Desigualdad en las prácticas de lactancia y alimentación complementaria en la Argentina, según nivel de ingresos del hogar en 2018-19 / Inequality in breastfeeding and complementary feeding practices in Argentina by household income level in 2018­2019

Introducción. La calidad de la alimentación es un derecho vinculado con la supervivencia, el crecimiento saludable, la prevención de enfermedades crónicas y malnutrición en todas sus formas. El objetivo de este trabajo fue analizar las prácticas de lactancia y de alimentación de menores de 2 años de áreas urbanas de la Argentina en 2018-19, según el nivel de ingreso de los hogares. Población y métodos. Estudio secundario con datos de la 2da. Encuesta Nacional de Nutrición y Salud 2018-19. Se analizaron indicadores de lactancia y alimentación complementaria, según metodología de la Organización Mundial de la Salud (OMS) y Unicef. Se estratificó según nivel de ingresos del hogar. Resultados. El análisis incluyó 5763 menores de 24 meses. Aunque el 97 % fue alguna vez amamantado, solo el 47 % de los menores de 6 meses tuvo lactancia exclusiva el día previo y el 48 % mantenía la lactancia luego del año, con mayor prevalencia en los niños/as de menores ingresos. En el día previo, el 23 % de los niños/as de 6 a 23 meses no consumió ninguna verdura o fruta; el 60 % consumió alimentos no saludables y el 50 %, bebidas dulces. Las bebidas dulces y la ausencia de frutas y verduras fueron mayores en aquellos de hogares de menores ingresos. Conclusión. La calidad de la alimentación de los niños/as dista de las recomendaciones y está condicionada por los ingresos. En los sectores empobrecidos, es menor el inicio temprano de la lactancia, la diversidad alimentaria mínima y el consumo de frutas y verduras, y es mayor el consumo de bebidas dulces.

Introduction. Diet quality is a right related to survival, healthy growth, prevention of chronic diseases, and malnutrition in all its forms. The objective of this study was to analyze breastfeeding and feeding practices in children younger than 2 years from urban areas of Argentina in 2018­2019 according to their household income level. Population and methods. Secondary analysis of data of the Second National Survey on Nutrition and Health (ENNyS2) of 2018­2019. Breastfeeding and complementary feeding indicators proposed by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) were analized. Data were stratified by household income level. Results. The analysis included 5763 children younger than 24 months old. Although 97% was ever breastfed, only 47% of infants younger than 6 months were exclusively breastfed the previous day and 48% continued with breastfeeding after 1 year old, with a higher prevalence in low-income children. The previous day, 23% of children aged 6 to 23 months did not eat any fruit or vegetable, 60% consumed unhealthy foods, and 50% consumed sweet beverages. The consumption of sweet beverages and the absence of fruit and vegetables were higher in low-income households. Conclusion. The quality of children's diet is far from the recommendations and is conditioned by income. Early initiation of breastfeeding, minimum dietary diversity, fruit and vegetable consumption are lower and sweet beverage consumption is greater in impoverished sectors.

Responsive feeding patterns during early childhood in urban areas. Argentina, 2018-2019. / Patrones de alimentación perceptiva durante la primera infancia en conglomerados urbanos. Argentina, 2018-19.

Introduction. Dietary quality involves both the quantity and quality of food offered, the way and the setting in which it is offered, and the responses of the person offering it. The objective of this study was to identify behavioral patterns related to responsive feeding in children aged 6 to 23 months in urban areas from Argentina in 2018-2019. Population and methods. Secondary analysis based on data from the second National Survey on Nutrition and Health of 2018-2019 conducted in a multistage probability sample from urban areas of 5000 inhabitants or more in Argentina. A descriptive analysis and a principal component analysis were performed to identify responsive feeding patterns in 4379 children aged 6 to 23 months. Results. Five responsive feeding patterns were identified; the first 2 dimensions explained 71.1% of inertia (p = 0.013). The pattern with a prevailing possibility of experimentation, autonomy, interaction, and the absence of screens, rewards and distractions was associated with children older than 12 months from the central and south regions (Cuyo, Pampa, Greater Buenos Aires, and Patagonia), whereas the pattern related to a lower autonomy, experimentation, and self-regulation corresponded to children aged 6 to 11 months from the Northwest and Northeast regions. Conclusion. There is evidence of responsive feeding practices that correspond to distinguishable patterns, associated with different stages of life and with the region where the children live.

Introducción. La calidad de la alimentación implica tanto la cantidad y calidad de los alimentos que se ofrecen como la forma en que se ofrecen, el entorno y las respuestas de quien los ofrece. El objetivo de este trabajo fue identificar patrones de comportamiento relacionados a la alimentación perceptiva en niños entre 6 y 23 meses de áreas urbanas de la Argentina en 2018-19. Población y métodos. Análisis secundario de datos de la 2.a Encuesta Nacional de Nutrición y Salud 2018-19, de una muestra probabilística polietápica de localidades urbanas de 5000 habitantes y más de Argentina. Se realizó análisis descriptivo y análisis de componentes principales para identificar los patrones de alimentación perceptiva en 4379 niños y niñas de 6 a 23 meses. Resultados. Se identificaron cinco patrones de alimentación perceptiva, las dos primeras dimensiones explicaron el 71,1 % de la inercia (p = 0,013). El patrón donde prevalecía la posibilidad de experimentación, la autonomía, la interacción y la ausencia de pantallas, premios y distracciones se asoció a niños/as mayores de 12 meses, de las regiones del centro y sur (Cuyo, Pampeana, Gran Buenos Aires y Patagonia), mientras que el patrón relacionado con menor autonomía, experimentación y autorregulación correspondió a las regiones Noroeste y Noreste, y a niños/as entre 6 y 11 meses. Conclusión. Se evidencian prácticas de alimentación perceptiva que se corresponden con patrones diferenciados entre sí, asociados a diferentes etapas y a la región donde viven los niños/as.

Inequality in breastfeeding and complementary feeding practices in Argentina by household income level in 2018-2019. / Desigualdad en las prácticas de lactancia y alimentación complementaria en la Argentina, según nivel de ingresos del hogar en 2018-19.

