McCloskey Morgan L, Tarazona-Meza Carla E, Jones-Smith Jessica C, Miele Catherine H, Gilman Robert H, Bernabe-Ortiz Antonio, Miranda J Jaime, Checkley William
Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, 1830 Monument St Room 555, Baltimore, MD, 21205, USA.
Biomedical Research Unit, A.B. PRISMA, Lima, Peru.
Int J Behav Nutr Phys Act. 2017 Jul 11;14(1):90. doi: 10.1186/s12966-017-0545-4.
Diet and activity are thought to worsen with urbanization, thereby increasing risk of obesity and chronic diseases. A better understanding of dietary and activity patterns across the urbanization divide may help identify pathways, and therefore intervention targets, leading to the epidemic of overweight seen in low- and middle-income populations. Therefore, we sought to characterize diet and activity in a population-based study of urban and rural residents in Puno, Peru.
We compared diet and activity in 1005 (503 urban, 502 rural) participants via a lifestyle questionnaire. We then recruited an age- and sex-stratified random sample of 50 (25 urban, 25 rural) participants to further characterize diet and activity. Among these participants, diet composition and macronutrient intake was assessed by three non-consecutive 24-h dietary recalls and physical activity was assessed using Omron JH-720itc pedometers.
Among 1005 participants, we found that urban residents consumed protein-rich foods, refined grains, sugary items, and fresh produce more frequently than rural residents. Among the 50 subsample participants, urban dwellers consumed more protein (47 vs. 39 g; p = 0.05), more carbohydrates (280 vs. 220 g; p = 0.03), more sugary foods (98 vs. 48 g, p = 0.02) and had greater dietary diversity (6.4 vs 5.8; p = 0.04). Rural subsample participants consumed more added salt (3.1 vs 1.7 g, p = 0.006) and tended to consume more vegetable oil. As estimated by pedometers, urban subsample participants burned fewer calories per day (191 vs 270 kcal, p = 0.03).
Although urbanization is typically thought to increase consumption of fat, sugar and salt, our 24-h recall results were mixed and showed lower levels of obesity in rural Puno were not necessarily indicative of nutritionally-balanced diets. All subsample participants had relatively traditional lifestyles (low fat intake, limited consumption of processed foods and frequent walking) that may play a role in chronic disease outcomes in this region.
人们认为饮食和活动状况会随着城市化进程而恶化，从而增加肥胖和慢性病风险。更好地了解城市化进程中不同人群的饮食和活动模式，可能有助于确定导致低收入和中等收入人群超重流行的途径，进而确定干预目标。因此，我们试图在一项针对秘鲁普诺城乡居民的基于人群的研究中，对饮食和活动状况进行描述。
我们通过一份生活方式问卷，比较了1005名参与者（503名城市居民，502名农村居民）的饮食和活动情况。然后，我们招募了一个按年龄和性别分层的50名参与者的随机样本（25名城市居民，25名农村居民），以进一步描述饮食和活动状况。在这些参与者中，通过连续三天的24小时饮食回顾来评估饮食组成和常量营养素摄入量，并使用欧姆龙JH-720itc计步器评估身体活动情况。
在1005名参与者中，我们发现城市居民比农村居民更频繁地食用富含蛋白质的食物、精制谷物、含糖食品和新鲜农产品。在50名子样本参与者中，城市居民摄入的蛋白质更多（47克对39克；p = 0.05），碳水化合物更多（280克对220克；p = 0.03），含糖食物更多（98克对48克，p = 0.02），饮食多样性更高（6.4对5.8；p = 0.04）。农村子样本参与者摄入的添加盐更多（3.1克对1.7克，p = 0.006），并且倾向于摄入更多植物油。根据计步器估计，城市子样本参与者每天消耗的卡路里更少（191千卡对270千卡，p = 0.03）。
尽管通常认为城市化会增加脂肪、糖和盐的摄入量，但我们24小时回顾的结果并不一致，而且普诺农村地区较低的肥胖水平并不一定意味着饮食营养均衡。所有子样本参与者都有相对传统的生活方式（低脂肪摄入、加工食品消费有限且经常步行），这可能对该地区的慢性病发病情况有影响。
