Abstract Purpose: To analyze diabetes mellitus (DM) in a multifactorial manner with the consumption of sugar-sweetened beverages (SSB) and variables like nutritional status, sex, genetic predisposition, age and ethnicity; in order to determine the relationship between BGA and DM in the Mazahua Otomí (MO) community. Methodological design: This quantitative survey on social and nutritional variables was designed, validated and applied. A logistic model was developed to find the relationship of DM in relation to the variables: SSB consumption, sex, genetic predisposition, age, body mass index and ethnicity. Results: The Mazahua otomi community has a monthly family income below the extreme poverty line; they do not have disease control: 68% are obese or overweight and SSB consumption is medium to high in 90% of the population. In a multifactorial manner and according to the model, there is a probability of manifesting DM depending on the variables mentioned above; while, with the exception of nutritional status and age, the others are the most significant. In taste and preferences, 52% opt for the Coca-Cola SSB brand. Research limitations: The results found should be complemented in other case studies in communities with similar characteristics and a broader probabilistic population sample. Finding: In the MO community there is a relationship between BGA consumption and DM and there is no control of the disease. This work contributes to the design of public policies to prevent health damage because of excessive consumption of SSB and its relationship with DM; likewise, those policies that rescue and promote good nutritional practices of the communities of indigenous peoples.

Resumen Objetivo: Analizar en forma multifactorial la diabetes mellitus (DM) con el consumo de las bebidas gaseosas azucaradas (BGA) y de las variables estado nutricional, sexo, predisposición genética, edad y etnia, para determinar la relación de las BGA y la DM en la comunidad Mazahua Otomí (MO). Diseño Metodológico: El estudio fue cuantitativo. Se diseñó, validó y aplicó una encuesta estructurada sobre variables sociales y nutricionales. Se elaboró un modelo logístico para encontrar la relación de DM con las variables: consumo de BGA, sexo, predisposición genética, edad, índice de masa corporal y etnia. Resultados: En la comunidad MO que se investigó un padre de familia promedio tiene un ingreso mensual por debajo de la línea de pobreza extrema y no existe control de la enfermedad de estudio: 68% tiene obesidad o sobrepeso y el consumo de BGA es entre medio y alto en 90% de la población. En forma multifactorial, hay probabilidad de manifestar la DM en función de las variables antes señaladas; mientras que, a excepción de estado nutricional y la edad, las demás son las más significativas. En gustos y preferencias, 52% opta por la marca de BGA Coca-Cola. Limitaciones de la investigación: Los resultados encontrados deberán complementarse con estudios de caso en comunidades con características similares y una muestra poblacional probabilística más amplia. Hallazgos: En la comunidad MO existe una relación entre el consumo de BGA y la DM y no hay control de la enfermedad. Este trabajo aporta al diseño de políticas públicas de prevención del daño a la salud por el consumo excesivo de BGA y su relación con la DM. De igual manera aquellas políticas públicas que rescaten y fomenten las buenas prácticas nutritivas entre las comunidades de los pueblos originarios.

Abstract Purpose: To analyze diabetes mellitus (DM) in a multifactorial manner with the consumption of sugar-sweetened beverages (SSB) and variables like nutritional status, sex, genetic predisposition, age and ethnicity; in order to determine the relationship between BGA and DM in the Mazahua Otomí (MO) community. Methodological design: This quantitative survey on social and nutritional variables was designed, validated and applied. A logistic model was developed to find the relationship of DM in relation to the variables: SSB consumption, sex, genetic predisposition, age, body mass index and ethnicity. Results: The Mazahua otomi community has a monthly family income below the extreme poverty line; they do not have disease control: 68% are obese or overweight and SSB consumption is medium to high in 90% of the population. In a multifactorial manner and according to the model, there is a probability of manifesting DM depending on the variables mentioned above; while, with the exception of nutritional status and age, the others are the most significant. In taste and preferences, 52% opt for the Coca-Cola SSB brand. Research limitations: The results found should be complemented in other case studies in communities with similar characteristics and a broader probabilistic population sample. Finding: In the MO community there is a relationship between BGA consumption and DM and there is no control of the disease. This work contributes to the design of public policies to prevent health damage because of excessive consumption of SSB and its relationship with DM; likewise, those policies that rescue and promote good nutritional practices of the communities of indigenous peoples.

