Yolanda Flores-Peña

Percepción materna de sobrepeso-obesidad infantil y riesgos de salud en Nuevo Laredo, Tamaulipas, México

OBJETIVOS: Evaluar 1) la percepcion materna (PM) del peso del hijo, 2) la PM de sobrepeso-obesidad (SP-OB) de ninos no emparentados(NNE),3)laPMde la imagenconriesgode salud y 4) el reconocimiento de riesgos de salud del SP-OB. MATERIAL Y METODOS: Participaron 325 diadas madre-hijo.Se utilizo un panel de siete imagenes.El indice de masa corporal medido del hijo fue el estandar de oro. RESULTADOS: 84 de 100 madres de ninos con SP-OB no percibieron adecuadamente el peso del hijo.El 97.5% percibio el SP-OB de NNE y 83.1% la imagen con SP-OB con riesgo de salud. La mayoria reconocio riesgos de salud. CONCLUSION: Es necesario disenar programas de intervencion multidisciplinarios para ayudar a las madres de ninos con SP-OB a reconocer de forma adecuada el peso de su hijo y asi disminuir la prevalencia de SP-OB en dicha poblacion.

7th to 9th grade obese adolescents perceptions about obesity in tamaulipas, Mexico

O objetivo foi explorar as percepcoes da obesidade de adolescentes obesos, estudantes do 7o ao 9o grau de uma instituicao publica de Tamaulipas, Mexico. E estudo qualitativo, do qual participaram 24 adolescentes que tinham indice de massa corporal superior ao percentil 95. Realizou-se entrevista semiestruturada ate a saturacao dos dados e comprensao do significado. Os adolescentes definiram obesidade de acordo com um padrao de medicao, identificaram como causa principal o fator hereditario, com tendencia para subestimar a obesidade e a ter baixa autoestima, apresentan problemas quando realizam atividade fisica e para conseguirem roupas para melhorar a propria imagen, sao rejeitados pelos seus pares ou iguais, na escola. Identificou-se, tambem, que possuem mecanismos psicologicos de defesa ante a obesidade e alguns deles estao realizando acoes para diminuir o peso. A obesidade tem implicacoes na saude, no aspecto psicologico e social de quem a padece, recomenda-se, aqui, implementar intervencoes.The objective was to explore obese adolescents perceptions about obesity among students in the seventh to ninth grade of a public school in Tamaulipas, Mexico. This is a qualitative study. Participants were 24 adolescents with a body mass index equal to or greater than the 95th percentile. Semistructured interviews were conducted until data saturation was reached and the meaning was understood. The adolescents defined obesity according to standards of measurement. They identified the hereditary factor as the main obesity cause, tended to underestimate obesity and had low self-esteem. They reported problems to do physical exercise and get clothes in order to improve their image, and feel rejected by their peers in school. It was identified that these adolescents have psychological defense mechanisms against obesity and that some of them are making efforts to lose weight. Obesity entails social and psychological health implications for persons suffering from this problem. Interventions should be put in practice.

Maternal Eating and Physical Activity Strategies and their Relation with Children's Nutritional Status

