Consumo de frutas, verduras y legumbres en adultos de Santiago Oriente, Chile: ¿Ha influido el confinamiento por COVID-19?

RESUMEN El confinamiento por la pandemia del COVID-19 pudo impactar negativamente los hábitos alimentarios en Chile, principalmente debido al menor acceso a alimentos y los efectos psicológicos del encierro, cambiando patrones de consumo de frutas, verduras y legumbres. El objetivo del estudio fue comparar la frecuencia y cantidad consumida de frutas, verduras y legumbres y el cumplimiento de las guías alimentarias para estos alimentos en adultos residentes del sector oriente de Santiago, antes y durante el confinamiento. Se realizó mediante una encuesta digital de frecuencia de consumo y participaron 1.351 residentes de las comunas en confinamiento pertenecientes al sector oriente, mayores de 18 años y ambos sexos. En los resultados se observó una disminución en la frecuencia y cantidad consumida de frutas y verduras y un aumento en la frecuencia y cantidad de legumbres consumidas durante el confinamiento. El cumplimiento de la guía alimentaria de legumbres aumentó, para las frutas disminuyó y para las verduras se mantuvo. El confinamiento afectó negativamente el consumo de frutas, mantuvo el de verduras y el consumo de legumbres aumentó pero sigue siendo insuficiente. Los efectos del confinamiento en la alimentación podrían agravar la situación epidemiológica de los chilenos.

ABSTRACT Confinement due to COVID-19 pandemic could have a negative impact on eating habits in Chile, mainly due to decreased food access, the psychological effects of confinement, and the changing patterns of fruit, vegetable and legume consumption. The objective of the study was to compare frequency and quantity of fruits, vegetables and legumes consumed by adults from the eastern sector of Santiago de Chile before and during confinement, as well as compliance with dietary guidelines for these foods. 1.351 subjects over 18 years old, of both sexes and residents of localities in confinement within the eastern sector of Santiago answered a digital food frequency questionnaire. Results showed a decrease in the frequency and quantity of fruits and vegetables consumed and an increase in the frequency and quantity of legumes consumed during confinement. Compliance with the dietary guideline for legumes increased, it decreased for fruits and was unchanged for vegetables. Confinement negatively affected consumption of fruits, did not alter that of vegetables, and legume consumption increased, yet is still insufficient. The effects of confinement on food habits could aggravate the epidemiological situation of Chileans.

Aplicación y efectividad de un modelo educativo en hábitos saludables con entrega de fruta y programa de actividad física en escolares

RESUMEN El objetivo fue evaluar una intervención educativa en hábitos de alimentación saludable basada en el programa Colación BKN en pre-escolares y escolares entre los años 2013-2018. Diseño longitudinal con comparación de cortes trasversales en escolares de prekínder a cuarto año básico durante 4 años en 14 escuelas de la Región Metropolitana de Chile. El programa consistió en entrega de fruta como colación, educación alimentaria, mejora de la actividad física y kioscos escolares, con participación de profesores y familias. Como resultado se observó una mejoría de los conocimientos en alimentación saludable de los niños, con una excelente satisfacción de usuarios. Sobrepeso y obesidad se mantuvieron el 2016 y 2018, pero aumentaron el 2015 y 2017. En escuelas similares no intervenidas el exceso de peso fue mayor con respecto a las del programa. Hubo una tendencia a disminuir el consumo de dulces y bebidas azucaradas en prekínder y kínder entre 2014 y 2017 y el consumo de 3 porciones al día de frutas y verduras en niños intervenidos fue superior al promedio nacional de 2 porciones al día.Conclusiones: Hubo un aumento exitoso en el consumo de frutas y verduras, educación alimentaria y actividad física para el cambio hacia hábitos más saludables.

ABSTRACT The objective was to evaluate an educational intervention for healthy eating habits based on the Colación BKN program, among preschool and schoolchildren, carried out in 2013-2018. We conducted a longitudinal study with cross-sectional data among preschool and school-age children (up to the fourth grade) over four years in 14 schools in the Metropolitan Region of Chile. The intervention program consisted of fruit delivery, nutrition education and improvements in physical activity and school food kiosks, with active participation of teachers and parents. There was an improvement in knowledge of healthy foods in children and excellent user satisfaction. Overweight and obesity did not increase during 2016 and 2018, but increased in 2015 and 2017. In similar not-intervened schools there was an increase of overweight and obesity compared with Colación BKN schools. For food consumption, there was a decrease in consumption of candy and soft drinks in preschool students and all children consumed more than three portions of fruits and vegetables per day, which is greater than the national average of two portions per day in the general population. Conclusions: There was a successful increase in fruit and vegetable consumption with nutrition education and promotion of healthy habits, such as physical activity and healthy food consumption.

