Browsing by Author "Cortes, Lilia Yadira"

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    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
    (2024) Monge-Rojas, Rafael; Vargas-Quesada, Rulaman; Previdelli, Agatha Nogueira; Kovalskys, Irina; Herrera-Cuenca, Marianella; Cortes, Lilia Yadira; Garcia, Martha Cecilia Yepez; Liria-Dominguez, Reyna; Rigotti, Attilio; Fisberg, Regina Mara; Ferrari, Gerson; Fisberg, Mauro; Gomez, Georgina
    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.
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    Accelerometer-Measured Daily Step Counts and Adiposity Indicators among Latin American Adults: A Multi-Country Study
    (2021) Ferrari, Gerson; Marques, Adilson; Barreira, Tiago V.; Kovalskys, Irina; Gomez, Georgina; Rigotti, Attilio; Cortes, Lilia Yadira; Garcia, Martha Cecilia Yepez; Pareja, Rossina G.; Herrera-Cuenca, Marianella; Guajardo, Viviana; Leme, Ana Carolina B.; Guzman Habinger, Juan; Valdivia-Moral, Pedro; Suarez-Reyes, Monica; Ihle, Andreas; Gouveia, Elvio R.; Fisberg, Mauro
    The aim of the present study was to examine the sex-related associations between accelerometer-measured daily step counts and adiposity indicators in adults from eight Latin American countries. We analyzed data from 2524 adults (aged 18-65 years) from the Latin American Study of Nutrition and Health. Device-measured daily step counts were measured by accelerometers (ActiGraph GT3X). The outcomes were body mass index (BMI; (kg/m2), waist and neck circumference (in cm). Overall, the mean of daily steps counts, BMI, waist and neck circumference were 10699.8, 27.3, 89.6, and 35.8. Weak and negative associations were observed between daily steps counts and BMI (r = -0.17; p < 0.05) and waist circumference (r = -0.16; p < 0.05); however, step counts was not associated with neck circumference. Daily steps counts were negatively associated with BMI (beta: -0.054; 95%CI: -0.077; -0.012) and waist circumference (-0.098; -0.165; -0.030) independently of age and socioeconomic level. In men, there were significant negative associations between daily steps counts with BMI (-0.075; -0.119; -0.031) and waist circumference (-0.140; -0.233; -0.048), and in women, there was no significant association with either of the body composition indicators. The findings from this study need to be examined in prospective settings that use device-measured from Latin America.
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    Adherence to the EAT-Lancet Diet is Not Associated With Weight Status in a Latin American Urban Multicentric Study
    (Wiley, 2025) Vargas-Quesada, Rulaman; Monge-Rojas, Rafael; Romero-Zuniga, Juan Jose; Araya-Bastias, Carolina; Kovalskys, Irina; Herrera-Cuenca, Marianella; Cortes, Lilia Yadira; Garcia, Martha Cecilia Yepez; Liria-Dominguez, Reyna; Rigotti Rivera, Attilio; Fisberg, Mauro; Gomez, Georgina
    The overweight/obesity high prevalence and the effects of climate change in Latin America underscores the possible positive outcomes of adopting a healthy and sustainable diet to respond to the region's burden of nutrition-related noncommunicable diseases (NCDs). However, research on adherence to the EAT-Lancet diet in Latin America and its association with overweight/obesity is limited. This study explores the relationship between the EAT-Lancet diet adherence and overweight/obesity in a cross-sectional and urban multicentric study involving 6683 participants aged 15-65. Adherence to the EAT-Lancet diet was evaluated using the Planetary Health Diet Index (PHDI). The findings indicate that high adherence to the EAT-Lancet diet (fifth quintile) was not significantly associated with overweight/obesity (reference: first PHDI quintile, PR: 1.057, CI: 0.993-1.125, p-trend = 0.140) after adjusting for key covariates. Equivalent outcomes were found when assessing adherence to the EAT-Lancet diet using the EAT-Lancet Index, the World Index for Sustainability and Health (WISH), and the Healthy and Sustainable Diet Index (HSDI), after adjusting for the same variables. The persistently high prevalence of overweight/obesity among different adherence levels to the dietary pattern and the study's design, do not appear to be the key factors contributing to the lack of association between these variables. Instead, the considerably low adherence to the EAT-Lancet diet in the sample as well as the low variability in adherence across participants with and without excess weight might help explain the lack of observed association. However, further research is needed to verify this conclusion.
