Association of GC Variants with Bone Mineral Density and Serum VDBP Concentrations in Mexican Population

Vitamin D-binding protein (VDBP) is encoded by the GC gene and is an active participant in the control of bone metabolism. However, the effect of its major variants on VDBP concentration and bone mineral density (BMD) remains unclear. Our aim was to analyze the effect of major GC variants on serum VDBP concentration and BMD. We recruited individuals from the Health Workers Cohort Study, which includes employees of the Mexican Institute of Social Security (IMSS). A total of 1853 adults were included. The single nucleotide polymorphisms (SNPs) rs7041 and rs4588 were genotyped to identify the three best characterized haplotypes of GC. Serum VBDP, 25(OH)D and BMD were also measured. Among women, the G allele of rs7041 was associated with higher VDBP and BMD compared to homozygous TT. The A allele of rs4588 was associated with lower VDBP and BMD compared to CC homozygous. In men, GC variants were only associated with VDBP levels. We did not observe an association between free/bioavailable 25(OH)D and BMD in men and women. Our results support an association of VDBP in bone health. The G and C alleles, from rs7041 and rs4588, respectively, are associated with high concentrations of VDBP and BMD in this sample of Mexican postmenopausal women.

Sugar-sweetened beverage consumption and risk of hyperuricemia: a longitudinal analysis of the Health Workers Cohort Study participants in Mexico

ABSTRACT Background The elevated consumption of sugar-sweetened beverages (SSBs) in Mexico is an important public health concern. However, the association between SSB consumption and hyperuricemia has been scarcely studied and not well documented. Objectives To prospectively evaluate the association between SSB consumption and risk of hyperuricemia in Mexican adults. Methods A longitudinal analysis was conducted using data from the Health Workers Cohort Study. Participants were followed from 2004 to 2018, with measurements every 6 y. The analysis sample consisted of 1300 adults, aged 18 to 85 y. SSB consumption during the previous year was evaluated through a semiquantitative FFQ. Hyperuricemia was defined as a concentration of uric acid ≥7.0 mg/dL in men and ≥5.7 mg/dL in women. We evaluated the association of interest using 2 methodologies: fixed-effects logistic regression and generalized estimating equations (GEEs). Potential confounders were included in both approaches. Results At baseline, median intake of SSBs was 472.1 mL/wk (IQR: 198.8–1416.4 mL/wk), and 233 participants had hyperuricemia. Uric acid was higher in participants with an SSB intake ≥7 servings/wk, compared with those with an intake <1 serving/wk (P < 0.001). Participants who changed from the lowest to the highest category of servings consumption experienced 2.6 increased odds of hyperuricemia (95% CI: 1.27, 5.26). Results from the GEE model indicated the odds of hyperuricemia increased by 44% (OR=1.44; 95% CI: 1.13, 1.84) in the 2–6 servings/wk group, and by 89% (OR=1.89; 95% CI: 1.39, 2.57) in the ≥7 servings/wk categories, compared with the <1 serving/wk category. Diet soft drinks were not associated with hyperuricemia. Conclusions Our results suggest that the consumption of SSBs is associated with an increased risk of hyperuricemia in Mexican adults, but diet soft drink consumption is not, which supports the need to strengthen existing recommendations to reduce the intake of SSBs. The Health Workers Cohort Study (HWCS) has been approved by the Institutional Review Board of the Mexican Social Security Institute (12CEI 09 006 14), and the National Institute of Public Health of Mexico (13CEI 17 007 36).

Adherence to the EAT-Lancet Recommendations in a Sample of Mexican Health Workers

