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Robert RC, Penny ME, Barbagelatta G, Gainer SA. Feeding Homemade Sugar Sweetened Beverages in Addition to Breastfeeding: Survey Results from Caregivers of Infants and Young Children in Peri-Urban Lima, Peru. Matern Child Health J 2023; 27:2105-2112. [PMID: 37209377 DOI: 10.1007/s10995-023-03668-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2023] [Indexed: 05/22/2023]
Abstract
OBJECTIVES Consumption of sugar sweetened beverages (SSB) is associated with childhood obesity and other negative health conditions. Feeding SSB to infants and young children (IYC) under 2 years may displace consumption of breastmilk and nutrient rich foods critical for optimal growth and development. The World Health Organization (WHO) recommends avoiding added sugar (e.g. SSB) for IYC under 2 years. We sought to describe the variety of homemade and commercial SSB as well as breastmilk and beverages without added sugar fed to IYC aged 4-23 months living in a low-income, populous peri-urban area of Lima, Peru. METHODS A cross-sectional survey was conducted with 181 households with IYC aged 4-23 months. A list of common local homemade and commercial beverages was used to investigate what caregivers had fed to the child in the past 24 h. RESULTS A total of 93.9% of caregivers reported feeding at least one beverage to their child other than breastmilk in the past 24 h. This included a variety of homemade SSB (73.5%), commercial SSB (18.2%) and homemade beverages without added sugar (70.2%). A high percentage (83.4%) of children were also breastfed. CONCLUSIONS FOR PRACTICE Our findings suggest that interventions to address feeding homemade SSB to IYC within households are needed to support WHO recommendations and complement current commercial SSB policy regulations in Peru.
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Affiliation(s)
- Rebecca C Robert
- Conway School of Nursing, The Catholic University of America, 620 Michigan Ave. N.E, Washington, DC, USA.
- Instituto de Investigación Nutricional, Lima, Peru.
| | - Mary E Penny
- Instituto de Investigación Nutricional, Lima, Peru
| | | | - Sally A Gainer
- Conway School of Nursing, The Catholic University of America, 620 Michigan Ave. N.E, Washington, DC, USA
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Devia C, Flórez KR, Costa SA, Huang TTK. Insights from a cross-sectional binational study comparing obesity among nonimmigrant Colombians in their home country and Colombian immigrants in the U.S. BMC Public Health 2023; 23:1495. [PMID: 37544992 PMCID: PMC10405453 DOI: 10.1186/s12889-023-16322-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/17/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Latinos in the United States (U.S.) represent a heterogeneous minority population disproportionally impacted by obesity. Colombians in the U.S. are routinely combined with other South Americans in most obesity studies. Moreover, most studies among Latino immigrants in the U.S. solely focus on factors in the destination context, which largely ignores the prevalence of obesity and contextual factors in their country of origin, and warrant transnational investigations. METHODS Using 2013-17 data from the New York City Community Health Survey (NYC CHS, U.S.) and the National Survey of the Nutritional Situation (ENSIN, Colombia), Colombians that immigrated to the U.S. and are living in NYC (n = 503) were compared to nonimmigrant Colombians living in their home country (n = 98,829). Prevalence ratios (PR) for obesity (BMI ≥ 30 kg/m2) by place of residence were estimated using multivariable logistic regression adjusting for socio-demographic characteristics and daily consumption of sugar-sweetened beverages. RESULTS The prevalence of obesity was 49% greater for immigrant Colombians living in NYC when compared to nonimmigrant Colombians living in in their home country (PR = 1.49; 95% CI 1.08, 2.07). Colombian immigrant men in NYC were 72% more likely to have obesity compared to nonimmigrant men living in their home country (PR = 1.72; 95% CI 1.03, 2.87). No significant differences were found in the adjusted models among women. CONCLUSIONS Colombian immigrants in NYC exhibit a higher prevalence of obesity compared to their nonimmigrant counterparts back home and sex strengthens this relationship. More obesity research is needed to understand the immigration experience of Colombians in the U.S. and the underlying mechanisms for sex difference. Public health action focused on women in Colombia and both Colombian men and women immigrants in the U.S. is warranted to avert the long-term consequences of obesity.
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Affiliation(s)
- Carlos Devia
- Center for Systems and Community Design, Graduate School of Public Health and Health Policy, City University of New York, 55 West 125th Street, New York, NY, 10027, USA
| | - Karen R Flórez
- Center for Systems and Community Design, Graduate School of Public Health and Health Policy, City University of New York, 55 West 125th Street, New York, NY, 10027, USA
| | - Sergio A Costa
- Center for Systems and Community Design, Graduate School of Public Health and Health Policy, City University of New York, 55 West 125th Street, New York, NY, 10027, USA
| | - Terry T-K Huang
- Center for Systems and Community Design, Graduate School of Public Health and Health Policy, City University of New York, 55 West 125th Street, New York, NY, 10027, USA.
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Huo Y, Cao S, Liu J, Zhang B, Xu K, Wang Y, Liu H, Yang P, Zeng L, Yan H, Dang S, Mi B. The Association between Plant-Based Diet Indices and Metabolic Syndrome in Chinese Adults: Longitudinal Analyses from the China Health and Nutrition Survey. Nutrients 2023; 15:nu15061341. [PMID: 36986071 PMCID: PMC10057991 DOI: 10.3390/nu15061341] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 03/12/2023] Open
Abstract
Objectives: To investigate the association between a plant-based diet and metabolic syndrome (MetS) among Chinese adults. Methods: Based on the data from the 2004–2015 China Health and Nutrition Survey and the corresponding edition of China Food Composition, we calculated the healthy plant-based diet indices (hPDI) and unhealthy plant-based diet indices (uPDI). The Cox proportional hazards regression model was used to estimate the hazard ratios (HRs) with 95% confidence intervals (CIs) for MetS. Mediation analysis was further conducted to explore the mediator role of Body Mass Index (BMI) in the association between hPDI and MetS. Results: We included 10,013 participants, and over a median follow-up of 5 years, 961 patients (9.60%) developed MetS. Compared to those in the lowest quintile of hPDI score, we found that those in the highest quintile of hPDI score had a 28% lower ([HR]: 0.72, 95% CI 0.56–0.93, Ptrend = 0.021) risk of developing MetS and had a 20% lower (hazard ratio [HR]: 0.80, 95% CI 0.70–0.92, Ptrend = 0.004) risk of developing abdominal obesity. No significant associations were observed between uPDI and the MetS, but those in the highest quintile of uPDI score had a 36% higher (hazard ratio [HR]: 1.36, 95% CI 1.20–1.64, Ptrend < 0.001) risk of developing abdominal obesity, compared to those in the lowest quintile of uPDI score. In exploratory analysis, we observed that BMI at baseline mediated 27.8% of the association between hPDI and incident MetS, and BMI at baseline mediated 29.7% of the association between hPDI and abdominal obesity. Conclusion: The current findings reveal a possible causal relationship between a healthy plant-based diet and a reduced risk of MetS, especially abdominal obesity. It is observed that BMI may mediate the relationship between hPDI score and MetS. Controlling early dietary patterns and BMI may help reduce the risk of MetS.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Baibing Mi
- Correspondence: ; Tel.: +86-029-826-551-04207
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Pereira TN, Bortolini GA, Campos RDF. Barriers and Facilitators Related to the Adoption of Policies to Reduce Ultra-Processed Foods Consumption: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4729. [PMID: 36981638 PMCID: PMC10048733 DOI: 10.3390/ijerph20064729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/24/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
UNLABELLED Cost-effective regulatory and fiscal interventions are recommended to address non-communicable diseases. While some countries are advancing regarding these actions, others have found it difficult to approve them. AIM to conduct a scoping review to answer the question "What factors have influenced the adoption of food taxes, front-of-pack labeling and restrictions on marketing to children?". METHODS A scoping review was developed from four databases. Studies that described and analyzed policy processes were included. Analysis was performed to identify the barriers and enablers mentioned under the guidance of Swinburn et al., Huang et al., Mialon et al., and Kingdon. RESULTS 168 documents were identified, describing experiences from five regions or groups and 23 countries, which have generated 1584 examples of 52 enablers (689 examples; 43.5%) and 55 barriers (895 examples; 56.5%) that may have influenced policies. The main enablers were related to the government environment and governance and to civil society strategies. Corporate political activity strategies were the main examples of barriers. CONCLUSIONS This scoping review consolidated barriers and facilitators related to policies aimed at reducing ultra-processed foods consumption, demonstrating that factors related to the actions of governments and civil society are the main facilitators. On the other hand, as the most interested actor in promoting the consumption of these products, the strategies adopted by the companies that produce these products constitute the main barrier to these policies in all the studied countries and should be overcome.
