Lifestyle intervention as a treatment for obesity in school-age-children in Celaya, Guanajuato: An experimental study

Introduction: Obesity is a risk factor in chronic diseases, and its frequency among children in Mexico is increasing. Objective: To determine the effect of lifestyle intervention as a treatment for obesity in school-age-children from Celaya, Mexico.Methodology: For this experimental study, four schools were randomly selected. Children and parents participated voluntarily and signed consent forms. Two schools were chosen as the experimental group and the other two formed the control group. Age, gender, weight, height, BMI and blood pressure were recorded for each participant. Intervention: Children and parents were asked to walk in their schools for 30 minutes a day Monday through Friday and to attend 8 instructional sessions over a period of four months dedicated to the selection and preparation of meals. Statistical Analysis: The OR and 95% CI were calculated to determine the effect of the intervention; a Z-test for two proportions for overweight and obesity in the control and experimental groups were carried out for comparison.Results: 157 children were included in the experimental group and 144 in the control group. To compare the proportions of the overweight and the obese between the groups, a Z-test = - 0.36 (p-value 0.72) were obtained showing no effect of the intervention in lifestyle; OR =1.09, 95% CI (0.67, 1.77). It was adjusted according to the attendance to the sessions resulting in an OR = 2.00, 95% CI (0.69, 5.77), demonstrating that not attending the sessions was a confounder.Conclusions: Intervention in lifestyle should be measured over a longer period of time in order to determine what effects it may have on changes in body mass index

Barreras percibidas y nivel de actividad física en adultos mayores de Aguascalientes, Ags.: Un estudio transversal

Introduction. Mexico is in demographic transition being more than 10% of its population older adults who have a high frequency of non-communicable diseases. The objective was to know the relationship between perceived barriers and physical activity level in older adults from Aguascalientes in Mexico. Material and methods. The present study is cross-sectional, analytic, and observational.150 older adults registered in the Family Integral Development System from Aguascalientes State were included at random, who accepted to participate by signing a consent form. A questionnaire to detect perceived barriers as well as an international physical activity questionnaire was applied. Statistical analysis. Z for two proportions, p-value and odds ratio, 95% confidence interval were calculated, between external and internal perceived barriers and low physical activity level in older adults from the sample. Results. In reference to the sample, 71.3% were between 60 and 70 years old; 72% were female, 78% had low physical activity level. The lack of information about physical activity benefits is a barrier in relation to low physical activity (Z=2.36, p=0.02, OR=2.97 95%CI=1.28 to 6.90); the lack of support from their family is another barrier in relation to their low physical activity (Z=2.91, p=0.003, OR=3.82, 95%CI=161 to 9.10); another barrier was the lack of places (such as health centers and gyms for older adults) to perform physical activity (Z=4.2, p<0.05, OR=5.8, 95%CI=2.5 to 13.3). Conclusion. The nursing designing programs to perform physical activity in older adults should take into account these perceived barriers.Introducción. México está en transición demográfica con más del 10% de su población, siendo adultos mayores, quienes tienen elevada prevalencia de enfermedades no transmisibles. El objetivo fue conocer la relación entre las barreras percibidas y el nivel de actividad física en adultos mayores de Aguascalientes, Ags.Materiales y métodos. Es un estudio transversal, observacional, analítico. 150 adultos mayores registrados en el Sistema de Desarrollo Integral Familiar de Aguascalientes, que firmaron el consentimiento, fueron incluidos. Se aplicaron los cuestionarios de barreras percibidas y el internacional de actividad física.Análisis estadístico. Z para dos proporciones, valor de p, Razón de Momios e intervalos de confianza al 95% fueron calculados, entre barreras percibidas externas e internas y el nivel de actividad física que realizaban los adultos mayores de la muestra.Resultados. La muestra estuvo integrada por adultos mayores con edad entre los 60 y 70 años; 72% fueron mujeres, 78% tenían bajo nivel de actividad física. La falta de información acerca de los beneficios de la actividad física es una barrera para tener mejor nivel de actividad física (Z=2.36, p=0.02, RM=2.97 IC95%=1.28 a 6.90); la falta de apoyo de las familias es otra barrera para la actividad física (Z=2.91, p=0.003, RM=3.82, IC95%=161 a 9.10); también fue una barrera la falta de espacios para realizar actividad física, tales como centros de salud y gimnasios para adultos mayores (Z=4.2, p<0.05, RM=5.8, IC95=2.5 a 13.3).Conclusión. El diseño de programas de enfermeríapara realizar actividad física en adultos mayores, deberán tomar en cuenta las barreras percibidas

