COVID-19, body weight and the neighbourhood: food system dimensions and consumption associated with changes in body weight of Peruvian adults during first wave lockdowns.

Objective: The objective of this study is to assess changes in the dimensions of the food system and consumption associated with body weight variations during the first month's lockdown in Peruvian adults in Metropolitan Lima. Methods: A cross-sectional study conducted during the first months of lockdowns in Peru. 694 adults completed a web-based survey about changes experienced in the process of acquiring food during lockdown, changes in their intake and self-perceived body weight. A multinomial logistic regression analysis was conducted to evaluate the factors associated with changes in body weight. Results: Weight gain was perceived in 38% of the participants and 22.8% perceived weight loss. 39.2% did not perceive changes in their weight. Risk factors for body weight gain were increased alcohol consumption (OR=4.510, 95% CI 1.764 to 11.531) and decreased fruit consumption (OR=2.129, 95% CI 1.290 to 3.515), while decreasing cereal intake (OR=0.498, 95% CI 0.269 to 0.922) and choosing nutritious food as a driver for purchase (OR=0.512, 95% CI 0.320 to 0.821) were found to be protective against gaining weight. Decreasing food intake during the pandemic (OR=2.188, 95% CI 1.348 to 3.550) and having to miss important foods (OR=2.354, 95% CI 1.393 to 3.978), were associated with weight loss. Conclusions: During confinement, weight gain was mostly associated with food consumption and personal food system factors. Meanwhile, weight loss was associated with external food system factors.

Eliminación y prevención de la deficiencia de yodo en mujeres gestantes de Perú / Elimination and prevention of iodine deficiency in pregnant women from Peru

RESUMEN La deficiencia de yodo (DI) causa daño a través de todos los ciclos de la vida, la vulnerabilidad es mayor durante la gestación y la infancia. La yodación universal de la sal (IUS) para consumo humano es la estrategia más costo-efectiva y sostenible para su control. Perú ha logrado la eliminación sostenida de los desórdenes por deficiencia de yodo (DDI) desde 1994. Objetivo: Determinar la efectividad del programa nacional de control de los DDI y la estrategia IUS para satisfacer el mayor requerimiento de yodo y asegurar la nutrición óptima de yodo de las mujeres embarazadas de la sierra, una región con severa deficiencia natural de yodo. Material y Métodos: El estudio ha incluido a 489 mujeres embarazadas de la sierra, seleccionadas entre las asistentes a control pre natal en los centros asistenciales. En cada sujeto se verificó el consumo de sal yodada y se colectó una muestra casual de orina para el análisis de la concentración de yodo y creatinina. Resultados: Según la encuesta de admisión el 99.6 % de los hogares consumen sal yodada. La mediana global de la concentración urinaria de yodo (CUI) 209 µg/L está dentro del rango adecuado para gestantes y demuestra un estado nutricional de yodo normal. La concentración de creatinina en la orina es normal. Conclusión: Estos resultados confirman la eficiencia y el éxito del programa nacional para la eliminación sostenida de los DDI, garantizando la nutrición normal de yodo durante la gestación y, por lo tanto, previniendo el riesgo de daño cerebral de los recién nacidos cada año en la sierra.

ABSTRACT Iodine is an essential element for synthesizing thyroid hormones, it is also essential for cell metabolism and tissue development, especially in the brain. Iodine requirements are higher during pregnancy and lactation. Iodine deficiency (ID) is a widespread condition all over the world; it is frequent in Peruvian highlands and rainforest. ID causes damage in all life periods, and vulnerability for this is greater during pregnancy and infancy. Universal salt iodination (USI) for human use is the most cost-effective and sustainable strategy for controlling ID. Peru has achieved the sustained elimination of iodine deficiency disorders (IDD) since 1994. Objective. To determine the effectiveness of the national program for controlling IDDs and the USI strategy for complying with the increased iodine requirement and to assure optimal iodine nutrition in pregnant women from the Peruvian highlands, a region with severe natural iodine deficiency. Material and Methods. The study included 489 pregnant women from the highlands, who were selected from those attending prenatal assessment in healthcare centers. Iodinated salty consumption was verified in each subject and a casual urine sample was collected for measuring iodine and creatinine concentration. Results. According to the admission survey, 99.6% of household use iodinated salt. The overall mean of iodine urine concentration (IUC) was 209 µg/L, which is well within the adequate range for pregnant women, and it shows a normal iodine nutrition status. The creatinine urinary concentration was normal. Conclusion. These results confirm the efficiency and success of the national program for the sustained elimination of IDDs, assuring normal iodine nutritional supply during pregnancy; and, therefore, preventing the risk for brain damage in newborns every year in the highlands.

[Iodized salt intake in households and iodine nutritional status in women of childbearing age in Peru, 2008]. / Ingesta de sal yodada en hogares y estado nutricional de yodo en mujeres en edad fértil en Perú, 2008.