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Affiliation(s)
| | - Gisele Ane Bortolini
- Food and Nutrition National Coordination, Ministry of Health, Brasilia 70058-900, Brazil
| | - Roberta de Freitas Campos
- Center for Studies on Bioethics and Diplomacy in Health, Oswaldo Cruz Foundation, Brasilia 70910-900, Brazil
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González-Sánchez DL, Murillo-Prado BR, Zaragoza-Calderón CM, Armenta-Rojas E, Cornejo-Bravo JM, Andrade-Soto VH, Pineda-García G, Serrano-Medina A. Micronutrient Deficiency Pre- and Post-bariatric Metabolic Surgery in Latin America: a Systematic Review. Obes Surg 2023; 33:635-664. [PMID: 36571582 DOI: 10.1007/s11695-022-06424-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 12/06/2022] [Accepted: 12/14/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Persons submitted to bariatric metabolic surgery present micronutrient deficiency before and after surgery, due to the lack of proper supplementation. The aim of this study is to establish the prevalence of micronutrient deficiency in people before and after bariatric metabolic surgery in Latin America. METHODS This review was conducted in accordance with the 2020 PRISMA Guidelines. RESULTS Twenty-seven studies and 2135 participants were included. The highest prevalence of deficiency before surgery was reported for vitamin D (74%), zinc (71%), and hemoglobin (62%); after surgery, they were vitamin A (90.6%), vitamin D (90%), and zinc (68%). CONCLUSIONS There is a high prevalence of micronutrient deficiency before and after bariatric metabolic surgery from Latin American persons; the micronutrients with the highest deficiency prevalence were vitamin D before and vitamin A after bariatric metabolic surgery.
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Affiliation(s)
- Daniela L González-Sánchez
- Medicine and Psychology Faculty, Autonomous University of Baja California, Calzada Universidad 14418, Parque Industrial Internacional 22300, Tijuana, Mexico
| | - Brian R Murillo-Prado
- Medicine and Psychology Faculty, Autonomous University of Baja California, Calzada Universidad 14418, Parque Industrial Internacional 22300, Tijuana, Mexico
| | - Claudia M Zaragoza-Calderón
- Medicine and Psychology Faculty, Autonomous University of Baja California, Calzada Universidad 14418, Parque Industrial Internacional 22300, Tijuana, Mexico
| | - Efraín Armenta-Rojas
- Medicine and Psychology Faculty, Autonomous University of Baja California, Calzada Universidad 14418, Parque Industrial Internacional 22300, Tijuana, Mexico
| | - José M Cornejo-Bravo
- Chemical Sciences and Engineering Faculty, Autonomous University of Baja California, Calzada Universidad 14418, Parque Industrial Internacional 22300, Tijuana, Mexico
| | - Víctor H Andrade-Soto
- Health Sciences Faculty, Autonomous University of Baja California, Blvd Universitario, 1000 Valle de Las Palmas, 22260, Tijuana, Mexico
| | - Gisela Pineda-García
- Medicine and Psychology Faculty, Autonomous University of Baja California, Calzada Universidad 14418, Parque Industrial Internacional 22300, Tijuana, Mexico
| | - Aracely Serrano-Medina
- Medicine and Psychology Faculty, Autonomous University of Baja California, Calzada Universidad 14418, Parque Industrial Internacional 22300, Tijuana, Mexico.
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Identification and Association of Single Nucleotide Polymorphisms of the FTO Gene with Indicators of Overweight and Obesity in a Young Mexican Population. Genes (Basel) 2023; 14:genes14010159. [PMID: 36672899 PMCID: PMC9858641 DOI: 10.3390/genes14010159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/29/2022] [Accepted: 01/04/2023] [Indexed: 01/10/2023] Open
Abstract
(1) Background: obesity is a global public health problem; various factors have been associated with this disease, and genetic factors play a very important role. Previous studies in multiple populations have associated a gene with fat mass and obesity (FTO). Thus, the present work aims to identify and determine associations between genetic variants of FTO with indicators of overweight and obesity in the Mexican population. (2) Methods: a total of 638 subjects were evaluated to compile data on body mass index (BMI), the percentage of body fat (%BF), the waist circumference (WC), the serum levels of triglycerides (TG), and food consumption. A total of 175 genetic variants in the FTO gene were sampled by a microarray in the evaluated population, followed by association statistical analyses and comparisons of means. (3) Results: a total of 34 genetic variants were associated with any of the 6 indicators of overweight and obesity, but only 15 showed mean differences using the recessive model after the Bonferroni correction. The present study shows a wide evaluation of FTO genetic variants associated with a classic indicator of overweight and obesity, which highlights the importance of genetic analyses in the study of obesity.
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Borges CA, Khandpur N, Neri D, Duran AC. Comparing Latin American nutrient profile models using data from packaged foods with child-directed marketing within the Brazilian food supply. Front Nutr 2022; 9:920710. [PMID: 36532519 PMCID: PMC9755586 DOI: 10.3389/fnut.2022.920710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 11/08/2022] [Indexed: 01/18/2024] Open
Abstract
OBJECTIVES This study aimed to examine and compare the extent to which different nutrient profile models (NPMs) from Latin America (LA) identify packaged foods and beverages with child-directed marketing sold in Brazil as being high in nutrients associated to the risk of non-communicable diseases (NCDs). MATERIALS AND METHODS In this cross-sectional study, we evaluated 3,464 foods found in the five largest Brazilian supermarkets. Child-directed marketing was coded using the International Network for Food and Obesity/NCDs Research, Monitoring and Action Support (INFORMAS) protocol. Differences in medians of sugar, saturated fats, and sodium per 100 kcal in foods, with the presence and absence of child-directed marketing, were tested using the Mann-Whitney test. We compared six NPMs in LA and examined to what extent they targeted these products using prevalence ratios. Analyses were performed overall and by the degree of food processing according to the Nova food classification. RESULTS We found 1,054 packages with child-directed marketing. Among these, candies, cakes and pies, sauces and creams, and sugar-sweetened beverages were significantly higher in sugar, saturated fat, and sodium per 100 kcal than products that are not targeted at children (p < 0.05). Compared with PAHO and the Mexico models, the Brazilian NPMs would allow three times more ultra-processed foods to omit warnings for sodium (p < 0.05). The Uruguayan NPM also flagged fewer ultra-processed foods high in sodium (p < 0.05). The Brazilian model also allows four times more sugar-sweetened beverages and six times more dairy drinks to omit warnings for sugar than the Mexico and PAHO models. In comparison to all other NPMs, the Brazilian model showed the worst performance in identifying baked goods as high in sodium. Chile, Uruguay, and Peru models would also target significantly less sugar-sweetened beverages and high in at least one critical nutrient than PAHO and Mexico models. CONCLUSION Compared with other NPMs in LA, the NPM criteria adopted in Brazil are more permissive and less likely to inform consumers of the poor nutritional quality of ultra-processed foods and beverages with child-directed marketing.
