Validating the Emotion Regulation Questionnaire in Mexican Children and Adolescents

Relationships between physical activity and bone mineral content and lean mass in Mexican adolescents.

To evaluate patterns of water consumption from plain water, beverages and foods among Mexican children and adolescents and to compare actual patterns of total daily water intake with the Dietary Reference Intakes (DRI). We analysed one 24 h dietary recall from Mexican children and adolescents. We calculated intakes of total daily water and water from foods and from beverages. Actual total water intake per capita was subtracted from the DRI for water to calculate the shortfall. Mexican National Health and Nutrition Survey in 2012. Mexican children and adolescents (n 6867) aged 1-18 years. Approximately 73% of children and adolescents aged 1-18 years reported drinking plain water. Beverages and plain water represented 65·5% and 26·5% of total daily water intake, respectively. Among 1-3-year-olds, the top three main sources of water were from foods, plain water and water from plain milk. Among 4-8- and 9-13-year-olds, the main sources were from foods, plain water and agua fresca (fruit water). Among 14-18-year-olds, the main sources of water were plain water, water from foods and soda. A higher proportion of 1-3-year-olds and 4-8-year-olds met the DRI for water (38% and 29%, respectively). Among 9-13-year-olds and 14-18-year-olds, 13-19% of children met the DRI for water. Total daily water intakes remain below DRI levels in all age groups. Although plain water still contributes the greatest proportion to daily water intake among fluids, caloric beverages are currently major sources of water especially among older children and adolescents.

The prevalence of overweight and obesity has been rising among Mexican children and adolescents in the last decades. To systematically review obesity prevention interventions delivered to Mexican children and adolescents. Thirteen databases and one search engine were searched for evidence from 1995 to 2021. Searches were done in English and Spanish to capture relevant information. Studies with experimental designs, delivered in any setting (e.g., schools or clinics) or digital domains (e.g., social media campaigns) targeting Mexican children or adolescents (≤ 18 years) and reporting weight outcomes, were included in this review. In addition, the risk of bias was appraised with the Effective Public Health Practice Project Quality Assessment Tool. Twenty-nine studies with 19,136 participants (3–17 years old) were included. The prevalence of overweight and obesity at baseline ranged from 21 to 69%. Most of the studies (89.6%) were delivered in school settings. The duration ranged from 2 days to 3 school years, and the number of sessions also varied from 2 to 200 sessions at different intensities. Overall, anthropometric changes varied across studies. Thus, the efficacy of the included studies is heterogeneous and inconclusive among studies. Current evidence is heterogeneous and inconclusive about the efficacy of interventions to prevent obesity in Mexican children and adolescents. Interventions should not be limited to educational activities and should include different components, such as multi-settings delivery, family inclusion, and longer-term implementations. Mixed-method evaluations (including robust quantitative and qualitative approaches) could provide a deeper understanding of the effectiveness and best practices.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11121-021-01316-6.

Seventy percent of Mexican households experience some level of food insecurity (FI). Studies have shown positive associations between FI and poor dietary quality. As far as it is known, this is the first time the Healthy Eating Index (HEI-2010) has been used to assess dietary quality of children and adolescents in Mexico, and to examine if FI is related to it. The objective of this research is to assess dietary quality and its association with FI among Mexican children and adolescents from a nationally representative cross-sectional sample. We analyzed data from 4635 2-19-year-old Mexican children and adolescents participating in the Mexican National Health and Nutrition Survey (Ensanut 2012). FI was measured using the Latin American and Caribbean Household Food Security Scale (ELCSA) and dietary quality with the HEI-2010. We examined the association between FI and dietary quality using multivariate linear regressions. Dietary quality was worst as FI became more severe among children and adolescents compared with their counterparts living in households with food security. Specifically, FI had a negative association with fruits, vegetables, and protein foods, and a positive association with refined grains consumption. Dairy intake was negatively associated with FI among older children and adolescents. Added sugars were not associated with FI, but intake was excessive across the population at 15% of total daily energy intake. Decreasing FI may help improve dietary quality of Mexican children and adolescents.

