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Purpose Understanding whole-grain intake and its associated factors is essential to tackle the double burden of malnutrition faced by Latin American countries. This study aimed to characterize total and whole grain intake in Latin American countries and to investigate foods contributing to these intake in the region. Methods Data were obtained from the multicenter cross-sectional survey Latin American Study of Nutrition and Health (ELANS), including 9128 participants residing in urban areas of eight Latin American countries. Data collection was performed via two household visits using a standardized questionnaire and two 24 h dietary recalls. Usual dietary intake of total grain foods and foods containing whole grains was estimated. The association between the intake of grain food groups and sociodemographic variables was investigated using multiple linear regression models with random intercepts. Results Mean intake of total grain foods and foods containing whole grains was 318.6 g/d and 14.7 g/d, respectively. Total grain foods were less consumed by participants at older ages (−9.8 g/d), and females (−9.9 g/d), and more consumed by those in the lowest socioeconomic category (24.8 g/d). Foods containing whole grains were more consumed by participants at older ages (3.3 g/d), and females (4.0 g/d), while those in the lowest socioeconomic category consumed 2.9 g/d less. Major contributors to energy provided from foods containing whole grains were oatmeal, masa harina, whole-wheat bread, corn chips, and wheat crackers. Conclusion The intake of grain foods represented a substantial part of the Latin American population’s diet, but the intake of foods containing whole grains was extremely low in all assessed countries.

Human milk oligosaccharides (HMO), the third most abundant component of human milk, are thought to be important contributors to infant health. Studies have provided evidence that geography, stage of lactation, and Lewis and secretor blood groups are associated with HMO profile. However, little is known about how variation across the genome may influence HMO composition among women in various populations. In this study, we performed genome-wide association analyses of 395 women from 8 countries to identify genetic regions associated with 19 different HMO. Our data support FUT2 as the most significantly associated (P

Neighborhood built environment is associated with domain-specific physical activity. However, few studies with representative samples have examined the association between perceived neighborhood safety indicators and domain-specific active transportation in Latin America. This study aimed to examine the associations of perceived neighborhood safety with domain-specific active transportation in adults from eight Latin American countries. Data were obtained from the Latin American Study of Nutrition and Health (n = 8547, aged 18–65). Active transportation (walking and cycling) was assessed using the long form of the International Physical Activity Questionnaire. Specifically, traffic density and speed as well as street lightening, visibility of residents regarding pedestrians and bicyclists, traffic lights and crosswalks, safety of public spaces during the day and at night, crime rate during the day and at night were used to evaluate perceived neighborhood safety. Slow traffic speeds, unsafe public spaces during the day, and crime during the day were associated with ≥10 min/week vs.

The purpose of this study was to examine the associations between self-reported and device-based measures of sedentary behavior (SB) with obesity markers in adults from Latin American countries. Sitting time and total time spent in different SBs were self-reported using two different questionnaires. Accelerometers were used to assess total sedentary time. Body mass index, waist, and neck circumferences were assessed. The highest self-reported sitting time was in Argentina, the highest total time spent in different SBs was in Brazil and Costa Rica, and the highest device-based sedentary time was observed in Peru. Neither self-reported sitting time, total time spent in different SBs or device-based sedentary time were associated with body mass index. Device-based sedentary time was positively associated with waist circumference and self-reported sitting time was positively associated with neck circumference. Caution is warranted when comparing the associations of self-reported and device-based assessments of SB with anthropometric variables. Universidad de Costa Rica//UCR/Costa Rica UCR::Vicerrectoría de Docencia::Salud::Facultad de Medicina::Escuela de Medicina

This study aims to establish cut-off points for the number of minutes of physical activity intensity and the number of daily steps that identify overweight/obesity in adolescents, adults, and older adults. This study examined data from 2737 participants. Physical activity intensity and the number of daily steps were assessed using GT3X+ ActiGraph model accelerometers. Body mass index, waist-to-height ratio, and waist-to-hip ratio were used as indicators of overweight/obesity. The cut-off points for moderate-to-vigorous physical activity for the prevention of overweight/obesity according to body mass index in women ranged from 15.1 to 30.2 min/day; in men, the values were from 15.4 to 33.8 min/day. The lowest cut-off point for daily steps was established in the adolescent group for women and men (7304 and 5162). The highest value in women was 11,412 (51–65 years) and 13,234 in men (18–30 years). Results from measurements different from BMI, show average cut-off points for moderate-to-vigorous physical activity and daily steps of 29.1/8348 and 43.5/10,456 according to waist-to-height ratio; and results of 29.3/11,900 and 44.3/11,056 according to the waist-to-hip ratio; in women and men respectively. A more specific recommendation of physical activity and daily steps adjusted by sex and age range is suggested to prevent overweight/obesity.

