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Lobão SL, Oliveira AS, Bressan J, Pinto SL. Contribution of Ultra-Processed Foods to Weight Gain Recurrence 5 Years After Metabolic and Bariatric Surgery. Obes Surg 2024; 34:2492-2498. [PMID: 38762612 DOI: 10.1007/s11695-024-07291-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 05/11/2024] [Accepted: 05/14/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND The aim of this study was to evaluate evolution of ultra-processed food intake and recurrent weight gain in patients who underwent Roux-en-Y gastric bypass. MATERIALS AND METHODS This study is an observational longitudinal study that evaluated patients who underwent metabolic and bariatric surgery at four time points: before surgery and at 3, 12, and 60 months after surgery. Anthropometric and dietary intake data were collected through two 24-h dietary recalls. All foods consumed were classified according to degree of processing. Recurrent weight gain was considered the difference between current weight and nadir weight. RESULTS The sample consisted of 58 patients with a mean age of 38.7 ± 8.9 years and 68% female. After 60 months, mean excess weight loss and recurrent weight gain were 73.6 ± 27.2% and 22.5 ± 17.4%. Calorie and macronutrient intake decreased significantly between the pre-surgery period, and 3 and 12 months post-surgery; however, there was no significant difference after 60 months. In relation to food groups or macronutrients, no difference was observed between the pre-surgery period and 60 months post-surgery. The contribution of unprocessed or minimally processed foods to calorie intake gradually decreased after 3 months post-surgery. CONCLUSION The profile of dietary intake after 60 months of metabolic and bariatric surgery tends to approach that of the pre-surgery period. The contribution of unprocessed and minimally processed foods to calorie intake decreased after 60 months, while ultra-processed food contribution increased.
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Affiliation(s)
- Stephany L Lobão
- Federal University of Tocantins, Avenida NS-15, Quadra 109, Norte, S/N - Plano Diretor Norte, AlCNO 14, Bloco D, Palmas, TO CEP 77001-090, Brazil
| | - Adler S Oliveira
- Federal University of Tocantins, Avenida NS-15, Quadra 109, Norte, S/N - Plano Diretor Norte, AlCNO 14, Bloco D, Palmas, TO CEP 77001-090, Brazil
| | - Josefina Bressan
- Department of Nutrition and Health, Federal University of Viçosa, Viçosa, MG, Brazil
| | - Sônia L Pinto
- Federal University of Tocantins, Avenida NS-15, Quadra 109, Norte, S/N - Plano Diretor Norte, AlCNO 14, Bloco D, Palmas, TO CEP 77001-090, Brazil.
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da Silva BF, de Arruda Neta ADCP, de Alencar Rodrigues RE, de Araújo JM, Moreira PVL, Ferreira FELL, de Toledo Vianna RP, da Silva Neto JM, de Carli E, de Lima RLFC. Costs of obesity attributable to the consumption of sugar-sweetened beverages in Brazil. Sci Rep 2024; 14:13936. [PMID: 38886385 PMCID: PMC11183236 DOI: 10.1038/s41598-024-59991-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 04/17/2024] [Indexed: 06/20/2024] Open
Abstract
Excess sugar is considered one of the primary factors contributing to overweight status. In Brazil, sugar-sweetened beverages (SSBs) contain a significant amount of this nutrient and are consumed excessively. These beverages are associated with adverse health outcomes and impose costs on the healthcare system. The literature currently lacks studies that aim to attribute specific nutrients or foods as causes of diseases and also evaluate their economic impact, especially in middle- and low-income countries. This study aims to estimate the direct and indirect costs of obesity, stratified by sex and age group, resulting from the excessive consumption of sugar-sweetened beverages in Brazil from 2008 to 2020, and to project these costs for the year 2036. The estimation of obesity costs attributable to excessive consumption of SSBs was based on relative risks and the population prevalence of obesity, considering expenditures on hospitalizations and outpatient procedures in the Unified Health System (SUS). Cost information was obtained from the health information systems available at SUS. The highest burden attributable to the consumption of SSBs was observed among younger individuals and progressively decreased with advancing age. The total direct costs in the period between 2008 and 2020 amounted to approximately US$ 6.33 million, 87% of which was related to expenses for females. Additionally, deaths resulting from the consumption of SSBs cost the economy US$ 40 million due to the premature loss of productivity. The total costs of obesity attributable to the consumption of SSBs are substantial, impacting public spending and generating social and productivity losses that burden the economy. It is crucial to develop and implement cost-effective fiscal and regulatory policies aimed at preventing and combating obesity.
