RESUMO
Ultraprocessed foods (UPF) consumption plays a critical role in the development of chronic diseases, but evidence of their effect on children's health is limited. We hypothesized that the consumption of UPF can influence blood pressure levels in 6-year-old children. This study is a secondary analysis of a randomized field trial in Brazil that is registered at clinicaltrial.gov (NCT00635453). Dietary intake was obtained using 2 multiple-pass 24-hour recalls when 305 children were 3 and 6 years old. We classified foods according to the NOVA system and determined the percentage of total energy intake derived from ultraprocessed foods. We collected anthropometric measures from and evaluated systolic and diastolic blood pressures of 6-year-old children. Linear regression analysis was used to assess the association between UPF consumption and blood pressure levels. UPF represented 40.3% (interquartile range, 34.1-48.5) of the total energy intake at 3 years and 45.2% (interquartile range, 41.5-53.2) at 6 years. The adjusted linear regression analyses showed that systolic blood pressure was associated with UPF consumption at 6 years (P = .05), birth weight (P = .02), waist circumference (P < .01), and physical activity (P = .04), whereas diastolic blood pressure was associated with UPF consumption at 3 and 6 years (P = .01 and P < .01, respectively), birth weight (P = .05), and waist circumference (P < .01). Our data suggest that UPF consumption played a role in increasing 6-year-old children's blood pressure. These results reinforce the importance of effective strategies to prevent the excessive consumption of UPF in childhood.
Assuntos
Ingestão de Energia , Hipertensão , Criança , Pré-Escolar , Humanos , Peso ao Nascer , Pressão Sanguínea , Brasil , Dieta/métodos , Fast Foods , Alimentos , Manipulação de Alimentos/métodosRESUMO
Although ultra-processed foods represent more than half of the total energy consumed by the UK population, little is known about the trend in food consumption considering the degree of food processing. We evaluated the trends of the dietary share of foods categorised according to the NOVA classification in a historical series (2018-2019) among the UK population. Data were acquired from the NDNS, a survey that collects diet information through a 4-d food record. We used adjusted linear regression to estimate the dietary participation of NOVA groups and evaluated the linear trends over the years. From 2008 to 2019, we observed a significant increase in the energy share of culinary ingredients (from 3·7 to 4·9 % of the total energy consumed; P-trend = 0·001), especially for butter and oils; and reduction of processed foods (from 9·6 to 8·6 %; P-trend = 0·002), especially for beer and wine. Unprocessed or minimally processed foods (â 30 %, P-trend = 0·505) and ultra-processed foods (â 56 %, P-trend = 0·580) presented no significant change. However, changes in the consumption of some subgroups are noteworthy, such as the reduction in the energy share of red meat, sausages and other reconstituted meat products as well as the increase of fruits, ready meals, breakfast cereals, cookies, pastries, buns and cakes. Regarding the socio-demographic characteristics, no interaction was observed with the trend of the four NOVA groups. From 2008 to 2019 was observed a significant increase in culinary ingredients and a reduction in processed food. Furthermore, it sheds light on the high share of ultra-processed foods in the contemporary British diet.
Assuntos
Fast Foods , Manipulação de Alimentos , Dieta , Alimento Processado , Reino Unido , Ingestão de EnergiaRESUMO
BACKGROUND: Breastfeeding offers the best nutrition during the first months of life. Scholars have identified a dose-response association between breastfeeding duration and reduced risk for child morbidity and mortality. In upper-middle-income countries, including Mexico, maternal employment has been negatively associated with breastfeeding duration. Despite increasing numbers of women entering the workforce and disproportionately participating in the informal sector, where they are un-entitled to paid maternity leave, little is known about how these factors may affect breastfeeding practices. RESEARCH AIM: To determine whether household income moderated the association between maternal employment status (defined as unemployed, formal, and informal full- and part-time employed) and any breastfeeding for ≥ 6 months. METHODS: We conducted a cross-sectional study using retrospective secondary data from the 2018-2019 Mexican Health and Nutrition Survey. The analytic sample included data about 2,156 children aged 6-36 months. We computed logistic regression models stratified by household income. RESULTS: The association between maternal employment and breastfeeding duration varied by household income. Compared to unemployed women, among lower-income households, children were less likely to be breastfed for ≥ 6 months when the participants was part-time informally employed (AOR = 0.30, 95% CI [0.13, 0.69]). Among higher-income households, children were less likely to be breastfed for ≥ 6 months when the participants was full-time formally employed (AOR = 0.52, 95% CI [0.30, 0.88]). CONCLUSIONS: To increase breastfeeding duration, stakeholders need to continue strengthening and enforcing policies among formally employed women, and strategies are urgently needed to support women in the informal sector, particularly those in lower-income households.
