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González Zapata LI, Restrepo Mesa SL, Mancilla López L, Sepúlveda Herrera D, Estrada Restrepo A. Inequalities in food consumption the Colombian households: Results from the National Survey of Nutritional Status. Hacia Promoc. Salud [Internet]. 2021 Jan. 1 [cited 2024 May 17];26(1):98-117. Available from: https://ucaldas.metarevistas.org/index.php/hacialapromociondelasalud/article/view/4322
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Authors
Laura Inés González Zapata
Perfil Google Scholar
Lorena Mancilla López
Diana Sepúlveda Herrera
Alejandro Estrada Restrepo
Abstract
Introduction: adverse socioeconomic conditions may cause food intake characterized by inequality that derives in malnutrition increases. Objective. To identify inequalities in food consumption among the Colombian population according to socioeconomic status and the food security classification for
households. Methods. the data were obtained from the 2005 National Survey of Nutritional Status, and the analysis used the first 24-hour recall n=39,413 Colombians. The statistical analysis took into account descriptive statistics and 95% confidence intervals. A multivariate analysis was performed through multinomial logistic regression models, with each of the food groups as a dependent variable. Finally, a latent class analysis was performed to understand the heterogeneity of the inequalities in food consumption in the households. Results. Low-socioeconomic status households showed higher
consumption of cereals, tubers and plantains, non-alcoholic beverages, and fats. I contrast, higher socioeconomic status households showed higher consumption of dairy products, fruit, vegetables, and sugars/sweets. The food security classification found that food-secure households had a higher
consumption of meat, dairy, vegetables, fruit, and sugars/sweets. Households classified as food-insecure showed a higher consumption of cereals, tubers and plantains, and non-alcoholic beverages. The consumption of tubers and plantains showed a clear social gradient, in higher socioeconomic status there was lower consumption probability of those products. Conclusion. There are inequalities in food consumption in Colombia according to socioeconomic status and the food security classification; therefore, people and families with the most unfavorable socioeconomic status have diets with less nutritional value.
Keywords:
References
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FAO/OPS/OMS. Panorama de la Seguridad Alimentaria y Nutricional en América Latina y el Caribe. Sistemas alimentarios sostenibles para poner fin al hambre y la malnutrición. Santiago: FAO/OPS/OMS; 2017. Retrieved from: http://www.fao.org/3/a-i6747s.pdf.
Departamento Administrativo Nacional de Estadísticas –DANE-. Boletín técnico. Pobreza monetaria en Colombia, año 2019. [Internet]. Bogotá D.C.; 2020; [Retrieved on 2020/08/18]. Retrieved from: https://www.dane.gov.co/files/investigaciones/condiciones_vida/pobreza/2019/Boletin-pobrezamonetaria_2019.pdf
Whitehead M. The concepts and principles of equity and health. Health Promot Int. 1991; 6(3):217-228.
Lee H, Kim D, Lee S, Fawcett J. The concepts of health inequality, disparities and equity in the era of population health. Appl Nurs Res. 2020; 56:151367.
Brunner EJ, Welch AA. Concepts and definitions use in public health nutrition. In: Buttriss JL, Welch AA, Kearney JM, Lanham-New SA, editores. Public Health Nutrition. Second edition. United Kingdom: John Wiley; 2018. p.9-17
Cristine-Pessoa M, Loures-Mendes L, Teixeira-Caiaffa W, Carvalho-Malta D, Velásquez-Meléndez G. Availability of food stores and consumption of fruit, legumes and vegetables in a Brazilian urban area. Nutr Hosp. 2014; 31(3):1438-43.
Instituto Colombiano de Bienestar Familiar, Profamila. Evaluación cualitativa de la seguridad alimentaria en el hogar. In: Encuesta Nacional de la Situación Nutricional en Colombia 2005. Bogotá D.C.: Instituto Colombiano de Bienestar Familiar; 2006. p. 317-50.
Instituto Colombiano de Bienestar Familiar, Profamila. Evaluación de la seguridad alimentaria en el hogar. In: Encuesta Nacional de la Situación Nutricional en Colombia 2010. Bogotá D.C.: Instituto Colombiano de Bienestar Familiar; 2011. p. 339-91.
