Homero Martínez

Nutrition International · TEAM Folate

Hepcidin production is regulated by iron concentration, erythropoietic activity, and inflammation. There is no reference method for determining its levels, but results obtained through various methods strongly correlate and can be compared using recalibration equations. Objective: To describe recalibrated serum hepcidin values at different percenti...

(1) Background: Fortifying maize and wheat flours with folic acid has effectively reduced neural tube defect-affected births. However, maize and wheat flours may not be widely consumed in all countries; further reduction in neural tube defect-affected births could benefit from the identification of alternative food vehicles. We aimed to use dietary...

Global health and fortification of micronutrients

Introduction Neural tube defects represent a global public health problem, mainly in countries where effective prevention strategies are not yet in place. The global prevalence of neural tube defects is estimated at 18.6/10,000 (uncertainty interval: 15.3–23.0) live births, where ~ 75% of cases result in under-five mortality. Most of the mortality...

Purpose (1) To describe how Costa Rica implemented an integrated surveillance strategy of folate deficiency, neural tube defects (NTDs) prevalence, NTDs-associated infant mortality rate (NTDs-IMR), and folic acid food fortification (FAFF), to support with evidence NTDs prevention policies; (2) to disseminate updated data from monitoring programs....

Recibido: 26 de agosto 2022; Aceptado: 4 de enero 2023 Resumen El estado nutricio de menores de 5 años puede deteriorarse por prácticas inadecuadas de alimentación. Para evaluar el efecto en los conocimientos y prácticas de alimentación infantil de madres, y en el estado nutricio de niños, se realizó una intervención educativa participativa. Se inc...

Objectives Weekly iron–folic acid (IFA) supplements are recommended for all menstruating women in countries where anaemia prevalence is > 20%. Anaemia caused by folate deficiency is low worldwide, and the need to include folic acid is in question. Including folic acid might reduce the risk of a neural tube defect (NTD) should a woman become pregnan...

Abstract Background Global and country specific recommendations on Delayed umbilical cord clamping (DCC) are available, though guidance on their implementation in program settings is lacking. In India, DCC (clamping not earlier than 1 min after birth) is a component in the package of services delivered as part of the India Newborn Action Plan (INAP...

Nutrition modeling tools (NMTs) generate evidence to inform policy and program decision making; however, the literature is generally limited to modeling methods and results, rather than use cases and their impacts. We aimed to document the policy influences of 12 NMTs and identify factors influencing them. We conducted semistructured interviews wit...

Introduction: Total fluid intake and the type of fluids consumed have been reported by many studies [ 1 - 3 ] and have shown that while an individual may be drinking sufficiently, in terms of volume, to meet or exceed recommendations on fluid intake, there may be a wide variety of combinations of fluids within that total volume [ 4 - 6 ]. Moreover...

Salutogenesis focuses on factors that generate health and is a useful construct for identifying factors that promote health and for guiding activities to this end. This article describes health assets identified in a community diagnosis and how to leverage them with actions for improvement to deepen the understanding of this concept and its impact...

In primary health care, a community diagnosis is necessary to provide a detailed description of the community as well as an evaluation of the community’s health, including the main factors responsible for it and the needs felt by the population. This article presents a community health diagnosis following a participatory design, taking the perspect...

The aim of this study was to identify serum ferritin (SF) cut-off points (COPs) in a cohort of healthy full-term normal birth weight infants who had repeated measurements of SF and haemoglobin every 3 months during the first year of life. The study included 746 full-term infants with birth weight ≥2,500 g, having uncomplicated gestations and births...

The purpose of this study was to describe the changes in iron status indicators at 6 and 12 months of age, controlling by inflammation by measuring alpha-1 acid glycoprotein (AGP). This longitudinal study included 48 healthy-term singleton infants with birth weight ≥ 2500 g, born in hospitals of the Mexican Institute for Social Security. Complete b...

Adults consuming sugar-sweetened beverages (SSBs) are at increased risk of becoming overweight/obese and developing lifestyle-related diseases. Furthermore, a low water intake is associated with increased health risks, such as CKD. These issues are especially pressing in Mexico where SSB intake is high. The present research aimed to describe the at...

Modern epidemiology advocates context-specific evidence evaluation to support public health policy decisions, avoiding excessive reliance on experimental designs. We present the rationale for a paradigm shift in evaluation of the evidence derived from independent studies as well as systematic reviews and meta-analyses of observational studies, appl...

