 23.4% have books and 57.7% experiment violent discipline. Improved language levels are associate with socioeconomic capacities, maternal education, preschool attendance, support for learning and household books. Children exposed to more protective factors present a language level 1.5 standard deviations higher than their peers exposed to more risk factors. CONCLUSIONS: There is a need to increase the coverage of ECD care services and to improve early development opportunities within households.

OBJETIVO: Evaluar el desarrollo infantil temprano (DIT) y sus determinantes en niños/as de 12 a 59 meses residentes en localidades de menos de 100 000 habitantes. MATERIAL Y MÉTODOS: . La Encuesta Nacional de Salud y Nutrición en localidades con menos de 100 000 habitantes (Ensanut 100k) evaluó el nivel de lenguaje, acceso a servicios de atención al DIT e indicadores de calidad del contexto de desarrollo. Se estiman prevalencias de indicadores y puntajes estandarizados de lenguaje según variables de interés. RESULTADOS: 20.7% de los niños/as asistió a ocho consultas del niño sano en su primer año, 13.0% recibió evaluación de DIT, 75.0% recibe apoyo al aprendizaje, 23.4% cuenta con libros y 57.7% sufre disciplina violenta. Mejores niveles de lenguaje se asocian con las capacidades económicas, escolaridad materna, asistencia a preescolar, apoyo al aprendizaje y acceso a libros. Los niños/as expuestos a más factores protectores presentan nivel de lenguaje 1.5 DE mayor que en niños/as con más factores de riesgo. CONCLUSIONES: Se requiere aumentar la cobertura de atención al DIT y mejorar las oportunidades de desarrollo en hogares.

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Resumen: Objetivo: Evaluar el desarrollo infantil temprano (DIT) y sus determinantes en niños/as de 12 a 59 meses residentes en localidades de menos de 100 000 habitantes. Material y métodos: La Encuesta Nacional de Salud y Nutrición en localidades con menos de 100 000 habitantes (Ensanut 100k) evaluó el nivel de lenguaje, acceso a servicios de atención al DIT e indicadores de calidad del contexto de desarrollo. Se estiman prevalencias de indicadores y puntajes estandarizados de lenguaje según variables de interés. Resultados: 20.7% de los niños/as asistió a ocho consultas del niño sano en su primer año, 13.0% recibió evaluación de DIT, 75.0% recibe apoyo al aprendizaje, 23.4% cuenta con libros y 57.7% sufre disciplina violenta. Mejores niveles de lenguaje se asocian con las capacidades económicas, escolaridad materna, asistencia a preescolar, apoyo al aprendizaje y acceso a libros. Los niños/as expuestos a más factores protectores presentan nivel de lenguaje 1.5 DE mayor que en niños/as con más factores de riesgo. Conclusión: Se requiere aumentar la cobertura de atención al DIT y mejorar las oportunidades de desarrollo en hogares.

Abstract: Objective: To evaluate early childhood development (ECD) and its determinants in 12 to 59 months old children residents of communities <100 000 inhabitants. Materials and methods: The Encuesta Nacional de Salud y Nutrición of communities <100 000 inhabitants (Ensanut 100k) evaluated language level, access to ECD care services and standardized indicators of the eight quality of the development environment. We report indicator prevalence and standardized language scores according to variables of interest. Results: 20.7% of children attended eight well-child care visits within the first year of life, 13.0% received an ECD assessment, 75.0% receive support for learning, 23.4% have books and 57.7% experiment violent discipline. Improved language levels are associate with socioeconomic capacities, maternal education, preschool attendance, support for learning and household books. Children exposed to more protective factors present a language level 1.5 standard deviations higher than their peers exposed to more risk factors. Conclusion: There is a need to increase the coverage of ECD care services and to improve early development opportunities within households.

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OBJECTIVE: To update information on the mortality trend due to lung cancer in Mexico from 1990 to 2016. MATERIALS AND METHODS: Age-adjusted rates were obtained using the direct method. The percentage of annual change in the mortality of lung cancer was obtained through joinpoint analysis at the national level, by region, sex and rural-urban stratum, and in the last two the age-cohort-period effect. RESULTS: There was an annual decrease in mortality rates due to this neoplasm in the last 10 years, significantly higher in men (-3.5% CI95% -4.0,-2.9) than in women (-1.9% CI95% -2.1,-1.7), and a generational gap between men and women and urban-rural stratum with a decreasing trend in the risk of death. CONCLUSIONS: Mortality trends due to lung cancer from 1993 to 2016 show a decrease in different magnitudes and specific periods.

