RESUMO
Sugar-sweetened beverages (SSBs) are implicated in weight gain and adverse cardiometabolic heath. Social networks of stakeholders involved in providing potable water and sugar-sweetened beverages (SSBs) in high schools in Costa Rica were studied using social analysis network. In public and private schools, the interactions between the stakeholders in charge of providing beverages are fragmented and their role in preventing the availability of SSBs is weak. School canteen owners ultimately decide what beverages are available at school, which may cause students to choose beverages that increase the risk of overweight/obesity. It is therefore urgently necessary to improve the capacity for two-way interactions between the stakeholders to enhance their roles in the provision of beverages. Hence, it is essential to reinforce the stakeholders' leadership, and set up innovative ways to exert it in order to develop a shared vision of the types of drinks that should be available in the school environment.
Assuntos
Bebidas , Bebidas Adoçadas com Açúcar , Humanos , Costa Rica , Bebidas/efeitos adversos , Instituições Acadêmicas , Bebidas Adoçadas com Açúcar/efeitos adversos , Rede SocialRESUMO
OBJECTIVE: Sugar-sweetened beverages (SSB) are implicated in the increasing risk of diabetes in the Caribbean. Few studies have examined associations between SSB consumption and diabetes in the Caribbean. DESIGN: SSB was measured as teaspoon/d using questions from the National Cancer Institute Dietary Screener Questionnaire about intake of soda, juice and coffee/tea during the past month. Diabetes was measured using self-report, HbA1C and use of medication. Logistic regression was used to examine associations. SETTING: Baseline data from the Eastern Caribbean Health Outcomes Research Network Cohort Study (ECS), collected in Barbados, Puerto Rico, Trinidad and Tobago and US Virgin Islands, were used for analysis. PARTICIPANTS: Participants (n 1701) enrolled in the ECS. RESULTS: Thirty-six percentage of participants were unaware of their diabetes, 33% aware and 31% normoglycaemic. Total mean intake of added sugar from SSB was higher among persons 40-49 (9·4 tsp/d), men (9·2 tsp/d) and persons with low education (7·0 tsp/d). Participants who were unaware (7·4 tsp/d) or did not have diabetes (7·6 tsp/d) had higher mean SSB intake compared to those with known diabetes (5·6 tsp/d). In multivariate analysis, total added sugar from beverages was not significantly associated with diabetes status. Results by beverage type showed consumption of added sugar from soda was associated with greater odds of known (OR = 1·37, 95 % CI (1·03, 1·82)) and unknown diabetes (OR = 1·54, 95 % CI (1·12, 2·13)). CONCLUSIONS: Findings indicate the need for continued implementation and evaluation of policies and interventions to reduce SSB consumption in the Caribbean.
Assuntos
Diabetes Mellitus Tipo 2 , Bebidas Adoçadas com Açúcar , Masculino , Humanos , Bebidas Adoçadas com Açúcar/efeitos adversos , Estudos de Coortes , Bebidas Gaseificadas , Açúcares , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/etiologia , Porto Rico/epidemiologiaRESUMO
Consumption of added sugars, especially from sugar-sweetened beverages (SSBs), has been associated with several negative health outcomes during adolescence. This study aimed to identify dietary intake and food sources of added sugars in the home, school, and neighborhood environments of Costa Rican adolescents. Dietary intake of added sugars was determined using 3-day food records in a cross-sectional study of 818 adolescents aged 12 to 19 and enrolled in rural and urban schools in the province of San José. On average, 90% of adolescents consumed more than 10% of their total energy intake from added sugars. Furthermore, 74.0% of added sugars were provided at home, 17.4% at school, and 8.6% in the neighborhood. Added sugars were primarily provided by frescos (29.4%), fruit-flavored still drinks (22.9%), and sugar-sweetened carbonated beverages (12.3%), for a total contribution of 64.6%. Our findings suggest that Costa Rican adolescents have a plethora of added sugar sources in all food environments where they socialize. However, it is relevant for public health to consider the home and school environments as fundamental units of interventions aimed at reducing added sugars in the adolescent diet. Frescos prepared at home and school and fruit-flavored still drinks must be the focus of these interventions.
