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AbstractThe Nutrition Transition model posits that vegetable oils, animal source foods (ASFs) and caloric sweeteners contribute to increases in adiposity and hence body mass index. Body mass index (BMI) is increasing more rapidly among Latin American populations of low versus high socioeconomic status (SES). The objectives of this study among Costa Rican women were to: (1) compare indicators of adiposity and dietary intake by SES and (2) evaluate the relationship between intake of foods high in vegetable oils, ASFs or caloric sweeteners and body fatness. This cross-sectional study, conducted in 2014–2015, included 128 low-, middle- and high-SES non-pregnant, non-lactating women aged between 25 and 45 years with 1–4 live births. Anthropometry was used to assess BMI, body composition and body fat distribution. Dietary recalls (n = 379) were used to assess dietary intake. Percentage body fat was greater in low- versus high-SES women (31.5 ± 3.9 vs 28.2 ± 4.7%). Skinfold measurements at four sites on the upper and lower body were greater in low- versus high-SES women. Body mass index did not vary in low- versus high-SES women. Intake frequency of foods high in vegetable oils was greater in low- and middle- (1.8 and 1.8 times/day, respectively) versus high- (1.1 times/day) SES women. For individual foods, intake frequency varied significantly by SES for high-fat condiments, fried vegetables, dairy, sweetened coffee/tea and pastries and desserts. Intake frequency of Nutrition Transition food categories was not associated with percentage body fat after adjustment for energy intake. Indicators of body composition provide additional information beyond BMI that are useful in understanding SES–adiposity associations in Latin America. Approaches to understanding diet and adiposity in Latin America that focus on vegetable oils, ASFs and caloric sweeteners should consider within-country variation in the pace of the Nutrition Transition, especially when explaining variation in adiposity by SES.

Purpose:To assess adherence to the 2015-2020 Dietary Guidelines for Americans and 2018 Physical Activity Guidelines, and identify sociodemographic predictors of adherence among children.Design:Cross sectional.Setting:Colorado, United States.Participants:Children aged 5 (n = 482).Measures:Sex, race/ethnicity, maternal education, maternal employment, maternal subjective social status and household income were assessed via questionnaires. Diet was assessed via 2 interviewer-administered 24-hour dietary recalls. Physical activity was objectively-measured with accelerometry for 7 days. Adherence was defined as a Healthy Eating Index-2015 score of ≥70 and/or ≥6 hours/day of light, moderate and vigorous activity.Analysis:For each predictor, logistic regression was used to estimate odds ratios for adherence to the diet guidelines only, the activity guidelines only or both guidelines.Results:In the full sample, 29% of children were non-adherent to both guidelines, 6% adhered to the dietary guidelines only, 50% adhered to the activity guidelines only and 14% adhered to both. Girls had a 41% lower odds of adhering to the physical activity guidelines than boys (p = 0.01), after adjustment for race/ethnicity, household income and maternal education level, perceived social status and employment status.Conclusion:Efforts to improve the health of young children should promote adherence to the Dietary Guidelines for Americans among all children. Targeted interventions that increase physical activity among girls may help to mitigate health disparities.

Purpose Assess family-level factors associated with childhood immunization schedule adherence. Design Prospective cohort; Setting; The Healthy Start study enrolled 1,410 pregnant women in Denver, Colorado 2009-2014 Subjects Children with available vaccination data in medical records (0-6 years old) Measures Vaccine schedule completion and compliance Analysis Logistic regression comparing family-level factors that differ based on vaccine schedule adherence Results Most immunizations required in Colorado for school entry were below national completion goals with 61.8% of participants (n = 532/861) completing the full vaccination series. Most participants received the first dose of individual vaccines on time (73.5% - 90.7%), but fewer received all doses on time (21.0% - 39.5%). Factors associated with not completing the vaccination series (OR [95% CI]) included: in-utero exposure to cigarette smoke (1.97 [1.41, 2.75]), single parent household (1.70 [1.21, 2.38]), children identified as non-White (Hispanic 1.40 [1.01, 1.94]; Black 1.88 [1.24, 2.85]; Other 2.17 [1.34, 3.49]), mothers not working outside the home (1.98 [1.46, 2.67]), and household income <$70,000 per year (<$40,000 1.93 [1.35, 2.75]; $40,000-$70,000 1.64 [1.09, 2.46]). Conversely, families with more educated mothers (0.47 [0.29, 0.76]) and older parents (0.97 [0.94, 0.99]) were significantly more likely to complete the series. Conclusions These findings may help identify groups at risk of immunization schedule non-adherence and may be used to target education/advocacy campaigns to reduce hesitancy and increase access in these populations.