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Affiliation(s)
- Camila Aparecida Borges
- Center for Epidemiological Research in Nutrition and Health, Faculty of Public Health, University of São Paulo, São Paulo, Brazil
- Center for Food Studies and Research, State University of Campinas, São Paulo, Brazil
| | - Neha Khandpur
- Center for Epidemiological Research in Nutrition and Health, Faculty of Public Health, University of São Paulo, São Paulo, Brazil
- Department of Nutrition, School of Public Health, Harvard University, Boston, MA, United States
| | - Daniela Neri
- Center for Epidemiological Research in Nutrition and Health, Faculty of Public Health, University of São Paulo, São Paulo, Brazil
| | - Ana Clara Duran
- Center for Food Studies and Research, State University of Campinas, São Paulo, Brazil
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Wang CY, Hsu CJ, Cai D. Effects of food nutrition labels on the health awareness of school-age children. BMC Public Health 2022; 22:1249. [PMID: 35751054 PMCID: PMC9230083 DOI: 10.1186/s12889-022-13613-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 05/09/2022] [Indexed: 12/05/2022] Open
Abstract
Background Overweight and obesity have been described as a global epidemic that seriously affects the health of adults and children. Front of Package (FOP) Nutrition Labeling can increase consumers’ awareness of unhealthy foods. The purpose of this study is to find effective deterrence and improve children’s health awareness via the FOP. Methods This study examined children’s health awareness of snack packaging using the four labels: guideline daily amounts (GDA), traffic light system (TLS), Apple label (designed in this study), and Warning label. This study recruited 343 children in the sixth grade, including 223 children living in cities and 120 children living in rural areas. First, 30 children in grades 3 to 6 selected 8 snacks that they often buy. Then, each snack was synthesized into these four labels according to their nutritional content for a total of 32 samples. Finally, a questionnaire was used to evaluate the health of snack packaging and the visibility of nutrition labels. Results Four results can be drawn: (1) GDA, Apple label and TLS can help children determine healthier snack choices, (2) black Warning label cannot induce children to make healthier choices, (3) children who often buy snacks have low health awareness, and (4) rural children have weak health awareness of snack packaging. Conclusions These results can provide a packaging label design, which can effectively improve children’s health awareness. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13613-y.
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Affiliation(s)
- Ching-Yi Wang
- Department of Creative Product Design, Asia University, No. 500, Lioufeng Rd., Wufeng, Taichung City, 41354, Taiwan
| | - Chung-Jia Hsu
- Department of Visual Communication Design, Asia University, No. 500, Lioufeng Rd., Wufeng, Taichung City, 41354, Taiwan
| | - Dengchuan Cai
- Department of Industrial Design National, Yunlin University of Science and Technology, No.123, Sec. 3, University Rd, Douliou, Yunlin City, 64002, Taiwan.
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Liver Diseases in Latin America: Current Status, Unmet Needs, and Opportunities for Improvement. CURRENT TREATMENT OPTIONS IN GASTROENTEROLOGY 2022; 20:261-278. [PMID: 35729970 PMCID: PMC9202671 DOI: 10.1007/s11938-022-00382-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/06/2022] [Indexed: 02/07/2023]
Abstract
Purpose of review
To assess the current challenges regarding liver diseases, including the burden of disease, access to care, screening, and treatment needs in Latin America. Recent findings Latin America is a region with a rich multicultural heritage and important socioeconomic differences. The burden of liver diseases is high and mainly determined by a high level of alcohol intake and the surge of risk factors associated with NAFLD (i.e., sedentary lifestyles, broader access to highly processed foods, obesity, and type 2 diabetes mellitus). Hepatotropic viruses also play a role in the development of chronic liver diseases, although their comparative frequency has been decreasing over the last decades. There are important disparities in access to screening and treatment for liver diseases in Latin America, which are reflected in low access to critical treatments such as direct-acting antiviral agents and drugs to treat hepatocellular carcinoma. Also, important barriers to liver transplantation are present in multiple countries, including a low deceased donors’ rate and a lack of availability in several countries (especially in Central America). Our region also has disadvantages in research and education in liver diseases, which limits regional academic development and improvement in quality of care of liver diseases. Summary In order to tackle an increasing health burden due to liver diseases, Latin America urgently needs tailored interventions aiming to control the main risk factors for these disorders through the establishment of effective public health policies. Also, development of liver transplantation programs and improvement of medical education and research capabilities as well as extensive collaboration between all stakeholders are keys to address the liver disease agenda in the region.
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Hernández-Ruiz Á, Madrigal C, Soto-Méndez MJ, Gil Á. Challenges and perspectives of the double burden of malnutrition in Latin America. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2022; 34 Suppl 1:S3-S16. [PMID: 35153111 DOI: 10.1016/j.arteri.2021.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 11/22/2021] [Indexed: 06/14/2023]
Abstract
Nutrition is a key factor in the development of non-communicable chronic diseases (NCCDs), especially cardiovascular diseases (CVD) and their risk factors. The "double burden of malnutrition" (DBM) is the coexistence of undernutrition and overnutrition in the same population across the life-course. In Latin America, the transition from a predominantly underweight to an overweight and obese population has increased more rapidly than in other regions in the world. Undernutrition and the micronutrient deficiencies particularly iron, zinc, and vitamins A and D, present high heterogeneity in Latin American countries, and are currently considered important public health problems. In this region, NCCDs account for 50% of the disability-adjusted life-years, led by CVD. The most prevalent cardiovascular risk factors are overweight, obesity, hypertension, dyslipidemia and type 2 diabetes mellitus. Because of the cost of treatment and the potential years of life lost due to premature death, CVD is known to affect the poorest segments of the population, affecting communities, and governments. More than 80% of CVD deaths occur in low- and middle-income countries. The persistence of damage in some cells due to undernutrition may explain certain findings regarding the increase in NCCD. These aspects together with epigenetic changes have highlighted the importance of a lifelong approach to nutritional policy development. Reducing DBM requires major societal interventions in public health and nutrition to achieve holistic change that can be sustained over the long term and spread throughout the global food system. The implementation of effective state policies of double impact actions should influence both sides of the burden and be considered an urgent priority, considering country-specific inequalities and socio-demographic differences in the Latin American region, using diverse and multidisciplinary strategies.