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/., This study examines the associations between perceived urban environment attributes and obesity indices by country using data from an eight-nation study from Latin America. The data were collected from 8185 adults. The Neighbourhood Environment Walkability-abbreviated scale was used to assess perceived urban environment attributes. Obesity indices considered were body mass index, waist circumference, neck circumference, a body shape index and waist-to-height ratio. The perception of a more and better land use mix-diversity (β - 0.44; 95% CI - 0.59, - 0.28), traffic safety (- 0.39; - 0.66, - 0.12), and safety from crime (- 0.36; - 0.57, - 0.15) was associated with lower body mass index across the entire sample. Land use mix-diversity (- 1.21; - 1.60, - 0.82), street connectivity (- 0.26; - 0.37, - 0.15), and traffic safety (- 0.79; - 1.47, - 0.12) were negatively associated with waist circumference. Land use mix-diversity (- 0.11; - 0.20, - 0.03), land use mix-access (- 0.23; - 0.34, 0.12), walking/cycling facilities (- 0.22; - 0.37, - 0.08), and safety from crime (- 0.27; - 0.42, - 0.12) were negatively associated with neck circumference. No associations between perceived urban environment attributes and a body shape index were found. Land use mix-diversity (- 0.01; - 0.02, - 0.01), aesthetics (- 0.02; - 0.03, - 0.01), and safety from crime (- 0.02; - 0.04, - 0.01) were associated with waist-to-height ratio. Environmental interventions involving urban environment attributes are associated with obesity indices and, therefore, may help decrease the prevalence of overweight and obesity.

Neck circumference (NC) is being used to identify the risk of chronic diseases. There is a high prevalence of overweight and obesity in Latin America, and neck circumference is a simple and practical measurement to assess this, especially in primary health centers. We analyzed the correlation between the NC anthropometric indicator and other anthropometric measurements such as BMI and waist circumference (WC) in eight Latin American cities. We applied Pearson’s correlation to identify the correlate NC with the other anthropometric variables stratified by sex, the sensitivity (Se) and specificity (Sp) by sex were evaluated according to the cut-off established with the Youden Index. The strongest correlations between NC and WC were found when stratified by sex (women: r = 0.71, men: r = 0.69, respectively) followed by the correlation between NC and BMI (r = 0.65, both sex). NC cut-off points of 39.0 cm in men and 32.9 cm in women identified those individuals with an increased WC and 39.8 and 33.7 cm, respectively, for a substantial increase in WC. For BMI ≥ 25.0 kg/m2 for men, the cut-off point was 37.5 cm, and for women, it was 33.1 cm, and for BMI ≥ 30 kg/m2, the cut-off points were 39.2 and 34.2 cm, for men and women, respectively. Conclusion: NC proved to be a useful, practical, and inexpensive tool that can be used to identify, evaluate, and monitor overweight and obese individuals.

© The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data., Background: Active transportation is a crucial sort of physical activity for developing sustainable environments and provides essential health benefits. This is particularly important in Latin American countries because they present the highest burden of non-communicable diseases relative to other worldwide regions. This study aimed to examine the patterns of active transportation and its association with sociodemographic inequities in Latin American countries. Methods: This cross-sectional study was conducted in eight countries. Participants (n = 8547, 18-65 years) self-reported their active transportation (walking, cycling, and total) using the International Physical Activity Questionnaire. Sex, age, ethnicity, socioeconomic level, education level, public and private transport use, and transport mode were used as sociodemographic inequities. Results: Participants spent a total of 19.9, 3.1, and 23.3 min/day with walking, cycling, and total active transportation, respectively. Mixed and other ethnicity (Asian, Indigenous, Gypsy, and other), high socioeconomic level as well as middle and high education level presented higher walking than Caucasian, low socioeconomic and education level. Private transport mode and use of ≥ 6 days/week of private transport showed lower walking than public transport mode and ≤ 2 days/week of private transport. Use of ≥ 3 days/week of public transport use presented higher walking than ≤ 2 days/week of public transport. Men had higher cycling for active transportation than women. Use of ≥ 3 days/week of public transport use presented higher cycling than ≤ 2 days/week of public transport. ≥6 days/week showed lower cycling than ≤ 2 days/week of private transport use. Men (b: 5.57: 95 %CI: 3.89;7.26), black (3.77: 0.23;7.31), mixed (3.20: 1.39;5.00) and other ethnicity (7.30: 2.55;12.04), had higher total active transportation than women and Caucasian. Private transport mode (-7.03: -11.65;-2.41) and ≥ 6 days/week of private transport use (-4.80: -6.91;-0.31) showed lower total active transportation than public transport mode and ≤ 2 days/week of private transport use. Use of 3-5 (5.10: 1.35;8.85) and ≥ 6 days/week (8.90: 3.07;14.73) of public transport use presented higher total active transportation than ≤ 2 days/week of public transport use. Differences among countries were observed. Conclusions: Sociodemographic inequities are associated differently with active transportation across Latin American countries. Interventions and policies that target the promotion of active policies transportation essential to consider sociodemographic inequities.

