[Questionnaire for measuring risk eating behaviors for excess malnutrition in adolescents]. / Cuestionario para medir conductas alimentarias de riesgo de malnutrición por exceso en adolescentes.

INTRODUCTION: Introduction: there are behavioral factors that predispose to the development of excess malnutrition, and which can be key to the promotion of healthy habits. The purpose of this study was to construct and validate a questionnaire to identify risky eating behaviors in adolescents. Objective: to evaluate the psychometric properties of a questionnaire to measure risky eating behaviors related to excess malnutrition in adolescents in the province of Concepción, Chile. Materials and methods: quantitative psychometric research with correlational scope; non-experimental, cross-sectional design. The population was composed by adolescents aged 10 to 15 years in the province of Concepción, from different socio-economic levels. A total of 303 students, chosen by non-probabilistic sampling, responded to the Questionnaire on Alimentary Malnutrition Risk Behaviors, CARME. A subsample of 115 students also answered a body image questionnaire, and 80 were assessed anthropometrically. Exploratory factor analyses and correlation evaluations were performed. Results: four factors were identified for the CARME: response to food, feeding without control, consumption of highly caloric foods, and emotional feeding, with reliability between α = 0.64 and α = 0.87. Scores showed differences by sex, and relationships with perceived body image (p < 0.05), but not with nutritional status. Conclusions: the evidence supports the construct validity, reliability and criteria validity of CARME. The questionnaire would be appropriate to measure dietary risk behaviors for overweight and obesity in adolescents. However, no associations were found between nutritional status and questionnaire dimensions.

INTRODUCCIÓN: Introducción: existen conductas que predisponen al desarrollo de malnutrición por exceso cuya detección es clave para la promoción de hábitos saludables. Esto hace necesario contar con instrumentos con evidencia de validez y confiabilidad que permitan diagnosticar e investigar este fenómeno oportunamente. Objetivo: construir y evaluar las propiedades psicométricas de un cuestionario que evalúa las conductas alimentarias de riesgo de malnutrición por exceso en adolescentes chilenos. Material y métodos: se realizó una investigación cuantitativa, psicométrica, analítico-relacional por encuesta. La población estuvo compuesta por adolescentes de 11 a 18 años de la provincia de Concepción, Chile. De esta, 303 estudiantes, elegidos por muestreo no probabilístico por cuotas, respondieron el Cuestionario de Conductas Alimentarias de Riesgo de Malnutrición por Exceso (CARME). Una submuestra respondió además a un cuestionario de imagen corporal y fue evaluada antropométricamente. Se realizó un análisis factorial exploratorio del CARME, se analizó su confiabilidad y se evaluó su relación con otras variables para evaluar su validez de criterio. Resultados: los ítems del CARME se organizaron en cuatro factores: respuesta frente a alimentos, alimentación sin control, consumo de alimentos altamente calóricos y alimentación emocional. Sus confiabilidades fueron de cuestionables (α = 0,64) a muy buenas (α = 0,87). Al evaluar su asociación con otras variables se encontraron relaciones con la percepción de la imagen corporal (p < 0,05), pero no con el estado nutricional. Conclusiones: la evidencia apoya la validez de constructo, la confiabilidad y la validez de criterio del CARME. El cuestionario sería adecuado para medir conductas alimentarias de riesgo de sobrepeso y obesidad en adolescentes.

Adequate and excessive food consumption in Suriname: a multiethnic middle-income country.

OBJECTIVES: To explore food consumption among different sex, age, ethnic, urban, education and income groups in Suriname. METHODS: Data from a cross-sectional population study (n = 5748; 15-64 year) were used. Food consumption was defined adequate if (1) fruit and vegetable intake was conformable to WHO recommendations, (2) mostly vegetable oil was used, and (3) whole-wheat products were used ≥ 3 days/week. Food consumption was defined excessive if 3 out of the following 5 items scored positive: consumption of (1) snack, (2) sweet, (3) fast food, or (4) soft drink ≥ 3 days/week, or (5) salt was always added while preparing a hot meal. RESULTS: 6.4% (95% CI 5.8-7.1) had an adequate and 21.9% (95% CI 20.9-23.0) an excessive food consumption pattern, with differences among ethnic groups (p < 0.05). Adequate consumption increased, while excessive consumption decreased with increasing age (p < 0.05). Both adequate and excessive consumption increased with higher degree of urbanization, level of education and income (p < 0.05). Except for level of education for adequate consumption, all characteristics remained in both models with adequate and excessive consumption as outcome (p < 0.09). CONCLUSIONS: Our study suggests interventions to promote adequate food consumption in general and to limit excessive food consumption mainly focused on youngsters and those living in urbanized areas of higher socioeconomic status.

Sex and race differences in caloric intake during sleep restriction in healthy adults.

