Food exchange list based on macronutrients: adapted for the Ecuadorian population.

Background: Food exchange lists allow health professionals to generate healthy eating plans adapted to individual or population needs. The objective of this study was to develop the first food exchange list based on the macronutrients and energy provided by the various food groups of the Ecuadorian diet. Methods: The list of Ecuadorian food exchanges was constructed by going through the following phases: (1) Selection of household measurements; (2) Selection of tables and databases of the nutritional composition of food items; (3) Definition of food groups and quantities; (4) Determination of the average energy and macronutrient values of each group; and (5) Photographic record. For the definition of food quantities, statistical criteria were applied according to a standard deviation of ±2SD; thus, for carbohydrates: ±5 g, total fat: ±2 g, and protein: ±3 g. To ensure the inclusion of the food items in the groups, a coefficient of variation of less than 30% and a Z value of ±2 were also considered. Results: The list of food exchanges is presented with eight general groups according to the predominant nutrient (carbohydrates, proteins, or fats), and, where necessary, subgroups are included according to the second predominant nutrient. The list includes 404 food items with their photographic record, represented by their net weights and corresponding household measurement. All food items met the statistical criteria that help to reduce the variability of the nutritional composition of the food items in each group. Conclusion: This is the first list of Ecuadorian food exchanges based on statistical criteria. It represents a novel tool for public health professionals as well as researchers. Resulting healthier eating plans may improve daily dietetic practice, facilitate better clinical trial designs and help establish guidelines according to Ecuador's cultural and dietary patterns. The described methodology can further be used to develop other food exchanges lists for patients with specific nutritional requirements.

Knowledge, attitudes and practices surrounding sodium intake in Ecuador: a pilot study / Conocimientos, actitudes y prácticas en torno a la ingesta de sodio en Ecuador: estudio piloto

ABSTRACT Objective To identify the main sources of sodium in the Ecuadorian diet and determine knowledge, attitudes and practices related to the use of salt/sodium. Materials and Methods A cross-sectional study was conducted by taking a convenience sample of 177 adults. Socio-demographic, anthropometric and clinical data were collected. Frequency of consumption of food items high in sodium and knowledge, attitudes and practices regarding salt intake were evaluated. Results Meat products, sugary drinks, sausages, canned fish and seasonings are the food items with the highest consumption and sodium content. Nearly 97% of participants had a misperception about their sodium intake. While 99% know that a diet high in salt causes health problems, only 38.4% take a systematic action to regulate their salt intake. Conclusions There were a common misperception about sodium consumption. Only a small number of people take an action to reduce their consumption, although these actions was ineffective.

RESUMEN Objetivo Identificar las principales fuentes de sodio en la dieta ecuatoriana y determinar los conocimientos, actitudes y prácticas relacionadas con el uso de sal. Materiales y Métodos Estudio transversal con una muestra conveniencia de 177 adultos. Se recogieron datos sociodemográficos, antropométricos y clínicos. Se evaluó la frecuencia de consumo de alimentos ricos en sodio y los conocimientos, actitudes y prácticas con respecto al consumo de sal. Resultados Los productos cárnicos, bebidas azucaradas, salchichas, pescado en conserva y condimentos son los alimentos de mayor consumo y contenido de sodio. Casi el 97% de los participantes tuvo una percepción errónea sobre el consumo de sodio. El 99% conoció que una dieta alta en sal causa problemas de salud, pero solo el 38.4% tomo una acción sistémica para regular su consumo. Conclusiones Existe una percepción errónea común sobre el consumo de sodio. Solo un pequeño número de personas toma medidas, inefectivas, para reducir su consumo.

Food insecurity and malnutrition in vulnerable households with children under 5 years on the Ecuadorian coast: a post-earthquake analysis.

INTRODUCTION: A household's nutritional status and food security can be affected after a natural disaster, especially in families who live in risk situations. The objective of this study was to determine the prevalence of food insecurity, inadequate dietary diversity and poor nutritional status of mothers and children under 5 years old from vulnerable families residing in the rural community of La Punta, after the earthquake in Ecuador on 16 April 2016. METHODS: Through a non-probabilistic sampling, 28 families were selected. The levels of food insecurity in households were determined by applying a food safety scale and household dietary diversity score. Moreover, Z-scores were used to evaluate the nutritional status of children, while body mass index was used in mothers. RESULTS: All households suffered food insecurity, with mild food insecurity being the most prevalent (51.9%), followed by severe food insecurity (33.3%). Although all households had high diversity scores, the products they most consumed have low nutritional value, such as rice, soft drinks and oils. There was a low consumption of whole grains, fruits and vegetables. Additionally, there was a high percentage of overweight and obese mothers (57.1%) and a high prevalence of chronic undernutrition (40.9%) and global undernutrition (13.6%) in children under 5 years old. CONCLUSION: The predominance of severe food insecurity occurred in overweight and obese mothers with inadequate dietary diversity. This probably happened because of a lack of access to food to adequately meet the nutritional needs of each member of the family. The results suggest that health promotion with actions aimed at food security is a priority within an integral action plan for natural disasters.

