A Landscape of Micronutrient Dietary Intake by 15- to 65-Years-Old Urban Population in 8 Latin American Countries: Results From the Latin American Study of Health and Nutrition.

BACKGROUND: Latin American countries have shifted from traditional diets rich in micronutrients to a Westernized diet rich in high energy-dense foods and low in micronutrients. OBJECTIVE: This study aimed to determine the prevalence of adequate micronutrient intakes in urban populations of 8 Latin American countries. METHOD: Micronutrient dietary intake data were collected from September 2014 to August 2015 from 9216 men and women aged 15.0 to 65.0 years living in urban populations of 8 Latin American countries. Dietary intake was collected using two 24-hour recalls on nonconsecutive days. Micronutrient adequacy of intake was calculated using the Estimated Average Requirement cut-off method. RESULTS: In general terms, the prevalence of inadequate intake of thiamine, riboflavin, niacin, folate, cobalamin, iron, phosphorus, copper, and selenium ranged from 0.4% to 9.9%. In contrast, the prevalence of inadequacy of pyridoxine, zinc, vitamin C, and vitamin A ranged from 15.7% to 51.5%. The nutrients with a critical prevalence of inadequacy were magnesium (80.5%), calcium (85.7%), and vitamin D (98.2%). The highest prevalence of inadequate intakes was observed in the low educational level, participants with overweight/obesity, in men, and varies according to socioeconomic status. CONCLUSIONS: There is an urgent need to define direct regional actions and strategies in Latin America aimed at improving micronutrient adequacy, either through staple food fortification programs, agronomic biofortification, or food policies that facilitate economic access to micronutrient-rich foods.

Plain language titleDescription of the Vitamin and Mineral Consumption Status in Urban Cities of Latin America: Results of the Latin American Health and Nutrition Study.Plain language summaryVitamins and minerals are essential for maintaining good health. However, traditional Latin American diets are changing to include foods that have a lot of sugar and fat but fewer vitamins and minerals. This study was designed to analyze the consumption of these nutrients in urban cities of 8 Latin American countries. We collected food consumption information from September 2014 to August 2015 from 9216 men and women between 15 and 65 years old using a method called 24-hour recall. To find out if participants were consuming the necessary daily amounts of vitamins and minerals, intakes were compared with the daily recommended amounts suggested by the Institutes of Medicine of the United States. We found that Latin American urban populations consume fewer vitamins and minerals than recommended. In some cases, few people do not consume the required amounts of vitamins and minerals, but in other cases, many do not. For example, few do not consume enough thiamine, riboflavin, niacin, folate, cobalamin, iron, phosphorus, copper, and selenium. However an intermediate number of people do not consume enough pyridoxine and zinc, a high number consume little vitamin C and vitamin A, and many people consume very little magnesium, calcium, and vitamin D. We found that the people who consume fewer vitamins and minerals are mostly males, overweight/obese, have lower education and varies according to their financial resources. A deficient intake of vitamins and minerals showed up in most age groups, from adolescence to adulthood. To improve vitamins and minerals intake, it is important that some foods that are frequently eaten are fortified or that the price of foods that are high in vitamins and minerals is lowered.

Biofortified Yellow-Fleshed Potatoes Provide More Absorbable Zinc than a Commonly Consumed Variety: A Randomized Trial Using Stable Isotopes in Women in the Peruvian Highlands.

BACKGROUND: Zinc-biofortified potatoes have considerable potential to reduce zinc deficiency because of their low levels of phytate, an inhibitor of zinc absorption, and their high consumption, especially in the Andean region of Peru. OBJECTIVES: The purpose of this study was to measure fractional and total zinc absorption from a test meal of biofortified compared with regular potatoes. METHODS: We undertook a single-blinded randomized crossover study (using 67Zn and 70Zn stable isotopes) in which 37 women consumed 500-g biofortified or regular potatoes twice a day. Urine samples were collected to determine fractional and total zinc absorption. RESULTS: The zinc content of the biofortified potato and regular potato was 0.48 (standard deviation [SD]: 0.02) and 0.32 (SD: 0.03) mg/100 g fresh weight, respectively. Mean fractional zinc absorption (FZA) from the biofortified potatoes was lower than from the regular potatoes, 20.8% (SD: 5.4%) and 25.5% (SD: 7.0%), respectively (P < 0.01). However, total zinc absorbed was significantly higher (0.49; SD: 0.13 and 0.40; SD: 0.11 mg/500 g, P < 0.01, respectively). CONCLUSIONS: The results of this study demonstrate that biofortified potatoes provide more absorbable zinc than regular potatoes. Zinc-biofortified potatoes could contribute toward reducing zinc deficiency in populations where potatoes are a staple food. This trial was registered at clinicaltrials.gov as NCT05154500.

