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Gómez O, Campusano C, Cerdas-P S, Mendoza B, Páez-Talero A, de la Peña-Rodríguez MP, Reza-Albarrán AA, Rueda-Plata PN. Clinical Practice Guidelines of the Latin American Federation of Endocrinology for the use of vitamin D in the maintenance of bone health: recommendations for the Latin American context. Arch Osteoporos 2024; 19:46. [PMID: 38850469 PMCID: PMC11162390 DOI: 10.1007/s11657-024-01398-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 05/01/2024] [Indexed: 06/10/2024]
Abstract
INTRODUCTION These guidelines aim to provide evidence-based recommendations for the supplementation of Vitamin D in maintaining bone health. An unmet need persists in Latin American regarding the availability of clinical and real-world data for rationalizing the use of vitamin D supplementation. The objective of these guidelines is to establish clear and practical recommendations for healthcare practitioners from Latin American countries to address Vitamin D insufficiency in clinical practice. METHODS The guidelines were developed according to the GRADE-ADOLOPMENT methodology for the adaptation or adoption of CPGs or evidence-based recommendations. A search for high quality CPGs was complemented through a comprehensive review of recent literature, including randomized controlled trials, observational studies, and systematic reviews evaluating the effects of Vitamin D supplementation on bone health. The evidence to decision framework proposed by the GRADE Working Group was implemented by a panel of experts in endocrinology, bone health, and clinical research. RESULTS The guidelines recommend Vitamin D supplementation for individuals aged 18 and above, considering various populations, including healthy adults, individuals with osteopenia, osteoporosis patients, and institutionalized older adults. These recommendations offer dosing regimens depending on an individualized treatment plan, and monitoring intervals of serum 25-hydroxyvitamin D levels and adjustments based on individual results. DISCUSSION The guidelines highlight the role of Vitamin D in bone health and propose a standardized approach for healthcare practitioners to address Vitamin D insufficiency across Latin America. The panel underscored the necessity for generating local data and stressed the importance of considering regional geography, social dynamics, and cultural specificities when implementing these guidelines.
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Affiliation(s)
- Oscar Gómez
- Department of Psychiatry and Mental Health, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia.
| | - Claudia Campusano
- Facultad de Medicina de La Universidad de los Andes, Unidad de Endocrinología de La Clínica Universidad de los Andes, Sociedad Chilena de Endocrinología y Diabetes (SOCHED), Santiago, Chile
| | - Sonia Cerdas-P
- Facultad de Medicina de la Universidad de Costa Rica, Servicio de Endocrinología del Hospital Cima San José, Asociación Costarricense de Endocrinología (ASCEND), San José, Costa Rica
| | - Beatriz Mendoza
- Clínica de Endocrinología y Metabolismo de La Facultad de Medicina de La República Oriental del Uruguay, Clínica de Endocrinología y Metabolismo del Hospital Manuel Quintela, Sociedad Uruguaya de Endocrinología y Metabolismo (SUEM), Montevideo, Uruguay
| | - Amanda Páez-Talero
- Asociación Colombiana de Endocrinología, Diabetes y Metabolismo (ACE), Bogotá, Colombia
| | - María Pilar de la Peña-Rodríguez
- Departamento de Endocrinología de La Facultad de Medicina de la Universidad Autónoma de Guadalajara (UAG), Presidenta Electa Para La Federación Latinoamericana de Endocrinología (FELAEN), Sociedad Mexicana de Nutrición y Endocrinología, Colegio Jalisciense de Endocrinología y Nutrición, Servicios Médicos De La Peña, SC, Guadalajara, México
| | - Alfredo Adolfo Reza-Albarrán
- Departamento de Endocrinología y Metabolismo del Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Universidad Nacional Autónoma de México, Sede Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Sociedad Mexicana de Nutrición y Endocrinología y Consejo Mexicano de Endocrinología, Ciudad de Mexico, México
| | - Pedro Nel Rueda-Plata
- Federación Latinoamericana de Endocrinología (FELAEN), Universidad Nacional de Colombia, Asociación Colombiana de Endocrinología, Diabetes y Metabolismo (ACE), Bogotá, Colombia
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Pfluger BA, Giunta A, Calvimontes DM, Lamb MM, Delgado-Zapata R, Ramakrishnan U, Ryan EP. Pilot Study of Heat-Stabilized Rice Bran Acceptability in Households of Rural Southwest Guatemala and Estimates of Fiber, Protein, and Micro-Nutrient Intakes among Mothers and Children. Nutrients 2024; 16:460. [PMID: 38337744 PMCID: PMC10856929 DOI: 10.3390/nu16030460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 02/01/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024] Open
Abstract
