1
|
Ancira-Moreno M, Burrola-Méndez S, Muñoz-Manrique C, Omaña-Guzmán I, Hoyos-Loya E, Trejo-Domínguez A, Hernández-Cordero S, Mazariegos M, Smith N, Tavano-Colaizzi L, Mier-Cabrera J, Avendaño-Álvarez F, Espino y Sosa S, Muciño-Sandoval K, Ibarra-González L, Medina-Avilés C. A scoping review and critical evaluation of the methodological quality of clinical practice guidelines on nutrition in the preconception. Front Nutr 2023; 10:1122289. [PMID: 37927499 PMCID: PMC10621738 DOI: 10.3389/fnut.2023.1122289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction Clinical practice guidelines (CPGs) contain recommendations for specific clinical circumstances, including maternal malnutrition. This study aimed to identify the CPGs that provide recommendations for preventing, diagnosing, and treating women's malnutrition. Additionally, we sought to assess the methodological quality using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. Methods An online search for CPGs was performed, looking for those that contained lifestyle and nutritional recommendations to prevent, diagnose and treat malnutrition in women during the preconception period using PubMed and different websites. The reviewers utilized the AGREE II instrument to appraise the quality of the CPGs. We defined high-quality guidelines with a final score of > 70%. Results The titles and abstracts from 30 guidelines were screened for inclusion, of which 20 guidelines were fully reviewed for quality assessment. The overall quality assessment of CPGs was 73%, and only 55% reached a high-quality classification. The domains in the guidelines classified as high-quality had the highest scores in "Scope and Purpose" and "Clarity of Presentation" with a median of 98.5 and 93%, respectively. Discussion Further assessment is needed to improve the quality of the guidelines, which is an opportunity to strengthen them, especially in the domains with the lowest scores.
Collapse
Affiliation(s)
- Mónica Ancira-Moreno
- Department of Health, Universidad Iberoamericana, Mexico City, Mexico
- Maternal and Child Health and Nutrition Network (MaCHiNNe), Observatorio Materno Infantil, Universidad Iberoamericana, Mexico City, Mexico
| | - Soraya Burrola-Méndez
- Department of Health, Universidad Iberoamericana, Mexico City, Mexico
- Maternal and Child Health and Nutrition Network (MaCHiNNe), Observatorio Materno Infantil, Universidad Iberoamericana, Mexico City, Mexico
| | - Cinthya Muñoz-Manrique
- Maternal and Child Health and Nutrition Network (MaCHiNNe), Observatorio Materno Infantil, Universidad Iberoamericana, Mexico City, Mexico
- Coordination of Nutrition and Bioprogramming, Instituto Nacional de Perinatología, Mexico City, Mexico
| | - Isabel Omaña-Guzmán
- Maternal and Child Health and Nutrition Network (MaCHiNNe), Observatorio Materno Infantil, Universidad Iberoamericana, Mexico City, Mexico
- Pediatric Obesity Clinic and Wellness Unit, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City, Mexico
| | - Elizabeth Hoyos-Loya
- Maternal and Child Health and Nutrition Network (MaCHiNNe), Observatorio Materno Infantil, Universidad Iberoamericana, Mexico City, Mexico
| | - Alejandra Trejo-Domínguez
- Maternal and Child Health and Nutrition Network (MaCHiNNe), Observatorio Materno Infantil, Universidad Iberoamericana, Mexico City, Mexico
| | - Sonia Hernández-Cordero
- Maternal and Child Health and Nutrition Network (MaCHiNNe), Observatorio Materno Infantil, Universidad Iberoamericana, Mexico City, Mexico
- Research Center for Equitable Development EQUIDE, Universidad Iberoamericana, Mexico City, Mexico
| | - Mónica Mazariegos
- Maternal and Child Health and Nutrition Network (MaCHiNNe), Observatorio Materno Infantil, Universidad Iberoamericana, Mexico City, Mexico
- Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
| | - Natalia Smith
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, United States
| | | | - Jennifer Mier-Cabrera
- Maternal and Child Health and Nutrition Network (MaCHiNNe), Observatorio Materno Infantil, Universidad Iberoamericana, Mexico City, Mexico
| | - Fermín Avendaño-Álvarez
- Maternal and Child Health and Nutrition Network (MaCHiNNe), Observatorio Materno Infantil, Universidad Iberoamericana, Mexico City, Mexico
| | - Salvador Espino y Sosa
- Maternal and Child Health and Nutrition Network (MaCHiNNe), Observatorio Materno Infantil, Universidad Iberoamericana, Mexico City, Mexico
- Clinical Research Branch, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Karla Muciño-Sandoval
- Maternal and Child Health and Nutrition Network (MaCHiNNe), Observatorio Materno Infantil, Universidad Iberoamericana, Mexico City, Mexico
| | - Lizeth Ibarra-González
- Maternal and Child Health and Nutrition Network (MaCHiNNe), Observatorio Materno Infantil, Universidad Iberoamericana, Mexico City, Mexico
- Nutrition and Dietetics Service, Instituto Nacional de Perinatología, Mexico City, Mexico
| | - Cristina Medina-Avilés
- Maternal and Child Health and Nutrition Network (MaCHiNNe), Observatorio Materno Infantil, Universidad Iberoamericana, Mexico City, Mexico
- Sub-Direction of Gynecology and Obstetrics Instituto Nacional de Perinatología, Mexico City, Mexico
| |
Collapse
|
2
|
