Relationship of Frailty, Nutritional Status and Oral Health-Related Quality of Life in Mexico City Nursing Home Residents

BACKGROUND

We aimed to identify the association among nutritional status, Oral Health-Related Quality of Life (OHRQoL) and frailty, and to estimate the mediation effect of these conditions between age and frailty in a group of Mexico City nursing home residents.

METHODS

We conducted a cross-sectional study. Fried's phenotype criteria, Full Mini Nutritional Assessment, and General Oral Health Assessment Index was applied.

RESULTS

The participants (n = 286) mean age was 82.4 (± 9.2) years. The prevalence of frailty was 58%, and the prevalence of malnutrition and the risk of malnutrition were 22.7% and 59.5%, respectively. A higher risk of frailty was associated with older age (p = 0.015), sex (women) (p = 0.041), poor nutritional status (p <0.001) and compromised OHRQoL (p <0.001). Approximately 40% of the effect of age on frailty was mediated by nutritional status and OHRQoL (p <0.05).

CONCLUSION

A strong association between nutritional status and frailty was observed. Additionally, OHRQoL was associated with frailty. The effect of age on frailty was mediated by OHRQoL and nutritional status. Interventions targeted to improve nutritional status and oral health may contribute to preventing or delaying the onset of frailty.

Depression symptoms and sweet foods consumption in Mexican college men: the role of emotional eating

Introduction

Objective: to evaluate the association between depression symptoms and frequency of unhealthy food consumption, and to explore the mediation effect of emotional eating in this relationship in college men. Method: a cross-sectional study was performed on 764 men at a public university in Mexico City. To assess emotional eating (EE), a validated Spanish-language version of the Eating and Appraisal Due to Emotions and Stress Questionnaire (EADES) was applied. Depression symptoms were evaluated using the scale elaborated by the Center for Epidemiologic Studies (CES-D) and a Questionnaire of Frequency of Food Consumption was used to measure frequency of food consumption. Path and mediation analysis were applied. Results: one-fifth (20.42 %) of college men reported depression symptoms (CES-D ≥ 16). Students with depression symptoms had a higher mean EE score (p < 0.001), a higher frequency of fried food (p = 0.049), sweetened beverages (p = 0.050), and sweet foods consumption (p = 0.005) than students with low CES-D score. According to the mediation analysis, the effect of depression symptoms on the frequency of sweet foods consumption was partially mediated by EE (23.11 % of the total effect). Conclusion: the prevalence of depression symptoms was high. EE is an important mediator in the relationship between depression symptoms and the consumption of sweet foods. Understanding the manifestation of eating behaviors in men and their relationship with depression symptoms may help clinicians and health authorities develop treatment and prevention programs aimed to decrease the risk of obesity and eating disorders.

Construct Validity of a Questionnaire on Eating and Physical Activity Habits for Adolescents in Mexico City

The assessment of eating and physical activity habits is an important step in promoting healthy behaviors among the adolescent population and is key in the prevention and management of chronic non-communicable diseases, such as obesity, diabetes, and cardiovascular disease. For this purpose, reliable and valid measuring instruments are essential. In this context, the aim of this article is to present the validation of a self-report questionnaire on eating and physical activity habits among adolescents in Mexico City. In order to validate the questionnaire, a cross-sectional study was conducted with a sample of 2710 adolescents between 11 and 12 years of age, the piloting of the questionnaire was carried out in September 2022 with a focus group, and the programming of the anthropometric measurements was established with the Federal Educational Authority of CDMX, as well as the application of the questionnaire to 33 schools, with these activities being scheduled from 7 November 2022 to 3 February 2023 and having an application duration of 15-25 min for each of the groups to which it was applied; the questionnaire that was applied consists of 31 questions that refer to the frequencies, quantity, or performance of behaviors related to the frequency and type of food, type of physical activity and behaviors related to the act of eating referring to the place where it is carried out (home or away from home) and with whom it is carried out (alone or in company), and about the individual's lifestyle. Subsequently, the reliability of the instrument was evaluated using Cronbach's alpha coefficient, and an exploratory factor analysis was conducted to determine the structure of the questionnaire. The results obtained showed that the questionnaire was adequately reliable (α = 0.778) with an eight-factor structure: four questions on mealtime frequencies, four questions on physical activity and lifestyles, six questions on the consumption of high-calorie foods, four questions on company and food consumption, four questions on the consumption of vegetables and fruits, four questions on the place of food consumption, two questions on the consumption of alcoholic beverages, and three questions on the consumption of sugary drinks, plain water, and milk. In conclusion, the self-report questionnaire on eating and physical activity habits among adolescents in Mexico City is reliable, has adequate internal consistency, and can therefore be used as a useful tool for the evaluation of eating and physical activity habits in this population.

