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Guias Alimentarias Basadas en Alimentos del Ecuador
Abstract
La información presentada en este capítulo corresponde al diagnóstico de la situación
alimentaria y nutricional del país desde varias aristas: 1) el contexto socioeconómico,
2) el perfil epidemiológico nutricional de la población, 3) la soberanía alimentaria y
patrimonio alimentario; y, finalmente, 4) el estado de la seguridad alimentaria y sus
componentes.
En síntesis, este diagnóstico recoge los principales aspectos de los sistemas alimentarios del Ecuador que resultan en la construcción de las Guías Alimentarias Basadas en Alimentos (GABA), como un instrumento edu-comunicacional, sencillo y útil, que guie el comportamiento alimentario, individual, familiar y comunitario.
Contents:
1. Envejecimiento en el Ecuador: la confluencia de tres transiciones I. Aspectos Metodológicos y Conceptuales 2. Situación ecuatoriana 3. Propuesta de la encuesta SABE 4. Metodología 5. Construcción de categorías de índice de condiciones sociales II. Características Generales del País 6. Transformaciones en la estructura demográfica 7. Transición epidemiológica 8. El sistema de salud III. Resultados 9. Características demográficas y socioeconómicas IV. Características de hogar/familia y de las redes sociales 10. Construcción de datos sobre transferencias familiares y comunitarias y redes sociales 11. Características de las redes sociales V. Estado general de salud VI. Estilos de vida y nutrición VII. Limitaciones funcionales VIII. Uso y acceso a servicio de salud 12. Acceso a seguro de salud 13. Uso ambulatorio de servicios 14. Uso de hospitales 15. Accesibilidad a servicios de salud 16. Uso y accesos a medicamentos y hospitales 17. Costos de los servicios IX. Maltrato y violencia 18. Factores de riesgo y consecuencia.
Background
Approximately 20%–25% of the world adult population and nearly 30% of Indians have metabolic syndrome disorder. Our objective was designed to find out the association between important nutrients and potential lifestyle risk factors such as diet, physical inactivity, and smoking and alcohol consumption with the number of metabolic syndrome components.
Methods
This was a cross-sectional study. A total of 205 patients of metabolic syndrome were enrolled for this study. Diagnosis of metabolic syndrome was done on the basis of National Cholesterol Education Program Adult Treatment Panel III criteria (NCEP ATP III 2004). Dietary data were collected with the validated food frequency questionnaire and 24 h dietary recall method, and the nutrient intake was calculated with the specially designed software.
Results
Unhealthy dietary habits were seen more among the participants who had more than 3 risk factors. Results showed the odds of taking >5 times junk foods was 3 times higher (odds ratio [OR]: 2.97; 95% confidence interval [CI]: 1.61–5.47), and sweet dishes was 2.3 times higher (OR: 2.33; 95% CI: 1.28–4.24) among the participants who had 4–5 risk factors. However, milk and dairy products > 4 servings/day (OR: 0.54; 95% CI: 0.175–1.67) and pulses and legumes more than 2 servings/day (OR: 0.57; 95% CI: 0.25–1.29) was protective against hypertension. Mean carbohydrate, saturated fat, and sodium intake was significantly higher in the participants who had 4–5 metabolic risk factors compared to 3 risk factors (P < 0.0001).
Conclusions
It was concluded that low intake of fruits, vegetables, and higher intake of flesh food and inadequate physical activity significantly associated with the metabolic syndrome risk factors.
Obesity and cardiovascular disease (CVD) risk are public health concerns in adolescents, yet few studies have examined the association of their diet to CVD risk factors. This study investigated associations between diet, body mass index (BMI), waist circumference (WC), blood pressure (BP), and blood lipids in 163 16-17 year olds. Diet recall data were converted into Healthy Eating Index-2010 (HEI) to assess diet quality. Differences in diet between groups with normal or obese BMI, normal or hypertensive BP, and normal or altered lipids were determined. Associations between diet and BMI, WC, BP, and lipids, controlling for race, gender, and socioeconomic status, were examined. Mean HEI was 49.2 (±12.0), with no differences observed between groups. HEI was not associated with any CVD risk. Sweetened beverage consumption was higher in obese adolescents, and positively related to total cholesterol (TC). Fruit intake was negatively related to BMI and diastolic BP. Total vegetable intake was negatively related to systolic BP. Greens and beans were negatively related to TC and LDL. Whole grains were negatively related to HDL. This research suggests a cardioprotective effect of diets rich in fruits and vegetables, as well as low in sweetened beverages in adolescents.
