Patrones de consumo alimentario y pobreza monetaria en Colombia / Food consumption patterns and monetary poverty in Colombia

RESUMEN Se estimaron las desigualdades en tres patrones de consumo alimentario en adultos colombianos (18 y 64 años) relacionadas con la pobreza monetaria. Se realizó un estudio ecológico, que relacionó la pobreza monetaria de 33 unidades geo-demográficas con tres patrones de consumo obtenidos mediante análisis de factores de la Encuesta Nacional de Situación Nutricional en Colombia- 2010. Utilizando Epidat v. 4.2®, se calcularon índices de desigualdad basados en rangos, disparidad o dispersión, en desproporcionalidad, basados en modelos de regresión y los basados en el concepto de entropía. El coeficiente de determinación (r2) para el patrón frutaverdura/lácteos fue de 0,30; para el patrón tradicional/almidón de 0,08 y para el patrón snack de 0,00. La razón de tasas más alta fue para el patrón fruta-verdura/lácteos (2,61), seguida por la razón para el patrón tradicional/almidón (0,93) y la más baja para el patrón snack (0,85). La desigualdad, alcanzó el mayor coeficiente de Gini en el patrón de consumo snack (0,26), le sigue el alcanzado en el patrón tradicional/almidón (0,17) y el fruta-verdura/lácteos (0,12). Concluimos que la mayor desigualdad ocurrió en el patrón de consumo fruta-verdura/lácteos, es deseable aumentar la adherencia la patrón tradicional y disminuir la ingesta de proteínas en los más ricos.

ABSTRACT We estimated the inequalities in three patterns of food consumption in Colombian adults (18 and 64 years) related to monetary poverty. An ecological study was conducted, which linked the monetary poverty of 33 geo-demographic units with three consumption patterns obtained through factor analysis using the National Nutrition Situation Survey in Colombia-2010. Using Epidat v. 4.2®, inequality indexes based on ranges, disparity or dispersion were calculated, in disproportionality, based on regression models and those based on the concept of entropy. The determination coefficient (r2) for the fruit-vegetable/dairy pattern was 0.30, 0.08 for the traditional pattern/starch, 0.00 and for the snack pattern. The highest rate ratio was for the fruit-vegetable/dairy pattern (2.61), followed by the ratio for the traditional pattern/starch (0.93), and the lowest for the snack pattern (0.85). Inequality reached the highest Gini coefficient in the pattern of snack consumption (0.26), followed by that reached in the traditional pattern/starch (0.17) and the fruit-vegetable/dairy pattern (0.12). We showed that the greatest inequality occurred in the fruit-vegetable / dairy consumption pattern, it is desirable to increase the adherence to the traditional pattern and decrease the protein intake in the richest population.

Consumption of sweetened-beverages and poverty in Colombia: when access is not an advantage.

BACKGROUND: This study characterizes the intake of sweetened beverages and establishes whether economic inequalities in their consumption exists. METHODS: Ecological study. Mixed methods using food frequency questionnaire and inequality indices. Based on the National Nutrition Survey, Colombia, 2010. The sweetened beverage intake of 17,514 subjects in 33 geodemographic units was estimated with a food frequency questionnaire and summarized. The calculation of inequality was based on the monetary poverty. The prevalence (yes/no) and frequency (times/day) of sweetened beverage consumption were estimated. Indices of economic inequality were calculated for both prevalence and frequency. RESULTS: The prevalence of sweetened beverage consumption was between 79.2% (95% CI, 75.7 to 82.8) in adults and 88.5% (95% CI, 85.8 to 91.3) in minors. The frequency of consumption in terms of times/day, was between 0.20 (95% CI, 0.16 to 0.24) in adults and 0.40 (95% CI, 0.33 to 0.46) in minors. The Gini coefficient for the prevalence was close to zero, between 0.04 and 0.08; for the frequency, it was slightly higher, between 0.12 and 0.25. CONCLUSIONS: It was established that there is no economic inequality in the consumption of sweetened beverages. Consumption taxes could be regressive.

