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Alsharif SN. High-Polyphenol Fruit and Vegetable Consumption and Cardiovascular Disease (CVD) Risk Factors Among Adults in Jeddah, Saudi Arabia. Cureus 2024; 16:e66863. [PMID: 39144417 PMCID: PMC11323877 DOI: 10.7759/cureus.66863] [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] [Accepted: 08/12/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Polyphenols found in food is a potential modifiable factor in disease prevention, especially when it comes to cardiovascular diseases (CVDs). This study aimed to determine the total polyphenol intake from fruits and vegetables (FV) in patients at King of Abdulaziz University Hospital, Jeddah, Saudi Arabia, and its association with vascular risk biomarkers. METHODS A cross-sectional study was done on 151 adult patients with at least one CVD risk factor. Data about demographics, smoking status, physical activity, height and weight, waist-to-hip ratio (WHR), waist circumference (WC), disease history, current disease (CD), and amount of polyphenol intake (mg/100 g) from rich polyphenol FV sources were collected. RESULTS Of the participants, 127 (84.1%) were females, 49 (32.5%) had an age ranging from 45 to 54 years, and 110 (72.8%) were married. Of them, 54 (35.8%) had a bachelor's education, and 64 (42.4%) were employed. Moreover, 89 (59.3%) were physically inactive, 18 (11.9%) were smokers, 105 (69.5%) were obese, 116 (76.9%) had high WC, and 103 (68.2%), 109 (72.2%), and 90 (59.6%) had a family history of diabetes mellitus (DM), hypertension (HTN), and hyperlipidemia, respectively. The mean total polyphenol consumption/gm was significantly higher among older and married participants, and patients with HTN had a significantly lower mean total polyphenol consumption/gm. A significant positive correlation was found between the total polyphenol consumption/gm and participants' age. CONCLUSION The consumption of polyphenols was associated with age, marital status, and blood pressure. Polyphenols from FV may have a preventive effect against cardiovascular illnesses. Including a range of foods high in polyphenols in a balanced diet is still a potential way to support cardiovascular health.
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Affiliation(s)
- Sarah N Alsharif
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, SAU
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2
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Soós R, Bakó C, Gyebrovszki Á, Gordos M, Csala D, Ádám Z, Wilhelm M. Nutritional Habits of Hungarian Older Adults. Nutrients 2024; 16:1203. [PMID: 38674893 PMCID: PMC11053580 DOI: 10.3390/nu16081203] [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] [Received: 03/25/2024] [Revised: 04/12/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
There are many nutritional changes that come with aging, mostly as consequences of health regression. Malnutrition and overweight often start with inadequate food consumption, followed by alterations in biochemical indices and body composition. In our study, we aimed to analyze the feeding habits and energy and nutrient intake of a Hungarian elderly population, focusing on macronutrient, water, fruit, and vegetable consumption while searching for possible nutritional factors leading to NCD and many other chronic diseases in this population. Two questionnaires were used. These were the Mini Nutritional Assessment (MNA) and one asking about nutritional habits, and a 3-day feeding diary was also filled. Subjects (n = 179, 111; females (F), 68 males (M), older than 50 years were recruited. Based on MNA results, 78 adults (43.57% of the studied population) were malnourished or at risk of malnutrition, although, according to BMI categories, 69% were overweight and 7.3% were obese among M, while 42.3% were overweight among F. The average daily meal number was diverse. The amount of people consuming fruit (11.7%) and vegetables (8.93%) several times a day was extremely low (15.3% of F and 4.4% of M). Daily fruit consumption in the whole sample was 79.3%. Overall, 36.3% consumed 1 L of liquid and 0.5 L of consumption was found in 15.1% of participants. A significant gender difference was found in water consumption, with F drinking more than M (p ≤ 0.01). In our sample, 27.93% of the respondents took dietary supplements. Further analysis and research are needed to explore the specific health implications of and reasons behind these findings.
