Background: A common risk behavior in adolescence is the early initiation of unprotected sex that exposes adolescents to an unplanned pregnancy or sexually transmitted infections. Schools are an ideal place to strengthen adolescents’ sexual knowledge and modify their behavior, guiding them to exercise responsible sexuality. The purpose of this article was to evaluate the knowledge of public secondary school teachers who received training in comprehensive education in sexuality (CES) and estimate the counseling’s effect on students’ sexual behavior. Methods: Seventy-five public school teachers were trained in participatory and innovative techniques for CES. The change in teacher knowledge (n = 75) was assessed before and after the training using t-tests, Wilcoxon ranks tests and a Generalized Estimate Equation model. The students’ sexual and reproductive behavior was evaluated in intervention (n = 650) and comparison schools (n = 555). We fit a logistic regression model using the students’ sexual debut as a dependent variable. Results: Teachers increased their knowledge of sexuality after training from 5.3 to 6.1 (p < 0.01). 83.3% of students in the intervention school reported using a contraceptive method in their last sexual relation, while 58.3% did so in the comparison schools. The students in comparison schools were 4.7 (p < 0.01) times more likely to start sexual initiation than students in the intervention schools. Conclusion: Training in CES improved teachers’ knowledge about sexual and reproductive health. Students who received counseling from teachers who were trained in participatory and innovative techniques for CES used more contraceptive protection and delayed sexual debut.
Objetivo. Describir la prevalencia de obesidad en adultos de la Encuesta Nacional de Salud y Nutrición Continua 2020-2023 (Ensanut Continua 2020-2023), sus principales características sociodemográficas, su asociación con enfermedades crónicas, factores de riesgo y consumo de bebidas energéticas industrializadas (BEI), así como las tendencias en los últimos 23 años, para contribuir en la generación de evidencia para el diseño de políticas de salud pública. Material y métodos. Se analizó la información de 32 889 participantes para caracterizar a la población adulta mexicana por grupos de índice de masa corporal (IMC) y estratificados por variables sociodemográficas. Se usaron modelos de regresión logística para estimar las asociaciones de esos grupos con las variables de interés. Finalmente, se exploró la tendencia de los grupos de IMC en las últimas seis encuestas nacionales (2000-2023). Resultados. La prevalencia de obesidad en adultos fue 37.1% (41.0% mujeres, 33.0% hombres). El porcentaje de energía proveniente de BEI fue el doble en hombres que en mujeres (6.8 vs. 3.3%). Los hombres del cuartil más alto del porcentaje de energía proveniente de BEI tuvieron 2.29 veces mayor posibilidad de tener obesidad (p0.05). Conclusiones. La prevalencia nacional de obesidad en adultos mostró un incremento de 41.7% en el periodo 2000-2016. A partir del 2016 hubo una estabilización de la tendencia. El alto consumo de BEI aumenta la posibilidad de tener obesidad. Se requieren intervenciones con una visión integral y multisistémica que permitan la prevención y control de la obesidad.
Evidence supports that television food advertisements influence children’s food preferences and their consumption. However, few studies have examined the extent and nature of food marketing to children in low and middle income countries. This study aims to assess the nutritional quality of foods and beverages advertised on Mexican TV, applying the Mexican, World Health Organization (WHO) European and United Kingdom (UKNPM) nutrient profile models, before the Mexican regulation on food marketing came into effect. We recorded 600 h on the four national public and free TV channels with the highest national ratings, from December 2012 to April 2013. Recordings were done for 40 randomly selected (week, weekend, school and vacation) days, from 7 am to 10 pm. Nutritional information per 100 g/ml of product was obtained from the product labels or company websites. A total of 2,544 food and non-alcoholic beverage advertisements were broadcast, for 275 different products. On average, the foods advertised during cartoon programming had the highest energy (367 kcal) and sugar (30.0 g) content, while foods advertised during sport programming had the highest amount of total fat (9.5 g) and sodium (412 mg) content. More than 60 % of the foods advertised did not meet any nutritional quality standards. 64.3 % of the products did not comply with the Mexican nutritional standards, as compared with 83.1 % and 78.7 % with WHO Europe and UKNPM standards, respectively. The food groups most frequently advertised were beverages (24.6 %), followed by chocolate and confectionery sugar (19.7 %), cakes, sweet biscuits and pastries (12.0 %), savory snacks (9.3 %), breakfast cereals (7.1 %), ready-made food (6.4 %) and dairy products (6.0 %). The majority of foods and beverages advertised on Mexican TV do not comply with any nutritional quality standards, and thus should not be marketed to children. The nutritional quality standards applied by the Mexican regulation are much weaker than those applied by the WHO Europe and United Kingdom. The Mexican government should improve the nutrition standards in its new regulation, especially the sugar cut off points.
