Showing papers by "Tonatiuh Barrientos-Gutiérrez published in 2020"
TL;DR: This study’s aim was to explore the association of obesity, type 2 diabetes, and hypertension with severe coronavirus disease 2019 on admission on admission.
Abstract: OBJECTIVE: This study's aim was to explore the association of obesity, type 2 diabetes, and hypertension with severe coronavirus disease 2019 (COVID-19) on admission METHODS: In the present study, a total of 23,593 patient samples were evaluated by a laboratory from the Mexican Institute of Epidemiological Diagnosis and Reference Of these, 18,443 were negative for COVID-19, 3,844 were positive for COVID-19, and 1,306 were positive for other respiratory viruses Severe types of respiratory disease were defined by the presence of pneumonia and other organ failure that requires intensive care Multivariable logistic regression models were used to explore factors associated with severe COVID-19 on admission RESULTS: Patients who tested positive for COVID-19 had a higher proportion of obesity (174%), diabetes (145%), and hypertension (189%) compared with those without a confirmed diagnosis Compared with patients without obesity, those with obesity showed a 143-fold higher odds of developing severe COVID-19 on admission, whereas subjects with diabetes and hypertension showed a 187-fold and 177-fold higher odds of developing severe COVID-19 on admission, respectively CONCLUSIONS: Obesity, diabetes, and hypertension were significantly associated with severe COVID-19 on admission and the association of obesity was stronger in patients < 50 years of age
70 citations
TL;DR: The Mexican sugar sweetened beverage tax was associated with a reduction in the probability of consuming soft drinks in this cohort of employees from a healthcare provider, suggesting that three years after implementation, the tax had helped to increase the proportion of people who do not consume soft drinks while decreasing theportion of high and medium consumers.
Abstract: Objective To examine changes in categories of soft drink consumption in a cohort of Mexican adults, three years after the implementation of the sugar sweetened beverage tax. Design Open cohort longitudinal analysis. Setting Three waves of the Health Workers Cohort Study, Mexico, spanning 2004 to 2018. Participants 1770 people aged 19 years or older with information on drinks consumption available in at least one of the three cohort waves. Main outcome measure Change in probability of belonging to one of four categories of soft drinks consumption (non, low, medium, high) after the tax was implemented. Heterogeneity of associations by income and education was also assessed. Results Before the implementation of the tax, more than 50% of the participants were medium and high consumers of soft drinks and less than 10% were in the non-consumer category. After the tax was implemented, 43% of the population was categorised as medium or high consumers and the prevalence of non-consumers increased to 14%. Three years after implementation of the tax on 1 January 2014, the probability of being a non-consumer of soft drinks increased by 4.7 (95% confidence interval 0.3 to 9.1) percentage points and that of being a low consumer increased by 8.3 (0.6 to 16.0) percentage points compared with the pre-tax period. Conversely, the probability of being in the medium and high levels of soft drinks consumption decreased by 6.8 (0.5 to 13.2) percentage points and 6.1 (0.4 to 11.9) percentage points, respectively. No significant heterogeneity of the tax across income levels was observed, but stronger effects of the tax were seen in participants with secondary school education or higher, compared with those with elementary school or less. Conclusions The Mexican sugar sweetened beverage tax was associated with a reduction in the probability of consuming soft drinks in this cohort of employees from a healthcare provider. The results cannot be extrapolated to the Mexican population, but they suggest that three years after implementation, the tax had helped to increase the proportion of people who do not consume soft drinks while decreasing the proportion of high and medium consumers.
45 citations
TL;DR: It is estimated that warning labels may effectively reduce obesity and obesity-related costs in Mexico and other countries could benefit from this intervention.
