Grado de adherencia a la Dieta Mediterránea e ingesta de nutrientes durante las guardias de 24h del personal residente de medicina del Hospital Reina Sofía de Córdoba, España / Degree of adherence to the Mediterranean Diet and nutrient intake duringthe 24-hour shifts of the resident medical staff at the Reina Sofia Hospital in Cordoba, Spain

Introducción: Diversos estudios sugieren que el personal sanitario, que realiza guardias de 24h y turnos de noche, sigue una alimentación poco saludable. Una situación que afecta directamente a su calidad de vida y que puede repercutir en la calidad de la atención a los pacientes. Objetivo: Valorar el grado de adherencia a la Dieta Mediterránea y la adecuada ingesta de nutrientes de residentes de medicina del Hospital Universitario Reina Sofía de Córdoba que realizan guardias de 24h. Métodos: Estudio transversal con una muestra de 35 residentes de medicina. Se empleó una aplicación diseñada específicamente para el estudio (App eFoodDiary) para recoger información de dos cuestionarios de adherencia a la Dieta Mediterránea y el registro diario de alimentos durante el día de guardia de 24h, el día anterior y posterior. Se aplicó el Modelo Lineal General Multivariante (MLGM) a las puntuaciones obtenidas por ambos test (PrediMed y MedLife) y un estudio de correlación entre las puntuaciones de ambos cuestionarios (curvas ROC). Para la valoración nutricional se realizó un estudio estadístico de los %IDR del día completo y por tomas a través del MLGM. Resultados: Los resultados muestran una adherencia baja a la Dieta Mediterránea de los participantes (71%). Respecto a la valoración nutricional, los resultados denotan una ingesta de energía inferior a la recomendada y una dieta poco equilibrada a nivel de nutrientes, resaltando una ingesta superior a la recomendada de proteínas y ácidos grasos saturados, y un déficit de ingesta de hierro entre las mujeres (p<0.001). Durante las guardias de 24h se observa una mayor ingesta de energía, carbohidratos, vitamina A y B6. Conclusión: El bajo porcentaje de personal residente de medicina que sigue una dieta saludable y adecuada a sus necesidades nutricionales, evidencia la importancia de incorporar programas que mejoren la alimentación de este colectivo.(AU)

ntroduction: Various studies suggest that health person-nel, who carryout 24-hour shifts and nightshifts, follow an un-healthy diet. A situation that directly affects their quality oflife and that can affect the quality of patientcare. Objective: To assess the degree of adherence to theMediterranean Diet and nutritional status of the medical residents of the Reina Sofia de Córdoba University Hospital whocarry out 24-hour shifts. Methods: Cross-sectional study with a sample of 35 med-ical residents. An application designed specifically for thestudy (App eFoodDiary) was used to collect information fromtwo questionnaires of adherence to the Mediterranean Dietand the daily food record of the day on duty, the previous andthe subsequent one. The Multivariate General Linear Model(MLGM) was applied to the scores obtained by both tests(PrediMed and MedLife) and a correlation study between thescores of both questionnaires (ROC curves). For the nutri-tional assessment, a statistical study of the% RDI of the fullday and by doses was carried out through the MLGM. Results: The results show a low adherence to the Medite -rranean Diet of the participants (71%). Regarding the nutri-tional assessment, the results denote an energy intake lowerthan recommended and a diet that is not very balanced interms of nutrients, highlighting an intake higher than the rec-ommended protein and saturated fatty acids, and a deficit ofiron intake among the women (p <0.001). During the 24-hourshifts, a higher intake of energy, carbohydrates, vitamin A andB6 is observed. Conclusion: The low percentage of medical residents whofollow a healthy diet appropriate to their nutritional needs,shows the importance of incorporating programs that improvethe diet of this group.(AU)

Covid 19: Eating behavior changes related to individual and household factors during the COVID-19 lockdown in Spain

