Feasibility of Implementing a Mindfulness-Based Online Program for Latina Immigrants and the Staff that Work with Them.

Objective: Post-migration stress and trauma impact the way Latino/a immigrants in the USA experience everyday life. Mindfulness-based interventions (MBIs) reduce stress and strengthen mental health by improving the response to stressors and promoting physical and psychological well-being; however, they have not been tested extensively with Latino/a immigrants in the USA, particularly MBIs implemented online. Thus, more information is needed about the feasibility of online MBIs adapted for Latino/a immigrants. Method: This study focuses on the feasibility of an online MBI for Latina mothers and community staff members working with them (n = 41). Qualitative (three focus groups) data were collected to assess feasibility, appropriateness, acceptability, and quantitative (questionnaires) data asking about self-reported changes on stress, mindfulness, mind-body connection, subjective well-being, and perceived physical and mental health after the program. Results: Participants in the three groups indicated the program was appropriate, feasible, and acceptable for Latina immigrant mothers and the staff serving them. Mothers' and Promotoras' (community health workers) mean scores for subjective well-being and perceived physical and mental health increased significantly from baseline to post-test. No significant changes were observed in surveys completed by the staff, even though focus group participants reported meaningful improvement. Conclusion: Overall, the feasibility study was well received and relevant for the organization and the population they serve. The study's findings provide guidance to others who are implementing online mindfulness practices with Latina immigrants and the staff that work with them. Preregistration: This study is not preregistered. Supplementary Information: The online version contains supplementary material available at 10.1007/s12671-023-02123-6.

Building a More Diverse and Inclusive Science: Mindfulness-Based Approaches for Latinx Individuals.

Objectives: This article represents a call to action for the mindfulness field to be more diverse and inclusive of Latinx individuals. Building a diverse and inclusive science around mindfulness-based approaches (MBAs) that considers important group-level cultural and contextual information is an important public health challenge in need of innovative solutions. Methods: We describe ways that the Latinx population is poised to benefit from MBAs. We further elucidate challenges, describe potential solutions, and outline a research agenda that may hold promise for building a more inclusive mindfulness movement. Results: Our recommendations center around developing nuanced cultural adaptations to MBAs, engaging Latinx individuals in research, increasing the rigor of scientific studies pertaining to Latinx individuals, relying on implementation science to develop innovative methods for disseminating MBAs to Latinx individuals, developing training and certification mechanisms to increase diversity and representation of Latinx mindfulness teachers, and creating mechanisms for the oversight of MBAs within this group. Conclusions: There has been a lack of inclusivity of Latinx individuals in the field of MBAs with regards to research studies, barriers to access for economically disadvantaged groups, and lack of diversity in its workforce. Considering the recognition of adverse social drivers of health that generate chronic stress and health disparities, the Latinx population is especially poised to benefit greatly from MBAs. A diverse and inclusive mindfulness science holds promise to enhance the effectiveness, acceptability, feasibility, and wide-scale dissemination and implementation of MBAs.

Lessons Learned for Emergency Feeding During Modifications to 11 School Feeding Programs in Latin America and the Caribbean During the COVID-19 Pandemic.

BACKGROUND: School feeding programs (SFPs) can play a crucial role in the emergency food and nutrition response, but there is a dearth of information on how SFPs operate during emergencies. DESIGN AND METHODS: A rapid comparative assessment of 11 SFPs throughout Latin America and the Caribbean during the COVID-19 pandemic. Data from (1) systematic document search and (2) surveys with key informants (n = 23) about barriers/facilitators to modifications were systematically analyzed using a multiple case study approach. RESULTS: During the pandemic, all SFPs continued (although continuation plans varied from a few days in Chile to > 1 month in Puerto Rico) via food kits, food vouchers, and/or grab n' go meals. The SFP implementation was highly dependent on the programs' autonomy and financial support, which impacted their logistics to acquire and distribute foods during the pandemic. The types of foods offered in some SFPs suggest that established nutritional guidelines were not always followed. Key informants expressed concerns about the deterioration of the nutritional quality of foods offered during the pandemic and lack of community engagement that impeded distribution to the neediest. CONCLUSIONS: Results underscore the urgency for clear implementation guidance on how to modify SFP during emergencies. Public health implications include (1) allocation of autonomous resources to an intersectoral working group to safeguard nutritional benefits during emergencies, (2) strengthening efforts of SFP community engagement before and during emergencies, and (3) establishing guidelines of the types of foods that can be distributed to meet the nutritional needs of beneficiaries during emergencies.

