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Trinidad and Tobago has experienced an epidemiological transition over recent decades characterised by reduced rates of communicable diseases but rapidly increasing rates of obesity and non-communicable chronic diseases. The objective of the present study was to investigate the changes in energy and nutrient supply that have taken place in Trinidad and Tobago between 1961 and 2007.
Design
Food balance sheets for each year between 1961 and 2007 were downloaded from the FAOSTAT database and daily per capita supply for seventeen food commodity groupings was calculated. After appropriate coding, energy and nutrient supply were determined using dietary analysis software.
Setting
FAO food balance sheets for Trinidad and Tobago from 1961 to 2007.
Subjects
None.
Results
The food supply in 2007 provided an extra 1561 kJ (373 kcal)/capita per d than it did in 1961. Energy from carbohydrate as a percentage of total energy fell from 62 % in 1961 to 57 % in 2007, whereas energy from fat as a percentage of total energy increased from 26 % to over 30 % and now lies at the upper end of WHO recommendations. Sugars increased from 20 % to over 26 % of total energy and are well above WHO recommendations. When expressed on a nutrient density basis, supplies of vitamin A, folate and Ca are lower than WHO recommendations.
Conclusions
Nutritional imbalances in the Trinidadian food supply need to be addressed to combat the rise in nutrition-related chronic disease that is projected to cause increased disability and premature death in the country in the coming years.
To examine socio-economic inequalities in malnutrition among Colombian children and adolescents, and to assess the contribution of individual-, household- and community-level factors to those inequalities.
Design
Cross-sectional data were used from two sources: 2005 Colombian Demographic and Health Survey and 2005 Colombian census. Malnutrition outcomes included stunting and overweight. Multilevel Poisson models were used to estimate the association between individual, household and contextual characteristics and malnutrition. Changes in prevalence ratios of the poorest quintile (v. richest) were compared to assess the contribution of different characteristics to inequalities in malnutrition.
Setting
Population-based, representative of Colombia.
Subjects
Children and adolescents <18 years of age (n 30 779) from the Colombian Demographic and Health Survey.
Results
Children and adolescents living in the poorest households were close to five times more likely to be stunted, while those from the richest households were 1·3–2·8 times more likely than their poorest counterparts to be overweight. Care practices and household characteristics, particularly mother's education, explained over one-third of socio-economic inequalities in stunting. The proportion explained by access to services was not negligible (between 6 % and 14 %). Access to sanitation was significantly associated with a lower prevalence of stunting for all age groups. Between 14 % and 32 % of socio-economic disparities in overweight were explained by maternal and household characteristics. Mother's overweight was positively associated with overweight of the child.
Conclusion
Socio-economic inequalities in stunting and overweight coexist among children and adolescents in Colombia. Malnutrition inequalities are largely explained by household characteristics, suggesting the need for targeted interventions.