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Affiliation(s)
- Ángela Hernández-Ruiz
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3.ª pta., Armilla 18016, Granada, Spain
| | - Casandra Madrigal
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3.ª pta., Armilla 18016, Granada, Spain; Department of Nutrition and Food Science, Faculty of Pharmacy, University of Granada, Granada, Spain
| | - María José Soto-Méndez
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3.ª pta., Armilla 18016, Granada, Spain
| | - Ángel Gil
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3.ª pta., Armilla 18016, Granada, Spain; Department of Biochemistry and Molecular Biology II University of Granada, University of Granada, Granada, Spain; Institute of Nutrition and Food Technology "José Mataix," Biomedical Research Center, University of Granada, Granada, Spain; Biosanitary Research Institute IBS.GRANADA, Granada University Hospital Complex, Granada, Spain; CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, Madrid, Spain.
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Healthcare professionals' perceptions of childhood obesity in Iquitos, Peru: a qualitative study. BMC Health Serv Res 2022; 22:175. [PMID: 35144599 PMCID: PMC8832769 DOI: 10.1186/s12913-022-07519-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 12/08/2021] [Indexed: 01/18/2023] Open
Abstract
Background Childhood obesity is an urgent worldwide concern associated with increased morbidity in adulthood. Healthcare professionals (HCPs) are well placed to influence childhood obesity trends and implement interventions. English-language studies regarding HCPs’ perceptions of childhood obesity are limited to high-income countries. Peru is an upper-middle-income country with regional disparities in childhood obesity prevalence. This qualitative study aims to explore HCPs’ perceptions of childhood obesity in Iquitos, Peru, where prevalence is relatively low. Methods Twenty-one HCPs with child healthcare experience were purposively recruited from two primary healthcare centres. Semi-structured, individual interviews were conducted with a translator and audio recorded. Transcribed data were analysed using thematic analysis. Results Eight themes were identified and divided into four categories: (1) HCPs’ perceptions and attitudes towards childhood obesity (level of concern regarding childhood obesity, perceived consequences of childhood obesity); (2) Factors which HCPs perceive to be important in the development of childhood obesity (parental factors, contextual factors); (3) HCPs’ perceptions of their role in childhood obesity prevention and management (educating parents about childhood obesity, regular monitoring of child growth); and (4) Barriers and facilitators in childhood obesity prevention and management (in healthcare, in schools). Conclusions HCPs had a low level of concern regarding childhood obesity in Iquitos and prioritised undernutrition. Parental factors were perceived to be the most influential in the development of childhood obesity. HCPs perceived themselves to have minimal influence due to prevailing positive views of excess weight and difficulties engaging parents. Educating parents about childhood obesity was felt to be essential to prevention and management although regular monitoring of child growth and home healthcare visits were viewed as useful additional measures. This study can help to inform the development of targeted public health strategies which are sensitive to local contexts and could prevent the upward childhood obesity trends evident elsewhere in Peru. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07519-z.
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12
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Yin X, Ye L, Xin X, Xiang L, Yu Y, Yan R, Wen K, Tian M, Jones A, Pettigrew S, Liu W, Yang Y, Zhang J. Key Stakeholder Perspectives on Introducing a Front-of-Pack Labelling Scheme on Packaged Foods in China: A Qualitative Study. Nutrients 2022; 14:nu14030516. [PMID: 35276875 PMCID: PMC8840240 DOI: 10.3390/nu14030516] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 01/19/2022] [Accepted: 01/21/2022] [Indexed: 01/17/2023] Open
Abstract
Front-of-pack (FoP) labelling on foods is recommended by the World Health Organization (WHO) to address the growing global burden of diet-related noncommunicable diseases (NCDs), but this policy has not yet been implemented in China. The aim of this study was to ascertain key stakeholders’ views on barriers and facilitators to developing a feasible and acceptable FoP labelling policy in the Chinese context. Semistructured interviews were used to elicit opinions from diverse representatives in roles of FoP labelling policy influence. Participants were identified by purposive and snowball sampling. The Consolidated Framework for Implementation Research (CFIR) was adopted to facilitate data collection and analysis. Themes and subthemes were generated using deductive and inductive approaches. Thirty participants were interviewed. The major barriers were the absence of national contextual analysis, perceived complexity of the process of policy development, disagreement on a preferred FoP labelling format, cost for the food industry, low priority compared to food safety policies, lack of existing regulatory framework or authorised nutrient profiling system, limited knowledge of FoP labelling, and the lack of planning and engagement with stakeholders. Facilitators included existing prerequisites, experiences and lessons from the pilot, policy coherence with Healthy China 2030, and support from external agents (e.g., WHO). Further efforts are required to develop and collate evidence to demonstrate the scientific, legal, and political feasibility of introducing effective FoP labelling.
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Affiliation(s)
- Xuejun Yin
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia; (X.Y.); (A.J.); (S.P.)
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China; (L.Y.); (L.X.); (R.Y.)
| | - Lihong Ye
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China; (L.Y.); (L.X.); (R.Y.)
| | - Xin Xin
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China; (X.X.); (Y.Y.); (K.W.); (W.L.)
| | - Lin Xiang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China; (L.Y.); (L.X.); (R.Y.)
| | - Yue Yu
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China; (X.X.); (Y.Y.); (K.W.); (W.L.)
| | - Ruijie Yan
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China; (L.Y.); (L.X.); (R.Y.)
| | - Kehan Wen
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China; (X.X.); (Y.Y.); (K.W.); (W.L.)
| | - Maoyi Tian
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia; (X.Y.); (A.J.); (S.P.)
- School of Public Health, Harbin Medical University, Harbin 150088, China
- Correspondence: (J.Z.); (M.T.)
| | - Alexandra Jones
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia; (X.Y.); (A.J.); (S.P.)
| | - Simone Pettigrew
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia; (X.Y.); (A.J.); (S.P.)
| | - Wei Liu
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China; (X.X.); (Y.Y.); (K.W.); (W.L.)
| | - Yuexin Yang
- Chinese Nutrition Society, Beijing 100022, China;
| | - Juan Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China; (L.Y.); (L.X.); (R.Y.)
- Correspondence: (J.Z.); (M.T.)
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13
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Saavedra-Garcia L, Moscoso-Porras M, Diez-Canseco F. An Experimental Study Evaluating the Influence of Front-of-Package Warning Labels on Adolescent’s Purchase Intention of Processed Food Products. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031094. [PMID: 35162126 PMCID: PMC8833989 DOI: 10.3390/ijerph19031094] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/12/2022] [Accepted: 01/17/2022] [Indexed: 01/27/2023]
Abstract
Front-of-package warning labels (WLs) are among the public health policies adopted by some countries, mainly in Latin-America, to tackle childhood obesity; however, their impact is still under review. The aim of this study was to assess, using an experimental design, whether WLs influence purchase intention of processed foods and identification of the healthiest products among adolescents in Peru, in May 2019, just before WLs mandatory implementation. Four hundred forty-nine adolescents from two public schools were randomly assigned to an experimental group (received three different processed products with either zero, one or two WLs, informing if they were high in sugar, sodium and/or saturated fats) or a control group (received the same products but unlabeled). Participants chose which product they would buy, and which they considered to be the healthiest. No differences between groups were found neither in purchase intention (p = 0.386) nor in the identification of the healthiest product (p = 0.322). In both groups, the most-selected product was always the healthiest of the triad (>40% in purchase intention and >80% in identification of the healthiest). Front-of-package WLs did not influence purchase intention, or identification of healthier products among adolescents from public schools in Peru. Mass media and educational campaigns should accompany the WLs implementation to help achieve the policy objective.
