Salud Pública de Méxicohttps://scielosp.org/feed/spm/2003.v45suppl4/2021-01-13T00:10:00ZUnknown authorVol. 45 - 2003WerkzeugUnknow titleS0036-363420030010000012021-01-13T00:10:00Z2017-01-20T00:02:00ZLos resultados de la Segunda Encuesta Nacional de Nutrición: las condiciones de nutrición de la niñez y de las mujeres de MéxicoS0036-363420030010000022021-01-13T00:10:00Z2017-01-20T00:02:00ZFrenk, Silvestre
<em>Frenk, Silvestre</em>;
<br/><br/>
Nutritional status of indigenous children younger than five years of age in Mexico: results of a national probabilistic surveyS0036-363420030010000032021-01-13T00:10:00Z2017-01-20T00:02:00ZRivera, Juan AMonterrubio, Eric AGonzález-Cossío, TeresaGarcía-Feregrino, RaquelGarcía-Guerra, ArmandoSepúlveda-Amor, Jaime
<em>Rivera, Juan A</em>;
<em>Monterrubio, Eric A</em>;
<em>González-Cossío, Teresa</em>;
<em>García-Feregrino, Raquel</em>;
<em>García-Guerra, Armando</em>;
<em>Sepúlveda-Amor, Jaime</em>;
<br/><br/>
OBJECTIVE: To compare the prevalence of undernutrition and anemia in indigenous and non-indigenous children <5 years of age at the national level, by region and by urban and rural areas, and to evaluate the degree to which the socioeconomic condition of the family predicts the differences. MATERIAL AND METHODS: A national probabilistic survey was conducted in Mexico in 1999. Indigenous families were identified as those in which at least one woman 12-49 years of age in the household spoke a native language. The prevalence of undernutrition (stunting, wasting and underweight) and anemia was compared between indigenous and non-indigenous children. Probability ratios (PR) were used to compare prevalences in indigenous and non-indigenous children adjusting for socioeconomic status (SES) of the family and for other covariates. RESULTS: The prevalences of stunting and underweight were greater in indigenous than in non-indigenous children. At the national level and in urban areas the prevalences were three times greater and in rural areas ~2 times greater (p<0.05). No differences were found in the prevalence of wasting (p>0.05). The prevalence of anemia in indigenous children was one third greater than in non-indigenous children at the national level (p<0.05) and was between 30 and 60% greater in urban areas and in the regions studied (p<0.05) but was not statistically significant (p>0.05) in rural areas. These differences were reduced to about half when adjusting for SES but remained significantly higher in indigenous children (p<0.05). CONCLUSIONS: Indigenous children have higher probabilities of stunting and underweight than non-indigenous children. The differences are larger in urban areas and in higher socioeconomic geographic regions and are explained mostly by socioeconomic factors. The overall difference in the probability of anemia is small, is higher only in urban relative to rural areas, and is explained to a lesser degree by socioeconomic factors. Policy and programs should be designed and implemented to reduce the dramatic differences in nutritional status between indigenous and non-indigenous children in Mexico.Breast-feeding practices in Mexico: results from the Second National Nutrition Survey 1999S0036-363420030010000042021-01-13T00:10:00Z2017-01-20T00:02:00ZGonzález-Cossío, TeresaMoreno-Macías, HortensiaRivera, Juan AVillalpando, SalvadorShamah-Levy, TeresaMonterrubio, Eric AHernández-Garduño, Adolfo
<em>González-Cossío, Teresa</em>;
<em>Moreno-Macías, Hortensia</em>;
<em>Rivera, Juan A</em>;
<em>Villalpando, Salvador</em>;
<em>Shamah-Levy, Teresa</em>;
<em>Monterrubio, Eric A</em>;
<em>Hernández-Garduño, Adolfo</em>;
<br/><br/>
