Agricultural Food Production Diversity and Dietary Diversity among Female Small Holder Farmers in a Region of the Ecuadorian Andes Experiencing Nutrition Transition.

Some rural areas of Ecuador, including the Imbabura Province of the Andes Highlands, are experiencing a double burden of malnutrition where micronutrient deficiencies persist at the same time obesity is increasing as many traditional home-grown foods are being replaced with more commercially prepared convenience foods. Thus, the relationships among agricultural food production diversity (FPD), dietary diversity (DD), and household food insecurity (HFI) of the rural small holder farmers need further study. Therefore, we examined these associations in small holder farmers residing in this Province in the Andes Highlands (elevation > 2500 m). Non-pregnant maternal home managers (n = 558, x age = 44.1, SD = 16.5 y) were interviewed regarding the number of different agricultural food crops cultivated and domestic animals raised in their family farm plots. DD was determined using the Minimum Dietary Diversity for Women Score (MDD-W) based on the number of 10 different food groups consumed, and household food insecurity (HFI) was determined using the 8-item Household Food Insecurity Experience Scale. The women reported consuming an average of 53% of their total food from what they cultivated or raised. Women with higher DD [MMD-W score ≥ 5 food groups (79% of total sample)] were on farms that cultivated a greater variety of crops (x = 8.7 vs. 6.7), raised more animals (x = 17.9 vs. 12.7, p < 0.05), and reported lower HFI and significantly higher intakes of energy, protein, iron, zinc, and vitamin A (all p < 0.05). Multiple regression analyses demonstrated that FPD was only modestly related to DD, which together with years of education, per capita family income, and HFI accounted for 26% of DD variance. In rural areas of the Imbabura Province, small holder farmers still rely heavily on consumption of self-cultivated foods, but greater diversity of crops grown in family farm plots is only weakly associated with greater DD and lower HFI among the female caretakers.

Indice de masa corporal y porcentaje de grasa en adultos indígenas ecuatorianos awá / Body mass index and fat percentage in adults Ecuadorian indigenous awá

Este estudio observacional transversal evaluó el estado nutricional de 120 adultos indígenas ecuatorianos Awá para determinar la correlación entre IMC y porcentaje de grasa corporal mediante bioimpedancia, y evaluar la precisión diagnóstica del IMC para la detección de exceso de grasa. La media de IMC fue de 23,81 ± 1,95 kg / m2 en hombres y 23,58 ± 1,95 kg / m2 en mujeres, y la media de porcentaje de grasa fue de 11,4 ± 5,9 en hombres y 19,97 ± 7,19 en mujeres. Se observó una correlación positiva significativa entre IMC y porcentaje de grasa en hombres (r=0,54, p<0,01) y en mujeres (r=0,72, p<0,01). También hubo una correlación positiva significativa en los grupos de 18-40 años (r=0,79, p<0,01) y 40-59 años (r=0,49, p<0,01), mientras que en mayores de 60 años, la correlación fue positiva pero no significativa (r=0,50, p=0,97). Además, hubo una correlación significativa en el grupo de adiposidad saludable (r=0,54, p<0,001), pero no se encontró significancia en los grupos de baja y alta adiposidad (r=0,07 p=0,57, r=0,38 p=0,31 respectivamente). Un IMC ≥25 kg/m2 tuvo una sensibilidad de 90%, especificidad de 75% y un área bajo la curva de 0,88 (IC del 95% 0,81 a 0,95) para detectar exceso de grasa. En conclusión, aunque el uso del IMC como predictor de exceso de grasa se justifica en esta población, es necesario establecer otros indicadores que permitan evaluar de manera más integral y compleja el estado nutricional, no solamente enfocados en los problemas de sobrepeso y obesidad(AU)

This cross-sectional study assessed the nutritional status of 120 Ecuadorian indigenous adults Awá to determine the correlation between BMI and body fat percentage estimated by bioelectrical impedance, as well as to evaluate the diagnostic accuracy of BMI to detect excess body fat percentage in this population. Mean BMI was 23.81 ± 1.95 kg / m2 in men and 23.58 ± 1.95 kg / m2 in women, and mean body fat percentage was 11.4 ± 5.9 in men and 19.97 ± 7.19 in women. A significant positive correlation was observed between BMI and body fat percentage in men (r=0.54, p<0.01) and in women (r=0.72, p<0.01). There was also a significant positive correlation in groups of 18-40 years (r=0.79, p<0.01) and 40-59 years (r=0.49, p<0.01), while in older than 60 years the correlation was positive but not significant (r=0.50, p=0.97). There was significant correlation in the group considered healthy by fat percentage (r=0.54, p<0.001), but there was no significant correlation in under fat and over fat groups (r=0.07 p=0.57, r=0.38 p=0.31 respectively). BMI ≥25 kg/m2 showed a sensitivity of 90%, specificity 75% and an area under the curve of 0.88 (95% CI from 0.81 to 0,95) to detect excess body fat. In conclusion, although the use of BMI as a predictor of excess fat is justified in this population, it is necessary to conduct more studies to develop additional indicators for assessing the nutritional status of in more comprehensive way, not only focused on overweight and obesity(AU)