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Affiliation(s)
- Rita Soós
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary;
| | - Csilla Bakó
- Institute of Sport Sciences and Physical Education, Faculty of Sciences, University of Pécs, 7624 Pécs, Hungary;
| | - Ádám Gyebrovszki
- Doctoral School of Biology and Sportbiology, Faculty of Sciences, University of Pécs, 7624 Pécs, Hungary; (Á.G.); (D.C.)
| | - Mónika Gordos
- Doctoral School of Biology and Sportbiology, Faculty of Sciences, University of Pécs, 7624 Pécs, Hungary; (Á.G.); (D.C.)
| | - Dávid Csala
- Doctoral School of Biology and Sportbiology, Faculty of Sciences, University of Pécs, 7624 Pécs, Hungary; (Á.G.); (D.C.)
| | - Zoltán Ádám
- Department of Pharmaceutical Biotechnology, Faculty of Pharmacy, University of Pécs, 7624 Pécs, Hungary;
- Wnt-Signaling Research Group, Szentagothai Research Center, University of Pécs, 7624 Pécs, Hungary
| | - Márta Wilhelm
- Institute of Sport Sciences and Physical Education, Faculty of Sciences, University of Pécs, 7624 Pécs, Hungary;
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3
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Leung T, Schoenmakers S, Willemsen S, van Rossem L, Dinnyes A, Rousian M, Steegers-Theunissen RP. The Effect of an eHealth Coaching Program (Smarter Pregnancy) on Attitudes and Practices Toward Periconception Lifestyle Behaviors in Women Attempting Pregnancy: Prospective Study. J Med Internet Res 2023; 25:e39321. [PMID: 36719733 PMCID: PMC9929732 DOI: 10.2196/39321] [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: 05/06/2022] [Revised: 10/03/2022] [Accepted: 11/25/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Lifestyle behaviors during the periconception period contribute to achievement of a successful pregnancy. Assessment of attitudes and practices toward these modifiable behaviors can aid in identifying gaps in unhealthy lifestyle behaviors with impact on intervention effectiveness. OBJECTIVE This study investigates the effectiveness of coaching by the eHealth program Smarter Pregnancy during the periconception period on improvement of attitudes and practices toward fruit and vegetable intake and smoking in women attempting pregnancy through assisted reproductive technology (ART) or natural conception. METHODS Women attempting pregnancy through ART (n=1060) or natural conception (n=631) were selected during the periconception period. The intervention groups, conceived through ART or naturally, received Smarter Pregnancy coaching for 24 weeks, whereas the control group conceived through ART and did not receive coaching. Attitudes and practices at baseline and follow-up periods were obtained from self-administered online questionnaire provided by the program. Attitudes were assessed in women with unhealthy behaviors as their intention to increase their fruit and vegetable intake and to quit smoking using a yes/no question. Outcomes on practices, suggesting effectiveness, included daily fruit (pieces) and vegetable (grams) intake, and if women smoked (yes/no). Changes in attitudes and practices were compared at 12 and 24 weeks with baseline between the ART intervention and ART control groups, and within the intervention groups between ART and natural conception. Changes in practices at 12 and 24 weeks were also compared with baseline between women with negative attitude and positive attitude within the intervention groups: ART and natural conception. Analysis was performed using linear and logistic regression models adjusted for maternal confounders and baseline attitudes and practices. RESULTS The ART intervention group showed higher vegetable intake and lower odds for negative attitudes toward vegetable intake after 12 weeks (βadj=25.72 g, P<.001; adjusted odds ratio [ORadj] 0.24, P<.001) and 24 weeks of coaching (βadj=23.84 g, P<.001; ORadj 0.28, P<.001) compared with ART controls. No statistically significant effect was observed on attitudes and practices toward fruit intake (12 weeks: P=.16 and .08, respectively; 24 weeks: P=.16 and .08, respectively) and smoking behavior (12 weeks: P=.87; 24 weeks: P=.92). No difference was observed for the studied attitudes and practices between the ART intervention and natural conception intervention groups. Women with persistent negative attitude toward fruit and vegetable intake at week 12 showed lower fruit and vegetable intake at week 24 compared with women with positive attitude (βadj=-.49, P<.001; βadj=-30.07, P<.001, respectively). CONCLUSIONS The eHealth Smarter Pregnancy program may improve vegetable intake-related attitudes and practices in women undergoing ART treatment. Women with no intention to increase fruit and vegetable intake had less improvement in their intakes. Despite small changes, this study demonstrates again that Smarter Pregnancy can be used to improve vegetable intake, which can complemented by blended care that combines face-to-face and online care to also improve fruit intake and smoking behavior.