Urinary sodium excretion in a young to middle-aged adult urban population: a pilot study in Ecuador / Excreción de sodio urinario en una población urbana de adultos jóvenes y de mediana edad: un estudio piloto en Ecuador

ABSTRACT Objective High sodium consumption is associated with cardiovascular disease (CVD). CVD is the leading cause of mortality in Ecuador, which may be caused in part by unhealthy eating habits. Currently, there are no data on the consumption of sodium using 24-hr urine samples. The aims of the study were to provide preliminary data of sodium intake in an urban population sample consisting of adults between 25 and 64 years old, and to explore the feasibility to conduct a population-level sodium intake determination by using 24-hr urine samples. Methods A cross-sectional study was conducted in a sample of 129 adults living in an urban setting. 24-hr urinary samples were collected and the WHO STEPS instrument was used to collect the socio-demographic and clinical characteristics of participants. A reference value of 2.0 g/day was used to differentiate between normal and high sodium intake groups. Results Participants' median age was 39 years, 91% of them identified themselves as belonging to the mestizo race, and 60% were female. The average sodium intake was 2 655(±1 185) mg/d (range: 1 725 to 3 404), which is equivalent to a salt intake of 6.8 g/d (range: 4.4 to 8.7). Sodium intake was significantly higher in males than in females: 3 175(±1 202) mg/d vs. 2 304(±1 042) mg/d, respectively, (p<.01). Conclusions Sodium consumption in two-thirds of the participants was higher than the WHO recommended level. These results should help to support the execution of a national sodium intake survey that, in turn, would provide information to guide and plan public health strategies seeking to decrease cardiovascular diseases occurrence rates in Ecuador.(AU)

RESUMEN Objetivo Un exceso de sodio dietético se asocia con enfermedades cardiovasculares (ECV). Las ECV son la principal causa de mortalidad en el Ecuador, tal vez por patrones dietéticos no saludables en su población. Al momento no existe información del consumo de sodio usando orina de 24-hr. Los objetivos del estudio fueron proveer información preliminar de la ingesta de sodio en una muestra urbana de adultos de 25-64 años, y explorar la factibilidad de realizar un estudio a nivel nacional. Métodos Estudio de corte-transversal de 129 adultos residentes en un entorno urbano. Se recolectó muestras urinarias de 24-hr y se recolectaron características socio-demográficas y clínicas usando los cuestionarios STEPS de la OMS. Un valor de referencia de 2.0 g/día fue utilizado para discriminar entre consumidores normales y altos de sodio. Resultados La mediana de edad de la población estudiada fue de 39 años, 91% se autodefinió de raza mestiza, y 60% fueron femeninas. La ingesta promedio de sodio fue de 2 655(±1 185) mg/d (rango: 1 725 to 3 404), que es equivalente a una ingesta de sal de 6.8 g/d (rango: 4.4 to 8.7). La ingesta masculina fue significativamente mayor que el de las mujeres 3 175(±1 202) mg/d vs. 2 304(±1 042) mg/d, respectivamente, (p<.01). Conclusiones Dos tercios de la población estudiada consume sodio mayor al recomendado por la OMS. Estos resultados apoyan la ejecución de un estudio nacional que guíe la planificación en salud pública e informe estrategias para mejorar la salud cardiovascular en el Ecuador.(AU)

Urinary sodium excretion in a young to middle-aged adult urban population: a pilot study in Ecuador.

OBJECTIVE: High sodium consumption is associated with cardiovascular disease (CVD). CVD is the leading cause of mortality in Ecuador, which may be caused in part by unhealthy eating habits. Currently, there are no data on the consumption of sodium using 24-hr urine samples. The aims of the study were to provide preliminary data of sodium intake in an urban population sample consisting of adults between 25 and 64 years old, and to explore the feasibility to conduct a population-level sodium intake determination by using 24-hr urine samples. METHODS: A cross-sectional study was conducted in a sample of 129 adults living in an urban setting. 24-hr urinary samples were collected and the WHO STEPS instrument was used to collect the socio-demographic and clinical characteristics of participants. A reference value of 2.0 g/day was used to differentiate between normal and high sodium intake groups. RESULTS: Participants' median age was 39 years, 91% of them identified themselves as belonging to the mestizo race, and 60% were female. The average sodium intake was 2 655(±1 185) mg/d (range: 1 725 to 3 404), which is equivalent to a salt intake of 6.8 g/d (range: 4.4 to 8.7). Sodium intake was significantly higher in males than in females: 3 175(±1 202) mg/d vs. 2 304(±1 042) mg/d, respectively, (p<.01). CONCLUSIONS: Sodium consumption in two-thirds of the participants was higher than the WHO recommended level. These results should help to support the execution of a national sodium intake survey that, in turn, would provide information to guide and plan public health strategies seeking to decrease cardiovascular diseases occurrence rates in Ecuador.