Raquel Campos

Dietary characteristics of complementary foods offered to Guatemalan infants vary between urban and rural settings

The objective of this study was to describe and compare the dietary variety, diversity, and origins of complementary foods given to urban and rural Guatemalan infants in the second semester of life. Dietary intake from a total of 128 infants of both sexes, aged 6.0 to 12.0 months on admission, from a low-income district of Guatemala City and a rural Mayan village was collected by means of 3 nonconsecutive 24-hour quantitative intake recalls and breast-feeding histories. We hypothesized that rural/urban, age, and sex differences would occur with respect to dietary variety and diversity scores and descriptive features at 7 levels, that is, animal or plant origin (animal, plant, both, or water); solids or semisolids vs soups and stews vs liquids; infant vs family foods; modern vs traditional foods; processed vs nonprocessed foods; commercial vs noncommercial foods; and fortified vs nonfortified foods. Overall dietary variety and diversity scores did not differ significantly between sampling areas or between sexes. Infants aged 9 to 12 months had a higher dietary variety and diversity than infants aged 6 to 9 months. Plant sources constituted a large part of the diet in both areas. Foods prepared specifically for infants, rather than for the household, were not common, although more common in the urban area than in the rural area. Commercial, processed, and fortified foods were commonly consumed in both settings. It can be concluded that although no geographical differences were seen in dietary variety or diversity, distinctions between types of selected and consumed foods were observed.

The Positive Deviance Approach Can Be Used to Create Culturally Appropriate Eating Guides Compatible with Reduced Cancer Risk

The 1997 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Report provides 14 individual guidelines to reduce global cancer risk. The positive deviance approach could be appropriate for creating class-appropriate, healthy eating menu guides for consuming a diet to minimize cancer risk in Guatemala. Guatemalan adult participants (n = 873) were enrolled in the Concordance Project from 3 socioeconomic strata: rural area (n = 301), lower urban (n = 298), and higher urban (n = 274). Participants with intakes below recommended nutrient intakes and current smokers were excluded from the analysis. Concordance with 14 selected WCRF/AICR individual guideline components was evaluated. We selected participants for making a set of 14 rotating menus for a cancer prevention healthy eating guide. A priority sorting through the 873 participants of the survey identified a total of 23 and 21 model participants, respectively, from the rural and urban poor groups (concordant with 12 of 14 recommendation components) and 15 from the urban middle class (concordant with 11 of 14 recommendation components), with the highest degree of concordance with the WCRF/AICR guidelines. The most commonly violated recommendation was sugar consumption, followed by maintaining weight stability. The FFQ for 14 individuals from each class were transformed into a day menu to create a rotating diet guide derived from members of each social group. A potentially useful personal guide for eating compatibly with adequate nutrient intake and reduced cancer risk, appropriate to the culture and economic means of distinct social classes in Guatemala, is approaching the stage for application.

Several ‘problem nutrients’ are identified in complementary feeding of Guatemalan infants with continued breastfeeding using the concept of ‘critical nutrient density’

Background/Objectives:The World Health Organization (WHO) recommends nutritionally adequate complementary feeding (CF) through the introduction of indigenous foodstuffs and local foods while breastfeeding for at least 2 years. To determine the adequacy of the contribution of CF to the diets of Guatemalan infants at the 7th–12th month of life receiving high-intensity continued breastfeeding.Subjects/Methods:Critical nutrient densities for CF were modelled using age- and sex-specific energy and protein requirements assuming children to be at the 50th weight percentile of local peers and 15th weight percentiles of the 2006 WHO standards. Nutrient requirements for the total diet were determined using the recommended nutrient intakes. Breast milk was assumed to provide 75% of total energy at the 7th–9th month and 50% at the 10th–12th month. Gaps between computed critical nutrient densities and the CF consumption of 128 Guatemalan infants based on data collected by means of three nonconsecutive 24-h quantitative intake recalls were examined. Locally consumed foods with nutrient densities above the modelled critical densities were identified.Results:Observed non-breast milk complementation would result in total diets providing inadequate nutrient density for vitamin A, niacin and vitamin C in some age groups. Major gaps for calcium, iron and zinc were ubiquitous across all groups. Few foods commonly consumed among Guatemalan infants had adequate densities of ‘problem nutrients’.Conclusions:The critical nutrient density concept is useful to evaluate the nutrient adequacy of the infant’s diet. Fortified foods are essential sources of the main ‘problem nutrients’, namely calcium, iron and zinc, given that natural sources are scarce.

