FACTORES SOCIOCULTURALES Y DEL ENTORNO QUE INFLUYEN EN LAS PRÁCTICAS ALIMENTARIAS DE GESTANTES CON Y SIN OBESIDAD

Identificar y describir factores socioculturales y del entorno que afectan las prácticas alimentarias de un grupo de gestantes mexicanas con y sin sobrepeso u obesidad. Estudio transversal descriptivo realizado en Instituto Nacional de Perinatología durante el 2009. Se invitó  a embarazadas asistentes a control prenatal y se dividieron en dos grupos: gestantes con peso normal y con sobrepeso u obesidad. A todas se aplicó una encuesta para identificar autopercepción del peso y  alimentación, preferencias de alimentos, creencias y fuentes de información.  Se calcularon medidas de dispersión y tendencia central, X2 de Pearson y T de Student. Participaron 301 gestantes. Las mayores de 30 años con sobrepeso u obesidad tuvieron mayor inconformidad con su peso corporal que las de IMC normal (42 vs 14%, p=0.001). El 34% de las gestantes practicó algún tratamiento para bajar de peso antes del embarazo. Una mayor proporción de participantes con peso normal reportó tener una alimentación buena o excelente comparadas con las de sobrepeso u obesidad (61% vs 39%, p=0.004) independientemente del nivel socioeconómico. La mayoría de las gestantes (95-97%) consideraron el sobrepeso u obesidad como factor de riesgo para presentar alguna co-morbilidad. La información sobre dietas y alimentación en todas las participantes se obtuvo principalmente de la familia (14% p=0.022). El 88% de las gestantes reportaron una influencia positiva de su pareja y/o madre. El 30% de las embarazadas omitieron un tiempo de comida de dos a tres veces por semana, y no consumieron los tres grupos de alimentos en forma constante. La falta de voluntad y de poder adquisitivo para la compra de ciertos alimentos fueron limitantes para una alimentación correcta. La obesidad es un problema prevalente en el embarazo. La falta de orientación resulta en prácticas alimentarias inadecuadas, posiblemente por falta de información o a que la información obtenida no siempre es la correcta. Es indispensable establecer estrategias educativas para brindar información veraz, tomando en cuenta el contexto de las mujeres, así como a sus familias. Abstract Identify and describe sociocultural and environmental factors affecting feeding practices in a group of Mexican pregnant women with and without obesity. Descriptive cross-sectional study conducted at the National Institute of Perinatology during 2009. Pregnant women who attend antenatal care were invited to participate and were divided into two groups: pregnant women with normal weight and overweight or obese. A survey was applied in all women in order to identify the self-perception of their weight and diet, food preferences, beliefs and sources of information. Measures of dispersion and central tendency (Pearson's X2 and T-Student) were calculated. A total of 301 pregnant women participate in this study. Overweight or obese women over 30 years were more dissatisfied with their actual weight than those with normal weight (42 vs 14%, p = 0.001). 34% of pregnant women underwent a loss weight treatment before pregnancy. A greater proportion of women with normal weight reported having a good or excellent diet compared with overweight or obese women (61% vs 39%, p = 0.004) regardless of socioeconomic status. Most pregnant women (95-97%) considered overweight or obesity as a risk factor for presenting comorbidities. The information about diet and nutrition was mainly obtained from the family (14% p = 0.022). A positive influence of their mother/partner was observed in 88% of pregnant women.  One third of the women skipped one meal time two to three times a week, and not always consumed foods from the three main food groups. The lack of will and money to purchase certain foods limited the practice of good eating habits. Obesity is prevalent problem in pregnancy. Lack of nutrition education results in inappropriate feeding practices, possibly because of lack of information or because the information obtained is not always the correct. It is essential to establish educational strategies to provide truthful information, taking into account the context of women and their families.Palabras clave: Embarazo, obesidad, creencias, prácticas alimentaria

CONOCIMIENTOS DE NUTRICIÓN, HÁBITOS ALIMENTARIOS Y RIESGO DE ANOREXIA EN UNA MUESTRA DE ADOLESCENTES EN LA CUIDAD DE MÉXICO

