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Monge-Rojas R.,Costa Rican Institute for Research and Education on Nutrition and Health INCIENSA | Fuster-Baraona T.,National University of Costa Rica | Garita-Arce C.,SAN security | Sanchez-Lopez M.,National University of Costa Rica | And 2 more authors.
Journal of Physical Activity and Health | Year: 2017

Background: In Latin America, more than 80% of adolescent girls are physically inactive. Inactivity may be reinforced by female stereotypes and objectification in the Latin American sociocultural context. Methods: We examined the influence of objectification on the adoption of an active lifestyle among 192 adolescents (14 and 17 years old) from urban and rural areas in Costa Rica. Analyses of 48 focus-groups sessions were grounded in Objectification Theory. Results: Vigorous exercises were gender-typed as masculine while girls had to maintain an aesthetic appearance at all times. Adolescents described how girls were anxious around the prospect of being shamed and sexually objectified during exercises. This contributed to a decrease in girls' desire to engage in physical activities. Among males, there is also a budding tolerance of female participation in vigorous sports, as long as girls maintained a feminine stereotype outside their participation. Conclusion: Self-objectification influenced Costa Rican adolescent girls' decisions to participate in physical activities. Interventions may include: procuring safe environments for physical activity where girls are protected from fear of ridicule and objectification; sensitizing boys about girl objectification and fostering the adoption of a modern positive masculine and female identities to encourage girls' participation in sports. © 2017 Human Kinetics, Inc.


Mattei J.,Harvard University | Malik V.,Harvard University | Wedick N.M.,Harvard University | Hu F.B.,Harvard University | And 27 more authors.
Globalization and Health | Year: 2015

Background: The prevalence of type 2 diabetes has been reaching epidemic proportions across the globe, affecting low/middle-income and developed countries. Two main contributors to this burden are the reduction in mortality from infectious conditions and concomitant negative changes in lifestyles, including diet. We aimed to depict the current state of type 2 diabetes worldwide in light of the undergoing epidemiologic and nutrition transition, and to posit that a key factor in the nutrition transition has been the shift in the type and processing of staple foods, from less processed traditional foods to highly refined and processed carbohydrate sources. Discussion: We showed data from 11 countries participating in the Global Nutrition and Epidemiologic Transition Initiative, a collaborative effort across countries at various stages of the nutrition-epidemiologic transition whose mission is to reduce diabetes by improving the quality of staple foods through culturally-appropriate interventions. We depicted the epidemiologic transition using demographic and mortality data from the World Health Organization, and the nutrition transition using data from the Food and Agriculture Organization food balance sheets. Main staple foods (maize, rice, wheat, pulses, and roots) differed by country, with most countries undergoing a shift in principal contributors to energy consumption from grains in the past 50 years. Notably, rice and wheat products accounted for over half of the contribution to energy consumption from staple grains, while the trends for contribution from roots and pulses generally decreased in most countries. Global Nutrition and Epidemiologic Transition Initiative countries with pilot data have documented key barriers and motivators to increase intake of high-quality staple foods. Summary: Global research efforts to identify and promote intake of culturally-acceptable high-quality staple foods could be crucial in preventing diabetes. These efforts may be valuable in shaping future research, community interventions, and public health and nutritional policies. © 2015 Mattei et al.


Monge-Rojas R.,Costa Rican Institute for Research and Education on Nutrition and Health INCIENSA | Smith-Castro V.,University of Costa Rica | Colon-Ramos U.,George Washington University | Aragon M.C.,Washington State University | Herrera-Raven F.,University of Costa Rica
Nutrition | Year: 2013

