Objectives To determine differences in nutritional status to guide the culturally specific education interventions. Methods Pilot training occurred in each country using consistent equipment and measurement protocols. The IRB approved protocol for pretesting and educational interventions was conducted daily for a month at each location. Descriptive statistics and Pearson 2-tailed correlations were performed. Results Subjects, all non-pregnant, non-lactating women (n = 126 DR, n = 101 ES, n = 132 HN), ranged in age from 18 to 78 yrs with 30% in their 30’s; mean ages 32.9 DR, ES 37.0, HN 42.8 (all differed, P ≤ 0.05). Most reported their ethnicity as Hispanic/Latino-Americano. At pre-testing, subjects (%) with normal BMI distributions = DR 5.6, ES 18.8, HN 15.9; obese/overweight = DR 88.8, ES 75.3, HN 62.9 (all differed, P ≤ 0.05). Mean (SD) for WC (in) = DR 38.3 ± 5.6, ES 37.4 ± 5.1, HN 36.3 ± 5.7; waist: height ratios in HN 14% lower than mean measures for DR and ES. BMI and WC were closely correlated (r = 0.70, P ≤ 0.01). Self-reported data on physical activity, weekly household income, health insurance and level of education provided insight on factors contributing to nutritional status. Conclusions BMI and WC measures were convenient, noninvasive, inexpensive and available for comparative assessments. Pre-testing data indicate subjects, the majority in their 20’s and 30’s in all three countries, had BMI and waist measures higher than recommended indicating greater risk for disease. Physical activity and socioeconomic factors highlight disparities, particularly the lack of health insurance. Our findings support the need for country specific educational interventions in future research protocols to support weight management programs. This study highlights the valuable uniqueness of the VCOM international service area clinic model. Funding Sources VCOM REAP Program FY19.