Diversidad de la dieta en la población urbana costarricense: resultados del Estudio Latino Americano de Nutrición y Salud.

Introducción: El índice de diversidad de la dieta (IDD) es una medida de la calidad de la alimentación, ya que entre mayor sea la variedad de la dieta, mayor será la posibilidad de cubrir las recomendaciones de nutrientes esenciales. Objetivo general: Determinar el IDD en una muestra representativa de la población urbana costarricense. Metodología: Se evaluó el consumo de alimentos a través de un recordatorio de 24 horas. Los alimentos reportados se clasificaron en 10 grupos, según la metodología propuesta por la FAO. Al consumo de cada uno de estos grupos se le asigna un punto, hasta un máximo de 10 puntos. Resultados: Se obtuvo un promedio de 4,97 puntos, el cual fue significativamente mayor en los hombres y conforme aumentó el poder adquisitivo. No se encontraron diferencias al comparar por edad o estado situación nutricional. El 64,4% de los participantes cum- plió con la recomendación de consumir al menos cinco grupos diferentes de alimentos. Conclusiones: La dieta de la población urbana costarricense presentan poca diversidad, principalmente en la mujeres y en las personas de menor nivel socioeconómico. Esta información permitirá enfocar adecuadamente los esfuerzos a realizar para mejorar la calidad de la dieta en el país.Introduction: The diet diversity index (IDD) is a measure of the quality of the diet, since the greater the variety of the diet, the greater the possibility of covering recommendations of essential nutrients. Aim: To determine IDD in a representative sample of the Costa Rican urban population, food consumption was evaluated through a 24-hour reminder. Methodology: The reported foods were classifie1 into 10 groups, according to the methodology proposed by FAO. To the consumption of each of these groups one point was assigned, up to a maximum of 10 points. Results: An average of 4,97 points was obtained, which was significantly higher in men and as socioeconomic level increased. No differences were found when comparing by age or nutritional status. 64,4% of participants achieved with the recommendation to consume at least five different food groups. Conclusions: Costa Rican urban populations reports a non-diverse diet, mainly among woman and those of low socioeconomic status. This information will allow to properly focus the efforts to improve quality of the diet in the country.Universidad de Costa RicaCoca Cola CompanyUCR::Vicerrectoría de Docencia::Salud::Facultad de Medicina::Escuela de MedicinaUCR::Vicerrectoría de Docencia::Salud::Facultad de Medicina::Escuela de Nutrició

Índice de Qualidade da Dieta Revisado para população brasileira

El Índice de Calidad de la Dieta Revisado es un indicador de calidad de la dieta desarrollado cónsono con las recomendaciones nutricionales vigentes. Los datos dietéticos fueron provenientes del estudio de base poblacional Inquérito de Saúde e Alimentação (ISA - Pesquisa de Salud y Alimentación)-Capital-2003. El Índice contiene 12 componentes, siendo nueve fundamentados en los grupos de alimentos de la Guía Alimentaria Brasileña de 2006, cuyas porciones diarias son expresadas en densidad energética; dos nutrientes (sodio y grasa saturada); y Gord_AA (calorías provenientes de grasa sólida, alcohol y azúcar de adición). El Índice de Calidad de la Dieta Revisado propicia medir varios factores de riesgos dietéticos para enfermedades crónicas, permitiendo, simultáneamente, evaluar y monitorear la dieta en nivel individual o poblacional.O Índice de Qualidade da Dieta Revisado é um indicador de qualidade da dieta desenvolvido consoante com as recomendações nutricionais vigentes. Os dados dietéticos foram provenientes do estudo de base-populacional, Inquérito de Saúde e Alimentação (ISA)-Capital-2003. O Índice contém 12 componentes, sendo nove fundamentados nos grupos de alimentos do Guia Alimentar Brasileiro de 2006, cujas porções diárias são expressas em densidade energética; dois nutrientes (sódio e gordura saturada); e Gord_AA (calorias provenientes de gordura sólida, álcool e açúcar de adição). O Índice de Qualidade da Dieta Revisado propicia mensurar variados fatores de riscos dietéticos para doenças crônicas, permitindo, simultaneamente, avaliar e monitorar a dieta em nível individual ou populacional.The revised version of the Brazilian Healthy Eating Index is an indicator of dietary quality developed according to current nutritional recommendations. Dietary data were obtained from a population-based survey, the 2003 Inquérito de Saúde e Alimentação (ISA - Health and Diet Survey)-Capital. The Revised Index consists of 12 components: nine food groups included in the 2006 Brazilian Dietary Guidelines, in which daily portions are expressed in terms of energy density; two nutrients (sodium and saturated fats), and SoFAAS (calories from solid fat, alcohol and added sugar). The Revised Brazilian Healthy Eating Index allows for the measurement of dietary risk factors for chronic diseases, evaluating and monitoring the diet at both individual and population levels

