Energy Imbalance Gap, Anthropometric Measures, Lifestyle, and Sociodemographic Correlates in Latin American Adults-Results from the ELANS Study

Martha Cecilia Yépez García, Marianella Herrera-Cuenca, Gerson Ferrari, Lilia Yadira Cortés Sanabria, Pablo Hernández, Rafaela Yépez Almeida, Mónica Villar Cáceres, Georgina Gómez, Rossina Pareja, Attilio Rigotti, Irina Kovalskys, Mauro Fisberg, Martha Cecilia Yépez García, Marianella Herrera-Cuenca, Gerson Ferrari, Lilia Yadira Cortés Sanabria, Pablo Hernández, Rafaela Yépez Almeida, Mónica Villar Cáceres, Georgina Gómez, Rossina Pareja, Attilio Rigotti, Irina Kovalskys, Mauro Fisberg

Abstract

Overweight and obesity are often explained by an imbalance between energy intake and expenditure. This, in addition to metabolic effects, makes it difficult to assess the real state of individual energy balance. This study aims to analyze the energy gaps between intake and expenditure in the adult population of Latin America, as well as its relationships with sociodemographic variables and nutrition status, to draw an epidemiological perspective based on the trends observed. The energy imbalance gap was used to this end. The difference between energy intake and expenditure can be applied as a reference to explain whether weight equilibrium can prevent weight gain. Moreover, the energy imbalance gap allows for a better understanding of the design of public health policies. Using data from the Latin American Study of Nutrition and Health, the energy imbalance gap in adult population from eight Latin-American countries was assessed in 5994 subjects aged from 19-65. Usual dietary intake was measured using two non-consecutive 24 h dietary recalls. The sociodemographic questionnaire was supplemented by anthropometric measurements. Physical activity was measured through the long International Physical Activity Questionnaire. Energy expenditure was obtained using the basal metabolic rate. For the overall sample, the mean energy intake was 1939.1 kcal (95% CI: 1926.9; 1951.3), the mean of energy expenditure was 1915.7 kcal (95% CI: 1906.4; 1924.9), and the mean of energy imbalance gap was 23.4 kcal (95% CI: 11.9; 35.0). Results show that energy intake and expenditure were higher in men. Moreover, subjects aged 19-34, of high socioeconomic level, who completed high school, were mestizos and were of normal weight consumed the highest number of calories. Overall, a positive energy imbalance gap was observed. Overweight and obese from Argentina, Costa Rica, Ecuador, Peru, and Venezuela showed a significantly lower energy imbalance gap than underweight subjects. These findings confirm the high variability of energy imbalance gap and the accompanying correlates of energy intake and expenditure. Further research is needed to specifically address interventions in low and middle-income countries such as many in Latin America, to help reduce the prevalence of obesity and eradicate undernutrition.

Trial registration: ClinicalTrials.gov NCT02226627.

Keywords: energy balance; energy expenditure; energy intake.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of selection of ELANS participants.
Figure 2
Figure 2
Energy intake (A), energy expenditure (B), and energy imbalance (C) gap percentiles by country.

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