El entorno construido en los programas diseñados para promover la actividad física entre las niñas, niños y jóvenes latinos que viven en Estados Unidos y América Latina.

Prevenir la obesidad entre los jóvenes latinos que viven en Estados Unidos y en países latinoamericanos requiere reconocer la especificidad de los contextos y las interacciones entre actividad física (AF) y entorno construido (EC). El objetivo de este artículo es avanzar en la agenda de investigación sobre el EC y la AF con el fin de prevenir la obesidad en Latinoamérica y entre los jóvenes latinos de Estados Unidos mediante (1) la identificación de indicadores del entorno que contribuyan en el diseño de intervenciones y políticas; (2) la identificación de enfoques metodológicos interdisciplinarios para el estudio de la relación compleja que se establece entre el EC y la AF y (3) la presentación de estudios de casos sobre programas de EC que promueven la AF. Un grupo de científicos estadounidenses y latinoamericanos trabajó en colaboración para proponer nuevos indicadores sobre el EC, establecer enfoques metodológicos que permitan estudiar la relación compleja entre EC y AF, y revisar estudios de caso sobre programas de EC que promueven la AF en ambas regiones. Como resultado, se identificaron lagunas de conocimiento, se propusieron indicadores del entorno (como el paisaje, el diseño de las calles, los patrones de movilidad, la delincuencia y la seguridad), se revisaron enfoques metodológicos (análisis de redes sociales, métodos de ciencia ciudadana) y se analizaron estudios de caso de programas del EC que promueven la AF (calles para el juego, desplazamiento activo a la escuela e intervenciones en el entorno escolar). La prevención de la obesidad entre los jóvenes latinos y latinoamericanos exige una investigación avanzada del EC y de la AF que aborde las prioridades específicas de cada contexto y permita intercambiar las lecciones aprendidas.

Capacidad de investigación en obesidad infantil en Latinoamérica y en las poblaciones latinas de Estados Unidos: estado de la investigación, problemas, oportunidades y líneas de trabajo para el futuro.

La obesidad infantil es un problema grave en Latinoamérica y entre la población latina de EE. UU. Para ser eficaces, las políticas de salud pública tienen que estar guiadas por evidencias contextuales pertinentes, lo cual exige una capacidad de investigación sostenida a través del tiempo. Los objetivos de este estudio son determinar la productividad de la investigación enfocada en las poblaciones latinas en Latinoamérica y Estados Unidos, y examinar los dominios de la capacidad de investigación (infraestructuras, programas de formación, mentoría, financiamiento y redes de contactos). Realizamos una revisión exploratoria de artículos indexados relacionados con la obesidad infantil publicados entre junio de 2015 y diciembre de 2019. Recabamos información sobre las percepciones de los investigadores latinoamericanos respecto a la capacidad de investigación en obesidad infantil a través de una encuesta en línea. Identificamos 612 artículos relacionados con la obesidad infantil (505 de Latinoamérica, 124 de EE. UU. y 17 de colaboraciones entre EE. UU. y Latinoamérica). Brasil, México, Chile, Colombia y Estados Unidos son los países con más publicaciones. Encontramos aproximadamente el mismo número de artículos sobre obesidad, nutrición y actividad física; sin embargo, observamos que la capacidad de investigación sobre actividad física está rezagada en otros dominios (formación en investigación, financiamiento y oportunidades para establecer contactos). Otras áreas de investigación complementarias, como el comportamiento sedentario, la ciencia de sistemas y los estudios de políticas, son poco frecuentes en Latinoamérica, pero más habituales en Estados Unidos, mientras que la investigación sobre el sueño es incipiente en ambas regiones. Para cumplir la promesa de crear un programa eficaz de colaboración transfronteriza para la prevención de la obesidad infantil será necesario invertir en todos los dominios de la capacidad de investigación y en todos los temas pertinentes.

Effectiveness of a Gamification Strategy to Prevent Childhood Obesity in Schools: A Cluster Controlled Trial.