Dietary transition and excess weight in adults according to the Encuesta de la Situación Nutricional en Colombia, 2010.

INTRODUCTION: Dietary transition is codetermined by demographic and nutritional transitions.  OBJECTIVES: To establish the prevalence of overweight individuals among Colombians aged 18 to 64, identify their dietary patterns and establish the relationship between this and their excess weight.  MATERIALS AND METHODS: We analyzed the Encuesta de la Situación Nutricional en Colombia, 2010 (National Survey of the Nutritional Situation in Colombia, 2010). Dietary patterns were established with factor analysis in 5,217 subjects, who answered a questionnaire on food consumption frequency. The relationship between excess weight and adherence to quartiles in the patterns was established with binomial regression.  RESULTS: The prevalence of excess weight was 47.4% in men (95% CI: 44.7; 50.0) and 57.1% in women (95% CI: 54.9; 59.3, p<0.0001). Three patterns were established: protein/fiber, sandwich/snack and traditional/starch. When the models were adjusted for age, sex and level of food security in the home, the protein/fiber and traditional/starch patterns were found to be associated with excess weight (test of linear trend for quartiles of adherence, p=0.007 and p=0.001, respectively). Neither the frequency of consumption of carbonated and sugary drinks, with an adjusted relative risk of 100 (95% CI: 93 - 109; p=0.913), nor that of fast food with 102 (95% CI: 89; 117; p=0.759) were associated with excess weight.  CONCLUSIONS: Excess weight increases constantly with age, particularly in women, and is associated positively with indicators of socioeconomic status and subjects changing from the traditional/starch pattern to the protein/fiber one.

La transición alimentaria y el exceso de peso en adultos evaluados con base en la Encuesta de la Situación Nutricional en Colombia, 2010 / Dietary transition and excess weight in adults according to the Encuesta de la Situación Nutricional en Colombia, 2010

Introducción. La transición alimentaria está determinada por las transiciones demográfica y nutricional. Objetivos. Establecer la prevalencia del exceso de peso en colombianos de 18 a 64 años de edad, determinar su patrón alimentario y su relación con el exceso de peso. Materiales y métodos. Se analizó la Encuesta Nacional de la Situación Nutricional en Colombia, 2010. Los patrones alimentarios se establecieron mediante un análisis de factores en 5.217 sujetos que contestaron un cuestionario de frecuencia de consumo. La relación entre el exceso de peso y la inclusión en los cuartiles de los patrones se estableció con regresión binomial. Resultados. La prevalencia del exceso de peso en hombres fue de 47,4 % (IC 95% 44,7-50,0) y en mujeres de 57,1 % (IC 95% 54,9 59,3; p<0,0001). Se establecieron tres patrones alimentarios: proteína-fibra, bocadillo- snack y tradicional-almidón. Los modelos ajustados por edad, sexo y nivel de seguridad alimentaria del hogar, evidenciaron que los patrones de proteína-fibra y tradicional-almidón estaban asociados al exceso de peso (test de tendencia lineal para la inclusión en los cuartiles: p=0,007 y p=0,001, respectivamente). Ni la frecuencia del consumo de gaseosas y refrescos azucarados, con un sesgo relativo ajustado de 100 (IC 95% 93-109; p=0,913), ni de comidas rápidas, con un sesgo de 102 (IC 95% 89-117; p=0,759), se asociaron al exceso de peso. Conclusiones. El exceso de peso aumentó de manera constante con la edad y más en las mujeres, y se asoció con los indicadores de estatus socioeconómico y con el cambio del patrón tradicional-almidón al de proteína-fibra.