Using a predetermined set of criteria, including burden of anemia and neural tube defects (NTDs) and an enabling environment for large-scale fortification, this paper identifies 18 low-and middle-income countries with the highest and most immediate potential for large-scale wheat flour and/or rice fortification in terms of health impact and economi...

Weekly iron and folic acid supplementation (WIFAS) is among the 8 key effective actions for improving adolescent nutrition included by the WHO in the 2018 guidelines. However, at present WIFAS in the WHO-recommended formulation is not included in the Model Essential Medicines List (MEML), limiting the potential for countries to import, produce, and...

Breastfeeding mothers often report perceived insufficient milk (PIM) believing their infant is crying too much, which leads to introducing formula and the early abandonment of breastfeeding. We sought to determine if infant crying was associated with reported PIM (yes/no) and number of problems associated with lactation (lactation problem score [LP...

Dietary patterns provide valuable information for the development of public health policies. Despite increasing interest in the role of fluids in health and disease there are limited data on drinking patterns in adults. The aim of this analysis was to identify and characterize patterns of fluid intake in adults in cross-sectional surveys in China,...

Health care professionals often ask their patients questions about their water intake, or water drinking frequency. The aim of the present analysis was to compare 3 questions (prospective 7-day fluid record, an open question (OQ) and a frequency question (FQ)) used to record the volumes of water drank. 8159 participants (18–65 years) from Argentina...

Our objective in this comment is to highlight several limitations in an ecological research study that was published in Nutrients by Murphy and Westmark (2020) in January 2020. The study used data from the Food Fortification Initiative (FFI) website, and applying an ecological study design, made an error of “ecologic fallacy” in concluding that “na...

An ongoing challenge to our ability to address the role of food and nutrition in health promotion and disease prevention is how to design and implement context-specific interventions and guidance that are safe, efficacious, and avoid unintended consequences. The integration to effective implementation (I-to-I) concept is intended to address the com...

Hepcidin regulates iron metabolism. Its synthesis increases in infection and decreases in iron deficiency. The aim of this study was to evaluate the relationship between H. pylori infection and iron deficiency by levels of hepcidin in children. A total of 350 school-age children participated in this cross-sectional study. Determinations of serum fe...

Objectives: To develop a global action plan for the control of folate deficiency and folic acid responsive neural tube defects (anencephaly and spina bifida). Methods: •Establish a multi- and inter-disciplinary group to develop a global action plan for folate-sensitive NTD prevention•Ensure regional lab capacity exists to assess folate status ap...

Background:: Food insecurity and malnutrition present challenges to HIV management, but little research has been done in Latin America and the Caribbean (LAC). Objective:: To assess levels of food insecurity and malnutrition among people living with HIV (PLHIV) across multiple countries in LAC to inform pilot projects and policy. Methods:: Thr...

Background: Food fortification and biofortification are well-established strategies to address micronutrient deficiencies in vulnerable populations. However, the effectiveness of fortification programs is not only determined by the biological efficacy of the fortified foods but also by effective and sustainable implementation, which requires conti...

Purpose: The primary aim of this survey was to report total fluid intake (TFI) and different fluid types for children (4-9 years) and adolescents (10-17 years) in Mexico, Brazil, Argentina and Uruguay. The second aim was to compare TFI with the adequate intake (AI) of water from fluids as recommended by the USA Institute of Medicine. Methods: Da...

Purpose: To report total fluid intake (TFI) and the intake of different fluid types in adults (≥ 18 years old) from Mexico, Argentina, Brazil and Uruguay. To compare intakes between countries and with recommended adequate intake (AI) of water from fluids. Methods: Cross-sectional data were collected using a validated liquid intake 7-day record (...

Purpose: This study aimed to identify and characterize patterns of fluid intake in children and adolescents from six countries: Argentina, Brazil, China, Indonesia, Mexico and Uruguay. Methods: Data on fluid intake volume and type amongst children (4-9 years; N = 1400) and adolescents (10-17 years; N = 1781) were collected using the validated 7-...

Purpose: To assess drinking occasions (volume and type) according to consumption with food in or outside meals, and location, for six countries. Methods: A total of 10,521 participants aged 4-65 years from Argentina, Brazil, China, Indonesia, Mexico and Uruguay completed a validated 7-day fluid intake record. For each drinking event, the volume...

