Changes in the nutritional status of Bolivian women 1994-1998: demographic and social predictors

Introduction: Bolivia, as one of the poorest Latin American countries, has dealt with the problems of undernutrition for the last 50 y. Little importance has been given to the increase in overweight and obesity among the population, despite the scientific evidence linking overweight and obesity with mortality and morbidity. Objective: To describe the social and demographic determinants of the nutritional status among women in Bolivia between 1989 and 1998 to gain a better understanding of the nutrition transition phenomena and to identify urgent research needs. Methodology: Secondary analysis of the raw data of the Bolivian National Demographic and Health Surveys of 1994 and 1998. Changes in the prevalence of underweight, obesity and overweight are described by sociodemographic characteristics of Bolivian women. Social and demographic determinants of nutritional status have been fitted into a logistic model. Results: The prevalence of overweight (defined as 25 less than or equal to BMI < 30 kg/m(2)) among women of reproductive age (20-44 y) increased by 9 percentage points between 1994 and 1998 (P < 0.001), while the prevalence of normal BMI decreased by 10 percentage points (P < 0.001). The decrease in the prevalence of underweight (defined as BMI <18.5 kg/m(2)) from 2.4% in 1994 to less than 1% in 1998 was statistically significant (P < 0.001). Obesity (defined as BMI &GE;30 kg/m(2)) was positively associated with geographical region (P = 0.001), educational level (P < 0.001), age (P = 0.003) and total number of children (P = 0.001) and negatively associated to rural locality (P = 0.001) and native languages(P < 0.001). Overweight was inversely associated with rural locality (P = 0.013) and with Quechua language (P = 0.04), while the total number of children (P < 0.001) and year of survey (P < 0.001) were positively associated. Underweight decreased dramatically (P < 0.001), being positively associated with the region of residence (P = 0.04) and inversely associated with the total number of children (P = 0.006). Conclusion: The present study suggests that the population of Bolivia is in a transitional stage, with overweight becoming as much of a problem as undernutrition

Estado nutricional y características de la dieta de un grupo de adolescentes de la localidad rural de Calama, Bolivia

In 2003 a pilot study was carried out in the rural area of the Bolivian Department of La Paz aiming at the identification of dietary patterns among a group of secondary school adolescents who have little or scarce contact with the urban centres. The study consisted of a food intake survey (24 h recall), the measurement of anthropometrics and sociodemographic information. Nine percent was the global prevalence of overweight, although it was more present in girls. No statistically significant differences were found between nutrients in the diets of boys and girls. The energy intake was distributed in the five usual eating times as follows: 22% breakfast, 20% break time at school, 24% lunch, 12% tea time and 22% dinner. Furthermore, the anthropometric measures of boys were compared with their urban counterparts, where the differences were only significant with students in private schools. The present study can be used for the formulation of nutritional policies in Bolivia

Desarrollo y evaluación de un cuestionario semi-cuantitativo de frecuencias alimenticias para adolescentes bolivianos

Introduction: Since previous studies suggest that the dietary patterns and lifestyle in adolescence have an impact in health later in life, it is pertinent to monitor and document their dietary patterns. Objective: To develop and test the reliability and validity of a semi-quantitative food frequency questionnaire for Bolivian adolescents. Setting: La Paz, September - October 2004. Methodology: A convenience sample of 82 students from a secondary participated in the study. A semi quantitative food frequency questionnaire was applied twice with one month interval (Q1 and Q2). A 3 days dietary record (3R) was obtained from 32 of the Students as standard. Results: Most of the questions (87%) reporting intake of each individual food item agreed moderately to substantially while only 2 individual food items fell into the category of slight agreement and 11 into the category of fair agreement using the kappa statistic. Quantities obtained from both applications of the questionnaire yielded similar results (P > 0.05). Nutrient estimates obtained from the Q1 and Q2 and the 3R were not statistically different (P > 0.05). Conclusion: The semi - quantitative food frequency questionnaire is apparently reliable and valid for the measurement of absolute food intake in Bolivian adolescents. Care will be taken in the future to prevent overestimation of intake measured by this particular questionnaire

Anthropometry of height, weight, arm, wrist, abdominal circumference and body mass index, for Bolivian adolescents 12 to 18 years: Bolivian adolescent percentile values from the MESA study

Anthropometry is important as clinical tool for individual follow-up as well as for planning and health policy-making at population level. Recent references of Bolivian Adolescents are not available. The aim of this cross sectional study was to provide age and sex specific centile values and charts of Body Mass Index, height, weight, arm, wrist and abdominal circumference from Bolivian Adolescents. Data from the MEtabolic Syndrome in Adolescents (MESA) study was used. Thirty-two Bolivian clusters from urban and rural areas were selected randomly considering population proportions, 3445 school going adolescents, 12 to 18 y, 45% males; 55% females underwent anthropometric evaluation by trained personnel using standardized protocols for all interviews and examinations. Weight, height, wrist, arm and abdominal circumference data were collected. Body Mass Index was calculated. Smoothed age- and gender specific 3(rd), 5(th), 10(th), 25(th), 50(th) 75(th), 85(th), 90(th), 95(th) and 97(th) Bolivian adolescent percentiles(BAP) and Charts(BAC) where derived using LMS regression. Percentile-based reference data for the antropometrics of for Bolivian Adolescents are presented for the first time

Lessons for public health campaigns from analysing commercial food marketing success factors: a case study

Background: Commercial food marketing has considerably shaped consumer food choice behaviour. Meanwhile, public health campaigns for healthier eating have had limited impact to date. Social marketing suggests that successful commercial food marketing campaigns can provide useful lessons for public sector activities. The aim of the present study was to empirically identify food marketing success factors that, using the social marketing approach, could help improve public health campaigns to promote healthy eating. Methods: In this case-study analysis, 27 recent and successful commercial food and beverage marketing cases were purposively sampled from different European countries. The cases involved different consumer target groups, product categories, company sizes and marketing techniques. The analysis focused on cases of relatively healthy food types, and nutrition and health-related aspects in the communication related to the food. Visual as well as written material was gathered, complemented by semi-structured interviews with 12 food market trend experts and 19 representatives of food companies and advertising agencies. Success factors were identified by a group of experts who reached consensus through discussion structured by a card sorting method. Results: Six clusters of success factors emerged from the analysis and were labelled as “data and knowledge”, “emotions”, “endorsement”, “media”, “community” and “why and how”. Each cluster subsumes two or three success factors and is illustrated by examples. In total, 16 factors were identified. It is argued that the factors “nutritional evidence”, “trend awareness”, “vertical endorsement”, “simple naturalness” and “common values” are of particular importance in the communication of health with regard to food. Conclusions: The present study identified critical factors for the success of commercial food marketing campaigns related to the issue of nutrition and health, which are possibly transferable to the public health sector. Whether or not a particular factor contributes to future success depends on the specific context of use, the combination of factors and the environment. Consideration of the specific applicability of the success factors identified in this study during the design of marketing activities could benefit public sector food and health-related campaigns