To describe epidemiologic trends in mortality from cardiovascular diseases (CVD), ischemic heart disease (IHD), and acute myocardial infarction (AMI) in Costa Rica, by sex and geographic region, between 1970 and 2001. We performed a descriptive study of mortality from CVD, IHD, and AMI in Costa Rica between 1970 and 2001. Information was obtained from the Central American Population Center's database. Mortality data for IHD and AMI between 1970 and 2001 were analyzed in accordance with the latest revision of the International Classification of Diseases (ICD). Costa Rica's territory was divided into the following regions: the metropolitan area (8 cantons), the semi-urban area of Valle Central (18 cantons), the rural area of Valle Central (17 cantons), the semi-urban lowlands (12 cantons), and the rural lowlands (26 cantons). Mortality trends by quinquennia (between 1970 and 1999) and for the 2000-2001 biennium were examined in the form of crude mortality rates per 100 000 inhabitants for each cause or group of causes, by age, sex, and year of death. All rates were adjusted for sex, age, year of death, and geographic region through the direct method of standardization, using the population of Latin America in 1960 as the standard population. Mortality from CVD dropped by an average of 33% (46.6% among women and 20.2% among men), while mortality from IHD rose by an average of 18.4% (6.1% among women and 28.4% among men). The adjusted mortality rate for AMI among men rose by 12.8% over the study period and dropped slightly by 4.4% among women. Mortality from CVD, IHD, and AMI was greater in men than in women during the entire study period. Mortality rates for IHD and AMI rose in semi-urban and urban areas, especially in the rural lowlands, where they increased with respect to the 1995-1999 rates by 123.9% and 76.9%, respectively. A reduction in mortality from CVD was noted. The largest rates were seen among men and in persons 75 years of age or older. The largest increases in mortality rates from IHD and AMI were seen in semi-urban and rural areas, among men, and in persons 75 years of age or older. Special attention should be paid to risk factors for CVD, such as smoking, arterial hypertension, overweight and obesity, sedentary habits, and an unhealthy diet.

Sodium availability and food sources in 2018–2019 were estimated and trends analyzed for 15 years (2004–2019) in Costa Rica. Food purchase records from the National Household Income and Expenditure Survey (ENIGH) 2018–2019 were converted to energy and sodium using food composition tables measuring “apparent consumption”. Foods were classified by sodium content. ENIGH is a probabilistic, stratified, two-stage and replicated national survey, carried out regularly by the national statistics institution. Results from the 2004–2005 and 2012–2013 ENIGHs came from previous analysis. Differences between periods were determined through descriptive and inferential statistics. The available sodium adjusted to 2000 kcal/person/day was 3.40, 3.86, and 3.84 g/person/day (g/p/d) for periods 2004–2005, 2013–2014, and 2018–2019, respectively. In this last period, this was 3.94 urban and 3.60 g/p/d rural (p < 0.05), with a non-linear increase with income. During 2004–2019 sodium from salt and salt-based condiments increased from 69.5 to 75.5%; the contribution of common salt increased, from 60.2 to 64.8% and condiments without added salt from 9.3 to 10.7%. From 2012–2013 to 2018–2019, processed and ultra-processed foods with added sodium intake increased from 14.2 to 16.9% and decreased in prepared meals (7.2 to 2.8%). Costa Rica has been successful in reducing salt/sodium available for consumption; after a 12% increase of salt consumption between 2004–2005 and 2012–2013, to a level almost twice as high as recommended, it has stabilized in the last period.

