Wilma B. Freire

• MS, PHD
• Research Director at Ministry of Heath

Background and Objectives While recognizing the acknowledged difference in dementia prevalence between Indigenous and non-Indigenous populations, most previous studies were conducted in the Global North. This study aims to examine the relationship between Indigenous ethnic identity and dementia status with a special focus on urban-rural differences...

In Ecuador, overweight and obesity (ow/ob) reach alarmingly high levels of prevalence in adult and adolescent population. Sedentary habits, loss of dietary diversity and consumption of ultra-processed foods (UPF) are among the identified factorsthat increase the prevalence of ow/ob, which are part of a phenomenon identified as nutritional transitio...

This manual was created to train the surveyors who will be in charge of applying the electronic versions of the “NOVA 27 UPF Categories Tracker” and the “24-hour reminder multi-step method” questionnaires.

This manual was created to assist in the online application of the “24-hour reminder multi-step method” survey and the “NOVA 27 UPF Categories Tracker”.

Overweight and obesity have reached alarming levels worldwide and they affect all age groups. Furthermore, according to the World Health Organization (1), overweight and obesity will continue to rise in the following decade. It is estimated that the population of children under the age of 5 will increase worldwide from 33.3 million in the year 2000...

Este manual fue elaborado para la capacitación de encuestadores que tendrá a cargo la aplicación de dos cuestionarios, en su respectivo formato electrónico el «Rastreador NOVA 27 categorías de UPF» y «24 horas recordatorio método multipasos».

Objetivo del manual para uso del «Atlas fotográfico de alimentos y bebidas estandarizadas» Este manual fue elaborado para apoyar a la aplicación virtual de la encuesta de «24 horas recordatorio método multipasos» y del «Rastreador NOVA de 27 categorías de UPF». Fuentes de información para la construcción del atlas Para la construcción del Atlas fot...

National-level survey data show that Galapagos has the highest rate of overweight and obesity of all Ecuadorian provinces. This phenomenon reflects trends observable nationally and globally, but also are the product of unique characteristics of the Galapagos population. Most importantly, nearly all food must be brought from the Ecuadorian mainland,...

Early and timely diagnosis of dementia has been recognized as key to improving health outcomes. However, underdiagnosis among the indigenous population has not been adequately investigated. This study examines the association between indigenous ethnic identity and receiving a diagnosis of dementia and identifies factors associated with receiving a...

Este documento presenta los resultados de la segunda evaluación cualitativa de percepciones, uso y comprensión del Reglamento Sanitario Sustitutivo de Etiquetado de Alimentos Procesados para el Consumo Humano por parte de los consumidores —tras siete años de haberse implementado el reglamento y seis años después de la primera evaluación— para deter...

This study aims to identify those populations that should be targeted by specific interventions. A cross-sectional design was utilized. Ordered logistic regression analysis was utilized to assess the association between ethnic identity and risk of malnutrition. Data were drawn from Ecuador’s Survey of Health, Welfare and Aging (SABE). The final sam...

Mientras aumenta el número y la proporción de adultos mayores como producto de la transición demográfica y epidemiológica, es cada vez más importante reconocer la heterogeneidad de este grupo. Los determinantes socioeconómicos de salud afectan a los adultos mayores de varias maneras, generando desigualdades socioeconómicas y de salud. Este estudio...

Background: Best practices in breastfeeding are often not followed despite appropriate levels of knowledge and positive attitudes regarding the benefits of human milk. For many reasons, some women do not initiate breastfeeding, suspend breastfeeding early, or initiate complementary feeding earlier than recommended. Usual measurement methods use la...

Background Best practices in breastfeeding are often not followed in spite of appropriate levels of knowledge and positive attitudes regarding the many benefits of human milk. For a variety of reasons, particular, women do not initiate breastfeeding, suspend breastfeeding early, or initiate complementary feeding earlier than recommended. This paper...

Background: Best practices in breastfeeding are often not followed despite appropriate levels of knowledge and positive attitudes regarding the benefits of human milk. For many reasons, some women do not initiate breastfeeding, suspend breastfeeding early, or initiate complementary feeding earlier than recommended. Usual measurement methods use lar...

Background: Best practices in breastfeeding are often not followed despite appropriate levels of knowledge and positive attitudes regarding the benefits of human milk. For many reasons, some women do not initiate breastfeeding, suspend breastfeeding early, or initiate complementary feeding earlier than recommended. Usual measurement methods use lar...

Objective To describe and quantify the magnitude and distribution of stunting, wasting, anaemia, overweight and obesity by wealth, level of education and ethnicity in Ecuador. Design We used nationally representative data from the 2012 Ecuadorian National Health and Nutrition Survey. We used the Multidimensional Poverty Index (MPI) as a proxy of w...

Background: In order to understand why rates of overweight and obesity are so high in the Ecuadorian province of Galapagos, this study analyzes changes in household food expenditures and perceptions and practices related to food consumption patterns. Galapagos is understood as an unusual but not unique case because conditions there graphically ill...