Nutrient-dense, acceptable foods are needed in low-resource settings. Rice bran, a global staple byproduct of white rice processing, is rich in amino acids, fibers, and vitamins, when compared to other cereal brans. This pilot study examines the nutritional contribution of rice bran to the daily diets of mother-child pairs in rural southwest Guatemala. Thirty households were screened. Mothers (≥18 years) and children (6 to 24 months) completed 24 h dietary recalls at baseline and after 12 weeks (endline) for diet intake and diversity analyses. During biweekly visits for 12 weeks, households with <5 members received 14 packets containing 60 g of heat-stabilized rice bran, and those with ≥5 members received 28 packets. The macro- and micro-nutrient contributions of rice bran and whole, cooked black beans were included in dietary simulation models with average intakes established between the recalls and for comparison with dietary reference intakes (DRIs). A baseline child food frequency questionnaire was administered. The 27 mothers and 23 children with complete recalls were included in analyses. Daily maternal consumption of 10 g/d of rice bran plus 100 g/d of black beans resulted in all achieving at least 50% of the fiber, protein, magnesium, niacin, potassium, and thiamin DRIs. Daily child consumption of 3 g/d of rice bran plus 10 g/d of black beans resulted in all achieving at least 50% of the magnesium, niacin, phosphorous, and thiamine DRIs. For 15/17 food categories, male children had a higher intake frequency, notably for animal-source foods and coffee. Dietary rice bran coupled with black beans could improve nutritional adequacy, especially for fiber and key micro-nutrients, with broader implications for addressing maternal and child malnutrition in low-resource settings.
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Affiliation(s)
- Brigitte A. Pfluger
- Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA 30322, USA;
| | - Alexis Giunta
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO 80523, USA;
| | - Diva M. Calvimontes
- Center for Human Development, Fundacion para la Salud Integral de los Guatemaltecos, FUNSALUD, Coatepeque 09020, Quetzaltenango, Guatemala;
- Departament of Pediatrics, Center for Global Health, University of Colorado, Aurora, CO 80045, USA
- Center for Global Health, Colorado School of Public Health, Aurora, CO 80045, USA; (M.M.L.); (R.D.-Z.)
| | - Molly M. Lamb
- Center for Global Health, Colorado School of Public Health, Aurora, CO 80045, USA; (M.M.L.); (R.D.-Z.)
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO 80045, USA
| | - Roberto Delgado-Zapata
- Center for Global Health, Colorado School of Public Health, Aurora, CO 80045, USA; (M.M.L.); (R.D.-Z.)
- Department of Community & Behavioral Health, Colorado School of Public Health, Aurora, CO 80045, USA
| | - Usha Ramakrishnan
- Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA 30322, USA;
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Elizabeth P. Ryan
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523, USA
- Colorado School of Public Health, Colorado State University, Fort Collins, CO 80523, USA
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Monge-Rojas R, Vargas-Quesada R, Marrón-Ponce JA, Sánchez-Pimienta TG, Batis C, Rodríguez-Ramírez S. Exploring Differences in Dietary Diversity and Micronutrient Adequacy between Costa Rican and Mexican Adolescents. CHILDREN (BASEL, SWITZERLAND) 2024; 11:64. [PMID: 38255378 PMCID: PMC10814227 DOI: 10.3390/children11010064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 01/24/2024]
Abstract
Diet diversity becomes especially relevant during adolescence to satisfy the adequate micronutrient intake. Diet diversity (DD) and micronutrient probability of adequacy (PA) were studied in 818 Costa Rican (CR) and 1202 Mexican (MX) adolescents aged 13-18 years. DD was compared using the Minimum Dietary Diversity (MDD) score. Receiver-operating characteristic (ROC) curves were employed to identify the optimal MDD for each sample from the respective countries. The mean MDD for the overall CR sample was 4.17 ± 1.43 points, and for the MX sample, the mean MDD was 4.68 ± 1.48 points. The proportion of adolescents with a DD was significantly higher in Costa Rica than in Mexico (66.5% vs. 55.6%; p < 0.0001). Also, DD was higher in rural Costa Rican adolescents, while no difference was found in the MX adolescents by area of residence. CR adolescents reported significantly higher PA than MX participants for 6 of the 11 micronutrients assessed. The calcium PA in MX adolescents was significantly higher than in the CR sample (MX: 0.84 vs. CR: 0.03; p < 0.0001), while low PA was obtained for iron in both countries (CR: 0.01 vs. MX: 0.07; p < 0.0001). In Costa Rica and Mexico, nutritional interventions and assessing the compliance of food-fortifying programs are needed to improve the PA of diverse micronutrients.