OBJETIVOS: describir las estrategias maternas de alimentacion y actividad fisica (monitoreo, disciplina, control, limites y reforzamiento) [EMAA]; Determinar la relacion de EMAA con el estado nutricional del hijo [indice de masa corporal (IMC) y porcentaje de grasa corporal (PGC)]; Verificar si las EMAA son diferentes de acuerdo al estado nutricional del hijo. METODO: participaron 558 madres e hijos (3 a 11 anos) estudiantes de escuelas publicas. Se aplico la Escala Estrategias Parentales de Alimentacion y Actividad (PEAS), se midio peso, talla y PGC del hijo. Para el analisis se obtuvieron estadisticas descriptivas, se aplico regresion lineal multiple y prueba de Kruskal Wallis. RESULTADOS: reforzamiento presento la media mas alta (62.72) y control la mas baja (50.07). Disciplina, control y limites explicaron 12% del IMC, disciplina y control el 6% del PGC. Se ejerce mayor control en hijos con obesidad (χ2=38.36, p=0.001) y mayor reforzamiento en hijos con bajo peso (χ2=7.19, p<0.05). CONCLUSIONES: las madres ejercen mayor control (presion para comer) en hijos con obesidad y otorgan mayor reconocimiento (felicitar por comer saludable) en hijos con bajo peso. Se recomienda modificar las estrategias parentales para fortalecer habitos saludables de alimentacion y actividad fisica.Objectives to describe the maternal eating and physical activity strategies (monitoring, discipline, control, limits and reinforcement) [MEES]; to determine the relation between MEES and the childs nutritional status [body mass index (BMI) and body fat percentage (BFP)]; to verify whether the MEES differ according to the childs nutritional status. Method participants were 558 mothers and children (3 to 11 years of age) who studied at public schools. The Parental Strategies for Eating and Activity Scale (PEAS) was applied and the childs weight, height and BFP were measured. For analysis purposes, descriptive statistics were obtained, using multiple linear regression and the Kruskal-Wallis test. Results the highest mean score was found for reinforcement (62.72) and the lowest for control (50.07). Discipline, control and limits explained 12% of the BMI, while discipline and control explained 6% of the BFP. Greater control is found for obese children (χ2=38.36, p=0.001) and greater reinforcement for underweight children (χ2=7.19, p<0.05). Conclusions the mothers exert greater control (pressure to eat) over obese children and greater recognition (congratulating due to healthy eating) in underweight children. Modifications in parental strategies are recommended with a view to strengthening healthy eating and physical activity habits.

Validez de dos pruebas para evaluar la percepción materna del peso del hijo

Objective. To assess maternal perception of their children weight using words (PP) and using images (PI) and evaluate the validity of the two tests by determining their sensitivity and specificity. Material and Methods. A total of 418 motherchild diads were selected from urban areas in the Monterrey, Nuevo Leon area. A questionnaire was administered to the mothers about perceptions regarding physical appearance and health. Sensitivity and specificity were calculated and the body mass index measurement of the child was the gold standard. Results. Mothers underestimated overweight (SP) and obesity (OB), with 20.34% of mothers of children with SP and 7.41% of children with OB perceiving their child’s condition with the PP test, and 62.71% of mothers of children with SP and 81.48% of those of children with OB perceiving it with the PI test. The tests had 12% sensitivity and 21% specificity for PP and 75% sensitivity and 15% specificity for PI. Conclusions. The mothers of children with SP-OB underestimate the weight of their children. Images are useful for mothers to recognize their child’s condition.

Homogeneity of Maternal Perception of Her Child's Weight in Northeastern Mexico

Abstract The objectives were to assess a maternal perception of her child’s weight through two tests, words, and images, to validate tests; and to compare perception among Mexican populations. Participants 2,842 mother– child dyads; the child’s body mass index measurement was the gold standard. Sensitivity, specificity, Kappa value, Z test and homogeneity of Kappas were calculated. By words found that 55.1%, 77.5%, 32.2% and 25.1% of mothers of underweight, normal, overweight, and obese children had an adequate perception. By images found that 76.4%, 92.9%, 73.0%, and 89% of mothers of underweight, normal, overweight, and obese children had an adequate perception. Sensitivity, specificity, and Kappa values for the words were 28.4%, 22.5% and 0.442 (p=0.000); for the images were 81.6%, 23.6% and 0.043 (p=0.001). A small proportion of mothers of overweightobese children had adequate perception by words . The images had higher sensitivity. There are various levels of homogeneity across the States.

Estrategias Maternas de Alimentación y Actividad Física y su Relación con el Estado Nutricional de los Hijos