Underreporting and overreporting of energy intake (EI) have been recognized as potential sources of bias. Dietary data mainly rely on proxy respondents, but little is known about the determinants of misreporting of EI among Latin American (LA) populations. This study was conducted using data from the multicenter Latin American Study of Nutrition and Health that consisted of information about sociodemographics, physical activity, and dietary intake from 9218 individuals aged 15 to 65 years who were living in urban areas in 8 LA countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela). Goldberg methodology was applied to classify the participants into categories of overreporter (OR), plausible reporter (PR), or underreporter (UR) of EI. Associations between misreporting and covariates were examined by the Kruskal-Wallis test, logistic regression, and linear regression. The prevalence of UR was 12.1% and OR was 14.1%. Costa Rica had the highest percentage of UR (24.4%) and the lowest of OR (7.3%), and Colombia had the lowest of UR (5.7%) and the highest of OR (22.4%). Furthermore, underreporters were more likely to be females from older groups with minimal education, white, physically active, overweight or obese, and living in Costa Rica. Overreporters were more likely to be younger, single, of low socioeconomic level, nonwhite, physically active, underweight or with normal weight, and from Colombia. The results demonstrated that sex, age, race, education status, and nationality seemed to influence the reporting behavior, which is essential to correctly interpreting potentially biased associations between diet and health outcomes, and improving nutritional interventions and public health policies. The ELANS was supported by a scientific grant from the Coca Cola Company and support from the Instituto Pensi/Hospital Infantil Sabara, International Life Science Institute of Argentina, Universidad de Costa Rica, Pontificia Universidad Católica de Chile, Pontificia Universidad Javeriana, Universidad Central de Venezuela (CENDES-UCV)/Fundación Bengoa, Universidad San Francisco de Quito, and Instituto de Investigación Nutricional de Peru. UCR::Vicerrectoría de Docencia::Salud::Facultad de Medicina::Escuela de Medicina

Previously published data from our group and others demonstrate that human milk oligosaccharide (HMOs), as well as milk and infant fecal microbial profiles, vary by geography. However, little is known about the geographical variation of other milk-borne factors, such as lactose and protein, as well as the associations among these factors and microbial community structures in milk and infant feces. Here, we characterized and contrasted concentrations of milk-borne lactose, protein, and HMOs, and examined their associations with milk and infant fecal microbiomes in samples collected in 11 geographically diverse sites. Although geographical site was strongly associated with milk and infant fecal microbiomes, both sample types assorted into a smaller number of community state types based on shared microbial profiles. Similar to HMOs, concentrations of lactose and protein also varied by geography. Concentrations of HMOs, lactose, and protein were associated with differences in the microbial community structures of milk and infant feces and in the abundance of specific taxa. Taken together, these data suggest that the composition of human milk, even when produced by relatively healthy women, differs based on geographical boundaries and that concentrations of HMOs, lactose, and protein in milk are related to variation in milk and infant fecal microbial communities, This research was funded by the National Science Foundation IOS-BIO 1344288; the Ministry of Economy and Competitiveness, Spain (AGL2013-4190-P); the European Commission (624773-FP-7-PEOPLE-2013-IEF, to LR); and in part by National Institutes of Health NICHD R01-HD092297 and COBRE Phase III grant P30GM103324. Sterile, single-use milk collection kits were provided by Medela Inc.

Vitamin E was identified as a lipophilic compound essential to maintain rat pregnancy. Low vitamin E intake during early pregnancy associates with congenital malformations and embryonic loss in animals and with miscarriage and intrauterine growth restriction in humans. Vitamin E protects cell membranes from lipoperoxidation and exerts non-antioxidant activities. Its function can be restored by vitamin C, thus, intake and circulating levels of both micronutrients are frequently analyzed together. Although substantial vitamin E inadequacy was reported worldwide, its consumption in Latin America (LatAm) is mostly unknown. Using data from the Latin American Study of Nutrition and Health (Estudio Latinoamericano de Nutrición y Salud, ELANS), we evaluated vitamin E and C intake in women of reproductive age (WRA) from eight LatAm countries and identified their main food sources. Two non-consecutive 24-h dietary recalls in 3704 women aged from 15 to 49 years and living in urban locations showed low average intake of vitamin E (7.9 mg/day vs. estimated average requirement (EAR) of 12 mg/day) and adequate overall vitamin C consumption (95.5 mg/day vs. EAR of 60 mg/day). The mean regional inadequacy was 89.6% for vitamin E and 36.3% for vitamin C. The primary food sources of vitamin E were fats and oils, as well as vegetables. Vitamin C intake was explained mainly by the consumption of fruit juices, fruits, and vegetables. Combined deficient intake of both vitamins was observed in 33.7% of LatAm women. Although the implications of low antioxidant vitamins’ consumption in WRA are still unclear, the combined deficient intake of both vitamins observed in one-third of ELANS participants underscores the need for further research on this topic.

Increased consumption of energy-dense, nutrient-poor foods can lead to inadequate intakes of shortfall nutrients, including vitamin A, D, C, and E, dietary folate, calcium, iron, magnesium, potassium, and fiber. The objective was to examine the prevalence of inadequate intake of shortfall nutrients and identify food sources of shortfall nutrients in eight Latin American countries. Data from ELANS, a multi-country, population-based study of 9218 adolescents and adults were used. Dietary intake was collected through two 24 h Recalls from participants living in urban areas of Argentina, Brazil, Chile, Colombia, Ecuador, Peru, and Venezuela. Foods and beverages were classified using the adapted version of the NHANES “What We Eat in America” system. Nutrients inadequacy was estimated using the Institute of Medicine recommendations and descriptive statistics were calculated. Prevalence of inadequacy was above 50% for most of the nutrients, which the exception of vitamin C with a prevalence of inadequacy of 39%. Milk, cheese, seafoods, breads, and fruit juices/drinks were among the top 5 sources for each of the 10 shortfall nutrients examined. Many food categories were top contributors to more than one dietary component examined. Understanding the nutrient intake and food sources can help inform dietary guidance and intervention approaches.