Micronutrients inadequacy in urban population of Costa Rica

La inadecuación de micronutrientes es frecuente en los países en vías de desarrollo. En Costa Rica existe poca información acerca de la ingesta de micronutrientes y del impacto de los programas de fortificación obligatoria de alimentos. El objetivo de este estudio fue evaluar la ingesta de vitaminas y minerales y el aporte de la fortificación de alimentos a la ingesta total de micronutrientes en la población urbana costarricense. Se analizó el consumo de alimentos en una muestra de la población urbana costarricense, participantes del Estudio Latinoamericano de Nutrición y Salud (ELANS). El riesgo de ingesta inadecuada se estimó según sexo y grupo de edad, utilizando el método de punto de corte del Requerimiento Medio Estimado (EAR). Para el hierro, se utilizó el método de aproximación probabilística. Más del 85% de la muestra presentó riesgo de ingesta inadecuada para vitamina E, calcio y vitamina D. Una menor prevalencia de riesgo de ingesta inadecuada se presentó para la niacina, tiamina, folatos, hierro y selenio. La fortificación de alimentos tiene un efecto notorio en la ingesta de micronutrientes, especialmente de hierro, niacina, tiamina y folatos. La ingesta de calcio, vitamina D y vitamina E es preocupantemente inadecuada, siendo las mujeres y las personas mayores de 50 años los grupos más afectados. Resulta fundamental el establecimiento de programas y políticas públicas para asegurar el cumplimiento del requerimiento establecido para los diferentes micronutrientes.Micronutrient deficiencies are still very common in developing countries. In Costa Rica there is little information on micronutrients intake and the impact of food fortification.This study aimed to determine the contribution of food fortification to the total intake, and to estimate the risk of inadequate intake of vitamins and minerals in an urban Costa Rican population. As a part of the Latin American Nutrition and Health Study, we analyzed data from a nationally representative sample of 798 urban residents from Costa Rica (15-65 years old) whom provided two 24-h dietary recalls. The prevalence of inadequate micronutrient intake was estimated according to the EAR cut-point method. Iron was analyze using the probability approach. We observed a 100% of the sample are at risk of inadequate intake of vitamin D, and similar percentages were obtained for calcium and vitamin E, ranging from 92.9 to 100% and 85.5 to 99.2% respectively. A lower risk of inadequate intake was observed for niacin, thiamin, folate, iron and selenium. Food fortificationmakes an important contribution to folate, thiamin, iron and niacin intake. Despite the efforts that have been made to ensure adequate micronutrient intake in Costa Rica, the intake of calcium, vitamin D and vitamin E is still very low, especially among women and people over 50 are the most affected. Based on the above, it is recommended to promote a healthy diet through nutritional education as part of public health policies, in order to facilitates compliance to nutritional requirementCoca Cola Company///Estados UnidosUniversidad de Costa Rica/[422-B4-320]/UCR/Costa RicaInternational Life Science Institute//ILSI/ArgentinaEstudio Latinoamericano de Nutrición y Salud/[#NCT02226627]/ELANS/Costa RicaUCR::Vicerrectoría de Docencia::Salud::Facultad de Medicina::Escuela de MedicinaUCR::Vicerrectoría de Docencia::Salud::Facultad de Medicina::Escuela de Nutrició

Is it possible to modify the obesogenic environment? - Brazil case

In recent decades, the prevalence of obesity has reached increasingly high rates among children and adolescents worldwide as the result of interactions between obesogenic environments and genetics. In Brazil, a middle-income country, the rates of overweight and obesity reached 18.9% and 8.7%, respectively, in 2015, corresponding to a prevalence of excess weight of 27.6%. Concomitant with these worrying data, the prevalence of insufficient physical activity in adolescents is 66.2% based on objective accelerometer measurements. The Brazilian government has taken concrete actions to contain the advance of obesity and physical inactivity and is taking part in political efforts combined with scientific evidence to develop laws, programs, and guidelines. While access to food outside the home, with the unstoppable intake of sweet beverages, sodium, and fat, is contributing to increased obesity, a lack of physical activity in leisure time or transportation must also be considered. However, while Brazil has been taking actions to address the obesogenic environment, with a view to reduce the prevalence and incidence of obesity and physical inactivity, more efforts are needed to implement these actions and approve measures that are still in progress.UCR::Vicerrectoría de Docencia::Salud::Facultad de Medicina::Escuela de Medicin

Childbearing age women characteristics in Latin America. Building evidence bases for early prevention. Results from the ELANS Study