Abstract: Background In October 2019, Mexico approved a law to establish that nonalcoholic beverages and packaged foods that exceed a threshold for added calories, sugars, fats, trans fat, or sodium should have an "excess of" warning label. We aimed to estimate the expected reduction in the obesity prevalence and obesity costs in Mexico by introducing warning labels, over 5 years, among adults under 60 years of age. Methods and findings Baseline intakes of beverages and snacks were obtained from the 2016 Mexican National Health and Nutrition Survey. The expected impact of labels on caloric intake was obtained from an experimental study, with a 10.5% caloric reduction for beverages and 3.0% caloric reduction for snacks. The caloric reduction was introduced into a dynamic model to estimate weight change. The model output was then used to estimate the expected changes in the prevalence of obesity and overweight. To predict obesity costs, we used the Health Ministry report of the impact of overweight and obesity in Mexico 1999-2023. We estimated a mean caloric reduction of 36.8 kcal/day/person (23.2 kcal/day from beverages and 13.6 kcal/day from snacks). Five years after implementation, this caloric reduction could reduce 1.68 kg and 4.98 percentage points (pp) in obesity (14.7%, with respect to baseline), which translates into a reduction of 1.3 million cases of obesity and a reduction of US$1.8 billion in direct and indirect costs. Our estimate is based on experimental evidence derived from warning labels as proposed in Canada, which include a single label and less restrictive limits to sugar, sodium, and saturated fats. Our estimates depend on various assumptions, such as the transportability of effect estimates from the experimental study to the Mexican population and that other factors that could influence weight and food and beverage consumption remain unchanged. Our results will need to be corroborated by future observational studies through the analysis of changes in sales, consumption, and body weight. Conclusions In this study, we estimated that warning labels may effectively reduce obesity and obesity-related costs. Mexico is following Chile, Peru, and Uruguay in implementing warning labels to processed foods, but other countries could benefit from this intervention.
42 citations
TL;DR: Describing changes in the composition of the retail food environment in Mexican neighborhoods from 2010 to 2016 and examining the association between these changes and diabetes cases diagnosed over the same period could inform policies that improve the quality of food environments in cities.
27 citations
TL;DR: A highly inflammatory diet is associated with metabolic syndrome, hypertension, abdominal obesity, and hypertriglyceridemia; yet, a reduction in dietary components that have been linked to inflammation is desirable.
27 citations
TL;DR: Using current evidence linking SSBs to cardiometabolic disease and obesity-related cancers, earlier estimates of Mexican mortality attributable to SSBs could have been underestimated.
Abstract: In 2010, sugar sweetened beverages (SSBs) were estimated to cause 12% of all diabetes, cardiovascular disease (CVD) and obesity-related cancer deaths in Mexico. Using new risk estimates for SSBs consumption, we aimed to update the fraction of Mexican mortality attributable to SSBs, and provide subnational estimates by region, age, and sex. We used an established comparative risk assessment framework. All-cause mortality estimates were calculated from a recent pooled cohort analysis. Age- and sex-specific relative risks for SSBs-disease relationships were obtained from updated meta-analyses. Demographics and nationally representative estimates of SSBs intake were derived from the National Health and Nutrition Survey 2012; and mortality rates, from the National Institute of Statistics and Geography. Attributable mortality was calculated by estimating the population attributable fraction of each disease, with uncertainty in data inputs propagated through Monte Carlo probabilistic sensitivity analyses. In Mexican adults 20 years and older, 6.9% (95%UI: 5.4–8.5) of all cause-mortality was attributable to SSBs, representing 40,842 excess deaths/year (95%UI: 31,950–50,138). Furthermore, 19% of diabetes, CVD and obesity-related cancer mortality was attributable to SSBs (95%UI: 11.0–26.5), representing 37,000 excess deaths/year (95%UI 21,240–51,045). Of these, 35.6% were diabetes-related (95%UI 16.4–52.0). Proportional burden was highest in the South (22.8%), followed by the Center (18.0%) and North (17.4%). Men aged 45–64-years in the Center region had highest proportional mortality (37.2%), followed by 20–44-year-old men living in the South (35.7%) and both men and women aged 20–44 living in the Center (34.4%). Utilizing current evidence linking SSBs to cardiometabolic disease and obesity-related cancers, earlier estimates of Mexican mortality attributable to SSBs could have been underestimated. Mexico urgently needs stronger policies to reduce SSBs consumption and reduce these burdens.
23 citations
TL;DR: The estimation of the magnitude of the epidemic through a nationwide seroprevalence panel, as well as new strategies to monitor the epidemic in real time, and the negative externalities associated to the pandemic are analyzed.
Abstract: Covid-19 represents one of the largest challenges in the recent history of public health. It is fundamental that we strengthen scientific cooperation under a common goal: to protect the health of the population. In this article, we present ideas that need urgent and collaborative efforts. We discuss the estimation of the magnitude of the epidemic through a nationwide seroprevalence panel, as well as new strategies to monitor the epidemic in real time. We also analyze the negative externalities associated to the pandemic. Finally, we present a general framework to develop ideas to come out of the lockdown, highlighting the importance of implementing sustainable and equitable structural interventions. We call for solidarity and cooperation, focusing our efforts and creativity in the resolution of the problems that currently affect Mexico and the world.