Recent work has demonstrated the existence of large inter-individual and inter-population variability in the microbiota of human milk from healthy women living across variable geographical and socio-cultural settings. However, no studies have evaluated the impact that variable sequencing approaches targeting different 16S rRNA variable regions may have on the human milk microbiota profiling results. This hampers our ability to make meaningful comparisons across studies. In this context, the main purpose of the present study was to re-process and re-sequence the microbiome in a large set of human milk samples (n = 412) collected from healthy women living at diverse international sites (Spain, Sweden, Peru, United States, Ethiopia, Gambia, Ghana and Kenya), by targeting a different 16S rRNA variable region and reaching a larger sequencing depth. Despite some differences between the results obtained from both sequencing approaches were notable (especially regarding alpha and beta diversities and Proteobacteria representation), results indicate that both sequencing approaches revealed a relatively consistent microbiota configurations in the studied cohorts. Our data expand upon the milk microbiota results we previously reported from the INSPIRE cohort and provide, for the first time across globally diverse populations, evidence of the impact that different DNA processing and sequencing approaches have on the microbiota profiles obtained for human milk samples. Overall, our results corroborate some similarities regarding the microbial communities previously reported for the INSPIRE cohort, but some differences were also detected. Understanding the impact of different sequencing approaches on human milk microbiota profiles is essential to enable meaningful comparisons across studies. Clinical Trial Registration: www.clinicaltrials.gov, identifier NCT02670278., This project was primarily funded by the National Science Foundation (award 36 #1344288). LR (Spain) was funded by grant 624773 (FP-7-PEOPLE-2013-IEF, European Commission), project AGL2013-4190-P (Ministry of Economy and Competitiveness, Spain), and has received funding from RTI2018-095021-J-I00 (Ministry of Science Innovation and Universities CIU/AEI/FEDER, UE).

Breastfeeding provides defense against infectious disease during early life. The mechanisms underlying this protection are complex but likely include the vast array of immune cells and components, such as immunoglobulins, in milk. Simply characterizing the concentrations of these bioactives, however, provides only limited information regarding their potential relationships with disease risk in the recipient infant. Rather, understanding pathogen and antigen specificity profiles of milk-borne immunoglobulins might lead to a more complete understanding of how maternal immunity impacts infant health and wellbeing. Milk produced by women living in 11 geographically dispersed populations was applied to a protein microarray containing antigens from 16 pathogens, including diarrheagenicE. coli,Shigellaspp., Salmonella entericaserovar Typhi,Staphylococcus aureus,Streptococcus pneumoniae, Mycobacterium tuberculosisand other pathogens of global health concern, and specific IgA and IgG binding was measured. Our analysis identified novel disease-specific antigen responses and suggests that some IgA and IgG responses vary substantially within and among populations. Patterns of antibody reactivity analyzed by principal component analysis and differential reactivity analysis were associated with either lower-to-middle-income countries (LMICs) or high-income countries (HICs). Antibody levels were generally higher in LMICs than HICs, particularly forShigellaand diarrheagenicE. coliantigens, although sets ofS. aureus,S. pneumoniae, and someM. tuberculosisantigens were more reactive in HICs. Differential responses were typically specific to canonical immunodominant antigens, but a set of nondifferential but highly reactive antibodies were specific to antigens possibly universally recognized by antibodies in human milk. This approach provides a promising means to understand how breastfeeding and human milk protect (or do not protect) infants from environmentally relevant pathogens. Furthermore, this approach might lead to interventions to boost population-specific immunity in at-risk breastfeeding mothers and their infants.

The aim of the present study was to examine the sex-related associations between accelerometer-measured daily step counts and adiposity indicators in adults from eight Latin American countries. We analyzed data from 2524 adults (aged 18–65 years) from the Latin American Study of Nutrition and Health. Device-measured daily step counts were measured by accelerometers (ActiGraph GT3X). The outcomes were body mass index (BMI, (kg/m2), waist and neck circumference (in cm). Overall, the mean of daily steps counts, BMI, waist and neck circumference were 10699.8, 27.3, 89.6, and 35.8. Weak and negative associations were observed between daily steps counts and BMI (r = −0.17, p &lt, 0.05) and waist circumference (r = −0.16, 0.05), however, step counts was not associated with neck circumference. Daily steps counts were negatively associated with BMI (β: −0.054, 95%CI: −0.077, −0.012) and waist circumference (−0.098, −0.165, −0.030) independently of age and socioeconomic level. In men, there were significant negative associations between daily steps counts with BMI (−0.075, −0.119, −0.031) and waist circumference (−0.140, −0.233, −0.048), and in women, there was no significant association with either of the body composition indicators. The findings from this study need to be examined in prospective settings that use device-measured from Latin America.

