Barbara Vizmanos

The duration of puberty in girls is related to the timing of its onset

OBJECTIVE To observe the time lapse between the start of puberty and the advent of menarche in groups of girls maturing at different ages. SUBJECTS A sample of 163 girls subgrouped by pubertal onset at 9 (n = 22), 10 (n = 53), 11 (n = 54), 12 (n = 27), and 13 (n = 7) years of age. DESIGN Clinical follow-up from 10 to 17 years of age. METHODS Onset of puberty was defined by the combined observation of mammary development on the Tanner scale and the height curve. The date of menarche was recorded (month and year), and the time lapse was expressed as a function of the date of birth. RESULTS In the overall study sample, the duration of puberty was 1.96 +/- 0.06 years. For the subgroups of girls starting puberty at 9, 10, 11, 12, and 13 years of age, the time lapse to menarche was 2.77 +/- 0.16, 2.27 +/- 0.16, 1.78 +/- 0.08, 1.44 +/- 0.10, and 0.65 +/- 0.09 years, respectively (p < 0.001). The correlation coefficient (r) between the onset of puberty and its duration was r = -0.62 (p < 0.001), and that of age of pubertal onset versus age of menarche was r = 0.66 (p < 0.001). CONCLUSION The duration of puberty in girls depends on the timing of its onset; the earlier the onset of puberty the longer its duration.

Implications of the weaning pattern on macronutrient intake, food volume and energy density in non-breastfed infants during the first year of life.

OBJECTIVES To evaluate the implications of the patterns of weaning on the intake of macronutrients, energy intake, food volume and the energy density in healthy infants in the Mediterranean area of Spain. SUBJECTS AND STUDY DESIGN Cross-sectional study of 120 clinically-healthy, non-breastfed infants at the ages of 4, 6, 9 and 12 months randomly recruited from three pediatric out-patient clinics. Nutrition data were obtained from the infants food preparer using the 24-hour dietary recall method. RESULTS Energy intake/kg body weight was within the recommended daily allowance and did not vary significantly with age (423 kJ/kg body weight at 4 months and 443.7 kJ/kg at 12 months). There was a progressive decrease in the intake volume (p < 0.001) in which carbohydrate-rich foodstuffs were the major factors, and an increase in the energy density (p < 0.001) in which the protein-rich items were the principal contributors. Lipid intake diminished progressively (p < 0.01) to a nadir of 26.4% of energy intake at 9 months of age. In each of the meals there was a tendency towards a progressive increase in energy intake with age. This increase was achieved by a significant increase in energy density (p < 0.001 in all meals, except dinner p < 0.05). Conversely, the intake volume of breakfast, lunch and dinner remained essentially unchanged between 6 and 12 months while that of the mid-evening meal decreased markedly. CONCLUSION Increased energy requirements for growth is achieved, mainly, by an increase in the energy density rather than the intake volume during food-item diversification in the non-breastfed infant. Cereals were the central food item in the weaning diet in our study sample and which adequately compensates, in terms of energy requirement, for the early reliance on the lipids contained in milk.

Effect of Ala54Thr polymorphism of FABP2 on anthropometric and biochemical variables in response to a moderate-fat diet

