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This study assessed the impact of nutrient warnings on product selection and ability to identify food products high in nutrients of concern in Colombia. In an online experiment (May-June 2023), Colombian adults were randomized to a nutrient warning, guideline daily amounts (GDA), Nutri-Score, or no-label condition (n = 8,004). Participants completed selection tasks between two fruit drinks labeled according to their condition, one high in sugar and one not. Next, participants answered questions about products high in sugar, sodium, and/or saturated fat (\"high-in\" product). Finally, they selected which label would most discourage them from consuming a high-in product. Fewer participants (17%) exposed to the nutrient warning indicated they would purchase the high-sugar fruit drink compared to Nutri-Score (27%, Holm-adjusted (adj) p<0.001) and no label conditions (31%, adj p<0.001); there were no differences between the nutrient warning and GDA label (14%, adj p = 0.087). Compared to the nutrient warning, the GDA label was slightly more effective at helping consumers identify which drink was high in sugar (89% versus 92%, adj p<0.001), while the Nutri-Score and no-label conditions were less effective. Compared to all other conditions, nutrient warnings were more effective at helping participants identify that products were high in nutrients of concern, were more effective at decreasing intentions to purchase these high-in products and were perceived as more effective. Nutrient warnings were most often selected as the label that most discouraged consumption. Nutrient warnings are a promising policy to help consumers identify and discourage consumption of products high in nutrients of concern. Trial Registration: NCT05783726.

Background/objectivesAdherence to a “Western” style dietary pattern has been related to behavior problems in children in high-income countries; however, dietary patterns may differ in countries undergoing the nutrition transition. Associations of dietary patterns with behavior problems in a Latin American context have not been evaluated.Subjects/MethodsMothers of 385 children 5 to 12 y old completed a food frequency questionnaire (FFQ) on the children’s usual intake at enrollment into a cohort study. Four dietary patterns were identified through principal component analysis of the FFQ: animal protein, snacking, cheaper protein, and traditional/starch. After a median 6 y follow-up, adolescents reported behavior problems via the Youth Self Report, a standardized questionnaire. We compared the continuous distributions of externalizing and internalizing behavior problems and their subscales across quartiles of adherence to the four dietary patterns using multivariable linear regression.ResultsBoys in the highest quartile of adherence to the animal protein pattern in middle childhood had an adjusted 5.5 units lower (95% CI −9.5, −1.5) mean total externalizing problems score compared with boys in the lowest quartile (P trend = 0.008). Adherence to the animal protein pattern was also inversely related to the aggressive behavior externalizing subscale in a dose–response manner among boys (P trend = 0.009). There were no associations between adherence to other dietary patterns and externalizing problems in boys or girls. There were no associations with internalizing problems.ConclusionAdherence to an animal protein dietary pattern in middle childhood was associated with less externalizing behavior problems in adolescent boys.

To establish the relationship between the marketing strategies and nutritional quality of foods and beverages promoted in television food advertisements (TV ads) seen by Colombian child audiences overall and based on child gender and socio-economic strata (SES). A quantitative content analysis of marketing appeals was combined with nutritional data of the food products advertised and matched with TV audience ratings data for each food and beverage ads for Colombian children between 4 and 11 years. All beverages and foods TV ads cable or over-the-air channels in Colombia in 2017. N/A. Compared with rational appeals (e.g. freshness, health or nutrition messages), emotional appeals (referencing or depicting human senses or emotions, e.g. using cartoons to suggest fun) were more frequently used in the TV ads most viewed by Colombian children. Female children and children in lower SES tended to be more exposed to emotional appeals in TV ads than their male or higher SES counterparts. Furthermore, TV ads using more emotional appeals tended to be for products high in problematic nutrients. The findings of this study highlight the need to implement statutory measures to reduce the deleterious effect of food marketing on children.