Do People with Type 2 Diabetes Think They are Unhealthy? A Cross-Sectional Study in Celaya, Mexico

Background: Type 2 diabetes is a chronic disease that presents a significant burden on health care systems in many countries. With the rise of obesity, the incidence of Type 2 diabetes has also been steadily increasing. A healthy lifestyle and understanding of diabetes management are important factors for delaying the onset of comorbidities associated with Type 2 diabetes. The objective of this study was to evaluate the self-perception of health in individuals with Type 2 diabetes as it relates to BMI status, which has important implications for the implementation of preventive programs. Methods: A cross-sectional lifestyle survey was implemented in the region of Celaya, Guanajuato, Mexico, targeting 100 participants diagnosed with Type 2 diabetes. Anthropometric measurements and participant characteristics were also obtained. Fisher’s exact test was used to determine if the proportions of lifestyles perceptions differed by BMI status. Results:  Participants had a mean age of 56.12 ± 10.26, a mean BMI of 29.13 ± 5.48 kg/m2, were mostly married (67.0%), and female (70.0%). None of the normal weight participants perceived themselves as unhealthy. 95% of overweight/obese participants perceived themselves to be healthy, despite a diagnosis of diabetes and being overweight/obese, while only 5% perceived themselves to be unhealthy. However, these differences in the perceptions of health classified by BMI status were not statistically significant (p = 0.42).Conclusion: Our findings indicate that overweight and obese persons with Type 2 diabetes in Celaya, Mexico may have misperceptions about their own health, even though these findings were not statistically significant. These preliminary data highlight the importance of implementing prevention and educational programs among those with diabetes, in order to combat health misperceptions and raise awareness about the dangers of diabetes and obesity. Furthermore, more research with larger sample sizes is needed  in order to fully understand the effects of perception of health on actual health.