Purpose: To describe total fluid intake (TFI) and types of fluid consumed in urban China by age, gender, regions and city socioeconomic status relative to the adequate intakes (AI) set by the Chinese Nutrition Society. Methods: In 2016, participants aged 4-9, 10-17 and 18-55 years were recruited via a door-to-door approach in 27 cities in China....

Purpose To report daily total fluid intake (TFI) and fluid types in Indonesia according to age, sex, socio-economic status (SES) and geographic region, and compare TFI with the Indonesian adequate fluid intake (AI) recommendations. Methods Data were collected in 32 cities over nine regions from children (4–9 years, n = 388), adolescents, (10–17 ye...

Background The uptake of an intervention aimed at improving health-related lifestyles may be influenced by the participant’s stage of readiness to change behaviors. Objective We conducted secondary analysis of the Grupo de Investigación en Salud Móvil en América Latina (GISMAL) trial according to levels of uptake of intervention (dose-response) to...

BACKGROUND The uptake of an intervention aimed at improving health-related lifestyles may be influenced by the participant’s stage of readiness to change behaviors. OBJECTIVE We conducted secondary analysis of the Grupo de Investigación en Salud Móvil en América Latina (GISMAL) trial according to levels of uptake of intervention (dose-response) to...

As infectious disease control programs achieve increasing success, further reductions in child mortality in low- and middle-income countries (LMICs) will require focused prevention strategies for birth defects and other noninfectious diseases. Neural tube defects (NTDs) can cause early death or lifelong disability. Preventing NTDs provides a feasib...

Food insecurity is an important risk factor for overweight and obesity among low-income populations in high income countries, but has not been well-studied among people living with HIV (PLHIV), particularly in resource-poor settings. To explore the association between food insecurity and overweight and obesity among PLHIV in the Dominican Republic,...

This project showed nutritional education as an effective strategy to improve primary alterations in liver function associated with nonalcoholic fatty liver disease (NAFLD) in obese children who had NAFLD in Mexico. Researchers evaluated the effect of a 4-month nutritional counseling program on hepatic abnormalities associated with NAFLD in 46 part...

The informed-consent process seeks to provide complete information to participants about a research project and to protect personal information they may disclose. In this article, we present an informed-consent process that we piloted and improved to obtain consent from older adults in Yucatan, Mexico. Respondents had limited fluency in Spanish, sp...

Reliable data at population level are essential to firmly establish links between fluid intake, hydration and health, investigate dose-response relationships and develop meaningful public health strategies or reference intake values. However, limited research exists regarding the most appropriate methodology for assessing beverage or total fluid in...

Objective: To assess the intake of water and all other beverages in children, adolescents and adults. Methods: Three thousand six hundred eleven children (8 ± 2 years), 8,109 adolescents (13 ± 2 years) and 16,276 adults (40 ± 14 years) (47% men) were recruited in 15 cross-sectional surveys (liquid intake across 7 days, Liq.In7 study) and complet...

Stemming the tide of noncommunicable diseases (NCDs) worldwide requires a multipronged approach. Although much attention has been paid to disease control measures, there is relatively little consideration of the importance of training the next generation of health-related researchers to play their important role in this global epidemic. The lack of...

Stemming the tide of noncommunicable diseases (NCDs) worldwide requires amultipronged approach. Although much attention has been paid to disease control measures, there is relatively little consideration of the importance of training the next generation of health-related researchers to play their important role in this global epidemic. The lack of...

Background Previous healthy lifestyle interventions based on the Salud para Su Corazón curriculum for Latinos in the United States, and a pilot study in Guatemala, demonstrated improvements in patient knowledge, behavior, and clinical outcomes for adults with hypertension. This article describes the implementation of a healthy lifestyle group educa...

Background: Poor diet and physical inactivity strongly affect the growing epidemic of cardiovascular disease worldwide. Mobile phone-based health interventions (mHealth) have been shown to help promote weight loss and increase physical activity and are an attractive approach for health-care systems with limited resources. We aimed to assess whethe...

Background: Food insecurity and poor nutrition are key barriers to anti-retroviral therapy (ART) adherence. Culturally-appropriate and sustainable interventions that provide nutrition counseling for people on ART and of diverse nutritional statuses are needed, particularly given rising rates of overweight and obesity among people living with HIV (...