OBJECTIVE: To assess breast-feeding (BF) practices and determinants of exclusive BF (EBF) <4 and <6 months (mo) among women and infants <23 mo in the NNS-1999. MATERIAL AND METHODS: BF practices from the day and night before the interview were ascertained, and median duration estimated. Determinants of EBF<4 and <6 mo were analysed by logistic regression models for complex surveys. RESULTS: Prevalence of EBF<4 mo was 25.7%, and of <6 mo 20.3%. The overall rate of continued BF (second year) was 30.9%, median duration of BF 9 mo, and the national proportion of children ever breast-fed 92.3%. The probability (p) of EBF<4 mo was determined by infant age and sex, by maternal socio-economic level (SEL) and ethnicity, and by the interaction between infant sex and SEL. The pEBF<6 mo was determined by infant age and length, by maternal ethnicity, and employment. CONCLUSIONS: EBF rates and duration are low in Mexico and have improved only slightly in the last 20 y. Infant and maternal characteristics determine the pEBF. If improvements in infant health are a national priority, aggressive interventions to promote and protect BF are urgently needed in Mexico, as well as formal evaluation of current initiatives.Prevalence of anemia in children 1 to 12 years of age: results from a nationwide probabilistic survey in MexicoS0036-363420030010000052021-01-13T00:10:00Z2017-01-20T00:02:00ZVillalpando, SalvadorShamah-Levy, TeresaRamírez-Silva, Claudia IvonneMejía-Rodríguez, FabiolaRivera, Juan A
<em>Villalpando, Salvador</em>;
<em>Shamah-Levy, Teresa</em>;
<em>Ramírez-Silva, Claudia Ivonne</em>;
<em>Mejía-Rodríguez, Fabiola</em>;
<em>Rivera, Juan A</em>;
<br/><br/>
OBJECTIVE: To describe the epidemiology and analyze factors associated with iron deficiency anemia in a probabilistic sample of the Encuesta Nacional de Nutrición 1999 (ENN-99) [National Nutritional Survey 1999 (NNS-99)]. MATERIAL AND METHODS: The sample included 8 111 children aged 1 to 12 years, and was nationaly representative by rural and urban strata and by four geographical regions. Capillary hemoglobin was measured using a portable photometer (HemoCue). The analysis of the determining factors of anemia was performed by odds ratios derived from a logistic regression model and multiple regression models. RESULTS: The prevalence of anemia was 50% in infants <2 years of age, with no significant differences between urban and rural strata or among regions. It varied between 14 and 22% in 6-11 year-old children and was higher in the South region and among the indigenous children. Dietary intake of iron was 50% of the recommended daily allowance in children <2 years of age, but not in older children. Phytate (»500-800 mg/d) and tannin (»19 mg/d) intakes were very high in children over 7 years of age. Hemoglobin was positively associated with nutritional status of children (p=0.01), socioeconomic status (p range 0.05-0.001), duration of lactation in children under 2 years of age (p=0.1), and iron and calcium intake (p=0.02), but not with folic acid or vitamin B12 intake. Hemoglobin was negatively associated with maternal education (p=0.01) in older children, but not in those under 2 years of age. CONCLUSIONS: We present evidence of an alarming national epidemic of anemia, particularly marked in children 12 to 24 months of age. The control of anemia should be considered as an urgent national concern given its grave consequences on the physical and mental development of these children and on their long-term health.Anemia in Mexican women: a public health problemS0036-363420030010000062021-01-13T00:10:00Z2017-01-20T00:02:00ZShamah-Levy, TeresaVillalpando, SalvadorRivera, Juan A.Mejía-Rodríguez, FabiolaCamacho-Cisneros, MarthaMonterrubio, Eric A
<em>Shamah-Levy, Teresa</em>;
<em>Villalpando, Salvador</em>;
<em>Rivera, Juan A.</em>;
<em>Mejía-Rodríguez, Fabiola</em>;
<em>Camacho-Cisneros, Martha</em>;
<em>Monterrubio, Eric A</em>;
<br/><br/>