Validation of a new screening questionnaire for disordered eating behaviors in men

PURPOSE

The aim of this study was to develop an instrument to identify disordered eating behaviors (DEB) in college men (hereafter, DEBM-Q).

METHODS

A two-stage project consisting of a diagnostic scale construction (n₁ = 9 for interviews, n₂ = 9 for cognitive laboratory) and a validation study with a cross-sectional sample (N = 570) was carried out. Both semi-structured interviews and a cognitive laboratory with nine participants were conducted to obtain DEBM-Q items. DEBM-Q was applied to 570 freshmen male in Mexico City. Psychometric characteristics and internal consistency (Cronbach's alpha) were analyzed. An item-total correlation value greater than 0.30 was determined, and factor loads greater than 0.40 were considered valid. Exploratory factor analysis (EFA, n₁ = 297) and confirmatory factor analysis (CFA, n₂ = 273) were performed.

RESULTS

Two fixed factors explaining 55.08% of the total variance were extracted. Factor 1, "Drive for Thinness" (8 items), explained 30.84% of the variance, whereas factor 2, "Drive for Muscularity" (8 items), explained 24.23% of the variance. Cronbach's alpha for the whole questionnaire was 0.84. DEBM-Q was correlated with the Dutch Food Restriction Scale (RS) (r = 0.52, p < 0.001), Eating Disorder Examination-Questionnaire (EDE-Q) (r = 0.46, p < 0.001), Emotional Eating Scale (EES) (r = 0.18, p < 0.001), and Negative Affect Subscale (PANAS-X) (r = 0.11, p < 0.005).

CONCLUSION

DEBM-Q is a valid and practical short screening tool (16 items) allowing early identification of disordered eating in young men, thereby facilitating clinical management.

LEVEL OF EVIDENCE

Level V: Opinions of authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

Work Environment, Mental Health, and Eating Behavior in Mexican Nurses

Nursing staff in public hospitals face highly demanding working conditions, which are related to mental health and eating problems. The current study aimed to identify the most frequent work characteristics associated with mental health problems and eating behavior in nursing staff. A cross-sectional study was performed on a random sample of 190 nurses at a specialized hospital in Mexico City. Work characteristics, mental health problems (stress, depression, and anxiety), emotional eating, and loss-of-control eating were measured using standardized scales. Associations among relevant work variables and mental health and eating behavior were assessed using logistic regression models adjusted for sociodemographic characteristics. High prevalence of stress (28%), depression (35%), anxiety (33%), emotional eating (27%), and loss-of-control eating (38%) were found. These mental health problems have been associated with variables related to work overload, little appreciation of work, and exposure to the suffering and death of patients. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Prevalence of Malnutrition and Depression in Older Adults Living in Nursing Homes in Mexico City