BACKGROUND: Evidence indicates that men and African Americans may be more susceptible to weight gain resulting from sleep loss than women and whites, respectively. Increased daily caloric intake is a major behavioral mechanism that underlies the relation between sleep loss and weight gain. OBJECTIVE: We sought to assess sex and race differences in caloric intake, macronutrient intake, and meal timing during sleep restriction. DESIGN: Forty-four healthy adults aged 21-50 y (mean ± SD: 32.7 ± 8.7 y; n = 21 women, n = 16 whites) completed an in-laboratory protocol that included 2 consecutive baseline nights [10 or 12 h time in bed (TIB)/night; 2200-0800 or 2200-1000] followed by 5 consecutive sleep-restriction nights (4 h TIB/night; 0400-0800). Caloric intake and meal-timing data were collected during the 2 d after baseline sleep and the first 3 d after sleep restriction. RESULTS: During sleep restriction, subjects increased daily caloric intake (P < 0.001) and fat intake (P = 0.024), including obtaining more calories from condiments, desserts, and salty snacks (Ps < 0.05) and consumed 532.6 ± 295.6 cal during late-night hours (2200-0359). Relative to women, men consumed more daily calories during baseline and sleep restriction, exhibited a greater increase in caloric intake during sleep restriction (d = 0.62), and consumed a higher percentage of daily calories during late-night hours (d = 0.78, Ps < 0.05). African Americans and whites did not significantly differ in daily caloric intake, increased caloric intake during sleep restriction, or meal timing. However, African Americans consumed more carbohydrates, less protein, and more caffeine-free soda and juice than whites did during the study (Ps < 0.05). CONCLUSIONS: Men may be more susceptible to weight gain during sleep loss than women due to a larger increase in daily caloric intake, particularly during late-night hours. These findings are relevant to the promotion of public health awareness by highlighting nutritional risk factors and modifiable behaviors for weight gain related to sleep-wake timing.

A reassessment of the hyperphagia/weight-loss paradox during sleep deprivation.

STUDY OBJECTIVES: Sleep deprivation is a well-known paradigm to investigate the deleterious effects of prolonged wakefulness. Previous studies have shown that, during sleep deprivation, rats are hyperphagic but, paradoxically, lose body weight. This phenomenon has been attributed to increased metabolism. However, most previous studies have failed to account for food spillage, which may be considerable during sleep deprivation. DESIGN: In the present study, we revisited the issue of feeding changes in sleep-deprived rats and introduced different procedures to allow accurate estimation of food spillage prior to, during, and after 120 hours of sleep deprivation by a single platform technique. SETTING: Animal Sleep Research Laboratory, Psychobiology Department, Universidade Federal de São Paulo, Brazil. MEASUREMENTS AND RESULTS: The main finding was that, once corrected for spillage, food intake was not significantly increased during sleep deprivation. Increases in food removed from feeders were accompanied by proportional increases in food spillage, resulting in no net changes in food intake. Further, weight loss did occur during the sleep-deprivation period, especially in the first 24 hours, and it was actually explained by a reduction in food intake. CONCLUSION: The hyperphagia/weight-loss paradox previously seen during prolonged sleep deprivation does not necessarily occur with shorter periods of deprivation. Although we found no evidence of hyperphagia for up to 5 days of sleep deprivation in chow-fed rats, our data suggest that an impairment in the ability to increase food intake in response to increased energy expenditure contributes to the energy deficit during sleep deprivation in rats.

[Nutritional pathology in Latin America and the Caribbean]. / Patología nutricional en América Latina y el Caribe.

The Latin American and Caribbean Region has different general characteristics as compared to other regions of the world. These peculiarities have determined certain food and nutritional problems which require specific programs and policies. Even though the universal coverage of basic needs is desirable, this is not the situation in the Region, and it is possible to identify integral vulnerable groups in every population. The study of problems related to food and nutrition requires a global and multidisciplinary approach considering ecological, economical, social and cultural factors affecting communities, especially marginal urban and rural populations. Nutritional diseases represent the last stages of the natural development of malnutrition, and although they are used as indicators of the nutritional situation, their magnitude always underestimate their real impact. It is in the large cities of Latin America that we can really understand the concept of malnutrition, which includes diseases related with both deficient and excessive food consumption. In fact, the development of sub-urban poor communities in large cities, short lactation period, low wages, low maternal schooling, soon lead to the development of under-nutrition in young urban populations. On the other hand, the interaction of urbanization, sedentary jobs, deficient food knowledge and excessive consumption of cheap foods, sometimes produces on the "survivors of under-nutrition" over-nutrition diseases, a problem which is acquiring more prevalence, especially in adults (obesity, diabetes and atherosclerosis). The real nutritional diseases in Latin America do not depend on the deficit or excess of a specific nutrient. The true causes are to be properly identified in order to state recommendations which benefit population groups, and not only reach academic purposes.