BACKGROUND: Increasing trends in global obesity have been attributed to a nutrition transition where healthy foods are replaced by ultra-processed foods. It remains unknown if this nutrition transition has occurred in Venezuela, a country undergoing a socio-political crisis with widespread food shortages. METHODS: We described dietary intake of Venezuelans from a nationally representative study conducted between 2014 and 2017. We conducted a cross-sectional analysis of dietary, sociodemographic, and clinical data from Venezuelans ≥20 years of age (n = 3420). Dietary intake was assessed using a semi-quantitative food frequency questionnaire. Standardized clinical and anthropometric measurements estimated obesity, type 2 diabetes, and hypertension. A Dietary Diversity Score (DDS) was calculated using an amended Minimum Dietary Diversity for Women score where the range was 0 to 8 food groups, with 8 being the most diverse. Analyses accounted for complex survey design by estimating weighted frequencies of dietary intake and DDS across sociodemographic and cardiometabolic risk-based subgroups. RESULTS: The prevalence of obesity was 24.6% (95% CI: 21.6-27.7), type 2 diabetes was 13.3% (11.2-15.7), and hypertension was 30.8% (27.7-34.0). Western foods were consumed infrequently. Most frequently consumed foods included coffee, arepas (a salted corn flour cake), and cheese. Mean DDS was 2.3 food groups (Range: 0-8, Standard Error: 0.07) and this score did not vary among subgroups. Men, younger individuals, and those with higher socioeconomic status were more likely to consume red meat and soft drinks once or more weekly. Women and those with higher socioeconomic status were more likely to consume vegetables and cheese once or more daily. Participants with obesity, type 2 diabetes, and hypertension had lower daily intake of red meat and arepas compared to participants without these risk factors. CONCLUSIONS: Despite high prevalence of cardiometabolic risk factors, adults in Venezuela have not gone through a nutrition transition similar to that observed elsewhere in Latin America. Dietary diversity is low and widely consumed food groups that are considered unhealthy are part of the traditional diet. Future studies are needed in Venezuela using more comprehensive measurements of dietary intake to understand the effect of the socio-political crisis on dietary patterns and cardiometabolic risk factors.

Department of Global Health and Population Harvard TH Chan School of Public Health Boston MA USA

Department of Nutrition Harvard TH Chan School of Public Health Boston MA 02115 USA

Endocrine Associates of Florida Research Department Orlando Florida USA

Foundation for Clinic Public Health and Epidemiology Research of Venezuela Caracas Venezuela

International Clinical Research Center St Ann's University Hospital Brno Czech Republic

LifeDoc Health Memphis TN USA

Public Health Research Unit Department of Social and Preventive Medicine School of Medicine Universidad Centro Occidental Lisandro Alvarado Barquisimeto Venezuela

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Afshin A, Sur PJ, Fay KA, Cornaby L, Ferrara G, Salama JS, et al. Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the global burden of disease study 2017. Lancet, 2019;393(10184):1958–72. PubMed PMC

Collaborators GRF Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1923–1994. doi: 10.1016/S0140-6736(18)32225-6. PubMed DOI PMC

Popkin BM. The nutrition transition in low-income countries: an emerging crisis. Nutr Rev. 1994;52(9):285–298. doi: 10.1111/j.1753-4887.1994.tb01460.x. PubMed DOI

Popkin BM. Nutritional patterns and transitions. Popul Dev Rev. 1993;19(1):138–157. doi: 10.2307/2938388. DOI

Jaacks LM, Vandevijvere S, Pan A, McGowan CJ, Wallace C, Imamura F, et al. The obesity transition: stages of the global epidemic. Lancet Diabetes Endocrinol. 2019;7(3):231–240. doi: 10.1016/S2213-8587(19)30026-9. PubMed DOI PMC

Popkin BM, Corvalan C, Grummer-Strawn LM. Dynamics of the double burden of malnutrition and the changing nutrition reality. Lancet. 2020;395(10217):65–74. doi: 10.1016/S0140-6736(19)32497-3. PubMed DOI PMC