OBJECTIVE: The aim of this study was to examine the effectiveness of a school-based gamification strategy to prevent childhood obesity. METHODS: Schools were randomized in Santiago, Chile, between March and May 2018 to control or to receive a nutrition and physical activity intervention using a gamification strategy (i.e., the use of points, levels, and rewards) to achieve healthy challenges. The intervention was delivered for 7 months and participants were assessed at 4 and 7 months. Primary outcomes were mean difference in BMI z score and waist circumference (WC) between trial arms at 7 months. Secondary outcomes were mean difference in BMI and systolic and diastolic blood pressure between trial arms at 7 months.  RESULTS: A total of 24 schools (5 controls) and 2,197 students (653 controls) were analyzed. Mean BMI z score was lower in the intervention arm compared with control (adjusted mean difference -0.133, 95% CI: -0.25 to -0.01), whereas no evidence of reduction in WC was found. Mean BMI and systolic blood pressure were lower in the intervention arm compared with control. No evidence of reduction in diastolic blood pressure was found. CONCLUSIONS: The multicomponent intervention was effective in preventing obesity but not in reducing WC. Gamification is a potentially powerful tool to increase the effectiveness of school-based interventions to prevent obesity.

Built environment in programs to promote physical activity among Latino children and youth living in the United States and in Latin America.

To prevent obesity among Latino youth in the United States and Latin America, it is necessary to understand the specific context and interplay of physical activity (PA) and the built environment (BE). This paper aims to advance the research agenda of BE and PA for obesity prevention in Latin America and among Latino youth in the United States by (1) identifying environmental indicators to inform the design of interventions and policy, (2) identifying interdisciplinary methodological approaches for the study of the complex association between BE and PA, and (3) presenting case studies of PA-promoting BE programs. A group of U.S. and Latin American scientists collaboratively worked to propose innovative indicators of the BE, methodological approaches for the study of the complex association between BE and PA, and review case studies of PA-promoting BE programs in both regions. The results identified gaps in knowledge, proposed environmental indicators (e.g., landscape, street design, mobility patterns, and crime and safety), reviewed methodological approaches (social network analysis, citizen science methods), and case studies illustrating PA-promoting BE programs (i.e., play streets, active school transport, and school setting interventions). The obesity prevention among Latino and Latin American youth requires advanced research on BE and PA addressing context-specific priorities and exchanging lessons learned.

Capacity for childhood obesity research in Latin American and US Latino populations: State of the field, challenges, opportunities, and future directions.

Childhood obesity is a major problem in Latin America and among US Latinos. Effective public health policies require contextually relevant evidence to guide them, which demands sustained research capacity. The objectives of this study are to determine research productivity in Latin America and in the United States focused on Latino populations and examine domains of research capacity (research infrastructure, training programs, mentoring, funding, and networks). We conducted a scoping review of indexed childhood obesity-related articles published June 2015-December 2019. We collected data on perceptions of capacity for childhood obesity research among Latin American investigators through an online survey. We identified 612 childhood obesity-related articles (505 from Latin America, 124 from the United States, and 17 US-Latin America collaborations). Brazil, Mexico, Chile, Colombia, and the United States are the top publishing countries. There are similar numbers of obesity, nutrition, and physical activity articles, but physical activity research capacity lagged in other domains (research training, funding, and networking opportunities). Complementary research areas, including sedentary behavior, systems science, and policy studies, are uncommon in Latin America but more prevalent in the United States, whereas sleep research is nascent across settings. Realizing the promise of an effective cross-border collaborative childhood obesity prevention agenda will require committed investment in all domains of research capacity and across all relevant topics.

Asociación entre lactancia materna y probabilidad de obesidad en la infancia en tres países latinoamericanos / Association between exclusive breastfeeding and obesity in children: a cross-sectional study of three Latin American countries

Objetivo: Determinar si la lactancia materna ≥ 6 meses se asocia con menor sobrepeso y obesidad en niños/as de 2 a 5 años de edad. Método: Análisis transversal de datos de encuestas nacionales de demografía y salud de Bolivia, Colombia y Perú. Se definieron sobrepeso y obesidad según los criterios de la Organización Mundial de la Salud. Se calculó la odds ratio (OR) utilizando regresión logística multinomial. Resultados: La prevalencia de obesidad en niños/as de 2 a 5 años fue del 10,4% (intervalo de confianza del 95% [IC95%]: 8,2-12,6) en Bolivia, del 4,9% (IC95%: 4,0-5,8) en Colombia y del 6,4% (IC95%: 5,2-8,0) en Perú. La lactancia materna ≥ 6 meses en la población estudiada fue del 89,9% (IC95%: 87,8-91,9) en Bolivia, del 73,9% (IC95%: 72,2-75,6) en Colombia y del 92,8% (IC95%: 91,2-94,4) en Perú. Se encontró evidencia de asociación entre lactancia materna ≥ 6 meses y menor posibilidad de obesidad en comparación con no lactancia o lactancia < 6 meses para Bolivia (OR = 0,30; IC95%: 0,16-0,57), y una asociación marginal para Colombia (OR = 0,71; IC95%: 0,47-1,06) y Perú (OR = 0,49; IC95%: 0,23-1,04). No hubo evidencia de asociación entre lactancia materna y sobrepeso. Conclusión: La lactancia materna ≥ 6 meses está asociada con una menor posibilidad de tener obesidad en niños/as de 2 a 5 años en Bolivia. Este patrón fue similar, pero marginal, para Colombia y Perú. (AU)

