The Globo Diet-Latin America initiative: towards the implemention of the Latin-American branch of the IARC-who joint global nutrition surveillance initiative

La dieta project: the globodiet-Latin America pilot study in Brazil and Mexico

Dirce Marchioni

São Paulo University, São Paulo, Brasil

In Latin America (LA), the Latin America Dietary Assessment (La Dieta) project seeks to adapt and validate the existing international dietary methodology available at IARC (24-hour dietary recall software), starting in parallel with Mexico and Brazil as the two first pilot countries in this WHO region, as a prerequisite before actual implementation and further dissemination. We aim to report the development and implementation of the La-Dieta project in Brazil and Mexico. The project started in 2012 aiming to 1) to develop a Spanish and a Portuguese version adapted from the existing dietary methodology; 2) to validate the adapted existing methodology against recovery biomarkers and test its feasibility and 3) to evaluate the feasibility to expand these two initial versions to other LA countries and to develop an adapted approach for children. A collaboration to meet these objectives was established between IARC in France, the National Institute of Public Health in Mexico and the three Universities in Brazil: University of Sao Paulo, Federal University of Rio de Janeiro and the State University of Rio de Janeiro. As part of the GloboDiet-LA branch, the “La Dieta” project proposal is being conducted by using mainly in-kind resources (at IARC , Mexico and Brazil). For Brazilian and Mexican versions of the platform, about 70 common and specific to each country databases are being translated and customized. Based on National and regional surveys, the databases include food lists and recipes, food supplements and quantification methods. All the steps follow internationally established standard operating procedures. In Brazil, up to now, 1746 foods were classified into 18 groups and 97subgroups and 380 recipes were included. Quantification methods are being critically evaluated and adapted taking into account the amounts of food regularly eaten, portion sizes, dimensions of food and food packaging available in each country, among others. An adaptation of the GloboDiet picture book for estimating food portion amounts is being developed in parallel. The number of foods selected for photos was based on variability analysis using stepwise regression to detect between person variation for selected nutrients by region and sex. Foods with over 90% accumulated r-square for the different nutrients in each region and sex were selected. In addition, a top-list with 50 most often consumed foods was generated. Accordingly, 34 new photos will be added: Brazil and Mexico will have 7 new photos in common and the final albums will comprise 91 and 66 photos, respectively. The first customizated Latin American versions of GloboDiet software, piloted in Mexico and Brazil, are foreseen for 2015. The next step will aim of validating and testing the feasibility of these two Portuguese and Spanish versions adapted for Brazil and Mexico, respectively, following a stepwise strategy. In a first phase, the GloboDiet standardized methodology will be validated and tested in two pilot countries within the context of LA. Secondly, its expansion and implementation will be carefully designed and main key stakeholders in LA will be approached. GloboDiet-LA will represent a major benefit for LA in terms of standardized dietary methodologies, for multiple surveillance, research and prevention purposes. Key words: dietary assessment, dietary methodologies, nutritional surveillance, standardized methodology, food intake.