Background: Ultraprocessed products (UPPs) have been associated with unfavorable health outcomes; however, until now, they have not been associated with the coexistence of undernutrition and overnutrition, known as the double burden of malnutrition (DBM) at the individual level. Methods: Cross-sectional analyses were performed on data collected from children and adolescents participating in the 2006 and 2016 Mexican National Health and Nutrition Surveys. The food and beverages reported in the food frequency questionnaire (SFFQ) were classified as UPPs as defined by the NOVA classification system. Associations of UPPs with anemia, excess weight, and the DBM were estimated with logistic regression models. A pseudo-panel was generated using the cohorts of children born from 1997 to 2001 to estimate the effect of the UPPs on anemia, excess weight, and the DBM. Results: The consumption of UPPs (% energy) was higher in 2016 (children 30.1% and adolescents 28.3%) than in 2006 (children 27.3% and adolescents 23.0%) in both age-groups. The higher contribution of UPPs was positively associated with excess weight and the DBM in children’s lower tertile of socioeconomic status (SES) and the DBM in higher tertile of SES in adolescents. The pseudo-panel analysis shows the positive association between UPPs and DBM in lower SES. Conclusions: These results provide evidence of the association between the consumption of UPPs and the DBM and excess weight in children and adolescents.
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.
Controversy remains surrounding vitamin D routine supplementation in healthy pregnancy, and the doses are unclear. The aim of this study was to describe maternal vitamin D status throughout pregnancy in a group of Mexican women and evaluate the effect of frequently prescribed doses of vitamin D3 on longitudinal 25-OH-D concentrations, adjusting for obesity, season, and other factors. We conducted a cohort study (Instituto Nacional de Perinatología-INPer) (2017–2020)) of healthy pregnant women without complications. Pregestational overweight/obesity (body mass index ≥ 25), vitamin D3 supplementation (prescribed by physician; 0–250, 250–400, and >400 IU/day), and serum 25-OH-D concentrations (ELISA) were evaluated in each trimester of pregnancy. Vitamin D deficiency or insufficiency was computed (<20 and <30 ng/mL, respectively). We studied 141 adult women; 58.5% had pregestational obesity or overweight. In the first trimester, 45.8% of the women were supplemented with vitamin D3; 51.4% had vitamin D insufficiency and 37.3%, deficiency. In the third trimester, 75.4% of the women were supplemented, and 20% of them still had deficiency. The final general mixed linear model showed that 25-OH-D significantly increased throughout pregnancy (p < 0.001); the highest increase was observed in the third trimester in women with doses >400 IU/day of vitamin D3 (+4 ng/mL, 95% CI: 1.72–8.11 ng/mL). In winter/autumn, 25-OH-D concentrations were also lower (p ≤ 0.05). In this group of pregnant Mexican women, the prevalence of vitamin D deficiency and insufficiency was high. A higher increase in 25-OH-D concentrations during pregnancy was observed when the women were supplemented with >400 IU/day. Common supplementation doses of 250–400 IU/day were insufficient for achieving an adequate maternal vitamin D status.