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Evidence strongly supports that to improve breastfeeding practices it is needed to strengthen actions of promotion, protection and support. To achieve this goal, it is necessary to establish a multisectoral national policy that includes elements such as design, implementation, monitoring and evaluation of programs and policies, funding research, advocacy to develop political willingness, and the promotion of breastfeeding from the national to municipal level, all coordinated by a central level. It is until now that Mexico has initiated a reform process to the establish a National Strategy for Breastfeeding Action. This strategy, is the result not only of the consistent scientific evidence on clear and strong benefits of breastfeeding on population health and the development of human capital, but also for the alarming data of deterioration of breastfeeding practices in the country. The comprehensive implementation of the National Strategy for Breastfeeding Action that includes the establishment of a national committee, intra- and inter-sectoral coordination of actions, setting clear goals and monitoring the International Code of Marketing of Breast- Milk Substitutes, is the awaiting responsibility of the public health agenda of the country. [ABSTRACT FROM AUTHOR]

Objective. To describe the design, methods, and challenges encountered during a randomized clinical trial aimed to promote water intake for reducing risks of metabolic syndrome in Mexican women. Materials and methods. In a randomized clinical trial in Cuernavaca, Mexico, overweight and obese (body mass index [BMI] = 25 < 39) women, 18 - < 45 years old with an intake of sugar-sweetened beverages = 250 kilocalories per day (kcal/day) were randomly allocated to the water and education provision group (n = 120) or the education provision only group (n = 120). Results. We screened 1 756 women. The main difficulties encountered were identifying participants with the recruitment criteria, delivering water to participants, and the time demanded from the study participants. Conclusions. The trial's main challenges were difficulties surrounding recruitment, delivery of the intervention, and the time demanded from the study participants. Modifications were effectively implemented without jeopardizing the original protocol. [ABSTRACT FROM AUTHOR]

Objective. To study the magnitude, distribution and trends of undernutrition and overweight in Mexican children under five years between 1988 and 2016. Materials and methods. Underweight, wasting, stunting and overweight prevalences were calculated, at national, regional and rural/ urban locality levels in children under five years from the 1988, 1999, 2006, 2012 and 2016 national probabilistic surveys. Results. Currently 3.9% suffer underweight, 1.9% wasting and 10% stunting. There was an decrease in stunting from 1988 to 2016 (26.9 vs 10.0%), in rural (43.1 vs 12.6%) and urban (22.5 vs 9.1%) localities and in South (38.6 vs 13.4%), Center (29.2 vs 8.4%) and Mexico City (13.6 vs 4.7%). In the North region the decrease was smaller (13.3 vs 11.4%). Overweight diminished from 9.7% to 5.8, mainly between 2012-2016. Conclusions. Stunting has continued its decline in Mexico, but high prevalences persist in some vulnerable groups. Overweight had an unexpected decline between 2012-2016. [ABSTRACT FROM AUTHOR]

Objective. To analyze the association between dietary patterns and metabolic syndrome (MS) components in adult women with excess weight. Materials and methods. Cross-sectional study with anthropometric, dietary, biochemical and blood pressure data. Dietary patterns were identified by factor analysis and multiple logistic regression models were used to analyze associations. Results. The prevalence of altered glucose was 14.6%, of hypertriglyceridemia 40.4%, of altered concentration of high density lipoprotein cholesterol (HDLc) 45.0%, hypertension 4.6% and MS 30%. The pattern with high consumption of corn tortillas, meats and legumes, was associated with less possibility of hyperglycemia (OR= 0.62; 95%CI 0.39-0.98). The pattern with high consumption of sweet and salty snacks, milk, rice, soaps and pasta, was inversely associated with the possibility of low HDLc concentration (OR= 0.76; 95%CI 0.60-0.97). Conclusions. A dietary pattern with greater consumption of legumes, meats and corn tortillas was associated with less possibility of having hyperglycemia. [ABSTRACT FROM AUTHOR]