Introduction. Diet quality is a right related to survival, healthy growth, prevention of chronic diseases, and malnutrition in all its forms. The objective of this study was to analyze breastfeeding and feeding practices in children younger than 2 years from urban areas of Argentina in 2018-2019 according to their household income level. Population and methods. Secondary analysis of data of the Second National Survey on Nutrition and Health (ENNyS2) of 2018-2019. Breastfeeding and complementary feeding indicators proposed by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) were analized. Data were stratified by household income level. Results. The analysis included 5763 children younger than 24 months old. Although 97% was ever breastfed, only 47% of infants younger than 6 months were exclusively breastfed the previous day and 48% continued with breastfeeding after 1 year old, with a higher prevalence in low-income children. The previous day, 23% of children aged 6 to 23 months did not eat any fruit or vegetable, 60% consumed unhealthy foods, and 50% consumed sweet beverages. The consumption of sweet beverages and the absence of fruit and vegetables were higher in low-income households. Conclusion. The quality of children's diet is far from the recommendations and is conditioned by income. Early initiation of breastfeeding, minimum dietary diversity, fruit and vegetable consumption are lower and sweet beverage consumption is greater in impoverished sectors.

Introducción. La calidad de la alimentación es un derecho vinculado con la supervivencia, el crecimiento saludable, la prevención de enfermedades crónicas y malnutrición en todas sus formas. El objetivo de este trabajo fue analizar las prácticas de lactancia y de alimentación de menores de 2 años de áreas urbanas de la Argentina en 2018-19, según el nivel de ingreso de los hogares. Población y métodos. Estudio secundario con datos de la 2.a Encuesta Nacional de Nutrición y Salud 2018-19. Se analizaron indicadores de lactancia y alimentación complementaria, según metodología de la Organización Mundial de la Salud (OMS) y Unicef. Se estratificó según nivel de ingresos del hogar. Resultados. El análisis incluyó 5763 menores de 24 meses. Aunque el 97 % fue alguna vez amamantado, solo el 47 % de los menores de 6 meses tuvo lactancia exclusiva el día previo y el 48 % mantenía la lactancia luego del año, con mayor prevalencia en los niños/as de menores ingresos. En el día previo, el 23 % de los niños/as de 6 a 23 meses no consumió ninguna verdura o fruta; el 60 % consumió alimentos no saludables y el 50 %, bebidas dulces. Las bebidas dulces y la ausencia de frutas y verduras fueron mayores en aquellos de hogares de menores ingresos. Conclusión. La calidad de la alimentación de los niños/as dista de las recomendaciones y está condicionada por los ingresos. En los sectores empobrecidos, es menor el inicio temprano de la lactancia, la diversidad alimentaria mínima y el consumo de frutas y verduras, y es mayor el consumo de bebidas dulces.

Consumo de alimentos ultraprocesados en niños entre 6 y 23 meses según la Segunda Encuesta Nacional de Nutrición y Salud de Argentina / Consumption of ultra-processed foods among children aged 6 to 23 months as per the Second National Survey on Nutrition and Health of Argentina

Introducción. Contar con los datos del consumo de alimentos ultraprocesados en los niños resulta importante para planificar políticas públicas. Objetivos. Describir la prevalencia de consumo de alimentos ultraprocesados en menores de 2 años e identificar factores asociados. Describir la proporción que los alimentos ultraprocesados representan del número total de los alimentos consumidos en el día. Métodos. Análisis secundario de los datos de niños entre 6 y 23 meses de edad con al menos un recordatorio de 24 horas de consumo de alimentos de la Segunda Encuesta Nacional de Nutrición y Salud de Argentina del año 2018. Se estudiaron como variables principales: "consumo de alimentos ultraprocesados" (según el sistema NOVA) categorizada en sí/no y la "proporción de ultraprocesados del total de alimentos consumidos". Los factores asociados explorados fueron lactancia materna, sexo, edad y el número de alimentos no ultraprocesados consumidos. Se realizó un modelo de regresión logística multivariable y se aplicó un factor de expansión para ponderar los datos. Resultados. Se incluyeron 4224 niños (ponderado 908 104). La prevalencia de consumo de ultraprocesados fue del 90,8 % (IC95%: 89,5-92) y fue asociado con mayor edad (OR 3,21; IC95% 2,28-4,52) y con el número de alimentos no ultraprocesados consumidos (OR 1,17; IC95% 1,13-1,23). Los ultraprocesados representaron una mediana del 20 % (RIC: 12,5-28,6 %) del total de alimentos consumidos en el día. Conclusiones. Este estudio señala la alta penetración de los alimentos ultraprocesados en la alimentación complementaria.

Introduction. The availability of data on the consumption of ultra-processed foods among children is important for planning public policies. Objectives. To describe the prevalence of consumption of ultra-processed foods in children under 2 years of age and identify associated factors. To describe the proportion that ultra-processed foods represent out of the total number of foods consumed in a day. Methods. Secondary analysis of data from children aged 6­23 months with at least a 24-hour recall of food consumption based on the Second National Survey on Nutrition and Health of Argentina (2018). The following primary variables were studied: "consumption of ultra-processed foods" (according to the NOVA system) categorized into yes/no and "proportion of ultra-processed out of total foods consumed." The following associated factors were studied: breastfeeding, sex, age, and number of non-ultra-processed foods consumed. A multivariate logistic regression model was developed and an expansion factor was applied to weight the data. Results. A total of 4224 children were included (weighed: 908 104). The prevalence of ultra-processed food consumption was 90.8% (95% CI: 89.5­92) and was associated with an older age (OR: 3.21, 95% CI: 2.28­4.52) and the number of non-ultra-processed foods consumed (OR: 1.17, 95% CI: 1.13­1.23). Ultra-processed foods accounted for a median 20% (IQR: 12.5­28.6%) of all foods consumed in a day. Conclusions. This study highlights the high penetration of ultra-processed foods in complementary feeding.

Consumption of ultra-processed foods among children aged 6 to 23 months as per the Second National Survey on Nutrition and Health of Argentina. / Consumo de alimentos ultraprocesados en niños entre 6 y 23 meses según la Segunda Encuesta Nacional de Nutrición y Salud de Argentina.

