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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