Sharkey J, Dean W, Johnson C. Association of household and community characteristics with adult and child food insecurity among Mexican-Origin households in Colonias along the Texas-Mexico border. Int J Equity Health. 2011; 10(1):19.
Álvares L, Amaral T. Food insecurity and associated factors in the Portuguese population. Food Nutrition Bull. 2014; 35(4):395-402.
Mello J, Gans K, Risica P, Kirtania U, Strolla L, Fournier L. How is food insecurity associated with dietary behaviors? An analysis with low-income, ethnically diverse participants in a nutrition intervention study. J Am Diet Assoc. 2010; 110(12):1906-1911.
Instituto Colombiano de Bienestar Familiar, Profamila. Ingesta Dietética. In: Encuesta Nacional de la Situación Nutricional en Colombia 2005. Bogotá D.C.: Instituto Colombiano de Bienestar Familiar; 2006. p. 227-316.
Manjarrés L. Métodos para precisar la recolección de la ingesta en estudios poblacionales. Perspec Nutr Humana. 2007; 9(2):155-163.
Departamento Nacional de Planeación. Consejo Nacional de Política Económica y Social. Declaración de importancia estratégica del sistema de identificación de potenciales beneficiarios (SISBEN IV). Documento Conpes 3877 [Internet]. Bogotá D.C.; 2016; [Retrieved on 16 de octubre 2020]. 60 p. Retrieved from: https://www.sisben.gov.co/Documents/Compes%20IV/6285-CONPES%203877.pdf
Álvarez M, Estrada A, Montoya E, Melgar H. Validación de la escala de seguridad alimentaria doméstica en Antioquia, Colombia. Salud Pública México. 2006; 48(6):474-481.
Agresti A. Models for multinomial responses. In: Categorical data analysis, Third ed. New Jersey: Wiley and Sons; 2013:267-313.
Kleinbaum DG, Klein M. Politomous logistic regression. In: Logistic regression. A self-learning text, Third ed. New York: Springer; 2010. p. 429-62.
Nylund-Gibson K, Choi A. Ten Frequently Asked Questions about latent class analysis. Transl Issues Psychol Sci. 2018; 4(4):460-61.
Drew A, Jeffrey B. poLCA: An R package for polytomous variable latent class analysis. J Stat Softw. 2011; 42(10):1-29.
Bragança A, Dias de Aguiar D, Aparecida E. Padrão de consumo de alimentos no Brasil. Rev Econ Sociol Rural. 2009; 47(2):335-362.
Giacomo D, Miguel M, Calçada M, Vieira C, Wolf A, Passarelli C. Consumo Alimentar de famílias de baixa renda no município de Piracicaba/SP. Saúde Rev Piracicaba. 2004; 6(13):63-70.
Bermúdez O, Palma P. Consumo de Alimentos y Patrones Dietéticos de la Población de Nicaragua 2008. Programa Regional de Seguridad Alimentaria y Nutricional para Centroamérica. Retrieved from: http://www.sica.int/presanca
Álvarez LS, Mancilla L, González LI. Perfil Alimentario y Nutricional de Medellín 2010. Medellín: Alcaldía de Medellín, Universidad de Antioquia; 2010.
Prada G, Herrán O, Ortiz R. Patrón alimentario y acceso a los alimentos en familias desplazadas en el municipio de Girón, Santander, Colombia. Rev Panam Salud Publica. 2008; 23(4):257-263.
Fisher J, Johnson DS, Smeeding TM. Inequality of income and consumption in the U.S.: measuring the trends in inequality from 1984 to 2011 for the same individuals. Review of Income and Wealth. 2015; 61(4):630-650.
Darmon N, Drewnowski A. Contribution of food prices and diet cost to socioeconomic disparities in diet quality and health: a systematic review and analysis. Nutrition Reviews. 2015; 73(10):643–60.
de Mestral C, Chatelan A, Marques-Vidal P, Stringhini S, Bochud M. The contribution of diet quality to socioeconomic inequalities in obesity: a population-based study of swiss adults. Nutrients. 2019; 11(7):1573. https://doi.org/10.3390/nu11071573.
