Front-of-pack food labels (FOPL) can help consumers make healthy and informed food choices. FOPL are used in the food market but evaluations of their understanding and acceptability are scanty. This study aimed to explore the subjective understanding and acceptability of four FOPL among Hispanic consumers. A qualitative study was conducted in six States of Mexico, in 18 urban elementary schools. A purposive sample of 135 parents of fifth-grade children was selected. Four FOPL were assessed: Logos, Rating Stars, Guideline Daily Allowances (GDA’s), and Multiple Traffic Lights (MTL). Trained interviewers performed 18 focus groups with the participants, using an interview guide. Participants were asked about their subjective understanding and acceptability of the FOPL, displaying 16 generic breakfast cereal boxes designed for this study (four for each FOPL), varying in their nutritional value. Afterwards, participants were asked to choose among the four cereal boxes the one to best communicate the product healthiness and their reasons for choice, proposals for improving the FOPL, and desirable characteristics for new FOPL. Finally, a socio-demographic questionnaire was applied. Thematic analysis of the transcriptions of the focus groups was performed, using Altlas.tiV5 software. Logos were perceived as easy to understand, highly acceptable, and useful for decision-making; institutional endorsement of Logos was related to greater confidence in the label. The GDA’s were hard to understand considering the nutritional knowledge and time needed for interpretation. The Rating Stars were related to the quality in businesses rather than foods. The MTL were viewed as indicating the high/low content of specific nutrients, but the meaning of the amber color was not fully understood. Participants highlighted the need for a simple FOPL that allows easily identification of healthy products while considering food purchasing time limitations and interpretation of food portions. Logos with an institutional endorsement was the best understood and accepted FOPL, and the GDA’s and Rating Stars were the least. Our findings provide valuable insights about Hispanic consumers´ perceptions regarding FOPL and to guide public health policy. Further studies are needed in populations with chronic diseases and diverse social contexts.

Objetivo. Evaluar cambios en la magnitud de la inseguridad alimentaria (IA) en hogares mexicanos en pobreza, en el periodo entre 2012 y 2018 y analizar la asociación entre IA y acceso, disponibilidad y consumo de alimentos. Material y métodos. Se incluyó información de 4 464 hogares de la Encuesta Nacional de Salud y Nutrición en localidades de México con menos de 100 000 habitantes (Ensanut 100k). La IA se midió con la Escala Latinoamericana y Caribeña de Seguridad Alimentaria. El acceso y la disponibilidad se anali­zaron con gasto en alimentos, mientras que el consumo se analizó con la diversidad de la dieta en mujeres. Se estimó la asociación entre IA y gasto en alimentos y la asociación entre IA y diversidad de la dieta con modelos de regresión logística múltiple. Resultados. La IA moderada y severa se mantuvo en 43% entre 2012 y 2018. Mayor gasto en azúcar, aceite y comida fuera de casa, así como el consumo de carnes y lácteos, se asociaron con menor posibilidad de IA. Conclusión. Es importante integrar distintas dimensiones de la IA para forta­lecer su medición y monitoreo.

OBJECTIVE: To describe the magnitude and distribution of folate and vitamin B12 deficiency in Mexican children. MATERIALS AND METHODS: Folate and vitamin B12 serum concentrations were measured in a probabilistic sample of 2 099 children. Adjusted prevalence, mean concentrations and relevant associations were calculated based on series of logistic and linear regression models. RESULTS: The overall prevalence of folate and vitamin B12 deficiency were 3.2% and 7.7%, respectively. The highest prevalence of folate was found in the 2-year-old (7.9%), and of vitamin B12 in the 1 year-old (9.1%) groups. Being a beneficiary of the fortified milk program Liconsa was protectively associated with serum folate (p=0.001) and daily Intake of milk with vitamin B12 (p=0.002) concentrations. CONCLUSIONS: We describe the magnitude of folate and vitamin B12 deficiencies in Mexican children. The deficiency of both vitamins in children under 2 years old is a moderate public health problem in Mexico.

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.

Iron deficiency is a major public health problem worldwide, with the highest burden among children. The objective of this randomized efficacy feeding trial was to determine the effects of consuming iron-biofortified beans (Fe-Beans) on the iron status in children, compared to control beans (Control-Beans). A cluster-randomized trial of biofortified beans (Phaseolus vulgaris L.), bred to enhance iron content, was conducted over 6 months. The participants were school-aged children (n = 574; 5–12 years), attending 20 rural public boarding schools in the Mexican state of Oaxaca. Double-blind randomization was conducted at the school level; 20 schools were randomized to receive either Fe-Beans (n = 10 schools, n = 304 students) or Control-Beans (n = 10 schools, n = 366 students). School administrators, children, and research and laboratory staff were blinded to the intervention group. Iron status (hemoglobin (Hb), serum ferritin (SF), soluble transferrin receptor (sTfR), total body iron (TBI), inflammatory biomarkers C-reactive protein (CRP) and α-1-acid glycoprotein (AGP)), and anthropometric indices for individuals were evaluated at the enrollment and at the end of the trial. The hemoglobin concentrations were adjusted for altitude, and anemia was defined in accordance with age-specific World Health Organization (WHO) criteria (i.e., Hb <115 g/L for <12 years and Hb 5.0 mg/L), and 11.6% had elevated AGP (>1.0 g/L) concentrations at baseline. During the 104 days when feeding was monitored, the total mean individual iron intake from the study beans (Fe-bean group) was 504 mg (IQR: 352, 616) over 68 mean feeding days, and 295 mg (IQR: 197, 341) over 67 mean feeding days in the control group (p < 0.01). During the cluster-randomized efficacy trial, indicators of iron status, including hemoglobin, serum ferritin, soluble transferrin receptor, and total body iron concentrations improved from the baseline to endline (6 months) in both the intervention and control groups. However, Fe-Beans did not significantly improve the iron status indicators, compared to Control-Beans. Similarly, there were no significant effects of Fe-Beans on dichotomous outcomes, including anemia and iron deficiency, compared to Control-Beans. In this 6-month cluster-randomized efficacy trial of iron-biofortified beans in school children in Mexico, indicators of iron status improved in both the intervention and control groups. However, there were no significant effects of Fe-Beans on iron biomarkers, compared to Control-Beans. This trial was registered at clinicaltrials.gov as NCT03835377.

Objetivo. Identificar la viabilidad de la Escala de Experiencias de Inseguridad del Agua en el Hogar (Household Water Insecurity Experiences Scale, HWISE, por sus siglas en inglés) como herramienta para evaluar las experiencias de hogares mexicanos en relación con la inseguridad en el acceso al agua. Material y métodos. La escala fue integrada en la Encuesta Nacional de Salud y Nutrición Continua 2021 (Ensanut Continua 2021) y se utilizaron tres criterios para evaluar su viabilidad: 1) Consistencia interna: Se aplicó la prueba Alfa de Cronbach para estimar la correlación entre los ítems de la escala. Se consideró un punto de corte de al menos 0.80 como criterio de confiabilidad; 2) Equivalencia de los ítems para distintos indicadores sociodemográficos; y 3) Variables asociadas con inseguridad del agua. Resultados. La escala HWISE mostró: 1) Buena confiabilidad o consistencia interna (Alfa de Cronbach de 0.928); 2) comportamiento equivalente de los ítems en los contextos urbano y rural, en nueve regiones del país y por terciles de condiciones de bienestar; y 3) asociación significativa con variables predictoras de inseguridad del agua. Conclusiones. La escala HWIS, adaptada para México, es apropiada para su uso en evaluar la condición de inseguridad del agua en hogares mexicanos.