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The bars and restaurants of the University of Cuenca are a meeting point for the university community. Ensuring that these spaces prepare and sell safe food is an important pillar of the ̈Cuenca Ciudad Universitaria ̈ initiative. The objective of this study was to analyze compliance with basic food safety standards in eight bars and restaurants for the preparation and consumption of food on the campus of the University of Cuenca. A checklist of Good Manufacturing Practices was applied in each of the bars and restaurants and a microbiological control of total coliforms and Escherichia coli was carried out on 10 inert surfaces in contact with food for each of the bars, according to ministerial resolution No. 461-2007/MINSA (Technical Guidance for the microbiological testing on surfaces in contact with food and drink - Peruvian Standard). The results obtained indicated that compliance with GMP in the bars and restaurants of the University of Cuenca was 77,4% ± 10,3 (95% IC: 68,8 - 86,0). 63,8% of surfaces analyzed complies with the permissible limits for total coliforms, while none of the surfaces exceeded the permissible limit for E.coli. These results correspond to the fact that five of the eight bars and restaurants analyzed present compliance with basic food safety standards of around 75%. In conclusion, this evaluation of degree of compliance with basic food safety standards highlights the biological risk present in the inert surfaces analyzed, therefore, it is recommended to standardize cleaning and disinfection processes in the bars and restaurants evaluated.

The present study seeks to determine the factors associated with the development of jaundice and how newborns respond to treatment, in the Neonatology area of the Vicente Corral Moscoso Hospital, during the year 2020, through the statistical analysis of variables obtained from the review of clinical histories and laboratory results. To determine the relationship between the variables studied, the Chi-Square statistical test was applied, the behavior of the variables that showed correlation and the response to treatment was analyzed using the following programs: SPSS v 26.0 and Excel 2016. The variables determined as factors associated with the development of neonatal jaundice were: gestational age, weight, blood group incompatibility, maternal illness during pregnancy, type of delivery and complications, obstetric trauma, comorbidity and type of feeding. Regarding treatment, the most frequently applied therapeutic measure was Simple Phototherapy, the greatest decrease in serum bilirubin concentration was achieved with the use of Intensive Phototherapy + Phenobarbital, reserved for patients at higher risk. The main adverse effect recorded was dehydration, the treatment that presented the most adverse effects was Intensive Phototherapy + Phenobarbital, while Simple Phototherapy was the treatment that reported the least adverse effects. The results obtained show that neonatal jaundice is an important public health problem due to the high prevalence found, most of the neonates were diagnosed after 24 hours of birth and were at risk of developing bilirubin encephalopathy, in addition discrepancies were observed between the clinical evaluation and laboratory results, which is related to the high rate of readmissions associated with this disorder.

The food industry uses nutrient claims, health claims, offers, and the use of promotional characters as marketing strategies. The inclusion of these strategies can affect the purchasing patterns of children and teenagers, becoming a public health issue by influencing childhood obesity. The present study evaluated compliance with the Ecuadorian policies that regulate nutritional labeling (INEN NTE 1334-1, 2 and 3; INEN RTE 022). This study also aimed to identify the proportion of health/nutrient claims and promotional strategies mostly used in sweet snacks sold in Cuenca, Ecuador according to the INFORMAS protocol. The data was obtained from 284 sweet snacks, within 11 different categories, purchased in a representative supermarket in Cuenca. A standardized photographic database was developed and used to fill out a form in the KoboKollect application, then analyzed in Excel. The general results were: NTE 1334-1 on basic labeling requirements was fully met. NTE 1334-2 on the mandatory nutrients was not reported on all products. RTE-022 was complied in most cases and there was a high percentage of “HIGH IN…” sugar and fat. The declarations were analyzed according to the INFORMAS protocol since NTE 1334- 3 lacks depth, such as not taking into account the “Environmental declarations” and “Other declarations related to health”. The most used advertising strategies were the use of the company's own characters, web pages, and recognitions or awards. The main problem found was that the current policies aren’t as rigorous as policies that have been demonstrated effective in other countries. Ecuador implements the mandatory use of the nutritional traffic light in its label, but it has not proven to be effective to lower the consume of ultra processed foods like the case of the warning symbols. Ecuador needs new and strict policies to regulate the marketing strategies that influence the health of Ecuadorian children and teens.

