Food consumption in economically disadvantaged women in Cali, Colombia 1990-95 and 2008: Evidence of a nutrition transition? Richard L Bender 1 , Darna L Dufour 1 , and Julio C Reina 2 1 Department of Anthropology, University of Colorado, Boulder; 2 Department of Pediatrics, Universidad del Valle and Centro Medico Imbanaco, Cali, Colombia Introduction Our objectives are to assess the changes in food choice and dietary intake of women of low socioeconomic status in Cali, Colombia between 1990-95 and 2008, and compare these changes to those expected in developing countries undergoing a nutrition transition. The expectations are that the consumption of roots/tubers and other vegetables will decline, while the consumption of simple carbohydrates (added sugars), vegetable oils, meat/fish and processed foods will increase (Popkin & Gordon-Larsen, 2004). Concurrently, the prevalence of overweight and obesity is expected to increase (Popkin, 2001). Here, we analyze dietary data both in terms of food group intake and of dietary energy and macronutrient intake. We place the analysis within the context of changes in overweight and obesity that have occurred in Cali over the last two decades and assess whether there is evidence for a nutrition transition in this urban setting. Methods •The data were collected during two separate studies: 1990-95 and 2008. Sample sizes were 85 women in each study, and all were from economically disadvantaged neighborhoods. •Food choice and dietary intake were based on one 24-hour dietary recall in each study. Foods were classified into 16 groups (Table 1), and food choice was defined as the frequency of different food groups in the diet. •Energy intake was expressed as kilocalories per woman per day, while macronutrient intake was expressed as % of total energy. Intake values for energy and macronutrients were calculated using literature values, laboratory analyses of samples, and software written for the project. •Dietary energy and macronutrient intakes were compared between the study periods with t-tests. Correlation analysis was used to assess the relationship between total number of food items consumed and total daily energy intake. Statistical analyses were performed in PASW Statistics 18.0 with α = 0.05. Results •Figure 1: Between 1990-95 and 2008 there was an increase in the consumption of vegetables, legumes, and fruit juices, and a decrease in the consumption of coffee, chocolate, soft drinks and roots/tubers. There was little change in meat/fish consumption. •Table 1: The greatest percentage increases in food choice were vegetables and fruit juices, while the greatest decreases were in soft drinks and alcohol. However, alcohol consumption was negligible in both study periods •The consumption of processed foods and food prepared away from home remained minimal (data not shown). •Table 2: There were no significant changes in total energy intake, carbohydrate intake, or protein intake, but fat intake increased significantly from 1990-95 to 2008. •Figure 2: In 2008, there was a positive but weak correlation between the total number of food items consumed per day and total daily energy intake (r 2 = 0.29, p < 0.01). The relationship between these two variables was similar in 1990-95 (r 2 = 0.41, p < 0.01; Dufour et al., 1999). Discussion The data suggest little change in the overall diet between 1990-95 and 2008. The types of foods consumed and the patterns of meals were similar, as was the relationship between the number of food items consumed and total daily energy intake. The decrease in roots/tubers and increase in fat intake follow predictions of the nutrition transition. The increased consumption of vegetables and fruit juices, the decreased consumption of soft drinks, and the relative steady state of meat/fish consumption are contrary to what is expected in developing countries undergoing a nutrition transition. However, despite there being little evidence of change in the overall diet, overweight and obesity among economically disadvantaged women in Cali, Colombia increased in the past two decades. This shift in nutritional status is particularly apparent in the lowest socioeconomic groups (Figure 3). The next stage of this research is to quantify the physical activity patterns within this economically disadvantaged population. It is likely that the increasing prevalence of overweight and obesity observed in many developing nations is the result not only of changes in diet, but also in patterns of energy expenditure. Acknowledgments This research was supported by NSF SGER 0707.05 and NIH 5-R22-DK39734. Presented at the 36 th Annual Meeting of the Human Biology Association, Minneapolis MN, April 13, 2011 References •Dufour DL, Staten LK, Waslien CI, Reina JC, Spurr GB. 1999. Estimating energy intake of urban women in Colombia: comparison of diet records and recalls. Am J Phys Anthropol 108:53-63. •Popkin BM. 2001. The nutrition transition and obesity in the developing world. J Nutr 131:871S-873S. •Popkin BM, Gordon-Larsen P. 2004. The nutrition transition: worldwide obesity dynamics and their determinants. Int J Obes 28:S2-S9. Conclusions •Dietary energy and macronutrient intake did not change from 1990-95 to 2008. •The types of foods consumed were similar between 1990-95 and 2008. •Evidence for a nutrition transition in Cali, Colombia is mixed: There is little evidence of changes in diet, but ample evidence for an increase in the prevalence of obesity. Main Questions •Did dietary energy and macronutrient intake change from 1990-95 to 2008? •Did the types of foods consumed change from 1990-95 to 2008? •Is there evidence for a nutrition transition in Cali, Colombia? TABLE 1. Change in frequency of consumption of 16 food groups between studies Food Group Frequency (’90-’95) Frequency (’08) % change Coffee, chocolate, aguapanela 2.37 1.88 - 20.68 Rice, pasta 1.83 1.86 + 1.64 Meat, fish and mixed dishes 1.63 1.65 + 1.23 Soft drinks, other drinks 1.63 0.78 - 52.15 Bread, pastry, cookies 1.57 1.59 + 1.27 Roots, tubers, plantains 0.80 0.45 - 43.75 Fruit juices 0.70 0.99 + 41.43 Legumes 0.50 0.60 + 20.00 Soup, stew 0.47 0.49 + 4.26 Candy 0.30 0.36 + 20.00 Fruits 0.30 0.26 - 13.33 Other 0.23 0.31 + 34.78 Salads, vegetables 0.20 0.38 + 90.00 Milk and milk products 0.17 0.21 + 23.53 Mixed vegetable dishes 0.13 0.35 + 169.23 Alcohol 0.03 0.01 - 66.67 TABLE 2. Comparison (t-test) of energy intake and macronutrient composition (mean ± SD) between studies 1990-95 (N = 85) 2008 (N = 85) p-value Kilocalories 1894 ± 484 1808 ± 580 0.30 Carbohydrate % 70.6 ± 17.3 67.0 ± 10.0 0.10 Protein % 11.4 ± 3.3 11.4 ± 2.7 0.99 Fat % 19.3 ± 7.5 22.3 ±7.8 0.01* 2.37 1.88 1.83 1.65 1.63 0.78 1.57 1.59 0.80 0.45 0.70 0.99 0.50 0.60 Figure 2. Relationship between number of food items consumed and daily energy intake (2008) Figure 3. Changes in BMI by SES group Figure 1. Changes in consumption frequencies of eight most common food groups Food items/day 4 6 8 10 12 14 16 18 20 Energy intake (kcal/day) 500 1000 1500 2000 2500 3000 3500 4000 4500 Low BMI (kg/m 2 ) 15 20 25 30 35 40 45 Percent 0 10 20 30 Middle 15 20 25 30 35 40 45 0 10 20 30 High 15 20 25 30 35 40 45 0 10 20 30 1987 2007 r 2 = 0.29