Alcohol Contribution to Total Energy Intake and Its Association with Nutritional Status and Diet Quality in Eight Latina American Countries.

Alcohol consumption is a modifiable risk factor for non-communicable diseases. This study aimed to characterize alcohol consumers at the nutritional, anthropometric, and sociodemographic levels. Data from 9218 participants from Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela participating in "Latin American Health and Nutrition Study (ELANS)", a multi-country, population-based study, were used. Dietary intake was collected through two, 24 h recalls. Participants were classified into consumers (n = 1073) and non-alcohol consumers (n = 8145) using a cut-off criterium of ≥15 g/day of alcohol consumption calculated from the estimation of their usual daily intake. Among alcohol consumers, the mean alcohol consumption was 69.22 ± 2.18 grams (4.6. beverages/day), contributing to 484.62 kcal, which corresponded to 16.86% of the total energy intake. We found that the risk of alcohol consumption was higher in young and middle-aged men from low and middle socioeconomic status. Argentine, Brazil, and Chile had the highest percentage of consumers, while Ecuador showed the highest alcohol consumption. Alcohol drinkers were characterized by having higher body weight and wider neck, waist, hips circumferences. Alcohol drinkers had a higher energy intake, with macronutrients providing relatively less energy at the expense of the energy derived from alcohol. Alcohol drinkers showed lower and higher consumptions of healthy and unhealthy food groups, respectively. In addition, adequacy ratios for all micronutrients assessed were lower in alcohol consumers. All these deleterious effects of alcohol on nutritional and anthropometric parameters increased with the number of alcoholic beverages consumed daily. Altogether, these findings suggest that limiting alcohol consumption can contribute to reducing the risk of obesity, metabolic syndrome, and diet-related diseases.

Correlation between Neck Circumference and Other Anthropometric Measurements in Eight Latin American Countries. Results from ELANS Study.

Neck circumference (NC) is being used to identify the risk of chronic diseases. There is a high prevalence of overweight and obesity in Latin America, and neck circumference is a simple and practical measurement to assess this, especially in primary health centers. We analyzed the correlation between the NC anthropometric indicator and other anthropometric measurements such as BMI and waist circumference (WC) in eight Latin American cities. We applied Pearson's correlation to identify the correlate NC with the other anthropometric variables stratified by sex; the sensitivity (Se) and specificity (Sp) by sex were evaluated according to the cut-off established with the Youden Index. The strongest correlations between NC and WC were found when stratified by sex (women: r = 0.71; men: r = 0.69, respectively) followed by the correlation between NC and BMI (r = 0.65, both sex). NC cut-off points of 39.0 cm in men and 32.9 cm in women identified those individuals with an increased WC and 39.8 and 33.7 cm, respectively, for a substantial increase in WC. For BMI ≥ 25.0 kg/m2 for men, the cut-off point was 37.5 cm, and for women, it was 33.1 cm, and for BMI ≥ 30 kg/m2, the cut-off points were 39.2 and 34.2 cm, for men and women, respectively. Conclusion: NC proved to be a useful, practical, and inexpensive tool that can be used to identify, evaluate, and monitor overweight and obese individuals.