Ancira-Moreno M, Omaña-Guzmán I, Bautista-Morales AC, Acosta-Ruiz O, Hernández Cordero S, Burrola-Méndez S, Vilar-Compte M, Monterrubio Flores E, Kaufer-Horwitz M, Pérez Navarro C, Muñoz-Manrique C, Mazariegos M, Trejo-Domínguez A, Sánchez Muzquiz B, Cajero A, Brero M, Sachse M, Cobo Armijo F. Development and validation of a new set of indicators to assess the quality of maternal and child nutritional care at the primary care. Front Med (Lausanne) 2022; 9:1011940. [PMID: 36569141 PMCID: PMC9769120 DOI: 10.3389/fmed.2022.1011940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Maternal and child malnutrition is a worldwide public health problem with short, medium, and long-term adverse consequences for both mother and child. In Mexico, maternal and child malnutrition represents a serious public health problem that must be urgently addressed. In this context, Primary Health Care (PHC) plays an important role in the prevention, detection, monitoring, and treatment of the different forms of maternal and child malnutrition. Assessing the quality of nutritional care offered at this level of care is necessary in order to improve it; however, there are no indicators for the evaluation of this quality. Therefore, this study aimed at developing a set of indicators to assess the quality of maternal and child nutritional care at PHC. Methods We developed indicators for different stages of life: preconception, pregnancy, infancy, and preschool age. A systematic review of the literature on clinical guidelines for the prevention, diagnosis, and treatment of the different forms of malnutrition was carried out; the recommendations of the guidelines evaluated with good quality were extracted. Results Based on these recommendations, 22 indicators were constructed. A pilot study was carried out to validate the indicators and 16 indicators were selected to assess the maternal and child nutritional care at PHC.
Collapse
Affiliation(s)
| | | | | | - Omar Acosta-Ruiz
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Sonia Hernández Cordero
- Instituto de Investigaciones para el Desarrollo con Equidad (EQUIDE), Universidad Iberoamericana, Mexico City, Mexico
| | | | - Mireya Vilar-Compte
- Department of Public Health, Montclair State University, Montclair, NJ, United States
| | - Eric Monterrubio Flores
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Martha Kaufer-Horwitz
- Clínica de Obesidad y Trastornos de la Conducta Alimentaria, Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Cinthya Muñoz-Manrique
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Mexico City, Mexico
| | - Mónica Mazariegos
- INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
| | | | | | - Ariana Cajero
- Department of Health, Universidad Iberoamericana, Mexico City, Mexico
| | - Mauro Brero
- United Nations International Children’s Emergency Fund (UNICEF), Mexico City, Mexico
| | - Matthias Sachse
- United Nations International Children’s Emergency Fund (UNICEF), Mexico City, Mexico
| | - Fernanda Cobo Armijo
- United Nations International Children’s Emergency Fund (UNICEF), Mexico City, Mexico
| |
Collapse
|
3
|
Muñoz-Manrique C, Trejo-Valdivia B, Hernández-Cordero S, Cantoral A, Deierlein AL, Colicino E, Niedzwiecki MM, Wright RO, Baccarelli AA, Téllez-Rojo MM. Weight gain trajectories patterns from pregnancy to early postpartum: identifying women at risk and timing to prevent weight regain. BMC Pregnancy Childbirth 2022; 22:811. [PMID: 36333677 PMCID: PMC9635073 DOI: 10.1186/s12884-022-05154-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022] Open
Abstract
Background Woman's weight changes during pregnancy and postpartum contribute to obesity and health outcomes later in life. This study aimed to identify and characterize weight change trajectories from pregnancy to one year postpartum among adult women. Methods We used data from an ongoing cohort of healthy adult women (n = 819) with singleton pregnancies from 2007 – 2011. Sociodemographic data, pre-pregnancy body weight, and sedentary and breastfeeding practices were collected using questionaries applied by trained professionals. We applied a group-based trajectory modeling to distinguish weight change measured in the second and third trimesters of pregnancy and at one month, six, and 12 months postpartum. Multinomial regression models were run to characterize each trajectory. Results We identified six weight change trajectories with the main difference in the patterns followed after one month of delivery. One in three women (36.7%) was classified in some of the three postpartum weight gain trajectories and regained weight from the second trimester of the first year postpartum. Women who followed some of these trajectories were more likely to have higher age, obesity before pregnancy, < 10 years of schooling, and partner, compared with women (10.7%, n = 87) in a postpartum sustained-fast-lost-weight trajectory (p < 0.05). Conclusions Women with obesity before pregnancy have higher odds of regaining gestational weight after delivery without reaching their pre-pregnancy weight. The first six months postpartum are crucial to establishing obesity prevention strategies. Further research is needed to evaluate the effect of the interventions that prevent substantial weight gain through reproductive years in high-risk women.