Taste sensitivity influences an individual's food preferences; therefore, they are important predictors of food intake. The main objective of this titration work is to determine the thresholds of sensitivity to salt and patterns of consumption of foods rich in salt, in schoolchildren aged 7 to 12 years with a diagnosis of moderate to severe dental fluorosis. An exploratory descriptive observational study was carried out in 43 children from rural parishes of Cuenca, the "Test of perception and recognition of the taste for the salty taste" was applied; The research is complemented with the identification of the frequency of consumption of foods with high sodium content through the Frequency of Consumption Questionnaire (CFC). The perception and recognition threshold was established at the dilution 0.02 mol / L and 0.04 mol / L (NaCl) respectively, it was determined that the degree of fluorides is not related to the sensitivity of taste for salt; the foods most consumed by children are presented in groups. The carbohydrates most consumed are white rice (61%, N = 2-3 times per day), nickname (44%, N = 1 time per day), white salt bread (39.5%) and cereal breakfast (26%) consumed 2 to 4 times a week and cooked potatoes (33%, N = 1 time a week); from the protein group: dry chicken and beans (42%, N = 2-4 times per week); cooked egg (75%), fried fish (47%), tuna in oil (44%), beef broth (44%) are consumed once a week; It was determined that there is little variety in the ingredients of the salads (tomato, onion, lettuce, oil, lemon and salt) (44%, N = 2 to 4 times per week). Of the foods consumed, salchipapa (35%, N = 1 time per week), G pipes (44%) and fried sausage (37%), are consumed 2 to 4 times per month. The results obtained contribute significantly to the study of "Evaluation of salt consumption habits and its relationship with moderate and severe dental fluorosis in schoolchildren aged 7 to 12 in rural parishes of the Cuenca Canton, in the period January 2019 - Dece

The main objective of this study was to priority the food security and knowledge, attitudes and practices of parents whose children are enrolled in the public institution “Centro de Desarrollo Infantil” (CDI) belonging to “Ministerio de Inclusion Economica y Social” (MIES) located in the city of Paute. The total of participants were 80 parents (95.2%), the surveys used for data collection were two: the first one about the knowledge, attitudes, and practices (KAP) of parents (Annex 1). An the second about the food security of their families (Annex 2). These data were obtained by telephone calls and the answers were scored to determine the level of food safety (KAP, Table 1) and food security (Table 2). The results obtained from each survey were rated out of 100 %, of which those who obtained > 70 % in knowledge and practices were considered as satisfactory, and about attitudes were considered as positive. The results showed to be mostly sufficient in knowledge and practices with percentages of 65 % and 89 % respectively, as for attitudes they were positive in 95 %. The most frequently questions were: 1) The attitudes of the parents depend on the knowledge obtained in training sessions. 2) The best way to eliminate germs out of food, the majority selected to cook the food completely. 3) Since most of the respondents are mothers, it is almost inevitable that they will cook and serve food when they get sick, which is why their attitude responses did not parallel with their practice responses. In terms of food security, in 46.3% of the families were found mild food insecure, and 53.7% were divided into the following 3 degrees: moderate food insecurity with 26.3%, food secure and severe food insecurity with 14.8% each.

The daily intake of fluoride comes mainly from fluoridated salt, food, drinking water, fluoridated supplements, and also from toothpastes, mouthwashes, gels and varnishes. However, excessive intake has been associated with the development of dental fluorosis. Objective: The objective of this study was to estimate the intake of fluoride from salt sources, to know the oral hygiene habits related to the intake of fluoride by consumption of toothpastes and mouthwashes, and to identify the frequency of consumption of foods rich in salt to estimate possible sources of fluoride from food. Methodology: An exploratory descriptive study was carried out in a sample taken at convenience in children without dental fluorosis from 5 rural parishes of the Cuenca canton. The 24hour reminder was applied to estimate the intake of fluoride from the salt added to food according to the recipes, a questionnaire of oral hygiene habits to identify the intake of fluoride by the consumption of toothpastes or mouthwashes, and a questionnaire of frequency of consumption to estimate possible sources of fluoride from foods rich in salt. Results: 46 children, 7 to 12 years old, participated in the present study. With the 24hour recall it was evidenced that on average the daily intake of salt from foods prepared according to recipes was 3,50 g / day with a standard deviation of 2,14, which on average gave an intake of fluoride of 0,70 mg / day with a standard deviation of 0,43. Through the oral hygiene habits questionnaire, it is considered that 43,5% accidentally ingested toothpaste while brushing, 60,9% brushed their teeth twice a day, 60,9% placed a quantity of toothpaste tooth in the middle of the brush; and only 21,7% have used toothpastes at an age of three years or later. With the questionnaire of frequency of consumption it was evidenced that the most frequent food consumed by children was white rice with or without oil. Conclusions: In conclusion, according to the results, the participants