OBJECTIVE: The purpose of this study is to quantify the prevalence and distribution of anemia among women of childbearing age (12 to 49 years) participating in the 1999 National Nutrition Survey (NNS-1999). MATERIAL AND METHODS: The survey had a probabilistic design and was representative at the national level, of urban and rural areas and four regions: North, South, Center, and Mexico City. Hemoglobin concentration was determined in capillary blood samples using a portable photometer (HemoCue), in 17 194 women, 697 of whom were pregnant. RESULTS: The overall prevalence of anemia was 27.8% in pregnant women and 20.8% in non-pregnant women. Higher prevalences were observed in rural as compared to urban areas, both in pregnant (28.0% vs 27.7%) and non-pregnant (22.6% vs 20.0%) women, but the differences were not statistically significant (p >0.05). Women in the South had the greatest prevalence (23.2%), followed by those in the North (20.9%), Center (20.6%), and Mexico City (16.4%). Non-pregnant indigenous women had a prevalence of 24.8%, while in non-indigenous women the prevalence was 20.4%. CONCLUSIONS: Anemia in women of childbearing age is a growing public health problem that justifies the implementation of interventions for its prevention and control.Vitamins A, and C and folate status in Mexican children under 12 years and women 12-49 years: a probabilistic national surveyS0036-363420030010000072021-01-13T00:10:00Z2017-01-20T00:02:00ZVillalpando, SalvadorMontalvo-Velarde, IreneZambrano, NormaGarcía-Guerra, ArmandoRamírez-Silva, Claudia IvonneShamah-Levy, TeresaRivera, Juan A
<em>Villalpando, Salvador</em>;
<em>Montalvo-Velarde, Irene</em>;
<em>Zambrano, Norma</em>;
<em>García-Guerra, Armando</em>;
<em>Ramírez-Silva, Claudia Ivonne</em>;
<em>Shamah-Levy, Teresa</em>;
<em>Rivera, Juan A</em>;
<br/><br/>
OBJECTIVE: To describe the epidemiology of Vitamin A and C and folic acid deficiencies and their association with sociodemographic and dietary factors in a national probabilistic sample of Mexican women and children. MATERIAL AND METHODS: This is a probabilistic sample from the National Nutrition Survey 1999 (ENN-99) including 1 966 children and 920 women. Vitamins A and C were measured in serum by high-performance liquid chromatography, and folic acid in total blood by a microbiological method. Determinants for such deficiencies were explored by multiple regression models. RESULTS: Vitamin A deficiency (retinol <10 µg/dl) was rare in both children and women. But subclinical deficiency (retinol >10 and <20 µg/dl) was present in 25% of children. The likelihood of subclinical deficiency of vitamin A was less in older children (OR=0.98, p=0.01) and in women with higher body mass index (OR=0.93, p=0.01). About 30% of children <2 years of age and 40% of women were vitamin C deficient. The likelihood of vitamin C deficiency was less in children and women as socioeconomic level increased (OR=0.69, p=0.03, and OR=0.80, p=0.04), and higher in older women (OR=1.02, p=0.05). The prevalence of folate deficiency varied in children (2.3 to 11.2), in women it was 5%. Folate deficiency was less in children of higher socioeconomic level (OR=0.62, p=0.01 ), and in those eating more vegetables (OR= 0.22, p=0.01). CONCLUSIONS: The high prevalence of subclinical deficiency of vitamin A in children is indicative of risk of further deterioration under adverse circumstances. Vitamin C deficiency in both children and women implies in addition diminished ability for iron absorption.Iron, zinc and iodide status in Mexican children under 12 years and women 12-49 years of age: a probabilistic national surveyS0036-363420030010000082021-01-13T00:10:00Z2017-01-20T00:02:00ZVillalpando, SalvadorGarcía-Guerra, ArmandoRamírez-Silva, Claudia IvonneMejía-Rodríguez, FabiolaMatute, GuadalupeShamah-Levy, TeresaRivera, Juan A
<em>Villalpando, Salvador</em>;
<em>García-Guerra, Armando</em>;