Introduction. The availability of data on the consumption of ultra-processed foods among children is important for planning public policies. Objectives. To describe the prevalence of consumption of ultra-processed foods in children under 2 years of age and identify associated factors. To describe the proportion that ultra-processed foods represent out of the total number of foods consumed in a day. Methods. Secondary analysis of data from children aged 6-23 months with at least a 24-hour recall of food consumption based on the Second National Survey on Nutrition and Health of Argentina (2018). The following primary variables were studied: "consumption of ultra-processed foods" (according to the NOVA system) categorized into yes/no and "proportion of ultra-processed out of total foods consumed." The following associated factors were studied: breastfeeding, sex, age, and number of non-ultra-processed foods consumed. A multivariate logistic regression model was developed and an expansion factor was applied to weight the data. Results. A total of 4224 children were included (weighed: 908 104). The prevalence of ultra-processed food consumption was 90.8% (95% CI: 89.5-92) and was associated with an older age (OR: 3.21, 95% CI: 2.28-4.52) and the number of non-ultra-processed foods consumed (OR: 1.17, 95% CI: 1.13-1.23). Ultra-processed foods accounted for a median 20% (IQR: 12.5-28.6%) of all foods consumed in a day. Conclusions. This study highlights the high penetration of ultra-processed foods in complementary feeding.

Introducción. Contar con los datos del consumo de alimentos ultraprocesados en los niños resulta importante para planificar políticas públicas. Objetivos. Describir la prevalencia de consumo de alimentos ultraprocesados en menores de 2 años e identificar factores asociados. Describir la proporción que los alimentos ultraprocesados representan del número total de los alimentos consumidos en el día. Métodos. Análisis secundario de los datos de niños entre 6 y 23 meses de edad con al menos un recordatorio de 24 horas de consumo de alimentos de la Segunda Encuesta Nacional de Nutrición y Salud de Argentina del año 2018. Se estudiaron como variables principales: "consumo de alimentos ultraprocesados" (según el sistema NOVA) categorizada en sí/no y la "proporción de ultraprocesados del total de alimentos consumidos". Los factores asociados explorados fueron lactancia materna, sexo, edad y el número de alimentos no ultraprocesados consumidos. Se realizó un modelo de regresión logística multivariable y se aplicó un factor de expansión para ponderar los datos. Resultados. Se incluyeron 4224 niños (ponderado 908 104). La prevalencia de consumo de ultraprocesados fue del 90,8 % (IC95%: 89,5-92) y fue asociado con mayor edad (OR 3,21; IC95% 2,28-4,52) y con el número de alimentos no ultraprocesados consumidos (OR 1,17; IC95% 1,13-1,23). Los ultraprocesados representaron una mediana del 20 % (RIC: 12,5-28,6 %) del total de alimentos consumidos en el día. Conclusiones. Este estudio señala la alta penetración de los alimentos ultraprocesados en la alimentación complementaria.

Anaemia in adolescent women: A priority for the nutrition agenda in Mexico. A comparison of data from the ENSANUT 2012 and 2018-2019 surveys.

The risk of anaemia in adolescence increases due to accelerated growth. This study aims to: (1) estimate the prevalence of anaemia in 2012 and 2018-2019 (Encuesta Nacional de Salud y Nutricion - ENSANUT [n = 5841 in 2012 and n = 2380 in 2018-2019]) in non-pregnant, Mexican adolescent women aged 12-19 years, and the changes in prevalence over this period according to sociodemographic, health and nutrition characteristics; (2) estimate the associations between anaemia and sociodemographic, health and nutrition characteristics in each year and overall, in non-pregnant Mexican adolescent women. Anaemia was defined as capillary haemoglobin <12 g/dL. The distribution of characteristics and their changes between 2012 and 2018-2019 were described. The covariate-adjusted prevalence of anaemia in 2012 and 2018-2019 and the changes over that period were estimated from a multiple log-binomial regression model and the factors associated with anaemia were assessed in each survey year and in both years combined. The prevalence of anaemia was 7.7% in 2012 and 13.1% in 2018-2019 (69% increase, Prevalence Ratio: PR = 1.69; 95%CI: 1.35, 2.13). The covariate-adjusted prevalence of anaemia increased from 6.9% to 10.5% in the overall population (PR = 1.53, 95%CI: 1.19, 1.96), and increased considerably in the age group 12-14 years (PR = 1.94, 95%CI: 1.36, 2.75), and in the northern region (PR = 3.68, 95%CI: 2.55, 5.32). Those receiving iron supplements or school breakfasts did not register a significant increase. A higher household wellbeing status and older age were associated with a lower prevalence of anaemia. Anaemia in non-pregnant adolescent women continues to be a public health problem. To improve the development and health of adolescent women in Mexico and to pave the way to a healthy pregnancy for the next generation, the causes of anaemia should be identified.

Trends of height-for-age Z-scores according to age among Brazilian children under 5 years old from 2006 to 2019 / Tendências dos escores Z de estatura por idade entre crianças brasileiras menores de cinco anos de 2006 a 2019 / Tendencias de las puntuaciones Z de la talla por edad entre los niños brasileños menores de cinco años de 2006 a 2019

This study compared the distribution of stunting and height-for-age (HAZ) Z-scores among age groups in data from the Brazilian National Survey on Demography and Health of Women and Children (PNDS 2006) and the Brazilian National Survey on Child Nutrition (ENANI-2019). The final sample comprised 4,408 and 14,553 children < 59 months of age in the PNDS 2006 and ENANI-2019, respectively. Children with HAZ scores < -2 according to the World Health Organization (WHO) growth standard were classified as stunted. Prevalence, 95% confidence intervals (95%CI), means, and standard deviations were estimated for Brazil and according to age. The distribution of HAZ scores at each age (in months) was estimated using the svysmooth function of the R survey package. Analyses considered the complex sampling design of the studies. Statistical differences were determined by analyzing the 95%CI of the overlap of point estimates. From 2006 to 2019, the prevalence of stunting for children < 12 months of age increased from 4.7% to 9%. As expected, the smoothed curves showed a higher mean HAZ score for children < 24 months of age in 2006 than in 2019 with no overlap of 95%CI among children aged 6-12 months. For children ≥ 24 months of age, we observed a higher mean HAZ score in 2019. Although the prevalence of stunting among children < 59 months of age was similar between 2006 and 2019, mean HAZ scores among children ≥ 24 months of age increased, whereas the mean HAZ score among children < 24 months of age decreased. Considering the deterioration in living conditions and the potential impact of the COVID-19 pandemic, we expect a greater prevalence of stunting in Brazil in the near future.

