Dilemas éticos na pesquisa em saúde e nutrição

  Ethical dilemmas refer to unanswered questions or questions with multiple answers where considerations vary depending on the context. There is no particular methodology to resolve ethical dilemmas; it should rather involve an exercise of reflection for the researcher and the ethics committees.  Los dilemas éticos se refieren a preguntas sin respuesta o a preguntas con varias respuestas, cuyas consideraciones varían según el contexto. No existe una metodología específica para resolver los dilemas éticos; estos deben ser un ejercicio de reflexión del investigador y de los comités de ética.  Os dilemas éticos referem-se a perguntas sem resposta ou perguntas com várias respostas onde as considerações variam dependendo do contexto. Não existe uma metodologia específica para resolver os dilemas éticos; deve ser um exercício de reflexão por parte do pesquisador e dos comitês de ética

Género y autocuidado de la diabetes mellitus tipo 2 en el Estado de México

La diabetes mellitus es un problema epidemiológico nacional poco tratado en los estudios de género. La obesidad, la inadecuada alimentación y el sedentarismo son factores de riesgo de esta patología que se diagnostica con mayor frecuencia a edades más tempranas, impactando en el equilibrio de las familias. Aunque esta enfermedad se presenta en ambos géneros, la prevalencia es más elevada en mujeres. Se realizó un estudio de diseño transversal con una muestra no probabilística de 239 personas de dos comunidades del Estado de México, a quienes previo consentimiento informado se aplicó un cuestionario para analizar el género como factor de riesgo para el autocuidado en diabetes mellitus tipo 2. El estudio da a conocer los factores no clínicos que pueden considerarse como diferenciales de género. La prevención considera aspectos educativos de autocuidado con un abordaje transdisciplinario e incorporando a la familia para el cuidado de la salud, por sus creencias, saberes y prácticas

Understanding traditional and modern eating: The TEP10 framework

Across the world, there has been a movement from traditional to modern eating, including a movement of traditional eating patterns from their origin culture to new cultures, and the emergence of new foods and eating behaviors. This trend toward modern eating is of particular significance because traditional eating has been related to positive health outcomes and sustainability. Yet, there is no consensus on what constitutes traditional and modern eating. The present study provides a comprehensive compilation of the various facets that seem to make up traditional and modern eating. Specifically, 106 facets were mentioned in the previous literature and expert discussions, combining international and interdisciplinary perspectives. The present study provides a framework (the TEP10 framework) systematizing these 106 facets into two major dimensions, what and how people eat, and 12 subdimensions. Hence, focusing only on single facets of traditional and modern eating is an oversimplification of this complex phenomenon. Instead, the multidimensionality and interplay between different facets should be considered to gain a comprehensive understanding of the trends, consequences, and underlying factors of traditional and modern eating

Examining the validity and consistency of the Adult Eating Behaviour Questionnaire-Español (AEBQ-Esp) and its relationship to BMI in a Mexican population

Purpose: Appetitive traits in adults and their associations with weight can be measured using the Adult Eating Behaviour Questionnaire (AEBQ). The aim of this study was to confirm the factor structure of the Spanish AEBQ (AEBQ-Esp) in a Mexican sample and explore associations between the eight traits with body mass index (BMI). Method: A sample of 1023 adults, mean age of 36.8 ± 12.8 years, was recruited from Guadalajara, Mexico. Researchers weighed and measured participants, and they completed the AEBQ-Esp either online or in paper format and reported sociodemographic data. To test two alternative factor structures (eight factors including Hunger; seven factors excluding Hunger), confirmatory factor analysis (CFA) was used. Internal reliability was assessed using Cronbach’s alpha; test–retest reliability was assessed using intra-class correlation coefficients. Multivariate linear regressions were used to test for associations between the AEBQ subscales and BMI, adjusted for age, sex, format of AEBQ responses, education, marital and employment status. Results: A seven-factor structure was the best model fit using CFA, excluding the Hunger subscale but similar to the original AEBQ. Internal reliability was good for all subscales (Cronbach’s α = 0.70–0.86), and the intra-class correlation coefficient (0.70–0.91) reflected good test–retest reliability. In the fully adjusted models, Satiety Responsiveness [β = − 0.61; (− 1.01, − 0.21)] and Slowness in Eating [β = − 0.70; (− 1.01, − 0.39)] were negatively associated with BMI, and Emotional Over-Eating [β = 0.94; (0.62, 1.27)] was positively associated with BMI. Conclusions: The AEBQ-Esp (excluding Hunger) appears to be a valid and reliable psychometric questionnaire for measuring appetitive traits in a Mexican Spanish-speaking population. Some traits appear to be associated with BMI in adulthood and warrant further exploration. Level of evidence: Level III evidence obtained from well-designed cohort or case–control analytic studies. Although this was just an observational study, it was well designed and provided new evidence