Factores bioquímicos y nutricionales asociados a la viscosidad sanguínea en adultos de la sierra urbana (Imbabura), Ecuador / Biochemical and nutritional factors associated with blood viscosity in adults living in a mountain chain, (Imbabura), Ecuador

La asociación de la viscosidad sanguínea (VS) con la hipertensión y la diabetes mellitus 2, indica que debe ser considerada sobre todo en poblaciones que viven en la sierra donde el hematocrito y la hemoglobina son más elevados. Se evaluó la asociación de la VS con factores de riesgo cardiovascular y de síndrome metabólico (SM) en una población de 237 adultos (20-60 años) de la sierra urbana ecuatoriana. Se calculó el índice de masa corporal (IMC), porcentaje de grasa y agua corporal, se midieron la circunferencia de la cintura (CC) y la presión arterial. Se realizaron determinaciones de parámetros bioquímicos, hematológicos y de VS (mediante fórmula validada). El 14,76% de la población presentó hiperviscosidad (HV). El 42,8% de las personas con HV presentó SM contra 33% en el grupo con normoviscosidad (NV). El ácido úrico (AU) se observó más elevado en los grupos HV y NV con SM. Se encontró una correlación lineal simple de las concentraciones de glucosa (GLU) y de triglicéridos (TRI) con la VS en el grupo HV sin SM. El análisis de regresión lineal múltiple indicó que la GLU, el AU y la presión sistólica son variables que influyen independientemente con el incremento de la VS en el grupo HV sin SM. Las variables GLU y % de agua influyen en el incremento de la VS en el grupo NV sin SM. El incremento de las concentraciones de glucosa y de ácido úrico son los dos factores que mayormente influyen en la VS en esta población.

The association of blood viscosity (BV) with hypertension and diabetes mellitus type 2 indicates that it should be considered, especially in populations living in mountain chains where the hemoglobin and hematocrit values are higher. In fact, this work analyzed the association of BV with nutritional and biochemical risk factors in the development of cardio metabolic diseases in healthy adults (20-60 years old; 46.39% female and 53.61% male) living in the urban Ecuadorian sierra. The body mass index (BMI) was calculated. The body fat percentage, body water percentage, waist circumference (WC) and blood pressure were measured. Determinations of biochemical and hematological parameters were performed using established methodologies and a validated formula was used to determine the BV. Hyperviscosity (HV) was present in 14.76% of the population: 10.46% men, 4.3% women. In this group, 42.8% showed metabolic syndrome (MS) against 33% in the normoviscosity group (NV). Uric acid (UA) was observed statistically higher in HV and NV with MS groups. A simple positive linear correlation was found between glucose (GLU) and triglycerides (TRI) concentrations and BV in HV without MS group. The multiple linear regression analysis indicated that GLU, UA and systolic pressure influence to increase BV in the HV without MS group. Glucose concentration and percentage of water, independently influence the BV in the NV without MS group. The increase in GLU and UA concentrations are the most influencing factors on BV in this population.

Efecto del consumo de jugo de tomate de árbol (Cyphomandra betacea) sobre el perfil lipídico y las concentraciones de glucosa en adultos con hiperlipidemia, ecuador / Effect of consumption of tree tomato juice (Cyphomandra betacea) on lipid profile and glucose concentrations in adults with hyperlipidemia, ecuador

En este trabajo se evaluó el efecto del consumo del jugo de tomate de árbol (Cyphomandra betacea) sobre parámetros nutricionales y bioquímicos en 54 voluntarios (44 mujeres y 10 hombres) con edades 45±8 años de Ecuador. Al inicio se les realizó una evaluación nutricional y bioquímica, luego se les invitó a consumir el jugo (100g de fruto en 150 ml de agua) diariamente durante 6 semanas. Finalizado este tiempo, se procedió a realizar la evaluación nutricional y bioquímica nuevamente. La evaluación nutricional determinó 67% de obesidad abdominal. Disminuyendo a 53% después del consumo del jugo de tomate de árbol. El 87% de los voluntarios antes del tratamiento, mostraron hipercolesterolemia; 40,7% y 46,3% tenían los triglicéridos y el LDL elevados y 18,5% valores de glucosa entre 98-130mg/dL. Valores que disminuyeron significativamente en este grupo después de la toma del jugo En general, tanto en voluntarios con y sin sobrepeso se observó disminución significativa de colesterol total, LDL y glucosa; sin cambios significativos en los valores de HDL. El consumo del jugo no afectó la actividad de las enzimas alanina-aminotransferasa ni aspartato-aminotransferasa, tampoco las concentraciones de creatinina, urea y ácido úrico; ni la presión arterial, demostrando que no afecta la función hepática ni renal. Estos resultados indican que el consumo del jugo de tomate de árbol, durante seis semanas, parece ejercer un efecto hipolipemiante y moduladora en el metabolismo de la glucosa y colocan a C betacea como uno de los frutos andinos con alto potencial nutraceutico. Sin embargo, estos aspectos deben ser investigados con más detalles(AU)