Consumo de frutas y vegetales en la población urbana costarricense: Resultados del Estudio Latino Americano de Nutrición y Salud (ELANS)-Costa Rica / Fruits and vegetables intake among Costa Rican urban population: results from the Latin American Study of Nutrition and Health: ELANS-Costa Rica

Resumen: Introducción: El consumo suficiente de frutas y vegetales ha sido ampliamente asociado con diversos beneficios para la salud, entre ellos, el actuar como factor protector contra el desarrollo de enfermedades crónicas no transmisibles, cáncer y enfermedades mentales. La Organización Mundial de la Salud (OMS) recomienda un consumo diario de 400 gramos entre frutas y vegetales. Este estudio tuvo como objetivo la caracterización del consumo de frutas y vegetales, según variables sociodemográficas en la población costarricense y el cumplimiento de la recomendación de la OMS. Metodología: Los datos se obtuvieron del Estudio Latino Americano de Nutrición y Salud (ELANS)-Costa Rica. Se reclutaron 798 sujetos de 15 a 65 años, residentes en zonas urbanas del país, y se evaluó el consumo de alimentos mediante dos recordatorios de 24 horas. El consumo de frutas y vegetales se analizó según el sexo, el grupo de edad y el nivel socioeconómico. Resultados: Se encontró un consumo promedio de frutas y vegetales de 220g/d/p; el cual incrementó con la edad (p=0.035 entre el grupo de 15 a 19 años y el grupo de 50 a 65 años) y con el nivel socioeconómico (p=0.004 entre el NSE bajo y medio). Sin asociación con el sexo y al nivel educativo (p>0.05). Solamente el 12.0 % de la población urbana costarricense cumple con la recomendación de la OMS. Conclusiones: Los datos obtenidos ponen en evidencia la necesidad de la implementación de programas e intervenciones adaptados a las características y preferencias de la población costarricense para la promoción del aumento en el consumo de frutas y vegetales. Es necesario extender estos estudios a la población rural de Costa Rica, pues el consumo y los factores asociados a este, podría ser diferente entre regiones.

Abstract: Introduction: Consumption of fruit and vegetables has been widely associated with different health benefits such as protection against non-transmissible chronic diseases, cancer and mental disorders. Due to these benefits, the World Health Organization (WHO) recommends daily consumption of 400 grams of fruit and vegetables. This study is aimed at characterize fruit and vegetable consumption according to socioeconomic variables, among the Costa Rican population and the degree to which this meets the WHO recommended intake. Methods: Data were obtained from the Latin American Nutrition and Health Study (ELANS)-Costa Rica. 798 subjects aged 15-65 years, living in urban areas were interviewed and their food consumption assessed by two 24-hour Recalls. Fruit and vegetable consumption were analyzed by gender, age group and socioeconomic status. Results: Average daily consumption of fruit and vegetables was 220g/p/d and increased with age (p=0.035 between with 15-19 and 50-65 years old) and socioeconomic status (p=0.004 between low and middle). No association was found with gender or education level (p>0.05). Only 12.0 % of the urban Costa Rican population met the WHO recommendation. Conclusions: The results provide evidence for the need for programs and interventions adapted to the characteristics and preferences of the Costa Rican population, to promote an increase of the consumption of fruits and vegetables. Similar studies are needed in the rural areas of Costa Rica as food habits and factors associated with them may differ

Factores asociados al consumo de frutas y verduras en Argentina: un estudio multinivel / Factors associated with the consumption of fruits and vegetables in Argentina: A multilevel study

RESUMEN INTRODUCCIÓN Algunos estudios apuntan a una asociación entre la evolución de la prevalencia de enfermedades crónicas no transmisibles con los patrones alimentarios y la situación nutricional de la población. El objetivo de este estudio fue describir el consumo de frutas y verduras en Argentina y su asociación con factores socioeconómicos, demográficos y de actividad física, a nivel individual, provincial y regional. MÉTODOS Se utilizó un modelo multinivel, con información de la Encuesta Nacional de Factores de Riesgo (2013) y del Censo Nacional (2001 y 2010). RESULTADOS El modelo demostró que ser del sexo femenino, tener más años de edad, ingreso a partir de 4.501 pesos y nivel de instrucción secundario completo o más se asocia de manera positiva al consumo de estos alimentos. En contraste, estar separado/a, divorciado/a, viudo/a o soltero/a y practicar actividad física moderada o baja se asocia negativamente a la ingesta de frutas y verduras. El efecto de la variabilidad explicada a nivel provincial y regional resultó ser mínimo. CONCLUSIONES El trabajo se enmarca en una línea de estudios que señalan que los factores relacionados con la alimentación saludable están vinculados a los entornos sociales y físicos, principalmente a características socioeconómicas del grupo de pertenencia y al contexto en que se vive. En este sentido, sería importante contar con información con mayores niveles de desagregación.