Assuntos
Bebidas , Açúcares , Adolescente , Adulto , Criança , Estudos Transversais , Ingestão de Alimentos , Humanos , Edulcorantes , Adulto JovemRESUMO
Descriptions of the implementation of community-based participatory mixed-methods research (CBPMMR) in all phases of the engagement approach are limited. This manuscript describes the explicit integration of mixed-methods in four stages of CBPR: (1) connecting and diagnosing, (2) prescribing-implementing, (3) evaluating, and (4) disseminating and refining an intervention that aimed to motivate Latino parents (predominantly Central American in the US) of infants and toddlers to replace sugary drinks with filtered tap water. CBPMMR allowed for co-learning that led to the identification of preliminary behavioral outcomes, insights into potential mechanisms of behavior change, and revisions to the intervention design, implementation and evaluation.
Assuntos
Pesquisa Participativa Baseada na Comunidade/métodos , Água Potável/administração & dosagem , Emigrantes e Imigrantes/estatística & dados numéricos , Hispânico ou Latino/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde/métodos , Bebidas Adoçadas com Açúcar , Adolescente , Adulto , Idoso , América Central/etnologia , Pré-Escolar , Filtração , Humanos , Lactente , Pessoa de Meia-Idade , Pais , Projetos Piloto , Estados Unidos , Adulto JovemRESUMO
Background: Widespread vaccination against COVID-19 is essential to control the pandemic. Estimates of unwillingness and uncertainty toward COVID-19 vaccination and factors associated with it remain unclear among adults in Puerto Rico (PR).Objective: To examine factors associated with uncertainty and unwillingness of COVID-19 vaccination among adults in PR.Methods: The Health Belief Model was used to develop an online survey. Analyses included adjusted logistic regressions (aOR). A total of 1,911 adults completed the survey from December 2020 to February 2021.Results: Overall, 76.2% were females, 33.7% were aged 50 or older, and 82.7% reported an intent to get vaccinated. Individuals who did not perceive that their chances of getting COVID-19 were high (aOR = 2.94; 95%CI = 2.24-3.86), that getting COVID-19 was not a possibility for them (aOR = 2.86; 95%CI = 2.19-3.74), or unafraid of getting COVID-19 (aOR = 3.80; 95%CI = 2.76-5.23) had higher odds of uncertainty and unwillingness to get vaccinated against COVID-19. Participants who perceived that COVID-19 complications were not serious also had higher odds of uncertainty and unwillingness (aOR = 7.50; 95%CI = 3.94-14.3), whereas those who did not perceive that they would get very sick with COVID-19 had 89% increased odds. Those who agreed that they would only take the vaccine if many individuals took it had higher odds of uncertainty and unwillingness (aOR = 3.32; 95%CI = 2.49-4.43). The most reported reasons for uncertainty and unwillingness toward COVID-19 vaccination were vaccine safety (63.8%), efficacy (49.4%), and novelty (45.5%).Discussion: Although COVID-19 vaccination intent was high, the study highlights concern over vaccine safety and efficacy that should be addressed by public health campaigns and interventions to enhance vaccine uptake.
Assuntos
COVID-19 , Vacinas , Adulto , Atitude , Vacinas contra COVID-19 , Estudos Transversais , Feminino , Humanos , Percepção , Porto Rico , SARS-CoV-2 , Incerteza , VacinaçãoRESUMO
Childhood obesity is a major problem in Latin America and among US Latinos. Effective public health policies require contextually relevant evidence to guide them, which demands sustained research capacity. The objectives of this study are to determine research productivity in Latin America and in the United States focused on Latino populations and examine domains of research capacity (research infrastructure, training programs, mentoring, funding, and networks). We conducted a scoping review of indexed childhood obesity-related articles published June 2015-December 2019. We collected data on perceptions of capacity for childhood obesity research among Latin American investigators through an online survey. We identified 612 childhood obesity-related articles (505 from Latin America, 124 from the United States, and 17 US-Latin America collaborations). Brazil, Mexico, Chile, Colombia, and the United States are the top publishing countries. There are similar numbers of obesity, nutrition, and physical activity articles, but physical activity research capacity lagged in other domains (research training, funding, and networking opportunities). Complementary research areas, including sedentary behavior, systems science, and policy studies, are uncommon in Latin America but more prevalent in the United States, whereas sleep research is nascent across settings. Realizing the promise of an effective cross-border collaborative childhood obesity prevention agenda will require committed investment in all domains of research capacity and across all relevant topics.