Objectives To evaluate the adherence to the EAT-Lancet recommendations in a sample of Mexican health workers. Methods We used data on 1908 men and women aged 19 to 59 who participated in the third wave of the Health Workers Cohort Study (HWCS), carried out in 2016. Dietary intake was estimated by using a 116-item semi-quantitative food frequency questionnaire. To evaluate the adherence to EAT, we adapted the EAT-Lancet score proposed by Knuppel et al. We used 13 out of 14 EAT-Lancet score components: 1) whole grains, 2) tubers and starchy vegetables, 3) vegetables, 4) fruits, 5) whole milk or derivative equivalents (dairy) , 6) beef, lamb and pork, 7) chicken and other poultry, 8) eggs, 9) fish, 10) dry beans, lentils and peas (legumes), 11) peanuts and tree nuts, and 12) added fats. We additionally created the component of processed meats, where the recommendation is zero consumption. Participants were assigned a point for meeting each of the recommendations, resulting in a range of scores from 0 (nonadherence) to 13 (perfect adherence). We calculated the median and interquartile range (IQR) for the total adapted EAT-Lancet score. Also, we estimated the percentage of participants achieving each one of the EAT-Lancet recommendations. Results More than 90% of participants met the recommendations for fruits [95.1%, 95% confidence interval (CI): 93.6–96.2%], fish (97.5%, 95% CI: 96.4–98.3%), dairy(95.4%, 95% CI: 93.9–96.4%) and legumes (96.3%, 95% CI: 95.1–97.3%). The lowest adherences were observed for whole grains (9.38%, 95% CI: 7.8–11.2%), process meat (4.1%, 95% CI: 3.1–5.5%) and, the peanuts or tree nuts group (6.9%, 95% CI: 5.6–8.6%). As a result, the median of total adapted EAT-Lancet score was 8.0 (IQR: 8.0–9.0) and only 9.18% of individuals had an adherence > = 10 to the EAT-Lancet recommendations. Conclusions Mexican workers achieved the recommendations for fruits, eggs, fish, whole milk, dry beans, and fats, suggesting that only a subset of recommendations may fit the Mexican diet. Important diet changes should be promoted in Mexico in order to improve the adherence to the EAT-Lancet recommendations. Funding Sources This project was partially funded by CONACYT (grants nos. M-7876, etc, etc), the Instituto Mexicano del Seguro Social (grants nos. 2005–785-012), and Bloomberg Philanthropy.

Association between tax on sugar sweetened beverages and soft drink consumption in adults in Mexico: open cohort longitudinal analysis of Health Workers Cohort Study

Objective To examine changes in categories of soft drink consumption in a cohort of Mexican adults, three years after the implementation of the sugar sweetened beverage tax. Design Open cohort longitudinal analysis. Setting Three waves of the Health Workers Cohort Study, Mexico, spanning 2004 to 2018. Participants 1770 people aged 19 years or older with information on drinks consumption available in at least one of the three cohort waves. Main outcome measure Change in probability of belonging to one of four categories of soft drinks consumption (non, low, medium, high) after the tax was implemented. Heterogeneity of associations by income and education was also assessed. Results Before the implementation of the tax, more than 50% of the participants were medium and high consumers of soft drinks and less than 10% were in the non-consumer category. After the tax was implemented, 43% of the population was categorised as medium or high consumers and the prevalence of non-consumers increased to 14%. Three years after implementation of the tax on 1 January 2014, the probability of being a non-consumer of soft drinks increased by 4.7 (95% confidence interval 0.3 to 9.1) percentage points and that of being a low consumer increased by 8.3 (0.6 to 16.0) percentage points compared with the pre-tax period. Conversely, the probability of being in the medium and high levels of soft drinks consumption decreased by 6.8 (0.5 to 13.2) percentage points and 6.1 (0.4 to 11.9) percentage points, respectively. No significant heterogeneity of the tax across income levels was observed, but stronger effects of the tax were seen in participants with secondary school education or higher, compared with those with elementary school or less. Conclusions The Mexican sugar sweetened beverage tax was associated with a reduction in the probability of consuming soft drinks in this cohort of employees from a healthcare provider. The results cannot be extrapolated to the Mexican population, but they suggest that three years after implementation, the tax had helped to increase the proportion of people who do not consume soft drinks while decreasing the proportion of high and medium consumers.

Health workers cohort study: methods and study design

Objective. To examine different health outcomes that are associated with specific lifestyle and genetic factors. Materials and methods. From March 2004 to April 2006, a sample of employees from three different health and academic institutions, as well as their family members, were enrolled in the study after providing informed consent. At baseline and follow-up (2010-2013), participants completed a self-administered questionnaire, a physical examination, and provided blood samples. Results. A total of 10 729 participants aged 6 to 94 years were recruited at baseline. Of these, 70% were females, and 50% were from the Mexican Social Security Institute. Nearly 42% of the adults in the sample were overweight, while 20% were obese. Conclusion. Our study can offer new insights into disease mechanisms and prevention through the analysis of risk factor information in a large sample of Mexicans.