Costa Rican Adolescents Research Articles

Exploring Differences in Dietary Diversity and Micronutrient Adequacy between Costa Rican and Mexican Adolescents.

Diet diversity becomes especially relevant during adolescence to satisfy the adequate micronutrient intake. Diet diversity (DD) and micronutrient probability of adequacy (PA) were studied in 818 Costa Rican (CR) and 1202 Mexican (MX) adolescents aged 13-18 years. DD was compared using the Minimum Dietary Diversity (MDD) score. Receiver-operating characteristic (ROC) curves were employed to identify the optimal MDD for each sample from the respective countries. The mean MDD for the overall CR sample was 4.17 ± 1.43 points, and for the MX sample, the mean MDD was 4.68 ± 1.48 points. The proportion of adolescents with a DD was significantly higher in Costa Rica than in Mexico (66.5% vs. 55.6%; p < 0.0001). Also, DD was higher in rural Costa Rican adolescents, while no difference was found in the MX adolescents by area of residence. CR adolescents reported significantly higher PA than MX participants for 6 of the 11 micronutrients assessed. The calcium PA in MX adolescents was significantly higher than in the CR sample (MX: 0.84 vs. CR: 0.03; p < 0.0001), while low PA was obtained for iron in both countries (CR: 0.01 vs. MX: 0.07; p < 0.0001). In Costa Rica and Mexico, nutritional interventions and assessing the compliance of food-fortifying programs are needed to improve the PA of diverse micronutrients.

Validity and reliability of a Food Frequency Questionnaire (FFQ) assessing food groups consumption and nutrients intake in Costa Rican adolescents

Introduction: Food Frequency Questionnaires (FFQ) have been widely used in several age groups, including adolescents, due to their greater advantages over other dietary measurement methods. Therefore, this study was designed to assess the validity and reliability of a FFQ designed for use on Costa Rican adolescents. Methodology: The validation and reproducibility studies were carried out in a sample of 107 adolescents of San José province selected through convenience sampling. For validation, a comparison of the nutrient intake and food consumption data obtained with the FFQ was made with those derived from the 3-day food record (3FR). Reliability was assessed by comparing nutrient intake and food consumption derived from the first FFQ with another FFQ performed four weeks after the first. Results: FFQ overestimates 3FR, with an average overestimation of 40.2% for foods and 38.8% for nutrients. The cross-classification was good for 24 of 26 nutrients and for 12 of the 21 food groups, and the weighted kappa showed an acceptable discriminant ability of the FFQ to categorize individuals into broad nutrient intake (except for protein and cholesterol) and food groups categories (dairy products, white rice, beans, vegetables, fruits and fruit juice, sugary drinks, breakfast cereal, candies and sweets, snacks, fast foods, fat, and ice cream). Conclusions: The FFQ designed for Costa Rican adolescents was unable to assess absolute dietary intakes; however, it is a reasonable tool to categorize adolescents into broad ranges of dietary intakes and could be used to evaluate dietary patterns in epidemiological studies of diet-disease associations.

Association between Fathers' and Mothers' Parenting Styles and the Risk of Overweight/Obesity among Adolescents in San José Province, Costa Rica.

Parenting styles are a risk factor for adolescents overweight/obesity worldwide, but this association is not well understood in the context of Latin America. This study examines the association between the parenting styles of mothers and fathers and the risk of overweight/obesity among Costa Rican adolescents. Data are cross-sectional from a sample of adolescents (13-18 years old) enrolled in ten urban and eight rural schools (n = 18) in the province of San José, Costa Rica, in 2017. Hierarchical logistic regression analyses were performed to assess the likelihood of adolescents being overweight according to the mothers' and fathers' parenting styles. A significant association was found between the risk of adolescent overweight/obesity and the paternal authoritarian style only in rural areas (B = 0.622, SE = 0.317, Wald = 3.864, ExpB = 1.863, p = 0.04), and between said risk and the paternal permissive style only in male adolescents (B = 0.901, SE = 0.435, Wald = 4.286, ExpB = 2.461, p = 0.038). For maternal parenting styles, no associations reached significant levels once logistic regression models were adjusted for the fathers' parenting styles. These findings underscore the importance of further studying the role of fathers' paternal parenting styles on Latin American adolescent weight outcomes. Expanding our understanding of the parenting styles of fathers has important implications for the design and implementation of culturally- and gender-appropriate family interventions.