<em>Ramírez-Silva, Claudia Ivonne</em>;
<em>Mejía-Rodríguez, Fabiola</em>;
<em>Matute, Guadalupe</em>;
<em>Shamah-Levy, Teresa</em>;
<em>Rivera, Juan A</em>;
<br/><br/>
OBJECTIVE: To describe the epidemiology of iron, zinc and iodide deficiencies in a probabilistic sample of Mexican women and children and explore its association with some dietary and socio-demographic variables. MATERIAL AND METHODS: We carried out in 1999 an epidemiological description of iron (percent transferrin saturation, PTS, <16%), serum zinc (<65ug/dl) and iodide (<50 ug/l urine) deficiencies in a probabilistic sample of 1,363 Mexican children under 12 years and of 731 women of child-bearing age. Serum iron, Total Iron Binding Capacity (TIBC) and zinc were measured by atomic absorption spectrometry, and urinary iodide by a colorimetric method. Logistic regression models explored determinants for such micromineral deficiencies. RESULTS: Iron deficiency was higher (67%) in infants <2 years of age. Prevalence declined (34-39%) at school age. The prevalence for iron deficiency in women was 40%. Zinc deficiency was higher in infants <2 years of age (34%) than in school-age children (19-24%). Prevalence in women was 30%, with no rural/urban difference. In women the likelihood of iron deficiency decreased as SEL improved (p=0.04) and increased with the intake of cereals (p=0.01). The likelihood of low serum zinc levels was greater in women and children of low socioeconomic level (SEL) (p<0.02 and p=0.001) iodide deficiency was negligible in both children and women. CONCLUSIONS: The data shows high prevalence of iron deficiency- specially in infants 12 to 24 months of age. It is suggested that in older children and women 12 to 49 years of age that iron bioavailability is low. The prevalence of zinc deficiency was also very high.Energy and nutrient consumption in Mexican women 12-49 years of age: analysis of the National Nutrition Survey 1999S0036-363420030010000092021-01-13T00:10:00Z2017-01-20T00:02:00ZBarquera, SimónRivera, Juan AEspinosa-Montero, JuanSafdie, MargaritaCampirano, FabricioMonterrubio, Eric A
<em>Barquera, Simón</em>;
<em>Rivera, Juan A</em>;
<em>Espinosa-Montero, Juan</em>;
<em>Safdie, Margarita</em>;
<em>Campirano, Fabricio</em>;
<em>Monterrubio, Eric A</em>;
<br/><br/>
OBJECTIVE: To describe the reported energy and nutrient intake and adequacies in Mexican women. MATERIAL AND METHODS: A 24-hour dietary recall was used to obtain nutrient intake in a representative sub-sample of 2 630 women from 12 to 49 years of age from the National Nutrition Survey 1999. Nutrient adequacies were estimated using the Dietary Reference Intakes and stratified according to region, area (urban or rural), socioeconomic status and obesity status (non-obese: BMI <30 kg/m², obese: >30 kg/m²). Differences were analyzed using linear regression for complex surveys of log-transformed intake and adequacy, adjusting for multiple comparisons with the Bonferroni test. RESULTS: The median national energy intake was 1 471 kcal. The Risk of Inadequacy (RI) (prevalence of adequacy <50%) was: vitamin A:38.3%, vitamin C: 45.5%, and folate: 34.3%. Carbohydrates, folate, iron and calcium intake was significantly higher in rural than in urban areas. The RI was higher in women of the lowest socioeconomic status tertile for all nutrients with the exception of carbohydrates and calcium. Macro-nutrient adequacies were significantly higher in non-obese women. CONCLUSIONS: Differences within the country among regions, rural and urban areas, and socioeconomic status tertile reflect an increasing availability of inexpensive calorie-dense foods in marginal groups. However, total energy, cholesterol, saturated and total fat were consumed in greater quantities by women from the higher socioeconomic status tertile and from urban areas. These patterns could be a contributing factor to the rise of obesity and other non-communicable nutrition-related chronic diseases in Mexico.Energy and nutrient intake in preschool and school age Mexican children: National Nutrition Survey 1999S0036-363420030010000102021-01-13T00:10:00Z2017-01-20T00:02:00ZBarquera, SimónRivera, Juan ASafdie, MargaritaFlores, MarioCampos-Nonato, IsmaelCampirano, Fabricio