Collapse
|
4
|
Hernandez-Pacheco JA, Torres-Torres J, Martinez-Portilla RJ, Solis-Paredes JM, Estrada-Gutierrez G, Mateu-Rogell P, Nares-Torices MA, Lopez-Marenco ME, Escobedo-Segura KR, Posadas-Nava A, Villafan-Bernal JR, Rojas-Zepeda L, Becerra-Navarro NP, Casillas-Barrera M, Pichardo-Cuevas M, Muñoz-Manrique C, Cortes-Ramirez IA, Espino-y-Sosa S. sFlt-1 Is an Independent Predictor of Adverse Maternal Outcomes in Women With SARS-CoV-2 Infection and Hypertensive Disorders of Pregnancy. Front Med (Lausanne) 2022; 9:894633. [PMID: 35615097 PMCID: PMC9125178 DOI: 10.3389/fmed.2022.894633] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 03/31/2022] [Indexed: 12/19/2022] Open
Abstract
BackgroundPreeclampsia (PE) and COVID-19 share a common vascular–endothelial physiopathological pathway that may aggravate or worsen women's outcomes when both coexist. This study aims to evaluate the association of sFlt-1 levels and adverse maternal outcomes among positive SARS-CoV-2 pregnant women with and without hypertensive disorders of pregnancy (HDP).MethodsWe performed a multicenter retrospective cohort study of pregnant women with confirmed SARS-CoV-2 infection that required hospital admission. The exposed cohort comprised women with a diagnosis of an HDP. The primary outcome was a composite definition of adverse maternal outcome. The association between predictors and the main and secondary outcomes was assessed using an elastic-net regression which comprised a Lasso and Ridge regression method for automatic variable selection and penalization of non-statistically significant coefficients using a 10-fold cross-validation where the best model if automatically chosen by the lowest Akaike information criterion (AIC) and Bayesian information criteria (BIC).ResultsAmong 148 pregnant women with COVID-19, the best predictive model comprised sFlt-1 MoMs [odds ratio (OR): 5.13; 95% CI: 2.19–12.05], and HDP (OR: 32.76; 95% CI: 5.24–205). sFlt-1 MoMs were independently associated with an increased probability of an adverse maternal outcome despite adjusting for HDP.ConclusionsOur study shows that sFlt-1 is an independent predictor of adverse outcomes in women with SARS-CoV-2 despite hypertension status.
Collapse
Affiliation(s)
- Jose Antonio Hernandez-Pacheco
- Clinical Research Branch, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
- Hospital de la Mujer, Mexico City, Mexico
| | - Johnatan Torres-Torres
- Clinical Research Branch, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
- Hospital General de Mexico Dr. Eduardo Liceaga, Mexico City, Mexico
- Iberoamerican Research Network in Obstetrics, Gynecology and Translational Medicine, Mexico City, Mexico
| | - Raigam Jafet Martinez-Portilla
- Clinical Research Branch, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
- Iberoamerican Research Network in Obstetrics, Gynecology and Translational Medicine, Mexico City, Mexico
| | - Juan Mario Solis-Paredes
- Clinical Research Branch, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Guadalupe Estrada-Gutierrez
- Clinical Research Branch, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Paloma Mateu-Rogell
- Clinical Research Branch, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
- Iberoamerican Research Network in Obstetrics, Gynecology and Translational Medicine, Mexico City, Mexico
- Centro de Investigación en Ciencias de la Salud, FCS, Universidad Anahuac México Campus Norte, Huixquilucan, Mexico
| | - Miguel Angel Nares-Torices
- Clinical Research Branch, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | | | | | | | - Jose Rafael Villafan-Bernal
- Iberoamerican Research Network in Obstetrics, Gynecology and Translational Medicine, Mexico City, Mexico
- Laboratory of Immunogenomics and Metabolic Diseases, Instituto Nacional de Medicina Genomica, Mexico City, Mexico
| | - Lourdes Rojas-Zepeda
- Iberoamerican Research Network in Obstetrics, Gynecology and Translational Medicine, Mexico City, Mexico
