Andrea Pedroza Tobias

All Publications

• Chronic kidney disease risk prediction scores assessment and development in Mexican adult population FRONTIERS IN MEDICINE Colli, V. A., Gonzalez-Rocha, A., Canales, D., Hernandez-Alcaraz, C., Pedroza, A., Perez-Chan, M., Barquera, S., Denova-Gutierrez, E. 2022; 9: 903090

  Abstract

  Chronic kidney disease (CKD) is a major public health problem, with considerable growth in prevalence and mortality in recent years. Screening of CKD at primary care is crucial for the implementation of prevention strategies. The aims of this study are to assess CKD risk prediction scores and to develop a risk prediction score for the Mexican adult population.Data from the Mexican National Health and Nutrition Survey 2016 was utilized and 3463 participants ≥ 20 years old were included. Reduced renal function with Glomerular filtration rate and/or the presence of albuminuria was defined as CKD. Multiple logistic regression models were performed for the creation of a training and validation model. Additionally, several models were validated in our Mexican population.The developed training model included sex, age, body mass index, fast plasma glucose, systolic blood pressure, and triglycerides, as did the validation model. The area under the curve (AUC) was 0.78 (95% CI: 0.72, 0.79) for training model, and 0.76 (95% CI: 0.71, 0.80) in validation model for Mexican adult population. Age, female gender, presence of diabetes and hypertension, elevated systolic and diastolic blood pressure, serum and urinary creatinine, and higher HbA1c were significantly associated with the prevalent chronic kidney disease. Previous CKD risk predictive models were evaluated with a representative sample of the Mexican adult population, their AUC was between 0.61 and 0.78.The designed CKD risk predictive model satisfactorily predicts using simple and common variables in primary medical care. This model could have multiple benefits; such as, the identification of the population at risk, and prevention of CKD.

  View details for DOI 10.3389/fmed.2022.903090

  View details for Web of Science ID 000888290800001

  View details for PubMedID 36341240

  View details for PubMedCentralID PMC9631933

• Dietary intake of the Mexican population: comparing food group contribution to recommendations, 2012-2016 SALUD PUBLICA DE MEXICO Aburto, T. C., Batis, C., Pedroza-Tobias, A., Pedraza, L. S., Ramirez-Silva, I., Rivera, J. A. 2022; 64 (3): 267-279

  Abstract

  To estimate energy contribution (EC) of food groups in 2016, to compare consumption against Mexican Dietary Guidelines, and to examine changes in EC from 2012 to 2016.We analyzed 24-hour dietary recalls from the 2012 and 2016 National Health and Nutrition Surveys (Ensanut). Foods and beverages were clas-sified into eight food groups: cereals, legumes, dairy, meats, fruit and vegetables, fats and oils, sugar-sweetened beverages, and high in saturated fat and added sugar (HSFAS) products.Cereals had the highest EC (30.1%), followed by meats (15.9%), HSFAS products (15.5%), and SSBs (10.5%). Fruits and vegetables, and legumes had the lowest contribu-tion with 6.4 and 3.8%, respectively. SSBs, meats, and HSFAS products were 250, 59 and 55% above the recommended intake, respectively.This analysis confirms the need to generate a food environment conducive to a healthier diet.

  View details for DOI 10.21149/13091

  View details for Web of Science ID 000894128600010

  View details for PubMedID 36130389

• Food and beverage industry interference in science and policy: efforts to block soda tax implementation in Mexico and prevent international diffusion BMJ GLOBAL HEALTH Pedroza-Tobias, A., Crosbie, E., Mialon, M., Carriedo, A., Schmidt, L. A. 2021; 6 (8)

  Abstract

  Mexico is the largest soft drink market in the world, with high rates of obesity and type 2 diabetes. Due to strains on the nation's productivity and healthcare spending, Mexican lawmakers implemented one of the world's first public health taxes on sugar-sweetened beverages (SSBs) in 2014. Because Mexico's tax was designed to reduce SSB consumption, it faced strong opposition from transnational food and beverage corporations. We analysed previously secret internal industry documents from major corporations in the University of California San Francisco's Food Industry Documents Archive that shed light on the industry response to the Mexican soda tax. We also reviewed all available studies of the Mexican soda tax's effectiveness, contrasting the results of industry-funded and non-industry-funded studies. We found that food and beverage industry trade organisations and front groups paid scientists to produce research suggesting that the tax failed to achieve health benefits while harming the economy. These results were disseminated before non-industry-funded studies could be finalized in peer review. Mexico still provided a real-world context for the first independent peer-reviewed studies documenting the effectiveness of soda taxation-studies that were ultimately promoted by the global health community. We conclude that the case of the Mexican soda tax shows that industry resistance can persist well after new policies have become law as vested interests seek to roll back legislation, and to stall or prevent policy diffusion. It also underscores the decisive role that conflict-of-interest-free, peer-reviewed research can play in implementing health policy innovations.

  View details for DOI 10.1136/bmjgh-2021-005662

  View details for Web of Science ID 000687296700004

  View details for PubMedID 34413076

  View details for PubMedCentralID PMC8378381

• Prevalence of inadequate intake of vitamins and minerals in the Mexican population correcting by nutrient retention factors. Ensanut 2016 SALUD PUBLICA DE MEXICO Ramirez-Silva, I., Rodriguez-Ramirez, S., Barragan-Vazquez, S., Castellanos-Gutierrez, A., Reyes-Garcia, A., Martinez-Pina, A., Pedroza-Tobias, A. 2020; 62 (5): 521-531

  Abstract

  To estimate the usual intake and the prevalence of inadequacy of selected nutrients in the Mexican population and the potential effect that the nutrient retention factors (NRF) could have on these estimates. Likewise, document the methodology used in the analysis of the 24 hours of the mid-way National Health and Nutrition Survey 2016 (Ensanut MC 2016).Dietary information from the Ensanut MC 2016 was analyzed with and without the use of NRFs.Results. Most nutrients evaluated showed a relevant inadequacy prevalence above 10% in all age groups. Likewise, we documented that, when NRFs were not applied, estimated intakes and prevalence were significantly under-estimated in a range of 2% to 55.5%.We documented the relevance of the application of NRFs for adequate estimation of the prevalence of inadequate intake of selected nutrients in population studies.

  View details for DOI 10.21149/11096

  View details for Web of Science ID 000597326100018

  View details for PubMedID 33027862

• Dyslipidemia prevalence, awareness, treatment and control in Mexico: results of the Ensanut 2012 SALUD PUBLICA DE MEXICO Hernandez-Alcaraz, C., Aguilar-Salinas, C. A., Mendoza-Herrera, K., Pedroza-Tobias, A., Villalpando, S., Shamah-Levy, T., Rivera-Dommarco, J., Hernandez-Avila, M., Barquera, S. 2020; 62 (2): 137-146

  Abstract

  To describe in a national sample 1) the prevalence, awareness, treatment and control of dyslipidemias 2) the prevalence of dyslipidemias through previous national surveys.We analyzed data of the National Health and Nutrition Survey 2012, a representative cross-sectional study. Serum samples of 9 566 adults ≥20 years old with fasting ≥8 hours were analyzed for lipid fractions. Age-adjusted prevalences were calculated, by sociodemographic variables. Prevalence of awareness, treatment and control was estimated. A description of the dyslipidemia prevalence reported in previous surveys is reported.Hypoalphalipoproteinemia and elevated LDL-C are the most prevalent dyslipidemias in Mexican adults. One in four adults had hypercholesterolemia at the moment of the interview without previous diagnosis. Awareness, treatment and control of dyslipidemia were 12.6, 3.7 and 3.1%, respec- tively.Dyslipidemias are the most prevalent risk factor for cardiovascular diseases in Mexico. Public policies to increase awareness, access to therapy and sustained control are urgently needed.