ABSTRACT INTRODUCTION Some studies show an association between the evolution of the prevalence of non-communicable chronic diseases with eating patterns and nutritional situation of the population. The purpose of this research was to describe fruit and vegetable consumption in Argentina and its association with socio-economic, demographic and physical activity factors at individual, provincial and regional levels. METHODS A multilevel model approach was used, with information provided in the Argentina National Survey of Risk Factors (2013) and National Census of Population (200! and 2010). RESULTS The model showed a positive association between fruit and vegetable consumption and being female, being older, having a monthly income over the ARS $450! threshold and having finished secondary school. In contrast, being separated, divorced, widowed or single, and practicing moderate or low physical activity were negatively associated with the intake of fruits and vegetables. The effect of the variability at provincial and regional level turned out to be minimal. CONCLUSIONS This work is part of a series of studies that link factors related to healthy eating with social and physical environments, mainly with socioeconomic characteristics of the peer group and its context. In this sense, it would be important to provide more disaggregated information.

The role of emotional states in fruit and vegetable consumption in Brazilian adults / O papel dos estados emocionais no consumo de frutas e vegetais em adultos brasileiros

Abstract The objective was to investigate the association between emotional states with adequate fruit and vegetable consumption (FVC). This is a population-based cross-sectional study with 1,100 adults from a medium-sized city in Southern Brazil. Adequate FVC was defined as concomitant intake ≥ 3 fruits and ≥ 5 tablespoons of vegetables per day. Exposures were self-perception of nervousness/stress and minor psychiatric disorders (MPD). Data analysis used logistic regression. After controlling for demographic, socioeconomic and behavioral variables, adults reporting lack of nervousness/stress were twice more likely to report adequate FVC than those who reported it. Similarly, those reporting not having MPD symptoms were 52% more likely to have adequate FVC than those who did not. These effects increased and remained significant among women.

Resumo O objetivo foi verificar a associação entre a autopercepção do estado emocional com o consumo adequado de frutas, verduras e legumes (FVL). Este é um estudo transversal de base populacional com uma amostra probabilística de 1100 adultos residentes na zona urbana de um município de médio porte do Brasil. Considerou-se como consumo adequado uma ingestão ≥ 3 frutas concomitante com ≥ 5 colheres de verduras/legumes ao dia. O estado emocional foi avaliado através da autopercepção do nervosismo/stress e distúrbios psiquiátricos menores (DPM). Potenciais fatores de confundimento incluíam variáveis demográficas, socioeconômicas e comportamentais. Foram observadas associações significativas entre a autopercepção de nervosismo/stress e DPM com o consumo adequado de FVL. Após o controle de fatores de confusão, adultos relatando ausência de nervosismo/stress possuíam uma chance de apresentar um consumo adequado duas vezes maior do que aqueles relatando nervosismo/stress. Similarmente, participantes com ausência de distúrbios psiquiátricos possuíam uma chance de consumo adequado FVL 52% mais elevada quando comparados àqueles que relataram presença desses sintomas. Quando estratificada por gênero, esse efeito aumentou e manteve-se com significância estatística apenas entre as mulheres.

Food environment and family support in relation to fruit and vegetable intake in pregnant women

The aim of the study was to investigate predictor factors related to self-perceived food environment, food practices, and family support and fruit and vegetable intake during pregnancy. A cross-sectional study was conducted among 282 pregnant women at the second trimester of pregnancy living in the city of Ribeirão Preto, Brazil. A food frequency questionnaire, and two 24-hour dietary recalls were obtained, and the Multiple Source Method was used to estimate the usual intake. Self-perceived food environment, food practice and family support were assessed by structured questionnaires. Logistic regression models adjusted for education, age, socioeconomic class, and BMI by gestational age were used to evaluate the relationship between self-perceived food environment, food practice and family support and fruit and vegetable intake. No association between self-perceived food environment and fruit and vegetable intake was found. However, the women who reported a greater number of meals per day (OR 1.95 (95% CI = 1.06; 3.56), p = 0.03), those who believed they consumed enough fruit and vegetable (3.71 (2.23; 6.20), p < 0.001), and who reported to have family support for a healthy diet (3.16 (1.78; 5.60), p < 0.001), were more likely to consume greater amounts of these foods. Our data suggests that the family support and a higher number of meals per day might be relevant to achieve a higher fruit and vegetable intake among pregnant women(AU)