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Affiliation(s)
- Bruna Farias da Silva
- Postgraduate Program in Nutrition Science, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
| | | | | | | | | | | | - Rodrigo Pinheiro de Toledo Vianna
- Postgraduate Program in Nutrition Science, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
- Department of Nutrition, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
| | | | - Eduardo de Carli
- Department of Nutrition, School of Public Health. University of São Paulo, São Paulo, Brazil
| | - Rafaela Lira Formiga Cavalcanti de Lima
- Postgraduate Program in Nutrition Science, Federal University of Paraíba, João Pessoa, Paraíba, Brazil.
- Department of Nutrition, Federal University of Paraíba, João Pessoa, Paraíba, Brazil.
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Brandão JM, Sichieri R, Paravidino VB, Ribas SA, Cunha DB. Treatment of childhood obesity based on the reduction of ultra-processed foods plus energy restriction: A randomised controlled trial based on the Brazilian guidelines. Clin Obes 2024; 14:e12648. [PMID: 38400699 DOI: 10.1111/cob.12648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 06/27/2023] [Accepted: 01/31/2024] [Indexed: 02/25/2024]
Abstract
Reducing ultra-processed foods (UPF) improves diet quality and may curb energy consumption. This study aimed to compare an intervention based on the reduction of UPF, according to the Dietary Guideline for the Brazilian Population (DGBP), with and without advice on energy intake. A parallel and randomised controlled trial was carried out with children with obesity from 7 to 12 years old. Both control (CG) and intervention groups (IG) participated monthly in 6 standardised educational activities based on the 10 steps of the DGBP. An individualised food plan was also provided to the IG. The rate of change for body mass index (BMI), waist circumference, body weight, and UPF consumption were investigated based on mixed-effect models. At the end of the study, the BMI declined in the IG (Δ = -0.27 kg/m2) compared to the CG (Δ = + 0.53 kg/m2) (p = .0002). Both groups showed a decline in grams of UPF until the fourth month and a gradual increase in the following months. Combining the qualitative approach of the DGBP with counselling on energy restriction through the diet plan proved to be effective in reducing childhood obesity. Clinical Trial Registration: This trial is registered at the Brazilian Registry of Clinical Trials (REBEC), under the RBR-3st5sn registry, available at http://www.ensaiosclinicos.gov.br/rg/RBR-3st5sn/. The datasets generated by the current study are not publicly available but are available from the corresponding author on reasonable request.