18 citations
TL;DR: In Mexico, a 10% tax to sugar‐sweetened beverages was implemented in 2014 and projections of the potential health effect of this tax in children are not available.
Abstract: BACKGROUND In Mexico, a 10% tax to sugar-sweetened beverages was implemented in 2014. Projections of the potential health effect of this tax in children are not available. OBJECTIVE To estimate the 1-year effect of the tax on the body weight of children 5 to 17 years old, and estimated alternative scenarios with higher tax rates (20%, 30%, and 40%). METHODS We used a dynamical mathematical model, recalibrated to the Mexican population. Input data were obtained from the Mexican National Health and Nutrition Survey 2006 and 2012. We estimated the expected average weight reduction, stratified by category of sugar-sweetened beverages consumption. RESULTS With a 10% tax, we estimated an overall weight reduction of 0.26 kg for children and 0.61 kg for adolescents; in high consumers, the reduction could reach 0.50 and 0.87 kg, respectively. Higher tax rates would produce larger weight decreases; in high consumers a 40% tax would result in a reduction of 1.99 kg for children and 3.50 kg for adolescents. CONCLUSION The tax represents an effective component of any child or adolescent weight control program, and must be considered as part of any integrated population-level program for children and adolescent obesity prevention.
11 citations
TL;DR: While coronary heart disease (CHD) mortality is falling in Argentina, modest falls in Colombia and substantial increases in Mexico highlight the need for the region to propose and implement population-wide prevention policies.
Abstract: Mortality rates due to coronary heart disease (CHD) have decreased in most countries, but increased in low and middle-income countries. Few studies have analyzed the trends of coronary heart disease mortality in Latin America, specifically the trends in young-adults and the effect of correcting these comparisons for nonspecific causes of death (garbage codes). The objective of this study was to describe and compare standardized, age-specific, and garbage-code corrected mortality trends for coronary heart disease from 1985 to 2015 in Argentina, Colombia, and Mexico. Deaths from coronary heart disease were grouped by country, year of registration, sex, and 10-year age bands to calculate age-adjusted and age and sex-specific rates for adults aged ≥25. We corrected for garbage-codes using the methodology proposed by the Global Burden of Disease. Finally, we fitted Joinpoint regression models. In 1985, age-standardized mortality rates per 100,000 population were 136.6 in Argentina, 160.6 in Colombia, and 87.51 in Mexico; by 2015 rates decreased 51% in Argentina and 6.5% in Colombia, yet increased by 61% in Mexico, where an upward trend in mortality was observed in young adults. Garbage-code corrections produced increases in mortality rates, particularly in Argentina with approximately 80 additional deaths per 100,000, 14 in Colombia and 13 in Mexico. Latin American countries are at different stages of the cardiovascular disease epidemic. Garbage code correction produce large changes in the mortality rates in Argentina, yet smaller in Mexico and Colombia, suggesting garbage code corrections may be needed for specific countries. While coronary heart disease (CHD) mortality is falling in Argentina, modest falls in Colombia and substantial increases in Mexico highlight the need for the region to propose and implement population-wide prevention policies.
10 citations
10 Sep 2020
TL;DR: The physical and social environments of Latin American cities, the lack of public health and health-care infrastructure, and pro-active measures to address these issues need to be considered.
Abstract: Latin America is the most unequal and urbanized region of the world. The physical and social environments of Latin American cities, the lack of public health and health-care infrastructure, and pro...
10 citations
TL;DR: The consumption of soft drinks was associated with a higher risk of type 2 diabetes in a cohort of Mexican adults, and recommendations to limit soft drinks intake to address the growing diabetes epidemic in Mexico are supported.