Assuntos
Aleitamento Materno , Mães , Criança , Feminino , Humanos , Gravidez , Estudos Transversais , Estudos Retrospectivos , México , EmpregoRESUMO
Alcohol consumption is a modifiable risk factor for non-communicable diseases. This study aimed to characterize alcohol consumers at the nutritional, anthropometric, and sociodemographic 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 consumption. Alcohol drinkers were characterized by having higher body weight and wider neck, waist, hips circumferences. Alcohol drinkers had a higher energy intake, with macronutrients providing 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 addition, 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 number 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.
Assuntos
Ingestão de Energia , Estado Nutricional , Estudos Transversais , Dieta , Hispânico ou Latino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Estados UnidosRESUMO
INTRODUCTION AND OBJECTIVE: To determine the prevalence of elevated liver enzyme levels and the fatty liver index according to specific sociodemographic, clinical, anthropometric, and metabolic risk factors in Mexican adult population. MATERIAL AND METHODS: The present analysis was conducted using data from the Mexican National Health and Nutrition Survey 2016. For the present study, 3,490 adults with complete information on liver enzymes, sociodemographic, lifestyle, and metabolic factors were analyzed. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) levels were determined from blood samples. We computed the fatty liver Index (FLI), as a surrogate marker of non-alcoholic fatty liver disease. The associations are reported as adjusted odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: At the national level, the prevalence of high serum levels of ALT, AST, and GGT were 7.9%, 13.5, and 12.9 respectively. We observed that men had higher prevalences of altered ALT, GGT and FLI compared to women. Additionally, we observe that individuals with obesity, metabolic syndrome and insulin resistance are significantly more likely to present elevated concentrations of AST, ALT, GGT and FLI. Finally, we found that the subjects of the lowest socioeconomic level and indigenous population were more likely to present elevated levels of AST, ALT, GGT, and FLI. CONCLUSION: In Mexico, non-alcoholic fatty liver disease affect people with obesity, diabetes, and metabolic syndrome as well as men, subjects of low socioeconomic status, subjects who live in rural areas and indigenous population. Interventions to reduce this condition should be a public health priority.
Assuntos
Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Fígado/patologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Inquéritos Nutricionais , Medição de Risco/métodos , Adulto , Idoso , Feminino , Seguimentos , Humanos , Fígado/metabolismo , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/enzimologia , Prevalência , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem , gama-Glutamiltransferase/sangueRESUMO
OBJECTIVE: Colombia is experiencing a nutrition transition, characterised by nutritionally poor diets and an increased prevalence of non-communicable diseases (NCD). We aimed to investigate the association between diet quality and general health outcomes related to the risk of NCD, in a nationally representative sample of Colombian adolescents and adults. DESIGN: Cross-sectional analysis. The Alternative Healthy-Eating Index (AHEI) was derived to calculate diet quality. Adjusted regressions were used to examine the association between AHEI, self-perceived general health status (GHS) and anthropometric variables (i.e. age-specific z-scores for height, and BMI for adolescents; waist circumference and BMI for adults). SETTING: Nationally representative data from the Colombian National Nutrition Survey (ENSIN) 2010. PARTICIPANTS: Adolescents aged 10-17 years (n 6566) and adults aged ≥18 years (n 6750). RESULTS: AHEI scores were similar between adolescents (mean 29·3 ± 7·2) and adults (mean 30·5 ± 7·2). In the whole sample, a better diet quality (higher AHEI score) was associated with worse self-perceived GHS (adjusted (a) ß-coefficient: -0·004; P < 0·001) and with a smaller waist circumference ((a) ß-coefficient: -0·06; P < 0·01). In adults, a higher AHEI score was negatively associated with BMI ((a) ß-coefficient: -0·02; P < 0·05), whilst in adolescents it was associated with a reduced height-for-age z-score ((a) ß-coefficient: -0·009; P < 0·001). CONCLUSIONS: A better diet quality was associated with reduced prevalence of predictors of NCD and with some indicators of general health in the Colombian population. In light of the high prevalence of overweight, our findings support the need for public health interventions focused on sustainable positive changes in dietary habits in the general population.