Latin American (LA) women have been exposed to demographic and epidemiologic changes that have transformed their lifestyle, with increasing sedentary and unhealthy eating behaviors. We aimed to identify characteristics of LA women to inform public policies that would benefit these women and their future children. The Latin American Study of Nutrition and Health (ELANS) is a multicenter cross-sectional study of representative samples in eight Latin American countries (n = 9218) with a standardized protocol to investigate dietary intake, anthropometric variables, physical activity, and socioeconomic characteristics. Here we included the subsample of all 3254 women of childbearing age (15 to <45 years). The majority of ELANS women had a low socioeconomic status (53.5%), had a basic education level (56.4%), had a mostly sedentary lifestyle (61.1%), and were overweight or obese (58.7%). According to the logistic multiple regression model, living in Peru and Ecuador predicts twice the risk of being obese, and an increased neck circumference is associated with a 12-fold increased obesity risk. An increased obesity risk was also predicted by age <19 years (Relative Risk (RR) 19.8) and adequate consumption of vitamin D (RR 2.12) and iron (RR 1.3). In conclusion, the identification of these risk predictors of obesity among Latin American women may facilitate targeted prevention strategies focusing on high-risk groups to promote the long-term health of women and their children.Coca Cola Company/[]//Estados UnidosHospital Infantil Sabará/[]//BrazilInternational Life Science Institute/[]/ILSI/ArgentinaUniversidad de Costa Rica/[]/UCR/Costa RicaPontificia Universidad Católica de Chile/[]//ChilePontificia Universidad Javeriana/[]//ColombiaUniversidad Central de Venezuela/[]/UCV/VenezuelaUniversidad San Francisco de Quito/[]//EcuadorInstituto de Investigación Nutricional de Perú/[]//PerúUCR::Vicerrectoría de Docencia::Salud::Facultad de Medicina::Escuela de Medicin

Contribution of food groups to energy, grams and nutrients-to-limit: The Latin American Study of Nutrition and Health/ Estudio Latino Americano de Nutrición y Salud (ELANS)

Objective: To quantify the energy, nutrients-to-limit and total gram amount consumed and identify their top food sources consumed by Latin Americans. Design: Data from the Latin American Study of Nutrition and Health (ELANS). Setting: ELANS is a cross-sectional study representative of eight Latin American countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela. Participants: Two 24-h dietary recalls on non-consecutive days were used to estimate usual dietary intake of 9218 participants with ages between 15-65 years. 'What We Eat in America' food classification system developed by United States Department of Agriculture was adapted and used to classify all food items consumed by the ELANS population. Food sources of energy, added sugars, SFA, Na and total gram amount consumed were identified and ranked based on percentage of contribution to intake of total amount. Results: Three-highest ranked food categories of total energy consumed were: rice (10·3%), yeast breads (6·9%), and turnovers and other grain-based items (6·8 %). Highest ranked food sources of total gram amount consumed were fruit drinks (9·6%), other 100% juice (9·3%) and rice (8·3%). Three highest ranked sources for added sugars were other 100% juice (24·1 %), fruit drinks (16·5%), and sugar and honey (12·4%). SFA ranked foods were turnovers and other grain-based (12·6 %), cheese (11·9%), and pizza (10·3%). Three top sources of Na were rice (13·9%), soups (9·1 %) and rice mixed dishes (7·3 %). Conclusion: Identification of top sources of energy and nutrients-to-limit among Latin Americans is critical for designing strategies to help them meet nutrient recommendations within energy needs.Coca Cola Company///Estados UnidosHospital Infantil Sabará///BrazilInternational Life Science Institute//ILSI/ArgentinaUniversidad de Costa Rica//UCR/Costa RicaPontificia Universidad Católica de Chile///ChilePontificia Universidad Javeriana///ColombiaUniversidad Central de Venezuela//UCV/VenezuelaInstituto de Investigación Nutricional de Perú///PerúUCR::Vicerrectoría de Docencia::Salud::Facultad de Medicina::Escuela de Medicin

Breakfast in Latin America: Evaluation of Nutrient and Foot Group Intake Toward a Nutrient-Based Recommendation

