Nutrición

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A Comparison of Associations Between Self-Reported and Device-Based Sedentary Behavoir and Obesity Markers in Adults: A Multi-National Cross-Sectional Study
(2021-05-28) Ferrari, Gerson Luis de Moraes; Herrera Cuenca, Marianella; Zalcman Zimberg, Ioná; Guajardo, Viviana; Gómez Salas, Georgina; Rigotti, Attilio; Cortés Sanabria, Lilia Yadira; Yépez García, Martha Cecilia; Pareja Torres, Rossina Gabriella; Peralta, Miguel; Marques, Adilson; Leme, Ana Carolina Barco; Kovalskys, Irina; Scott, Rollo; Fisberg, Mauro
The purpose of this study was to examine the associations between self-reported and device-based measures of sedentary behavior (SB) with obesity markers in adults from Latin American countries. Sitting time and total time spent in different SBs were self-reported using two different questionnaires. Accelerometers were used to assess total sedentary time. Body mass index, waist, and neck circumferences were assessed. The highest self-reported sitting time was in Argentina, the highest total time spent in different SBs was in Brazil and Costa Rica, and the highest device-based sedentary time was observed in Peru. Neither self-reported sitting time, total time spent in different SBs or device-based sedentary time were associated with body mass index. Device-based sedentary time was positively associated with waist circumference and self-reported sitting time was positively associated with neck circumference. Caution is warranted when comparing the associations of self-reported and device-based assessments of SB with anthropometric variables.
Accelerometer-measured daily step counts and adiposity indicators among Latin American aults: a multi-country study
(2021) Ferrari, Gerson Luis de Moraes; Marques, Adilson; Barreira, Tiago V.; Kovalskys, Irina; Gómez Salas, Georgina; Rigotti, Attilio; Cortés Sanabria, Lilia Yadira; Yépez García, Martha Cecilia; Pareja Torres, Rossina Gabriella; Herrera Cuenca, Marianella; Guajardo, Viviana; Leme, Ana Carolina Barco; Guzmán Habinger, Juan Manuel; Valdivia Moral, Pedro; Suárez Reyes, Mónica; Ihle, Andreas; Gouveira, Élvio Rúbio; Fisberg, Mauro
The aim of the present study was to examine the sex-related associations between accelerometer-measured daily step counts and adiposity indicators in adults from eight Latin American countries. We analyzed data from 2524 adults (aged 18-65 years) from the Latin American Study of Nutrition and Health. Device-measured daily step counts were measured by accelerometers (ActiGraph GT3X). The outcomes were body mass index (BMI; (kg/m2), waist and neck circumference (in cm). Overall, the mean of daily steps counts, BMI, waist and neck circumference were 10699.8, 27.3, 89.6, and 35.8. Weak and negative associations were observed between daily steps counts and BMI (r = -0.17; p < 0.05) and waist circumference (r = -0.16; p < 0.05); however, step counts was not associated with neck circumference. Daily steps counts were negatively associated with BMI (β: -0.054; 95%CI: -0.077; -0.012) and waist circumference (-0.098; -0.165; -0.030) independently of age and socioeconomic level. In men, there were significant negative associations between daily steps counts with BMI (-0.075; -0.119; -0.031) and waist circumference (-0.140; -0.233; -0.048), and in women, there was no significant association with either of the body composition indicators. The findings from this study need to be examined in prospective settings that use device-measured from Latin Americ
Active Transportation and Obesity Indicators in Adults from Latin America: ELANS Multi-Country Study
(2020-09-24) Guzmán Habinger, Juan Manuel; Lobos Chávez, Javiera; Mahecha Matsudo, Sandra Marcela; Kovalskys, Irina; Gómez Salas, Georgina; Rigotti, Attilio; Cortés Sanabria, Lilia Yadira; Yépez García, Martha Cecilia; Pareja Torres, Rossina Gabriella; Herrera Cuenca, Marianella; Zalcman Zimberg, Ioná; Guajardo, Viviana; Pratt, Michael; Cofre Bolados, Cristian Javier; Farías Valenzuela, Claudio; Marques, Adilson; Peralta, Miguel; Leme, Ana Carolina Barco; Fisberg, Mauro; Werneck, André de Oliveira; da Silva, Danilo Rodrigues; Ferrari, Gerson Luis de Moraes
Purpose: The aim of this study was to determine the association between active transportation and obesity indicators in adults from eight Latin American countries. Methods: Data from the ELANS study, an observational multi-country study (n: 8336; 18-65 years), were used. Active transportation (walking and cycling) and leisure time physical activity was assessed using the International Physical Activity Questionnaire (long version). The obesity indicators considered were: body mass index, and waist and neck circumference. Results: In the total sample, the average time dedicated to active transportation was 24.3 min/day, with the highest amount of active transportation being Costa Rica (33.5 min/day), and the lowest being Venezuela (15.7 min/day). The countries with the highest proportion of active transportation were Ecuador (71.9%), and the lowest was Venezuela (40.5%). Results from linear regression analyses suggest that active transportation was significantly and independently associated with a lower body mass index (β: -0.033; 95% CI: -0.064; -0.002), but not with waist circumference (β: -0.037; 95% CI: -1.126; 0.390 and neck circumference (β: -0.007; 95% CI: -0.269; 0.130). Conclusions: Active transportation is significantly associated with a lower body mass index. Governments should incentivize this type of transportation as it could help to reduce the obesity pandemic in Latin America.
