Browsing by Author "Yepez Garcia, Martha Cecilia"

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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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    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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    Contribution of food groups to energy, grams and nutrients-to-limit: the Latin American Study of Nutrition and Health/Estudio Latino Americano de Nutricion y Salud (ELANS)
    (2021) Fisberg, Regina Mara; Leme, Ana Carolina Barco; Previdelli, Agatha; de Mello, Aline Veroneze; Martinez, Angela Graciela; Hermes Sales, Cristiane; Gomez, Georgina; Kovalskys, Irina; Herrera-Cuenca, Marianella; Cortes Sanabria, Lilia Yadira; Yepez Garcia, Martha Cecilia; Torres, Rossina G.; Rigotti, Attilio; Fisberg, Mauro
    Objective:
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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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    Developing a cooperative multicenter study in Latin America: Lessons learned from the Latin American Study of Nutrition and Health Project
    (2017) Fisberg, Mauro; Kovalskys, Irina; Gomez Salas, Georgina; Pareja Torres, Rossina Gabriella; Yepez Garcia, Martha Cecilia; Cortes Sanabria, Lille Yadira; Herrera-Cuenca, Marianella; Rigotti, Attilio; Guajardo, Viviana; Zimberg, Ione Zalcman; Previdelli, Agatha Nogueira; Moreno, Luis A.; Pratt, Michael; Koletzko, Berthold; Tucker, Katherine L.
    This report examines the challenges of conducting a multicenter, cross-sectional study of countries with diverse cultures, and shares the lessons learned. The Latin American Study of Nutrition and Health (ELANS) was used as a feasibility study involving the most populous cities of eight countries in Latin America (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela) in 2014-2015, about 40% of the population of the Americas. The target sample included 9 000 individuals, 15-65 years of age, and was stratified by geographic location (only urban areas), gender, age, and socioeconomic status.
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    Dietary Diversity and Micronutrients Adequacy in Women of Childbearing Age: Results from ELANS Study
    (2020) Gomez, Georgina; Previdelli, Agatha Nogueira; Fisberg, Regina Mara; Kovalskys, Irina; Fisberg, Mauro; Herrera-Cuenca, Marianella; Cortes Sanabria, Lilia Yadira; Yepez Garcia, Martha Cecilia; Rigotti, Attilio; Reyna Liria-Dominguez, Maria; Guajardo, Viviana; Quesada, Dayana; Murillo, Ana Gabriela; Carlos Brenes, Juan
    Dietary diversity, an important component of diet quality, is associated with an increased probability of adequate micronutrient intake. Women of childbearing age (WCA) are particularly vulnerable to micronutrient inadequacy. The Minimum Dietary Diversity for Women (MDD-W) has been used widely as a proxy measurement of micronutrient adequacy. This study aimed to assess the association between MDD-W and nutrients adequacy among WCA of eight Latin American countries. Nutrient intakes from 3704 WCA were analyzed with two 24-hour dietary recalls. Dietary diversity was calculated based on ten food groups with a cut-off point of intake >= 5 groups. The mean dietary diversity score was 4.72 points, and 57.7% of WCA achieved MDD-W. Vitamin D and E showed a mean Nutrient Adequacy Ratio (NAR) of 0.03 and 0.38, respectively. WCA with a diverse diet (MDD-W > 5) reported a significantly higher intake of most micronutrients and healthy food groups with less consumption of red and processed meats and sugar-sweetened beverages. MDD-W was significantly associated with the mean adequacy ratio (MAR) of 18 micronutrients evaluated. Nevertheless, even those women with a diverse diet fell short of meeting the Estimated Average Requirements (EAR) for vitamins D and E. MDD-W is an appropriate tool to evaluate micronutrients adequacy in WCA from Latin America, showing that women who achieved the MDD-W reported higher adequacy ratios for most micronutrients and an overall healthier diet.
