Factors associated with the consumption of fruits and vegetables in latin american university students

Objective: Explore the association between compliance with recommended consumption (5-a-day) of fruits and vegetables (F&V) with sociodemographic factors of university students of Latin America. Subjects: We conducted an analytical cross-sectional study in which 4,880 university students from 10 Latin American countries completed a self-administered online survey. Methods: F&V consumption and other sociodemographic variables were measured according to a validated survey. Body mass index was self-reported. Ordinal logistic regression models were applied. Results: Regarding the consumption of F&V, 4.7% of men complied with the recommendation, while in women this value reached 7.7%. In the adjusted model, having a normal weight (OR= 0.59; 95% CI 0.44-0.7; p=<0.001), being female (OR= 0.67; 95% CI 0.49-0.89; p=<0.01), being enrolled in a health-related degree program (OR= 0,60; IC95% 0,45-0,78; p<0.001), having professional parents (OR= 0.75; 95% CI 0.60-0.95; p=<0.05) and practicing physical activity (OR= 0.34; 95% CI 0.27-0.42; p=<0.001) were associated with compliance to F&V consumption recommendations. In the analysis by country, physical activity was the variable most associated with F&V consumption. Conclusion: We observed a low consumption of F&V in university students. The variables associated with compliance to the F&V recommendation were being normal weight, female, being enrolled in a health-related degree program, having professional parents, and practicing physical activity, the latter being the most important variable.

Objetivo: Explorar la asociación de la frecuencia de cumplimiento de las recomendaciones de consumo (5 al día) de frutas y verduras (F&V) con factores sociodemográficos de estudiantes universitarios de América Latina. Metodología: Se realizó un estudio transversal analítico con 4.880 estudiantes universitarios de 10 países de América Latina, quienes completaron una encuesta en línea autoadministrada. Se midió el consumo de F&V y otras variables sociodemográficas según una encuesta previamente validada. El índice de masa corporal fue autoinformado. Se aplicaron modelos de regresión logística ordinal. Resultados: En cuanto al consumo de F&V, en los hombres el 4,7% cumple con la recomendación, mientras que en las mujeres este valor alcanza el 7,7%. En el modelo más ajustado, presentar normopeso (OR= 0,59; IC 95% 0,44-0,7; p=<0,001), ser mujer (OR= 0,67; IC 95% 0,49-0,89; p=<0,01), estar matriculado en carrera relacionada con la salud (OR= 0,60; IC95% 0,45-0,78; p<0,001), tener padres profesionales (OR= 0,75; IC 95% 0,60-0,95; p=<0,05) y realizar actividad física (OR= 0,34; IC 95% 0,27-0,42; p=<0,001) fueron las variables asociadas al cumplimiento del consumo de F&V. En el análisis por país, la actividad física fue la variable más asociada al consumo de F&V. Conclusión: Se observa un bajo consumo de F&V en estudiantes universitarios, y entre las variables asociadas al cumplimiento de la recomendación de F&V se encuentran estar normopeso, sexo femenino, estar cursando una carrera relacionada con la salud, tener los padres y la práctica de actividad física, siendo esta última la variable más importante.

Calidad de los Carbohidratos en la dieta de la población urbana costarricense / Carbohydrate Quality in the diet of the Costa Rican urban population

Introducción. La calidad de los carbohidratos consumidos juega un papel importante en la prevención de las enfermedades crónicas no transmisibles (ECNT). Objetivo. Analizar el índice de calidad de los carbohidratos (ICC) en la población urbana costarricense y su relación con las variables sociodemográficas, antropométricas y la calidad y la diversidad de la dieta. Materiales y métodos. Los datos provienen del Estudio Latinoamericano de Nutrición y Salud, en una muestra representativa de 798 personas entre 15 y 65 años que residen en zonas urbanas de Costa Rica (2014- 2015). En una visita domiciliaria se administró un cuestionario para recolectar los datos sociodemográficos y se pesó y midió a los participantes. El consumo dietético se obtuvo mediante dos recordatorios de 24 horas en días no consecutivos. El ICC se calculó mediante el consumo de fibra, el índice glicémico, la relación carbohidratos sólidos/líquidos y la relación granos enteros/granos totales. Se comparó el ICC según el sexo, el grupo de edad, el nivel socioeconómico, el estado nutricional, la circunferencia de cintura y la calidad y diversidad de la dieta de los participantes. Resultados. El ICC se asoció positivamente con un mayor consumo de energía, carbohidratos totales, proteínas, grasas, colesterol, frutas, vegetales y leguminosas (p<0,001). Un mayor ICC se asoció positivamente con un mayor porcentaje de adecuación de micronutrientes y mayor índice de diversidad y calidad de la dieta (p<0,001), así como con un menor índice de masa corporal y una menor circunferencia de cintura al ajustar por sexo y edad (p<0,005). Conclusiones. El presente estudio demostró que un mayor ICC se asocia significativamente con mejores indicadores dietéticos e índice de masa corporal, por lo que resulta fundamental establecer en Costa Rica pautas dietéticas que permitan aumentar la calidad de los carbohidratos de la dieta con el fin de contribuir en la prevención de las ECNT(AU)