- Maternal Fetal Medicine Department, Instituto Materno Infantil del Estado de Mexico, Toluca, Mexico
| | | | | | | | - Cinthya Muñoz-Manrique
- Clinical Research Branch, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
- Iberoamerican Research Network in Obstetrics, Gynecology and Translational Medicine, Mexico City, Mexico
| | | | - Salvador Espino-y-Sosa
- Clinical Research Branch, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
- Iberoamerican Research Network in Obstetrics, Gynecology and Translational Medicine, Mexico City, Mexico
- *Correspondence: Salvador Espino-y-Sosa
| |
Collapse
|
5
|
Chávez-Courtois M, Godínez-Martínez E, Muñoz-Manrique C, Negrete-Martínez V, González-Leyva CP, Tolentino-Dolores M, Suárez-Rico B, Estrada-Gutierrez G, Perichart-Perera O. Vitamin D Status and Its Determinants in Mexican Pregnant Women from a Rural and an Urban Area: A Comparative Study. Int J Environ Res Public Health 2021; 18:ijerph18094571. [PMID: 33925817 PMCID: PMC8123424 DOI: 10.3390/ijerph18094571] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND During pregnancy, vitamin D requirements are higher due to fetal growth and development. Vitamin D production occurs mainly through sunlight exposure, which is affected by geographic location and lifestyle factors. METHODS This was a case-control study nested within two cohorts of adult pregnant women (n = 298): urban (Mexico City) and rural (Cuetzalan). To reduce confounding, pairs were selected by age, pregestational body mass index, and pregnancy trimester. Generalized linear models were used to assess the two groups according to their vitamin D status. RESULTS A total of 298 adult women were studied: 149 from a rural area and 149 from an urban area. Vitamin D deficiency and insufficiency were observed in 28% and 38.2% of women, respectively. A trend for higher 25(OH)D concentrations was observed in women from the rural area (27.5 ng/mL vs. 25.8 ng/mL), probably related to the type of job, where women with partial jobs showing less probability of having vitamin D deficiency (OR = 0.26; CI = 0.06-1.16; p = 0.08) and vitamin D insufficiency (OR = 0.24; CI = 0.06-0.99; p = 0.05). Women whose Last Menstrual Period occurred in spring showed lower vitamin D concentration compared to those whose LMP occurred in winter (p < 0.01). CONCLUSIONS A high prevalence of vitamin D deficiency was observed in both rural and urban areas. Women living in rural areas tended to have higher 25(OH)D concentrations, probably related to more sunlight exposure associated with their type of job.
Collapse
Affiliation(s)
- Mayra Chávez-Courtois
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología, Mexico City 11000, Mexico; (M.C.-C.); (E.G.-M.); (C.M.-M.); (V.N.-M.); (C.P.G.-L.); (M.T.-D.)
| | - Estela Godínez-Martínez
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología, Mexico City 11000, Mexico; (M.C.-C.); (E.G.-M.); (C.M.-M.); (V.N.-M.); (C.P.G.-L.); (M.T.-D.)
| | - Cinthya Muñoz-Manrique
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología, Mexico City 11000, Mexico; (M.C.-C.); (E.G.-M.); (C.M.-M.); (V.N.-M.); (C.P.G.-L.); (M.T.-D.)
| | - Viviana Negrete-Martínez
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología, Mexico City 11000, Mexico; (M.C.-C.); (E.G.-M.); (C.M.-M.); (V.N.-M.); (C.P.G.-L.); (M.T.-D.)
| | - Carla Patricia González-Leyva
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología, Mexico City 11000, Mexico; (M.C.-C.); (E.G.-M.); (C.M.-M.); (V.N.-M.); (C.P.G.-L.); (M.T.-D.)
| | - Maricruz Tolentino-Dolores
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología, Mexico City 11000, Mexico; (M.C.-C.); (E.G.-M.); (C.M.-M.); (V.N.-M.); (C.P.G.-L.); (M.T.-D.)
| | - Blanca Suárez-Rico
- Community Interventions Research Branch, Instituto Nacional de Perinatología, Mexico City 11000, Mexico;
| | | | - Otilia Perichart-Perera
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología, Mexico City 11000, Mexico; (M.C.-C.); (E.G.-M.); (C.M.-M.); (V.N.-M.); (C.P.G.-L.); (M.T.-D.)