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    Agreement Between Self-Reported and Device-Based Sedentary Time among Eight Countries: Findings from the ELANS
    (2021) Ferrari, Gerson; Werneck, Andre O.; Silva, Danilo R.; Kovalskys, Irina; Gomez, Georgina; Rigotti, Attilio; Cortes, Lilia Yadira; Garcia, Martha Yepez; Liria, Maria; Herrera-Cuenca, Marianella; Zimberg, Iona Zalcman; Guajardo, Viviana; Pratt, Michael; Cristi-Montero, Carlos; Marques, Adilson; Peralta, Miguel; Bolados, Cristian Cofre; Leme, Ana Carolina B.; Rollo, Scott; Fisberg, Mauro
    The purpose of this study was to analyze the agreement between self-reported and device-based sedentary time among eight countries in Latin America. As part of the Latin American Study of Nutrition and Health (ELANS), data were collected from 2524 participants (18-65 years) across eight countries. Participants reported time spent sedentary in different activities (computer use at home, videogame use, reading, sitting down to chat with friends/relatives or listening to music, speaking on the phone, watching TV, and riding in a car). Overall sitting time was assessed using a single item from the International Physical Activity Questionnaire (IPAQ). Device-based sedentary time was assessed using Actigraph GT3X accelerometers. Self-reported overall sitting time (227.1 min/day) produced the lowest values of the three assessment methods, followed by self-reported sum of different types of sedentary behavior (364.1 min/day) and device-based sedentary time (568.6 min/day). Overall, correlation coefficients and ICC varied from weak to moderate (rho: 0.25-0.39; ICC: 0.21:0.39) between self-reported sum of different types of sedentary behavior, self-reported overall sitting time, and device-based sedentary time. The Bland-Altman plots indicated low to moderate agreement between self-reported overall sitting time and device-based sedentary time by sex. Self-report measures underestimate sedentary behavior and overall sitting time when compared with device-based measures. The weak and moderate level of agreement between methods indicates that caution is required when comparing associations between different self-report and device-based measures of sedentary behavior with health outcomes.
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    Alcohol Contribution to Total Energy Intake and Its Association with Nutritional Status and Diet Quality in Eight Latina American Countries
    (2021) Brenes, Juan Carlos; Gomez, Georgina; Quesada, Dayana; Kovalskys, Irina; Rigotti, Attilio; Cortes, Lilia Yadira; Yepez Garcia, Martha Cecilia; Liria-Dominguez, Reyna; Herrera-Cuenca, Marianella; Guajardo, Viviana; Fisberg, Regina Mara; Leme, Ana Carolina B.; Ferrari, Gerson; Fisberg, Mauro; ELANS Study Grp
    Alcohol consumption is a modifiable risk factor for non-communicable diseases. This study aimed to characterize alcohol consumers at the nutritional, anthropometric, and sociodemographic levels. Data from 9218 participants from Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela participating in "Latin American Health and Nutrition Study (ELANS)", a multi-country, population-based study, were used. Dietary intake was collected through two, 24 h recalls. Participants were classified into consumers (n = 1073) and non-alcohol consumers (n = 8145) using a cut-off criterium of >= 15 g/day of alcohol consumption calculated from the estimation of their usual daily intake. Among alcohol consumers, the mean alcohol consumption was 69.22 +/- 2.18 grams (4.6. beverages/day), contributing to 484.62 kcal, which corresponded to 16.86% of the total energy intake. We found that the risk of alcohol consumption was higher in young and middle-aged men from low and middle socioeconomic status. Argentine, Brazil, and Chile had the highest percentage of consumers, while Ecuador showed the highest alcohol consumption. Alcohol drinkers were characterized by having higher body weight and wider neck, waist, hips circumferences. Alcohol drinkers had a higher energy intake, with macronutrients providing relatively less energy at the expense of the energy derived from alcohol. Alcohol drinkers showed lower and higher consumptions of healthy and unhealthy food groups, respectively. In addition, adequacy ratios for all micronutrients assessed were lower in alcohol consumers. All these deleterious effects of alcohol on nutritional and anthropometric parameters increased with the number of alcoholic beverages consumed daily. Altogether, these findings suggest that limiting alcohol consumption can contribute to reducing the risk of obesity, metabolic syndrome, and diet-related diseases.