Introduction. The carbohydrate quality index (CQI) plays an important role in the prevention of chronic non-communicable diseases (NCD) and adequate macro and micronutrient intake. Objective. To analyze the carbohydrate quality index (CCI) in the Costa Rican urban population and its relationship with sociodemographic and anthropometric variables and the quality and diversity of the diet. Materials and methods. Data come from the Latin American Nutrition and Health Study (ELANS), in a representative sample of 798 people between 15 and 65 years of age who reside in urban areas of Costa Rica (2014-2015). During a home visit, a questionnaire was administered to collect sociodemographic data, and participants were measured and weighed. Dietary intake was obtained through two 24-hour recalls in non- consecutive days. The CQI was calculated using fiber intake, glycemic index, liquid/solid carbohydrate ratio, and whole grain/total grains. CCI was then compared according to sex, age-group, socioeconomic level, nutritional status and diet quality and diet diversity. Results. The CQI was positively associated with energy intake, total carbohydrates, proteins, fats, cholesterol, fruits, vegetables, and legumes (p<0,001). Also, CQI was associated with a higher percentage of micronutrient adequacy and diet quality and diversity (p<0,001), as well as with a lower body mass index and lower waist circumference when adjusting for sex and age (p<0,005). Conclusions. The present study showed that higher CQI is associated with better dietary and body mass index, which shows that it is essential to establish dietary guidelines for public health in Costa Rica that allows increasing the quality of carbohydrates in the diet to contribute to the prevention of chronic NCD(AU)

Actividad física en la población urbana costarricense y su relación con patrones sociodemográficos y antropométricos / Physical activity in Costa Rican urban population and its relationship to socio-demographic and anthropometric patterns

Gómez, G., Salas, E., Sheik, A. y Ferrari, G. (2023). Actividad física en la población urbana costarricense y su relación con patrones sociodemográficos y antropométricos. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 21(1), 1-20. El objetivo de este estudio fue describir la cantidad de actividad física realizada por la población urbana costarricense y determinar su asociación con variables sociodemográficas y antropométricas. Se analizó una muestra representativa de la población urbana costarricense, constituida por 798 individuos. Los datos de actividad física (desplazamiento, tiempo libre y total) se tomaron mediante el Cuestionario Internacional de Actividad Física (IPAQ, por sus siglas en inglés). Los participantes fueron clasificados como activos o inactivos conforme la recomendación internacional de actividad física. El 37.1% de los participantes no cumplió con estas recomendaciones. Se observó, además, que el tiempo de actividad física fue significativamente mayor (p< .001) en los hombres (535.3 vs 371.3 min/sem), en las personas de menor edad (584.3 min/sem en el grupo de 15 a 19 años vs 309.2 min/sem en el grupo de 50 a 65 años) y en los que no presentaron exceso de peso (521.3 vs 411.7min/sem). La circunferencia de cintura fue significativamente menor entre las personas activas (90.6 vs 94.1 cm, p < .011) y, los hombres activos también mostraron una menor circunferencia de cuello (38.2 vs 39.6 cm, p < .001), menor peso (75.7 vs 79.3 kg, p = .025) y menor índice de masa corporal (26.1 vs 27.9 kg/m2, p = .004). Estos resultados podrían usarse para concientizar sobre la necesidad de mejoras en la implementación de políticas y prácticas globales que promuevan la actividad física.

Gómez, G., Salas, E., Sheik, A. & Ferrari, G. (2023). Physical activity in Costa Rican urban population and its relationship to socio-demographic and anthropometric patterns. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 21(1), 1-20. The objective of this study was to describe the amount of physical activity carried out by Costa Rican urban population and to determine its relationship to socio-demographic and anthropometric variables. A representative sample of Costa Rican urban population, made up of 798 individuals, was analyzed. The physical activity data (displacement, free time and total) were taken through the International Physical Activity Questionnaire (IPAQ). Participants were classified as active or inactive according to the international recommendation for physical activity. 37.1% of participants did not meet the recommendations. It was also observed that the time of physical activity was significantly longer (p< .001) in men (535.3 vs. 371.3 min/week) in younger people (584.3 min/week in the 15-19 years old group vs. 309.2 min/week in the 50-65 years old group) and in people that were not overweight (521.3 vs. 411.7 min/week). The waist circumference was significantly lower in active people (90.6 vs. 94.1 cm, p < .011), and active men also showed a lower neck circumference (38.2 vs. 39.6 cm, p < .001), lower weight (75.7 vs. 79.3 kg, p = .025) and a lower body mass index (26.1 vs. 27.9 kg/m2, p = .004). These results could be used to raise awareness on the need for improvement in the implementation of global policies and practices to promote physical activity.

Gómez, G., Salas, E., Sheik, A. e Ferrari, G. (2023). Atividade física na população urbana costarriquenha e sua relação com os padrões sociodemográficos e antropométricos. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 21(1), 1-20. O objetivo deste estudo foi descrever a quantidade de atividade física realizada pela população urbana costarriquenha e determinar sua associação com variáveis sociodemográficas e antropométricas. Foi analisada uma amostra representativa da população urbana costarriquenha de 798 indivíduos. Os dados de atividade física (deslocamento, lazer e total) foram coletados utilizando o Questionário Internacional de Atividade Física (IPAQ). Os participantes foram classificados como ativos ou inativos, de acordo com a recomendação internacional de atividade física. Dos participantes, 37,1% não cumpriram estas recomendações. Também foi observado que o tempo de atividade física foi significativamente maior(p<0,001) nos homens (535,3 vs 371,3 min/sem), nas pessoas mais jovens (584,3 min/sem na faixa etária de 15-19 anos vs 309,2 min/sem na faixa etária de 50-65 anos) e naqueles que não apresentaram excesso de peso (521,3 vs 411,7min/sem). A circunferência da cintura foi significativamente menor nas pessoas ativas (90,6 vs 94,1 cm, p < .011) e, os homens ativos também mostraram circunferência inferior do pescoço (38,2 vs 39,6 cm, p < .001), peso inferior (75,7 vs 79,3 kg, p = .025) e índice de massa corporal inferior (26,1 vs 27,9 kg/m2, p = .004). Estes resultados poderiam ser usados para aumentar a conscientização da necessidade de melhorias na implementação de políticas e práticas globais que promovam a atividade física.

