Article

Metabolic responses to a traditional Mexican diet compared with a commonly consumed US diet in women of Mexican descent: A randomized crossover feeding trial

December 2015
American Journal of Clinical Nutrition 103(2)

DOI:10.3945/ajcn.115.119016

Authors:

Fred Hutch Cancer Center

Background: Mexican immigrants are disproportionally affected by diet-related risk of metabolic dysfunction. Whether adhering to a traditional Mexican diet or adopting a US diet contributes to metabolic changes associated with future risk of type 2 diabetes and other chronic diseases has not been investigated. Objective: The purpose of this study was to test in a randomized crossover feeding trial the metabolic responses to a Mexican diet compared with a commonly consumed US diet. Design: First- and second-generation healthy women of Mexican descent (n = 53) were randomly assigned in a crossover design to consume a Mexican or US diet for 24 d each, separated by a 28-d washout period. Diets were eucaloric and similar in macronutrient composition. The metabolic responses to diets were assessed by measuring fasting serum concentrations of glucose, insulin, insulin-like growth factor 1 (IGF-1), insulin-like growth factor binding protein 3 (IGFBP-3), adiponectin, C-reactive protein (CRP), and interleukin 6 (IL-6), as well as the homeostasis model assessment of insulin resistance (HOMA-IR) at the beginning and end of each period. Linear mixed models tested the intervention effect on the biomarkers, while adjusting for diet sequence, feeding period, baseline and washout biomarker concentrations, age, acculturation, and BMI. Results: Compared with the US diet, the Mexican diet reduced insulin by 14% [geometric means (95% CIs): 9.3 (8.3, 10.3) compared with 8.0 (7.2, 8.9) μU/mL; P = 0.02], HOMA-IR by 15% [2.0 (1.8, 2.3) compared with 1.7 (1.6, 2.0); P = 0.02], and IGFBP-3 by 6% (mean ± SEM: 2420 ± 29 compared with 2299 ± 29 ng/mL; P < 0.01) and tended to reduce circulating concentrations of IGF-1 by 4% (149 ± 2.6 compared with 144 ± 2.5 ng/mL; P = 0.06). There was no significant intervention effect on serum concentrations of glucose, adiponectin, CRP, or IL-6 in the US compared with the Mexican diet. Conclusion: Compared with the commonly consumed US diet, the traditional Mexican diet modestly improved insulin sensitivity under conditions of weight stability in healthy women of Mexican descent, while having no impact on biomarkers of inflammation. This trial was registered at clinicaltrials.gov as NCT01369173.

Adherence to a traditional Mexican diet and non-communicable disease-related outcomes: Secondary data analysis of the cross-sectional Mexican National Health and Nutrition Survey

Article

Full-text available

Jul 2022

This study evaluated the association between adherence to a traditional Mexican diet (TMexD) and obesity, diabetes, and cardiovascular (CVD)-related outcomes in secondary data analysis of the cross-sectional Mexican National Health and Nutrition Survey 2018-19. Data from 10,180 Mexican adults were included, collected via visits to randomly selected households by trained personnel. Adherence to the TMexD (characterised by mostly plant-based foods like maize, legumes, vegetables) was measured through an adapted version of a recently developed TMexD index, using food frequency questionnaire data. Outcomes included obesity (anthropometric measurements), diabetes (biomarkers and diagnosis), and CVD (lipid biomarkers, blood pressure, hypertension diagnosis, and CVD-event diagnosis) variables. Percentage differences and odds ratios for presenting non-communicable disease (NCD)-related outcomes (with 95% confidence intervals [CI]) were measured using multiple linear and logistic regression, respectively, adjusted for relevant covariates. Sensitivity analyses were conducted according to sex, excluding people with an NCD diagnosis, and using multiple imputation. In fully adjusted models, high, compared to low, TMexD adherence was associated with lower insulin (-9.8%; 95% CI: -16.0, -3.3), LDL-cholesterol (-4.3%; 95% CI -6.9, -1.5), non-HDL cholesterol (-3.9%; 95% CI: -6.1, -1.7), and total cholesterol (-3.5%; 95% CI: -5.2, -1.8) concentrations. Men and those with no NCD diagnosis had overall stronger associations. Effect sizes were smaller, and associations weakened in multiple imputation models. No other associations were observed. While results may have been limited due to the adaptation of a previously developed index, the results highlight the potential association between the TMexD and lower insulin and cholesterol concentrations in Mexican adults.

Associations between acculturation, weight, diet quality, and physical activity among Latina breast cancer survivors: The ¡Mi Vida Saludable! study

Article

Apr 2022

Background Among Latinos, greater acculturation to the United States (US) is associated with risk of obesity and obesity-related comorbidities. Less is known about the associations between acculturation and obesity-related modifiable risk factors, such as diet quality and physical activity (PA) among Latina breast cancer survivors. Objective To explore associations between acculturation, weight status, diet quality, and PA among Latina breast cancer survivors. Design This is a cross-sectional secondary analysis of baseline data on demographics, clinical characteristics, acculturation, anthropometric measures, dietary intake, and PA collected from Latina breast cancer survivors enrolled in the ¡Mi Vida Saludable! (My Healthy Life) behavioral diet and PA intervention trial. Participants/setting Latina women (n=167) residing in New York City, with a medical history of stage 0-III breast cancer, no evidence of recurrent or metastatic disease, and at least 90 days post cancer treatment who participated in the ¡Mi Vida Saludable! randomized controlled trial between July 2016 to October 2018. Main outcome measures Acculturation status was measured by the Short Acculturation Scale for Hispanics (SASH) score, language preference, place of birth, and duration of US residence. Weight, height, waist, and hip circumference were measured at an in-person clinic visit. Diet was collected via three telephone-based 24-hour dietary recalls and physical activity was collected via staff administered 7-day recalls. Statistical analyses performed Linear regression models examined associations between acculturation, weight status, diet quality, and PA. Results Based on the SASH acculturation score, more acculturated compared to less acculturated Latinas were younger in age, more educated, and had higher annual household incomes (all p values <0.05). Compared to Spanish-speaking Latinas, English-speaking Latinas had higher waist circumference (103 vs. 96.1cm; p=0.01) and poorer quality diets (HEI-2015 scores, 57.3 vs. 71.5; p<0.001). Greater levels of acculturation were also associated with higher levels of leisure walking at a moderate-to-vigorous intensity (265.8 vs. 179.0 minutes/week; p=0.04). Conclusions Greater levels of acculturation were associated with higher central obesity and poorer quality diets. Future lifestyle modification trials tailored to the unique role of acculturation on adopting behavior change recommendations is a promising next step in this line of research.

Assessing the Physiological Effects of Traditional Regional Diets Targeting the Prevention of Cardiovascular Disease: A Systematic Review of Randomized Controlled Trials Implementing Mediterranean, New Nordic, Japanese, Atlantic, Persian and Mexican Dietary Interventions

Article

Full-text available

Aug 2021

Traditional regional diets are considered as sustainable dietary patterns, while many have been examined with regard to their health benefits. The aim of the present systematic review was to aggerate all evidence on the physiological effects of regional diets among adults at high risk for cardiovascular disease (CVD). Three databases were searched for randomized controlled trials (RCTs) implementing any regional diet (Mediterranean (MedD), Persian, Southern European Atlantic, Japanese, Chinese, new Nordic, or other) while examining cardiovascular risk factors among adults at increased risk. Primary outcomes included anthropometric indices and secondary outcomes involved blood lipid concentrations, glucose metabolism, inflammation and other markers of CVD progression. Twenty RCTs fulfilled the study’s criteria and were included in the qualitative synthesis, with the majority implementing a MedD. Adherence to most of the regional diets induced a reduction in the BW and anthropometric indices of the participants. The majority of RCTs with blood pressure endpoints failed to note a significant reduction in the intervention compared to the comparator arm, with the exception of some new Nordic and MedD ones. Despite the interventions, inflammation markers remained unchanged except for CRP, which was reduced in the intervention groups of one new Nordic, the older Japanese, and the Atlantic diet RCTs. With regard to blood lipids, regional diet interventions either failed to induce significant differences or improved selective blood lipid markers of the participants adhering to the experimental regional diet arms. Finally, in the majority of RCTs glucose metabolism failed to improve. The body of evidence examining the effect of regional dietary patterns on CVD risk among high-risk populations, while employing an RCT design, appears to be limited, with the exception of the MedD. More research is required to advocate for the efficacy of most regional diets with regard to CVD.

Acculturation and biological stress markers: A systematic review

Article

Jul 2021
PSYCHONEUROENDOCRINO

Background The association of acculturation with health among immigrant populations is believed to be mediated, in part, by acculturation-related stress and stress biology. Objectives To review and qualitatively synthesize empirical findings on the relationship of acculturation with stress-related inflammatory and endocrine biomarkers and composite allostatic load (AL) scores. Methods A literature search was performed in the PubMed and PsycInfo databases. Article titles, abstracts or full-texts were screened and checked for match with the search criteria. Studies were eligible if they empirically tested the relationship between acculturation and inflammatory/endocrine stress biomarkers or composite AL scores, and were published in the English language. Results Among the 41 articles identified as relevant and included in this review, the majority were published after 2010, included adult Hispanic U.S.-based populations, used cross-sectional study designs, operationalized acculturation as a unidimensional construct, and varied considerably in the selection of covariates in the analyses. Acculturation was significantly associated with stress biomarkers in 29 studies, but the direction of effects varied across studies. Specifically, acculturation, operationalized as a higher orientation towards the host culture, was associated with inflammatory biomarkers in 10 of 14 studies, with endocrine stress biomarkers in 12 of 20 studies, and with composite AL scores in 7 of 8 studies. Overall, language-based proxy measures of acculturation were related to higher levels of stress-related inflammatory and endocrine biomarkers and to lower levels of AL scores, whereas nativity-, generation status- and length of stay-based proxy measures of acculturation were related to higher levels of inflammatory biomarkers and AL score. Discussion The majority of studies reported associations between measures of acculturation and stress biomarkers, however the directions of effects varied across studies. We suggest this heterogeneity may, in part, be a function of limitations imposed by cross-sectional research designs and unidimensional measures of acculturation measures, and we highlight the need for longitudinal studies and use of multidimensional measures of acculturation to better uncover the biobehavioral mechanisms and pathways linking acculturation with health outcomes.

Effect of whole foods and dietary patterns on markers of subclinical inflammation in weight stable overweight and obese adults – A Systematic Literature Review

Article

May 2019
OBES RES CLIN PRACT

Incorporating an Increase in Plant-Based Food Choices into a Model of Culturally Responsive Care for Hispanic/Latino Children and Adults Who Are Overweight/Obese

Article

Full-text available

Jul 2020
Int J Environ Res Publ Health

Introduction: The national rate of obesity in US Hispanic/Latinos exceeds all other major ethnic subgroups and represents an important health disparity. Plant-based diet interventions that emphasize whole plant foods with minimal processing and less refined grains and sugar have shown have shown great promise in control of obesity, but there is a paucity of data translating this treatment effect to disparate populations. The objective of our study was to evaluate the efficacy of the Healthy Eating Lifestyle Program (HELP) for accomplishing weight management in a hospital-based, family centered, culturally tailored, plant-based diet intervention for Hispanic/Latino children who were overweight or obese. Methods: Our mixed methods evaluation included: (1) A one arm study to measure changes in body mass index (BMI) from pre- to post-intervention, and (2) A stakeholder analysis of the program staff. Results: For children ages 5–12 years who were overweight/obese, we found no evidence of excess weight gain evidenced by BMI Z scores (Zpost-pre = −0.02, p = 0.11). Among the parent/guardians who were overweight or obese, we found a decrease in BMI that was stronger in men (BMI post-pre = −0.75 kg/m2, p = 0.01) than in women (BMI post-pre = −0.12 kg/m2, p = 0.30). A program strength was the cultural tailoring of the plant-based diet choices. Conclusions: The evaluation raises the possibility that incorporating intervention components of HELP (plant-based food choices, family-based, cultural tailoring) into pediatric weight management can improve the standard of care.

Dietary Patterns with Healthy and Unhealthy Traits Among Overweight/Obese Hispanic Women with or at High Risk for Type 2 Diabetes

Article

Jun 2020

Hispanic women are at high risk for type 2 diabetes (T2D), with obesity and unhealthy eating being important contributing factors. A cross-sectional design was used in this study to identify dietary patterns and their associations with diabetes risk factors. Participants completed a culturally adapted Food Frequency Questionnaire capturing intake over the prior 3 months. Overweight/obese Hispanic women (n = 191) with or at risk for T2D were recruited from a community clinic into a weight loss intervention. Only baseline data was used for this analysis. Dietary patterns and their association with diabetes risk factors (age, body mass index, abdominal obesity, elevated fasting blood glucose [FBG], and hemoglobin A1c). An exploratory factor analysis of dietary data adjusted for energy intake was used to identify eating patterns, and Pearson correlation coefficient (r) to assess the association of the eating patterns with the diabetes risk factors. Six meaningful patterns with healthful and unhealthful traits emerged: (1) sugar and fat-laden, (2) plant foods and fish, (3) soups and starchy dishes, (4) meats and snacks, (5) beans and grains, and (6) eggs and dairy. Scores for the “sugar and fat-laden” and “meats and snacks” patterns were negatively associated with age (r = − 0.230, p = 0.001 and r = − 0.298, p < 0.001, respectively). Scores for “plant foods and fish” were positively associated with FBG (r = 0.152, p = 0.037). Being younger may be an important risk factor for a diet rich in sugar and fat; this highlights the need to assess dietary patterns among younger Hispanic women to identify traits potentially detrimental for their health.

Definition of the Traditional Mexican Diet and Its Role in Health: A Systematic Review

Article

Full-text available

Nov 2019

Promoting traditional diets could potentially reduce the current high rates of non-communicable diseases (NCDs) globally. While the traditional Mexican diet (TMexD) could be specifically promoted in Mexico, a concise definition of the TMexD and evidence of its association with NCDs are needed before its promotion. To evaluate what constitutes this diet pattern, we aimed to systematically review, for the first time, how the TMexD has been described in the literature to date. A secondary aim was to examine whether the TMexD, as described by available definitions, is associated with NCD outcomes. We searched for records describing a whole TMexD up to July 2019 in 12 electronic databases, reference lists, a relevant journal, and by contacting experts on the topic. We reported the results using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. We included 61 records for the definition of the diet and six for the association with NCD outcomes. The food groups characterising the TMexD that were consistently mentioned in all the study subgroups were grains and tubers, legumes, and vegetables; specific foods included maize, beans, chile, squash, tomato, and onion. Other groups also mentioned, although with lesser frequency, were maize products, fruits, beverages, fish and seafood, meats, sweets and sweeteners, and herbs and condiments. Only a few studies reported on the frequency of consumption or the amounts in which these foods were consumed in the TMexD. It was not possible to reach strong conclusions for the association between adherence to the TMexD and NCD outcomes. The TMexD was weakly associated with developing breast cancer, not associated with triglyceride levels, and inconsistently associated with obesity and diabetes outcomes. However, results were limited by the small number of studies (n = 6), of which most were of observational nature and evaluated diets using different TMexD definitions. These findings provide systematically identified evidence of the characteristics of the TMexD. More studies are needed to ascertain the exact quantities by which foods were consumed in the TMexD in order to establish whether this dietary pattern is associated with health and should be promoted within the Mexican population.

Effect of whole foods and dietary patterns on markers of subclinical inflammation in weight-stable overweight and obese adults: a systematic review

Article

Aug 2019
NUTR REV

Context: Reduction of subclinical inflammation is a potential target for chronic disease management. Adiposity is a known modifier of meta-inflammation; however, the influence of dietary factors is less clear. Objective: This review examines evidence from human trials evaluating effects of whole foods or dietary patterns on circulating inflammatory markers in weight-stable overweight and obese adults. It is the first review to investigate effects of diet on inflammation, independent of changes in adiposity. Data sources: The Ovid MEDLINE, EMBASE, CINAHL, and Cochrane databases were searched. Data extraction: Data extraction was conducted using the Cochrane Collaboration Handbook for Systematic Reviews of Interventions. Data analysis: Study quality was evaluated using the Cochrane Collaboration Risk of Bias Assessment tool. Thirty-three studies were included assessing effects of 17 foods and dietary patterns on 39 inflammatory markers. Conclusions: Overall, foods and dietary patterns were not found to have significant effects on inflammatory markers in weight-stable individuals. Inconsistencies among studies were largely due to methodological limitations. Future research should invest in longer intervention periods and standardization of inflammatory marker panels paired with novel technologies, while ensuring anthropometric measures are monitored and adequately controls are used. Systematic review registration: Prospero registration number CRD42017067765.

Traditional Foods, Globalization, Migration, and Public and Planetary Health: The Case of Tejate, a Maize and Cacao Beverage in Oaxacalifornia

Article

Full-text available

Jan 2023

We are in the midst of an unprecedented public and planetary health crisis. A major driver of this crisis is the current nutrition transition—a product of globalization and powerful multinational food corporations promoting industrial agriculture and the consumption of environmentally destructive and unhealthy ultra-processed and other foods. This has led to unhealthy food environments and a pandemic of diet-related noncommunicable diseases, as well as negative impacts on the biophysical environment, biodiversity, climate, and economic equity. Among migrants from the global south to the global north, this nutrition transition is often visible as dietary acculturation. Yet some communities are defying the transition through selective resistance to globalization by recreating their traditional foods in their new home, and seeking crop species and varieties customarily used in their preparation. These communities include Zapotec migrants from the Central Valleys of the southern Mexican state of Oaxaca living in greater Los Angeles, California. Focusing on the traditional and culturally emblematic beverage tejate, we review data from our research and the literature to outline key questions about the role of traditional foods in addressing the public and planetary health crisis. We conclude that to answer these questions, a transnational collaborative research partnership between community members and scientists is needed. This could reorient public and planetary health work to be more equitable, participatory, and effective by supporting a positive role for traditional foods and minimizing their harms.