Resumen Objetivo: Analizar en forma multifactorial la diabetes mellitus (DM) con el consumo de las bebidas gaseosas azucaradas (BGA) y de las variables estado nutricional, sexo, predisposición genética, edad y etnia, para determinar la relación de las BGA y la DM en la comunidad Mazahua Otomí (MO). Diseño Metodológico: El estudio fue cuantitativo. Se diseñó, validó y aplicó una encuesta estructurada sobre variables sociales y nutricionales. Se elaboró un modelo logístico para encontrar la relación de DM con las variables: consumo de BGA, sexo, predisposición genética, edad, índice de masa corporal y etnia. Resultados: En la comunidad MO que se investigó un padre de familia promedio tiene un ingreso mensual por debajo de la línea de pobreza extrema y no existe control de la enfermedad de estudio: 68% tiene obesidad o sobrepeso y el consumo de BGA es entre medio y alto en 90% de la población. En forma multifactorial, hay probabilidad de manifestar la DM en función de las variables antes señaladas; mientras que, a excepción de estado nutricional y la edad, las demás son las más significativas. En gustos y preferencias, 52% opta por la marca de BGA Coca-Cola. Limitaciones de la investigación: Los resultados encontrados deberán complementarse con estudios de caso en comunidades con características similares y una muestra poblacional probabilística más amplia. Hallazgos: En la comunidad MO existe una relación entre el consumo de BGA y la DM y no hay control de la enfermedad. Este trabajo aporta al diseño de políticas públicas de prevención del daño a la salud por el consumo excesivo de BGA y su relación con la DM. De igual manera aquellas políticas públicas que rescaten y fomenten las buenas prácticas nutritivas entre las comunidades de los pueblos originarios.

The South African food system is facing severe challenges as increasing hunger, rising food costs, lack of dietary diversity, child stunting, foodborne illnesses, food waste and an obesity epidemic coupled with malnutrition are observed. In this study, we aimed to establish the application of science and technology advances in the food and beverage industry in South Africa in response to food consumption pattern changes since 1994 and how they could be used to address food security challenges. We found that food consumption shifts have been towards sugar-sweetened beverages, processed and packaged food, animal-source foods and added caloric sweeteners, and away from vegetables. These dietary shifts are concerning as they relate to public health. Most commitments to improve the nutritional status of South Africans have been limited to corporate social investment strategies and should be extended into core business strategies. Furthermore, although the South African food and beverage industry has kept pace with developments in food manufacturing practices, there has been little experimentation with non-commercial novel technologies. The expert survey revealed that indigenous African crops and food waste recovery are the two most promising emerging food sources that could be available to South Africans in the shortest time frame. South Africa has many enabling drivers to become a global leader in food technology advances. However, many barriers need to be overcome for industry, academia and government to collaborate to advance novel food science and technologies to reach commercialisation. SIGNIFICANCE: • Drivers and consequences of food consumption changes in South Africa were modelled and broad food consumption trends between 1994 and 2009/2012 were identified. • For the first time, the Access to Nutrition Index methodology was applied to South African owned food companies to identify strategies to enhance nutrition practices. Companies need to do more to deliver affordable and accessible products. • Drivers and barriers in adopting advanced food science and technology were modelled. A collective ecosystem approach with industry, academia and government mobilisation around critical areas like hunger, malnutrition and poverty could be a way to tackle the failing food system.

RESUMEN La brecha digital hace referencia a la forma de exclusión social que afecta el uso de la tecnología e impacta en mayor medida a los pueblos originarios. En Oaxaca, por su alta densidad de población indígena, se observa un continuum histórico de desigualdad que se expresa en la pobreza, la marginación, la baja escolaridad y el bajo poder adquisitivo, barreras para el acceso a las tecnologías digitales. El objetivo de este trabajo es analizar los factores sociodemográficos, económicos, culturales y geográficos que inciden en el acceso a Internet por parte de la población indígena, así como una revisión de las políticas de inclusión digital emprendidas para la reducción de la brecha digital. Tal abordaje supuso el uso del modelo estadístico probit, utilizando datos del Censo de población y vivienda 2020. Las estadísticas arrojaron que la educación, el poder adquisitivo, el acceso a servicios básicos y el hecho de residir en lugares de mayor concentración poblacional son condicionantes para fomentar el acceso a Internet. Asimismo, se vislumbró la necesidad de diseñar y aplicar políticas digitales con la participación de los tres niveles gubernamentales (federal, estatal y municipal) y agentes sociales locales, bajo un marco del reconocimiento de la diversidad cultural; políticas que vayan más allá de lo instrumental y que promuevan la inversión pública-privada en telecomunicaciones, además de seguir avanzando en mejorar el bienestar de la población indígena.