Este estudo comparou a distribuição dos escores Z de estatura (ZAI) e déficit de estatura por faixas etárias nos dados da Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher (PNDS 2006) e da Pesquisa Nacional de Nutrição Infantil (ENANI-2019). Nossa amostra final foi composta por 4.408 e 14.553 crianças < 59 meses de idade da PNDS 2006 e ENANI-2019, respectivamente. Crianças com escores HAZ < -2 de acordo com o padrão de crescimento da Organização Mundial da Saúde (OMS) foram classificadas como tendo déficit de estatura. Prevalências, intervalos de 95% de confiança (IC95%), médias e desvios padrão foram estimados para o Brasil e de acordo com a idade. A distribuição dos HAZ em cada idade (em meses) foi estimada usando a função svysmooth do pacote R. Nossas análises consideraram o desenho amostral complexo dos estudos. Diferenças estatísticas foram determinadas pela análise da sobreposição pontual dos IC95%. Entre 2006 e 2019, a prevalência de déficit de estatura para crianças < 12 meses de idade aumentou de 4,7% para 9%. Como esperado, as curvas suavizadas revelaram um HAZ médio maior para crianças < 24 meses de idade em 2006 do que em 2019, sem sobreposição de IC95% entre crianças de 6-12 meses. Para crianças ≥ 24 meses de idade, observamos um HAZ médio maior em 2019. Embora a prevalência de déficit de estatura entre crianças < 59 meses de idade tenha sido semelhante entre 2006 e 2019, observamos um aumento no HAZ médio entre crianças ≥ 24 meses de idade e uma diminuição no HAZ médio entre crianças < 24 meses de idade. Considerando a deterioração das condições de vida e o potencial impacto da pandemia de COVID-19, espera-se uma maior prevalência de déficit de estatura no Brasil no futuro próximo.

Este estudio comparó la distribución de las puntuaciones Z de talla (ZTE) y el déficit de estatura por grupos de edad en los datos de la Encuesta Nacional de Demografía y Salud del Niño y de la Mujer (PNDS 2006) y la Encuesta Nacional de Nutrición Infantil (ENANI-2019). Nuestra muestra final consistió en 4.408 y 14.553 niños < 59 meses de edad de PNDS 2006 y ENANI-2019, respectivamente. Los niños con puntuaciones HAZ < -2 según el patrón de crecimiento de la Organización Mundial de la Salud (OMS) se clasificaron como con déficit de talla para edad. Las prevalencias, los intervalos de 95% de confianza (IC95 %), las medias y las desviaciones estándar se estimaron para Brasil y según la edad. La distribución de HAZ para cada edad (en meses) se estimó utilizando la función svysmooth del paquete R. Nuestros análisis tuvieron en cuenta el complejo diseño de muestra de los estudios. Las diferencias estadísticas se determinaron mediante el análisis de la superposición puntual de los IC95 %. Entre 2006 y 2019, la prevalencia del déficit de talla para edad en niños < 12 meses de edad aumentó del 4,7 % al 9%. Como se esperaba, las curvas suavizadas revelaron un HAZ promedio mayor para los niños < 24 meses de edad en 2006 que en 2019, sin una superposición del IC95 % entre los niños de 6-12 meses. Para los niños ≥ 24 meses de edad, observamos un HAZ promedio mayor en 2019. Aunque la prevalencia del déficit de talla para edad entre los niños < 59 meses de edad fue similar entre 2006 y 2019, observamos un aumento en el HAZ promedio entre los niños ≥ 24 meses de edad y una disminución en el HAZ promedio entre los niños < 24 meses de edad. Teniendo en cuenta el deterioro de las condiciones de vida y el impacto potencial de la pandemia de COVID-19, se espera una mayor prevalencia de déficit de talla para edad en Brasil en un futuro cercano.

Hunger and its associated factors in the western Brazilian Amazon: a population-based study.

BACKGROUND: Hunger affects millions of people worldwide. In the current pandemic scenario of coronavirus Brazil has experienced an epidemic peak of hunger, amplifying existing prepandemic vulnerabilities, mainly in the North Region of the country. The aim of the present study was to investigate the prevalence of food insecurity and its associated factors in homes with children under 5 years of age in an urban area of a municipality of the western Brazilian Amazon. METHODS: A household survey was conducted with a probabilistic sample of 557 children and their families. Food insecurity (FI) was determined using the Brazilian Food Insecurity Scale. Associations between variables were analyzed based on the prevalence ratio (PR) and respective 95% confidence intervals (CI) calculated through multiple Poisson regression analysis. Variables with a P value < 0.05 after adjustments were considered significantly associated with the outcome. RESULTS: A prevalence of 76.5% (CI 1.36-2.67) food insecurity was found among the families in the study; 42.9% had moderate (CI 1.31-2.83) and severe (CI 1.10-1.83) food insecurity. Moderate and severe FI was associated with low family income (P = 0.00), participation in governmental income transfer programs (P = 0.01), and heads of household with less than 7 years of schooling (P = 0.02). Moreover, substantial frequencies of height deficit and being overweight were found among the children. CONCLUSIONS: The high prevalence of hunger and food insecurity and its associated factors reflects the context of geographic isolation and social exclusion in which these families live, suggesting that a substantial portion of the population under 5 years of age had experienced episodes of hunger in the 90 days prior to the survey. The prevalence of height deficit and being overweight among the children reveals a scenario of epidemiological/nutritional polarization, requiring the formulation of specific public policies for this population.