- Correspondence: ; Tel.: +52-55-5520-9900 (ext. 402/120)
| |
Collapse
|
6
|
Orozco-Guillien AO, Muñoz-Manrique C, Reyes-López MA, Perichat-Perera O, Miranda-Araujo O, D'Alessandro C, Piccoli GB. Quality or Quantity of Proteins in the Diet for CKD Patients: Does "Junk Food" Make a Difference? Lessons from a High-Risk Pregnancy. Kidney Blood Press Res 2021; 46:1-10. [PMID: 33535222 DOI: 10.1159/000511539] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 09/11/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND How to manage patients with severe kidney disease in pregnancy is still a matter of discussion, and deciding if and when to start dialysis is based on the specialist's experience and dialysis availability. The effect of toxic substances usually cleared by the kidney may be more severe and readily evident. The review, and related case, underlines the importance of considering the presence of additives in food in delicate conditions, such as CKD pregnancy. The Case: A 39-year-old indigenous woman from a low-resourced area in Mexico was referred to the obstetric nephrology at 25 gestational weeks because of serum creatinine at 3.6 mg/dL, hypertension on low-dose alpha-methyl-dopa, and nephrotic-range proteinuria. Kidney ultrasounds showed small poorly differentiated kidneys; foetal ultrasounds detected a female foetus, normal for gestational age. The patient's baseline protein intake, which was estimated at 1.2-1.3 g/kg/day, was mostly of animal-origin (>70%) poor-quality food ("junk food"). In the proposed diet, protein intake was only slightly reduced (1.0-1.2 g/kg/day), but the source of proteins was changed (only 30% of animal origin) with attention to food quality. A remarkable decrease in BUN was observed, in concomitance with adequate dietary follow-up, with rapid rise of BUN when the patient switched temporarily back to previous habits. A healthy female baby weighing 2,460 g (11th centile for gestational age) was delivered at 37 gestational weeks. Discussion and Literature Review: While data on patients with chronic kidney disease are scant, the long list of contaminants present in food, especially if of low quality, should lead us to reflect on their potential negative effect on kidney function and make us realize that eating healthy, unprocessed "organic" food should be encouraged, in delicate conditions such as pregnancy and breastfeeding and for young children, in particular when kidney function is failing. The case herein described gave us the opportunity to reflect on the importance of diet quality and on the potential risks linked to food additives, many of which, including phosphates and potassium, are not declared on food labels, while others, including dyes, antioxidants, thickeners, emulsifiers, and preservatives, are qualitatively, but not quantitatively, reported.
Collapse
Affiliation(s)
| | - Cinthya Muñoz-Manrique
- Nutrition and Bioprogramming Research Department, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Maria Angelica Reyes-López
- Nutrition and Bioprogramming Research Department, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Otilia Perichat-Perera
- Nutrition and Bioprogramming Research Department, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Osvaldo Miranda-Araujo
- Department of Gynaecology and Obstetrics, Instituto Nacional de Perinatología Isidro Espinoza de los Reyes, Mexico City, Mexico
| | | | - Giorgina B Piccoli
- Néphrologie, Centre Hospitalier Le Mans, Le Mans, France, .,Department of Clinical and Biological Sciences, Università di Torino, Turin, Italy,
| |
Collapse
|
7
|
Hernández-Barrera L, Trejo Valdivia B, Téllez-Rojo MM, Barquera S, Muñoz-Manrique C. Validity assessment of self-reported weight and its correction process among Mexican adult women of reproductive age. PLoS One 2020; 15:e0235967. [PMID: 32726317 PMCID: PMC7390308 DOI: 10.1371/journal.pone.0235967] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 06/25/2020] [Indexed: 11/18/2022] Open
Abstract
Objective We aimed to evaluate the agreement between self-reported weight (SRW) and measured weight (MW) in adult women of reproductive age, identify characteristics associated with the difference between SRW and MW (DW), and develop a correction procedure for SRW. Methods We used data from 3,452 non-pregnant or non-lactating adult women who participated in the Mexican Family Life Survey. Standardized personnel asked women about their weight before measuring weight and height. We conducted a Bland-Altman analysis for agreement and adjusted linear regression models for sociodemographic characteristics. Results Mean DW was -0.59±3.21 kg. Difference varied according to Body Mass Index (BMI) and region of residence (p< 0.05). Correction model for log-MW, included the log-SRW, age group (18–34 and 35–49 years), interaction term (age × SRW), log-height, Southern region, and living with a partner. Based on self-reported weight, we observed an overestimation of underweight/normal weight prevalence and an underestimation of overweight or obesity prevalence. Conclusion SRW has limitations to be considered as an alternative to MW among women of reproductive age with specific characteristics. Our proposed correction equation may decrease SRW imprecision improving the estimation of overweight and obesity. We suggest that studies consider and adjust the possible bias associated with weight misreporting on health outcomes.
