Dietary Glycemic Index, Dietary Glycemic Load, Blood Lipids, and Coronary Heart Disease

Objective. To examine the associations of dietary glycemic index (GI) and dietary glycemic load (GL) with blood lipid concentrations and coronary heart disease (CHD) in nondiabetic participants in the Health Worker Cohort Study (HWCS). Materials and Methods. A cross-sectional analysis was performed, using data from adults who participated in the HWCS baseline assessment. We collected information on participants' socio-demographic conditions, dietary patterns and physical activity via self-administered questionnaires. Dietary GI and dietary GL were measured using a validated food frequency questionnaire. Anthropometric and clinical measurements were assessed with standardized procedures. CHD risk was estimated according to the sex-specific Framingham prediction algorithms. Results. IIn the 5,830 individuals aged 20 to 70 who were evaluated, dietary GI and GL were significantly associated with HDL-C, LDL-C, LDL-C/HDL-C ratio, and triglycerides serum levels. Subjects with high dietary GI have a relative risk of 1.56 (CI 95%; 1.13–2.14), and those with high dietary GL have a relative risk of 2.64 (CI 95%; 1.15–6.58) of having an elevated CHD risk than those who had low dietary GI and GL. Conclusions. Our results suggest that high dietary GI and dietary GL could have an unfavorable effect on serum lipid levels, which are in turn associated with a higher CHD risk

Exercise-referral scheme to promote physical activity among hypertensive patients: design of a cluster randomized trial in the Primary Health Care Units of Mexico’s Social Security System

BACKGROUND: Although the benefits of physical activity (PA) on to prevent and manage non-communicable diseases are well known, strategies to help increase the levels of PA among different populations are limited. Exercise-referral schemes have emerged as one effective approach to promote PA; however, there is uncertainty about the feasibility and effectiveness of these schemes in settings outside high-income countries. This study will examine the effectiveness of a scheme to refer hypertensive patients identified in Primary Health Care facilities (PHCU) of the Mexican social security institution to a group PA program offered in the same institution. METHODS AND DESIGN: We will describe the methods of a cluster randomized trial study designed to evaluate the effectiveness of an exercise referral scheme to increasing physical activity in hypertensive patients compared to a non-referral scheme. Four PHCU were selected for the study; the PHCU will take part as the unit of randomization and sedentary hypertensive patients as the unit of assessment. 2 PHCU of control group (GC) will provide information to hypertensive patients about physical activity benefits and ways to increase it safely. 2 PHCU of intervention group (IG) will refer patients to sports facilities at the same institution, to follow a group-based PA program developed to increase the PA levels with a designed based on the Transtheoretical Model and Social Cognitive Theory. To evaluate the effects of the intervention as well as short-term maintenance of the intervention’s effects, PA will be assessed at baseline, at 24 and 32 weeks of follow-up. The main outcome will be the difference before and after intervention in the percentage of participants meeting recommended levels of PA between and within intervention and control groups. PA will be measured through self-report and with objective measure by accelerometer. DISCUSSION: This study will allow us to evaluate a multidisciplinary effort to link the primary care and community-based areas of the same health care system. Our findings will provide important information about the feasibility and effectiveness of an exercise-referral scheme and will be useful for decision-making about the implementation of strategies for increasing PA among hypertensive and other clinical populations in Mexico and Latin America. TRIAL REGISTRATION: Clinicaltrials.gov Identifier: NCT01910935. Date of registration: 07/05/2013