Acute Hepatic Response to Diet Modification and Exercise-induced Endotoxemia during a Laboratory-based Duathlon
(2010-01) Moncada Jiménez, José; Plaisance, Eric Paul; Araya Ramírez, Felipe; Taylor, James K.; Ratcliff, Lance; Mestek, Michael L.; Grandjean, Peter Walter; Aragón Vargas, Luis Fernando
The purpose of the study was to compare the acute hepatic response to diet modification and exercise-induced endotoxemia, and to determine if associations exist between liver damage markers, body core temperature, and IL-6 responses to a laboratory-based duathlon. Eleven moderately-trained healthy males followed a low-carbohydrate (CHO) and a high CHO diet to change their glycogen stores two-days before completing a duathlon. Blood samples were obtained at rest, immediately after and 1- and 2-h following the duathlon for determination of endotoxin-lipopolysaccharide binding protein (LPS-LBP) complex, IL-6, and liver integrity markers AST, ALT, and AST/ALT ratio. Hydration status and body core temperature were assessed at rest, during, and after the duathlon. Athletes were more dehydrated and had higher AST/ALT ratios in the lowcompared to the high-CHO diet trial regardless of the measurement time (p<0.05). IL-6 increased from resting to immediately after, 1- and 2-h following duathlon regardless of the diet (p<0.05). A higher LPS-LBP complex concentration was observed from rest to immediately after the duathlon. No significant correlations were found between LPS-LBP complex levels and body core temperature. In conclusion, athletes on a low-CHO diet showed higher hepatic structural damage and finished more dehydrated compared to athletes on a high-CHO diet. Body core temperature and LPS-LBP complex levels were unrelated beyond the increase in body core temperature explained by exercise. No significant associations were found between body core temperature, IL-6 and LPS-LBP complex concentrations.
Adaptation and validation of the nutrition environment measures survey in stores (NEMS-S) in Costa Rica
(2022) Golfin, Francesca; Murillo, Carla; Jensen Madrigal, Melissa Lorena; Frongillo, Edward A.
This study adapted and validated the NEMS-S in Costa Rica. Twenty-nine food stores were assessed, three times, by two raters. Inter-rater precision and intra-rater stability were quantified. Construct validity was determined with the known-groups method. Relative precision ranged from 0.54 to 0.77 and was 0.87 for total score. Relative stability ranged from 0.58 to 0.96 and was 0.94 for total score. For construct validity, the hypothesized relationship that supermarkets would have the highest scores was supported. The instrument has moderate to excellent precision and stability, has construct validity, and can be useful to develop policies that encourage healthy environments in food stores.
Agreement Between Self-Reported and Device-Based Sedentary Time among Eight Countries: Findings from the ELANS
(2021-01-27) Ferrari, Gerson Luis de Moraes; Werneck, André de Oliveira; Silva, Danilo Rodrigues; Kovalskys, Irina; Gómez Salas, Georgina; Rigotti, Attilio; Cortés Sanabria, Lilia Yadira; Yépez García, Martha Cecilia; Liria Domínguez, María Reyna; Herrera Cuenca, Marianella; Zalcman Zimberg, Ioná; Guajardo, Viviana; Pratt, Michael; Cristi Montero, Carlos; Marques, Adilson; Peralta, Miguel; Cofre Bolados, Cristian Javier; Leme, Ana Carolina Barco; Rollo, Scott; Fisberg, Mauro
The purpose of this study was to analyze the agreement between self-reported and device-based sedentary time among eight countries in Latin America. As part of the Latin American Study of Nutrition and Health (ELANS), data were collected from 2524 participants (18–65 years) across eight countries. Participants reported time spent sedentary in different activities (computer use at home, videogame use, reading, sitting down to chat with friends/relatives or listening to music, speaking on the phone, watching TV, and riding in a car). Overall sitting time was assessed using a single item from the International Physical Activity Questionnaire (IPAQ). Device-based sedentary time was assessed using Actigraph GT3X accelerometers. Self-reported overall sitting time (227.1 min/day) produced the lowest values of the three assessment methods, followed by self-reported sum of different types of sedentary behavior (364.1 min/day) and device-based sedentary time (568.6 min/day). Overall, correlation coefficients and ICC varied from weak to moderate (rho: 0.25–0.39; ICC: 0.21:0.39) between self-reported sum of different types of sedentary behavior, self-reported overall sitting time, and device-based sedentary time. The Bland-Altman plots indicated low to moderate agreement between self-reported overall sitting time and device-based sedentary time by sex. Self-report measures underestimate sedentary behavior and overall sitting time when compared with device-based measures. The weak and moderate level of agreement between methods indicates that caution is required when comparing associations between different self-report and device-based measures of sedentary behavior with health outcomes.