ABSTRACT The digital divide refers to the form of social exclusion that affects the use of technology and has a greater impact on indigenous peoples. In Oaxaca, due to its high density of indigenous population, there is a historical continuum of inequality that is expressed in poverty, marginalisation, low schooling and low purchasing power, which are barriers to access to digital technologies. The aim of this paper is to analyse the socio-demographic, economic, cultural and geographic factors that affect access to the Internet by the indigenous population, as well as a review of the digital inclusion policies undertaken to reduce the digital divide. This approach involved the use of the probit statistical model, using data from the 2020 Population and Housing Census. The statistics showed that education, purchasing power, access to basic services and residing in places with a higher population concentration are conditioning factors for promoting access to the Internet. Likewise, the need to design and implement digital policies with the participation of the three levels of government (federal, state and municipal) and local social agents, within a framework of recognition of cultural diversity; policies that go beyond the instrumental and that promote public-private investment in telecommunications, in addition to continuing to make progress in improving the well-being of the indigenous population.

RESUMO A brecha digital refere-se à forma de exclusão social que afeta o uso da tecnologia e impacta em maior medida os povos indígenas. Em Oaxaca, devido à sua alta densidade de população indígena, observa-se um continuum histórico de desigualdade que se expressa na pobreza, na marginalização, na baixa escolaridade e no baixo poder de compra, barreiras ao acesso às tecnologias digitais. O objetivo deste trabalho é analisar os fatores sociodemográficos, econômicos, culturais e geográficos que afetam o acesso à Internet da população indígena, bem como uma revisão das políticas de inclusão digital empreendidas para reduzir a brecha digital. Esta abordagem envolveu o uso do modelo estatístico probit, utilizando dados do Censo Demográfico e Habitacional de 2020. As estatísticas mostraram que a escolaridade, o poder de compra, o acesso a serviços básicos e o fato de residir em locais com maior concentração populacional são fatores condicionantes para promover o acesso à internet. Da mesma forma, percebeu-se a necessidade de desenhar e aplicar políticas digitais com a participação dos três níveis de governo (federal, estadual e municipal) e dos agentes sociais locais, num quadro de reconhecimento da diversidade cultural; políticas que vão além do instrumental e promovam o investimento público-privado em telecomunicações, além de continuar avançando na melhoria do bem-estar da população indígena.

A partir da geopoética, esse artigo busca introduzir o conceito mais específico da geopoética da lama como forma relevante de abordagem analítica estética para a percepção do estresse ambiental e social do mundo contemporâneo. Para tanto, buscamos, em diversas manifestações artísticas brasileiras, como a poesia, a música, o cinema e as artes visuais, exemplos em que a materialidade e a simbologia da lama são usadas para revelar uma miséria que reflete, de certa forma, o descompasso entre o ser humano e o meio ambiente. Tal descompasso está na reflexão de pensadores de distintas áreas, como o médico e geógrafo Josué de Castro, o poeta e professor Michel Collot, o filósofo Gaston Bachelard, o sinólogo Augustin Berque e os pensadores indígenas Davi Kopenawa e Ailton Krenak. Essa reflexão sobre os espaços atuais acaba revelando as cargas racista e colonial que ainda imperam em suas organizações e ocupações, como apontam Silvio Almeida e Enrique Dussel. No entanto, embora seja indício dessa violência, observamos que a lama possui, devido ao poder de expressão artística de sua elasticidade formal e simbólica, potência política não apenas para denunciar mazelas socioambientais como também para propor resistências e possibilidades, que passam também pela consciência por meio da sensibilização e pela reconciliação do ser humano com seu meio.

Based on geopoetics, this article seeks to introduce the more specific concept of geopoetics of mud as a relevant form of an aesthetic analytical approach to the perception of environmental and social stress in the contemporary world. To this end, we sought, in various Brazilian artistic expressions, such as poetry, music, cinema, and visual arts, examples in which the materiality and symbolism of mud are used to reveal poverty and misery that reflect, in a certain way, the mismatch between human beings and the environment. This disconnection is reflected in the meditations of academicians from different areas, such as the doctor and geographer Josué de Castro, the poet and professor Michel Collot, the philosopher Gaston Bachelard, the sinologist Augustin Berque as well as the indigenous thinkers Davi Kopenawa and Ailton Krenak. This reflection on current spaces ends up revealing the racist and colonial burden that still prevails in their organizations and occupations, as Silvio Almeida and Enrique Dussel point out. However, although it is an indication of this violence, we observe that mud has, through the power of artistic expression on its material and symbolic elasticity, political power not only to denounce socio-environmental problems but also to propose resistance and possibilities, which also involve awareness through sensibility and reconciliation of human beings with their environment.