Background: The simultaneous presence of undernutrition and over-nutrition represents a paradox in global public health and is of increasing concern in Ecuador, where chronic malnutrition and overweight and obesity occur in the context of demographic and epidemiologic transitions. Two overlapping trends are present in Ecuador; while levels of stun...

Objective: To analyse patterns of knowledge, comprehension, attitudes and practices regarding the traffic light label placed on processed food packages to inform Ecuadorian consumers about levels of added fat, sugar and salt. Design: Twenty-one focus group discussions organized by age group, sex and place of residence. Interviews with representa...

In the past few years, ethical discussion on nutrition research, planning, and programme implementation has focused on the increasingly prominent role of corporate interests in shaping how long-standing and also emerging nutrition problems are addressed. Many health professionals have grave concerns regarding the influence of transnational corporat...

Background: Ecuador’s current nutrition policies have not taken adequate notice of the double burden of malnutrition and continue to focus on stunting and to a lesser extent on overweight, without addressing the simultaneous presence of undernutrition, micronutrient deficiencies, and overweight or obesity (OW/OB). Objective: The aim of this article...

Iron deficiency anemia is among the greatest nutritional problems in the world. Although its etiology is understood and intervention at low cost is available, the problem persists. The present review begins with a general estimate of the dimensions of the problem. It suggests the necessary elements for the design, implementation, and measurement of...

La anemia por deficiencia de hierro es uno de los problemas nutricionales de mayor magnitud en el mundo. A pesar de conocer su etiología y tener a disposición el conocimiento de cómo enfrentarla y de saber que las intervenciones son de bajo costo, aún no se ha podido superar este problema. Este documento parte de una estimación de la magnitud del p...

Iron deficiency anemia is one of the major micronutrient deficiencies in the world. Its etiology is well understood, and inexpensive solutions to the problem have been identified. Nevertheless, the problem persists. This paper estimates the magnitude of iron deficiency anemia and presents strategies suggested by the Pan American Health Organization...

Risk factors associated with the recall of a recent episode of acute respiratory infection (ARI) were evaluated in 1,553 Ecuadorian preschool children enrolled into a cross-sectional health and nutrition survey. In a univariate analysis, ARI recall was significantly higher in children living in low altitude regions (Relative Risk, RR = 2.4), in you...

The titers of serum antibodies to natural infection with enteric and respiratory pathogens, to a food antigen and to tetanus and diphtheria toxoid were evaluated by enzyme-linked immunosorbent assay in 1,554 Ecuadorian children younger than 5 years of age. The nutritional status of the children was assessed by anthropometry and measurement of bioch...

To propose a correction for the hemoglobin (Hb) increase induced by altitude-associated hypoxia. Part of a national study of nutrition and health of preschool children (0-59 months), based on a stratified, probabilistic, cluster sample. Coastal and Andean regions of Ecuador, comprising about 97% of the population, living at altitudes ranging from s...

Risk factors associated with diarrhoea, based on the recall of a recent episode were evaluated from a cross-sectional national nutrition and health study in 1,620 Ecuadorian children less than 5 years old. Prevalence of diarrhoea varied with the age of the children; 6- to 23-months-old children showed the highest prevalence. In this age range the p...

Between October 1985 and June 1986, a national vaccination campaign was launched in Ecuador. Between March and November 1986, 7798 Ecuadorian children <5 years old were enrolled in a representative health survey, According to their vaccination cards, 65% of children had a complete series of three doses of diphtheria-tetanus-pertussis (DTP) vaccinat...

The statistical association of rotavirus- and enterotoxigenic Escherichia coli-specific serum antibody with demographic and hygienic factors was tested in Ecuadorian children enrolled in a cross-sectional survey. In 7- to 10-month-old children, enterotoxigenic E. coli-specific antibody was associated (P less than 0.05) with poor drinking water qual...

beta-Lactoglobulin (BLG)-specific serum IgG antibody was measured by enzyme-linked immunosorbent assay in 1,392 serum samples from newborn to 5-year-old Ecuadorian children enrolled into a representative nutrition and health survey. At a 1:100 serum dilution, 62% of the children showed specific antibody (blank-corrected optical density greater than...

Serum samples from 1397 Ecuadorian children 0–5 years of age were tested by ELISA for antibodies to enterotoxigenic Escherichia coli (ETEC). A gradual prevalence and titer increase was seen for IgG antibodies to heat-labile enterotoxin in children 6–18 months old; 90% prevalences were reached in the second year of life. At this age <10% of West Ger...

The age-specific prevalence of antibody to rotavirus was studied in 1404 Ecuadorian children enrolled in a national nutrition and health survey. ELISA and neutralizing antibody analysis showed evidence for primary rotavirus infection in 6- to 12-month-old children, who showed also a more-than-threefold increase in significant diarrheal episodes in...

The use of hemoglobin as a predictor of response to iron therapy, for screening, and for prevalence estimates was studied. An Fe supplementation trial was performed in Quito, Ecuador, in which 412 pregnant women were randomly assigned to treatment and control groups. Women in the treatment group received 390 mg ferrous sulfate/d for 2 mo. The preva...