Objective. The objective of this analysis was to test the impact of daily supplementation with multiple micronutrients (MM) during pregnancy on Zn, vitamin A and folate status compared to iron only (Fe). Material and Methods. The study was carried out during 1997-2000 in a semi-urban community in Morelos state, Mexico. Women were randomly assigned to MM (n= 249) or Fe (n= 258) and received supplements daily (6 d/wk) under supervision by the field team from recruitment (approximately 9 weeks pregnancy) until delivery. Blood samples were collected on a sub-sample of women at baseline, 32 weeks pregnancy and one month postpartum (1PP) and assessed for serum zinc, retinol and whole blood folate (baseline and 1PP only). A breast milk sample was extracted at 1PP and assessed for retinol content. Result. At baseline there was no significant difference between supplementation groups in mean Zn, retinol or folate concentrations or the prevalence of deficiencies (Zn 12.2%, vitamin A 2.8%, folate 5.3%). Mean change in Zn and retinol concentrations from baseline to 32 weeks pregnancy did not differ between groups or between baseline and 1PP for Zn, retinol or folate. At 1PP, there was a tendency (p= 0.09) towards a lower prevalence of folate deficiency/depletion in the MM group (10.0%) than the Fe group (18.5%). Conclusions. MM supplementation during pregnancy did not improve zinc or vitamin A status compared to Fe only. There is some indication that folate status may have improved with MM supplementation despite low prevalence of deficiency. While lack of response in serum retinol may be explained by generally adequate status, the lack of impact on zinc status requires further exploration. [ABSTRACT FROM AUTHOR]

Objective. To analyze risk factors associated with overweight and obesity (OW+O) among female Mexican teenagers (12 to 19 years old). Materials and methods. Secondary analysis of 1 072 teenagers from the Halfway National Survey of Health and Nutrition (Ensanut MC, 2016). Ordinal logistic regression models were used to estimate the association between OW+O and screen time, living with adults with OW+O, marital union, and dietary patterns, among others. Results. OW+O in adolescents was higher when living with overweighed and obese adults (OR= 2.13), >2 hours of screen time (OR= 2.5), discretionary food consumption pattern (OR= 1.81), living in marital union (OR = 2.13), classified in the highest tertile of household wealth index (OR= 1.86), work and doing housework (OR= 5.4). Conclusions. The most important risk factors associated with OW+O in Mexican teenagers were related to family factors and lifestyles. [ABSTRACT FROM AUTHOR]

Objective. This paper describes the rationale, design, and methods of a two-year randomized controlled trial conducted to evaluate the effectiveness of an environmental intervention in 27 elementary schools in Mexico City. Materials and methods. There were two units of analysis, school level addressing changes in elementary public part-time schools, and individual-level addressing behavioral changes in students 9 to 11 years of age. Two intensities of an intervention program were implemented (basic and plus), each containing two intervention components: physical activity and nutrition, supported by a communication/education component. Evaluation of the intervention was carried out during the school cycles 2006-2007 and 2007-2008. Results. Primary outcomes were overweight and obesity prevalence and fitness; environmental and behavioural measures were also examined. Conclusions. This is the first institutional multilevel, multifactorial project, consistent with the best practices available in current literature, carried out in Mexico to prevent childhood obesity in schools. [ABSTRACT FROM AUTHOR]

Objective. This paper describes the rationale, design, and methods of a two-year randomized controlled trial conducted to evaluate the effectiveness of an environmental intervention in 27 elementary schools in Mexico City. Materials and methods. There were two units of analysis, school level addressing changes in elementary public part-time schools, and individual-level addressing behavioral changes in students 9 to 11 years of age. Two intensities of an intervention program were implemented (basic and plus), each containing two intervention components: physical activity and nutrition, supported by a communication/education component. Evaluation of the intervention was carried out during the school cycles 2006-2007 and 2007-2008. Results. Primary outcomes were overweight and obesity prevalence and fitness; environmental and behavioural measures were also examined. Conclusions. This is the first institutional multilevel, multifactorial project, consistent with the best practices available in current literature, carried out in Mexico to prevent childhood obesity in schools. [ABSTRACT FROM AUTHOR]