Asociación entre consumo de alcohol y exceso de peso entre estudiantes universitarios de América Latina

Introducción: El sobrepeso y la obesidad son problemas de salud pública de nivel mundial. Si bien existe información respecto al consumo de alcohol en estudiantes universitarios durante la pandemia, pocos autores han señalado la asociación entre este hábito y el exceso de peso en esta población. El objetivo fue determinar la asociación entre el consumo de alcohol y el exceso de peso en estudiantes universitarios de 10 países de Latinoamérica durante la pandemia por COVID-19. Metodología: Se realizó un estudio transversal y multicéntrico con 4.539 estudiantes universitarios matriculados en diez países de América Latina. Para la valoración del consumo de alcohol se utilizó la pregunta ¿Consumes bebidas alcohólicas? (1 porción 1 vaso de 200 ml). El índice de masa corporal (IMC) se determinó a partir del peso y la altura auto informado. Para determinar si el exceso de peso (IMC ≥25 kg/m2) estaba asociado con el consumo de alcohol, se utilizó un análisis de regresión logística, ajustado por edad, sexo, año de estudio, nivel socioeconómico, actividad física y tabaquismo. Resultados: Entre los estudiantes con estado nutricional normal, un 59,6% no consumía alcohol, mientras entre los que presentaban un exceso de peso era un 55,1%. Los estudiantes que consumían 2 o más porciones de alcohol al día tenían 2,18 veces más riesgo de tener exceso de peso (OR: 2.18 [95% IC: 1,26 a 3,77]), comparado con aquellos que no consumían alcohol. Conclusión: Se observó que aquellos estudiantes que consumieron más alcohol tuvieron más probabilidades de tener exceso de peso.

Introduction: Overweight and obesity are public health problems worldwide. Alcoholic beverages could increase total energy intake causing an increase in body weight. However, few authors have pointed out the association between this habit and excess weight in this population. The objective of this study was to determine the association between alcohol consumption and excess weight in university students from 10 Latin American countries during the COVID-19 pandemic. Methodology: A cross-sectional and multicenter study was carried out with 4,539 university students enrolled in ten Latin American countries. To assess alcohol consumption, the question Do you consume alcoholic beverages? (1 portion 1 glass of 200 ml). Body mass index (BMI) kg/m2 was determined from self-reported weight and height. To determine if excess weight was associated with alcohol consumption, a logistic regression analysis was used, adjusted for age, sex, year of study, socioeconomic level, physical activity, and smoking. Results: Among students with normal nutritional status, 59.6% did not consume alcohol, while among those with a BMI ≥25 kg/m2 it was 55.1%. Students who consumed 2 or more servings of alcohol per day had a 2.18 times greater risk of being overweight (OR: 2.18 [95% CI: 1.26 to 3.77]), compared with those who did not consume alcohol. Conclusion: It was observed that those students who consumed more alcohol were more likely to be overweight.

Consumo de edulcorantes no calóricos en la población adulta de Argentina / Non-caloric sweeteners consumption in the adult population of Argentina

Resumen Introducción: Los edulcorantes no calóricos (ENC) se utilizan para sustituir azúcares en alimentos y bebidas. Para que este reemplazo sea beneficioso para la salud, la ingesta de cada ENC no de bería superar su ingesta diaria admisible (IDA). El objetivo principal de este estudio es determinar el consumo de aspartamo, acesulfame-K, sucralosa y sacarina en la población argentina de 15 a 65 años y evaluar este consumo en relación con la IDA. Otros objetivos son estratificar el consumo en función de distintas variables sociodemográficas y determinar las principales fuentes de ENC consumidas por la población argentina. Métodos: La muestra fue de 1266 individuos (población urbana 15-65 años), estratificada por región, edad, sexo y nivel socioeconómico. Los datos de ingesta fueron recolectados con dos recordatorios de 24 horas. Resultados: En Argentina, el consumo promedio de sacarina, aspartamo, acesulfame-K y sucralosa está muy por debajo de su respectiva IDA: 8.4%, 3.2%, 2% y 0.3% de la IDA respectivamente. Los consumos máximos reportados tampoco superan la IDA. Hay una mayor proporción de mujeres consumidoras de ENC. La proporción de consumidores de ENC aumenta con la edad. Las regiones noreste y sur presentan el menor porcentaje de consumidores de ENC. Las bebidas constituyen la principal fuente de ENC, seguidas por los edulcorantes de mesa. La contri bución de los alimentos al consumo de ENC es despreciable. Discusión: En Argentina existe un buen margen de seguridad para la reformulación de productos azucarados tendiente a disminuir el exceso de calorías y el consumo de azúcares añadidos.

Abstract Introduction: Non-caloric sweeteners (NCS) are used to replace added sugars in foods and bev erages. For this replacement to be a health benefit, the intake of each NCS should not exceed its Acceptable Daily Intake (ADI). The main objective of this study is to determine the consumption of aspartame, acesulfame-K, sucralose, and saccharin in the argentine population aged 15 to 65 years and to evaluate this consumption in relation to the ADI. Other objectives are to stratify the consumption based on different sociodemographic vari ables and to determine the main sources of NCS consumed by the argentine population. Methods: The sample consisted of 1266 individuals (urban population aged 15-65), stratified by region, age, sex, and socioeconomic level. Intake data was collected with two 24-hour recalls. Results: In Argentina, the average consumption of saccharin, aspartame, acesulfame-K and sucralose is well below their respective ADI: 8.4%, 3.2%, 2% and 0.3% of the ADI, respectively. The maximum reported consumptions do not exceed the ADI either. There is a higher proportion of women who consume NCS. The proportion of NCS consumers increases with age. The Northeast and South regions have the lowest percentage of NCS consumers. Beverages constitute the main source of NCS, followed by tabletop sweeteners. The contribution of food to NCS consumption is negligible. Discussion: In Argentina there is a good safety margin for the reformulation of sugary products aimed at reduc ing the excess calories and added sugars consumed by the population.

