Nutrición
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Ítem Design, development and validation of a mobile application for goal setting and self-monitoring of dietary behaviors(2016) Quesada López, Christian; Jensen Madrigal, Melissa Lorena; Zúñiga Flores, Giselle; Chinnock Mc'Neil, Anne Eliza; Jenkins Coronas, MarceloThe potential of mobile technologies are being used increasingly has not been fully exploited in relation to health research. There are Application (app) stores have thousands of healthrelated apps in the market, but generally, what is available publicly has not been fully evaluated by experts. This paper presents a case study where Human-Computer Interaction techniques and agile methodologies were applied in the design, development and validation of a health system in an interdisciplinary project. The system consisted of a mobile software platform that includes a nutrition mobile application for dietary self-monitoring based on behavioral change techniques. The essential background on behavioral change is provided. The application was designed using contextual design and other DCU methodologies. The system architecture and the main features of the end user mobile application are shown. The prototype was evaluated by nutrition domain experts and the preliminary results suggest that the application can improve the nutrition care process by facilitating a more effective communication between nutritionists and patients.Ítem Current use and perceived usefulness of mobile technologies in the practice of dietetics in Costa Rica(2019) Quesada López, Christian; Zúñiga Flores, Giselle; Jensen Madrigal, Melissa Lorena; Jenkins Coronas, MarceloOver the past 15 years, there has been an increase in the use of information and communication technologies in the field health (eHealth), in particular regarding mobile technologies (mHealth). However, little is known about how nutritionists have such technologies in their practice in Costa Rica. The objective of this study was to identify how nutritionists use mobile technologies, as well as the perceived usefulness of different services that could be incorporated in their practice. We conducted an online survey, and the responses of 185 nutritionists were analyzed. Of the sample, 69.7% perceived that the use of mobile devices in nutrition is "very important" and "very useful" (77.3%) as a support to the nutrition care process. Although 79.5% showed their willingness to offer personalized mobile services, the use of such services in practice is scarce. According to our results, here are opportunities for the implementation of mobile technology services in areas such as the electronic health file, the self-monitoring of goal progress by the patient, as well as and reminders by the nutritionist.Ítem Implementation of a regulatory food policy to reduce availability of energy-dense foods in Costa Rican high schools(2021) Jensen Madrigal, Melissa Lorena; Gonzalez, Wendy; Bolaños Palmieri, Carolina; Monge Rojas, Rafael; Frongillo, Edward A.Objective: To assess the extent to which mandatory Guidelines to improve the school food environment were being implemented in Costa Rican high schools and to explore the perspectives of key policy actors towards the Guidelines. Design: Semi-structured interviews and site observations. Interviews were recorded, transcribed verbatim and imported to NVivo 12 for analysis. Inductive and deductive themes were identified, and elements of the RE-AIM framework and the social process framework were used when classifying these themes. Setting: Sixteen public high schools in San José, Costa Rica. Participants: High school principal and kiosk concessionaires Results: Products that did not adhere to the Guidelines were still widely available in schools, and amongst the most prevalent challenges to implementation that emerged from our interviews, were a lack of understanding of the policy content, a lack of monitoring and accountability, and competing values amongst actors which affected their views on the role that the school must have in offering a healthy food environment. Conclusion: Most products offered in high schools did not meet the criteria required by the mandatory Guidelines, and several contextual factors were found to influence implementation. Strengthening the implementation of the Costa Rican Guidelines will require further actions at the governmental and school levels.