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Affiliation(s)
- Joana Maia Brandão
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rosely Sichieri
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Vitor Barreto Paravidino
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Physical Education and Sports, Naval Academy-Brazilian Navy, Rio de Janeiro, Brazil
| | - Simone Augusta Ribas
- Departament of Nutrition in Public Health, School of Nutrition, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Diana Barbosa Cunha
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Moreira PVL, de Arruda Neta ADCP, Ferreira FELL, de Araújo JM, Rodrigues REDA, de Lima RLFC, Vianna RPDT, da Silva Neto JM, O’Flaherty M. Predicting the prevalence of type 2 diabetes in Brazil: a modeling study. Front Public Health 2024; 12:1275167. [PMID: 38756893 PMCID: PMC11096587 DOI: 10.3389/fpubh.2024.1275167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 04/08/2024] [Indexed: 05/18/2024] Open
Abstract
Aims We adopted a modeling approach to predict the likely future prevalence of type 2 diabetes, taking into account demographic changes and trends in obesity and smoking in Brazil. We then used the model to estimate the likely future impact of different policy scenarios, such as policies to reduce obesity. Methods The IMPACT TYPE 2 DIABETES model uses a Markov approach to integrate population, obesity, and smoking trends to estimate future type 2 diabetes prevalence. We developed a model for the Brazilian population from 2006 to 2036. Data on the Brazilian population in relation to sex and age were collected from the Brazilian Institute of Geography and Statistics, and data on the prevalence of type 2 diabetes, obesity, and smoking were collected from the Surveillance of Risk and Protection Factors for Chronic Diseases by Telephone Survey (VIGITEL). Results The observed prevalence of type 2 diabetes among Brazilians aged over 25 years was 10.8% (5.2-14.3%) in 2006, increasing to 13.7% (6.9-18.4%) in 2020. Between 2006 and 2020, the observed prevalence in men increased from 11.0 to 19.1% and women from 10.6 to 21.3%. The model forecasts a dramatic rise in prevalence by 2036 (27.0% overall, 17.1% in men and 35.9% in women). However, if obesity prevalence declines by 1% per year from 2020 to 2036 (Scenario 1), the prevalence of diabetes decreases from 26.3 to 23.7, which represents approximately a 10.0% drop in 16 years. If obesity declined by 5% per year in 16 years as an optimistic target (Scenario 2), the prevalence of diabetes decreased from 26.3 to 21.2, representing a 19.4% drop in diabetes prevalence. Conclusion The model predicts an increase in the prevalence of type 2 diabetes in Brazil. Even with ambitious targets to reduce obesity prevalence, type 2 diabetes in Brazil will continue to have a large impact on Brazilian public health.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Martin O’Flaherty
- Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom
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Oliveira RKG, Domingos IR, Leal VS, Oliveira JS, de Lira PIC, de Souza NP. Consumption of in natura and ultra-processed foods in adults: an analysis of social, metabolic, and lifestyle determinants. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2024; 27:e240018. [PMID: 38695431 PMCID: PMC11057841 DOI: 10.1590/1980-549720240018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 12/04/2023] [Accepted: 02/06/2024] [Indexed: 05/06/2024] Open
Abstract
OBJECTIVE To assess the social, metabolic, and lifestyle determinants of consumption of fruits, vegetables, and greens (FVG) and ultra-processed food (ULT) in adults from Pernambuco. METHODS Cross-sectional and analytical study, conducted in 2015/2016. In addition to sociodemographic variables, the determinants of lifestyle were level of physical activity, alcohol consumption, tobacco use, and metabolic variables were self-reported hypertension, blood glucose, and Body Mass Index (BMI). Consumption was measured by the Food Frequency Questionnaire, then created the Frequency of Consumption Index (SFI) of the mean intake of ULT and FVG foods. The indices of FVG and ULT consumption were transformed into quartiles and these variables were included in the multinomial logistic regression, considering their determinants when p<0.05. RESULTS The sample was representative of the state, with 1,067 people being interviewed, whose intake of ULT was higher than that of FVG in the lowest and highest quartile of the consumption index. Consumption of fruit and vegetables was higher in higher consumption of alcoholic beverages (p=0.031) and BMI>25 kg/m2 (p=0.047); and lower in the lowest income (p=0.001). ULT intake was higher in young adults (p=0.005), lower income (p=0.044), and controlled blood glucose (p=0.021). Rural areas were 52% less exposed to medium-high ULT consumption (p<0.006). CONCLUSION Higher rate of ULT consumption in relation to fresh foods, with income as a common determinant, inversely associated with ULT intake and directly related to FVG, which demands structuring policies.