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Affiliation(s)
| | - Sam Schoenmakers
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Sten Willemsen
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Lenie van Rossem
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Andras Dinnyes
- BioTalentum Ltd, Godollo, Hungary.,Department of Physiology and Animal Health, Institute of Physiology and Animal Nutrition, Hungarian University of Agriculture and Life Sciences, Godollo, Hungary
| | - Melek Rousian
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
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4
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Landais E, Miotto-Plessis M, Bene C, Maitre d’Hotel E, Truong MT, Somé JW, Verger EO. Consumption of food away from home in low- and middle-income countries: a systematic scoping review. Nutr Rev 2022; 81:727-754. [PMCID: PMC10170323 DOI: 10.1093/nutrit/nuac085] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
Context Consumption of food away from home represents an increasing share of people’s food consumption worldwide, although the percentage of food intake that is consumed away from home varies among countries and among individuals. Previous systematic reviews have reported that, overall, consumption away from home negatively affects an individual’s diet and nutritional status. However, these reviews have mainly focused on high-income countries, leaving a gap in knowledge and data for people in low- and middle-income countries (LMICs). Objective The present review aimed to describe trends in the consumption of food away from home in an apparently healthy population in low- and middle-income countries (LMICs) and to investigate any associations between this behavior and diet quality, nutritional status, and health outcomes. Data Sources A structured search strategy was developed for retrieving (from MEDLINE [via PubMed], Web of Science, and Scopus) peer-reviewed articles published in English from March 2011 until May 2021. Data Extraction Forty studies were included, and from them information was obtained based on data from 12 different countries. A qualitative and descriptive approach was used to review the evidence. Data Analysis It was found that there was large heterogeneity in the definition of food consumed away from home and the methods used to measure it, making comparisons and syntheses difficult. Consumption of food away from home in LMICs was relatively common and was positively driven by factors such as being a male, being young, having a high socio-economic status, being educated, and living in urban areas. As in high-income countries, consumption of food away from home in LMICs had unfavorable effects on an individual’s diet quality, nutritional status, and health. Conclusion There is a need to develop harmonized surveillance systems for better monitoring of the phenomenon of food consumption away from home in LMICs, including a need for a standardized definition for food consumed away from home, to enable the design of effective regulatory policies.
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Affiliation(s)
- Edwige Landais
- are with the MoISA, University of Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
| | - Mathilda Miotto-Plessis
- are with the MoISA, University of Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
| | - Chris Bene
- is with the International Center for Tropical Agriculture, Cali, Colombia
- is with the Wageningen Economic Research Group, Wageningen University, The Netherlands
| | - Elodie Maitre d’Hotel
- are with the MoISA, University of Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
- is with the CIRAD, UMR MOISA, Montpellier, France
| | - Mai Tuyet Truong
- is with the Nutrition-Network Department, National Institute of Nutrition, Hanoi, Vietnam
| | - Jérome W Somé
- is with the Département Biomédical et Santé Publique, Centre National de la Recherche Scientifique et Technologique, Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
| | - Eric O Verger
- are with the MoISA, University of Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
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Pradeilles R, Irache A, Wanjohi MN, Holdsworth M, Laar A, Zotor F, Tandoh A, Klomegah S, Graham F, Muthuri SK, Kimani-Murage EW, Coleman N, Green MA, Osei-Kwasi HA, Bohr M, Rousham EK, Asiki G, Akparibo R, Mensah K, Aryeetey R, Bricas N, Griffiths P. Urban physical food environments drive dietary behaviours in Ghana and Kenya: A photovoice study. Health Place 2021; 71:102647. [PMID: 34375838 PMCID: PMC8520917 DOI: 10.1016/j.healthplace.2021.102647] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 06/20/2021] [Accepted: 08/02/2021] [Indexed: 11/26/2022]
Abstract
We identified factors in the physical food environment that influence dietary behaviours among low-income dwellers in three African cities (Nairobi, Accra, Ho). We used Photovoice with 142 males/females (≥13 years). In the neighbourhood environment, poor hygiene, environmental sanitation, food contamination and adulteration were key concerns. Economic access was perceived as a major barrier to accessing nutritionally safe and healthy foods. Home gardening supplemented household nutritional needs, particularly in Nairobi. Policies to enhance food safety in neighbourhood environments are required. Home gardening, food pricing policies and social protection schemes could reduce financial barriers to safe and healthy diets.