Introduction: Dietary transition is codetermined by demographic and nutritional transitions. Objectives: To establish the prevalence of overweight individuals among Colombians aged 18 to 64, identify their dietary patterns and establish the relationship between this and their excess weight. Materials and methods: We analyzed the Encuesta de la Situación Nutricional en Colombia, 2010 ( National Survey of the Nutritional Situation in Colombia, 2010). Dietary patterns were established with factor analysis in 5,217 subjects, who answered a questionnaire on food consumption frequency. The relationship between excess weight and adherence to quartiles in the patterns was established with binomial regression. Results: The prevalence of excess weight was 47.4% in men (95% CI: 44.7; 50.0) and 57.1% in women (95% CI: 54.9; 59.3, p<0.0001). Three patterns were established: protein/fiber, sandwich/snack and traditional/starch. When the models were adjusted for age, sex and level of food security in the home, the protein/fiber and traditional/starch patterns were found to be associated with excess weight (test of linear trend for quartiles of adherence, p=0.007 and p=0.001, respectively). Neither the frequency of consumption of carbonated and sugary drinks, with an adjusted relative risk of 100 (95% CI: 93 - 109; p=0.913), nor that of fast food with 102 (95% CI: 89; 117; p=0.759) were associated with excess weight. Conclusions: Excess weight increases constantly with age, particularly in women, and is associated positively with indicators of socioeconomic status and subjects changing from the traditional/starch pattern to the protein/fiber one.

Derecho a la alimentación en población en situación de desplazamiento forzado en Bucaramanga, Colombia / Right to food in population in a situation of forced displacement in Bucaramanga, Colombia

Objetivo: Se analizó el acceso a la alimentación en el marco del goce efectivo de derechos en población en situación de desplazamiento forzado en el Área Metropolitana de Bucaramanga, Colombia. Materiales y métodos: Durante el segundo semestre de 2010 y el primero de 2011, se entrevistaron 272 familias siguiendo los parámetros de las Encuestas Nacionales de Verificación (ENV2007-ENV2010). Resultados: La principal causa de desplazamiento fue la amenaza directa (71,8%), seguida de los asesinatos (11,3%). El 91,2% de las familias se encontraba en el Registro Único de Población Desplazada (RUDP). El 33,5% de las familias, afirmó consumir menos alimentos de los necesarios, porque la comida no alcanzó. En el 24,6%, dejó de consumir al menos una comida principal por falta de dinero. Estar inscrito en el RUDP no se traduce en ventajas relativas con respecto al derecho a la alimentación. Conclusión: La situación de la población del Área Metropolitana de Bucaramanga en materia del goce efectivo del derecho a la alimentación no se cumple y corrobora la existencia de un estado de cosas inconstitucional. La situación de inseguridad alimentaria que atraviesan las familias en situación de desplazamiento forzado es similar a la que se registra en el país a través de las Encuestas Nacionales de Verificación.

Objective: The access to food in the framework of the full enjoyment of rights in population in a situation of forced displacement in the Metropolitan Area of Bucaramanga, Colombia was analyzed. Materials and methods: 272 families were interviewed during the second half of 2010 and the first half of 2011 taking into account the parameters of the National Surveys of Verification (ENV2007-ENV2010). Results: The main cause of displacement was the direct threat (71.8%), followed by murder (11.3%). 91.2% of the families was registered in the Single Register of Displaced Population (RUDP). 33.5% of the families claimed they were consuming less food than needed because the food was not enough. 24.6% of the families stopped eating at least one main meal due to lack of money. Being enrolled in RUDP does not mean they have relative advantages with respect to the right to food. Conclusion: The situation of the population of the Metropolitan Area of Bucaramanga in terms of the effective enjoyment of the right to food is not fulfilled and confirms the existence of an unconstitutional state of affairs. The situation of food insecurity that families in a situation of forced displacement deal with is similar to that registered around the country through the National Surveys of Verification.

[Forced displacement, childhood and adolescence: scenarios regarding socioeconomic stability]. / Desplazamiento forzado, niñez y adolescencia: escenarios en relación con su estabilización socioeconómica.

