Rene Urquidez-Romero

Environmentally Driven Increases in Type 2 Diabetes and Obesity in Pima Indians and Non-Pimas in Mexico Over a 15-Year Period: The Maycoba Project

OBJECTIVE The global epidemics of type 2 diabetes and obesity have been attributed to the interaction between lifestyle changes and genetic predisposition to these diseases. We compared the prevalences of type 2 diabetes and obesity in Mexican Pima Indians, presumed to have a high genetic predisposition to these diseases, to those in their non-Pima neighbors, both of whom over a 15-year period experienced a transition from a traditional to a more modern lifestyle. RESEARCH DESIGN AND METHODS Prevalence of diabetes, impaired fasting glucose, impaired glucose tolerance, and obesity in Mexican Pimas (n = 359) and non-Pima Mexicans (n = 251) were determined in 2010 using methods identical to those used in 1995. RESULTS During this 15-year period, age-adjusted diabetes prevalence was unchanged in Pima men (5.8% in 1995 vs. 6.1% in 2010) yet increased in non-Pima men from 0.0 to 8.6% (P < 0.05). Diabetes prevalence tended to increase in both Pima women (9.4 vs. 13.4%) and non-Pima women (4.8 vs. 9.5%). Age-adjusted prevalence of obesity increased significantly in all groups (6.6 vs. 15.7% in Pima men; 8.5 vs. 20.5% in non-Pima men; 18.9. vs 36.3% in Pima women; 29.5 vs. 42.9% in non-Pima women). CONCLUSIONS Type 2 diabetes prevalence increased between 1995 and 2010 in non-Pima men, and to a lesser degree in women of both groups, but it did not increase in Pima men. Prevalence of obesity increased among Pimas and non-Pimas of both sexes. These changes occurred concomitantly with an environmental transition from a traditional to a more modernized lifestyle.

Study design of the Maycoba Project: obesity and diabetes in Mexican Pimas.

OBJECTIVE To focus on the rationale and methods of the Maycoba Project. METHODS Study population included Mexican Pima Indians (MPI) and Blancos aged ≥20-years, living in the village of Maycoba and surrounding area. Surveys in 1995 and 2010 included a medical history, biochemical and anthropomet- ric measurements. Additionally, socio- economic, physical activity, and dietary interviews were conducted. The 2010 study incorporated investigations on type 2 diabetes (T2D) and obesity-associated genetic alleles and human-envi- ronment changes. RESULTS The study results are limited to demographic data and description of the eligible and ex- amined sample. CONCLUSIONS This study may yield important information on T2D and obesity etiology in a traditional population exposed to environmental changes.

Double-blind randomised controlled trial of the independent and synergistic effect of Spirulina maxima with exercise (ISESE) on general fitness, lipid profile and redox status in overweight and obese subjects: study protocol

Introduction In order to reduce cardiovascular disease risk factors, a healthy diet must include dietary antioxidants from different sources (eg, Spirulina maxima) and regular practice of exercise should be promoted. There is some evidence from animal studies that S. maxima and exercise decrease cardiovascular disease risks factors. However, very few studies have proved the independent or synergistic effect of S. maxima plus exercise in humans. This study attempts to address the independent and synergistic effects in overweight and obese subjects participating in a systematic physical exercise programme at moderate intensity on general fitness, plasma lipid profile and antioxidant capacity. Methods and analysis Using a randomised, double-blind, placebo-controlled, counterbalanced crossover study design, 80 healthy overweight and obese subjects will be evaluated during a 12-week isoenergetic diet accompanied by 4.5 g/day S. maxima intake and/or a physical systematic exercise programme at moderate intensity. Body composition, oxygen uptake, heart rate, capillary blood lactate, plasma concentrations of triacylglycerols, total, low-density and high-density lipoprotein cholesterol, antioxidant status, lipid oxidation, protein carbonyls, superoxide dismutase, catalase, glutathione, glutathione peroxidase, glutathione reductase and paraoxonase will be assessed. Ethics and dissemination This study and all the procedures have been approved by the Universidad Autonoma de Ciudad Juarez Bioethics Committee. Findings will be disseminated through peer-reviewed journals, national and international conferences. Trial registration number ClinicalTrials.gov: NCT02837666.

