Anthropometric, Blood Pressure, Dietary, and Physical Activity Differences in Urban‐Compared to Rural‐Dwelling Women in the Chimborazo Region of Ecuador

Abstract

BackgroundRapidly increasing rates of obesity and hypertension (as well as heart disease, and type 2 diabetes) in Ecuador suggest that the nutrition transition from ancestral dietary patterns to convenience dietary patterns characterized by greater consumption of high energy density foods, as well as the physical activity transition to more sedentary lifestyles are occurring in many areas of the country. The magnitude of these nutrition and activity transitions is influenced by economic resources and location, but even residents of limited resource, remote rural areas in Ecuador have increasing access to a variety of convenience, processed foods including sugar‐sweetened beverages. Therefore in this cross‐sectional investigation we sought to determine differences in anthropometric characteristics, blood pressure (BP), and dietary and physical activity patterns in women residing in rural and urban locations in a region of Ecuador characterized by limited economic resources.MethodsUrban‐dwelling women (UW, n= 190, × age=44y) were randomly selected from 3 neighborhoods within the city of Riobamba (250,000 population) and rural‐dwelling women (RW; n=210, × age=47y) were randomly selected from three rural communities outside of Riobamba in the Chimborazo region of the Andes highlands. Food intake patterns were measured by a food frequency questionnaire (FFW) and by 24‐h dietary recall; physical activity patterns were determined by questionnaire. Height, weight, and waist circumference were measured by standard procedures and BP was determined using an automated sphygmomanometer.Results91% of the UW obtained their food primarily through markets and local food stores compared to only 35% of the RW. 65% of the RW women obtained their food from their own cultivation. Based on food‐frequency questionnaire data, UW compared to RW women reported significantly greater consumption of sugar‐sweetened juices and sodas, cookies, white rice, and refined white bread, and lower intakes of dietary fiber, all of which are characteristic of a nutrition transition to a more highly processed, commercial, convenience dietary pattern. UW compared to RW women also reported spending significantly more time in sedentary activities, and less time walking and in strenuous work. The dietary and physical activity patterns of UW were associated with twice the prevalence of obesity (BMI>30 kg/m2) compared to RW (UW= 18.5%; RW=9.6%), higher mean body mass index (UW: x±SD=26.8±4.2 kg/m2; RW: x±SD=25.0±3.8; p<0.001), higher waist circumference (UW: x±SD=88.2±11.4 cm; RW: x±SD=85.5±10.8; p<0.001), and higher age‐adjusted resting systolic BP (UW: x±SEM=117.4±1.0 mmHg; RW: x±SEM=113.2±0.9; p<0.005). On the other hand, RW compared to UW reported significantly lower intakes of protein‐rich foods including beef, chicken, and pork, and the 24‐h dietary recall data revealed lower intakes of energy, protein, zinc, iron, vitamin A, and folate.ConclusionThe nutrition transition from a more ancestral pattern characterized by consumption primarily of locally grown foods to a pattern with greater consumption of commercially available foods, and the physical activity transition to more a more sedentary lifestyle are more evident in urban compared to rural‐dwelling women. These patterns in UW are associated with greater risk for overweight and obesity and higher blood pressure, but lower risk for protein and specific micro‐nutrient deficiencies compared to RW.Support or Funding InformationFunding: Fulbright Foundation, Colorado School of Public Health