Fat Intake and Obesity-related Parameters Predict Striatal BDNF Gene Expression and Dopamine Metabolite Levels in Cafeteria Diet-fed Rats.

Modern westernized diet is a major risk factor associated with the current obesity epidemic. To study the effects of dietary choices of Western societies, the cafeteria diet has been validated as a preclinical model of obesity. We aimed to investigate the behavioral and metabolic alterations induced by a cafeteria diet on gene expression and neurotransmitter contents involved in neural plasticity and reward processing. Male Wistar rats were exposed to either standard or cafeteria diet for 9 weeks. Food intake and body weight were scored daily. Behavioral effects were assessed in the elevated plus-maze (EPM) and open field (OFT) tests. Serum biochemical parameters, brain monoamines, and BDNF, TrkB, CRF, CREB, and Dnmt3A mRNA levels were analyzed in reward-related brain regions. We found that cafeteria-diet rats consumed more energy and food than the control group, leading to increased body weight gain and adiposity. The cafeteria-diet rats showed an anxiolytic-like effect in the OFT, but not in the EPM. The cafeteria diet increased BDNF expression in the dorsal striatum (DS), and norepinephrine, 5-HT, TrkB, CREB, and Dnmt3A levels in the hippocampus. Additionally, multiple regression analysis showed that accumbal DOPAC and BDNF mRNA levels were robustly predicted by hyperphagia, fat mass accumulation, and body weight gain only in the cafeteria group. Overall, cafeteria diet-induced hyperphagia could lead to alterations in hedonic and motivational control of food intake through changes in dopamine metabolism and BDNF signaling in the nucleus accumbens and the DS.

Perceived Urban Environment Attributes and Device-Measured Physical Activity in Latin America: An 8-Nation Study.

INTRODUCTION: Attributes of the neighborhood-built environment are associated with self-reported physical activity, but only a few studies have concentrated on device-measured physical activity in Latin America. This study examines the associations of perceived neighborhood-built environment attributes, device-measured sedentary time, and light-intensity and moderate-to-vigorous physical activity in adults from 8 Latin American countries. METHODS: Data from Estudio Latinoamericano de Nutrición y Salud adult study, an observational multicountry study (N=2,478), were analyzed in 2020. Data were collected between 2014 and 2015. Perceived neighborhood-built environment attributes were measured using the Neighbourhood Environment Walkability Survey. Sedentary time, light-intensity physical activity, and moderate-to-vigorous physical activity data were collected using accelerometers. RESULTS: No associations between perceived neighborhood-built environment attributes and sedentary time were found. Positive perceptions of walking/cycling facilities (ß=6.50, 95% CI=2.12, 10.39) were associated with more light-intensity physical activity. Perceptions of better aesthetics (Argentina) and better walking/cycling facilities (Brazil and Ecuador) were positively associated with light-intensity physical activity. Land use mix-diversity (ß=0.14, 95% CI=0.03, 0.25), walking/cycling facilities (ß=0.16, 95% CI=0.05, 0.27), aesthetics (ß=0.16, 95% CI=0.02, 0.30), and safety from traffic (ß=0.18, 95% CI=0.05, 0.24) were positively associated with moderate-to-vigorous physical activity. Land use mix-diversity, street connectivity, and safety from traffic were positively associated with moderate-to-vigorous physical activity in Venezuela. CONCLUSIONS: These findings have implications for policy recommendations, which can guide policies to promote physical activity in the region. Land use mix-diversity, walking/cycling facilities, aesthetics, and safety from traffic can maintain or increase the levels of light-intensity and moderate-to-vigorous physical activity among Latin American adults.

Association between Active Transportation and Public Transport with an Objectively Measured Meeting of Moderate-to-Vigorous Physical Activity and Daily Steps Guidelines in Adults by Sex from Eight Latin American Countries.

This study aimed to examine the associations between active transportation and public transport and the objectively measured meeting of moderate-to-vigorous physical activity (MVPA) and steps per day guidelines in adults by sex from eight Latin American countries. As part of the Latin American Study of Nutrition and Health (ELANS), data were collected from 2524 participants aged 18-65 years. MVPA and steps per day were evaluated using Actigraph GT3X accelerometers. The mode of transportation, its frequency and duration were collected using a self-reported questionnaire. The average time dedicated to active transportation was 12.8 min/day in men (IQR: 2.8-30.0) and 12.9 min/day in women (IQR: 4.3-25.7). A logistic regression analysis was conducted, showing that active transportation (≥10 min) was associated with higher odds of meeting MVPA guidelines (men: OR: 2.01; 95%CI: 1.58-2.54; women: OR: 1.57; 95%CI: 1.25-1.96). These results show a greater association when considering active transportation plus public transport (men: OR: 2.98; 95%CI: 2.31-3.91; women: OR: 1.82; 95%CI: 1.45-2.29). Active transportation plus public transport was positively associated with meeting steps per day guidelines only in men (OR: 1.55; 95%CI: 1.15-2.10). This study supports the suggestion that active transportation plus public transport is significantly associated with meeting the MVPA and daily steps recommendations.

Association between built environment and physical activity in Latin American countries: a multicentre cross-sectional study.