  View details for DOI 10.21149/10520

  View details for Web of Science ID 000597318900006

  View details for PubMedID 32237556

• Attributable Burden and Expenditure of Cardiovascular Diseases and Associated Risk Factors in Mexico and other Selected Mega-Countries INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH Mendoza-Herrera, K., Pedroza-Tobias, A., Hernandez-Alcaraz, C., Avila-Burgos, L., Aguilar-Salinas, C. A., Barquera, S. 2019; 16 (20)

  Abstract

  This paper describes the health and economic burden of cardiovascular diseases (CVD) in Mexico and other mega-countries through a review of literature and datasets.Mega-countries with a low (Nigeria), middle (India), high (China/Brazil/Mexico), and very high (the U.S.A./Japan) human development index were included. The review was focused on prevalence of dyslipidemias and CVD economic impact and conducted according to the PRISMA statement. Public datasets of CVD indicators were explored.Heterogeneity in economic data and limited information on dyslipidemias were found. Hypertriglyceridemia and hypercholesterolemia were higher in Mexico compared with other countries. Higher contribution of dietary risk factors for cardiovascular mortality and greater probability of dying prematurely from CVD were observed in developing countries. From 1990-2016, a greater decrease in cardiovascular mortality in developed countries was registered. In 2015, a CVD expense equivalent to 4% of total health expenditure was reported in Mexico. CVD ranked first in health expenditures in almost all these nations and the economic burden will remain significant for decades to come.Resources should be assured to optimize CVD risk monitoring. Educational and medical models must be improved to enhance CVD diagnosis and the prescription and adherence to treatments. Long-term benefits could be attained by modifying the food system.

  View details for DOI 10.3390/ijerph16204041

  View details for Web of Science ID 000494779100255

  View details for PubMedID 31652519

  View details for PubMedCentralID PMC6843962

• Challenges of frontal food labeling to reduce sodium consumption (salt) SALUD PUBLICA DE MEXICO Vargas-Meza, J., Pedroza-Tobias, A., Campos-Nonato, I., Nilson, E., Jauregui, A., Barquera, S. 2019; 61 (5): 555

  View details for DOI 10.21149/10593

  View details for Web of Science ID 000501743900001

  View details for PubMedID 31661728

• Hypertension in Mexican adults: prevalence, diagnosis and type of treatment. Ensanut MC 2016 SALUD PUBLICA DE MEXICO Campos-Nonato, I., Hernandez-Barrera, L., Pedroza-Tobias, A., Medina, C., Barquera, S. 2018; 60 (3): 233-243

  Abstract

  To describe the prevalence, awareness and proportion of adults with an adequate control of hypertension.Blood pressure was measured at 8 352 adults who participated in the Ensanut MC 2016. The adults who reported having diagnosis of hypertension or had systolic blood pressure values (TAS) ≥140mmHg or diastolic blood pressure (TAD) ≥90mmHg were classified as hypertensive. Hypertension was considered controlled when blood pressure was TAS <140mmHg and TAD <90mmHg.The prevalence of hypertension was 25.5%. Of these, 40.0% were unaware of having high blood pressure. Of the hypertensive adults who had previous diagnosis of hypertension and receiving drug treatment (79.3%), 45.6% had blood pressure under control.A high percentage of adults are unaware of having hypertension and nearly half have inadequate control. The relevance of current programmes for diagnosing hypertension should be assessed, as well as the effectiveness of their control strategies.

  View details for DOI 10.21149/8813

  View details for Web of Science ID 000442172800004

  View details for PubMedID 29746740

• A Diabetic Retinopathy Screening Tool for Low-Income Adults in Mexico PREVENTING CHRONIC DISEASE Mendoza-Herrera, K., Quezada, A. D., Pedroza-Tobias, A., Hernandez-Alcaraz, C., Fromow-Guerra, J., Barquera, S. 2017; 14: E95

  Abstract

  A national diabetic retinopathy screening program does not exist in Mexico as of 2017. Our objective was to develop a screening tool based on a predictive model for early detection of diabetic retinopathy in a low-income population.We analyzed biochemical, clinical, anthropometric, and sociodemographic information from 1,000 adults with diabetes in low-income communities in Mexico (from 11,468 adults recruited in 2014-2016). A comprehensive ophthalmologic evaluation was performed. We developed the screening tool through the following stages: 1) development of a theoretical predictive model, 2) performance assessment and validation of the model using cross-validation and the area under the receiver operating characteristic curve (AUC ROC), and 3) optimization of cut points for the classification of diabetic retinopathy. We identified points along the AUC ROC that minimized the misclassification cost function and considered various scenarios of misclassification costs and diabetic retinopathy prevalence.Time since diabetes diagnosis, high blood glucose levels, systolic hypertension, and physical inactivity were considered risk factors in our screening tool. The mean AUC ROC of our model was 0.780 (validation data set). The optimized cut point that best represented our study population (z = -0.640) had a sensitivity of 82.9% and a specificity of 61.9%.We developed a low-cost and easy-to-apply screening tool to detect people at high risk of diabetic retinopathy in Mexico. Although classification performance of our tool was acceptable (AUC ROC > 0.75), error rates (precision) depend on false-negative and false-positive rates. Therefore, confirmatory assessment of all cases is mandatory.

  View details for DOI 10.5888/pcd14.170157

  View details for Web of Science ID 000423786000008

  View details for PubMedID 29023230

  View details for PubMedCentralID PMC5645201

• Dissonant health transition in the states of Mexico, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013 LANCET Gomez-Dantes, H., Fullman, N., Lamadrid-Figueroa, H., Cahuana-Hurtado, L., Darney, B., Avila-Burgos, L., Correa-Rotter, R., Rivera, J. A., Barquera, S., Gonzalez-Pier, E., Aburto-Soto, T., de Castro, E., Barrientos-Gutierrez, T., Basto-Abreu, A. C., Batis, C., Borges, G., Campos-Nonato, I., Campuzano-Rincon, J. C., Cantoral-Preciado, A., Contreras-Manzano, A. G., Cuevas-Nasu, L., de la Cruz-Gongora, V. V., Diaz-Ortega, J. L., Garcia-Garcia, M., Garcia-Guerra, A., Gonzalez de Cossio, T., Gonzalez-Castell, L. D., Heredia-Pi, I., Hijar-Medina, M. C., Jauregui, A., Jimenez-Corona, A., Lopez-Olmedo, N., Magis-Rodriguez, C., Medina-Garcia, C., Medina-Mora, M. E., Mejia-Rodriguez, F., Montanez, J. C., Montero, P., Montoya, A., Moreno-Banda, G. L., Pedroza-Tobias, A., Perez-Padilla, R., Quezada, A. D., Richardson-Lopez-Collada, V. L., Riojas-Rodriguez, H., Blancas, M., Razo-Garcia, C., Romero Mendoza, M. P., Sanchez-Pimienta, T. G., Sanchez-Romero, L. M., Schilmann, A., Servan-Mori, E., Shamah-Levy, T., Tellez-Rojo, M. M., Texcalac-Sangrador, J. L., Wang, H., Vos, T., Forouzanfar, M. H., Naghavi, M., Lopez, A. D., Murray, C. L., Lozano, R. 2016; 388 (10058): 2386-2402

