Inseguridad alimentaria y obesidad en madres concurrentes a centros de atención primaria de salud del NOA

La inseguridad alimentaria (IA) es un fenómeno multidimensional que presenta un continuum de estadios de gravedad. La IA se relaciona con estados nutricionales inadecuados ya sea por insuficiencia o por exceso. En América Latina la paradojal relación entre IA y obesidad no se ha constatado en forma consistente, aún en estudios realizados en un mismo país pero enfocados en distintas localidades o poblaciones. Resulta entonces relevante conocer las situaciones locales para aportar al diagnóstico regional pormenorizado, y para dar respuestas adaptadas y adecuadas, desde los sistemas de salud. Se analizó la relación entre IA y estado nutricional en 1107 madres de niños concurrentes a Centros de Atención Primaria de Salud (CAPS), de 4 provincias del Noroeste Argentino. Se aplicó un cuestionario con la pregunta de tamizaje para seguridad alimentaria del Household Food Security Scale (HFSS). El 20,2% de las madres reportó IA severa, el 18,1% moderada, el 26,1% leve y el 31,0% reportó seguridad alimentaria (SA). La prevalencia de obesidad fue significativamente mayor entre las participantes con IA severa (35,6%) y moderada (28,6%), en comparación a aquellas con IA leve (19,8%) o con SA (22,1%) (p 0,001). Esta asociación significativa se mantiene aún luego de considerar variables demográficas, nivel de ingreso, asistencia alimentaria y otras características individuales. Se complementan estos resultados con entrevistas semiestructuradas realizadas a 11 madres concurrentes a CAPS de la Provincia de Jujuy, que atravesaban situación de IA. El análisis fue guiado por marcos teóricos socioambientales y los temas emergentes incluyeron los recursos materiales e inmateriales del hogar, sistemas de apoyo social y prácticas de obtención y preparación de comidas. En la provincia de Jujuy, donde no se ha superado completamente el problema del bajo peso, se debe abordar la paradoja de la obesidad asociada a la pobreza. Estos resultados indicarían que la relación entre la IA y el estado nutricional involucra mecanismos y procesos más complejos que los referidos exclusivamente al poder adquisitivo, incluyendo una multiplicidad de factores considerados en los marcos teóricos socioambientales.GT45: Antropología de la Alimentación: aportes y debates actuales.Universidad Nacional de La Plat

Food insecurity and obesity among mothers in Northwest Argentina: local study in global context