Role of Residence Area on Diet Diversity and Micronutrient Intake Adequacy in Urban and Rural Costa Rican Adolescents.

Dietary diversity might be essential to meet nutritional demands during adolescence. Diet diversity among 818 urban and rural Costa Rican adolescents aged 13−18 years was studied using the Minimum Dietary Diversity Score for Women. The Nutrient Adequacy Ratio (NAR) was calculated for 11 nutrients to estimate the nutrient adequacy of the diet. A NAR < 0.7 was considered inadequate for micronutrient intake. The optimal Diet Diversity Score (DDS) cut-off point for this study was 4, established using receiver-operating characteristic curves. The mean DDS for the overall sample was 4.17 ± 1.43, although DDS was significantly higher in adolescents from rural vs. urban areas (4.33 ± 1.43 vs. 4.00 ± 1.42, p-value = 0.001). The odds of having a diverse diet were 62% higher in rural vs. urban adolescents. Overall, 80−95% of adolescents reached a NAR ≥ 0.70 for 8 nutrients except for calcium, zinc, and vitamin A. The residence area plays a key role in adolescent dietary diversity. Although overall DDS was low, foods that make up the rural adolescent diet were nutritionally dense enough to satisfy the EAR for most micronutrients. A high DDS is not necessarily required for the diet to meet most micronutrient demands in adolescence. Improved dietary adequacy of vitamin A, zinc, and calcium is required due to the importance of these micronutrients in maintaining optimal health.

Addiction to New Technologies and Cyberbullying in the Costa Rican Context

Addiction to new technologies (Internet, smartphone and video games) as well as cyber-aggression presents a growing incidence at a global level. Correlational research is proposed with a sample of n = 127 Costa Rican adolescents, with a mean age of 16.32 years, comprising 67 men and 60 women. The objective was to determine the prevalence of Internet, smartphone and video game addiction and its close relationship with cyberbullying (cyber-victim role, cyberbully role and mixed role) in the Costa Rican context. The results show a high rate of abusive use (connection time) of the Internet and “smartphones”, and the correlation study, multiple regressions, backward elimination method and network analysis show how the behavior of cyberbullies is moderately mediated by “Lack of control of Smartphone” and to a large extent by “Avoidance and social problem video games”, while that of victims is moderately mediated by “Avoidance and social problem video games”, and is slightly mediated for “Lack of control of Smartphone” and for “Lack of control of Internet”. In addition, there is a strong relationship between holding both the role of cyber-victim and cyberbully, developing feelings of revenge and lack of empathy. The practical implications, and the relevance of the socio-demographic and social explanatory variables of both phenomena are discussed. It is concluded that there is evidence of an explanatory and close relationship between the phenomena of cybervictimization, cyber-aggression and addiction to the Internet, smartphone and video games.

Influence of Parenting Styles on Willingness to Use Marijuana among Rural and Urban Costa Rican Adolescents

Influence of Parenting Styles on Willingness to Use Marijuana among Rural and Urban Costa Rican Adolescents

Association Between Parental Feeding Styles and Excess Weight, and Its Mediation by Diet in Costa Rican Adolescents