Effect of Metformin on Glycemic Control Regarding Carriers of the SLC22A1/OCT1 (rs628031) Polymorphism and Its Interactions with Dietary Micronutrients in Type 2 Diabetes

Article

Full-text available

Jun 2022

Purpose: Differences in metformin effect on glycemic control in type 2 Diabetes (T2D) have been associated with diet, obesity, years since T2D diagnosis and genetic factors, such as the Met408Val (rs628031) SLC22A1/OCT1 gene polymorphism. This study aimed to analyze the effect of metformin and diet on glycemic control and its association with the Met408Val polymorphism in patients with T2D from western Mexico. Patients and methods: A total of 240 T2D adult patients were enrolled in this cross-sectional study. Anti-hyperglycemic therapy, dietary intake, body composition and glycemic profile were recorded and the determination of genotypes of SLC22A1/OCT1 gene (rs628031) was performed using an allelic discrimination assay. Results: The type of metformin therapy was 47% monotherapy, 45% dual therapy (metformin+glibenclamide or metformin+insulin) and 8% triple therapy (metformin+glibenclamide+insulin). Individuals with metformin monotherapy had a higher glycemic control frequency (%HbA1c <7.0) compared with the dual and triple treatment schemes (77% vs 35% and 15%, respectively; p<0.001). Interestingly, a high potassium intake was documented in the three anti-hyperglycemic therapies and a lower intake of micronutrients, including calcium, magnesium, and zinc. An interaction was found between calcium intake and carriers of the risk allele A (408Val) with %HbA1c (P interaction=0.028), and potassium intake with the TyG index (P interaction=0.027). In addition, there was a positive correlation between calcium intake and %HbA1c (r=0.682; p=0.010), and potassium intake vs TyG index (r=0.593; p=0.033) in risk allele A (408Val) carriers with metformin monotherapy. Genotype frequencies were GG homozygotes (76.6%), GA heterozygotes (21.5%) and AA homozygotes (1.9%). The allele frequency was 87.4% for the ancestral allele G and 12.6% for the risk allele A. Conclusion: These findings suggest a differing effect of metformin on glycemic control regarding calcium and potassium intake and the Met408Val SLC22A1/OCT1 gene polymorphism in T2D patients.

The water footprint and nutritional implications of diet change in Mexico: a principal component analysis

Article

Full-text available

Sep 2022
EUR J NUTR

Purpose Nutrition transition (NT) has modified the way that the Mexican population eats, while their body composition has also been modified. These changes have been linked with environmental impacts; however, little is known regarding water footprint (WF). The objective of this paper was to analyze the NT process in Mexico and evaluate its impact on WF using principal component analysis (PCA). Methods A validated Food Consumption Frequency Questionnaire (FCFQ) was modified and applied to 400 adults from the Metropolitan Zone of Guadalajara, Mexico. The WF was calculated according to the WF Assessment Method. PCA and tertiles analysis was carried out to define dietary patterns WFs (DPWF). Questions covering sociodemographic and socioeconomic factors, as well as body composition data and physical activity levels were measured. Results The average DPWF was 6619.58 ± 3182.62 L per person per day (L p⁻¹d⁻¹). We found three DPWF by PCA: Medium NT (55% from the total sample), Healthy plant-based (28%), and High in animal protein (17%). The highest energy consumption, western and Mexican foods intake, and dietary WF were found in Medium NT DPWF, as well as obesity prevalence. Fruits and vegetable consumption was higher in Healthy plant-based DPWF. Muscle mass percentage was higher in the High in animal protein DPWF. Conclusions Although most of the population is currently on Medium NT, new dietary patterns have emerged, where there was found a trend to plant-based diets but also diets high in animal food sources that can influence nutritional status.

Editorial: The Impact of Dietary Changes on Non-communicable Diseases in Latin America

Article

Full-text available

Apr 2022

Pramil Singh

Health Promotion Among Mexican-Origin Survivors of Breast Cancer and Caregivers Living in the United States–Mexico Border Region: Qualitative Analysis From the Vida Plena Study

Article

Full-text available

Feb 2022

Background Hispanic survivors of cancer experience increased cancer burden. Lifestyle behaviors, including diet and physical activity, may reduce the cancer burden. There is limited knowledge about the posttreatment lifestyle experiences of Hispanic survivors of cancer living on the United States–Mexico border. Objective This study aims to support the development of a stakeholder-informed, culturally relevant, evidence-based lifestyle intervention for Mexican-origin Hispanic survivors of cancer living in a border community to improve their dietary quality and physical activity. Methods Semistructured interviews with 12 Mexican-origin Hispanic survivors of breast cancer and 7 caregivers were conducted through internet-based teleconferencing. The interviews explored the impact of cancer on lifestyle and treatment-related symptoms, perception of lifestyle as an influence on health after cancer, and intervention content and delivery preferences. Interviews were analyzed using a deductive thematic approach grounded in the Quality of Cancer Survivorship Care Framework. Results Key survivor themes included perception of Mexican diet as unhealthy, need for reliable diet-related information, perceived benefits of physical activity after cancer treatment, family support for healthy lifestyles (physical and emotional), presence of cancer-related symptoms interfering with lifestyle, and financial barriers to living a healthy lifestyle. Among caregivers, key themes included effects of the cancer caregiving experience on caregivers’ lifestyle and cancer-preventive behaviors and gratification in providing support to the survivors. Conclusions The interviews revealed key considerations to the adaptation, development, and implementation of a theory-informed, evidence-based, culturally relevant lifestyle program to support lifestyle behavior change among Mexican-origin Hispanic survivors of cancer living in border communities. Our qualitative findings highlight specific strategies that can be implemented in health promotion programming aimed at encouraging cancer protective behaviors to reduce the burden of cancer and comorbidities in Mexican-origin survivors of cancer living in border communities.

Culturally-consistent diet among individuals of Mexican descent at the US-Mexico border is associated with sleep duration and snoring

Article

Full-text available

Aug 2021

Background Existing studies show that consuming food consistent with one’s culture reduces cardiometabolic risk. However, few studies have assessed whether these dietary choices influence sleep health. Accordingly, this study assessed how Mexican food consumption by individuals of Mexican descent residing at the US-Mexico border, was associated with various measures of sleep, after accounting for acculturation. Methods Data were provided by 100 adults between the ages of 18–60, in the city of Nogales, AZ. Questionnaires were provided in either Spanish or English. Acculturation was assessed with the Acculturation Scale for Mexican-Americans (ARSMA-II), with an additional question, asking how often “my family cooks Mexican foods.” Frequency of cooking Mexican food was coded as either “yes” or “no.” Sleep was assessed, using validated measures that include the Insomnia Severity Index (ISI), the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), and sleep duration with the item “how many hours of actual sleep did you get at night?” Regression models estimated the associations between sleep health variables as outcomes and consumption of Mexican food as the independent variable. Covariates included age, sex, and acculturation scores. Parental education level was also included, as an indicator of childhood socioeconomic status and since food culture likely involves parents. Result We found that among individuals who identified as Mexican-Americans who consumed culturally-consistent foods, was associated with, on average, 1.41 more hours of sleep (95% CI 0.19, 2.62; p = 0.024) and were less likely to report snoring (OR: 0.25; 95% CI 0.07, 0.93; p = 0.039). Consuming Mexican food was not associated with sleep quality, insomnia severity or sleepiness. Conclusion Individuals of Mexican descent residing at the US-Mexico border who regularly consumed Mexican food, reported more sleep and less snoring. Mexican acculturation has been shown previously to improve sleep health. This is likely due to consumption of a culturally- consistent diet. Future studies should examine the role of acculturation in sleep health, dietary choices, and subsequent cardiometabolic risk.

Diet quality indices and risk of metabolic syndrome among postmenopausal women of Mexican ethnic descent in the Women’s Health Initiative Observational Study

Article

Full-text available

Nov 2020

Background: The prevalence of metabolic syndrome is higher among minority populations, including individuals of Mexican ethnic descent. Whether alignment to healthy dietary patterns is associated with lower risk of metabolic syndrome in this population is largely unknown. Objective: To prospectively evaluate the associations between a priori diet quality scores and risk of metabolic syndrome and its components among postmenopausal women of Mexican ethnic descent. Methods: A total of 334 women of Mexican ethnic descent who participated in the Women's Health Initiative (WHI) observational study without metabolic syndrome or diabetes at baseline (1993-1998) were included. Baseline diets were scored with the Alternate Mediterranean Diet (aMED), the Dietary Approaches to Stop Hypertension (DASH), the Healthy Eating Index (HEI-2010), the Mediterranean Diet Score (MDS), and the traditional Mexican Diet (MexD) score. Multivariable linear and logistic regression models were used to test the associations between baseline diet quality and risk of metabolic syndrome and its individual components at follow-up (2012-2013). Results: Approximately 16% of women met the criteria for metabolic syndrome at follow-up. None of the diet quality indices were associated with risk of metabolic syndrome. However, higher vs lower DASH scores were associated with lower waist circumference (85.2 vs 88.0 cm) and glucose concentrations (90.0 vs 95.1 mg/dL), and higher HDL cholesterol (62.6 vs 59.0 mg/dL), while higher vs lower HEI-2010 scores were associated with lower waist circumference (83.9 vs 88.1 cm), triglycerides (103 vs 117 mg/dL) and glucose concentrations (89.5 vs 94.4 mg/dL), and higher HDL cholesterol levels (63.9 vs 58.5 mg/dL). Conclusions: Diet quality was not associated with risk of metabolic syndrome in this population. However, the results suggest that alignment to DASH and HEI-2010 recommendations may be beneficial for reducing some individual components of metabolic syndrome among postmenopausal women of Mexican descent.

A Regionalized Genome-Based Mexican Diet Improves Anthropometric and Metabolic Parameters in Subjects at Risk for Obesity-Related Chronic Diseases

Article

Full-text available

Feb 2020

Obesity-related chronic diseases (CD) are highly prevalent in Mexicans who show moderate to high frequencies of diet-related adaptive gene (DRAG) polymorphisms and recent shifts in traditional dietary habits and lifestyles. This study first evaluated the effects of a regionalized genome-based Mexican (GENOMEX) diet on anthropometric and biochemical parameters and, subsequently their relationship with the genetic profile of DRAG polymorphisms in subjects with metabolic risk factors for obesity-related CD. Thirty-seven eligible subjects underwent a 24-week dietary intervention with a GENOMEX diet. The DRAG polymorphisms were determined by an allelic discrimination real-time assay to evaluate their association with the clinical response to diet. The GENOMEX diet significantly improved anthropometric parameters such as total weight, body mass index, waist circumference, and body fat percentage, with an average weight loss of 6.6% (5.3 ± 5.3 kg). The frequency of subjects with insulin resistance, hypertriglyceridemia and elevated VLDL-c (48.5% vs. 24.2%, p = 0.041; 45.5% vs. 12.1%, p = 0.003; and 39.4% vs. 15.2%, p = 0.027, baseline vs. 24-weeks, respectively) was reduced. A more significant favorable effect in HOMA-IR and insulin was observed in MTHFR 677T adaptive allele carriers, but no other DRAG polymorphism was associated with clinical changes. The GENOMEX diet improved the metabolic risk factors for obesity-related CD. The recommendation and habitual consumption of a traditional Mexican diet based on knowledge of the population´s genetic and cultural history may be effective in preventing current obesity-related CD.

Microbial determinants of dementia risk in subjects of Mexican descent with type 2 diabetes living in South Texas

Preprint

Full-text available

Mar 2024

Type 2 diabetes (T2D) is a common forerunner of neurodegeneration and dementia, including Alzheimer’s Disease (AD), yet the underlying mechanisms remain unresolved. Individuals of Mexican descent living in South Texas have increased prevalence of comorbid T2D and early onset AD, despite low incidence of the predisposing APOE-χ4 variant and an absence of the phenotype among relatives residing in Mexico – suggesting a role for environmental factors in coincident T2D and AD susceptibility. Here, in a small clinical trial, we show dysbiosis of the human gut microbiome could contribute to neuroinflammation and risk for AD in this population. Divergent Gastrointestinal Symptom Rating Scale (GSRS) responses, despite no differences in expressed dietary preferences, provided the first evidence for altered gut microbial ecology among T2D subjects (sT2D) versus population-matched healthy controls (HC). Metataxonomic 16S rRNA sequencing of participant stool revealed a decrease in alpha diversity of sT2D versus HC gut communities and identified BMI as a driver of gut community structure. Linear discriminant analysis effect size (LEfSe) identified a significant decrease in the relative abundance of the short-chain fatty acid-producing taxa Lachnospiraceae , Faecalibacterium , and Alistipes and an increase in pathobionts Escherichia-Shigella , Enterobacter , and Clostridia innocuum among sT2D gut microbiota, as well as differentially abundant gene and metabolic pathways. These results suggest characterization of the gut microbiome of individuals with T2D could identify key actors among “disease state” microbiota which may increase risk for or accelerate the onset of neurodegeneration. Furthermore, they identify candidate microbiome-targeted approaches for prevention and treatment of neuroinflammation in AD. Importance Mexican Americans are at increased risk for developing type 2 diabetes (T2D) that precedes Alzheimer’s Disease (AD), compared to non-Hispanic whites; however, the reason remains unknown. The leading risk factor for T2D is obesity. Among Texans, individuals of Mexican descent are disproportionately affected by obesity and T2D. Mexican immigrants to the US and their descendants face significant environmental pressures, including dietary changes. Diet is the primary determinant of gut microbiome composition, which is increasingly linked to both metabolic and brain health. Here, we performed a case-control, cross-sectional observational clinical study to test the hypothesis that diet-driven shifts in gut microbiome composition contribute to T2D and AD susceptibility in individuals of Mexican descent living in South Texas. Our results identify a microbial signature, characterized by decreased short-chain fatty acid producers with an increase in opportunistic pathogenic species, that could contribute to the increased risk for neurodegenerative disorders among individuals with T2D.

Dieta de la Milpa: A Culturally-Concordant Plant-Based Dietary Pattern for Hispanic/Latine People with Chronic Kidney Disease

Article

Full-text available

Feb 2024

Chronic kidney disease (CKD) disproportionately affects minorities in the United States, including the Hispanic/Latine population, and is a public health concern in Latin American countries. An emphasis on healthy dietary patterns, including the Mediterranean and the Dietary Approaches to Stop Hypertension (DASH) diets, has been suggested as they are associated with a lower incidence of CKD, slower CKD progression, and lower mortality in kidney failure. However, their applicability may be limited in people from Latin America. The Dieta de la Milpa (Diet of the Cornfield) was recently described as the dietary pattern of choice for people from Mesoamerica (Central Mexico and Central America). This dietary pattern highlights the intake of four plant-based staple foods from this geographical region, corn/maize, common beans, pumpkins/squashes, and chilies, complemented with seasonal and local intake of plant-based foods and a lower intake of animal-based foods, collectively classified into ten food groups. Limited preclinical and clinical studies suggest several health benefits, including cardiometabolic health, but there is currently no data concerning CKD. In this narrative review, we describe and highlight the potential benefits of the Dieta de la Milpa in CKD, including acid-base balance, protein source, potassium and phosphorus management, impact on the gut microbiota, inflammation, and cultural appropriateness. Despite these potential benefits, this dietary pattern has not been tested in people with CKD. Therefore, we suggest key research questions targeting measurement of adherence, feasibility, and effectiveness of the Dieta de la Milpa in people with CKD.

Traditional Mexican dietary pattern and cancer risk among women of Mexican descent

Article

Full-text available

Feb 2024
CANCER CAUSE CONTROL

Purpose To examine the association of a traditional Mexican diet score with risk of total, breast, and colorectal cancer among women of Mexican ethnic descent in the Women’s Health Initiative (WHI). Methods Participants were WHI enrollees who self-identified as being of Mexican descent. Data from food frequency questionnaires self-administered at study baseline were used to calculate the MexD score, with higher scores indicating greater adherence to an a priori-defined traditional Mexican diet (high in dietary fiber, vegetables, and legumes). Incident cancers were self-reported by participants from 1993 to 2020 and adjudicated by trained physicians. We used multivariable-adjusted Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Results Among 2,343 Mexican descent women (median baseline age: 59 years), a total of 270 cancers (88 breast, 37 colorectal) occurred during a mean follow-up of 14.4 years. The highest tertile of MexD score was associated with a lower risk of all-cancer incidence (HR: 0.67; 95% CI 0.49–0.91; p-trend: 0.01) and colorectal cancer (HR: 0.38; 95% CI 0.14–0.998; p-trend < 0.05), with each unit increase in the MexD score associated with a 6% lower risk of all-cancer incidence (HR: 0.94; 95% CI 0.88–0.99). There was no statistically significant association with risk of breast cancer. Conclusion Consumption of a traditional Mexican diet was associated with a significantly lower risk of all-cancer incidence and colorectal cancer. Confirmation of these findings in future studies is important, given the prevalence of colorectal cancer and a growing U.S. population of women of Mexican descent.

Feasibility and Acceptability of a Text Message Intervention to Promote Adherence to Nutrition and Physical Activity Guidelines in a Predominantly Hispanic Sample of Cancer Survivors and Their Informal Caregivers: Results from a Pilot Intervention Trial

Article

Full-text available

Nov 2023

Hispanic cancer survivors face unique barriers to meeting American Cancer Society (ACS) nutrition and physical activity guidelines, which reduce the risk of cancer recurrence and mortality and improve quality of life. This pilot intervention trial evaluated the feasibility and acceptability of a two-week ACS guideline-based nutrition and physical activity text message intervention in a predominantly Hispanic sample of cancer survivors and their informal caregivers. A mixed methods approach was used to assess feasibility and acceptability of the intervention. Feasibility and acceptability were measured by meeting a-priori cut-offs of >80% for recruitment, retention, and text message response rate. Participants also completed a semi-structured exit interview by telephone that assessed intervention components. Thirteen cancer survivors and six caregivers (n = 19) participated in this pilot study; 78% self-identified as Hispanic. Mean time since treatment completion for survivors was 11.9 years (SD 8.4), and 67% had breast cancer. Cancer survivors had a higher acceptability rate for physical activity (94%) compared to nutrition messages (86%), whereas equal acceptability rates were observed for both types of messages among caregivers (91%). Texting interventions are a feasible, acceptable, and a cost-effective strategy that have the potential to promote lifestyle behavior change among Hispanic cancer survivors and caregivers.