  Abstract

  Child and maternal health outcomes have notably improved in Mexico since 1990, whereas rising adult mortality rates defy traditional epidemiological transition models in which decreased death rates occur across all ages. These trends suggest Mexico is experiencing a more complex, dissonant health transition than historically observed. Enduring inequalities between states further emphasise the need for more detailed health assessments over time. The Global Burden of Diseases, Injuries, and Risk Factors Study 2013 (GBD 2013) provides the comprehensive, comparable framework through which such national and subnational analyses can occur. This study offers a state-level quantification of disease burden and risk factor attribution in Mexico for the first time.We extracted data from GBD 2013 to assess mortality, causes of death, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) in Mexico and its 32 states, along with eight comparator countries in the Americas. States were grouped by Marginalisation Index scores to compare subnational burden along a socioeconomic dimension. We split extracted data by state and applied GBD methods to generate estimates of burden, and attributable burden due to behavioural, metabolic, and environmental or occupational risks. We present results for 306 causes, 2337 sequelae, and 79 risk factors.From 1990 to 2013, life expectancy from birth in Mexico increased by 3·4 years (95% uncertainty interval 3·1-3·8), from 72·1 years (71·8-72·3) to 75·5 years (75·3-75·7), and these gains were more pronounced in states with high marginalisation. Nationally, age-standardised death rates fell 13·3% (11·9-14·6%) since 1990, but state-level reductions for all-cause mortality varied and gaps between life expectancy and years lived in full health, as measured by HALE, widened in several states. Progress in women's life expectancy exceeded that of men, in whom negligible improvements were observed since 2000. For many states, this trend corresponded with rising YLL rates from interpersonal violence and chronic kidney disease. Nationally, age-standardised YLL rates for diarrhoeal diseases and protein-energy malnutrition markedly decreased, ranking Mexico well above comparator countries. However, amid Mexico's progress against communicable diseases, chronic kidney disease burden rapidly climbed, with age-standardised YLL and DALY rates increasing more than 130% by 2013. For women, DALY rates from breast cancer also increased since 1990, rising 12·1% (4·6-23·1%). In 2013, the leading five causes of DALYs were diabetes, ischaemic heart disease, chronic kidney disease, low back and neck pain, and depressive disorders; the latter three were not among the leading five causes in 1990, further underscoring Mexico's rapid epidemiological transition. Leading risk factors for disease burden in 1990, such as undernutrition, were replaced by high fasting plasma glucose and high body-mass index by 2013. Attributable burden due to dietary risks also increased, accounting for more than 10% of DALYs in 2013.Mexico achieved sizeable reductions in burden due to several causes, such as diarrhoeal diseases, and risks factors, such as undernutrition and poor sanitation, which were mainly associated with maternal and child health interventions. Yet rising adult mortality rates from chronic kidney disease, diabetes, cirrhosis, and, since 2000, interpersonal violence drove deteriorating health outcomes, particularly in men. Although state inequalities from communicable diseases narrowed over time, non-communicable diseases and injury burdens varied markedly at local levels. The dissonance with which Mexico and its 32 states are experiencing epidemiological transitions might strain health-system responsiveness and performance, which stresses the importance of timely, evidence-informed health policies and programmes linked to the health needs of each state.Bill & Melinda Gates Foundation, Instituto Nacional de Salud Pública.

  View details for DOI 10.1016/S0140-6736(16)31773-1

  View details for Web of Science ID 000387436900027

  View details for PubMedID 27720260

• Overview of the Dietary Intakes of the Mexican Population: Results from the National Health and Nutrition Survey 2012 JOURNAL OF NUTRITION Rivera, J. A., Pedraza, L. S., Aburto, T. C., Batis, C., Sanchez-Pimienta, T. G., Gonzalez de Cosio, T., Lopez-Olmedo, N., Pedroza-Tobias, A. 2016; 146 (9): 1851-1855

  Abstract

  Mexico is facing the double burden of malnutrition: stunting and micronutrient deficiencies in young children, iron deficiency in pregnant women, and widespread obesity across age groups.The aim was to summarize and discuss findings published in this supplement on dietary intakes and the eating habits of the Mexican population.A 24-h recall questionnaire that used the multiple-pass method with a repeated measure in a fraction of the sample was applied in a nationally representative sample. We estimated mean intakes and percentages of inadequacy for macronutrients and micronutrients; mean intakes and percentages of the population who adhere to dietary recommendations for food groups; sources of added sugars; intakes of discretionary foods by mealtime, place, and activity; and mean dietary intakes in children <2 y old.Infant formula was consumed by almost half of infants aged <6 mo and sugar-sweetened beverages were consumed by two-thirds of children aged 12-23 mo. In the different age groups, a high proportion of the population had excessive intakes of added sugars (58-85%) and saturated fats (54-92%), whereas a high prevalence of insufficient intakes was found for fiber (65-87%), vitamin A (8-70%), folates (13-69%), calcium (26-88%), and iron (46-89%). Discretionary foods (nonbasic foods high in saturated fats and/or added sugars) contributed 26% of the population's total energy intake, whereas only 1-23% met recommendations for legumes, seafood, fruit, vegetables, and dairy foods.High proportions of Mexicans consume diets that do not meet recommendations. Breastfeeding and complementary feeding diverged from recommendations, intakes of discretionary foods were high, and the prevalence of nutrient inadequacies and age groups not meeting intake recommendations of basic food groups were also high. The results are consistent with the high prevalence of the double burden of malnutrition and are useful to design food and nutrition policies.