OBJECTIVE: Describing and analysing socio-economic stabilisation scenarios for populations which have been forcibly displaced paying special attention to the situation of children and adolescents. METHOD: The analytic hierarchy process (AHP) multi-criteria decision-making method developed by Professor Thomas Saaty was used through expert workshops, involving researchers, leaders of NGOs and displaced communities living in the city of Bucaramanga. RESULTS: The partial result of this research showed that some elderly adults from forcibly displaced communities preferred to adapt themselves to urban centres, rather than return to their places of origin, particularly when it came to protecting younger children and dealing with their welfare. The method's consistency index and consistency ratio came within the expected parameters. CONCLUSION: Government-promoted social and economic stabilisation programmes must be rethought regarding forcibly displaced populations, particularly when situations are envisaged involving the welfare of children and adolescents.

Inseguridad alimentaria: variables asociadas y elementos para la política social / Food insecurity: associated variables and issues for public policy

Introducción. La vigencia de las explicaciones cambia con las transiciones demográfica, epidemiológica y nutricional. Objetivo. Establecer la magnitud de inseguridad alimentaria y sus variables asociadas. Materiales y métodos . Se clasificaron 432 hogares mediante cinco métodos; se utilizaron las escalas de percepción de seguridad alimentaria (EPSA), la latinoamericana y caribeña (ELCSA), y otros tres: a) según el consumo usual de energía del jefe del hogar, b) según el consumo usual de energía de todos los miembros, y c) según un algoritmo basado en el consumo y la condición de los menores. Mediante regresión binomial, se establecieron las variables asociadas a la inseguridad alimentaria. Resultados. La inseguridad varió entre 35,9 y 87 %. Según la ELCSA y b), los hogares con menores tienen menor riesgo de inseguridad 0,51 (IC95% 0,25-0,90) y 0,72 (IC95% 0,48-0,96). Según la EPSA y la ELCSA, no pagar los servicios públicos 1,75 (IC95% 1,23-2,28) y que el jefe del hogar declare que no accede a los alimentos 1,48 (IC95% 1,20-1,68), aumentan la inseguridad. Obtener ingresos esporádicamente se asoció con el método a), 1,34 (IC95% 1,04-1,53) y el método b), 1,32 (IC95% 1,03-1,52). Pagar arriendo 1,12 (IC95% 1,01-1,16), el tiempo de permanencia en el municipio 0,59 (IC95% 0,23-0,93) y no contar con alcantarillado 1,13 (IC95% 1,01-1,16), se asociaron a la inseguridad por el método c). Conclusiones. No es pertinente o útil recomendar estos métodos con fines de elaborar la política social.

Introduction. The validity of the explanations change over time according to the state of demographic, epidemiological and nutritional transitions. Objective. Five methods were compared to establish t he magnitude of food insecurity and related variables. Material and methods. Four hundred and thirty-two households in Colombia were classified using five methods, including (1) the scale of perceptions of food safety (EPSA),(2) the Latin American and Caribbean scale (ELCSA), (3) the usual intake of energy from the head of household, (4) the usual consumption of energy of all members of the home, and (5) an algorithm based on consumption and status of children. Binomial regression established variables associated with food insecurity. Results . Insecurity varied between 35.9% and 87.0%. According ELCSA and method 3, households with children have a lower risk of insecurity, 0.51 (95% CI 0.25 to 0.90) and 0.72 (95% CI 0.48 to 0.96). Under the EPSA and ELCSA, increased insecurity is associated with nonpayment of utilities, 1.75 (95% CI: 1.23 to 2.28) and the head of household declared limited access to food, 1.48 (95% CI: 1, 20 to 1.68). Sporadic income was associated with the method 3, 1.34 (95% CI 1.04 to 1.53) and method 4, 1.32 (95% CI 1.03 to 1.52). Paying rent, 1.12 (95% CI: 1.01 to 1.16), time spent in the municipality, 0.59 (95% CI 0.23 to 0.93) and not having sewer, 1.13 (95% CI 1.01 to 1.16) were associated with the food insecurity using method 5. Conclusions . Since the country has reliable information that is obtained routinely it is not relevant or useful to use these methods with the purpose of developing social policies.