INTRODUCCIÓN: La inseguridad alimentaria (IA) es un fenómeno multidimensional, que obliga a las personas a reducir la cantidad o calidad de los productos que consumen y presenta un contínuum de niveles de gravedad (de leve a severa). El objetivo fue analizar la relación entre IA y estado nutricional en madres de niños concurrentes a Centros de Atención Primaria de Salud de cuatro provincias del Noroeste de Argentina. MÉTODOS: Se aplicó un cuestionario con el indicador de insuficiencia alimentaria de la USDA y NHANES III a 995 madres. El estado nutricional se evaluó mediante el índice de masa corporal (IMC) y la circunferencia de cintura. RESULTADOS: La prevalencia de obesidad (IMC >30 kg/m2 ) fue mayor entre las participantes con IA severa (37,1%) y moderada (28,7%) que en aquellas con IA leve (20,3%) o con seguridad alimentaria (SA) (22,4%) (p 0,003). En modelos de regresión logística multivariada la IA severa incrementaba la probabilidad de IMC ≥30 kg/m2 (OR 1,8) y de circunferencia de cintura >80 cm (OR 1,8). Tener bajos niveles de ingresos y de educación, estar casada o en pareja y consumir asiduamente comidas fritas también constituían factores de riesgo significativos. DISCUSIÓN: Las políticas alimentarias deben combinarse con políticas de empleo y de distribución de ingresos, de producción y acceso a alimentos saludables, junto a legislación sobre la composición y publicidad de alimentos y bebidas, y a la diseminación de información y de buenas prácticas alimentarias.INTRODUCTION: Food insecurity (FI) is a multidimensional phenomenon which forces people to reduce the quantity or quality of consumed products and has a continuum of severity levels (from mild to severe). The objective of this study was to analyze the relationship between FI and nutritional status in mothers attending Primary Health Care Centers in four provinces of Argentine Northwest. METHODS: A questionnaire with USDA and NHANES III FI indicator was applied to 995 mothers. Nutritional status was assessed using body mass index (BMI) and waist circumference. RESULTS: The prevalence of obesity (BMI ≥30 kg/m2 ) was higher among women with severe (37.1%) and moderate (28.7%) FI than in women reporting low FI (20.3%) or food security (FS) (22.4%) (p 0.003). In multivariate logistic regression models, severe FI increased the likelihood of BMI ≥30 kg/m2 (OR 1.8) and of waist circumference >80 cm (OR 1.8). Low income and education level, being married/living with a partner, and fried food consumption also were significant risk factors for obesity. DISCUSSION: Food policies should combine with employment and income distribution, production and access to healthy foods, food and beverage composition and advertising regulations, together with the dissemination of information and healthy nutrition practices.Fil: Monteban, Madalena. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta. Unidad Ejecutora en Ciencias Sociales Regionales y Humanidades. Universidad Nacional de Jujuy. Unidad Ejecutora en Ciencias Sociales Regionales y Humanidades; Argentina. Instituto de Ciencia y Tecnología Regional; Argentin

Maternal Knowledge and Use of Galactagogues in Andean Communities of Cusco, Peru

A commonly reported reason for early breastfeeding cessation is inadequate milk production. In response, women across the globe turn to galactagogues – substances used to increase the milk supply. Andean women have traditional knowledge about the medicinal and nutritional properties of plants and animals that are considered good to eat during breastfeeding. This research explores the maintenance and use of galactagogues, and specifically the use of the Andean flicker bird, within the wider framework of breastfeeding and nutrition policies in Peru. To elicit maternal knowledge and use of galactagogues, semi-structured and free-listing interviews were conducted with 33 mothers. Data analysis calculated the frequency and percentage of women reporting each type of galactagogue. In addition, thematic codes and relevant text passages were used in an iterative analytic process to document emerging themes. Identified galactagogues included five plants and six animals. Several galactagogues included protein-rich foods such as lamb meat and the Andean flicker bird. The use of protein-rich galactagogues as solid food is reinforced by public health messages. However, galactagogues in the research communities are usually consumed as soups or drinks, which are less rich in proteins than solid meals. The potential role of liquid galactagogues in the maintenance of appropriate hydration levels during breastfeeding in an environment where safe drinking water is scarce is a new contribution to the existing literature. The results are relevant to the design of maternal and child health policies that comply with intercultural health premises that value and respect the knowledge and practices of Andean Peoples.</p

Comparing Indigenous and public health infant feeding recommendations in Peru: opportunities for optimizing intercultural health policies