Alcohol Contribution to Total Energy Intake and Its Association with Nutritional Status and Diet Quality in Eight Latina American Countries
(2021-11-05) Brenes Sáenz, Juan Carlos; Gómez Salas, Georgina; Quesada Quesada, Dayana; Kovalskys, Irina; Rigotti, Attilio; Cortés Sanabria, Lilia Yadira; Yépez García, Martha Cecilia; Liria Domínguez, María Reyna; Herrera Cuenca, Marianella; Guajardo, Viviana; Fisberg, Regina Mara; Leme, Ana Carolina Barco; Ferrari, Gerson Luis de Moraes; Fisberg, Mauro
Alcohol consumption is a modifiable risk factor for non-communicable diseases. This study aimed to characterize alcohol consumers at the nutritional, anthropometric, and sociodemo- graphic levels. Data from 9218 participants from Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela participating in “Latin American Health and Nutrition Study (ELANS),” a multi-country, population-based study, were used. Dietary intake was collected through two, 24 h recalls. Participants were classified into consumers (n = 1073) and non-alcohol consumers (n = 8145) using a cut-off criterium of ≥15 g/day of alcohol consumption calculated from the estimation of their usual daily intake. Among alcohol consumers, the mean alcohol consumption was 69.22 ± 2.18 grams (4.6. beverages/day), contributing to 484.62 kcal, which corresponded to 16.86% of the total energy intake. We found that the risk of alcohol consumption was higher in young and middle-aged men from low and middle socioeconomic status. Argentine, Brazil, and Chile had the highest percentage of consumers, while Ecuador showed the highest alcohol con- sumption. Alcohol drinkers were characterized by having higher body weight and wider neck, waist, hips circumferences. Alcohol drinkers had a higher energy intake, with macronutrientsproviding relatively less energy at the expense of the energy derived from alcohol. Alcohol drinkers showed lower and higher consumptions of healthy and unhealthy food groups, respectively. In ad- dition, adequacy ratios for all micronutrients assessed were lower in alcohol consumers. All these deleterious effects of alcohol on nutritional and anthropometric parameters increased with the num- ber of alcoholic beverages consumed daily. Altogether, these findings suggest that limiting alcohol consumption can contribute to reducing the risk of obesity, metabolic syndrome, and diet-related diseases.
Alcohol intake, drinking patterns, and risk of nonfatal acute myocardial infarction in Costa Rica
(2005-12) Kabagambe, Edmond K.; Baylin, Ana; Ruiz Narváez, Edward A.; Rimm, Eric B.; Campos Núñez, Hannia
Background: Moderate alcohol consumption is associated with a lower risk of myocardial infarction (MI). Whether alcohol is truly protective or whether the amount, type, or pattern of intake is the most important is still under debate. Objective: The purpose of this study was to determine whether alcohol intake and drinking patterns are associated with plasma lipids and the risk of MI in Costa Ricans, a population with a low intake of wine. Design: We conducted a study of 2090 cases of a first nonfatal acute MI and 2090 population-based controls matched by age, sex, and residence in Costa Rica, a country with diet and lifestyles different from those of Western countries. Alcohol and dietary intakes were assessed by using validated questionnaires. Results: In a multivariate conditional regression model that controlled for other cardiovascular disease risk factors, the lowest risk of MI [odds ratio (OR) = 0.44; 95% CI: 0.31, 0.61] was observed for those who drank on average 3 drinks/wk (compared with lifelong abstainers). When we looked at the frequency of consumption, we found that the risk of MI among daily drinkers (OR = 0.64; 95% CI: 0.41, 1.01) was not significantly different (P = 0.23) from that of weekend drinkers (OR = 0.76; 95% CI: 0.59, 0.98) regardless of the amount consumed. HDL cholesterol increased with the amount and frequency of alcohol intake. Similar to a few other populations, apparent protection was observed at very low alcohol intakes. Conclusion: Low to moderate consumption of alcohol 1–2 d/wk is independently associated with a reduced risk of MI.