Prevalence of prediabetes and modifiable factors in an ethnic group of Mexico: the Comcáac Project

OBJECTIVE To determine the prevalence of and modifiable factors associated with prediabetes in the Comcáac Indians. DESIGN Cross-sectional study where prediabetes was defined using fasting plasma glucose, 2 h plasma glucose and glycated Hb (HbA1c). Physical, anthropometric and biochemical measurements, medical record, socio-economic, dietary and physical activity information were collected. The modifiable factors associated with prediabetes were assessed using multiple logistic regression. Settings Comcáac Indian communities of Punta Chueca and El Desemboque, Sonora, Mexico. SUBJECTS Adults (n 227) aged 20 years or older. RESULTS The sex- and age-adjusted prevalence (95 % CI) of prediabetes was 47·1 (40·8, 53·5) % in the overall population; age-adjusted prevalence was 47·3 (35·6, 59·0) % in men and 46·7 (39·1, 54·3) % in women. The modifiable factors associated with a risk of prediabetes (OR; 95 % CI) were light-intensity physical activity (per 1 h/week increase: 1·04; 1·01, 1·07) and insulin resistance (homeostasis model assessment of insulin resistance score >6·1 v. <4·1: 4·62; 1·37, 15·51). Increased consumption of a traditional dietary pattern based on fish and seafood, low-fat cereals, fruits and vegetables was a protective factor (0·49; 0·31, 0·79). All variables were modelled together and adjusted for age and sex. CONCLUSIONS The high prediabetes prevalence found in the Comcáac community is alarming because it represents a large number of people who are at risk for type 2 diabetes. The identification of modifiable factors associated with prediabetes that are specific to this population may be useful for designing effective strategies to prevent prediabetes.

Food neophobia, Mediterranean diet adherence and acceptance of healthy foods prepared in gastronomic workshops by Spanish students

INTRODUCTION food neophobia can affect dietary variety and hedonic acceptance due to rejection of healthy foods. OBJECTIVE to evaluate the impact of dietary neophobia on adherence to the Mediterranean diet and on the hedonic acceptance of healthy foods made in gastronomic workshops by schoolchildren. METHODOLOGY descriptive cross-sectional study of Primary (8-11) and Secondary (12-18) schoolchildren from Murcia, Spain, participating in gastronomic workshops, where two recipes were prepared and tasted (vegetables + blue fish and fruits). Food neophobia (FN) and adherence to the Mediterranean diet (KIDMED) were identified and each participant assessed the acceptance of each recipe using a hedonic scale (seven points). RESULTS a total of 1,491 students (49.5% girls) participated in the study; 13.5% were neophobic and 61.1% presented optimal diet quality. A linear inverse relationship between the degree of neophobia and the quality of the diet (ρ[rho] = -0.31, p = 0.001) was found. High adherence to the Mediterranean diet was associated with lower neophobia and better hedonic scores, compared to intermediate or low adhesions (p < 0.0001). Neophobic schoolchildren presented significantly worse results in vegetable consumption, especially at the Secondary level, and in the acceptance of healthy preparations (p < 0.05). A good acceptance of the prepared preparations was associated with the usual adequate consumption of fruits, vegetables, fish and legumes. CONCLUSION food neophobia affects the adherence to the Mediterranean diet and the acceptance of healthy foods elaborated in gastronomic workshops by Spanish schoolchildren.