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Affiliation(s)
- Rebecca Pradeilles
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom.
| | - Ana Irache
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Michelle Holdsworth
- IRD (French National Research Institute for Sustainable Development), NUTRIPASS Unit, Université de Montpellier-IRD, Montpellier, France
| | - Amos Laar
- University of Ghana, Department of Population, Family & Reproductive Health, School of Public Health, Accra, Ghana
| | - Francis Zotor
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Akua Tandoh
- University of Ghana, Department of Population, Family & Reproductive Health, School of Public Health, Accra, Ghana
| | - Senam Klomegah
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Fiona Graham
- Population Health Sciences Institute, Newcastle University, United Kingdom
| | | | | | - Nathaniel Coleman
- University of Ghana, Department of Population, Family & Reproductive Health, School of Public Health, Accra, Ghana; Department of Obstetrics and Gynaecology, University of Ghana Medical School, College of Health Sciences, Accra, Ghana
| | - Mark A Green
- Department of Geography and Planning, University of Liverpool, UK
| | | | - Marco Bohr
- School of Art & Design, Nottingham Trent University, UK
| | - Emily K Rousham
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
| | - Gershim Asiki
- African Population and Health Research Center, Nairobi, Kenya
| | - Robert Akparibo
- Public Health Section, School of Health and Related Research, University of Sheffield, United Kingdom
| | - Kobby Mensah
- Department of Marketing and Entrepreneurship, University of Ghana Business School, Accra, Ghana
| | - Richmond Aryeetey
- University of Ghana, Department of Population, Family & Reproductive Health, School of Public Health, Accra, Ghana
| | - Nicolas Bricas
- UMR MOISA, CIRAD- Agricultural Research & International Cooperation Organization, Montpellier, France
| | - Paula Griffiths
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
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6
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Amoutzopoulos B, Page P, Roberts C, Roe M, Cade J, Steer T, Baker R, Hawes T, Galloway C, Yu D, Almiron-Roig E. Portion size estimation in dietary assessment: a systematic review of existing tools, their strengths and limitations. Nutr Rev 2021; 78:885-900. [PMID: 31999347 DOI: 10.1093/nutrit/nuz107] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
CONTEXT Overestimation or underestimation of portion size leads to measurement error during dietary assessment. OBJECTIVE To identify portion size estimation elements (PSEEs) and evaluate their relative efficacy in relation to dietary assessment, and assess the quality of studies validating PSEEs. DATA SELECTION AND EXTRACTION Electronic databases, internet sites, and cross-references of published records were searched, generating 16 801 initial records, from which 334 records were reviewed and 542 PSEEs were identified, comprising 5% 1-dimensional tools (eg, food guides), 46% 2-dimensional tools (eg, photographic atlases), and 49% 3-dimensional tools (eg, household utensils). Out of 334 studies, 21 validated a PSEE (compared PSEE to actual food amounts) and 13 compared PSEEs with other PSEEs. CONCLUSION Quality assessment showed that only a few validation studies were of high quality. According to the findings of validation and comparison studies, food image-based PSEEs were more accurate than food models and household utensils. Key factors to consider when selecting a PSEE include efficiency of the PSEE and its applicability to targeted settings and populations.