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    Anthropometric Profile of Latin American Population: Results From the ELANS Study
    (2021) Herrera-Cuenca, Marianella; Kovalskys, Irina; Gerardi, Alejandro; Hernandez, Pablo; Sifontes, Yaritza; Gomez, Georgina; Yepez Garcia, Martha Cecilia; Mendez-Perez, Betty; Landaeta-Jimenez, Maritza; Pareja, Rossina; Cortes, Lilia Yadira; Rigotti, Attilio; Fisberg, Mauro; Zimberg, Iona Zalcman
    Background: Latin America has experienced changes in lifestyle since 1960.Aim: The aim was to determine the prevalence of obesity and stunting among eight countries of Latin American and to identify the determinant risk factors for obesity.Subjects and Methods: Data were obtained from 9,218 participants of the Latin American Study of Nutrition and Health (ELANS), a multicenter cross-sectional study of the representative samples in eight Latin American countries. All the participants completed a standard protocol to investigate the nutrient intake and anthropometric variables (weight, height, and circumferences) analyzed by country, gender, age, and socioeconomic status.Results: The prevalence of obesity was higher in Costa Rica and Venezuela (29%) and lower in Colombia (16%), stunting was reported higher in Peru (47%) and lower in Argentina (17%), and waist and neck circumferences showed the higher values in Costa Rica (43%) and Chile (52%) and lower values in Colombia (23 and 26%).Conclusion: This study indicates an increasing trend toward overweight and obesity that are associated with lower socioeconomic status, being a woman, and concurs with inadequate intakes of calcium, which may be related to poor quality diet and in the long term could constitute risk factors for the chronic diseases and a health burden to the region.
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    Association between Active Transportation and Public Transport with an Objectively Measured Meeting of Moderate-to-Vigorous Physical Activity and Daily Steps Guidelines in Adults by Sex from Eight Latin American Countries
    (2021) Herreros-Irarrazabal, Diego; Guzman-Habinger, Juan; Mahecha Matsudo, Sandra; Kovalskys, Irina; Gomez, Georgina; Rigotti, Attilio; Cortes, Lilia Yadira; Garcia, Martha Cecilia Yepez; Pareja, Rossina G.; Herrera-Cuenca, Marianella; Farias-Valenzuela, Claudio; Marques, Adilson; Leme, Ana Carolina B.; Fisberg, Mauro; Drenowatz, Clemens; Ferrari, Gerson
    This study aimed to examine the associations between active transportation and public transport and the objectively measured meeting of moderate-to-vigorous physical activity (MVPA) and steps per day guidelines in adults by sex from eight Latin American countries. As part of the Latin American Study of Nutrition and Health (ELANS), data were collected from 2524 participants aged 18-65 years. MVPA and steps per day were evaluated using Actigraph GT3X accelerometers. The mode of transportation, its frequency and duration were collected using a self-reported questionnaire. The average time dedicated to active transportation was 12.8 min/day in men (IQR: 2.8-30.0) and 12.9 min/day in women (IQR: 4.3-25.7). A logistic regression analysis was conducted, showing that active transportation (>= 10 min) was associated with higher odds of meeting MVPA guidelines (men: OR: 2.01; 95%CI: 1.58-2.54; women: OR: 1.57; 95%CI: 1.25-1.96). These results show a greater association when considering active transportation plus public transport (men: OR: 2.98; 95%CI: 2.31-3.91; women: OR: 1.82; 95%CI: 1.45-2.29). Active transportation plus public transport was positively associated with meeting steps per day guidelines only in men (OR: 1.55; 95%CI: 1.15-2.10). This study supports the suggestion that active transportation plus public transport is significantly associated with meeting the MVPA and daily steps recommendations.
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    Association between built environment and physical activity in Latin American countries: a multicentre cross-sectional study
    (2021) Barreno, Mishell; Sisa, Ivan; Garcia, Martha Cecilia Yepez; Shen, Hua; Villar, Monica; Kovalskys, Irina; Fisberg, Mauro; Gomez, Georgina; Rigotti, Attilio; Cortes, Lilia Yadira; Pareja, Rossina G.; Herrera-Cuenca, Marianella; Guajardo, Viviana
    Objective To assess the association between the physical activity level and the built environment by accessibility, microinfrastructure and security in Latin America (LA).