Purpose: The aim of this study was to identify socio-demographic correlates of total and domain-specific sedentary behavior (SB). Methods: Cross-sectional findings are based on 9218 participants (15&ndash, 65 years) from the Latin American Study of Nutrition and Health. Data were collected between September 2014 and February 2015. Participants reported time spent in SB across specific domains. Sex, age, ethnicity, socioeconomic (SEL), and education level were used as sociodemographic indicators. Results: Participants spent a total of 373.3 min/day engaged in total SB. Men, younger adults, other ethnicities, higher SEL and educational level presented higher total SB when compared with women, older adults, white/Caucasian, and low SEL and educational level. Men spent more time on the playing videogames (b: 32.8: 95% CI: 14.6, 51.1) and riding in an automobile (40.5: 31.3, 49.8). Computer time, reading, socializing or listening to music was higher in younger participants (&lt, 30 years) compared with those &ge, 50 years in the total sample. Compared to the low SEL and educational level groups, middle (11.7: 5.7, 17.6) and higher (15.1: 5.3, 24.9) SEL groups as well as middle (9.8: 3.6, 15.9) and higher (16.6: 6.5, 26.8) education level groups reported more time spent reading. Conclusion: Socio-demographic characteristics are associated with SB patterns (total and specific) across Latin American countries.

Dietary diversity, define as the number of food items or food groups consumed over a given period of time measured at the household or individual level, is widely recognized as a key dimension of diet quality. This analysis investigated dietary diversity in eight Latin-American countries and its associations with sociodemographic and anthropometric parameters.Data from the ELANS study conducted in eight Latin-American countries (Argentina, Brazil, Colombia, Costa Rica, Chile, Ecuador, Peru and Venezuela) were analyzed. The ELANS study interviewed 9,218 subjects living in the main cities in each country. Food intake were collected using two 24-hour dietary recalls, following the Multiple Pass Method. For calculation of diet diversity score, only the first 24-hour recall was analyzed. Dietary diversity was assessed at individual level. All food items reported to be consumed during the first 24-hour recall were classified into nine food groups: 1. Cereals, 2. White roots and tubers, 3. Vegetables, 4. Fruits, 5. Meat, poultry and offal, 6. Fish and seafood, 7. Eggs, 8. Pulses, legumes and nuts and 9. Milk and milk products. The selection of these groups was based on the Women's Dietary Diversity Score Projectfood groups classification. Consumption of at least 15 g of each food group was assigned 1 point or 0 points if consumption was less than 15 g. Thus, the score ranged from a minimum of 0 and a maximum of 9 points. Higher scores indicated higher diversity as more food groups were eaten. Analysis was performed by age group, gender, and socioeconomic level (SES) as well as anthropometric measurements.Mean diet diversity score (DDS) for the whole sample was 4.48 ± 1.16, ranging from 0 to 9 points. Men showed significant higher DDS. No difference was observed among age groups. Among countries, Ecuador and Peru showed the highest DDS, 4.88 ± 1.22 and 4.82 ± 1.12 points, respectively; while Argentina (4.20 ± 1.13) and Venezuela (4.27 ± 1.04) reported the lowest. We found a statistically significant trend (p < 0.001) to a higher DDS among those subjects in the high socio-economic level. Regarding anthropometric measurements, no differences were found in DDS among different nutritional status or based on waist and neck circumference measures.This study revealed that dietary diversity is limited among Latin American countries regardless of sex, age, socioeconomic level, and nutritional status. Nutritional interventions emphasizing the importance of maximizing dietary diversity should be encouraged to ensure optimum nutritional adequacy within the region

Additional file 1: Table S1. Logistic regression models for transport-related physical activity (PA) by country. Table S2. Linear regression models for transport-related physical activity (PA) by country. Table S3. Logistic regression models for leisure-time physical activity (PA) by country. Table S4. Linear regression models for leisure-time physical activity (PA) by country

Purpose: The aim of this study was to determine the association between active transportation and obesity indicators in adults from eight Latin American countries. Methods: Data from the ELANS study, an observational multi-country study (n: 8336, 18–65 years), were used. Active transportation (walking and cycling) and leisure time physical activity was assessed using the International Physical Activity Questionnaire (long version). The obesity indicators considered were: body mass index, and waist and neck circumference. Results: In the total sample, the average time dedicated to active transportation was 24.3 min/day, with the highest amount of active transportation being Costa Rica (33.5 min/day), and the lowest being Venezuela (15.7 min/day). The countries with the highest proportion of active transportation were Ecuador (71.9%), and the lowest was Venezuela (40.5%). Results from linear regression analyses suggest that active transportation was significantly and independently associated with a lower body mass index (β: −0.033, 95% CI: −0.064, −0.002), but not with waist circumference (β: −0.037, 95% CI: −1.126, 0.390 and neck circumference (β: −0.007, 95% CI: −0.269, 0.130). Conclusions: Active transportation is significantly associated with a lower body mass index. Governments should incentivize this type of transportation as it could help to reduce the obesity pandemic in Latin America.