Ítem Television, food, and beverage marketing to children in Costa Rica: current state and policy implications(2019) Zamora Corrales, Irina; Jensen Madrigal, Melissa Lorena; Vandevijvere, Stephanie; Ramírez Zea, Manuel; Kroker Lobos, María FernandaObjective: To examine the frequency of television (TV) food and beverage advertisements (F&B ads) to which children (4–11 years) are likely exposed and the nutrient profile of products advertised. Design: TV broadcasting between September and November 2016 was recorded (288 h of children’s programming; 288 h of family programming) resulting in 8980 advertisements, of which 1862 were F&B ads. Of those, 1473 could be classified into one of the seventeen food groups, and into permitted/non-permitted according to the WHO-EU nutrient profile model. Persuasive marketing techniques used were also identified. Setting: TV programming was recorded for four weekdays and four weekend days, between 06.00 and 00.00 hours (576 total hours), for four channels (two national and two cable), in Costa Rica. Results: Mean (SD) number of F&B ads/h was greater in cable than national channels (3·7 (0·4) v. 2·8 (0·4), P < 0·05) and during children’s peak viewing hours (4·4 (0·4) v. 2·9 (0·3)). Of F&B ads classified with WHO-EU nutrient profile model (n 1473, 71·1 %), 91·1 % were non-permitted to be marketed to children. Categories most frequently advertised were ready-made/convenience foods (16 %), chocolates/confectionery/desserts (15 %), breakfast cereals (14 %), beverages (15 %), edible ices (9 %) and salty snacks (8 %). Non-permitted F&B ads were more likely to use promotional characters, brand benefit claims, and nutrition and health claims than permitted F&B ads. Conclusions: Children watching popular TV channels in Costa Rica are exposed to a high number of unhealthy F&B ads daily. Our findings help justify the need for regulatory actions by national authorities.Ítem Estimación del peso de porciones de alimentos ilustrados en fotografías digitales(2020) Solano Piedra, Alison; Chinnock Mc'Neil, Anne Eliza; González Urrutia, Rocío; Jensen Madrigal, Melissa Lorena; Cerdas Núñez, Milena MaríaObjetivo: evaluar el uso de fotografías digitales para estimar el peso de diferentes preparaciones de alimentos. Metodología: se compraron 102 platos servidos como almuerzos, desayunos y repostería de 52 establecimientos comerciales en San Pedro de Montes de Oca, se pesaron y fotografiaron los alimentos servidos, resultando un total de 261 porciones de alimentos. Al recibir por correo las imágenes digitales de los platos de comida, se estimó el peso de cada alimento por medio de una comparación con un manual de fotografías estándar. El proceso de pesaje y fotografiado de los alimentos fue realizado de forma independiente del proceso de estimación del peso. Para comparar los pesos reales y los pesos estimados se utilizó la prueba t de Student y coeficientes de correlación. Resultados: para 6 de los 11 tipos de alimentos, el peso estimado presentado en una imagen digital no fue significativamente diferente al peso real y ambos valores tenían un grado de asociación significativo. En el caso de los otros 5 tipos de alimentos que consistían en preparaciones con un mayor número de ingredientes, hubo diferencias significativas entre los pesos estimados y los pesos reales. Conclusión: en el caso de alimentos simples o con pocos ingredientes, ilustrados en fotografías digitales, su peso se estimó con suficiente exactitud; no así para preparaciones con varios ingredientes. Se requiere más investigación antes de recomendar su uso en encuestas de consumo de alimentos.Ítem Participating in a food-assisted maternal and child nutrition and health program in rural Guatemala alters household dietary choices(2016) Jensen Madrigal, Melissa Lorena; Frongillo, Edward A.; Leroy, Jef L.; Blake, Christine E.Background: Food assistance programs may alter food choices, but factors determining households! decisions regarding food acquisition, preparation, and consumption in the context of food aid are not well understood. Objective: This study aimed to understand how the Programa Comunitario Materno Infantil de Diversificacion Alimentaria ´ (Mother–Child Community Food Diversification Program; PROCOMIDA), a food-assisted maternal and child health and nutrition program in rural Alta Verapaz, Guatemala, altered household food choices. Methods: We conducted semistructured interviews and focus groups with 63 households in 3 participating (n = 32 households) and 3 control (n = 31) villages. A last-day food recall (without estimating quantities) and food-frequency questionnaire that used food cards assessed dietary choices. Qualitative analysis used thematic a priori and emergent coding; food group consumption frequencies were analyzed by using 2-level, logistic, mixed modeling, and chi-square testing while accounting for community clustering. Results: Compared with control households, PROCOMIDA changed household food choices through a combination of providing food resources (with monthly food rations) and new knowledge and skills related to health and food (in the program!s behavior change communication component) while reinforcing existing knowledge and beliefs. PROCOMIDA families consumed rice, red beans, and oil more frequently than did control families (differences of 2.20 (P < 0.001), 2.68 (P < 0.001), and 1.64 (P = 0.038) times/wk, respectively); these foods were in the rations. PROCOMIDA families also ate chicken, local plants, and some vegetables more frequently. The importance of these foods was emphasized in the behavioral change communication component; these foods may have been more accessible because provision of food rations freed resources. Conclusion: Our findings suggest that if a program provides food free of cost to rural indigenous families in the context of a maternal and child nutrition and health program, it may be important to include a well-designed behavioral change communication component to improve household food choicesÍtem Adaptation and validation of the nutrition environment measures survey in stores (NEMS-S) in Costa Rica(2022) Golfin, Francesca; Murillo, Carla; Jensen Madrigal, Melissa Lorena; Frongillo, Edward A.This study adapted and validated the NEMS-S in Costa Rica. Twenty-nine food stores were assessed, three times, by two raters. Inter-rater precision and intra-rater stability were quantified. Construct validity was determined with the known-groups method. Relative precision ranged from 0.54 to 0.77 and was 0.87 for total score. Relative stability ranged from 0.58 to 0.96 and was 0.94 for total score. For construct validity, the hypothesized relationship that supermarkets would have the highest scores was supported. The instrument has moderate to excellent precision and stability, has construct validity, and can be useful to develop policies that encourage healthy environments in food stores.Ítem Aspectos importantes a incorporar en una aplicación móvil para la adherencia al tratamiento de la diabetes mellitus tipo 2 en Costa Rica según pacientes y profesionales de salud(2016) Porras Leiva, Yulissa; Richmond Solera, Daniela; García Calvo, María Fernanda; Jensen Madrigal, Melissa LorenaAntecedentes: la diabetes mellitus (DM) afecta al 12,8 % de los costarricenses. Recientemente, se ha presentado en Costa Rica un auge en el uso de tecnología móvil que permite innovar en el campo de aplicaciones móviles para la diabétes mellitus tipo 2 (DM2). Objetivo: explorar las perspectivas de pacientes y profesionales de la salud sobre los aspectos que podría contener una aplicación móvil para apoyar la adherencia del tratamiento en pacientes con DM2 en Costa Rica. Materiales y métodos: se utilizó un enfoque cualitativo para explorar la perspectiva de los participantes respecto al diseño de una aplicación móvil para DM2. Se aplicaron entrevistas semiestructuradas y grupos focales a 16 pacientes con DM2; y entrevistas semiestructuradas a 12 profesionales en salud (nutricionistas, enfermeras y médicos endocrinólogos). Resultados: solo dos pacientes habían utilizado una aplicación móvil para la DM2, y dos profesionales han recomendado su uso. Ambos grupos tienen intención de utilizar esta herramienta. La función de común interés es el registro de glucemia, aunque también se mencionaron otras. Los profesionales recomiendan supervisión continua en el uso de estas aplicaciones móviles. Conclusiones: los posibles usuarios brindan información valiosa con respecto a sus necesidades y expectativas de una aplicación móvil para DM2 para Costa Rica. La sencillez y el hecho de ser una aplicación móvil adaptada a Costa Rica son las características deseables más mencionadas.