Sonia Rodríguez-Ramírez

In Mexico, about one third of school-age population is overweight or obese and the diet is one of the main determinants. The purpose of this study was to identify the dietary patterns of Mexican school-age children and to determine their association with the risk of overweight/obesity. This study included 8252 school-age children who participated in the 2006 National Health and Nutrition Survey (ENSANUT-2006). Dietary data were collected using a 7-day Food Frequency Questionnaire (FFQ). Foods were classified into 25 groups and dietary patterns were defined by cluster analysis. Body Mass Index and prevalence of overweight/obesity were calculated. Logistic regression models were used to evaluate the association between dietary patterns and overweight/obesity. Five dietary patterns were identified: Rural dietary pattern (high intake of tortilla and legumes), sweet cereal and corn dishes pattern (high intake of sugary cereals, tortilla, and maize products); diverse pattern (intake of several food groups); western pattern (high intake of sweetened beverages, fried snacks, industrial snack cakes, and sugary cereals), and whole milk and sweet pattern (high intake of whole milk and sweets). We found that children with sweet cereal and corn dishes and western dietary patterns showed an association with overweight and obesity (prevalence ratio 1.29 and 1.35, respectively, using as reference the rural dietary pattern). Patterns characterized by high intakes of sugary cereals, sweetened beverages, industrial snack, cakes, whole milk, and sweets were associated with a higher risk of overweight/obesity among in Mexican school-age children.

Background: Energy-dense non-essential snacks are subject to 8% excise tax in Mexico. Objectives: To model the impact on diet quality of (1) replacing energy-dense snacks with pistachios and (2) adding small amounts of pistachios to the diet. Methods: Data came from the Mexico National Health and Nutrition survey (ENSANUT, by its Spanish acronym) 2012 (n = 7132) and 2016 (n = 14,764). Dietary intakes were collected using a semi-quantitative food frequency questionnaire. Substitution analyses replaced energy-dense snack foods with equicaloric amounts of pistachios (Model 1) or with mixed nuts/seeds (Model 2). Additional analyses (Model 3) added small amounts of pistachios (10–28 g) to the daily diet. Added sugars, sodium, and saturated fat along with protein fiber, vitamins, and minerals were the main nutrients of interest. Dietary nutrient density was assessed using the Nutrient-Rich Food (NRF9.3) Index. Separate modeling analyses were performed for ENSANUT 2012 and 2016 and for children and adults. Results: Energy-dense foods, mostly sweet, accounted for about 20% of daily energy. Modeled diets with pistachios and mixed nuts/seeds were much lower in added sugars (p < 0.05). Significant improvements in dietary quality held across all socio-demographic strata. Adding small amounts of pistachios (10–28 g) to the diet (Model 3) increased calories but also led to better diets and higher NRF9.3 dietary nutrient density scores. Conclusions: Modeled diets with pistachios replacing energy-dense snack foods had less added sugars and sodium and more protein, fiber, vitamins, and minerals. Adding small amounts of pistachios also led to better diets. Pistachios are a healthy snack and can be an integral component of healthy diets.

Objetivo. Describir el consumo de grupos de alimentos recomendables y no recomendables para consumo cotidiano y su asociación con características sociodemográficas en población mexicana. Material y métodos. Información proveniente de las Encuestas Nacionales de Salud y Nutrición continuas 2020-2024, utilizando un cuestionario de frecuencia de consumo de alimentos de 7 días. Se estimaron terciles de consumo en gramos de ocho grupos de alimentos por grupo poblacional y se analizó su asociación con características sociodemográficas mediante modelos de regresión logística ordinal. Resultados. El consumo de frutas, verduras y leguminosas fue muy bajo en todas las edades. Vivir en regiones sur y centro se asoció con mayor posibilidad de estar en los terciles más altos de consumo de frutas y verduras y menor posibilidad de consumo de leguminosas y carnes procesadas y en localidades urbanas mayor posibilidad de consumir carnes procesadas. Conclusión. La población de región sur y centro tuvieron mayor consumo de alimentos recomendables.