OBJECTIVE: To estimate the iodine nutritional status in women of childbearing age and to evaluate the intake of salt adequately iodized in their households in Peru. MATERIALS AND METHODS: Cross-sectional study performed with a multistage, probabilistic, cluster sampling that included 1573 households and 2048 women in childbearing age, distributed in five domains (Lima, rest of the coast, rural highlands and jungle area). The use of iodized salt was evaluated in the households and the urinary iodine was evaluated in the childbearing age women. RESULTS: 97.5% (95%CI. 96.7-98.5%) of peruvian households have iodized salt consumption, being it lower in the rural highland (95%) and higher in Lima (100%). The national mean of urinary iodine was 266 µg/L, being it lower in the jungle areas (206 µg/L) and higher in the rest of the coast (302 µg/L), these values are above the level recommended by the World Health Organization in all domains (average higher than 200 µg/L), value that ensures control over the iodine deficiency disorders (IDD). CONCLUSIONS: Control of IDD associated with iodized salt consumption is good, and monitoring of the presence of iodine in salt, particularly in the areas with lowest access, should continue.

Ingesta de sal yodada en hogares y estado nutricional de yodo en mujeres en edad fértil en Perú, 2008 / Iodized salt intake in households and iodine nutritional status in women of childbearing age in Peru, 2008

Objetivo. Estimar el estado nutricional de yodo en mujeres en edad fértil y evaluar la ingesta de sal adecuadamente yodada en sus hogares en el Perú. Materiales y métodos. Estudio transversal realizado con un muestreo probabilístico multietápico por conglomerados que incluyó 1573 hogares y 2048 mujeres en edad fértil, distribuidas en cinco dominios (Lima, resto de costa, sierra rural, sierra urbana y selva). Se evaluó el uso de sal yodada en hogares y el yodo urinario en mujeres en edad fértil. Resultados. El 97,5% (IC95%: 96,7 - 98,5%) de hogares peruanos consumen sal yodada, siendo menor en sierra rural (95%) y mayor en Lima metropolitana (100%). La mediana de yoduria nacional fue de 266 microgramos por litro, siendo menores en la selva (206 microgramos por litro) y mayores en el resto de costa (302 microgramos por litro), estos valores se encuentran por encima del límite recomendado por la Organización Mundial de la Salud en todos los dominios (mediana mayor a 200 microgramos por litro), valor que asegura un control de desórdenes por deficiencia de yodo (DDI). Conclusiones. En control de los DDI por el consumo de sal yodado es bueno, se debe continuar con la vigilancia de la presencia de yodo en la sal, particularmente en las áreas con menor acceso.

Objective. To estimate the iodine nutritional status in women of childbearing age and to evaluate the intake of salt adequately iodized in their households in Peru. Materials and methods. Cross-sectional study performed with a multistage, probabilistic, cluster sampling that included 1573 households and 2048 women in childbearing age, distributed in five domains (Lima, rest of the coast, rural highlands and jungle area). The use of iodized salt was evaluated in the households and the urinary iodine was evaluated in the childbearing age women. Results. 97.5% (95% CI. 96.7-98.5%) of peruvian households have iodized salt consumption, being it lower in the rural highland (95%) and higher in Lima (100%). The national mean of urinary iodine was 266 micrograms by liter, being it lower in the jungle areas (206 micrograms by liter) and higher in the rest of the coast (302 micrograms by liter), these values are above the level recommended by the World Health Organization in all domains (average higher than 200 micrograms by liter), value that ensures control over the iodine deficiency disorders (IDD). Conclusions. Control of IDD associated with iodized salt consumption is good, and monitoring of the presence of iodine in salt, particularly in the areas with lowest access, should continue.

Iodine nutrition improves in Latin America.

Iodine deficiency has been a public health problem in most Latin American countries. Massive programs of salt iodization have achieved great progress toward its elimination but no consistent monitoring has been applied. We used the ThyroMobil model to visit 163 sites in 13 countries and assess randomly selected schoolchildren of both genders 6-12 years of age. The median urinary iodine concentration (8208 samples) varied from 72 to 540 microg/L. One national median was below the recommended range of 100-200 microg/L; five were 100-200 microg/L, and seven were higher than 200 microg/L, including three greter than 300 microg/L. Urinary iodine concentration correlated with the iodine content of salt in all countries. Median values of thyroid volume were within the normal range for age in all countries, but the goiter prevalence varied markedly from 3.1% to 25.0% because of scatter. The median iodine content of salt from local markets (2734 samples) varied from 5.9 parts per million (ppm) to 78 ppm and was greater than 15 ppm in 83.1% of all samples. Only seven countries had higher than 15 ppm iodine in 80% of the samples, and only three had greater than 15 ppm in at least 90%. Iodized salt was available at retail level in all countries but its median iodine content was within the recommended range (20-40 ppm) in only five. This study, the first to apply a standardized assessment strategy to recent iodine nutrition in Latin America, documents a remarkable success in the elimination of iodine deficiency by iodized salt in all but 1 of the 13 countries. Some iodine excess occurs, but side effects have not been reported so far, and two countries have already decreased their legal levels of salt iodization and improved the quality control of iodized salt, in part because of our results. The present work should be followed by regular monitoring of iodine nutrition and thyroid function, especially in the countries presently exposed to iodine excess.