© The Author(s). 2020 Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data., Background: Characteristics of the neighborhood built environment are associated with physical activity (PA). However, few studies with representative samples have examined environmental correlates of domain-specific PA in Latin America. We examined the associations of the perceived neighborhood built environment with domain-specific PA in a large sample of adults from eight Latin American countries. Methods: This study examined data from 8185 adults (aged 18–65 years) from eight Latin American countries. The Neighbourhood Environment Walkability Survey - Abbreviated (NEWS-A) scale was used to assess perceptions of land use mix–diversity, land use mix-access, street connectivity, walking/cycling facilities, aesthetics, safety from traffic, and safety from crime. Perceived proximity from home to public open spaces (metropolitan parks, playgrounds, public squares) and to shopping centers was also measured. Transport-related and leisure-time PA were assessed using the long form of the International Physical Activity Questionnaire. Both logistic and linear regression models were estimated on pooled data. Results: Perceptions of higher land use mix-access (OR: 1.40; 95% CI: 1.22,1.61), the existence of many alternative routes in the neighbourhood (1.12; 1.04,1.20), slow speed of traffic (1.19; 1.03,1.35) and few drivers exceeding the speed limits (1.09; 1.03,1.15) were associated with greater odds of reporting at least 10 min/week of transport-related PA. Perceptions of higher levels of land use mix-diversity, better aesthetics and greater safety from crime, the presence of crosswalks and pedestrian signals, and greater proximity of shopping centers were associated with more min/week of transport-related PA. Perceptions of higher land use mix-diversity (1.12; 1.05,1.20), higher land use mix-access (1.27; 1.13,1.43), more walking/cycling facilities (1.18; 1.09,1.28), and better aesthetics (1.10; 1.02,1.18) were associated with greater odds of engaging in at least 10 min/week of leisure-time PA versus none. Perceptions of higher land use mix-diversity were associated with more min/week of leisure PA. Conclusions: Different perceived neighborhood built environment characteristics were associated with domain-specific PA among adults from Latin America countries. Interventions designed to modify perceptions of the neighbourhood built environment might influence initiation or maintenance of domain-specific PA., Fieldwork and data analysis compromised in ELANS protocol was supported by a scientific grant from the Coca Cola Company, and by grant and/ or support from Instituto Pensi/Hospital Infantil Sabara, International Life Science Institute of Argentina, Universidad de Costa Rica, Pontificia Universidad Católica de Chile, Pontificia Universidad Javeriana, Universidad Central de Venezuela (CENDES-UCV)/Fundación Bengoa, Universidad San Francisco de Quito, and Instituto de Investigación Nutricional de Peru. André Werneck is supported by the São Paulo Research Foundation (FAPESP) with a PhD scholarship (FAPESP process: 2019/24124–7). This paper presents independent research. The views expressed in this publication are those of the authors and not necessarily those of the acknowledged institutions. The funding sponsors had no role in study design; the collection, analyses, or interpretation of data; writing of the manuscript; or in the decision to publish the results.

This study aimed to examine the associations between active transportation and public transport and the objectively measured meeting of moderate-to-vigorous physical activity (MVPA) and steps per day guidelines in adults by sex from eight Latin American countries. As part of the Latin American Study of Nutrition and Health (ELANS), data were collected from 2524 participants aged 18–65 years. MVPA and steps per day were evaluated using Actigraph GT3X accelerometers. The mode of transportation, its frequency and duration were collected using a self-reported questionnaire. The average time dedicated to active transportation was 12.8 min/day in men (IQR: 2.8–30.0) and 12.9 min/day in women (IQR: 4.3–25.7). A logistic regression analysis was conducted, showing that active transportation (≥10 min) was associated with higher odds of meeting MVPA guidelines (men: OR: 2.01, 95%CI: 1.58–2.54, women: OR: 1.57, 95%CI: 1.25–1.96). These results show a greater association when considering active transportation plus public transport (men: OR: 2.98, 95%CI: 2.31–3.91, women: OR: 1.82, 95%CI: 1.45–2.29). Active transportation plus public transport was positively associated with meeting steps per day guidelines only in men (OR: 1.55, 95%CI: 1.15–2.10). This study supports the suggestion that active transportation plus public transport is significantly associated with meeting the MVPA and daily steps recommendations.

ObjectiveTo assess the association between the physical activity level and the built environment by accessibility, microinfrastructure and security in Latin America (LA).DesignWe conducted a multicentre cross-sectional study to collect physical activity and built environment data. The levels of physical activity were calculated through the International Physical Activity Questionnaire survey. Using the Neighbourhood Environment Walkability Scale-Abbreviated, characteristics of the built environment were measured through three domains: accessibility, microinfrastructure and security. To estimate the association of the built environment and physical activity, we used mixed effects logistic regression analysis. In addition, likelihood ratio test to account for clustered effect within countries and/or cities was used.SettingEight countries in LA.ParticipantsAdults aged 15–65 years (n=9218) living in urban areas and consented to participate of the Latin American Study of Nutrition and Health.ResultsMost of the population in LA had access to a grocery store (97.2%), public transport stop (91.5%) and children’s playground (81.6%). Metropolitan parks were more accessible in Ecuador (59.8%) and Colombia (59.2%) than in Venezuela (33.5%). Individuals located within 20 min of walking from sport facilities or children’s playground areas were more likely to perform moderate-to-high physical activity OR 1.20 (95% CI 1.06 to 1.36) and OR 1.25 (95% CI 1.02 to 1.53), respectively. Only 14.5% of the population from the region considered that their neighbourhood had an adequate design for walking or cycling. Likewise, among adults living in LA, only 39.75% had the perception of living in a safe neighbourhood.ConclusionsThis multicentre study shows that currently, LA built environment does not promote physical activity in the region. Our findings provide the rationale to push forward, at regional and national levels, policies and interventions that will help to achieve a safe, healthy and friendly built environment to encourage participation in active recreation and sports in leisure time.Trial registration numberNCT02226627.