OBJECTIVE To analyze the effect of the fatty acid-binding protein (FABP2) gene Ala54Thr polymorphism on anthropometric and biochemical variables in response to a moderate-fat diet in overweight or obese subjects. METHODS One hundred nine subjects with a body mass index ≥ 25 kg/m(2) were studied. Participants underwent a dietary intervention that consisted of 30% fat (saturated fat <7% of total calories), 15% protein, and 55% carbohydrates. The FABP2 genotypes were analyzed by polymerase chain reaction-restriction fragment length polymorphism. Anthropometric and biochemical data were measured at baseline, 1 mo, and 2 mo of nutritional intervention. RESULTS The mean age was 38.6 ± 11.3 y and the mean body mass index 32.7 ± 6.1 kg/m(2), with 20 men (18%) and 89 women (82%). Fifty-three patients (48.6%) had genotype Ala54Ala (wild-type group) and 56 patients had genotype Ala54Thr/Thr54Thr (51.4%, mutant group). At baseline, no significant difference was found between the FABP2 genotypes groups, except for the carbohydrate intake and resting metabolic rate, which were higher in the Ala54Thr/Thr54Thr group (P < 0.05). At 2 mo, participants had lost 6.8% of their initial weight. The Ala54Thr/Thr54Thr group compared with the Ala54Ala group showed significant decreases in the parameters of weight (-7.5 versus -4.2 kg), body mass index (-2.1 versus -1.2 kg/m(2)), waist circumference (-7.6 versus -5.2 cm), waist-to-hip ratio (-0.04 versus -0.02), and C-reactive protein (-1.4 versus -0.76 mg/L), respectively (P < 0.05). After the resting metabolic rate was adjusted, the decreases in waist circumference, waist-to-hip ratio, and C-reactive protein remained significant between the two groups. CONCLUSIONS This study showed that the Thr54 allele carriers responded better to a moderate-fat diet.

A REVIEW OF GRAPHICAL REPRESENTATIONS USED IN THE DIETARY GUIDELINES OF SELECTED COUNTRIES IN THE AMERICAS, EUROPE AND ASIA.

INTRODUCTION Food-Based Dietary Guidelines (FBDGs) are an initiative by the United Nations Food and Agriculture Organization (FAO) and the World Health Organization (WHO) designed to help countries establish their own nutrition education principles. Such principles should be expressed through clear and specific messages that provide guidance and promote good health among populations. Many of these guidelines contain graphical representations (GRs) as visual aids for dietary guidance. OBJECTIVES to analyze the characteristics of GRs used in various countries on four continents to identify international trends in these graphical messages and assess their usefulness as educational tools for their target populations. METHODS a review of GRs used in the FBDGs of countries in the Americas, Europe and Asia for which data were available in Spanish or English. RESULTS AND DISCUSSION the models most used are the food circle and pyramid. The GRs (n = 37) depict the following recommendations: food groups (37), physical activity (21), water intake (17), low salt intake (7), family meals (1) and relaxation (1). In addition, 10 quantitative recommendations were detected. The GRs of Greece and the United States do not show images of food. The aspects considered in the GRs vary by the regions, cultures and epidemiological characteristics of each country. A tendency to use the food circle and to include lifestyle recommendations in illustrations was observed in the United States, Spain and Mexico. Quantitative recommendations may help to clarify information provided during the educational process.

Effect of the ADIPOQ Gene -11391G/A Polymorphism Is Modulated by Lifestyle Factors in Mexican Subjects.

Background/Aims: Single nucleotide polymorphisms (SNPs) in the ADIPOQ gene could explain the adiponectin level. However, the knowledge about the influence of genetic and lifestyle factors is not sufficient. The aim was to analyze whether the effect of the -11391G/A SNP in the ADIPOQ gene is modulated by lifestyle factors in Mexican subjects. Methods: A cross-sectional study was performed in which 394 participants were analyzed. Genetic, anthropometric, biochemical, dietary, clinical and physical activity parameters were measured. Statistical analysis was performed with SPSSv19 software. Results: The distribution of the -11391G/A SNP genotypes was 55.6 and 44.4% for GG and AG, respectively. The adiponectin level was modulated by the -11391G/A SNP in response to the body mass index (BMI); A allele carriers showed a higher adiponectin level compared to G homozygous carriers but only in the minor BMI tertile group (p = 0.032). Adiponectin level variability was explained by gender [(r) = 1.5, 95% CI 1.1-1.9, p = 0.000], insulin resistance [(r) = -1.2, 95% CI -0.8 to -1.6, p = 0.000], physical activity [(r) = 0.6, 95% CI 0.2-0.9, p = 0.002] and monounsaturated fat intake [(r) = 0.5, 95% CI 0.38-1.0, p = 0.047]. Conclusions: The adiponectin level was modulated by the interaction between BMI and -11391G/A SNP; this suggests that the lifestyle rather than genetic factors modulates serum adiponectin.