Differences in Body Composition in Older People from Two Regions of Mexico: Implications for Diagnoses of Sarcopenia and Sarcopenic Obesity

Background Mexico is a country that is rich in ethnicity and cultural diversity, divided into three well-defined socioeconomic, ecological, and epidemiological areas. However, we do not know the influence that these factors may have on body composition. Therefore, this study was designed to assess body composition and compare appendicular skeletal muscle mass (ASM) in older people from two areas of the country. Methods This is a cross-sectional study that included 430 subjects ≥60 years of age from northwestern and central Mexico. Body composition, including ASM, was measured by dual-energy X-ray absorptiometry, while anthropometry, handgrip strength, demographic variables, health status/chronic conditions, and energy expenditure data were all included. Results Men and women from the northwestern region had 5.9 kg and 3.8 kg more body fat, respectively, and 3.9 kg more as a group than their counterparts from central Mexico (p ≤ 0.0001). While there were no significant differences across gender or region in terms of ASM, the older subjects from central Mexico had a significantly higher ASM index (ASMI) than the sample from the northwest. When ASM was adjusted for age, body weight, height, health status/chronic conditions, estimated energy expenditure, and demographic variables, the subjects from central Mexico had significantly higher adjusted mean values of ASM and ASMI than their counterparts from the northwest. Conclusion Older people from two regions of Mexico had significantly different estimates of body composition. Our findings highlight the importance of regionalizing estimates of ASM and ASMI if they are to be used for diagnostic purposes. It is also important to emphasize that appendicular skeletal muscle mass, or the ASM index, should be adjusted for other associated biological variables.

Analysis of type 2 diabetes and obesity genetic variants in Mexican Pima Indians: Marked allelic differentiation among Amerindians at HLA

Prevalence of diabetes and obesity in Mexican Pima Indians is low, while prevalence in US Pima Indians is high. Although lifestyle likely accounts for much of the difference, the role of genetic factors is not well explored. To examine this, we genotyped 359 single nucleotide polymorphisms, including established type 2 diabetes and obesity variants from genome‐wide association studies (GWAS) and 96 random markers, in 342 Mexican Pimas. A multimarker risk score of obesity variants was associated with body mass index (BMI; β = 0.81 kg/m2 per SD, P = 0.0066). The mean value of the score was lower in Mexican Pimas than in US Pimas (P = 4.3 × 10−11), and differences in allele frequencies at established loci could account for approximately 7% of the population difference in BMI; however, the difference in risk scores was consistent with evolutionary neutrality given genetic distance. To identify loci potentially under recent natural selection, allele frequencies at 283 variants were compared between US and Mexican Pimas, accounting for genetic distance. The largest differences were seen at HLA markers (e.g., rs9271720, difference = 0.75, P = 8.7 × 10–9); genetic distances at HLA were greater than at random markers (P = 1.6 × 10–46). Analyses of GWAS data in 937 US Pimas also showed sharing of alleles identical by descent at HLA that exceeds its genomic expectation (P = 7.0 × 10–10). These results suggest that, in addition to the widely recognized balancing selection at HLA, recent directional selection may also occur, resulting in marked allelic differentiation between closely related populations.

Body Image Satisfaction as a Physical Activity Indicator in University Students

OBJECTIVE We examined the association of body image satisfaction (BIS) with physical activity (PA) in university athletes and non-athletes from northern Mexico. METHODS In a non-probability cross-sectional study, 294 participants (51% male, 41% athletes; 18-35 years old) completed 2 self-administered questionnaires to evaluate BIS and PA. We categorized somatotypes (endomorphy-mesomorphy-ectomorphy) by international standardized anthropometry. Data analysis included the Mann-Whitney U test, χ2test, Kendalls Tau-b correlation, binary logistic regression analysis, and receiver operating characteristic (ROC) curves. RESULTS Self-perceived sports abilities and desirable body shape predicted 30% of sports participation in students, whereas an endomorphic shape (<5.4 units) and being male predicted 15.4% of sports participation. CONCLUSIONS BIS was a reliable indicator of sports participation among these university students.