Objective: To determine if breastfeeding for at least the first six months of life is associated with overweight and obesity in children 2 to 5 years old. Method: Cross sectional analysis of data from national demographic and health surveys conducted in Bolivia, Colombia and Peru. Overweight and obesity were defined using World Health Organization standard definitions. Odds ratios (OR) were calculated using multinomial logistic regression. Results: The prevalence of obesity in children 2 to 5 years old was 10.4% (95% confidence interval [95%CI]: 8.2-12.6) in Bolivia, 4.9% in Colombia (95%CI: 4.0-5.8), and 6.4% (95%CI: 5.2-8.0) in Peru. Prevalence of exclusive breastfeeding for at least the first 6 months in the study population was 89.9% (95%CI: 87.8-91.9) in Bolivia, 73.9% (95%CI: 72.2-75.6) in Colombia, and 92.8% (95%CI: 91.2-92.4) in Peru. Exclusive breastfeeding was associated with a decreased risk of obesity in children as compared to no breastfeeding or breastfeeding for less than 6 months in Bolivia (OR = .30; 95%CI: .16-.57) and a marginal association in Colombia (OR = .71; 95%CI: .47-1.06) and Peru (OR = .49; 95%CI: 0.23-1.04). No association between breastfeeding and overweight was found. Conclusion: Exclusive breastfeeding for at least the first six months of life decreases the risk of obesity in children 2 to 5 years old in Bolivia. A similar but weaker pattern was observed for children in Colombia and Peru. (AU)

Disparities in Text Messaging Interventions to Improve Diabetes Management in the United States.

Substantial progress has been made in the development of evidence-based interventions to facilitate the management of type 2 diabetes. The increase in ownership of mobile phones has made short messaging services (SMS, or text messaging) a feasible way to enhance information delivery. The goals of this study were to 1) summarize characteristics of diabetes SMS interventions implemented in the United States and 2) identify the extent to which disadvantaged populations are represented in SMS-based diabetes management intervention studies. We conducted a literature search to identify published studies of type 2 diabetes self-management SMS interventions conducted with adults in the United States. Of the 792 articles retrieved, only 9 met inclusion criteria. We systematically extracted data on the theoretical basis, recruitment, incentives, inclusion/exclusion criteria, strategies toward ensuring a racially/ethnically or income-diverse sample, text message delivery, and study duration. Sixty-three percent of the participants across the nine studies were non-white. Only two studies reported participants' education level, and four captured non-English-speaking status. Interventions varied in offering one-way, two-way, or a combination of messaging strategies. Five studies did not describe cultural adaptations or report results separately for different cultural groups. None of the studies provided cell phones, and not having texting capability was an exclusion criterion for six studies. There is a dearth of published research on type 2 diabetes management interventions using text messaging among racially/ethnically or income-diverse populations. Future interventions should be better tailored to these target populations and include the collection of complete sociodemographic data and cell phone/smartphone availability, thereby ensuring cultural appropriateness.

[Association between exclusive breastfeeding and obesity in children: a cross-sectional study of three Latin American countries]. / Asociación entre lactancia materna y probabilidad de obesidad en la infancia en tres países latinoamericanos.