Collapse
Affiliation(s)
- Lucia Hernández-Barrera
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Morelos, México
| | - Belem Trejo Valdivia
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Morelos, México
| | - Martha Maria Téllez-Rojo
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Morelos, México
| | - Simón Barquera
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Morelos, México
| | - Cinthya Muñoz-Manrique
- Department of Nutrition and Bioprogramming, National Institute of Perinatology, Mexico City, Mexico
- * E-mail:
| |
Collapse
|
8
|
Rodríguez-Cano AM, Mier-Cabrera J, Allegre-Dávalos AL, Muñoz-Manrique C, Perichart-Perera O. Higher fat mass and fat mass accretion during the first six months of life in exclusively breastfed infants. Pediatr Res 2020; 87:588-594. [PMID: 31434104 PMCID: PMC7033039 DOI: 10.1038/s41390-019-0542-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 04/16/2019] [Accepted: 07/25/2019] [Indexed: 12/03/2022]
Abstract
BACKGROUND Early nutrition influences infant growth and body composition, which may play a role in the infant's metabolic programming. Breastfed infants appear to have higher fat mass than formula-fed infants, but most comparisons have been cross-sectional, and evidence is scarce. The aim of this study was to describe fat mass and fat mass accretion during the first six months of life and evaluate differences by type of feeding (OMS). METHODS Prospective cohort of healthy pregnant women and their infants (Mexico City, 2009-2014). At 1 (T1), 3 (T2) and 6 (T3) months of age, fat mass (FM) (PEAPOD) and type of feeding (feeding questionnaire) were evaluated. RESULTS We included 109 healthy infants (mean ± SD age: 39 ± 1.1 weeks; birthweight: 2959 ± 294 g). Exclusive/predominant breastfed (EBF) infants had higher FM at T2 and T3 compared with non-EBF (%FM T3: 29.7 ± 5.9% vs 24.7 ± 5.6%, respectively) (p < 0.05). All infants increased their FM throughout time (p < 0.001). EBF infants showed a significant higher FM accretion (β: 3.61; 95% CI: 1.57-5.66, p < 0.01); the difference was maintained after controlling for confounding variables. CONCLUSIONS Exclusive/predominant breastfeeding promotes higher accretion of FM during the first six months of life which could have an important effect in the programming of health outcomes later in life.
Collapse
Affiliation(s)
- Ameyalli M Rodríguez-Cano
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes", Ciudad de México, Mexico
| | - Jennifer Mier-Cabrera
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes", Ciudad de México, Mexico
| | - Ana L Allegre-Dávalos
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes", Ciudad de México, Mexico
| | - Cinthya Muñoz-Manrique
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes", Ciudad de México, Mexico
| | - Otilia Perichart-Perera
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes", Ciudad de México, Mexico.
| |
Collapse
|
9
|
Rodríguez-Cano AM, Mier-Cabrera J, Muñoz-Manrique C, Cardona-Pérez A, Villalobos-Alcázar G, Perichart-Perera O. Anthropometric and clinical correlates of fat mass in healthy term infants at 6 months of age. BMC Pediatr 2019; 19:60. [PMID: 30777039 PMCID: PMC6378706 DOI: 10.1186/s12887-019-1430-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 02/11/2019] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Body composition in infancy plays a central role in the programming of metabolic diseases. Fat mass (FM) is determined by personal and environmental factors. Anthropometric measurements allow for estimations of FM in many age groups; however, correlations of these measurements with FM in early stages of life are scarcely reported. The aim of this study was to evaluate anthropometric and clinical correlates of FM in healthy term infants at 6 months of age. METHODS Healthy term newborns (n = 102) from a prospective cohort. Weight, length, skinfolds (biceps, triceps, subscapular and the sum -SFS-) and waist circumference (WC) were measured at 6 months. Body mass index (BMI) and WC/length ratio were computed. Type of feeding during the first 6 months of age was recorded. Air displacement plethysmography was used to asses FM (percentage -%-) and FM index (FMI) was calculated. Correlations and general linear models were performed to evaluate associations. RESULTS Significant correlations were observed between all anthropometric measurements and FM (% and index)(p < 0.001). Exclusive/predominant breastfed infants had higher FM and anthropometric measurements at 6 months. Models that showed the strongest associations with FM (% and index) were SFS + WC + sex + type of feeding. CONCLUSIONS Anthropometry showed good correlations with FM at 6 months of age. Skinfolds sum and waist circumference were the strongest anthropometric variables associated to FM. Exclusive/predominant breastfeeding was strongly associated with FM.