Dietary practices of university students according to the Dietary Guidelines for the brazilian population: PADu study / Práticas alimentares de ingressantes na universidade segundo o Guia Alimentar para a população brasileira: estudo PADu

ABSTRACT Objective To evaluate factors associated with dietary practices in students of a institution of higher education, included in the PADu study: "Anxiety and depression symptoms among university students in Minas Gerais: a longitudinal study". Methods Cross-sectional study of PADu project baseline with undergraduate first period students, who responded in person to a printed and self-administered questionnaire. Dietary practices were evaluated through a 24 items scale based on recommendations of Dietary Guidelines for the Brazilian Population. Answer choices are four-point Likert scale: "strongly agree", "agree", "disagree" and "strongly disagree". The sum of the items corresponded a score ranging (0-72 points), a high score indicating greater adequacy. The explanatory variables were: sociodemographics (gender, age, knowledge area, skin color, marital status, monthly household income), behaviors (excess alcohol consumption, physical exercise, screen exposure, internet use), health conditions (self-rated health, nutritional status, symptoms of depression, anxiety, stress). Adjusted multiple linear regression model was used to estimate the coefficients and their 95% CI. Results 356 students participated in the study. The average of dietary practices was 34.9±9.3 (0-63) points. Physical exercise practice (β: 3.75; CI: 1.83; 5.67) was associated with higher scores in the eating students score. We observed factors associated with the lowest score greater exposure to screens (β: -0.44; CI: -0.67; -0.13), excessive internet use (β: -3.05; CI: -5.22; -0.88), poor health self-assessment (β: -3.63; CI: -4.97; -1.21), excessive alcohol consumption (β: -2.09; CI: -3.92;-0.26) and stress symptoms (β: -2.81; CI: -4.72; -0.77). Conclusion Most students have inadequate dietary practices associated with internet use, alcohol consumption and stress.

RESUMO Objetivo Avaliar os fatores associados às práticas alimentares em estudantes de uma instituição de Ensino Superior incluídos no estudo PADu: "Sintomas de ansiedade e depressão em universitários de Minas Gerais: um estudo longitudinal". Métodos Estudo transversal da linha de base do projeto PADu com alunos do primeiro período da graduação, que responderam pessoalmente a um questionário impresso e autoaplicável. As práticas alimentares desses estudantes foram avaliadas por meio de uma escala de 24 itens baseada nas recomendações do Guia Alimentar para a População Brasileira. As opções de resposta foram coletadas em escala Likert de quatro pontos: "concordo totalmente", "concordo", "discordo" e "discordo totalmente". A soma dos itens correspondeu a uma pontuação (0-72 pontos), onde uma pontuação alta indicava maior adequação. As variáveis explicativas foram: características sociodemográficas (sexo, idade, área do conhecimento, cor da pele, estado civil, renda familiar total mensal), comportamentos (consumo excessivo de álcool, exercícios físicos, exposição a telas e uso de internet) e condições de saúde (autoavaliação saúde, estado nutricional, sintomas de depressão, ansiedade e stress). O modelo de regressão linear múltipla ajustado foi usado para estimar os coeficientes e seus IC 95%. Resultados 356 alunos participaram do estudo. A média das práticas alimentares foi de 34,9±9,3 (0-63) pontos. A prática de exercícios físicos (β: 3,75; IC: 1,83; 5,67) esteve associada a maiores escores no escore de hábitos alimentares dos escolares. Foram observados fatores associados ao menor escore maior exposição a telas (β: -0,44; IC: -0,67; -0,13), uso excessivo de internet (β: -3,05; IC: -5,22; -0,88), ruim autoavaliação de saúde (β: -3,63; IC: -4,97; -1,21), consumo excessivo de álcool (β: -2,09; IC: -3,92; -0,26) e sintomas de estresse (β: -2,81; IC: -4,72; -0,77). Conclusão A maioria dos estudantes apresenta práticas alimentares inadequadas associadas ao uso da internet, consumo de álcool e estresse.

Study of Food Intake and Physical Activity Patterns in the Working Population of the Uruguayan State Electrical Company (UTE): Design, Protocol and Methodology.

Noncommunicable diseases are the main cause of death globally, and most are potentially preventable; they are long term diseases and generally evolve slowly. In Uruguay 64.9% of the population between 25 and 64 years of age are either overweight or obese. The available scientific data show that workplaces are good for developing food-intake interventions for a healthier life. The present study aims to report the design, protocol and methodology for the evaluation of the food intake and physical activity patterns of the Uruguayan State Electrical Company (UTE) workers, as it is distributed across the whole country, and has established associations with overweight and obesity in order to establish institutional strategies to improve the situation. This study uses a population and a cross-sectional, randomized, representative sample of UTE workers with a precision of 3% and a confidence level of 95%. The considered anthropometric variables are weight, height, waist circumference, percentage of fat mass and percentage of visceral fat. A questionnaire on frequency of consumption of different foods and two 24-h dietary recalls (24-h DR) will be performed to evaluate the food intake. Accelerometry will be used to evaluate physical activity, and the International physical activity questionnaire (IPAQ) will be applied. Clinical data will be obtained from the UTE clinical charts. This is the first study of its kind that will be undertaken in Uruguay. It is registered under ClinicalTrials.gov Identifier nº NCT04509908.

Measuring the sports nutrition knowledge of elite Australian athletes using the Platform to Evaluate Athlete Knowledge of Sports Nutrition Questionnaire.

AIMS: To evaluate the nutrition knowledge of elite Australian athletes, and to obtain feedback from sports dietitians on the Platform to Evaluate Athlete Knowledge of Sports Nutrition Questionnaires' (PEAKS-NQ) suitability. METHODS: Sports dietitians from the National Institute Network across Australia recruited athletes to complete the online, 50-item PEAKS-NQ which contained two sections (General Nutrition and Sports Nutrition). Sports dietitians provided feedback on the PEAKS-NQ using a 14-item questionnaire (with two open-ended items). The main outcome measures were nutrition knowledge score and tool suitability (usefulness, acceptability and feasibility) scores. For knowledge scores, independent t-tests, ANOVA and Chi-square tests were used to evaluate differences between groups. Suitability was evaluated using descriptive statistics. RESULTS: Twelve sports dietitians from the National Institute Network in Australia recruited a convenience sample of 240 athletes (21.3 ± 4.3 years, 63.5% female, 63.3% competed internationally). Athletes scored 70.7 ± 10.5%, with better general vs sports nutrition knowledge. Females had higher overall scores (P < .001) with no differences for age or sport played. University-educated athletes scored higher than non-tertiary educated athletes (P = .004). Knowledge gaps were identified in fats (role and food sources), recovery nutrition and managing body composition. Sports dietitians rated suitability of PEAKS-NQ positively with complete agreement on 8 of 12 items. CONCLUSIONS: Athletes have greater understanding of general nutrition compared to sports nutrition concepts and may benefit from education on applying nutrition in sports-specific contexts. Sports dietitians' responses showed PEAKS-NQ was a highly acceptable, feasible and useful measure.

