Functions of Social Networks in Maternal Food Choice for Children in Mexico

Food choice for children has important implications in establishing early-life dietary habits and preferences. Food choice for children has been studied as parent–child dyad dynamics, but little is known about the extended system of relationships in maternal food choice for children. The objective of this study was to understand the functions of mothers\u27 social networks in the food choices that mothers make for their children ages 1 to 5 years old in rural Mexico. In-depth interviews were conducted with 46 participants in three rural communities. The interviews inquired about participants\u27 child-feeding practices, personal and local beliefs about child feeding and the individuals with whom they had conversations about food and child feeding. All interviews were conducted in Spanish, audio-recorded, transcribed verbatim, verified for quality and analysed using the constant comparative method. Five interconnected networks emerged, consisting of household family, non-household family, community, children\u27s initial school and health and nutritional programme personnel. Each network had functions in food choice that ranged from shared food decision-making in the household family network to imparting formal dietary guidance in the health and nutritional programme personnel network. Across the networks, professionals, participants\u27 mothers and mothers-in-law, community senior women and other women with children emerged as prominent figures whom participants would turn to for child-feeding advice. These findings provide empirical evidence that social networks, as an organized system of interconnected relationships, have vital functions in establishing social norms for food choices made for children that can be leveraged to promote healthy food choices

Safety profile of enhanced thromboprophylaxis strategies for critically ill COVID-19 patients during the first wave of the pandemic: observational report from 28 European intensive care units

Introduction: Critical illness from SARS-CoV-2 infection (COVID-19) is associated with a high burden of pulmonary embolism (PE) and thromboembolic events despite standard thromboprophylaxis. Available guidance is discordant, ranging from standard care to the use of therapeutic anticoagulation for enhanced thromboprophylaxis (ET). Local ET protocols have been empirically determined and are generally intermediate between standard prophylaxis and full anticoagulation. Concerns have been raised in regard to the potential risk of haemorrhage associated with therapeutic anticoagulation. This report describes the prevalence and safety of ET strategies in European Intensive Care Unit (ICUs) and their association with outcomes during the first wave of the COVID pandemic, with particular focus on haemorrhagic complications and ICU mortality. Methods: Retrospective, observational, multi-centre study including adult critically ill COVID-19 patients. Anonymised data included demographics, clinical characteristics, thromboprophylaxis and/or anticoagulation treatment. Critical haemorrhage was defined as intracranial haemorrhage or bleeding requiring red blood cells transfusion. Survival was collected at ICU discharge. A multivariable mixed effects generalised linear model analysis matched for the propensity for receiving ET was constructed for both ICU mortality and critical haemorrhage. Results: A total of 852 (79% male, age 66 [37\u201385] years) patients were included from 28 ICUs. Median body mass index and ICU length of stay were 27.7 (25.1\u201330.7) Kg/m2 and 13 (7\u201322) days, respectively. Thromboembolic events were reported in 146 patients (17.1%), of those 78 (9.2%) were PE. ICU mortality occurred in 335/852 (39.3%) patients. ET was used in 274 (32.1%) patients, and it was independently associated with significant reduction in ICU mortality (log odds = 0.64 [95% CIs 0.18\u20131.1; p = 0.0069]) but not an increased risk of critical haemorrhage (log odds = 0.187 [95%CI 12 0.591 to 12 0.964; p = 0.64]). Conclusions: In a cohort of critically ill patients with a high prevalence of thromboembolic events, ET was associated with reduced ICU mortality without an increased burden of haemorrhagic complications. This study suggests ET strategies are safe and associated with favourable outcomes. Whilst full anticoagulation has been questioned for prophylaxis in these patients, our results suggest that there may nevertheless be a role for enhanced / intermediate levels of prophylaxis. Clinical trials investigating causal relationship between intermediate thromboprophylaxis and clinical outcomes are urgently needed