<em>Barquera, Simón</em>;
<em>Rivera, Juan A</em>;
<em>Safdie, Margarita</em>;
<em>Flores, Mario</em>;
<em>Campos-Nonato, Ismael</em>;
<em>Campirano, Fabricio</em>;
<br/><br/>
OBJECTIVE: To estimate energy and nutrient intake and adequacy in preschool and school age Mexican children, using the National Nutrition Survey 1999 (NNS-1999). MATERIAL AND METHODS: Twenty four-h dietary recalls from pre-school (n=1 309) and school (n=2 611) children obtained from a representative sub-sample of the NNS-1999 were analyzed. Intakes and adequacies were estimated and compared across four regions, socio-economic strata, and between urban and rural areas, and indigenous vs. non-indigenous children. RESULTS: Median energy intake in pre-school children was 949 kcal and in school children 1 377 kcal, with adequacies <70% for both groups. Protein adequacy was >150% in both age groups. The North and Mexico City regions had the highest fat intake and the lowest fiber intake. Children in the South region, indigenous children, and those in the lowest socio-economic stratum had higher fiber and carbohydrate intakes and the lowest fat intake. These children also showed the highest risks of inadequacies for vitamin A, vitamin C, folate, iron, zinc and calcium. CONCLUSIONS: Mexico is experiencing a nutrition transition with internal inequalities across regions and socio-economic strata. Food policy must account for these differences in order to optimize resources directed at social programs.Factors associated with overweight and obesity in Mexican school-age children: results from the National Nutrition Survey 1999S0036-363420030010000112021-01-13T00:10:00Z2017-01-20T00:02:00ZHernández, BernardoCuevas-Nasu, LucíaShamah-Levy, TeresaMonterrubio, Eric ARamírez-Silva, Claudia IvonneGarcía-Feregrino, RaquelRivera, Juan ASepúlveda-Amor, Jaime
<em>Hernández, Bernardo</em>;
<em>Cuevas-Nasu, Lucía</em>;
<em>Shamah-Levy, Teresa</em>;
<em>Monterrubio, Eric A</em>;
<em>Ramírez-Silva, Claudia Ivonne</em>;
<em>García-Feregrino, Raquel</em>;
<em>Rivera, Juan A</em>;
<em>Sepúlveda-Amor, Jaime</em>;
<br/><br/>
OBJECTIVE: The objective of the study was to measure the prevalence of overweight and obesity in Mexican school-age children (5-11 years) in the National Nutrition Survey 1999 (NNS-1999). MATERIAL AND METHODS: Overweight and obesity (defined as an excess of adipose tissue in the body) were evaluated through the Body Mass Index (BMI) in 10,901 children, using the standard proposed by the International Obesity Task Force. Sociodemographic variables were obtained using a questionnaire administered to the children's mothers. RESULTS: The national prevalence of overweight and obesity was reported to be 19.5%. The highest prevalence figures were found in Mexico City (26.6%) and the North region (25.6%). When adjusting by region, rural or urban area, sex, maternal schooling, socioeconomic status, indigenous ethnicity and age, the highest prevalences of overweight and obesity were found among girls. The risks of overweight and obesity were positively associated with maternal schooling, children's age and socioeconomic status. CONCLUSIONS: Overweight and obesity are prevalent health problems in Mexican school-age children, particularly among girls, and positively associated with socioeconomic status, age, and maternal schooling. This is a major public health problem requiring preventive interventions to avoid future health consequences.Methods of the National Nutrition Survey 1999S0036-363420030010000122021-01-13T00:10:00Z2017-01-20T00:02:00ZResano-Pérez, ElsaMéndez-Ramírez, IgnacioShamah-Levy, TeresaRivera, Juan ASepúlveda-Amor, Jaime