  View details for DOI 10.3945/jn.115.221275

  View details for Web of Science ID 000382422800029

  View details for PubMedID 27511939

• Usual Vitamin Intakes by Mexican Populations JOURNAL OF NUTRITION Pedroza-Tobias, A., Hernandez-Barrera, L., Lopez-Olmedo, N., Garcia-Guerra, A., Rodriguez-Ramirez, S., Ramirez-Silva, I., Villalpando, S., Carriquiry, A., Rivera, J. A. 2016; 146 (9): 1866-1873

  Abstract

  In the past several years, the consumption of high-energy, nutrient-poor foods has increased globally. Dietary intake data collected by the National Health and Nutrition Survey (ENSANUT) 2012 provide information to assess the quality of the Mexican diet and to guide food and nutrition policy.The aim was to describe the usual intake and the prevalence of inadequate intakes of vitamins for the overall Mexican population and by subgroups defined by sex, age, region, urban or rural areas, and socioeconomic status (SES).ENSANUT 2012 is a cross-sectional probabilistic survey representative of the Mexican population. Dietary information was collected by using the 24-h recall automated multiple-pass method (n = 10,096) with a repeated measurement on a subsample (n = 889) to permit adjustment for intraindividual variability with the use of the Iowa State University method. Mean usual intakes and the prevalence of inadequate intakes of thiamin, riboflavin, niacin, folate, and vitamins A, D, E, C, B-6, and B-12 were calculated for children aged 1-4 y (CH1-4y), children aged 5-11 y (CH5-11y), adolescents aged 12-19 y, and adults aged ≥20 y.In all of the age groups, prevalences of inadequate intakes of vitamins D and E were the highest (77-99% of adults and adolescents and 53-95% of CH5-11y and CH1-4y) and those of folate and vitamin A were intermediate (47-70% of adults and adolescents, 15-23% of CH5-11y and 8-13% of CH1-4y), whereas those of thiamin, riboflavin, niacin, and vitamins B-6, B-12, and C were the lowest (0-37% of adults, 1-27% of adolescents, and 0-2.4% of CH5-11y and CH1-4y). With few exceptions, the highest prevalences of inadequate intakes for vitamins were observed in the poorest populations (rural South region and the lowest tertile of SES).The intake of vitamins among Mexicans is inadequate overall. Information collected by ENSANUT can help target food assistance programs and develop strategies to prevent vitamin deficiencies.

  View details for DOI 10.3945/jn.115.219162

  View details for Web of Science ID 000382422800031

  View details for PubMedID 27511936

• Cardiovascular diseases in mega-countries: the challenges of the nutrition, physical activity and epidemiologic transitions, and the double burden of disease CURRENT OPINION IN LIPIDOLOGY Barquera, S., Pedroza-Tobias, A., Medina, C. 2016; 27 (4): 329-344

  Abstract

  There are today 11 mega-countries with more than 100 million inhabitants. Together these countries represent more than 60% of the world's population. All are facing noncommunicable chronic disease (NCD) epidemic where high cholesterol, obesity, diabetes, and cardiovascular diseases are becoming the main public health concerns. Most of these countries are facing the double burden of malnutrition where undernutrition and obesity coexist, increasing the complexity for policy design and implementation. The purpose of this study is to describe diverse sociodemographic characteristics of these countries and the challenges for prevention and control in the context of the nutrition transition.Mega-countries are mostly low or middle-income and are facing important epidemiologic, nutrition, and physical activity transitions because of changes in food systems and unhealthy lifestyles. NCDs are responsible of two-thirds of the 57 million global deaths annually. Approximately, 80% of these are in low and middle-income countries. Only developed countries have been able to reduce mortality rates attributable to recognized risk factors for NCDs, in particular high cholesterol and blood pressure.Mega-countries share common characteristics such as complex bureaucracies, internal ethnic, cultural and socioeconomic heterogeneity, and complexities to implement effective health promotion and education policies across population. Priorities for action must be identified and successful lessons and experiences should be carefully analyzed and replicated.