To analyze the influence of individual and household factors on eating behavior (EB) and other determinants related to eating during the home lockdown in the Covid-19 pandemic. Method: Online survey (April 17 to May 10, 2020) to collect sociodemographic information, health, and various EB attitudes. Statistical analysis of the factors: country, setting, sex, BMI classification, lockdown period, a household with children under 15 years, nutritional needs, age groups, type and size household, monthly income, and religion. Results: 1055 households participated. 75% have modified their eating habits, with differences due to being overweight or obese in the person surveyed (p <0.05). Changes in EB and other lifestyles are influenced by household structure (p <0.001) and the effects that the pandemic has had on the economy of families (p <0.001). Compared to those who do not have them, households with children tend to plan much more meals, spend more time eating, seek a healthier diet, increase the number of daily meals, and look more at labeling. In contrast, people who live alone have worsened the hourly routines of the main meals. Conclusions: Confinement has modified eating behavior differently depending on the individual and domestic factors analyzed(AU)

Analizar la influencia de factores individuales y del hogar sobre el comportamiento alimentario (CA), y otros determinantes relacionados con la alimentación, durante el confinamiento domiciliario en la pandemia por Covid-19. Método: Encuesta online (17 abril al 10 de mayo de 2020) para recopilar información sociodemográfica, de salud y diversas actitudes del CA. Análisis estadístico sobre los factores: país, ámbito, sexo, IMC, tiempo de confinamiento, hogar con menores de 15 años, necesidades nutricionales, grupos de edad, tipo y tamaño del hogar, ingresos y religión. Resultados: Participaron 1055 hogares. El 75% ha modificado sus hábitos alimentarios, con diferencias por sobrepeso u obesidad de la persona encuestada (p<0.05). Los cambios en el CA y otros estilos de vida están influenciados por la estructura del hogar (p<0.001) y los efectos que la pandemia ha tenido sobre la economía de las familias (p<0.001). Los hogares que tienen hijos/as, respecto a los que no los tienen, tienden a planificar mucho más las comidas, dedicar más tiempo a la alimentación, procuran una alimentación más saludable, incrementan el número de comidas diarias y miran más el etiquetado. Por el contrario, las personas que viven solas han empeorado las rutinas horarias de las principales comidas. Conclusiones: El confinamiento ha modificado de manera diferenciada el comportamiento alimentario en función de los factores individuales y domésticos analizados(AU)

Caracterización del consumo de alimentos e ingesta de nutrientes de población residente en las Islas Galápagos / Characterization of food consumption and nutrient intake of population resident in the Galapagos Islands

Las Islas Galápagos es una de las provincias de Ecuador con mayores índices de sobrepeso y obesidad en población adulta. Debido a las restricciones de producción de alimentos, la presión turística y otros factores sociales; la disponibilidad, el acceso y consumo de alimentos saludables y recomendables puede estar afectando al estado de seguridad alimentaria y nutricional de su población. Por ello, el objetivo de este estudio es analizar el consumo de alimentos de la población y su adecuación a las necesidades nutricionales. Sobre una muestra de 120 personas residentes en las Islas Galápagos se aplicaron 3 R24h. Los resultados de la valoración nutricional fueron comparados con las IDR, realizando un análisis factorial multivariante para analizar diferencias por grupo de edad o desempeño profesional. Se realizó un análisis de componentes principales para caracterizar el perfil de ingesta de nutrientes. Para energía y principios inmediatos se sobrepasan las recomendaciones, principalmente entre las mujeres, a la vez que se evidencia una ingesta inadecuada de fibra, iodo, ácido fólico y vitamina E. Respecto a los grupos de alimentos, el consumo medio de frutas y verduras frescas es muy escaso y el aporte proteico proviene en mayor medida de productos cárnicos (46%), seguido de pescado (24%) y arroz (17%). Los resultados de este estudio evidencian la necesidad de asegurar el acceso a alimentos frescos y saludables, en especial frutas y verduras, y promover la adopción de pautas nutricionales que promuevan un consumo adecuado de ciertos alimentos(AU)