The Effect of Dietary Patterns and Nutrient Intake on Oxidative Stress Levels in Pregnant Women: A Systematic Review

Article

Full-text available

Jul 2023

During pregnancy, reactive oxygen species (ROS) may physiologically increase due to changes and growth of mother and fetal tissues. Consequently, oxidative stress (OS) may occur and be involved in the onset of pregnancy and newborn complications. Among exogenous antioxidant sources, diet is a cost-effective prevention strategy supporting the health of mothers and newborns; however, there is still a lack of nutritional education during pregnancy interviews. This review aims to systematically summarize the knowledge on the association between OS and diet during pregnancy. Four electronic databases (PubMed Central, EMBASE, Web of Science, and Food Science and Technology Abstracts) were searched on 22 December 2022. Among 4162 records, 13 original articles were finally included. Overall, 80% of the studies considered dietary patterns as exposure and 60% of them assessed the association with malondialdehyde levels in blood and urine. Three studies analyzed the influence of daily intakes of fruit and vegetables on different OS biomarkers (malondialdehyde, nitric oxide and 8-hydroxy-2'-deoxyguanosine). Among studies exploring dietary fat intakes (39%), 80% focused on polyunsaturated fatty acids, finding a positive association with glutathione peroxidase, biopirryn and isoprostane levels, respectively. Four studies analyzed vitamin intakes and 50% of them in association with 8-hydroxy-2'-deoxyguanosine.

Sustainable-psycho-nutritional intervention program for a sustainable diet (the 'NutriSOS' study) and its effects on eating behavior, diet quality, nutritional status, physical activity, metabolic biomarkers, gut microbiota, and water and carbon footprints in Mexican population: study protocol of an mHealth randomized controlled trial

Article

Full-text available

Mar 2023
BRIT J NUTR

Mexico is going through an environmental and nutritional crisis related to unsustainable dietary behaviors. Sustainable diets could solve both problems together. This study protocol aims to develop a 3-stages, 15 weeks mHealth randomized controlled trial (RCT) of a sustainable-psycho-nutritional intervention program to promote Mexican population adherence to a sustainable diet and to evaluate its effects on health and environmental outcomes. In stage 1, the program will be designed using the sustainable diets, behavior change wheel, and COM-B models. A sustainable food guide, recipes, meal plans, and a mobile application will be developed. In stage 2, the intervention will be implemented for seven weeks, and a 7-weeks follow-up period in a young Mexican adults (18 to 35 years) sample, randomly divided (1:1 ratio) into a control group (n=50) and an experimental group (n=50), that will be divided in two arms at week 8. Outcomes will include health, nutrition, environment, behavior, and nutritional-sustainable knowledge. Additionally, socioeconomics and culture will be considered. Thirteen behavioral objectives will be included using successive approaches in online workshops twice a week. The population will be monitored using the mobile application consisting of behavioral change techniques. In stage 3, the effects of the intervention will be assessed using mixed-effect models on dietary intake and quality, nutritional status, physical activity, metabolic biomarkers (serum glucose and lipid profile), gut microbiota composition, and dietary water and carbon footprints of the evaluated population. Improvements in health outcomes and a decrease in dietary water and carbon footprints are expected.

Differences in Metabolomic Profiles by Birthplace in Mexican-Origin Hispanic Men Who Participated in a Weight Loss Lifestyle Intervention

Article

Full-text available

Feb 2023
AM J MENS HEALTH

Birthplace, as a proxy for environmental exposures (e.g., diet), may influence metabolomic profiles and influence risk of cancer. This secondary analysis investigated metabolomic profile differences between foreign and U.S.-born Mexican-origin (MO) Hispanic men to shed light on potential mechanisms through which foreign- and U.S.-born individuals experience differences in cancer risk and risk factors. Plasma samples from MO Hispanic men (N = 42) who participated in a previous lifestyle intervention were collected pre-and post-intervention. Metabolomic profiles were characterized from samples using ultra performance liquid chromatography-quadrupole time of flight mass spectrometry (UPLC-QTOF). Models were visualized using supervised orthogonal projections to latent structures-discriminant analysis (OPLS-DA). Progenesis QI was used for peak integration and metabolite identification. Plasma metabolomic profiles differed between foreign- and U.S.-born pre-intervention (R2 = .65) and post-intervention (R2 = .62). Metabolomic profiles differed pre- versus post-intervention (R2 = .35 and R2 = .65) for the foreign- and U.S.-born group, respectively. Both endogenous metabolites and dietary components characterized differences between foreign- and U.S.-born participants pre- and post-intervention. Plasma metabolomic profiles from MO Hispanic men differed by birthplace. These results advance our understanding of relevant exposures that may affect cancer risk among MO Hispanic men born abroad or in the United States.

Association between Dietary Fatty Acid Intake and Liver Steatosis and Fibrosis in a Sample of Mexican-Origin Hispanic Adults with Overweight or Obesity

Article

Full-text available

Feb 2023
Int J Environ Res Publ Health

Rates of non-alcoholic fatty liver disease (NAFLD) vary dramatically among Hispanic subpopulations, with Mexican-origin (MO) Hispanics experiencing a disproportionate burden. This study examined dietary fatty acid (FA) intake among overweight and obese MO Hispanic adults in the United States (US) and evaluated its association with liver steatosis and fibrosis. Participants (N = 285, MO Hispanic adults) completed 24-h dietary recalls to assess dietary FA exposure. Liver steatosis and fibrosis were estimated using transient elastography (FibroScan ®). Multiple regression analysis tested relationships between FA intakes and liver steatosis or fibrosis, adjusting for age, sex, body mass index (BMI) and total energy. A total of 51% (n = 145) of participants were suspected to have NAFLD and 20% self-reported a type 2 diabetes diagnosis. No significant association was observed between Linoleic Acid and α-Linolenic Acid (LA:ALA) ratio, or omega-6 to omega-3 (n-6:n-3) ratio and liver steatosis. However, a one-point increase in the LA:ALA ratio resulted in a 1.01% increase in the liver fibrosis scores (95% CI: [1.00, 1.03]; p = 0.03), and a one-point increase in the n-6:n-3 ratio resulted in a 1.02% increase in liver fibrosis score (95% CI: [1.01, 1.03]; p = 0.01). Further research is needed to determine if modulation of FA intake could reduce NAFLD risk in this high-risk population.

Culturally adapting the Mediterranean Diet pattern - a way of promoting more "sustainable" dietary change?

Article

Full-text available

Jun 2022
BRIT J NUTR

Average diet quality is low in the UK and is socioeconomically patterned, contributing to risk of non-communicable disease and poor health. Achieving meaningful dietary change in the long-term is challenging, with intervention required on a number of difference levels which reflect the multiple determinants of dietary choice. Dietary patterns have been identified which contribute positively to health outcomes; one of these is the Mediterranean Diet which has been demonstrated to be associated within reduced non-communicable disease risk. Most research exploring the health benefits of the Mediterranean Diet has been conducted in Mediterranean regions but, increasingly, research is also being conducted in non-Mediterranean regions. The MD is a dietary pattern that could have positive impacts on both health and environmental outcomes, while being palatable, appetising and acceptable. In this review, we consider the studies that have explored transferability of the Mediterranean Diet. To achieve long-term dietary change towards a Mediterranean Diet it is likely that the dietary pattern will have to be culturally adapted, yet preserving the core health-promoting elements and nutritional composition, while considering the food system transition required to support changes at population-level. Population-specific barriers need to be identified and ways sought of overcoming these barriers, for example, key food availability and cost. This should follow a formal cultural adaptation framework. Such an approach is likely to enhance the extent of adherence in the longer-term, thus having an impact on population health.

Sleep duration, physical activity, and caloric intake are related to weight status in Mexican American children: a longitudinal analysis

Article

Full-text available

Jul 2021
INT J BEHAV NUTR PHY

Abstract Background Obesity is a serious issue, spanning all ages, and, in the U.S., disproportionately affects Latinos and African Americans. Understanding sleep, physical activity and dietary behaviors that may predict childhood obesity can help identify behavioral intervention targets. Methods Data were drawn from a U.S. cohort study of 323 Mexican American 8–10-year-old children and their mothers, who participated in a longitudinal study over a 2-year period. Measures were collected at baseline (BL; child mean age = 8.87, SD = 0.83), year 1 (FU1) and year 2 (FU2). Mothers reported on household income and acculturation at BL. Child height and weight were collected and BMI z-scores (BMIz) were calculated for weight status at BL, FU1, and FU2. Accelerometer-estimated sleep duration (hours) and moderate-to-vigorous physical activity (MVPA; minutes) were collected across 3 days at BL, FU1, and FU2. Two 24-h dietary recalls were performed at each time point; from these, average energy intake (EI, kcals/day) was estimated. Cross-lagged panel analysis was used to examine behavioral predictors on BMIz at each time point and across time. Results At BL and FU1, longer sleep duration (β = − 0.22, p

Development and Application of a Total Diet Quality Index for Toddlers

Article

Full-text available

Jun 2021

For the first time, the 2020–2025 Dietary Guidelines for Americans include recommendations for infants and toddlers under 2 years old. We aimed to create a diet quality index based on a scoring system for ages 12 to 23.9 months, the Toddler Diet Quality Index (DQI), and evaluate its construct validity using 24 h dietary recall data collected from a national sample of children from the Feeding Infants and Toddlers Study (FITS) 2016. The mean (standard error) Toddler DQI was 49 (0.6) out of 100 possible points, indicating room for improvement. Toddlers under-consumed seafood, greens and beans, and plant proteins and over-consumed refined grains and added sugars. Toddler DQI scores were higher among children who were ever breastfed, lived in households with higher incomes, and who were Hispanic. The Toddler DQI performed as expected and offers a measurement tool to assess the dietary quality of young children in accordance with federal nutrition guidelines. This is important for providing guidance that can be used to inform public health nutrition policies, programs, and practices to improve diets of young children.

Food and Nutrient Intake and Diet Quality among Older Americans

Article

Full-text available

Feb 2021

Objective A suboptimal diet and nutritional deficiencies can have important influences on health with significant impact among older adults. This study aims to assess the presence of suboptimal dietary intake among older Americans and identify risk and protective factors influencing diet quality. Design Cross-sectional secondary analysis Setting United States Participants A nationally representative sample of 5,614 community-dwelling older adults over age 54 in the Health and Retirement Study – Health Care and Nutrition Survey Results Overall, only 10.7% of respondents had a good quality diet (HEI score 81 and above); the majority had diets considered poor or needing improvement. Less than 50% of respondents met dietary guidelines and nutritional goals for most individual food groups and nutrients. Respondents with low socioeconomic status, fewer psychosocial resources, and those who had limited access to healthy food outlets were more likely to have a diet of suboptimal quality. Conclusions Efforts to remove identified barriers that put older adults at risk for poor nutrition and to provide resources that increase access to healthy food should be made to encourage healthy eating and enhance diet quality.

Dielectric properties of Mexican sauces for microwave‐assisted pasteurization process

Article

Full-text available

Dec 2020
J FOOD SCI

The dielectric properties and specifically the complex relative permittivity of foods are key elements for the design of pasteurization processes with high frequency electromagnetic waves. Mexican sauces are recognized worldwide for their flavor and nutritional properties. In this work, the complex permittivity of four of the most representative sauces of Mexican cuisine (chipotle chili, habanero chili, red and green sauce) is presented. The permittivity was measured with the open coaxial probe method at temperatures of 25, 40, 55, 70, 85 °C and in the frequency range of 500 MHz to 6 GHz. Additionally, moisture content, specific heat, viscosity, water activity, density and electrical conductivity are reported, these last three at 25 °C. Dielectric properties were affected by the sauce formulation. The loss factor of each sauce sample at any temperature presents significant changes in relation to the frequency. At 915 and 2,450 MHz, dε′′dT>0, which would cause a thermal runaway effect or the uncontrolled rise in temperature in the sauces during the microwave pasteurization. At 5,800 MHz, dε′′dT<0, which would give better control for microwave heating than at 915 and 2,450 MHz. At 915 MHz, the loss factor of all sauces is higher than at 2,450 and 5,800 MHz, therefore, more rapid heating can be produced. Moreover, at 915 MHz, microwaves exhibit higher penetration depth than at 2,450 and 5,800 MHz; therefore, at 915 MHz, the greatest uniform microwave dielectric heating would be achieved. Thus, 915 MHz is the frequency recommended for the studied sauces pasteurization. Practical Application This work provides the dielectric properties of Mexican sauces at different temperatures and their penetration depths in the microwave range, which are key information for further microwave‐assisted pasteurization process and for getting safer sauces for consumers. Moreover, this research supplies suggestions about what frequency for ISM (Industrial, Scientific and Medical) applications is the best for microwave‐assisted pasteurization according to the penetration depth of the electromagnetic wave in the sauces and microwave dielectric heating speed of the sauces.

The Impact of Childhood Growth Stunting and Post-Migration Dysbiosis on the Development of Metabolic Syndrome Among Indigenous Immigrant Mexican Women

Article

Full-text available

Jul 2020
BIOL RES NURS

While weight gain is common following migration to a new country and Mexican Americans have a disparate prevalence of overweight and obesity. In particular, Mexican American women have one of the world's highest rates of Metabolic Syndrome (MetS), characterized by abdominal obesity, insulin resistance, hypertension, and dyslipidemia, all of which increase the risk for atherosclerotic cardiovascular disease (CVD). Although the etiology of this dilemma is not well understood, using the framework of allostatic load (AL), we posit that exposure to multiple physiologic, psychosocial and environmental stressors over the course of the lifespan may contribute to an increased risk of MetS among indigenous Mexican immigrant women. Two such frequently overlooked stressors are: 1) a history of childhood growth stunting (CGS) and 2) dietary changes post migration that result in decreased diversity of the gut microbiome (dysbiosis). To date, little is known about how migration experiences differentially affect the relationship between CGS and MetS in adulthood. The purpose of this theoretical article is to present a proposed model of how early life stressors (ELS), specifically CGS, may interact with insalubrious aspects of the immigration experience to promote an increased risk for MetS among indigenous Mexican immigrant women. This model may be used in a bi-national effort to guide intervention efforts to decrease CGS in Mexico and to prevent, monitor or delay the components of MetS post migration in the US.

Diet and Cancer Prevention Research: From Mechanism to Implementation

Article

Full-text available

Jun 2020

Johanna W Lampe

Between 30% to 50% of cancer cases are estimated to be preventable through reduced exposure to tobacco, occupational carcinogens, and infectious agents, and adoption of lifelong healthy eating and a physically active lifestyle. In the past, diet and cancer prevention research has aimed to understand the effects of specific foods and nutrients on cancer-related mechanisms. More recently, there has been a shift in emphasis toward a more holistic focus on patterns of diet, reflecting the goal to understand the impact of adhering to broader public health recommendations. It is increasingly apparent from observational studies that different patterns of diet and physical activity are manifest in a metabolic state that is more, or less, conducive to the acquisition of genetic and epigenetic alterations leading to carcinogenesis. Experimental studies in cell systems, animals and humans have expanded our understanding of the many mechanisms by which specific dietary constituents may modulate inflammation and immune function, carcinogen metabolism, hormone and growth-factor regulation, DNA repair capacity, cell-cycle control, and proliferation and apoptosis. However, few mechanistic studies in animal models have evaluated diets containing the complex mixtures that make up human diets. Overall, more studies are needed across the continuum of prevention research, from basic mechanistic research on the effects of diet patterns on fundamental biologic processes to studies testing the efficacy of implementing lifestyle-directed cancer prevention strategies.

Traditional Mexican foods as functional agents in the treatment of cardiometabolic risk factors

Article

Apr 2020

Major cardiometabolic risk phenotypes include insulin resistance (IR), hyperinsulinemia, overweight, obesity and dyslipidemia, which contribute to the current prevalent chronic disease pandemia worldwide. Among traditional treatments, dietary habits represent one of the most difficult and controversial aspects to implement in handling metabolic disturbances. The use of herbal remedies by latinos and hispanics, as part of self-care of metabolic diseases has been well documented in several studies, mainly because they are “natural”, consistent with their culture, family-related, accessible, and affordable. Phytochemicals are present in fruits, vegetables and various plants, and constitute nonessential nutrients such as vitamins or minerals, many of them being consumed in a popular way or used as herbal remedies or dietary supplements. In this narrative review, we present evidence on traditional endemic Mexican foods such as cacao, corn, common bean, prickle pear, chili, avocado and salba-chia as functional agents to improve the metabolic status in risk phenotypes.

A Review of Recent Evidence from Meal-Based Diet Interventions and Clinical Biomarkers for Improvement of Glucose Regulation

Article

Full-text available

Mar 2020

In recent decades, the prevalence of diabetes has rapidly increased worldwide. Medical nutrition therapy has been identified as a major therapeutic support for diabetic patients, while preventive strategies in prediabetic or high-risk individuals have mainly focused on supplementation with bioactive compounds. Recently, meal-based interventions have been investigated as novel and safe long-term strategies for improving glucose regulation. However, evaluation of meal-based interventions is difficult since it requires analysis of sensitive markers. Biomarkers can also be used to identify individuals at risk for diabetes, which is important for disease prevention. In this review, we summarize current evidence from meal-based intervention studies conducted with the aim of improving glucose homeostasis in individuals at risk of diabetes using clinical biomarkers currently used to assess diabetic risk. Very low-calorie diets have significantly improved glucose regulation in obese adults and in adults with type 2 diabetes mellitus. In particular, changing the ratios of macronutrients through calorie restriction reduces fasting glucose level and hemoglobin A1c levels in patients with diabetes mellitus. However, this effect is limited in both obese and healthy adults. To date, multiple glucose-related markers have been identified as clinical biomarkers of diabetes. Additional clinical biomarkers include cholesterol levels, hematological markers, and inflammatory markers. Taken together, the evidence presented in this review may help for selection of clinical biomarkers for meal-based preventive approaches for non- or pre-diabetic individuals to prevent onset of diabetes.