Objective: The aim of this study was to identify psychosocial factors that influence fast-food consumption in urban and rural Costa Rican adolescents. Methods: A self-administered questionnaire designed for the study asked about sociodemographic information, frequency of fast-food consumption, meaning of "fast food," location of purchase, and psychosocial correlates. Five psychosocial factors were extracted by using principal components analysis with Varimax rotation method and eigenvalues. Descriptive statistics and a hierarchical linear regression model were used to predict the frequency of fast-food consumption. Results: Responses from 400 adolescents (ages 12-17 y) reveal that daily consumption of fast food was 1.8 times more frequently mentioned by rural adolescents compared with urban youth. Urban and rural differences were found in the way adolescents classified fast foods (rural adolescents included more traditional foods like chips, sandwiches, and Casado-a dish consisting of rice, black beans, plantains, salad, and a meat), and in purchasing locations (rural adolescents identified neighborhood convenience stores as fast-food restaurants). Living in rural areas, convenience and availability of foods, and the presence of external loci of control were predictors of a higher frequency of fast-food consumption, whereas health awareness predicted a lower frequency. Conclusions: The development of interventions to reduce fast-food consumption in Costa Rican adolescents should consider not only convenience, but also the availability of these foods where adolescents are more exposed, particularly in rural areas. Interventions such as improving the convenience of healthy fast foods available in school canteens and neighborhood stores, policies to increase the price of unhealthy fast food, and activities to provide adolescents with the skills to increase self-efficacy and reduce the effect of external loci of control are recommended. © 2013 Elsevier Inc.


Colon-Ramos U.,George Washington University | Perez-Cardona C.M.,University of Puerto Rico at San Juan | Monge-Rojas R.,Costa Rican Institute for Research and Education on Nutrition and Health INCIENSA
Revista Panamericana de Salud Publica/Pan American Journal of Public Health | Year: 2013

Objective. To identify socio-demographic, behavioral, and health-related correlates of food preferences in Puerto Rico that will help determine Caribbean-region populations vulnerable to nutrition transition. Methods. Data from a cross-sectional study of a representative sample of 858 adults residing in the San Juan Metropolitan Area of Puerto Rico were analyzed. Multivariable ordinal logistic regressions were used to model the frequency of consumption of 1) fruits and vegetables, 2) tubers/starchy root vegetables, 3) fried foods, and 4) Western-style fast foods as a function of socio-demographic, behavioral, and health-related characteristics. Results. Higher frequency of consumption of fruits and vegetables was associated with being physically active and older and having a medium to high level of education, whereas intake of tubers was associated with being older, having a low income, not using government insurance, and having elevated levels of triglycerides. Frequency of consumption of fast food was associated with younger age, higher income, 12-15 years of formal education, and a higher body mass index (BMI), whereas frequency of consumption of fried food was associated with being younger and male, not being a smoker, and having elevated levels of fasting blood glucose. Conclusions. The results indicate a nutrition transition in Puerto Rico with health consequences for the Caribbean region. The characteristics of this nutrition transition seem to be determined by income, education, and age, but may also be dictated by access to various food groups. These results set the stage for needed investigation of environmental and individual-level factors that could shape patterns in food consumption. © American Public Health Association, 2013.


Colon-Ramos U.,George Washington University | Monge-Rojas R.,Costa Rican Institute for Research and Education on Nutrition and Health INCIENSA | Campos H.,Huntington University
Health Policy and Planning | Year: 2014

Background The World Health Organization (WHO) has deemed that there is enough evidence to recommend the elimination of industrially produced trans-fatty acids (TFA) from the food supply. This article evaluates government-led public health strategies in countries in Latin America and the Caribbean (LAC), and factors perceived to affect following WHO's recommendation to eliminate industrially produced TFA. Methods Descriptive, prospective multiple case studies integrated data from open-ended questionnaires to representatives of ministries of health, and systematic review of internal and publicly available documents in 13 LAC countries. Findings Overall, government efforts to follow WHO recommendations have not been well co-ordinated throughout the region. Evidence for this includes the lack of standardization of TFA definitions. For example, some countries exclude naturally occurring TFA from the definitions, whereas others leave the option open to their inclusion. As a consequence, the criteria for trans-free nutrient claims and labelling requirements are inconsistent across the region. Government-led strategies varied from banning or limiting TFA content in the food supply to voluntary labelling of TFA. The identified challenges to the implementation of policies to reduce TFA include the shortage of information on TFA content of diets and foods, consumer unawareness of TFA and lack of monitoring and surveillance. The identified enabling factors were intersectoral collaboration with industry, mandatory labelling regulation and international and national visibility of the topic, which facilitated reduction of TFA content. Interpretation A co-ordinated effort is required to achieve virtual elimination of all TFA in the region, as recommended by WHO. Standardization of the definition of TFA across the region would facilitate regulation, consumer education efforts and monitoring and surveillance efforts. Simultaneously, countries need to determine their level of exposure to TFA through the implementation of small surveys to assess blood TFA levels using blood spots, and the evaluation of TFA in fat sources that are commonly used. © 2013 The Author.