Background: Little is known about breakfast habits of the Latin American (LA) population to support nutritional recommendations for a balanced breakfast in this region. Objective: To evaluate the nutritional composition of breakfast in the LA population and to propose recommendations for a balanced breakfast. Design: This multicenter cross-sectional study evaluated food and nutrient intake of nationally representative samples of urban populations of 8 LA countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela) in 2014-2015. Participants/setting: The sample comprised 8714 participants from the Latin American Study of Nutrition and Health, aged 15 to 65 years, randomly recruited according to geographical location, sex, age, and socioeconomic level. Main outcome measures: Two 24-hour recalls were used to examine dietary intake. Breakfast consumers were stratified by tertiles of Nutrient-Rich Foods Index 9.3 (NRF9.3) to assess the overall diet quality of individuals. Nutrient intake at breakfast of those in the upper tertile of NRF9.3 pooled for the 8 countries was used as a reference for the development of recommendations for LA adolescents and adults. Statistical analyses: Comparison of food and nutrient intake of breakfast across NRF9.3 tertiles were analyzed using the Kruskal-Wallis rank sum test. Results: Overall breakfast was an important contributor to protein, carbohydrate, and B vitamin intakes but also to added sugar and total and saturated fat intakes relative to daily intakes. Individuals in the upper NRF9.3 tertile had higher intake of key micronutrients such as calcium and potassium at breakfast compared with other tertiles. White breads/rolls/tortillas were the most consumed food group (60%), followed by butter/margarine (40%) and coffee/tea without milk (34%-50%). Conclusions: Breakfast contributed to the daily intake of B vitamins, protein, and carbohydrates but also added sugar and total and saturated fat intakes for all countries. The proposed recommendations support the nutrient density of existing highest-quality breakfast in the LA population while addressing concerns about nutrients to be encouraged or reduced.UCR::Vicerrectoría de Docencia::Salud::Facultad de Medicina::Escuela de Medicin

Anthropometry, dietary intake, physical activity and sitting time patterns in adolescents aged 15-17 years; an interational comparison in eigth Latina American countries

Background: Although there is high prevalence of obesity and other cardiovascular risk factors among Latin American adolescents, there is limited evidence on dietary intake and physical activity (PA) patterns in this population. Therefore, we characterized anthropometry, dietary intake, PA and sitting time (ST) in adolescents aged 15-17 years from eight Latin American countries. Methods: Six hundred seventy-one adolescents (41.4% girls) from the Latin American Study of Nutrition and Health (ELANS) were included. Nutritional status was classified by four BMI (kg/m2) categories. Waist circumference (WC) was categorized as above or below thresholds. Dietary intake was assessed through two non-consecutive 24-h dietary recalls. PA and ST were measured using the International Physical Activity Questionnaire (IPAQ). We calculated overall and country-specific estimates by sex and tested for differences between boys and girls. Results: Differences in the prevalence of overweightness (15.1 and 21.6%) and obesity (8.5 and 6.5%) between boys and girls, respectively, were statistically insignificant (p = 0.059). Average energy intake was 2289.7 kcal/day (95% CI: 2231-2350) for boys and 1904.2 kcal/day (95% CI: 1840-1963) for girls (p 0.05 for all outcomes). There was no statistically significant difference in the prevalence of total energy (TE) saturated fat and added sugar (>10% of TE) between girls and boys (49.6% versus 44.8 and 81.7% versus 76.1%, respectively). Prevalence of physical inactivity was 19% in boys and 43.7% in girls (p 0.05). Conclusions: These findings highlight the high prevalence of poor dietary intake and physical inactivity in adolescents from Latin American countries. Therefore, effective and sustainable strategies and programmes are needed that promote healthier diets, regular PA and reduce ST among Latin American adolescents.Coca Cola Company///Estados UnidosFerrero///ItaliaInternational Life Science Institute//ILSI/ArgentinaUniversidad de Costa Rica//UCR/Costa RicaPontificia Universidad Católica de Chile///ChilePontificia Universidad Javeriana///ColombiaUniversidad Central de Venezuela//UCV/VenezuelaUniversidad San Francisco de Quito////EcuadorInstituto de Investigación Nutricional de Perú///PerúHospital Infantil Sabará///BrasilUCR::Vicerrectoría de Docencia::Salud::Facultad de Medicina::Escuela de Medicin

Socioeconomic status impact on diet quality and body mass index in eight Latin American countries: ELANS study results

Poor health and diet quality are associated with living within a low socioeconomic status (SES). This study aimed to investigate the impact of SES on diet quality and body mass index in Latin America. Data from the “Latin American Health and Nutrition Study (ELANS)”, a multi-country, population-based study of 9218 participants, were used. Dietary intake was collected through two 24 h recalls from participants of Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela. Diet quality was assessed using the dietary quality score (DQS), the dietary diversity score (DDS) and the nutrients adequacy ratio (NAR). Chi-squared and multivariate-variance analyses were used to estimate possible associations. We found that participants from the low SES consumed less fruits, vegetables, whole grains, fiber and fish and seafood and more legumes than those in the high SES. Also, the diet quality level, assessed by DQS, DDS and NAR mean, increased with SES. Women in the low SES also showed a larger prevalence of abdominal obesity and excess weight than those in the middle and high SES. Health policies and behavioral-change strategies should be addressed to reduce the impact of socioeconomic factors on diet quality and body weight, with gender as an additional level of vulnerability.UCR::Vicerrectoría de Docencia::Salud::Facultad de Medicina::Escuela de MedicinaUCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias de la Salud::Centro de Investigación en Neurociencias (CIN)UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Sociales::Instituto de Investigaciones Psicológicas (IIP