OBJECTIVE: To assess the association between the physical activity level and the built environment by accessibility, microinfrastructure and security in Latin America (LA). DESIGN: We conducted a multicentre cross-sectional study to collect physical activity and built environment data. The levels of physical activity were calculated through the International Physical Activity Questionnaire survey. Using the Neighbourhood Environment Walkability Scale-Abbreviated, characteristics of the built environment were measured through three domains: accessibility, microinfrastructure and security. To estimate the association of the built environment and physical activity, we used mixed effects logistic regression analysis. In addition, likelihood ratio test to account for clustered effect within countries and/or cities was used. SETTING: Eight countries in LA. PARTICIPANTS: Adults aged 15-65 years (n=9218) living in urban areas and consented to participate of the Latin American Study of Nutrition and Health. RESULTS: Most of the population in LA had access to a grocery store (97.2%), public transport stop (91.5%) and children's playground (81.6%). Metropolitan parks were more accessible in Ecuador (59.8%) and Colombia (59.2%) than in Venezuela (33.5%). Individuals located within 20 min of walking from sport facilities or children's playground areas were more likely to perform moderate-to-high physical activity OR 1.20 (95% CI 1.06 to 1.36) and OR 1.25 (95% CI 1.02 to 1.53), respectively. Only 14.5% of the population from the region considered that their neighbourhood had an adequate design for walking or cycling. Likewise, among adults living in LA, only 39.75% had the perception of living in a safe neighbourhood. CONCLUSIONS: This multicentre study shows that currently, LA built environment does not promote physical activity in the region. Our findings provide the rationale to push forward, at regional and national levels, policies and interventions that will help to achieve a safe, healthy and friendly built environment to encourage participation in active recreation and sports in leisure time. TRIAL REGISTRATION NUMBER: NCT02226627.

Principales alimentos con azúcares añadidos y su variación geográfica y sociodemográfica: estudio latinoamericano de nutrición y salud (ELANS) / Main foods with added sugars and their geographic and sociodemographic variation: Latin American study of nutrition and health (ELANS)

Diversos estudios epidemiológicos y de intervención apuntan a una asociación fuerte y consistente entre la ingesta excesiva de azúcares y el riesgo de desarrollar caries dentales y enfermedades crónicas no transmisibles. El objetivo fue describir los 10 principales alimentos que contribuyen a la ingesta de azúcares añadidos en muestras representativas de poblaciones urbanas de ocho países latinoamericanos, y considerar diferencias por país, sexo, nivel socioeconómico (NSE) y grupo de edad. Se realizó una encuesta transversal multinacional en hogares de Argentina, Brasil, Chile, Colombia, Costa Rica, Ecuador, Perú y Venezuela (N=9218; 15­65 años). La contribución porcentual a la ingesta total del nutriente sirvió para identificar los alimentos aportadores. Los datos se estratificaron por país, sexo, NSE y grupo de edad y se compararon los gramos por día. Excepto en Perú y en el grupo de 50 a 65 años, los refrescos figuraron como el principal contribuyente a la ingesta de azúcares añadidos. Las bebidas caseras y las industrializadas también destacaron. Argentina fue el país con mayor ingesta de azúcares añadidos aportados por bebidas industrializadas, y Chile el país con menor frecuencia de bebidas como fuentes. Entre los 10 contribuyentes, la ingesta de azúcares añadidos fue mayor en el sexo masculino, excepto para sacarosa y pasteles dulces. Mayores ingestas de azúcares provenientes del jugo de fruta natural y sacarosa fueron observadas en el NSE más bajo. Las mayores y menores ingestas en los grupos de edad cambian de acuerdo con la fuente alimentaria. En conclusión, las bebidas azucaradas fueron los principales contribuyentes a la ingesta de azúcares añadidos, y la ingesta varió según la ubicación geográfica y los factores sociodemográficos(AU)

This study aimed to describe the top 10 foods that contribute to added sugars intake in representative samples of urban populations in eight Latin American countries, and consider differences by country, sex, socioeconomic level (SEL), and age group. A household-based, multinational, cross-sectional survey was conducted in Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela (N=9218; 15­65 years). Contributors to added sugars were identified and listed based on the percentage of contribution to total intake of this nutrient. Data were stratified by country, sex, SEL, and age group, and the grams per day compared. Except in Peru and in the 50 to 65 years age group, soft drinks were the leading contributor to added sugar intake. Homemade beverages together industrialized beverages have been a prominent position on ranking. In general, the highest intake of added sugars by industrialized beverages was from Argentina, and the lowest frequency of beverages as sources of added sugars was observed in Chile. Among the top 10 contributors, male sex had highest added sugar intake, except for sucrose and sweet cakes. Higher intakes of sugars from natural fruit juice and sucrose were observed in the lower SEL. The highest and lowest intakes in the age groups change according to the food source. In conclusion, sugar-sweetened beverages were main contributors to added sugar intake, and the intake vary with geographical location and sociodemographic factors(AU)

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.

Is the perceived neighborhood built environment associated with domain-specific physical activity in Latin American adults? An eight-country observational study.