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Obesidade Infantil , Criança , Exercício Físico , Hispânico ou Latino , Humanos , América Latina/epidemiologia , México , Obesidade Infantil/epidemiologia , Obesidade Infantil/prevenção & controle , Estados Unidos/epidemiologiaRESUMO
OBJECTIVE: To examine the association between family environment variables (parenting styles, family meal atmosphere), gender-based stereotypes and food intake in Latin American adolescents. DESIGN: Structural equation modelling applied to cross-sectional data, 2017. SETTING: Urban and rural sites of San José, Costa Rica. PARTICIPANTS: n 813; 13-18 years old. RESULTS: Data suggest direct associations between gender-based stereotypes and intake of fruits and vegetables (FV) (ß = 0·20, P < 0·05), unhealthy foods (fast food (FF)) (ß = -0·24, P < 0·01) and ultra-processed foods (ß = -0·15, P < 0·05) among urban girls; intake of legumes among rural girls (ß = 0·16, P < 0·05) and intake of sugar-sweetened beverages (SSB) among rural boys (ß = 0·22, P < 0·05). Family meal atmosphere was associated with legume intake (ß = 0·19, P <·05) among rural girls. Authoritative parenting style was associated with FV intake (ß = 0·23, P < 0·05) among urban boys and FF intake (ß = 0·17, P < 0·05) among urban girls. Authoritarian parenting style was associated with FV consumption (ß = 0·19, P < 0·05) among rural boys, and with SSB and FF consumption (ß = 0·21, P < 0·05; ß = 0·14, P < 0·05, respectively) among urban girls. CONCLUSIONS: Findings are the first to describe the complex family environment and gender-based stereotypes within the context of a Latin American country. They emphasise the need for culturally relevant measurements to characterise the sociocultural context in which parent-adolescent dyads socialise and influence food consumption.
Assuntos
Comportamento Alimentar , Verduras , Adolescente , Estudos Transversais , Ingestão de Alimentos , Humanos , Poder FamiliarRESUMO
BACKGROUND: Adolescence offers a window of opportunity to prevent adult obesity and noncommunicable disease risk factors. With the rising prevalence of adolescent obesity over the last 20 y, identifying any changes in dietary risk factors is crucial. OBJECTIVES: We aimed to assess the dietary intake of major nutrients and their food sources in Costa Rican adolescents from 1996 to 2017. METHODS: Means from 3-d food records from adolescents (ages 13-18 y) living in San José (the province with the highest concentration of adolescents in Costa Rica) were obtained in 1996 (n = 276), 2006 (n = 133), and 2017 (n = 818). Differences in consumption of major nutrients and selected food groups by sex and survey period were tested using age- and area-adjusted ANOVAs. RESULTS: In 2017, adolescents consumed significantly (P < 0.05) less saturated and trans fats [saturated: -3.2% of total energy (TE); trans: -1.4% TE], vegetables (-24 g/d), beans (-42 g/d), and white rice (22 g/d) than in 1996. The 2017 adolescents also reported significantly higher consumption of unsaturated fatty acids (MUFAs: up from 8.2% to 15.3% TE; PUFAs: up from 5.5% to 9.5% TE; P < 0.05), sugary drinks (+134 g/d), pastries/desserts (+55 g/d), other refined starchy foods (+36 g/d), and snacks/fast foods (+26 g/d) than their 1996 counterparts. In 1996 and 2006, the main source of calories was white rice, whereas in 2017, it was sugary drinks (12% TE and 15% TE, respectively; P < 0.05). The intake ratio of beans to white rice was significantly higher in 1996 (1:1.6) than in 2017 (1:3.5). CONCLUSIONS: The changes in the intake of major nutrients and food sources of Costa Rican adolescents present new public health challenges for cardiometabolic risk prevention. Costa Rica should prioritize the design of comprehensive strategies that target added sugar intake while simultaneously increasing access to and promotion of healthful items.