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Affiliation(s)
- Birdem Amoutzopoulos
- MRC Elsie Widdowson Laboratory, Cambridge, UK.,NIHR BRC Diet, Anthropometry and Physical Activity Group, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Polly Page
- MRC Elsie Widdowson Laboratory, Cambridge, UK.,NIHR BRC Diet, Anthropometry and Physical Activity Group, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Caireen Roberts
- MRC Elsie Widdowson Laboratory, Cambridge, UK.,NIHR BRC Diet, Anthropometry and Physical Activity Group, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Mark Roe
- EuroFIR AISBL, Brussels, Belgium
| | - Janet Cade
- Nutritional Epidemiology Group, University of Leeds, Leeds, UK
| | - Toni Steer
- MRC Elsie Widdowson Laboratory, Cambridge, UK.,NIHR BRC Diet, Anthropometry and Physical Activity Group, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Ruby Baker
- MRC Elsie Widdowson Laboratory, Cambridge, UK
| | | | | | - Dove Yu
- MRC Elsie Widdowson Laboratory, Cambridge, UK
| | - Eva Almiron-Roig
- Centre for Nutrition Research, University of Navarra, Pamplona, Spain
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Arce S, Gugole Ottaviano F, Sosa M. Sensory acceptability, consumption frequency, and factors associated with consumption of fruits and vegetables among low and medium income consumers in Argentina. J SENS STUD 2020. [DOI: 10.1111/joss.12632] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Soledad Arce
- Instituto Superior Experimental de Tecnología Alimentaria (ISETA), Departamento de Evaluación Sensorial de Alimentos (DESA) Buenos Aires Argentina
- Comisión de Investigaciones Científicas de La Plata (CIC) Buenos Aires Argentina
| | - Fernanda Gugole Ottaviano
- Instituto Superior Experimental de Tecnología Alimentaria (ISETA), Departamento de Evaluación Sensorial de Alimentos (DESA) Buenos Aires Argentina
- Comisión de Investigaciones Científicas de La Plata (CIC) Buenos Aires Argentina
| | - Miriam Sosa
- Instituto Superior Experimental de Tecnología Alimentaria (ISETA), Departamento de Evaluación Sensorial de Alimentos (DESA) Buenos Aires Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) Buenos Aires Argentina
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Factors influencing dietary behaviours in urban food environments in Africa: a systematic mapping review. Public Health Nutr 2020; 23:2584-2601. [PMID: 32450938 PMCID: PMC7116038 DOI: 10.1017/s1368980019005305] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Objective: To identify factors influencing dietary behaviours in urban food environments in Africa and identify areas for future research. Design: We systematically reviewed published/grey literature (protocol CRD4201706893). Findings were compiled into a map using a socio-ecological model on four environmental levels: individual, social, physical and macro. Setting: Urban food environments in Africa. Participants: Studies involving adolescents and adults (11–70 years, male/female). Results: Thirty-nine studies were included (six adolescent, fifteen adolescent/adult combined and eighteen adult). Quantitative methods were most common (twenty-eight quantitative, nine qualitative and two mixed methods). Studies were from fifteen African countries. Seventy-seven factors influencing dietary behaviours were identified, with two-thirds at the individual level (45/77). Factors in the social (11/77), physical (12/77) and macro (9/77) environments were investigated less. Individual-level factors that specifically emerged for adolescents included self-esteem, body satisfaction, dieting, spoken language, school attendance, gender, body composition, pubertal development, BMI and fat mass. Studies involving adolescents investigated social environment-level factors more, for example, sharing food with friends. The physical food environment was more commonly explored in adults, for example, convenience/availability of food. Macro-level factors associated with dietary behaviours were food/drink advertising, religion and food prices. Factors associated with dietary behaviour were broadly similar for men and women. Conclusions: The dominance of studies exploring individual-level factors suggests a need for research to explore how social, physical and macro-level environments drive dietary behaviours of adolescents and adults in urban Africa. More studies are needed for adolescents and men, and studies widening the geographical scope to encompass all African countries.