Background A healthy lifestyle intervention was implemented in primary care health centers in urban parts of Tuxtla Gutiérrez, Chiapas, Mexico with an aim of reducing cardiovascular disease risk for patients with type 2 diabetes and/or hypertension. During implementation, research questions emerged. Considerably fewer men participated in the interv...

Objectives. To evaluate the acceptability and feasibility of an intervention based on mobile health, for the adoption of healthy lifestyles in prehypertensive people living in low-income urban areas in Argentina, Guatemala and Peru. Materials and methods. Prehypertensive people aged 30-60 years were recruited for a pilot study. The intervention inc...

To describe the intake of water and all other beverages in children and adolescents in 13 countries of three continents. Data of 3611 children (4-9 years) and 8109 adolescents (10-17 years) were retrieved from 13 cross-sectional surveys (47 % males). In three countries, stratified cluster sampling design was applied to randomly recruit schools clas...

To describe the intake of water and all other fluids and to evaluate the proportion of adults exceeding the World Health Organisation (WHO) recommendations on energy intake from free sugar, solely from fluids. A total of 16,276 adults (46 % men, mean age 39.8 years) were recruited in 13 countries from 3 continents. A 24-h fluid-specific record over...

To evaluate the total fluid intake from drinking water and beverages in adult populations from different countries and assess the percentage of individuals complying with the European Food Safety Agency (EFSA) adequate intake (AI) of water from fluids. A total of 16,276 adults (7580 men and 8696 women) aged between 18 and 70 years (mean age 39.8 ye...

To describe total fluid intake (TFI) according to socio-demographic characteristics in children and adolescents worldwide. Data of 3611 children (4-9 years) and 8109 adolescents (10-18 years) were retrieved from 13 cross-sectional surveys (47 % males). In three countries, school classes were randomly recruited with stratified cluster sampling desig...

To evaluate the acceptability and feasibility of an intervention based on mobile health, for the adoption of healthy lifestyles in prehypertensive people living in low-income urban areas in Argentina, Guatemala and Peru. Prehypertensive people aged 30-60 years were recruited for a pilot study. The intervention included two counseling calls made by...

The present study describes the processes related to the implementation of mHealth interventions for lifestyle modification in a randomized controlled trial conducted with prehypertensive subjects in Argentina, Guatemala, and Peru from low-resource settings. In the intervention group, participants received, during the course of a year, a monthly co...

Background: Mobile health (mHealth) has been posited to contribute to the reduction in health gaps and has shown fast and widespread growth in developing countries. This growth demands understanding of, and preparedness for, local cultural contexts. Objective: To describe the design and validation of text messages (short message service, SMS) that...

Ethical and legal considerations require that human research subjects who provide certain kinds of information be able to provide informed consent when doing so. Obtaining consent from older people and from people with low levels of literacy or limited language fluency can pose challenges. For field trials, researchers evaluating the impact of a pe...

Optimal strategies to improve food security and nutrition for people living with HIV (PLHIV) may differ in settings where overweight and obesity are prevalent and cardiovascular disease risk is a concern. However, no studies among PLHIV have investigated the impact of food support on nutritional outcomes in these settings. We therefore assessed the...

líquidos por mujeres mexicanas durante el embarazo y primer semestre de lactancia. 135 Introducción Existen diversos mecanismos que ayudan a controlar y regular el estado de hidratación, de manera que la osmolalidad del plasma se mantenga entre 285 y 295 mOsm/kg. De manera resumida, estos mecanismos incluyen señales fisiológicas para motivar la ing...

Background Iron deficiency is one of the most common nutritional deficiencies worldwide. It is more prevalent when iron requirements are increased during pregnancy and during growth spurts of infancy and adolescence. The last stage in the process of iron depletion is characterized by a decrease in hemoglobin concentration, resulting in iron deficie...

EDITORIAL Beneficios de la alimentación del recién nacido con fórmula de inicio: libre demanda contra capacidad gástrica Benefits of newborn feeding with the initiation formula: On-demand vs. gastric capacity Las controversias que existen acerca del tema de la ali-mentación más adecuada para el recién nacido de término podrían resolverse de manera...

Background: A limited number of studies have examined infant crying patterns in less affluent societies, but none of them have been longitudinal in nature. The aim of this study was to describe reported infant crying patterns in a cohort of Mexican infants and examine how these are associated with crying-related maternal expectations, general perce...