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Affiliation(s)
- Rafael Monge-Rojas
- Nutrition and Health Unit, Costa Rican Institute for Research and Education on Nutrition and Health (INCIENSA), Ministry of Health, Tres Ríos 4-2250, Costa Rica;
| | - Rulamán Vargas-Quesada
- Nutrition and Health Unit, Costa Rican Institute for Research and Education on Nutrition and Health (INCIENSA), Ministry of Health, Tres Ríos 4-2250, Costa Rica;
| | - Joaquín Alejandro Marrón-Ponce
- Nutrition and Health Research Center (CINyS), National Institute of Public Health, Mexico (INSP), Cuernavaca 62100, Mexico; (J.A.M.-P.); (C.B.); (S.R.-R.)
| | - Tania G. Sánchez-Pimienta
- CONAHCYT, Nutrition and Health Research Center (CINyS), National Institute of Public Health, Mexico (INSP), Cuernavaca 62100, Mexico
| | - Carolina Batis
- Nutrition and Health Research Center (CINyS), National Institute of Public Health, Mexico (INSP), Cuernavaca 62100, Mexico; (J.A.M.-P.); (C.B.); (S.R.-R.)
| | - Sonia Rodríguez-Ramírez
- Nutrition and Health Research Center (CINyS), National Institute of Public Health, Mexico (INSP), Cuernavaca 62100, Mexico; (J.A.M.-P.); (C.B.); (S.R.-R.)
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Monge-Rojas R, Vargas-Quesada R, Previdelli AN, Kovalskys I, Herrera-Cuenca M, Cortés LY, García MCY, Liria-Domínguez R, Rigotti A, Fisberg RM, Ferrari G, Fisberg M, Gómez G. A Landscape of Micronutrient Dietary Intake by 15- to 65-Years-Old Urban Population in 8 Latin American Countries: Results From the Latin American Study of Health and Nutrition. Food Nutr Bull 2023:3795721231215267. [PMID: 38112070 DOI: 10.1177/03795721231215267] [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: 12/20/2023]
Abstract
BACKGROUND Latin American countries have shifted from traditional diets rich in micronutrients to a Westernized diet rich in high energy-dense foods and low in micronutrients. OBJECTIVE This study aimed to determine the prevalence of adequate micronutrient intakes in urban populations of 8 Latin American countries. METHOD Micronutrient dietary intake data were collected from September 2014 to August 2015 from 9216 men and women aged 15.0 to 65.0 years living in urban populations of 8 Latin American countries. Dietary intake was collected using two 24-hour recalls on nonconsecutive days. Micronutrient adequacy of intake was calculated using the Estimated Average Requirement cut-off method. RESULTS In general terms, the prevalence of inadequate intake of thiamine, riboflavin, niacin, folate, cobalamin, iron, phosphorus, copper, and selenium ranged from 0.4% to 9.9%. In contrast, the prevalence of inadequacy of pyridoxine, zinc, vitamin C, and vitamin A ranged from 15.7% to 51.5%. The nutrients with a critical prevalence of inadequacy were magnesium (80.5%), calcium (85.7%), and vitamin D (98.2%). The highest prevalence of inadequate intakes was observed in the low educational level, participants with overweight/obesity, in men, and varies according to socioeconomic status. CONCLUSIONS There is an urgent need to define direct regional actions and strategies in Latin America aimed at improving micronutrient adequacy, either through staple food fortification programs, agronomic biofortification, or food policies that facilitate economic access to micronutrient-rich foods.