RESUMO A partir da geopoética, esse artigo busca introduzir o conceito mais específico da geopoética da lama como forma relevante de abordagem analítica estética para a percepção do estresse ambiental e social do mundo contemporâneo. Para tanto, buscamos, em diversas manifestações artísticas brasileiras, como a poesia, a música, o cinema e as artes visuais, exemplos em que a materialidade e a simbologia da lama são usadas para revelar uma miséria que reflete, de certa forma, o descompasso entre o ser humano e o meio ambiente. Tal descompasso está na reflexão de pensadores de distintas áreas, como o médico e geógrafo Josué de Castro, o poeta e professor Michel Collot, o filósofo Gaston Bachelard, o sinólogo Augustin Berque e os pensadores indígenas Davi Kopenawa e Ailton Krenak. Essa reflexão sobre os espaços atuais acaba revelando as cargas racista e colonial que ainda imperam em suas organizações e ocupações, como apontam Silvio Almeida e Enrique Dussel. No entanto, embora seja indício dessa violência, observamos que a lama possui, devido ao poder de expressão artística de sua elasticidade formal e simbólica, potência política não apenas para denunciar mazelas socioambientais como também para propor resistências e possibilidades, que passam também pela consciência por meio da sensibilização e pela reconciliação do ser humano com seu meio. contemporâneo tanto buscamos brasileiras poesia música visuais reflete ambiente áreas Castro Collot Bachelard Krenak ocupações Dussel entanto violência possui simbólica possibilidades

ABSTRACT Based on geopoetics, this article seeks to introduce the more specific concept of geopoetics of mud as a relevant form of an aesthetic analytical approach to the perception of environmental and social stress in the contemporary world. To this end, we sought, in various Brazilian artistic expressions, such as poetry, music, cinema, and visual arts, examples in which the materiality and symbolism of mud are used to reveal poverty and misery that reflect, in a certain way, the mismatch between human beings and the environment. This disconnection is reflected in the meditations of academicians from different areas, such as the doctor and geographer Josué de Castro, the poet and professor Michel Collot, the philosopher Gaston Bachelard, the sinologist Augustin Berque as well as the indigenous thinkers Davi Kopenawa and Ailton Krenak. This reflection on current spaces ends up revealing the racist and colonial burden that still prevails in their organizations and occupations, as Silvio Almeida and Enrique Dussel point out. However, although it is an indication of this violence, we observe that mud has, through the power of artistic expression on its material and symbolic elasticity, political power not only to denounce socio-environmental problems but also to propose resistance and possibilities, which also involve awareness through sensibility and reconciliation of human beings with their environment. world end sought expressions poetry music cinema arts reflect way environment areas Castro Collot Bachelard Krenak occupations out However violence has elasticity socioenvironmental socio possibilities

ABSTRACT The article focuses on the trajectories of care and attention during pregnancy, childbirth and post-partum that the shipibo-konibo women of the self-proclaimed Shipibo-konibo Community of Cashahuacra go through. This community was formed almost 15 years ago when a group of families from this amazonian indigenous people from Ucayali settled in the Cashahuacra ravine (Santa Eulalia District, Huarochirí province). More than detailing the practices and knowledge of these trajectories, I emphasize how this social space under construction, which is this indigenous community located in a marginal urban area, characterized by poverty and constant mobility, leaves its mark on the formation of these trajectories. In these, the knowledge and practices of the Shipibo-konibo culture are current but without rejecting those coming from institutional medicine against which there is a critical and pragmatic view in accordance with what it means for a shipibo-konibo woman to be a mother in the city.

RESUMEN El artículo se enfoca en las trayectorias de cuidado y atención del embarazo, parto y posparto por las que transitan las mujeres shipibo-konibo de la autodenominada Comunidad Shipiba de Cashahuacra. Esta comunidad se conformó hace casi 15 años cuando un grupo de familias de este pueblo indígena amazónico procedente de Ucayali se estableció en la quebrada de Cashahuacra (distrito Santa Eulalia, provincia Huarochirí). Más que detallar las prácticas y conocimientos de estas trayectorias, pongo énfasis en destacar cómo este espacio social en construcción, caracterizado por la pobreza y una constante movilidad en esta comunidad indígena ubicada en una zona urbana marginal, imprime su huella en la formación de estas trayectorias. En ellas, los saberes y prácticas de la cultura shipibo-konibo están vigentes, pero sin rechazar los recursos y cuidados provenientes de la medicina institucional, frente a la que existe una mirada crítica y pragmática, acorde con lo que significa para una mujer shipibo-konibo ser madre en la ciudad.

