Background: Breastfeeding can be affected by maternal employment. This is important considering that in 2019, 47.1% of women globally participated in the labor force. The aim of this study was to review workplace interventions to promote, protect and support breastfeeding practices among working mothers globally. Methods: A systematic review was conducted following the guidance of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Observational, experimental and qualitative peer-reviewed studies in English and Spanish, published between 2008 and 2019 were included. The review focused on working women who were pregnant, breastfeeding or who recently had a child, and women’s working environments. The outcomes of interest included breastfeeding intentions, initiation, exclusivity and duration, confidence in breastfeeding or breastmilk extraction, and perceived support at workplace. Quality was assessed according to National Institute for Health and Care Excellence (NICE) checklist for systematic reviews. It was registered on PROSPERO (#140624). Results: Data was extracted from 28 quantitative and 9 qualitative studies. The most common interventions were designated spaces for breastfeeding or breastmilk extraction (n = 24), and the support from co-workers (n = 20). The least common interventions were providing breast pumps (n = 4) and giving mothers the flexibility to work from home (n = 3). Studies explored how interventions affected different breastfeeding outcomes including breastfeeding duration, breastfeeding exclusivity, confidence in breastmilk expression, and breastfeeding support. The evidence suggests that workplace interventions help increase the duration of breastfeeding and prevent early introduction of breastmilk substitutes. Having a lactation space, breastmilk extraction breaks, and organizational policies are key strategies. However, to achieve equitable working conditions for breastfeeding mothers, organizational and interpersonal changes need to occur as well. Conclusions: The systematic review revealed that interventions at the workplace are important in protecting, promoting and supporting breastfeeding among working mothers. To achieve equitable work environments and fair nutritional opportunities for infants of working mothers, interventions should focus at the three ecological layers – individual, interpersonal, and organizational. The quality of studies can be improved. There is a need for studies assessing impacts of workplace interventions on infant feeding practices, mothers’ self-esteem and outcomes such productivity and abstentionism.

Background/objective: Changes in metabolism and extensive hemodynamic adjustments occur during normal pregnancy. The presence of maternal obesity imposes an overload to these physiological adaptations that may result in increased risk for the development of cardiometabolic complications during and after pregnancy. The aim of this study is to describe total cholesterol (TC), triglycerides (TG), glucose, and arterial blood pressure (BP) trajectories and to analyze the association of these cardiometabolic risk indicators during pregnancy with pre-pregnancy body mass index (pBMI) and monthly gestational weight gain (MGWG). Subjects/methods: A prospective cohort study of pregnant women was conducted in Mexico City. Monthly samples of blood were taken during clinical follow-up and biochemical and blood pressure were measured during each visit. Adjusted linear mixed-effect regression models were fit to describe the trajectories of these biomarkers during pregnancy and to analyze the association with pBMI and MGWG. Results: Seven hundred and twenty women were included of which 16.6% had pre-gestational obesity, 33.2% had pre-gestational overweight, 45.8% had normal pBMI and 4.4% had pre-gestational underweight. Women with pre-gestational obesity had higher lipids concentrations in the beginning of pregnancy (TC: $$\hat \beta$$β ̂ = 33.08, p = 0.010; TG: $$\hat \beta$$β ̂ = 31.29, p = <0.001) but the concentrations increased less than in women with normal pBMI (TC: $$\hat \beta$$β ̂ = −14.18, p = 0.001; TG: $$\hat \beta$$β ̂ = −5.42, p < 0.001). By the end of pregnancy, women with pre-gestational obesity had lower concentrations of lipids than women with normal pBMI. By contrast, women with pre-gestational obesity had higher glucose concentrations and higher BP levels than women with normal pBMI over pregnancy. Conclusions: pBMI is differentially associated with longitudinal trajectories of maternal biochemical markers of cardiometabolic risk. MGWG did not significantly affect the biochemical indicators or BP trajectories. Our results suggest that pBMI is more relevant to predicting adverse cardiometabolic markers trajectories during pregnancy than MGWG.

Background and Objectives: Metabolic-dysfunction-associated steatotic liver disease or MASLD is the main cause of chronic liver diseases in children, and it is estimated to affect 35% of children living with obesity. This study aimed to identify metabolic phenotypes associated with two advanced stages of MASLD (hepatic steatosis and hepatic steatosis plus fibrosis) in Mexican children with obesity. Materials and Methods: This is a cross-sectional analysis derived from a randomized clinical trial conducted in children and adolescents with obesity aged 8 to 16 years. Anthropometric and biochemical data were measured, and targeted metabolomic analyses were carried out using mass spectrometry. Liver steatosis and fibrosis were estimated using transient elastography (Fibroscan^® Echosens, Paris, France). Three groups were studied: a non-MASLD group, an MASLD group, and a group for MASLD + fibrosis. A partial least squares discriminant analysis (PLS-DA) was performed to identify the discrimination between the study groups and to visualize the differences between their heatmaps; also, Variable Importance Projection (VIP) plots were graphed. A VIP score of >1.5 was considered to establish the importance of metabolites and biochemical parameters that characterized each group. Logistic regression models were constructed considering VIP scores of >1.5, and the receiver operating characteristic (ROC) curves were estimated to evaluate different combinations of variables. Results: The metabolic MASLD phenotype was associated with increased concentrations of ALT and decreased arginine, glycine, and acylcarnitine (AC) AC5:1, while MASLD + fibrosis, an advanced stage of MASLD, was associated with a phenotype characterized by increased concentrations of ALT, proline, and alanine and a decreased Matsuda Index. Conclusions: The metabolic MASLD phenotype changes as this metabolic dysfunction progresses. Understanding metabolic disturbances in MASLD would allow for early identification and the development of intervention strategies focused on limiting the progression of liver damage in children and adolescents.