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Affiliation(s)
- Rafael Monge-Rojas
- Costa Rican Institute for Research and Education on Nutrition and Health (INCIENSA), Tres Ríos, Cartago, Costa Rica
| | - Rulamán Vargas-Quesada
- Costa Rican Institute for Research and Education on Nutrition and Health (INCIENSA), Tres Ríos, Cartago, Costa Rica
| | | | - Irina Kovalskys
- Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
| | - Marianella Herrera-Cuenca
- Universidad Central de Venezuela, Caracas, Venezuela
- Framingham State University, Framingham, MA, USA
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Neves ACM, de Menezes Junior LAA, Canuto R, Bruno TCV, Carvalho de Menezes M, de Deus Mendonça R, Meireles AL, Carraro JCC. Racial disparities in lifestyle habits and dietary patterns in university students during the COVID-19 pandemic. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023:1-11. [PMID: 37361280 PMCID: PMC10249555 DOI: 10.1007/s10389-023-01946-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/11/2023] [Indexed: 06/28/2023]
Abstract
Objectives To evaluate lifestyle habits and dietary patterns among university students during the COVID-19 pandemic and their association with skin color. Methods This cross-sectional study was conducted with 1315 undergraduate students from a public higher education institution. Sociodemographic characteristics, lifestyle habits, and food consumption were collected. Factor analysis was used to identify dietary patterns and multivariate logistic regression was conducted to estimate the associations between race/skin color and outcomes. Results Black individuals were less likely to show behaviors associated with the use of cigarettes or tobacco products (OR = 0.61; 95% CI 0.42-0.89). However, black individuals with higher income (greater than, or equal to one minimum wage per person) were less likely to show behaviors associated with illicit drug use (OR = 0.54; 95% CI 0.31-0.96), use of cigarettes or tobacco products (OR = 0.46; 95% CI 0.24-0.87) and alcohol consumption (OR = 0.64; CI 95% 0.42-0.98). In addition, individuals of race/skin color black with lower income (less than one minimum wage per person) showed decreased consumption of vegetables (OR = 0.68; CI 95% 0.48-0.96). Conclusions Black college students with higher income were less likely to show undesirable behaviors related to the use of psychoactive substances. In contrast, individuals with lower income had lower consumption of foods from the vegetable group, which can be considered an unfavorable health-related behavior.
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Affiliation(s)
- Ana Cláudia Morito Neves
- Postgraduate Program in Health and Nutrition, School of Nutrition, Universidade Federal de Ouro Preto (UFOP), University Campus, s/n - Morro do Cruzeiro., Ouro Preto, MG CEP 35400-000 Brazil
| | - Luiz Antônio Alves de Menezes Junior
- Postgraduate Program in Health and Nutrition, School of Nutrition, Universidade Federal de Ouro Preto (UFOP), University Campus, s/n - Morro do Cruzeiro., Ouro Preto, MG CEP 35400-000 Brazil
| | - Raquel Canuto
- Department of Nutrition and coordinator of the Program in Food, Nutrition and Health, Faculty of Medicine, Universidade Federal Do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul Brazil
| | - Thaís Calcagno Vidon Bruno
- Postgraduate Program in Health and Nutrition, School of Nutrition, Universidade Federal de Ouro Preto (UFOP), University Campus, s/n - Morro do Cruzeiro., Ouro Preto, MG CEP 35400-000 Brazil
| | - Mariana Carvalho de Menezes
- Department of Clinical and Social Nutrition, School of Nutrition, Universidade Federal de Ouro Preto (UFOP), Ouro Preto, MG Brazil
| | - Raquel de Deus Mendonça
- Department of Clinical and Social Nutrition, School of Nutrition, Universidade Federal de Ouro Preto (UFOP), Ouro Preto, MG Brazil
| | - Adriana Lúcia Meireles
- Department of Clinical and Social Nutrition, School of Nutrition, Universidade Federal de Ouro Preto (UFOP), Ouro Preto, MG Brazil
| | - Júlia Cristina Cardoso Carraro
- Department of Clinical and Social Nutrition, School of Nutrition, Universidade Federal de Ouro Preto (UFOP), Ouro Preto, MG Brazil