ObjectivesParental feeding styles (PFS) influence children’s diet and weight; we aimed to evaluate this relationship in adolescents. MethodsCross-sectional study in 686 Costa Rican adolescents (13–18y). Parents responded to a questionnaire from which four validated PFS scores were derived: promotion (verbal encouragement of healthy eating); verbal sanctions/scolding (indirect control of healthy food intake); direct control over diet; instrumental/emotional (food to regulate emotions). Adolescents completed a 3-day food record, from which the validated Traditional Costa Rica Adolescents Diet Score (TCRAD) was defined. Excess weight was dichotomized following standards. Multivariate regression-based mediation analysis estimated the natural direct, indirect, and total effects (NDE/NID/TE) of the following pathway (general/sex-stratified): PFS → TCRAD → excess weight. ResultsExcess weight was present in 33% of adolescents. TCRAD mean was similar between excess weight categories. Each additional point of the direct control PFS score was associated with higher odds of excess weight [(TE-OR: 1.55; 95%CI: 1.04–2.31; p = 0.033), (NDE-OR: 1.52; 95%CI: 1.02–2.27; p = 0.039)]. This association was accentuated in boys vs. girls. A non-significant tendency for lower odds of excess weight was observed for the emotional PFS in boys [(TE-OR: 0.44; 95%CI: 0.19–1.05; p = 0.064), (NDE-OR: 0.43; 95%CI: 0.18–1.02; p = 0.056)] and the promotion PFS in the total sample (TE-OR: 0.74; 95%CI: 0.47–1.17; p = 0.202). TCRAD seemed to have a mediation role between the promotion PFS and excess weight (NID-OR: 0.94; 95%CI: 0.88–1.00; p = 0.056). ConclusionsHealthy eating behaviors encouraged by parents might benefit Costa Rican adolescents’ weight via dietary intake. In contrast, parents directly controlling food access and intake may adversely influence adolescents’ weight, especially in boys. Our work constitutes a first approach studying PFS and obesity among adolescents. Further research is needed to confirm the role of the promotion PFS in obesity prevention and evaluate the contribution of PFS to other diet-related outcomes among adolescents in diverse cultural contexts. Funding SourcesThe Mexican Council of Science and Technology; Fundación México en Harvard; The Costa Rican Ministry of Health; Inciensa Foundation.

Association between Parental Feeding Styles and Excess Weight, and Its Mediation by Diet, in Costa Rican Adolescents.

Background. Whereas parental feeding styles (PFS) influence children’s diet, less is known about this relationship in adolescents. Methods. A cross-sectional study in 686 Costa Rican adolescents (13–18 years) evaluated 4 validated PFS scores: healthy eating verbal encouragement; scolding; directly controlling diet; instrumental/emotional. Diet was evaluated through 3-day food records, deriving a Traditional Costa Rica Adolescents Diet Score (TCRAD). Excess weight (EW) measured by BMI was dichotomized following standards. Regression-based mediation analysis estimated the overall and sex-stratified odds ratios of EW for natural direct (NDE), natural indirect (NIE), and total effects (TE) of the pathway PFS→TCRAD→EW. Results. A one-unit increase in the direct control PFS score was associated with higher EW odds overall [(TE: 1.55; 95% CI: 1.04–2.31; p-value = 0.033), (NDE: 1.52; 95% CI: 1.02–2.27; p-value = 0.039)], and in boys [(TE: 2.13; 95% CI: 1.04–4.38; p-value = 0.039), (NDE: 2.10; 95% CI: 1.03–4.31; p-value = 0.042)]. Non-significant mediation by TCRAD was observed for the healthy eating verbal encouragement PFS overall (p-value = 0.06). Associations for the instrumental/emotional and scolding PFS were not significant. Conclusions. Direct diet control from parents may contribute to adolescents’ excess weight, particularly among boys. Parents encouraging healthy eating might support adolescents’ healthy weight through a healthy diet. Longitudinal research should clarify the association between PFS and diet-related outcomes among diverse adolescents.

Dietary Intake and Sources of Added Sugars in Various Food Environments in Costa Rican Adolescents.

Consumption of added sugars, especially from sugar-sweetened beverages (SSBs), has been associated with several negative health outcomes during adolescence. This study aimed to identify dietary intake and food sources of added sugars in the home, school, and neighborhood environments of Costa Rican adolescents. Dietary intake of added sugars was determined using 3-day food records in a cross-sectional study of 818 adolescents aged 12 to 19 and enrolled in rural and urban schools in the province of San José. On average, 90% of adolescents consumed more than 10% of their total energy intake from added sugars. Furthermore, 74.0% of added sugars were provided at home, 17.4% at school, and 8.6% in the neighborhood. Added sugars were primarily provided by frescos (29.4%), fruit-flavored still drinks (22.9%), and sugar-sweetened carbonated beverages (12.3%), for a total contribution of 64.6%. Our findings suggest that Costa Rican adolescents have a plethora of added sugar sources in all food environments where they socialize. However, it is relevant for public health to consider the home and school environments as fundamental units of interventions aimed at reducing added sugars in the adolescent diet. Frescos prepared at home and school and fruit-flavored still drinks must be the focus of these interventions.