OBJECTIVE: To determine if breastfeeding for at least the first six months of life is associated with overweight and obesity in children 2 to 5 years old. METHOD: Cross sectional analysis of data from national demographic and health surveys conducted in Bolivia, Colombia and Peru. Overweight and obesity were defined using World Health Organization standard definitions. Odds ratios (OR) were calculated using multinomial logistic regression. RESULTS: The prevalence of obesity in children 2 to 5 years old was 10.4% (95% confidence interval [95%CI]: 8.2-12.6) in Bolivia, 4.9% in Colombia (95%CI: 4.0-5.8), and 6.4% (95%CI: 5.2-8.0) in Peru. Prevalence of exclusive breastfeeding for at least the first 6 months in the study population was 89.9% (95%CI: 87.8-91.9) in Bolivia, 73.9% (95%CI: 72.2-75.6) in Colombia, and 92.8% (95%CI: 91.2-92.4) in Peru. Exclusive breastfeeding was associated with a decreased risk of obesity in children as compared to no breastfeeding or breastfeeding for less than 6 months in Bolivia (OR = .30; 95%CI: .16-.57) and a marginal association in Colombia (OR = .71; 95%CI: .47-1.06) and Peru (OR = .49; 95%CI: 0.23-1.04). No association between breastfeeding and overweight was found. CONCLUSION: Exclusive breastfeeding for at least the first six months of life decreases the risk of obesity in children 2 to 5 years old in Bolivia. A similar but weaker pattern was observed for children in Colombia and Peru.

Geographic Distribution of the Ciclovia and Recreovia Programs by Neighborhood SES in Bogotá: How Unequal is the Geographic Access Assessed Via Distance-based Measures?

Ciclovia, also known as Open Streets initiatives in other countries, are city streets that are closed to motorized traffic and opened during certain times to residents for engaging in physical activity (PA). These initiatives are viewed by policy makers and health and community advocates as being beneficial to social, environmental, and community health. This study explores the geographic distribution of Ciclovia and Recreovia and the differences in geographic access assessed via distance-based measures, based on the socioeconomic status (SES) of the area. Results from this study show that the median distance to the Ciclovia according to SES ranges from 2930 m for SES 1 (most disadvantaged) to 482 m for SES 6 (wealthiest). The median distance to the Recreovia sites ranges from 5173 m for SES 1 to 3869 m for SES 6. This study found revealing urban inequities in the distribution of Ciclovia, whereas there was less inequalities within the Recreovia sites. This study shows that urban interventions are needed to promote recreational activity and reduce health disparities in under resourced, low SES areas.

Sociodemographic factors associated with the consumption of ultra-processed foods in Colombia.

OBJECTIVE: To analyze the consumption of ultra-processed foods in the Colombian population across sociodemographic factors. METHODS: We used data from the 2005 National Survey of the Nutritional Status in Colombia. Food consumption was assessed using a 24-hour food recall in 38,643 individuals. The food items were classified according to the degree and extent of industrial processing using the NOVA classification. RESULTS: The mean calorie contribution of ultra-processed foods ranged from 0.2% in the lowest quintile of consumers to 41.1% in the highest quintile of consumers. The greatest increases were due to the consumption of industrialized breads, sweet and savory snacks, sugary drinks, processed meats, and confectionery. No major differences were found in the consumption of ultra-processed foods between men and women. We observed significant differences by age, socioeconomic status, area of residence, and geographic region. Children and adolescents showed a higher intake of ultra-processed foods, almost double that of participants over 50 years of age. Children consumed significantly more snacks, confectionery products, processed cereals, milk-based drinks and desserts. Participants over 50 years consumed fewer products from these sub-groups of ultra-processed foods but had the highest consumption of industrialized bread. Individuals from urban areas, those with high socioeconomic status, participants residing in the Bogotá region had 1.5 to 1.7 times higher calorie intake from ultra-processed foods compared with those from a lower socioeconomic status and those residing in rural regions. CONCLUSION: In Colombia, industrialized bread is the ultra-processed product that is most easily assimilated into the traditional diet, along with snacks and sugary drinks. Children and adolescents residing in urban areas and households with greater purchasing power have some of the highest intakes of ultra-processed foods in the country.

Scoping review of studies on food marketing in Latin America: Summary of existing evidence and research gaps.

OBJECTIVE: To document the evidence about marketing of ultra-processed foods and "non-alcoholic" beverages in Latin America. METHODS: We performed a structured search of quantitative and qualitative studies in PubMed, SciELO and LILACS, published between January 2000 and May 2017 and conducted in Latin America. We conducted a quality assessment following a standardized tool and a thematic analysis to identify key typologies of marketing across studies. RESULTS: Out of 521 studies screened by title and abstract, we included 36 in this review; 27 of them analyzed television advertisement. Other marketing channels studied were food packaging, point of sale and outdoor advertisement. Studies found television advertises foods and beverages that are mostly ultraprocessed foods and have low nutritional value, particularly those promoted during children's programming. We also observed children have a literal interpretation of images printed on food packaging, so this can be deceiving. Several studies also found proximity to unhealthy foods may increase their consumption. Finally, the thematic analysis identified the following typologies of food marketing: a) television advertisement, b) food packaging marketing, c) marketing strategies at points of sale and d) other marketing strategies. We found almost no advertisements for unprocessed or minimally processed foods such as fruits and vegetables. We did not find any studies on digital marketing conducted in the region. CONCLUSIONS: This review found that the main channel of food marketing was television advertising. This synthesis provides insights to the challenges unhealthy eating represents to the public health of Latin America and identifies knowledge gaps to guide future research.