BACKGROUND: Characteristics of the neighborhood built environment are associated with physical activity (PA). However, few studies with representative samples have examined environmental correlates of domain-specific PA in Latin America. We examined the associations of the perceived neighborhood built environment with domain-specific PA in a large sample of adults from eight Latin American countries. METHODS: This study examined data from 8185 adults (aged 18-65 years) from eight Latin American countries. The Neighbourhood Environment Walkability Survey - Abbreviated (NEWS-A) scale was used to assess perceptions of land use mix-diversity, land use mix-access, street connectivity, walking/cycling facilities, aesthetics, safety from traffic, and safety from crime. Perceived proximity from home to public open spaces (metropolitan parks, playgrounds, public squares) and to shopping centers was also measured. Transport-related and leisure-time PA were assessed using the long form of the International Physical Activity Questionnaire. Both logistic and linear regression models were estimated on pooled data. RESULTS: Perceptions of higher land use mix-access (OR: 1.40; 95% CI: 1.22,1.61), the existence of many alternative routes in the neighbourhood (1.12; 1.04,1.20), slow speed of traffic (1.19; 1.03,1.35) and few drivers exceeding the speed limits (1.09; 1.03,1.15) were associated with greater odds of reporting at least 10 min/week of transport-related PA. Perceptions of higher levels of land use mix-diversity, better aesthetics and greater safety from crime, the presence of crosswalks and pedestrian signals, and greater proximity of shopping centers were associated with more min/week of transport-related PA. Perceptions of higher land use mix-diversity (1.12; 1.05,1.20), higher land use mix-access (1.27; 1.13,1.43), more walking/cycling facilities (1.18; 1.09,1.28), and better aesthetics (1.10; 1.02,1.18) were associated with greater odds of engaging in at least 10 min/week of leisure-time PA versus none. Perceptions of higher land use mix-diversity were associated with more min/week of leisure PA. CONCLUSIONS: Different perceived neighborhood built environment characteristics were associated with domain-specific PA among adults from Latin America countries. Interventions designed to modify perceptions of the neighbourhood built environment might influence initiation or maintenance of domain-specific PA. TRIAL REGISTRATION: ClinicalTrials. Gov NCT02226627 . Retrospectively registered on August 27, 2014.

Gingival Health Related to Intake of Different Types of Foods and Body Mass Index in 12-year-old Schoolchildren / Salud gingival y su relación con la ingesta de diferentes tipos de alimentos y el índice de masa corporal en escolares de 12 años

Abstract: Research on gingival health of 12-year-old schoolchildren in Costa Rica is scarce. Since nutrition is an integral component of oral health, this study aimed to determine gingival status of 12-year-olds at Carmen Lyra Public School, San José, Costa Rica, and correlate these variables with the frequency of intake of different types of food and body mass index (BMI (kg/m2)). Sixty-two 12-year-old schoolchildren were recruited. A periodontist assessed Plaque Index (Silness and Löe,1964), presence of calculus, and Gingival Index (Löe and Silness, 1967). Gingivitis was defined as the presence of bleeding on probing (BOP) on at least one site, and the extent was classified according to the percentage of teeth whose gingiva presented BOP limited: 25-49% of teeth tested; extensive >50% of teeth tested. A semi-quantified food consumption frequency questionnaire was administered. BMI was calculated for each participant. Overall Plaque Index was 1.18. Calculus was present on 40.40% of the sample, 19.4% had supragingival calculus and 21% had either supragingival/subgingival calculus or both. Presence of calculus was related with number of bleeding surfaces (p=0.030). Number of teeth with calculus was related to bleeding(p=0.029), and number of bleeding surfaces (p=0.009). Gingival Index was 0.97, mild gingivitis. Gingivitis was present on 96.8% of children examined. Limited gingivitis was present in 11.5% of children and extensive gingivitis in 88.5%. None of the variables measured differed by gender. No relationships were found between the consumption of starchy foods, animal and vegetable protein sources, fruit, vegetables, fast foods, sugar sweetened beverages and desserts with Plaque Index, calculus, Gingival Index, and BOP. Teeth calculus was related with being overweight (chi- square=0.038). BMI for males was 20.21 and females 20.11. BMI was not related to BOP or calculus. Within the limitations of this pilot study, we concluded the prevalence of gingivitis and calculus is high in the sample examined. A greater sample is needed to determine correlations between the frequency of foods evaluated and gingival health.

Resumen: La investigación sobre la salud gingival en escolares de 12 años en Costa Rica es escasa. Dado que la nutrición es un componente integral de la salud oral, este estudio tuvo como objetivo determinar el estado de salud gingival de los niños de 12 años de la escuela Carmen Lyra, San José, Costa Rica, y correlacionar estas variables con la frecuencia de ingesta de diferentes tipos de alimentos y el índice de masa corporal (IMC (kg/m2)). Sesenta y dos escolares de 12 años fueron reclutados. Una periodoncista calibrada, evaluó el índice de placa (Silness y Löe, 1964), la presencia de cálculo y el índice gingival (Löe y Silness, 1967). La gingivitis se definió como la presencia de sangrado al sondaje en al menos un sitio. La extensión se clasificó de acuerdo con el porcentaje de dientes que presentaba sangrado al sondaje. Entre un 25-49% de los dientes con sangrado al sondaje, gingivitis limitada y extensiva, si presentaba más del 50% de dientes con sangrado al sondaje. Se administró un cuestionario de frecuencia de consumo de alimentos. El IMC se calculó para cada participante. El índice de placa fue de 1,18. El cálculo estuvo presente en el 40.40% de la muestra, el 19.4% tenía cálculo supragingival y el 21% tenía cálculo supragingival / subgingival o ambos. La presencia de cálculo se relacionó con el número de superficies sangrantes (p=0.030). El número de dientes con cálculo, se relacionó con el sangrado (p=0.029) y el número de superficies sangrantes (p=0.009). El índice gingival fue de 0.97, gingivitis leve. La gingivitis estuvo presente en el 96,8% de los niños examinados. La gingivitis limitada estuvo presente en el 11.5% de los niños y la gingivitis extensa en el 88.5%. Ninguna de las variables evaluadas difirió por género. No se encontraron relaciones entre el consumo de harinas, fuentes de proteínas animales y vegetales, frutas, verduras, comidas rápidas, bebidas azucaradas y postres con el índice de placa, cálculo, índice gingival y sangrado al sondaje. El cálculo se relacionó con el sobrepeso (chi-cuadrado=0.038). El IMC para los hombres fue 20.21 y las mujeres 20.11. El IMC no estaba relacionado con el sangrado al sondaje o cálculo. Dentro de las limitaciones de este estudio piloto, concluimos que la prevalencia de gingivitis y cálculo es alta en la muestra examinada. Se necesita una muestra mayor para determinar las correlaciones entre la ingesta de los diferentes tipos de alimentos evaluados y la salud gingival.