Miller V, Yusuf S, Chow CK, Dehghan M, Corsi DJ, Lock K et al. Availability, affordability, and consumption of fruits and vegetables in 18 countries across income levels: findings from the Prospective Urban Rural Epidemiology (PURE) study. Lancet Glob Health. 2016; 4(10): e695–703.
Kovalskys I, Rigotti A, Koletzko B, Fisberg M, Gómez G, Herrera-Cuenca M, et al. Latin American consumption of major food groups: Results from the ELANS study. PLoS ONE. 2019; 14(12):e0225101. https://doi.org/10.1371/journal.pone.0225101.
Valencia-Valero RG, Ortiz-Hernández L. Disponibilidad de alimentos en los hogares mexicanos de acuerdo con el grado de inseguridad alimentaria. Salud Pública Mex 2014;56:154-164.
Haddad L, Achadi E, Bendech MA, Ahuja A, Bhatia K, Bhutta Z et al. The Global Nutrition Report 2014: actions and accountability to accelerate the world’s progress on nutrition. J Nutr. 2015; 145(4): 663–671. doi:10.3945/jn.114.206078.
Mancilla-López LP, Molina-Marín G. Algunos planteamientos teóricos frente a los programas de transferencias condicionadas y el derecho a la alimentación. Hacia promoc. Salud. 2018; 23(2): 137-151.
Morón C, Alonso L, Crovetto M. Cambios en la estructura del con sumo de alimentos y nutrientes de América Latina 1979-1981 a 1999-2001.Organización de las Naciones Unidas para la Agricultura y la Alimentación (FAO), Oficina Regional de la FAO para América Latina y el Caribe. 2005; Santiago de Chile. p.63.
Mancilla L, Conde A. Análisis de la disponibilidad de los alimentos prioritarios en Colombia, 2007-2009. In: Observatorio de Seguridad Alimentaria y Nutricional: componentes y lineamientos para su implementación. Medellín; Universidad de Antioquia, Instituto Nacional de Salud; 2011.
Marmot M, Bell R. Social determinants and non-communicable diseases: time for integrated action. BMJ. 2019; 364:l251. doi: 10.1136/bmj.l251.
Braveman P, Gottlieb L. The social determinants of health: it’s time to consider the causes of the causes. Public Health Rep. 2014 Jan-Feb; 129(Suppl 2): 19–31. doi: 10.1177/00333549141291S206.
Rodríguez-Takeuchi L, Imai KS. Food price surges and poverty in urban Colombia: New evidence from household survey data. Food Policy. 2013; 43:227–236.
Poblacion AP, Cook JT, Marín-León L, Segall-Corrêa AM, Silveira JA, Konstantyner T, Taddei JA. food insecurity and the negative impact on Brazilian children’s health—why does food security matter for our future prosperity? Brazilian National Survey (PNDS 2006/07). Food Nutr Bull. 2016; 37(4):585-598.
WHO. Global status report on noncommunicable diseases 2014. WHO [Internet]. 2014; 280. [Retrieved on 2016/06/24]. Retrieved from: http://apps.who.int/iris/itstream/10665/148114/1/9789241564854_eng.pdf.
FAO/OPS/OMS. Panorama de la Seguridad Alimentaria y Nutricional en América Latina y el Caribe. Sistemas alimentarios sostenibles para poner fin al hambre y la malnutrición. Santiago: FAO/OPS/OMS; 2017. Retrieved from: http://www.fao.org/3/a-i6747s.pdf.
Departamento Administrativo Nacional de Estadísticas –DANE-. Boletín técnico. Pobreza monetaria en Colombia, año 2019. [Internet]. Bogotá D.C.; 2020; [Retrieved on 2020/08/18]. Retrieved from: https://www.dane.gov.co/files/investigaciones/condiciones_vida/pobreza/2019/Boletin-pobrezamonetaria_2019.pdf
Whitehead M. The concepts and principles of equity and health. Health Promot Int. 1991; 6(3):217-228.
Lee H, Kim D, Lee S, Fawcett J. The concepts of health inequality, disparities and equity in the era of population health. Appl Nurs Res. 2020; 56:151367.