Ítem Are U.S. food and beverage companies now advertising healthy products to children on television? An evaluation of improvements in industry self-regulation, 2017–2021(2023) Jensen Madrigal, Melissa Lorena; Fleming Milici, Frances; Harris, Jennifer L.Background Through the Children’s Food and Beverage Advertising Initiative (CFBAI), U.S. food companies pledge to only advertise healthier products in children’s television (TV) programming, but previous research shows that highly advertised products do not qualify as nutritious according to independent nutrition criteria. In 2020, the CFBAI implemented stricter nutrition criteria for products that may be advertised to children, but the potential impact of these changes has not been assessed. This observational study evaluates (1) improvements in energy and individual nutrient composition of products that companies indicated may be advertised to children (i.e., CFBAIlisted products) in 2020 versus 2017, (2) amount of advertising on children’s TV for CFBAI-listed versus other products in 2021, and 3) the nutrition quality of advertised versus non-advertised CFBAI-listed products. Methods Data include energy, saturated fat, sodium, and sugar content and overall nutrition quality (Nutrition Profle Index [NPI] scores) of CFBAI-listed products in 2017 (n=308) and 2020 (n=245). Nielsen data provided total ad spend‑ ing and children’s exposure to ads on children’s TV channels for all foods and beverages in 2021. Results From 2017 to 2021, energy, saturated fat and sugar declined for CFBAI-listed products in three of six food categories (yogurt, sweet and salty snacks). Although CFBAI-listed products accounted for 79% of food ads viewed by children on children’s TV channels, just 50% of CFBAI-listed food and 36% of drink brands were advertised on children’s TV. Moreover, advertised products were signifcantly less nutritious than non-advertised CFBAI-listed products. Conclusion Despite revised nutrition standards and improvements in nutrient content of some product categories, participating companies continued to primarily advertise nutritionally poor food and beverages on children’s TV. CFBAI companies have not delivered on their promises to advertise healthier products to children.Ítem TV advertising and dietary intake in adolescents: a pre- and post- study of Chile’s Food Marketing Policy(2021) Jensen Madrigal, Melissa Lorena; Dillman Carpentier, Francesca R.; Adair, Linda; Corvalán, Camila; Popkin, Barry Michael; Taillie, Lindsey SmithBackground: The first phase of a comprehensive marketing policy was implemented in Chile in 2016. The policy restricted child-directed marketing of foods and beverages considered high in energy, total sugars, sodium or saturated fat (“high-in”). The objective of this study was to examine the role of high-in TV food advertising as a mediator in the association between policy implementation and consumption of high-in foods and beverages between 2016 and 2017. Methods: Dietary data were from 24-hour diet recalls collected in 2016 and 2017 in a cohort of 12–14 y children (n = 721). Television use was assessed concurrently and linked to analyses of food advertisements on broadcast and paid television to derive individual-level estimates of exposure to high-in food advertising. A multilevel mediation analysis examined direct and indirect effects of the policy through advertising exposure. Results: Following the policy implementation, high-in advertising exposure was significantly reduced (p < 0.01). High-in food intake decreased in adolescents with lower levels, but not higher levels, of high-in advertising at baseline. We did not find evidence of mediation by changes in high-in ad exposure. Conclusions: Adolescents’ exposure to high-in TV advertising decreased after the 2016 implementation of the Chilean Food Labeling and Marketing Law. However, evidence that changes in advertisement mediated dietary changes was not found. Further research is needed to understand how marketing changes will relate to dietary changes after full implementation of the law and in the long term.Ítem Food environment solutions for childhood obesity in Latin America and among Latinos living in the United States(2021) Duran, Ana Clara; Mialon, Melissa; Crosbie, Eric; Jensen Madrigal, Melissa Lorena; Harris, Jennifer L.; Batis, Carolina; Corvalán, Camila; Taillie, Lindsey SmithThe food environment is a major contributor to unhealthy diets in children and, therefore, to the increasing rates of obesity. Acclaimed by scholars across the world, Latin American countries have been leaders in implementing policies that target different aspects of the food environment. Evidence on the nature and to what extent children are exposed and respond to unhealthy food environments in the region and among Latinos in the United States