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14
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Miracolo A, Sophiea M, Mills M, Kanavos P. Sin taxes and their effect on consumption, revenue generation and health improvement: a systematic literature review in Latin America. Health Policy Plan 2021; 36:790-810. [PMID: 33885782 PMCID: PMC8173601 DOI: 10.1093/heapol/czaa168] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2020] [Indexed: 11/14/2022] Open
Abstract
Sin or public health taxes are excise taxes imposed on the consumption of potentially harmful goods for health [sugar-sweetened beverages (SSBs), tobacco, alcohol, among others], aiming to reduce consumption, raise additional revenue and/or improve population health. This paper assesses the extent to which sin taxes (a) can reduce consumption of potentially harmful goods, (b) raise revenue for national health systems and (c) contribute to population health in Latin America. A systematic literature review was conducted on peer-reviewed and grey literature; endpoints included: impact of raising sin taxes on consumption, ability to raise revenue for health and the possibility of population health improvements. Risk of bias for each study was assessed. The synthesis of the literature on sin tax implementation showed improvements in all three endpoints across the study countries. Following the introduction of sin taxes or by simulating their potential impact, nearly all studies explicitly reported that consumption of potentially harmful goods (mainly SSBs and tobacco) declined; revenue was found to have increased in almost all countries, suggesting that there may be additional scope for further tax increase. Simulated improvements in population health have also been shown, by demonstrating a relationship between sin tax increases and reduction in prevalence of diabetes, stroke, heart attacks and associated deaths. However, sin tax effects on health would be better quantified over the long-term. Data quality and availability challenges did place some limitations on sin tax impact assessment. Sin taxes can be effective in reducing consumption of potentially harmful goods, improve population health and generate additional revenue. Promoting further research on this topic should be a priority.
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Affiliation(s)
- Aurelio Miracolo
- Department of Health Policy and Medical Technology Research Group - LSE Health, The London School of Economics and Political Science, Cowdrey House, Houghton Street, London WC2A 2AE, UK
| | - Marisa Sophiea
- Faculty of Medicine, School of Public Health, Imperial College, London, Medical School Building, St Mary's Hospital, Norfolk Place, London W2 1PG, UK
| | - Mackenzie Mills
- Department of Health Policy and Medical Technology Research Group - LSE Health, The London School of Economics and Political Science, Cowdrey House, Houghton Street, London WC2A 2AE, UK
| | - Panos Kanavos
- Department of Health Policy and Medical Technology Research Group - LSE Health, The London School of Economics and Political Science, Cowdrey House, Houghton Street, London WC2A 2AE, UK
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15
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Qi W, Zhou Y, You D, Liu J, Li L, Xu G, Hu J, Wang S, Xu L, Yang D, Liu H. Cardiovascular health behaviours of young adolescents: Results from the global school-based student health survey. J Paediatr Child Health 2021; 57:566-573. [PMID: 33486849 DOI: 10.1111/jpc.15268] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 08/28/2020] [Accepted: 10/27/2020] [Indexed: 11/29/2022]
Abstract
AIM Levels of American Heart Association-defined cardiovascular (CV) health behaviours have not been fully reported among young adolescents in low- and middle-income countries (LMICs). We describe poor, intermediate and ideal levels of American Heart Association-defined CV health behaviours among young adolescents in LMICs. METHODS We categorised the levels of CV health behaviours (smoking, body mass index, physical activity and diet) as poor, intermediate, or ideal and calculated the prevalence of each level and the cumulative number of ideal CV health behaviours using the latest data from the global school-based health survey during 2009-2015. The weighted prevalence and 95% confidential intervals were calculated for the whole sample and for sub-groups stratified by gender and age. Pooled overall and regional estimates were calculated using a random-effects model. This study included 153 759 young adolescents from 45 countries. RESULTS Overall, 86.3% (95% confidence interval, 82.7-89.9), 80.1% (79.8-80.4), 15.4% (13.7-17.2) and 1.7% (1.1-2.2) of respondents reported ideal levels for smoking, body mass index, physical activity and a healthy diet score, respectively. Overall, 0.3% (0.2-0.4) of respondents had 'four' cumulative ideal CV health behaviours. This 'percentage' was lowest in the Americas (0.2%) and highest in Southeast Asia (0.5%). CONCLUSIONS Consistently low proportions of young adolescents in LMICs met the ideal levels of physical activity and a healthy diet score or had 'four' ideal CV health behaviours. For this population, physical activity and a healthy dietary pattern should be strongly prioritised.
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Affiliation(s)
- Wanfu Qi
- Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China.,Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China
| | - Yanji Zhou
- School of public health, Kunming Medical University, Kunming, China
| | - Dingyun You
- School of public health, Kunming Medical University, Kunming, China
| | - Jingjing Liu
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, China
| | - Lian Li
- Department of Epidemiology, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, China
| | - Guodong Xu
- Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China.,Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China
| | - Jingcen Hu
- Department of Epidemiology, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, China
| | - Shuyu Wang
- Department of Epidemiology, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, China
| | - Lei Xu
- Department of Epidemiology, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, China
| | - Delun Yang
- Department of Epidemiology, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, China
| | - Huina Liu
- Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China.,Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China
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16
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Halpern B, Louzada MLDC, Aschner P, Gerchman F, Brajkovich I, Faria-Neto JR, Polanco FE, Montero J, Juliá SMM, Lotufo PA, Franco OH. Obesity and COVID-19 in Latin America: A tragedy of two pandemics-Official document of the Latin American Federation of Obesity Societies. Obes Rev 2021; 22:e13165. [PMID: 33230898 PMCID: PMC7753730 DOI: 10.1111/obr.13165] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 10/12/2020] [Indexed: 12/25/2022]
Abstract
In May 2020, Latin America became the epicenter of the COVID-19 pandemic, a region already afflicted by social disparities, poor healthcare access, inadequate nutrition and a large prevalence of noncommunicable chronic diseases. Obesity and its comorbidities are increasingly prevalent in Latin America, with a more rapid growth in individuals with lower income, and currently a disease associated with COVID-19 severity, complications and death. In this document, the Latin American Association of Obesity Societies and collaborators present a review of the burden of two pandemics in Latin America, discuss possible mechanisms that explain their relationship with each other and provide public health and individual recommendations, as well as questions for future studies.