Background: School-age children require a high biological demand for nutrients to ensure adequate physical and mental development. For this reason, an appropriate diet plays an essential role in avoiding nutritional problems such as: malnutrition, overweight and obesity. Objective: To determine the eating habits, socioeconomic level and anthropometric measures of school students from 9 to 12 years in Cuenca city. Materials and Methods: Non-experimental descriptive study, 90 students from a public and private school participated, chosen randomly. Suitable instruments were used to determine anthropometric measurements (weight, height, skin folds) and the development of surveys on children's eating habits and the socioeconomic level of their parents. Finally, Stata software was applied for data analysis. Results: 45 children from a public school and 45 children from a private school, between the ages of 9 and 12, participated. Regarding nutritional status, in the private sector 35.6% of schoolchildren were overweight and 22.2% obese, while in the public sector 26.7% of schoolchildren were overweight and 11.1% obese. Finally, a relationship was found between socioeconomic level and nutritional status.

Sustainable food is defined as "components such as wellbeing, health, accessibility, biodiversity, availability, based on the sustainable use of environmental resources and the elimination of unsustainable habits of food consumption and production". Because sustainable feeding is based on measurements, several strategies have been created, including the development of reproducible and reliable questionnaires that facilitate the collection and analysis of information. Therefore, this thesis represents the methodological journey made for the validation of questionnaires about sustainable food, which will allow taking the necessary actions to understand and access a sustainable food system. Objective: To validate questionnaires of sustainable feeding in students of private Educational Units of the Cuenca canton. Methodology: This is a questionnaire validation study that is part of a project that runs between the University of Cuenca and the University of Osnabrück, where part of the data will be shown and consists of measurement properties that are relevant for the validation: content validity, cultural validation, internal consistency and temporal stability. It consists of 17 questionnaires with 129 items, in a sample of 149 students. Results: The content validation and cultural validation allowed to consider that the formulations of the items are reasonable and their presence in the questionnaires is justified. It was possible to obtain an internal consistency by means of the Alpha coefficients of Cronbach and Omega equal or superior to 0,70 and 0,65 respectively in 9 of the 17 questionnaires. Regarding the reliability of the questionnaire, a temporary stability was achieved in 12 of the 17 questionnaires. Conclusions: Good internal consistency and temporal stability were obtained in the questionnaires' 'Type of food', 'Frequency of consumption according to the list of foods',' Consumption of meat ',' Intention of meat consumption ',' Dislike ', 'Neophobia', 'Familia

Postpartum depression is a public health problem that is rarely addressed in developing countries. The objective of this study was to evaluate the relationship of the concentration of Magnesium in urine, the physical activity performed by mothers in the postpartum period and the perception of family support as risk factors in postpartum depression in women treated at the Pablo Foundation Humanitarian Clinic Jaramillo Crespo of the city of Cuenca. A case-control study of correlational scope was carried out, in which 56 women of up to 8 weeks postpartum, aged 18 to 35 years, participated. The patients were evaluated by means of a survey to determine the presence of depression (Edinburgh Postnatal Depression Scale). Additionally, I) evaluated the physical activity performed by the patient (Survey Pregnancy Physical Activity Questionnaire or PPAQ); II) the family functionality (APGAR survey: Adaptation, Participation, Gradient of personal resources, Affection and Resources) and III) the concentration of urinary magnesium of 24 hours. For data tabulation and analysis, the EPIDATA 3.1 and STATA 13 programs were used respectively. The results showed that in 100% of the cases magnesium levels were lower than those recommended in 24-hour urine. For the other factors analyzed, there was no statistically significant association between cases and controls. Apparently, the low level of magnesium is associated with postpartum depression its relationship with magnesium consumption