This study assessed nutrient warnings' impact on product selection and identification of food products high in nutrients of concern in Colombia. In an online experiment (October 2020), 8,061 Colombians were randomized to a nutrient warning, guideline daily amounts (GDA), Nutri-Score, or no-label condition. They viewed two fruit drinks labeled according to their condition, one high in sugar and one not, and completed selection tasks. Next, they assessed four products high in sugar, sodium, and/or saturated fat (\"high in\" product). Finally, they selected which label would most discourage them from consuming a \"high in\" product. The nutrient warning performed better on most outcomes. Twenty percent of participants exposed to the nutrient warning would purchase the high-sugar fruit drink compared to GDA (24%, p<0.01), Nutri-Score (33%, p<0.001), and no label (29%, p<0.001). GDA performed slightly better than the nutrient warning in identifying the high-sugar fruit drink (91% vs 88%, p<0.001). The nutrient warning best helped participants correctly identify other \"high in\" products (75% vs. 23% no-label, 26% Nutri-Score, and 43% GDA, all p<0.001) and had the highest perceived message effectiveness (3.86 on 5-point scale vs. 2.97 GDA and 2.70 Nutri-Score, both p<0.001) and lowest likelihood of purchasing \"high in\" products (2.58 on 5-point scale vs. 3.23 GDA, 3.49 Nutri-Score, and 3.51 no label, all p<0.001). The nutrient warning most discouraged participants from wanting to consume \"high in\" products. Nutrient warnings are a promising policy to help consumers identify and discourage consumption of products high in nutrients of concern. Trial Registration: NCT04567004.

Background/Objectives: Colombia has implemented a tiered tax on sugar-sweetened beverages (SSBs), reaching 20% for high-sugar products by 2025. To inform evaluations of this policy, we estimated taxed and untaxed beverage intake prior to implementation and examined differences across sociodemographic groups. Methods: We analyzed 24 h dietary recall data from the 2015 National Survey of the Nutritional Situation of Colombia (ENSIN; n = 11,877 adults aged 18–64), which uses a stratified, multistage cluster sampling design covering all regions of the country. Beverages were categorized by 2025 tax thresholds: untaxed (<5 g added sugar/100 mL), taxed (≥5 g), and high-sugar taxed (≥9 g). Intake (mL, kcal) was estimated per capita and per consumer using survey-weighted two-part models, adjusting for sociodemographic characteristics. Results: Eighty-four percent of adults consumed taxed beverages, with per capita intake of 209 kcal (95% CI: 203–216) and 481 mL (95% CI: 464–497). Sixty-three percent consumed high-sugar taxed beverages, with intake of 134 kcal (95% CI: 130–139) and 292 mL (95% CI: 282–303) per capita. Untaxed beverages accounted for 109 kcal (95% CI: 106–112) and 837 mL (95% CI: 793–882) per capita. Across categories, the highest per capita kcal intakes were from untaxed dairy/milk substitutes (67 kcal, 95% CI: 64–69), any taxed fruit/vegetable juices (61 kcal, 95% CI: 55–66), and any taxed sodas/carbonated beverages (47 kcal, 95% CI: 44–50). Males consumed more taxed beverages of any type (255 kcal, 95% CI: 247–264) than females (174 kcal, 95% CI: 165–182). Conclusions: Prior to its SSB tax, Colombians had a high consumption of SSBs that would be subject to the tax. Future research should assess how consumption changed in response to the tax.

Background/ObjectivesWe sought to determine the associations of n-3 and n-6 polyunsaturated fatty acids (PUFA) in middle childhood with externalizing and internalizing behavior problems in adolescence.Subjects/MethodsUsing gas-liquid chromatography, we quantified n-3 and n-6 PUFA in serum samples of 444 Colombian schoolchildren aged 5–12 years at the time of enrollment into a cohort study. After a median 6 years, adolescent externalizing and internalizing behavior problems were determined with the Youth Self Report (YSR) questionnaire. We estimated adjusted mean behavior problem score differences with 95% confidence intervals (CIs) between quartiles of each PUFA using multivariable linear regression. We also considered as exposures the Δ6-desaturase (D6D) and Δ5-desaturase (D5D) enzyme activity indices.ResultsDocosahexaenoic acid (DHA) was positively associated with externalizing problems; every standard deviation (SD) of DHA concentration was associated with an adjusted one unit higher externalizing problem score (95% CI: 0.1, 1.9). The D5D enzyme activity index was inversely related to externalizing problem scores. Alpha-linolenic acid concentration was positively associated with internalizing problem scores, whereas adrenic acid was inversely related to this outcome.ConclusionsSerum PUFA in middle childhood were related to behavior problems in adolescence. Some of these associations might reflect the role of D5D enzyme activity.