Desplazamiento forzado, niñez y adolescencia: escenarios en relación con su estabilización socioeconómica / Forced displacement, childhood and adolescence: scenarios regarding socioeconomic stability

Objetivo Describir y analizar escenarios de estabilización socioeconómica para población en situación de desplazamiento forzado, en los que se preste especial atención a la situación de niños, niñas y adolescentes. Métodos Se utiliza, a partir de talleres de expertos, el método Analytic Hierarchy Process (AHP), elaborado por el profesor Thomas Saaty con participación investigadores, ONG y de comunidades en situación de desplazamiento del Área Metropolitana de Bucaramanga. Resultados El resultado parcial de esta investigación muestra como algunos adultos mayores de comunidades en situación de desplazamiento forzado prefieren adaptarse a los centros urbanos, antes que retornar sus lugares de origen, en particular cuando se trata de la protección y el bienestar de sus hijos menores. El índice de consistencia y la relación de consistencia del método están dentro de los parámetros previstos. Conclusión Es necesario repensar los programas de estabilización socioeconómica promovidos por el gobierno en relación con la población en situación de desplazamiento forzado, en particular cuando se prevén situaciones que comprometen el bienestar de los niños, niñas y adolecentes.

Objective Describing and analysing socio-economic stabilisation scenarios for populations which have been forcibly displaced paying special attention to the situation of children and adolescents. Method The analytic hierarchy process (AHP) multi-criteria decision-making method developed by Professor Thomas Saaty was used through expert workshops, involving researchers, leaders of NGOs and displaced communities living in the city of Bucaramanga. Results The partial result of this research showed that some elderly adults from forcibly displaced communities preferred to adapt themselves to urban centres, rather than return to their places of origin, particularly when it came to protecting younger children and dealing with their welfare. The method's consistency index and consistency ratio came within the expected parameters. Conclusion Government-promoted social and economic stabilisation programmes must be rethought regarding forcibly displaced populations, particularly when situations are envisaged involving the welfare of children and adolescents.

[Food insecurity: associated variables and issues for public policy]. / Inseguridad alimentaria: variables asociadas y elementos para la política social.

INTRODUCTION: The validity of the explanations change over time according to the state of demographic, epidemiological and nutritional transitions. OBJECTIVE: Five methods were compared to establish t he magnitude of food insecurity and related variables. MATERIAL AND METHODS: Four hundred and thirty-two households in Colombia were classified using five methods, including (1) the scale of perceptions of food safety (EPSA),(2) the Latin American and Caribbean scale (ELCSA), (3) the usual intake of energy from the head of household, (4) the usual consumption of energy of all members of the home, and (5) an algorithm based on consumption and status of children. Binomial regression established variables associated with food insecurity. RESULTS: Insecurity varied between 35.9% and 87.0%. According ELCSA and method 3, households with children have a lower risk of insecurity, 0.51 (95% CI 0.25 to 0.90) and 0.72 (95% CI 0.48 to 0.96). Under the EPSA and ELCSA, increased insecurity is associated with nonpayment of utilities, 1.75 (95% CI: 1.23 to 2.28) and the head of household declared limited access to food, 1.48 (95% CI: 1, 20 to 1.68). Sporadic income was associated with the method 3, 1.34 (95% CI 1.04 to 1.53) and method 4, 1.32 (95% CI 1.03 to 1.52). Paying rent, 1.12 (95% CI: 1.01 to 1.16), time spent in the municipality, 0.59 (95% CI 0.23 to 0.93) and not having sewer, 1.13 (95% CI 1.01 to 1.16) were associated with the food insecurity using method 5. CONCLUSIONS: Since the country has reliable information that is obtained routinely it is not relevant or useful to use these methods with the purpose of developing social policies.