In this work the effect of consumption of tree tomato juice (Cyphomandra betacea) was evaluated on nutritional and biochemical parameters in 54 volunteers (44 women and 10 men) aged 45 ± 8 years-Ecuador. A nutritional and biochemical evaluation was performed in volunteers; then they were invited to drink tree tomato juice (100g of fruit in 150 ml of water) daily for 6 weeks. Finished these 6 weeks, volunteers were nutritional and biochemical evaluated again. 67% abdominal obesity was found, decreasing at 53% after drinking the established dosage of juice. 87% of the volunteers before treatment, showed hypercholesterolemia, 40.7% and 46.3% had hypertriglyceridemia and elevated LDL, respectively and 18.5% glucose concentrations between 98-130 mg/dL. These values decrease significantly in this group after drinking tomato juice. In general, Total Cholesterol, LDL and glucose concentrations decrease significantly after drinking tree tomato juice in all the voluntaries with or without overweight. There is no change in HDL concentrations. The consumption of tree tomato juice did not affect the activity of alanine aminotransferase or aspartate aminotransferase enzymes either creatinine, urea and uric acid concentrations, neither blood pressure suggesting that does not affect renal or liver function. These results indicate that consumption of tree tomato juice for six weeks appears to have a lipid-lowering and modulating effect on glucose metabolism, suggesting C betacea as one of the high Andean fruits nutraceutical potential. However, this issue should be investigated in more detail(AU)

Biochemical and nutritional factors associated with blood viscosity in adults living in a mountain chain, (Imbabura), Ecuador. / Factores bioquímicos y nutricionales asociados a la viscosidad sanguínea en adultos de la sierra urbana (Imbabura), Ecuador.

The association of blood viscosity (BV) with hypertension and diabetes mellitus type 2 indicates that it should be considered, especially in populations living in mountain chains where the hemoglobin and hematocrit values are higher. In fact, this work analyzed the association of BV with nutritional and biochemical risk factors in the development of cardio metabolic diseases in healthy adults (20-60 years old; 46.39% female and 53.61% male) living in the urban Ecuadorian sierra. The body mass index (BMI) was calculated. The body fat percentage, body water percentage, waist circumference (WC) and blood pressure were measured. Determinations of biochemical and hematological parameters were performed using established methodologies and a validated formula was used to determine the BV. Hyperviscosity (HV) was present in 14.76% of the population: 10.46% men, 4.3% women. In this group, 42.8% showed metabolic syndrome (MS) against 33% in the normoviscosity group (NV). Uric acid (UA) was observed statistically higher in HV and NV with MS groups. A simple positive linear correlation was found between glucose (GLU) and triglycerides (TRI) concentrations and BV in HV without MS group. The multiple linear regression analysis indicated that GLU, UA and systolic pressure influence to increase BV in the HV without MS group. Glucose concentration and percentage of water, independently influence the BV in the NV without MS group. The increase in GLU and UA concentrations are the most influencing factors on BV in this population.

Effect of consumption of tree tomato juice (Cyphomandra betacea) on lipid profile and glucose con centrations in adults with hyperlipidemia, Ecuador.

In this work the effect of consumption of tree tomato juice (Cypho-mandra betacea) was evaluated on nutritional and biochemical parameters in 54 volunteers (44 women and 10 men) aged 45 ±8 years-Ecuador. A nutritional and biochemical evaluation was performed in volunteers; then they were invited to drink tree tomato juice (IOOg of fruit in 150 ml of water) daily for 6 weeks. Finished these 6 weeks, volunteers were nutritional and biochemical evaluated again. 67% abdominal obesity was found, decreasing at 53% after drinking the established dosage of juice. 87% of the volunteers before treatment, showed -hypercholesterolemia, 40.7% and 46.3% had hypertriglyceridemia and elevated LDL, respectively and 18.5% glucose concentrations between 98-130 mg/dL. These values decrease significantly in this group after drinking tomato juice. In ge- neral, Total Cholesterol, LDL and glucose concentrations decrease significantly after drinking tree tomato juice in all the voluntaries with or without overweight. There is no change in HDL concentrations. The consumption of tree tomato juice did not affect the activity of alanine aminotransferase or aspartate aminotransferase enzymes either creatinine, urea and uric acid concentrations, neither blood pressure suggesting that does not affect renal or liver function. These results indicate that consumption of tree tomato juice for six weeks appears to have a lipid-lowering and modulating effect on glucose metabolism, suggesting C betacea as one of the high Andean fruits nutraceutical potential. However, this issue should be investigated in more detail.

