Diabetes Mellitus is a highly prevalent disease in Mexico and in the world, among whose complications is diabetic neuropathy. DN is a group of disorders that present signs and/or symptoms of peripheral nerve dysfunction and have different clinical manifestations in both peripheral neuropathy and autonomic neuropathy. As a part of the mechanisms by which DN develops, oxidative stress and inflammation have been described. Cocoa is a plant origin product which includes around 300 components and through different studies, it has been suggested that cocoa has different mechanisms of action through which exerts its beneficial effects on health. It has been proposed that cocoa has hypoglycemic, lipid-lowering, antioxidant and anti-inflammatory effects, and thus, potentially have a beneficial direct or indirect effect on diabetic neuropathy. Specially in preclinical studies, the anti-inflammatory and anti-nociceptive effect of cocoa has been evaluated through different mechanisms of action. However, most of the studies presented concerning this complication, are in vitro or preclinical studies, so there is still a great area of opportunity regarding the use of cocoa on diabetic neuropathy.

Objective: To determine the association between education level and cardiometabolic risk factors in Mexican adults.Design: Case-control study. Setting and participants: Previously recollected database.Main measures: Overweight or obesity, hypertension (SAH), hyperglycemia, and hypercholesterolemia were considered as cardiometabolic risk factors. These were further associated with education levels: low, basic, middle, and superior.Analysis: Descriptive statistics, chi-square tests with subsequent odds ratio calculation for each cardiometabolic abnormality, considering the basic education level as reference (i.e., OR=1). Results:Prevalence for overweight and obesity was ≈70%, hypertension 28.1%, hypercholesterolemia 18.2%, and hyperglycemia 9.4%. SAH and hyperglycemia were inversely associated with educational level, whilst hypercholesterolemia presented the same trend up to high education but then increased when reaching a superior education level. Obesity was less prevalent in more educated subjects; but no clear-cut trend was identified for overweight. Odds ratio showed that low educational level doubles the risk of presenting all cardiometabolic abnormalities; with the exception of hypercholesterolemia. Conclusions and implications:Education level plays an important role in the presence of cardiometabolic risks, therefore it is mandatory to extend health-education policies nationwide. Background and objectiveIn Mexico, the education system scheme is divided in three broad categories: basic (preescolar, primaria (elementary), secundaria (junior high)), mid-superior (profesional técnico (technical), preparatoria (high school)), and superior (licenciatura (college), posgrado (posgraduated)) levels. Although in 2012, almost 35 million students were enrolled nationwide, completion rates (i.e., terminal efficiency) dramatically decrease as education grades increase thus, just 24 out of 100 children who started basic education level, complete the mid superior stage; and only 13 of them get the academic superior degree [1]. Finally, barely 16 of every 10,000 Mexicans undergo graduate school.Recent national surveys have reported a combined prevalence of ≈70% of adult overweight and obesity. Such abnormal nutritional statuses are major determinants for the development of diabetes mellitus (DM), systemic arterial hypertension (SAH) and cardiovascular disease. Although these cardiometabolic ailments, according to the World Health Organization (WHO), are associated to ≈30% of the worldwide deaths, the obesity-related epidemics has affected certain social groups more than others; particularly those with a lower level of education [2]. Although the association between education level and overweight/ obesity and its associated cardiometabolic consequences has been widely described [3,4], their cause-effect link is rather complex, hence the full understanding of the nature of the precise mechanisms affecting

Diabetes Mellitus is a public health problem associated with complications such as neuropathy; however, it has been proposed that these may begin to develop during prediabetes and may also be present in persons with obesity. Diabetic peripheral neuropathy is the presence of signs and/or symptoms of peripheral nerve dysfunction in people living with diabetes, which increases the risk of developing complications and has a deleterious impact on quality of life. As part of the therapeutic protocol for diabetes, screening tests to identify peripheral neuropathy are suggested, however, there are no recommendations for people with prediabetes and obesity without symptoms such as pain, numbness, or paresthesias. Moreover, clinical screening tests that are usually used to recognize this alteration, such as tendon reflex, temperature sensation, and pressure and vibration perception, might be subjective as they depend on the evaluator’s experience thus the incorrect application of these tests may not recognize the damage to small or large-nerve fibers. Recent evidence suggests that an objective study such as the impairment of the rate-dependent depression of the H-reflex could be used as a biomarker of spinal disinhibition and hence may provide more information on sensorimotor integration.

Dysphagia is known as any alteration of the swallowing process that affects the ability to eat a The use of mild and aromatic nd/or drink and presents in 30−40% of hospitalized patients. In the elderly, it is highly relevant due to its association with the development of frailty, malnutrition, and the high risk of morbidity and mortality. A set of factors has been proposed as a cause of dysphagia, such as anatomical and physiological alterations, neurological pathologies, drugs, and sarcopenia. Thickening liquids and texture-modified foods may be beneficial for patients with dysphagia, but they can also promote malnutrition if not prescribed properly. That is why nutritional support is key to avoid the risk of aspiration and malnutrition, which in turn, contribute to the development of dysphagia.