Collapse
Affiliation(s)
- Ameyalli M Rodríguez-Cano
- Nutrition and Bioprogramming Department, Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes", Montes Urales 800, Col. Lomas de Virreyes, 11000, Ciudad de México, CP, Mexico
| | - Jennifer Mier-Cabrera
- Nutrition and Bioprogramming Department, Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes", Montes Urales 800, Col. Lomas de Virreyes, 11000, Ciudad de México, CP, Mexico
| | - Cinthya Muñoz-Manrique
- Nutrition and Bioprogramming Department, Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes", Montes Urales 800, Col. Lomas de Virreyes, 11000, Ciudad de México, CP, Mexico
| | - Arturo Cardona-Pérez
- General Director, Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes", Montes Urales 800, Col. Lomas de Virreyes, 11000, Ciudad de México, CP, Mexico
| | - Gicela Villalobos-Alcázar
- Neonatal Ward, Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes", Montes Urales 800, Col. Lomas de Virreyes, 11000, Ciudad de México, CP, Mexico
| | - Otilia Perichart-Perera
- Nutrition and Bioprogramming Department, Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes", Montes Urales 800, Col. Lomas de Virreyes, 11000, Ciudad de México, CP, Mexico.
| |
Collapse
|
10
|
León-Reyes G, Guzmán-Grenfell AM, Medina-Navarro R, Montoya-Estrada A, Moreno-Eutimio MA, Fuentes-García S, Perichart Perera O, Muñoz-Manrique C, Espino Y Sosa S, Hicks G JJ, Torres-Ramos YD. Is gestational diabetes mellitus in obese women predicted by oxidative damage in red blood cells? Gynecol Endocrinol 2018; 34:995-1000. [PMID: 29790384 DOI: 10.1080/09513590.2018.1473360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Abstract
Obesity in pregnant women has been associated with an increased risk of maternal complications, including gestational diabetes mellitus (GDM), a process that is related to oxidative stress (OS). To evaluate the biomarkers of OS in red blood cells (RBCs), we assigned 80 pregnant women to one of three groups: control (n = 28), overweight (n = 26) and obese (n = 26). Then, we measured in plasma, the levels of glucose, triacylglycerol (TAG), insulin, free fatty acids (FFAs), leptin and cytokines (e.g. interleukin-6 [IL-6] and tumor necrosis factor-alpha [TNF-alpha]) and OS biomarkers, such as lipohydroperoxides (LHP), malondialdehyde (MDA) and protein carbonylation (PC) in RBCs. We found significant positive correlations between OS biomarkers, body mass index (BMI) and pregnancy progression. Seven (26.9%) obese women who were diagnosed with GDM at 24-28 weeks of pregnancy showed significantly increased concentrations of FFAs, insulin, leptin, TNF-alpha and biomarkers of OS measured at 12-13 weeks of gestation. We propose to quantify LHP, MDA and PC in membranes of erythrocytes as possible markers to diagnose GDM from weeks 12-14.
Collapse
Affiliation(s)
- Guadalupe León-Reyes
- a Department of Immuno-Biochemistry , National Institute of Perinatology, Ministry of Health , México City , México
| | | | - Rafael Medina-Navarro
- b Department of Experimental Metabolism , Center for Biomedical Research of Michoacán (CIBIMI-IMSS) , Morelia , Michoacán , México
| | - Araceli Montoya-Estrada
- a Department of Immuno-Biochemistry , National Institute of Perinatology, Ministry of Health , México City , México
| | | | - Silvia Fuentes-García
- a Department of Immuno-Biochemistry , National Institute of Perinatology, Ministry of Health , México City , México
| | - Otilia Perichart Perera
- d Department of Nutrition , National Institute of Perinatology, Ministry of Health , México City , México
| | - Cinthya Muñoz-Manrique
- d Department of Nutrition , National Institute of Perinatology, Ministry of Health , México City , México
| | - Salvador Espino Y Sosa
- e Subaddress Clinical Research , National Institute of Perinatology, Ministry of Health , México City , México
| | - Juan José Hicks G
- f Health Research Policies , Coordinating Commission of National Health Institutes and Highly Specialized Hospitals , Mexico City , Mexico
| | - Yessica Dorin Torres-Ramos
- a Department of Immuno-Biochemistry , National Institute of Perinatology, Ministry of Health , México City , México
| |
Collapse
|
11
|
Perichart-Perera O, Muñoz-Manrique C, Reyes-López A, Tolentino-Dolores M, Espino y Sosa S, Ramírez-González MC. Metabolic markers during pregnancy and their association with maternal and newborn weight status. PLoS One 2017; 12:e0180874. [PMID: 28749954 PMCID: PMC5531808 DOI: 10.1371/journal.pone.0180874] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 06/22/2017] [Indexed: 12/11/2022] Open
Abstract
Background/Aims Obesity during pregnancy increases the risk of adverse clinical outcomes and is associated with low-grade chronic inflammation. We describe maternal metabolic risk and inflammation by maternal weight status, and evaluate the association of metabolic and inflammatory markers with birthweight in a group of pregnant Mexican women. Methods This study derived from a prospective cohort of healthy pregnant women <14 weeks of gestation, receiving prenatal care at National Institute of Perinatology (Mexico, 2009–2013). Metabolic and inflammatory markers were measured in maternal serum in all three pregnancy trimesters (1st: 11.42±1.7; 2nd: 21.06±2.4; 3rd: 32.74±2.3 weeks). Pregestational weight was self-reported, and body mass index (BMI) was calculated. Gestational weight gain was evaluated in the third trimester. Newborn´s weight was measured at birth. We carried out correlations, general mixed linear model and regression analyses, based on pregestational weight (self-reported), body mass index (BMI), gestational weight gain (evaluated in the third trimester) and newborn weight (measured at birth). Results Of the 177 women included in the study (mean age = 26.93±8.49), thirty-eight percent (n = 67) were overweight or had obesity, and 32.8% (n = 58) showed excessive gestational weight gain. We found insulin, lipids (including total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides-TG), leptin and interleukin 1b (IL-1b) all increased significantly (p<0.05) during pregnancy. Pregestational maternal weight status altered longitudinal concentrations of insulin, leptin, adiponectin, TG and C reactive protein. Excessive gestational weight gain was associated with higher maternal insulin in the third trimester (p<0.05). Early pregnancy leptin and TNFα were determinants of birthweight in women with normal weight, but not in overweight or obese women. Conclusions Maternal weight status affected the concentrations of insulin, leptin, adiponectin, triglycerides and C reactive protein throughout pregnancy. The role of early leptin and TNFα in fetal growth need further study given the association was only observed in normal weight women. This study presents data distribution of metabolic and inflammatory markers of normal weight and overweight/obese women that did not develop GDM, preeclampsia nor macrosomia.