Caloric beverage consumption patterns in Mexican children

<p>Abstract</p> <p>Background</p> <p>Mexico has seen a very steep increase in child obesity level. Little is known about caloric beverage intake in this country as well as all other countries outside a few high income countries. This study examines overall patterns and trends in all caloric beverages from two nationally representative surveys from Mexico.</p> <p>Methods</p> <p>The two nationally representative dietary intake surveys (1999 and 2006) from Mexico are used to study caloric beverage intake in 17, 215 children. The volume (ml) and caloric energy (kcal) contributed by all beverages consumed by the sample subjects were measured. Results are weighted to be nationally representative.</p> <p>Results</p> <p>The trends from the dietary intake surveys showed very large increases in caloric beverages among pre-school and school children. The contribution of whole milk and sugar-sweetened juices was an important finding. Mexican pre-school children consumed 27.8% of their energy from caloric beverages in 2006 and school children consumed 20.7% of their energy from caloric beverages during the same time. The three major categories of beverage intake are whole milk, fruit juice with various sugar and water combinations and carbonated and noncarbonated sugared-beverages.</p> <p>Conclusion</p> <p>The Mexican government, greatly concerned about obesity, has identified the large increase in caloric beverages from whole milk, juices and soft drinks as a key target and is initiating major changes to address this problem. They have already used the data to shift 20 million persons in their welfare and feeding programs from whole to 1.5% fat milk and in a year will shift to nonfat milk. They are using these data to revise school beverage policies and national regulations and taxation policies related to an array of less healthful caloric beverages.</p

Are research priorities in Latin America in line with the nutritional problems of the population?

OBJECTIVE: Concordance of nutritional research priorities with the related burden of disease is essential to develop cost-effective interventions to address the nutritional problems of populations. The present study aimed to evaluate whether nutrition research priorities are in agreement with the population's nutritional problems in Latin America. DESIGN: The epidemiological profile was contrasted with the research priorities and research produced by academic institutions for each country. Qualitative analysis of research production by type of contribution to problem solving was also conducted. SETTINGS: Nine Latin American countries. RESULTS: Obesity (high body mass index (BMI)) and micronutrient deficiencies (anaemia) emerged as key problems, followed by stunting, breast-feeding/lactation and low birth weight. Wasting in children and women (low BMI) was uncommon. Concordance of ranked research priorities with the epidemiological profile of the country was generally good for nutrition-related chronic diseases, micronutrients and low birth weight, but not for undernutrition, stunting and breast-feeding. Studies on the efficacy and effectiveness of interventions were uncommon. CONCLUSIONS: The present research agenda insufficiently supports the goal of public health nutrition, which is to ensure the implementation of cost-effective nutrition programmes and policies. A more rational approach to define research priorities is needed

Overweight and obesity trends in Mexican children 2 to 18 years of age from 1988 to 2006 Tendencias de sobrepeso y obesidad en niños mexicanos de 2 a 18 años de edad: 1988 a 2006

OBJECTIVE: To describe prevalences and trends of overweight and obesity/OW&OB in Mexican children from 1988 to 2006 at the national level and by relevant subpopulations. MATERIAL AND METHODS: Prevalences of OW&OB in children aged 2-18 years were estimated using body mass index data from three national surveys conducted in 1988, 1999 and 2006. RESULTS: Prevalences of OW&OB are high in children of all ages, particularly among school-age and adolescent groups disaggregated by regions, socioeconomic status, urban and rural areas, and ethnic groups. The overall prevalence of OW&OB in children 2 to 18 years old in 2006 was 26.3%. Prevalences by age groups were 16.7% in preschool-age, 26.2% in school-age, and 30.9% in adolescents, using the IOTF classification system. CONCLUSIONS: Upward trends were observed in school-age children and adolescents at the national level and in all subpopulations.OBJETIVO: Describir las prevalencias y tendencias de sobrepeso y obesidad (SPyO) en niños mexicanos, de 1988 a 2006, en el ámbito nacional y por subgrupos relevantes de población. MATERIAL Y MÉTODOS: Las prevalencias de SPyO (peso no saludable) se estimaron usando cifras de índice de masa corporal de tres encuestas nacionales realizadas en 1988, 1999 y 2006. RESULTADOS: Las prevalencias de SPyO son altas en niños de todas las edades, particularmente en niños de edad escolar y adolescentes, estratificados por regiones, estado socioeconómico, áreas urbanas, rurales y grupo étnico. La prevalencia de SPyO en 2006 fue de 26.3% en el grupo de entre 2 a 18 años de edad, 16.7% en preescolares, 26.2% en escolares y 30.9% en adolescentes, usando la clasificación de The International Obesity Task Force (IOTF). CONCLUSIONES: Se observa una tendencia de sobrepeso y obesidad en aumento en niños de edad escolar y adolescentes, para todos los subgrupos de población