[Background] Microbial communities in human milk and those in feces from breastfed infants vary within and across populations. However, few researchers have conducted cross-cultural comparisons between populations, and little is known about whether certain “core” taxa occur normally within or between populations and whether variation in milk microbiome is related to variation in infant fecal microbiome. The purpose of this study was to describe microbiomes of milk produced by relatively healthy women living at diverse international sites and compare these to the fecal microbiomes of their relatively healthy infants. [Methods] We analyzed milk (n = 394) and infant feces (n = 377) collected from mother/infant dyads living in 11 international sites (2 each in Ethiopia, The Gambia, and the US; 1 each in Ghana, Kenya, Peru, Spain, and Sweden). The V1-V3 region of the bacterial 16S rRNA gene was sequenced to characterize and compare microbial communities within and among cohorts. [Results] Core genera in feces were Streptococcus, Escherichia/Shigella, and Veillonella, and in milk were Streptococcus and Staphylococcus, although substantial variability existed within and across cohorts. For instance, relative abundance of Lactobacillus was highest in feces from rural Ethiopia and The Gambia, and lowest in feces from Peru, Spain, Sweden, and the US; Rhizobium was relatively more abundant in milk produced by women in rural Ethiopia than all other cohorts. Bacterial diversity also varied among cohorts. For example, Shannon diversity was higher in feces from Kenya than Ghana and US-California, and higher in rural Ethiopian than Ghana, Peru, Spain, Sweden, and US-California. There were limited associations between individual genera in milk and feces, but community-level analyses suggest strong, positive associations between the complex communities in these sample types. [Conclusions] Our data provide additional evidence of within- and among-population differences in milk and infant fecal bacterial community membership and diversity and support for a relationship between the bacterial communities in milk and those of the recipient infant's feces. Additional research is needed to understand environmental, behavioral, and genetic factors driving this variation and association, as well as its significance for acute and chronic maternal and infant health., This study was supported by the National Science Foundation (award 1344288), the Ministry of Economy and Competitiveness, Spain (project AGL2013-4190-P), and the European Commission [grant 624773 (FP-7-PEOPLE-2013-IEF)]. Sterile, single-use milk-collection kits were generously provided by Medela Inc. This work was supported in part by NIH COBRE Phase III grant P30GM103324.

[Objectives] Establishment and development of the infant gastrointestinal microbiome (GIM) varies cross‐culturally and is thought to be influenced by factors such as gestational age, birth mode, diet, and antibiotic exposure. However, there is little data as to how the composition of infants' households may play a role, particularly from a cross‐cultural perspective. Here, we examined relationships between infant fecal microbiome (IFM) diversity/composition and infants' household size, number of siblings, and number of other household members. [Materials and methods] We analyzed 377 fecal samples from healthy, breastfeeding infants across 11 sites in eight different countries (Ethiopia, The Gambia, Ghana, Kenya, Peru, Spain, Sweden, and the United States). Fecal microbial community structure was determined by amplifying, sequencing, and classifying (to the genus level) the V1–V3 region of the bacterial 16S rRNA gene. Surveys administered to infants' mothers identified household members and composition. [Results] Our results indicated that household composition (represented by the number of cohabitating siblings and other household members) did not have a measurable impact on the bacterial diversity, evenness, or richness of the IFM. However, we observed that variation in household composition categories did correspond to differential relative abundances of specific taxa, namely: Lactobacillus, Clostridium, Enterobacter, and Klebsiella. [Discussion] This study, to our knowledge, is the largest cross‐cultural study to date examining the association between household composition and the IFM. Our results indicate that the social environment of infants (represented here by the proxy of household composition) may influence the bacterial composition of the infant GIM, although the mechanism is unknown. A higher number and diversity of cohabitants and potential caregivers may facilitate social transmission of beneficial bacteria to the infant gastrointestinal tract, by way of shared environment or through direct physical and social contact between the maternal–infant dyad and other household members. These findings contribute to the discussion concerning ways by which infants are influenced by their social environments and add further dimensionality to the ongoing exploration of social transmission of gut microbiota and the “old friends” hypothesis, National Science Foundation, Grant/AwardNumber: 1344288; National Institutes of Health COBRE Phase III Grant, Grant/AwardNumber: P30GM10332

