The Determinants of Obesity among the Adult Population in San Joaquin, Ecuador Público

Abstract

Background: Malnutrition is a complex and serious issue in Ecuador. While
undernutrition exists, severe problems with obesity are gaining recognition. In 2005,
approximately 40% of men and 50% of women in Ecuador were overweight (BMI > 25)
and 6% of men and 16% women were obese (BMI >30). It has been argued that Ecuador
is in a period of nutrition transition due to availability of new and diverse food products
as well as the shifts in age structure and urbanization. These changes increase Ecuador's
risk of an overweight and obesity epidemic
Objective: To explore the dietary and food consumption patterns of adults in the peri-
urban community of San Joaquin, Ecuador, to determine the risk factors of a high body
mass index (BMI) and determinants of low diet diversity and to explore whether diet
diversity is associated with overweight and obesity.
Methods: One hundred and thirty nine household surveys were conducted door to door
among adults residing in 6 sectors in San Joaquin. These surveys primarily sought to
determine the food consumption patterns of the adults residing in the community. A
market survey determined food availability and costs.
Results: Approximately 31.5% of the participants were overweight and 20.8% were
obese. While education was negatively associated with a high BMI and grain
consumption was positively associated with a high BMI, diet diversity was not found to
have any significant association with BMI. Income was positively associated with low
diet diversity and residing in Cañaro or Pinchisana was negatively associated with diet
diversity.
Discussion: The determinants of low diet diversity found in this study indicate a need for
special attention to families that reside in the outskirts of San Joaquin and those who have
low household incomes. An association between grain consumption and a high BMI
suggests that more research is needed to establish why that relationship exists within San
Joaquin. The average family in the community has significantly less money to spend
than is necessary to meet current food intake recommendations. Increased partnership
with the cooperative in San Joaquin and further research into possible subsidization
options are needed to bridge this gap.

Table of Contents

Table of Contents

List of Tables .................................................................................................................... ix
List of Figures .....................................................................................................................x

Chapter 1: Introduction .................................................................................................... 1

Background ........................................................................................................................1
Purpose of Study ................................................................................................................3
Research Questions .............................................................................................................4
Significance of Study ...........................................................................................................4

Chapter 2: Literature Review ............................................................................................ 5

Nutrition Transition .............................................................................................................5
Obesity in Latin America ......................................................................................................7
Obesity in Ecuador .............................................................................................................8
Consumption Pattern in Ecuador.............................................................................................8
Diet Diversity and Obesity ....................................................................................................9
Negative Health Effects of Obesity .......................................................................................11

Chapter 3: Methodology.................................................................................................. 13

Study Site and Population ..................................................................................................13
Procedures ......................................................................................................................15
Instruments .....................................................................................................................17
Statistical Analysis ...........................................................................................................18
Development of Low Cost Food Plan Market Basket .................................................................20

Chapter 4: Results.......................................................................................................... 23

Chapter 5: Discussion and Recommendations .................................................................. 32

Discussion .......................................................................................................................32
Recommendations .............................................................................................................38
Limitations .......................................................................................................................41

References ....................................................................................................................44

Appendices ................................................................................................................... 47

Appendix A: Survey (English and Spanish) ..............................................................................47
Appendix B: Market availability and prices ..............................................................................55
Appendix C: IRB (Institutional Review Board) Approval Letter .....................................................57

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Nutrition Health Sciences, Public Health
Palabra Clave	diet diversity Ecuador nutrition obesity
Committee Chair / Thesis Advisor	McFarland, Deborah A, Emory University
Committee Members	Girard, Amy Webb, Emory University
Partnering Agencies	National or regional non-profit organization (e.g., American Cancer Society)

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