Development of a live coding method to assess infant/toddler food acceptance.

Validated measures predicting infant consumption of nutrient supplements or fortified foods are essential for the success of nutritional interventions to improve undernutrition. Behavioural coding of food acceptance is one promising approach, though the required time and resources are limiting. The overarching goal of the present study was to adapt a video coding (VC) protocol for use as a live coding (LC) method to assess infant food acceptance in naturalistic settings. Infants (n = 59; ages 7-24 months) were fed a small-quantity lipid-based nutrient supplement (SQ-LNS) mixed with a familiar food by caregivers in the State of Morelos, Mexico. Trained coders used a VC scheme to rate infant acceptance of each spoon offer using a 4-point scale. The VC scheme was subsequently adapted for use as an LC method to be used in participant homes and a video live coding (VLC) method to monitor reliability. Reliability and validity of the LC method were tested in a subsample of dyads (n = 20). Intraclass correlation coefficients (ICCs) indicated that the inter-rater reliability between coders using the LC method was moderate or good when compared to VC methods (ICCs = 0.75 and 0.87). Live coded acceptance scores were also moderately associated with consumption of the SQ-LNS (ρ = 0.50, p = 0.03). The LC scheme demonstrated initial reliability and validity as an assessment of infant food acceptance. Since VC is both resource and time-intensive, the LC scheme may be useful for assessing infant food acceptance in resource-limited settings

Consumption of Micronutrient Powder, Syrup or Fortified Food Significantly Improves Zinc and Iron Status in Young Mexican Children: A Cluster Randomized Trial

The objective of this study was to compare the effect of three micronutrient products on biomarkers of iron and zinc status of Mexican children 6&ndash;12 months of age. As part of research to improve the impact of a national program, 54 communities were randomly assigned to receive: (1) fortified food (FF), provided by the program at the time, or (2) micronutrient powders (MNP) or (3) syrup. Each product contained 10 mg each of zinc and iron, plus other micronutrients. Children consumed the product 6 days/week for four months. Primary outcomes were changes in serum zinc, ferritin, soluble transferrin receptor, hemoglobin concentrations, and their deficiencies. Zinc concentration increased significantly from baseline to follow-up in all groups, with the largest change in the syrup group (geometric mean difference: +4.4 &micro;mol/L; 95%CI: 3.2, 5.5), followed by MNP (+2.9 &micro;mol/L; 95%CI: 2.1, 3.6) and FF (+0.9 &micro;mol/L; 95%CI: 0.3, 1.6). There was a significant increase in hemoglobin concentration (+5.5 g/L; 2.5, 8.4) and a significant reduction in anemia prevalence (44.2% to 26.8%, p &lt; 0.01) only in the MNP group. Compliance differed significantly among groups (MNP vs. FF, p = 0.04; MNP vs. syrup, p = 0.04), but may not fully explain the greater improvement in zinc and iron status in the syrup and MNP groups. The food matrix may influence nutrient utilization from supplements