The Galapagos Islands are one of the provinces of Ecuador with the highest rates of overweight and obesity among the adult population. Due to its restrictions on local production, tourist pressure and other social factors; availability, access and consumption to food is a problem that is related to the state of food and nutritional security of its population. Therefore, the objective of this study is to analyze the pattern of food consumption of healthy and recommended foods may be affecting the food insecurity or nutritional status of its population. Therefore, the objective of this study is to analyze the food consumption of the population and its adaptation to nutritional needs. On a sample of 120 people resident in the Galapagos Islands, 3 R24h were applied. The results of the nutritional assessment were compared with the RDI. A multivariate factor analysis has been performed to analyze differences by age group or professional performance. Principal component analysis (PCA) was performed to characterize the nutrient intake. Recommendations are exceeded for energy and immediate principles, mainly among women. On the other hand, there is an inadequate intake of fiber, iodine, folic acid and vitamin E. Regarding food groups, the average consumption of fresh fruits and vegetables is very low and protein intake comes mostly from meat products (46%), followed by fish (24%) and rice (17%). The results of this study demonstrate the need to ensure access to fresh and healthy foods, especially fruits and vegetables, and to promote the adoption of nutritional guidelines that promote adequate food intake(AU)

Validation of a photographic atlas of food portions designed as a tool to visually estimate food amounts in Ecuador / Validación de un atlas fotográfico de porciones de alimentos diseñado como una herramienta para estimar visualmente las cantidades de alimentos en Ecuador

Introduction: the use of real images of food portions constitutes a useful and effective tool to help measure the amount of food consumed. Objective: to validate content and visual perception of the images of a photographic atlas of food portions designed for Ecuador. Methods: first, eight experts assessed the content in an atlas of food portions, using the Delphi technique. Then, 56 adults (aged 18-59) gave an assessment of their visual perception of about 35 portions of nine selected products. The concordance in the estimation using the atlas versus an estimation without the atlas was evaluated through the intra-class correlation coefficient (ICC), the Bland-Altman graphical method, and a hypothesis contrast. The differences between the real amounts and the estimation were assessed using the Wilcoxon test (p < 0.05). For each of the food items, the percentage of participants who chose the correct photograph, the one directly above or below was calculated. Results: the assessment carried out by experts showed that this instrument is relevant and appropriate. ICC values of between 0.576 and 0.956 were obtained using the atlas, as well as significant differences between the real amounts and the estimation without the atlas (p < 0.001). There was a sufficient correlation between the actual image and its perception for all food items except mayonnaise. The correct photograph was chosen in 66% of 500 estimations. Conclusions: the photographic atlas of food portions for Ecuador is an appropriate tool for helping to estimate the amount of food consumed by adults

Introducción: utilizar imágenes reales de porciones de alimentos es útil y efectivo para estimar la cantidad de alimentos consumidos. Objetivo: validar el contenido y la percepción visual de las imágenes de un atlas fotográfico de porciones de alimentos diseñado para Ecuador. Métodos: primero, ocho expertos evaluaron el contenido de un atlas de porciones de alimentos utilizando la técnica Delphi. Luego, 56 adultos (18-59 años) participaron en la evaluación de la percepción visual de 35 porciones de nueve productos seleccionados. La concordancia en la estimación utilizando el atlas respecto a una estimación sin el atlas se evaluó a través del coeficiente de correlación intraclase (CCI), el método gráfico de Bland-Altman y el contraste de hipótesis. Las diferencias entre las cantidades reales y las estimadas se evaluaron mediante la prueba de Wilcoxon (p < 0,05). Para cada alimento, se calculó el porcentaje de participantes que eligieron la fotografía correcta, la adyacente superior o la inferior. Resultados: la evaluación realizada por expertos mostró que esta herramienta es relevante y apropiada. Se obtuvieron valores de CCI entre 0,576 y 0,956 utilizando el atlas, así como diferencias significativas entre las cantidades reales y la estimación sin el atlas (p < 0,001). Hubo una adecuada concordancia entre la percepción de la imagen realizada y la imagen real para todos los alimentos, excepto para la mayonesa. La fotografía correcta fue elegida en el 66% de las 500 estimaciones realizadas. Conclusiones: el atlas fotográfico de porciones de alimentos para Ecuador es una herramienta apropiada para ayudar en la estimación de la cantidad de alimento consumido

Validation of a photographic atlas of food portions designed as a tool to visually estimate food amounts in Ecuador.