Assuntos
Dieta , Comportamento Alimentar , Alimentos/classificação , Adolescente , Ciências da Nutrição Infantil , Costa Rica , Inquéritos sobre Dietas , Ingestão de Energia , Fast Foods , Ácidos Graxos , Feminino , Humanos , Masculino , NutrientesRESUMO
BACKGROUND: Emergency foods distributed during a federal disaster relief response must follow the federal Dietary Guidelines for Americans according to the 1990 National Nutrition Monitoring Related Research Act. Nutrition information about emergency foods for household distribution is scarce. METHODS: According to structured observation protocols, foods received daily at a federal distribution center in Puerto Rico after Hurricane María (November 10-25, 2017) were grouped into Dietary Guidelines for Americans ChooseMyPlate food groups. Data about their sodium, saturated fat, added sugar, and fiber content per serving were captured. Registered dietitians designed meal plans with the foods distributed. RESULTS: Of 107 unique food items, 41% were snacks and sweets; and 13%, 4%, 13%, and 7% were fruits, vegetables, proteins, and grains, respectively. Fifty-eight percent of all foods were low in fiber (≤1 g); 46% included high amounts of sodium, saturated fats, or added sugars (≥20% daily value). The registered dietitians were able to design meal plans that complied with the Dietary Guidelines for Americans food group recommendations, but they exceeded upper daily limits for sodium, saturated fat, or added sugars. CONCLUSIONS: In view of projected increases in natural disasters and diet-related chronic diseases, DGA compliance must be improved so that federal emergency foods can support the health of survivors.
Assuntos
Tempestades Ciclônicas , Desastres , Governo Federal , Assistência Alimentar/legislação & jurisprudência , Fidelidade a Diretrizes/legislação & jurisprudência , Política Nutricional/legislação & jurisprudência , Planejamento em Desastres , Qualidade dos Alimentos , Humanos , Refeições , Valor Nutritivo , Estudos de Casos Organizacionais , Porto Rico , População Rural , Estados Unidos , População UrbanaRESUMO
BACKGROUND: Hurricane Maria struck Puerto Rico on Sept 20, 2017, devastating the island. Controversy surrounded the official death toll, fuelled by estimates of excess mortality from academics and investigative journalists. We analysed all-cause excess mortality following the storm. METHODS: We did a time-series analysis in Puerto Rico from September, 2017, to February, 2018. Mortality data were from the Puerto Rico Vital Statistics System. We developed two counterfactual scenarios to establish the population at risk. In the first scenario, the island's population was assumed to track the most recent census estimates. In the second scenario, we accounted for the large-scale population displacement. Expected mortality was projected for each scenario through over-dispersed log-linear regression from July, 2010, to August, 2017, taking into account changing distributions of age, sex, and municipal socioeconomic development, as well as both long-term and seasonal trends in mortality. Excess mortality was calculated as the difference between observed and expected deaths. FINDINGS: Between September, 2017, and February, 2018, we estimated that 1191 excess deaths (95% CI 836-1544) occurred under the census scenario. Under the preferred displacement scenario, we estimated that 2975 excess deaths (95% CI 2658-3290) occurred during the same observation period. The ratio of observed to expected mortality was highest for individuals living in municipalities with the lowest socioeconomic development (1·43, 95% CI 1·39-1·46), and for men aged 65 years or older (1·33, 95% CI 1·30-1·37). Excess risk persisted in these groups throughout the observation period. INTERPRETATION: Analysis of all-cause mortality with vital registration data allows for unbiased estimation of the impact of disasters associated with natural hazards and is useful for public health surveillance. It does not depend on certified cause of death, the basis for the official death toll in Puerto Rico. Although all sectors of Puerto Rican society were affected, recovery varied by municipal socioeconomic development and age groups. This finding calls for equitable disaster preparedness and response to protect vulnerable populations in disasters. FUNDING: Forensic Science Bureau, Department of Public Safety, and Milken Institute School of Public Health of The George Washington University (Washington, DC, USA).
Assuntos
Causas de Morte , Tempestades Ciclônicas/mortalidade , Desastres Naturais/mortalidade , Fatores Etários , Humanos , Porto Rico , Fatores SexuaisRESUMO
To understand the process by which immigrants adopt dietary practices, this study offers a binational comparison of factors that predispose, enable, and reinforce healthful eating in the sending and receiving countries. Data are from two qualitative studies that examined barriers and facilitators to healthful eating in El Salvador (four focus groups, n = 28 adults) and in the US (30 in-depth interviews n = 15 mothers recently migrated from Central America). There was a strong emphasis on hygiene and vitamin-content of foods among participants in El Salvador. In both settings, participants perceived that their respective community food environments (schools, food stores) exposed their families to highly processed, unhealthful foods. In both settings, they described similar struggles to encourage their families to eat foods healthfully (traditional, home-made foods). These results underscore the importance of acknowledging the changing food environment in sending countries where people may already be exposed to processed foods.