is, however, deficient. The objective of this review is to use the integrated International Network for Food and Obesity/noncommunicable diseases (NCDs) Research, Monitoring and Action Support (INFORMAS) framework to create healthy food environment to (i) compare the key elements of childhood obesity-related food environments in Latin America and for Latinos living in the United States; (ii) describe the evidence on solutions to improve childhood obesity-related food environments; and (iii) identify research priorities to inform solutions to fight childhood obesity in these populations. We found that an integrated body of evidence is needed to inform an optimal package of policies to improve food environments to which children in Latin America and Latino children in the United States are exposed and more efficiently translate policy solutions to help curb growing childhood obesity levels across borders.Ítem Snacking patterns among Chilean children and adolescents: is there potential for improvement?(2019) Jensen Madrigal, Melissa Lorena; Corvalán, Camila; Reyes, Marcela; Popkin, Barry Michael; Taillie, Lindsey SmithObjective: To examine snacking patterns, food sources and nutrient profiles of snacks in low- and middle-income Chilean children and adolescents. Design: Cross-sectional. Dietary data were collected via 24 h food recalls. We determined the proportion of snackers, snacks per day and energy from top food and beverage groups consumed. We compared the nutrient profile (energy, sodium, total sugars and saturated fat) of snacks v. meals. Setting: South-east region of Chile. Participants: Children and adolescents from two cohorts: the Food Environment Chilean Cohort (n 958, 4–6 years old) and the Growth and Obesity Cohort Study (n 752, 12–14 years old). Results: With a mean of 2·30 (SE 0·03) snacks consumed daily, 95·2 % of children and 89·9 % of adolescents reported at least one snacking event. Snacks contributed on average 1506 kJ/d (360 kcal/d) in snacking children and 2218 kJ/d (530 kcal/d) in snacking adolescents (29·0 and 27·4 % daily energy contribution, respectively). Grain-based desserts, salty snacks, other sweets and desserts, dairy foods and cereal-based foods contributed the most energy from snacks in the overall sample. For meals, cereal-based foods, dairy beverages, meat and meat substitutes, oils and fats, and fruits and vegetables were the top energy contributors. Conclusions: Widespread snacking among Chilean youth provides over a quarter of their daily energy and includes foods generally considered high in energy, saturated fat, sodium and/or total sugars. Future research should explore whether snacking behaviours change as the result of Chile’s national regulations on food marketing, labelling and school environments.Ítem Junk food consumption trends point to the need for retail policies(2021) Jensen Madrigal, Melissa Lorena; Schwartz, Marlene B.The term “junk food” is generally understood to include processed foods and beverages that are high in calories, added sugars, sodium, and saturated fat (1). These products are harmful because excessive consumption is associated with increased risk of negative health outcomes (e.g., obesity, hypertension, and cancer) (2). In response, a range of strategies have been tried to discourage consumption of these foods, ranging from guidance in the Dietary Guidelines for Americans to limit calories from these foods, to the USDA’s “Smart Snacks” regulations that control what can be sold in schools, to industry self-regulation promises to improve the nutritional quality of products marketed to children. But have things gotten better?Ítem Caregivers’ provision of sweetened fruit-flavoured drinks to young children: importance of perceived product attributes and differences by socio-demographic and behavioural characteristics(2022) Choi, Yoon Young; Jensen Madrigal, Melissa Lorena; Fleming Milici, Frances; Harris, Jennifer L.Objective: Drinks containing added sugar and/or non-nutritive sweeteners are not recommended for children under 6 years. Yet, most young children consume these products. The current study examined factors associated with caregivers’ provision of sweetened drinks to their young child. Design: Caregivers reported frequency of providing sweetened fruit-flavoured drinks (fruit drinks and flavoured water) and unsweetened juices (100 % juice and juice/water blends) to their 1- to 5-year-old child in the past month and perceived importance of product attributes (healthfulness, product claims and other characteristics), other drinks provided, reading the nutrition facts panel and socio-demographic characteristics. A partial proportional odds model measured the relationship between these factors and frequency of providing sweetened fruit-flavoured drinks. Setting: Online cross-sectional survey. Participants: U.S. caregivers (n 1763) with a young child (ages 1–5). Results: The majority (74 %) of caregivers provided sweetened fruit-flavoured drinks to their child in the past month; 26 % provided them daily. Provision frequency was positively associated with some drink attributes, including perceived healthfulness, vitamin C claims and box/pouch packaging; child requests and serving other sweetened drinks and juice/water blends. Provision frequency was negatively associated with perceived importance of ‘no/less sugar’ and ‘all natural’ claims. Reading nutrition facts panels, serving water to their child and child’s age were not significant. Conclusion: Misunderstanding of product healthfulness and other marketing attributes contribute to frequent provision of sweetened drinks to young children. Public health efforts to address common misperceptions, including counter marketing, may raise awareness among caregivers about the harms of providing sweetened drinks to young children.Ítem Estudio comprueba las propiedades hidratantes de la leche deslactosada y descremada(2024-06-11) Aragón Vargas, Luis Fernando; Garzón Mosquera, Julián; Montoya Arroyo, Jhonny; Salas Murillo, OttoUn equipo de expertos del Cimohu de la UCR demostró las capacidades de esta bebida para reponer el agua y los electrolitos que pierde una persona al ejercitarse.Ítem Promoción de estilos de vida saludables en funcionarios públicos, Costa Rica(2014) Jensen Madrigal, Melissa Lorena; Ugalde González, Maciel; Araya Blanco, Silvia; Chinnock Mc'Neil, Anne ElizaObjetivo: Desarrollar un programa para la promoción de hábitos de alimentación y estilos de vida saludables para los funcionarios del Ministerio de Comercio Exterior de Costa Rica. Materiales y Métodos: El programa de 12 semanas se denominó "¡Cuido mi salud!" e incluyó cuatro componentes: suministro de meriendas saludables, educación nutricional para los funcionarios, reto "¡Cuido mi salud!" y actividad física. Resultados: Aumento en el consumo de frutas, vegetales, agua y conocimiento en temas relacionados con nutrición. Discusión: Gran parte de las actividades y metodologías desarrolladas pueden ser adaptadas a otros escenarios laborales y de esta forma promover hábitos de alimentación y estilos de vida saludables en la población adulta.Ítem Cambios antropométricos y satisfacción personal con una intervención educativa que incluyó el uso de una aplicación móvil para personas con sobrepeso u obesidad(2019) Aguilar García, Mayra; Altamirano Herrera, Melissa; Leiva Acuña, Ana Gabriela; Marín Romero, Paula; Rodríguez Mena, Milena; Quesada López, Christian; Zúñiga Flores, Giselle; Jensen Madrigal, Melissa LorenaAntecedentes: las tecnologías móviles pueden coadyuvar en el cambio de comportamientos alimentarios en personas con exceso de peso. Sin embargo, la evidencia con aplicaciones móviles adaptadas en el contexto latinoamericano es limitada. Objetivo: evaluar cambios antropométricos y satisfacción personal en una intervención educativa para personas con exceso de peso, la cual incluyó el uso de una aplicación móvil (NutriMetas). Materiales y métodos: estudio experimental clásico con diseño de pre-post prueba en personas con exceso de peso (IMC >25,0 y ≤34,9 kg/m2). Los participantes asistieron a sesiones de educación nutricional y registraron sus metas en la aplicación NutriMetas (grupo experimental, n=26) o en papel (grupo control, n=26). Se utilizaron modelos de regresión mixto multinivel para evaluar diferencias antropométricas (peso, IMC, circunferencia de cintura y porcentaje de grasa) entre los grupos. Resultados: el grupo experimental obtuvo una pérdida de peso promedio de 2,1±2,6 kg, en comparación con 0,7±1,6 kg para el grupo control (p=0,08). La interacción entre grupo y tiempo mostró una tendencia a la significancia en el IMC (p=0,064) y en la pérdida de peso (p=0,082), que podría ser de importancia desde el punto de vista clínico. Los atributos de apariencia, efectividad, eficiencia y facilidad de aprendizaje de NutriMetas fueron valorados favorablemente por la mayoría de los participantes. Conclusiones: el uso de NutriMetas como parte de una intervención educativa resultó ser una herramienta efectiva para los pacientes.