  View details for DOI 10.1097/MOL.0000000000000320

  View details for Web of Science ID 000381040500003

  View details for PubMedID 27389629

  View details for PubMedCentralID PMC4947537

• Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013 LANCET Forouzanfar, M. H., Alexander, L., Anderson, H. R., Bachman, V. F., Biryukov, S., Brauer, M., Burnett, R., Casey, D., Coates, M. M., Cohen, A., Delwiche, K., Estep, K., Frostad, J. J., Astha, K. C., Kyu, H. H., Moradi-Lakeh, M., Ng, M., Slepak, E. L., Thomas, B. A., Wagner, J., Aasvang, G. M., Abbafati, C., Ozgoren, A. A., Abd-Allah, F., Abera, S. F., Aboyans, V., Abraham, B., Abraham, J. P., Abubakar, I., Abu-Rmeileh, N. M., Aburto, T. C., Achoki, T., Adelekan, A., Adofo, K., Adou, A. K., Adsuar, J. C., Afshin, A., Agardh, E. E., Al Khabouri, M. J., Al Lami, F. H., Alam, S. S., Alasfoor, D., Albittar, M. I., Alegretti, M. A., Aleman, A. V., Alemu, Z. A., Alfonso-Cristancho, R., Alhabib, S., Ali, R., Ali, M. K., Alla, F., Allebeck, P., Allen, P. J., Alsharif, U., Alvarez, E., Alvis-Guzman, N., Amankwaa, A. A., Amare, A. T., Ameh, E. A., Ameli, O., Amini, H., Ammar, W., Anderson, B. O., Antonio, C. A., Anwari, P., Cunningham, S. A., Arnlov, J., Arsenijevic, V. S., Artaman, A., Asghar, R. J., Assadi, R., Atkins, L. S., Atkinson, C., Avila, M. A., Awuah, B., Badawi, A., Bahit, M. C., Bakfalouni, T., Balakrishnan, K., Balalla, S., Balu, R. K., Banerjee, A., Barber, R. M., Barker-Collo, S. L., Barquera, S., Barregard, L., Barrero, L. H., Barrientos-Gutierrez, T., Basto-Abreu, A. C., Basu, A., Basu, S., Basulaiman, M. O., Ruvalcaba, C. B., Beardsley, J., Bedi, N., Bekele, T., Bell, M. L., Benjet, C., Bennett, D. A., Benzian, H., Bernabe, E., Beyene, T. J., Bhala, N., Bhalla, A., Bhutta, Z. Q., Bikbov, B., Bin Abdulhak, A. A., Blore, J. D., Blyth, F. M., Bohensky, M. A., Basara, B. B., Borges, G., Bornstein, N. M., Bose, D., Boufous, S., Bourne, R. R., Brainin, M., Brazinova, A., Breitborde, N. J., Brenner, H., Briggs, A. D., Broday, D. M., Brooks, P. M., Bruce, N. G., Brugha, T. S., Brunekreef, B., Buchbinder, R., Bui, L. N., Bukhman, G., Bulloch, A. G., Burch, M., Burney, P. G., Campos-Nonato, I. R., Campuzano, J. C., Cantoral, A. J., Caravanos, J., Cardenas, R., Cardis, E., Carpenter, D. O., Caso, V., Castaneda-Orjuela, C. A., Castro, R. E., Catala-Lopez, F., Cavalleri, F., Cavlin, A., Chadha, V. K., Chang, J., Charlson, F. J., Chen, H., Chen, W., Chen, Z., Chiang, P. P., Chimed-Ochir, O., Chowdhury, R., Christophi, C. A., Chuang, T., Chugh, S. S., Cirillo, M., Classen, T. K., Colistro, V., Colomar, M., Colquhoun, S. M., Contreras, A. G., Cooper, C., Cooperrider, K., Cooper, L. T., Coresh, J., Courville, K. J., Criqui, M. H., Cuevas-Nasu, L., Damsere-Derry, J., Danawi, H., Dandona, L., Dandona, R., Dargan, P. I., Davis, A., Davitoiu, D. V., Dayama, A., de Castro, E. F., De la Cruz-Gongora, V., De Leo, D., de Lima, G., Degenhardt, L., Del Pozo-Cruz, B., Dellavalle, R. P., Deribe, K., Derrett, S., Jarlais, D. C., Dessalegn, M., deVeber, G. A., Devries, K. M., Dharmaratne, S. D., Dherani, M. K., Dicker, D., Ding, E. L., Dokova, K., Dorsey, E. R., Driscoll, T. R., Duan, L., Durrani, A. M., Ebel, B. E., Ellenbogen, R. G., Elshrek, Y. M., Endres, M., Ermakov, S. P., Erskine, H. E., Eshrati, B., Esteghamati, A., Fahimi, S., Faraon, E. J., Farzadfar, F., Fay, D. F., Feigin, V. L., Feigl, A. B., Fereshtehnejad, S., Ferrari, A. J., Ferri, C. P., Flaxman, A. D., Fleming, T. D., Foigt, N., Foreman, K. J., Paleo, U. F., Franklin, R. C., Gabbe, B., Gaffikin, L., Gakidou, E., Gamkrelidze, A., Gankpe, F. G., Gansevoort, R. T., Garcia-Guerra, F. A., Gasana, E., Geleijnse, J. M., Gessner, B. D., Gething, P., Gibney, K. B., Gillum, R. F., Ginawi, I. A., Giroud, M., Giussani, G., Goenka, S., Goginashvili, K., Dantes, H. G., Gona, P., de Cosio, T. G., Gonzalez-Castell, D., Gotay, C. C., Goto, A., Gouda, H. N., Guerrant, R. L., Gugnani, H. C., Guillemin, F., Gunnell, D., Gupta, R., Gupta, R., Gutierrez, R. A., Hafezi-Nejad, N., Hagan, H., Hagstromer, M., Halasa, Y. A., Hamadeh, R. R., Hammami, M., Hankey, G. J., Hao, Y., Harb, H. L., Haregu, T. N., Haro, J. M., Havmoeller, R., Hay, S. I., Hedayati, M. T., Heredia-Pi, I. B., Hernandez, L., Heuton, K. R., Heydarpour, P., Hijar, M., Hoek, H. W., Man, H. J., Hornberger, J. C., Hosgood, H. D., Hoy, D. G., Hsairi, M., Hu, G., Hu, H., Huang, C., Huang, J. J., Hubbell, B. J., Huiart, L., Husseini, A., Iannarone, M. L., Iburg, K. M., Idrisov, B. T., Ikeda, N., Innos, K., Inoue, M., Islami, F., Ismayilova, S., Jacobsen, K. H., Jansen, H. A., Jarvis, D. L., Jassal, S. K., Jauregui, A., Jayaraman, S., Jeemon, P., Jensen, P. N., Jha, V., Jiang, F., Jiang, G., Jiang, Y., Jonas, J. B., Juel, K., Kan, H., Roseline, S. S., Karam, N. E., Karch, A., Karema, C. K., Karthikeyan, G., Kaul, A., Kawakami, N., Kazi, D. S., Kemp, A. H., Kengne, A. P., Keren, A., Khader, Y. S., Khalifa, S. E., Khan, E. A., Khang, Y., Khatibzadeh, S., Khonelidze, I., Kieling, C., Kim, D., Kim, S., Kim, Y., Kimokoti, R. W., Kinfu, Y., Kinge, J. M., Kissela, B. M., Kivipelto, M., Knibbs, L. D., Knudsen, A. K., Kokubo, Y., Kose, M. R., Kosen, S., Kraemer, A., Kravchenko, M., Krishnaswami, S., Kromhout, H., Ku, T., Defo, B. K., Bicer, B. K., Kuipers, E. J., Kulkarni, C., Kulkarni, V. S., Kumar, G. A., Kwan, G. F., Lai, T., Balaji, A. L., Lalloo, R., Lallukka, T., Lam, H., Lan, Q., Lansingh, V. C., Larson, H. J., Larsson, A., Laryea, D. O., Lavados, P. M., Lawrynowicz, A. E., Leasher, J. L., Lee, J., Leigh, J., Leung, R., Levi, M., Li, Y., Li, Y., Liang, J., Liang, X., Lim, S. S., Lindsay, M. P., Lipshultz, S. E., Liu, S., Liu, Y., Lloyd, B. K., Logroscino, G., London, S. J., Lopez, N., Lortet-Tieulent, J., Lotufo, P. A., Lozano, R., Lunevicius, R., Ma, J., Ma, S., Machado, V. M., MacIntyre, M. F., Magis-Rodriguez, C., Mahdi, A. A., Majdan, M., Malekzadeh, R., Mangalam, S., Mapoma, C. C., Marape, M., Marcenes, W., Margolis, D. J., Margono, C., Marks, G. B., Martin, R. V., Marzan, M. B., Mashal, M. T., Masiye, F., Mason-Jones, A. J., Matsushita, K., Matzopoulos, R., Mayosi, B. M., Mazorodze, T. T., Mckay, A. C., McKee, M., McLain, A., Meaney, P. A., Medina, C., Mehndiratta, M. M., Mejia-Rodriguez, F., Mekonnen, W., Melaku, Y. A., Meltzer, M., Memish, Z. A., Mendoza, W., Mensah, G. A., Meretoja, A., Mhimbira, F. A., Micha, R., Miller, T. R., Mills, E. J., Misganaw, A., Mishra, S., Ibrahim, N. M., Mohammad, K. A., Mokdad, A. H., Mola, G. L., Monasta, L., Hernandez, J. C., Montico, M., Moore, A. R., Morawska, L., Mori, R., Moschandreas, J., Moturi, W. N., Arian, D. M., Mueller, U. O., Mukaigawara, M., Mullany, E. C., Murthy, K. S., Naghavi, M., Nahas, Z., Naheed, A., Naidoo, K. S., Naldi, L., Nand, D., Nangia, V., Narayan, K. M., Nash, D., Neal, B., Nejjari, C., Neupane, S. P., Newton, C. R., Ngalesoni, F. N., Ngirabega, J. d., Nguyen, G., Nguyen, N. T., Nieuwenhuijsen, M. J., Nisar, M. I., Nogueira, J. R., Nolla, J. M., Nolte, S., Norheim, O. F., Norman, R. E., Norrving, B., Nyakarahuka, L., Oh, I., Ohkubo, T., Olusanya, B. O., Omer, S. B., Opio, J. N., Orozco, R., Pagcatipunan, R. S., Pain, A. W., Pandian, J. D., Panelo, C. I., Papachristou, C., Park, E., Parry, C. D., Caicedo, A. J., Patten, S. B., Paul, V. K., Pavlin, B. I., Pearce, N., Pedraza, L. S., Pedroza, A., Stokic, L. P., Pekericli, A., Pereira, D. M., Perez-Padilla, R., Perez-Ruiz, F., Perico, N., Perry, S. A., Pervaiz, A., Pesudovs, K., Peterson, C. B., Petzold, M., Phillips, M. R., Phua, H. P., Plass, D., Poenaru, D., Polanczyk, G. V., Polinder, S., Pond, C. D., Pope, C. A., Pope, D., Popova, S., Pourmalek, F., Powles, J., Prabhakaran, D., Prasad, N. M., Qato, D. M., Quezada, A. D., Quistberg, D. A., Racape, L., Rafay, A., Rahimi, K., Rahimi-Movaghar, V., Rahman, S. u., Raju, M., Rakovac, I., Rana, S. M., Rao, M., Razavi, H., Reddy, K. S., Refaat, A. H., Rehm, J., Remuzzi, G., Ribeiro, A. L., Riccio, P. M., Richardson, L., Riederer, A., Robinson, M., Roca, A., Rodriguez, A., Rojas-Rueda, D., Romieu, I., Ronfani, L., Room, R., Roy, N., Ruhago, G. M., Rushton, L., Sabin, N., Sacco, R. L., Saha, S., Sahathevan, R., Sahraian, M. A., Salomon, J. A., Salvo, D., Sampson, U. K., Sanabria, J. R., Sanchez, L. M., Sanchez-Pimienta, T. G., Sanchez-Riera, L., Sandar, L., Santos, I. S., Sapkota, A., Satpathy, M., Saunders, J. E., Sawhney, M., Saylan, M. I., Scarborough, P., Schmidt, J. C., Schneider, I. J., Schoettker, B., Schwebel, D. C., Scott, J. G., Seedat, S., Sepanlou, S. G., Serdar, B., Servan-Mori, E. E., Shaddick, G., Shahraz, S., Levy, T. S., Shangguan, S., She, J., Sheikhbahaei, S., Shibuya, K., Shin, H. H., Shinohara, Y., Shiri, R., Shishani, K., Shiue, I., Sigfusdottir, I. D., Silberberg, D. H., Simard, E. P., Sindi, S., Singh, A., Singh, G. M., Singh, J. A., Skirbekk, V., Sliwa, K., Soljak, M., Soneji, S., Soreide, K., Soshnikov, S., Sposato, L. A., Sreeramareddy, C. T., Stapelberg, N. J., Stathopoulou, V., Steckling, N., Stein, D. J., Stein, M. B., Stephens, N., Stoeckl, H., Straif, K., Stroumpoulis, K., Sturua, L., Sunguya, B. F., Swaminathan, S., Swaroop, M., Sykes, B. L., Tabb, K. M., Takahashi, K., Talongwa, R. T., Tandon, N., Tanne, D., Tanner, M., Tavakkoli, M., Ao, B. J., Teixeira, C. M., Rojo, M. M., Terkawi, A. S., Texcalac-Sangrador, J. L., Thackway, S. V., Thomson, B., Thorne-Lyman, A. L., Thrift, A. G., Thurston, G. D., Tillmann, T., Tobollik, M., Tonelli, M., Topouzis, F., Towbin, J. R., Toyoshima, H., Traebert, J. E., Tran, B. X., Trasande, L., Trillini, M., Trujillo, U., Dimbuene, Z. T., Tsilimbaris, M., Tuzcu, E. M., Uchendu, U. S., Ukwaja, K. N., Uzun, S. B., van de Vijver, S., Van Dingenen, R., van Gool, C. H., van Os, J., Varakin, Y. Y., Vasankari, T. J., Vasconcelos, A. M., Vavilala, M. S., Veerman, L. J., Velasquez-Melendez, G., Venketasubramanian, N., Vijayakumar, L., Villalpando, S., Violante, F. S., Vlassov, V. V., Vollset, S. E., Wagner, G. R., Waller, S. G., Wallin, M. T., Wan, X., Wang, H., Wang, J., Wang, L., Wang, W., Wang, Y., Warouw, T. S., Watts, C. H., Weichenthal, S., Weiderpass, E., Weintraub, R. G., Werdecker, A., Wessells, K. R., Westerman, R., Whiteford, H. A., Wilkinson, J. D., Williams, H. C., Williams, T. N., Woldeyohannes, S. M., Wolfe, C. D., Wong, J. Q., Woolf, A. D., Wright, J. L., Wurtz, B., Xu, G., Yan, L. L., Yang, G., Yano, Y., Ye, P., Yenesew, M., Yentuer, G. K., Yip, P., Yonemoto, N., Yoon, S., Younis, M. Z., Younoussi, Z., Yu, C., Zaki, M. E., Zhao, Y., Zheng, Y., Zhou, M., Zhu, J., Zhu, S., Zou, X., Zunt, J. R., Lopez, A. D., Vos, T., Murray, C. J. 2015; 386 (10010): 2287-2323