Abstract: Although high consumption of soft drinks has been associated with excess of type 2 diabetes risk, the strength of this association in the Mexican population, where a type 2 diabetes genetic susceptibility has been well established, has been scarcely studied. This study aimed to estimate the risk of type 2 diabetes due to soft drinks consumption in a cohort of Mexicans. We used data on 1445 participants from the Health Workers Cohort Study, a prospective cohort conducted in Cuernavaca, Mexico. Soft drinks consumption was assessed with a semi-quantitative 116-item food frequency questionnaire. Incident type 2 diabetes was defined as self-report of physician-diagnosed type 2 diabetes, fasting glucose > 126 mg/dl, or hypoglycemic medication at any examination. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models. With a total of 9526.2 person-years of follow-up, 109 incident cases of type 2 diabetes were observed. Type 2 diabetes incidence rate was 7.6, 11.0, and 17.1 per 1000 person-years across levels of soft drinks consumption of < 1, 1–4, and ≥ 5 servings/week, respectively (p < 0.001 for trend). The intake of ≥5 soft drinks/week was significantly associated with an increased risk of type 2 diabetes (HR 1.9 95% CI:1.0–3.5) compared with consumption of < 1/week (p-trend = 0.040). The HR was attenuated by further adjustment for body mass index (HR 1.5 95%CI:0.8–2.8) and abdominal obesity (HR 1.6 95%CI:0.8–3.0). The consumption of soft drinks was associated with a higher risk of type 2 diabetes in a cohort of Mexican adults. Our results further support recommendations to limit soft drinks intake to address the growing diabetes epidemic in Mexico.
TL;DR: Soft drink intake was associated with weight gain, and the idea that leisure-time physical activity is sufficient to counterbalance weight gain associated to soft drink intake is challenged.
Abstract: While soft drink intake is positively associated with weight gain, no previous study has investigated whether leisure-time physical activity modifies this association. We estimated the association between soft drink intake and body weight, and explored if this association differed by levels of leisure-time physical activity. We used data from the health workers cohort study, a prospective study of Mexican adults (20 to 85y old), including 1268 health workers and their families, who were assessed at baseline (2004–2006) and follow-up (2010–2012). We assessed soft drink intake (cola and flavored soda) using a validated food frequency questionnaire. We measured leisure-time physical activity using a self-report questionnaire, and categorized according to the 2010 World Health Organization (WHO) recommendations. Body weight was measured by trained personnel. The association between changes in soft drink intake and weight change, and if such association varied by levels of physical activity was estimated through fixed-effect models. An increase in one serving per day of soft drink was associated with 0.10 kg (95% CI 0.00, 0.19) increase in weight per year. This association was not modified by leisure-time physical activity, as demonstrated by the magnitude of the coefficient of the interaction between soft drink, leisure-time physical activity, and time (− 0.03 kg, 95% CI − 0.27 to 0.21); people who complied with the WHO physical activity recommendations gained 0.36 kg/year per serving of soft drink, compared to 0.48 kg/year for people without sufficient physical activity. Soft drink intake was associated with weight gain. Leisure-time physical activity did not modify the association between soft drink intake and weight gain. This finding challenges the idea that leisure-time physical activity is sufficient to counterbalance weight gain associated to soft drink intake.
TL;DR: Assessment of the effectiveness of using surgical masks in community settings to reduce the probability of infection by SARS-CoV-2 or other acute viral respiratory infection, compared to not using surgical mask found insufficient scientific evidence to support the general use of surgical masks.
Abstract: Objective: To assess the effectiveness of using surgical masks in community settings to reduce the probability of infection by SARS-CoV-2 or other acute viral respiratory infection, compared to not using surgical masks. Material and methods: We followed the Cochrane rapid review methodology. The search strategy encompasses one academic database and pre-prints until April 1, 2020. Titles and abstracts were reviewed by one investigator. The full text review was divided among three researchers. The results were synthesized in a narrative way. Results: 713 manuscripts were identified, of which 21 met the inclusion criteria. Of six systematic reviews, four found no reduction in the probability of transmission. Experimental home studies found no differences in the probability of contagion associated with the use of mouth masks. Three modeling studies estimated reductions of 20% in the incidence of respiratory disease, assuming that 10 to 50% of the population has correct use of mouth masks. Conclusions: We did not find sufficient scientific evidence to support the general use of surgical masks to reduce the number of viral respiratory infection.
TL;DR: In this paper, the authors used multivariate models, with logistic or linear regression, depending on the outcome variable, to estimate levels of early childhood develop-ment (ECD) and associated factors in Mexican population aged 19-59 months.