(1) Background: Dietary fiber intake may provide beneficial effects on the components of metabolic syndrome (MetS); however, observational studies reported inconsistent results for the relationship between dietary fiber intake and MetS risk. We conducted a meta-analysis to quantify previous observational studies and a narrative review to summarize mechanisms involved in the potential relationship. (2) Methods: The literature was searched on PubMed and Web of Science until 28 November 2017. A random-effects model was used to calculate the summary risk estimates. Eleven cross-sectional studies and three cohort studies were included in the meta-analysis. Results from the original studies were reported as odds ratios (ORs) or relative ratios (RRs) of the MetS associated with different levels of dietary fiber intake, and the ORs/RRs comparing the highest with lowest categories of the intake were pooled. (3) Results: For the cross-sectional studies, the pooled OR was 0.70 (95% confidence interval (CI): 0.61–0.82) with evidence of high heterogeneity (I2 = 74.4%, p < 0.001) and publication bias (p for Egger’s test < 0.001). After removing four studies, results remained significant (OR = 0.67, 95% CI: 0.58–0.78) and the heterogeneity was largely reduced (I2 = 32.4%, p = 0.181). For the cohort studies, the pooled RR was 0.86 (95% CI: 0.70–1.06). (4) Conclusion: Although the meta-analysis suggests an inverse association between dietary fiber intake and risk of MetS, and the association was supported by a wide range of mechanism studies, the findings are limited by insufficient cohort data. More prospective studies are needed to further verify the association between dietary fiber intake and the risk of MetS.
Background/Objective
Our study aimed to assess the effects of physical activity interventions via standing banners (point-of-decision prompt) and aerobics classes to promote physical activity among individuals with metabolic syndrome.
Methods
We conducted a cluster randomized controlled intervention trial (16-week intervention and 8-week follow-up). Malaysian government employees in Putrajaya, Malaysia, with metabolic syndrome were randomly assigned by cluster to a point-of-decision prompt group (n = 44), an aerobics group (n = 42) or a control group (n = 103) based on sample size calculation formula. Step counts were evaluated by Lifecorder e-STEP accelerometers for all participants. Metabolic syndrome was defined according to the ‘harmonizing’ definition, in which individuals who have at least three of the five metabolic risk factors (waist circumference, high-density lipoprotein cholesterol, triglycerides, fasting glucose levels, systolic and diastolic blood pressure) will be classified as having metabolic syndrome. A total of 80% of the enrolled government employees with metabolic syndrome completed the programme. Data were analyzed using SPSS for Windows (version 20, SPSS, Chicago, IL).
Results
There were significantly higher step counts on average in the aerobics group compared to the control group over assessments. Assessments at baseline, post-intervention and follow-up showed a significant difference in step counts between the intervention and control groups. The greatest reductions in the proportions of individuals with metabolic syndrome were observed in the aerobics group with a reduction of 79.4% in the post-intervention assessment compared to the assessment at baseline.
Conclusion
The findings of this study suggest that physical activity intervention via aerobics classes is an effective strategy for improving step counts and reducing the prevalence of metabolic syndrome.
In the last decades, the development of new technologies applied to lipidomics has revitalized the analysis of lipid profile alterations and the understanding of the underlying molecular mechanisms of lipid metabolism, together with their involvement in the occurrence of human disease. Of particular interest is the study of omega-3 and omega-6 long chain polyunsaturated fatty acids (LC-PUFAs), notably EPA (eicosapentaenoic acid, 20:5n-3), DHA (docosahexaenoic acid, 22:6n-3), and ARA (arachidonic acid, 20:4n-6), and their transformation into bioactive lipid mediators. In this sense, new families of PUFA-derived lipid mediators, including resolvins derived from EPA and DHA, and protectins and maresins derived from DHA, are being increasingly investigated because of their active role in the "return to homeostasis" process and resolution of inflammation. Recent findings reviewed in the present study highlight that the omega-6 fatty acid ARA appears increased, and omega-3 EPA and DHA decreased in most cancer tissues compared to normal ones, and that increments in omega-3 LC-PUFAs consumption and an omega-6/omega-3 ratio of 2-4:1, are associated with a reduced risk of breast, prostate, colon and renal cancers. Along with their lipid-lowering properties, omega-3 LC-PUFAs also exert cardioprotective functions, such as reducing platelet aggregation and inflammation, and controlling the presence of DHA in our body, especially in our liver and brain, which is crucial for optimal brain functionality. Considering that DHA is the principal omega-3 FA in cortical gray matter, the importance of DHA intake and its derived lipid mediators have been recently reported in patients with major depressive and bipolar disorders, Alzheimer disease, Parkinson's disease, and amyotrophic lateral sclerosis. The present study reviews the relationships between major diseases occurring today in the Western world and LC-PUFAs. More specifically this review focuses on the dietary omega-3 LC-PUFAs and the omega-6/omega-3 balance, in a wide range of inflammation disorders, including autoimmune diseases. This review suggests that the current recommendations of consumption and/or supplementation of omega-3 FAs are specific to particular groups of age and physiological status, and still need more fine tuning for overall human health and well being.