Alimentación y nutrición durante la pandemia del COVID-19
(2020) Deossa Restrepo, Gloria C.; Orozco Soto, Diana María; Urrego Borja, Yiviani; Andrade Pérez, Laura Milena; Segura Buján, Marco Vinicio
El coronavirus (SARS-Cov-2) es el causante de la enferme- dad COVID-19, altamente contagiosa, y que ha sido declarada por la Organización Mundial de la Salud (OMS), como una emergencia mundial de salud pública. Esta pandemia surgió en Wuhan, China, a finales del año 2019, causando manifestaciones respiratorias, digestivas y sistémicas que afectan la salud humana. El virus pertenece a la familia Betacoronavirus, puede infectar neumocitos tipo 2 y células epiteliales, lo cual puede causar enfermedades respiratorias, que van de leves a moderadas, tales como el resfriado común hasta enfermedades graves que pueden llevar a neumonía e incluso la muerte. El aislamiento social o las cuarentenas declaradas por los gobiernos para evitar la propagación del virus, aunado a las dificultades económicas asociadas con esto por la pérdida de empleos, entre otras situaciones, ha llevado a las familias a realizar un confinamiento en muchos casos sin poder cubrir sus requerimientos calóricos y nutricionales mínimos, poniendo en riesgo su seguridad alimentaria y su estado nutricional, que con el paso de los días tiende a empeorar. Esto se agrava cuando las personas por diferentes motivos, no tienen claridad en qué tipo de alimentos comprar para mantener una dieta saludable, como prepararlos adecuadamente, o simplemente no cuentan con recursos para adquirirlos, por lo que posiblemente privilegian la compra de alimentos altos en carbohidratos y grasas, pues generan saciedad, son económicos y rendidores, pero también se sabe que aportan muchas calorías y son pobres en micronutrientes.
Análisis de la canasta básica alimentaria de Costa Rica: oportunidades desde la alimentación y nutrición
(2020-06-18) Hidalgo Víquez, Cindy María; Andrade Pérez, Laura Milena; Rodríguez González, Shirley; Dumani Echandi, Marcela; Alvarado Molina, Nadia Libertad; Cerdas Núñez, Milena María; Quirós Blanco, Grettel
La canasta básica alimentaria (CBA) es un conjunto de alimentos y bebidas, que se elabora a partir del consumo reportado por los costarricenses y considera tres criterios fundamentales: universalidad, aporte energético y porcentaje del gasto. Objetivo: Identificar la congruencia de la estructura de la CBA actual, con el derecho humano a la alimentación de la población costarricense. Metodología: A partir de la estructura de la CBA urbana actual, se compararon las cantidades de alimentos allí sugeridas con las recomendaciones de las Guías Alimentarias para Costa Rica. Se comparó el perfil de energía y nutrientes contra las recomendaciones dietéticas diarias. Se realizó una recreación de las cantidades de alimentos de la CBA para un día. Se realizaron modificaciones para una CBA sugerida con un mejor perfil nutricional y se costeó para comparar el costo de la CBA sugerida con la CBA actual. Resultados y discusión: Se incorporan en la CBA sugerida 21 alimentos, se eliminan seis, se aumenta la cantidad sugerida de dos y se disminuye la cantidad sugerida de uno. Se logra con ello aumentar el aporte de fibra dietética, calcio, magnesio, potasio, zinc, vitaminas C, E y K y reducir la cantidad de azúcar total, azúcar agregada, sodio y colesterol. Con estos cambios, el costo de la CBA sugerida se reduce ligeramente Conclusiones: Se necesita contemplar en la CBA otros aspectos nutricionales, además del aporte energético de los alimentos, como el aporte de los micronutrientes, los cuales son esenciales para la prevención y el tratamiento de enfermedades crónicodegenerativas, que son uno de los principales problemas de salud que aqueja la población en la actualidad. Por lo tanto, la CBA debe ser replanteada para ofrecer un mínimo alimentario congruente, de manera que se estimule y favorezca una alimentación balanceada, variada y adecuada para las necesidades nutricionales de la población en Costa Rica.
Anthropometric Profile of Latin American Population: Results from the ELANS Study
(2021-11-08) Herrera Cuenca, Marianella; Kovalskys, Irina; Gerardi, Alejandro; Hernández Rivas, Pablo Ignacio; Sifontes, Yaritza; Gómez Salas, Georgina; Yépez García, Martha Cecilia; Méndez Pérez, Betty; Landaeta Jiménez, Maritza; Pareja Torres, Rossina Gabriella; Cortés Sanabria, Lilia Yadira; Rigotti, Attilio; Fisberg, Mauro; Zalcman Zimberg, Ioná
Background: Latin America has experienced changes in lifestyle since 1960. Aim: The aim was to determine the prevalence of obesity and stunting among eight countries of Latin American and to identify the determinant risk factors for obesity. Subjects and Methods: Data were obtained from 9,218 participants of the Latin American Study of Nutrition and Health (ELANS), a multicenter cross-sectional study of the representative samples in eight Latin American countries. All the participants completed a standard protocol to investigate the nutrient intake and anthropometric variables (weight, height, and circumferences) analyzed by country, gender, age, and socioeconomic status. Results: The prevalence of obesity was higher in Costa Rica and Venezuela (29%) and lower in Colombia (16%), stunting was reported higher in Peru (47%) and lower in Argentina (17%), and waist and neck circumferences showed the higher values in Costa Rica (43%) and Chile (52%) and lower values in Colombia (23 and 26%). Conclusion: This study indicates an increasing trend toward overweight and obesity that are associated with lower socioeconomic status, being a woman, and concurs with inadequate intakes of calcium, which may be related to poor quality diet and in the long term could constitute risk factors for the chronic diseases and a health burden to the region.