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Affiliation(s)
- Renata Kelly Gomes Oliveira
- Universidade Federal de Pernambuco, Centro Acadêmico de Vitória, Nutrition Center – Vitória de Santo Antão (PE), Brazil
| | - Ivanildo Ribeiro Domingos
- Universidade Federal de Pernambuco, Health Sciences Center, Department of Nutrition – Recife (PE), Brazil
| | - Vanessa Sá Leal
- Universidade Federal de Pernambuco, Centro Acadêmico de Vitória, Nutrition Center – Vitória de Santo Antão (PE), Brazil
| | - Juliana Souza Oliveira
- Universidade Federal de Pernambuco, Centro Acadêmico de Vitória, Nutrition Center – Vitória de Santo Antão (PE), Brazil
| | | | - Nathália Paula de Souza
- Universidade Federal de Pernambuco, Centro Acadêmico de Vitória, Nutrition Center – Vitória de Santo Antão (PE), Brazil
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de Farias VF, Soares LA, Aranha LN, Luiz RR, de Oliveira GMM, Rosa G. Social vulnerability and cardiovascular risk factors in adolescents. BMC Public Health 2024; 24:982. [PMID: 38589841 PMCID: PMC11000392 DOI: 10.1186/s12889-023-16959-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 10/11/2023] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Social vulnerability can influence in the development of cardiovascular risk factors in adolescents (CRF). For this reason, the objective of our study was to evaluate the presence of CRF in adolescents, according to social vulnerability. METHODS This is a cross-sectional study with 517 adolescents of both sexes, from 10 to 19 years of age, classified into 2 groups by social vulnerability, according to socioeconomic characteristics collected by means of questionnaires, where adolescents who did not have access to drinking water, sewage network, and adequate per capita income were classified as vulnerable. Anthropometric, biochemical, and blood pressure data were evaluated. Level of physical activity was assessed by an adapted questionnaire, and food intake was assessed by a 3-day food record. Independent T, Mann-Whitney, and χ2 tests were used, according to the scale of measurement of the variables, on the statistical program SPSS, version 25, at a significance level of 5%. RESULTS Adolescents had median age of 14 (11 to 15) years; 58.4% were female; 32.4% were overweight, and 52.4% were physically inactive in leisure. Mean consumption of ultra-processed food was observed to account for 45.0% of calorie intake. Adolescents classified as vulnerable had lower weight, body mass index, waist circumference, hip circumference, and neck circumference when compared to non-vulnerable adolescents. Both groups had cholesterol concentrations above the normal level. Non-vulnerable adolescents had higher triglyceride concentrations, higher alcohol consumption, and lower fiber intake compared to vulnerable adolescents. CONCLUSIONS Adolescents with social vulnerability are less likely to have cardiovascular risk factors.
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Affiliation(s)
- Viviane Freire de Farias
- Postgraduate Program in Medicine (Cardiology), Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Larissa Almenara Soares
- Department of Nutrition and Dietetics, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Luciana Nicolau Aranha
- Postgraduate Program in Medicine (Cardiology), Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Ronir Raggio Luiz
- Institute for Studies in Collective Health, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Gláucia Maria Moraes de Oliveira
- Postgraduate Program in Medicine (Cardiology), Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
- Universidade Federal do Rio de Janeiro, UFRJ, Cidade Universitária, R. Prof. Rodolpho P. Rocco, 255 - 8, Andar Sala 6, Rio de Janeiro, RJ, Brazil.