La adolescencia es una etapa en la cual se pueden adquirir y en algunas ocasiones modificar nhábitos alimentarios. Al mismo tiempo que los adolescentes se van independizando, son más frecuentes las comidas fuera del hogar, predominando las denominadas comidas rápidas. Material y métodos. Estudio de encuesta descriptiva, con alumnos de un Colegio de Bachilleres en la Cuidad de México. Se aplicó una encuesta que recabó datos generales tales como edad, sexo, escolaridad y responsabilidad en la compra y preparación de sus alimentos,datos de conocimientos sobre grupos de alimentos, el estilo de alimentación, número de tiempos de comida y alimentos que incluyen. Se abarcó sobre el conocimiento y uso del Plato del Bien Comer, hábitos y conductas alimentarias para determinar el riego de anorexia propuesto por Evers en 1987. El análisis estadístico consistió en medidas de tendencia central y c2 de Pearson.Resultados. Participaron 69 sujetos con una edad promedio de 16.8±1.4 años, 16.6±1.1 en mujeres y 17.2±1.8 en hombres. El 68% (46 casos) fueron mujeres. La mayoría de los adolescentes (69% de los casos) reconocieron equivalentes por tipo de alimentos (vgr fruta/fruta), no así entre mismo grupo de alimento pero diferente tipo (35% de los casos) (vgr fruta/verdura). Menos de una terceraparte de los participantes consume los tres grupos de alimentos en cada tiempo de comida, los cereales y alimentos de origen animal son los que más se incluyen, sin embargo las verduras y frutas es el grupo que más se omite en cada tiempo de comida. Los hombres acostumbran realizar tres tiempos de comida y las mujeres dos o menos (p≤0.001), el tiempo de comida que más se omitió fue la cena. El riesgo de anorexia se detectó en 0.13 de las mujeres, entre hombres no huboriesgo. Estos resultados muestran la necesidad de impartir desde etapas tempranas y en especial en la adolescencia, educación en materia de orientación alimentaria para mejorar la calidad en su alimentación.Palabras clave: hábitos alimentarios, anorexia, educación nutricional, conocimiento, adolescencia, México.Behavior foods, anorexia, nutritional education, knowledge, adolescence, Mexic

Barriers to Lose Weight from the Perspective of Children with Overweight/Obesity and Their Parents: A Sociocultural Approach

Introduction. There are not enough studies about the barriers to lose weight from the perspective of children and their parents. Methods. Children and adolescents diagnosed with overweight/obesity in the Department of Endocrinology and their parents were invited to participate in a series of focus group discussions (FGD). Twenty-nine children 10–16 years old and 22 parents participated in 7 focus groups; 2 mothers and 2 adolescents participated in depth interviews. All interviews were recorded, transcribed, and analyzed through grounded theory. Results. Parents went to the hospital only when their children presented any obesity complication; for them, overweight was not a health problem. Parents referred to lack of time to supervise about a healthy diet and exercise; besides, the same parents, relatives, friends, and the mass media encourage the consumption of junk food. Children accepted eating a lot, not doing exercise, skipping meals, and not understanding overweight consequences. Both, parents and children, demanded support to do the time recommended for exercise inside the schools. They also suggested getting information from schools and mass media (TV) about overweight consequences, exercise, and healthy food by health workers; they recommended prohibiting announcements about junk food and its sale. Conclusions. The barriers detected were lack of perception of being overweight, its identification as a disease and its consequences, lack of time to supervise a healthy lifestyle, and a big social influence to eat junk food

Factores relacionados a la presencia del síndrome de Burnout en una muestra de enfermeras del Sector Salud, Ciudad de México.

Introducción: Las enfermeras son un grupo profesional con alto riesgo de sufrir síndrome de Burnout. Algunos factores sociodemográficos y psicológicos se relacionan a dicho síndrome. El objetivo del presente trabajo fue evaluar la relación entre el estrés psicológico, los tres factores descritos para el síndrome de Burnout, y las  características socio-demográficas y psicológicas en un grupo de enfermeras. Material y Métodos: Participaron 265 enfermeras de un centro especializado en salud reproductiva. Todas completaron las evaluaciones sobre características socio-demográficas y aspectos relacionados con sus condiciones de trabajo. Se aplicaron además el Inventario de Burnout de Maslach, el Inventario de Coopersmith, y el Cuestionario General de Salud. Resultados: Se observaron altos niveles de agotamiento emocional en 17.4%  de la muestra. El 4.9% de las enfermeras mostraron bajos niveles de realización personal. La autoestima estuvo relacionada con el agotamiento emocional, la despersonalización y la realización personal. El agotamiento emocional se relacionó con la atención de pacientes seriamente enfermos, y con el trabajo en el horario matutino. Conclusiones: Los factores del síndrome de Burnout, particularmente el agotamiento emocional se relacionan con las condiciones de trabajo. Otros elementos que se relacionan con este síndrome son el estrés psicológico y la autoestima