Anthropometry, dietary intake, physical activity and sitting time patterns in adolescents aged 15-17 years; an interational comparison in eigth Latina American countries
(2020-01-21) Ferrari, Gerson Luis de Moraes; Kovalskys, Irina; Fisberg, Mauro; Gómez Salas, Georgina; Rigotti, Attilio; Cortés Sanabria, Lilia Yadira; Yépez García, Martha Cecilia; Pareja Torres, Rossina Gabriella; Herrera Cuenca, Marianella; Zalcman Zimberg, Ioná; Guajardo, Viviana; Pratt, Michael; Previdelli, Ágatha Nogueira; Scholes, Shaun; Celis Morales, Carlos A.; Solé, Dirceu
Background: Although there is high prevalence of obesity and other cardiovascular risk factors among Latin American adolescents, there is limited evidence on dietary intake and physical activity (PA) patterns in this population. Therefore, we characterized anthropometry, dietary intake, PA and sitting time (ST) in adolescents aged 15-17 years from eight Latin American countries. Methods: Six hundred seventy-one adolescents (41.4% girls) from the Latin American Study of Nutrition and Health (ELANS) were included. Nutritional status was classified by four BMI (kg/m2) categories. Waist circumference (WC) was categorized as above or below thresholds. Dietary intake was assessed through two non-consecutive 24-h dietary recalls. PA and ST were measured using the International Physical Activity Questionnaire (IPAQ). We calculated overall and country-specific estimates by sex and tested for differences between boys and girls. Results: Differences in the prevalence of overweightness (15.1 and 21.6%) and obesity (8.5 and 6.5%) between boys and girls, respectively, were statistically insignificant (p = 0.059). Average energy intake was 2289.7 kcal/day (95% CI: 2231-2350) for boys and 1904.2 kcal/day (95% CI: 1840-1963) for girls (p < 0.001). In relation to macronutrient intake for boys and girls, respectively, the average intake (expressed as percentage of total energy) was 15.0 and 14.9% for protein; 55.4 and 54.9% for carbohydrates; 14.1 and 14.5% for added sugar; 29.5 and 30.1% for total fat; and 9.6 and 9.9% for saturated fat (p > 0.05 for all outcomes). There was no statistically significant difference in the prevalence of total energy (TE) saturated fat and added sugar (>10% of TE) between girls and boys (49.6% versus 44.8 and 81.7% versus 76.1%, respectively). Prevalence of physical inactivity was 19% in boys and 43.7% in girls (p < 0.001). Median levels of vigorous-intensity PA and total PA were significantly higher for boys than for girls (p < 0.05 for both outcomes); whereas levels of ST were similar (273.7 versus 220.0 min/day for boys and girls, respectively; p > 0.05). Conclusions: These findings highlight the high prevalence of poor dietary intake and physical inactivity in adolescents from Latin American countries. Therefore, effective and sustainable strategies and programmes are needed that promote healthier diets, regular PA and reduce ST among Latin American adolescents.
Antioxidant and Anti-inflammatory in Vitro Activities of Phenolic Compounds from Tropical Highland Blackberry (Rubus adenotrichos)
(2013-05-22) Azofeifa Cordero, Gabriela; Quesada Mora, Silvia; Boudard, Frederic; Morena, Marion; Cristol, Jean Paul; Pérez Carvajal, Ana Mercedes; Vaillant, Fabrice; Michel, Alain
This study evaluates the antioxidant and anti-inflammatory activities in a polyphenol extract from blackberries. The antioxidant activity measured via oxygen radical absorbance capacity (ORAC) was higher for the blackberry extract (4339 ± 144 μM TE/g) than for quercetin and ellagic acid. The blackberry phenolic compounds protected liposomes and liver homogenates against lipid peroxidation; in both models, the antioxidant activity (IC50 = 7.0 ± 0.5 and 20.3 ± 4.2 μg/mL, respectively) was greater than that found with Trolox. The extract inhibited superoxide production by NADPH oxidase in THP-1 cells and nitrite production in J774A.1 cells stimulated with LPS+IFNγ, with nitrite production decreasing after 4 h of incubation with the extract, mainly through a strong scavenging activity. However, 24 h of treatment reduced the amount of nitrites (IC50 = 45.6 ± 1.2 μg/mL) because of a down-regulation of iNOS protein expression, as demonstrated by Western blotting. The inhibitory activities found in blackberry phenols suggest a potential beneficial effect against oxidative stress and inflammatory processes.