ABSTRACT This article aims to approach the broad theme of childhood, social movements and the urban environment and its relationship with teacher training processes and the relationship with school curricula, which often disregard what is around schools , from daycare centers, and other forms of political and social organization, as fundamental elements to be developed in a sensitive and in-depth manner in all educational segments: childhood, poverty, indigenous and street populations, urban life, participatory processes, heritage and the city , are themes that are related to the production of the lives of all people, from babies onwards, who also invent and produce cities. There is no intention to present the state of the art or knowledge, but only to touch on important issues and produce thoughts about them. In the end, we seek to guide the display of articles contained in this dossier and that address the topic, offering contributions to the continuity of the debates started here. childhood curricula centers organization indepth depth segments poverty populations life people onwards cities knowledge them end topic here

RESUMO Este artigo tem como objetivo aproximar-se do tema amplo infância, movimentos sociais e o urbano e sua relação com processos de formação de professores e professoras e a relação com currículos escolares, os quais, muitas vezes, desconsideram o que há em torno das escolas, desde a creche, e demais formas de organização política e social, como elementos fundamentais a serem desenvolvidos de modo sensível e aprofundado em todos os segmentos educacionais: infância, pobreza, populações indígenas e de rua, vida urbana, processos participativos, patrimônio e cidade, são temáticas que se relacionam na produção da vida de todas as pessoas, desde bebês, que também inventam e produzem as cidades. Não há qualquer intenção de realizar a apresentação do estado da arte ou do conhecimento, mas apenas de tocar em questões importantes e produzir pensamentos sobre elas. Ao final, buscamos orientar a mostra de artigos contidos neste dossiê e que abordam o tema oferecendo contribuições para a continuidade dos debates aqui iniciados. aproximarse aproximar infância escolares quais vezes escolas creche social educacionais pobreza rua urbana participativos cidade pessoas bebês cidades conhecimento elas final iniciados

Resumen El objetivo de este artículo es explorar, mediante dos modelos de regresión logística multinominal, los factores que inciden en la pobreza multidimensional de las personas adultas mayores en México y en particular analizar cómo difieren entre mujeres y hombres. La fuente de información es la Encuesta Nacional de Ingresos y Gastos de los Hogares 2020. Los resultados muestran la relevancia de analizar la pobreza desde un enfoque multidimensional, ya que las distintas categorías de pobreza pueden tener disimilitudes en sus determinantes. Igualmente arrojan algunas diferencias notables entre mujeres y hombres, en un contexto de feminización de la vejez. Las odds ratio del modelo econométrico muestran que ser jefe de hogar incrementa las razones de probabilidad para las mujeres y las reduce para los hombres; hablar lengua indígena y vivir en una localidad rural; aunque tienen el mismo efecto positivo para ambos, el incremento es mayor para las mujeres. Contar con red económica tiene un efecto inverso en todos los cuadrantes, con un efecto menor entre la población femenina.

Abstract The objective of this article is to explore, through two models of multinomial logistic regression, the factors that affect the multidimensional poverty among the elderly in Mexico and in particular to analyze how they differ between women and men. The source is the National Survey of Household Income and Expenditure 2020. Our econometric results show the relevance of analyzing poverty from a multidimensional approach, since we find noteworthy dissimilarities among the determinants by poverty categories. Moreover, the gender approach throws differences between women and men, in a context of old age feminization. Female household heading increases the odds ratio while reducing them for men. Speaking an indigenous language and living in a rural location, although with positive effect for both, the probability increase is greater for women. Lastly access to economic networks has an inverse effect in all categories, with a smaller effect among the female population.

ABSTRACT The purpose of this research was to understand the problems and challenges experienced by young Mayan students in higher, scientific and technological education in Yucatan. A multiple case study was carried out, resoting to different informants and techniques for the collection of information. We worked with two cases, the Technological Institute of Oxkutzcab and the Technological Institute of Valladolid. It is concluded that poverty, discrimination and school segregation are determining factors in the trajectory of young Mayan students in higher education. It is recommended to study with greater emphasis the issue of discrimination by ethnicity, as well as the incursion of Mayan women in technological higher education.