OBJETIVO: Actualizar información sobre la tendencia de mortalidad por cáncer de pulmón en México de 1990 a 2016. MATERIAL Y MÉTODOS: Se obtuvieron tasas ajustadas por edad mediante el método directo. Se obtuvo el porcentaje de cambio anual de la mortalidad por cáncer de pulmón, mediante análisis joinpoint a nivel nacional, por región, sexo y estrato rural-urbano y, en estos dos últimos, el efecto de edad-periodo-cohorte. RESULTADOS: Se observó un decremento anual en las tasas de mortalidad por esta neoplasia en los últimos 10 años, significativamente mayor en los hombres (-3.5% IC95% -4.0,-2.9) que en las mujeres (-1.9% IC95% -2.1,-1.7), una brecha generacional entre hombres y mujeres y estrato urbano-rural con tendencia decreciente en el riesgo de muerte. CONCLUSIONES: Las tendencias de mortalidad por cáncer de pulmón de 1993 a 2016 presentan una disminución en diferentes magnitudes y periodos específicos.

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Resumen: Objetivo: Actualizar información sobre la tendencia de mortalidad por cáncer de pulmón en México de 1990 a 2016. Material y métodos: Se obtuvieron tasas ajustadas por edad mediante el método directo. Se obtuvo el porcentaje de cambio anual de la mortalidad por cáncer de pulmón, mediante análisis joinpoint a nivel nacional, por región, sexo y estrato rural-urbano y, en estos dos últimos, el efecto de edad-periodo-cohorte. Resultados: Se observó un decremento anual en las tasas de mortalidad por esta neoplasia en los últimos 10 años, significativamente mayor en los hombres (-3.5% IC95% -4.0,-2.9) que en las mujeres (-1.9% IC95% -2.1,-1.7), una brecha generacional entre hombres y mujeres y estrato urbano-rural con tendencia decreciente en el riesgo de muerte. Conclusión: Las tendencias de mortalidad por cáncer de pulmón de 1993 a 2016 presentan una disminución en diferentes magnitudes y periodos específicos.

Abstract: Objective: To update information on the mortality trend due to lung cancer in Mexico from 1990 to 2016. Materials and methods: Age-adjusted rates were obtained using the direct method. The percentage of annual change in the mortality of lung cancer was obtained through joinpoint analysis at the national level, by region, sex and rural-urban stratum, and in the last two the age-cohort-period effect. Results: There was an annual decrease in mortality rates due to this neoplasm in the last 10 years, significantly higher in men (-3.5% CI95% -4.0,-2.9) than in women (-1.9% CI95% -2.1,-1.7), and a generational gap between men and women and urban-rural stratum with a decreasing trend in the risk of death. Conclusion: Mortality trends due to lung cancer from 1993 to 2016 show a decrease in different magnitudes and specific periods.

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Sexually transmitted infections and its contribution to prostate cancer (PC) development have been relevant in different populations. MSMB gene polymorphism (rs10993994) has exhibited an association both with PC as well as the susceptibility to sexually transmitted infections. Hitherto, these conditions have been not studied in Mexico yet, neither if sexually transmitted infections could modify the MSMB and PC association. Herein, socio-demographic features, sexually transmitted infections records, the reproductive backgrounds, and the genetic characterisation were analysed in 322 incident PC cases and 628 population healthy controls from Mexico City. Whole PC, early-onset PC (PC at < 60 years old), late-onset PC (≥ 60 years old), and PC aggressiveness were used to evaluate the genetic variants contribution to PC risk using unconditional logistic regression models. Overall, none associations between the allelic variants of rs10993994 polymorphisms with whole and PC aggressiveness were found. Howbeit, the TT genotype carriers presented the highest susceptibility to develop early-onset PC (OR = 2.66; 95% CI = 1.41, 5.04; p = 0.03) than CC+CT carriers, both with codominant and recessive models. Although none association between whole PC and MSMB gene polymorphism was found, our results were reinforced by prior studies in European descendent populations, suggesting a contribution between rs10993994 and early-onset PC development.

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BACKGROUND: Mexico City has air, water and food pollution problems; however, human exposure to cadmium and its sources have not been described. OBJECTIVES: To determine the blood cadmium (BCd) level and its main exposure sources among males aged 40 years or older living in different areas of Mexico City. METHODS: After receiving informed consent, we interviewed 702 males aged ≥40 years to collect data on their sociodemographic characteristics, lifetime occupation, smoking history, and dietary habits, using a validated questionnaire. The BCd level (µg/L) was determined by atomic absorption spectrophotometry. RESULTS: The BCd mean level ±â€¯SD was 2.61 ±â€¯0.82 µg/L, and 20% of men reported a potential cadmium occupational exposure. After adjusting for age and other potential confounders, the main determinants of the BCd level were the current smoking status at interview, with low (ß≤8.5packs/year vs. non-smoker = 0.46; 95% CI: 0.28-0.64 µg/L; p < 0.01) and high (ß> 8.5 packs/year vs. non-smoker = 0.71; 95% CI: 0.56-0.87 µg/L; p < 0.01) smoking intensity, and living in the Center (ßCenter vs. South = 0.20; 95% CI: 0.02-0.37 µg/L; p = 0.02) or West area of the city (ßWest vs. South = 0.40, 95% CI: 0.21-0.58 µg/L; p < 0.001). Moreover, the potential dietary sources of BCd included: liver (ßYes vs. No = 0.13, 95% CI: 0.03-0.23 µg/L; p = 0.01), "Chorizo" (ß>1-3servings/month vs. No = 0.14, 95% CI: 0.01-0.26 µg/L; p < 0.001), sausage and ham. CONCLUSIONS: The BCd levels observed in this population are high and only similar to those observed in workers from a sanitary landfill area in Southern Thailand. Potential environmental Cd exposure sources, such as industrial activity and previous land use, in the West and Center areas of the city should be explored in detail, especially in vulnerable population groups, such as children.

