Evaluation of starch digestibility of Andean crops oriented to healthy diet recommendation

[EN] Starchy Andean crops are often underutilized by consumers, despite their nutritional properties. The starch digestibility of a food is an indicator of its nutritional quality, mainly to prevent cardiometabolic food-related diseases. Limited information on Andean crops' starch digestibility restricts nutritionists for designing adequate nutrition recommendations. This research evaluates the in-vitro starch digestibility of nine Andean crops flours and provides the knowledge, attitudes, and practices (KAP) survey about them among Ecuadorian nutritionists. The results were analyzed with a principal component analysis (PCA) using starch digestion characteristics (rapidly digested starch, RDS; slowly digested starch, SDS; resistant starch, RS; and estimated glycemic index, eGI). The findings showed that the studied crops could be divided into three groups: (1) Puca shungo potato with high RS, low RDS, SDS, and eGI. (2) Melloco, zarandaja, firiguero, and centenario with low RDS, SDS, eGI, and middle RS; (3) finally, quinoa, amaranth, maca, and arracacha with high RDS, SDS, low RS, and middle to high eGI. In addition, the KAP survey indicated that nutritionists lack knowledge about the starch digestibility of Andean crops, despite having positive attitudes toward recommending them. Our results would allow nutritionists to design healthy diet recommendations.This work was supported by the Ecuadorian Research Network of Universities and Polytechnic Schools (REDU) [PI-REDU-2015-012].Cornejo, F.; Salazar, R.; Martínez-Espinosa, R.; Villacrés, E.; Paredes-Escobar, M.; Ruales, J.; Penafiel, D. (2022). Evaluation of starch digestibility of Andean crops oriented to healthy diet recommendation. International Journal of Food Properties. 25(1):1146-1155. https://doi.org/10.1080/10942912.2022.20740361146115525

Born to eat wild: an integrated conservation approach to secure wild food plants for food security and nutrition

Overlooked in national reports and in conservation programs, wild food plants (WFPs) have been a vital component of food and nutrition security for centuries. Recently, several countries have reported on the widespread and regular consumption of WFPs, particularly by rural and indigenous communities but also in urban contexts. They are reported as critical for livelihood resilience and for providing essential micronutrients to people enduring food shortages or other emergency situations. However, threats derived from changes in land use and climate, overexploitation and urbanization are reducing the availability of these biological resources in the wild and contributing to the loss of traditional knowledge associated with their use. Meanwhile, few policy measures are in place explicitly targeting their conservation and sustainable use. This can be partially attributed to a lack of scientific evidence and awareness among policymakers and relevant stakeholders of the untapped potential of WFPs, accompanied by market and non‐market barriers limiting their use. This paper reviews recent efforts being undertaken in several countries to build evidence of the importance of WFPs, while providing examples of cross‐sectoral cooperation and multi‐stakeholder approaches that are contributing to advance their conservation and sustainable use. An integrated conservation approach is proposed contributing to secure their availability for future generations

Dietary species richness as a measure of food biodiversity and nutritional quality of diets

Biodiversity is key for human and environmental health. Available dietary and ecological indicators are not designed to assess the intricate relationship between food biodiversity and diet quality. We applied biodiversity indicators to dietary intake data from and assessed associations with diet quality of women and young children. Data from 24-hour diet recalls (55% in the wet season) of n = 6,226 participants (34% women) in rural areas from seven lowand middle-income countries were analyzed. Mean adequacies of vitamin A, vitamin C, folate, calcium, iron, and zinc and diet diversity score (DDS) were used to assess diet quality. Associations of biodiversity indicators with nutrient adequacy were quantified using multilevel models, receiver operating characteristic curves, and test sensitivity and specificity. A total of 234 different species were consumed, of which < 30% were consumed in more than one country. Nine specieswere consumed in all countries and provided, on average, 61% of total energy intake and a significant contribution of micronutrients in the wet season. Compared with Simpson's index of diversity and functional diversity, species richness (SR) showed stronger associations and better diagnostic properties with micronutrient adequacy. For every additional species consumed, dietary nutrient adequacy increased by 0.03 (P < 0.001). Diets with higher nutrient adequacy were mostly obtained when both SR and DDS were maximal. Adding SR to the minimum cutoff for minimum diet diversity improved the ability to detect diets with higher micronutrient adequacy in women but not in children. Dietary SR is recommended as the most appropriate measure of food biodiversity in diets