Assuntos
Dieta Saudável/etnologia , Emigrantes e Imigrantes , Preferências Alimentares/etnologia , Hispânico ou Latino , Adolescente , América Central/etnologia , District of Columbia , Características da Família , Feminino , Grupos Focais , Humanos , Entrevistas como Assunto , Masculino , Pesquisa QualitativaRESUMO
OBJECTIVE: To assess progress towards the elimination of trans-fatty acids (TFA) in foods after the 2008 Pan American Health Organization (PAHO) recommendation of virtual elimination of TFA in Latin America. DESIGN: A descriptive, comparative analysis of foods that were likely to contain TFA and were commonly consumed in four cities in Latin America. SETTING: San José (Costa Rica), Mexico City (Mexico), Rio de Janeiro (Brazil), Buenos Aires (Argentina). SUBJECTS: Foods from each city were sampled in 2011; TFA content was analysed using GC. TFA of selected foods was also monitored in 2016. RESULTS: In 2011-2016, there was a significant decrease in the content of TFA in the sampled foods across all sites, particularly in Buenos Aires (from 12·6-34·8 % range in 2011-2012 to nearly 0 % in 2015-2016). All sample products met the recommended levels of TFA content set by the PAHO. TFA were replaced with a mixture of saturated and unsaturated fats. CONCLUSIONS: Our results indicate a virtual elimination of TFA from major food sources in the cities studied. This could be due to a combination of factors, including recommendations by national and global public health authorities, voluntary and/or mandatory food reformulation made by the food industry.
Assuntos
Abastecimento de Alimentos , Implementação de Plano de Saúde , Ácidos Graxos trans/efeitos adversos , Saúde da População Urbana , Argentina , Brasil , Costa Rica , Inquéritos sobre Dietas , Análise de Alimentos , Abastecimento de Alimentos/normas , Indústria de Processamento de Alimentos/tendências , Fidelidade a Diretrizes/tendências , Humanos , Colaboração Intersetorial , México , Política Nutricional , Organização Pan-Americana da Saúde , Análise Espaço-Temporal , Ácidos Graxos trans/análiseRESUMO
OBJECTIVE: To understand how mothers who recently migrated from Central America to the USA feed their children in a neighbourhood saturated with unhealthful food choices ('food swamp') and to formulate a mother-driven plan of action to facilitate their acquisition of foods. Design/Setting/Subjects We purposively sampled mothers with children (<10 years old) who were recent immigrants/refugees from Central America and lived in a 'food swamp' neighbourhood. We used the photovoice approach to elicit textual data from thirty in-depth interviews, a participatory workshop, and visual data from photographs. Analyses were guided by the Social Ecological Framework and Social Cognitive Theory to identify barriers, facilitators and strategies that support parents in feeding their children. RESULTS: Mothers valued foods that they considered to be 'traditional' and 'healthful'. They navigated their food retail environment looking for these foods (of good quality and well-priced). Food values were reinforced by pre-migration food customs and culture, health professionals' advice and, in some cases, by the desire to avoid conflict with their children. The neighbourhood food environment could directly influence children's food preferences and often created conflict between what the child wanted to eat and the foods that mothers valued. Mothers in this 'food swamp' wanted to be engaged in addressing the selection of foods offered in schools and in neighbourhood food venues to reflect their own food values. CONCLUSIONS: These mothers' feeding choices were influenced directly by their food values, and indirectly by the neighbourhood and school food environments via their children's preferences.
Assuntos
Comportamento de Escolha , Conhecimentos, Atitudes e Prática em Saúde , Hispânico ou Latino , Mães/psicologia , Características de Residência , América Central , Criança , Comportamento Infantil/psicologia , Dieta Saudável/psicologia , Preferências Alimentares/psicologia , Serviços de Alimentação , Comportamentos Relacionados com a Saúde , Humanos , Instituições Acadêmicas , Meio SocialRESUMO
Latinos consume more sugary drinks and less water than other demographic groups. Our objective was to understand beverage choice motivations and test promotional concepts that can encourage Central American Latino urban youth to drink more water. Two rounds of focus group discussions were conducted (n = 10 focus groups, 61 participants, 6-18 years old). Data were transcribed verbatim and analyzed using inductive and deductive coding approaches. Youth motivations for drinking water were shaped by level of thirst, weather, energy, and perceptions of health benefits. Youth were discouraged from drinking water due to its taste and perceptions of the safety and cleanliness of tap water. Youth beverage preference depended on what their friends were drinking. Availability of water versus other beverages at home and other settings influenced their choice. Promotional materials that included mixed language, informative messages about the benefits of drinking water, and celebrities or athletes who were active, energized, and drinking water were preferred. A promotional campaign to increase water consumption among these Latino youth should include bicultural messages to underscore the power of water to quench true thirst, highlight the health benefits of drinking water, and address the safety of tap water.