RESUMEN Esta investigación tuvo como propósito comprender los problemas y retos que experimentan los jóvenes mayas que cursan la educación superior, científica y tecnológica en Yucatán. Se llevó a cabo un estudio de caso múltiple, recurriendo a diversos informantes y técnicas de recolección. Se trabajó con dos casos: el Instituto Tecnológico de Oxkutzcab y el Instituto Tecnológico de Valladolid. Se concluye que la pobreza, la discriminación y la segregación escolar son factores determinantes en la trayectoria de los jóvenes mayas en la educación superior. Se recomienda estudiar con mayor énfasis el tema de la discriminación por etnia, así como la incursión de las mujeres mayas en la educación superior tecnológica.

Abstract. The objective was to analyze the experiences and conditions that enhanced the violation of obstetric violence in a group of Nahua women. Qualitative study in which ten women who experienced childbirth in the last three years were interviewed. The interviews were transcribed and analyzed using Strauss and Corbin’s proposal. Women faced higher levels of vulnerability because of their gender status, and also because they live with high levels of poverty and marginalization, they do not understand Spanish well and they have a worldview that makes them experience the disowning of their bodies more painfully, within sexist, patriarchal and lacking-of-interculturality institutions.

Resumen. El objetivo de este estudio cualitativo fue analizar las experiencias y condiciones que potenciaron la vulneración en un grupo de mujeres nahuas frente a la violencia obstétrica. Se entrevistaron a diez mujeres, quienes vivieron la experiencia de un parto en los últimos tres años. Las entrevistas se transcribieron y analizaron mediante la propuesta de Strauss y Corbin. Las mujeres enfrentaron una mayor vulnerabilidad no solo por su condición de género, sino también porque viven con altos niveles de pobreza y marginación, no entienden bien el español y tienen una cosmovisión que les hacen vivir de forma más dolorosa la desapropiación de sus cuerpos, dentro de instituciones machistas, patriarcales y carentes de interculturalidad.

Abstract Beriberi is the clinical manifestation of severe and prolonged thiamine (vitamin B1) deficiency. It is a neglected disease that affects low-income populations facing food and nutrition insecurity. The aim of this study was to compare cases of beriberi among indigenous and non-indigenous people in Brazil. We conducted a cross-sectional study using data on cases of beriberi during the period July 2013-September 2018 derived from beriberi notification forms available on the FormSUS platform. Cases in indigenous and non-indigenous patients were compared using the chi-squared test or Fisher’s exact test, adopting a significance level of 0.05. A total of 414 cases of beriberi were reported in the country during the study period, 210 of which (50.7%) were among indigenous people. Alcohol consumption was reported by 58.1% of the indigenous patients and 71.6% of the non-indigenous patients (p = 0.004); 71.0% of the indigenous patients reported that they consumed caxiri, a traditional alcoholic drink. Daily physical exertion was reported by 76.1% of the indigenous patients and 40.2% of the non-indigenous patients (p < 0.001). It is concluded that beriberi disproportionately affects indigenous people and is associated with alcohol consumption and physical exertion. vitamin B1 B deficiency lowincome low income insecurity nonindigenous non Brazil crosssectional cross sectional 2013September September 2013 201 platform chisquared chi squared Fishers Fisher s 005 0 05 0.05 41 21 50.7% 507 50 7 (50.7% 581 58 1 58.1 716 71 6 71.6 p 0.004 0004 004 0.004) 710 71.0 caxiri drink 761 76 76.1 402 40 2 40.2 0.001. 0001 0.001 . 001 0.001) 20 00 0.0 4 50.7 5 (50.7 58. 71. 0.00 000 76. 40. 0. 50. (50. (50 (5 (