This study evaluated the association between nutritional status, depressive symptoms, and the number of prescription drugs taken by older adults living in nursing homes in Mexico City. In a cross-sectional study, 262 participants were subjected to anthropometric and nutritional (Mini Nutritional Assessment (MNA)) evaluations; additionally, their depression (Geriatric Depression Scale (GDS)) and functional status were assessed. Multiple logistic regression was used for identifying factors associated with the risk of malnutrition/malnourishment. The mean age of participants was 83.1 ± 8.6 years. A total of 59.9% and 21.1% were at risk of malnutrition and malnourished, respectively. With respect to depression, 27.9% of the participants had mild depression, while 11.4% showed severe depression. An inverse correlation between MNA evaluations and depression scores was found (Spearman's ρ = -0.4624, p < 0.001); residents with a better nutritional status had lower depression scores. Individuals with depressive symptoms were approximately five times more likely to be at risk of malnutrition or malnourished (OR = 5.82, 95% CI = 2.27-14.89) than individuals without depression. Residents taking three or more prescription drugs daily (OR = 1.83, 95% CI = 1.27-2.63, p < 0.001) were more likely to be at risk of malnutrition or malnourished. In summary, poor nutritional status was associated with depression, while the intake of numerous prescription drugs was associated with being at risk of malnutrition or malnourished.

Sarcopenia, nutritional status and type 2 diabetes mellitus: A cross-sectional study in a group of Mexican women residing in a nursing home

AIM

To evaluate the prevalence of sarcopenia and its association with nutritional status and type 2 diabetes mellitus (T2DM) in older women living in a nursing home.

METHODS

This cross-sectional study assessed nutritional status using the Mini Nutritional Assessment (MNA). Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People; hand grip strength and physical performance were determined by dynamometry and gait speed, respectively. Muscle mass was assessed using calf circumference.

RESULTS

The mean age of the 114 participants was 84.1 ± 7.0 years. The prevalence of sarcopenia and T2DM was 30.7% and 10.5%, respectively. The majority (66.7%) had a normal nutritional status, 29.8% were at risk of malnutrition, and 3.5% were undernourished. The prevalence of sarcopenia in participants at risk of malnutrition and those who were undernourished was higher compared with participants with a normal NS (P < 0.0001). A statistically significant difference was observed in the Barthel Index (BI) between women with and without sarcopenia (P = 0.048). The multivariate logistic regression model, adjusted by age (p = 0.007) showed an association between sarcopenia and nutritional status. Women with a poor nutritional status were more likely to have sarcopenia (OR 4.97, P = 0.003) whilst those with T2DM showed a higher probability of sarcopenia (OR 5.52, P = 0.019) than women without T2DM.

CONCLUSIONS

Sarcopenia was highly prevalent in women with a poor nutritional status and T2DM. It is necessary to implement intervention programs to reduce adverse outcomes.

Dating Violence in Mexican College Students: Evaluation of an Educational Workshop

Dating violence represents an important health problem among adolescents and young adults, not only because of its high prevalence but also because of its negative consequences for individual and social development. Educational programs aimed at the prevention and reduction of aggression are indispensable; therefore, the aims of this study were to assess perception and attitudes toward dating violence, and to evaluate the effectiveness of an educational workshop among college students. A total of 212 students from a public university in Mexico City participated in the study. The participants were distributed into two groups: the intervention group (IG; which received a workshop on dating violence) and the control group (CG; which did not participate in the workshop). A self-reported questionnaire was applied to assess students' perception and attitudes toward violence. Means and standard deviations were calculated. In both groups, the comparison between pre- and post-evaluation scores was carried out using the test for matched pairs. The MANOVA test was performed for repeated measurements. The participants of the workshop showed positive changes in perception and attitudes toward dating violence, p < .0001; these changes were not observed in the CG, p = .98. Women in the IG showed a higher improvement than men, p = .04. Findings highlight the importance of creating long-term health promotion programs to improve human relationships, particularly in such important areas as dating violence.

Comparison of the prevalence of sarcopenia using skeletal muscle mass index and calf circumference applying the European consensus definition in elderly Mexican women

AIM

To compare the prevalence of sarcopenia using two indicators: skeletal muscle mass index (SMI) and calf circumference (CC) used in the algorithm proposed by the European Working Group on Sarcopenia in Mexican elderly women.