Assuntos
Água Potável/administração & dosagem , Promoção da Saúde/métodos , Hispânico ou Latino/psicologia , População Urbana , Adolescente , Bebidas , América Central/etnologia , Criança , Comportamento de Escolha , Comportamento do Consumidor , District of Columbia , Feminino , Grupos Focais , Hispânico ou Latino/estatística & dados numéricos , Humanos , Masculino , Motivação , Projetos de Pesquisa , População Urbana/estatística & dados numéricosRESUMO
Puerto Ricans in the US experience higher deaths from diabetes and other causes compared to non-Hispanic Whites and other Hispanic groups. We compared mortality in Puerto Rico to that of Puerto Ricans in the US as a first step to investigate if similar or worse mortality patterns originate from the sending country (Puerto Rico). Age-adjusted death rates were generated using national vital statistics databases in the US and territories for all-cause and the top ten causes of death among Hispanics in 2009. Mortality ratios in the archipelago of Puerto Rico (APR) were compared to mainland US Puerto Ricans (MPR). Rates for other ethnic/racial groups (Mexican Americans, Cubans, and non-Hispanic Whites, Blacks, American Indians, and Asians) were calculated to provide a context. APR had significantly higher all-cause mortality and death rates for diabetes, nephritis, pneumonia/influenza, and homicide/assault compared to MPR (APR/MPR ratio for all-cause: 1.08, diabetes: 2.04, nephritis: 1.84, pneumonia/influenza: 1.33, homicide/assault: 3.15). Death rates for diabetes and homicide/assault (particularly among men) were higher among APR compared to any other racial/ethnic groups in the US. In contrast, deaths from heart disease, cancer, and chronic liver disease were significantly lower for APR compared to MPR (MPR/APR ratio 0.72, 0.91, 0.41, respectively). Among APR women, death rates for these causes were also lower compared to any other group in the US. Substantial mortality variability exists between Puerto Ricans in Puerto Rico and those in the US, re-emphasizing the need to study of how socio-environmental determinants of health differ in sending and receiving countries. Explanations for disparate rates include access to and availability of healthcare and unique factors related to the migration experience of this group.
Assuntos
Hispânico ou Latino/estatística & dados numéricos , Mortalidade/etnologia , Causas de Morte , Estudos Transversais , Etnicidade/estatística & dados numéricos , Feminino , Humanos , Masculino , Porto Rico/epidemiologia , Grupos Raciais/estatística & dados numéricos , Estados Unidos/epidemiologia , Índias Ocidentais/etnologiaRESUMO
BACKGROUND: In Latin America, more than 80% of adolescent girls are physically inactive. Inactivity may be reinforced by female stereotypes and objectification in the Latin American sociocultural context. METHODS: We examined the influence of objectification on the adoption of an active lifestyle among 192 adolescents (14 and 17 years old) from urban and rural areas in Costa Rica. Analyses of 48 focus-groups sessions were grounded in Objectification Theory. RESULTS: Vigorous exercises were gender-typed as masculine while girls had to maintain an aesthetic appearance at all times. Adolescents described how girls were anxious around the prospect of being shamed and sexually objectified during exercises. This contributed to a decrease in girls' desire to engage in physical activities. Among males, there is also a budding tolerance of female participation in vigorous sports, as long as girls maintained a feminine stereotype outside their participation. CONCLUSION: Self-objectification influenced Costa Rican adolescent girls' decisions to participate in physical activities. Interventions may include: procuring safe environments for physical activity where girls are protected from fear of ridicule and objectification; sensitizing boys about girl objectification and fostering the adoption of a modern positive masculine and female identities to encourage girls' participation in sports.