The purpose of this study is to determine the relationship between the Body Mass Index (BMI), dietary regimen, and socioeconomic level with postpartum depression among mothers attended at the "Pablo Jaramillo" Humanitarian Clinic in the city of Cuenca. A non-experimental case-control study was carried out, with a sample size of 56 participants: 28 cases and 28 controls; for its respective differentiation, I administered the Edinburgh Scale questionnaire with a threshold of ≥ 9 points. At the same time, section 1 of the SPTEPS was applied for the description and collection of general data of the population, as well as the use of the expanded section of the STEPS questionnaire of the Health Organization (WHO) to assess their fruit intake. vegetables and salt consumption; the Survey of Socioeconomic Level Stratification (NSE) 2011 granted by the National Institute of Statistics and Census (INEC). Data collection for anthropometric measurements was carried out with previous training and assistance from health personnel. For its descriptive and statistical analysis, the software SPSS version 2018 was used. According to the results obtained, no statistically significant results were found for the variable depression versus BMI, diet and socioeconomic status. The patients who were considered cases during the study were referred to the Ministry of Public Health to receive adequate attention.

The present study determined the prevalence of intestinal protozoa and identified feeding patterns in children from 6 to 8 years old who attend the Zoila Aurora Palacios School, in the city of Cuenca, fulfilling in this way with two of the objectives outlined in the main project entitled Study of the immunological status of children at school age and its relationship with the intestinal microbiome and drinking water consumed (REDCEDIA, 2018) of which our work formed part. The study was developed as an exploratory type. It was worked with an infant population of 90 children. To determine the prevalence of intestinal parasitism, 71 stool samples were collected that were processed using the modified Ritchie method, while for feeding patterns, information about nutritional intake was obtained through the application of 24-hour reminders. The results showed a low prevalence of intestinal protozoa, the most common parasites were Entamoeba histolytica/Entamoeba dispar (5,6%) and Entamoeba coli (5,6%). In terms of feeding patterns, the results indicated that the carbohydrates constitute the main source of daily energy, followed by lipids and proteins, however deficiencies in the consumption of fiber and lipids were evidenced; sodium consumption was high. The most consumed food groups by these children are refined cereals and dairy products. It was also determined that most of children eat more of 5 meals a day, and foods prepared at home are those that provide the greatest amount of daily energy.

The objective of this work was an association between nutritional habits and the lipid and liver profile in children from 6 to 7 years of Zoila Aurora Palacios school in Cuenca. 97 children were studied, who were in the second or third of basic education in the school year 2017 - 2018. anthropometric measurements and biochemical tests were performed, measuring total cholesterol, HDL cholesterol (high density lipid), LDL (low density lipid) cholesterol, triglycerides, AST (aspartate aminotransferase) and ALT (alanine aminotransferase), were analyzed by spectrophotometry, and reminders of 24 hours to the feeding of children, the data obtained were entered into a specific software that was developed to process them, in addition, 24-hour dietary recall were made about the children's feeding, the data obtained were entered into a specific software that was developed to process them to obtain the amount of macronutrients ingested per day, also the foods ingested by the children were classified according to the NOVA classification. From the data obtained from both blood chemistry and the 24h dietary recall, a descriptive, categorical and correlational statistical analysis were carried out using Stata 13, finding worrying percentages of overweight and obesity (41,3%), lipid profile test values were at levels outside those recommended (triglycerides 51,04% high values, total cholesterol 59,79% high values, HDL cholesterol, 30,61% low values and LDL cholesterol 43,3% high values), in terms of ALT and AST values were mostly within the reference values. Regarding macronutrients intake, the highest percentage of daily energy came from carbohydrates in 59,1%, and in the NOVA classification the first place was unprocessed or minimally processed foods (48% E/day The BMI showed positive statistical association with ALT, triglycerides and negative with HDL cholesterol, there was also statistical association of total cholesterol with the female sex; and LDL cholesterol with the percen

The main objective of this research is to determine the prevalence of musculoskeletal disorders and their relationship between the physical load in a meat distribution and sale company in the City of Cuenca. The population is composed of 56 workers who were applied the Nordic Musculoskeletal Disorders Questionnaire. For the evaluation of the physical load were used the methods REBA to evaluate the postural load, INSHT to evaluate the manual handling of loads and OCRA for the evaluation of repetitive movements. In the 76.78% of the population present discomfort at the dorso-lumbar level, and 48.2% in neck. In relation to the presence of postural load risk, the 50% of the workers present an average risk, followed by 41.1% of workers with a low risk and 8.9% identifies with a high risk. About correlational analyzes, workers with medium and high REBA index were 10 times more prone to report dorsal-lumbar discomfort (95% CI 1.68 to 65.2, p = 0.012). Women reported neck discomfort more frequently (OR: 5.06, 95% CI 1.08-23.6, P = 0.039). Plant workers were 60% less prone to have dorsal-lumbar pain compared to administrative employees (OR: 0.04, 95% CI: 0.03-0.70, P = 0.028)