Directed motor-auditory EEG connectivity is modulated by music tempo

Beat perception is fundamental to how we experience music, and yet the mechanism behind this spontaneous building of the internal beat representation is largely unknown. Existing findings support links between the tempo (speed) of the beat and enhancement of electroencephalogram (EEG) activity at tempo-related frequencies, but there are no studies looking at how tempo may affect the underlying long-range interactions between EEG activity at different electrodes. The present study investigates these long-range interactions using EEG activity recorded from 21 volunteers listening to music stimuli played at 4 different tempi (50, 100, 150 and 200 beats per minute). The music stimuli consisted of piano excerpts designed to convey the emotion of “peacefulness”. Noise stimuli with an identical acoustic content to the music excerpts were also presented for comparison purposes. The brain activity interactions were characterized with the imaginary part of coherence (iCOH) in the frequency range 1.5–18 Hz (δ, θ, α and lower β) between all pairs of EEG electrodes for the four tempi and the music/noise conditions, as well as a baseline resting state (RS) condition obtained at the start of the experimental task. Our findings can be summarized as follows: (a) there was an ongoing long-range interaction in the RS engaging fronto-posterior areas; (b) this interaction was maintained in both music and noise, but its strength and directionality were modulated as a result of acoustic stimulation; (c) the topological patterns of iCOH were similar for music, noise and RS, however statistically significant differences in strength and direction of iCOH were identified; and (d) tempo had an effect on the direction and strength of motor-auditory interactions. Our findings are in line with existing literature and illustrate a part of the mechanism by which musical stimuli with different tempi can entrain changes in cortical activity

Perceived Diet Quality, Eating Behaviour, and Lifestyle Changes in a Mexican Population with Internet Access during Confinement for the COVID-19 Pandemic: ESCAN-COVID19Mx Survey

Perceived changes in diet quality, emotional eating, physical activity, and lifestyle were evaluated in a group of Mexican adults before and during COVID-19 confinement. In this study, 8289 adults answered an online questionnaire between April and May 2020. Data about sociodemographic characteristics, self-reported weight and height, diet quality, emotional eating, physical activity, and lifestyle changes were collected. Before and after confinement, differences by sociodemographic characteristics were assessed with Wilcoxon, Anova, and linear regression analyses. Most participants were women (80%) between 18 and 38 years old (70%), with a low degree of marginalisation (82.8%) and a high educational level (84.2%); 53.1% had a normal weight and 31.4% were overweight. Half (46.8%) of the participants perceived a change in the quality of their diet. The Diet Quality Index (DQI) was higher during confinement (it improved by 3 points) in all groups, regardless of education level, marginalisation level, or place of residence (p 0.001). Lifestyle changes were present among some of the participants, 6.1% stopped smoking, 12.1% stopped consuming alcohol, 53.3% sleep later, 9% became more sedentary, and increased their screen (43%) as well as sitting and lying down time (81.6%). Mexicans with Internet access staying at home during COVID-19 confinement perceived positive changes in the quality of their diet, smoking, and alcohol consumption, but negative changes in the level of physical activity and sleep quality. These results emphasise the relevance of encouraging healthy lifestyle behaviours during and after times of crisis to prevent the risk of complications due to infectious and chronic diseases

Volviéndonos mejores: necesidad de acción inmediata ante el reto de la obesidad. Una postura de profesionales de la salud.

La creciente epidemia de obesidad ha sido uno de los retos más importantes de salud pública en México durante los últimos años. Con apoyo de la Federación Mundial de Obesidad, en 2021 formamos un grupo de profesionales para identificar y resumir las acciones prioritarias en las que puede enfocarse nuestro país para hacer frente a esta epidemia. Al proceso de desarrollo y discusión de este grupo se sumaron más de 1 000 profesionales de la salud para retomar recomendaciones de documentos y guías de alto nivel previamente publicados. En conmemoración del Día Mundial de la Obesidad, en este 2022 se presenta esta postura como insumo para el desarrollo de acciones en el ámbito profesional y de los diferentes sectores, en la que se incluyen 10 recomendaciones de acción, desde la perspectiva poblacional hasta la atención individualizada, y se enfatiza en la importancia de la participación social, de las intervenciones integrales con visión centrada en la persona y de la sostenibilidad planetaria, además de mejorar la educación y las campañas de difusión, propiciar un ambiente promotor de entornos activos y blindar de conflictos de interés los esfuerzos de prevención y control. La postura hace un llamado para abordar la obesidad de manera seria, con base en la evidencia científica, oportuna e integral, con enfoque de curso de vida, de forma ética y sensible, y sin perpetuar las barreras del estigma de peso en la sociedad