Abstract: espanolObjetivo. Estimar el nivel de desarrollo infantil temprano (DIT) y sus factores asociados en poblacion mexicana de 19 a 59 meses. Material y metodos. La Encuesta Nacional de Salud Publica y Nutricion 2018-19 evaluo el DIT mediante el Indice de Desarrollo Infantil Temprano (ECDI) y el nivel de desarrollo de lenguaje. Se estimaron modelos multivariados de acuerdo con la variable de resultado, usando modelos de regresion logistica o lineal. Resultados. Los ninos/as de hogares con mayor nivel socioeconomico y que cuentan con libros infantiles en el hogar tienen mayores posibilidades de DIT adecuado, mientras que los/as ninos/as educados con metodos de disciplina violenta tienen menores posibilidades. Ademas,los ninos/as residentes de areas rurales, hijos/as de madres con mayor escolaridad, sin desnutricion y con oportunidades de aprendizaje tienen un mayor puntaje de lenguaje. Conclusion. Las politicas publicas encaminadas a mejorar el desarrollo en la primera infancia deben tomar en cuenta los factores modificables asociados EnglishObjective. To estimate levels of early childhood develop-ment (ECD) and associated factors in Mexican population aged 19-59 months. Materials and methods. The Ensanut 2018-19 evaluated ECD using the Early Childhood Development Index (ECDI) and level of language develop-ment. We used multivariate models, with logistic or linear regression, depending on the outcome variable. Results. Children of wealthier households and with children’s books at home are more likely of having an adequate ECDI; in contrast, children who experienced violent discipline methods are less likely. Children living in rural areas, with more highly educated mothers, who were not undernourished, and with support for learning have higher language scores. Conclusion. Public policies aimed to enhance early childhood development should take into account the associated modifiable factors.
TL;DR: The results suggest that the consumption of SSBs is associated with an increased risk of hyperuricemia in Mexican adults, but diet soft drink consumption is not, which supports the need to strengthen existing recommendations to reduce the intake of SSB.
TL;DR: There was wide variation in adolescent exposure to tobacco between cities (within countries), which suggested major heterogeneity of policy implementation at the local level, and policies related to media/promotions and secondhand smoke need strengthening.
Abstract: Our objective was to describe the prevalence and changes in tobacco use and tobacco control policies in Latin American countries and cities before and after ratification of the 2003 Framework Convention on Tobacco Control (FCTC). Country-level tobacco policy data came from reports on the global tobacco epidemic (World Health Organization, 2007-2014). Global Youth Tobacco Survey data, 2000-2011, came from six countries (Argentina, Brazil, Chile, Colombia, Mexico, Peru), 31 cities and 132,065 students. Pre- and post-FCTC prevalence and relative changes were estimated. All countries showed improvements in tobacco control policies but Mexico and Peru showed the smallest improvements. In general, adolescents reduced their tobacco use, reported less exposure to smoking at home, more tobacco education, and more retailer refusals to sell them cigarettes. Adolescents reported smaller reductions in secondhand smoke exposure outside the home and no change in exposure to tobacco media/promotions. Pre-FCTC prevalence and relative changes during the post-FCTC period were more heterogeneous across cities than across countries. Despite overall improvements in tobacco policies and the decline in exposure to tobacco, policies related to media/promotions and secondhand smoke need strengthening. There was wide variation in adolescent exposure to tobacco between cities (within countries), which suggested major heterogeneity of policy implementation at the local level.
TL;DR: The hypothesis that, in Mexican adults, a higher soft drink consumption is associated with an increase in HOMA-IR, despite known risk factors is supported, and the need for reinforcing policies to reduceSoft drink consumption in the population is supported.
TL;DR: In this article, the authors determine the nivel de evidencia sobre the probabilidad of transmision of enfermedades respiratorias agudas in the transporte publico.