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    Energy Imbalance Gap, Anthropometric Measures, Lifestyle, and Sociodemographic Correlates in Latin American Adults-Results from the ELANS Study
    (2022) Yepez Garcia, Martha Cecilia; Herrera-Cuenca, Marianella; Ferrari, Gerson; Sanabria, Lilia Yadira Cortes; Hernandez, Pablo; Almeida, Rafaela Yepez; Villar Caceres, Monica; Gomez, Georgina; Pareja, Rossina; Rigotti, Attilio; Kovalskys, Irina; Fisberg, Mauro
    Overweight and obesity are often explained by an imbalance between energy intake and expenditure. This, in addition to metabolic effects, makes it difficult to assess the real state of individual energy balance. This study aims to analyze the energy gaps between intake and expenditure in the adult population of Latin America, as well as its relationships with sociodemographic variables and nutrition status, to draw an epidemiological perspective based on the trends observed. The energy imbalance gap was used to this end. The difference between energy intake and expenditure can be applied as a reference to explain whether weight equilibrium can prevent weight gain. Moreover, the energy imbalance gap allows for a better understanding of the design of public health policies. Using data from the Latin American Study of Nutrition and Health, the energy imbalance gap in adult population from eight Latin-American countries was assessed in 5994 subjects aged from 19-65. Usual dietary intake was measured using two non-consecutive 24 h dietary recalls. The sociodemographic questionnaire was supplemented by anthropometric measurements. Physical activity was measured through the long International Physical Activity Questionnaire. Energy expenditure was obtained using the basal metabolic rate. For the overall sample, the mean energy intake was 1939.1 kcal (95% CI: 1926.9; 1951.3), the mean of energy expenditure was 1915.7 kcal (95% CI: 1906.4; 1924.9), and the mean of energy imbalance gap was 23.4 kcal (95% CI: 11.9; 35.0). Results show that energy intake and expenditure were higher in men. Moreover, subjects aged 19-34, of high socioeconomic level, who completed high school, were mestizos and were of normal weight consumed the highest number of calories. Overall, a positive energy imbalance gap was observed. Overweight and obese from Argentina, Costa Rica, Ecuador, Peru, and Venezuela showed a significantly lower energy imbalance gap than underweight subjects. These findings confirm the high variability of energy imbalance gap and the accompanying correlates of energy intake and expenditure. Further research is needed to specifically address interventions in low and middle-income countries such as many in Latin America, to help reduce the prevalence of obesity and eradicate undernutrition.
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    Food Sources of Shortfall Nutrients among Latin Americans: Results from the Latin American Study of Health and Nutrition (ELANS)
    (2021) Barco Leme, Ana Carolina; Fisberg, Regina Mara; Veroneze de Mello, Aline; Sales, Cristiane Hermes; Ferrari, Gerson; Haines, Jess; Rigotti, Attilo; Gomez, Georgina; Kovalskys, Irina; Cortes Sanabria, Lilia Yadira; Herrera-Cuenca, Marianella; Yepez Garcia, Martha Cecilia; Pareja, Rossina G.; Fisberg, Mauro
    Increased consumption of energy-dense, nutrient-poor foods can lead to inadequate intakes of shortfall nutrients, including vitamin A, D, C, and E, dietary folate, calcium, iron, magnesium, potassium, and fiber. The objective was to examine the prevalence of inadequate intake of shortfall nutrients and identify food sources of shortfall nutrients in eight Latin American countries. Data from ELANS, a multi-country, population-based study of 9218 adolescents and adults were used. Dietary intake was collected through two 24 h Recalls from participants living in urban areas of Argentina, Brazil, Chile, Colombia, Ecuador, Peru, and Venezuela. Foods and beverages were classified using the adapted version of the NHANES "What We Eat in America" system. Nutrients inadequacy was estimated using the Institute of Medicine recommendations and descriptive statistics were calculated. Prevalence of inadequacy was above 50% for most of the nutrients, which the exception of vitamin C with a prevalence of inadequacy of 39%. Milk, cheese, seafoods, breads, and fruit juices/drinks were among the top 5 sources for each of the 10 shortfall nutrients examined. Many food categories were top contributors to more than one dietary component examined. Understanding the nutrient intake and food sources can help inform dietary guidance and intervention approaches.