| | - Glorimar Rosa
- Postgraduate Program in Medicine (Cardiology), Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Department of Nutrition and Dietetics, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Hovadick ACDA, Cardoso MA. Family-Based WhatsApp Intervention to Promote Healthy Eating Behaviors Among Amazonian School Children: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e54446. [PMID: 38373039 PMCID: PMC10912988 DOI: 10.2196/54446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND Stunting and micronutrient deficiencies have persistently affected children in the Brazilian Amazon for decades. However, in recent years, a notable increase in childhood overweight prevalence has been observed, particularly in the context of heightened food insecurity exacerbated by the COVID-19 pandemic. Despite the limited number of effective solutions proposed to tackle this problem, digital interventions have shown great promise worldwide in preventing obesity and promoting healthy diets. OBJECTIVE This study aims to describe the protocol of a family-based WhatsApp intervention, specifically designed to investigate the efficacy of multimedia messaging in preventing excessive weight gain and improving healthy eating practices among school-aged children in the Amazon region. METHODS This study protocol outlines a theory-driven randomized controlled trial based on the cognitive theory of multimedia learning and the social cognitive theory. A total of 240 parents or caregivers of children enrolled in the Maternal and Child Health and Nutrition Cohort Study in Acre (MINA-Brazil) will be recruited by phone and social media. The intervention group will receive persuasive multimedia messages through WhatsApp over 19 weeks, while the waitlist control group will remain in the usual care. The primary outcome is a change in children's BMI in z score. Secondary outcomes are changes in dietary intake and biochemical indicators of the children. Outcome measures will be assessed at baseline and 5 months after randomization in comparison to usual care. The analysis will use an intent-to-treat approach and will be conducted using the statistical package Stata (version 18.0), with a significance level set at P<.05. Paired and unpaired 2-tailed t tests will be applied to compare mean changes in the outcomes. RESULTS Data collection started in June 2023, and final measurements are scheduled to be completed in December 2023. The results of the main analysis are expected to be available in 2024. CONCLUSIONS This innovative multimedia message intervention holds significant potential for fostering behavioral changes among Amazonian children. TRIAL REGISTRATION Brazilian Clinical Trials Registry RBR-5zdnw6t; https://ensaiosclinicos.gov.br/rg/RBR-5zdnw6t. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/54446.
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Affiliation(s)
| | - Marly Augusto Cardoso
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa (UNL), Lisbon, Portugal
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da Silva GM, de Assumpção D, Freiria CN, Borim FSA, de Brito TRP, Corona LP. Association of Food Consumption According to the Degree of Processing and Sociodemographic Conditions in Older Adults. Foods 2023; 12:4108. [PMID: 38002166 PMCID: PMC10670687 DOI: 10.3390/foods12224108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/07/2023] [Accepted: 10/10/2023] [Indexed: 11/26/2023] Open
Abstract
Several factors can impact food consumption in older adults, including those of sociodemographic, physiological, and chronic non-communicable diseases. This study aimed to evaluate the association of food consumption according to its degree of processing with sociodemographic conditions in community-dwelling older adults. Food intake was evaluated from 24-h recall data. All food items were classified according to the degree of processing into four groups as follows: in natura or minimally processed, culinary ingredients, processed, and ultra-processed foods. Food groups were considered dependent variables in a quantile regression model, adjusting for sex, age, schooling, ethnicity, and number of residents. Women and individuals with higher levels of education had lower consumption of in natura or minimally processed foods and higher consumption of ultra-processed foods. The yellow or indigenous ethnicity presented the lowest consumption of processed foods; older people who lived with three or more individuals had the highest consumption of culinary ingredients, whereas the older people who lived with one to two people had the highest consumption of processed foods and the lowest consumption of ultra-processed. These groups may be the target of educational and public policies to improve diet quality and contribute to quality of life in older ages.
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Affiliation(s)
- Graziele Maria da Silva
- Faculdade de Ciências Aplicadas, Universidade Estadual de Campinas, Street Pedro Zaccaria, 1300, Limeira 13484-350, São Paulo, Brazil;
| | - Daniela de Assumpção
- Faculdade de Ciências MédicasUniversidade Estadual de Campinas, Street Tessália Vieira de Camargo, 126-Cidade Universitária, Campinas 13083-887, São Paulo, Brazil; (D.d.A.); (C.N.F.); (F.S.A.B.)
| | - Carolina Neves Freiria
- Faculdade de Ciências MédicasUniversidade Estadual de Campinas, Street Tessália Vieira de Camargo, 126-Cidade Universitária, Campinas 13083-887, São Paulo, Brazil; (D.d.A.); (C.N.F.); (F.S.A.B.)
| | - Flávia Silva Arbex Borim
- Faculdade de Ciências MédicasUniversidade Estadual de Campinas, Street Tessália Vieira de Camargo, 126-Cidade Universitária, Campinas 13083-887, São Paulo, Brazil; (D.d.A.); (C.N.F.); (F.S.A.B.)