Assuntos
Dieta , Adolescente , Adulto , Colômbia/epidemiologia , Estudos Transversais , Humanos , América Latina , Inquéritos NutricionaisRESUMO
OBJECTIVES: To describe the changes in diet quality in Colombians using nationally representative samples from the 2005 and 2015 nutrition surveys. METHODS: Repeated cross-sectional analyses of the National Nutrition Surveys from 2005 and 2015. Children (4-17 y.o.) and adults (≥ 18 y.o.) were included. The Alternative Healthy-Eating Index (AHEI) was derived from 24-h recall questionnaires and used to examine diet quality. RESULTS: A total of 33,971 participants (20,122 children, 13,849 adults) were included in 2005, and 26,445 participants (15,304 children, 11,141 adults) in 2015. Over the ten-year period, the AHEI decreased from 46.3 to 44.3 in children (Cohen's d = 0.19) and from 49.0 to 46.2 in adults. (Cohen's d = 0.25). On average, those in the highest socioeconomic level had the worst diet quality; however, the difference between the less and most affluent groups shrank by 4.0% over the observation period. CONCLUSIONS: Between 2005 and 2015, there was a worsening in the diet quality of Colombian children and adults. Less affluent individuals had a greater worsening of diet quality compared to groups from higher socioeconomic levels.
Assuntos
Dieta Saudável/estatística & dados numéricos , Dieta Saudável/tendências , Dieta/estatística & dados numéricos , Dieta/tendências , Inquéritos Nutricionais/estatística & dados numéricos , Inquéritos Nutricionais/tendências , Estado Nutricional , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Colômbia , Estudos Transversais , Feminino , Previsões , Humanos , Masculino , Pessoa de Meia-Idade , Vigilância da População , Inquéritos e Questionários , Adulto JovemRESUMO
AIM: The aim of this study was to analyse the relationship between socioeconomic characteristics of mothers and dietary diversity (DD) as well as food group (FG) consumption of their children in Mexico. METHODS: A sample of 1041 children aged 1 to 4 years from the 2012 Mexican National Health and Nutrition Survey was analysed. DD included nine FG: dairy, meat, egg, fish, fruits, vegetables, legumes, tubers and cereals. For DD as well as for each FG, relative means were estimated from Poisson regressions with covariates of mothers' socioeconomic characteristics such as attained educational level, occupation, Indigenous language spoken, household socioeconomic status and child's characteristics. Standard errors were adjusted to account for data dependencies within primary sampling units. RESULTS: Children whose mothers had college education were less likely to have low DD (-57%, P < .01) and more likely to consume meat (+27%, P < .05), fruits (+17%, P < .01) and vegetables (+43%, P < .01) compared to children whose mothers had elementary education or none. Children of mothers who speak an Indigenous language had considerably higher (58%, P < .001) probability of low DD than non-Indigenous speaking mothers. CONCLUSIONS: Specific mother characteristics may either limit or facilitate access to nutrient diverse diets. These characteristics should be taken into account for designing public policies geared towards improving diet and nutritional status during the first years of life.
Assuntos
Dieta , Mães , Animais , Criança , Feminino , Humanos , México , Estado Nutricional , Fatores SocioeconômicosRESUMO
The contribution of 100% fruit juice (FJ) to the total daily intakes of energy, sugars, and select vitamins and minerals and to the recommended dietary allowances (RDAs) or adequate intake (AI) of these micronutrients was assessed in individuals reporting the consumption of 100% FJ in the national dietary intake surveys of the United States (U.S.; n = 8661), the United Kingdom (UK; n = 2546) and Brazil (n = 34,003). Associations of 100% FJ intake with the odds of being overweight or obese also were assessed. Data from the U.S. National Health and Nutrition Examination Survey (2013-2014), the UK National Diet and Nutrition Survey (2012-2014), and Brazil's Pesquisa de Orçamentos Familiares (2008-2009) were used, and all analyses were limited to individuals reporting consumption of 100% FJ on at least one day of the dietary intake survey. Approximately 34%, 37%, and 42% of individuals surveyed reported the consumption of 100% FJ on at least one day of the dietary intake survey in the U.S., UK, and Brazil, respectively, and the average daily intakes of 100% FJ were 184 g, 130 g, and 249 g, respectively. Across the 3 countries, 100% FJ contributed to 3-6% of total energy intakes, 12-31% of total sugar intakes, 21-54% of total vitamin C intakes, 1-12% of total vitamin A intakes, 4-15% of total folate intakes, 7-17% of total potassium intakes, 2-7% of total calcium intakes, and 4-12% of total magnesium intakes. In a multivariate logistic regression model, juice intake was associated with a significant reduction in the odds of being overweight or obese in UK adults (OR = 0.79; 0.63, 0.99), and significant increases in the odds of being overweight or obese in UK children (OR = 1.16; 1.01, 1.33) and Brazilian adults (OR = 1.04; 1.00, 1.09). Nutrient contributions of 100% FJ vary according to regional intake levels. In all three countries studied, 100% FJ contributed to more than 5% of the RDAs for vitamin C and folate. In the U.S. and Brazil, 100% FJ contributed to more than 5% of the RDA for magnesium and more than 5% of the AI for potassium.