A relação entre o ambiente alimentar e o suporte familiar e o consumo de frutas, verduras e legumes em gestantes. O objetivo do presente estudo foi investigar fatores preditores relacionados à percepção do ambiente alimentar, práticas alimentares e suporte familiar e o consumo de frutas, verduras e legumes durante a gestação. Trata-se de um estudo transversal, conduzido entre 282 gestantes residentes em Ribeirão Preto, SP, Brasil, durante o segundo trimestre gestacional. O consumo alimentar foi avaliado por meio de um questionário de frequência alimentar e dois recordatórios de 24 horas. Para estimar o consumo usual de alimentos foi utilizado o Multiple Source Method. A percepção do ambiente alimentar, práticas alimentares e suporte familiar foram avaliados por meio de um questionário estruturado. Modelos de regressão logística ajustados por escolaridade, idade, classe social e IMC por idade gestacional foram utilizados para avaliar a relação entre a percepção do ambiente alimentar, práticas alimentares e suporte familiar com o consumo de frutas, verduras e legumes. Nenhuma relação foi encontrada entre a percepção do ambiente alimentar e o consumo de frutas, verduras e legumes. Por outro lado, as gestantes que relataram um maior número de refeições ao dia (OR 1,95 (95%IC = 1,06; 3,56), p = 0,03), aquelas que consideravam que consumiam uma quantidade suficiente de frutas, verduras e legumes (3,71 (2,23; 6,20), p < 0,001), e aquelas que relataram suporte familiar para ter uma alimentação saudável (3,16 (1,78; 5,60), p < 0,001), apresentaram maior chance de consumir uma maior quantidade destes alimentos. Os resultados sugerem que o suporte familiar e um maior número de refeições sejam relevantes para o alcance do maior consumo de frutas, verduras e legumes entre gestantes(AU)

Caracterización de hábitos relacionados con enfermedades crónicas en población universitaria de Honduras / Characterization of habits related to chronic diseases in the university population of Honduras

Objetivo: caracterizar por primera vez los principales hábitos relacionados con las enfermedades crónicas no transmisibles en estudiantes universitarios. Método: estudio descriptivo transversal en una muestra estimada de 248 estudiantes entre indígenas y mestizos que ingresaron en 2012 en la Universidad Nacional de Agricultura, Honduras. Se contó con la aprobación del Comité de Ética del Instituto de Nutrición de Centroamérica y Panamá y con el consentimiento de los participantes. Se aplicó el cuestionario STEPS para recolectar información sociodemográfica, consumo de frutas, verduras, tabaquismo, alcoholismo y actividad física. Se realizó examen físico que incluyó toma de presión arterial, medida de la cintura, talla, peso y glucometría. Resultados: en la muestra, 139 (56,28 por ciento) eran hombres. La edad promedio fue de 21,5 años. El 22,22 por ciento tenía sobrepeso; 4,12 por ciento bajo peso y 3,29 por ciento obesidad; 12,75 por ciento declararon fumar y 53,5 por ciento consumir alcohol. En promedio, hombres y mujeres, consumían 1,6 y 1,1 porciones de frutas y verduras al día respectivamente. El 94,74 por ciento utilizaba bicicleta o caminaba al menos 10 minutos; 58,1 por ciento practicaba deportes. El 98 pior ciento tenía presión arterial normal y el 5,74 por ciento prediabetes (101-125 mg/dL en ayunas). Conclusiones: la población estudiantil lenca y otras etnias no se diferencian en su estado nutricional de los mestizos. La población posee factores protectores para las enfermedades crónicas no transmisibles como actividad física y bajo consumo de tabaco, pero ingieren apenas frutas y verduras. Las mujeres participan menos en deportes(AU)

Objective: to characterize for the first time the main habits related to non-communicable chronic diseases in university students. Methods: a cross-sectional and descriptive study was conducted in an estimated sample of 248 students from native and mixed groups, who joined the National University of Agriculture in 2012 in Honduras. The study was approved by the Ethics Committee of the Institute of Nutrition of Central America and Panama. The participants gave their informed consent. The questionnaire STEPS was used for collecting socio-demographic information, data on consumption of fruits, vegetables, smoking, alcohol and physical activity. A physical examination including measurement of height, weight, waist, blood pressure and blood glucose levels was performed in all of them. Results: of the surveyed 248 students, 139 (56.28 percent) were men. The average age was 21.5 years and 63.71 percent of the participants had a monthly family income of less than US$255. In the group, 22.22 percent ere overweighed, 3.29 percent obese and 4.12 percent low weighed. Alcohol was taken by 53.5 percent and 12.75 percent were current smokers. An average of 1.6 and 1.1 portions of fruits and vegetables per day were consumed, respectively. In this sample, 94.74 percent rode a bicycle or walked at least 10 minutes a day; 58.1 percent played sports. Most of them (98 percent ad normal blood pressure and 5.74 percent howed pre-diabetic glucose levels (101-125 mg/dL on fasting). Conclusions: the lencas and other native groups were not important different in nutritional status from students of mixed race. The population has protective factors that prevent it from developing non communicable diseases like physical activity and low smoking indexes; however, they barely consume fruits and vegetables. Women were especially less involved in sports(AU)