Background/Objective: Insulin resistance (IR) is a metabolic disorder that is increasing worldwide and has been associated with several negative health outcomes. The aim of this study was to evaluate the relationship between different dietary patterns and IR among Mexican children and adolescents. Methods: We performed a cross-sectional analysis on baseline data from Mexican children and adolescents aged 7–18 years participating in the Health Workers Cohort Study. We included 916 children and adolescents of both sexes. Fasting serum glucose and insulin levels were determined by standardized methods. We defined IR using the homeostasis model assessment (HOMA) as ≥3.5. Factor analysis was used to identify dietary patterns. The associations of interest, those between IR and dietary patterns, were analyzed with multiple logistic regression models. Results: IR prevalence was 20.3% among girls and boys aged 7–18 years, for whom the prevalence of overweight and obesity was 29.7%. We identified 3 major dietary patterns in this group: ‘Western’, ‘prudent’ and ‘high protein/fat’. For the purposes of this analysis we compared the upper versus the lower quintile of each dietary pattern. Independently of other covariates, participants in the highest quintile of the Western pattern had 92% greater odds of IR (OR 1.92, 95% CI: 1.08–3.43) compared with those in the lowest quintile. Conclusions: These findings support the hypothesis that high carbohydrate diets like our Western dietary pattern may increase IR in young people. This result emphasizes the importance of preventive nutrition interventions geared toward Mexican children and adolescents.

The prevalence of abdominal obesity in Mexican children has risen dramatically in the past decade. Genome-wide association studies (GWAS) for waist-to-hip ratio (WHR) performed predominantly in European descent adult populations have identified multiple single-nucleotide polymorphisms (SNPs) with larger effects in women. The contribution of these SNPs to WHR in non-European children is unknown. Mexican children and adolescents (N = 1421, 5-17 years) were recruited in Mexico City. Twelve GWAS SNPs were genotyped using TaqMan Open Array and analyzed individually and as a gene score (GS). Mexican boys and girls displayed 2.81 ± 0.29 and 3.10 ± 0.31 WHR standard deviations higher than children and adolescents from the United States. WHR was positively associated with TG (β = 0.733 ± 0.190, P = 1.1 × 10-4) and LDL-C (β = 0.491 ± 0.203, P = 1.6 × 10-2), and negatively associated with HDL-C (β = -0.652 ± 0.195, P = 8.0 × 10-4), independently of body mass index. The effect allele frequency (EAF) of 8 of 12 (67%) SNPs differed significantly (P < 4.17 × 10-3) in Mexican children and European adults, with no evidence of effect allele enrichment in both populations (4 depleted and 4 enriched; binomial test, P = 1). Ten out of 12 SNPs (83.3%) had effects that were directionally consistent with those reported in GWAS (P = 0.04). HOXC13 rs1443512 displayed the best fit when modeled recessively, and was significantly associated with WHR under a recessive mode of inheritance (β = 0.140 ± 0.06, P = 2.3 × 10-2). Significant interactions with sex were also observed for HOXC13 rs1443512 and the GS on WHR (P = 2.2 × 10-2 and 1.2 × 10-2, respectively). HOXC13 rs1443512 (β = 0.022 ± 0.012, P = 4.7 × 10-2) and the GS (β = 0.007 ± 0.003, P = 7.0 × 10-3) were significantly associated with WHR in girls only. This study demonstrates that Mexican children are at high risk for abdominal obesity and detrimental lipid profiles. Our data support a partial transferability of sex-specific European GWAS WHR association signals in children and adolescents from the admixed Mexican population.

Obesity and mental health issues increasingly affect children and adolescents, but whether obesity is a risk factor for mental health issues is unclear. To systematically review the association between obesity and mental health issues (ie, anxiety and/or depression) among Mexican children and adolescents. A literature search of 13 databases and 1 search engine was conducted. Population, exposure, comparison, outcomes, and study design data were extracted, analyzed, and narratively synthesized. The JBI critical appraisal tool was used to evaluate evidence quality. A total of 16 studies with 12 103 participants between 8 and 18 years old were included. Four studies focused on anxiety outcomes, 10 on depression, and 2 on both (ie, anxiety and depression). Evidence is unclear about the association of obesity with anxiety. However, most evidence shows that Mexican children and adolescents with overweight or obesity are more likely to have depression or report a higher number of depressive symptoms than normal-weight participants. Such likelihood is greater for females. Health promotion interventions to treat or prevent obesity could also consider mental health outcomes. PROSPERO registration no. CRD42019154132.

Obesity and micronutrient deficiencies in the pediatric population of Mexico pose significant public health challenges. However, the relationship between these two conditions is still being studied. To systematically review evidence on the association between overweight and obesity and micronutrient deficiencies among Mexican children and adolescents. A systematic search was conducted in 13 databases and one search engine. Sixteen studies met the eligibility criteria and were included in this review. A total of 20 043 participants were included across the included studies, and the results were highly varied, as not all micronutrients showed a significant deficit in the presence of obesity. Calcium, phosphorus, magnesium, and vitamin E deficiencies were noted among participants with obesity; however, these did not significantly differ from those of individuals with normal weight. Current evidence suggests that Mexican children who have overweight or obesity are more likely to have zinc, iron, and vitamins D and B6 deficiency. A random-effects meta-analysis of 4 studies showed that children who have overweight or obesity were significantly more likely to have a deficit of vitamin D (odds ratio [OR], 1.84; 95% CI, 1.46-2.32), which was stronger for school-aged children (OR, 1.99; 95% CI, 1.56-2.55). Current evidence suggests that Mexican children and adolescents who have overweight or obesity are more likely to experience vitamin D deficiency, and some evidence suggests that they are also prone to zinc, iron, and vitamin B6 deficiencies. For this reason, health-promotion and -prevention efforts must be comprehensive and address micronutrient deficiencies, common risk factors, and broader social determinants linked to noncommunicable diseases. PROSPERO registration no. CRD42019154132.