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Kovalskys I, Rigotti A, Koletzko B, Fisberg M, Gómez G, Herrera-Cuenca M, Cortés Sanabria LY, Yépez García MC, Pareja RG, Zimberg IZ, Del Arco A, Zonis L, Previdelli AN, Guajardo V, Moreno LA, Fisberg R. Latin American consumption of major food groups: Results from the ELANS study. PLoS One 2019; 14:e0225101. [PMID: 31877144 PMCID: PMC6932811 DOI: 10.1371/journal.pone.0225101] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 10/29/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The Latin American (LA) region is still facing an ongoing epidemiological transition and shows a complex public health scenario regarding non-communicable diseases (NCDs). A healthy diet and consumption of specific food groups may decrease the risk of NCDs, however there is a lack of dietary intake data in LA countries. OBJECTIVE Provide updated data on the dietary intake of key science-based selected food groups related to NCDs risk in LA countries. DESIGN ELANS (Latin American Study of Nutrition and Health) is a multicenter cross-sectional study assessing food consumption from an urban sample between15 to 65 years old from 8 LA countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela). Two 24-HR were obtained from 9,218 individuals. The daily intake of 10 food groups related to NCDs risk (fruits; vegetables; legumes/beans; nuts and seeds; whole grains products; fish and seafood; yogurt; red meat; processed meats; sugar-sweetened beverages (ready-to-drink and homemade)) were assessed and compared to global recommendations. RESULTS Only 7.2% of the overall sample reached WHO's recommendation for fruits and vegetables consumption (400 grams per day). Regarding the dietary patterns related to a reduced risk of NCDs, among the overall sample legumes and fruits were the food groups with closer intake to the recommendation, although much lower than expected (13.1% and 11.5%, respectively). Less than 3.5% of the sample met the optimal consumption level of vegetables, nuts, whole grains, fish and yogurt. Largest country-dependent differences in average daily consumption were found for legumes, nuts, fish, and yogurt. Mean consumption of SSB showed large differences between countries. CONCLUSION Diet intake quality is deficient for nutrient-dense food groups, suggesting a higher risk for NCDs in the urban LA region in upcoming decades. These data provide relevant and up-to-date information to take urgent public health actions to improve consumption of critically foods in order to prevent NCDs.
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Affiliation(s)
- Irina Kovalskys
- Nutrition, Health and Wellbeing Area, International Life Science Institute (ILSI-Argentina), Buenos Aires, Argentina
- Pontifica Universidad Catolica Argentina Facultad de Medicina, Buenos Aires, Argentina
| | - Attilio Rigotti
- Departamento de Nutrición, Diabetes y Metabolismo, Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Berthold Koletzko
- Ludwig-Maximilians-Universität Munich, Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany
| | - Mauro Fisberg
- Instituto Pensi, Fundação Jose Luiz Egydio Setubal, Hospital Infantil Sabara, São Paulo, Brazil
- Departamento de Pediatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Georgina Gómez
- Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica
| | - Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES-UCV)/Fundación Bengoa, Caracas, Venezuela
| | | | | | | | - Ioná Zalcman Zimberg
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Ana Del Arco
- Departamento de Pediatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Luciana Zonis
- Nutrition, Health and Wellbeing Area, International Life Science Institute (ILSI-Argentina), Buenos Aires, Argentina
| | | | - Viviana Guajardo
- Nutrition, Health and Wellbeing Area, International Life Science Institute (ILSI-Argentina), Buenos Aires, Argentina
| | - Luis A. Moreno
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), University of Zaragoza, Zaragoza, Spain
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), University of Zaragoza, Zaragoza, Spain
| | - Regina Fisberg
- Departmento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil
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Abassi MM, Sassi S, El Ati J, Ben Gharbia H, Delpeuch F, Traissac P. Gender inequalities in diet quality and their socioeconomic patterning in a nutrition transition context in the Middle East and North Africa: a cross-sectional study in Tunisia. Nutr J 2019; 18:18. [PMID: 30898119 PMCID: PMC6427851 DOI: 10.1186/s12937-019-0442-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 03/04/2019] [Indexed: 12/13/2022] Open
Abstract