Jiwani SS, Carrillo-Larco RM, Hernández-Vásquez A, Barrientos-Gutiérrez T, Basto-Abreu A, Gutierrez L, et al. The shift of obesity burden by socioeconomic status between 1998 and 2017 in Latin America and the Caribbean: a cross-sectional series study. Lancet Glob Health. 2019;7(12):e1644–e1e54. doi: 10.1016/S2214-109X(19)30421-8. PubMed DOI PMC

Rivera JA, Barquera S, Gonzalez-Cossio T, Olaiz G, Sepulveda J. Nutrition transition in Mexico and in other Latin American countries. Nutr Rev. 2004;62(7 Pt 2):S149–S157. doi: 10.1111/j.1753-4887.2004.tb00086.x. PubMed DOI

Rivera JA, Barquera S, Campirano F, Campos I, Safdie M, Tovar V. Epidemiological and nutritional transition in Mexico: rapid increase of non-communicable chronic diseases and obesity. Public Health Nutr. 2002;5(1a):113–122. doi: 10.1079/PHN2001282. PubMed DOI

Conde WL, Monteiro CA. Nutrition transition and double burden of undernutrition and excess of weight in Brazil. Am J Clin Nutr. 2014;100(6):1617s–1622s. doi: 10.3945/ajcn.114.084764. PubMed DOI

Monteiro CA, Mondini L, de Souza AL, Popkin BM. The nutrition transition in Brazil. Eur J Clin Nutr. 1995;49(2):105–113. PubMed

Doocy S, Ververs M-T, Spiegel P, Beyrer C. The food security and nutrition crisis in Venezuela. Soc Sci Med. 2019;226:63–68. doi: 10.1016/j.socscimed.2019.02.007. PubMed DOI

Nieto-Martínez R, Hamdy O, Marante D, Inés Marulanda M, Marchetti A, Hegazi RA, et al. Transcultural diabetes nutrition algorithm (tDNA): Venezuelan application. Nutrients. 2014;6(4):1333–1363. doi: 10.3390/nu6041333. PubMed DOI PMC

Nieto-Martínez R, González-Rivas JP, Lima-Martínez M, Stepenka V, Rísquez A, Mechanick JI. Diabetes Care in Venezuela. Ann Glob Health. 2015;81(6):776–791. doi: 10.1016/j.aogh.2015.11.002. PubMed DOI

Gómez G, Fisberg RM, Nogueira Previdelli Á, et al. Diet Quality and Diet Diversity in Eight Latin American Countries: Results from the Latin American Study of Nutrition and Health (ELANS) Nutrients. 2019;11(7):1605. doi: 10.3390/nu11071605. PubMed DOI PMC

Ekmeiro JS, Moreno RR, García ML, Cámara FM. Food consumption pattern at a family level of urban areas of Anzoátegui. Venezuela. Nutr Hosp. 2015;32(4):1758–1765. PubMed

Page KR, Doocy S, Reyna Ganteaume F, Castro JS, Spiegel P, Beyrer C. Venezuela's public health crisis: a regional emergency. Lancet. 2019;393(10177):1254–1260. doi: 10.1016/S0140-6736(19)30344-7. PubMed DOI

Nieto-Martínez R, Inés Marulanda M, González-Rivas JP, Ugel E, Durán M, Barengo N, et al. Cardio-metabolic health Venezuelan study (EVESCAM): design and implementation. Investigacion Clinica. 2017;58(1):56–69. PubMed

FAO F . Minimum dietary diversity for women: a guide for measurement. Rome: FAO; 2016.

Méndez-Castellano H, Méndez MC. Estratificación social y humana. Método de Graffar modificado. Arch Venez Puer Pediatr. 1986;49:93–104.

Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults--The Evidence Report. National Institutes of Health. Obes Res 1998;6 Suppl 2:51S-209S. PubMed

Vera-Cala LM, Orostegui M, Valencia-Angel LI, Lopez N, Bautista LE. Accuracy of the Omron HEM-705 CP for blood pressure measurement in large epidemiologic studies. Arq Bras Cardiol. 2011;96(5):393–8. PubMed

Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL, et al. Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. hypertension. 2003;42(6):1206-52. PubMed

American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2019. Diabetes Care. 2019;42(Supplement 1):S13. PubMed

Newson R. Confidence intervals for rank statistics: Somers' D and extensions. Stata J. 2006;6(3):309–334. doi: 10.1177/1536867X0600600302. DOI

Mainous AG, Diaz VA, Geesey ME. Acculturation and healthy lifestyle among Latinos with diabetes. Ann Fam Med. 2008;6(2):131–137. doi: 10.1370/afm.814. PubMed DOI PMC

FAO. Latin America and the Caribbean. Food and Agriculture Organization of the United Nations.

Drouin-Chartier J-P, Li Y, Ardisson Korat AV, Ding M, Lamarche B, Manson JE, et al. Changes in dairy product consumption and risk of type 2 diabetes: results from 3 large prospective cohorts of US men and women. Am J Clin Nutr. 2019;110(5):1201–1212. doi: 10.1093/ajcn/nqz180. PubMed DOI PMC

Fraser B, Willer H. Venezuela: aid needed to ease health crisis. Lancet. 2016;388(10048):947–949. doi: 10.1016/S0140-6736(16)31523-9. PubMed DOI

Izquierdo M, Oráa E, de los Ríos V, Drayer R, Urbina D. Índice glucémico e insulinémico de alimentos ricos en carbohidratos. Rev Venezol Endocrinol Metab. 2006;4:25.

Reynolds A, Mann J, Cummings J, Winter N, Mete E, Te Morenga L. Carbohydrate quality and human health: a series of systematic reviews and meta-analyses. Lancet. 2019;393(10170):434–445. doi: 10.1016/S0140-6736(18)31809-9. PubMed DOI

Collaboration NRF Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19· 2 million participants. Lancet. 2016;387(10026):1377–1396. doi: 10.1016/S0140-6736(16)30054-X. PubMed DOI PMC

Kain J, Hernández Cordero S, Pineda D, de Moraes AF, Antiporta D, Collese T, et al. Obesity prevention in Latin America. Curr Obes Rep. 2014;3(2):150–155. PubMed

Goodman JR. Flabless is fabulous: how Latina and Anglo women read and incorporate the excessively thin body ideal into everyday experience. J Mass Commun Q. 2002;79(3):712–727.

Mattei J, Tamez M, Ríos-Bedoya CF, Xiao RS, Tucker KL, Rodríguez-Orengo JF. Health conditions and lifestyle risk factors of adults living in Puerto Rico: a cross-sectional study. BMC Public Health. 2018;18(1):491. doi: 10.1186/s12889-018-5359-z. PubMed DOI PMC

Omboni S, Aristizabal D, De la Sierra A, Dolan E, Head G, Kahan T, et al. Hypertension types defined by clinic and ambulatory blood pressure in 14 143 patients referred to hypertension clinics worldwide. Data from the ARTEMIS study. J Hypertens. 2016;34(11):2187–2198. doi: 10.1097/HJH.0000000000001074. PubMed DOI

Nieto-Martínez R, González-Rivas JP, Ugel E. Prevalence of cardiometabolic risk factors in three populations from Venezuela: the VEMSOLS STUDY 2006-2010. Medicas UIS. 2018;31(1):15–22.

International Diabetes Federation. IDF Diabetes Atlas 2019. 9th ed; 2019. PubMed

Herforth A, Arimond M, Alvarez-Sanchez C, Coates J, Christianson K, Muehlhoff E. A global review of food-based dietary guidelines. Adv Nutr. 2019;10(4):590–605. doi: 10.1093/advances/nmy130. PubMed DOI PMC

von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ (Clinical research ed). 2007;335(7624):806–8. PubMed PMC

The diabetes care continuum in Venezuela: Cross-sectional and longitudinal analyses to evaluate engagement and retention in care

Feasibility and Effectiveness of a Preventive Care Program during the Compound Humanitarian Crisis and COVID-19 Pandemic in Venezuela