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Affiliation(s)
- Bruno Halpern
- Executive Committee, Latin American Federation of Obesity Societies (FLASO), Executive Committee, Santo Domingo, Dominican Republic.,Obesity Group, Department of Endocrinology, University of São Paulo, São Paulo, Brazil.,Weight Control Center, Hospital 9 de Julho, São Paulo, Brazil
| | - Maria Laura da Costa Louzada
- School of Public Health, University of São Paulo, São Paulo, Brazil.,Center of Epidemiology Research on Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Pablo Aschner
- Javeriana University School of Medicine, San Ignacio University Hospital, Bogotá, Colombia
| | - Fernando Gerchman
- Internal Medicine Department, Post-graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul. Endocrine and Metabolism Division, Hospital de Clínicas, Porto Alegre, Brazil
| | - Imperia Brajkovich
- Department of Internal Medicine B-School of Medicine "Luis Razetti", University Hospital of Caracas-Universidad Central de Venezuela, Caracas, Venezuela
| | - José Rocha Faria-Neto
- Center for Clinical and Epidemiological Research (EpiCenter), School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Felix Escaño Polanco
- Executive Committee, Latin American Federation of Obesity Societies (FLASO), Executive Committee, Santo Domingo, Dominican Republic
| | - Julio Montero
- Executive Committee, Latin American Federation of Obesity Societies (FLASO), Executive Committee, Santo Domingo, Dominican Republic.,Executive Committee, Argentinian Society of Obesity and Alimentary Disorders, Buenos Aires, Argentina
| | - Silvia María Marín Juliá
- Executive Committee, Latin American Federation of Obesity Societies (FLASO), Executive Committee, Santo Domingo, Dominican Republic.,Obesity Group, Universidad de Ciencias Médicas de La Habana, Havana, Cuba
| | - Paulo Andrade Lotufo
- Department of Internal Medicine, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Oscar H Franco
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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17
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Li L, Sun N, Zhang L, Xu G, Liu J, Hu J, Zhang Z, Lou J, Deng H, Shen Z, Han L. Fast food consumption among young adolescents aged 12-15 years in 54 low- and middle-income countries. Glob Health Action 2020; 13:1795438. [PMID: 32762333 PMCID: PMC7480506 DOI: 10.1080/16549716.2020.1795438] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Most countries worldwide, especially low- and middle-income countries (LMICs), are facing an increasing prevalence of fast-food consumption and multiple burdens of malnutrition among young adolescents. OBJECTIVE To compare the prevalence of fast-food consumption among young adolescents in LMICs. METHODS We used data from the most recent Global School-Based Student Health Survey (2009-2015), which had been collected using a standardized questionnaire. The weighted prevalence and 95% confidential intervals of fast-food consumption were calculated overall and in subgroups stratified by age, sex, and nutritional status. The pooled overall and regional estimates were obtained using a random-effects model. Heterogeneity was assessed using the I2 statistic. The associated risk factors for fast-food consumption were explored using logistic regression analysis. RESULTS Our study comprised 153,496 young adolescents (46.90% boys) from 54 LMICs. Overall, approximately 55.2% (51.3-59.1%) of the adolescents consumed fast food at least 1 day per week, and 10.3% (8.3-12.4%) did so 4-7 days per week. The prevalence of fast-food consumption 4-7 days per week was lowest in the Americas (8.3%; 6.7-9.9%) and highest in Southeast Asia (17.7%; 2.3-33.2%). At a country level, the prevalence was lowest in Pakistan (1.5%; 1.0-2.0%) and highest in Thailand (43.3%; 40.4-46.1%). Furthermore, in subgroups stratified by nutritional status, the prevalence was lowest in the obesity group (6.6%; 4.5-8.7%). Factors such as age, sex, BMI, food insecurity, fruit consumption, vegetable consumption, soft-drink consumption, smoking, physical activity level, and sedentary behavior level were found to be correlated with fast-food consumption. CONCLUSIONS The identified high prevalence of fast-food consumption among young adolescents in LMICs indicates the urgent need to prioritize the implementation of healthy-diet promotion programs to improve adolescent health in these countries.
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Affiliation(s)
- Lian Li
- Department of Epidemiology, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University , Ningbo, China
| | - Ning Sun
- School of Nursing, Ningbo College of Health Sciences , Ningbo, Zhejiang, PR China
| | - Lina Zhang
- Department of Epidemiology, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University , Ningbo, China
| | - Guodong Xu
- Department of Epidemiology, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University , Ningbo, China
| | - Jingjing Liu
- Department of Social Medicine, School of Public Health, Harbin Medical University , Harbin, China
| | - Jingcen Hu
- Department of Epidemiology, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University , Ningbo, China
| | - Zhiying Zhang
- Teaching and Research Department, Affiliated Hospital of Weifang Medical University , Weifang, China
| | - Jianjun Lou
- Nutrition Department, Yuyao People's Hospital , Yuyao, Zhejiang, PR China
| | - Hongxia Deng
- Department of Otorhinolaryngology Head and Neck Surgery, Ningbo Medical Center Lihuili Hospital , Ningbo, Zhejiang, PR China
| | - Zhisen Shen
- Department of Otorhinolaryngology Head and Neck Surgery, Ningbo Medical Center Lihuili Hospital , Ningbo, Zhejiang, PR China
| | - Liyuan Han
- Hwa Mei Hospital, University of Chinese Academy of Sciences , Ningbo, Zhejiang, PR China.,Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences , Ningbo, Zhejiang, PR China
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18
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Sales Vieira C, Celis C, Galán G, Hernández L, Díaz I, López J. Drospirenone: a Latin American perspective for oestrogen-free oral contraception. EUR J CONTRACEP REPR 2020; 26:73-78. [PMID: 33155847 DOI: 10.1080/13625187.2020.1837364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AIM Combined hormonal contraceptives, despite their high efficacy, are associated with an increased relative risk of cardiovascular events. The contraceptive mechanism of action of combined pills depends fundamentally on their progestin component. METHODS A narrative review was performed. RESULTS The drospirenone-only pill, including this synthetic progestogen with antimineralocorticoid and antiandrogenic activity, has high contraceptive efficacy that has been demonstrated with a 24-day schedule of 4-day administration of hormone-free pills. Due to its safety profile, the drospirenone-only pill is suitable even in high-risk populations, such as women with high blood pressure, thromboembolism, smoking or dyslipidemia. CONCLUSION Considering the increasing prevalence of these comorbidities in Latin America, the 4 mg drospirenone-only pill is suggested as one of the strategies of choice in the region for those women who choose oral contraceptives.
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Affiliation(s)
- Carolina Sales Vieira
- Department of Obstetrics and Gynecology of the Medical School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Cuauhtémoc Celis
- The Mexican Federation of Obstetric and Gynecology Colleges, Mexico City, Mexico
| | - Guillermo Galán
- Centro de Capacitación e Investigaciones Clínicas, Santiago, Chile
| | | | - Ivonne Díaz
- Procreación Médicamente Asistida, Bogotá, Colombia
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19
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Adasme-Berríos C, Aliaga-Ortega L, Schnettler B, Sánchez M, Pinochet C, Lobos G. What Dimensions of Risk Perception are Associated with Avoidance of Buying Processed Foods with Warning Labels? Nutrients 2020; 12:E2987. [PMID: 33003539 PMCID: PMC7601917 DOI: 10.3390/nu12102987] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 09/19/2020] [Accepted: 09/27/2020] [Indexed: 01/17/2023] Open
Abstract
Nutritional Warning Labels (NWLs) inform consumers about processed foods that exceed critical nutrient levels activating the risk perception in consumers. However, this information is limited. The objective was to identify the dimensions of risk perception and to study their associations with avoidance of buying processed foods with warning labels. A survey was applied to 807 decision-makers who choose what to eat at home. The four dimensions of risk perception (performance, financial, physical, and psychological) were identified through exploratory factor analysis. Through a multiple regression model, we determined the dimensions of risk perception and sociodemographic variables that affect the intention to avoid buying processed foods with NWLs. The results show that the performance risk, physical risk, and psychological risk positively affect the intention of avoiding processed foods with NWLs. In addition, the female gender considers NWLs to purchase foods. Nevertheless, the high frequency of consumption and belonging to a lower-income socioeconomic group are barriers to the use of NWLs. In conclusion, NWLs help people to choose processed food that does not impact negatively their food expectations, as well as their mental and physical health. However, health authorities must invest in nutrition education. Specifically, in groups who pay less attention to NWLs. Such groups include people with high daily consumption of processed foods, males, and low-income socioeconomic groups.