Abstract Background The problem of childhood undernutrition in low-income countries persists despite long-standing efforts by local governmental and international development agencies. In order to address this problem, the Peruvian Ministry of Health has focused on improving access to primary healthcare and providing maternal and child health monitoring and education. Current maternal-child health policies in Peru introduce recommendations that are in some respect distinct from those of Indigenous highland communities. This paper analyses the similarities and differences between public health and mothers’ infant feeding recommendations. Furthermore, it analyses persistence and change in those recommendations among women who were mothers before and after the introduction of current public health policies. Methods Semi-structured interviews were conducted with 18 older mothers, 15 currently breastfeeding mothers, and 15 public health staff in highland rural communities of Peru. During data analysis, thematic codes and text passages were used in an iterative analytic process to document emerging themes. Results The results highlight the existence of a traditional corpus of beliefs surrounding infant feeding and care that is consistent with Andean ethnomedical beliefs. This is illustrated by mother’s accounts referring to the importance of maintaining a dietary balance of fluids and semi-fluids and of maintaining harmony with the elements in the natural environment. Mothers also incorporate aspects of public health recommendations that they find useful including initiating breastfeeding immediately after birth and exclusive breastfeeding up until 6 months. There are also tensions between the two systems including differences in the conceptualization of breastfeeding and infant food, the imposition of public health care services by coercive means, and negative stereotyping of rural Andean diets and mothers. Conclusions Identifying similarities and differences between distinct systems may provide useful input for effective intercultural health policies. Sources of tension should be carefully assessed with the aim of improving public health policies. Such efforts should apply a process of cultural humility engaging health care professionals in exchange and conversations with patients and communities acknowledging the assumptions and beliefs that are embedded in their own understanding. This process should also recognize and value the knowledge and practices of Andean mothers and their role as primary caretakers

Smoking and exposure to racial insults among multiethnic youth in Jujuy, Argentina

Área de Salud, Economía y Socieda

Indicators of Readiness and Capacity for Implementation of Healthy Eating Strategies in Child Care Settings Serving Low-Income Children

Objective: Identify factors perceived to influence implementation of healthy eating policy, systems, and environmental strategies (PSEs) in child care settings serving low-income children. Design: This mixed-methods study, conducted in 2015–2016, used semi-structured interviews (n = 18), focus groups (n = 23), and an expert panel. Participants: Public health (n = 11) and Supplemental Nutrition Assistance Program–Education practitioners (n = 9) and community residents (n = 174) from 9 counties in Ohio. Expert panelists (n = 10) had experience implementing PSEs in child care settings. Phenomenon of Interest: Implementation factors influencing healthy eating PSEs in child care settings. Analysis: Qualitative thematic analysis of 41 transcripts using a grounded theory approach. Indicators for each theme were operationalized. Consensus feedback from an expert panel weighted themes and indicators based on perceived importance for implementation. Results: Identified themes relevant to implementation of PSEs included (1) organizational and practitioner capacity, (2) child care capacity, (3) networks and relationships, and (4) community resources and motivations. Nineteen indicators related to the 4 themes were identified and weighted. Conclusions and Implications: Findings highlighted key factors within domains of influence and informed the operationalization of the indicators and the development of an assessment tool. The assessment tool is designed to tailor PSE implementation to the realities of different child care settings.Fil: Parsons, Allison A.. Cincinnati Children's Hospital Medical Center;Fil: Monteban, Madalena. Case Western Reserve University; Estados UnidosFil: Lee, Eunlye. Case Western Reserve University; Estados UnidosFil: Bebo, Pat. Ohio State University; Estados UnidosFil: Zubieta, Ana Claudia. Ohio State University; Estados UnidosFil: Ginnetti, Sarah. Ohio Department Of Health;Fil: Hewitt, Julie. Case Western Reserve University; Estados UnidosFil: Freedman, Darcy. Case Western Reserve University; Estados Unido

People and places shaping food procurement among recipients of Supplemental Nutrition Assistance Program (SNAP)

A key gap in existing food environment research is a more complex understanding of the interplay between physical and social contexts, including the influence of social networks on food habits. This mixed methods research examined the nature of social connections at food procurement places among a sample of 30 people receiving Supplemental Nutrition Assistance Program (SNAP) benefits in an urban setting. Results highlight the significance of social connections as motivators to use food places, the value of access to information and other resources at food places, and the role of weak ties with actors within food places to facilitate utilization and interaction. Social connections at the varied places individuals procure food may be leveraged to disseminate information and resources to further healthy food access.Fil: Monteban, Madalena

Effect of Appreciation for Indigenous Cultures and Exposure to Racial Insults on Alcohol and Drug use Initiation among Multiethnic Argentinean Youth

Área de Salud, Economía y Socieda