Assuntos
Comportamento do Adolescente , Imagem Corporal/psicologia , Exercício Físico , Adolescente , Costa Rica , Características Culturais , Feminino , Grupos Focais , Humanos , Masculino , Saúde da MulherRESUMO
PURPOSE: To identify the influence of gender stereotypes on eating habits among Costa Rican adolescents. DESIGN: Qualitative, descriptive research was used in this study. SETTING: Adolescents and parents were recruited from socioeconomically diverse populations in rural and urban areas of San José, Costa Rica. SUBJECTS: Subjects were 92 adolescents (14 to 17 years old) and 48 parents. METHODS: Focus group data were transcribed and entered into the qualitative data analysis software Atlas.ti version 5.0. Analyses were grounded on the social cognitive theory. RESULTS: Five themes emerged from the focus group discussions: (1) Costa Rican adolescents associate the consumption of moderate quantities of healthy foods with femininity and male homosexuality. (2) The consumption of hearty portions of nonhealthy foods was associated with masculinity and male heterosexuality. (3) There is an emerging view that it is acceptable for heterosexual male adolescents to take care of their bodies through healthy eating. (4) Body care among female adolescents is an element of femininity and body image. (5) Parents reinforce their daughters' persistent concern with weight control because they perceive it as feminine behavior. CONCLUSION: Health promoters should be aware of the existing and changing food stereotypes around gender as an avenue for the promotion of healthy eating.
Assuntos
Imagem Corporal/psicologia , Comportamento Alimentar/psicologia , Identidade de Gênero , Homossexualidade Masculina/psicologia , Estereotipagem , Adolescente , Costa Rica , Feminino , Grupos Focais , Preferências Alimentares , Promoção da Saúde , Humanos , Masculino , Pais/psicologia , Pesquisa Qualitativa , População RuralRESUMO
Health information correlates of fruit and vegetable intake and of knowledge of the fruit and vegetable recommendations were examined using bivariate and multivariate regressions with data from the 2007-2008 U.S. National Cancer Institute's Health Information National Trends Survey in the United States and in Puerto Rico. Residents from Puerto Rico had the lowest reported fruit and vegetable intake and the lowest knowledge of the recommended servings of fruits and vegetables to maintain good health, compared with U.S. Hispanics, non-Hispanic Whites, and Blacks. Sixty-seven percent of Puerto Rican residents and 62% of U.S. Hispanics reported never seeking information on health or medical topics. In multivariate analysis, those who never sought information on health or medical topics reported significantly lower fruit and vegetable intake (coefficient = -0.24; 95% CI [-0.38, -0.09]), and were less likely to know the fruit and vegetable recommendations (OR = 0.32; 95% CI [0.20, 0.52]), compared with those who obtained information from their health care providers. Health promotion initiatives in the United States and Puerto Rico have invested in mass media campaigns to increase consumption of and knowledge about fruit and vegetables, but populations with the lowest intake are less likely to seek information. Strategies must be multipronged to address institutional, economic, and behavioral constraints of populations who do not seek out health information from any sources.
Assuntos
Informação de Saúde ao Consumidor/estatística & dados numéricos , Dieta/estatística & dados numéricos , Frutas , Conhecimentos, Atitudes e Prática em Saúde , Comportamento de Busca de Informação , Recomendações Nutricionais , Verduras , Adolescente , Adulto , Negro ou Afro-Americano/estatística & dados numéricos , Idoso , Dieta/etnologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Inquéritos Epidemiológicos , Hispânico ou Latino/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Porto Rico , Fatores Socioeconômicos , Estados Unidos , População Branca/estatística & dados numéricos , Adulto JovemRESUMO
OBJECTIVE: To identify socio-demographic, behavioral, and health-related correlates of food preferences in Puerto Rico that will help determine Caribbean-region populations vulnerable to nutrition transition. METHODS: Data from a cross-sectional study of a representative sample of 858 adults residing in the San Juan Metropolitan Area of Puerto Rico were analyzed. Multivariable ordinal logistic regressions were used to model the frequency of consumption of 1) fruits and vegetables, 2) tubers/starchy root vegetables, 3) fried foods, and 4) Western-style fast foods as a function of socio-demographic, behavioral, and health-related characteristics. RESULTS: Higher frequency of consumption of fruits and vegetables was associated with being physically active and older and having a medium to high level of education, whereas intake of tubers was associated with being older, having a low income, not using government insurance, and having elevated levels of triglycerides. Frequency of consumption of fast food was associated with younger age, higher income, 12-15 years of formal education, and a higher body mass index (BMI), whereas frequency of consumption of fried food was associated with being younger and male, not being a smoker, and having elevated levels of fasting blood glucose. CONCLUSIONS: The results indicate a nutrition transition in Puerto Rico with health consequences for the Caribbean region. The characteristics of this nutrition transition seem to be determined by income, education, and age, but may also be dictated by access to various food groups. These results set the stage for needed investigation of environmental and individual-level factors that could shape patterns in food consumption.