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    Co-Occurrence and Clustering of Sedentary Behaviors, Diet, Sugar-Sweetened Beverages, and Alcohol Intake among Adolescents and Adults: The Latin American Nutrition and Health Study (ELANS)
    (2021) B. Leme, Ana Carolina; Ferrari, Gerson; Fisberg, Regina M.; Kovalskys, Irina; Gomez, Georgina; Cortes, Lilia Yadira; Yepez Garcia, Martha Cecilia; Herrera-Cuenca, Marianella; Rigotti, Attilo; Liria-Dominguez, Maria Reyna; Fisberg, Mauro
    Poor diet, sedentary behaviors, sugar-sweetened beverages (SSB) and alcohol intake seem to co-exist in complex ways that are not well understood. The aim of this study was to provide an understanding of the extent to which unhealthy behaviors cluster in eight Latin America countries. A secondary aim was to identify socio-demographic characteristics associated with these behaviors by country. Data from adolescents and adults from the "Latin American Health and Nutrition Study" was used and the prevalence of screen-time, occupational and transportation-sedentary time, socializing with friends, poor diet, SSB and alcohol intake, alone and in combination, were identified. The eight Latin America (LA) countries added to analyses were: Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela. Logistic regression was used to estimate associations between >= 2 behaviors clustering, socio-demographics and weight status. Among 9218 individuals, the most prevalent behaviors were transportation and occupation-sedentary time, SSB and alcohol intake. Younger, female, married/living with a partner, low and middle-income and obese individuals had higher chances for these clustering behaviors. These results provide a multi-country level of understanding of the extent to which behaviors co-occur in the LA population.
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    Correlation between Neck Circumference and Other Anthropometric Measurements in Eight Latin American Countries. Results from ELANS Study
    (2021) Liria-Dominguez, Reyna; Perez-Albela, Marcela; Vasquez, Maria-Paz; Gomez, Georgina; Kovalskys, Irina; Fisberg, Mauro; Cortes, Lilia Yadira; Yepez Garcia, Martha Cecilia; Herrera-Cuenca, Marianella; Rigotti, Attilio; Ferrari, Gerson; Pareja, Rossina G.
    Neck circumference (NC) is being used to identify the risk of chronic diseases. There is a high prevalence of overweight and obesity in Latin America, and neck circumference is a simple and practical measurement to assess this, especially in primary health centers. We analyzed the correlation between the NC anthropometric indicator and other anthropometric measurements such as BMI and waist circumference (WC) in eight Latin American cities. We applied Pearson's correlation to identify the correlate NC with the other anthropometric variables stratified by sex; the sensitivity (Se) and specificity (Sp) by sex were evaluated according to the cut-off established with the Youden Index. The strongest correlations between NC and WC were found when stratified by sex (women: r = 0.71; men: r = 0.69, respectively) followed by the correlation between NC and BMI (r = 0.65, both sex). NC cut-off points of 39.0 cm in men and 32.9 cm in women identified those individuals with an increased WC and 39.8 and 33.7 cm, respectively, for a substantial increase in WC. For BMI & GE; 25.0 kg/m(2) for men, the cut-off point was 37.5 cm, and for women, it was 33.1 cm, and for BMI & GE; 30 kg/m(2), the cut-off points were 39.2 and 34.2 cm, for men and women, respectively. Conclusion: NC proved to be a useful, practical, and inexpensive tool that can be used to identify, evaluate, and monitor overweight and obese individuals.
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    Exploring the FAO Minimum Dietary Diversity Indicator as a Suitable Proxy of Micronutrient Adequacy in Men and Women Across Reproductive and Non-reproductive Ages in 8 Latin American Countries
    (2024) Gomez, Georgina; Monge-Rojas, Rafael; Vargas-Quesada, Rulaman; Previdelli, Agatha Nogueira; Quesada, Dayana; Kovalskys, Irina; Herrera-Cuenca, Marianella; Cortes, Lilia Yadira; Garcia, Martha Cecilia Yepez; Liria-Dominguez, Reyna; Rigotti, Attilio; Fisberg, Regina Mara; Ferrari, Gerson; Fisberg, Mauro; Brenes, Juan C.