Background In a context of nutrition transition and major shifts in lifestyle and diet, the Middle East and North Africa features a marked gender excess adiposity gap detrimental to women. In this setting, where gender issues are especially acute, we investigated gender differences in dietary intake with a focus on diet quality, and how the differences varied with the area of residence and socio-demographic characteristics. Methods The study was conducted in 2009–2010 in the Greater Tunis region (Tunisia), as a case study of an advanced nutrition transition context in the region. A cross-sectional survey used a random, stratified, clustered sample of households: 1689 women and 930 men aged 20–49 years were analyzed. Dietary intake was assessed using a 3-day food record. Nutrient content was derived from a specific Tunisian food composition database. We analysed the Diet Quality Index-International (DQI-I) and sub-scores (variety, adequacy, moderation and balance). A score of DQI-I > 60 defined good diet quality. Inequality measures were women vs. men differences in means for interval variables and odds-ratios (OR) for DQI-I > 60. Their variation with socio-demographic characteristics was estimated using models featuring gender x covariate interactions. Results Mean energy intake/day was 2300 ± 15 kcal for women vs. 2859 ± 32 kcal for men. By 1000 g/kcal/d women consumed more fruits and sweets but less red meat and soft drinks than men. Women had a higher mean moderation sub-score than men (+ 1.8[1.4, 2.2], P < 0.0001) but lower variety (− 2.0[− 2.3, − 1.6], P < 0.0001) and adequacy (− 1.8[− 2.0, − 1.5], P < 0.0001). Thus, the overall mean DQI-I was lower among women than men (58.6 ± 0.3 vs. 60.4 ± 0.3, − 1.8[− 2.6, − 1.0], P < 0.0001) as was the proportion of DQI-I > 60 (45.2% vs. 55.7%, OR = 0.7[0.5, 0.8], P < 0.0001). Adjusted gender differences in DQI-I decreased with age but were higher in larger households and extreme categories of education (no-schooling and university) vs. the middle categories. Conclusion In this nutrition transition context with only average diet quality, it was somewhat lower for women. Socioeconomic patterning of gender contrasts was mild. Beyond, that women had lower adequacy and variety scores but better moderation is a possible pathway for gender specific prevention messages. Electronic supplementary material The online version of this article (10.1186/s12937-019-0442-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mohamed Mehdi Abassi
- Faculté des Sciences de Tunis, Université Tunis El Manar, 2092, Tunis, Tunisia.,INNTA (National Institute of Nutrition and Food Technology), SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research Laboratory, 11 rue Jebel Lakhdar, Bab Saadoun, Tunis, Tunisia
| | - Sonia Sassi
- Faculté des Sciences de Tunis, Université Tunis El Manar, 2092, Tunis, Tunisia.,INNTA (National Institute of Nutrition and Food Technology), SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research Laboratory, 11 rue Jebel Lakhdar, Bab Saadoun, Tunis, Tunisia
| | - Jalila El Ati
- INNTA (National Institute of Nutrition and Food Technology), SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research Laboratory, 11 rue Jebel Lakhdar, Bab Saadoun, Tunis, Tunisia
| | - Houda Ben Gharbia
- INNTA (National Institute of Nutrition and Food Technology), SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research Laboratory, 11 rue Jebel Lakhdar, Bab Saadoun, Tunis, Tunisia
| | - Francis Delpeuch
- IRD (French Research Institute for Sustainable Development), NUTRIPASS Unit, IRD - Université de Montpellier - SupAgro Montpellier, 911 avenue Agropolis, 34394, Montpellier, France
| | - Pierre Traissac
- IRD (French Research Institute for Sustainable Development), NUTRIPASS Unit, IRD - Université de Montpellier - SupAgro Montpellier, 911 avenue Agropolis, 34394, Montpellier, France.
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Abstract
Africa is currently experiencing rapid urbanisation impacting on people's food environments and dietary habits. Such changes are associated with higher prevalence of obesity coexisting with undernutrition. The present paper provides an overview of the healthiness of African urban food environments. We discuss the ways that food environments can be characterised and summarise the methods that can be used to investigate and intervene in the food environment. Data for Africa over a 50-year period (1961–2013) suggest an increasing availability of energy, animal products, fruit and vegetables, vegetable oils, sugar and sweeteners but a decrease in animal fats. There is a lack of evidence about how social, physical and macro-environments drive dietary habits in urban Africa, as most research has focused on the individual level. Examining how food consumption is embedded in everyday life, by investigating social environments is crucial to developing effective interventions. The informal food sector plays an important role in the retail food environment. Macro-level food price changes are an important factor influencing nutritional quality of African diets. The rapid expansion of food/beverages advertising in Africa threatens traditional food habits. Liberalisation of food trade is already impacting on the nutritional quality of food available. Improving African food environments represents a pressing public health concern and has the potential to prevent all forms of malnutrition. Hence, by conducting research into the role of urban social, physical and macro-environments, emerging interventions and policies are likely to positively impact on nutritional status, thereby enhancing social and economic development.