Significados del consumo de frutas y hortalizas en dos comunidades de zona rural del municipio de Turbo, Urabá Antioqueño / The meanings of eating fruits and vegetables in two rural communities of municipality of Turbo, Uraba Antioqueño

La presente investigación tuvo como objetivo: interpretar el significado atribuido al consumo de frutas y hortalizas en un grupo de familias de Turbo. El enfoque metodológico fue cualitativo, el cual permitió comprender las realidades alimentarias de los sujetos que vivencian la situación y en los escenarios y contextos donde ocurrieron los hechos. El método utilizado fue la etnografía; las técnicas para recabar la información fueron la entrevista cualitativa, el grupo de discusión y la observación. Hallazgos: en las familias participantes quienes más consumen frutas y hortalizas son las madres y los niños menores de nueve años, éstas son también quienes enseñan a los menores a consumir dichos alimentos. A las frutas y hortalizas les atribuyen propiedades en la prevención y curación de enfermedades, principalmente respiratorias y del tracto gastrointestinal.

The present study aimed at interpreting the meaning of fruits and vegetables consumption for a group of families of Turbo. The methodological approach was qualitative, which allowed the understanding of food realities through the subjects who experience the situations, scenarios and contexts where the studied facts occurred. The method used was ethnography; the techniques for gathering information were qualitative interviewing, group discussion, and observations. Findings: Mothers and children under nine are the ones who eat more fruits and vegetables among families; mothers are also those who teach the children to consume such foods. Fruits and vegetables are regarded as helps to prevent and cure diseases, especially respiratory and gastrointestinal ones.

Efecto de una intervención educativa sobre el consumo de frutas, verduras y pescado en familias de niños preescolares y escolares / Effect of a nutrition education intervention on consumption of fruits, vegetables and fish in families of prescholers and scholers

El objetivo del estudio fue evaluar el efecto de una intervención educativa sobre el consumo de frutas, verduras y pescado en familias de niños preescolares y escolares mediante una intervención de tres meses y una evaluación antes y después, en 27 familias intervenidas y 32 controles, de colegios municipales de una comuna de Santiago, Chile. Al inicio y final de la intervención se aplicó a cada niño y su padre una encuesta de frecuencia de consumo de frutas, verduras y pescado y de conocimientos, actitudes y prácticas de alimentación familiar. La intervención consistió en seis talleres de cocina de 90 minutos cada uno para los encargados de la preparación de alimentos en el hogar, utilizando además video y fotografía participativa. Los resultados mostraron un mayor consumo de frutas, verduras y pescado en el grupo intervenido (test de Kolmogorov-Smirnov, test de Wilcoxon, p<0,05). Al comparar el consumo pre-post por grupo, las diferencias resultaron significativas para el intervenido en todos los casos (test de Wilcoxon para muestras pareadas, p<0,05). En los padres, el consumo de frutas aumentó en 135,8 g, el de verduras en 19,5 g y el de pescado en 10,2 g diarios. En los niños, las frutas aumentaron 92,1 g, las verduras 65,9 g y el pescado 5,2 g al día. Todas las familias intervenidas (n=22) incorporaron algún cambio significativo en la alimentación saludable de su hogar. Los resultados muestran que es posible realizar cambios en los hábitos alimentarios de las familias, con la implementación de una intervención educativa que incluya talleres de cocina y materiales audiovisuales.

The objective of this study was to assess the impact of a nutrition education intervention on fruits, vegetables and fish consumption in pre-school and school age children families, through a three months education intervention with a pre-post evaluation in 27 intervened families and 32 controls from public schools in Santiago, Chile. A food-frequency questionnaire on fruits, vegetables and fish, and a survey on food and nutrition knowledge, attitudes and practices were applied to children and their parents. The intervention consisted in six 90 minutes cooking workshops, including the utilization of videos and photovoice for those who cooked in the families. Results showed a significant more consumption of fruits, vegetables and fish in the intervened than in the control group (test de Kolmogorov-Smirnov, test de Wilcoxon, p<0,05). Comparing pre-post consumption by group, significance differences were for the intervened group in all cases. (test de Wilcoxon for paired samples, p<0,05). In parents, fruit consumption increased 135.8 g, vegetables 19.5 g, and fish 10,2 g per day. In children, the increase in fruits was 92.1 g, vegetables 65.9, and fish 5.2 g per day. All the intervened families (n=22) introduced a significant healthy food improvement at home. Results showed that it is possible to change food habits in families with the implementation of a nutrition education intervention including cooking workshops, videos and photovoice.