Arachidonic acid in adipose tissue is associated with nonfatal acute myocardial infarction in the Central Valley of Costa Rica
(2004-11) Baylin, Ana; Campos Núñez, Hannia
Arachidonic acid (AA), a precursor of prothrombotic eicosanoids, is potentially atherogenic, but epidemiologic data are scarce. We evaluated the hypothesis that increased AA in adipose tissue is associated with increased risk of nonfatal acute myocardial infarction (MI), and if so, whether this association is related to dietary or adipose tissue linoleic acid. We studied the association between AA and MI in 466 cases of a first nonfatal acute MI, matched on age, gender, and residence to 466 population controls. Fatty acids (FA) were assessed by GC in adipose tissue samples collected from all subjects. Odds ratios (OR) and 95% CI were calculated from multivariate conditional logistic regression models. Subjects in the highest quintile of adipose tissue AA (0.64% of total FA) had a higher risk of nonfatal acute MI than those in the lowest quintile (0.29% of total FA), after adjusting for potential confounders including (n-3) and trans FAs (OR = 1.94, 95% CI: 1.07, 3.53, P for trend = 0.026). Adipose tissue AA was not correlated with dietary AA (r = 0.07), linoleic acid (r = 0.04), or other dietary (n-6) FAs, or with adipose tissue linoleic acid (r = −0.07). These data suggest that the association between MI and adipose tissue AA is not related to dietary intake of (n-6) FAs including linoleic acid. Better understanding of the metabolic factors that increase AA in adipose tissue is urgently needed.
Are U.S. food and beverage companies now advertising healthy products to children on television? An evaluation of improvements in industry self-regulation, 2017–2021
(2023) Jensen Madrigal, Melissa Lorena; Fleming Milici, Frances; Harris, Jennifer L.
Background Through the Children’s Food and Beverage Advertising Initiative (CFBAI), U.S. food companies pledge to only advertise healthier products in children’s television (TV) programming, but previous research shows that highly advertised products do not qualify as nutritious according to independent nutrition criteria. In 2020, the CFBAI implemented stricter nutrition criteria for products that may be advertised to children, but the potential impact of these changes has not been assessed. This observational study evaluates (1) improvements in energy and individual nutrient composition of products that companies indicated may be advertised to children (i.e., CFBAIlisted products) in 2020 versus 2017, (2) amount of advertising on children’s TV for CFBAI-listed versus other products in 2021, and 3) the nutrition quality of advertised versus non-advertised CFBAI-listed products. Methods Data include energy, saturated fat, sodium, and sugar content and overall nutrition quality (Nutrition Profle Index [NPI] scores) of CFBAI-listed products in 2017 (n=308) and 2020 (n=245). Nielsen data provided total ad spend‑ ing and children’s exposure to ads on children’s TV channels for all foods and beverages in 2021. Results From 2017 to 2021, energy, saturated fat and sugar declined for CFBAI-listed products in three of six food categories (yogurt, sweet and salty snacks). Although CFBAI-listed products accounted for 79% of food ads viewed by children on children’s TV channels, just 50% of CFBAI-listed food and 36% of drink brands were advertised on children’s TV. Moreover, advertised products were signifcantly less nutritious than non-advertised CFBAI-listed products. Conclusion Despite revised nutrition standards and improvements in nutrient content of some product categories, participating companies continued to primarily advertise nutritionally poor food and beverages on children’s TV. CFBAI companies have not delivered on their promises to advertise healthier products to children.
Aspectos importantes a incorporar en una aplicación móvil para la adherencia al tratamiento de la diabetes mellitus tipo 2 en Costa Rica según pacientes y profesionales de salud
(2016) Porras Leiva, Yulissa; Richmond Solera, Daniela; García Calvo, María Fernanda; Jensen Madrigal, Melissa Lorena
Antecedentes: la diabetes mellitus (DM) afecta al 12,8 % de los costarricenses. Recientemente, se ha presentado en Costa Rica un auge en el uso de tecnología móvil que permite innovar en el campo de aplicaciones móviles para la diabétes mellitus tipo 2 (DM2). Objetivo: explorar las perspectivas de pacientes y profesionales de la salud sobre los aspectos que podría contener una aplicación móvil para apoyar la adherencia del tratamiento en pacientes con DM2 en Costa Rica. Materiales y métodos: se utilizó un enfoque cualitativo para explorar la perspectiva de los participantes respecto al diseño de una aplicación móvil para DM2. Se aplicaron entrevistas semiestructuradas y grupos focales a 16 pacientes con DM2; y entrevistas semiestructuradas a 12 profesionales en salud (nutricionistas, enfermeras y médicos endocrinólogos). Resultados: solo dos pacientes habían utilizado una aplicación móvil para la DM2, y dos profesionales han recomendado su uso. Ambos grupos tienen intención de utilizar esta herramienta. La función de común interés es el registro de glucemia, aunque también se mencionaron otras. Los profesionales recomiendan supervisión continua en el uso de estas aplicaciones móviles. Conclusiones: los posibles usuarios brindan información valiosa con respecto a sus necesidades y expectativas de una aplicación móvil para DM2 para Costa Rica. La sencillez y el hecho de ser una aplicación móvil adaptada a Costa Rica son las características deseables más mencionadas.
