Objective: The objective of this paper is to characterise the epidemiological and nutritional transition and their determinants in Mexico. Design: Age-adjusted standardised mortality rates (SMRs) due to acute myocardial infarction (AMI), diabetes mellitus and hypertension were calculated for 1980-1998. Changes in the prevalences of overweight and obesity in women and children and of dietary intake from 1988 to 1999 were also used in the analysis. Quantities of food groups purchased by adult equivalent (AE) and food expenditures away from home between 1984 and 1989 were used to assess trends. All information was analysed at the national and regional levels, and by urban and rural areas. Results: SMR for diabetes, AMI and hypertension increased dramatically parallel to obesity at the national and regional levels. Fat intake in women and the purchase of refined carbohydrates, including soda, also increased. Discussion: The results suggest that obesity is playing a role in the increased SMRs of diabetes, AMI and hypertension in Mexico. Total energy dietary intake and food purchase data could not explain the rise in the prevalence of obesity. The increases in fat intake and the purchase of refined carbohydrates may be risk factors for increased mortality. Information on physical activity was not available. Conclusion: SMRs due to diabetes, hypertension and AMI have increased dramatically in parallel with the prevalence of obesity; therefore actions should be taken for the prevention of obesity. Reliable information about food consumption and physical activity is required to assess their specific roles in the aetiology of obesity.

Objetivo. Evaluar el impacto de una intervención de 18 meses para la prevención de obesidad en escolares de 4o y 5o grados basada en el modelo ecológico en conductas saludables en México. Material y métodos. Diseño experimental para asignar 27 escuelas a uno de los tres tratamientos: intervenciones básicas, intervenciones plus y control. Se midió el impacto en el ambiente escolar, la alimentación y la actividad física e índice de masa corporal en niños. La evaluación se llevó a cabo en dos años en 830 estudiantes. Resultados. En las escuelas de intervención, la disponibilidad de alimentos sanos aumentó y la disponibilidad de alimentos poco saludables disminuyó. La ingesta de alimentos en niños no mostraron las mismas tendencias. En las escuelas de intervención, los niños no participaron más en actividad física moderada y vigorosa. La prevalencia de obesidad no se modificó. Conclusión. La intervención mejoró el entorno alimentario escolar y las conductas saludables de alimentación y actividad física. * The project was supported by the Pan American Health Organization (PAHO), the HLHP program of the International Life Science Institute (ILSI), the Mexican Council for Science and Technology (Conacyt), and the Mexican Ministry of Health (SSa). This work was carried out with support from the Global Health Research Initiative (GHRI), a collaborative research funding partnership of the Canadian Institute of Health Research, the Canadian International Development Agency, Health Canada, the International Development Research Centre, and the Public Health Agency of Canada.

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Objective. To quantify the physical activity (PA) of students and describe the school environment surrounding PA. Material and Methods. Between November 2005 and March 2006, in Mexico City, we conducted quantitative and qualitative observations to describe the PA and the school context. Results. Recess and physical education class (PE) were the only opportunities to participate in PA. PE occurred one time per week with a duration of 39.8±10.6 minutes which is less than national and international recommendations. Students participated in moderate-to-vigorous PA 29.2±17.8% of PE.The dynamics of PE did not promote the inclusion of all students or PA. During recess there was overcrowding of the school patio and no equipment for PA or organization of PA. Discussion. The PA of students in public schools in Mexico City can be improved by increasing the quantity and quality of PE and increasing opportunities for activity during recess.

Contribution of formative research to design an environmental program for obesity prevention in schools in Mexico City. Salud Publica Mex 2014;56 suppl 2:S139-S147. AbstractObjective. This paper describes the methods and key findings of formative research conducted to design a schoolbased program for obesity prevention. Materials and methods. Formative research was based on the ecological model and the principles of social marketing. A mixed method approach was used. Qualitative (direct observation, indepth interviews, focus group discussions and photo-voice) and quantitative (closed ended surveys, checklists, anthropometry) methods were employed. Results. Formative research key findings, including barriers by levels of the ecological model, were used for designing a program including environmental strategies to discourage the consumption of energy dense foods and sugar beverages. Conclusion. Formative research was fundamental to developing a context specific obesity prevention program in schools that seeks environment modification and behavior change.Key words: interdisciplinary research; obesity; school feeding; environment; Mexico Bonvecchio A, Théodore FL, Safdie M, Duque T, Villanueva MA, Torres C, Rivera J. Contribución de la investigación formativa para el diseño de un programa para la prevención de obesidad en escuelas de la Ciudad de México. Salud Publica Mex 2014;56 supl 2:S139-S147. ResumenObjetivo. Describir los aspectos metodológicos y principales resultados de una investigación formativa realizada para diseñar un programa ambiental para la prevención de obesidad en escuelas. Material y métodos. La investigación formativa se basó en el modelo ecológico y los principios del mercadeo social. Se utilizó un enfoque de métodos mixtos: cualitativos (observación directa, entrevistas en profundidad, grupos de discusión y foto-voz) y cuantitativos (cuestionarios cerrados, inventarios de alimentos y bebidas, antropometría). Resultados. Los principales resultados de la investigación formativa, incluyendo las barreras identificadas en los niveles del modelo ecológico, fueron contemplados para el diseño del programa, que incluyó estrategias ambientales para desincentivar el consumo de alimentos de alta densidad energética y bebidas azucaradas. Conclusión. La investigación formativa fue fundamental para diseñar un programa de prevención de obesidad para la modificación del ambiente y cambios de comportamientos, factible y adaptado al contexto de las escuelas públicas de la Ciudad de México.