Etapas del cambio, motivaciones y barreras relacionadas con el consumo de frutas y verduras y la actividad física en madres de preescolares atendidas en centros de atención primaria de salud / Stages of change, motivations and barriers related to the consumption of fruits and vegetables and physical activity in mothers of preschool children attending primary health centers

In order to design effective interventions for the prevention of childhood obesity the stages of change, motivations and barriers related to the consumption of five daily portions of fruit and vegetables and physical activity were determined in 323 mothers of preschool children attending Primary Health Centers, through the application of a previously validated survey. Only 5% of them consumed 5 or more portions with the majority (61.3%) consuming 1 to 2 portions. The main motivations to eat 5 portions were "I like them" and "to lose weight" while the main barrier was "I forget to eat them". With respect to physical activity, 33.1% considered themselves on the maintenance stage and 18.9% on the action stage. Main motivations were: "Makes me feel good", "To lose weight". Main barrier: "I don't have time". It is suggested that educational interventions consider the mother attitudes and beliefs to be more effective.

Con el fin de diseñar intervenciones efectivas que contribuyan a prevenir la obesidad infantil, se determinaron las etapas del cambio de la conducta, las motivaciones y barreras para consumir 5 porciones diarias de frutas y verduras y realizar actividad física en 323 madres de preescolares atendidas en Centros de Atención Primaria de Salud, mediante la aplicación de una encuesta validada en estudios previos. Sólo el 5% de ellas consumía 5 o más porciones diarias, la mayoría consumía 1 a 2 porciones (61,3%). Las principales motivaciones para comer 5 porciones fueron: "me gustan" y "para perder peso". La principal barrera "se me olvida comerlas". En la actividad física, el 33,1% indicó encontrarse en la etapa de mantenimiento y el 18,9% en acción. Las principales motivaciones: "me hace sentir bien" y "para perder peso". La principal barrera: "no tengo tiempo". Se sugiere que las intervenciones educativas consideren las actitudes y creencias de las madres, para ser más efectivas.

Obstaculizadores y facilitadores para aumentar el consumo de frutas y verduras en seis países de Latinoamérica / Barriers and facilitators to increase consumption of fruits and vegetables in six countries in Latin America

El bajo consumo frutas y verduras se encuentra entre los factores de riesgo para desarrollar enfermedades cardiovasculares y algunos tipos de cáncer. Los países han implementado políticas alimentarias para promover su consumo. El identificar las barreras que percibe la población para consumirlas ayuda a reconocer los recursos que estarían dispuestos a intercambiar para recibir beneficios. Los objetivos de este estudio son: determinar cuáles son los facilitadores y las barreras para aumentar el consumo de frutas y verduras en seis países de Latinoamérica y establecer si existe relación entre las guías alimentarias y el programa 5 al día. Este estudio es de campo y cualitativo. Se usaron las técnicas de entrevistas grupales a profesionales de salud y de los medios de comunicación, y entrevistas a expertos en políticas alimentarias. Los facilitadores destacados fueron la publicidad televisiva de las campañas que promueven su consumo, y la existencia de ferias libres en los barrios. Los obstaculizadores resaltados fueron la falta de políticas públicas de regulación sobre la publicidad y ganchos comerciales de los alimentos, de autosustentabilidad, de financiamiento de los programas relacionados, y de investigación sociológica del tema. La principal barrera para el consumo de frutas y verduras en estos países fue la falta de apoyo normativo y de políticas públicas relacionadas, siendo vital una buena campaña publicitaria en el éxito de los programas que fomentan su consumo. La principal relación existente entre las Guías Alimentarias y el Programa 5 al día es que ambos promueven el consumo de verduras y frutas.

Low intake of fruits and vegetables is among the risk factors for cardiovascular disease and some cancers. The countries have implemented policies to promote food consumption. Identifying the barriers perceived by people to consume it helps to recognize the resources that would be willing to exchange for benefits. The objectives of this study are to determine what factors are facilitators and barriers to increasing consumption of fruits and vegetables in six countries in Latin America, and a possible relationship between the 5 a day program and the food based dietary guidelines. This is a qualitative and field study. Techniques used were group interviews with health professionals and the media, and interviews with experts in food policy. The outstanding facilitators were television advertising campaigns promoting their use, and the existence of fruits and vegetables markets in the neighborhoods. Highlighted those obstacles were lack of public policies of advertising regulations and trade hooks of food, of self-sustainability, of funding for related programs, and of sociological research of the topic. The main barrier to the consumption of fruits and vegetables in these countries was the lack of policy support and related public policy, being a good advertising campaign vital to the success of programs that encourage consumption. The main relationship between the Dietary Guidelines and the 5 A Day Program is to both promote the consumption of vegetables and fruits.