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Barco Leme AC, Laila A, Hou S, Fisberg RM, Ma DWL, Fisberg M, Haines J. Perceptions of the 2019 Canada's Food Guide: a qualitative study with parents from Southwestern Ontario. Appl Physiol Nutr Metab 2021; 47:1-7. [PMID: 34411486 DOI: 10.1139/apnm-2021-0414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In January 2019, Health Canada released a revised Canada's Food Guide (CFG). This study aimed to understand the perceptions of the 2019 CFG among Canadian parents with children aged 2-12 years. From October 2019-January 2020, 8 focus groups with parents from Southwestern Ontario were conducted using a semi-structured interview script focused on understanding perceptions of the 2019 CFG. A hybrid thematic approach with inductive and deductive analyses was used. Forty parents (72.5% mothers, 77.5% white) with diverse levels of education and income participated. Most parents were aware of the 2019 CFG. Positive perceptions of the 2019 CFG were that the guide was visually appealing and less biased from the food industry compared with previous guides. Parents also reported that the focus on eating behaviours could support healthy eating among their families. Negative perceptions included insufficient information about plant-based proteins, removal of milk and alternatives food group, and lack of representation of various cultures in the guide. Challenges to following the CFG recommendations, including time constraints and limited knowledge regarding how to identify and prepare plant-based proteins, were discussed. Parent perceptions of the CFG can help inform public health policies and behavioural-change strategies designed to support adherence to the 2019 CFG recommendations. Novelty: Awareness of the 2019 Canada's Food Guide (CFG) was high. Parents identified that the 2019 CFG was visually appealing and less biased from the food industry. Concerns about the recommendations of plant-based proteins, "exclusion" of dairies, and lack of cultural representation.
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Affiliation(s)
- Ana Carolina Barco Leme
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada
- Center of Excellence in Nutrition and Feeding Difficulties, PENSI Institute/Sabará Children's Hospital, São Paulo, 01228-200, Brazil
| | - Amar Laila
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - Sophia Hou
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - Regina Mara Fisberg
- Departament of Nutrition, School of Public Health, University of São Paulo, São Paulo, 01246-904, Brazil
| | - David W L Ma
- Department of Human Health and Nutrition Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - Mauro Fisberg
- Center of Excellence in Nutrition and Feeding Difficulties, PENSI Institute/Sabará Children's Hospital, São Paulo, 01228-200, Brazil
| | - Jess Haines
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada
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Socioeconomic Status Impact on Diet Quality and Body Mass Index in Eight Latin American Countries: ELANS Study Results. Nutrients 2021; 13:nu13072404. [PMID: 34371915 PMCID: PMC8308629 DOI: 10.3390/nu13072404] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 12/21/2022] Open
Abstract
Poor health and diet quality are associated with living within a low socioeconomic status (SES). This study aimed to investigate the impact of SES on diet quality and body mass index in Latin America. Data from the "Latin American Health and Nutrition Study (ELANS)", a multi-country, population-based study of 9218 participants, were used. Dietary intake was collected through two 24 h recalls from participants of Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela. Diet quality was assessed using the dietary quality score (DQS), the dietary diversity score (DDS) and the nutrients adequacy ratio (NAR). Chi-squared and multivariate-variance analyses were used to estimate possible associations. We found that participants from the low SES consumed less fruits, vegetables, whole grains, fiber and fish and seafood and more legumes than those in the high SES. Also, the diet quality level, assessed by DQS, DDS and NAR mean, increased with SES. Women in the low SES also showed a larger prevalence of abdominal obesity and excess weight than those in the middle and high SES. Health policies and behavioral-change strategies should be addressed to reduce the impact of socioeconomic factors on diet quality and body weight, with gender as an additional level of vulnerability.
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