Background and objectives:
The association between fruit and vegetable (FV) intake and risk of the metabolic syndrome (MetS) has not been elucidated fully, particularly by menopausal status. Method and Study Design: The study population was 2,999 women aged 40-64 years participating in the 4th Korea National Health and Nutrition Examination Survey. The definition of MetS and its components was based on the modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) for Koreans. Dietary data were assessed by a 24-hour recall.
Results:
Fruit intake was inversely related only to the risk of high blood pressure (BP), but not MetS. Total vegetable consumption was inversely associated with the MetS risk, and when combined with fruits, the inverse association was observed even in its features of high triglycerides (TG) and low HDLcholesterol as well as MetS. Assessing women by menopausal status revealed that the inverse association with the MetS risk was found only in postmenopausal women having greater total vegetables and total FV intake (aOR=0.47, 95% CI=0.29-0.75, p-trend=0.003 and aOR=0.54, 95% CI=0.35-0.85, p-trend=0.007, respectively). Analysis regarding MetS features showed that while the inverse association of total vegetables or total FV intake was observed with high TG risk in postmenopausal women, fruits intake was inversely associated with high BP risk in premenopausal women (aOR=0.54, 95% CI=0.37-0.79, p-trend=0.004).
Conclusion:
Results suggest that while fruit intake was inversely associated with high BP in premenopausal women, greater dietary intake of vegetables and total FV may protect against the risk of MetS, particularly in postmenopausal women.
Objective:
The objectives of this study were to determine the efficacy of a current physical therapy and weight loss program model on exercise performance, physical function, and cardiometabolic risk factors in obese patients.
Design:
Retrospective pre-post design.
Subjects:
A total of 192 patients who previously underwent testing of anthropometric measurements, cardiovascular biomarkers, and lower extremity function scale (LEFS) were included.
Results:
There was a significant reduction in body weight [5.91 ± 3.47 (95% CI, 5.4 to 6.4) kg; p < 0.001; n = 187] and waist circumference [7.1 ± 5 (95% CI, 6.3 to 7.9) cm; p < 0.001; n = 187]. Submaximal exercise capacity (VO2ex) increased by [5.29 ± 4.74 (95% CI, 4.38 to 6.19) ml/kg/min; p < 0.001; n = 107], and lower extremity functional scale (LEFS) improved by [9 ± 11 (95% CI, 7 to 12) scale points; p < 0.001; n = 75]. Both systolic (pre SBP: 125.7 ± 15 vs. post SBP: 118.4 ± 12 mmHg; p < 0.001; n = 150) and diastolic (pre DBP: 78.5 ± 10 vs. post DBP: 74 ± 8.5 mmHg; p < 0.001; n = 150) blood pressures as well as fasting blood glucose (pre FBG: 112.8 ± 37 vs. post FBG: 99 ± 18 mg/dL; p < 0.001; n = 132) were significantly reduced.
Conclusions:
This study indicates the importance and significance of weight loss in improving physical function and cardiometabolic risk profiles across a cohort of outpatient physical therapy patients. Our study also suggests that weight loss can be achieved in a comprehensive exercise intensive physical therapy program for obese patients.
Dietary fiber is well-known for its satiety inducing properties. Adding fibers to mixed dishes is one way to increase fiber intake. However, adding fibers to foods versus including foods inherently containing fiber may reveal differing effects on satiety. The present study aimed to explore the satiety effects of adding fiber to a mixed meal versus using beans (Phaseolus vulgaris) as a source of intrinsic fiber in the meal. In this pilot study, 12 men and women with metabolic syndrome were randomly assigned to eat three standard meals in a crossover design on three different occasions that contained either no added fiber (control (NF)), extrinsic or added fiber (AF), or whole black beans as the source of intrinsic fiber (BN). Meals were matched for energy and macronutrient composition. Five hour postprandial subjective satiety was measured along with blood glucose, insulin, and the GI hormones, cholecystokinin (CCK) and peptide tyrosine tyrosine (PYY3-36). All meals induced fullness to a similar degree; however, the AF meal suppressed prospective consumption (F2,187 = 9.05, P = 0.0002) compared to the BN or NF meals. The NF meal tended to result in more satisfaction than the BN meal (F2,187 = 5.91, P = 0.003). The BN meal produced significantly higher postprandial CCK concentrations compared to the AF (F2,187 = 6.82, P = 0.001) and NF meals (F2,187 = 6.82, P = 0.002). Similar findings were observed for PYY3-36 response for BN > AF meal (F2,170 = 9.11, P < 0.0001). Postprandial insulin was significantly reduced after the BN meal, compared to the NF (F2,187 = 22.36, P < 0.0001) meal. These findings suggest that incorporating whole black beans into a meal has acute beneficial metabolic and GI hormone responses in adults with metabolic syndrome and are preferred over adding equivalent amounts of fiber from a supplement.