A Traditional Costa Rican Adolescents' Diet Score Is a Valid Tool to Capture Diet Quality and Identify Sociodemographic Groups With Suboptimal Diet.

Traditional diet indices may capture diet quality according to local food culture. Higher adherence to traditional diet scores may help prevent disease, yet evidence in adolescents is limited. This cross-sectional study aimed to develop and validate a Traditional Costa Rica Adolescents Diet Score (TCRAD) and determine its association with sociodemographic characteristics, under the hypothesis that girls, adolescents from rural areas, and with low socioeconomic status, have a more traditional healthy diet. A total of 804 urban and rural adolescents (13–18 years old) participated in the study. The TCRAD showed adequate internal validity as shown by significant associations with intake of 14 traditional foods and nutrients (legumes, vegetables, fruits, oils, dairy, and corn tortilla scored as healthy; and white rice, red/processed meat, solid fats, desserts/pastries, sugar-sweetened beverages, snacks, fast food, and bread and cookies scored as unhealthy). A high TCRAD score, indicative of a healthier and more traditional diet, was observed among adolescents in the low socioeconomic group vs. medium or high socioeconomic categories (42.9, 41.2, and 38.2%, respectively, p < 0.05), adolescents living in rural areas vs. urban (47.6 vs. 34.2%, p < 0.05), and among boys vs. girls (46.9 vs. 37.5%, p < 0.05). The TCRAD score is a valid tool to capture diet quality of adolescents in Costa Rica and could be used to measure association of diet with disease outcomes in this and similar populations. Public health nutrition programs in Costa Rica should focus on improving intake of foods and nutrients, and prioritize girls, adolescents in urban areas, and adolescents with high socioeconomic status.

Intersectionality between parenting styles, area of residence and gender on food group consumption among Costa Rican adolescents

Little is known about how parenting styles can influence the adolescent’s consumption of sugar-sweetened beverages (SSB), fruits and vegetables (FV) and beans in Latin America. This study uses hierarchical moderated regression models to examine such association by area of residence, sex of the parent and of the adolescent in Costa Rica. Results showed that fathers' authoritarian style was significantly associated with lower intake of sugar-sweetened beverages (SSB) among boys (b = -0.163, p = 0.050), but not girls (b = 0.097, p = 0.114) while mother's authoritarian style was associated with lower SSB intake among girls (b = -0.138, p = 0.031), but not boys (b = 0.159, p = 0.059). Fathers’ authoritative style was associated with higher consumption of fruits and vegetables (FV) among boys in rural areas (b=0.440, p= 0.017), but this association was not significant for girls (b=-0.033, p= 0.800) in rural areas or for either gender in urban areas. Parenting styles of the mothers' and fathers' were not significantly associated with Costa Rican adolescent bean consumption, in general or for any of the subgroups. Findings suggest an intersectionality in the effects of parentchild interactions by child and parent sex, cultural and geographic context, and the eating behaviors examined.

Gender-based eating norms, the family environment and food intake among Costa Rican adolescents.

To examine the association between family environment variables (parenting styles, family meal atmosphere), gender-based stereotypes and food intake in Latin American adolescents. Structural equation modelling applied to cross-sectional data, 2017. Urban and rural sites of San José, Costa Rica. n 813; 13-18 years old. Data suggest direct associations between gender-based stereotypes and intake of fruits and vegetables (FV) (β = 0·20, P < 0·05), unhealthy foods (fast food (FF)) (β = -0·24, P < 0·01) and ultra-processed foods (β = -0·15, P < 0·05) among urban girls; intake of legumes among rural girls (β = 0·16, P < 0·05) and intake of sugar-sweetened beverages (SSB) among rural boys (β = 0·22, P < 0·05). Family meal atmosphere was associated with legume intake (β = 0·19, P <·05) among rural girls. Authoritative parenting style was associated with FV intake (β = 0·23, P < 0·05) among urban boys and FF intake (β = 0·17, P < 0·05) among urban girls. Authoritarian parenting style was associated with FV consumption (β = 0·19, P < 0·05) among rural boys, and with SSB and FF consumption (β = 0·21, P < 0·05; β = 0·14, P < 0·05, respectively) among urban girls. Findings are the first to describe the complex family environment and gender-based stereotypes within the context of a Latin American country. They emphasise the need for culturally relevant measurements to characterise the sociocultural context in which parent-adolescent dyads socialise and influence food consumption.