Energy and protein intake in the Colombian population: results of the 2015 ENSIN population survey.

The present study was aimed at (1) the differences between current weight v. ideal weight, (2) total energy intake and comparing it with required energy (Rkeer), (3) absolute protein intake in g/kg per d and g/1000 calories, (4) how energy and protein intake relate to the nutritional status of the subjects in terms of overall overweight (OEW) [overweight + obesity] and conservative overweight (CEW) [obesity] and (5) the contribution (%) of protein to total energy intake based on the acceptable macronutrient distribution range (AMDR). A dietary study was carried out in Colombia with 29 259 subjects between 1 and 64 years of age, based on cross-sectional data collected in 2015 by a 24-h dietary recall (24HR) administered as part of the National Nutrition Survey. Energy and protein intake did not differ by nutritional status. In the general population, energy intake was 2117 kcal/d (95 % CI 1969, 2264). The total protein intake was 64⋅3 g/d (95 % CI 61⋅4, 67⋅3). Adequate energy intake ranged from 90 to 100 %, except for the 1-4-year-old group, which ranged from 144 to 155 %. Protein intake was 1⋅64 g/kg per d (95 % CI 1⋅53, 1⋅75). The mean AMDR for protein to total energy intake was 13⋅3 % (95 % CI 12⋅9, 13⋅7). Excess weight began during the first 4 years of age. In conclusion, it is worth reviewing and updating energy and protein intake recommendations and dietary guidelines for the Colombian population and designing and modifying public policy.

Child Care Sites Participating in the Federal Child and Adult Care Food Program Provide More Nutritious Foods and Beverages.

OBJECTIVE: To compare food/beverage provisions between child care sites participating and not participating in the Child and Adult Care Food Program (CACFP). DESIGN: Cross-sectional survey administered in 2016. SETTING: Licensed child care centers and homes. PARTICIPANTS: Child care providers (n = 2,400) randomly selected from California databases (30% responded). Respondents (n = 680) were primarily site directors (89%) at child care centers (83%) participating in CACFP (70%). MAIN OUTCOME MEASURES: Meals/snacks served, and food/beverage provisions provided to children of age 1-5 years on the day before the survey. ANALYSIS: Odds ratios unadjusted and adjusted for the number of meals/snacks using logistic regression. RESULTS: Compared with CACFP sites, non-CACFP sites provided fewer meals/snacks; had lower odds of providing vegetables, meats/poultry/fish, eggs, whole grains, and milk; and had higher odds of providing candy, salty snacks, and sugary drinks. After adjusting for the number of meals/snacks, differences were attenuated but remained significant for meats/poultry/fish, milk, candy, salty snacks (centers only), and sugary drinks. Differences emerged in favor of CACFP for flavored/sugar-added yogurt, sweet cereals, frozen treats, and white grains. CONCLUSIONS AND IMPLICATIONS: Child care sites participating in CACFP are more likely to provide nutritious foods/beverages compared with non-CACFP sites. Child care sites are encouraged to participate in or follow CACFP program guidelines.

Red meat and egg intake and serum ferritin concentrations in Colombian children: results of a population survey, ENSIN-2015.

The present study aimed to (a) establish the frequency of consumption of red meat and eggs; (b) determine serum ferritin levels (µg/l); and (c) establish the relationship between serum ferritin and the consumption of red meat and eggs. In Colombia during 2014-2018, an analytical study was conducted in 13 243 Colombian children between the ages of 5 and 17 years, based on cross-sectional data compiled by ENSIN-2015 (Encuesta Nacional de la Situación Nutricional en Colombia-2015) on serum ferritin levels and dietary consumption based on a questionnaire of the frequency of consumption. Using simple and multiple linear regression, with the serum ferritin level as the dependent variable and the frequency of consumption as the main explanatory variable, the crude and adjusted partial regression coefficients (ß) between serum ferritin levels and consumption were calculated. The frequency of habitual consumption of red meat was 0⋅49 (95 % CI 0⋅47, 0⋅51) times/d. The frequency of habitual egg consumption was 0⋅76 (95 % CI 0⋅74, 0⋅78) times per d. The mean serum ferritin level in men was 41⋅9 (95 % CI 40⋅6, 43⋅1) µg/l and in women, 35⋅7 (95 % CI 34⋅3, 37⋅7) µg/l (P < 0⋅0001). The adjusted ß between the consumption of red meat and eggs and serum ferritin levels were ß = 3⋅0 (95 % CI 1⋅2, 4⋅7) and ß = 2⋅5 (95 % CI 1⋅0, 3⋅9) for red meat and eggs, respectively. In conclusion, red meat and eggs are determinants of serum ferritin levels in Colombia and, therefore, could be considered public policy options to reduce anaemia and Fe deficiency.

Descripción de la progresión de la obesidad y enfermedades relacionadas en Chile / Increasing frequency of obesity in Chile

Background: An explosive increase in overweight and obesity occurred in Chile since the 90's, without an integrative national policy. Aim: To describe the current obesity situation in Chile and its consequences. Material and Methods: Analysis of the available anthropometric data obtained by an annual census of anthropometry for students (Nutritional Map) collected by the Ministry of Education, and three National Health Surveys (2003, 2009-2010 y 2016-2017) performed by the Ministry of Health in adults. Results: According to the Nutritional Map the prevalence of obesity in 1987 was 7.5% among children of six years of age and increased to 24% in 2018 (8% with severe obesity). At 14 years of age, the frequency of obesity increased from 8 to 15% from 2011 to 2018. In children older than 15 years, overweight and obesity increased from 61 to 74% from 2003 to 2016. In the same period, total obesity increased from 23 to 34% and the frequency of diabetes duplicated from 6 to 12%. The frequency of hypertension did not change, but its prevalence is 45 and 73% after 45 and 65 years of age, respectively. Conclusions: The frequency of obesity will continue to increase, producing severe health risks for the population. Public policies addressing both structural and individual aspects are recommended.