Monge-Rojas R.,Costa Rican Institute for Research and Education on Nutrition and Health INCIENSA | Aragon M.C.,Clemson University | Chinnock A.,University of Costa Rica | Campos H.,Harvard University | Colon-Ramos U.,George Washington University
Nutrition | Year: 2013

Objective: To identify how dietary intake and food sources of saturated (SFA) and cis (PUFA) and trans (TFA) unsaturated fatty acids in the diet of Costa Rican adolescents changed from 1996 to 2006-a period with several public health nutrition changes. Methods: Cross-sectional comparisons used data from measured food records of 133 adolescents (ages 12-17 y) surveyed in 1996 and a similar group of adolescents surveyed in 2006. Values obtained in 1996 and 2006 were compared with the current World Health Organization guidelines for chronic disease prevention. Results: Adolescents surveyed in 2006 reported a significantly higher mean daily energy intake from linoleic acid (LA) and alpha-linolenic acid (ALA) (0.9% and 7.8%, respectively) compared with the 1996 cohort, whereas SFA and TFA were significantly lower (9.5% and 1.3%, respectively). Food sources of fat also changed. In 2006, 2% of SFA in the diet came from palm shortening (compared with 34% in 1996); 39% of TFA came from ruminant-derived foods (in 1996, soybean oil was the main contributor of TFA, 34%), and bakery products (mainly pre-packaged cookies) provided 25% of the source of TFA, compared with only 11% in 1996. Dietary fatty intake of Costa Rican adolescents in 2006 is closer to WHO guidelines compared with 1996. Conclusions: After public health initiatives that changed fatty acid profile of most foods, intakes of TFA, SFA, and food sources of fatty acids in adolescents' diets improved. Public health nutrition efforts should continue to strengthen diets that are low in SFA and TFA and higher in ALA content among Costa Rican adolescents. © 2013 Elsevier Inc.


Monge-Rojas R.,Costa Rican Institute for Research and Education on Nutrition and Health INCIENSA | Campos H.,Harvard University
Journal of Food Composition and Analysis | Year: 2011

This article presents the first Costa Rican database on food carotenoids and tocopherols. The report concerning the content of these nutrients in foods that are common to the Latin American diet and to native Costa Rican varieties and cultivars is particularly important. Celery, which includes the leaves in Costa Rica, shows the highest content of lutein. +. zeaxanthin (26,400. μg/100. g) and β-carotene (16,200. μg/100. g), and is ranked fourth as a source of α-carotene (168. μg/100. g). The amount of lutein. +. zeaxanthin and β-cryptoxanthin present in Costa Rican red peppers is significantly high (2600 and 730. μg/100. g, respectively) and the amount of lycopene provided by 100. g of sardines canned in tomato sauce is higher (3300. μg/100. g) than the same amount of home-style tomato sauce (1420. μg/100. g) or raw tomato (1260. μg/100. g). Soybean oil has the highest δ-tocopherol content of all oils and is second to corn oil in γ-tocopherol content. Olive and sunflower oil have the highest α-tocopherol content. However, the content of α-tocopherol in celery and broccoli stands out. On average, these vegetables provide only 3. mg/100. g less of α-tocopherol than sunflower oil (12. mg/100. g and 15. mg/100. g, respectively). The reported data, together with the recently published Brazilian database on food carotenoids, could be the first step towards the systematic development of a Latin America carotenoid and tocopherol food composition database. © 2010 Elsevier Inc.