  Abstract

  The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution.Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk-outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990-2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the first level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular filtration rate. For most risks, data for exposure were synthesised with a Bayesian meta-regression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol.All risks combined account for 57·2% (95% uncertainty interval [UI] 55·8-58·5) of deaths and 41·6% (40·1-43·0) of DALYs. Risks quantified account for 87·9% (86·5-89·3) of cardiovascular disease DALYs, ranging to a low of 0% for neonatal disorders and neglected tropical diseases and malaria. In terms of global DALYs in 2013, six risks or clusters of risks each caused more than 5% of DALYs: dietary risks accounting for 11·3 million deaths and 241·4 million DALYs, high systolic blood pressure for 10·4 million deaths and 208·1 million DALYs, child and maternal malnutrition for 1·7 million deaths and 176·9 million DALYs, tobacco smoke for 6·1 million deaths and 143·5 million DALYs, air pollution for 5·5 million deaths and 141·5 million DALYs, and high BMI for 4·4 million deaths and 134·0 million DALYs. Risk factor patterns vary across regions and countries and with time. In sub-Saharan Africa, the leading risk factors are child and maternal malnutrition, unsafe sex, and unsafe water, sanitation, and handwashing. In women, in nearly all countries in the Americas, north Africa, and the Middle East, and in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and south and east Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in north Africa and the Middle East, Europe, and Asia. For men and women, unsafe sex is the leading risk in a corridor from Kenya to South Africa.Behavioural, environmental and occupational, and metabolic risks can explain half of global mortality and more than one-third of global DALYs providing many opportunities for prevention. Of the larger risks, the attributable burden of high BMI has increased in the past 23 years. In view of the prominence of behavioural risk factors, behavioural and social science research on interventions for these risks should be strengthened. Many prevention and primary care policy options are available now to act on key risks.Bill & Melinda Gates Foundation.