Abstract: Objetivos. Determinar el nivel de evidencia sobre la probabilidad de transmision de enfermedades respiratorias agudas en el transporte publico, incluyendo transporte activo, e identificar medidas en el uso del transporte publico que puedan reducir la probabilidad de contagio por SARS-CoV-2 u otra infeccion respiratoria aguda de etiologia viral. Material y metodos. Se utilizo la metodologia de revisiones rapidas de Cochrane. La estrategia de busqueda abarco una base de datos academica y manuscritos pre-impresos hasta el 12 de mayo de 2020. Los titulos y resumenes fueron revisados por un investigador. La revision de textos completos y extraccion de datos fue dividida entre dos investigadores. Los resultados fueron sintetizados de forma narrativa. Resultados. Se identificaron 535 manuscritos publicados, de los cuales 13 cumplieron los criterios de seleccion. La mayoria de los estudios observacionales revisados reportaron un incremento en la probabilidad de infecciones respiratorias asociado al uso del transporte publico. La estimacion agrupando los estudios de cohorte que analizaron la incidencia de seroconversion fue de 54% mayor posibilidad de influenza A o B en personas con uso frecuente de transporte publico en comparacion con las personas con un uso poco frecuente del sistema de transporte publico (OR: 1.54; IC 95%: 1.06, 2.01); la inclusion de estudios sin confirmacion de casos atenuo esta asociacion, haciendola no significativa. Se identificaron tres estudios que modelaron medidas de mitigacion de transmision de enfermedades respiratorias en el transporte publico. Estos estudios sugieren que reducir el tiempo en transporte publico (no mas de 30 minutos), limitar el numero de pasajeros, y asegurar una adecuada ventilacion de las unidades de transporte podria ayudar a reducir el contagio. Conclusion. La evidencia cientifica sugiere que la probabilidad de contagio por enfermedades respiratorias agudas puede incrementar con el uso del transporte publico. Es importante identificar estrategias de mitigacion en el transporte publico que sean equitativas y permitan una variedad de opciones para los usuarios, incluyendo el transporte activo (caminar, bicicleta). [PREPRINT]
TL;DR: CHD mortality in Mexico is increasing due to adverse trends in major risk factors and suboptimal use of CHD treatments, and population-level interventions to reduce CHD risk factors are urgently needed.
Abstract: Background Mexico is still in the growing phase of the epidemic of coronary heart disease (CHD), with mortality increasing by 48% since 1980. However, no studies have analyzed the drivers of these trends. We aimed to model CHD deaths between 2000 and 2012 in Mexico and to quantify the proportion of the mortality change attributable to advances in medical treatments and to changes in population-wide cardiovascular risk factors. Methods We performed a retrospective analysis using the previously validated IMPACT model to explain observed changes in CHD mortality in Mexican adults. The model integrates nationwide data at two-time points (2000 and 2012) to quantify the effects on CHD mortality attributable to changes in risk factors and therapeutic trends. Results From 2000 to 2012, CHD mortality rates increased by 33.8% in men and by 22.8% in women. The IMPACT model explained 71% of the CHD mortality increase. Most of the mortality increases could be attributed to increases in population risk factors, such as diabetes (43%), physical inactivity (28%) and total cholesterol (24%). Improvements in medical and surgical treatments together prevented or postponed 40.3% of deaths; 10% was attributable to improvements in secondary prevention treatments following MI, while 5.3% to community heart failure treatments. Conclusions CHD mortality in Mexico is increasing due to adverse trends in major risk factors and suboptimal use of CHD treatments. Population-level interventions to reduce CHD risk factors are urgently needed, along with increased access and equitable distribution of therapies.
TL;DR: The findings support the development of strategies focused on promoting dietary patterns that can help to prevent and control the disease.
Abstract: The aims of the present study were to compare the adherence to dietary guidelines and evaluate potential differences in nutrient profiles among adults by diabetes status. We used the Mexican Alternate Healthy Eating Index (MxAHEI) to evaluate adherence to dietary guidelines. We calculated the MxAHEI scores (total and by dietary component) with scales from 0 (non-adherence) to 100 (perfect adherence) based on a food frequency questionnaire. Mean daily intakes of macronutrients and micronutrients (g, mg, mcg/1000 kcal per day) were also estimated by diabetes status. Sex-specific, multivariable linear regression models were estimated to test whether MxAHEI scores as well as nutrient intakes were different by diabetes status. Mexican adults had low adherence to the dietary guidelines irrespective of their diabetes status (score < 50 points). Among men, the MxAHEI score was 2.6 points higher among those with diabetes than those without diabetes (46.9; 95% confidence intervals (CI): 44.6, 49.2 vs. 44.3; 95% CI: 44.2, 45.6, respectively). Among women, the total MxAHEI score was similar in individuals with diabetes compared to those without diabetes. Lower intakes of carbohydrates and added sugars and higher intakes of protein, calcium, and zinc were observed in individuals with diabetes. Our findings support the development of strategies focused on promoting dietary patterns that can help to prevent and control the disease.
TL;DR: A revisión rápida de lo publicado en PubMed y MedRxiv, se incluyeron recomendaciones para reducir el riesgo de contagio indirecto, y se requieren estudios que determinen the dosis mínima infectante por autoinoculación.