    Background: Women's Dietary Diversity Score (WDDS) is an indicator of dietary diversity, a key component of diet quality in women of reproductive age (WRA). Limited information is available regarding its applicability in other population groups.Objective: To examine the ability of the Minimum Dietary Diversity for Women (MDD-W) of 5-food groups cutoff to predict micronutrient adequacy in men and women 15 to 65 years old from 8 Latin American countries.Methods: We used a 24-hour recall from 9216 participants in the Latin American Study on Nutrition and Health (ELANS) to determine Dietary Diversity Score (DDS) based on the consumption of 10 food groups. The Mean Probability of Adequacy (MPA) was associated with DDS for the overall sample, for men, WRA, and women of nonreproductive age (WNRA). Sensitivity and specificity analyses were performed to determine if the 5-food groups cutoff point for MDD can be used to correctly identify men, WRA, and WNRA with adequate micronutrient adequacy (MPA >= 0.70).Results: We found a mean DDS of 4.78 +/- 1.33 and an MPA of 0.64 +/- 0.16, with 59% of participants showing a diverse diet (DDS >= 5). The 5-food groups-cutoff point showed a better balance between sensitivity and specificity predicting an MPA >= 0.70 in men, WRA, and WNRA. MPA was significantly associated with DDS in WRA and for men and WNRA, as well.Conclusion: The 5-food group MDD, originally intended to be used in WRA, performed equally well in predicting MPA >= 0.70 in men, WRA, and WNRA, and can be used as a proxy of micronutrient adequacy in Latin American population.
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    Meeting 24-h movement guidelines and markers of adiposity in adults from eight Latin America countries: the ELANS study
    (2022) Ferrari, Gerson; Cristi-Montero, Carlos; Drenowatz, Clemens; Kovalskys, Irina; Gomez, Georgina; Rigotti, Attilio; Cortes, Lilia Yadira; Yepez Garcia, Martha; Liria-Dominguez, Maria Reyna; Herrera-Cuenca, Marianella; Peralta, Miguel; Marques, Adilson; Marconcin, Priscila; da Costa, Roberto Fernandes; Leme, Ana Carolina B.; Farias-Valenzuela, Claudio; Ferrero-Hernandez, Paloma; Fisberg, Mauro
    This study aimed to compare compliance with 24-h movement guidelines across countries and examine the associations with markers of adiposity in adults from eight Latin American countries. The sample consisted of 2338 adults aged 18-65 years. Moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) data were objectively measured using accelerometers. Sleep duration was self-reported using a daily log. Body mass index and waist circumference were assessed as markers of adiposity. Meeting the 24-h movement guidelines was defined as >= 150 min/week of MVPA; <= 8 h/day of SB; and between 7 and 9 h/day of sleep. The number of guidelines being met was 0.90 (95% CI 0.86, 0.93) with higher value in men than women. We found differences between countries. Meeting two and three movement guidelines was associated with overweight/obesity (OR: 0.75, 95% CI 0.58, 0.97 and OR: 0.69, 95% CI 0.51, 0.85, respectively) and high waist circumference (OR: 0.74, 95% CI 0.56, 0.97 and OR: 0.77, 95% CI 0.62, 0.96). Meeting MVPA and SB recommendations were related to reduced adiposity markers but only in men. Future research is needed to gain insights into the directionality of the associations between 24-h movement guidelines compliance and markers of adiposity but also the mechanisms underlying explaining differences between men and women.
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    Physical activity and daily steps cut offs points for overweight/obesity prevention among eight Latin American countries
    (2022) Ferrero-Hernandez, Paloma; Farias-Valenzuela, Claudio; Jofre-Saldia, Emilio; Marques, Adilson; Kovalskys, Irina; Gomez, Georgina; Rigotti, Attilio; Cortes, Lilia Yadira; Garcia, Martha Yepez; Pareja, Rossina G.; Herrera-Cuenca, Marianella; Fisberg, Mauro; Silva, Danilo R.; Sadarangani, Kabir P.; Ferrari, Gerson
    This study aims to establish cut-off points for the number of minutes of physical activity intensity and the number of daily steps that identify overweight/obesity in adolescents, adults, and older adults. This study examined data from 2737 participants. Physical activity intensity and the number of daily steps were assessed using GT3X+ ActiGraph model accelerometers. Body mass index, waist-to-height ratio, and waist-to-hip ratio were used as indicators of overweight/obesity. The cut-off points for moderate-to-vigorous physical activity for the prevention of overweight/obesity according to body mass index in women ranged from 15.1 to 30.2 min/day; in men, the values were from 15.4 to 33.8 min/day. The lowest cut-off point for daily steps was established in the adolescent group for women and men (7304 and 5162). The highest value in women was 11,412 (51-65 years) and 13,234 in men (18-30 years). Results from measurements different from BMI, show average cut-off points for moderate-to-vigorous physical activity and daily steps of 29.1/8348 and 43.5/10,456 according to waist-to-height ratio; and results of 29.3/11,900 and 44.3/11,056 according to the waist-to-hip ratio; in women and men respectively. A more specific recommendation of physical activity and daily steps adjusted by sex and age range is suggested to prevent overweight/obesity.