Participatory Methods to Identify Perceived Healthy and Sustainable Traditional Culinary Preparations across Three Generations of Adults: Results from Chile's Metropolitan Region and Region of La Araucanía

Article

Full-text available

Feb 2020

Traditional diets reflect different cultures and geographical locations, and may provide healthy diet options. In Chile, it is unknown whether traditional culinary preparations are still remembered, let alone consumed. Therefore, we adapted methods to identify traditional culinary preparations for healthy and sustainable dietary interventions. In Chile's Metropolitan Region and the Region of La Araucanía, we collected data on the variety of traditional diets through cultural domain analyses: direct participant observation (n = 5); free listing in community workshops (n = 10); and pile sort activities within semi-structured individual interviews (n = 40). Each method was stratified by age (25-45 year, 46-65 year and ≥ 65 year) and ethnic group (first nations or not). About 600 preparations and single-ingredient foods were identified that differed both in frequency and variety by region. The foods most consumed and liked (n = 24-27) were ranked in terms of sustainability for public nutrition purposes. Methods originally designed to collect information about plants of indigenous peoples can be extended to collect data on the variety of existing traditional culinary preparations, globally. Context, both geographical and cultural, matters for understanding food variety, and its subsequent use in the design of healthy and sustainable diet interventions.

Adoption of corporate governance practices in the computer science environment. Mexican food franchise analysis in the Colombian context

Article

Full-text available

Nov 2019

In a globalized world characterized by aggressive competition in all sectors of the economy, it is essential that organizations establish adequate corporate governance in order to properly coordinate interests within the organization to generate wealth. One of the models associated with corporate governance is the balanced scorecard consisting of four perspectives. This work provides an important input to consider within the organizational goals in the perspective of the balanced scorecard client in Mexican food franchises in Cali - Colombia, as is the client’s knowledge. The research approach is mixed and predominantly descriptive. As a result of the study there is a consumer profile in Mexican food franchises in the city of Cali. Thus, the average consumer of Mexican food is a young person, of medium socioeconomic status and who shares in family the consumption of this type of food. In addition, the study identifies the main variables that determine the decision to consume Mexican food, such as the possibility of home shopping through mobile applications, hygiene and food presentation.

Sauces: An undiscovered healthy complement in Mexican cuisine

Article

Apr 2019

Gastronomic differences between the countries cuisines around the world were largely defined due to the diversification of the use of spices and condiments during the European colonization of America, Asia and Africa. Hence, gastronomy tells the story of thousands of generations in a country and contains the culture of the population in multiple combinations of vegetables, types of meats or spices that depends on the geographical conditions. Particularly, the Mexican diet has been studied in a limited way but the findings of its consumption could ameliorate health status. Pre-Hispanic cultures developed many different dishes that still consumed nowadays. Surprisingly, Mexican population is developing acculturation, which includes lower intake of their most healthy traditional food, and so on, one of them are Mexican sauces, a mixture with hot pepper, tomato, husk tomato, onion, garlic, coriander and salt. It should be noted that the most common ingredients of Mexican sauces have been studied isolated but not combined, as they are frequently consumed. In addition, the potential health effects of the bioactive compounds (BC) that could be found in this staple Mexican food still undiscovered. In this review, the main BC present in common Mexican sauces ingredients and the effects of processing in the content of these compounds are stated in this review.

Associations Between Sociodemographic Factors and Adolescent Food Consumption During Independent Eating Occasions

Article

Dec 2024
ECOL FOOD NUTR

Associations were examined between sociodemographic characteristics of a US online survey sample of caregiver/adolescent dyads (n = 533) and food intake during independent eating occasions. Caregivers reported sociodemographic characteristics for dyads. Adolescents reported daily intake frequency of sugar-sweetened beverages, junk foods, sugary foods, fast food, and fruits and vegetables during independent eating occasions. Logistic regression analysis showed increased odds of sugar-sweetened beverage intake by White vs. Asian counterparts, decreased odds of sugary food intake by age (12 vs. 11-year-olds) and increased odds of sugary food intake by weight status (overweight/obesity vs. normal weight). Understanding these relationships may inform future intervention development.

Measuring Dietary Quality Among Toddlers in the Feeding Infants and Toddlers Study, 2016 Using the New Healthy Eating Index-Toddlers-2020

Article

Aug 2024

Adherence to a Traditional Mexican Diet Is Associated with Lower Hepatic Steatosis in US-Born Hispanics of Mexican Descent with Overweight or Obesity

Article

Full-text available

Dec 2023

Hispanics of Mexican descent have disproportionate rates of non-alcoholic fatty liver disease (NAFLD). The purpose of this work is to investigate the association between the traditional Mexican diet score (tMexS) and hepatic steatosis and fibrosis, two NAFLD-related clinical endpoints, in Hispanic adults of Mexican descent. Data from 280 Hispanic adults of Mexican descent (n = 102 men, 178 women) with overweight or obesity enrolled in a cross-sectional observational study were analyzed. The tMexS was calculated from 24 h dietary recalls. Hepatic steatosis and fibrosis measurements were assessed using transient elastography (Fibroscan®). Linear regression models testing the association between tMexS and hepatic steatosis and fibrosis were run individually and through the stratification of significant modifiers. Mean tMexS were 5.9 ± 2.1, hepatic steatosis scores were 288.9 ± 48.9 dB/m, and fibrosis scores were 5.6 ± 2.2 kPa. Among the US-born group, with every point increase in the tMexS, there was a statistically significant 5.7 lower hepatic steatosis point (95% CI: −10.9, −0.6, p-value = 0.07). Higher adherence to a traditional Mexican diet was associated with lower hepatic steatosis in US-born Hispanics of Mexican descent. Findings from the current work may serve to inform future culturally relevant interventions for NAFLD prevention and management in individuals of Mexican descent.

Impact of a Pharmacist-Led Diabetes Care Service for Hispanic Patients at a Free Medical Clinic

Article

Mar 2023
Clin Diabetes

This article describes a pharmacist-led diabetes care program implemented at a local free clinic for underserved Hispanic patients with low or no income. Patients are referred to the pharmacist after diagnosis with diabetes for a consultation that includes disease state education, diet/lifestyle education, medication management, and follow-up. The pharmacist works with patients to ensure timely follow-up and adequate medication adjustments to achieve goals. In its first 16 months, this service led to a statistically significant decrease in A1C for Hispanic patients, with an average 2 percentage point reduction in A1C.

Comparing diet quality indices for low-income 24-month-olds: exploring changes driven by 2020-2025 Dietary Guidelines for Americans

Article

Dec 2022
J NUTR

Background: Accurate assessment of toddler diet quality is essential for understanding current intakes and evaluating the effect of interventions and programs to promote healthy eating and prevent chronic disease. Objectives: The goal of this article was to assess the diet quality among toddlers using two different indices appropriate for 24-mo-old toddlers and compare differences in scoring between the measures by race and Hispanic origin. Methods: We used cross-sectional data from 24-mo-old toddlers participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Infant and Toddler Feeding Practices Study-2 (ITFPS-2), a national study that includes 24-hour dietary recall information from children enrolled in WIC at birth. The main outcome measure was diet quality using both the toddler diet quality index (TDQI) and the healthy eating index (HEI)-2015. We derived mean scores for overall diet quality and for each component. We examined associations between the distribution of diet quality scores across terciles and by race and Hispanic origin using Rao-Scott chi-square tests of association. Results: Nearly half of the mothers and caregivers self-identified as Hispanic (49%). Diet quality scores were higher when using the HEI-2015 compared with the TDQI (56.4 vs. 49.9, respectively). The difference in component scores was largest for refined grains, followed by sodium, added sugars, and dairy. Toddlers from Hispanic mothers and caregivers had significantly higher component scores for greens and beans and dairy but had lower scores for whole grains (P < 0.05) than those for the other racial and ethnic subgroups assessed. Conclusions: We found noteworthy differences in toddler diet quality depending on whether the HEI-2015 or TDQI is used, and children of different racial and ethnic subgroups may be differentially classified as having high or low diet quality depending on which index is used. This may have important implications for understanding which populations are at risk of future diet-related diseases.

Enhancing Capacity for Food and Nutrient Intake Assessment in Population Sciences Research

Article

Dec 2022

Nutrition influences health throughout the life course. Good nutrition increases the probability of good pregnancy outcomes, proper childhood development, and healthy aging, and it lowers the probability of developing common diet-related chronic diseases, including obesity, cardiovascular disease, cancer, and type 2 diabetes. Despite the importance of diet and health, studying these exposures is among the most challenging in population sciences research. US and global food supplies are complex; eating patterns have shifted such that half of meals are eaten away from home, and there are thousands of food ingredients with myriad combinations. These complexities make dietary assessment and links to health challenging for both population sciences research and for public health policy and practice. Furthermore, most studies evaluating nutrition and health usually rely on self-report instruments prone to random and systematic measurement error. Scientific advances involve developing nutritional biomarkers and then applying these biomarkers as stand-alone nutritional exposures or for calibrating self-reports using specialized statistics. Expected final online publication date for the Annual Review of Public Health, Volume 44 is April 2023. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Programas de intervención de estilo de vida para la adquisición de hábitos saludables y prevención de enfermedades cardiometabólicas adaptadas al aislamiento en casa ante la pandemia por la COVID-19: una revisión

Article

Full-text available

Jun 2022

El sobrepeso y la obesidad son los principales factores de riesgo de las enfermedades cardiometabólicas, entre ellas la diabetes mellitus tipo 2. En el año 2016 se reportó que en México el sobrepeso y obesidad afectaba al 72.5% de la población adulta, mientras que en el 2019 se estimó que 10% de la población tenía diabetes. Estas cifras tan alarmantes se deben, entre otros factores, al alto consumo de alimentos no saludables que prevalece en la población mexicana, el bajo nivel de actividad física y factores conductuales como el tabaquismo. Además, durante el último año, el encierro por la pandemia de COVID-19 se ha sumado entre los factores de riesgo de dichas condiciones. Debido a que el estilo de vida es uno de los determinantes de estas enfermedades, se deduce que la intervención en el estilo de vida debe ser una parte fundamental del tratamiento de las mismas. Por lo tanto, esta revisión tiene como objetivo evaluar el estado actual del conocimiento de los programas de intervención en el estilo de vida, así como los componentes claves que conforman dichos programas, que permitan disminuir el riesgo cardiometabólico de la población vulnerable. De acuerdo a los resultados analizados de la eficacia de algunas intervenciones del estilo de vida que han sido reportadas como casos de éxito para la adquisición de hábitos saludables, es clara la necesidad de incluir cada uno de los componentes para lograr el control, prevención o retraso del diagnóstico de enfermedades cardiometabólicas. Sin embargo, hace falta mayor análisis e investigación de programas realizados en condiciones específicas de salud y del grupo de población al que se aplicarían, para evaluar su eficacia en la situación actual que vive la población vulnerable.

A Systematic Review of Literature On the Representation of Racial and Ethnic Minority Groups in Clinical Nutrition Interventions

Article

Feb 2022

The racial and ethnic disparities in diet-related chronic diseases are major concerns. This systematic review examines the extent to which diet-induced changes in health outcomes such as cardiometabolic, inflammation, cancer, bone health, kidney function outcomes etc., have been reported and discussed by race or ethnicity in randomized trials with 2 or more diet arms that recruited both minority and non-Hispanic White groups. Databases i.e., PubMed, Cochrane library and Web of Science were searched up to August 2021. Thirty-four studies that discussed effects of defined dietary interventions on health outcomes by racial or ethnic minority group vs. non-Hispanic Whites were included in the systematic review (PROSPERO registration number: CRD42021229256). Acute trials and those with one diet arm that accounted for race or ethnicity in their analyses, and studies that focused on a single racial or ethnic group were discussed separately. Most studies were conducted in Black vs. White adults testing effects of energy restriction, macronutrient modification, sodium reduction, or variations of the Dietary Approaches to Stop Hypertension (DASH) diet on cardiometabolic outcomes. There was limited focus on other minority groups. Evidence suggests greater blood pressure reduction for Black adults compared to Whites particularly on DASH (or similar) diets. Overall, there was limited consideration for group-specific eating patterns and diet acceptability. Overall risk of bias was low. With emerging precision nutrition initiatives that aim to optimize metabolic responses in population subgroups through tailored approaches, it is imperative to ensure adequate representation of racial and ethnic subgroups for addressing health disparities. Factors that help explain variability in responses such as socioecological context should be included and adequately powered. Given the racial and ethnic disparities in chronic diseases, studying the adoption, maintenance, and effectiveness of dietary interventions on health outcomes among different groups is critical for developing approaches that can mitigate diet-related health disparities.

A step forward to control of COVID-19

Article

Jun 2020

Discovery of the reasons for the COVID-19 infection in humans, the nature of its spread and the methods of its medical, nutritional and environmental tolerance are very important factors to control the spread of COVID-19 and human recovery from this fierce virus. The objective of this study was to evaluate pharmacological, nutritional and environmental treatments that lead to the control of COVID-19 spread. Here, we confirm that this article carries a better tomorrow and a bright future for humanity. This study assumes that a patient with COVID-19 should be treated medically by the proposed antiviral drug in this article. A diet that is low in absorbable iron (Fe2+) by using low amounts of vitamin C and high amounts of tannins or phytate inhibited Fe2+ absorption. During virus spread, the following nutritional treatments should be avoided or reduced such as oysters, red meat and bats, as well as processed foods, ready-made foods, alcohol and milk. On contrary, some other foods should be increased such as poultry, fish and bread, as well as vegetables that contain a high level of sulfur such as onions and cabbage with using salt in this food. Some drinks should be increased such as chicken soup, coffee, cappuccino, black, red and green tea, mint and plenty of water. With respect to environmental treatments, it should be decreasing or changing the industrial activity to reduce toxic gas emissions in the atmosphere. The death toll was estimated at about 6.56% of the number of people infected with the virus, indicating that the diet system contributed significantly to tolerate the disease. Direct contact contributed positively in COVID-19 spreading by 84.73%. Growing plants (separately or intercropped) around homes contribute positively to reduce air pollutants and increase oxygen in the atmosphere.

A Systematic Review of Literature on Representation of Racial and Ethnic Minority Groups in Clinical Nutrition Interventions

Preprint

Full-text available

Jan 2021

There is a disproportionate increase in the incidence of diet-related cardiometabolic disorders in racial and ethnic minority groups. This systematic review examines the extent to which diet-induced changes in health outcomes have been discussed by race or ethnicity in randomized controlled trials recruiting both minority and non-Hispanic White groups. Databases i.e. PubMed, Cochrane library and Web of Science were searched up to November 2019. Studies that discussed effects of defined dietary interventions on health outcomes by racial or ethnic minority group vs. non-Hispanic Whites (n=29) were included in the review. Most studies were conducted in Black vs. White people testing effects of energy restriction, macronutrient modification, sodium reduction, or variations of the Dietary Approaches to Stop Hypertension (DASH) diet on cardiometabolic outcomes. There was limited focus on other minority groups. Evidence suggests greater blood pressure reduction for Black people compared to Whites particularly on DASH (or similar) diets. Overall, there was limited consideration for group-specific eating patterns and diet acceptability in most studies. Adequately powered studies are needed for accurate interpretation of race by diet effects. With emerging precision nutrition initiatives, it is imperative to ensure adequate representation of racial and ethnic subgroups for addressing nutrition-related health disparities.

Special Concerns Through an Early Pregnancy Journey

Article

Jul 2016

Nutrition and supplementation in the woman of reproductive age can have profound and lasting effects on her child’s health. Preconceptional planning for all women should include advice to begin folic acid supplementation at 400 μg/d as a means to prevent neural tube defects. Under some circumstances, it is recommended that a woman take a higher dose. Lifestyle interventions include reaching a healthy body weight before conception. The focus of preconceptional weight loss should be on cutting empty-calorie foods and increasing nutrient-dense foods such as fruits and vegetables, whole grains, dairy and lean meats, poultry, and fish. Increasing physical activity before becoming pregnant will have benefits in helping cope with some of the unpleasant side effects associated with pregnancy. Some women require physician assessment to determine the appropriate program. One of the most common side effects of pregnancy is “morning sickness,” with up to 80% of women experiencing nausea and vomiting at some point, usually beginning between the 4th and 7th weeks after their last menses and ending for most by the 20th week. For 10% of those women, it remains an ongoing battle throughout the pregnancy. Some women self-treat with herbs. Healthcare professionals should become skilled in patient activation and culturally appropriate counseling skills. We present a case from our Family Medicine practice to demonstrate an approach to the issues of prevention of neural tube defects and treatment of morning sickness in an overweight Hispanic woman living in a rural area of the United States.

Assessing Diet Quality in a Racially and Ethnically Diverse Cohort of Low-Income Toddlers

Article

Jul 2020

Background: Low-income racially and ethnically diverse children are at higher risk for obesity compared with their counterparts; yet, few studies have assessed their diet quality. Objective: To evaluate the diet quality of a racially and ethnically diverse cohort of 2-year-olds using the Healthy Eating Index (HEI)-2010. Methods: We used 24-hour dietary recall data from caregivers of toddlers (24-34 months) at 4 pediatric resident clinics that participated in the Greenlight Study to calculate compliance with the Dietary Guidelines for Americans (DGA) using total HEI score (range 0-100) and 12 component scores. Results: Participants (n = 231) were mostly Hispanic (57%) or non-Hispanic black (27%) and from low-income families. Mean HEI-2010 score was 62.8 (SD 10.5). Though not significant, Hispanics had the highest HEI score. Toddlers of caregivers without obesity, older than 35 years and born outside the U.S. had higher HEI scores. Most had high HEI component scores for dairy, fruit, and protein foods, but few achieved maximum scores, particularly for whole grains (13%), vegetables (10%), and fatty acid ratio (7%). Conclusion: Despite scores reflective of DGA recommendations for fruit, dairy and protein foods, toddlers in this diverse sample had low quality diets as measured by the HEI, driven largely by low component scores for whole grains, vegetables and ratio of unsaturated to saturated fatty acids.