Marcadores de estrés oxidativo y su relación con el estado nutricional en adultos, Ecuador / Relationships between biomarkers of oxidative stress and nutritional status in adults, Ecuador

Se evaluó la relación entre biomarcadores de estrés oxidativo (ácido úrico, bilirrubina y proteína C-reactiva) con el estado nutricional en 321 adultos de Ecuador, pertenecientes al personal administrativo de la Universidad Técnica del Norte, con edades de 43 ± 10 años, (46,30% femenino y 53,61% masculino). Se obtuvo información sociodemográfica, de estilo de vida y epidemiológica; se calculó el índice de Masa Corporal (IMC), porcentaje de grasa y agua corporal, se midió la circunferencia de la cintura (CC) y la presión arterial y se determinó las concentraciones de ácido úrico, bilirrubina y Proteína C reactiva (PCR). Se encontró que 17,9% de la población presentó obesidad y 51,72% sobrepeso. Los valores más elevados de ácido úrico se encontraron en obesos, hipertensos y en quienes realizan actividad física. La bilirrubina total, directa e indirecta se encontró en límites superiores en los grupos con obesidad abdominal, y con actividad física. Las variables % de grasa y de agua influyen en la PCR en el grupo con baja grasa corporal y en las mujeres. En hombres, la PCR se asocia con IMC y CC. En los grupos sobrepeso, alta grasa corporal y PHT, el ácido úrico mostró relación con el % de grasa y la CC En los obesos con el % de agua e IMC y en los grupos obesidad abdominal e HT se asoció con % de agua y CC Se concluye que el porcentaje de agua corporal es un importante indicador nutricional para el desarrollo de estrés oxidativo en esta población.

In this work it was evaluated the relationship between oxidative stress biomarkers (uric acid, bilirubin and C-reactive protein) with nutritional status in 321 adults of Ecuador, belonging to administrative staff of of the Universidad Tècnica del Norte , aged 43 ± 10 years old (46 30% female and 53.61% male). Socio demographic and epidemiological information and lifestyle were obtained through a survey; The Body Mass Index (BMI) and body fat and body water percentages were calculated; waist circumference (WC) and blood pressure was measured. Determinations of uric acid, bilirubin, and serum C-reactive protein (PCR) were performed. 17.9% of the populations were obese and 51.72% overweight. The highest values of uric acid were found in obese, hypertensive and physical activity groups. The total direct and indirect bilirubin were found in upper limits in abdominal obesity and physical activity groups. The CRP level was influenced by % fat and % water in the low body fat group and in females. In male, BMI and WC were associated with CRP. Uric acid showed relationship with % fat and WC in overweight, high body fat and PHT groups, uric acid was associated with the % water and BMI in obese. Finally, uric acid was associated with % water and the WC in the abdominal obesity, and HT groups’ .The body water percentage is an important indicator to development of oxidative stress in this population.

[Relationships between biomarkers of oxidative stress and nutritional status in adults, Ecuador]. / Marcadores de estrés oxidativo y su relación con el estado nutricional en adultos, Ecuador.

In this work it was evaluated the relationship between oxidative stress biomarkers (uric acid, bilirubin and C-reactive protein) with nutritional status in 321 adults of Ecuador, belonging to administrative staff of of the Universidad Tècnica del Norte, aged 43 ± 10 years old (46 30% female and 53.61% male). Socio demographic and epidemiological information and lifestyle were obtained through a survey; The Body Mass Index (BMI) and body fat and body water percentages were calculated; waist circumference (WC) and blood pressure was measured. Determinations of uric acid, bilirubin, and serum C-reactive protein (PCR) were performed. 17.9% of the populations were obese and 51.72% overweight. The highest values of uric acid were found in obese, hypertensive and physical activity groups. The total direct and indirect bilirubin were found in upper limits in abdominal obesity and physical activity groups. The CRP level was influenced by % fat and % water in the low body fat group and in females. In male, BMI and WC were associated with CRP. Uric acid showed relationship with % fat and WC in overweight, high body fat and PHT groups, uric acid was associated with the % water and BMI in obese. Finally, uric acid was associated with % water and the WC in the abdominal obesity, and HT groups'. The body water percentage is an important indicator to development of oxidative stress in this population.