1
|
Little B, Escobedo J, Pena Reyes ME, Shakib SH, O'Brien L, Kerber R, Velasco X, Lopez MC, Tillquist C. Environment driven changes in type 2 diabetes, overweight and obesity in an isolated Mixe community in the Valley of Oaxaca, southern Mexico. Am J Hum Biol 2024:e24119. [PMID: 39010757 DOI: 10.1002/ajhb.24119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 06/04/2024] [Accepted: 06/12/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND This study focused on type 2 diabetes mellitus (T2DM) in a group of adult Mixe, an Indigenous population from Oaxaca, Mexico. Mixe comprised an estimated 9.4% (n ≅ 90 000) of the Indigenous population in Oaxaca. Mexico. OBJECTIVE This study focused on a group of adult Mixe, an Indigenous population from Oaxaca, Mexico. To compare the prevalence of T2DM, overweight (OW), obesity (OB), and hypertension (HTN) between 2007 and 2017 for a small, isolated Mixe community in the Valley of Oaxaca, Mexico. We test whether or not environmental changes have affected T2DM prevalence. METHODS AND MATERIALS Demographic and medical record data were collected in the community in 2007 and 2017 from the medical clinic and the mayor's office. T2DM was medically diagnosed among adults (>34 years old), in 2007 (n = 730) and in 2017 (n = 829). RESULTS T2DM crude prevalence increased from 6.7% to 12.1% (p < .001) from 2007 to 2017. The mean age of the sample analyzed was 60.6 (SD = 9.7). Age-adjusted T2DM prevalence increased from 6.7% to 10.8% (p < .002). T2DM was 5.7%-5.5% among males (p < .53) and 7.1%-13.6% among females (p < .001). Sex-specific OW and OB simulation studies indicate females had 7% less OW in 2007, and males were unchanged compared with 2017. OB among males and females was significantly higher in 2017 compared with 2007 (increased by 15.2% and 8.3%, males and females, respectively). Sexes combined OW + OB increased 12.7% among males but was unchanged in females (-0.5%). In the sexes combined analysis, OW prevalence increased 12.7% to 27.1% (p < .001) and OB prevalence increased 10.7%-27.9% (p < .001) from 2007 to 2017. HTN did not change significantly from 2007 to 2017 (15.4% and 14.6%, respectively) (p = .63) in adults. Among T2DM individuals, the frequency of HTN was not significantly different in 2007 and 2017 (57.1% and 37%, respectively) (p = .65). Transition to a Western diet consisting of high-carbohydrate foods occurred at the same time as increased T2DM from 2007 to 2017, with a higher prevalence of T2DM noted among females in 2017. CONCLUSIONS An increased prevalence of T2DM, OW, and OB but not HTN was observed in the Mixe community from 2007 to 2017 and was associated with the adoption of a high-carbohydrate Western diet.
Collapse
Affiliation(s)
- Bert Little
- School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, USA
- Department of Anthropology, University of Louisville, Louisville, Kentucky, USA
| | - Jorge Escobedo
- Clinical Epidemiology Research Unit, IMMS, Mexico City, Mexico
| | - Maria Eugenia Pena Reyes
- Posgrado en Antropología Física de la Escuela Nacional de Antropología e Historia (ENAH), National School of Anthropology and History, Mexico City, Mexico
| | - Shaminul Hoque Shakib
- School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Liz O'Brien
- School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Rich Kerber
- School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Xochitl Velasco
- Clinical Chemistry, Tlacolula Rural Hospital, IMMS, Tlacolula, Oaxaca, Mexico
| | - Miguel Cruz Lopez
- Medical Research Unit in Biochemistry, Specialty Hospital, National Medical Center of the Twenty-First Century, Mexican Institute of Social Security, Mexico City, Mexico
| | | |
Collapse
|
2
|
Montesi L, Ramírez-Rojas MG, Elizarrarás-Rivas J. Health Care Delays and Social Suffering Among Indigenous People with Diabetic Foot Complications in Mexico. Med Anthropol 2024; 43:411-427. [PMID: 38865593 DOI: 10.1080/01459740.2024.2364241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
Diabetic foot (DF) is a leading cause of nontraumatic lower-extremity amputations, premature death, and a sign of social inequality in diabetes treatment. In Mexico, the incidence of DF is on the rise yet little is known about its impact among indigenous people, a disadvantaged group. Based on ethnographic research conducted in Oaxaca and analysis of institutional health-data, in this article we show the health care delays that rural indigenous people face when dealing with DF. Indigenous people's uncertainty regarding their right to health and the structural barriers to medical care favor DF complications, a phenomenon that should be read as social suffering. Since health data concerning indigenous health care service users is patchy and imprecise, indigenous people's social suffering is invisibilized. This omission or partiality in the official records limits public health decision-making and undermines the human rights of the population.