Características sociodemográficas de los consumidores de comida mexicana “TEX-MEX” en Cali-Colombia

Article

Full-text available

Sep 2019

Jonathan Virgüez

This article is supported by the inquiry "Mexican Food Consumption" Tex-Mex "in the Metropolitan Area of the City of Cali. A case analysis ”was promoted based on a mixed approach, where sociodemographic variables were examined and calculated; the peculiarities of consumers such as: individual and parental precedents for the consumption of Tex-Mex food, purchase motivations, consumption patterns and the abandonment of consumption towards products, the different forms of consumption where consumption patterns were investigated, means of consumption, customs and habits of consumers; In addition, economic, educational, family and health problems. This research is based on sociodemographic variations and certain particularities of consumers. Through 84 interviews with users of the Buffet Mexican Buffet franchises, which were located in different establishments of this brand; to those who were administered a semi-structured interview, the result of a pilot test and corroborated by experts, the results were analyzed in the INFOSTAT Software, where they prevailed: that men predominate as the main consumers of Tex-Mex food, particularly single and without children, aged between 14 and 45, with university studies, most of them located socioeconomically in the middle stratum and with family precedents of second degree of consanguinity and affinity, promoting the consumption of this type of food at an early age, between 14 and 21 years approximately, where a history of Tex-Mex food consumption is displayed.

Dietary pattern, inflammation, and incidence of type 2 diabetes in women

Article

Full-text available

Sep 2005

Prevalence of Obesity and Trends in the Distribution of Body Mass Index Among US Adults, 1999–2010

Article

Full-text available

Jan 2012

Global, Regional, and National Prevalence of Overweight and Obesity in Children and Adults during 1980–2013: A Systematic Analysis for the Global Burden of Disease Study 2013

Article

Full-text available

Aug 2014

Background: In 2010, overweight and obesity were estimated to cause 3·4 million deaths, 3·9% of years of life lost, and 3·8% of disability-adjusted life-years (DALYs) worldwide. The rise in obesity has led to widespread calls for regular monitoring of changes in overweight and obesity prevalence in all populations. Comparable, up-to-date information about levels and trends is essential to quantify population health effects and to prompt decision makers to prioritise action. We estimate the global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013. Methods: We systematically identified surveys, reports, and published studies (n=1769) that included data for height and weight, both through physical measurements and self-reports. We used mixed effects linear regression to correct for bias in self-reports. We obtained data for prevalence of obesity and overweight by age, sex, country, and year (n=19,244) with a spatiotemporal Gaussian process regression model to estimate prevalence with 95% uncertainty intervals (UIs). Findings: Worldwide, the proportion of adults with a body-mass index (BMI) of 25 kg/m(2) or greater increased between 1980 and 2013 from 28·8% (95% UI 28·4-29·3) to 36·9% (36·3-37·4) in men, and from 29·8% (29·3-30·2) to 38·0% (37·5-38·5) in women. Prevalence has increased substantially in children and adolescents in developed countries; 23·8% (22·9-24·7) of boys and 22·6% (21·7-23·6) of girls were overweight or obese in 2013. The prevalence of overweight and obesity has also increased in children and adolescents in developing countries, from 8·1% (7·7-8·6) to 12·9% (12·3-13·5) in 2013 for boys and from 8·4% (8·1-8·8) to 13·4% (13·0-13·9) in girls. In adults, estimated prevalence of obesity exceeded 50% in men in Tonga and in women in Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa. Since 2006, the increase in adult obesity in developed countries has slowed down. Interpretation: Because of the established health risks and substantial increases in prevalence, obesity has become a major global health challenge. Not only is obesity increasing, but no national success stories have been reported in the past 33 years. Urgent global action and leadership is needed to help countries to more effectively intervene. Funding: Bill & Melinda Gates Foundation.

Breast cancer and dietary patterns: A systematic review

Article

Full-text available

Dec 2013
NUTR REV

This systematic review collates research on the topic of dietary patterns and breast cancer risks. The literature search targeted epidemiological studies published up to December 2012 and was conducted using the Medline (U.S. National Library of Medicine, Bethesda MD, USA) and Lilacs (Latin American and Caribbean Health Sciences, São Paulo, Brazil) databases. The following search terms were used: breast cancer, breast neoplasm, breast carcinoma, diet, food, eating habits, dietary patterns, factor analysis, and principal component analysis. Only studies that used factor analysis techniques and/or principal component analysis were eligible, and a total of 26 studies were included. The findings of these studies suggest the Mediterranean dietary pattern and diets composed largely of vegetables, fruit, fish, and soy are associated with a decreased risk of breast cancer. There was no evidence of an association between traditional dietary patterns and risk of breast cancer, and only one study showed a significant increase in risk associated with the Western dietary pattern. Diets that include alcoholic beverages may be associated with increased risk.

New Measure of Insulin Sensitivity Predicts Cardiovascular Disease Better than HOMA Estimated Insulin Resistance

Article

Full-text available

Sep 2013
PLOS ONE

Accurate assessment of insulin sensitivity may better identify individuals at increased risk of cardio-metabolic diseases. To examine whether a combination of anthropometric, biochemical and imaging measures can better estimate insulin sensitivity index (ISI) and provide improved prediction of cardio-metabolic risk, in comparison to HOMA-IR. Healthy male volunteers (96 Chinese, 80 Malay, 77 Indian), 21 to 40 years, body mass index 18-30 kg/m(2). Predicted ISI (ISI-cal) was generated using 45 randomly selected Chinese through stepwise multiple linear regression, and validated in the rest using non-parametric correlation (Kendall's tau τ). In an independent longitudinal cohort, ISI-cal and HOMA-IR were compared for prediction of diabetes and cardiovascular disease (CVD), using ROC curves. The study was conducted in a university academic medical centre. ISI measured by hyperinsulinemic euglycemic glucose clamp, along with anthropometric measurements, biochemical assessment and imaging; incident diabetes and CVD. A combination of fasting insulin, serum triglycerides and waist-to-hip ratio (WHR) provided the best estimate of clamp-derived ISI (adjusted R(2) 0.58 versus 0.32 HOMA-IR). In an independent cohort, ROC areas under the curve were 0.77±0.02 ISI-cal versus 0.76±0.02 HOMA-IR (p>0.05) for incident diabetes, and 0.74±0.03 ISI-cal versus 0.61±0.03 HOMA-IR (p<0.001) for incident CVD. ISI-cal also had greater sensitivity than defined metabolic syndrome in predicting CVD, with a four-fold increase in the risk of CVD independent of metabolic syndrome. Triglycerides and WHR, combined with fasting insulin levels, provide a better estimate of current insulin resistance state and improved identification of individuals with future risk of CVD, compared to HOMA-IR. This may be useful for estimating insulin sensitivity and cardio-metabolic risk in clinical and epidemiological settings.

Racial/Ethnic disparities in association between dietary quality and incident diabetes in postmenopausal women in the United States: The Women's Health Initiative 1993- 2005

Article

Full-text available

May 2013
ETHNIC HEALTH

Objective: To examine the association of dietary quality and risk of incident diabetes overall and by race/ethnicity among postmenopausal women enrolled in the Women's Health Initiative (WHI). Research methods and procedures: The WHI recruited 161,808 postmenopausal women between 1993 and 1998, and followed them until 2005. Incident diabetes was determined annually over an average of 7.6 years from enrollment. At baseline, all participants completed a Food Frequency Questionnaire (FFQ). Dietary quality was assessed by the Alternate Healthy Eating Index (AHEI), calculated from the baseline FFQ responses. Results: There were 10,307 incident cases of self-reported treated diabetes over 1,172,761 person-years of follow-up. Most participants did not meet the AHEI dietary goals; that is, only 0.1% of women met or exceeded the recommended consumption of vegetables, and few (17.3%) met or exceeded the recommended level for total fiber. After adjusting for potential confounders, women in the highest quintile of the AHEI score were 24% less likely to develop diabetes relative to women in the lowest quintile of AHEI [hazard ratio (HR)=0.76 (95% CI: 0.70-0.82)]. This association was observed in Whites [HR=0.74 (95% CI: 0.68-0.82)] and Hispanics [HR=0.68 (95% CI: 0.46-0.99)], but not in Blacks [HR=0.85 (95% CI: 0.69-1.05)] or Asians [HR=0.88 (95% CI: 0.57-1.38)]. Conclusion: These findings support a protective role of healthful eating choices in reducing the risk of developing diabetes, after adjusting for other lifestyle factors, in White and Hispanic postmenopausal women. Future studies are needed to investigate the relationship between dietary quality and risk of diabetes among Blacks and Asians in relationship to other lifestyle factors.

Waist Circumference Independently Associates with the Risk of Insulin Resistance and Type 2 Diabetes in Mexican American Families

Article

Full-text available

Nov 2013
PLOS ONE

In spite of the growing recognition of the specific association of waist circumference (WC) with type 2 diabetes (T2D) and insulin resistance (IR), current guidelines still use body mass index (BMI) as a tool of choice. Our objective was to determine whether WC is a better T2D predictor than BMI in family-based settings. Using prospectively collected data on 808 individuals from 42 extended Mexican American families representing 7617.92 person-years follow-up, we examined the performance of WC and BMI as predictors of cumulative and incident risk of T2D. We used robust statistical methods that accounted for the kinships and included polygenic models, discrete trait modeling, Akaike information criterion, odds ratio (OR), relative risk (RR) and Kullback-Leibler R(2). SOLAR software was used to conduct all the data analyses. We found that in multivariate polygenic models, WC was an independent predictor of cumulative (OR = 2.76, p = 0.0002) and future risk of T2D (RR = 2.15, p = 3.56×10(-9)) and outperformed BMI when compared in a head-to-head fashion. High WC (≥94.65 cm after adjusting for age and sex) was also associated with high fasting glucose, insulin and triglyceride levels and low high-density lipoprotein levels indicating a potential association with IR. Moreover, WC was specifically and significantly associated with insulin resistant T2D (OR = 4.83, p = 1.01×10(-13)). Our results demonstrate the value of using WC as a screening tool of choice for future risk of T2D in Mexican American families. Also, WC is specifically associated with insulin resistant T2D.

Adherence to the Mediterranean diet and risk of bladder cancer in the EPIC cohort study

Article

Full-text available

May 2014
INT J CANCER

Epidemiological evidence suggests the Mediterranean diet (MD) could reduce risk of breast cancer (BC). Since evidence from prospective studies is still scarce and conflicting, we investigated the association between adherence to the MD and risk of BC among 335,062 women recruited from 1992-2000, in 10 European countries, and followed for 11 years on average. Adherence to the MD was estimated through an adapted relative Mediterranean diet (arMED) score excluding alcohol. Cox proportional hazards regression models were used while adjusting for BC risk factors. A total of 9,009 postmenopausal and 1,216 premenopausal first primary incident invasive BC were identified (5,862 estrogen or progesterone receptor positive (ER+/PR+) and 1,018 estrogen and progesterone receptor negative (ER-PR-)). The arMED was inversely associated with risk of BC overall and in postmenopausal women (high versus low arMED score; HR 0.94 (95% CI: 0.88, 1.00) p(trend) =0.048, and HR 0.93 (95% CI: 0.87, 0.99) p(trend) =0.037, respectively). The association was more pronounced in ER-PR- tumors (HR 0.80 (95% CI: 0.65, 0.99) p(trend) =0.043). The arMED score was not associated with BC in premenopausal women. Our findings show that adherence to a MD excluding alcohol was related to a modest reduced risk of BC in postmenopausal women, and this association was stronger in receptor negative tumors. The results support the potential scope for BC prevention through dietary modification. © 2012 Wiley Periodicals, Inc.

Obesity as a risk factor for triple-negative breast cancers: A systematic review and meta-analysis

Article

Full-text available

Nov 2012
BREAST CANCER RES TR

Triple-negative breast cancer (TNBC) is a subtype of breast tumor with unique characteristics in terms of clinical-pathological presentation, prognosis, and response to therapy. Epidemiological investigations focusing on the identification of risk factors involved in the onset and progression of TNBCs have identified unique demographic, anthropometric, and reproductive characteristics involved in the etiopathogenesis of this subtype of breast tumors. This systematic review and meta-analysis evaluates the association between TNBCs and obesity and menopause status. Eligible articles were identified through three databases and secondary reference analysis. The search was conducted from the first record to February 2012. Eleven original articles meeting a priori established inclusion criteria were incorporated in the quantitative analysis. Case-case and case-control comparisons were performed. In addition, a case-case comparison was conducted before and after stratification according to menopausal status. Based on the level of between-study heterogeneity, pooled odds ratio (OR) and 95 % confidence interval were calculated using fixed or random models. The case-case comparison showed a significant association between TNBC and obesity (OR: 1.20; 95 % CI: 1.03-1.40). These results were confirmed by the case-control comparison (OR: 1.24; 95 % CI: 1.06-1.46). Once stratification based on menopausal status was applied to the case-case analysis, significant results were observed only in the pre-menopausal group (OR: 1.43; 95 % CI: 1.23-1.65). According to this analysis, obese women are at a greater risk of presenting with a TNBC than non-obese women, and menopause status may be a mitigating factor. If validated, these findings should be taken into consideration for the development of targeted preventive programs.

Glycemic load effect on fasting and post-prandial serum glucose, insulin, IGF-1 and IGFBP-3 in a randomized, controlled feeding study

Article

Full-text available

Aug 2012

Background/Objectives The effect of a low glycemic load (GL) diet on insulin-like growth factor-1 (IGF-1) concentration is still unknown but may contribute to lower chronic disease risk. We aimed to assess the impact of GL on concentrations of IGF-1 and IGFBP-3. Subjects/Methods We conducted a randomized, controlled crossover feeding trial in 84 overweight-obese and normal weight healthy individuals using two 28-day weight-maintaining high- and low-GL diets. Measures were fasting and post-prandial concentrations of insulin, glucose, IGF-1 and IGFBP-3. 20 participants completed post-prandial testing by consuming a test breakfast at the end of each feeding period. We used paired t-tests for diet-component and linear mixed models for biomarker analyses. Results The 28-day low-GL diet led to 4% lower fasting concentrations of IGF-1 (10.6 ng/mL, p=0.04) and a 4% lower ratio of IGF-1/IGFBP-3 (0.24, p=0.01) compared to the high-GL diet. The low-GL test breakfast led to 43% and 27% lower mean post-prandial glucose and insulin responses, respectively; mean incremental areas under the curve for glucose and insulin, respectively, were 64.3±21.8 (mmol/L/240min) (p<0.01) and 2253±539 (μU/mL/240min) (p<0.01) lower following the low- compared to the high-GL test meal. There was no effect of GL on mean HOMA-IR or on mean integrated post-prandial concentrations of glucose-adjusted insulin, IGF-1 or IGFBP-3. We did not observe modification of the dietary effect by adiposity. Conclusions Low-GL diets resulted in 43% and 27% lower post-prandial responses of glucose and insulin, respectively, and modestly lower fasting IGF-1 concentrations. Further intervention studies are needed to weigh the impact of dietary GL on risk for chronic disease.

Determinants of Racial/Ethnic Disparities in Incidence of Diabetes in Postmenopausal Women in the U.S.: The Women's Health Initiative 1993-2009

Article

Full-text available

Jul 2012

OBJECTIVE To examine determinants of racial/ethnic differences in diabetes incidence among postmenopausal women participating in the Women’s Health Initiative. RESEARCH DESIGN AND METHODS Data on race/ethnicity, baseline diabetes prevalence, and incident diabetes were obtained from 158,833 women recruited from 1993–1998 and followed through August 2009. The relationship between race/ethnicity, other potential risk factors, and the risk of incident diabetes was estimated using Cox proportional hazards models from which hazard ratios (HRs) and 95% CIs were computed. RESULTS Participants were aged 63 years on average at baseline. The racial/ethnic distribution was 84.1% non-Hispanic white, 9.2% non-Hispanic black, 4.1% Hispanic, and 2.6% Asian. After an average of 10.4 years of follow-up, compared with whites and adjusting for potential confounders, the HRs for incident diabetes were 1.55 for blacks (95% CI 1.47–1.63), 1.67 for Hispanics (1.54–1.81), and 1.86 for Asians (1.68–2.06). Whites, blacks, and Hispanics with all factors (i.e., weight, physical activity, dietary quality, and smoking) in the low-risk category had 60, 69, and 63% lower risk for incident diabetes. Although contributions of different risk factors varied slightly by race/ethnicity, most findings were similar across groups, and women who had both a healthy weight and were in the highest tertile of physical activity had less than one-third the risk of diabetes compared with obese and inactive women. CONCLUSIONS Despite large racial/ethnic differences in diabetes incidence, most variability could be attributed to lifestyle factors. Our findings show that the majority of diabetes cases are preventable, and risk reduction strategies can be effectively applied to all racial/ethnic groups.