Monge-Rojas R.,Costa Rican Institute for Research and Education on Nutrition and Health INCIENSA | Mattei J.,Harvard University | Fuster T.,National University of Costa Rica | Willett W.,Harvard University | Campos H.,Harvard University
Appetite | Year: 2014

Little is known about the distinct perceptions towards rice and beans that may shape the consumption of these main staple foods among Costa Ricans. We aimed to identify barriers and motivators that could change the current staple into a healthier one, and assess the sensory perceptions of these foods in this population. Focus group discussions and sensory tastings of 8 traditional white or brown rice and beans preparations were conducted in 98 Costa Ricans, aged 40-65 years. Traditional habits and family support emerged as the two main drivers for current consumption. Consuming similar amounts of rice and beans, as well as unfamiliarity with brown rice, are habits engrained in the Costa Rican culture, and are reinforced in the family and community environment. Suggested strategies for consuming more brown rice and more beans included introducing them during childhood, disseminating information of their health benefits that take into account the importance of tradition, lowering the cost, increasing availability, engaging women as agents of change and for brown rice masking the perceived unpleasant sensory characteristics by incorporating them into mixed dishes. Plain brown rice received the lowest mean hedonic liking scores. The preparations rated highest for pleasant were the beans: rice 1:1 ratio regardless of the type of rice. This study identified novel strategies to motivate Costa Rican adults to adapt their food choices into healthier ones within their cultural and sensory acceptability. © 2014 Elsevier Ltd.


PubMed | Costa Rican Institute for Research and Education on Nutrition and Health INCIENSA
Type: Journal Article | Journal: Appetite | Year: 2010

This study designed and validated a questionnaire aimed at examining parental feeding styles to encourage healthy eating habits among Costa Rican adolescents. Adolescents (n=133; mean age 15.4 years), and their parents, participated in the study. The parents completed a parental feeding style questionnaire, and the adolescents completed 3-day food records. Confirmatory factor analyses suggest four distinct parental feeding styles, (a) verbal encouragement of healthy eating behaviors; (b) use of verbal sanctions to indirectly control the intake of healthy food; (c) direct control of access to and intake of food; and (d) use of food to regulate emotions and behavior. There were no correlations between dietary intake and the verbal encouragement of healthy eating behaviors, but there were significant negative correlations between (1) the use of verbal sanctions to indirectly control the intake of healthy food, and the consumption of fruit and vegetable, of calcium, iron, vitamin B6 and folic acid intake, and (2) between the direct control of access to and intake of food and fast food consumption and total carbohydrates intake. The use of food to regulate emotions and behavior was positively correlated with high energy-dense food consumption. Stratification of the data shows significant differences by gender in the correlations between parental feeding style and dietary intake. Understanding parental feeding styles in a Latin American context is a first step in helping researchers develops culturally-appropriate parenting intervention/prevention strategies to encourage healthy eating behaviors during adolescence.


PubMed | National University of Costa Rica, Costa Rican Institute for Research and Education on Nutrition and Health INCIENSA and Harvard University
Type: | Journal: Appetite | Year: 2014

Little is known about the distinct perceptions towards rice and beans that may shape the consumption of these main staple foods among Costa Ricans. We aimed to identify barriers and motivators that could change the current staple into a healthier one, and assess the sensory perceptions of these foods in this population. Focus group discussions and sensory tastings of 8 traditional white or brown rice and beans preparations were conducted in 98 Costa Ricans, aged 40-65years. Traditional habits and family support emerged as the two main drivers for current consumption. Consuming similar amounts of rice and beans, as well as unfamiliarity with brown rice, are habits engrained in the Costa Rican culture, and are reinforced in the family and community environment. Suggested strategies for consuming more brown rice and more beans included introducing them during childhood, disseminating information of their health benefits that take into account the importance of tradition, lowering the cost, increasing availability, engaging women as agents of change and for brown rice masking the perceived unpleasant sensory characteristics by incorporating them into mixed dishes. Plain brown rice received the lowest mean hedonic liking scores. The preparations rated highest for pleasant were the beans: rice 1:1 ratio regardless of the type of rice. This study identified novel strategies to motivate Costa Rican adults to adapt their food choices into healthier ones within their cultural and sensory acceptability.

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