Assuntos
Ácido Ascórbico/administração & dosagem , Análise de Dados , Ingestão de Alimentos , Ingestão de Energia , Ácido Fólico/administração & dosagem , Análise de Alimentos , Sucos de Frutas e Vegetais , Magnésio/administração & dosagem , Avaliação Nutricional , Inquéritos Nutricionais , Fenômenos Fisiológicos da Nutrição , Valor Nutritivo , Recomendações Nutricionais , Adulto , Fatores Etários , Ácido Ascórbico/análise , Brasil , Criança , Pré-Escolar , Carboidratos da Dieta/administração & dosagem , Carboidratos da Dieta/análise , Ácido Fólico/análise , Sucos de Frutas e Vegetais/análise , Humanos , Lactente , Magnésio/análise , Obesidade/etiologia , Obesidade/prevenção & controle , Sobrepeso/etiologia , Sobrepeso/prevenção & controle , Reino Unido , Estados UnidosRESUMO
BACKGROUND: Sociodemographic characteristics are associated with the dietary patterns of populations. However, the direction of the association is not consistent among countries: it is contingent on the nutritional transition phase, level of economic development, cultural contexts and both the social and health policies prevailing in each country. The objective of this study was to identify the trends in dietary patterns observed in 2006, 2012 and 2016 among Mexican adults by sociodemographic characteristic. METHODS: To determine and compare dietary patterns, we performed a secondary analysis of dietary and sociodemographic data for adults 20-59 years old. Data were drawn from the 2006 and 2012 National Health and Nutrition Surveys (ENSANUTs) together with the 2016 Half-Way National Health and Nutrition Survey (ENSANUTMC). To estimate the dietary patterns, we used an adapted version of the Healthy Eating Index-2015 (HEI-2015) and a quantile-based regression model to compare the HEI medians by sociodemographic characteristic. RESULTS: From 2006 to 2016, the quality of the diet of Mexican adults scored under 50 points on a scale of 0 to 100, markedly below the maximum scores for the majority of HEI-2015 components. Diet quality varied according to age, sex, socioeconomic status (SES), area (urban/rural) and region of residence, with the highest quality observed among older individuals (within the 40-59 age group), women, people of lower SES and residents of rural areas, particularly in southern Mexico. Although this trend remained constant overall throughout 2006, 2012 and 2016, specific HEI-2015 components showed an opposite trend by sociodemographic strata. CONCLUSION: The diet quality of Mexican adults was suboptimal from 2006 to 2016, with notorious disparities persisting over time among sociodemographic strata. Our results can serve as a basis for formulating recommendations on ways to improve the population diet, where those components diverging the most from adequate scores could be highlighted in public-health messages.
Assuntos
Dieta , População Rural , Adulto , Estudos Transversais , Feminino , Humanos , México , Inquéritos Nutricionais , Fatores SocioeconômicosRESUMO
OBJECTIVE: To assess the association between a healthy and sustainable dietary index (HSDI) and overweight and obesity in Mexican adults. MATERIALS AND METHODS: We analyzed a sample of Mexican adults (n=11 506) from the National Health and Nutrition Survey 2018-19 with body mass index and dietary intake data. We estimated the HSDI score based on foods and beverages recorded in a semi-quantitative food frequency questionnaire, which were classified into 13 food groups. Ordinal logistic model was fitted to analyze the association between HSDI score and overweight and obesity. RESULTS: The mean HSDI score was 6.7 out of 13 points. A significant interaction of HSDI score and sex was found. Men with higher HSDI score showed lower obesity prevalence (OR=0.55, p<0.05); this association was not sig-nificant in women. CONCLUSIONS: A higher HSDI is related to a lower prevalence of obesity and therefore of chronic diseases. Further research is required for its implementation at the population level.