Retirement and changes in life style of people with Diabetes type 2

Trata-se de um estudo qualitativo, que teve como objetivo compreender as mudanças de vida das pessoas aposentadas com diabete tipo 2. Primeiramente se caracteriza a população com diabetes tipo 2 da Clínica Hospital ISSSTE Celaya - México, onde extraiu-se uma amostra de 56 pacientes do quais 39,28% estão entre 60 e 69 anos de idade, 53,6% pertencem ao sexo feminino, 69,6% são casados, 35,7% são do lar, 41% têm nível básico de estudos, 92,8% vivem com algum familiar, 28,57% têm entre 1 e 5 anos de diagnóstico, 87,7% comparecem à consulta pelo menos uma vez ao mês, 60,7% foram em mais de uma ocasião, 39,3% ignoram as causas de hospitalização, 66,1% têm patologia associada, 98,2% fazem tratamento medicamentoso. A seguir se aplica uma entrevista semiestruturada com dez pacientes com diabetes tipo 2 e por meio da Análise de Conteúdo Modalidade Temática, chegou-se a quatro grandes temas: 1) vida dedicada ao trabalho; 2) insegurança em relação ao diabetes tipo 2; 3) alternativas depois da aposentadoria e 4) plano terapêutico para o controle do diabete tipo 2. O resultados evidenciaram que grande parte dos sujeitos tiveram uma vida dedicada ao trabalho, que gerou satisfação e insatisfação. Antes da aposentadoria relatam que não tiveram tempo para o cuidado com o controle metabólico do diabetes, priorizaram o trabalho, o cuidado dos filhos e do lar, além de que havia uma dupla jornada de trabalho que nem sempre era dividida com seus companheiros e filhos; mesmo reconhecendo que o diabetes tem um componente genético, isto não foi suficiente para que houvesse mudanças no estilo de vida, e consideram que os aspectos emocionais interferem no controle metabólico do diabetes; identificou-se que poucos sujeitos buscaram alternativas para o ocupação do tempo livre na aposentadoria, como participação em grupos comunitários ou no desenvolvimento de habilidades pessoais; foi possível apreender que além do tratamento convencional para o controle do diabetes, os sujeitos incorporam também as práticas não convencionais como o uso de plantas medicinais, como o Nopal, amplamente difundido e reconhecido na sociedade mexicana; além disso reconhecem que existe dificuldades para as mudanças no padrão alimentar, concorrendo para isso uma história alimentar com grandes quantidades de calorias e pela difusão de outras culturas alimentares na atualidade; não existe, no plano terapêutico, a prática das atividades físicas. Nas considerações finais reconhece-se que o México tem, no seu Plano Nacional de Saúde, referenciais teóricos mais amplos como o da atenção primária à saúde e da promoção da saúde, mas ao apresentar uma organização dos serviços de proteção social e de saúde organizados por Institutos de Seguridade Social. Estes detém autonomia para a incorporação e adequação da macro política no âmbito local, e que reflete na forma de atenção à saúde, dispensada para a população usuária. Mesmo incorporando parte da política de promoção da saúde, por meio da formação dos clubes de diabéticos, ainda não é considerado a focalização na família e o seu entorno social. Nesse sentido, percebe-se que as pessoas com diabetes tipo 2, não tem um seguimento regular na assistência, assim como no autogerenciamento do seu controle metabólico, fato, evidenciado pelo grande número de consultas e internações hospitalares durante o período de um ano. Também faz parte de nossas reflexões o fato as dificuldades para a adoção de mudanças no estilo de vida parecem estar relacionadas ao aparecimento e a confirmação do diabetes tipo 2 na fase adulta, onde os costumes, crenças e valores já estão incorporados no cotidiano, por isso qualquer mudança parece ser mais penosa para estas pessoas.This qualitative study aimed to understand life changes of retired people with diabetes type 2. First, the population with diabetes type 2 from the Clinic Hospital ISSSTE Celaya, México was characterize, from which a sample of 56 patients where extracted, 39.28% are between 60 and 69 years old, 53.6% female, 69.6% married, 35.7% housewives, 41% primary schooling, 92.8% live with relatives, 28.57% has one to five years of diagnosis, 87.7% attend consultation at least one a month, 60.7% attended more than one occasion, 39.3% ignored hospitalization causes, 66.1% has associated pathology, 98.2% is under medicament treatment. A semi-structured interview was applied to ten patients with diabetes type 2. Four main themes emerged through Content Analysis Thematic Modality: 1) life dedicated to work; 2) insecurity regarding the diabetes type 2; 3) alternatives after retirement and 4) therapeutic plan for the control of diabetes type 2. The results evidenced that a great portion of them had a life dedicated to work, which caused both satisfaction and dissatisfaction. They reported that before retiring they had no time for keeping the diabetes metabolic control, prioritized work, children and family, besides double work journey which was not always divided with their partners and children: the recognition that diabetes has a genetic component was not sufficient for changes in the life style and they consider that emotional aspects interfere in the metabolic control of diabetes; a few subjects sought alternatives for occupying their free time after retirement, such as the participation in communitarian groups or in the development of personal abilities. It was possible to infer that besides the conventional treatment for the diabetes control, subjects also incorporated non-conventional practices such as the use of medicinal plants, as Nopal, largely disseminated and known by the Mexican society. They also recognize there are difficulties in changing eating habits, which are coupled with a history of great quantity of calories ingested and to other cultural eating habits currently disseminated, no therapeutic plan or practice of physical activities. It is acknowledged, in the final considerations, that the Mexican National Health Plan follows ample theoretical references such as those of primary health care and health promotion. However, its organization of services for social protection and health are performed by Social Security Institutes. These institutes have autonomy to incorporate and adequate the macro policy in the local sphere which is reflected in the form of health care delivered to the user population. Even incorporating part of the health promotion policy through the creation of diabetic clubs, the family focus and its social environment have not being considered. In this sense, it is perceived that people with diabetes type 2 do not have a regular follow-up in the assistance or self manage their metabolic control, which is evidenced by the great number of consultations and hospitalizations during a one-year period. The difficulties in adopting changes in their life styles seem to be related to the appearance and confirmation of diabetes type 2 in adult age, when habits, beliefs and values are incorporated in routine; thus, any change seems to be more difficulty for them