Genome wide association studies (GWAS) have identified single-nucleotide polymorphisms (SNPs) that are associated with fasting plasma glucose (FPG) in adult European populations. The contribution of these SNPs to FPG in non-Europeans and children is unclear. We studied the association of 15 GWAS SNPs and a genotype score (GS) with FPG and 7 metabolic traits in 1,421 Mexican children and adolescents from Mexico City. Genotyping of the 15 SNPs was performed using TaqMan Open Array. We used multivariate linear regression models adjusted for age, sex, body mass index standard deviation score, and recruitment center. We identified significant associations between 3 SNPs (G6PC2 (rs560887), GCKR (rs1260326), MTNR1B (rs10830963)), the GS and FPG level. The FPG risk alleles of 11 out of the 15 SNPs (73.3%) displayed significant or non-significant beta values for FPG directionally consistent with those reported in adult European GWAS. The risk allele frequencies for 11 of 15 (73.3%) SNPs differed significantly in Mexican children and adolescents compared to European adults from the 1000G Project, but no significant enrichment in FPG risk alleles was observed in the Mexican population. Our data support a partial transferability of European GWAS FPG association signals in children and adolescents from the admixed Mexican population.

To describe the prevalence of anemia and con-sumption of iron rich groups among Mexican children and adolescents who participated in the Halfway National Health and Nutrition Survey, 2016. Our study sample included children and adolescents who provided full capillary hemoglobin data. Anemia was defined accord-ing to WHO criteria. Logistic regression models were used to explore the association among consumption of iron-rich food groups, sociodemographic characteristics and anemia. In 2016, the prevalence of anemia was 26.9% in children aged 1 to 4 years old, 12.5% in those aged 5 to 11, and 9.6% in adolescents aged 12 to 19 years. Rates were the highest among females who lived in the southern and central parts of Mexico, belonged to an indigenous ethnic group and fell within the first tercile of the Household Wealth Index. Consumption of beef by preschoolers and viscera by ado-lescents was associated with lower risk for anemia; higher risk was associated with consumption of Liconsa milk and non-heme iron by preschoolers. Anemia is highly prevalent in Mexican children and adolescents, affect-ing mainly the poorest and youngest populations. Sources of heme iron are the principal dietary factor associated with low risk for anemia.

IntroductionGiven the increasing incidence of chronic degenerative diseases related to changes in tissues, the availability of diagnostic tools with greater accuracy in the estimation of body composition (BC) has become necessary. Interpreting the BC values of individuals requires reference data obtained from a healthy population with the same ethnicity, to identify individuals at risk for the development of negative health outcomes.ObjectiveGenerate reference values (RV) of body composition (BC) for Mexican children and adolescents.MethodsThis was an urban-population-based cross-sectional study of healthy Mexican children and adolescents. BC estimations by anthropometry, multifrequency bioimpedance analysis (MF-BIA) and dual-energy X-ray absorptiometry (DXA) where used to create sex- and age-specific RV by means of generalized additive models for location, scale and shape (GAMLSS).ResultsWe assessed 2104 subjects, and after confirming a clinically and metabolically healthy status, we measured 1659 subjects aged 5–20 years, [806 females (49%) and 853 males (51%)] by anthropometry, MF-BIA and DXA to create sex- and age- smoothed reference centiles, lambda (L), mu (M), and sigma (S) values. We also built sex- and age-smoothed graphic curves for each variable of interest.ConclusionsWe present valid RV and curves for BC variables estimated by anthropometry, MF-BIA and DXA from clinically and metabolically healthy urban Mexican children and adolescents. These RV are different from those reported for other populations, and therefore, should be used for clinical and research purposes involving urban Mexican children and adolescents.