OBJETIVO: Determinar los correlatos sociodemográficos, conductuales y relacionados con la salud de las preferencias alimentarias en Puerto Rico a fin de ayudar a determinar las poblaciones vulnerables con respecto a la transición nutricional en el Caribe. MÉTODOS: Se analizaron datos procedentes de un estudio transversal de una muestra representativa de 858 adultos que residen en el área metropolitana de San Juan, en Puerto Rico. Se usaron regresiones logísticas ordinales con múltiples variables para modelar la frecuencia de consumo de 1) frutas y verduras, 2) tubérculos feculentos, 3) alimentos fritos y 4) comida rápida de estilo occidental, como una función de las características sociodemográficas, conductuales y relacionadas con la salud. RESULTADOS: Se asoció una mayor frecuencia de consumo de frutas y verduras con un comportamiento físicamente activo y mayor edad, al igual que un nivel de escolaridad de medio a alto, mientras que la ingesta de tubérculos se asoció a una edad mayor, ingresos bajos, no usar el seguro del gobierno y niveles elevados de triglicéridos. La frecuencia de consumo de comida rápida se asoció con una edad menor, ingresos más altos, de 12 a 15 años de educación formal y un índice de masa corporal mayor, mientras que la frecuencia del consumo de alimentos fritos se asoció con una edad más joven y el sexo masculino, no fumar y niveles elevados de glucemia en ayunas. CONCLUSIONES: Los resultados indican una transición nutricional en Puerto Rico con consecuencias para la salud en el Caribe. Las características de esta transición nutricional parecen estar determinadas por los ingresos, la escolaridad y la edad, pero también podrían estar determinadas por el acceso a diversos grupos alimentarios. Estos resultados establecen las condiciones necesarias para la investigación de los factores ambientales e individuales que podrían configurar los modelos de consumo de alimentos.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Dieta/tendências , Preferências Alimentares , Hispânico ou Latino/estatística & dados numéricos , Fatores Etários , Antropometria , Glicemia/análise , Culinária/métodos , Estudos Transversais , Comportamento Alimentar , Hispânico ou Latino/psicologia , Lipídeos/sangue , Porto Rico , Comportamento Sedentário , Fumar/epidemiologia , Fatores Socioeconômicos , População UrbanaRESUMO
OBJECTIVE: The aim of this study was to identify psychosocial factors that influence fast-food consumption in urban and rural Costa Rican adolescents. METHODS: A self-administered questionnaire designed for the study asked about sociodemographic information, frequency of fast-food consumption, meaning of "fast food," location of purchase, and psychosocial correlates. Five psychosocial factors were extracted by using principal components analysis with Varimax rotation method and eigenvalues. Descriptive statistics and a hierarchical linear regression model were used to predict the frequency of fast-food consumption. RESULTS: Responses from 400 adolescents (ages 12-17 y) reveal that daily consumption of fast food was 1.8 times more frequently mentioned by rural adolescents compared with urban youth. Urban and rural differences were found in the way adolescents classified fast foods (rural adolescents included more traditional foods like chips, sandwiches, and Casado-a dish consisting of rice, black beans, plantains, salad, and a meat), and in purchasing locations (rural adolescents identified neighborhood convenience stores as fast-food restaurants). Living in rural areas, convenience and availability of foods, and the presence of external loci of control were predictors of a higher frequency of fast-food consumption, whereas health awareness predicted a lower frequency. CONCLUSIONS: The development of interventions to reduce fast-food consumption in Costa Rican adolescents should consider not only convenience, but also the availability of these foods where adolescents are more exposed, particularly in rural areas. Interventions such as improving the convenience of healthy fast foods available in school canteens and neighborhood stores, policies to increase the price of unhealthy fast food, and activities to provide adolescents with the skills to increase self-efficacy and reduce the effect of external loci of control are recommended.