OBJETIVO: Evaluar la asociación de un patrón de dieta sostenible con sobrepeso y obesidad en adultos mexicanos. MATERIAL Y MÉTODOS: En 11 506 adultos de la Ensanut 2018-19, con información de índice de masa corporal y del cuestionario de frecuencia de consumo de alimentos, se es-timó el puntaje de un índice de dieta saludable y sostenible (IDSS) clasificando los alimentos y bebidas en 13 grupos. Mediante modelo logístico ordinal, se analizó la asociación entre el puntaje del IDSS y la presencia de sobrepeso y obesidad. RESULTADOS: El puntaje promedio del IDSS fue 6.7 de 13 puntos. Se encontró interacción significativa entre IDSS y sexo sobre la prevalencia de obesidad. Los hombres con mayor IDSS presentaron menor prevalencia de obesi-dad (OR=0.55, p<0.05); esta asociación no fue significativa en mujeres. CONCLUSIONES: Mayor IDSS se relaciona con menor prevalencia de obesidad y, por ende, de enfermedades crónicas. Se requiere mayor investigación para su implemen-tación a nivel poblacional.
Assuntos
Dieta Saudável , Obesidade , Sobrepeso , Adulto , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Masculino , Inquéritos Nutricionais , Obesidade/epidemiologia , Sobrepeso/epidemiologiaRESUMO
Resumen: Objetivo: Evaluar la asociación de un patrón de dieta sostenible con sobrepeso y obesidad en adultos mexicanos. Material y métodos: En 11 506 adultos de la Ensanut 2018-19, con información de índice de masa corporal y del cuestionario de frecuencia de consumo de alimentos, se estimó el puntaje de un índice de dieta saludable y sostenible (IDSS) clasificando los alimentos y bebidas en 13 grupos. Mediante modelo logístico ordinal, se analizó la asociación entre el puntaje del IDSS y la presencia de sobrepeso y obesidad. Resultados: El puntaje promedio del IDSS fue 6.7 de 13 puntos. Se encontró interacción significativa entre IDSS y sexo sobre la prevalencia de obesidad. Los hombres con mayor IDSS presentaron menor prevalencia de obesidad (OR=0.55,p<0.05); esta asociación no fue significativa en mujeres. Conclusiones: Mayor IDSS se relaciona con menor prevalencia de obesidad y, por ende, de enfermedades crónicas. Se requiere mayor investigación para su implementación a nivel poblacional.
Abstract: Objective: To assess the association between a healthy and sustainable dietary index (HSDI) and overweight and obesity in Mexican adults. Materials and methods: We analyzed a sample of Mexican adults (n=11 506) from the National Health and Nutrition Survey 2018-19 with body mass index and dietary intake data. We estimated the HSDI score based on foods and beverages recorded in a semi-quantitative food frequency questionnaire, which were classified into 13 food groups. Ordinal logistic model was fitted to analyze the association between HSDI score and overweight and obesity. Results: The mean HSDI score was 6.7 out of 13 points. A significant interaction of HSDI score and sex was found. Men with higher HSDI score showed lower obesity prevalence (OR=0.55,p<0.05); this association was not significant in women. Conclusions: A higher HSDI is related to a lower prevalence of obesity and therefore of chronic diseases. Further research is required for its implementation at the population level.
Assuntos
Adulto , Feminino , Humanos , Masculino , Sobrepeso , Dieta Saudável , Obesidade , Índice de Massa Corporal , Inquéritos Nutricionais , Estudos Transversais , Sobrepeso/epidemiologia , Obesidade/epidemiologiaRESUMO
OBJECTIVES: To assess the association between household food insecurity (FI) and the presence of anaemia among Mexican children who were between 12 and 59 months old, and to determine whether this association differs by geographical regions. METHODS: We analysed 7468 children of ages between 12 and 59 months, based on data from the 2012 National Health and Nutrition Survey (ENSANUT 2012). Haemoglobin was measured in capillary blood. Household FI levels were defined according to the Latin American and Caribbean Food Security Scale. An ordinal logistic regression model was developed to assess the relationship between FI and anaemia. The interaction between geographical regions and FI was determined. RESULTS: The highest proportion of anaemia occurred in children with severe household FI (24.3%), compared to those from households with food security (21.2%). Children from severe FI households have a higher adjusted prevalence of anaemia than those from households with food security. FI and anaemia were associated mainly among children residing in the southern region of Mexico. CONCLUSIONS: Our findings can contribute to a better understanding of FI and anaemia in children and to strengthen interventions to address these problems.