METHODS

This was a cross-sectional study. Lean body mass was determined by dual-energy X-ray absorptiometry. To define sarcopenia, the SMI was obtained using a cut-off value of 5.5 kg/m² , and the CC cut-off was 31 cm. For gait speed and handgrip strength, the cut-off values were 0.8 m/s and 20 kg, respectively.

RESULTS

A total of 137 women (mean age 73.8 ± 6.7 years) participated in the study. The prevalence of sarcopenia was 14.6% using SMI and 11.0% using CC (P = 0.009). Body mass index was associated with a lower probability of sarcopenia applying SMI or CC (OR 0.75, P = 0.002 for SMI and OR 0.71, P = 0.004 for CC). Sarcopenia evaluated either with dual-energy X-ray absorptiometry or CC was not associated with physical performance, such as five times chair stand test, timed up and go test and short physical performance battery. Additionally, SMI was not associated with physical performance, five times chair stand test (P = 0.775) and timed up-and-go test (P = 0.341).

CONCLUSIONS

The prevalence of sarcopenia in active elderly women was low. A higher prevalence of sarcopenia was detected using SMI compared with CC. It is important to identify the best methods to assess skeletal muscle mass to obtain a reliable diagnosis of sarcopenia. Geriatr Gerontol Int 2017; 17: 161-170.

Psychometric characteristics of the Eating and Appraisal Due to Emotions and Stress Questionnaire and obesity in Mexican university students

INTRODUCTION

Emotional eating has been defined as eating in a response to negative emotions and it is associated with weight gain. The English version of Eating Appraisal Due to Emotions and Stress Questionnaire (EADES) was developed to assess how individuals use food in order to cope with stress and emotions.

OBJECTIVE

To analyze psychometric characteristics of Spanish version of EADES and to identify whether the constructs of EADES were associated with obesity in university students.

METHODS

The EADES (Spanish version) was administered to 232 Mexican university students from 18 to 29 years old. Body Mass Index (BMI) was calculated. A test-retest evaluation was conducted with 75 participants.

RESULTS

Cronbach's alpha of EADES was 0.92; the interclass correlation coefficient was 0.88. Regarding BMI and EADES results, the subscale Emotion and Stress Related Eating was significantly associated with obesity (p = 0.026). Through factor analysis of the instrument, three factors were extracted and items that showed factor loading < 0.40 were eliminated. 40 items remained in the questionnaire. With regard to obesity and the 40-items version of the instrument, a statistically significance association was found for the total score (OR = 0.973, p = 0.020) and for the factor Self-confidence related to Emotional Eating component (OR = 0.940, p = 0.026).

CONCLUSIONS

A good internal consistency and temporal stability of the Spanish version of the instrument were found; the 40-item EADES version was positively associated with obesity. This instrument could be useful in assessing emotional eating.

[Dating violence and mental health in Mexican college students]

Antecedentes:

En las últimas dos décadas, ha aumentado el interés por la promoción de la salud en el sector educativo superior, a través del programa “Universidades Saludables” promovido por la Organización Mundial de la Salud (OMS). Es importante reconocer las necesidades relacionadas con la salud de los integrantes de la comunidad universitaria, así como reflexionar sobre las acciones dirigidas a cubrirlas. Uno de los problemas prioritarios respecto a la salud mental de los jóvenes universitarios es la violencia en el noviazgo. Considerando lo anterior, los objetivos del presente estudio fueron: evaluar la violencia en el noviazgo, la sintomatología depresiva y la autoestima en estudiantes universitarios; estudiar la relación entre la violencia, la depresión y la autoestima; y promover la implementación de programas preventivos entre la comunidad universitaria.

Métodos:

Se realizó un estudio transversal y descriptivo con las respuestas de 729 estudiantes universitarios, aplicando el “Conflict in Adolescent Dating Relationship Inventory,” el Inventario de Depresión de Beck y el Inventario de Coopersmith para evaluar la autoestima.

Resultados:

Los resultados mostraron una elevada prevalencia de violencia en los jóvenes universitarios, particularmente verbal-emocional (75%). Las agresiones fueron de carácter bidireccional, tanto hombres como mujeres cometieron y sufrieron la violencia. La conducta violenta se asoció con la baja autoestima en las mujeres y con síntomas depresivos en ambos sexos.