OBJETIVOS: describir las estrategias maternas de alimentacion y actividad fisica (monitoreo, disciplina, control, limites y reforzamiento) [EMAA]; Determinar la relacion de EMAA con el estado nutricional del hijo [indice de masa corporal (IMC) y porcentaje de grasa corporal (PGC)]; Verificar si las EMAA son diferentes de acuerdo al estado nutricional del hijo. METODO: participaron 558 madres e hijos (3 a 11 anos) estudiantes de escuelas publicas. Se aplico la Escala Estrategias Parentales de Alimentacion y Actividad (PEAS), se midio peso, talla y PGC del hijo. Para el analisis se obtuvieron estadisticas descriptivas, se aplico regresion lineal multiple y prueba de Kruskal Wallis. RESULTADOS: reforzamiento presento la media mas alta (62.72) y control la mas baja (50.07). Disciplina, control y limites explicaron 12% del IMC, disciplina y control el 6% del PGC. Se ejerce mayor control en hijos con obesidad (χ2=38.36, p=0.001) y mayor reforzamiento en hijos con bajo peso (χ2=7.19, p<0.05). CONCLUSIONES: las madres ejercen mayor control (presion para comer) en hijos con obesidad y otorgan mayor reconocimiento (felicitar por comer saludable) en hijos con bajo peso. Se recomienda modificar las estrategias parentales para fortalecer habitos saludables de alimentacion y actividad fisica.Objectives to describe the maternal eating and physical activity strategies (monitoring, discipline, control, limits and reinforcement) [MEES]; to determine the relation between MEES and the childs nutritional status [body mass index (BMI) and body fat percentage (BFP)]; to verify whether the MEES differ according to the childs nutritional status. Method participants were 558 mothers and children (3 to 11 years of age) who studied at public schools. The Parental Strategies for Eating and Activity Scale (PEAS) was applied and the childs weight, height and BFP were measured. For analysis purposes, descriptive statistics were obtained, using multiple linear regression and the Kruskal-Wallis test. Results the highest mean score was found for reinforcement (62.72) and the lowest for control (50.07). Discipline, control and limits explained 12% of the BMI, while discipline and control explained 6% of the BFP. Greater control is found for obese children (χ2=38.36, p=0.001) and greater reinforcement for underweight children (χ2=7.19, p<0.05). Conclusions the mothers exert greater control (pressure to eat) over obese children and greater recognition (congratulating due to healthy eating) in underweight children. Modifications in parental strategies are recommended with a view to strengthening healthy eating and physical activity habits.

Genetic structure of Mexican Mestizos with type 2 diabetes mellitus based on three STR loci.

BACKGROUND The aims of this population genetics study were: 1) to ascertain whether Mexicans with type 2 diabetes mellitus (DM) were genetically homogeneous and 2) to compare the genetic structure of this selected population with the previously reported data of four random populations (Nuevo León, Hispanics, Chihuahua, and Central Region of Mexico). METHODS A sample of 103 unrelated individuals with DM and whose 4 grandparents were born in five zones of Mexico was interviewed in 32 Medical Units in the Mexican Institute of Social Security (IMSS). The non-coding STRs D16S539, D7S820, and D13S317 were analyzed. RESULTS Genotype distribution was in agreement with Hardy-Weinberg expectations for all three markers. Allele frequencies were found to be similar between the selected population and the four random populations. Gene diversity analysis suggested that more than 99.57% of the total gene diversity could be attributed to variation between individuals within the population and 0.43% between the populations. CONCLUSIONS According to the present and previous studies using molecular and non-molecular nuclear DNA markers not associated with any disease, the Mexican Mestizo population is found to be genetically homogeneous and therefore the genetic causes of DM are less heterogeneous, thereby simplifying genetic epidemiological studies as has been found in a previous study with the same design in Mexican women with breast cancer.

An educational strategy for improving knowledge about breast and cervical cancer prevention among Mexican middle school students.

Introduction Prevention programs have not achieved the expected results in preventing mortality from breast and cervical cancer in Mexico. Therefore, we propose a complementary strategy. Methodology An educational strategy for high school students in Mexico (2011–2013) was designed (longitudinal design, two measurements and a single intervention). The postintervention assessment included: 1) knowledge acquired by students about cancer prevention and 2) The performance of the student as a health promoter in their household. The strategy was based on analysis of cases and developed in three sessions. An assessment tool was designed and validated (Test–Retest). The levels of knowledge according to the qualifications expected by chance were determined. Wilcoxon test compared results before and after intervention. Results An assessment instrument with 0.80 reliability was obtained. 831 high school students were analyzed. Wilcoxon rank-sum test showed a significant learning after the intervention (Z = − 2.64, p = 0.008) with improvement of levels of knowledge in a 154.5%. 49% of students had a good performance as health promoters. Conclusions The learning in preventive measures is important to sensitize individuals to prevention campaigns against cancer. This strategy proved to improve the level of knowledge of students in an easy and affordable way.