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Drivers of dietary behaviours in women living in urban Africa: a systematic mapping review. Public Health Nutr 2017; 20:2104-2113. [DOI: 10.1017/s1368980017000970] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveTo (i) systematically review the literature to determine the factors influencing diet and dietary behaviour in women living in urban Africa; (ii) present these in a visual map; and (iii) utilize this to identify potentially important areas for future research.DesignSystematic mapping review. The review protocol was registered at PROSPERO (http://www.crd.york.ac.uk/PROSPERO/; registration number CRD42015017749). Six databases were systematically searched, followed by reference and citation searching. Eligibility criteria included women aged 18–70 years living in urban Africa, any design/methodology, exploring any driver, using any measure of dietary behaviour. Quality appraisal occurred parallel with data extraction. Twelve predominantly cross-sectional quantitative studies were included; reported in seventeen publications. Determinants were synthesized narratively and compiled into a map adapted from an existing ecological model based on research in high-income countries.SettingUrban Africa.SubjectsAfrican women aged 18–70 years.ResultsDeterminants significantly associated with unhealthy dietary behaviour ranged from the individual to macro level, comprising negative body image perception, perceptions of insufficient food quantity and poorer quality, poorer food knowledge, skipping meals, snacking less, higher alcohol consumption, unhealthy overall lifestyle, older age, higher socio-economic status, having an education, lower household food expenditure, frequent eating outside the home and media influence. Marital status and strong cultural and religious beliefs were also identified as possible determinants.ConclusionsFew studies have investigated drivers of dietary behaviours in urban African settings. Predominantly individual-level factors were reported. Gaps in the literature identified a need for research into the neglected areas: social, physical and macro-level drivers of food choice.
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Mayén AL, Bovet P, Marti-Soler H, Viswanathan B, Gedeon J, Paccaud F, Marques-Vidal P, Stringhini S. Socioeconomic Differences in Dietary Patterns in an East African Country: Evidence from the Republic of Seychelles. PLoS One 2016; 11:e0155617. [PMID: 27214139 PMCID: PMC4877066 DOI: 10.1371/journal.pone.0155617] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 05/02/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND In high income countries, low socioeconomic status (SES) is related to unhealthier dietary patterns, while evidence on the social patterning of diet in low and middle income countries is scarce. OBJECTIVE In this study, we assess dietary patterns in the general population of a middle income country in the African region, the Republic of Seychelles, and examine their distribution according to educational level and income. METHODS Data was drawn from two independent national surveys conducted in the Seychelles among adults aged 25-64 years in 2004 (n = 1236) and 2013 (n = 1240). Dietary patterns were assessed by principal component analysis (PCA). Educational level and income were used as SES indicators. Data from both surveys were combined as no interaction was found between SES and year. RESULTS Three dietary patterns were identified: "snacks and drinks", "fruit and vegetables" and "fish and rice". No significant associations were found between SES and the "snacks and drinks" pattern. Low vs. high SES individuals had lower adherence to the "fruit and vegetables" pattern [prevalence ratio (95% CI) 0.71 (0.60-0.83)] but a higher adherence to the traditional "fish and rice" pattern [1.58 (1.32-1.88)]. Income modified the association between education and the "fish and rice" pattern (p = 0.02), whereby low income individuals had a higher adherence to this pattern in both educational groups. CONCLUSION Low SES individuals have a lower consumption of fruit and vegetables, but a higher consumption of traditional foods like fish and rice. The Seychelles may be at a degenerative diseases stage of the nutrition transition.
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Affiliation(s)
- Ana-Lucia Mayén
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland
| | - Pascal Bovet
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland
- * E-mail:
| | - Helena Marti-Soler
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland
| | | | - Jude Gedeon
- Ministry of Health, Victoria, Republic of Seychelles
| | - Fred Paccaud
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Silvia Stringhini
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland
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Socio-economic inequalities in diet and body weight: evidence, causes and intervention options. Public Health Nutr 2015; 18:759-63. [PMID: 25710706 DOI: 10.1017/s1368980015000233] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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