Browsing by Author "Garcia, Martha Cecilia Yepez"

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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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    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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    Breakfast skipping, nutritional status, and physical activity in a middle-aged Latin American population: a population-based study from Ecuador
    (2019) Lara, Melissa; Sisa, Ivan; Cecilia Yepez, Martha; Fisberg, Mauro; Kovalskys, Irina; Salas, Georgina Gomez; Rigotti, Attilio; Sanabria, Lilia Yadira Cortes; Garcia, Martha Cecilia Yepez; Torres, Rossina Gabriella Pareja; Herrera-Cuenca, Marianella; Koletzko, Berthold; Moreno, Luis A.; Pratt, Michael; Tucker, Katherine L.; Guajardo, Viviana; Zalcman Zimberg, Iona; Paz Amigo, Maria; Janezic, Ximena; Cardini, Fernando; Echeverria, Guadalupe; Landaeta, Leslie; Castillo, Oscar; Cortes Sanabria, Lilia Yadira; Nayibe Vargas, Luz; Fernanda Tobar, Luisa; Milena Castillo, Yuri; Gomez, Georgina; Monge Rojas, Rafael; Chinnock, Anne; Cecilia, Martha; Garcia, Yepez; Villar Caceres, Monica; Belen Ocampo, Maria; Pareja Torres, Rossina; Reyna Liria, Maria; Meza, Krysty; Abad, Mellisa; Penny, Mary; Landaeta, Maritza; Mendez, Betty; Vasquez, Maura; Ramirez, Guillermo; Hernandez, Pablo; Chiavegatto Filho, Alexandre D. P.; Bezerra Goncalves, Priscila; Alberico, Claudia; Ferrari, Gerson Luis de Moraes; Previdelli, Agatha Nogueira; Aparecida Grande de Franca, Natasha
    Introduction: the failure to eat breakfast has been associated with weight gain, a lower level of physical activity, and poor diet quality.
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    Contribution of Proteins to the Latin American Diet: Results of the ELANS Study
    (2023) Herrera-Cuenca, Marianella; Garcia, Martha Cecilia Yepez; Sanabria, Lilia Yadira Cortes; Hernandez, Pablo; Sifontes, Yaritza; Ramirez, Guillermo; Vasquez, Maura; Gomez, Georgina; Liria-Dominguez, Maria Reyna; Rigotti, Attilio; Fisberg, Mauro; Kovaslkys, Irina; Landaeta-Jimenez, Maritza
    Dietary protein intake is vital to life. Here we sought to characterize dietary sources of protein in eight Latin American countries. Survey data were collected for Estudio Latinoamericano de Nutricion y Salud (ELANS); participants were from Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela (n = 9218, 15-65 years old). The primary aim of this analysis was to quantify per-person daily protein consumption by country and sociodemographic factors. Secondary aims: to quantify proportional intake of proteins by source, amount and processing, and to determine the adequacy of protein/essential amino acid intake. Younger groups (adolescents 15-19 years, adults 20-33 years) had the highest intake of proteins; middle-aged adults (34-49 years) had a lower intake, and older adults (50-65 years) had a strikingly lower intake. Protein consumption was higher in men than women. Animal proteins comprised nearly 70% of total daily protein intake in Argentina and Venezuela, contrasting with <60% in Peru, Chile, and Costa Rica. Brazil and Venezuela showed the highest protein intake within the highest education level. The higher the socioeconomic level, the higher the protein intake, except for Argentina, Chile, and Peru. Proportional intake of animal- and plant-based protein generally reflected the food availability by country. This study presents a pre-pandemic regional baseline and offers a perspective for future studies of changes related to government policies, climate, and dietary practices.
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    Energy imbalance gap was associated with body mass index and sex in Latin American adolescents-results from the ELANS study
    (2024) Hernandez, Pablo; Herrera-Cuenca, Marianella; Ferrari, Gerson; Almeida, Rafaela Yepez; Garcia, Martha Cecilia Yepez; Caceres, Monica Villar; Sanabria, Lilia Yadira Cortes; Sifontes, Yaritza; Landaeta-Jimenez, Maritza; Gomez, Georgina; Monge-Rojas, Rafael; Pareja, Rossina G.; Rigotti, Attilio; Kovalskys, Irina; Fisberg, Mauro
    Introduction Energy imbalance gap (EIG) is defined as the average daily difference between energy intake (EI) and energy expenditure (EE). This study aimed to examine the associations between EIG and sociodemographic and anthropometric variables in the adolescent population of eight Latin America countries. Methods A total of 680 adolescents aged 15 to 18 were included in this study. The estimation of EI was based on two non-consecutive 24-h dietary recalls. EE was predicted from Schofield equations using physical activity level obtained through the long version of the International Physical Activity Questionnaire. Sociodemographic data and anthropometric measurements were also obtained. A descriptive analysis and multilevel linear regression models were used to examine associations between variables. Results The mean EI, EE, and EIG were 2091.3 kcal, 2067.8 kcal, and 23.5 kcal, respectively. Argentina had the highest EI and EIG, whereas Chile had the lowest EI and EIG. Males had a higher EI (2262.4 kcal) and EE (2172.2 kcal) than females (1930.1 kcal and 2084.5 kcal), respectively (p < 0.05). Overweight subjects had a lower EIG than did underweight and normal-weight subjects (p < 0.05). Subjects with low socioeconomic status (SES) had a lower EE (2047.0 kcal) than those with a high SES (2164.2 kcal) (p < 0.05). Conclusion Sex and BMI were associated with EIG in adolescents from Latin America.