Food variety, dietary diversity, and food characteristics among convenience samples of Guatemalan women

OBJECTIVE To compare variety and diversity patterns and dietary characteristics in Guatemalan women. MATERIAL AND METHODS Two non-consecutive 24-h recalls were conducted in convenience samples of 20 rural Mayan women and 20 urban students. Diversity scores were computed using three food-group systems.Variety and diversity scores and dietary origin and characteristics were compared between settings using independent t-test or Mann-Whitney-U-test. RESULTS Dietary variety and diversity were generally greater in the urban sample when compared to the rural sample, depending on the number of days and food-group system used for evaluation.The diet was predominantly plant-based and composed of non-fortified food items in both areas.The rural diet was predominantly composed of traditional,non-processed foods. The urban diet was mostly based on non-traditional and processed items. CONCLUSION Considerations of intervention strategies for dietary improvement and health protection for the Guatemalan countryside should still rely on promotion and preservation of traditional food selection.

Erythrocyte fatty acid status in a convenience sample of residents of the Guatemalan Pacific coastal plain

We report the fatty acid composition, and in particular, the n-3 and n-6 long-chain polyunsaturated fatty acids (LCPUFA), in erythrocytes from a convenience sample of 158 women and 135 schoolchildren residing in the southern Pacific Coast of Guatemala. Erythrocyte fatty acids were analyzed by gas-liquid chromatography with flame ionization detection and the profiles were expressed as a weight percent; the Omega-3 Index values were also determined. Schoolchildren had significantly higher mean ARA and total n-6 fatty acid levels than the women. Women had significantly higher EPA fatty acid levels than schoolchildren, but the reverse was true for DHA. For mean total n-3 fatty acid concentration, women and schoolchildren had similar values. The red cell weight percentages of selected fatty acids were also similar in women and schoolchildren. As compared with erythrocyte fatty acid data from developed countries, Guatemalan women and schoolchildren had consistently lower LCPUFA values. The traditional diet of Guatemalans living in the Pacific coastal region provided a worse erythrocyte fatty acid profile than that typically obtained from a Western diet. Additional fatty acid composition studies with associated dietary intake data in other inland locations may be useful for the interpretation of the nutritional status of Guatemalan children and adults.

Studies on variation in fecal reactive oxidative species generation in free-living populations in Guatemala*

Among the factors associated with the risk of colorectal cancer and other large bowel diseases are gender, with women having lower incidence than men, and free-radical mediated oxidation. Dietary fiber has been attributed a protective role in human gastro-intestinal health. The main aim of this study was to determine the degree of association between dietary fiber consumption and fecal free-radical production in healthy rural and urban Guatemalan women, moreover, to look for associations between gender and fecal reactive oxidative species (ROS) basal production, a marker of in situ colonic free-radical-based oxidation. For this purpose, we assessed the dietary fiber consumption, using two 24-h recalls, in urban and rural females, and compared the baseline data, i.e., of iron-supplement-free periods, in three previous studies. Two of these trials quantified the fecal ROS generation as total hydroxylated products resulting from free-radical attack on salicylic acid along with residual non-heme iron content in stool samples from 27 Fe-replete men. The third study assessed the same variables in 20 rural and 20 urban women, all consuming their respective habitual diets. The average fiber consumption for females was more than double in the rural group than in the urban population. As for the average ROS responses, a 2.5-fold difference was observed between men and women, with men having the higher concentrations of total hydroxylated products. This difference was sex-linked, unaffected by statistically significant differences in dietary fiber intake, nor by different concentrations of residual fecal non-heme iron between rural and urban women. The difference in background ROS production between men and women suggests a gender-related influence on intraintestinal oxidation that may protect women from harmful effects of dietary oxidants, such as iron.