INTRODUCTION: Introduction: the use of real images of food portions constitutes a useful and effective tool to help measure the amount of food consumed. Objective: to validate content and visual perception of the images of a photographic atlas of food portions designed for Ecuador. Methods: first, eight experts assessed the content in an atlas of food portions, using the Delphi technique. Then, 56 adults (aged 18-59) gave an assessment of their visual perception of about 35 portions of nine selected products. The concordance in the estimation using the atlas versus an estimation without the atlas was evaluated through the intra-class correlation coefficient (ICC), the Bland-Altman graphical method, and a hypothesis contrast. The differences between the real amounts and the estimation were assessed using the Wilcoxon test (p < 0.05). For each of the food items, the percentage of participants who chose the correct photograph, the one directly above or below was calculated. Results: the assessment carried out by experts showed that this instrument is relevant and appropriate. ICC values of between 0.576 and 0.956 were obtained using the atlas, as well as significant differences between the real amounts and the estimation without the atlas (p < 0.001). There was a sufficient correlation between the actual image and its perception for all food items except mayonnaise. The correct photograph was chosen in 66% of 500 estimations. Conclusions: the photographic atlas of food portions for Ecuador is an appropriate tool for helping to estimate the amount of food consumed by adults.

INTRODUCCIÓN: Introducción: utilizar imágenes reales de porciones de alimentos es útil y efectivo para estimar la cantidad de alimentos consumidos. Objetivo: validar el contenido y la percepción visual de las imágenes de un atlas fotográfico de porciones de alimentos diseñado para Ecuador. Métodos: primero, ocho expertos evaluaron el contenido de un atlas de porciones de alimentos utilizando la técnica Delphi. Luego, 56 adultos (18-59 años) participaron en la evaluación de la percepción visual de 35 porciones de nueve productos seleccionados. La concordancia en la estimación utilizando el atlas respecto a una estimación sin el atlas se evaluó a través del coeficiente de correlación intraclase (CCI), el método gráfico de Bland-Altman y el contraste de hipótesis. Las diferencias entre las cantidades reales y las estimadas se evaluaron mediante la prueba de Wilcoxon (p < 0,05). Para cada alimento, se calculó el porcentaje de participantes que eligieron la fotografía correcta, la adyacente superior o la inferior. Resultados: la evaluación realizada por expertos mostró que esta herramienta es relevante y apropiada. Se obtuvieron valores de CCI entre 0,576 y 0,956 utilizando el atlas, así como diferencias significativas entre las cantidades reales y la estimación sin el atlas (p < 0,001). Hubo una adecuada concordancia entre la percepción de la imagen realizada y la imagen real para todos los alimentos, excepto para la mayonesa. La fotografía correcta fue elegida en el 66% de las 500 estimaciones realizadas. Conclusiones: el atlas fotográfico de porciones de alimentos para Ecuador es una herramienta apropiada para ayudar en la estimación de la cantidad de alimento consumido.

Food Insecurity and the Double Burden of Malnutrition of Indigenous Refugee Épera Siapidara.

The goal of this paper is to assess food and nutritional security status of an indigenous population who migrated from Colombia to Ecuador. We collected data about the perception of food insecurity, anthropometric and food intake (n = 104). An analysis multivariate (Generalized Linear Model) we used to know the adequacy to the Dietary Reference Intake (DRI). All the households were food insecure, stunting affected 45.1% of children and adolescents and the 60% were overweight or obese women. Significant differences were observed by gender for energy, lipid, carbohydrate, fiber, and iron (p < 0.001). No age group meets the DRI for fiber, calcium and potassium (except in children 24-59 months) and iron. There was a deficiency in vitamins A, D, folic acid and thiamine. The Epera Siapidara people in Ecuador experience acute food insecurity and a double burden of malnutrition, which may seriously affect their health and general progress.