Objetivo. Estimar la contribución energética de los alimentos mínimamente procesados (MP) y productos ultraprocesados (PU) a la dieta de la población mexicana, y su asociación con factores sociodemográficos. Material y métodos. Se analizó información de dieta de 14 340 personas ≥5 años de la Encuesta Nacional de Salud y Nutrición Continua 2020-2024. Los alimentos se clasificaron con base en el sistema NOVA. Se estimó la contribución de energía de alimentos MP y PU. Se realizaron modelos de regresión cuantílica ajustados para evaluar la asociación entre características sociodemográficas y el consumo de alimentos MP y PU. Resultados. El porcentaje de energía proveniente de PU osciló entre 16.9 y 26.4%, siendo mayor en localidades urbanas y en la región Norte del país. En contraste, la contribución de energía de alimentos MP (38.9-44.1%) fue mayor en localidades rurales, en la región Sur y en hogares indígenas. Estas asociaciones fueron consistentes en los diferentes grupos de edad. Conclusiones. El consumo de PU fue alto en general y factores como vivir en localidades urbanas y en la región Norte se asociaron con mayor consumo. Se requiere fortalecer estrategias focalizadas para reducir el consumo de PU y aumentar el de alimentos MP en la población mexicana.

Objetivo. Estimar la prevalencia de sobrepeso y obesidad (SP+OB) en escolares y adolescentes mexicanos (2020-2024) y analizar factores sociodemográficos asociados. Material y métodos. Se estimaron prevalencias nacionales, regionales, por localidad, entidad federativa y factores sociodemográficos de SP+OB en 10 979 escolares (5-11 años) y 9 142 adolescentes (12-19 años) de Ensanut Continua 2020-2024. Se evaluó la asociación entre SP+OB y factores sociodemográficos con modelos de regresión logística multivariada. Resultados. La prevalencia de SP+OB fue de 36.6% en escolares y de 40.1% en adolescentes. Quintana Roo y Baja California presentaron las mayores prevalencias (≈50%). El SP+OB fue mayor en escolares con mayor escolaridad materna (licenciatura o más, RM= 2.10; IC95%: 1.60,2.76, respecto a primaria o menor); al tener padre/madre con SP+OB; y fue menor en aquellos de localidades rurales en ambos grupos de edad. Conclusiones. El SP+OB en escolares y adolescentes mexicanos sigue elevado, con heterogeneidad estatal. Aunque se requiere más investigación, los hallazgos subrayan la necesidad de políticas públicas diferenciadas.

Bjective. To identify dairy consumption patterns, trends, and associated characteristics in Mexican adults from 2012-2018. Materials and methods. We used data from 25 218 adults aged ≥20 years participating in the Mexican National Health and Nutrition Survey (Ensanut, by its acronym in Spanish) 2012, 2016 and 2018. Through a semiquantitative food frequency questionnaire, we estimated the energy-adjusted intake of 23 dairy products. Dairy patterns were identified using the principal component analysis. To identify associated characteristics and trends, we used independent linear regression models for each pattern. We included survey year as an independent variable in trend estimation (stratified by sex and region). Results. We identified three dairy patterns: 1) skim milk/light yogurt, 2) fresh cheese/high-fat milk and yogurt, and 3) mature cheese/ cream. The highest consumption of all dairy patterns was associated with high education and/or socioeconomic level. Consumption of the “skim milk/light yogurt” and “mature cheeses/cream” patterns increased, whereas “fresh cheese/high-fat milk and yogurt pattern” decreased steadily. These changes were similar among women and men and in all regions. Conclusion. Our findings support the existence of different population-specific dairy consumption patterns with variations over time, mainly determined by socioeconomic characteristics. This approach must be considered to evaluate the association between dairy consumption and health outcomes.