A Conceptual Framework for Healthy Eating Behavior in Ecuadorian Adolescents: A Qualitative Study

Objective: The objective of this study was to identify factors influencing eating behavior of Ecuadorian adolescents - from the perspective of parents, school staff and adolescents - to develop a conceptual framework for adolescents’ eating behavior. Study design: Twenty focus groups (N = 144 participants) were conducted separately with adolescents aged 11–15 y (n (focus groups) = 12, N (participants) = 80), parents (n = 4, N = 32) and school staff (n = 4, N = 32) in rural and urban Ecuador. A semi-structured questioning route was developed based on the ‘Attitude, Social influences and Self-efficacy’ model and the socio-ecological model to assess the relevance of behavioral and environmental factors in low- and middle-income countries. Two researchers independently analyzed verbatim transcripts for emerging themes, using deductive thematic content analysis. Data were analyzed using NVivo 8. Results: All groups recognized the importance of eating healthily and key individual factors in Ecuadorian adolescents’ food choices were: financial autonomy, food safety perceptions, lack of self-control, habit strength, taste preferences and perceived peer norms. Environmental factors included the poor nutritional quality of food and its easy access at school. In their home and family environment, time and convenience completed the picture as barriers to eating healthily. Participants acknowledged the impact of the changing socio-cultural environment on adolescents’ eating patterns. Availability of healthy food at home and financial constraints differed between settings and socio-economic groups. Conclusion: Our findings endorse the importance of investigating behavioral and environmental factors that influence and mediate healthy dietary behavior prior to intervention development. Several culture-specific factors emerged that were incorporated into a conceptual framework for developing health promotion interventions in Ecuador

Impact of hospital characteristics on implementation of a Pediatric Early Warning System in resource-limited cancer hospitals

BackgroundPediatric Early Warning Systems (PEWS) aid in identification of deterioration in hospitalized children with cancer but are underutilized in resource-limited settings. Proyecto EVAT is a multicenter quality improvement (QI) collaborative in Latin America to implement PEWS. This study investigates the relationship between hospital characteristics and time required for PEWS implementation.MethodsThis convergent mixed-methods study included 23 Proyecto EVAT childhood cancer centers; 5 hospitals representing quick and slow implementers were selected for qualitative analysis. Semi-structured interviews were conducted with 71 stakeholders involved in PEWS implementation. Interviews were recorded, transcribed and translated to English, then coded using a priori and novel codes. Thematic content analysis explored the impact of hospital characteristics and QI experience on time required for PEWS implementation and was supplemented by quantitative analysis exploring the relationship between hospital characteristics and implementation time.ResultsIn both quantitative and qualitative analysis, material and human resources to support PEWS significantly impacted time to implementation. Lack of resources produced various obstacles that extended time necessary for centers to achieve successful implementation. Hospital characteristics, such as funding structure and type, influenced PEWS implementation time by determining their resource-availability. Prior hospital or implementation leader experience with QI, however, helped facilitate implementation by assisting implementers predict and overcome resource-related challenges.ConclusionsHospital characteristics impact time required to implement PEWS in resource-limited childhood cancer centers; however, prior QI experience helps anticipate and adapt to resource challenges and more quickly implement PEWS. QI training should be a component of strategies to scale-up use of evidence-based interventions like PEWS in resource-limited settings

Traditional individual and environmental determinants of healthy eating in Vihiga County, Western Kenya

Traditional ethnic groups in Kenya are unlikely to eat a healthy and diversified diet due to many individual and environmental factors, which may result in poor health status. Therefore, the determinants of eating behavior need to be identified prior to any public health action. For this study, focus group discussions (15 in total) in a double-layer design were conducted, comprising adult men and women from 5 villages of Vihiga County. Questions explored knowledge; barriers and cues to action toward eating a healthy diet containing a variety of foods; including indigenous food species. We found that healthy eating concepts are known; however, several taboos that restrict food consumption reduce local diet quality in terms of diversity. Nutrition education is a cue to action. We identified several individual and environmental determinants of eating behavior in the studied communities. Public health action should focus on supporting healthy eating behaviors and refining some taboos’ beliefs

Participant characteristics.

<p><b>*</b>Date of birth was missing for 5 adolescents.</p><p><i>P</i>-values for urban-rural differences (two sample t-test, Chi square or Fisher Exact test).</p