Assuntos
Anemia/epidemiologia , Abastecimento de Alimentos/estatística & dados numéricos , Inquéritos Nutricionais , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , México/epidemiologia , PrevalênciaRESUMO
BACKGROUND: In Mexico, wheat and corn flour fortification with folic acid (FA) was implemented in 2001 and mandated in 2008, but without direct enforcement. Current Mexican nutrient-content tables do not account for FA contained in bakery bread and corn masa-based foods, which are dietary staples in Mexico. OBJECTIVE: The objective of this study was to examine the impact of FA fortification of dietary staples on the proportion of the population consuming below the Estimated Average Requirement (EAR) for folate or above the Tolerable Upper Intake Level (UL) for FA. METHODS: We measured FA and folate content in dietary staples (bakery bread and tortillas) using microbial assays and MS, and we recalculated FA intake from 24-h recall dietary intake data collected in the 2012 Mexican National Health and Nutrition Survey (Encuesta Nacional de Salud y Nutrición) utilizing estimates from our food measurements, using nutrient concentrations from tortillas to approximate nutrient content of other corn masa-derived foods. The revised FA intake estimates were used to examine population-level intake of FA and dietary folate equivalent (DFE) accounting for geographic differences in FA content with statistical models. RESULTS: FA content in dietary staples was variable, whereas use of FA-fortified flour in corn masa tortillas increased with population size in place of residence. Accounting for dietary staples' FA fortification increased population estimates for FA and DFE intake, resulting in a lower proportion with intake below the EAR and a higher proportion with intake above the UL. Despite accounting for FA-fortified staple foods, 9-33% of women of childbearing age still have intake below the EAR, whereas up to 12% of younger children have intake above the UL. CONCLUSIONS: Unregulated FA fortification of dietary staples leads to unpredictable total folate intake without adequately impacting the intended target. Our findings suggest that monitoring, evaluation, and enforcement of mandatory fortification policies are needed. Without these, alternate strategies may be needed in order to reach women of childbearing age while avoiding overexposing children.
Assuntos
Pão/análise , Ácido Fólico/metabolismo , Inquéritos Nutricionais , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Farinha/análise , Alimentos Fortificados/análise , Humanos , Lactente , México , Pessoa de Meia-Idade , Inquéritos Nutricionais/estatística & dados numéricos , Necessidades Nutricionais , Triticum/química , Triticum/metabolismo , Adulto Jovem , Zea mays/química , Zea mays/metabolismoRESUMO
RESUMEN Validar instrumentos de medición de datos es fundamental para constituir conocimiento certero y objetivo respecto a los hábitos en ingesta alimentaria. El artículo pretende adaptar y validar para el contexto de educación superior un cuestionario que originalmente es de atención primaria, y que se transforme en un insumo válido para medir hábitos alimentarios en estudiantes universitarios. Basados en un cuestionario validado por Pino, Díaz y López en el 2011, se ajustaron las preguntas para un contexto de educación terciaria. El instrumento se aplicó a una muestra estratificada de 405 estudiantes de pregrado de una universidad perteneciente al Consejo de Rectores de Chile (CRUCH) de la región del Maule. Los datos fueron procesados mediante el paquete estadístico SPSS 20, y contó con los respectivos resguardos éticos mediante consentimiento informado firmado. Siguiendo los pertinentes análisis estadísticos para la validación del instrumento, podemos dar cuenta de un cuestionario confiable y aceptable (α= 0,815), estableciéndose 10 dimensiones con 35 preguntas. Se concluye un instrumento válido y adaptado para ser aplicado en estudiantes con el fin de identificar sus hábitos alimentarios en educación superior.
ABSTRACT Validating data measurement instruments is essential to establish accurate and objective knowledge regarding dietary habits. This article aims to adapt and validate a questionnaire to measure dietary habits originally designed for the primary care setting for use in the context of higher education. Based on a questionnaire validated by Pino, Díaz and López in 2011, the questions were adjusted for a tertiary education context. The instrument was applied to a sample of 405 undergraduate students of a university belonging to the Council of Rectors of Chile (CRUCH) of the Maule region, stratified by college year. Data were analysed using SPSS 20; signed informed consent was obtained. Following the relevant statistical analysis for the validation of an instrument, 10 dimensions with 35 questions were established. Results indicated that the instrument is trustworthy and acceptable (α= 0.815). We conclude that the instrument is a valid adaptation and can be applied to higher education students in order to identify their eating habits.