Association between Active Transportation and Public Transportation with an Objectively Measured Meeting of Moderate-To-Vigorous Physical Activity and Daily Steps Guidelines in Adults by Sex from Eight Latin American Countries
(2021) Herreros Irarrázabal, Diego; Guzmán Habinger, Juan Manuel; Mahecha Matsudo, Sandra Marcela; Kovalskys, Irina; Gómez Salas, Georgina; Rigotti, Attilio; Cortés Sanabria, Lilia Yadira; Yépez García, Martha Cecilia; Pareja Torres, Rossina Gabriella; Herrera Cuenca, Marianella; Farías Valenzuela, Claudio; Marques, Adilson; Leme, Ana Carolina Barco; Fisberg, Mauro; Drenowatz, Clemens; Ferrari, Gerson Luis de Moraes
This study aimed to examine the associations between active transportation and public transport and the objectively measured meeting of moderate-to-vigorous physical activity (MVPA) and steps per day guidelines in adults by sex from eight Latin American countries. As part of the Latin American Study of Nutrition and Health (ELANS), data were collected from 2524 participants aged 18–65 years. MVPA and steps per day were evaluated using Actigraph GT3X accelerometers. The mode of transportation, its frequency and duration were collected using a self-reported questionnaire. The average time dedicated to active transportation was 12.8 min/day in men (IQR2.8–30.0) and 12.9 min/day in women (IQR: 4.3–25.7). A logistic regression analysis was conducted, showing that active transportation (≥10 min) was associated with higher odds of meeting MVPA guidelines (men: OR: 2.01; 95%CI: 1.58–2.54; women: OR: 1.57; 95%CI: 1.25–1.96). These results show a greater association when considering active transportation plus public transport (men: OR: 2.98; 95%CI: 2.31–3.91; women: OR: 1.82; 95%CI: 1.45–2.29). Active transportation plus public transport was positively associated with meeting steps per day guidelines only in men (OR: 1.55; 95%CI: 1.15– 2.10). This study supports the suggestion that active transportation plus public transport is significantly associated with meeting the MVPA and daily steps recommendations.
Association between built environment and physical activity in Latin American countries: a multicentre cross-sectional study
(2021) Barreno, Mishell; Sisa Caiza, Iván Fausto; Yépez García, Martha Cecilia; Shen, Hua; Villar Cáceres, Mónica; Kovalskys, Irina; Fisberg, Mauro; Gómez Salas, Georgina; Rigotti, Attilio; Cortés Sanabria, Lilia Yadira; Pareja Torres, Rossina Gabriella; Herrera Cuenca, Marianella; Guajardo, Viviana
Abstract Objective: To assess the association between the physical activity level and the built environment by accessibility, microinfrastructure and security in Latin America (LA). Design: We conducted a multicentre cross-sectional study to collect physical activity and built environment data. The levels of physical activity were calculated through the International Physical Activity Questionnaire survey. Using the Neighbourhood Environment Walkability Scale-Abbreviated, characteristics of the built environment were measured through three domains: accessibility, microinfrastructure and security. To estimate the association of the built environment and physical activity, we used mixed effects logistic regression analysis. In addition, likelihood ratio test to account for clustered effect within countries and/or cities was used. Setting: Eight countries in LA. Participants: Adults aged 15-65 years (n=9218) living in urban areas and consented to participate of the Latin American Study of Nutrition and Health. Results: Most of the population in LA had access to a grocery store (97.2%), public transport stop (91.5%) and children's playground (81.6%). Metropolitan parks were more accessible in Ecuador (59.8%) and Colombia (59.2%) than in Venezuela (33.5%). Individuals located within 20 min of walking from sport facilities or children's playground areas were more likely to perform moderate-to-high physical activity OR 1.20 (95% CI 1.06 to 1.36) and OR 1.25 (95% CI 1.02 to 1.53), respectively. Only 14.5% of the population from the region considered that their neighbourhood had an adequate design for walking or cycling. Likewise, among adults living in LA, only 39.75% had the perception of living in a safe neighbourhood. Conclusions: This multicentre study shows that currently, LA built environment does not promote physical activity in the region. Our findings provide the rationale to push forward, at regional and national levels, policies and interventions that will help to achieve a safe, healthy and friendly built environment to encourage participation in active recreation and sports in leisure time.