Neighborhood environment, self-rated health and quality of life in Latin America.

To conduct a systematic review examining the associations between neighborhood environments and self-rated health (SRH) and health-related quality of life (HR-QOL) in the urban context of Latin America. We conducted a structured search of quantitative studies in three bibliographic databases published in Spanish, English, Portuguese and French from January 1990 to December 2015. We restricted the search to studies conducted in Latin-American cities with one million and more inhabitants. Eleven studies were finally included in the analysis. Ten were cross-sectional studies and one was a cohort follow-up study. Two studies found positive associations between accessibility to parks and HR-QOL. One study found that high neighborhood social capital was positively associated with SRH. Neighborhood socioeconomic status was positively associated with both HR-QOL and SRH in two studies. A walkable neighborhood was positively associated with SRH in two studies. Three studies included attributes related with neighborhood security perception and road safety, with higher scores of HR-QOL, both in the physical and mental dimensions, while high levels of street noise were negatively associated. Narrowness and slope of streets were negatively associated with SRH. No association was found between the perception of neighborhood security and SRH. The results of this systematic review show that several studies conducted in Latin America have found significant associations between neighborhood environment and SRH and HRQOL. However, the relatively small number of studies and the heterogeneity among them require further studies to better understand this topic in the region.

Sociodemographic factors associated with the consumption of ultra-processed foods in Colombia / Factores sociodemográficos asociados al consumo de alimentos ultraprocesados en Colombia

ABSTRACT OBJECTIVE To analyze the consumption of ultra-processed foods in the Colombian population across sociodemographic factors. METHODS We used data from the 2005 National Survey of the Nutritional Status in Colombia. Food consumption was assessed using a 24-hour food recall in 38,643 individuals. The food items were classified according to the degree and extent of industrial processing using the NOVA classification. RESULTS The mean calorie contribution of ultra-processed foods ranged from 0.2% in the lowest quintile of consumers to 41.1% in the highest quintile of consumers. The greatest increases were due to the consumption of industrialized breads, sweet and savory snacks, sugary drinks, processed meats, and confectionery. No major differences were found in the consumption of ultra-processed foods between men and women. We observed significant differences by age, socioeconomic status, area of residence, and geographic region. Children and adolescents showed a higher intake of ultra-processed foods, almost double that of participants over 50 years of age. Children consumed significantly more snacks, confectionery products, processed cereals, milk-based drinks and desserts. Participants over 50 years consumed fewer products from these sub-groups of ultra-processed foods but had the highest consumption of industrialized bread. Individuals from urban areas, those with high socioeconomic status, participants residing in the Bogotá region had 1.5 to 1.7 times higher calorie intake from ultra-processed foods compared with those from a lower socioeconomic status and those residing in rural regions. CONCLUSION In Colombia, industrialized bread is the ultra-processed product that is most easily assimilated into the traditional diet, along with snacks and sugary drinks. Children and adolescents residing in urban areas and households with greater purchasing power have some of the highest intakes of ultra-processed foods in the country.

RESUMEN OBJETIVO Analizar el consumo de alimentos ultraprocessados en la población colombiana según factores sociodemográficos. MÉTODOS Se usaron datos de la Encuesta Nacional de la Situación Nutricional en Colombia del año 2005. El consumo de alimentos se evaluó por medio de recordatorio 24 horas en 38.643 individuos. Los ítems alimentarios se clasificaron según el grado y extensión de procesamiento industrial usando la propuesta NOVA. RESULTADOS La contribución promedio de calorías de los alimentos ultraprocesados varió del 0,2% en el primer quintil al 41,1% en el ultimo quintil. Los mayores incrementos se dieron por el consumo de panes industrializados, snacks dulces y salados, las bebidas azucaradas, las carnes procesadas y los productos de confitería. No hubo grandes diferencias en el consumo de alimentos ultraprocesados entre hombres y mujeres. Se observaron diferencias significativas por edad, estatus socioeconómico, área de residencia y región geográfica. Los niños y adolescentes presentaron mayor ingesta de alimentos ultraprocesados, casi el doble que los participantes mayores de 50 años. Los niños consumieron significativamente mayor cantidad de snacks, productos de confitería, cereales procesados, bebidas a base de leche y postres. Mientras que los participantes mayores de 50 años consumieron menor cantidad de productos de estos subgrupos de alimentos ultraprocesados, pero tenían el consumo más alto de pan industrializado. Los habitantes urbanos, con alto estatus socioeconómico, que residían en la región de Bogotá tenían entre 1,5 a 1,7 más veces de ingesta calórica de alimentos ultraprocesados en comparación con sus contrapartes de bajo estatus socioeconómico, y sus contrapartes rurales. CONCLUSIÓN En Colombia, el pan industrializado es el alimento ultraprocesado más fácilmente asimilable en la dieta tradicional, junto con los snacks y las bebidas azucaradas. Los niños y adolescentes residentes en zonas urbanas y hogares con mayor poder adquisitivo fueron más vulnerables en el consumo de alimentos ultraprocesados.