Seguridad alimentaria y desnutrición crónica en niños menores de cinco años del Valle del Río Apurimac Ene y Mantaro / No disponible

No disponible

Preferencia de etiquetado nutricional frontal: octógono frente a semáforo GDA en mercados de Lima, Perú / Preferred nutrition facts labeling: Octagon versus GDA semaphore in markets in Lima, Peru

Objetivo: Evaluar la preferencia de dos diseños de etiquetado frontal en productos industrializados (octógono vs. semáforo-GDA). Material y métodos: Estudio descriptivo transversal realizado con usuarios de mercados de Lima Metropolitana (Chorrillos, Breña, La Victoria y La Molina). Se utilizó una encuesta previamente validada que constó de cuatro preguntas basadas en láminas con cada etiquetado nutricional: ¿cuál de los productos le parece más saludable?", "¿por qué escogió este?", "¿cuál de las dos etiquetas le parece más fácil de entender?" y "¿cuál de los dos etiquetados le gusta más?". Los datos se presentaron en porcentajes y medianas (rango intercuartilar) y las diferencias entre los grupos se evaluaron con la prueba exacta de Fisher (datos categóricos). Resultados: Se encuestaron 93 usuarios, el semáforo-GDA fue elegido como el etiquetado más saludable (74,3%) y el que más les gustó (69,9%); sin embargo, el octógono fue el que les pareció más fácil de entender (58,4%). La mayoría de los usuarios consideró el semáforo como más saludable debido a que "tienen más símbolos verdes en la etiqueta", lo que podría confundir la finalidad de la advertencia nutricional, minimizando el impacto del símbolo rojo y/o amarillo por presentarse en menor cantidad. Conclusiones: Los participantes mencionaron que el octógono era más sencillo y fácil de leer; los símbolos verdes del semáforo-GDA podrían influir en que el producto se perciba como más saludable.

Objective: To determine preferences when choosing two designs for nutrition facts labeling in food products (octagon vs. GDA semaphore). Material and methods: This is a cross-sectional descriptive study that was performed in clients form markets in some Lima districts (Chorrillos, Breña, La Victoria, and La Molina). A previously validated questionnaire was used, which included 4 questions based in pictures showing options for nutrition facts labeling: Which one of these products do you consider is the healthiest?", "Why did you choose this one?", "Which one of these labels do you consider is the easiest to understand?", and "Which one of the two labels do you like the most?". Data were presented as percentages and medians (interquartile ranges), and differences between groups were assessed using Fisher's exact test (categorical data). Results: Ninety-three persons were interviewed, and the GDA semaphore was chosen as the healthiest nutrition facts labeling (74.3%), and it also was the most liked option. However, the octagon was deemed as the easiest to understand (58.4%). Most users considered the GDA semaphore as the healthiest choice, since "it shows more green signs on the label", which may confound the purpose of this nutritional warning system, minimizing the impact of the red and/or yellow symbols because they may be less frequently present. Conclusions: The interviewed persons mentioned that the octagon was easier to read and understand; the green symbols on the GDA semaphore may influence in considering the product as a healthier choice.

Satisfacción materna de la consejería en suplementación infantil con hierro realizada por el personal de salud / Maternal satisfaction about the counseling in iron supplementation by health personnel

Introducción. El momento de la consejería respecto a la suplementación es importante, porque permite transmitir mensajes claves para la prevención o tratamiento de la anemia, que posteriormente llegarían a acuerdos en beneficio de la salud del niño. Sin embargo, existe poca información sobre la satisfacción materna durante la consejería. El objetivo del presente estudio fue determinar el nivel de satisfacción de la madre respecto a consejería brindada por personal de salud que brinda la suplementación. Métodos. Se realizó un estudio cuantitativo, descriptivo y transversal con muestreo no probabilístico en el distrito de Puente Piedra, Lima - Perú, en el año 2016. Participaron 95 madres con niños menores de tres años. Se evaluaron tres dimensiones de satisfacción (técnico-científico, interpersonal y confort/soporte comunicacional) con una encuesta estructurada, validada por expertos. Las respuestas se calificaron entre 0 a 3 puntos (sí: 3, regularmente: 2, mínimamente: 1 y no: 0). El nivel de satisfacción se clasificó, sumando el puntaje de cada respuesta, como: bajo, medio, alto (0-7, 8-14, 15-21 puntos; respectivamente). Los resultados se presentan en frecuencias y porcentajes (variables cualitativas), y mediana y rango intercuartil (variables cuantitativas). Resultados. La satisfacción general de las madres fue media (45%), respecto a sus dimensiones la técnico-científico fue baja (57%), y la interpersonal y confort/soporte comunicacional fue media (40% y 43%, respectivamente). Conclusión. Existe una satisfacción media y baja en la consejería consejería brindada por personal de salud que brinda la suplementación.