Caracterización de la alimentación del pueblo indígena épera siapidara en ecuador / Characterization of indigenous food épera siapidara in ecuador

Las poblaciones indígenas y campesinas son los que más han sufrido las consecuencias del conflicto armado en Colombia. Tras un proceso de despojo de tierras y desplazamiento, el pueblo Épera Siapidara se asentó en Ecuador y se encuentra en una grave situación de inseguridad alimentaria. El objetivo de este estudio fue caracterizar la alimentación del pueblo Épera Siapidara en Ecuador. Tras la aplicación de 3 R24h a 111 Épera Siapidara, se seleccionaron las preparaciones más consumidas en base al número de apariciones. Las recetas (ingredientes y cantidades) fueron estandarizadas por 6 mujeres de la comunidad. Su composición nutricional se calculó con el software Nutriplato 2.0 y, para un tamaño medio de ración, se comparó con las recomendaciones de ingesta dietética (IDR). Se calculó la contribución de macronutrientes a la energía total de cada plato. Como resultado, 30 preparaciones y 3 guarniciones fueron seleccionadas (85,6% de los registros). El tamaño de ración medio fue 197,84g ± 7,54g (bebida), 225,04g ±50,53g (sopa), 79,89g ± 27,01g (plato principal) y 157,05g ±14,22g (guarnición). En relación al aporte a las IDR, destacan sopa de res y encocado de iguana (54% y 43% IDR proteína), tapado de carne de monte (25% IDR hierro) y sopa de verduras (99% y 89% IDR vitaminas A y C). Diseñar políticas públicas integrales que permitan potenciar las fortalezas de su sistema alimentario tradicional y atenuar riesgos asociados a la alimentación será clave para mejorar su seguridad alimentaria(AU)

Indigenous and peasant populations are the most affected by the armed conflict in Colombia. After a process of land dispossession and displacement, the Épera Siapidara people are seated in Ecuador and they are in severe food insecurity. The aim of the study was to characterize the food patterns of Épera Siapidara people in Ecuador. Next to pass out 3 R24h to 111 Epera Siapidara, the most consumed preparations were selected, based on the number of occurrences. The recipes (ingredients and quantities) were standardized by 6 women in the community. Nutritional composition was calculated with Nutriplato 2.0 software and, for an average serving size, it was compared with Recommendations Dietary Intake (RDI). Contribution of macronutrients to total energy was calculated by each dish. As a result, 30 preparations and 3 garnishes were selected (85.6% of the records). The average serving size was 197.84g ± 7.54g (drink), 225.04g ± 50.53g (soup), 79.89g ± 27.01g (main dish) and 157.05g ± 14.22g (garnish). In relation to contribution to RDI, stand out beef soup and encocado iguana (54% and 43% RDI protein), bushmeat tapado (25% RDI iron) and vegetable soup (99% and 89% IDR vitamins A and C). Designing comprehensive public policies that allow enhancing the strengths of its traditional food system and mitigate risks associated with food will be the key to improving its food security(AU)

Validation of a Food Frequency Questionnaire for the indigenous Épera-Siapidara people in Ecuador.

BACKGROUND: A Food Frequency Questionnaire (FFQ) must be designed and validated in the local environment to ensure that the method is adapted to the objectives of the study and the population. OBJECTIVE: The aim of this study was to validate an FFQ to evaluate the food consumption pattern of the Épera-Siapidara population of Ecuador. One hundred and fourindividuals (54% men and 46% women), aged between 2 and 84, took part in the study. METHODS: The validity of this tool was assessed by comparing the relationship between the average daily nutrient intake estimated by the FFQ and the intake estimated in the three non-consecutive 24 h dietary recalls (24hR). The existing correlations were evaluated by Pearson's or Spearman's correlation, the inter-class correlation coefficient, Lin's concordance correlation coefficient and a Bland-Altman plot. RESULTS: The values estimated by the FFQ were significantly higher for minerals and vitamins. The relative correlation coefficients ranged from 0.71 to 0.23 for Na and Ca, respectively, while the inter-class correlation coefficient ranged from 0.84 to 0.33 for Na and cholesterol, respectively. Lin's concordance correlation coefficient was higher for macronutrients, with values ranging from between 0.35 for lipids to 0.51 for energy. Only 6% of the participants were wrongly classified. The Bland-Altman plots showed an overestimation of macronutrient and calcium intake by the FFQ compared with the 24hR, and an underestimation of fiber intake. CONCLUSION: The FFQ demonstrated a good external consistency, which makes it a suitable instrument for correctly identifying the food and nutrient intake of the Épera-Siapidara population.