Consumo de frutas e hortaliças por idosos de baixa renda na cidade de São Paulo / Fruit and vegetable intake among low income elderly in the city of São Paulo, Southeastern Brazil

OBJETIVO: Estimar os fatores socioeconômicos e sociodemográficos associados ao consumo diário de cinco porções de frutas e hortaliças por idosos residentes em áreas de baixa renda, identificando as principais frutas e hortaliças que compõem a dieta desta população. MÉTODOS: Estudo transversal de base populacional com 2.066 idosos (>60 anos) de baixa renda residentes na cidade de São Paulo, SP, em 2003-2005. Para a avaliação do consumo de frutas e hortaliças foi aplicado questionário de freqüência alimentar. As respostas foram transformadas em consumo diário e comparadas às recomendações da Organização Mundial da Saúde (consumo de cinco ou mais porções diárias). A relação entre consumo recomendado de frutas e hortaliças e variáveis socioeconômicas foi avaliada mediante modelos de regressão logística. RESULTADOS: Dos participantes, 60,5 por cento eram mulheres e 39,5 por cento homens. Cerca de um terço dos idosos (n=723; 35,0 por cento) não consumia diariamente nenhum tipo de fruta ou hortaliça e 19,8 por cento relataram consumo diário de cinco ou mais porções de frutas e hortaliças. Este consumo esteve positivamente associado à renda e à escolaridade. CONCLUSÕES: O consumo de frutas e hortaliças de idosos de baixa renda do município de São Paulo mostrou-se insuficiente em relação às recomendações da Organização Mundial da Saúde e está associado a condições socioeconômicas desfavoráveis.

OBJECTIVE: To estimate the socioeconomic and sociodemographic factors associated with the daily intake of five servings of fruit and vegetables by elderly individuals living in low income areas, identifying the main fruits and vegetables which compose the diet of this population. METHODS: This is a cross-sectional population-based study with 2,066 low income elderly individuals (>60 years) living in the city of São Paulo, Southeastern Brazil, in 2003-2005. To assess the fruit and vegetable intake a Food Frequency Questionnaire was administered. The answers were transformed into daily intake and compared with the recommendations of the World Health Organization (five or more servings per day). The relationship between recommended fruit and vegetable intake and socioeconomic variables was analyzed using logistic regression models. RESULTS: Of the participants, 60.5 percent were women and 39.5 percent were men. Approximately one third of the elders (n=723; 35.0 percent) did not consume any kind of fruit or vegetable on a daily basis and 19.8 percent reported a daily intake of five or more servings of fruits and vegetables. This intake was positively associated with income and years of schooling. CONCLUSIONS: The fruit and vegetable intake of low income elderly individuals in the city of São Paulo was insufficient according to the recommendations of the World Health Organization and is associated with unfavorable socioeconomic conditions.

Etapas del cambio relacionadas con el consumo de frutas y verduras, actividad física y control del peso en estudiantes universitarios chilenos / Stages of change related to fruit and vegetables consumption, physical activity, and weight control in Chilean university students

Como línea base para diseñar intervenciones efectivas en promoción de salud, se determinó el estado nutricional y las etapas del cambio respecto al consumo de frutas y verduras, la actividad física y el control del peso en 955 estudiantes de ambos sexos en la Universidad del Bio-Bio, Chile. La muestra fue seleccionada aleatoriamente por sede, facultad y carrera, con un nivel de confianza del 95 por ciento y un error máximo del 3 por ciento. Se realizó un análisis descriptivo y se evaluó la asociación entre el estado nutricional y las variables estudiadas aplicando la prueba de Chi2. Para determinar el estado nutricional se usó el índice de masa corporal y los criterios de la OMS para adultos. Para evaluar las etapas del cambio se aplicó un instrumento previamente validado por el INTA. La prevalencia de sobrepeso y obesidad alcanzó al 48,2 por ciento en los hombres y al 25,5 por ciento en las mujeres, (p<0,0001). Sólo 3,1 por ciento de los hombres y 7,3 por ciento de las mujeres consumían las 5 porciones diarias recomendadas de frutas y verduras. La mayoría consumía 1 a 2 porciones (69,5 por ciento hombres y 54,3 por ciento mujeres), y el resto 3 a 4 porciones (18,2 por ciento y 34,7 por ciento, respectivamente) (p<0,0001). El 58 por ciento de los hombres y el 43 por ciento de las mujeres realizaban actividad física regularmente (p<0,0001). El 73,6 por ciento de los hombres y 79,3 por ciento de las mujeres estaban tratando de reducir o mantener su peso (p<0,0002). Se concluye que los estudiantes requieren intervenciones específicas y condiciones apropiadas para aumentar el consumo de frutas y verduras y la actividad física.