To assess the association between dietary consumption patterns of antioxidant and pro-oxidant nutrients with prostate cancer (PC) and its histological differentiation, we analyzed data from 394 histologically confirmed incident cases of PC and 793 age-matched population controls (± 5 years), residents of Mexico City. Cases were classified by Gleason score into well-, moderately-, and poorly differentiated categories. Dietary nutrient intake over the three years preceding diagnosis for cases and before the interview for controls was estimated using a semi-quantitative food frequency questionnaire. Using energy-adjusted residuals and a k-means approach, we identified three consumption patterns: 1) pro-oxidant (PRO), 2) moderate antioxidants/low pro-oxidants (MaLp), and 3) high antioxidants and pro-oxidants (HaHp). Associations were evaluated using independent unconditional logistic regression models; stratified models were analysed based on smoking status. Although proportions differed, the main food contributors to the MaLp and HaHp patterns included green vegetables, corn tortillas, seeds, and fruits. Compared to the PRO pattern, the MaLp (OR: 0.71; 95% CI 0.53–0.97) and HaHp (OR: 0.70; 95% CI 0.50–0.99) patterns were associated with lower odds of having PC. These associations were mainly observed with well-differentiated PC and among ever-smokers. Diets with a higher antioxidant content were associated with a reduced likelihood of PC. Further validation of these findings through prospective studies is needed.

Background/Objectives: Adolescents in Latin America are experiencing rising rates of overweight/obesity and non-communicable diseases, while public health nutrition efforts targeting this group remain limited. This study explores adherence to the EAT-Lancet diet and its relationship with micronutrient adequacy and ultra-processed food (UPF) consumption. Methods: Cross-sectional data from national nutrition surveys of 19,601 adolescents across six Latin American countries were analyzed. Data on sociodemographics, anthropometrics, and dietary habits were collected using standardized questionnaires and 24 h dietary recalls or food records. Nutrient intake was estimated via statistical modeling, and nutrient adequacy ratios were based on age- and sex-specific requirements. UPF intake was classified using the NOVA system, and adherence to the EAT-Lancet diet was assessed with the Planetary Health Diet Index. Results: Overall adherence to the EAT-Lancet diet was low (mean score: 28.3%). Rural adolescents had higher adherence than urban adolescents, and those aged 10–13 and 17–19 showed better adherence compared to adolescents aged 14–16. Adolescents from lower socioeconomic backgrounds adhered more than those from higher socioeconomic backgrounds. Adherence varied from 20.2% in Argentina to 30.2% in Brazil and Chile. Higher adherence was associated with lower UPF intake. Among urban adolescents, greater adherence was linked to a higher risk of inadequate riboflavin, niacin, and cobalamin intake, a trend not observed in rural adolescents. Conclusions: Adherence to the EAT-Lancet diet is low among Latin American adolescents, particularly in urban areas. Public health efforts should prioritize reducing UPF consumption, improving access to nutrient-dense, culturally appropriate foods, and supporting fortified staple foods.

Objetivo. Estimar el porcentaje de población mexicana escolar, adolescente y adulta con cumplimiento a las Guías Alimentarias Saludables y Sostenibles (GASS) e identificar las características sociodemográficas asociadas. Material y métodos. Con información de 2 500 escolares, 1 750 adolescentes y 5 174 adultos proveniente del cuestionario semicuantitativo de frecuencia de consumo de alimentos de la Encuesta Nacional de Salud y Nutrición de 2020 a 2023 se estimó el consumo de porciones de grupos de alimentos y el porcentaje de población que cumplió con la recomendación de frutas, verduras, leguminosas, nueces y semillas, y carne, por grupo de edad. Se realizaron modelos de regresión logística múltiple para identificar características sociodemográficas asociadas con el cumplimiento de las recomendaciones. Resultados. El cumplimiento de verduras fue 50%; leguminosas <1.4% y para frutas 45% en escolares, 36% en adultos y 27% en adolescentes. Las características asociadas al cumplimiento de las recomendaciones fueron el índice de condición de bienestar, sexo, localidad de residencia, escolaridad y edad, comportándose diferente entre grupos de edad y grupos de alimentos analizados. Conclusión. El cumplimiento de las recomendaciones de las GASS es muy bajo, por lo que es necesaria la participación intersectorial para promoverlas.