Factores asociados a la distorsión de la imagen corporal en mujeres adolescentes.

Introducción. En la adolescencia aumentan las necesidades nutricionales y se adquieren nuevos hábitos alimentarios, debido a influencias psicológicas y sociales que condicionan la aparición de distorsión de la imagen corporal. El objetivo del estudio fue identificar la relación de la distorsión de la imagen corporal en mujeres adolescentes con su estado de nutrición, síntomas depresivos, hábitos alimentarios, actividad física y sedentarismo.Material y métodos. Estudio transversal en 174 adolescentes en 2018.  Se evaluó el estado de nutrición por índice de masa corporal, se auto aplicó un cuestionario para conocer la percepción de imagen corporal, síntomas depresivos, hábitos alimentarios, actividad física y sedentarismo. Se realizó un análisis de regresión logística. La razón de momios se presenta con intervalos de confianza al 95 %. Se consideró estadísticamente significativo p <0.05.Resultados. La prevalencia de distorsión de imagen corporal fue 63.2 %, 52.3 % subestimaron su percepción, 50.6 % tenían sobrepeso y obesidad y 43.7 % presentaron síntomas depresivos. Las mujeres con distorsión realizan menos número de comidas, son más jóvenes y presentan mayor prevalencia de sobrepeso y obesidad.Conclusiones. Las adolescentes con distorsión de imagen corporal tienen mayor frecuencia de sobrepeso y obesidad, esto condiciona a mayor riesgo en la salud. 

Retinol and α-Tocopherol in the Breast Milk of Women after a High-Risk Pregnancy

Background: There is scant information about whether, after a high-risk pregnancy, breast milk provides enough vitamins for assuring satisfactory bodily reserves in newborns. Objective: To comparatively evaluate, in women with high-risk and normal pregnancy, the concentration of retinol and α-tocopherol in breast milk. Methods: This cross-sectional, analytical study was evaluated with reverse-phase high-performance liquid chromatography (HPLC). Informed consent was signed by 95 mothers with a high-risk pregnancy and 32 mothers with a normal pregnancy. From the mothers with a high-risk pregnancy were obtained: 23 samples of colostrum, 24 of transitional milk, and 48 of mature milk. From the normal pregnancy group, 32 mature milk samples were collected. Pregestational Body Mass Index (BMI) and the gestational weight gain were noted. Models of logistic regression were constructed to identify the variables related to a low concentration of either retinol or α-tocopherol in breast milk. Results: The concentration of retinol and α-tocopherol in mature milk was 60 (interquartile range (IQR), 41–90) and 276 (103–450) μg/dL, respectively, for the high-risk pregnancy group, and 76 (65–91) and 673 (454–866) µg/dL, respectively, for the normal pregnancy group (p = 0.001). The concentration of retinol and α-tocopherol was similar in the subgroups of mothers with different disorders during gestation. A clear correlation was found between a greater pregestational weight and a lower concentration of retinol (Rho = –0.280, p = 0.006), and between α-tocopherol and retinol in all cases (Rho = 0.463, p = 0.001). Among women having a high-risk pregnancy, those delivering prematurely rather than carrying their pregnancy to term had a reduced concentration of retinol (54 (37–78) vs. 70 (49–106) µg/dL; p = 0.002) and a tendency to a lower concentration of α-tocopherol in breast milk (185 (75–410) vs. 339 (160–500) µg/dL; p = 0.053). Compared to mothers with a normal pregnancy, those with a high-risk pregnancy (whether carried to term or ending in preterm delivery) exhibited a reduced concentration of retinol in mature milk (p = 0.003), as well as a tendency to a lower concentration of α-tocopherol (p = 0.054). Conclusion: Even though the women in the high-risk pregnancy group showed a deficiency of vitamins A and E in their breast milk, the unique biological benefits of this milk justify the promotion of breast feeding as the optimal method of nourishing neonates and infants. In these cases, it should be recommended that the woman increase her consumption of certain nutrients during pregnancy. Additionally, after childbirth mothers should consider the use of supplements to produce milk of adequate quality and thus meet the needs of the baby and prevent any deficiency in micronutrients

