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      Socioeconomic Status Impact on Diet Quality and Body Mass Index in Eight Latin American Countries: ELANS Study Results

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          Abstract

          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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          Most cited references61

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          Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)

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            Development of a WHO growth reference for school-aged children and adolescents

            OBJECTIVE: To construct growth curves for school-aged children and adolescents that accord with the WHO Child Growth Standards for preschool children and the body mass index (BMI) cut-offs for adults. METHODS: Data from the 1977 National Center for Health Statistics (NCHS)/WHO growth reference (1-24 years) were merged with data from the under-fives growth standards' cross-sectional sample (18-71 months) to smooth the transition between the two samples. State-of-the-art statistical methods used to construct the WHO Child Growth Standards (0-5 years), i.e. the Box-Cox power exponential (BCPE) method with appropriate diagnostic tools for the selection of best models, were applied to this combined sample. FINDINGS: The merged data sets resulted in a smooth transition at 5 years for height-for-age, weight-for-age and BMI-for-age. For BMI-for-age across all centiles the magnitude of the difference between the two curves at age 5 years is mostly 0.0 kg/m² to 0.1 kg/m². At 19 years, the new BMI values at +1 standard deviation (SD) are 25.4 kg/m² for boys and 25.0 kg/m² for girls. These values are equivalent to the overweight cut-off for adults (> 25.0 kg/m²). Similarly, the +2 SD value (29.7 kg/m² for both sexes) compares closely with the cut-off for obesity (> 30.0 kg/m²). CONCLUSION: The new curves are closely aligned with the WHO Child Growth Standards at 5 years, and the recommended adult cut-offs for overweight and obesity at 19 years. They fill the gap in growth curves and provide an appropriate reference for the 5 to 19 years age group.
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              The US Department of Agriculture Automated Multiple-Pass Method reduces bias in the collection of energy intakes.

              The US Department of Agriculture Automated Multiple-Pass Method (AMPM) is used for collecting 24-h dietary recalls in What We Eat In America, the dietary interview component of the National Health and Nutrition Examination Survey. Because the data have important program and policy applications, it is essential that the validity of the method be tested. The accuracy of the AMPM was evaluated by comparing reported energy intake (EI) with total energy expenditure (TEE) by using the doubly labeled water (DLW) technique. The 524 volunteers, aged 30-69 y, included an equal number of men and women recruited from the Washington, DC, area. Each subject was dosed with DLW on the first day of the 2-wk study period; three 24-h recalls were collected during the 2-wk period by using the AMPM. The first recall was conducted in person, and subsequent recalls were over the telephone. Overall, the subjects underreported EI by 11% compared with TEE. Normal-weight subjects [body mass index (in kg/m(2)) 30). Although the AMPM accurately reported EIs in normal-weight subjects, research is warranted to enhance its accuracy in overweight and obese persons.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                14 July 2021
                July 2021
                : 13
                : 7
                : 2404
                Affiliations
                [1 ]Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José 11501-2060, Costa Rica; dayana.quesada@ 123456ucr.ac.cr
                [2 ]Carrera de Nutrición, Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina, Buenos Aires C1107AAZ, Argentina; ikovalskys@ 123456gmail.com
                [3 ]Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada; acarol.leme@ 123456gmail.com
                [4 ]Departamento de Nutrição, Faculade de Saúde Publica, Universitade de São Paulo, São Paulo 01246-904, Brazil; rfisberg@ 123456usp.br (R.M.F.); agatha.usp@ 123456gmail.com (A.N.P.)
                [5 ]Centro de Excelencia em Nutrição e Dificuldades Alimentaes (CENDA), Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo 01228-200, Brazil; mauro.fisberg@ 123456gmail.com
                [6 ]Centro de Nutrición Molecular y Enfermedades Crónicas, Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8330024, Chile; arigotti@ 123456med.puc.cl
                [7 ]Departamento de Nutrición y Bioquímica, Pontificia Universidad Javeriana, Bogotá 110231, Colombia; ycortes@ 123456javeriana.edu.co
                [8 ]Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito 17-1200-841, Ecuador; myepez@ 123456usfq.edu.ec
                [9 ]Área de Investigación, Instituto de Investigación Nutricional, La Molina, Lima 15026, Peru; rliria@ 123456iin.sld.pe
                [10 ]Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru
                [11 ]Fundación Bengoa, Caracas 1070, Venezuela; manyma@ 123456gmail.com
                [12 ]Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES-UCV), Caracas 1010, Venezuela
                [13 ]Instituto Para la Cooperación Científica en Ambiente y Salud (ICCAS), Buenos Aires C1059ABF, Argentina; vguajardo@ 123456iccas.org.ar
                [14 ]Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago 7500618, Chile; gerson.demoraes@ 123456usach.cl
                [15 ]Departamento de Pediatria, Universidade Federal de São Paulo, São Paulo 04023-061, Brazil
                [16 ]Instituto de Investigaciones Psicológicas, Centro de Investigación en Neurociencias, Universidad de Costa Rica, San José 10501-2060, Costa Rica; juan.brenessaenz@ 123456ucr.ac.cr
                Author notes
                [* ]Correspondence: georgina.gomez@ 123456ucr.ac.cr ; Tel.: +506-2511-4516
                [†]

                Membership of the ELANS Study Group is provided in the Acknowledgments.

                Author information
                https://orcid.org/0000-0003-3514-2984
                https://orcid.org/0000-0001-8481-5415
                https://orcid.org/0000-0003-2782-4301
                https://orcid.org/0000-0003-2789-3219
                https://orcid.org/0000-0003-4119-238X
                https://orcid.org/0000-0002-5637-1519
                https://orcid.org/0000-0002-4490-9035
                https://orcid.org/0000-0003-0032-4323
                https://orcid.org/0000-0003-3177-6576
                https://orcid.org/0000-0003-2992-3215
                Article
                nutrients-13-02404
                10.3390/nu13072404
                8308629
                34371915
                0422ec85-21bf-4981-8901-8bf241b00d7d
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/).

                History
                : 31 May 2021
                : 08 July 2021
                Categories
                Article

                Nutrition & Dietetics
                diet quality,micronutrients,socioeconomic status,latin america,nutrition surveys

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