In order to design effective health promotion interventions, nutritional status and the stages of change related to the consumption of fruit and vegetables, physical activity, and weight control were determined in 955 students of both genders at the University of Bio-Bio, Chile. The sample was randomly selected by campus, faculty, and career, with a level of confidence of 95 percent and a maximum error of 3 percent. Beside the descriptive analysis, to evaluate the association among nutritional status, fruit and vegetables consumption, physical activity and weight control, Chi2 test was applied. Nutritional status was determined by Body Mass Index and WHO reference standards for adults. A questionnaire previously validated by INTA was applied to evaluate the stages of change. The prevalence of overweight and obesity reached 48.2 percent in men and 25.5 percent in women (p<0.0001). Only 3.1 percent of men and 7.3 percent of women consumed the 5 recommended daily servings of fruit and vegetables. The majority consumed 1 or 2 daily servings (69.5 percent men and 54.3 percent women), and the rest 3 to 4 servings (18.2 percent and 34.7 percent, respectively) (p<0.0001). 58 percent of men and 43 percent of women carried out physical activity regularly (p<0.0001). 73.1 percent of men and 79.3 percent of women were trying to reduce or not to increase their weight (p<0.0002). It is concluded that students require specific interventions and appropriate conditions to increase their fruit and vegetables consumption, and physical activity.

Motivaciones y barreras para consumir 5 porciones de frutas y verduras al día en madres de escolares y profesores de enseñanza básica / Motivation and barriers in the consumption of five daily servings of fruit and vegetables by mothers of school age children and primary school teachers

Como línea base para diseñar intervenciones más efectivas en promoción y educación, se estudió las etapas del cambio, motivaciones y barreras relacionadas con el consumo de 5 porciones diarias de frutas y verduras en 463 madres de escolares de distinto nivel socioeconómico (NSE) y 412 profesores de enseñanza básica. Estos grupos fueron escogidos por su influencia en la formación de hábitos en los niños. Para determinar las etapas del cambio, se aplicó un instrumento diseñado y validado por el Instituto Americano de Investigación del Cáncer, adaptado en Chile, contestado voluntariamente por los participantes. El 58 por ciento de las madres y el 61 por ciento de los profesores comían 1 a 2 porciones de frutas y verduras al día; el 29,4 y 32,3 por ciento 3 a 4 porciones, y sólo el 10,3 y 4,1 por ciento las 5 porciones, respectivamente. Entre las principales motivaciones para comer 5 porciones destacaron “me gustan”, para “prevenir enfermedades”, “me hacen sentir bien” y “para bajar de peso”. Entre las barreras: “se me olvida comerlas”, “no tengo tiempo”, “no me quitan el hambre” y “me da flojera prepararlas”, sin diferencias por NSE. El precio de las frutas y verduras fue considerado una barrera por el 15,1 por ciento de las madres de NSE medio alto y el 26,4 por ciento de las de NSE medio bajo (p<0,002). En los profesores, estas cifras alcanzaron al 25,4 por ciento en los hombres y al 11,7 por ciento en las mujeres (p<0,002). Se concluye que es necesario implementar intervenciones específicas para lograr que madres y profesores apoyen este saludable hábito en los niños.

As a baseline for the promotion of health and the design of educational interventions, the benefits, barriers and stages of change related to the consumption of five daily servings of fruit and vegetables were studied in 463 mothers of school age children from different socioeconomic levels (SEL) and 412 primary school teachers in 3 cities in Chile. These groups were selected because of their influence over children’s eating habits. For the evaluation of stages changes, a questionnaire designed by the American Institute for Cancer Research was adapted and applied. The questionnaire was answered voluntarily by the participants. 58 percent of the mothers and 60 percent of the teachers ate 1-2 servings of fruit and vegetables daily; 29.4 and 32.3 percent ate 3-4 servings and only 10 and 4 percent respectively ate 5 servings. Benefits reported from fruit and vegetable consumption in both groups were pleasure, wellness, a sense of well being and weight management. Barriers mentioned were forgetfulness, time constraints, non-satisfaction of appetite and lack of motivation. The price of fruit and vegetables was considered high by 15.1 percent of mothers of medium high SEL and by 26.4 percent of medium low SEL (p<0.002). Among teachers, 25.4 percent of men and 11.7 percent of women also considered price as a barrier (p<0.002). Such results show that both mothers and teachers need specific interventions to improve their own motivation for eating more fruit and vegetables and to thus support this healthy eating habit in children.