<em>Resano-Pérez, Elsa</em>;
<em>Méndez-Ramírez, Ignacio</em>;
<em>Shamah-Levy, Teresa</em>;
<em>Rivera, Juan A</em>;
<em>Sepúlveda-Amor, Jaime</em>;
<br/><br/>
OBJECTIVE: To describe the methods and analyses of the 1999 National Nutrition Survey (NNS-99). MATERIAL AND METHODS: The 1999 National Nutrition Survey (NNS-99) is a probabilistic survey with nationwide representativity. The NNS-99 included four regions and urban and rural areas of Mexico. The last sampling units were households, selected through stratified cluster sampling. The study population consisted of children under five years of age, school-age children (6-11 years), and women of childbearing age (12-49 years). Data were collected on anthropometric measurements, hemoglobin levels, morbidity and its determinants, and socioeconomic and demographic characteristics. In addition, data on diet and micronutrients intakes (iron, zinc, vitamin A, folic acid, vitamin C, and iodine) were obtained in a sub-sample of subjects. RESULTS: The response rate for the NNS-99 was 82.3%; the non-response rate was 5.9% and the remaining did not participate due to uninhabited houses. CONCLUSIONS: This survey updates the information on nutritional status in Mexico and should serve as the basis for food and nutrition policy-making and priority program design.Conclusions from the Mexican National Nutrition Survey 1999: translating results into nutrition policyS0036-363420030010000132021-01-13T00:10:00Z2017-01-20T00:02:00ZRivera, Juan ASepúlveda Amor, Jaime
<em>Rivera, Juan A</em>;
<em>Sepúlveda Amor, Jaime</em>;
<br/><br/>
OBJECTIVE: This article presents and overview of the main results and conclusions from the Mexican National Nutrition Survey 1999 (NNS-1999) and the principal nutrition policy implications of the findings. MATERIAL AND METHODS: The NNS-1999 was conducted on a national probabilistic sample of almost 18 000 households, representative of the national, regional, as well as urban and rural levels in Mexico. Subjects included were children <12 years and women 12-49 years. Anthropometry, blood specimens, diet and socioeconomic information of the family were collected. RESULTS: The principal public nutrition problems are stunting in children < 5 years of age; anemia, iron and zinc deficiency, and low serum vitamin C concentrations at all ages; and vitamin A deficiency in children. Undernutrition (stunting and micronutrient deficiencies) was generally more prevalent in the lower socioeconomic groups, in rural areas, in the south and in Indigenous population. Overweight and obesity are serious public health problems in women and are already a concern in school-age children. CONCLUSIONS: A number of programs aimed at preventing undernutrition are currently in progress; several of them were designed or modified as a result of the NNS-1999 findings. Most of them have an evaluation component that will inform adjustments or modifications of their design and implementation. However, little is being done for the prevention and control of overweight and obesity and there is limited experience on effective interventions. The design and evaluation of prevention strategies for controlling obesity in the population, based on existing evidence, is urgently needed and success stories should be brought to scale quickly to maximize impact.DesnutriciónS0036-363420030010000142021-01-13T00:10:00Z2017-01-20T00:02:00ZGómez, Federico
<em>Gómez, Federico</em>;
<br/><br/>
Alimentación y salud públicaS0036-363420030010000152021-01-13T00:10:00Z2017-01-20T00:02:00ZHernández, Mauricio
<em>Hernández, Mauricio</em>;
<br/><br/>