Assuntos
Humanos , Chile , Inquéritos Nutricionais , Estudos de Validação como Assunto , Comportamento Alimentar , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To develop and test a scale for healthy eating practices measurement according to the Dietary Guidelines for the Brazilian Population recommendations. DESIGN: Methodological study. The current Brazilian food-based dietary guideline highlights the importance of choosing foods, combining foods to create meals and modes of eating. These recommendations formed the main domains of the scale and served as a basis for the development of ninety-six items, each with a 4-point Likert response option. Content and face validity were tested. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to determine construct validity. Internal consistency was determined using α and ω coefficients, and reproducibility was tested using test-retest. SETTING: Brazil.ParticipantsA ten-member expert panel was used to assess content validity. Adults aged 18-60 years were included in the face validity (n 20), EFA (n 352), CFA and reliability tests (n 900). RESULTS: Of the ninety-six initial items, twenty-four were excluded and fifty-five were reworded following the content and face validations. EFA detected a four-domain structure (Food choices, Modes of eating, Planning and Domestic organization), which explained 41 % of the variance. CFA led to a final twenty-four-item model with acceptable goodness-of-fit indices and good reliability measures (α=0·77; ω=0·83). Intraclass correlation coefficient for the total score (0·82) and analysis of the Bland-Altman plot suggested good reproducibility of the scale. CONCLUSIONS: The scale presents good evidence of validity and reliability. This innovative study created a useful tool for evaluation of the impact of the Dietary Guidelines for the Brazilian Population.
Assuntos
Comportamento do Consumidor , Dieta , Características da Família , Preferências Alimentares , Política Nutricional , Valor Nutritivo , Inquéritos e Questionários/normas , Adolescente , Adulto , Brasil , Dieta Saudável , Análise Fatorial , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Adulto JovemRESUMO
OBJECTIVE: To estimate energy and nutrient intakes and adequacies in Mexican adolescents. MATERIALS AND METHODS: Dietary intake was assessed in 1 961 adolescents who participated in the National Health and Nutrition Survey 2012 (Ensanut 2012), by a food frequency questionnaire. Medians of intakes and adequacies were estimated for energy, macroand micronutrients and are presented by residence area, region and household wealth index (HWI). Consumption by food groups was estimated. RESULTS: Median daily energy intake was 2 000 Kcal in males and 1 800 Kcal in females. High prevalences of inadequacy were observed for fiber, PUFAs, iron, zinc and calcium. These inadequacies were higher among individuals of low HWI. Moreover, excessive intakes of total and saturated fat were higher among adolescents of higher HWI. CONCLUSIONS: The diet of Mexican adolescents is deficient in essential nutrients for good health and high in saturated fat. Actions are needed to promote a healthy diet.
Assuntos
Dieta , Ingestão de Energia , Desnutrição/epidemiologia , Nutrientes/análise , Adolescente , Criança , Transtornos da Nutrição Infantil/epidemiologia , Gorduras na Dieta , Comportamento Alimentar , Feminino , Humanos , Masculino , México , Inquéritos Nutricionais , Estado Nutricional , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto JovemRESUMO
Abstract Objective To estimate energy and nutrient intakes and adequacies in Mexican adolescents. Materials and methods Dietary intake was assessed in 1 961 adolescents who participated in the National Health and Nutrition Survey 2012 (Ensanut 2012), by a food frequency questionnaire. Medians of intakes and adequacies were estimated for energy, macro- and micronutrients and are presented by residence area, region and household wealth index (HWI). Consumption by food groups was estimated. Results Median daily energy intake was 2 000 Kcal in males and 1 800 Kcal in females. High prevalences of inadequacy were observed for fiber, PUFAs, iron, zinc and calcium. These inadequacies were higher among individuals of low HWI. Moreover, excessive intakes of total and saturated fat were higher among adolescents of higher HWI. Conclusion The diet of Mexican adolescents is deficient in essential nutrients for good health and high in saturated fat. Actions are needed to promote a healthy diet.