We carried out this study to compare the effect of consuming whole, partially defatted and defatted cows' milk for 4 months on serum concentrations of blood indicators of cardiovascular risk (CVR) in Mexican children and adolescents. Children aged between 6 and 16 years living in indigenous boarding schools in Mexico and who were usual consumers of whole milk were recruited to this study. Totally, thirteen boarding schools were randomly selected to receive full supplies of whole, partially defatted and defatted cows' milk for 4 months. Serum total cholesterol (TC), TAG, HDL-cholesterol, apoA and total apoB, and Lp(a) concentrations were measured before and after the intervention. Comparisons were made with multi-level mixed-effects linear regression models using the difference in differences approach. Compared with the whole milk group, TC, LDL-cholesterol, HDL-cholesterol and total apoB were lower in defatted milk consumers by -0·43, -0·28, -0·16 mmol/l and -0·05 g/l, respectively (all P<0·001). Compared with the whole milk group, the group that consumed partially defatted milk showed a significant decrease in the concentrations of LDL-cholesterol (-0·12, P=0·01), apoA (-0·05 g/l, P=0·01) and total apoB (-0·05 g/l, P=0·001). Defatted milk intake for 4 months reduced some of the serum indicators of CVR.

ContextA relationship between obesity and poor oral health has been reported.ObjectiveTo investigate the association between overweight/obesity and oral health in Mexican children and adolescents.Data SourcesA literature search was conducted of 13 databases and 1 search engine for articles published from 1995 onward.Data AnalysisA total of 18 publications were included. Evidence was inconclusive and varied according to sociodemographic factors or outcome measuring tools. The Decayed, Missing, and Filled Teeth and Filled Teeth Surfaces indices and the decayed extracted filled teeth index outcomes were included in a random effects model meta-analysis. Pooled estimates showed no statistically significant oral health differences (measured via the decayed extracted filled teeth or the Decayed, Missing, and Filled Teeth Surfaces indexes) among body mass index (BMI) categories. However, pooled estimates of 6 studies showed that children with higher BMI had worse oral health in permanent teeth (measured via the Decayed Missing Filled Teeth Index) than children with lower BMI (overall mean difference, –0.42; 95%CI, –0.74, –0.11).ConclusionWhether there is an association between poor oral health and high BMI is inconclusive; however, both co-exist among Mexican children. Therefore, health promotion and prevention efforts should address common risk factors and broader risk social determinants shared between noncommunicable diseases.

ResumenLa caries dental es una enfermedad bucodental multifactorial grave que provoca la desmineralización de los tejidos duros del diente y afecta a más de la mitad de la población mundial. El objetivo de esta revisión sistemática exploratoria fue determinar la prevalencia de caries dental en niños y adolescentes mexicanos, así como los factores relacionados como el sexo, el estado nutricional, el tipo de dentición, la educación, las condiciones de vida, el nivel socioeconómico y el tipo de área demográfica. Los criterios de elegibilidad fueron estudios observacionales cuya muestra incluyera mexicanos de 0 a 15 años en los que se hubiera evaluado la prevalencia o un índice de caries dental. Los estudios elegibles fueron identificados mediante la búsqueda realizada en 6 bases de datos y de manera manual, sin restricción de tiempo de publicación. Se encontraron 54 estudios que cumplieron con los criterios de elegibilidad. En estos estudios incluidos se observó que en las últimas décadas la prevalencia de caries en niños y adolescentes mexicanos exhibe una tendencia a la baja. En la década de 1980, se reportaron prevalencias de caries de hasta 92.8%; entre 1990-1999, la mayor prevalencia reportada fue de 97%; de 2000-2009, la prevalencia más alta reportada fue de 95%; de 2010 a 2019 la mayor prevalencia fue de 94.6%; y de 2020 y 2021, se reportaron prevalencias de hasta 88.5%. Aunque ha habido un decremento en la prevalencia de caries en niños mexicanos, esta enfermedad continúa vinculada a determinantes biológicas, conductuales y socioeconómicas.

Considering the high percentage of children and adolescents with developmental disorders, there is a clear need to build screening instruments that allow a quick and accurate assessment of the main processes that are affected in this population. So, the aim was to develop and obtain psychometric properties of a child neuropsychological scale for the evaluation of cognitive problems in Mexican children and adolescents. Primary caregivers of 728 children and adolescents with typical development, suspected developmental disorder or epilepsy, answered an online battery. Thirty items were developed and their content validity was evaluated by expert judgment. In Exploratory Factor Analysis, a 28 items-model with three factors explained 65.9% of the variance. Three factors were confirmed in Confirmatory Factor Analysis with 16 items: attentional, memory and executive problems; obtaining excellent fit indices (χ2[101] = 223.009; CMIN/DF = 2.208; NFI = .938; CFI = .965; SRMR = .0328; RMSEA = .058[.057-.068], p < .001). Reliability was high (α = .936, ω = .957), and construct/convergent validity were obtained with BRIEF-2 and PedsQL scales (.889 and .721). Significant differences were identified between subgroups with and without epilepsy (p < .001). Neuroescalita proved to be highly reliable and has multiple evidences of validity for adequate assessment of cognitive problems in Mexican children and adolescents.