ORE THAN HALF OF THE yearly 10.8 million d e a t h s o f c h i l d r e n younger than 5 years are attributed to malnutrition, 1 as assessed by underweight (Ն2 SDs below the weight expected for that age, according to the international reference recommended by the World Health Organization [WHO] 2). These deaths are not caused by higher frequency of common childhood diseases but by higher case fatality rates 3,4 and would not occur if the children were not malnourished. Malnourished children who survive have a high risk of impaired health and function throughout life, which contributes to the intergenerational continuation of poverty. 5 In developing countries more than one quarter of all children younger than 5 years, about 150 million total, are estimated to be malnourished. 6 Available nutritional interventions and technologies have proven, under controlled conditions, to be efficacious in preventing and controlling malnutrition 7-10 and improving survival. 11 Because large-scale programs do not provide similar controlled conditions, we would expect these strategies to have less impact when implemented in such

Objetivo. Describir la prevalencia de obesidad en adultosmexicanos estratificando por condiciones físicas y sociodemográficas,y analizar tendencias. Material y métodos.Análisis de 16 256 adultos de la Encuesta Nacional de Salud yNutrición (Ensanut) 2018-19. Se clasificó obesidad (OMS), adiposidadabdominal (IDF) y talla baja (NOM-008-SSA3-2017).Se realizaron modelos de regresión logística para asociarobesidad y factores de riesgo. Para evaluar tendencias seanalizaron Encuesta Nacional de Salud 2000 y Ensanut (2006,2012, 2018-19). Resultados. La prevalencia de sobrepesofue 39.1%, obesidad 36.1% y adiposidad abdominal 81.6%. Sepresentaron las prevalencias más altas en >40-50 años y enlas mujeres. No hubo diferencia por nivel socioeconómico.En el periodo 2000-2018 aumentó la prevalencia de obesidad42.2% y de obesidad mórbida 96.5%. Las mujeres con tallabaja tuvieron mayor riesgo (RM=1.84) de tener obesidad quelas mujeres sin esta condición, mientras que en hombres elriesgo fue menor (RM=0.79). Conclusiones. En México,la prevalencia de obesidad sigue aumentando sin importarnivel socioeconómico, región o localidad.

We aimed to assess the efficacy of whole cow's milk fortified with ferrous gluconate and zinc oxide, along with ascorbic acid, in reducing the prevalence of anemia and improving iron status of low income children 10-30 mo of age. Healthy children were randomly assigned to drink 400 mL/d of cow's whole milk, either fortified milk (FM) with 5.8 mg/400 mL of iron as ferrous gluconate, 5.28 mg/400 mL of zinc as zinc oxide, and 48 mg/400 mL of ascorbic acid, or nonfortified milk (NFM) with 0.2 mg iron/400 mL, 1.9 mg zinc/400 mL, and 6.8 mg ascorbic acid/400 mL. Hemoglobin, serum ferritin, soluble transferrin receptors (TfR), and C-reactive protein concentrations were measured at baseline and 6 mo after intervention. The prevalence of anemia declined from 41.4 to 12.1% (P < 0.001), or 29 percentage points, in the FM group; there was no change in the NFM group. Hemoglobin (coefficient = 0.22, P < 0.01) was positively and TfR (coefficient = -0.29, P < 0.001) negatively associated with treatment, controlling for their respective baseline values, age, and gender. Treatment with FM was negatively associated with the likelihood of being anemic (pseudo R(2) = 0.085, P < 0.03) after 6 mo of intervention. Ferrous gluconate added to whole cow's milk as a fortificant along with ascorbic acid is efficacious in reducing the prevalence of anemia and in improving iron status of Mexican toddlers. The results of this study lead to broadening a subsidized FM distribution program to 4.2 million beneficiary children 1-11 y of age in Mexico.

A large-scale iron-fortified subsidized-milk program was effective at reducing the rates of anemia and iron deficiency in Mexican children during 12 mo of implementation. This trial was registered at clinicaltrials.gov as NCT00508131.

Mexico has implemented a number of food and nutri-