Background: Currently, in Ecuador a valid tool of food densities and consistency is unavailable. The present study aims to develop a "catalog of food consistencies and densities" as a complementary tool to assess the habitual food consumption in Cuenca - Ecuador. Methods: this is a qualitative and quantitative mixed methodology study. In the first step, a list of the most consumed foods by the native population of Cuenca - Ecuador was obtained; these foods were classified into food groups and subsequently their weighted and measured (volume); with these data, the corresponding statistical analysis was performed to finally calculate the food density. Results: the proposed instrument includes seventy-seven foods classified into fourteen food groups; each food includes its weight in grams, volume in milliliters, density in grams per milliliter and nutritional information; these are distributed in 40 sheets, product of careful cooking phases and instrument design, including the revision of national and international reference materials; It also includes information that shows the size of seven food servings in three age groups and the classification of foods according to their density. Conclusion: a catalog of food densities and consistencies was developed. This might be a useful tool to be used in the evaluation of food consumption in both children and adults of Cuenca Ecuador, however to comply with that purpose must be validated to verify its validity and reliability.

Work related Musculoskeletal disorders (MSDs) increase globally. In Ecuador there is scarce documentation about risk factors (RF). The objective was to identify MSDs, their RF and a prevention strategy. A cross-sectional and correlational-scope study was carried out on the nursing staff from José Carrasco Arteaga Hospital (JCAH) (Azuay-Ecuador), from June 2017 to April 2018, in two phases: Quantitative; data collected about MSDs symptoms and individual, biomechanical, psychosocial and cultural RF; Qualitative; Interviews were carried out with JCAH actors, to identify barriers and facilitators of strategy implementation. MSDs prevalence was reported in percentages; logistic regression models were tested to identify associated RF. The transcripts of the interviews were coded according to ecological model constructs. The prevention strategy was structured based on the results of the two phases. MSDs prevalence in nursing staff (n=207, 94.6% females), in at least one body region, was 85.4% (95% CI: 80.6-90.3), lumbar region was the most frequent MSDs reported (66.5, 95% CI: 60.0-73.0). The somatizing tendency, as well as the beliefs "work associated" and "knowing people at work with pain" were associated with a higher prevalence of MSDs. The strategy proposes educate in psychosocial, musculoskeletal health, perform physical exercise, consider barriers (lack of staff time) and facilitators (positive attitude). The MSDs in the nursing staff are very prevalent, especially at lumbar area; Psychological and cultural RF are associated. Prevention strategy could generate positive effects on the musculoskeletal health of the personnel evaluated.

The project evaluated the risk factors for Depression associated to patterns of healthful feeding, Body Mass Index (BMI) and socioeconomic level in pregnant women, who attend to Humanitarian Clinic in Cuenca-Ecuador. A non-experimental cross-sectional case and control study was made in 56 pregnant women the analysis included a survey to evaluate the presence or absence of depression using Edinburgh Scale. In addition, was registered the food intake of the patients in Dietary section in the denominated instrument STEPS, whereas to know the socioeconomic situation was used the Survey of Stratification of Socioeconomic Level NSE 2011 presented by the National Institute of Statistic and Census (INEC). The data of the IMC were taken with calibrated instruments. The association was carried out between the depression and the consumption of healthy foods, relating to the nutritional status of the mother in general and the socioeconomic level, resulting in the independence between the variables. However, by means of the descriptive analysis that was carried out, it can be suggested that patients who have a low socioeconomic level, who have a lower consumption of fruits and vegetables per day and who have a higher consumption of alcohol have a higher tendency to present depression. In Addition, patients during the study were cases that were referred to the Ministry of Public Health to receive adequate care, thus improving the health status of the community Cuenca.