Nutrition Transition in Mexico and in Other Latin American Countries

Article

Full-text available

Apr 2008
NUTR REV

Mexico and other Latin American countries are currently undergoing important demographic, epidemiologic and nutrition transitions. Noncom-municable chronic diseases such as obesity, type 2 diabetes mellitus, and high blood pressure are becoming public health problems as the population experiences an important reduction in physical activity and an increase in energy-dense diets. In contrast, the prevalence of undernutrition is declining in most countries, although several decades will be needed before the prevalence drops to acceptable values. The objective of this article is to discuss the characteristics of the nutrition transition with emphasis in data from Mexico, Brazil, and Chile

The Relation of Acculturation to Overweight, Obesity, Pre-Diabetes and Diabetes Among US Mexican-American Women and Men

Article

Full-text available

Dec 2012

To estimate and compare the prevalences of overweight, obesity, pre-diabetes and diabetes among a nationally representative sample of Mexican-American, non-Latino white and black adults, and by acculturation for Mexican-Americans. DESIGN, SETTINGS AND PARTICIPANTS: The NHANES 1999-2008 data sets were used. Binomial regression models were used to compute prevalence ratios and their respective 95% confidence intervals to assess the relationships of race/ethnicity and acculturation with obesity, overweight, pre-diabetes and diabetes. Overweight, obesity, pre-diabetes, and diabetes. Mexican Americans had a higher prevalence of overweight than white non-Latinos and Black non-Latinos. Obesity was significantly more prevalent among the most acculturated Mexican Americans but not the least acculturated. In contrast, the least acculturated Mexican Americans had the highest prevalence of overweight. The prevalence of pre-diabetes was higher among Mexican Americans than white non-Latinos and black non-Latinos. The most acculturated Mexican Americans had a higher prevalence of diabetes and the prevalence of pre-diabetes was elevated in less acculturated Mexican Americans. In both unadjusted and adjusted models, the less acculturated were significantly more likely to be overweight and significantly less likely to be obese, compared to more acculturated Mexican Americans, and acculturation was not associated with diabetes or prediabetes in adjusted models. Our results suggest that obesity was less prevalent among the least acculturated Mexican-Americans but overweight was more prevalent.

New race and ethnicity standards: elucidating health disparities in diabetes

Article

Full-text available

Apr 2012
BMC MED

The concepts of race and ethnicity are useful for understanding the distribution of disease in the population and for identifying at-risk groups for prevention and treatment efforts. The U.S. Department of Health and Human Services recently updated the race and ethnicity classifications in order to more effectively monitor health disparities. Differences in chronic disease mortality rates are contributing to race and ethnic health disparities in life expectancy in the United States. The prevalence of diabetes is higher in African Americans and Hispanics compared to white Americans, and parallel trends are seen in diabetes risk factors, including physical inactivity, dietary patterns, and obesity. Further research is required to determine the extent to which the observed differences in diabetes prevalence are attributable to differences in lifestyle versus other characteristics across race and ethnic groups.

Prevalence of Obesity and Trends in Body Mass Index Among US Children and Adolescents, 1999-2010

Article

Full-text available

Feb 2012
J Am Med Assoc

The prevalence of childhood obesity increased in the 1980s and 1990s but there were no significant changes in prevalence between 1999-2000 and 2007-2008 in the United States. To present the most recent estimates of obesity prevalence in US children and adolescents for 2009-2010 and to investigate trends in obesity prevalence and body mass index (BMI) among children and adolescents between 1999-2000 and 2009-2010. Cross-sectional analyses of a representative sample (N = 4111) of the US child and adolescent population (birth through 19 years of age) with measured heights and weights from the National Health and Nutrition Examination Survey 2009-2010. Prevalence of high weight-for-recumbent length (≥95th percentile on the growth charts) among infants and toddlers from birth to 2 years of age and obesity (BMI ≥95th percentile of the BMI-for-age growth charts) among children and adolescents aged 2 through 19 years. Analyses of trends in obesity by sex and race/ethnicity, and analyses of trends in BMI within sex-specific age groups for 6 survey periods (1999-2000, 2001-2002, 2003-2004, 2005-2006, 2007-2008, and 2009-2010) over 12 years. In 2009-2010, 9.7% (95% CI, 7.6%-12.3%) of infants and toddlers had a high weight-for-recumbent length and 16.9% (95% CI, 15.4%-18.4%) of children and adolescents from 2 through 19 years of age were obese. There was no difference in obesity prevalence among males (P = .62) or females (P = .65) between 2007-2008 and 2009-2010. However, trend analyses over a 12-year period indicated a significant increase in obesity prevalence between 1999-2000 and 2009-2010 in males aged 2 through 19 years (odds ratio, 1.05; 95% CI, 1.01-1.10) but not in females (odds ratio, 1.02; 95% CI, 0.98-1.07) per 2-year survey cycle. There was a significant increase in BMI among adolescent males aged 12 through 19 years (P = .04) but not among any other age group or among females. In 2009-2010, the prevalence of obesity in children and adolescents was 16.9%; this was not changed compared with 2007-2008.

Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA 307: 491-497

Article

Full-text available

Feb 2012
J Am Med Assoc

Between 1980 and 1999, the prevalence of adult obesity (body mass index [BMI] ≥30) increased in the United States and the distribution of BMI changed. More recent data suggested a slowing or leveling off of these trends. To estimate the prevalence of adult obesity from the 2009-2010 National Health and Nutrition Examination Survey (NHANES) and compare adult obesity and the distribution of BMI with data from 1999-2008. NHANES includes measured heights and weights for 5926 adult men and women from a nationally representative sample of the civilian noninstitutionalized US population in 2009-2010 and for 22,847 men and women in 1999-2008. The prevalence of obesity and mean BMI. In 2009-2010 the age-adjusted mean BMI was 28.7 (95% CI, 28.3-29.1) for men and also 28.7 (95% CI, 28.4-29.0) for women. Median BMI was 27.8 (interquartile range [IQR], 24.7-31.7) for men and 27.3 (IQR, 23.3-32.7) for women. The age-adjusted prevalence of obesity was 35.5% (95% CI, 31.9%-39.2%) among adult men and 35.8% (95% CI, 34.0%-37.7%) among adult women. Over the 12-year period from 1999 through 2010, obesity showed no significant increase among women overall (age- and race-adjusted annual change in odds ratio [AOR], 1.01; 95% CI, 1.00-1.03; P = .07), but increases were statistically significant for non-Hispanic black women (P = .04) and Mexican American women (P = .046). For men, there was a significant linear trend (AOR, 1.04; 95% CI, 1.02-1.06; P < .001) over the 12-year period. For both men and women, the most recent 2 years (2009-2010) did not differ significantly (P = .08 for men and P = .24 for women) from the previous 6 years (2003-2008). Trends in BMI were similar to obesity trends. In 2009-2010, the prevalence of obesity was 35.5% among adult men and 35.8% among adult women, with no significant change compared with 2003-2008.

A Low-Glycemic Load Diet Reduces Serum C-Reactive Protein and Modestly Increases Adiponectin in Overweight and Obese Adults

Article

Full-text available

Dec 2011
J NUTR

Low-glycemic load (GL) diets improve insulin resistance and glucose homeostasis in individuals with diabetes. Less is known about whether low-GL diets, independent of weight loss, improve the health profile for persons without diabetes or other preexisting conditions. We conducted a randomized, cross-over feeding study testing low- compared to High-GL diets on biomarkers of inflammation and adiposity in healthy adults. Eighty participants (n = 40 with BMI 18.5-24.9 kg/m²; n = 40 with BMI 28.0-40.0 kg/m²) completed two 28-d feeding periods in random order where one period was a high-GL diet (mean GL/d = 250) and the other a low-GL diet (mean GL/d = 125). Diets were isocaloric with identical macronutrient content (as percent energy). All food was provided and participants maintained weight and usual physical activity. Height, weight, and DXA were measured at study entry and weight assessed again thrice per week. Blood was drawn from fasting participants at the beginning and end of each feeding period and serum concentrations of high-sensitivity CRP, serum amyloid A, IL-6, leptin, and adiponectin were measured. Linear mixed models tested the intervention effect on the biomarkers; models were adjusted for baseline biomarker concentrations, diet sequence, feeding period, age, sex, and body fat mass. Among participants with high-body fat mass (>32.0% for males and >25.0% for females), the low-GL diet reduced CRP (P = 0.02) and marginally increased adiponectin (P = 0.06). In conclusion, carbohydrate quality, independent of energy, is important. Dietary patterns emphasizing low-GL foods may improve the inflammatory and adipokine profiles of overweight and obese individuals.

A higher-carbohydrate, lower-fat diet reduces fasting glucose concentration and improves β-cell function in individuals with impaired fasting glucose

Article

Full-text available

Sep 2011

The objective was to examine the effects of diet macronutrient composition on insulin sensitivity, fasting glucose, and β-cell response to glucose. Participants were 42 normal glucose-tolerant (NGT; fasting glucose <100 mg/dL) and 27 impaired fasting glucose (IFG), healthy, overweight/obese (body mass index, 32.5 ± 4.2 kg/m(2)) men and women. For 8 weeks, participants were provided with eucaloric diets, either higher carbohydrate/lower fat (55% carbohydrate, 18% protein, 27% fat) or lower carbohydrate/higher fat (43:18:39). Insulin sensitivity and β-cell response to glucose (basal, dynamic [PhiD], and static) were calculated by mathematical modeling using glucose, insulin, and C-peptide data obtained during a liquid meal tolerance test. After 8 weeks, NGT on the higher-carbohydrate/lower-fat diet had higher insulin sensitivity than NGT on the lower-carbohydrate/higher fat diet; this pattern was not observed among IFG. After 8 weeks, IFG on the higher-carbohydrate/lower-fat diet had lower fasting glucose and higher PhiD than IFG on the lower-carbohydrate/higher-fat diet; this pattern was not observed among NGT. Within IFG, fasting glucose at baseline and the change in fasting glucose over the intervention were inversely associated with baseline PhiD (-0.40, P < .05) and the change in PhiD (-0.42, P < .05), respectively. Eight weeks of a higher-carbohydrate/lower-fat diet resulted in higher insulin sensitivity in healthy, NGT, overweight/obese individuals, and lower fasting glucose and greater glucose-stimulated insulin secretion in individuals with IFG. If confirmed, these results may have an impact on dietary recommendations for overweight individuals with and without IFG.

Food Acculturation Drives Dietary Differences among Mexicans, Mexican Americans, and Non-Hispanic Whites

Article

Full-text available

Aug 2011
J NUTR

Our aim was to examine the effects of food acculturation on Mexican Americans' (MA) diets, taking the Mexican diet as reference. We used nationally representative samples of children (2-11 y) and female adolescents and adults (12-49 y) from the Mexican National Nutrition Survey 1999 and NHANES 1999-2006 to compare the diets of Mexicans (n = 5678), MA born in Mexico (MAMX) (n = 1488), MA born in the United States (MAUS) (n = 3654), and non-Hispanic white Americans (NH-White) (n = 5473). One 24-h diet recall was used to examine the percentage consuming and percentage energy consumed from selected food groups. Most of the food groups analyzed displayed a fairly linear increase or decrease in percent energy/capita intake in this order: Mexican, MAMX, MAUS, NH-White. However, few significant differences were observed among the US subpopulations, especially among MAUS and NH-Whites. Overall, compared to Mexicans, the US subpopulations had greater intakes of saturated fat, sugar, dessert and salty snacks, pizza and French fries, low-fat meat and fish, high-fiber bread, and low-fat milk, as well as decreased intakes of corn tortillas, low-fiber bread, high-fat milk, and Mexican fast food. Furthermore, the patterns were similar in all age groups. Although we found a mix of positive and negative aspects of food acculturation, the overall proportion of energy obtained from unhealthy foods was higher among the US subpopulations. Our findings indicate that within one generation in the US, the influence of the Mexican diet is almost lost. In addition, our results reinforce the need to discourage critical unhealthful components of the American diet among MA.

Clinical review: Adiponectin biology and its role in inflammation and critical illness

Article

Full-text available

Apr 2011

Adiponectin is an adipokine first described just over a decade ago. Produced almost exclusively by adipocytes, adiponectin circulates in high concentrations in human plasma. Research into this hormone has revealed it to have insulin-sensitizing, anti-inflammatory and cardioprotective roles. This review discusses the history, biology and physiological role of adiponectin and explores its role in disease, with specific focus on adiponectin in inflammation and sepsis. It appears that an inverse relationship exists between adiponectin and inflammatory cytokines. Low levels of adiponectin have been found in critically ill patients, although data are limited in human subjects at this stage. The role of adiponectin in systemic inflammation and critical illness is not well defined. Early data suggest that plasma levels of adiponectin are decreased in critical illness. Whether this is a result of the disease process itself or whether patients with lower levels of this hormone are more susceptible to developing a critical illness is not known. This observation of lower adiponectin levels then raises the possibility of therapeutic options to increase circulating adiponectin levels. The various options for modulation of serum adiponectin (recombinant adiponectin, thiazolidinediones) are discussed.

Dietary Patterns Are Associated with Different Indexes of Adiposity and Obesity in an Urban Mexican Population

Article

Full-text available

Mar 2011
J NUTR

Our objective was to evaluate the relationships between dietary patterns and obesity, abdominal obesity, and high body fat proportion (measured by dual-energy X-ray absorptiometry; >25% in men and >35% in women) in an urban Mexican population. We conducted a cross-sectional analysis with the baseline data from 6070 men and women aged 20-70 y participating in the Health Workers Cohort Study, including information on participants' socio-demographic status and physical activity collected via self-administered questionnaires. Dietary intake was evaluated using a 116-item FFQ. Anthropometric measures were obtained using standardized procedures. We used factor analysis to identify 3 major dietary patterns: prudent, Westernized, and high animal protein/fat. We found that participants in the highest quintile of the prudent pattern were less likely to have high-body fat proportion (OR, 0.82; 95% CI: 0.70-0.98) and that participants in the highest quintile of the Westernized pattern had greater odds for obesity (OR, 1.46; 95% CI: 1.23-1.73), abdominal obesity (OR, 1.64; 95% CI: 1.37-1.96), and high-body fat proportion (OR, 1.17; 95% CI: 1.01-1.35). Additionally, participants in the upper quintile of the high-animal protein/-fat pattern had greater odds of being obese (OR, 1.23; 95% CI: 1.06-1.42). These results indicate that the dietary patterns of Mexican adults are associated with different levels of adiposity and obesity. Further prospective studies are required to confirm these associations.

Design, analysis, and presentation of crossover trials

Article

Full-text available

Feb 2009
TRIALS

Although crossover trials enjoy wide use, standards for analysis and reporting have not been established. We reviewed methodological aspects and quality of reporting in a representative sample of published crossover trials. We searched MEDLINE for December 2000 and identified all randomized crossover trials. We abstracted data independently, in duplicate, on 14 design criteria, 13 analysis criteria, and 14 criteria assessing the data presentation. We identified 526 randomized controlled trials, of which 116 were crossover trials. Trials were drug efficacy (48%), pharmacokinetic (28%), and nonpharmacologic (30%). The median sample size was 15 (interquartile range 8-38). Most (72%) trials used 2 treatments and had 2 periods (64%). Few trials reported allocation concealment (17%) or sequence generation (7%). Only 20% of trials reported a sample size calculation and only 31% of these considered pairing of data in the calculation. Carry-over issues were addressed in 29% of trial's methods. Most trials reported and defended a washout period (70%). Almost all trials (93%) tested for treatment effects using paired data and also presented details on by-group results (95%). Only 29% presented CIs or SE so that data could be entered into a meta-analysis. Reports of crossover trials frequently omit important methodological issues in design, analysis, and presentation. Guidelines for the conduct and reporting of crossover trials might improve the conduct and reporting of studies using this important trial design.

Birthplace Is Associated with More Adverse Dietary Profiles for US-Born Than for Foreign-Born Latino Adults

Article

Full-text available

Jan 2009
J NUTR

Our objective was to examine the association between ethnicity and birthplace and the percent of energy from selected food groups among Hispanics, the largest growing segment of the US population. We used data from NHANES 1999-2004, collected from Mexican (n = 3375) and other Hispanic (n = 622) adults (18 y and older), classified as foreign born (FB) or US born (USB). Using University of North Carolina's food-grouping system, we created 24 nutrient- and behavioral-based food groups. We examined percent consuming and per-consumer estimates using logistic and linear regression models, respectively. Predicted mean energy was estimated using marginal effect models. All models were controlled for gender, age, income, and education and were weighted to account for sampling design. FB Hispanics obtained more energy from food groups such as legumes, fruits, and low-fat/high-fiber breads, with differences accounted for by a greater percent consuming these foods rather than higher energy intake among consumers. Conversely, FB Hispanics consumed a lower percentage of energy from foods such as non-Mexican fast food and snacks and desserts. Speaking Spanish also was associated with greater consumption of legumes, rice, fruits, soups, and potatoes. Variation in diet may in part account for the difference in nutrition-related adverse health outcomes observed among USB Hispanics, particularly Mexicans. Targeted dietary interventions are needed to reduce health disparities associated with dietary intake.

Epidemiological and nutritional transition in Mexico: Rapid increase of non-communicable chronic diseases and obesity

Article

Full-text available

Mar 2002

The objective of this paper is to characterise the epidemiological and nutritional transition and their determinants in Mexico. Age-adjusted standardised mortality rates (SMRs) due to acute myocardial infarction (AMI), diabetes mellitus and hypertension were calculated for 1980-1998. Changes in the prevalences of overweight and obesity in women and children and of dietary intake from 1988 to 1999 were also used in the analysis. Quantities of food groups purchased by adult equivalent (AE) and food expenditures away from home between 1984 and 1989 were used to assess trends. All information was analysed at the national and regional levels, and by urban and rural areas. SMR for diabetes, AMI and hypertension increased dramatically parallel to obesity at the national and regional levels. Fat intake in women and the purchase of refined carbohydrates, including soda, also increased. The results suggest that obesity is playing a role in the increased SMRs of diabetes, AMI and hypertension in Mexico. Total energy dietary intake and food purchase data could not explain the rise in the prevalence of obesity. The increases in fat intake and the purchase of refined carbohydrates may be risk factors for increased mortality. Information on physical activity was not available. SMRs due to diabetes, hypertension and AMI have increased dramatically in parallel with the prevalence of obesity; therefore actions should be taken for the prevention of obesity. Reliable information about food consumption and physical activity is required to assess their specific roles in the aetiology of obesity.