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Affiliation(s)
- Cristian Adasme-Berríos
- Department of Economy and Administration, Universidad Católica del Maule, 3460000 Talca, Chile; (L.A.-O.); (C.P.)
| | - Luis Aliaga-Ortega
- Department of Economy and Administration, Universidad Católica del Maule, 3460000 Talca, Chile; (L.A.-O.); (C.P.)
| | - Berta Schnettler
- Faculty of Agricultural and Forest Sciences, Sci & Technol Bioresource Nucl BIOREN UFRO, Universidad de La Frontera, 4780000 Temuco, Chile;
| | - Mercedes Sánchez
- Department of Business Administration, IS-FOOD Research Institute, Public University of Navarra, 31006 Pamplona, Spain;
| | - Consuelo Pinochet
- Department of Economy and Administration, Universidad Católica del Maule, 3460000 Talca, Chile; (L.A.-O.); (C.P.)
| | - Germán Lobos
- Faculty of Economy and Business, Universidad de Talca, 3460000 Talca, Chile;
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20
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Ramírez-Vélez R, Izquierdo M, Castro-Astudillo K, Medrano-Mena C, Monroy-Díaz AL, Castellanos-Vega RDP, Triana-Reina HR, Correa-Rodríguez M. Weight Loss after 12 Weeks of Exercise and/or Nutritional Guidance Is Not Obligatory for Induced Changes in Local Fat/Lean Mass Indexes in Adults with Excess of Adiposity. Nutrients 2020; 12:nu12082231. [PMID: 32722652 PMCID: PMC7468717 DOI: 10.3390/nu12082231] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 01/17/2023] Open
Abstract
The objectives of this secondary analysis are (1) to investigate the differential effects of exercise training modalities-high-intensity interval training (HIIT), resistance training (RT), combined training (CT = HIIT + RT), and/or nutritional guidance (NG) alone-on local fat/lean mass indexes in adults with excess of adiposity; (2) to identify the individual patterns of response based on either a clinical criterion of weight loss (≥5%) and/or technical error (TE) of measurement of local fat/lean mass indexes; and (3) to assess the individual change for body composition parameters assigned either to HIIT, RT, CT, and/or NG groups utilizing a TE. A 12-week trial was conducted in 55 participants randomized to one of the four interventions. The primary outcome was clinical change in body weight (i.e., weight loss of ≥5%). Secondary outcomes included change in ratio of android and gynoid fat mass, as well as local fat and lean mass indexes (arms, trunk, and legs), before and after intervention. The main findings from the current analysis revealed that (i) after 12 weeks of follow-up, significant decreases in several body composition indexes were found including body weight, arm, trunk, and legs fat mass, and android and gynecoid fat mass were observed in HIIT, RT, and CT groups (p < 0.05); (ii) a significant proportion of individuals showed a positive response following 12 weeks of training, led by the HIIT group with 44% and followed by RT with 39% in 9 indexes; (iii) the HIIT group showed lowest rates of adverse responders with (6%); and (iv) the individual patterns of response utilizing clinically meaningful weight loss were not necessarily associated with the corresponding individual training-induced changes in body composition indexes in adults with excess of adiposity. Overall, the study suggests that HIIT has an important ability to reduce the prevalence of non-response to improve body composition indexes.
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Affiliation(s)
- Robinson Ramírez-Vélez
- Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Navarra, Spain;
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-695-526-321
| | - Mikel Izquierdo
- Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Navarra, Spain;
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Karem Castro-Astudillo
- Centro de Acondicionamiento Físico y Nutrición, KCFIT, Santiago de Cali, Valle 760011, Colombia;
| | - Carolina Medrano-Mena
- Facultad de Organización Deportiva, Universidad Autónoma de Nuevo León, Nuevo León 66455, Mexico;
| | - Angela Liliana Monroy-Díaz
- Programa de Bacteriología y Laboratorio Clínico, Facultad de Ciencias de la Salud-Universidad de Boyacá, Tunja 150003, Boyacá, Colombia;
| | | | - Héctor Reynaldo Triana-Reina
- Grupo GICAEDS, Programa de Cultura Física, Deporte y Recreación, Universidad Santo Tomás, Bogotá 110311, Colombia;
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21
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Belangero WD, Zublin CM, Martinez Siekavizza SN, Sánchez Rosenberg GF, Cardenas Quintero RA, Azi ML, Suarez Romero FA, Alvachian Fernandes HJ, Elguezabal IE, Badell G, Mouraria G, Kojima KE, Triana M, Prieto Mere JA, Malaret Baldo MJ, Mariolani JRL. Demographics and clinical features of humeral shaft fractures: The Latin American multicentre prospective study (HSF-LAMPS). J Orthop Surg (Hong Kong) 2020; 27:2309499019874506. [PMID: 31554467 DOI: 10.1177/2309499019874506] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To present transversal data (demographic and clinical) on isolated humeral shaft fractures (HSFs) in Latin American countries. METHODS Patients were enrolled between December 2015 and April 2017 at 11 medical institutions from six Latin America countries. INCLUSION CRITERIA Age ≥18 years and a closed, isolated 12A, 12B, or 12C fracture (Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) classification). The patients' demographic, comorbidity, and other baseline data were recorded. The outcome measures included the basal results of the research and the associations among the demographic factors, fracture features, and type of treatment applied. RESULTS A total of 123 patients were included. There was a preponderance of men (61.8%), whose mean age was significantly lower than that of the women (31.48 vs. 60.55). Overweight or obesity was present in 61.0% of women; 56.1% of patients were sedentary, 75.6% were nonsmokers, and 74.0% had no chronic disease. The type or treatment (operative/nonoperative) was not significantly associated with the patient's or fracture's characteristics. Falls and traffic accidents were the main causes of HSFs. Intramedullary nailing treatment was performed significantly more often in women, elderly patients, patients who did not participate in sports, and patients participating in only home activities. Minimally invasive plate osteosynthesis was performed significantly more frequently in men and in those who were self-employed. Open reduction internal fixation was performed significantly more often when the cause of the fracture was a traffic accident and when radial nerve palsy was present. CONCLUSION The demographics and etiological differences observed in comparison to the current literature show the importance of regional studies for both preventive measures and educational guidance.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Gerardo Badell
- Central of Medical Services of the State Insurance Bank, Montevideo, Uruguay
| | | | | | - Miguel Triana
- Children's Heart Foundation Cardiologic Institute and University Foundation of Health Sciences, Bogotá, Colombia
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Aminianfar A, Hassanzadeh Keshteli A, Esmaillzadeh A, Adibi P. Association between adherence to MIND diet and general and abdominal obesity: a cross-sectional study. Nutr J 2020; 19:15. [PMID: 32066452 PMCID: PMC7026971 DOI: 10.1186/s12937-020-00531-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 02/11/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Recently, a new eating pattern called as "Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND)" has been coined. Emerging studies are examining this dietary pattern with chronic conditions. We aimed to investigate the association between the MIND diet score and general and central obesity among adults. METHODS This cross-sectional study was conducted in a framework of the Study on the Epidemiology of Psychological Alimentary Health and Nutrition (SEPAHAN). Dietary information was collected using a validated self-administered 106-item Willett-format dish-based semi-quantitative food frequency questionnaire (DS-FFQ) in 6724 adults. Adherence to the MIND diet was examined based on components suggested in this eating pattern. Anthropometrics data were collected using a validated self-reported questionnaire. General obesity was defined as body mass index ≥30 kg/m2, and abdominal obesity as waist circumference > 102 cm for men and > 88 cm for women. RESULTS Mean age, BMI and WC in the study population was 36.8 ± 8.08 y, 24.9 ± 3.8 kg/m2 and 83.7 ± 16.02 cm, respectively. Overall, 9.5% of subjects were generally obese and 24.4 were abdominally obese. Examining the whole study population, we found no significant association between the MIND diet score and odds of general obesity, either before (ORs for comparing T3 vs. T1: 1.03; 95% CI: 0.83, 1.27; P-trend = 0.74) or after controlling for potential confounders (ORs for T3 vs. T1: 0.91; 95% CI: 0.67, 1.25; P-trend = 0.58). This was also the case for men and women when analyzed separately. We also failed to find any significant association between the MIND diet score and odds of abdominal obesity after controlling for potential confounders in the whole study population (ORs for T3 vs. T1: 1.00, 95% CI: 0.79, 1.27; P-trend = 0.87). However, women with the greatest adherence to the MIND diet were 19% less likely to be abdominally obese than those with the lowest adherence in crude model (OR = 0.81; 95% CIs: 0.67, 0.98; P-trend = 0.03). This association disappeared after controlling for potential confounders (OR = 0.87; 95% CIs: 0.66, 1.14; P-trend = 0.55). CONCLUSION No significant association was observed between adherence to the MIND diet and odds of general and central obesity.