Resumo O beribéri é a manifestação clínica da deficiência grave e prolongada de tiamina (vitamina B1). Doença negligenciada que acomete a população de baixa renda, em situação de insegurança alimentar e nutricional. O objetivo do estudo foi comparar casos de beribéri em indígenas com casos em não indígenas no Brasil. Trata-se de estudo transversal de casos notificados de beribéri no período de 2013 a 2018, no formulário do SUS (FormSUS) do Ministério da Saúde. Foram comparados os casos em indígenas e em não indígenas pelo teste qui-quadrado ou teste exato de Fisher com nível de significância de p < 0,05. No período estudado foram notificados no país 414 casos de beribéri, sendo 210 (50,7%) indígenas. Referiram consumo de bebidas alcoólicas 58,1% dos indígenas e 71,6% dos não-indígenas (p = 0,004); adicionalmente, 71,0% dos indígenas consumiam caxiri (bebida alcoólica tradicional fermentada). Relataram fazer esforço físico diário 76,1% dos indígenas e 40,2% dos não-indígenas (p <0 ,001). Conclui-se que o beribéri no país acomete mais indígenas e está relacionado ao consumo de álcool e ao esforço físico. vitamina B1. B1 B . B1) renda nutricional Brasil Tratase Trata se 201 2018 FormSUS (FormSUS Saúde quiquadrado qui quadrado 005 0 05 0,05 41 21 50,7% 507 50 7 (50,7% 581 58 1 58,1 716 71 6 71,6 nãoindígenas 0,004 0004 004 0,004) adicionalmente 710 71,0 bebida fermentada. fermentada fermentada) 761 76 76,1 402 40 2 40,2 ,001. 001 ,001 ,001) Concluise Conclui 20 00 0,0 4 50,7 5 (50,7 58, 71, 0,00 000 76, 40, ,00 0, 50, (50, ,0 (50 , (5 (

Resumo O beribéri é a manifestação clínica da deficiência grave e prolongada de tiamina (vitamina B1). Doença negligenciada que acomete a população de baixa renda, em situação de insegurança alimentar e nutricional. O objetivo do estudo foi comparar casos de beribéri em indígenas com casos em não indígenas no Brasil. Trata-se de estudo transversal de casos notificados de beribéri no período de 2013 a 2018, no formulário do SUS (FormSUS) do Ministério da Saúde. Foram comparados os casos em indígenas e em não indígenas pelo teste qui-quadrado ou teste exato de Fisher com nível de significância de p < 0,05. No período estudado foram notificados no país 414 casos de beribéri, sendo 210 (50,7%) indígenas. Referiram consumo de bebidas alcoólicas 58,1% dos indígenas e 71,6% dos não-indígenas (p = 0,004); adicionalmente, 71,0% dos indígenas consumiam caxiri (bebida alcoólica tradicional fermentada). Relataram fazer esforço físico diário 76,1% dos indígenas e 40,2% dos não-indígenas (p <0 ,001). Conclui-se que o beribéri no país acomete mais indígenas e está relacionado ao consumo de álcool e ao esforço físico.

Abstract Beriberi is the clinical manifestation of severe and prolonged thiamine (vitamin B1) deficiency. It is a neglected disease that affects low-income populations facing food and nutrition insecurity. The aim of this study was to compare cases of beriberi among indigenous and non-indigenous people in Brazil. We conducted a cross-sectional study using data on cases of beriberi during the period July 2013-September 2018 derived from beriberi notification forms available on the FormSUS platform. Cases in indigenous and non-indigenous patients were compared using the chi-squared test or Fisher’s exact test, adopting a significance level of 0.05. A total of 414 cases of beriberi were reported in the country during the study period, 210 of which (50.7%) were among indigenous people. Alcohol consumption was reported by 58.1% of the indigenous patients and 71.6% of the non-indigenous patients (p = 0.004); 71.0% of the indigenous patients reported that they consumed caxiri, a traditional alcoholic drink. Daily physical exertion was reported by 76.1% of the indigenous patients and 40.2% of the non-indigenous patients (p < 0.001). It is concluded that beriberi disproportionately affects indigenous people and is associated with alcohol consumption and physical exertion.

Resumen Objetivo: evaluar el cambio longitudinal de la anemia y su asociación con el indigenismo, el nivel socioeconómico (NSE) y la inseguridad alimentaria (IA) en una población infantil mexicana beneficiaria de dos programas sociales. Métodos: estudio longitudinal de 1164 niños menores de 18 meses de localidades rurales, residentes en tres estados de México. Se midió la concentración de hemoglobina en 2008 y 2012, y se determinó el cambio intrasujeto en la condición de anemia. Indigenismo, NSE e IA se obtuvieron en 2008. Su asociación con cuatro categorías de cambio de la anemia se evaluó mediante modelos de regresión logística multinomial ajustados por covariables. Resultados: en 2008, el 40,5 % de los niños padecían anemia. Para 2012, un 85,2 % de ellos ya no la tenían y el 9,8 % de los que no la habían tenido la presentaron. Las distribuciones de las categorías de cambio de estado de la anemia no se asociaron con la IA, mientras que sí se detectaron diferencias estadísticamente significativas en relación con el indigenismo y el NSE. Conclusiones: la alta prevalencia de la anemia que aqueja a la población infantil justifica la implementación de intervenciones basadas en la evidencia y de probada efectividad para su combate.