Background: Human milk is a complex fluid comprised of myriad substances, with one of the most abundant substances being a group of complex carbohydrates referred to as human milk oligosaccharides (HMOs). There has been some evidence that HMO profiles differ in populations, but few studies have rigorously explored this variability.Objectives: We tested the hypothesis that HMO profiles differ in diverse populations of healthy women. Next, we examined relations between HMO and maternal anthropometric and reproductive indexes and indirectly examined whether differences were likely related to genetic or environmental variations.Design: In this cross-sectional, observational study, milk was collected from a total of 410 healthy, breastfeeding women in 11 international cohorts and analyzed for HMOs by using high-performance liquid chromatography.Results: There was an effect of the cohort (P < 0.05) on concentrations of almost all HMOs. For instance, the mean 3-fucosyllactose concentration was >4 times higher in milk collected in Sweden than in milk collected in rural Gambia (mean ± SEM: 473 ± 55 compared with 103 ± 16 nmol/mL, respectively; P < 0.05), and disialyllacto-N-tetraose (DSLNT) concentrations ranged from 216 ± 14 nmol/mL (in Sweden) to 870 ± 68 nmol/mL (in rural Gambia) (P < 0.05). Maternal age, time postpartum, weight, and body mass index were all correlated with several HMOs, and multiple differences in HMOs [e.g., lacto-N-neotetrose and DSLNT] were shown between ethnically similar (and likely genetically similar) populations who were living in different locations, which suggests that the environment may play a role in regulating the synthesis of HMOs.Conclusions: The results of this study support our hypothesis that normal HMO concentrations and profiles vary geographically, even in healthy women. Targeted genomic analyses are required to determine whether these differences are due at least in part to genetic variation. A careful examination of sociocultural, behavioral, and environmental factors is needed to determine their roles in this regard. This study was registered at clinicaltrials.gov as NCT02670278.

Coca Cola Company Instituto Pensi/Hospital Infantil Sabara International Life Science Institute of Argentina Universidad de Costa Rica Pontificia Universidad Catolica de Chile Pontificia Universidad Javeriana Universidad Central de Venezuela (CENDES-UCV)/Fundacion Bengoa Universidad San Francisco de Quito Instituto de Investigacion Nutricional de Peru Background: Obesity is growing at an alarming rate in Latin America. Lifestyle behaviours such as physical activity and dietary intake have been largely associated with obesity in many countries; however studies that combine nutrition and physical activity assessment in representative samples of Latin American countries are lacking. The aim of this study is to present the design rationale of the Latin American Study of Nutrition and Health/Estudio Latinoamericano de Nutricion y Salud (ELANS) with a particular focus on its quality control procedures and recruitment processes. Methods/Design: The ELANS is a multicenter cross-sectional nutrition and health surveillance study of a nationally representative sample of urban populations from eight Latin American countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela). A standard study protocol was designed to evaluate the nutritional intakes, physical activity levels, and anthropometric measurements of 9000 enrolled participants. The study was based on a complex, multistage sample design and the sample was stratified by gender, age (15 to 65 years old) and socioeconomic level. A small-scale pilot study was performed in each country to test the procedures and tools. Discussion: This study will provide valuable information and a unique dataset regarding Latin America that will enable cross-country comparisons of nutritional statuses that focus on energy and macro-and micronutrient intakes, food patterns, and energy expenditure. Hosp Infantil Sabara, Fundacao Jose Luiz Egydio Setubal, Inst Pensi, BR-01239040 Sao Paulo, Brazil Univ Fed Sao Paulo, Rua Botucatu 862, BR-04023062 Sao Paulo, Brazil Int Life Sci Inst ILSI Argentina, Comm Nutr & Wellbeing, C1059ABF, Buenos Aires, DF, Argentina Univ Favaloro, Fac Ciencias Med, Dept Nutr, C1078AAI, Buenos Aires, DF, Argentina Univ Costa Rica, Escuela Med, Dept Bioquim, San Jose 11501, Costa Rica Pontificia Univ Catolica Chile, Escuela Med, Ctr Nutr Mol & Enfermedades Cron, Dept Nutr Diabet & Metab, Santiago 8330024, Chile Pontificia Univ Javeriana, Dept Nutr & Bioquim, Bogota, Colombia Univ Cent Venezuela CENDES UCV, Ctr Estudios Desarrollo, Fdn Bengoa, Caracas 1010, Venezuela Univ San Francisco Quito, Colegio Ciencias Salud, Quito 171200841, Ecuador Inst Invest Nutr, Lima 15026, Peru Univ Sao Paulo, Fac Saude Publ, Dept Epidemiol, BR-01255000 Sao Paulo, Brazil Emory Univ, Rollins Sch Publ Hlth, Hubert Dept Global Hlth, Nutr & Hlth Sci Program, Atlanta, GA 30322 USA Univ Munich, Med Ctr, Dr von Hauner Childrens Hosp, Div Metab & Nutr Med, D-80337 Munich, Germany Univ Massachusetts Lowell, Dept Clin Lab & Nutr Sci, Lowell, MA 01854 USA Rua Borges Lagoa 1080, BR-04038002 Sao Paulo, Brazil Univ Fed Sao Paulo, Rua Botucatu 862, BR-04023062 Sao Paulo, Brazil Rua Borges Lagoa 1080, BR-04038002 Sao Paulo, Brazil Web of Science