Introduction: Working conditions influence health status. Firefighters perform shifts of up to 24 hours, altering their circadian rhythm, predisposing them to present risk factors for chronic diseases. Objectives: To determine the cardiovascular risks and metabolic syndrome in the permanent staff of the Meritorious Volunteer Firefighting Corps in the city of Cuenca. Materials and Methods: Through a cross-sectional study of 83 permanent volunteer firefighters from the city of Cuenca. A survey was conducted to know the sociodemographic variables, anthropometric measurements, blood pressure and blood samples were analyzed to determine the lipid profile and blood glucose values. Cardiometabolic risk factors according to smoking were compared using the Chi square test and the two-sample T-test. Results: The average age of participants was 36.36 ± 8.51 years. The 60.2% had normal weight, 32.5% overweight and 7.2% obesity. A prevalence of metabolic syndrome of 14.5% (95% CI: 6.92 - 22.08) was found, which was more prevalent among the 35-44 year olds (95% CI: 0.89-11.11). A 20.5% reported a family history of hypertension, 2.4% of diabetes and 34.9% stated that they were smokers. A 19.3% had mixed dyslipidemia, 19.3% had arterial hypertension, 1.2% had diabetes and a 33.7% had abdominal obesity Conclusions: There is a high frequency of factors identified as cardiovascular risk. It is necessary to implement programs to prevent and promote habits and healthy lifestyles

Background: This study reports the prevalence of FS and FA as well as its burden on the quality of life of a group of adolescents from Santa Isabel-Ecuador. Methods: A cross-sectional study was carried-out among 462 adolescents attending schools in Santa Isabel from July 2014 to February 2016. Data collection comprised the application of a skin prick test including 19 food allergens and a self-reported questionnaire on symptoms suggestive of FA. All the adolescents with a positive skin prick test to one or more allergens and symptoms were tested for specific IgE to improve the FA diagnosis. Results: FS prevalence was 7.14%. FA prevalence was 4.33%. In both cases, shrimp and peanut were the most common allergens. The prevalence of FA after the application of specific IgE decreased to 2.4%. The burden of FA on the adolescents quality of life was rather small 0,05/6, DE±0,94 reflecting the lack of knowledge about their condition Conclusion: This study provides new information regarding adolescents FS and FA living in a Latin-American country. The importance of the study relies on the methodologies applied. FS and AA are prevalent among the studied population. Shrimp and peanut are the most important allergens; both have been correlated with fatal anaphylactic reactions in adolescents. Although the potential risks, the adolescents seem not no understand their condition as reflected in the lack of affectation on their quality of life.

The atopy constitute a health problem that can affect adolescents and adults, even be fatal in some cases. Research on this subject is scarce in our environment, which is why this study aims to determine the prevalence of atopy and common inhalant allergens among adolescents eighth and ninth basic of urban and rural areas of the canton Cuenca, by applying a "skin prick test". To this end students were evaluated eighth and ninth basic schools in the canton of Cuenca trade, including a representative random sample of 991 students. The results showed that more than half of the participants were Atopic for at least one of the allergens tested, a situation that reflects a public health problem that should be considered. The prevalence of atopy did not differ according to sex of participants; of the 20 allergens tested, the intra-household allergens and grasses were among the most prevalent, the five most common were D. pteronyssinus and B. tropicalis, cockroach epithelium, mixed grass pollens and ecynodon. A significant difference wasn’t found in the overall prevalence of atopy by geographical location of schools. However, allergen analysis revealed that cockroach epithelium atopy was higher among students attending rural schools and salix atopy was higher among adolescents in urban schools

Objective The objective of this study was to identify factors influencing eating behavior of Ecuadorian adolescents - from the perspective of parents, school staff and adolescents - to develop a conceptual framework for adolescents' eating behavior. Study design Twenty focus groups (N = 144 participants) were conducted separately with adolescents aged 11–15 y (n (focus groups) = 12, N (participants) = 80), parents (n = 4, N = 32) and school staff (n = 4, N = 32) in rural and urban Ecuador. A semi-structured questioning route was developed based on the ‘Attitude, Social influences and Self-efficacy’ model and the socio-ecological model to assess the relevance of behavioral and environmental factors in low- and middle-income countries. Two researchers independently analyzed verbatim transcripts for emerging themes, using deductive thematic content analysis. Data were analyzed using NVivo 8. Results All groups recognized the importance of eating healthily and key individual factors in Ecuadorian adolescents' food choices were: financial autonomy, food safety perceptions, lack of self-control, habit strength, taste preferences and perceived peer norms. Environmental factors included the poor nutritional quality of food and its easy access at school. In their home and family environment, time and convenience completed the picture as barriers to eating healthily. Participants acknowledged the impact of the changing socio-cultural environment on adolescents' eating patterns. Availability of healthy food at home and financial constraints differed between settings and socio-economic groups. Conclusion Our findings endorse the importance of investigating behavioral and environmental factors that influence and mediate healthy dietary behavior prior to intervention development. Several culture-specific factors emerged that were incorporated into a conceptual framework for developing health promotion interventions in Ecuador.