Changes in Dietary Intake of Major Nutrients and Food Sources among Costa Rican Adolescents in the Last 20 Years

Adolescence offers a window of opportunity to prevent adult obesity and noncommunicable disease risk factors. With the rising prevalence of adolescent obesity over the last 20 y, identifying any changes in dietary risk factors is crucial. We aimed to assess the dietary intake of major nutrients and their food sources in Costa Rican adolescents from 1996 to 2017. Means from 3-d food records from adolescents (ages 13-18 y) living in San José (the province with the highest concentration of adolescents in Costa Rica) were obtained in 1996 (n=276), 2006 (n=133), and 2017 (n=818). Differences in consumption of major nutrients and selected food groups by sex and survey period were tested using age- and area-adjusted ANOVAs. In 2017, adolescents consumed significantly (P<0.05) less saturated and trans fats [saturated: -3.2% of total energy (TE); trans: -1.4% TE], vegetables (-24g/d), beans (-42g/d), and white rice (22g/d) than in 1996. The 2017 adolescents also reported significantly higher consumption of unsaturated fatty acids (MUFAs: up from 8.2% to 15.3% TE; PUFAs: up from 5.5% to 9.5% TE; P<0.05), sugary drinks (+134g/d), pastries/desserts (+55g/d), other refined starchy foods (+36g/d), and snacks/fast foods (+26g/d) than their 1996 counterparts. In 1996 and 2006, the main source of calories was white rice, whereas in 2017, it was sugary drinks (12% TE and 15% TE, respectively; P<0.05). The intake ratio of beans to white rice was significantly higher in 1996 (1:1.6) than in 2017 (1:3.5). The changes in the intake of major nutrients and food sources of Costa Rican adolescents present new public health challenges for cardiometabolic risk prevention. Costa Rica should prioritize the design of comprehensive strategies that target added sugar intake while simultaneously increasing access to and promotion of healthful items.

Violent and Risk-Taking Behaviors Associated with Intake of Energy Drinks Mixed with Alcohol and Perceptions of This Consumption among Children and Adolescents in Costa Rica

Introduction: The consumption of energy drinks and its mix with alcohol has been associated with negative and violent behaviors in youngsters. Objective: To determine the risk-taking behaviors associated with the consumption of energy drinks mixed with alcohol in Costa Rican adolescents. Methods: A mixed cross-sectional study was performed with a population of 2667 students of 64 educative centers in 2016. Descriptive statistics were performed with the program SPSS 20.0 and a value of p 0.05 was considered significant. Results: The third part of the study population is usually a consumer of energy drinks (30%) and 3% make use of drinks mixed with alcohol. The children and adolescents, who consume energy-alcohol mixed drinks, are more likely to present risk-taking behaviors than those who do not consume these mixed beverages: combined use of medicines to get high; cocaine consumption, consumption of cement/glue, consumption of marijuana, physical violence (fighting), use of weapons, suicidal ideation, deliberate self-harm, low educational expectation, sexual intercourses, cyberbullying and school apathy. The students perceived the intake of energy beverages as of low risk for their health. They also agree that frequent consumption is because drinks have good flavors and nice logo designs and the ability to stay awake and with more energy for longer periods of time in order to improve in academic homework, sports performance and to endure more the consumption of alcoholic beverages. Conclusions: Public health policies should consider controlling the publicity aimed to children and adolescents regarding the marketing of energy and alcoholic drinks.