Abstract: Objetivo. Identificar evidencia cientifica sobre la transmision indirecta del SARS-CoV-2 en espacios extrahospitalarios y medidas poblacionales para su prevencion. Material y metodos. Una revision rapida de lo publicado en PubMed y MedRxiv entre 01/12/2019 y 24/04/2020 sobre los temas 1) la contaminacion y viabilidad del SARS-CoV-2 en distintas superficies inanimadas; 2) la efectividad desinfectante ante SARS-CoV-2 de productos accesibles a nivel domiciliario; 3) los casos y brotes de contagio de SARS-CoV-2 por medio de superficies. Resultados. Una alta proporcion de los objetos de personas infectadas con SARS-CoV-2 (inodoro, ollas y tabletas electronicas) se encuentran contaminados. Este virus permanece viable desde horas hasta dias en papel, carton, tela, vidrio, madera, plastico, acero y cubrebocas. El etanol, 2-propanol, cloro y jabon son efectivos para desactivarlo. Existe poca evidencia sobre casos y brotes por contagio indirecto. Conclusiones. Se requieren estudios que determinen la dosis minima infectante por autoinoculacion. Apelando al principio precautorio, se incluyeron recomendaciones para reducir el riesgo de contagio indirecto.
TL;DR: Es necesario fomentar el acceso y uso of MAC de manera consistente, basado en el respeto a los derechos sexuales y reproductivos, según las encuestas Nacionales de Salud y Nutrición 2012-2019.
Abstract: espanolObjetivo. Analizar la prevalencia de uso de metodos anticonceptivos (MAC) modernos en adolescentes de 12 a19 anos en 2012 y 2018-19, y factores asociados con su uso consistente. Material y metodos. A partir de las Encuestas Nacionales de Salud y Nutricion 2012 y 2018-19, se construyeron variables de interes: uso de anticonceptivos reversibles de accion prolongada (ARAP), proteccion dual y uso consistente de MAC. Se calcularon prevalencias y modelos logisticos para uso consistente de MAC. Resultados. El uso de ARAP en la ultima relacion se incremento entre encuestas (4.1 a 6.3%). Tener mayor edad, no embarazo y asistencia escolar incrementaron la posibilidad de uso consistente en mujeres; en hombres, la asistencia escolar la incremento, y vivir en union, inicio temprano de vida sexual y consumir >100 cigarrillos la disminuyeron. Conclusion. Es necesario fomentar el acceso y uso de MAC de manera consistente, basado en el respeto a los derechos sexuales y reproductivos. EnglishObjective. To analyze the prevalence of modern contracep-tive methods (CM) use in adolescents aged 12 to 19 years in 2012 and 2018-19, and the factors associated with consistent use of modern CM. Materials and methods. Using the Health and Nutrition National Surveys 2012 and 2018-19 we calculated the outcome variables: long-acting reversible con-traceptives (LARC) use, dual protection and consistent use of CM. We estimated prevalence by sex and adjusted logistic models with consistent use (which is understood as CM use in the first and last sexual relationship) as a dependent variable. Results. LARC use in last intercourse increased between surveys (4.1 to 6.3%). For women, being older, not having been pregnant, and school attendance increased the likelihood of consistent use. For men, school attendance increases the likelihood while cohabiting, early sexual initiation and having smoked more than 100 cigarettes reduces it. Conclusion.It is necessary to promote access and consistent use of MC, based on respect for sexual and reproductive rights.
TL;DR: In this article, the effectiveness of using surgical masks in community settings to reduce the probability of infection by SARS-CoV-2 or other acute viral respiratory infection, compared to not using surgical mask, was evaluated.
Abstract: Objective To assess the effectiveness of using surgical masks in community settings to reduce the probability of infection by SARS-CoV-2 or other acute viral respiratory infection, compared to not using surgical masks. Materials and methods We followed the Cochrane rapid review methodology. The search strategy encompasses one academic database and pre-prints until April 1, 2020. Titles and abstracts were reviewed by one investigator. The full text review was divided among three researchers. The results were synthesized in a narrative way. Results 713 manuscripts were identified, of which 21 met the inclusion criteria. Of six systematic reviews, four found no reduction in the probability of transmission. Experimental home studies found no differences in the probability of contagion associated with the use of mouth masks. Only one modeling study estimated a 20% reduction in the incidence of acute respiratory disease, assuming that 10 to 50% of the population use the surgical masks correctly. Conclusions The scientific evidence is inconclusive to recommend or discourage the use of surgical masks at the population level. Considering the potential negative effects, official recommendations should await for the results of natural experiments currently occurring in countries that have recommended the use of face masks at the population level.