Abstract Objectives: to evaluate longitudinal change in anemia and its association with indigenous status, socioeconomic status (SES), and food insecurity (FI) in Mexican children. Methods: a longitudinal study in 1164 children under 18 months of age in rural communities. Hemoglobin concentration was measured in 2008 and 2012, and changes in anemia status were determined. Indigenous status, SES and FI were obtained in 2008, and their associations with four categories of change in anemia status were assessed through multinomial logistic regression models including adjustment covariates. Results: in 2008, 40.5 % of children had anemia, and 85.2 % of these did not have anemia in 2012, whereas 9.9 % of those who did not have anemia in 2008 had developed it in 2012. The distributions of the categories of change in anemia status were not associated with FI, while statistically significant differences were detected according to indigenism and NSE. Conclusions: the high prevalence of anemia that affects the child population justifies the implementation of interventions based on evidence, of proven effectiveness to combat it.

Resumen Introducción: el 30 % de la población mundial presenta actualmente problemas de sobrepeso y obesidad, mientras que en Ecuador la incidencia es del 64,68 %. La identificación de grupos poblacionales más vulnerables al sobrepeso y la obesidad es un tema básico para establecer mejores políticas públicas. Objetivo: identificar a los grupos poblacionales con riesgo de sobrepeso y obesidad según determinantes sociodemográficos (etnia, estado civil, pobreza y edad). Métodos: estudio transversal. Se analizaron los datos de 89.212 adultos de ambos sexos provenientes del estudio ENSANUT-EC 2018. Se utilizó el índice de masa corporal (IMC) para evaluar la prevalencia del sobrepeso y la obesidad, y se realizó un análisis de regresión lineal múltiple para relacionar el IMC con los determinantes sociodemográficos. Resultados: las mujeres presentaron en promedio 1,03 kg/m2 más que los hombres y el IMC se elevó 0,04 kg/m2 por cada año de edad. En relación al estado civil, los casados presentaron 1,14 kg/m2 más que los solteros. Tomando en cuenta los quintiles de pobreza y al q1 como categoría de referencia, los quintiles 2, 3 y 4 mostraron un IMC mayor en 0,65, 0,88, 0,77 y 0,41 kg/m2, respectivamente (p < 0,001). En cuanto a la etnia, los indígenas presentaron un IMC 0,78 kg/m2 menor que el de los blancos; los montubios y los afroamericanos presentaron 0,37 y 0,61 kg/m2, respectivamente, más que los blancos. Las personas que residen en el área urbana presentan 0,41 kg/m2 más que los residentes del área rural. Conclusiones: identificamos grupos de mayor riesgo nutricional, como las mujeres y las personas casadas, para el sobrepeso y la obesidad, mientras que los indígenas y las personas más pobres tienen riesgo de bajo peso, lo que indica que en Ecuador los adultos presentan problemas tanto de exceso como de déficit. Es necesaria la implementación de políticas dirigidas a grupos poblacionales específicos.

Abstract Introduction: 30 % of the world population currently has overweight and obesity problems, while in Ecuador this is 64.68 %. The identification of population groups more vulnerable to overweight and obesity is a basic issue to establish better public policies. Objective: to identify the population groups at risk of overweight and obesity according to socio-demographic determinants (ethnicity, marital status, poverty and age). Methods: a cross-sectional study. Data from 89,212 adults of both sexes were analyzed. Body mass index (BMI) was used to assess the prevalence of overweight and obesity, and multiple linear regression analysis was performed to relate BMI to sociodemographic determinants. Results: women had an average of 1.03 kg/m2 more than men, and BMI rose by 0.04 kg/m2 for each year of age. In relation to marital status, married people presented 1.14 kg/m2 more than single people. Taking into account the poverty quintiles and q1 as a reference category, quintiles 2, 3 and 4 showed a higher BMI of 0.65, 0.88, 0.77 and 0.41 kg/m2, respectively (p < 0.001). Regarding ethnicity, indigenous people had a BMI 0.78 kg/m2 less than whites; Montubios and Afro-Americans had 0.37 and 0.61 kg/m2, respectively, more than whites. People residing in the urban area present 0.41 kg/m2 more than the residents in the rural area. Conclusions: we identified groups of higher nutritional risk such as women and married people for overweight and obesity, while indigenous people and the poorest people were at risk for low weight, which indicates that in Ecuador adults have problems of both excess and deficit. It is necessary to implement policies aimed at specific population groups.