Breastfeeding, feeding practices and stunting in indigenous Ecuadorians under 2 years of age.

BACKGROUND: The indigenous child population in Ecuador has a high prevalence of stunting. There is limited evidence of the association between breastfeeding, feeding practices, and stunting in indigenous children. This study aimed to analyze the prevalence of breastfeeding and complementary feeding practices and explore their association with stunting in Ecuadorian indigenous children under two years of age. METHODS: Cross-sectional study of secondary data analysis using the 2012 Ecuador National Health and Nutrition Study, in 625 children aged 0-23 months (48,069 expanded sample), representative for the indigenous population. Breastfeeding and complementary feeding indicators were analyzed by age groups. Timely initiation of breastfeeding (within one hour after birth), exclusive breastfeeding (infants under six months who received only breast milk for the previous day), and other indicators were measured. Chi-square test or Fisher's exact test and logistic regression for complex samples were used to explore association with demographic and socioeconomic factors and stunting. RESULTS: Twenty-six-point eight percent of the children were stunted. Stunting occurred mainly in children with rural residence, on poor households, and where there were four or more children. Most of the children had a timely initiation of breastfeeding (69.5% for 0-12 months and 75.5% for 13-23 months) and exclusive breastfeeding up to six months (78.2%). Among children between 6-12 months of age, 99.3% continued to be breastfed. In children from ages 6 to 12 months, 32.5% received food with adequate dietary diversity. Lower percentages of complementary feeding occurred in the poorest, adolescent mothers or those with less education. Children who did not receive the minimum frequency of meals for their age had higher odds of stunting (OR 3.28; 95% CI 1.3, 8.27). Children from age 19 to 23 months who consumed foods rich in iron showed lower probabilities of stunting (OR 0.04; 95% CI 0.00, 0.51). CONCLUSIONS: Breastfeeding practices reached a prevalence of 70% or more, without being associated with stunting. Complementary feeding practices showed differences by socioeconomic condition. Not reaching the minimum meal frequency between 6 and 12 months of age was associated with stunting. Plans and strategies are necessary to promote adequate feeding and breastfeeding practices in the indigenous population.

Treatment Eligibility and Therapeutic Responses of an Ecuadorian Population at High Cardiovascular Risk Based on the ATP III Guidelines

Abstract Background The Adult Treatment Panel III (ATPIII) guidelines aim to reduce cardiovascular morbidity and mortality. In Ecuador, 20% of people have high LDL cholesterol levels, and 39% have high triglyceride levels. Objective To analyze lipid-lowering regimens in Ecuadorian patients and determine the achievement rate of the ATPIII goals for lipid profile. Methods Using a retrospective analysis, 385 subjects older than 30 years, who received pharmacological treatment for dyslipidemia for at least three months was randomly selected from institutions at two large cities in Ecuador. Data were collected from patients' medical records and analyzed by chi-square test or paired t-test; p-values less than 0.05 were considered significant. Results Baseline total cholesterol values were above 200 mg/dL in 75% of subjects, LDL-c values above 129 mg/dL in 83% of subjects and triglycerides values above 150 mg/dL in 79% of subjects. Most (n = 253, 95.8%) patients at very high cardiovascular risk were taking statins, 50% of them atorvastatin. Considering the ATPIII guidelines' goals, only 24 subjects (19%) at high CV risk achieved an LDL-c < 100 mg/dl, while a significantly lower percentage (p = 0.04) of patients at very high risk reached an LDL-c < 70mg/dl (11%; n = 30). Conclusion These data indicate a low rate of compliance with the ATPIII guidelines, independent of the medication used or duration of the treatment. This may be attributed to the prescription of low doses of medication and a therapy targeting isolated lipid fractions rather than a complete lipid profile. (Int J Cardiovasc Sci. 2020; 33(4):371-376)