Whole-grain and fiber intake and the incidence of type 2 diabetes

Article

Full-text available

Apr 2003

Epidemiologic evidence of a preventive effect of whole grain against type 2 diabetes is mainly based on data from women. Information specific to men and women is needed. The objective was to study the relation between the intake of whole grain and fiber and the subsequent incidence of type 2 diabetes. The design was a cohort study of 2286 men and 2030 women aged 40-69 y and initially free of diabetes. Food consumption data were collected from 1966 through 1972 with the use of a dietary history interview covering the habitual diet during the previous year. During a 10-y follow-up, incident type 2 diabetes cases were identified in 54 men and 102 women from a nationwide register. Whole-grain consumption was associated with a reduced risk of type 2 diabetes. The relative risk (adjusted for age, sex, geographic area, smoking status, body mass index, energy intake, and intakes of vegetables, fruit, and berries) between the highest and lowest quartiles of whole-grain consumption was 0.65 (95% CI: 0.36, 1.18; P for trend = 0.02). Cereal fiber intake was also associated with a reduced risk of type 2 diabetes. The relative risk between the extreme quartiles of cereal fiber intake was 0.39 (95% CI: 0.20, 0.77; P = 0.01). An inverse association between whole-grain intake and the risk of type 2 diabetes was found. The similar result for cereal fiber intake suggests that the whole-grain association is due to cereal fiber or another factor related to cereal fiber intake.

A short acculturation scale for Mexican-American populations

Article

Full-text available

Feb 2005

Acculturation is important to examine variables that differentiate members of ethnic groups so that interventions can be appropriately targeted. By using a population-based sample of Mexican-origin adults, we sought to validate an acculturation scale for Mexican-American populations. The acculturation instrument included eight items adapted from the Acculturation Rating Scale for Mexican Americans (ARSMA). By using principal component analysis, we calculated eigenvalues for the eight items. The first principal component accounted for 66% of the variance. Language spoken most of the time, by itself, explained 62.4% of the variance of the full model, whereas birthplace, by itself, accounted for 74%. Slight increases in correlation values were observed beyond a four-item model that included language spoken most of the time, language thought, ethnic identity, and birthplace. Future studies should compare this scale with other multidimensional scales.

Adherence to the Mediterranean dietary pattern is positively associated with plasma adiponectin concentrations in diabetic women

Article

Aug 2006

The glycemic index of foods influences postprandial insulin-like growth factor–binding protein responses in lean young subjects

Article

Aug 2005

Background: Growth in normal and malignant tissues has been linked to hyperinsulinemia and insulin-like growth factors (IGFs). We hypothesized that IGF and IGF-binding protein (IGFBP) responses may be acutely affected by differences in the glycemic index (GI) of foods. Objective: We compared the postprandial responses of IGFs and IGFBP to 2 foods of similar macronutrient composition but with greatly different GIs—pearled barley (GI: 25) and instant mashed potato (GI: 85). Design: Ten young lean subjects consumed 50-g carbohydrate portions of the 2 foods or water (extended fast) in random order after an overnight fast. Capillary blood was collected at regular intervals over 4 h for measurement of blood glucose, insulin, and components of the IGF system. Results: Serum IGFBP-1 declined markedly after both meals, but the mean (±SEM) change at 4 h was significantly (P < 0.01) more prolonged after the low-GI meal (−55 ± 20 ng/mL) than after the high-GI meal (−13 ± 15 ng/mL). Conversely, the change in serum IGFBP-3 concentration at 4 h was significantly (P < 0.05) higher after the low-GI meal (251 ± 102 ng/mL) than after the high-GI meal (−110 ± 96 ng/mL); the same pattern was observed at 2 h. Changes in IGFBP-2, free IGF-1, and total IGF-1 responses were minimal and did not differ significantly from those during the 4-h fast. Conclusion: Acute changes in IGFBP-3 after low-GI and high-GI foods may provide a biologic mechanism linking cell multiplication with greater consumption of high-GI carbohydrates.

Adiponectin in relation to malignancies: a review of existing basic research and clinical evidence

Article

Sep 2007

Adiponectin, an adipocyte-secreted hormone that plays an important role in diabetes and cardiovascular disease, may also be of importance in the development and progression of several malignancies. Circulating adiponectin concentrations, which are determined mainly by genetic factors, nutrition, and adiposity, are lower in patients with breast, endometrial, prostate, and colon cancer. It has thus been proposed that adiponectin may be a biological link between obesity (especially central obesity) and increased cancer risk. Adiponectin may influence cancer risk through its well-recognized effects on insulin resistance, but it is also plausible that adiponectin acts on tumor cells directly. Several cancer cell types express adiponectin receptors that may mediate the effects of adiponectin on cellular proliferation. Herein, we review recent evidence supporting a role of serum adiponectin concentrations as a novel risk factor and possible diagnostic marker for obesity-related malignancies, including cancers of the breast, endometrium, colon, and prostate. Further studies are needed to fully elucidate the potential role of adiponectin in cancer diagnostics and therapeutics.

Major dietary patterns are related to plasma concentrations of markers of inflammation and endothelial dysfunction

Article

Oct 2004

Background: Endothelial dysfunction is one of the mechanisms linking diet and the risk of cardiovascular disease. Objective: We evaluated the hypothesis that dietary patterns (summary measures of food consumption) are directly associated with markers of inflammation and endothelial dysfunction, particularly C-reactive protein (CRP), interleukin 6, E-selectin, soluble intercellular adhesion molecule 1 (sICAM-1), and soluble vascular cell adhesion molecule 1 (sVCAM-1). Design: We conducted a cross-sectional study of 732 women from the Nurses' Health Study I cohort who were 43-69 y of age and free of cardiovascular disease, cancer, and diabetes mellitus at the time of blood drawing in 1990. Dietary intake was documented by using a validated food-frequency questionnaire in 1986 and 1990. Dietary patterns were generated by using factor analysis. Results: A prudent pattern was characterized by higher intakes of fruit, vegetables, legumes, fish, poultry, and whole grains, and a Western pattern was characterized by higher intakes of red and processed meats, sweets, desserts, French fries, and refined grains. The prudent pattern was inversely associated with plasma concentrations of CRP (P = 0.02) and E-selectin (P = 0.001) after adjustment for age, body mass index (BMI), physical activity, smoking status, and alcohol consumption. The Western pattern showed a positive relation with CRP (P < 0.001), interleukin 6 (P = 0.006), E-selectin (P < 0.001), sICAM-1 (P < 0.001), and sVCAM-1 (P = 0.008) after adjustment for all confounders except BMI; with further adjustment for BMI, the coefficients remained significant for CRP (P = 0.02), E-selectin (P < 0.001), sICAM-1 (P = 0.002), and sVCAM-1 (P = 0.02). Conclusion: Because endothelial dysfunction is an early step in the development of atherosclerosis, this study suggests a mechanism for the role of dietary patterns in the pathogenesis of cardiovascular disease.

Factors associated with overweight and obesity among Mexican Americans and Central Americans: Results from the 2001 California health interview survey

Article

Jan 2007

Introduction: Hispanics are the fastest growing demographic group in the United States; however, "Hispanic" is a broad term that describes people who are from or whose ancestors are from multiple countries of origin. This study examines, separately, the social, cultural, and behavioral factors associated with overweight and obesity among Mexican American adults and among Central American adults. Methods: To estimate the prevalence of overweight and obesity among Mexican and Central Americans living in California, we conducted a cross-sectional analysis of data from the 2001 California Health Interview Survey using SUDAAN software to account for the survey's multistage sampling design. Results: Of the 8304 Mexican Americans participating in the survey, 36.8% were overweight and 26.2% were obese. Of the 1019 Central Americans, 39.2% were overweight and 22.2% were obese. Among Mexican American men, age and marital status were associated with overweight and obesity; and education, acculturation, health insurance status, health status, and use of vitamins were associated with obesity only. Among Mexican American women, age, education, number of children, health status, and health behavior were associated with overweight and obesity. Among Central American men, age, education, and access to health care were associated with overweight, whereas marital status, acculturation, health care, and binge drinking were associated with obesity. Among Central American women, number of children was associated with overweight and obesity; and age and education were associated with obesity only. Conclusions Our findings of high rates of overweight and obesity among Mexican and Central Americans in California indicate the need for a wide variety of effective weight-loss interventions targeting these populations, and the differences we found in the factors associated with overweight and obesity may suggest the need for unique intervention strategies for different Hispanic subgroups.

Adiponectin in relation to malignancies: a review of existing basic research and clinical evidenced

Conference Paper

Sep 2007

Anthropometric Standardization Reference Manual

Article

Jan 1988

Effects of High vs Low Glycemic Index of Dietary Carbohydrate on Cardiovascular Disease Risk Factors and Insulin Sensitivity

Article

Dec 2014

Foods that have similar carbohydrate content can differ in the amount they raise blood glucose. The effects of this property, called the glycemic index, on risk factors for cardiovascular disease and diabetes are not well understood. To determine the effect of glycemic index and amount of total dietary carbohydrate on risk factors for cardiovascular disease and diabetes. Randomized crossover-controlled feeding trial conducted in research units in academic medical centers, in which 163 overweight adults (systolic blood pressure, 120-159 mm Hg) were given 4 complete diets that contained all of their meals, snacks, and calorie-containing beverages, each for 5 weeks, and completed at least 2 study diets. The first participant was enrolled April 1, 2008; the last participant finished December 22, 2010. For any pair of the 4 diets, there were 135 to 150 participants contributing at least 1 primary outcome measure. (1) A high-glycemic index (65% on the glucose scale), high-carbohydrate diet (58% energy); (2) a low-glycemic index (40%), high-carbohydrate diet; (3) a high-glycemic index, low-carbohydrate diet (40% energy); and (4) a low-glycemic index, low-carbohydrate diet. Each diet was based on a healthful DASH-type diet. The 5 primary outcomes were insulin sensitivity, determined from the areas under the curves of glucose and insulin levels during an oral glucose tolerance test; levels of low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides; and systolic blood pressure. At high dietary carbohydrate content, the low- compared with high-glycemic index level decreased insulin sensitivity from 8.9 to 7.1 units (-20%, P = .002); increased LDL cholesterol from 139 to 147 mg/dL (6%, P ≤ .001); and did not affect levels of HDL cholesterol, triglycerides, or blood pressure. At low carbohydrate content, the low- compared with high-glycemic index level did not affect the outcomes except for decreasing triglycerides from 91 to 86 mg/dL (-5%, P = .02). In the primary diet contrast, the low-glycemic index, low-carbohydrate diet, compared with the high-glycemic index, high-carbohydrate diet, did not affect insulin sensitivity, systolic blood pressure, LDL cholesterol, or HDL cholesterol but did lower triglycerides from 111 to 86 mg/dL (-23%, P ≤ .001). In this 5-week controlled feeding study, diets with low glycemic index of dietary carbohydrate, compared with high glycemic index of dietary carbohydrate, did not result in improvements in insulin sensitivity, lipid levels, or systolic blood pressure. In the context of an overall DASH-type diet, using glycemic index to select specific foods may not improve cardiovascular risk factors or insulin resistance. clinicaltrials.gov Identifier: NCT00608049.

Circulating IGF-axis Protein Levels and Their Relation with Levels of Plasma Adipocytokines and Macronutrient Consumption in Women

Article

Aug 2014
GROWTH HORM IGF RES

Low-dose diet supplement of a natural flavonoid, luteolin, ameliorates diet-induced obesity and insulin resistance in mice

Article

Jun 2014
MOL NUTR FOOD RES

Mast cells play important roles in diet-induced obesity and diabetes, and some synthetic mast cell stabilizers can improve related metabolic disturbances in mice. Luteolin (LU) is a potent natural mast cell stabilizer. However, a direct correlation between LU and these common metabolic diseases is not established. Male C57BL/6 mice were fed low-fat diet, high-fat diet (HFD), HFD with 0.002 and 0.01% LU for 12 wk, respectively. Dietary LU suppressed HFD-induced body weight gain, fat deposition, and adipocyte hypertrophy. Meanwhile, glucose intolerance and insulin sensitivity was also improved. Interestingly, dietary LU ameliorated angiogenesis and associated cell apoptosis and cathepsin activity in epididymis adipose tissues, which is a critical mechanism that mast cells are involved in diet-induced obesity and diabetes. Further, we showed dietary LU reduced mast cell and macrophage infiltrations and inflammatory cytokine levels in epididymis adipose tissues. Finally, LU inhibited mast cell-derived IL-6 expression, which is a key cytokine that contributes to mast cell-associated metabolic derangements, and protein kinase C activator phorbol myristoyl acetate reversed the inhibitory effects. As a natural flavonoid, low-dose diet supplement of LU ameliorates diet-induced obesity and insulin resistance in mice, suggesting a new therapeutic and interventional approach for these diseases.

Low-fat diet with omega-3 fatty acids increases plasma insulin-like growth factor concentration in healthy postmenopausal women

Article

Jul 2013

The insulin-like growth factor pathway plays a central role in the normal and abnormal growth of tissues; however, nutritional determinants of insulin-like growth factor I (IGF-I) and its binding proteins in healthy individuals are not well defined. Three test diets-high-fat diet (40% energy as fat), low-fat diet (LF; 20% energy as fat), and a diet with low fat and high omega-3 fatty acid (LFn3; 23% energy as fat)-were tested in a randomized crossover designed controlled feeding trial in healthy postmenopausal women. Plasma IGF-I, IGF binding protein-3 (IGFBP-3), insulin, glucose, and ratio of IGF-I/IGFBP-3 concentrations were measured in response to diets. Insulin sensitivity was calculated using the homeostatic model assessment of insulin resistance We hypothesized that IGF-I, insulin, and glucose concentrations would decrease and IGFBP-3 concentration would increase in response to the low-fat diets. Eight weeks of the LFn3 diet increased circulating IGF-I (P < .001) and IGFBP-3 (P = .01) and the LF diet increased IGFBP-3 (P = .04), resulting in trends toward an increased IGF-I/IGFBP-3 ratio with the LFn3 diet and a decreased IGF-I/IGFBP-3 ratio with the LF diet (P = .13 for both comparisons). No statistically significant differences were detected between treatments at baseline or 8 weeks for IGF-1, IGFBP-3, or the ratio of IGF-1/IGFBP-3. Insulin, glucose, and the homeostatic model assessment of insulin resistance were not altered by the interventions. Low-fat diet with high n-3 fatty acids may increase circulating IGF-I concentrations without adversely affecting insulin sensitivity in healthy individuals.

Bioactivity of Flavonoids on Insulin‐Secreting Cells

Article

Oct 2008
COMPR REV FOOD SCI F

Flavonoids are usually found in fruits and other plant organs and therefore widely consumed. They are antioxidants, anti-inflammatory, anticarcinogenic, and protective against coronary disease and metabolic disorders. These beneficial effects make them good candidates for the development of new functional foods with potential protective/preventive properties against several diseases. We must consider that this fact could lead to a higher intake of some of these flavonoids. Most of the studies concerning their beneficial effects showed peripheral activity of these molecules, but there is no clear information about their central effects on a key organ on metabolic control: the endocrine pancreas. The pancreas has an endocrine function of major importance to regulate nutrient metabolism, such as control of glucose homeostasis via insulin and glucagon secretion. Its importance in whole body nutrient equilibrium is highlighted by the fact that several pathologies, such as type 1 and/or 2 diabetes, are related at some point to a pancreatic cell deregulation. In this review, we compile the most relevant results concerning the effects of flavonoids on several aspects of pancreatic functionality. Studies using animals with drug-induced diabetes support the hypothesis that flavonoids can ameliorate this pathogenesis. The great diversity of flavonoid structures makes it difficult to establish common effects in the pancreas. Published data suggest that there might be direct effects of flavonoids on insulin secretion, as well as on prevention of beta-cell apoptosis, and they could even act via modulation of proliferation. The mechanisms of action involve mainly their antioxidant properties, but other pathways might also take place.

Differences in Diet Pattern Adherence by Nativity and Duration of US Residence in the Mexican-American Population

Article

Oct 2011

Literature on the diet of the Mexican-American population suggests that food consumption differs by nativity and duration of residence in the United States. However, no studies have used dietary pattern analysis to investigate these differences. To create dietary patterns, we used principal components analysis on food frequency questionnaire data for all adult respondents of the National Health and Nutrition Examination Survey years 2003-2006. Four dietary patterns were identified: Western, Healthy, Tomato/Tortilla, and Coffee/Sugar. Least squares means regression was used to test differences in adjusted mean dietary adherence scores among Mexico-born Mexican-American adults residing in the United States for <15 years (n=302), Mexico-born Mexican-American adults residing in the United States for ≥15 years (n=234), US-born Mexican-American adults (n=509), and US-born non-Hispanic whites (n=2,530) aged 18 to 69 years. Mean score for each diet pattern did not differ significantly by duration of US residence category in the Mexico-born Mexican-American population. However, in comparison to all Mexico-born Mexican Americans, US-born Mexican Americans had significantly lower score for the Tomato/Tortilla pattern, and significantly higher score for the Western pattern. Scores for the Healthy pattern were relatively low in all Mexican-American subgroups, indicating low adherence to the Healthy diet. However, Healthy diet scores of Mexico-born Mexican Americans among those aged ≤41 years appeared more similar to those of US-born non-Hispanic whites than US-born Mexican Americans. Education and policy action promoting healthy food access in Hispanic neighborhoods could help limit consumption of Western and Coffee/Sugar diet patterns and promote healthier choices in the Mexican-American population.