Collapse
Affiliation(s)
| | | | - Jesús Elizarrarás-Rivas
- Health Research Coordination, Mexican Institute of Social Security (IMSS), Oaxaca, Mexico
- Universidad Autónoma Benito Juárez de Oaxaca (UABJO), Oaxaca, Mexico
| |
Collapse
|
3
|
Fermín-Martínez CA, Paz-Cabrera CD, Basile-Alvarez MR, Castro PS, Núñez-Luna A, Perezalonso-Espinosa J, Ramírez-García D, Antonio-Villa NE, Vargas-Vázquez A, Fernández-Chirino L, Carrillo-Herrera KB, Cabrera-Quintana LA, Rojas-Martínez R, Seiglie JA, Bello-Chavolla OY. Prevalence of prediabetes in Mexico: a retrospective analysis of nationally representative surveys spanning 2016-2022. LANCET REGIONAL HEALTH. AMERICAS 2023; 28:100640. [PMID: 38076414 PMCID: PMC10701418 DOI: 10.1016/j.lana.2023.100640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/13/2023] [Accepted: 11/13/2023] [Indexed: 12/30/2023]
Abstract
Background Characterizing prediabetes phenotypes may be useful in guiding diabetes prevention efforts; however, heterogeneous criteria to define prediabetes have led to inconsistent prevalence estimates, particularly in low- and middle-income countries. Here, we estimated trends in prediabetes prevalence in Mexico across different prediabetes definitions and their association with prevalent cardiometabolic conditions. Methods We conducted a serial cross-sectional analysis of National Health and Nutrition Surveys in Mexico (2016-2022), totalling 22 081 Mexican adults. After excluding individuals with diagnosed or undiagnosed diabetes, we defined prediabetes using ADA (impaired fasting glucose [IFG] 100-125 mg/dL and/or HbA1c 5.7-6.4%), WHO (IFG 110-125 mg/dL), and IEC criteria (HbA1c 6.0-6.4%). Prevalence trends of prediabetes over time were evaluated using weighted Poisson regression and its association with prevalent cardiometabolic conditions with weighted logistic regression. Findings The prevalence of prediabetes (either IFG or high HbA1c [ADA]) in Mexico was 20.9% in 2022. Despite an overall downward trend in prediabetes (RR 0.973, 95% CI 0.957-0.988), this was primarily driven by decreases in prediabetes by ADA-IFG (RR 0.898, 95% CI 0.880-0.917) and WHO-IFG criteria (RR 0.919, 95% CI 0.886-0.953), while prediabetes by ADA-HbA1c (RR 1.055, 95% CI 1.033-1.077) and IEC-HbA1C criteria (RR 1.085, 95% CI 1.045-1.126) increased over time. Prediabetes prevalence increased over time in adults >40 years, with central obesity, self-identified as indigenous or living in urban areas. For all definitions, prediabetes was associated with an increased risk of cardiometabolic conditions. Interpretation Prediabetes rates in Mexico from 2016 to 2022 varied based on defining criteria but consistently increased for HbA1c-based definitions and high-risk subgroups. Funding This research was supported by Instituto Nacional de Geriatría in Mexico. JAS was supported by NIH/NIDDK Grant# K23DK135798.