Brunner EJ, Welch AA. Concepts and definitions use in public health nutrition. In: Buttriss JL, Welch AA, Kearney JM, Lanham-New SA, editores. Public Health Nutrition. Second edition. United Kingdom: John Wiley; 2018. p.9-17
Cristine-Pessoa M, Loures-Mendes L, Teixeira-Caiaffa W, Carvalho-Malta D, Velásquez-Meléndez G. Availability of food stores and consumption of fruit, legumes and vegetables in a Brazilian urban area. Nutr Hosp. 2014; 31(3):1438-43.
Instituto Colombiano de Bienestar Familiar, Profamila. Evaluación cualitativa de la seguridad alimentaria en el hogar. In: Encuesta Nacional de la Situación Nutricional en Colombia 2005. Bogotá D.C.: Instituto Colombiano de Bienestar Familiar; 2006. p. 317-50.
Instituto Colombiano de Bienestar Familiar, Profamila. Evaluación de la seguridad alimentaria en el hogar. In: Encuesta Nacional de la Situación Nutricional en Colombia 2010. Bogotá D.C.: Instituto Colombiano de Bienestar Familiar; 2011. p. 339-91.
Sharkey J, Dean W, Johnson C. Association of household and community characteristics with adult and child food insecurity among Mexican-Origin households in Colonias along the Texas-Mexico border. Int J Equity Health. 2011; 10(1):19.
Álvares L, Amaral T. Food insecurity and associated factors in the Portuguese population. Food Nutrition Bull. 2014; 35(4):395-402.
Mello J, Gans K, Risica P, Kirtania U, Strolla L, Fournier L. How is food insecurity associated with dietary behaviors? An analysis with low-income, ethnically diverse participants in a nutrition intervention study. J Am Diet Assoc. 2010; 110(12):1906-1911.
Instituto Colombiano de Bienestar Familiar, Profamila. Ingesta Dietética. In: Encuesta Nacional de la Situación Nutricional en Colombia 2005. Bogotá D.C.: Instituto Colombiano de Bienestar Familiar; 2006. p. 227-316.
Manjarrés L. Métodos para precisar la recolección de la ingesta en estudios poblacionales. Perspec Nutr Humana. 2007; 9(2):155-163.
Departamento Nacional de Planeación. Consejo Nacional de Política Económica y Social. Declaración de importancia estratégica del sistema de identificación de potenciales beneficiarios (SISBEN IV). Documento Conpes 3877 [Internet]. Bogotá D.C.; 2016; [Retrieved on 16 de octubre 2020]. 60 p. Retrieved from: https://www.sisben.gov.co/Documents/Compes%20IV/6285-CONPES%203877.pdf
Álvarez M, Estrada A, Montoya E, Melgar H. Validación de la escala de seguridad alimentaria doméstica en Antioquia, Colombia. Salud Pública México. 2006; 48(6):474-481.
Agresti A. Models for multinomial responses. In: Categorical data analysis, Third ed. New Jersey: Wiley and Sons; 2013:267-313.
Kleinbaum DG, Klein M. Politomous logistic regression. In: Logistic regression. A self-learning text, Third ed. New York: Springer; 2010. p. 429-62.
Nylund-Gibson K, Choi A. Ten Frequently Asked Questions about latent class analysis. Transl Issues Psychol Sci. 2018; 4(4):460-61.
Drew A, Jeffrey B. poLCA: An R package for polytomous variable latent class analysis. J Stat Softw. 2011; 42(10):1-29.
Bragança A, Dias de Aguiar D, Aparecida E. Padrão de consumo de alimentos no Brasil. Rev Econ Sociol Rural. 2009; 47(2):335-362.
Giacomo D, Miguel M, Calçada M, Vieira C, Wolf A, Passarelli C. Consumo Alimentar de famílias de baixa renda no município de Piracicaba/SP. Saúde Rev Piracicaba. 2004; 6(13):63-70.