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    Intake of Vitamin E and C in Women of Reproductive Age: Results from the Latin American Study of Nutrition and Health (ELANS)
    (2021) Busso, Dolores; David, Andrea; Penailillo, Reyna; Echeverria, Guadalupe; Rigotti, Attilio; Kovalskys, Irina; Gomez, Georgina; Cortes Sanabria, Lilia Yadira; Yepez Garcia, Martha Cecilia; Pareja, Rossina G.; Herrera-Cuenca, Marianella; Fisberg, Mauro
    Vitamin E was identified as a lipophilic compound essential to maintain rat pregnancy. Low vitamin E intake during early pregnancy associates with congenital malformations and embryonic loss in animals and with miscarriage and intrauterine growth restriction in humans. Vitamin E protects cell membranes from lipoperoxidation and exerts non-antioxidant activities. Its function can be restored by vitamin C; thus, intake and circulating levels of both micronutrients are frequently analyzed together. Although substantial vitamin E inadequacy was reported worldwide, its consumption in Latin America (LatAm) is mostly unknown. Using data from the Latin American Study of Nutrition and Health (Estudio Latinoamericano de Nutricion y Salud, ELANS), we evaluated vitamin E and C intake in women of reproductive age (WRA) from eight LatAm countries and identified their main food sources. Two non-consecutive 24-h dietary recalls in 3704 women aged from 15 to 49 years and living in urban locations showed low average intake of vitamin E (7.9 mg/day vs. estimated average requirement (EAR) of 12 mg/day) and adequate overall vitamin C consumption (95.5 mg/day vs. EAR of 60 mg/day). The mean regional inadequacy was 89.6% for vitamin E and 36.3% for vitamin C. The primary food sources of vitamin E were fats and oils, as well as vegetables. Vitamin C intake was explained mainly by the consumption of fruit juices, fruits, and vegetables. Combined deficient intake of both vitamins was observed in 33.7% of LatAm women. Although the implications of low antioxidant vitamins' consumption in WRA are still unclear, the combined deficient intake of both vitamins observed in one-third of ELANS participants underscores the need for further research on this topic.
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    Latin American consumption of major food groups: Results from the ELANS study
    (2019) Kovalskys, Irina; Rigotti, Attilio; Koletzko, Berthold; Fisberg, Mauro; Gomez, Georgina; Herrera-Cuenca, Marianella; Cortes Sanabria, Lilia Yadira; Yepez Garcia, Martha Cecilia; Pareja, Rossina G.; Zimberg, Iona Zalcman; Del Arco, Ana; Zonis, Luciana; Previdelli, Agatha Nogueira; Guajardo, Viviana; Moreno, Luis A.; Fisberg, Regina
    Background
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    Main foods with added sugars and their geographic and sociodemographic variation: Latin American study of nutrition and health (ELANS)
    (2021) Fisberg, Mauro; Kovalskys, Irina; Gomez, Georgina; Rigotti, Attilio; Cortes Sanabria, Lilia Yadira; Yepez Garcia, Martha Cecilia; Gabriela Pareja, Rossina; Herrera-Cuenca, Marianella; Koletzko, Berthold; Moreno Aznar, Luis A.; Mara Fisberg, Regina; Hermes Sales, Cristiane; Nogueira Previdelli, Agatha; Guajardo, Viviana
    This study aimed to describe the top 10 foods that contribute to added sugars intake in representative samples of urban populations in eight Latin American countries, and consider differences by country, sex, socioeconomic level (SEL), and age group. A household-based, multinational, crosssectional survey was conducted in Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela (N=9218; 15-65 years). Contributors to added sugars were identified and listed based on the percentage of contribution to total intake of this nutrient. Data were stratified by country, sex, SEL, and age group, and the grams per day compared. Except in Peru and in the 50 to 65 years age group, soft drinks were the leading contributor to added sugar intake. Homemade beverages together industrialized beverages have been a prominent position on ranking. In general, the highest intake of added sugars by industrialized beverages was from Argentina, and the lowest frequency of beverages as sources of added sugars was observed in Chile. Among the top 10 contributors, male sex had highest added sugar intake, except for sucrose and sweet cakes. Higher intakes of sugars from natural fruit juice and sucrose were observed in the lower SEL. The highest and lowest intakes in the age groups change according to the food source. In conclusion, sugar-sweetened beverages were main contributors to added sugar intake, and the intake vary with geographical location and sociodemographic factors. Arch Latinoam Nutr 2021; 71(3): 164-177.