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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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    Inadequate Intake of Choline and Essential Fatty Acids in Latin American Childbearing-Age Women as a Regional Pre-Conceptional Disadvantage: ELANS Results
    (2024) Herrera-Cuenca, Marianella; Garcia, Martha Cecilia Yepez; Sanabria, Lilia Yadira Cortes; Hernandez, Pablo; Ramirez, Guillermo; Vasquez, Maura; Sifontes, Yaritza; Gomez, Georgina; Liria-Dominguez, Maria Reyna; Rigotti, Attilio; Fisberg, Mauro; Kovalkys, Irina; Landaeta-Jimenez, Maritza
    Background/Objectives: Choline and essential fatty acids (EFA) are vital for fetal brain development, supporting pregnancy, and maintaining hormonal balance. They also promote overall health. The childbearing years present a window of opportunity to increase the intake of these key nutrients and develop healthy dietary habits. The aims of this study were to evaluate the intake of choline and EFA in women of childbearing age (15-49 years old), identify their food sources and determine if supplements containing choline and EFA were available across the Estudio Latinoamericano de Nutrici & oacute;n y Salud (ELANS) countries. Methods: Survey data were collected for the ELANS, including participants from Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela (n = 9218; 15-65 years old). Women of childbearing age were extracted from the largest database (n = 3704). Results: In general, choline intake was inadequate in all countries, while EFA intake was normal or above requirements. Chile had the lowest intake of choline, and Colombia had the highest. The results showed that some countries had more inadequate choline intake than others. Consuming a larger quantity of eggs helped reduce choline inadequacy, as did including eggs and fish in the diet. The intake of EFA, including ALA, EPA, and DHA, showed variability. The contributions of EPA and DHA were lower than that of ALA, and the results differed by age group. Conclusions: choline intake is inadequate, and EFA intake is variable among women of childbearing age in the ELANS study. More awareness and education are needed to achieve better intake of these nutrients.
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    Socio-demographic patterning of objectively measured physical activity and sedentary behaviours in eight Latin American countries: Findings from the ELANS study
    (2020) Ferrari, Gerson Luis de Moraes; Kovalskys, Irina; Fisberg, Mauro; Gomez, Georgina; Rigotti, Attilio; Sanabria, Lilia Yadira Cortes; Garcia, Martha Cecilia Yepez; Torres, Rossina Gabriella Pareja; Herrera-Cuenca, Marianella; Zimberg, Iona Zalcman; Guajardo, Viviana; Pratt, Michael; Cristi-Montero, Carlos; Rodriguez-Rodriguez, Fernando; Scholes, Shaun; Celis-Morales, Carlos A.; Chaput, Jean-Philippe; Sole, Dirceu
    Physical activity (PA) and sedentary behaviours (SB) are two independent risk factors for non-communicable diseases. However, there is a lack of objectively measured information on PA and SB in low- and middle-income countries. The aim of this study was to use objective data to characterise socio-demographic patterns of PA and SB in eight Latin American countries. 2732 participants (aged 15-65 years) from the Latin American Study of Nutrition and Health (ELANS) were included. PA and SB data were collected using accelerometers. Overall and country-specific average levels of time spent in PA and SB were compared by sex, age, socioeconomic and education level. Overall, the mean time spent in SB was 571.6 min/day, ranging from 553.8 min/day in Chile to 596.7 min/day in Peru. Average levels of light, moderate-to-vigorous physical activity (MVPA) and total PA were 311.1 min/day (95% CI: 307.7; 314.5), 34.9 min/day (95% CI: 34.0; 35.9) and 7531.2 MET-min/week (95% CI: 7450.4; 7611.9), respectively. MVPA and total PA were higher in men than women. The prevalence of physical inactivity was 40.6%, ranging from 26.9% (Chile) to 47% (Costa Rica and Venezuela). Women were more physically inactive than men (47.7% versus 33.0%). SB levels were highest among those with higher education; PA graded positively with socioeconomic level. Our findings can inform the planning of health policies and programmes designed to reduce levels of physical inactivity, as well as inform the local and cultural adaptation of these policies and programmes for implementation in Latin America. Highlights Worldwide studies of physical activity (PA) and sedentary behaviours (SB) have historically under-represented Latin American countries due to the lack of surveillance data. Across eight Latin American countries, the ELANS study collected data on PA and SB using an objective method (accelerometers) which we have analysed to quantify and characterise socio-demographic patterns. Over four-in-ten participants were physically inactive (40.6%); with a gender gap (47.7% women; 33.0% men); and striking differences between countries (47% Costa Rica and Venezuela; 26.9% Chile). In all countries, levels of moderate-to-vigorous physical activity (MVPA) were lowest, and levels of SB were highest, among participants in the higher education groups. Our findings on the unequal distribution of PA and SB increases the evidence base and can help to inform future intervention strategies in Latin America.