Autopercepción del estado de salud: una aproximación al los ancianos en México

OBJECTIVE: To evaluate health status of the elderly in Mexico through their self-perception and to describe social, organizational and health-related factors. METHODS: A study was carried out on secondary data from the 2000 National Health Survey in Mexico. Multiple logistic regression models were used. The dependent variable health status was measured through self-perception. The independent variables included were: sociodemographic characteristics, risk behaviors, accidents, disease diagnosis and clinical measures. RESULTS: A total of 7,322 adults aged 60 years and older were studied, which represents 7% of the total population in that age group in Mexico. Of them, 19.8% reported poor or very poor health status. Factors found to be associated to poor health were age, female sex, having no social security, being divorced, homemaker, disabled, unemployed, tobacco consumption, having a health condition, accidents and diagnosed with chronic diseases. CONCLUSIONS: The study allowed to identifying factors that may contribute to poor health status in the elderly. These findings could be taken into account in the development of actions and health care programs for this population in Mexico.OBJETIVO: Evaluar el estado de salud de los ancianos mexicanos a través de la autopercepción y analizar los factores sociales, de salud y organizacionales asociados. MÉTODOS: Estudio de datos secundarios de la Encuesta Nacional de Salud 2000 en México. Se realizó análisis de regresión logística múltiple. La variable dependiente fue el estado de salud medido a través de la autopercepción de salud. Las variables independientes seleccionadas fueron: características sociodemográficas, hábitos de riesgo, accidentes, diagnóstico de enfermedades y mediciones clínicas. RESULTADOS: Se analizó a 7,322 adultos de 60 años y mayores, que representan al total de la población (7%) en ese grupo de edad en México. De estos, 19.8% reportó estado de salud como malo o muy malo. Los factores asociados a mala salud fueron edad, sexo femenino, no tener seguro social, ser divorciado, dedicarse al hogar, estar incapacitado, no tener trabajo, consumo de tabaco, problema de salud, accidentes y diagnóstico de enfermedades crónicas. CONCLUSIONES: El análisis de factores asociados permitió determinar elementos que influyen en mal estado de salud de ancianos. Los hallazgos podrían considerarse en la formulación de acciones y programas de atención para esa población en México

Adult Smokers’ Awareness and Interest in Trying Heated Tobacco Products: Perspectives from Mexico, where HTPs and E-Cigarettes are Banned

Background: We evaluated smokers’ perceptions of heated tobacco products (HTPs) in Mexico, where industry publically lobbied to introduce HTPs into this country that banned both HTPs and e-cigarettes. Methods: Online surveys (November 2018 to July 2019) were analyzed from adults who only smoked cigarettes (n = 2091) or who smoked and used e-cigarettes (“dual users” n = 1128). Logistic models regressed HTP awareness, interest to trying HTPs, and having seen HTPs for sale (only among aware participants) on sociodemographics and tobacco-related variables. Results: Of the 17.1% who were aware of HTPs, 52.7% reported having seen HTPs for sale. Of all respondents, 75% were somewhat or very interested in trying HTPs. Compared to their counterparts, more frequent smokers, dual users, those exposed to online e-cigarette ads, and those with friends who used e-cigarettes were both more aware of and interested in trying HTPs. Greater awareness was also associated with higher education, recent attempts to quit, receipt of email e-cigarette ads, and smoking among friends and family. Seeing HTPs for sale was higher for those who recently attempted to quit, were exposed to e-cigarette ads online or by email, or had friends who used e-cigarettes. Conclusion: Interest in HTPs is high among smokers in Mexico, which already has a large black market for illegal e-cigarettes. HTPs use should be monitored in this context, especially given the public health impacts of HTPs are unclear

Dietary Glycemic Index, Dietary Glycemic Load, Blood Lipids, and Coronary Heart Disease

Objective. To examine the associations of dietary glycemic index (GI) and dietary glycemic load (GL) with blood lipid concentrations and coronary heart disease (CHD) in nondiabetic participants in the Health Worker Cohort Study (HWCS). Materials and Methods. A cross-sectional analysis was performed, using data from adults who participated in the HWCS baseline assessment. We collected information on participants' socio-demographic conditions, dietary patterns and physical activity via self-administered questionnaires. Dietary GI and dietary GL were measured using a validated food frequency questionnaire. Anthropometric and clinical measurements were assessed with standardized procedures. CHD risk was estimated according to the sex-specific Framingham prediction algorithms. Results. IIn the 5,830 individuals aged 20 to 70 who were evaluated, dietary GI and GL were significantly associated with HDL-C, LDL-C, LDL-C/HDL-C ratio, and triglycerides serum levels. Subjects with high dietary GI have a relative risk of 1.56 (CI 95%; 1.13-2.14), and those with high dietary GL have a relative risk of 2.64 (CI 95%; 1.15-6.58) of having an elevated CHD risk than those who had low dietary GI and GL. Conclusions. Our results suggest that high dietary GI and dietary GL could have an unfavorable effect on serum lipid levels, which are in turn associated with a higher CHD risk