Nutritional assessment of Esmeraldan adult population (Ecuador) / Avaliação nutricional da população adulta de Esmeraldas (Equador)

ABSTRACT Objective To analyse the nutritional status of the adult population in Esmeraldas by means of anthropometric measurements, the input of macro and micronutrients in the diet, and the adequacy estimation of nutrient intake by hispanic Dietary Reference Instakes along with the sex and the age influence. Methods Nutrient intake data were obtained by personal interview with the application of two 24 hour recalls (weekend and weekday). The anthropometric indicators analysed were body mass index, waist circumference and blood pressure. Nutriplato version 2.0 software was used for the two 24-hours food recall surveys data processing, and for the respective calculations of macronutrients, micronutrients and Dietary Reference Intakes. Means and standard deviations were calculated for anthropometry, nutrient intakes and Dietary Reference Instakes. The General Linear Model was applied to identify differences in relation to nutrient intakes considering sex, profession, body mass index, group, origin and day of the week as factors. Results Statistical analysis showed significant differences mainly in carbohydrates, fiber, calcium, phosphorus, iron, sodium, iodine, and vitamin E. Dietary intakes were compared with the Federación Española de Sociedades de Nutrición, Alimentación y Dietética Dietary Reference Intakes requirements and calcium, potassium, iodine, riboflavin, pantothenic acid, biotin, vitamin D, vitamin E, fiber, monounsaturated fatty acids and polyunsaturated fatty acids are below the Dietary Reference Instakes in all ages and gender subgroups. The anthropometric results obtained indicated that 67.0% of the population were overweight and obese, the 87.7% of the adults suffered from prehypertension and the waist circumference indicated that 73.0% of the subjects were established in the range of high risk of cardiovascular disease. Conclusion Priority nutrition actions and interventions are needed to be developed in Esmeraldas adult population.

RESUMO Objetivo Analisar o estado nutricional da população adulta de Esmeraldas utilizando medições antropométricas, o aporte dietético de macro e micronutrientes, e a estimação da adequação da ingestão de nutrientes por ingestão diária de referência hispânicos, juntamente com sexo e idade. Métodos Os dados de ingestão de nutrientes foram obtidos através de uma entrevista pessoal com a aplicação de dois lembretes de 24 horas (o fim de semana e o dia da semana). Os indicadores antropométricos analisados foram índice de massa corporal, circunferência da cintura e pressão arterial. O software Nutriplato versão 2.0 para o processamento dos dados obtidos com os dois lembretes de alimentos 24 horas e para os cálculos respectivos de macronutrientes, micronutrientes e ingestão diária de referência. As medias e desvios-padrão foram calculados para antropometria, ingestão de nutrientes e ingestão diária de referência. O General Linear Model foi aplicado para identificar diferenças na ingestão de nutrientes levando em consideração gênero, profissão, índice de massa corporal, grupo, origem e dia da semana como fatores. Resultados A análise estatística mostrou diferenças significativas principalmente em carboidratos, fibras, cálcio, fósforo, ferro, sódio, iodo e vitamina E. As ingestões dietéticas foram comparadas com a Ingestão Diária de Referência de Federación Española de Sociedades de Nutrición, Alimentación y Dietética e para todos os subgrupos e todas as idades não foram alcançadas a referência dietética para cálcio, potássio, iodo, riboflavina, ácido pantatênico, biotina, vitamina D, vitamina E, fibra e ácidos graxos monoinsaturados e poliinsaturados. Os resultados antropométricos obtidos indicaram que 67.0% da população estava com sobrepeso e obesidade, 87.7% dos adultos sofriam de pré-hipertensão e a circunferência da cintura indicou que 73.0% dos indivíduos apresentavam risco de doença cardiovascular. Conclusão Conclui-se que precisam de ações e intervenções prioritárias em nutrição para aplicá-las na população adulta de Esmeraldas.