Prevalence and determinants of misreporting of energy intake among Latin American populations: results from ELANS study.

Underreporting and overreporting of energy intake (EI) have been recognized as potential sources of bias. Dietary data mainly rely on proxy respondents, but little is known about the determinants of misreporting of EI among Latin American (LA) populations. This study was conducted using data from the multicenter Latin American Study of Nutrition and Health that consisted of information about sociodemographics, physical activity, and dietary intake from 9218 individuals aged 15 to 65 years who were living in urban areas in 8 LA countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela). Goldberg methodology was applied to classify the participants into categories of overreporter (OR), plausible reporter (PR), or underreporter (UR) of EI. Associations between misreporting and covariates were examined by the Kruskal-Wallis test, logistic regression, and linear regression. The prevalence of UR was 12.1% and OR was 14.1%. Costa Rica had the highest percentage of UR (24.4%) and the lowest of OR (7.3%), and Colombia had the lowest of UR (5.7%) and the highest of OR (22.4%). Furthermore, underreporters were more likely to be females from older groups with minimal education, white, physically active, overweight or obese, and living in Costa Rica. Overreporters were more likely to be younger, single, of low socioeconomic level, nonwhite, physically active, underweight or with normal weight, and from Colombia. The results demonstrated that sex, age, race, education status, and nationality seemed to influence the reporting behavior, which is essential to correctly interpreting potentially biased associations between diet and health outcomes, and improving nutritional interventions and public health policies.

[Determinants of non-essential energy-dense food consumption in Mexican population (Ensanut 2012).] / Determinantes del consumo de alimentos no básicos de alta densidad energética en población mexicana (Ensanut 2012).

OBJECTIVE: To characterize the sociodemographic profile associated with the probabilities of consumption of nonessential energy-dense foods (ANBADE), taxed since 2014. MATERIALS AND METHODS: We used the National Health and Nutrition Survey (Ensanut) 2012. ANBADE group was identified and probit models were estimated for the probabilities of consumption (PC) and of belonging to the high quintile of consumption after adjusting for total energy intake (PAC), as a function of sociodemographic characteristics. RESULTS: School-aged children have a PAC 10.7 percentage points (pp) higher vs. preschool-aged. Belonging to households with the highest expenditures or education of the head of the household are associated with a PC 3.3 or 3.2 pp higher vs. households with lower expenditures or education of the head, respectively. Living in metropolitan areas is associated with a PAC 5.2 pp higher vs. rural areas. CONCLUSIONS: The study identified the sociodemographic conditions associated with the largest PC or PAC of ANBADE, which may be considered in the design and evaluation of food policy.

OBJETIVO: Caracterizar el perfil sociodemográfico que se asocia con las probabilidades de consumo de alimentos no básicos de alta densidad energética (ANBADE), gravados desde 2014. MATERIAL Y MÉTODOS: Se utilizó la Encuesta Nacional de Salud y Nutrición (Ensanut) 2012. Se identificó el grupo de ANBADE y se estimaron modelos probit sobre las probabilidades de consumo (PC) y de alto consumo después de ajustar por energía total (PAC), en función de características sociodemográficas. RESULTADOS: Los escolares tienen 10.7 puntos porcentuales (pp) más PAC frente a los preescolares. Pertenecer a hogares con el mayor gasto o escolaridad del jefe se asocia con una PC 3.3 y 3.2 pp mayor en comparación con los hogares de menor gasto o escolaridad del jefe, respectivamente. Vivir en localidades metropolitanas se asocia con una PAC 5.2 pp mayor frente a localidades rurales. CONCLUSIONES: El estudio identificó las condiciones sociodemográficas que se asocian con las mayores PC o PAC de ANBADE, que podrán considerarse en el diseño y evaluación de la política alimentaria.

Determinantes del consumo de alimentos no básicos de alta densidad energética en población mexicana (Ensanut 2012) / Determinants of non-essential energy-dense food consumption in Mexican population (Ensanut 2012)

Resumen: Objetivo: Caracterizar el perfil sociodemográfico que se asocia con las probabilidades de consumo de alimentos no básicos de alta densidad energética (ANBADE), gravados desde 2014. Material y métodos: Se utilizó la Encuesta Nacional de Salud y Nutrición (Ensanut) 2012. Se identificó el grupo de ANBADE y se estimaron modelos probit sobre las probabilidades de consumo (PC) y de alto consumo después de ajustar por energía total (PAC), en función de características sociodemográficas. Resultados: Los escolares tienen 10.7 puntos porcentuales (pp) más PAC frente a los preescolares. Pertenecer a hogares con el mayor gasto o escolaridad del jefe se asocia con una PC 3.3 y 3.2 pp mayor en comparación con los hogares de menor gasto o escolaridad del jefe, respectivamente. Vivir en localidades metropolitanas se asocia con una PAC 5.2 pp mayor frente a localidades rurales. Conclusiones: El estudio identificó las condiciones sociodemográficas que se asocian con las mayores PC o PAC de ANBADE, que podrán considerarse en el diseño y evaluación de la política alimentaria.

Abstract: Objective: To characterize the sociodemographic profile associated with the probabilities of consumption of nonessential energy-dense foods (ANBADE), taxed since 2014. Materials and methods: We used the National Health and Nutrition Survey (Ensanut) 2012. ANBADE group was identified and probit models were estimated for the probabilities of consumption (PC) and of belonging to the high quintile of consumption after adjusting for total energy intake (PAC), as a function of sociodemographic characteristics. Results: School-aged children have a PAC 10.7 percentage points (pp) higher vs. preschool-aged. Belonging to households with the highest expenditures or education of the head of the household are associated with a PC 3.3 or 3.2 pp higher vs. households with lower expenditures or education of the head, respectively. Living in metropolitan areas is associated with a PAC 5.2 pp higher vs. rural areas. Conclusions: The study identified the sociodemographic conditions associated with the largest PC or PAC of ANBADE, which may be considered in the design and evaluation of food policy.

