Prevalence of diabetes among Indigenous women in Guatemala: A retrospective chart review study of 13 643 patients between 2015-2022.

There are limited data on diabetes among Indigenous populations in Guatemala. In a retrospective chart review of a clinical program serving more than 13 000 primarily Indigenous women in Guatemala, age-adjusted diabetes prevalence was 7.9% (95% CI: 7.3 to 8.5), and 37.9% (95% CI: 35.1 to 40.8%) of women were undiagnosed.

Mixed-Methods Implementation Study of a Home Garden Intervention in Rural Guatemala Using the RE-AIM Framework.

BACKGROUND: Home gardening is a strategy to improve nutrition and food security. More information is needed about optimizing gardens in different contexts. OBJECTIVE: The aim was to identify implementation barriers and facilitators for a home gardening intervention in rural Guatemala and inform future larger-scale interventions in the region. DESIGN: A mixed-methods implementation study using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework was conducted from January 2019 to July 2020. PARTICIPANTS/SETTING: Families (n = 70) in rural Guatemala participated in the intervention. Staff (n = 4), families (n = 6), and community stakeholders (n = 3) participated in interviews or focus groups. INTERVENTION: Participating households received seeds and seedlings for 16 crops, garden construction materials, agronomist-delivered education and assistance, and a standard-of-care nutrition program. MAIN OUTCOME MEASURES: Implementation data were collected from program records and observations, participant surveys, and interviews and focus groups. Crop count and nutritional functional diversity of home gardens were assessed. STATISTICAL ANALYSES PERFORMED: Descriptive statistics were calculated for quantitative outcomes. Qualitative data were double-coded and organized into overarching themes. RESULTS: Reach: Ninety percent of eligible households participated. Child nutritional eligibility criteria was a barrier to reach. EFFECTIVENESS: Participants and stakeholders felt the intervention improved access to diverse foods. Cultivated crops increased an average of five species (95% confidence interval [CI], 4-6) at 6 months, although not all were consumed. Adoption: The main community adoption barrier was water sourcing for garden irrigation. IMPLEMENTATION: Raised beds were the most common gardening method, with good adoption of agricultural best practices. Gray water filters and flexible implementation were important for participation. Maintenance: Crops failure rates were low. Seed availability was a sustainability challenge. Direct costs were 763 USD per household. CONCLUSIONS: Interest and engagement with a home garden intervention in Guatemala were high. Gaps between garden production and consumption, access to water, and seed sourcing should be addressed in future work.

Academy of Nutrition and Dietetics Nutrition Research Network: A Home Garden Intervention Improves Child Length-for-Age Z-Score and Household-Level Crop Count and Nutritional Functional Diversity in Rural Guatemala.

Home gardens may help address childhood malnutrition in low- and middle-income countries. In this quasi-experimental pilot study, the Academy of Nutrition and Dietetics, in collaboration with Maya Health Alliance, evaluated the feasibility of augmenting a standard-of-care nutrition-specific package for Maya children with length-for-age z score ≤-2 (stunting) in rural Guatemala with a nutrition-sensitive home garden intervention. Two agrarian municipalities in Guatemala were included. Families of 70 children with stunting from 1 municipality received the standard-of-care package (food supplementation, multiple micronutrient powders, monthly nutrition home visits, group nutrition classes). Families of 70 children with stunting from another municipality received the standard-of-care package plus a home garden intervention (garden materials, monthly agricultural home visits, agriculture classes). Maternal and child dietary diversity, household food insecurity, child growth, and agricultural indicators were collected at baseline and 6 months later and were analyzed using mixed linear and logistic regression models. Compared with the standard-of-care group, the garden intervention group had improved child (odds ratio [OR] 3.66, 95% CI 0.89-15.10, P = 0.07) and maternal dietary diversity (OR 2.31, 95% CI 0.80-6.65, P = 0.12) and decreased food insecurity (OR 0.38, 95% CI 0.11-1.35, P = 0.14); however, these effects were not statistically significant. Participation in gardens predicted a higher length-for-age z-score (change difference [CD] 0.22 SD, 95% CI 0.05-0.38, P = 0.009), greater crop species count (CD 2.97 crops, 95% CI 1.79-4.16, P < 0.001), and greater nutritional functional diversity (CD 0.04 points, 95% CI 0.01-0.07, P = 0.006) than standard-of-care alone. Home garden interventions are feasible in rural Guatemala and may have potential benefits for child growth when added to other nutrition-specific interventions.

The Lexicocalorimeter: Gauging public health through caloric input and output on social media.

We propose and develop a Lexicocalorimeter: an online, interactive instrument for measuring the "caloric content" of social media and other large-scale texts. We do so by constructing extensive yet improvable tables of food and activity related phrases, and respectively assigning them with sourced estimates of caloric intake and expenditure. We show that for Twitter, our naive measures of "caloric input", "caloric output", and the ratio of these measures are all strong correlates with health and well-being measures for the contiguous United States. Our caloric balance measure in many cases outperforms both its constituent quantities; is tunable to specific health and well-being measures such as diabetes rates; has the capability of providing a real-time signal reflecting a population's health; and has the potential to be used alongside traditional survey data in the development of public policy and collective self-awareness. Because our Lexicocalorimeter is a linear superposition of principled phrase scores, we also show we can move beyond correlations to explore what people talk about in collective detail, and assist in the understanding and explanation of how population-scale conditions vary, a capacity unavailable to black-box type methods.