Universidade Federal de São Paulo, São Paulo, Brasil
Developing countries are facing an increase in non-transmissible chronic diseases. The worldwide prevalence of obesity more than doubled between 1980 and 2014. In Latin America almost a quarter of the population is obese. It has been estimated that in the Americas, including the United States and non-continental countries, 50% to 60% of adults, and 20-25% of the children and adolescents are overweight or obese 1,2. Time trends suggest that these figures might rise further in the overall population by 2015 and by 2030 up to 81.9% of the Latin American and the Caribbean adult population could be either overweight or obese 3. Changes in dietary and physical activity patterns are considered the major preventable behavioral risk factors for obesity. Studies that combine nutrition and physical activity assessment in representative samples of Latin American countries are lacking. The purpose of this presentation is to describe the design and methodology of the Latin American Study of Nutrition and Health/Estudio Latinoamericano de Nutrición y Salud (ELANS). The ELANS is a household-based multinational cross-sectional survey conducted in urban setting of eight Latin American countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Perú, and Venezuela). The study aims to (1) provide up-to-date reliable and comparable data of dietary intake, physical activity, and its association with anthropometric profile among representative urban populations of eight Latin American countries; (2) measure variation in overweight, dietary intake and physical activity by region, cultural background, socioeconomic status, age and gender; (3) add new scientific-based evidence to describe the interplay among energy intake, energy expenditure, andanthropometric measurements. A standard study protocol was designed to evaluate the nutritional intakes, physical activity levels, and anthropometric measurements of 9,000 enrolled subjects, aged 15.0-65.0 years, stratified by geographical location (only urban areas), gender, age and socioeconomic status. The ELANS protocol included data collected via questionnaires and objective measurements administered in 2 household visits. Anthropometric variables included body weight, height, waist, hip and neck circumferences. Dietary intake data was obtained using two 24-hour dietary recalls, with ‘multiple pass’ procedure and a food frequency questionnaire. Nutritional data will be entered in Nutrition Data System for Research (NDS-R, Minnesota University) after a harmonization process between local foods and NDSR database. Physical activity and energy expenditure measures were assessed by IPAQ-long version questionnaire (adapted for Latin American countries) and 7-day accelerometry. A small-scale pilot study was performed in each country to test the procedures and tools. This study will result in a unique dataset for Latin America, enabling cross country comparisons in nutritional status, focusing both energy intake and expenditure. Thus, it will provide reliable information for planning of health policies and programs aimed to control nutritional inadequacies and their consequences that may be culturally adapted for implementation in Latin American countries. Key words: epidemiologic survey, sedentarism, nutrional evaluation, accelerometry, obesity. References 1. World Health Organization (WHO). Global Status Report on Noncommunicable Diseases 2014. Geneva; 2014. http://apps.who. int/iris/bitstream/10665/148114/1/9789241564854_eng.pdf. 2. Rivera JÁ, de Cossío TG, Pedraza LS, Aburto TC, Sánchez TG, Martorell R. Childhood and adolescent overweight and obesity in Latin America: a systematic review. Lancet Diabetes Endocrinol. 2014;2(4):321-332. doi:10.1016/ S2213- 8587(13)70173-6. 3. Kelly T, Yang W, Chen C-S, Reynolds K, He J. Global burden of obesity in 2005 and projections to 2030. Int J Obes (Lond). 2008;32(9):1431-1437. doi:10.1038/ijo.2008.102.