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Affiliation(s)
- Azadeh Aminianfar
- Students' scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran
| | - Ammar Hassanzadeh Keshteli
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran.
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular -Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Food Security Research Center, Department of Community Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Peyman Adibi
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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23
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The food environment in Latin America: a systematic review with a focus on environments relevant to obesity and related chronic diseases. Public Health Nutr 2019; 22:3447-3464. [PMID: 31666140 DOI: 10.1017/s1368980019002891] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Food environments may be contributing to the rapid increase in obesity occurring in most Latin American (LA) countries. The present study reviews literature from LA that (i) describes the food environment and policies targeting the food environment (FEP); and (ii) analytic studies that investigate associations between the FEP and dietary behaviours, overweight/obesity and obesity related chronic diseases. We focus on six dimensions of the FEP: food retail, provision, labelling, marketing, price and composition. DESIGN Systematic literature review. Three databases (Web of Science, SciELO, LILACS) were searched, from 1 January 1999 up to July 2017. Two authors independently selected the studies. A narrative synthesis was used to summarize, integrate and interpret findings. SETTING Studies conducted in LA countries. PARTICIPANTS The search yielded 2695 articles of which eighty-four met inclusion criteria. RESULTS Most studies were descriptive and came from Brazil (61 %), followed by Mexico (18 %) and Guatemala (6 %). Studies were focused primarily on retail/provision (n 27), marketing (n 16) and labelling (n 15). Consistent associations between availability of fruit and vegetable markets and higher consumption of fruits and vegetables were found in cross-sectional studies. Health claims in food packaging were prevalent and mostly misleading. There was widespread use of marketing strategies for unhealthy foods aimed at children. Food prices were lower for processed relative to fresh foods. Some studies documented high sodium in industrially processed foods. CONCLUSIONS Gaps in knowledge remain regarding policy evaluations, longitudinal food retail studies, impacts of food price on diet and effects of digital marketing on diet/health.
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Schnettler B, Ares G, Sepúlveda N, Bravo S, Villalobos B, Hueche C, Adasme-Berríos C. How do consumers perceive reformulated foods after the implementation of nutritional warnings? Case study with frankfurters in Chile. Food Qual Prefer 2019. [DOI: 10.1016/j.foodqual.2019.01.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Children are the most naturally physically active human beings; reduced physical activity is a cardinal sign of childhood disease, and exercise testing provides mechanistic insights into health and disease that are often hidden when the child is at rest. The physical inactivity epidemic is leading to increased disease risk in children and, eventually, in adults in unprecedented ways. Cardiopulmonary exercise testing (CPET) biomarkers are used to assess disease severity, progress, and response to therapy across an expanding range of childhood diseases and conditions. There is mounting data that fitness in children tracks across the life span and may prove to be an early, modifiable indicator of cardiovascular disease risk later in life. Despite these factors, CPET has failed to fulfill its promise in child health research and clinical practice. A major barrier to more accurate and effective clinical use of CPET in children is that data analytics and testing protocols have failed to keep pace with enabling technologies and computing capacity. As a consequence, biomarkers of fitness and physical activity have yet to be widely incorporated into translational research and clinical practice in child health. In this review, the author re-examines some of the long-held assumptions that mold CPET in children. In particular, the author suggests that current testing strategies that rely predominantly on maximal exercise may, inadvertently, obfuscate novel and clinically useful insights that can be gleaned from more comprehensive data analytics. New pathways to discovery may emanate from the simple recognition that the physiological journey that human beings undertake in response to the challenge of exercise may be far more important than the elusive destination of maximal or peak effort.
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26
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Banna J. Obesity Prevention in Children in Latin America Through Interventions Using Technology. Am J Lifestyle Med 2019; 13:138-141. [PMID: 30800017 DOI: 10.1177/1559827618823320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The number of children in Latin America with overweight and obesity has increased markedly in recent years. However, interventions focused on prevention of childhood obesity are still in their infancy in Latin America. Leveraging the use of technology in children and adolescents to introduce or reinforce patterns of healthy eating and mobility in interventions is a priority. Though there is a low number of intervention studies focused on obesity prevention in Latin America, several studies using technology have been conducted. Further implementation of such programs as part of multilevel interventions will allow for continued prevention efforts to address increasing rates of overweight and obesity in this population.
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Affiliation(s)
- Jinan Banna
- College of Tropical Agriculture and Human Resources, Honolulu, Hawaii
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27
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Performance of Waist-To-Height Ratio, Waist Circumference, and Body Mass Index in Discriminating Cardio-Metabolic Risk Factors in a Sample of School-Aged Mexican Children. Nutrients 2018; 10:nu10121850. [PMID: 30513720 PMCID: PMC6316407 DOI: 10.3390/nu10121850] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 11/16/2018] [Accepted: 11/20/2018] [Indexed: 12/11/2022] Open
Abstract
The most common tools used to screen for abdominal obesity are waist circumference (WC) and waist-to-height ratio (WHtR); the latter may represent a more suitable tool for the general non-professional population. The objective of this study was to evaluate the association of WHtR, WC, and body mass index with lipidic and non-lipidic cardio-metabolic risk factors and the prediction capability of each adiposity indicator in a sample of school-aged Mexican children. Overall, 125 children aged 6 to 12 years were analyzed. Anthropometric, biochemical, and dietary parameters were assessed. Receiving operating characteristic (ROC) analysis and univariate and multivariate linear and logistic regression analyses were performed. All the three adiposity indicators showed significant areas under the ROC curve (AURC) greater than 0.68 for high low-density lipoprotein cholesterol (LDL-c), triglycerides, and atherogenic index of plasma, and low high-density lipoprotein cholesterol (HDL-c). A significant increased risk of having LDL-c ≥ 3.4 mmol/L was observed among children with WHtR ≥ 0.5 as compared to those with WHtR < 0.5 (odds ratio, OR: 2.82; 95% confidence interval, CI: 0.75–7.68; p = 0.003). Fasting plasma glucose was not associated with any of the adiposity parameters. WHtR performed similarly to WC and z-BMI in predicting lipidic cardio-metabolic risk factors; however, a WHtR ≥ 0.5 was superior in detecting an increased risk of elevated LDL-c.
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