Purpose Leukocyte telomere length (LTL) is a biomarker of inflammation and oxidative stress that predicts chronic disease risk. Nutritional factors are related to LTL in adulthood, but these associations are not well characterized in children. We examined whether micronutrient status biomarkers were associated with LTL in school-age children. Methods We conducted a cross-sectional study of 330 boys and 393 girls aged 5–12 years from Bogotá, Colombia. We quantified blood concentrations of hemoglobin, ferritin, zinc, vitamin A, folate, and vitamin B-12; and measured LTL using qPCR in DNA extracted from buffy coat. We estimated mean differences in LTL by quartiles of micronutrient status biomarkers and categories of relevant sociodemographic and anthropometric covariates with the use of linear regression. Results In girls, plasma vitamin B-12 was positively associated with LTL (adjusted LTL difference between extreme vitamin B-12 quartiles = 0.11; P , trend = 0.02). LTL was also positively associated with birth order in girls ( P , trend = 0.02). In boys, LTL was not related to the micronutrient status biomarkers but, unexpectedly, it was positively associated with birth weight ( P  = 0.02), height-for-age Z score ( P , trend = 0.01), and serum C-reactive protein ( P , trend = 0.01). Conclusions LTL is associated with vitamin B-12 status among girls. LTL is also associated with birth weight, height, and C-reactive protein in boys.

Repetitive element DNA methylation is related to prominent obesity-related chronic diseases including cancer and cardiovascular disease; yet, little is known of its relation with weight status. We examined associations of LINE-1 DNA methylation with changes in adiposity and linear growth in a longitudinal study of school-age children from Bogotá, Colombia. We quantified methylation of LINE-1 elements from peripheral leukocytes of 553 children aged 5-12 years at baseline using pyrosequencing technology. Anthropometric characteristics were measured periodically for a median of 30 months. We estimated mean change in three age-and sex-standardized indicators of adiposity: body mass index (BMI)-for-age Z-score, waist circumference Z-score, and subscapular-to-triceps skinfold thickness ratio Z-score according to quartiles of LINE-1 methylation using mixed effects regression models. We also examined associations with height-for-age Z-score. There were non-linear, inverse relations of LINE-1 methylation with BMI-for-age Z-score and the skinfold thickness ratio Z-score. After adjustment for baseline age and socioeconomic status, boys in the lowest quartile of LINE-1 methylation experienced annual gains in BMI-for-age Z-score and skinfold thickness ratio Z-score that were 0.06 Z/year (P = 0.04) and 0.07 Z/year (P = 0.03), respectively, higher than those in the upper three quartiles. The relation of LINE-1 methylation and annual change in waist circumference followed a decreasing monotonic trend across the four quartiles (P trend = 0.02). DNA methylation was not related to any of the adiposity indicators in girls. There were no associations between LINE-1 methylation and linear growth in either sex. Lower LINE-1 DNA methylation is related to development of adiposity in boys.

Introducción. Para el profesional en nutrición, las tablas de intercambios de alimentos (TAI) son una herramienta que permite cuantificar la ingesta de calorías y nutrientes y planear la alimentación de manera práctica.Objetivo. Diseñar una TAI para uso en pediatría que facilite la labor del nutricionista en esta población.Materiales y métodos. Estudio descriptivo transversal. La selección de los alimentos consumidos con mayor frecuencia se realizó de acuerdo con recordatorios de 24 horas y una tabla de composición de alimentos (TCA). Se determinaron los tamaños de intercambio de alimentos teniendo en cuenta las porciones del grupo etario. Después del análisis químico de los alimentos se determinaron las medidas caseras (p. ej. cucharada, cucharadita, taza, etc.) y se diseñó y se validó la TIA.Resultados. Se incluyeron 241 alimentos, los cuales se distribuyeron en 9 grupos y 4 anexos. Se tuvo en cuenta un nutriente principal para cada grupo y la medida casera se definió según las características de cada alimento. Se observó concordancia en la evaluación de consumo entre la TIA para uso en pediatría y la TCA (CCI>0.81).Conclusión. Se desarrolló una TIA para población pediátrica confiable que permitirá evaluar la alimentación y diseñar planes de alimentación en preescolares y escolares de manera práctica.