Introduction. The moment of counseling regarding supplementation is important, because it allows agreements for the benefit of the child’s health, which would later reach agreements that benefit the child's health. However, there is little information about maternal satisfaction during counseling. The objective of the present study was to determine the level of satisfaction of the mother regarding counseling provided by health personnel who provide the supplementation. Methods. A quantitative, descriptive and cross-sectional study was carried out with non-probabilistic sampling in Puente Piedra district, Lima - Peru, in 2016. 95 mothers with children under three years of age participated. Three dimensions of satisfaction (technical-scientific, interpersonal and comfort / communication support) were evaluated with a structured survey, validated by experts. The answers were rated between 0 and 3 points (yes: 3, regularly: 2, minimally: 1 and not: 0). The level of satisfaction was classified, adding the score of each answer, as: low, medium, high (0-7, 8-14, 15-21 points, respectively). The results are presented in frequencies and percentages (qualitative variables), and median and interquartile range (quantitative variables). Results The general satisfaction of the mothers was medium (45%), regarding its dimensions the technical-scientific was low (57%), and in the interpersonal and comfort / communication support dimensions it was medium (40% and 43%, respectively). Conclusion. There is a medium and low satisfaction in the counseling provided by health personnel who provide supplementation.

[Strategies used by mothers to feed preschool-aged children in a marginal urban area of Lima, Peru]. / Estrategias usadas para alimentar a niños preescolares por madres de una zona urbano marginal de Lima, Perú.

This study explored the strategies for feeding preschool-aged children used by mothers in a marginal urban area of Lima. This qualitative, grounded theory method-based study included 30 mothers who participated in 1 of 4 focus group sessions and/or 1 of 11 in-depth interviews. Previously recorded in-depth interviews and focus groups were transcribed to identify the final issues. The mothers' ages ranged from 22 to 42 years, and 60% had not completed a basic education. The children's ages ranged from 36 to 66 months. The following positive strategies were identified: a) feeding when hungry and b) management of feeding opportunities. The following negative strategies were also identified: a) forcing a child to eat and b) use of punishment or reward to encourage complete food consumption. In conclusion, the mothers in our study cohort employed both positive and negative strategies to encourage food consumption in their children.

Estrategias usadas para alimentar a niños preescolares por madres de una zona urbano marginal de Lima, Perú / Strategies used by mothers to feed preschool-aged children in a marginal urban area of Lima, Peru

RESUMEN Se exploraron las estrategias que usan las madres de una zona urbano-marginal de Lima, para alimentar a sus hijos de 36 a 66 meses de edad. Estudio cualitativo con método de teoría fundamentada realizado en 30 madres que participaron en 1 de 4 grupos focales y/o 1 de 11 entrevistas a profundidad. Las entrevistas a profundidad y grupos focales, previamente grabadas, fueron transcritas para la identificación de los temas finales. La edad de las madres estuvo entre los 22 y 42 años; 60% de ellas con educación básica incompleta. Se encontraron como estrategias positivas dar de comer cuando tiene apetito y el manejo de oportunidades para dar de comer. Como estrategias negativas se encontró presionar para que coma y uso de castigo o premio para que termine su comida. Se concluye que las madres utilizaron estrategias positivas y negativas con la finalidad de que sus hijos coman toda su comida servida.

ABSTRACT This study explored the strategies for feeding preschool-aged children used by mothers in a marginal urban area of Lima. This qualitative, grounded theory method-based study included 30 mothers who participated in 1 of 4 focus group sessions and/or 1 of 11 in-depth interviews. Previously recorded in-depth interviews and focus groups were transcribed to identify the final issues. The mothers' ages ranged from 22 to 42 years, and 60% had not completed a basic education. The children's ages ranged from 36 to 66 months. The following positive strategies were identified: a) feeding when hungry and b) management of feeding opportunities. The following negative strategies were also identified: a) forcing a child to eat and b) use of punishment or reward to encourage complete food consumption. In conclusion, the mothers in our study cohort employed both positive and negative strategies to encourage food consumption in their children.