Article

Jan 2009
PUBLIC HEALTH NURS

Judith Aponte

The Hispanic Health and Nutritional Examination Survey (HHANES) was utilized to examine diabetes-related risk factor variables between and among 3 Hispanic subgroups. The study design that was conducted was descriptive using the HHANES secondary data set. Sample: The sample included individuals between 20 and 74 years of age, self-identified as Mexican American, Puerto Rican, and/or Cuban American and had been told by a doctor that they had diabetes. The 5 diabetes-related risk factor variables were obesity measured by body mass index (BMI), hypertension by systolic blood pressure (SBP) and diastolic blood pressure (DBP), hyperlipidemia by cholesterol and triglyceride levels, renal insufficiency by blood urea nitrogen (BUN), and creatinine and fasting plasma glucose. This study demonstrates significant differences between specific subgroups through chi-square. SBP in Cuban Americans was significantly higher than that of Puerto Ricans (28.39 mmHg) and of Mexican Americans (25.94 mmHg). Cuban Americans also had significantly higher cholesterol values than Mexican Americans (88.49 mg/dL) and Puerto Ricans (84.49 mg/dL). The only significant difference for triglyceride was between Mexican Americans and Puerto Ricans (37.25 mg/dL). For BUN, there were significant differences when Cuban Americans (9.06 mg/dL) and Mexican Americans (2.20 mg/dL) were separately compared from Puerto Ricans, and Cuban Americans had significantly higher creatinine values than Puerto Ricans (0.38 mg/dL) and Mexican Americans (0.25 mg/dL). Through linear regression, significant differences for the association of each diabetes-related risk factor and the risk for diabetes complications were computed for each subgroup. For Mexican Americans and Puerto Ricans there were significant differences in overweight BMI (25.0-29.9 kg/m2) and obesity (> or =30.0 kg/m2); for Mexican Americans, Puerto Ricans and Cuban Americans in elevated SBP (130-139 mmHg) or elevated DBP (80-89 mmHg), for high SBP (> or =140 mmHg) or high DBP (> or =90 mmHg), and for high glucose (> or =126 mg/dL); and for Mexican Americans in elevated triglyceride (> or =150 mg/dL), elevated BUN (> or =21 mg/dL), and elevated creatinine (> or =1.5 mg/dL). The findings of this study will add to the diabetes and Hispanic literature highlighting the need to evaluate Hispanic subgroups in future health behavior and outcomes research.

Dietary factors related to the increase of cardiovascular risk factors in traditional Tepehuanos communities from Mexico. A 10 year follow-up study

Article

Jul 2009

Tepehuanos Indians, a traditional Mexican ethnic group, followed a vegetarian diet exhibiting a low prevalence of obesity and the absence of diabetes. However, from the year 2000 the traditional diet of the Tepehuanos was modified by the introduction of western food. In this study we examine the changes in their customary diet and its impact on the prevalence of cardiovascular risk factors in this group. Individuals from 12 Tepehuanos communities were randomly enrolled during 1995-1996 and 2006-2007. Using a 64-item semiquantitative food frequency questionnaire macronutrient intakes were calculated from values of Mexican food-composition tables. Cardiovascular risk factors such as obesity, hypertension, hyperglycemia and dyslipidemia were determined. The median (25, 75 percentile) of total caloric intake (1476 [1083, 1842]-2100 [1366, 2680]kcal/day, p<0.001) as well as the percentage of energy consumed from saturated fat (3.0 [2.7,4.1]-7.2 [3.9,7.4], p<0.0001) and protein (8.2 [7.8,8.9]-16.8 [16.3,17.1], p<0.0001) increased, whereas the percentage of total calorie intake from carbohydrates (66.4 [61.3,69.5]-61.3 [61,68.8], p<0.0001), polyunsaturated fat (11.2 [10.3,12.1]-4.0 [3.9,4.3], p<0.0001), and the polyunsaturated:saturated fat ratio (3.84-0.53%, p<0.0001) decreased during the period of study. The prevalence of obesity (11.1-21.9%, p=0.04), impaired fasting glucose (5.9-14.9%, p=0.04), diabetes (0.0-0.88%, p=0.48), hypertension (1.7-3.4%, p=0.43), triglycerides (2.6-16.7%, p=0.0006), and low HDL-cholesterol (10.2-71.1%, p<0.0001) increased. Changes in the customary diet introduced in the Tepehuanos communities are related to the increase of cardiovascular risk factors.

The role of insulin-like growth factor-I and its binding proteins in glucose homeostasis and type 2 diabetes

Article

Jan 2009
DIABETES-METAB RES

This review addresses the possible role of the insulin-like growth factor (IGF)-axis in normal glucose homoeostasis and in the etiopathogenesis of type 2 diabetes. IGF-I, a peptide hormone, shares amino acid sequence homology with insulin and has insulin-like activity; most notably, the promotion of glucose uptake by peripheral tissues. Type 2 diabetes as well as pre-diabetic states, including impaired fasting glucose and impaired glucose tolerance, are associated cross-sectionally with altered circulating levels of IGF-I and its binding proteins (IGFBPs). Administration of recombinant human IGF-I has been reported to improve insulin sensitivity in healthy individuals as well as in patients with insulin resistance and type 2 diabetes. Further, IGF-I may have beneficial effects on systemic inflammation, a risk factor for type 2 diabetes, and on pancreatic beta-cell mass and function. There is considerable inter-individual heterogeneity in endogenous levels of IGF-I and its binding proteins; however, the relationship between these variations and the risk of developing type 2 diabetes has not been extensively investigated. Large prospective studies are required to evaluate this association.

Adherence to healthy eating patterns is associated with higher circulating total and high-molecular-weight adiponectin and lower resistin concentrations in women from the Nurses' Health Study1-3

Article

Nov 2008
AM J CLIN NUTR

Adherence to a healthy dietary pattern, such as the Alternate Healthy Eating Index (AHEI), is associated with a lower risk of diabetes and atherosclerosis. We aimed to determine whether adherence to the AHEI is associated with higher plasma total and high-molecular-weight (HMW) adiponectin concentrations and lower concentrations of resistin, as well as biomarkers of inflammation, endothelial dysfunction, and insulin resistance. The study evaluated 1922 women from the Nurses' Health Study (62% of whom were overweight) who had no history of diabetes or cardiovascular disease. Their plasma biomarker concentrations were measured in 1990, and data on dietary intake from semiquantitative food-frequency questionnaires administered in 1984, 1986, and 1990 were averaged to account for long-term dietary exposure and to reduce within-subject variability. After adjustment for age and energy intake, women with the highest adherence to the AHEI had 24% higher median total adiponectin and 32% higher median HMW adiponectin concentrations, as well as 16% lower resistin, 41% lower CRP, 19% lower sE-selectin, and 24% lower ferritin concentrations (P < 0.01 for all) than did women with the lowest adherence to the AHEI. These associations remained significant after adjustment for potential confounders. Inverse associations between the AHEI and soluble tumor necrosis factor-alpha receptor II, interleukin-6, soluble intercellular adhesion molecule 1, soluble vascular cell adhesion molecule 1, C-peptide, insulin, and glycated hemoglobin were evident, but they were not significant after adjustment for body mass index. The preventive effects of healthier dietary patterns on risk for diabetes and atherosclerosis may be mediated by improvements in plasma concentrations of adipokines or other biomarkers of risk for diabetes and cardiovascular disease.

A new predictive equation for resting energy expenditure in healthy individuals

Article

Mar 1990

A predictive equation for resting energy expenditure (REE) was derived from data from 498 healthy subjects, including females (n = 247) and males (n = 251), aged 19-78 y (45 +/- 14 y, mean +/- SD). Normal-weight (n = 264) and obese (n = 234) individuals were studied and REE was measured by indirect calorimetry. Multiple-regression analyses were employed to drive relationships between REE and weight, height, and age for both men and women (R2 = 0.71): REE = 9.99 x weight + 6.25 x height - 4.92 x age + 166 x sex (males, 1; females, 0) - 161. Simplification of this formula and separation by sex did not affect its predictive value: REE (males) = 10 x weight (kg) + 6.25 x height (cm) - 5 x age (y) + 5; REE (females) = 10 x weight (kg) + 6.25 x height (cm) - 5 x age (y) - 161. The inclusion of relative body weight and body-weight distribution did not significantly improve the predictive value of these equations. The Harris-Benedict Equations derived in 1919 overestimated measured REE by 5% (p less than 0.01). Fat-free mass (FFM) was the best single predictor of REE (R2 = 0.64): REE = 19.7 x FFM + 413. Weight also was closely correlated with REE (R2 = 0.56): REE = 15.1 x weight + 371.

Homeostatis model assessment - Insulin Resistance and Beta-Cell Function From Fasting Plasma-Glucose and insulin concentration in man

Article

Aug 1985

The steady-state basal plasma glucose and insulin concentrations are determined by their interaction in a feedback loop. A computer-solved model has been used to predict the homeostatic concentrations which arise from varying degrees beta-cell deficiency and insulin resistance. Comparison of a patient's fasting values with the model's predictions allows a quantitative assessment of the contributions of insulin resistance and deficient beta-cell function to the fasting hyperglycaemia (homeostasis model assessment, HOMA). The accuracy and precision of the estimate have been determined by comparison with independent measures of insulin resistance and beta-cell function using hyperglycaemic and euglycaemic clamps and an intravenous glucose tolerance test. The estimate of insulin resistance obtained by homeostasis model assessment correlated with estimates obtained by use of the euglycaemic clamp (Rs = 0.88, p less than 0.0001), the fasting insulin concentration (Rs = 0.81, p less than 0.0001), and the hyperglycaemic clamp, (Rs = 0.69, p less than 0.01). There was no correlation with any aspect of insulin-receptor binding. The estimate of deficient beta-cell function obtained by homeostasis model assessment correlated with that derived using the hyperglycaemic clamp (Rs = 0.61, p less than 0.01) and with the estimate from the intravenous glucose tolerance test (Rs = 0.64, p less than 0.05). The low precision of the estimates from the model (coefficients of variation: 31% for insulin resistance and 32% for beta-cell deficit) limits its use, but the correlation of the model's estimates with patient data accords with the hypothesis that basal glucose and insulin interactions are largely determined by a simple feed back loop.

Carbohydrates, dietary fiber, and incident type 2 diabetes in older women

Article

May 2000

Dietary carbohydrates may influence the development of type 2 (non-insulin-dependent) diabetes, for example, through effects on blood glucose and insulin concentrations. We examined the relations of baseline intake of carbohydrates, dietary fiber, dietary magnesium, and carbohydrate-rich foods and the glycemic index with incidence of diabetes. This was a prospective cohort study of 35988 older Iowa women initially free of diabetes. During 6 y of follow-up, 1141 incident cases of diabetes were reported. Total grain, whole-grain, total dietary fiber, cereal fiber, and dietary magnesium intakes showed strong inverse associations with incidence of diabetes after adjustment for potential nondietary confounding variables. Multivariate-adjusted relative risks of diabetes were 1.0, 0.99, 0.98, 0.92, and 0.79 (P for trend: 0.0089) across quintiles of whole-grain intake; 1.0, 1.09, 1.00, 0.94, and 0.78 (P for trend: 0.005) across quintiles of total dietary fiber intake; and 1.0, 0.81, 0.82, 0.81, and 0.67 (P for trend: 0.0003) across quintiles of dietary magnesium intake. Intakes of total carbohydrates, refined grains, fruit and vegetables, and soluble fiber and the glycemic index were unrelated to diabetes risk. These data support a protective role for grains (particularly whole grains), cereal fiber, and dietary magnesium in the development of diabetes in older women.

Validation of the Arizona Activity Frequency Questionnaire using doubly labeled water

Article

Nov 2001

Physical activity questionnaires (PAQs) are considered the most cost-efficient method to estimate total energy expenditure (TEE) in epidemiological studies. However, relatively few PAQs have been validated using doubly labeled water (DLW) in women or in samples with diverse ethnic backgrounds. This study was conducted to validate the Arizona Activity Frequency Questionnaire (AAFQ) for estimation of TEE and physical activity energy expenditure (PAEE) over 1 month using DLW as a reference method. Thirty-five relatively sedentary women completed the AAFQ before participating in an 8-d DLW protocol to measure TEE. TEE and PAEE were estimated from the AAFQ by calculating resting metabolic rate (RMR) using the equation of Mifflin et al. (AAFQmif), by measuring RMR using indirect calorimetry (AAFQic), and using MET conversion (AAFQmet). A predictive equation for TEE was generated. The mean +/- SD for TEE and PAEE from DLW were 9847 +/- 2555 kJ x d(-1) and 5578 +/- 2084 kJ x d(-1), respectively. Formulas using RMR to calculate the TEE and PAEE from the AAFQ tended to underestimate TEE and PAEE, whereas those that included only weight tended to overestimate TEE and PAEE. On the basis of the Mifflin et al. equation, the AAFQ tends to underestimate PAEE by 13%. This underestimation may be explained by the low lean body mass of the sample population and by effectiveness of the METs/RMR ratio in the obese. The following predictive equation was calculated: TEE (kJ x d(-1)) = (86.0 * average total daily METs) + (2.23 * RMRmif) - 6726. When the predictive equation is used, TEE calculated from the AAFQ is highly correlated with DLW TEE (adjusted r(2) = 0.70, P < 0.001). The AAFQ is an effective tool for the prediction of TEE and PAEE in epidemiological studies.

Effect of a Mediterranean-Style Diet on Endothelial Dysfunction and Markers of Vascular Inflammation in the Metabolic Syndrome

Article

Oct 2004
J Am Med Assoc

The metabolic syndrome has been identified as a target for dietary therapies to reduce risk of cardiovascular disease; however, the role of diet in the etiology of the metabolic syndrome is poorly understood. To assess the effect of a Mediterranean-style diet on endothelial function and vascular inflammatory markers in patients with the metabolic syndrome. Randomized, single-blind trial conducted from June 2001 to January 2004 at a university hospital in Italy among 180 patients (99 men and 81 women) with the metabolic syndrome, as defined by the Adult Treatment Panel III. Patients in the intervention group (n = 90) were instructed to follow a Mediterranean-style diet and received detailed advice about how to increase daily consumption of whole grains, fruits, vegetables, nuts, and olive oil; patients in the control group (n = 90) followed a prudent diet (carbohydrates, 50%-60%; proteins, 15%-20%; total fat, <30%). Nutrient intake; endothelial function score as a measure of blood pressure and platelet aggregation response to l-arginine; lipid and glucose parameters; insulin sensitivity; and circulating levels of high-sensitivity C-reactive protein (hs-CRP) and interleukins 6 (IL-6), 7 (IL-7), and 18 (IL-18). After 2 years, patients following the Mediterranean-style diet consumed more foods rich in monounsaturated fat, polyunsaturated fat, and fiber and had a lower ratio of omega-6 to omega-3 fatty acids. Total fruit, vegetable, and nuts intake (274 g/d), whole grain intake (103 g/d), and olive oil consumption (8 g/d) were also significantly higher in the intervention group (P<.001). The level of physical activity increased in both groups by approximately 60%, without difference between groups (P =.22). Mean (SD) body weight decreased more in patients in the intervention group (-4.0 [1.1] kg) than in those in the control group (-1.2 [0.6] kg) (P<.001). Compared with patients consuming the control diet, patients consuming the intervention diet had significantly reduced serum concentrations of hs-CRP (P =.01), IL-6 (P =.04), IL-7 (P = 0.4), and IL-18 (P = 0.3), as well as decreased insulin resistance (P<.001). Endothelial function score improved in the intervention group (mean [SD] change, +1.9 [0.6]; P<.001) but remained stable in the control group (+0.2 [0.2]; P =.33). At 2 years of follow-up, 40 patients in the intervention group still had features of the metabolic syndrome, compared with 78 patients in the control group (P<.001). A Mediterranean-style diet might be effective in reducing the prevalence of the metabolic syndrome and its associated cardiovascular risk.

Nutrition Transition in Mexico and in Other Latin American Countries

Article

Aug 2004

Mexico and other Latin American countries are currently undergoing important demographic, epidemiologic and nutrition transitions. Noncommunicable chronic diseases such as obesity, type 2 diabetes mellitus, and high blood pressure are becoming public health problems as the population experiences an important reduction in physical activity and an increase in energy-dense diets. In contrast, the prevalence of undernutrition is declining in most countries, although several decades will be needed before the prevalence drops to acceptable values. The objective of this article is to discuss the characteristics of the nutrition transition with emphasis in data from Mexico, Brazil, and Chile.

Lopez-Garcia E, Schulze MB, Fung TT, Meigs JB, Rifai N, Manson JE. Major dietary patterns are related to plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr 80, 1029-1035

Article

Nov 2004

Endothelial dysfunction is one of the mechanisms linking diet and the risk of cardiovascular disease. We evaluated the hypothesis that dietary patterns (summary measures of food consumption) are directly associated with markers of inflammation and endothelial dysfunction, particularly C-reactive protein (CRP), interleukin 6, E-selectin, soluble intercellular adhesion molecule 1 (sICAM-1), and soluble vascular cell adhesion molecule 1 (sVCAM-1). We conducted a cross-sectional study of 732 women from the Nurses' Health Study I cohort who were 43-69 y of age and free of cardiovascular disease, cancer, and diabetes mellitus at the time of blood drawing in 1990. Dietary intake was documented by using a validated food-frequency questionnaire in 1986 and 1990. Dietary patterns were generated by using factor analysis. A prudent pattern was characterized by higher intakes of fruit, vegetables, legumes, fish, poultry, and whole grains, and a Western pattern was characterized by higher intakes of red and processed meats, sweets, desserts, French fries, and refined grains. The prudent pattern was inversely associated with plasma concentrations of CRP (P = 0.02) and E-selectin (P = 0.001) after adjustment for age, body mass index (BMI), physical activity, smoking status, and alcohol consumption. The Western pattern showed a positive relation with CRP (P < 0.001), interleukin 6 (P = 0.006), E-selectin (P < 0.001), sICAM-1 (P < 0.001), and sVCAM-1 (P = 0.008) after adjustment for all confounders except BMI; with further adjustment for BMI, the coefficients remained significant for CRP (P = 0.02), E-selectin (P < 0.001), sICAM-1 (P = 0.002), and sVCAM-1 (P = 0.02). Because endothelial dysfunction is an early step in the development of atherosclerosis, this study suggests a mechanism for the role of dietary patterns in the pathogenesis of cardiovascular disease.

Metabolic responses to a traditional Mexican diet compared with a commonly consumed US diet in women of Mexican descent: A randomized crossover feeding trial

Abstract

No full-text available

Recommended publications

Metabolic Responses to a Traditional Mexican versus commonly consumed U.S. Diet among Women of Mexic...