Background: Sodium reduction is a cost-effective measure to prevent noncommunicable diseases. The World Health Organization (WHO) established a target of a 30% relative reduction in mean population intake of sodium by 2025. The Pan American Health Organization (PAHO) published sodium reduction targets (SRTs) for packaged foods in 2015, expanding and updating the targets in 2021 to help Member States with its efforts in reducing population sodium intake. Objective: This study examined the current sodium levels in packaged foods among five countries in the Americas and monitored cross-sectional and longitudinal compliance with the sodium targets from 2015 to 2022. Methods: Food labels were systematically collected from the main supermarkets in five countries in the Americas region in 2022. Sodium levels per 100g and per kcal for collected food labels in 16 PAHO categories and 75 subcategories were analyzed and compared against the updated SRTs. Further analysis of three countries that have longitudinal data for 2015–2016, 2017–2018 and 2022 was conducted to compare sodium per 100 g against the 2015 SRTs. Results: A total of 25,569 food items were analyzed. Overall, ‘processed meat and poultry’ had the highest sodium levels, although there were large variations within categories. 47% and 45% of products met the sodium per 100g and per kcal 2022 SRTs, respectively. Peru had the highest compliance, whereas Panama had the lowest for both targets. Among Argentina, Costa Rica and Peru, the proportion of foods meeting the 2015 PAHO lower targets were 48, 53 and 61% for 2015–2016, 2017–2018 and 2022, respectively (p < 0.001). Conclusions: This study showed that around half of the examined foods met their respective SRTs and there have been small improvements in compliance over time. Further efforts are required to reach the WHO’s global sodium reduction goal by 2025, such as implementation of mandatory SRTs and front-of-pack labelling regulations.

Objetivo: examinar la asociación entre la duración de la lactancia materna y la alimentación mixta con la obesidad, riesgo cardiometabólico, grasa corporal, conductas de riesgo dietéticas y de actividad física en niños y adolescentes. Sujetos y Método: estudio transversal en 1467 estudiantes de Costa Rica. Se aplicó una entrevista a padres e hijos para recopilar información socioeconómica, escolaridad, conductas de riesgo de la alimentación y actividad física de los jóvenes, duración de la lactancia materna y alimentación mixta. Se evaluó el índice de masa corporal, la circunferencia abdominal y la grasa corporal mediante análisis de bioimpedancia. El riesgo cardiometabólico se midió con el indicador cintura/talla (WHtR ≥ 0,5). Las mediciones fueron realizadas por personal estandarizado. Se aplicó estadística descriptiva y regresión logística. Resultados: la edad de los sujetos fue 11,4 ± 2,6 años; 50,9% hombres; 55,5% clase media; 60% sedentarios y 16% obesos. El 20% fue amamantado sin introducción de fórmula hasta los 6 meses y 13% nunca fue amamantado; más del 60% fue amamantado por ≥ 6 meses. El porcentaje de obesidad de los que recibieron leche materna, sola o en combinación con fórmula, durante ≥ 6 meses fue menor que los que fueron alimentados solo con fórmula (60,8 vs 39,2; p < 0,005). Los niños con riesgo cardiometabólico, dieta no saludable, sedentarismo y que fueron alimentados sólo con fórmula, presentaron mayor riesgo de ser obesos (OR = 18,8, IC 95% 13,2-26,0). Conclusiones: estos resultados son consistentes con otros estudios y refuerzan la protección evidente que tiene la lactancia materna frente al desarrollo de la obesidad.

Objetivo: evaluar los resultados de una intervención educativa grupal en diabetes mellitus tipo 2 (DM2) para determinar la capacidad de las personas participantes en el control metabólico de la enfermedad. Metodología: se realizaron diferentes análisis estadísticos; a saber, un análisis de correlación y de conglomerados mediante tres procedimientos (K medias con valores estandarizados de las variables involucradas, análisis jerárquico con variables estandarizadas) y una combinación de análisis factorial con K medias. Además, se llevó a cabo un análisis de normalización para determinar la efectividad del Programa de Intervención Nutricional en Enfermedades Crónicas. Resultados: completaron la intervención educativa 702 personas con diabetes, de las cuales la mayoría son mujeres, con edades entre 40 y 64 años. Las variables que resultaron estadísticamente significativas (p<0,001) para el análisis de conglomerados fueron glicemia posprandial, glicemia en ayunas, hemoglobina glicosilada, colesterol total y triglicéridos, donde los valores promedio disminuyeron en todas las pruebas clínicas después de la intervención educativa. Por medio de la combinación del análisis factorial y el análisis de conglomerados se generaron tres grupos: DM2 control bajo, DM2 control medio y DM2 control alto. En el análisis de normalización, se determinó que la intervención educativa del Programa de Intervención Nutricional en Enfermedades Crónicas fue efectiva. Conclusión: los resultados de estudio permitirán enfocar los objetivos terapéuticos de la intervención educativa mediante acciones propias y de seguimiento del tratamiento de una manera más certera.