Background Cardiovascular diseases (CVD) are amongst the leading causes of death worldwide. Risk factors of CVD develop during childhood and adolescence, and dietary quality has been linked to the development of CVD itself. This study examines the association between dietary patterns and cardiovascular risk in a group of urban and rural Ecuadorian adolescents from different socioeconomic backgrounds. Methods A cross-sectional study was conducted from January 2008 to April 2009 among 606 adolescents from the 8th, 9th and 10th grade in an urban area (Cuenca), and 173 adolescents from a rural area (Nabón) in Ecuador. Data collection involved measuring anthropometric data (weight, height and waist circumference), blood pressure, dietary intake (2-day 24 h recall) and socio-demographic characteristics. Fasting blood lipids and glucose were measured in a subsample of 334 adolescents. Factor analysis was used to identify dietary patterns and linear regression models were used to (i) identify differences in food intake practices according to socioeconomic status and place of residence and (ii) establish relationships between dietary patterns and cardiovascular risk factors. Results Median energy intake was 1851 kcal/day. Overall, fiber, fish and fruit and vegetables were scarcely consumed, while added sugar, refined cereals and processed food were important constituents of the diet. Two dietary patterns emerged, one labelled as “rice-rich non-animal fat pattern” and the other one as “wheat-dense animal-fat pattern”. The first pattern was correlated with a moderate increase in glucose in urban participants, while the second pattern was associated with higher LDL and cholesterol blood levels in rural participants. Conclusions This group of adolescents presented various dietary practices conducive to CVD development. Effective strategies are needed to prevent CVD in the Ecuadorian population by encouraging a balanced diet, which contains less refined cereals, added sugar, and

Introduction: Obesity is a problem with an increasing occurrence in young people and in developing countries. Poor nutrition is a risk factor for obesity and other chronic noncommunicable diseases. Methods: the recipes prepared by the staff of the bars in the control group for two days randomly selected using a kitchen scale to the nearest 1 gram were measured. The average of each bar recipe nutritional content compared with recommendations for snacks. It is further estimated the average energy density of prescriptions per school (kcal/g) and the average weight in grams of fruits and vegetables to compare these parameters with data already available from schools in the intervention group. Results: None of the schools offers healthy food. When comparing the control group with refreshments intervention group no significant differences in the content of fruit were found, but the energy density of the schools in the intervention group was modestly lower than the control group ( P = 0.01). Conclusion: Although the energy density of food was lower in the intervention group , overall not comply with recommendations . New preventive measures are urgently needed to improve the nutritional quality of the bars in the city of Cuenca and reverse the occurrence of overweight, obesity and chronic noncommunicable diseases. KEYWORDS : FEED , OVERWEIGHT , OBESITY , Chronic Noncommunicable Diseases , TEENS , NUTRITIONAL QUALITY FOOD , SCHOOLS, RAND STUDY GROUP CONTROL , AND BARS GROUP INTERVENTION , Activital NUTRITIONAL PROGRAM , MACRO AND MICRO , COMPARE , BASIN , ECUADOR .

Introduction: Research collecting population-based food consumption data requires tools for estimating portions accurately to minimize errors. Nowadays, such tools are unavailable in Ecuador. This thesis aims to develop a photography manual as a tool for estimating dietary intake among children and adults. Materials and Methods: Eighty-five foods/recipes highly consumed in Cuenca-Ecuador were selected. Foods were selected according to previous research conducted by the Group Alimentació Nutrición y Salud-Universidad de Cuenca and by means of in depth interviews with housewives, and school food-kiosks/restaurants staff. The weight and volume of at least 20 portions served for children and adults was measured for each food item. For each food, the mean portion size was calculated seven portions. Each portion size was then weighted by means of a digital scale or measured using test tubes. Finally, a picture was taken to build the photography manual. Result: The proposed tool comprises 85 foods, includes 381 sheets with 1 photography each one, 227 photography for adults and 154 photography for children. The manual is divided into two sections the first one for 6 to 12 years old children and the second one for adults older than 18 years. Conclusion: The photography manual of Food Portions has been designed as a useful tool for food consumption evaluation among children and adults. The manual must be validated to verify its reliability.