Association between Perceived Neighborhood Built Environment and Walking and Cycling for Transport among Inhabitants from Latin America: The ELANS Study
(2020) Ferrari, Gerson Luis de Moraes; Werneck, André de Oliveira; da Silva, Danilo Rodrigues; Kovalskys, Irina; Gómez Salas, Georgina; Rigotti, Attilio; Cortés Sanabria, Lilia Yadira; Yépez García, Martha Cecilia; Pareja Torres, Rossina Gabriella; Herrera Cuenca, Marianella; Zalcman Zimberg, Ioná; Guajardo, Viviana; Pratt, Michael; Cofre Bolados, Cristian Javier; Jofré Saldía, Emilio; Pires, Carlos; Marques, Adilson; Peralta, Miguel; de Victo, Eduardo Rossato; Fisberg, Mauro
Purpose: This study aimed to examine the associations of the perceived neighborhood built environment with walking and cycling for transport in inhabitants from Latin American countries. Methods: This cross-sectional study involved 9218 participants (15-65 years) from the Latin American Study of Nutrition and Health, which included a nationally representative sample of eight countries. All participants completed the International Physical Activity Questionnaire-Long Form for measure walking and cycling for transport and the Neighborhood Environment Walkability Scale-Abbreviated. Furthermore, perceived proximity from home to public open spaces and shopping centers was assessed. Results: Perceived land use mix-access (OR: 1.32; 95%CI: 1.16,1.50) and the existence of many alternative routes in the neighbourhood (1.09 1.01,1.17) were associated with higher odds of reporting any walking for transport (≥10 min/week). Perceived slow speed of traffic (1.88 1.82,1.93) and few drivers exceeding the speed limits (1.92; 1.86,1.98) were also related to higher odds of reporting any walking for transport. The odds of reporting any cycling for transport (≥10 min/week) were higher in participants perceiving more walking/cycling facilities (1.87 1.76,1.99), and better aesthetics (1.22 1.09,1.38). Conclusions: Dissimilar perceived neighborhood built environment characteristics were associated with walking and cycling for transport among inhabitants from Latin America.
Association of moderate-to vigorous physical activity with neck circumference in eigth Latin American countries
(2019) Ferrari, Gerson Luis de Moraes; Kovalskys, Irina; Fisberg, Mauro; Gómez Salas, Georgina; Rigotti, Attilio; Cortés Sanabria, Lilia Yadira; Yépez García, Martha Cecilia; Pareja Torres, Rossina Gabriella; Herrera Cuenca, Marianella; Zalcman Zimberg, Ioná; Guajardo, Viviana; Pratt, Michael; Pires, Carlos; Solé, Dirceu
Background: Physical activity is a cornerstone in the prevention and treatment of obesity. There are relatively few studies that explore the effect of accelerometer-determined moderate-to-vigorous physical activity (MVPA) on neck circumference (NC), most of them confined to single high-income countries. The present study investigated the association of accelerometer-determined MVPA with NC in adolescents and adults from eight Latin American countries, which are mostly upper-middle income countries. Methods: The sample consisted of 2370 participants (47.8% male) from the Latin American Study of Nutrition and Health, a multicenter cross-sectional nutrition and health surveillance study of a nationally representative sample from eight Latin American countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela). Times (min/day) in MVPA (defined as time accumulated at ≥1952 activity counts/min) was assessed by ActiGraph GT3X+ accelerometer over 7 days. NC for adolescent was categorized as abnormal if circumference was > 34.5 cm for boys and > 31.25 for girls, whereas for adults the cut-off points for abnormal were > 39 cm for men and > 35 cm women. Multilevel logistic models, including country and region as random effects and adjusted for sex, age, socioeconomic level, and educational level, were used to study the association between MVPA and NC. Results: The average time of MVPA was 34.88 min/day, ranging from 31.16 in Venezuela to 40.27 in Chile. Concerning NC, 37.0% of the sample was classified as having elevated NC. Chile was the country with the highest percentage of people with elevated NC (56.9%), and Colombia had the lowest percentage (24.8%). Overall, the MVPA (min/day) was associated with elevated NC (OR = 0.994, CI95% = 0.990-0.998). In Costa Rica and Peru, there were significant associations between MVPA and NC when analyzed by country. Conclusions: The present study provided evidence of significant associations between MVPA and NC in adolescents and adults from Latin America, independent of sex, age, socioeconomic level, and educational level. This analysis of accelerometry data and NC represents the first examination of these associations in eight Latin America countries. Further research is required to understand the differences between countries in the observed associations.

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