Ítem Food loss and waste in food services from educational institutions in Costa Rica(2021-04) Brenes Peralta, Laura Patricia; Rojas Vargas, Julián; Monge Fernández, Yanory; Jiménez Morales, María Fernanda; Arguedas Camacho, Manrique; Hidalgo Víquez, Cindy; Peña Vásquez, Marcela; Vásquez Rodríguez, BlancaOne-third of the worldwide food production is lost or wasted, generating impacts in the food systems. However, data indicates that one in nine people suffer from undernourishment or shortage of food in the world. Furthermore, this problem generates adverse impacts in the environment and the economy. Costa Rica is not exempt from this phenomenon; therefore, in compliance with target 12.3 of the Sustainable Development Goals, the country initiated actions through the Costa Rican Food Loss and Waste Reduction Network and one of its members, the Costa Rican Network of Sustainable Educational Institutions (REDIES). This latter committed itself to quantify the food loss and waste (FLW) in the canteens from a pilot group of their members. The objective of this case study was to determine the FLW in the restaurants of five institutions to generate data experience that allows to create indicators and useful information in the search for strategies against food waste. The amount of FLW was measured using the standardized methodology explained in the Guide for this purpose, published by the Costa Rican Network. In general terms, most FLW in this case study comes from the amount of food leftovers. Consequently, it is concluded and recommended to focus on awareness campaigns, quality and portioning to address the issue, and to consider that each institution must place emphasis through its reduction plan with respect to the findings generated in each food service or canteen.Ítem Invitation to learn more about our published research on skimmed, lactose-free milk. IJSNEM(2024-04) Aragón Vargas, Luis FernandoThis is a video invitation to promote the published article in the International Journal of Sport Nutrition and Exercise Metabolism: Skimmed, Lactose-Free Milk Ingestion Postexercise: Rehydration Effectiveness and Gastrointestinal Disturbances Versus Water and a Sports Drink in Physically Active People.Ítem Television viewing and using screens while eating: associations with dietary intake in children and adolescents(2021-09-01) Jensen Madrigal, Melissa Lorena; Dillman Carpentier, Francesca R.; Corvalán, Camila; Popkin, Barry Michael; Evenson, Kelly R.; Adair, Linda; Taillie, Lindsey SmithScreen time has been associated with overweight and obesity, as well as with poorer dietary quality. However, the reasons explaining these associations are not well understood. The objectives of this cross-sectional study were [1] to determine the extent of overall TV viewing as well as using screens while eating (e.g., watching TV or using a tablet), [2] to compare food and nutrient consumption of on-versus off-screen eating occasions, and [3] to determine whether TV viewing and using screens while eating is associated with overall dietary intake. Participants were from the Food Environment Chilean Cohort (n = 938, 4–6 y) and the Growth and Obesity Cohort Study (n = 752, 12–14 y). Dietary data was collected via one 24-h food recall. For each eating occasion, activity performed during consumption (e.g., watching TV, playing sports) was reported. Weekly TV viewing time was collected via an additional survey instrument. Analyses included multivariable linear and logistic regression. Post-hoc pairwise comparisons examined differences in outcomes by tertiles. Our sample reported a median of 9–13.5 weekly hours of TV viewing and 87.5% reported consuming at least one meal or snack per day while using screens. The median kilocalories contributed by eating during screen use was 387 kcal/d in children and 848 kcal/day in adolescents, which represents 34.7% and 42.3% of daily energy intake, respectively. There were no consistent differences when comparing eating occasions consumed on-screen versus off-screen. Higher weekly TV viewing was associated with elements of a less healthy diet including more sweets and desserts in children, and more sugar sweetened beverages in adolescents. A large percentage of Chilean children and adolescents’ daily energy is consumed while using screens. In depth, longitudinal work is needed to understand how screen time eating affects diet quality and nutritional status.