Bermúdez O, Palma P. Consumo de Alimentos y Patrones Dietéticos de la Población de Nicaragua 2008. Programa Regional de Seguridad Alimentaria y Nutricional para Centroamérica. Retrieved from: http://www.sica.int/presanca
Álvarez LS, Mancilla L, González LI. Perfil Alimentario y Nutricional de Medellín 2010. Medellín: Alcaldía de Medellín, Universidad de Antioquia; 2010.
Prada G, Herrán O, Ortiz R. Patrón alimentario y acceso a los alimentos en familias desplazadas en el municipio de Girón, Santander, Colombia. Rev Panam Salud Publica. 2008; 23(4):257-263.
Fisher J, Johnson DS, Smeeding TM. Inequality of income and consumption in the U.S.: measuring the trends in inequality from 1984 to 2011 for the same individuals. Review of Income and Wealth. 2015; 61(4):630-650.
Darmon N, Drewnowski A. Contribution of food prices and diet cost to socioeconomic disparities in diet quality and health: a systematic review and analysis. Nutrition Reviews. 2015; 73(10):643–60.
de Mestral C, Chatelan A, Marques-Vidal P, Stringhini S, Bochud M. The contribution of diet quality to socioeconomic inequalities in obesity: a population-based study of swiss adults. Nutrients. 2019; 11(7):1573. https://doi.org/10.3390/nu11071573.
Miller V, Yusuf S, Chow CK, Dehghan M, Corsi DJ, Lock K et al. Availability, affordability, and consumption of fruits and vegetables in 18 countries across income levels: findings from the Prospective Urban Rural Epidemiology (PURE) study. Lancet Glob Health. 2016; 4(10): e695–703.
Kovalskys I, Rigotti A, Koletzko B, Fisberg M, Gómez G, Herrera-Cuenca M, et al. Latin American consumption of major food groups: Results from the ELANS study. PLoS ONE. 2019; 14(12):e0225101. https://doi.org/10.1371/journal.pone.0225101.
Valencia-Valero RG, Ortiz-Hernández L. Disponibilidad de alimentos en los hogares mexicanos de acuerdo con el grado de inseguridad alimentaria. Salud Pública Mex 2014;56:154-164.
Haddad L, Achadi E, Bendech MA, Ahuja A, Bhatia K, Bhutta Z et al. The Global Nutrition Report 2014: actions and accountability to accelerate the world’s progress on nutrition. J Nutr. 2015; 145(4): 663–671. doi:10.3945/jn.114.206078.
Mancilla-López LP, Molina-Marín G. Algunos planteamientos teóricos frente a los programas de transferencias condicionadas y el derecho a la alimentación. Hacia promoc. Salud. 2018; 23(2): 137-151.
Morón C, Alonso L, Crovetto M. Cambios en la estructura del con sumo de alimentos y nutrientes de América Latina 1979-1981 a 1999-2001.Organización de las Naciones Unidas para la Agricultura y la Alimentación (FAO), Oficina Regional de la FAO para América Latina y el Caribe. 2005; Santiago de Chile. p.63.
Mancilla L, Conde A. Análisis de la disponibilidad de los alimentos prioritarios en Colombia, 2007-2009. In: Observatorio de Seguridad Alimentaria y Nutricional: componentes y lineamientos para su implementación. Medellín; Universidad de Antioquia, Instituto Nacional de Salud; 2011.
Marmot M, Bell R. Social determinants and non-communicable diseases: time for integrated action. BMJ. 2019; 364:l251. doi: 10.1136/bmj.l251.
Braveman P, Gottlieb L. The social determinants of health: it’s time to consider the causes of the causes. Public Health Rep. 2014 Jan-Feb; 129(Suppl 2): 19–31. doi: 10.1177/00333549141291S206.
Rodríguez-Takeuchi L, Imai KS. Food price surges and poverty in urban Colombia: New evidence from household survey data. Food Policy. 2013; 43:227–236.
Poblacion AP, Cook JT, Marín-León L, Segall-Corrêa AM, Silveira JA, Konstantyner T, Taddei JA. food insecurity and the negative impact on Brazilian children’s health—why does food security matter for our future prosperity? Brazilian National Survey (PNDS 2006/07). Food Nutr Bull. 2016; 37(4):585-598.