Physical activity and risk of Metabolic Syndrome in an urban Mexican cohort

Abstract Background In the Mexican population metabolic syndrome (MS) is highly prevalent. It is well documented that regular physical activity (PA) prevents coronary diseases, type 2 diabetes and MS. Most studies of PA have focused on moderate-vigorous leisure-time activity, because it involves higher energy expenditures, increase physical fitness, and decrease the risk of MS. However, for most people it is difficult to get a significant amount of PA from only moderately-vigorous leisure activity, so workplace activity may be an option for working populations, because, although may not be as vigorous in terms of cardio-respiratory efforts, it comprises a considerable proportion of the total daily activity with important energy expenditure. Since studies have also documented that different types and intensity of daily PA, including low-intensity, seem to confer important health benefits such as prevent MS, we sought to assess the impact of different amounts of leisure-time and workplace activities, including low-intensity level on MS prevention, in a sample of urban Mexican adults. Methods The study population consisted of 5118 employees and their relatives, aged 20 to 70 years, who were enrolled in the baseline evaluation of a cohort study. MS was assessed according to the criteria of the National Cholesterol Education Program, ATP III and physical activity with a validated self-administered questionnaire. Associations between physical activity and MS risk were assessed with multivariate logistic regression models. Results The prevalence of the components of MS in the study population were: high glucose levels 14.2%, high triglycerides 40.9%, high blood pressure 20.4%, greater than healthful waist circumference 43.2% and low-high density lipoprotein 76.9%. The prevalence of MS was 24.4%; 25.3% in men and 21.8% in women. MS risk was reduced among men (OR 0.72; 95%CI 0.57–0.95) and women (OR 0.78; 95%CI 0.64–0.94) who reported an amount of ≥30 minutes/day of leisure-time activity, and among women who reported an amount of ≥3 hours/day of workplace activity (OR 0.75; 95%CI 0.59–0.96). Conclusion Our results indicate that both leisure-time and workplace activity at different intensity levels, including low-intensity significantly reduce the risk of MS. This finding highlights the need for more recommendations regarding the specific amount and intensity of leisure-time and workplace activity needed to prevent MS

Hacia una base normativa mexicana en la medición de calidad de vida relacionada con la salud, mediante el Formato Corto 36

Objetivo. Presentar los resultados de la aplicación del cuestionario de formato corto 36 (SF-36) en dos estados de México (Sonora y Oaxaca), comparando con los niveles de calidad de vida en las provincias de Canadá y en Estados Unidos de América. Material y métodos. Los datos provienen de la encuesta de acceso, uso y calidad de los servicios de salud en dos estados de México. El instrumento del SF-36 incluye 36 preguntas que generan ocho dimensiones diferentes sobre calidad de vida relacionada con la salud; a partir de estas dimensiones, se estima un componente físico y otro mental. Para el análisis se calcularon las calificaciones promedio para cada dimensión del SF-36 para toda la muestra, por género y grupos de edad, en cada estado. Las diferencias regionales se evaluaron mediante la diferencia en los promedios. Resultados. Se obtuvo respuesta de 98.5% de las 4 200 viviendas seleccionadas, con porcentajes de respuesta similar en Oaxaca y Sonora. Respondieron al cuestionario 5 961 individuos mayores de 25 años de edad. Los hombres tuvieron mayores puntajes que las mujeres en todas las dimensiones y en los dos componentes. En uno u otro sexo la mayor variación en los adultos hasta de 64 años de edad tendió a concentrarse en tres dimensiones: salud general, función social y salud mental; en el grupo de 65 a 74 años de edad se concentró en función social y salud mental; y en mayores de 75 años, en salud mental. Se observó variación en un número mayor de dimensiones en los grupos de adultos jóvenes (25 a 44 años), mientras que en las mujeres se observó una mayor variación en los extremos, en los grupos de edad de 25 a 34 años de edad y de 75 y más. Los puntajes promedio en nuestra muestra fueron más altos que los observados en Canadá y Estados Unidos de América en cinco de las dimensiones y en los dos componentes, en tanto que Canadá presentó puntajes más altos en las tres dimensiones escalas restantes (salud general, función social y salud mental). Conclusiones. En ausencia de datos representativos del ámbito nacional, queremos proponer el uso de nuestros resultados como una base normativa en México, para que los investigadores que utilicen el SF-36 puedan comparar sus resultados con referencias ajustadas por género y edad a escala poblacional. Puesto que las dos regiones estudiadas son claramente contrastantes en su desarrollo social y económico, cuando se trate de pacientes de regiones con mayor desarrollo económico se recomendaría utilizar los datos de Sonora como estándar normativo, y Oaxaca en el caso de pacientes de regiones con menor desarrollo económico. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/ salud/index.htm