Collapse
Affiliation(s)
- Carlos A. Fermín-Martínez
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- MD/PhD (PECEM) Program, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - César Daniel Paz-Cabrera
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- Especialidad en Medicina Preventiva, Instituto Nacional de Salud Pública, Mexico City, Mexico
| | - Martín Roberto Basile-Alvarez
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Paulina Sánchez Castro
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Alejandra Núñez-Luna
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - Daniel Ramírez-García
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - Arsenio Vargas-Vázquez
- Especialidad en Medicina Preventiva, Instituto Nacional de Salud Pública, Mexico City, Mexico
| | | | | | | | | | - Jacqueline A. Seiglie
- Diabetes Unit, Massachusetts General Hospital, Harvard Medical School, MA, USA
- Department of Medicine, Harvard Medical School, MA, USA
| | | |
Collapse
|
4
|
Serna-Gutiérrez A, Castro-Juarez AA, Romero-Martínez M, Alemán-Mateo H, Díaz-Zavala RG, Quihui-Cota L, Álvarez-Hernández G, Gallegos-Aguilar AC, Esparza-Romero J. Prevalence of overweight, obesity and central obesity and factors associated with BMI in indigenous yaqui people: a probabilistic cross-sectional survey. BMC Public Health 2022; 22:308. [PMID: 35164732 PMCID: PMC8845338 DOI: 10.1186/s12889-022-12702-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 01/12/2022] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The Yaquis are an Indigenous group who inhabit in the state of Sonora in northwestern Mexico. This group has experienced changes in their lifestyle, moving from a traditional lifestyle to a more modern one, resulting in an increase of obesity and its comorbidities. However, few studies have been done in this group. The aim of this study was to determine the prevalence of overweight, obesity and central obesity and to identify the factors associated with body mass index (BMI) in a representative sample of Indigenous Yaqui people from Sonora, Mexico. METHODS A cross-sectional survey with multistage sampling was conducted among adults (N = 351) with residence in Yaqui traditional villages (Vícam, Pótam, Loma de Guamúchil, Loma de Bácum, Tórim, Ráhum, Huiribis or Belem). Anthropometric measurements were taken to diagnose overweight, obesity and central obesity. Food frequency and physical activity (PA) questionnaires designed for the Yaqui population were applied, as well as sociodemographic and clinical history questionnaires. The factors associated with BMI were assessed using multiple linear regression considering the complex design of the sampling. RESULTS The prevalence of overweight, obesity and central obesity in the population were 36.5%, 35.0% and 76.0%, respectively. Having higher values of the modernization index (β = 0.20, p = 0.049) was associated with a higher BMI, while having a higher consumption of a "prudent" dietary pattern (traditional dishes, fruits, vegetables and low-fat dairy) (β = -0.58, p = 0.009) and performing a greater number of hours per week of vigorous PA (β = -0.14, p = 0.017) were associated with a lower BMI. CONCLUSIONS The prevalence of the studied abnormalities is high. The evidence presented in this study suggests that interventions are needed and more research is required to determine the appropriate components of such interventions, in order to meet the needs of the Yaqui people.
Collapse
Affiliation(s)
- Araceli Serna-Gutiérrez
- Sociocultural Department, Technological Institute of Sonora, 85137, Cd. Obregón, Sonora, México
| | - Alejandro Arturo Castro-Juarez
- Diabetes Research Unit, Department of Public Nutrition and Health, Nutrition Coordination, Research Center for Food and Development (CIAD, A.C.), 83304, Hermosillo, Sonora, México
| | - Martín Romero-Martínez
- Evaluation and Surveys Research Center, National Institute of Public Health, 62100, Cuernavaca, Morelos, México
| | - Heliodoro Alemán-Mateo
- Department of Nutrition and Metabolism, Nutrition Coordination, Research Center for Food and Development (CIAD. A.C.), 83304, Hermosillo, Sonora, México
| | - Rolando Giovanni Díaz-Zavala
- Nutrition Health Promotion Center, Department of Chemical and Biological Sciences, University of Sonora, 83000, Hermosillo, Sonora, México
| | - Luis Quihui-Cota
- Department of Nutrition and Metabolism, Nutrition Coordination, Research Center for Food and Development (CIAD. A.C.), 83304, Hermosillo, Sonora, México
| | | | - Ana Cristina Gallegos-Aguilar
- Diabetes Research Unit, Department of Public Nutrition and Health, Nutrition Coordination, Research Center for Food and Development (CIAD, A.C.), 83304, Hermosillo, Sonora, México
| | - Julián Esparza-Romero
- Diabetes Research Unit, Department of Public Nutrition and Health, Nutrition Coordination, Research Center for Food and Development (CIAD, A.C.), 83304, Hermosillo, Sonora, México. .,Diabetes Research Unit, Deparment of Public Nutrition and Health, Nutrition Coordination, Research Center for Food and Development (CIAD, A.C.), Carretera Gustavo Enrique Astiazarán Rosas No. 46, Col. La Victoria, 83304, Hermosillo, Sonora, México.