Dynamics of the components of energy intake between Spanish and Mexican preschool children: energy density and food volume in two contexts

OBJECTIVE To determine the differences in the dynamics of dietary energy density (ED), food volume (FV) and energy intake (EI) between two groups of healthy children, in normal conditions, from Spain and Mexico. METHODS Crossectional study which analyses the habitual diet of two healthy children groups, 1-4 years old, from Reus (Spain, n = 203) and Guadalajara (Mexico, n = 147). Dietary intake was assessed using the 24-hour recall. Anthropometric data were also obtained. We estimated Z-score of weight, height and BMI, and EI (kcal/day), ED (kcal/g), FV (g/day), El/kg body weight (kcal/kg/day) and FV/kg body weight (g/kg/day). RESULTS The Spanish children consumed significantly more cereals (p < 0.05), vegetables, meat, fish and eggs than the Mexican children (p < 0.001), while the latter consumed significantly more sweets (p < 0.001). The mean El/kg body weight was 107.7 ± 36.2 kcal/kg/day in the children from Reus, and 102.4 ± 38.8 kcal/kg/day in the children from Guadalajara, without significant differences. While the ED was significantly higher (p < 0.001) in the Spanish sample (1.41 ± 0.35 kcal/g) that in the Mexican one (1.19 ± 0.37 kcal/g), we observed the contrary on FV per kilogram of weight: it was significantly (p < 0.001) greater in Mexicans (91.0 ± 36.1 g/kg/day) than in Spanish (79.5 ± 27.5 g/kg/day). CONCLUSION In two populations with different contexts, the balance between energy intake and energy requirements is achieved in different ways, allowing energy intake per unit of weight and growth to be adequate. Future studies are needed to clarify the factors of a possible alteration of this equilibrium through time, in such a way, that it would probably contribute to the development of overweight and obesity in several environments.

The Reproducibility and Relative Validity of a Mexican Diet Quality Index (ICDMx) for the Assessment of the Habitual Diet of Adults

The study of diet quality in a population provides information for the development of programs to improve nutritional status through better directed actions. The aim of this study was to assess the reproducibility and relative validity of a Mexican Diet Quality Index (ICDMx) for the assessment of the habitual diet of adults. The ICDMx was designed to assess the characteristics of a healthy diet using a validated semi-quantitative food frequency questionnaire (FFQ-Mx). Reproducibility was determined by comparing 2 ICDMx based on FFQs (one-year interval). Relative validity was assessed by comparing the ICDMx (2nd FFQ) with that estimated based on the intake averages from dietary records (nine days). The questionnaires were answered by 97 adults (mean age in years = 27.5, SD = 12.6). Pearson (r) and intraclass correlations (ICC) were calculated; Bland-Altman plots, Cohen’s κ coefficients and blood lipid determinations complemented the analysis. Additional analysis compared ICDMx scores with nutrients derived from dietary records, using a Pearson correlation. These nutrient intakes were transformed logarithmically to improve normality (log10) and adjusted according to energy, prior to analyses. The ICDMx obtained ICC reproducibility values ranged from 0.33 to 0.87 (23/24 items with significant correlations; mean = 0.63), while relative validity ranged from 0.26 to 0.79 (mean = 0.45). Bland-Altman plots showed a high level of agreement between methods. ICDMx scores were inversely correlated (p < 0.05) with total blood cholesterol (r = −0.33) and triglycerides (r = −0.22). ICDMx (as calculated from FFQs and DRs) obtained positive correlations with fiber, magnesium, potassium, retinol, thiamin, riboflavin, pyridoxine, and folate. The ICDMx obtained acceptable levels of reproducibility and relative validity in this population. It can be useful for population nutritional surveillance and to assess the changes resulting from the implementation of nutritional interventions.