Dietary Knowledge and Myths Vary by Age and Years of Schooling in Pregnant Mexico City Residents

Pregnancy is a stage in a woman’s life when she is more open to receiving health advice, especially related to diet. However, women are often caught between receiving scientifically unfounded myths and concrete empirical knowledge. Culturally perpetuated myths may be acted upon more than knowledge, but research on these concepts, especially in the Americas, is scarce. This cross-sectional study aimed to describe the frequency of diet and nutrition myths and knowledge and describe the associated factors in pregnant mothers receiving care in Mexico City. A total of 695 pregnant adults and 322 pregnant adolescents participated in this study, in which they responded to a questionnaire on nutrition and diet myths, knowledge, and practice during pregnancy and breastfeeding. The myths were examined individually, but for the purposes of statistical analysis, a score was obtained. We compared means of variables that could be associated to myth and knowledge scores, then calculated linear and logistical regressions. Forty-six percent of participants had below the mean myth scores. Ninety-two percent of participants had a knowledge score below the mean. Age (β = 0.025, SE 0.007, 95% CI 0.011–0.040, p = 0.001) and years of education (β = 0.166, SE 0.024, 95% CI 0.119–0.213, p = 0.001) explained the myth’s score, while age explained the knowledge score (β = 0.011, SE 0.020, 95% CI −0.032–−0.008, p = 0.002). We found that although most women reported not believing in the myths, they acted on them. The probability of practicing such myths as “You must eat for two during pregnancy” was associated with being an adolescent (OR 1.76, p = 0.001) and being married (OR 1.47, p = 0.007), “Not satisfying cravings leave a mark on the infant’s body” with being adolescent (OR 1.59, p = 0.003) and low socioeconomic level (OR 1.41, p = 0.038), “A frightened or angry mother should not nurse her baby” with being adult (OR 2.61, p = 0.004), and “Drinking atole or beer enhances breast milk production” with being single (OR 2.07, p = 0.001). The probability of not acting on some knowledge was associated with being an adolescent (p ≤ 0.003) and having a high school education or below (p ≤ 0.046). Almost all of our participants held at least one myth about nutrition and diet during pregnancy and breastfeeding; younger participants showed a higher frequency of holding myths. Years of schooling and age were associated with acting on myths and not acting on correct knowledge

Demographics and Psychological Factors Associated with Adiposity in Nurses

Adiposity-based chronic disease (ABCD), overweight-Ow- or obesity-Ob-) in health personnel is as frequent as in the general population, even though they understand well the importance of maintaining a healthy weight. Thus, it is highly likely that certain demographic and psychological conditions, independently of knowledge, are contributing to develop ABCD. The aim of this study was to examine the association between these factors and ABCD in nurses. Data were collected from a cross-sectional study conducted in a tertiary level institute in Mexico City from 2012 to 2013. All the nurses of the institute of any age, shift, service area and seniority were invited to participate and 55% (265) accepted. We found that ABCD was present in 79.6%, and low self-esteem and emotional distress in 26% and 10%, respectively. Working in the night shift (p = 0.031), labor seniority ≥15 years (p = 0.006), having 1 or more children (p = 0.021) and sessions of physical activity <30 min (p = 0.03) were associated with ABCD. Low self-esteem (OR = 2, 95% CI 1.150–3.07, p = 0.023) and emotional distress (OR = 4, 95% CI 1.472–13.078, p = 0.012) were associated with unhealthy lifestyle (less of 3 days per week and/or less of 30 min per session of physical activity and poor dietary habits). Therefore, strategies to prevent and treat ABCD must consider each context among nurses and psychological disorders need be identified to avoid an unhealthy lifestyle