RESUMO
Background: Food exchange lists allow health professionals to generate healthy eating plans adapted to individual or population needs. The objective of this study was to develop the first food exchange list based on the macronutrients and energy provided by the various food groups of the Ecuadorian diet. Methods: The list of Ecuadorian food exchanges was constructed by going through the following phases: (1) Selection of household measurements; (2) Selection of tables and databases of the nutritional composition of food items; (3) Definition of food groups and quantities; (4) Determination of the average energy and macronutrient values of each group; and (5) Photographic record. For the definition of food quantities, statistical criteria were applied according to a standard deviation of ±2SD; thus, for carbohydrates: ±5 g, total fat: ±2 g, and protein: ±3 g. To ensure the inclusion of the food items in the groups, a coefficient of variation of less than 30% and a Z value of ±2 were also considered. Results: The list of food exchanges is presented with eight general groups according to the predominant nutrient (carbohydrates, proteins, or fats), and, where necessary, subgroups are included according to the second predominant nutrient. The list includes 404 food items with their photographic record, represented by their net weights and corresponding household measurement. All food items met the statistical criteria that help to reduce the variability of the nutritional composition of the food items in each group. Conclusion: This is the first list of Ecuadorian food exchanges based on statistical criteria. It represents a novel tool for public health professionals as well as researchers. Resulting healthier eating plans may improve daily dietetic practice, facilitate better clinical trial designs and help establish guidelines according to Ecuador's cultural and dietary patterns. The described methodology can further be used to develop other food exchanges lists for patients with specific nutritional requirements.
RESUMO
INTRODUCTION: A household's nutritional status and food security can be affected after a natural disaster, especially in families who live in risk situations. The objective of this study was to determine the prevalence of food insecurity, inadequate dietary diversity and poor nutritional status of mothers and children under 5 years old from vulnerable families residing in the rural community of La Punta, after the earthquake in Ecuador on 16 April 2016. METHODS: Through a non-probabilistic sampling, 28 families were selected. The levels of food insecurity in households were determined by applying a food safety scale and household dietary diversity score. Moreover, Z-scores were used to evaluate the nutritional status of children, while body mass index was used in mothers. RESULTS: All households suffered food insecurity, with mild food insecurity being the most prevalent (51.9%), followed by severe food insecurity (33.3%). Although all households had high diversity scores, the products they most consumed have low nutritional value, such as rice, soft drinks and oils. There was a low consumption of whole grains, fruits and vegetables. Additionally, there was a high percentage of overweight and obese mothers (57.1%) and a high prevalence of chronic undernutrition (40.9%) and global undernutrition (13.6%) in children under 5 years old. CONCLUSION: The predominance of severe food insecurity occurred in overweight and obese mothers with inadequate dietary diversity. This probably happened because of a lack of access to food to adequately meet the nutritional needs of each member of the family. The results suggest that health promotion with actions aimed at food security is a priority within an integral action plan for natural disasters.