Waist Circumference Is an Anthropometric Parameter That Identifies Women with Metabolically Unhealthy Phenotypes

Metabolically healthy (MH) and metabolically unhealthy (MUH) phenotypes can be present in any subject independently of their body mass index (BMI). However, factors related to the presence of these phenotypes are poorly understood. Therefore, the aim of this cross-sectional study is to describe the prevalence and characteristics associated with the MH and MUH phenotypes in Mexican subjects with different BMI categories. Anthropometric and biochemical parameters were evaluated after 12 h of fasting. HMW (High Molecular Weight) adiponectin and insulin levels were measured by ELISA (enzyme-linked immunosorbent assay). A total of 345 subjects were included, of which, 73.9% were women. The prevalence of the MH phenotype was 69.9%, 46.7%, and 19% in normal weight, overweight, and obesity, respectively. ROC (receiver operating characteristic) curve analysis showed that the waist circumference demonstrated a statistical significance (p < 0.01) in detecting the MUH phenotype in each BMI group only in women. Furthermore, subjects with lower HMW adiponectin levels showed a 2.1 increased risk of presenting the MUH phenotype. In conclusion, in this Mexican population, waist circumference was an anthropometric parameter that identified women with the MUH phenotype in all BMI categories and hypoadiponectinemia was a risk factor for the presence of this phenotype.

Design and Reproducibility of a Mini-Survey to Evaluate the Quality of Food Intake (Mini-ECCA) in a Mexican Population

Evaluating food intake quality may contribute to the development of nutrition programs. In Mexico, there are no screening tools that can be administered quickly for the evaluation of this variable. The aim was to determine the reproducibility of a mini-survey designed to evaluate the quality of food intake (Mini-ECCA) in a Mexican population. Mini-ECCA consists of 12 questions that are based on Mexican and international recommendations for food and non-alcoholic beverage intake, with the support of photographs for food quantity estimation. Each question scores as 0 (unhealthy) or 1 (healthy), and the final score undergoes a classification procedure. Through the framework of a nutritional study, 152 employees of the municipal water company in Guadalajara, Mexico (April–August 2016), were invited to participate. The survey was administered in two rounds (test and retest) with a 15-day interval between them. We calculated the Spearman correlation coefficient, the intra-class correlation coefficient (ICC), and weighted kappa for score classification agreement (SPSS versus 14 p < 0.05 was considered statistically significant). The survey obtained a “good” reproducibility (ρ = 0.713, p < 0.001), and an excellent concordance (ICC = 0.841 Confidence Interval 95% 0.779, 0.885). It can thus be said that the Mini-ECCA displayed acceptable reproducibility and is suitable for the purpose of dietary assessment and guidance.

Metabolic syndrome components in young health professionals: LATIN America METabolic Syndrome (LATINMETS) Mexico study

INTRODUCTION metabolic syndrome (MS) components are independent risk factors for the development of cardiovascular disease and type 2 diabetes, major causes of mortality in the world. OBJECTIVE to evaluate the frequency of MS components and its association with sociodemographic variables and physical activity among young health professionals at the University of Guadalajara. METHODS a cross-sectional study entitled LATIN America METabolic Syndrome Mexico (LATINMETS-Mex) was conducted. Weight, height, waist circumference, blood pressure, triglycerides, glucose and HDL cholesterol were measured. Socio-demographic and physical activity data were surveyed. MS components were diagnosed based on the revised criteria of Alberti et al. (2009). Associations were assessed using logistic regression adjusted for age and sex. RESULTS a total of 316 volunteer subjects were analyzed (70.9% women, 83.8% ≤ 29 years). The frequency of MS was 7.0% and 55.5% of subjects presented one or more MS components (27.2% abdominal obesity, 26.6% low HDL cholesterol). After adjustment, abdominal obesity, high blood pressure and hypertriglyceridemia were positively associated with BMI ≥ 25 kg/m2. High blood pressure and hypertriglyceridemia were negatively associated with being female while low HDL cholesterol was positively associated with this gender after adjustment. Abdominal obesity was the only component negatively associated with physical activity (300 to 600 minutes per week) after adjusting for age and sex. No association between MS and sociodemographic variables or physical activity was found. CONCLUSIONS half of the participants presented one or more metabolic syndrome components. Actions are required to reduce cardiometabolic risk in the study population considering the sociodemographic and lifestyle variables associated.