Resumen Objetivo Estimar la ingesta de energía, nutrientes e inadecuaciones en adolescentes mexicanos. Material y métodos La ingesta se evaluó en 1 961 adolescentes mexicanos participantes en la Encuesta Nacional de Salud y Nutrición 2012 (Ensanut 2012), mediante un cuestionario de frecuencia. Se calcularon las medianas de ingestas y adecuaciones para la energía, macro y micronutrientes, y el consumo por grupo de alimentos. Resultados La ingesta energética diaria fue de 2 000 kcal en varones y 1 800 kcal en las mujeres. Se observó una alta prevalencia de inadecuación de fibra, grasa poliinsaturada, hierro, zinc y calcio. Las inadecuaciones fueron mayores en el índice de bienestar bajo, mientras que el nivel alto se caracterizó por ingesta excesiva de grasas. Conclusión La dieta de los adolescentes mexicanos es deficiente en nutrientes esenciales para la buena salud y es excesiva en grasas saturadas. Es necesario promover una dieta saludable.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Ingestão de Energia , Nutrientes/análise , Desnutrição/epidemiologia , Dieta , Fatores Socioeconômicos , Gorduras na Dieta , Transtornos da Nutrição Infantil/epidemiologia , Inquéritos Nutricionais , Estado Nutricional , Inquéritos e Questionários , Comportamento Alimentar , MéxicoRESUMO
We aimed to estimate the population fraction of poor early child health and developmental outcomes attributable to maternal depressive symptoms (DS) contrasting it between low- and middle/high-income households. We used a nationally representative probabilistic sample of 4240 children younger than 5 years old and their mothers, derived from the Mexican National Health and Nutrition Survey Data (ENSANUT 2012). Complex survey design, sampling, and analytic weights were taken into account in analyses. DS was measured by CESD-7. Child outcomes were as follows: breastfeeding, attending well-child check-ups, respiratory disease, diarrhea and general health problems, immunization, accidents, growth, obesity, and food insecurity. Prevalence of DS among mothers was 21.36%. In low-SES households, DS was associated with higher risk of never being breastfed (RR = 1.77; p < .05), health problems (RR = 1.37; p < .05), acute respiratory disease (RR = 1.51; p < .05), accidents requiring child hospitalization (RR = 2.16; p < .01), and moderate or severe food insecurity (RR = 1.58; p < .001). In medium- or high-SES households, DS was associated with higher risk of never attending a developmental check-up (RR = 2.14; p < .05) and moderate or severe food insecurity (RR = 1.75; p < .01). Population risks attributable to DS ranged from 2.30 to 17.45%. Prevention of DS could lead to reduction of problematic early childhood outcomes in both low and medium/high SES.
Assuntos
Desenvolvimento Infantil , Filho de Pais com Deficiência , Depressão/epidemiologia , Abastecimento de Alimentos/estatística & dados numéricos , Mães/psicologia , Pobreza/estatística & dados numéricos , Adulto , Criança , Pré-Escolar , Depressão/psicologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , México/epidemiologia , Estado Nutricional , Prevalência , Fatores de Risco , Determinantes Sociais da SaúdeRESUMO
BACKGROUND: Overweight and obesity prevalences in Mexico are among the highest in the world, with dietary factors being the third-leading category of risk contributing to the burden of disease. Consequently, studying the compliance of the Mexican population to food-based dietary recommendations is essential for informing nutritional policies. OBJECTIVES: We described the energy contribution of food groups to total dietary energy intake of the Mexican population and by sociodemographic subgroups and compared these results with Mexican dietary recommendations. METHODS: Twenty-four-hour dietary recalls for participants aged ≥5 y (n = 7983) from the 2012 Mexican National Health and Nutrition Survey were used. Foods and beverages were classified into 8 groups (the first 6 were called "basic foods" and the last 2 "discretionary foods"), as follows: 1) cereals, 2) legumes, 3) milk and dairy, 4) meat and animal products, 5) fruit and vegetables, 6) fats and oils, 7) sugar-sweetened beverages (SSBs), and 8) products high in saturated fat and/or added sugar (HSFAS). Recommendations were based on the Mexican Dietary Guidelines (MDG). Energy contributions from the food groups by age, sex, region, residence (rural or urban), and socioeconomic status (SES) were estimated. RESULTS: The highest contribution to total energy intake came from cereals (33%) followed by HSFAS (16%), meat and animal products (14%), and SSBs (9.8%). Fruit and vegetables (5.7%) and legumes (3.8%) had the lowest contribution. Energy contribution of several food groups differed significantly between population subgroups. Overall, discretionary foods contributed more than one-quarter of total energy intake (26%) and were 13 percentage points above the maximum allowed by the recommendations, whereas the intakes of legumes and fruit and vegetables were much lower than recommended. CONCLUSIONS: Our results show the need to generate a food environment conducive to a healthier diet in the Mexican population.