Comparison of self-report versus accelerometer - measured physical activity and sedentary behaviors and their association with body composition in Latin American countries.

BACKGROUND: Most population-based studies from Latin America have used questionnaires to measure physical activity (PA) and sedentary behaviors (SB). Low reliability and validity of the questionnaires has limited the capacity to examine associations between PA and health. The purpose of this study was to compare self-reported and accelerometer-measured PA and SB and their associations with body composition in Latin American countries. METHODS: Data were obtained from the Latin American Study of Nutrition and Health (aged 15-65 years), collected from September 2014 to February 2015. PA and SB were assessed using the International Physical Activity Questionnaire (long version) and the Actigraph GT3X+ accelerometer. Outcomes of interest included: body mass index (BMI), waist (WC) and neck circumference (NC). We used the Pearson and intraclass correlation coefficient, Bland-Altman plots, and multilevel linear regression models. RESULTS: Mean moderate-to-vigorous physical activity (MVPA) by accelerometer and IPAQ were 34.4 min/day (95% CI: 33.4 to 35.4) and 45.6 min/day (95% CI: 43.2 to 48.1), respectively. For SB (accelerometer and IPAQ) the means were 573.1 (95% CI: 568.2 to 577.9) and 231.9 min/day (95% CI: 225.5 to 238.3). MVPA, measured by the accelerometer was negatively associated with BMI (ß = -1.95; 95% CI: -2.83 to -1.08), WC (ß = -5.04; 95% CI: -7.18 to -2.89) and NC (ß = -1.21; 95% CI: -1.79 to -0.63). The MVPA estimated through IPAQ was not significantly associated with any of the three outcome variables. SB, measured by the accelerometer, was positively associated with BMI (ß = 0.26; 95% CI: 0.08 to 0.44) and WC (ß = 0.48; 95% CI: 0.13 to 0.91). SB estimated through IPAQ was positively associated with NC only. CONCLUSIONS: Low correlation coefficients were observed for accelerometer-derived and IPAQ-reported estimates of PA and SB. Caution is advised when making comparisons between accelerometer-measured and self-reported PA and SB. Further, studies examining associations between movement and health should discuss the impact of PA and SB measurement methodology on the results obtained.

Methodological design for the assessment of physical activity and sedentary time in eight Latin American countries - The ELANS study.

Worldwide studies of physical activity and sedentary time have historically under-represented low- and middle-income countries due to the lack of surveillance data. The purpose of this paper is to describe the methods and procedures used for the assessment of physical activity and sedentary time in the Latin American Study of Nutrition and Health (Estudio Latinoamericano de Nutrición y Salud; ELANS). ELANS is a multicentre, cross-sectional and surveillance study of a nationally representative sample from eight Latin American countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela. Two instruments were used to evaluate different domains and intensities of physical activity and sedentary time: self-reported data and a triaxial accelerometer (model GT3X+). ELANS will generate important self-reported and objective information for the Latin American populations, namely:•evidence on the distribution of physical activity and sedentary time across population subgroups (e.g. sex, age, socioeconomic- and educational level). These sets of information will increase the evidence base and can help to inform future intervention strategies in Latin America;•self-reported and objective information on physical activity and sedentary time.

Anthropometry, dietary intake, physical activity and sitting time patterns in adolescents aged 15-17 years: an international comparison in eight Latin 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 < 0.001). In relation to macronutrient intake for boys and girls, respectively, the average intake (expressed as percentage of total energy) was 15.0 and 14.9% for protein; 55.4 and 54.9% for carbohydrates; 14.1 and 14.5% for added sugar; 29.5 and 30.1% for total fat; and 9.6 and 9.9% for saturated fat (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 < 0.001). Median levels of vigorous-intensity PA and total PA were significantly higher for boys than for girls (p < 0.05 for both outcomes); whereas levels of ST were similar (273.7 versus 220.0 min/day for boys and girls, respectively; 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. TRIAL REGISTRATION: Clinical Trials NCT02226627. Retrospectively registered on August 27, 2014.

Socio-demographic patterning of objectively measured physical activity and sedentary behaviours in eight Latin American countries: Findings from the ELANS study.

Physical activity (PA) and sedentary behaviours (SB) are two independent risk factors for non-communicable diseases. However, there is a lack of objectively measured information on PA and SB in low- and middle-income countries. The aim of this study was to use objective data to characterise socio-demographic patterns of PA and SB in eight Latin American countries. 2732 participants (aged 15-65 years) from the Latin American Study of Nutrition and Health (ELANS) were included. PA and SB data were collected using accelerometers. Overall and country-specific average levels of time spent in PA and SB were compared by sex, age, socioeconomic and education level. Overall, the mean time spent in SB was 571.6 min/day, ranging from 553.8 min/day in Chile to 596.7 min/day in Peru. Average levels of light, moderate-to-vigorous physical activity (MVPA) and total PA were 311.1 min/day (95% CI: 307.7; 314.5), 34.9 min/day (95% CI: 34.0; 35.9) and 7531.2 MET-min/week (95% CI: 7450.4; 7611.9), respectively. MVPA and total PA were higher in men than women. The prevalence of physical inactivity was 40.6%, ranging from 26.9% (Chile) to 47% (Costa Rica and Venezuela). Women were more physically inactive than men (47.7% versus 33.0%). SB levels were highest among those with higher education; PA graded positively with socioeconomic level. Our findings can inform the planning of health policies and programmes designed to reduce levels of physical inactivity, as well as inform the local and cultural adaptation of these policies and programmes for implementation in Latin America. Highlights Worldwide studies of physical activity (PA) and sedentary behaviours (SB) have historically under-represented Latin American countries due to the lack of surveillance data. Across eight Latin American countries, the ELANS study collected data on PA and SB using an objective method (accelerometers) which we have analysed to quantify and characterise socio-demographic patterns. Over four-in-ten participants were physically inactive (40.6%); with a gender gap (47.7% women; 33.0% men); and striking differences between countries (47% Costa Rica and Venezuela; 26.9% Chile). In all countries, levels of moderate-to-vigorous physical activity (MVPA) were lowest, and levels of SB were highest, among participants in the higher education groups. Our findings on the unequal distribution of PA and SB increases the evidence base and can help to inform future intervention strategies in Latin America.

