Mexico study: Heart disease risk determined by quality of fat

Quality, rather than quantity of fat, is the determinant of heart disease risk, according to a study conducted in Mexico. The study found that although fat intake among three-quarters of Mexicans fell within World Health Organization recommendations, their saturated fat and trans fat intake exceeded healthy diet recommendations–placing them at higher risk for heart disease.

Around 60 percent of Mexicans surveyed had a high intake of saturated fats and a low intake of polyunsaturated fats, which help reduce the risk of heart disease and promote cardiovascular health.

“Public policies should be enacted to reduce the intake of saturated fats by improving the quality of baking lard and promoting the consumption of defatted milk,” the study recommended. These two foods are among the main sources of saturated fats in the Mexican diet.

In addition, consumption of foods rich in n-3 and n-6 fatty acids (such as fish and nuts) are very low in the typical Mexican diet; thus, alternatives like promoting a larger consumption of canola or soy bean oils or addition of n-3 fatty acids to cooking oils from other sources must be considered, the study concluded.

Citation:
1. Ramírez-Silva I, Villalpando S, Moreno-Saracho JE, Bernal-Medina D. Fatty acids intake in the Mexican population. Results of the National Nutrition Survey 2006. Nutrition & Metabolism 2011; 8: 33. (open access)

Diabetes linked to higher risk of tuberculosis in U.S./Mexico border

Patients with diabetes are at higher risk of contracting tuberculosis (TB) than non-diabetic patients, according to a study conducted in the Texas/Mexico border.

The prevalence of diabetes among TB patients was 39 percent in Texas and 36 percent in Mexico. Diabetes contributed 25 percent of the TB cases studied, whereas HIV infection contributed only five percent or fewer.

Among TB patients, fewer Mexicans than Texans were aware that they had diabetes before this study (four percent and 19 percent, respectively). Men were also less frequently aware than women that they had diabetes. Patients who knew that they had diabetes before the study had an eight-year history of the disease, on average, before being diagnosed with TB.

Citation:
1. Restrepo BI, Camerlin AJ, Rahbar MH, et al. Cross-sectional assessment reveals high diabetes prevalence among newly-diagnosed tuberculosis cases. Bulletin of the World Health Organization 2011; 89: 352-359. (open access)

Management of diabetes and associated cardiovascular risk factors in seven countries

A substantial proportion of individuals with diabetes remain undiagnosed and untreated, both in developed and developing countries, according to a multi-country study using nationally representative health examination surveys from Colombia, England, Iran, Mexico, Scotland, Thailand and the United States.

The figures range from 24 percent of women in Scotland and the United States to 62 percent of men in Thailand. The proportion of individuals with diabetes reaching treatment targets for blood glucose, arterial blood pressure, and serum cholesterol was very low, ranging from one percent of male patients in Mexico to about 12 percent in the United States. Income and education were not found to be significantly related to the rates of diagnosis and treatment anywhere except in Thailand, but in the three countries with available data insurance status was a strong predictor of diagnosis and effective management, especially in the United States.

Based on this comparison of how well these seven countries are performing in terms of population-level management of diabetes, hypertension and high cholesterol, the study researchers make the following recommendations:

1. It is critical to track diabetes care at the population level and to focus on actual outcomes, rather than on the process of care. It is also critical to study other countries with larger numbers of individuals with diabetes, such as China and India, for which nationally representative studies are not readily available.
2. It is important to prioritize the development and implementation of national guidelines and the use of new incentive programs for the management of hypertension and high cholesterol among individuals with diabetes in developing countries. The study findings suggest that such progress may be more feasible and more likely to have a larger population health impact than blood glucose control.
3. There are opportunities for innovation in providing incentives, in the technology of diabetes management and in improving financial access to care.

Real progress at the population level in the management of diabetes will likely require all three: monitoring performance in meeting treatment targets, expanding management of hypertension and high cholesterol in individuals with diabetes, and innovations in the delivery of and access to care.

The estimated global prevalence of diabetes is around 6.4 percent and more than 280 million people in the world have diabetes—the majority live in the developing world. Projections indicate that diabetes accounted for almost four million deaths worldwide in 2010. The burden of diabetes will only continue to grow, since the number of adults with diabetes in developing countries is projected to rise by more than two-thirds between 2010 and 2030.

Source:
1. Gakidou E, Mallinger L, Abbott-Klafter J, et al. Management of diabetes and associated cardiovascular risk factors in seven countries: a comparison of data from national health examination surveys. Bulletin of the World Health Organization 2011; 89: 172-183. (open access)

Impact of Mexico City’s smoking ban on local businesses

Smoking ban had positive impact on Mexico City businesses

Mexico City’s 2008 city-wide smoking ban has not had a negative effect on revenues, wages and employment levels in the businesses affected by the law, including restaurants, nightclubs, bars and taverns, a study finds.

The study’s findings are consistent with results from similar studies carried out in other countries and settings globally. Smoke-free environments protect the health of non-smokers and workers in the hospitality industry, and also contribute to decreasing the social acceptability of smoking and the consumption of active cigarette smokers.

“These results provide scientific evidence to policymakers and legislators in Mexico and in other countries to impel local laws that promote 100% smoke-free public places in order to fulfill the provisions of the Framework Convention on Tobacco Control,” the study concluded.

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Source:
1. Guerrero López CM, Jiménez Ruiz JA, Reynales Shigematsu LM, Waters HR. The economic impact of Mexico City’s smoke-free law. Tobacco Control, published online 3 Feb 2011.  (open access)

More than half of all 7 million diabetic adults in Mexico will be dead by 2026

Diabetes is the principal cause of death in Mexico. More than seven million Mexican adults have type 2 diabetes: nearly 14 percent of all adults in 2006, up from 6.7 percent in 1993. A new study suggests that the impact of diabetes on the Mexican health system will be significantly greater in the next two decades.

The study estimates that 53.9 percent of adults currently with diabetes will be dead by the year 2026. Their life expectancy will be reduced to an average of 10.9 years. The predicted 20 year-incidence of the principal cardiovascular complications per 1000 diabetic individuals are: ischemic heart disease 112, heart attack 260, heart failure 113, stroke 101 and amputation 62.

“These predictions must urge the Mexican health system to establish effective treatment programs and improve diabetes care,” according to the study. “In the absence of such measures, the resources required to manage future diabetes related complications will surpass the capability of the Mexican health system.”

Source:
1. Reynoso-Noverón N, Mehta R, Almeda-Valdes P, et al. Estimated incidence of cardiovascular complications related to type 2 diabetes in Mexico using the UKPDS outcome model and a population-based survey. Cardiovascular Diabetology 2011; 10: 1. (open access)

A tax increase on cigarettes reduced tobacco smoking in Mexico

A tobacco tax increase reduces smoking

Mexico implemented a cigarette tax increase in 2007, effectively raising the price that Mexican smokers pay for a cigarette pack by nearly 13 percent, which in turn led to a 29 percent reduction in cigarette smoking among Mexicans, according to a study published in the December 2010 issue of the journal Tobacco Control.

The study analyzed data from the International Tobacco Control (ICT) Policy Evaluation Survey conducted in 2006 and 2007 in Mexico.

“Since no other tobacco control policies or programs were implemented during the period analyzed, the tax increase appears likely to have decreased [cigarette] consumption,” the study said.

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Source:
1. Saenz-de-Miera B, Thrasher JF, Chaloupka FJ, et al. Self-reported price of cigarettes, consumption and compensatory behaviours in a cohort of Mexican smokers before and after a cigarette tax increase. Tobacco Control 2010; 19: 481-487. (open access)