The Influence of Gender Stereotypes on Eating Habits among Costa Rican Adolescents

To identify the influence of gender stereotypes on eating habits among Costa Rican adolescents. Qualitative, descriptive research was used in this study. Adolescents and parents were recruited from socioeconomically diverse populations in rural and urban areas of San José, Costa Rica. Subjects were 92 adolescents (14 to 17 years old) and 48 parents. Focus group data were transcribed and entered into the qualitative data analysis software Atlas.ti version 5.0. Analyses were grounded on the social cognitive theory. Five themes emerged from the focus group discussions: (1) Costa Rican adolescents associate the consumption of moderate quantities of healthy foods with femininity and male homosexuality. (2) The consumption of hearty portions of nonhealthy foods was associated with masculinity and male heterosexuality. (3) There is an emerging view that it is acceptable for heterosexual male adolescents to take care of their bodies through healthy eating. (4) Body care among female adolescents is an element of femininity and body image. (5) Parents reinforce their daughters' persistent concern with weight control because they perceive it as feminine behavior. Health promoters should be aware of the existing and changing food stereotypes around gender as an avenue for the promotion of healthy eating.

Self-esteem and its association with depression among Chinese, Italian, and Costa Rican adolescents: A cross-cultural study

This study investigated the factor structure of the Rosenberg Self-Esteem Scale (RSES), the differences in mean level of self-esteem and its association with depression in adolescents in three different cultures. The RSES and the Children’s Depression Inventory were administered to Chinese (N=350), Italian (N=352), and Costa Rican (N=343) adolescents. Confirmatory factor analyses supported the two-factor model of the RSES and it was demonstrated to be invariant across cultures using multi-group confirmatory factor analyses. MANOVA results indicated that Costa Rican adolescents scored higher on positive and negative self-esteem than their Chinese and Italian counterparts. Furthermore, both positive and negative self-esteem was related to depression across cultures. In conclusion, there are both cultural differences and similarities in self-esteem.

Parental attachment among Chinese, Italian, and Costa Rican adolescents: A cross-cultural study

The present study investigated the cultural and gender differences in parental attachment and preferred attachment figure. The revised version of Inventory of Parent and Peer Attachment (IPPA-R) was administered to Chinese (N=350), Italian (N=352), and Costa Rican (N=343) adolescents. The results indicated that: (1) the three-factor model of maternal and paternal attachment was optimal; (2) the factor structures of maternal and paternal attachment of IPPA-R were equivalent across countries; (3) Italian adolescents’ maternal attachment was stronger than Costa Rican adolescents, who, in turn, scored greater than did Chinese adolescents; (4) boys scored higher on Communication of paternal attachment than did girls; and (5) Chinese adolescents were less attached to mother than to father. In conclusion, the current research confirms that parental attachment in adolescents is culturally different.

La maternidad adolescente en el contexto de la migración internacional: el caso de Costa Rica

Adolescent maternity and international migration are two crucial issues in Central America, yet few studies have considered the interplay between them. With a view to doing so, this study examines differences in adolescent maternity among Nicaraguan immigrants and Costa Rican adolescents using data from the most recent Costa Rican census. The study has three primary objectives. Firstly, to estimate the prevalence of adolescent maternity among women aged 15 to 19 years residing in Costa Rica. The second is to ascertain whether this is the result of a selection process by comparing non-migrant adolescents in Nicaragua and Nicaraguan immigrants in Costa Rica, with special attention to factors associated with fertility, such as education, age and marital status. The third objective is to compare Nicaraguan immigrants, according to their length of residence in Costa Rica, with Costa Rican adolescents and to determine, using a multivariate logistic regression model, whether immigrants are more likely to become adolescent mothers. The results suggest that the prevalence of adolescent maternity in Costa Rica has declined over the last decade. There appears to be a selection process among Nicaraguan immigrants since they are, on average, older than their counterparts residing in Nicaragua when they have children and are more likely to be married or in a union when they do so. There is also a higher prevalence of adolescent maternity among Nicaraguan immigrants to Costa Rica than among their compatriots who remain in Nicaragua. Although the prevalence of adolescent maternity in Costa Rica is generally low, it is markedly higher among Nicaraguan immigrants than their Costa Rican peers. However, differences are found among immigrants depending on how long they have lived in Costa Rica. The results from the multivariate logistic regression analysis show that adolescent maternity is less prevalent among recent immigrants than among Costa Rican adolescents, but more prevalent among less recent immigrants than among their Costa Rican counterparts. Thus, while a process of selection may exist whereby Nicaraguan adolescents emigrating to Costa Rica are more likely to be mothers than those who stay in Nicaragua, it is also likely that the challenges and situations of vulnerability encountered in Costa Rica put them at an increased risk of pregnancy and limit their ability to prevent pregnancy or mitigate its effects once it occurs. This paper contributes to the ongoing debate on adolescent maternity and international migration by providing a more updated and nuanced picture of adolescent maternity among immigrants in the context of South-South migration.