  View details for DOI 10.1016/S0140-6736(15)00128-2

  View details for Web of Science ID 000365993200031

  View details for PubMedCentralID PMC4685753

• Global Overview of the Epidemiology of Atherosclerotic Cardiovascular Disease ARCHIVES OF MEDICAL RESEARCH Barquera, S., Pedroza-Tobias, A., Medina, C., Hernandez-Barrera, L., Bibbins-Domingo, K., Lozano, R., Moran, A. E. 2015; 46 (5): 328-338

  Abstract

  Atherosclerotic cardiovascular disease (ACD) is the leading cause of mortality worldwide. The objective of this paper is to provide an overview of the global burden of ACD and its risk factors and to discuss the main challenges and opportunities for prevention. Publicly available data from the Global Burden of Disease Study were analyzed for ischemic heart disease (IHD), ischemic stroke and ACD risk factors. Data from the WHO Global Health Observatory were used to describe prevalence of diverse cardiometabolic risk factors. World Bank Gross Domestic Product per capita (GDPc) information was used to categorize countries according to income level. Cardiovascular mortality decreased globally from 1990-2010 with important differences by GDPc; during 1990 there was a positive association between IHD mortality and GDPc. Higher-income countries had higher rates compared to those of lower-income countries. High levels of body mass index (BMI), blood pressure, glucose and cholesterol have a differential contribution to mortality by income group over time; high-income countries have been able to reduce the contribution from these risk factors in the last 20 years, whereas lower/middle income countries show an increasing trend in mortality attributable to high BMI and glucose. Although age-adjusted ACD mortality rate trends decreased globally, the absolute number of ACD deaths is increasing in part due to the growth of the population and aging, as well as to important lifestyle and food-system changes that likely attenuate gains in prevention. Population and individual level preventable causes of ACD must be aggressively and efficiently targeted in countries of lower economic development in order to reduce the growing burden of disease due to ACD.

  View details for DOI 10.1016/j.arcmed.2015.06.006

  View details for Web of Science ID 000359181900002

  View details for PubMedID 26135634

• The double burden of undernutrition and excess body weight in Mexico AMERICAN JOURNAL OF CLINICAL NUTRITION Kroker-Lobos, M. F., Pedroza-Tobias, A., Pedraza, L. S., Rivera, J. A. 2014; 100 (6): 1652S-1658S

  Abstract

  In Mexico, stunting and anemia have declined but are still high in some regions and subpopulations, whereas overweight and obesity have increased at alarming rates in all age and socioeconomic groups.The objective was to describe the coexistence of stunting, anemia, and overweight and obesity at the national, household, and individual levels.We estimated national prevalences of and trends for stunting, anemia, and overweight and obesity in children aged <5 y and in school-aged children (5-11 y old) and anemia and overweight and obesity in women aged 20-49 y by using the National Health and Nutrition Surveys conducted in 1988, 1999, 2006, and 2012. With the use of the most recent data (2012), the double burden of malnutrition at the household level was estimated and defined as the coexistence of stunting in children aged <5 y and overweight or obesity in the mother. At the individual level, double burden was defined as concurrent stunting and overweight and obesity in children aged 5-11 y and concurrent anemia and overweight or obesity in children aged 5-11 y and in women. We also tested if the coexistence of the conditions corresponded to expected values, under the assumption of independent distributions of each condition.At the household level, the prevalence of concurrent stunting in children aged <5 y and overweight and obesity in mothers was 8.4%; at the individual level, prevalences were 1% for stunting and overweight or obesity and 2.9% for anemia and overweight or obesity in children aged 5-11 y and 7.6% for anemia and overweight or obesity in women. At the household and individual levels in children aged 5-11 y, prevalences of double burden were significantly lower than expected, whereas anemia and the prevalence of overweight or obesity in women were not different from that expected.Although some prevalences of double burden were lower than expected, assuming independent distributions of the 2 conditions, the coexistence of stunting, overweight or obesity, and anemia at the national, household, and intraindividual levels in Mexico calls for policies and programs to prevent the 3 conditions.

  View details for DOI 10.3945/ajcn.114.083832

  View details for Web of Science ID 000345267600033

  View details for PubMedID 25411308

• Classification of metabolic syndrome according to lipid alterations: analysis from the Mexican National Health and Nutrition Survey 2006 BMC PUBLIC HEALTH Pedroza-Tobias, A., Trejo-Valdivia, B., Sanchez-Romero, L. M., Barquera, S. 2014; 14: 1056

  Abstract

  There are 16 possible Metabolic Syndrome (MS) combinations out of 5 conditions (glucose intolerance, low levels of high-density lipoprotein Cholesterol (HDL-C), high triglycerides, high blood pressure and abdominal obesity), when selecting those with at least three. Studies suggest that some combinations have different cardiovascular risk. However evaluation of all 16 combinations is complex and difficult to interpret. The purpose of this study is to describe and explore a classification of MS groups according to their lipid alterations.This is a cross-sectional study with data from the Mexican National Health and Nutrition Survey 2006. Subjects (n = 5,306) were evaluated for the presence of MS; four mutually-exclusive MS groups were considered: mixed dyslipidemia (altered triglycerides and HDL-C), hypoalphalipoproteinemia: (normal triglycerides but low HDL-C), hypertriglyceridemia (elevated triglycerides and normal HDL-C) and without dyslipidemia (normal triglycerides and HDL-C). A multinomial logistic regression model was fitted in order to identify characteristics that were associated with the groups.The most frequent MS group was hypoalphalipoproteinemia in females (51.3%) and mixed dyslipidemia in males (43.5%). The most prevalent combination of MS for both genders was low HDL-C + hypertension + abdominal obesity (20.4% females, 19.4% males). The hypoalphalipoproteinemia group was characteristic of women and less developed areas of the country. The group without dyslipidemia was more frequent in the highest socioeconomic level and less prevalent in the south of the country. The mixed dyslipidemia group was characteristic of men, and the Mexico City region.A simple system to classify MS based on lipid alterations was useful to evaluate prevalences by diverse biologic and sociodemographic characteristics. This system may allow prevention and early detection strategies with emphasis on population-specific components and may serve as a guide for future studies on MS and cardiovascular risk.