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BACKGROUND: Inconsistent associations between smoking status and prostate cancer (PC) could be due to exposure assessment error. Reconstructing smoking behaviors over the life course could reduce exposure assessment error. METHODS: As part of a case-control study, we identified 402 incident and histologically confirmed PC cases that were matched by age (±5 years) to 805 population controls. Through direct interview, we obtained information about: age at smoking onset, intensity and frequency of cigarette smoking at different life stages, and smoking cessation age. Smoking status at interview and average smoking index over the lifetime (packs/year) were estimated. Life course smoking patterns were obtained applying the k-means+ method for longitudinal data to the smoking index (pack/year) for each life stage. RESULTS: Two life-course smoking patterns were identified among ever smokers: "pattern A" characterized by males who reported low and constant smoking intensity (87.8%), and "pattern B" (12.2%) males with an initial period of low intensity, followed by an increase during the second period. Compared to never smokers, pattern B was associated with higher poorly differentiated PC, (OR 2.30; 95% CI 1.21-4.38). No association was observed with average smoking index. CONCLUSION: Life course smoking patterns seem to capture the smoking variability during life course and reduce the likelihood of reverse causation. Using this assessment strategy our findings support the potential role of tobacco smoking in PC, particularly poorly differentiated PC. Prospective studies with comprehensive smoking history during the lifetime are needed to confirm these findings.

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OBJECTIVE: This study determined the main dietary sources of urinary molybdenum (Mo) concentrations in a sample of 124 pregnant women in Mexico. MATERIALS AND METHODS: Dietary data was collected during pregnancy, through a semi-qualitative food frequency questionnaire, with information of 84 foods. Urine Mo levels were determined by atomic absorption spectrometry, for at least two trimesters of pregnancy. The associations with Mo levels were estimated by generalized mixed effect regression models. RESULTS: Between 5.8 to 12.7% of the samples were above the 95th percentile of urinary Mo distribution reported by National Health and Nutrition Examination Survey (NHANES) 2009-2010 for women (151 µg/L and 148 µg/g creatinine). After bootstrap resampling was conducted, women with high-consumption of hot peppers (ß=1.34µg/g; 95% CI: 1.00-1.80; p= 0.05) had marginally higher urinary Mo concentration levels, creatinine adjusted, compared to women with low-consumption. CONCLUSION.: Hot chili pepper consumption may contribute to body burden Mo levels in this population.

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Abstract: Objective: This study determined the main dietary sources of urinary molybdenum (Mo) concentrations in a sample of 124 pregnant women in Mexico. Materials and methods: Dietary data was collected during pregnancy, through a semi-qualitative food frequency questionnaire, with information of 84 foods. Urine Mo levels were determined by atomic absorption spectrometry, for at least two trimesters of pregnancy. The associations with Mo levels were estimated by generalized mixed effect regression models. Results: Between 5.8 to 12.7% of the samples were above the 95th percentile of urinary Mo distribution reported by National Health and Nutrition Examination Survey (NHANES) 2009-2010 for women (151 μg/L and 148 μg/g creatinine). After bootstrap resampling was conducted, women with high-consumption of hot peppers (β=1.34μg/g; 95% CI: 1.00-1.80; p= 0.05) had marginally higher urinary Mo concentration levels, creatinine adjusted, compared to women with low-consumption. Conclusion. Hot chili pepper consumption may contribute to body burden Mo levels in this population.

Resumen: Objetivo: Determinar las fuentes dietéticas de molibdeno (Mo) urinario en 124 mujeres embarazadas residentes en el estado de Morelos, México. Material y métodos: Mediante un cuestionario de frecuencia de consumo de 84 alimentos, se obtuvo información dietética durante el embarazo. Las concentraciones urinarias de Mo se determinaron por espectrometría de absorción atómica, en al menos dos trimestres del embarazo. La asociación se estimó mediante modelos de efectos mixtos generalizados. Resultados: Entre 5.8 y 12.7% de las muestras superaron el P95 (151 µg/L y 148 µg/g creatinina) de la distribución de Mo urinario reportado para mujeres por la Encuesta Nacional de Nutrición y Salud de Estados Unidos (NHANES) 2009-2010. El mayor consumo de chile (β=1.34μg/g; IC95%: 1.00-1.80; p=0.05) se asoció con concentraciones marginalmente mayores de Mo. Conclusión: Probablemente debido a los fertilizantes o el sistema de riego utilizado en su cultivo, el consumo de chile es una posible fuente de exposición a Mo, en esta población.

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