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    Methodological design for the assessment of physical activity and sedentary time in eight Latin American countries - The ELANS study
    (2020) de Moraes Ferrari, Gerson Luis; Kovalskys, Irina; Fisberg, Mauro; Gomez, Georgina; Rigotti, Attilio; Cortes Sanabria, Lilia Yadira; Yepez Garcia, Martha Cecilia; Pareja Torres, Rossina Gabriella; Herrera-Cuenca, Marianella; Zimberg, Iona Zalcman; Guajardo, Viviana; Pratt, Michael; Scholes, Shaun; Goncalves, Priscila Bezerra; Sole, Dirceu
    Worldwide studies of physical activity and sedentary time have historically under-represented low- and middle-income countries due to the lack of surveillance data. The purpose of this paper is to describe the methods and procedures used for the assessment of physical activity and sedentary time in the Latin American Study of Nutrition and Health (Estudio Latinoamericano de NutriciOn y Salud; ELANS). ELANS is a multicentre, cross-sectional and surveillance study of a nationally representative sample from eight Latin American countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela. Two instruments were used to evaluate different domains and intensities of physical activity and sedentary time: self-reported data and a triaxial accelerometer (model GT3X+). ELANS will generate important self-reported and objective information for the Latin American populations, namely:
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    Perceived Neighborhood Safety and Active Transportation in Adults from Eight Latin American Countries
    (2022) Castillo-Paredes, Antonio; Iglesias, Beatriz; Farias-Valenzuela, Claudio; Kovalskys, Irina; Gomez, Georgina; Rigotti, Attilio; Yadira Cortes, Lilia; Yepez Garcia, Martha Cecilia; Pareja, Rossina G.; Herrera-Cuenca, Marianella; Fisberg, Mauro; Drenowatz, Clemens; Ferrero-Hernandez, Paloma; Ferrari, Gerson
    Neighborhood built environment is associated with domain-specific physical activity. However, few studies with representative samples have examined the association between perceived neighborhood safety indicators and domain-specific active transportation in Latin America. This study aimed to examine the associations of perceived neighborhood safety with domain-specific active transportation in adults from eight Latin American countries. Data were obtained from the Latin American Study of Nutrition and Health (n = 8547, aged 18-65). Active transportation (walking and cycling) was assessed using the long form of the International Physical Activity Questionnaire. Specifically, traffic density and speed as well as street lightening, visibility of residents regarding pedestrians and bicyclists, traffic lights and crosswalks, safety of public spaces during the day and at night, crime rate during the day and at night were used to evaluate perceived neighborhood safety. Slow traffic speeds, unsafe public spaces during the day, and crime during the day were associated with >= 10 min/week vs. <10 min/week of walking. Furthermore, drivers exceeding the speed limit and crime rate during the day were associated with reporting >= 10 min/week vs. <10 min/week of cycling. These results indicate a stronger association of the perceived neighborhood safety with walking compared to cycling.
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    Perceived Urban Environment Attributes and Device-Measured Physical Activity in Latin America: An 8-Nation Study
    (2022) Ferrari, Gerson; Werneck, Andre O.; Silva, Danilo R.; Kovalskys, Irina; Gomez, Georgina; Rigotti, Attilio; Cortes, Lilia Y.; Yepez Garcia, Martha Cecilia; Liria-Dominguez, Maria R.; Herrera-Cuenca, Marianella; Pratt, Michael; Marques, Adilson; Van Dyck, Delfien; Leme, Ana Carolina B.; Fisberg, Mauro
    Introduction: Attributes of the neighborhood-built environment are associated with self-reported physical activity, but only a few studies have concentrated on device-measured physical activity in Latin America. This study examines the associations of perceived neighborhood-built environment attributes, device-measured sedentary time, and light-intensity and moderate-to-vigorous physical activity in adults from 8 Latin American countries.
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    Socioeconomic Status Impact on Diet Quality and Body Mass Index in Eight Latin American Countries: ELANS Study Results
    (2021) Gomez, Georgina; Kovalskys, Irina; Leme, Ana Carolina B.; Quesada, Dayana; Rigotti, Attilio; Cortes Sanabria, Lilia Yadira; Yepez Garcia, Martha Cecilia; Reyna Liria-Dominguez, Maria; Herrera-Cuenca, Marianella; Fisberg, Regina Mara; Previdelli, Agatha Nogueira; Guajardo, Viviana; Ferrari, Gerson; Fisberg, Mauro; Brenes, Juan Carlos
    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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    Total and Added Sugar Intake: Assessment in Eight Latin American Countries
    (2018) Fisberg, Mauro; Kovalskys, Irina; Gomez, Georgina; Rigotti Rivera, Attilio; Cortes Sanabria, Lilia Yadira; Yepez Garcia, Martha Cecilia; Pareja Torres, Rossina Gabriella; Herrera-Cuenca, Marianella; Zimberg, Iona Zalcman; Koletzko, Berthold; Pratt, Mic