Aging involves significant changes in body composition, marked by declines in muscle mass and bone mineral density alongside an increase in fat mass. Sarcopenia is characterized by low strength and muscle mass, and osteosarcopenia is the coexistence of sarcopenia and osteopenia/osteoporosis. Physiologically, there is a crosstalk between muscle and bone tissues mediated by several pathways. Both, sarcopenia and osteosarcopenia, have been related with adverse outcomes such as functional disability. However, there is a lack of longitudinal studies. Therefore, this study aimed to assess whether sarcopenia and osteosarcopenia phenotypes increased the risk of functional disability in a longitudinal cohort of community-dwelling adults. This study constitutes a secondary longitudinal analysis of data derived from the prospective cohort FraDySMex (Frailty, Dynapenia, and Sarcopenia in Mexican adults). FraDySMex is conducted in community-dwelling adults aged 50 years or older living in Mexico City. Data from 2014 to 2015 was considered as baseline evaluation, and the 2019 wave was the follow-up evaluation. Individuals with complete baseline and follow-up evaluations were included in the analysis. Sarcopenia diagnosis adhered to the FNIH criteria, while osteopenia/osteoporosis classification followed WHO guidelines. Osteosarcopenia was defined as the concurrent presence of sarcopenia and osteopenia/osteoporosis. Functional disability was identified by the Lawton Instrumental Activities of Daily Living (IADL) Scale. Adjusted mixed-effects logistic regression models were estimated to evaluate the effect of body composition phenotype on the risk of functional disability. The final sample included 320 adults with complete longitudinal data. The majority of were women (83.4%) and had 7-12 years of education (48.4%). At the baseline evaluation, 50.9% aged 50-70. The osteosarcopenia phenotype was associated with a higher risk of functional disability (OR: 2.17, p = 0.042) compared with the no osteopenia/sarcopenia group. Conversely, sarcopenia (OR: 1.50, p = 0.448) and osteopenia/osteoporosis (OR: 1.50, p = 0.185) phenotypes were not associated with functional disability. Our study underscores that osteosarcopenia significantly increased the risk of functional disability, particularly in terms of Instrumental Activities of Daily Living (IADL). These results emphasize the importance of screening for sarcopenia, osteopenia/osteoporosis, and osteosarcopenia across various clinical settings. Early detection and intervention hold promise for averting functional disability and mitigating associated adverse outcomes in adults.

According to the WHO, low birth weight (LBW) affects 15–20% of newborns worldwide. In Mexico, there are no national, state, nor municipal estimates that inform the country’s situation over time. The purpose of this study was to estimate the incidence of LBW at the national, state, and municipal levels from 2008 to 2017, and to estimate the LBW incidence based on maternal sociodemographic characteristics, prenatal care and marginalization indexes at the national level using open national data. We used spatial data analysis to georeferenced LBW incidence at the three levels of geographical disaggregation studied. At the national level, the incidence of LBW increased progressively from 6.2% (2008) to 7.1% (2017), and the country’s capital represented the area with the highest incidence. Southeastern and central states reported the highest LBW regional incidence. At the municipal level, the number of municipalities with an incidence of LBW ≥8% increased in both male and female newborns. The incidence of LBW was higher as the marginalization indexes increases. The results from this study may assist in the identification of vulnerable groups and the development of public health programs and policies with an intersectoral approach that improves maternal and child nutrition.

Introduction: Maternal and child malnutrition is a worldwide public health problem with short, medium, and long-term adverse consequences for both mother and child. In Mexico, maternal and child malnutrition represents a serious public health problem that must be urgently addressed. In this context, Primary Health Care (PHC) plays an important role in the prevention, detection, monitoring, and treatment of the different forms of maternal and child malnutrition. Assessing the quality of nutritional care offered at this level of care is necessary in order to improve it; however, there are no indicators for the evaluation of this quality. Therefore, this study aimed at developing a set of indicators to assess the quality of maternal and child nutritional care at PHC.Methods: We developed indicators for different stages of life: preconception, pregnancy, infancy, and preschool age. A systematic review of the literature on clinical guidelines for the prevention, diagnosis, and treatment of the different forms of malnutrition was carried out; the recommendations of the guidelines evaluated with good quality were extracted.Results: Based on these recommendations, 22 indicators were constructed. A pilot study was carried out to validate the indicators and 16 indicators were selected to assess the maternal and child nutritional care at PHC.