A qualitative study of older adults' perspectives on initiating exercise and mindfulness practice.

BACKGROUND: Mindfulness practice and exercise are ways by which older adults can improve and maintain their physical, emotional and cognitive health. METHODS: This single-site qualitative study gathered insights of older adults' perceptions about initiating and maintaining mindfulness and exercise practices. We carried out focus groups with 41 adults aged 65-85 who had recently initiated Mindfulness Based Stress Reduction (MBSR), structured exercise, or their combination as part of participation in a clinical trial. We used a semi-structured interview to ask them open-ended questions regarding the benefits, barriers and facilitators of participating in mindfulness and/or exercise interventions. The interview also included questions regarding translation of these practices into community settings as well as the long-term maintenance potential of these practices. RESULTS: Older adults indicated that the mindfulness training increased their awareness and self-reflection and fostered a more self-accepting attitude. Furthermore, they improved their self-care habits and reported having better familial and social relationships. The main barrier for both the exercise and Mindfulness group was time management. The social benefits and sense of community were some of the primary motivators for older adults in the exercise and/or MBSR interventions. However, the research on how to motivate older adults to initiate healthy behavioral changes also needs to be answered. The benefits of exercise and MBSR are a motivation in and of themselves, as indicated by some of the participants. CONCLUSIONS: This study indicates that mindfulness training and exercise can serve as tools to cultivate important health lifestyle qualities among older adults, who are in the midst of mental, social, emotional and physical change. If it were not for the purpose of the research or the incentives provided by the research team, these older adults may have never started the healthy behavioral changes. From the responses, this may indicate that older adults may need more incentives to begin and maintain behavioral changes other than for their own health benefit.

The shift of obesity burden by socioeconomic status between 1998 and 2017 in Latin America and the Caribbean: a cross-sectional series study.

BACKGROUND: The burden of obesity differs by socioeconomic status. We aimed to characterise the prevalence of obesity among adult men and women in Latin America and the Caribbean by socioeconomic measures and the shifting obesity burden over time. METHODS: We did a cross-sectional series analysis of obesity prevalence by socioeconomic status by use of national health surveys done between 1998 and 2017 in 13 countries in Latin America and the Caribbean. We generated equiplots to display inequalities in, the primary outcome, obesity by wealth, education, and residence area. We measured obesity gaps as the difference in percentage points between the highest and lowest obesity prevalence within each socioeconomic measure, and described trends as well as changing patterns of the obesity burden over time. FINDINGS: 479 809 adult men and women were included in the analysis. Obesity prevalence across countries has increased over time, with distinct patterns emerging by wealth and education indices. In the most recent available surveys, obesity was most prevalent among women in Mexico in 2016, and the least prevalent among women in Haiti in 2016. The largest gap between the highest and lowest obesity estimates by wealth was observed in Honduras among women (21·6 percentage point gap), and in Peru among men (22·4 percentage point gap), compared with a 3·7 percentage point gap among women in Brazil and 3·3 percentage points among men in Argentina. Urban residents consistently had a larger burden than their rural counterparts in most countries, with obesity gaps ranging from 0·1 percentage points among women in Paraguay to 15·8 percentage points among men in Peru. The trend analysis done in five countries suggests a shifting of the obesity burden across socioeconomic groups and different patterns by gender. Obesity gaps by education in Mexico have reduced over time among women, but increased among men, whereas the gap has increased among women but remains relatively constant among men in Argentina. INTERPRETATION: The increase in obesity prevalence in the Latin American and Caribbean region has been paralleled with an unequal distribution and a shifting burden across socioeconomic groups. Anticipation of the establishment of obesity among low socioeconomic groups could provide opportunities for societal gains in primordial prevention. FUNDING: None.