Conclusiones:

Desde el enfoque del programa “Universidades Saludables,” es importante que las instituciones de educación superior sean promotoras de la salud mediante la creación y difusión del conocimiento, la formación de recursos humanos y la promoción de la organización comunitaria. Los resultados del estudio indican la necesidad de desarrollar programas educativos orientados a la prevención de la violencia, al manejo de emociones y a la resolución de conflictos.

The relationship between sarcopenia,undernutrition, physical mobility and basic activities of daily living in a group of elderly women of Mexico City

BACKGROUND

Sarcopenia is a geriatric syndrome, which affects the functional status and mobility of individuals.

OBJECTIVE

To identify the prevalence of sarcopenia and undernutrition, and to assess the association between sarcopenia and mobility, and sarcopenia and basic activities of daily living (ADL) in a group of elderly women.

SUBJECTS AND METHODS

A cross-sectional study was performed in patients attending a geriatric service at a government hospital in Mexico City. Sarcopenia was identified applying Baumgartner's equation by obtaining skeletal muscle mass index (SMI) and undernutrition was diagnosed using mini-nutritional assessment instrument (MNA). The SENECA questionnaire and Katz index were used to evaluate mobility and ADL, respectively.

STATISTICAL ANALYSIS

lineal regression models were constructed fitting SMI as a dependent variable and SENECA, and ADL scores as independent variables, adjusted for age.

RESULTS

90 women with a mean age of 78.2 (± 6.8) were studied. Undernutrition was identified in 15.5% of the patients. The prevalence of sarcopenia was 41.1%. Patients with sarcopenia presented a high prevalence of undernutrition (p < 0.001). Sarcopenia was associated with difficulty in climbing stairs (OR = 2.63, p = 0.03), adjusted for age. The mobility score was associated with sarcopenia, in the group without sarcopenia the mean score was 16.3, and with sarcopenia it was 18.3, (p = 0.04). Regarding ADL, 64.9% of the patients with intermediate independence and dependence had sarcopenia, while 35.1% with total independence presented sarcopenia (p < 0.001).

CONCLUSIONS

The elder women with sarcopenia had a higher prevalence of undernutrition. Sarcopenia was associated with difficulties in mobility, particularly difficulties in climbing stairs.

Obesity, eating behaviour and mental health among university students in Mexico City

INTRODUCTION

Psychological factors are important in the development of obesity; however these are frequently underestimated in intervention programs.

OBJECTIVE

To examine the association of mental health with altered eating behavior related to weigh gain, and with abdominal obesity among college students in order to provide more comprehensive guidelines for intervention programs.

METHODS

A cross-sectional study was performed with 1,122 university students (from a total population of 1,820 freshmen students) at the Metropolitan Autonomous University, Mexico City. Body mass index and waist circumference (WC) were recorded. A six items questionnaire was applied to assess altered eating behavior. Self-reported questionnaires for depression (Beck Depression Inventory), anxiety (General Anxiety Disorder Scale of Carrol and Davidson), and impulsiveness symptoms (Plutchik Impulsivity Scale) were used. Multiple logistic regression models were performed.

RESULTS

An increased WC was associated with depression symptoms (OR=1.4), female sex (OR=1.5), and age (OR=1.1). Students with altered eating behaviors showed elevated levels of impulsivity (e.g. have difficulties to stop eating, OR=4.2) and depression (e.g. have problem to eat at regular times, OR=6.98). In addition, higher WC was associated with female sex, parents' obesity, and unhealthy eating behaviors (e.g. have difficulties to stop eating, OR=1.42; and constantly feel hungry, and eat too much, OR=2.25).

CONCLUSIONS

Although preventive programs directed at development of adequate eating habits and physical activity are considered a key component of intervention programs, strategies for the management of emotions, the promotion of positive mood and impulsivity-reduction techniques are a necessary complement for a comprehensive approach to overweight and obesity.