Percepciones de la obesidad de adolescentes obesos estudiantes del 7º al 9º grado residentes en Tamaulipas, México

O objetivo foi explorar as percepcoes da obesidade de adolescentes obesos, estudantes do 7o ao 9o grau de uma instituicao publica de Tamaulipas, Mexico. E estudo qualitativo, do qual participaram 24 adolescentes que tinham indice de massa corporal superior ao percentil 95. Realizou-se entrevista semiestruturada ate a saturacao dos dados e comprensao do significado. Os adolescentes definiram obesidade de acordo com um padrao de medicao, identificaram como causa principal o fator hereditario, com tendencia para subestimar a obesidade e a ter baixa autoestima, apresentan problemas quando realizam atividade fisica e para conseguirem roupas para melhorar a propria imagen, sao rejeitados pelos seus pares ou iguais, na escola. Identificou-se, tambem, que possuem mecanismos psicologicos de defesa ante a obesidade e alguns deles estao realizando acoes para diminuir o peso. A obesidade tem implicacoes na saude, no aspecto psicologico e social de quem a padece, recomenda-se, aqui, implementar intervencoes.The objective was to explore obese adolescents perceptions about obesity among students in the seventh to ninth grade of a public school in Tamaulipas, Mexico. This is a qualitative study. Participants were 24 adolescents with a body mass index equal to or greater than the 95th percentile. Semistructured interviews were conducted until data saturation was reached and the meaning was understood. The adolescents defined obesity according to standards of measurement. They identified the hereditary factor as the main obesity cause, tended to underestimate obesity and had low self-esteem. They reported problems to do physical exercise and get clothes in order to improve their image, and feel rejected by their peers in school. It was identified that these adolescents have psychological defense mechanisms against obesity and that some of them are making efforts to lose weight. Obesity entails social and psychological health implications for persons suffering from this problem. Interventions should be put in practice.

Study protocol: intervention in maternal perception of preschoolers’ weight among Mexican and Mexican-American mothers

BackgroundChildhood obesity is a public health issue negatively affecting children’s physical and psychosocial health. Mothers are children’s primary caregivers, thus key players in childhood obesity prevention. Studies have indicated that mothers underestimate their children’s weight. If mothers are unaware of their children’s weight problem, they are less likely to participate in activities preventing and treating excess weight. The “Healthy Change” intervention is designed to change maternal perception of child’s weight (MPCW) through peer-led group health education in childcare settings.Methods/DesignThe “Healthy Change” is a multicenter two-arm randomized trial in four centers. Three centers are in Mexican States (Nuevo Leon, Tamaulipas, and Zacatecas). The fourth center is in San Antonio, Texas, USA. A total of 360 mother-child pairs (90 pairs per center) are to be randomly and evenly allocated to either the intervention or the control group. Intervention group will receive four-session group obesity prevention education. Control group will receive a four-session personal and food hygiene education. The education is delivered by trained peer-mother promotoras. Data will be collected using questionnaires and focus groups. The primary outcome is a change in proportion of mothers with accurate MPCW. Secondary outcomes include change in maternal feeding styles and practices, maternal self-efficacy and actions for managing child excessive weight gain.McNemar’s Test will be used to test the primary outcome. The GLM Univariate procedure will be used to determine intervention effects on secondary outcomes. The models will include the secondary outcome measures as the dependent variables, treatment condition (intervention/control) as the fixed factor, and confounding factors (e.g., mother’s education, children’s gender and age) as covariates. Sub-analyses will be performed to compare intervention effects on primary and secondary outcomes between the samples from Mexico and Texas, USA. Qualitative data will be analyzed through analysis of inductive content. A combined coding model will be developed and used to code transcripts using the NVivo software.DiscussionHealthy Change intervention could help change MPCW, an initial step for obesity prevention among preschoolers. This study presents a first of its kind intervention available in Spanish and English targeting Mexican and Mexican-American mothers in Mexico and USA.Trial registrationISRCTN12281648