Sinonasal risk factors for eustachian tube dysfunction: Cross-sectional findings from NHANES 2011-2012.

BACKGROUND: Sinonasal pathology is frequently cited as a cause of eustachian tube dysfunction (ETD), despite a lack of evidence. Using a large, nationally representative sample, we investigated whether abnormal tympanometry, an objective marker of ETD, was associated with infectious, allergic, and exposure-related sinonasal risk factors. METHODS: Relevant data were extracted from the 2011-2012 National Health and Nutrition Examination Survey (NHANES). Tympanometric types (A, B, and C) were determined using peak pressure and compliance values. Participants with a type B or C tympanogram in at least one ear were classified as having ETD. Demographic and clinicopathologic risk factors with putative associations with ETD were determined. Statistical analysis, including regression modeling, was performed using Stata (version 15.1) to determine the correlation between sinonasal factors and ETD. RESULTS: The final analysis included 1253 subjects and 19 variables. We controlled for demographic data including age, gender, race, and income. In both univariate and multivariate logistic regression, statistically significant correlations were found between abnormal tympanometric values and: (1) having a persistent cold/flu in the last 12 months (univariate: adjusted odds ratio [OR], 2.42; p = 0.006; multivariate: adjusted OR, 2.15; p = 0.006); and (2) experiencing "hay fever" (ie, allergic rhinitis) within the last 12 months (univariate: adjusted OR, 1.95; p = 0.021; multivariate: adjusted OR, 1.71; p = 0.039). CONCLUSION: Using a large, representative data set, we identified significant correlations between ETD and (1) persistent cold/flu symptoms and (2) self-reported allergic rhinitis.

La actividad física y el estado nutricional en médicos / Physical activity and nutritional status in doctors

Contexto: el personal médico, debido a su conocimiento sobre la salud física y los medios para mantener la misma, constituye un ejemplo para la comunidad en general de un correcto estilo de vida en base a una alimentación saludable y la realización de ejercicio, pero la realidad es que no se conocen datos sobre el grado de actividad física y la nutrición del personal sanitario y su estado físico. Objetivo: establecer la prevalencia de sobrepeso y describir el nivel de actividad física del personal médico que labora en el Hospital San Francisco del IESS, de la ciudad de Quito. Sujetos y métodos: se realizó un estudio epidemiológico descriptivo transversal para describir la prevalencia de sobrepeso del personal médico, para lo cual se utilizó el IMC, el IPAQ versión corta y un cuestionario de consumo de alimentos. Mediciones principales: actividad física, estado nutricional, adición de sal, consumo de grasas saturadas y frutas. Resultados: se estudiaron 80 profesionales médicos, de los cuales 46, ( 57,5%; IC95%: 46,57%-67,74%) son mujeres. El 86,2% de los sujetos se encuentran en el rango de edad de 30 a 50 años. La clasificación realizada según la encuesta IPAQ, demostró que la mitad de los participantes (50%; n=40; IC95%: 39,30%-60,70%) realizan una actividad física leve, también denominada "caminata", y que solo 17 (21,3%; IC: 13,71%-31,42%) de los participantes realizan actividad física vigorosa. Las mujeres caminan más que los hombres (33% vs. 18%). El 53,8% (n= 43); IC95%: 42.9 ­ 64.3% de los médicos tienen sobrepeso y obesidad. Los hombres tienen mayor sobrepeso y obesidad que las mujeres (30% vs. 24%). El 41,3 % afirmaron que si agregan sal a sus alimentos diarios. El 22.5% si consumen grasas saturadas. En relación al consumo de frutas y verduras, el 60% (n=48); IC: 49,05%-70,04% revelaron que poseen un consumo moderado y relevante de estos productos. Habría cierta relación entre el incremento de actividad física y la disminución de IMC, la mediana del IMC tiende a disminuir. Igualmente, quienes disminuyen la actividad física incrementan el peso. Conclusión: la mitad del personal médico tiene sobrepeso. Debido a factores externos adicionales, la actividad física no es un determinante único para la reducción de peso en el personal médico. (AU)

Context: due to their knowledge about physical well-being and how to achieve it, healthcare professionalought to set the example for the community in general regarding a healthy lifestyle based on eating good food and exercising. However, in real terms, there are no data available concerning the physical condition, level oactivity and nutrition of health professionals. Objective: to establish the degree of excess weight and physical activity of the medical practitioners working aIESS (National Health Service) Hospital San Francisco in Quito. Subjects and methods: This is an epidemiologic cross-sectional descriptive study aimed at defining the prevalence of excess weight of medical personnel using BMI, IPAQ (short version) and a food consumption survey. Principal measurements: physical activity, nutritional condition, added salt, consumption of saturated fats and fruits. Results: the number of medical professionals taking part was 80, out of which 46, i.e. 57.5%; IC95%: 46.57%-67.74%) are women. 86.2% of the subjects are between 30 to 50 years of age. The IPAQ classification indicated that half of the participants (50%; n=40; IC95%: 39.30%-60.70%) undertake a moderate form ophysical activity such as walking, and that just 17 (21.3%; IC: 13.71%-31.42%) of the participants perform vigorous physical workouts. Females walk more than males (33% vs. 18%). Moreover, 53.8% (n= 43); IC95%:n 42.9 ­ 64.3% health practitioners are classed as overweight or obese. The males tended to be more overweight/ obese than the females: (30% vs. 24%). Also, 41.3 % of the subjects admitted adding salt to their food daily, and 22.5% knowingly consume saturated fats. Regarding the consumption of fruits and vegetables, 60% (n=48); IC: 49.05%-70.04% revealed that they have moderate or relevant consumption of these products. There is a correlation between increased physical activity and decreased BMI whereby the average BMI tends to go down. Likewise, those participants with decreased physical activity, tended to put on weight. Conclusion: half of the medical personnel are overweight. Due to additional external influences, physicaactivity is not the only determining factor for weight loss among the medical staff analysed. (AU)