Psychosocial factors influencing the frequency of fast-food consumption among urban and rural Costa Rican adolescents

ObjectiveThe aim of this study was to identify psychosocial factors that influence fast-food consumption in urban and rural Costa Rican adolescents. MethodsA self-administered questionnaire designed for the study asked about sociodemographic information, frequency of fast-food consumption, meaning of “fast food,” location of purchase, and psychosocial correlates. Five psychosocial factors were extracted by using principal components analysis with Varimax rotation method and eigenvalues. Descriptive statistics and a hierarchical linear regression model were used to predict the frequency of fast-food consumption. ResultsResponses from 400 adolescents (ages 12–17 y) reveal that daily consumption of fast food was 1.8 times more frequently mentioned by rural adolescents compared with urban youth. Urban and rural differences were found in the way adolescents classified fast foods (rural adolescents included more traditional foods like chips, sandwiches, and Casado—a dish consisting of rice, black beans, plantains, salad, and a meat), and in purchasing locations (rural adolescents identified neighborhood convenience stores as fast-food restaurants). Living in rural areas, convenience and availability of foods, and the presence of external loci of control were predictors of a higher frequency of fast-food consumption, whereas health awareness predicted a lower frequency. ConclusionsThe development of interventions to reduce fast-food consumption in Costa Rican adolescents should consider not only convenience, but also the availability of these foods where adolescents are more exposed, particularly in rural areas. Interventions such as improving the convenience of healthy fast foods available in school canteens and neighborhood stores, policies to increase the price of unhealthy fast food, and activities to provide adolescents with the skills to increase self-efficacy and reduce the effect of external loci of control are recommended.

Changes in dietary intake and food sources of saturated and cis and trans unsaturated fatty acids in Costa Rican adolescents: 1996 versus 2006

ObjectiveTo identify how dietary intake and food sources of saturated (SFA) and cis (PUFA) and trans (TFA) unsaturated fatty acids in the diet of Costa Rican adolescents changed from 1996 to 2006—a period with several public health nutrition changes. MethodsCross-sectional comparisons used data from measured food records of 133 adolescents (ages 12–17 y) surveyed in 1996 and a similar group of adolescents surveyed in 2006. Values obtained in 1996 and 2006 were compared with the current World Health Organization guidelines for chronic disease prevention. ResultsAdolescents surveyed in 2006 reported a significantly higher mean daily energy intake from linoleic acid (LA) and alpha-linolenic acid (ALA) (0.9% and 7.8%, respectively) compared with the 1996 cohort, whereas SFA and TFA were significantly lower (9.5% and 1.3%, respectively). Food sources of fat also changed. In 2006, 2% of SFA in the diet came from palm shortening (compared with 34% in 1996); 39% of TFA came from ruminant-derived foods (in 1996, soybean oil was the main contributor of TFA, 34%), and bakery products (mainly pre-packaged cookies) provided 25% of the source of TFA, compared with only 11% in 1996. Dietary fatty intake of Costa Rican adolescents in 2006 is closer to WHO guidelines compared with 1996. ConclusionsAfter public health initiatives that changed fatty acid profile of most foods, intakes of TFA, SFA, and food sources of fatty acids in adolescents’ diets improved. Public health nutrition efforts should continue to strengthen diets that are low in SFA and TFA and higher in ALA content among Costa Rican adolescents.