| |
Collapse
|
5
|
Predictors of diabetes risk in urban and rural areas in Colombia. Heliyon 2022; 8:e08653. [PMID: 35024487 PMCID: PMC8732783 DOI: 10.1016/j.heliyon.2021.e08653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 11/22/2021] [Accepted: 12/17/2021] [Indexed: 11/25/2022] Open
Abstract
Background Nutritional habits low in fruits and vegetables and sedentary lifestyle are associated with a higher risk of developing Type 2 Diabetes (T2D). However, it is important to assess differences between urban and rural areas. This study aimed to analyze the associations between the risk of developing T2D and setting in the Colombian north coast in 2017. Methods This cross-sectional study included 1,005 subjects. Data was collected by interviewing self-identified members of an urban community and a rural-indigenous population. The interaction terms were evaluated as well as the confounders. Then, adjusted binary logistic regressions were used to estimate the odds ratio (OR) and 95% Confidence Intervals (CI). Results subjects with a high risk of T2D are more likely to belong to the urban setting (OR = 1.908; 95%CI = 1.201–2.01) compared with those with lower T2D after adjusting for age, Body Mass Index (BMI), physical activity, history of high levels of glycemia, and diabetes in relatives. Conclusions Urban communities are more likely to have T2D compared with rural-indigenous populations. These populations have differences from the cultural context, including personal, and lifestyle factors.
Collapse
|
6
|
Núñez-Rocha GM, Esqueda-Eguía BM, Salinas-Martínez AM, Ávila-Ortiz MN, Castro-Sánchez AE, Zambrano-Moreno A, Hernández-Ruiz KJ. Differences in Social Determinants of Health between Urban Indigenous Migrants and Non-Indigenous People in North-Eastern Mexico: An Analysis to Prioritize. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168464. [PMID: 34444213 PMCID: PMC8392500 DOI: 10.3390/ijerph18168464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/25/2021] [Accepted: 08/06/2021] [Indexed: 11/20/2022]
Abstract
The degree to which social determinants of health differ between indigenous migrants and non-indigenous people born and raised locally is currently unknown. We compared social determinants of health between indigenous migrants and non-indigenous people from urban north-eastern Mexico. Additionally, we ranked priorities for addressing the negative social determinants of health. This was a population-based comparative cross-sectional study (n = 235 indigenous migrants and 168 non-indigenous people). A two-stage non-random sampling was carried out from June to August of 2019. Heads of households ≥18 years and those with the ability to communicate in Spanish were recruited house by house. Structural and intermediary determinants of health were identified according to the World Health Organization Conceptual Framework and priorities were ranked using Z-scores. Being a migrant indigenous increased 1.6 times the odds of low education (95% CI = 1.1, 2.4). In addition, the migrant indigenous status increased the odds of poor housing, unhealthy behaviour and low social cohesion (p < 0.05). Housing, behaviours and health service accessibility were top priorities for indigenous migrants and structural determinants for non-indigenous people. The findings show that the right to access the social determinants of health has not yet been guaranteed for indigenous communities.
Collapse
Affiliation(s)
- Georgina Mayela Núñez-Rocha
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Nuevo León 66455, Mexico; (B.M.E.-E.); (A.M.S.-M.); (M.N.Á.-O.); (A.E.C.-S.); (A.Z.-M.); (K.J.H.-R.)
- Correspondence:
| | - Brenda Mayela Esqueda-Eguía
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Nuevo León 66455, Mexico; (B.M.E.-E.); (A.M.S.-M.); (M.N.Á.-O.); (A.E.C.-S.); (A.Z.-M.); (K.J.H.-R.)
| | - Ana María Salinas-Martínez
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Nuevo León 66455, Mexico; (B.M.E.-E.); (A.M.S.-M.); (M.N.Á.-O.); (A.E.C.-S.); (A.Z.-M.); (K.J.H.-R.)
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social, Nuevo León 64360, Mexico
| | - María Natividad Ávila-Ortiz
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Nuevo León 66455, Mexico; (B.M.E.-E.); (A.M.S.-M.); (M.N.Á.-O.); (A.E.C.-S.); (A.Z.-M.); (K.J.H.-R.)
| | - Ana Elisa Castro-Sánchez
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Nuevo León 66455, Mexico; (B.M.E.-E.); (A.M.S.-M.); (M.N.Á.-O.); (A.E.C.-S.); (A.Z.-M.); (K.J.H.-R.)
| | - Adriana Zambrano-Moreno
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Nuevo León 66455, Mexico; (B.M.E.-E.); (A.M.S.-M.); (M.N.Á.-O.); (A.E.C.-S.); (A.Z.-M.); (K.J.H.-R.)
| | - Karina Janett Hernández-Ruiz
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Nuevo León 66455, Mexico; (B.M.E.-E.); (A.M.S.-M.); (M.N.Á.-O.); (A.E.C.-S.); (A.Z.-M.); (K.J.H.-R.)
| |
Collapse
|