  View details for DOI 10.1186/1471-2458-14-1056

  View details for Web of Science ID 000345134600001

  View details for PubMedID 25300324

  View details for PubMedCentralID PMC4288637

• Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet Ng, M., Fleming, T., Robinson, M., Thomson, B., Graetz, N., Margono, C., Mullany, E. C., Biryukov, S., Abbafati, C., Abera, S. F., Abraham, J. P., Abu-Rmeileh, N. M., Achoki, T., Albuhairan, F. S., Alemu, Z. A., Alfonso, R., Ali, M. K., Ali, R., Guzman, N. A., Ammar, W., Anwari, P., Banerjee, A., Barquera, S., Basu, S., Bennett, D. A., Bhutta, Z., Blore, J., Cabral, N., Nonato, I. C., Chang, J., Chowdhury, R., Courville, K. J., Criqui, M. H., Cundiff, D. K., Dabhadkar, K. C., Dandona, L., Davis, A., Dayama, A., Dharmaratne, S. D., Ding, E. L., Durrani, A. M., Esteghamati, A., Farzadfar, F., Fay, D. F., Feigin, V. L., Flaxman, A., Forouzanfar, M. H., Goto, A., Green, M. A., Gupta, R., Hafezi-Nejad, N., Hankey, G. J., Harewood, H. C., Havmoeller, R., Hay, S., Hernandez, L., Husseini, A., Idrisov, B. T., Ikeda, N., Islami, F., Jahangir, E., Jassal, S. K., Jee, S. H., Jeffreys, M., Jonas, J. B., Kabagambe, E. K., Khalifa, S. E., Kengne, A. P., Khader, Y. S., Khang, Y., Kim, D., Kimokoti, R. W., Kinge, J. M., Kokubo, Y., Kosen, S., Kwan, G., Lai, T., Leinsalu, M., Li, Y., Liang, X., Liu, S., Logroscino, G., Lotufo, P. A., Lu, Y., Ma, J., Mainoo, N. K., Mensah, G. A., Merriman, T. R., Mokdad, A. H., Moschandreas, J., Naghavi, M., Naheed, A., Nand, D., Narayan, K. M., Nelson, E. L., Neuhouser, M. L., Nisar, M. I., Ohkubo, T., Oti, S. O., Pedroza, A., Prabhakaran, D., Roy, N., Sampson, U., Seo, H., Sepanlou, S. G., Shibuya, K., Shiri, R., Shiue, I., Singh, G. M., Singh, J. A., Skirbekk, V., Stapelberg, N. J., Sturua, L., Sykes, B. L., Tobias, M., Tran, B. X., Trasande, L., Toyoshima, H., van de Vijver, S., Vasankari, T. J., Veerman, J. L., Velasquez-Melendez, G., Vlassov, V. V., Vollset, S. E., Vos, T., Wang, C., Wang, X., Weiderpass, E., Werdecker, A., Wright, J. L., Yang, Y. C., Yatsuya, H., Yoon, J., Yoon, S., Zhao, Y., Zhou, M., Zhu, S., Lopez, A. D., Murray, C. J., Gakidou, E. 2014; 384 (9945): 766-781

  Abstract

  In 2010, overweight and obesity were estimated to cause 3·4 million deaths, 3·9% of years of life lost, and 3·8% of disability-adjusted life-years (DALYs) worldwide. The rise in obesity has led to widespread calls for regular monitoring of changes in overweight and obesity prevalence in all populations. Comparable, up-to-date information about levels and trends is essential to quantify population health effects and to prompt decision makers to prioritise action. We estimate the global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013.We systematically identified surveys, reports, and published studies (n=1769) that included data for height and weight, both through physical measurements and self-reports. We used mixed effects linear regression to correct for bias in self-reports. We obtained data for prevalence of obesity and overweight by age, sex, country, and year (n=19,244) with a spatiotemporal Gaussian process regression model to estimate prevalence with 95% uncertainty intervals (UIs).Worldwide, the proportion of adults with a body-mass index (BMI) of 25 kg/m(2) or greater increased between 1980 and 2013 from 28·8% (95% UI 28·4-29·3) to 36·9% (36·3-37·4) in men, and from 29·8% (29·3-30·2) to 38·0% (37·5-38·5) in women. Prevalence has increased substantially in children and adolescents in developed countries; 23·8% (22·9-24·7) of boys and 22·6% (21·7-23·6) of girls were overweight or obese in 2013. The prevalence of overweight and obesity has also increased in children and adolescents in developing countries, from 8·1% (7·7-8·6) to 12·9% (12·3-13·5) in 2013 for boys and from 8·4% (8·1-8·8) to 13·4% (13·0-13·9) in girls. In adults, estimated prevalence of obesity exceeded 50% in men in Tonga and in women in Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa. Since 2006, the increase in adult obesity in developed countries has slowed down.Because of the established health risks and substantial increases in prevalence, obesity has become a major global health challenge. Not only is obesity increasing, but no national success stories have been reported in the past 33 years. Urgent global action and leadership is needed to help countries to more effectively intervene.Bill & Melinda Gates Foundation.

  View details for DOI 10.1016/S0140-6736(14)60460-8

  View details for PubMedID 24880830

• Screen time in Mexican children: findings from the 2012 National Health and Nutrition Survey (ENSANUT 2012) SALUD PUBLICA DE MEXICO Janssen, I., Medina, C., Pedroza, A., Barquera, S. 2013; 55 (5): 484-491

  Abstract

  To provide descriptive information on the screen time levels of Mexican children.5 660 children aged 10-18 years from the 2012 National Health and Nutrition Survey (ENSANUT 2012) were studied. Screen time (watching television, movies, playing video games and using a computer) was self-reported.On average, children engaged in 3 hours/day of screen time, irrespective of gender and age. Screen time was higher in obese children, children from the northern and Federal District regions of the country, children living in urban areas, and children in the highest socioeconomic status and education categories. Approximately 33% of 10-14 year olds and 36% of 15-18 year olds met the screen time guideline of ≤ 2 hours/day.10-18 year old Mexican children accumulate an average of 3 hours/day of screen time. Two thirds of Mexican children exceed the recommended maximal level of time for this activity.

  View details for Web of Science ID 000326356800006

  View details for PubMedID 24626619

• Prevalence of obesity in Mexican adults, ENSANUT 2012 SALUD PUBLICA DE MEXICO Barquera, S., Campos-Nonato, I., Hernandez-Barrera, L., Pedroza-Tobias, A., Rivera-Dommarco, J. A. 2013; 55: S151-S160

  Abstract

  To describe the prevalence of overweight and obesity in Mexican adults ≥20 y of age, as well as to describe its trends in the last three Mexican health surveys.A sample of 38 208 adults with anthropometric's. The classification to categorize body mass index (BMI) was the World health Organization's (WHO). To define abdominal obesity classification was used the International Diabetes Federation (IDF) data.The prevalence of overweight and obesity was 71.3% (overweight 38.8% and obesity 32.4%). The prevalence of abdominal adiposity was 74.0%, being higher in women (82.8%) than in men (64.5%). Over the past 12 years the mean annualized BMI percent increase was 1.3%. This increase was higher in the 2000-2006 (1%) than in the 2006-2012 (0.3%) period.In spite of the deacceleration of the increasing prevalence, there is no evidence to infer that prevalences will decrease in the next years. Thus, public policies for obestiy prevention and control should be strengthened and improved.

  View details for DOI 10.21149/spm.v55s2.5111

  View details for Web of Science ID 000323631100012

  View details for PubMedID 24626691

• Hypertension: prevalence, early diagnosis, control and trends in Mexican adults SALUD PUBLICA DE MEXICO Campos-Nonato, I., Hernandez-Barrera, L., Rojas-Martinez, R., Pedroza-Tobias, A., Medina-Garcia, C., Barquera, S. 2013; 55: S144-S150

  Abstract

  The present study aims to describe the prevalence, distribution and trends of hypertension (HT) in Mexican adults ≥20 years, and to describe the prevalence of early diagnosis and treatment of HT.A total of 10 898 adults were considered. The measurement of blood pressure was performed following the procedures recommended by the American Heart Association. An adult was considered, hypertensive when he met the diagnostic criteria of JNC-7.The prevalence of HT was 31.5%, of which 47.3% were unaware of their condition. Pharmacological treatment was not associated with a higher percentage of subjects under control.Prevalences from 2000, 2006 and 2012 suggest that there is a stabilization. A health problem of this magnitude requires better diagnosis, care and training of the medical sector so that appropriate treatments are prescribed and HT control can be enhanced.

  View details for DOI 10.21149/spm.v55s2.5110

  View details for Web of Science ID 000323631100011

  View details for PubMedID 24626690