Original research Socio-demographic patterning of self-reported physical activity and sitting time in Latin American countries: findings from ELANS.

BACKGROUND: Low levels of physical activity (PA) and prolonged sitting time (ST) increase the risk of non-communicable diseases and mortality, and can be influenced by socio-demographic characteristics. The aim of this study was to use self-report data to characterise socio-demographic patterns of PA and ST in eight Latin American countries. METHODS: Data were obtained from the Latin American Study of Nutrition and Health (ELANS), a household population-based, multi-national, cross-sectional survey (n = 9218, aged 15-65 years), collected from September 2014 to February 2015. Transport and leisure PA and ST were assessed using the International Physical Activity Questionnaire-long version. Overall and country-specific mean and median levels of time spent in transport and leisure PA and ST were compared by sex, age, socioeconomic and education level. RESULTS: Mean levels of transport and leisure PA were 220.3 min/week (ranging from 177.6 min/week in Venezuela to 275.3 min/week in Costa Rica) and 316.4 min/week (ranging from 272.1 min/week in Peru to 401.4 min/week in Ecuador). Transport and leisure PA were higher (p < 0.005) in men than women with mean differences of 58.0 and 34.0 min/week. The mean and median for transport PA were similar across age groups (15-29 years: mean 215.5 and median 120 min/week; 30-59 years: mean 225.0 and median 120 min/week; ≥60 years: mean 212.0 and median 120 min/week). The median time spent in transport and leisure PA between three strata of socioeconomic and education levels were similar. The prevalence of not meeting PA recommendations were 69.9% (95% CI: 68.9-70.8) for transport and 72.8% (95% CI: 72.0-73.7) for leisure. Men, younger people (15-29 years), individuals with higher socioeconomic and education levels spent significantly (p < 0.001) more time sitting than women, older people (30-59 years and ≥ 60 years) and those in the middle and low socioeconomic and education groups, respectively. CONCLUSIONS: Transport and leisure PA and ST range widely by country, sex, and age group in Latin America. Programs for promoting leisure and transport PA and reducing ST in Latin America should consider these differences by age and gender and between countries. TRIAL REGISTRATION: ClinicalTrials.Gov NCT02226627. Retrospectively registered on August 27, 2014.

Hábitos alimentarios de la población urbana costarricense / Food habits of urban Costa Rican population

Resumen Objetivo: Es sabido que los malos hábitos alimentarios contribuyen a la aparición de enfermedades crónicas, como la obesidad y la diabetes mellitus, sin embargo, no existe información actualizada respecto a la alimentación de la población urbana en Costa Rica. El objetivo de este estudio fue analizar los hábitos alimentarios de la población costarricense incluida en el Estudio Latinoamericano de Nutrición y Salud (ELANS). Métodos: Se incluyó una muestra de 798 participantes entre 15 y 65 años del área urbana de Costa Rica. Se determinó el consumo diario promedio de alimentos y la frecuencia por tiempo de comida de acuerdo al sexo, el grupo de edad y el nivel socioeconómico. Resultados: Los grupos de alimentos más consumidos en el desayuno fueron café y panes, en la merienda de la mañana frutas, en la merienda de la tarde café y panes y en el almuerzo y la cena arroz blanco, bebidas con azúcar y leguminosas. Se determinaron algunas diferencias en los alimentos incluidos en los diferentes tiempos de comida entre hombres y mujeres, según el grupo de edad y el nivel socioeconómico de los participantes. Conclusión: Los hábitos alimentarios de la población costarricense se caracterizaron por ser poco variados, y poseer un alto consumo de café, panes, arroz blanco y bebidas con azúcar y un consumo insuficiente de leguminosas, frutas, vegetales no harinosos y pescado. Esta información puede ser utilizada para la implementación de programas nutricionales tendientes a mejor los hábitos de alimentación en el país.

Abstract Objective: It is known that poor eating habits contribute to the onset of chronic diseases, such as obesity and diabetes mellitus, among others, however there is no recent information regarding the diet of the urban population in Costa Rica. The objective of this study was to analyze the dietary habits of the Costa Rican population included in the Latin American Nutrition and Health Study (ELANS). Methods: A sample of 798 participants between 15 and 65 years of urban areas of Costa Rica was included. The average daily consumption of food and the frequency per meal time were determined according to sex, age group and socioeconomic level. Results: The most consumed food groups at breakfast were coffee and bread, in the morning snack fruits, in the afternoon snack coffee and bread and at lunch and dinner white rice, sweetened beverages and legumes. Some differences were determined in the foods included in the different meal times between according to sex, age group and socioeconomic status of the participants. Conclusion: The dietary habits of the Costa Rican population were characterized by having little variety, a high consumption of coffee, bread, white rice and sweetened beverages and insufficient consumption of legumes, fruits, non-starchy vegetables and fish. This information can be used for the implementation of nutritional programs aimed at improving eating habits in the country.