Dietary intake patterns, nutrient adequacy and associated factors in a multi-ethnic Caribbean population.

Background: Diet is a significant contributor to health and wellbeing of individuals. Aim: In this study we investigated patterns of dietary intakes, levels of nutrient inadequacies and associated sociodemographic, anthropometric and lifestyle factors among adults in Trinidad and Tobago. Method: The study was cross-sectional in nature. A convenience sample of 11783 persons from districts throughout Trinidad and Tobago completed a self-administered questionnaire comprising socio-demographic and lifestyle items. Anthropometry was self-reported with 15% of participants having measurements done according to recommended procedures. Dietary patterns were determined by principal component analysis (PCA) while nutrient intakes and adequacy were assessed using the NutriGenie 7.0 software and nutrient adequacy ratio (MAR) respectively. Foods were categorised as unprocessed/minimally processed and processed/ultra-processed. The University of The West Indies Ethics Committee approved the study. Results: Approximately 72.5% of participants met the Goldberg criteria for plausible reporting. The three predominant dietary patterns 'Typical', 'Fruits and Vegetables', and 'High Fat' explained 45% of the total variance in foods consumed. Processed/ultra-processed foods accounted for most of the energy (80%) and nutrients consumed. Nutrient inadequacies were observed for potassium, vitamins B12, D, E, K, fibre, magnesium; and iron among females. The mean adequacy ratio (MAR) for participants was 67%. MAR was positively associated with predominant dietary patterns independent of socioe demographic and lifestyle factors (p < 0.001). Conclusion: Irrespective of their nature, the predominant dietary pattern was associated with nutrient adequacy among participants. Reducing the risk of inadequate nutrient intakes may be addressed by increasing availability, access and consumption of appropriate sources of these micronutrients.

Socio-demographic factors in relation to habitual sodium and potassium intakes among adults in Trinidad and Tobago.

BACKGROUND: Approximately one-third of adults in Trinidad and Tobago have high blood pressure (hypertension). Excessive consumption of sodium (Na+) is a known risk factor for hypertension. AIM: We investigated Na+ and potassium (K+) intakes and their correlates in a multi-ethnic Caribbean population. METHOD: Volunteers completed a self-administered questionnaire comprising socio-demographic items, physical activity (PA) and a semiquantitative food frequency questionnaire. Foods eaten were classified by level of processing using the NOVA classification system and analysed for Na+ and K+ levels using appropriate dietary analysis software. The study was approved by the University of the West Indies at Saint Augustine Ethics Committee. RESULTS: 11,783 adults participated in the study. Approximately 83.2% of total calories, 79% of Na+ and 40% of K+ was derived from the consumption of highly processed foods. Median daily Na+ and K+ intakes were 2759 mg and 2853 mg, respectively. Na+ intakes showed significant nonlinear increases with age (p < 0.001) and body mass index (BMI) (p < 0.001), and non-linear decreases with educational attainment (p < 0.001). K+ intakes showed significant nonlinear decreases with age (p < 0.001) and BMI (p < 0.001), and linear increases with educational attainment (p < 0.001). Males had higher intakes of Na+ and K+ than females. Na+: K+ was lower among persons participating in moderate to high intensity PA ≥ 150 minutes/week compared to those participating in such activities < 150 minutes/week. CONCLUSION: Socio-demographic factors were significantly correlated with Na+ and K+ intakes among participants and must be considered in strategies aimed at achieving healthy intakes of these nutrients.

Accuracy of resting metabolic rate prediction equations among healthy adults in Trinidad and Tobago.

BACKGROUND: Over 50% of adults in Latin America and the Caribbean have a body mass index (BMI) ≥ 25 suggesting excess energy intakes relative to energy expenditure. Accurate estimation of resting metabolic rate (RMR), the largest component of total energy requirements, is crucial to strategies aimed at reducing the prevalence and incidence of overweight and obesity. AIM: We evaluated the accuracies of established and locally developed RMR prediction equations (RMRP) among adults. METHODS: Four hundred adult volunteers ages 20 to 65 years had RMR measured (RMRM) with a MedGem® indirect calorimeter according to recommended procedures. RMRP were compared to RMRM with values ± 10% of RMRM deemed accurate. Anthropometry was measured using standard procedure. Linear regression with bootstrap analyses was used to develop local RMRP equations based on anthropometric and demographic variables. The University of the West Indies Ethics Committee approved the study. RESULTS: Males had higher mean absolute RMR (p < 0.001) but similar mean age-adjusted measured RMR per kg of body (20.9 vs. 21.5 kcals/day; p = 0.1) to females. The top performing established anthropometry-based RMRP among participants by sex, physical activity (PA) level and BMI status subgroups were Mifflin-St Jeor, Owen, Korth, Harris-Benedict, and Livingston, while Johnstone, Cunningham, Müller (body composition (BC)), Katch and McArdle, Mifflin-St Jeor (BC) were the most accurate BC-based RMRP. Locally developed RMRP had accuracies comparable to their top-ranked established RMRP counterparts. CONCLUSIONS: Accuracies of established RMRP depended on habitual PA level, BMI status, BC and sex. Furthermore, locally developed RMRP provide useful alternatives to established RMRP.

The effects of a school-based intervention programme on dietary intakes and physical activity among primary-school children in Trinidad and Tobago.

OBJECTIVE: Childhood obesity is increasingly being recognized as a major public health problem in the Caribbean. The objective of the present study was to evaluate the effectiveness of a short-term, school-based, multi-component education intervention on improving the knowledge, attitudes and behaviour of primary-school children towards better dietary and activity habits. DESIGN: The study was a randomized, controlled, school-based nutrition education and physical activity intervention. Participating schools were randomly assigned to the intervention (IVG) and non-intervention (NIVG) groups. SETTING: All primary schools in Sangre Grande, north-east Trinidad. SUBJECTS: Five hundred and seventy-nine pupils in their sixth year of primary-school education were enrolled from twelve schools in Sangre Grande, north-east Trinidad. RESULTS: Approximately 23 % of participants had BMI >or= 85th percentile of the Centers for Disease Control and Prevention age- and gender-specific cut-off values. In multivariate regression equations controlling for age, gender, BMI and baseline value, intervention was associated with lower intake levels of fried foods, snack foods high in fat, sugar and salt (HFSS) and sodas (P < 0.05). In similar analyses, intervention was associated with higher knowledge scores (P < 0.01). Intervention was not significantly associated with physical activity and Children's Eating Attitude Test-26 (ChEAT26) scores after controlling for age, gender, BMI and the relevant baseline values. CONCLUSIONS: The intervention was associated with lower intake levels of fried foods, HFSS foods, sodas and higher knowledge scores independent of age, gender, BMI, ethnicity and the appropriate baseline value. Finally, the intervention was not associated with changes in physical activity behaviours in multivariate analyses.