Marcela Pérez-Rodríguez

Dietary and Physical Activity/Inactivity Factors Associated with Obesity in School-Aged Children

Diet and physical activity (PA) are essential components of nutritional status. Adequate nutrition and an active lifestyle are key factors during childhood, because food habits track into adulthood. Children spend more time in school than in any other environment away from home. Studying the diet factors and patterns of PA that affect obesity risk in children during school hours and the complete school day can help identify opportunities to lower this risk. We directly measured the time children spent performing moderate to vigorous PA (MVPA) at school, compared the amount and intensity of PA during school hours with after-school hours, and tried to determine if diet behaviors and PA or inactivity were associated with excess weight and body fat. This cross-sectional study included 143 normal-weight (NLW) and 48 obese children aged 8-10 y. Diet data were obtained from two 24-h recalls. Body composition was measured by bioimpedance. Screen time and sports participation data were self-reported. NLW children drank/ate more dairy servings than the obese children, who consumed more fruit-flavored water than the NLW group. Consumption of soft drinks, sugar-added juices, and fresh juices was low in both groups. Children were less active during school hours than after school. MVPA was lower during school hours in the obese group than in the NLW group. Schools, parents, and authorities should be more involved in promoting strategies to improve the dietary habits and PA levels of school-aged children, because this group is not achieving the recommended level of daily MVPA.

Physical Activity Patterns in Mexican School-Aged Children

Aims: To describe physical activity patterns, and explore the associations of physical activity with demographic and anthropometric characteristics in Mexican children. Relevance: Knowledge of physical activity patterns in school-age children may offer ways in ameliorating early childhood obesity in Mexico. Methods: Physical activity by accelerometry was measured in 358 children aged 7 to 11 years attending 24 Mexico City schools. Anthropometric measurements (height, weight, hip and waist circumferences, and triceps skinfold) were also done. Results: Only 31% of the girls and 51% of the boys achieved the minimum of one hour per day recommended by WHO of moderate to vigorous physical activity (MVPA). This deficit was less critical for Friday and Weekends, a finding that we believe obeyed to the lack of school homework that leaves them with more playtime. We also observed that activity decreased with age and school grade, starting in the third grade, and that physical activity was higher in girls with a high hip-waist ratio. Limitations: We were able to recruit a very low proportion of schools (24 of more than 400 invited). Conclusions: The deficit of MVPA in our children, especially girls, may be larger in the schools that refused to participate.

Association between Apolipoprotein E Variants and Obesity-Related Traits in Mexican School Children

Background/Aim: Genetic variation in apolipoprotein E (ApoE) has a key role in lipid metabolism. However, its contribution to the amount and distribution of body fat is under investigation. The aim of this study was to analyze the association between genetic variation in ApoE and obesity-related traits in Mexican school children. Material and Methods: Anthropometric, body composition and physical activity measures were conducted using standard methods in 300 children (177 girls/123 boys) who fulfilled the inclusion criteria. DNA was isolated from saliva. ApoE genotypes were analyzed by allelic discrimination. The association between variation in ApoE and anthropometric and body composition measures was investigated using the General Linear Model. Results: The mean ± SD values for age, body mass index (BMI) and waist circumference (WC) were 9.05 ± 0.80 years, 19.01 ± 3.83 and 67.98 ± 10.97 cm, respectively. Approximately 46% of the participants were overweight or obese. A significant association between ApoE isoforms and WC was found after controlling for age, sex and the percentage of physical activity (p = 0.025). Significant main effects were found for vigorous physical activity and light physical activity influencing the adiposity-related BMI (p < 0.001) and WC (p = 0.044), respectively. Conclusions: Variation in ApoE and physical activity intensity were associated with adiposity-related phenotypes in Mexican school children.

Escenario actual de los medicamentos biocomparables en México: posicionamiento del Colegio Mexicano de Reumatología, 2016

The present document is a position statement of the Mexican College of Rheumatology on the use of biosimilars in rheumatic diseases. This position considers that biosimilars should be considered as interchangeable, that automatic substitution without previous notice in stable patients during follow-up is not ethical, that the approval of a biosimilar should only be given after exhaustive review of preclinical and clinical data marked by Mexican regulations, that it should be clearly stated in the nomenclature of biologic drugs which is the innovator and which is the biosimilar, that it is not correct to choose a biosimilar as treatment based only on economic reasons or extrapolate indications based only on the approval of the innovator and in the absence of safety and efficacy data for the biosimilar.

Guía de práctica clínica para el manejo del lupus eritematoso sistémico propuesta por el Colegio Mexicano de Reumatología

There are national and international clinical practice guidelines for systemic lupus erythematosus treatment. Nonetheless, most of them are not designed for the Mexican population or are devoted only to the treatment of certain disease manifestations, like lupus nephritis, or are designed for some physiological state like pregnancy. The Mexican College of Rheumatology aimed to create clinical practice guidelines that included the majority of the manifestations of systemic lupus erythematosus, and also incorporated guidelines in controversial situations like vaccination and the perioperative period. The present document introduces the «Clinical Practice Guidelines for the Treatment of Systemic Lupus Erythematosus» proposed by the Mexican College of Rheumatology, which could be useful mostly for non-rheumatologist physicians who need to treat patients with systemic lupus erythematosus without having the appropriate training in the field of rheumatology. In these guidelines, the reader will find recommendations on the management of general, articular, kidney, cardiovascular, pulmonary, neurological, hematologic and gastrointestinal manifestations, and recommendations on vaccination and treatment management during the perioperative period.

Jugando a Ganar Salud ("Playing to Gain Health"): A Summer-Vacation Physical Activity and Correct Eating Workshop for School-Aged Children - A Pilot Study

According to the most recent data on nutritional evaluation in Mexican population, one of every four children between 5 and 11 years of age (26%) presents overweight or obesity, dramatically surpassing the estimate calculated for 2010 for childhood obesity at the worldwide level of 6.7% (Olaiz-Fernandez G, 2006). This problem acquires great relevance not only because of the prevalence of obesity, but also due to the consequences associated with this condition, such as high risk of adult-age obesity and chronic diseases such as diabetes mellitus, high blood pressure, dyslipidemias, obstructive apnea sleep disorder syndrome, and non-alcoholic steatosis (Pimenta AM, 2010; Elizondo-Montemayor L, 2010). Conclusive evidence has been established that physical activity is a promoter of healthy lifestyle promoter and a preventer of excessive weight gain (Summerbell CD, 2005) and other diseases. In particular, habitual physical activity at early ages increases the probability of exerting an impact on the mortality and longevity of persons, as well as improving some cardiovascular risk indicators (Hills AP, 2007; Balas-Nakaxh M, 2010). Generality in existing consensuses for the prevention and treatment of childhood obesity cites the promotion of physical activity as an imperative strategy. The different guidelines that exist on physical activity in children recommend 60 min of physical activity daily of at least moderate intensity, including vigorous aerobic activity at least 3 days a week (Jasen I, 2010; O’Donovan G, 2010). Unfortunately, in Mexico, the reality concerning the time devoted to physical activity in children lies very far from these recommendations. An observational study conducted in Mexico quantified the physical activity engaged in within the school environment, identifying that children have few opportunities to participate in moderateand vigorous-intensity physical activity, scarcely achieving one half of the time recommended by international guidelines for this age group (Jennings-Aburto N ,2009). A large proportion of the reports on studies examining the promotion of physical activity in this age group are hardly encouraging in terms of the results obtained regarding body weight modification, eating habits, and a sedentary lifestyle at the