Collapse
Affiliation(s)
- Otilia Perichart-Perera
- Nutrition and Bioprogramming Department, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
- * E-mail:
| | - Cinthya Muñoz-Manrique
- Nutrition and Bioprogramming Department, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Angélica Reyes-López
- Nutrition and Bioprogramming Department, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Maricruz Tolentino-Dolores
- Nutrition and Bioprogramming Department, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Salvador Espino y Sosa
- Clinical Research Subdirection, Instituto Nacional de Perinatología, Mexico City, Mexico
| | - Ma. Cristina Ramírez-González
- Nutrition and Bioprogramming Department, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| |
Collapse
|
12
|
Campos-Collado AX, Reyes-López MA, Orozco-Guillén A, Muñoz-Manrique C, Perichart-Perera O. Medical Nutrition Therapy for Chronic Kidney Disease in Pregnancy: A Case Report. J Acad Nutr Diet 2015; 116:213-218. [PMID: 26496805 DOI: 10.1016/j.jand.2015.08.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Indexed: 11/30/2022]
|
13
|
Balas-Nakash M, Rodríguez-Cano A, Muñoz-Manrique C, Vásquez-Peña P, Perichart-Perera O. [Adherence to a medical nutrition therapy program in pregnant women with diabetes, measured by three methods, and its association with glycemic control]. Rev Invest Clin 2010; 62:235-243. [PMID: 20815129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
INTRODUCTION The measurement of adherence to nutrition therapy is essential to evaluate if the outcomes are related to given recommendations. MATERIAL AND METHODS The aim of this study was to describe adherence to a Medical Nutrition Therapy Program in Mexican pregnant women with diabetes, using three different methods; and evaluate its association with glycemic control. Adherence was measured with a questionnaire (0-100%), women's self-perception (0-100%) and energy intake adequacy by multiple pass 24 hour recall (85-115% of recommendation). Women were randomly assigned to two different dietary strategies. Glycemic control was determined by capillary glucose self-monitoring. RESULTS Women analyzed in this study (n=69) had an age range of 22-42 years; 47.8% had type 2 diabetes (DM2) and 52.2% had gestational diabetes (GDM). Energy intake adequacy was higher in women with GDM (41.9% vs. 37.7%, p = 0.001). Average adherence measured with the questionnaire was 55%; no differences were found by type of diabetes. Self-perception was higher in women with DM2 (84%) when compared to women with GDM (70%) (p = 0.039). No differences were found in the three methods by study group. Optimal glycemic control was observed in 50% of women; no association was found with adherence measured with any of the three methods studied. CONCLUSIONS The observed differences in adherences suggest that it may be recommendable to combine different measurement methods and include social and psychological factors that affect behavioral change.
Collapse
Affiliation(s)
- Margie Balas-Nakash
- Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Lomas de Virreyes, DF México
| | | | | | | | | |
Collapse
|
14
|
Perichart-Perera O, Balas-Nakash M, Rodríguez-Cano A, Muñoz-Manrique C, Monge-Urrea A, Vadillo-Ortega F. Correlates of Dietary Energy Sources with Cardiovascular Disease Risk Markers in Mexican School-Age Children. ACTA ACUST UNITED AC 2010; 110:253-60. [DOI: 10.1016/j.jada.2009.10.031] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2009] [Accepted: 08/26/2009] [Indexed: 10/19/2022]
|