Lifestyle intervention as a treatment for obesity in school-age-children in Celaya, Guanajuato: An experimental study

Introduction: Obesity is a risk factor in chronic diseases, and its frequency among children in Mexico is increasing. Objective: To determine the effect of lifestyle intervention as a treatment for obesity in school-age-children from Celaya, Mexico. Methodology: For this experimental study, four schools were randomly selected. Children and parents participated voluntarily and signed consent forms. Two schools were chosen as the experimental group and the other two formed the control group. Age, gender, weight, height, BMI and blood pressure were recorded for each participant. Intervention: Children and parents were asked to walk in their schools for 30 minutes a day Monday through Friday and to attend 8 instructional sessions over a period of four months dedicated to the selection and preparation of meals. Statistical Analysis: The OR and 95% CI were calculated to determine the effect of the intervention; a Z-test for two proportions for overweight and obesity in the control and experimental groups were carried out for comparison. Results: 157 children were included in the experimental group and 144 in the control group. To compare the proportions of the overweight and the obese between the groups, a Z-test = - 0.36 (p-value 0.72) were obtained showing no effect of the intervention in lifestyle; OR =1.09, 95% CI (0.67, 1.77). It was adjusted according to the attendance to the sessions resulting in an OR = 2.00, 95% CI (0.69, 5.77), demonstrating that not attending the sessions was a confounder. Conclusions: Intervention in lifestyle should be measured over a longer period of time in order to determine what effects it may have on changes in body mass index

Do People with Type 2 Diabetes Think They are Unhealthy? A Cross-Sectional Study in Celaya, Mexico

Background: Type 2 diabetes is a chronic disease that presents a significant burden on health care systems in many countries. With the rise of obesity, the incidence of Type 2 diabetes has also been steadily increasing. A healthy lifestyle and understanding of diabetes management are important factors for delaying the onset of comorbidities associated with Type 2 diabetes. The objective of this study was to evaluate the self-perception of health in individuals with Type 2 diabetes as it relates to BMI status, which has important implications for the implementation of preventive programs. Methods: A cross-sectional lifestyle survey was implemented in the region of Celaya, Guanajuato, Mexico, targeting 100 participants diagnosed with Type 2 diabetes. Anthropometric measurements and participant characteristics were also obtained. Fisher’s exact test was used to determine if the proportions of lifestyles perceptions differed by BMI status. Results:  Participants had a mean age of 56.12 ± 10.26, a mean BMI of 29.13 ± 5.48 kg/m2, were mostly married (67.0%), and female (70.0%). None of the normal weight participants perceived themselves as unhealthy. 95% of overweight/obese participants perceived themselves to be healthy, despite a diagnosis of diabetes and being overweight/obese, while only 5% perceived themselves to be unhealthy. However, these differences in the perceptions of health classified by BMI status were not statistically significant (p = 0.42). Conclusion: Our findings indicate that overweight and obese persons with Type 2 diabetes in Celaya, Mexico may have misperceptions about their own health, even though these findings were not statistically significant. These preliminary data highlight the importance of implementing prevention and educational programs among those with diabetes, in order to combat health misperceptions and raise awareness about the dangers of diabetes and obesity. Furthermore, more research with larger sample sizes is needed  in order to fully understand the effects of perception of health on actual health