Arch parameters and dental discrepancy (crowding and spacing) in a sample of an Afro-Colombian population.

The aim of this study was to determine the differences in arch length, inter-canine distance, inter-premolar distance, intermolar distance and arch shape between dental discrepancies (crowding and spacing) in a sample of dental casts from the Afro-Colombian population of San Basilio de Palenque. An analytical, cross-sectional study was conducted on a convenience sample of 63 subjects aged 11 to 57years, of Afro-Colombian origin, with full dentition from first molar to first molar, without extensive caries or restorations, and excluding casts with defects due to loss. The differences between arch (upper and lower) variables were analyzed according to dental discrepancies. Plaster models digitalized with a TR1OS3 Mono scanner with exactitude (6.9 ± 0.9 pm) and precision (4.5 ± 0.9 pm) were analyzed with Orthonalyzer software. Statistical analyses were done on SPSS software (Version 20 for Windows) and Real Statistics. Spacing discrepancy of68.25% was found for upper arch and 66.66% for lower arch; crowding discrepancy of 19.04% for upper arch and 20.63% for lower arch, and an adequate ratio of 12.69% for both arches. No statistically significant difference (p>0.05) was found between arch parameters except for inter-premolar distance on the lower arch. The most frequent arch shape in the population was oval for both upper arch, with 76.19%, and lower arch, with 71.42%. Tooth size was larger in males than females but the difference was not statistically significant.

El objetivo de este estudio fue determinar las diferencias en longitud de arco, distancia intercanina, interpremolar, intermolar y la forma de arco entre discrepancias dentales (apiñamiento y espaciamiento), en una muestra de modelos dentales de la población afrocolombiana de San Basilio de Palenque. Se realizó un estudio analítico transversal, en una muestra por conveniencia de 63 sujetos con un rango de edad entre 11 y 57 años, de origen afrocolombiano, quienes tuvieron dentición completa de primer molar a primer molar, sin caries extensas, ni restauraciones; se excluyeron los modelos con defectos por el vaciado. Se analizaron las diferencias entre las variables de los maxilares (superior e inferior) con las discrepancias dentales. Se utilizaron modelos de yeso que fueron digitalizados con el escánerTR1OS3 Mono con una exactitud de (6.9 ± 0.9 pm) y una precisión de (4.5 ± 0.9 pm)y analizados con el software Orthonalyzer. Los análisis estadísticos se llevaron a cabo utilizando el software SPSS (Versión 20 para Windows) y Real Statistics. Se encontró una discrepancia de espaciamiento de un 68,25% para el arco superior y 66,66% en el arco inferior; y una discrepancia de apiñamiento en el arco superior de 19,04% e inferior de 20,63% y una relación adecuada de 12,69% para los dos arcos. No se encontraron diferencias estadísticamente significativas (p>0.05) en los parámetros de arco a excepción de la distancia interpremolar del arco inferior. La forma de arco más frecuente en la población fue ovalada tanto en el arco superior con un 76,19% como en el arco inferior con un 71,42%. En cuanto al tamaño dental, se presentó mayor tamaño en los hombres que en las mujeres, pero este no fue estadísticamente significativo.

Evaluating Park Use and Satisfaction: The Case of Trojan Park in St. Louis Missouri.

Background: Providing public access to exercise and play is vital for health promotion across populations. We evaluated the use of and satisfaction at Trojan Park, a multigenerational playground with multiple activity areas and fitness zones in the city of Wellston in St. Louis County, MO. Methods: We used video footage and the System for Observing Play and Recreation in Communities (SOPARC), which is a valid and reliable system for collecting data on physical activity in parks. We then performed intercept interviews to gather user information and measure overall satisfaction with the park. Results: The park received a variety of attendees across age groups, with children and middle-aged adults representing 41.1% and 50.3% of total park users, respectively. During the time observed, 47% of attendees were engaged in moderate to vigorous physical activity (MVPA), 22% were engaged in light physical activity (walking), and 30% were sedentary. We also observed participants spending the most time on the basketball court (38%), playground (28%), and picnic (17%) areas. Park users traveled a wide range of distances to access the park and the overwhelming majority reported a high level of satisfaction. Conclusions: Our findings demonstrate that multigenerational playgrounds with access to various activities and fitness zones may provide social and physical health benefits.