| | - Tábatta Renata Pereira de Brito
- School of Nutrition, Federal University of Alfenas, Street Nabor Toledo Lopes, 598-Parque das Nações, Alfenas 37130-000, Minas Gerais, Brazil;
| | - Ligiana Pires Corona
- Faculdade de Ciências Aplicadas, Universidade Estadual de Campinas, Street Pedro Zaccaria, 1300, Limeira 13484-350, São Paulo, Brazil;
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Reeve E, Ravuvu A, Johnson E, Nasiga S, Brewer T, Mounsey S, Thow AM. Scaling up food pricing policies in the Pacific: a guide to action. BMJ Glob Health 2023; 8:e012041. [PMID: 37813442 PMCID: PMC10565307 DOI: 10.1136/bmjgh-2023-012041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/21/2023] [Indexed: 10/13/2023] Open
Abstract
There are calls for governments around the world to adopt pricing policies, including taxes, subsidies and price controls that ensure all people have access to, and can afford, healthy diets. Despite the strong potential of pricing policies to promote healthy diets and to support a post-COVID-19 recovery, there are gaps in evidence with regard to 'how' to design and apply effective food taxes in practice, and countries report challenges in navigating the different policy options.In this practice piece, we examine the global evidence for food taxes with a view to identifying practical lessons for policy design, adoption and implementation, using the Pacific Islands Region as a case study. We present a systematic resource that draws on locally generated evidence, and a Pacific conceptualisation of healthy diets, to address considerations in setting the tax base, rate and mechanisms, and to ensure tax targets are clearly identifiable within national tax and administrative systems. Health and Finance collaboration at the country level could ensure tax design addresses concerns for the impacts of food taxes on employment, economics and equity, as well as position food taxes as an opportunity to fund revenue shortfalls faced by governments following the COVID-19 pandemic. We demonstrate a need to review other policies for consistency with national health objectives to ensure that countries avoid inadvertently undermining health taxes, for example, by ensuring that foods with known non-communicable disease risk are not being price protected or promoted.
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Affiliation(s)
- Erica Reeve
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Amerita Ravuvu
- Non-Communicable Disease (NCD) Prevention and Control Programme, Public Health Division, Pacific Community, Suva, Fiji
| | - Ellen Johnson
- Sydney School of Public Health, The University of Sydney Menzies Centre for Health Policy, Sydney, New South Wales, Australia
| | - Selai Nasiga
- Independent consultant, Commonwealth Secretariat, London, UK
| | - Tom Brewer
- Australian National Centre for Ocean Resources and Security, University of Wollongong, Wollongong, New South Wales, Australia
| | - Sarah Mounsey
- Sydney School of Public Health, The University of Sydney Menzies Centre for Health Policy, Sydney, New South Wales, Australia
| | - Anne Marie Thow
- Sydney School of Public Health, The University of Sydney Menzies Centre for Health Policy, Sydney, New South Wales, Australia
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Clark SGF, Mendes LL, Honório OS, Oliveira JS, Canuto R. Social inequities in the food retail patterns around schools in Recife, Brazil. CIENCIA & SAUDE COLETIVA 2023; 28:2665-2675. [PMID: 37672455 DOI: 10.1590/1413-81232023289.15882022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 01/25/2023] [Indexed: 09/08/2023] Open
Abstract
This study aimed to describe the community food environment surrounding schools and its association with territorial socio-environmental vulnerability in the city with the highest intraurban social inequity index in Brazil. METHODS this ecological observational study includes data on the presence and type of food retail in a 400 m buffer surrounding public and private schools in Recife. We have also described the Health Vulnerability Index (HVI) of census tracts and conducted multivariate analyses. RESULTS through factor analysis, we observed two grouping patterns of food retail. The "diverse food outlets" pattern was positively associated with middle HVI (β 0.14, 95% confidence interval [CI] - 0.11; 0.16) and higher HVI areas (β 0.15, 95%CI - 0.11; 0.17), while "the large food retail chains" pattern was inversely associated with middle HVI (β -0.42, 95% CI - 0.53; -0.30) and high HVI areas (β -0.32, 95%CI - 0.45; -0.18) and positively associated with private schools (β 0.15, 95%CI - 0.030; 0.27). CONCLUSION the greatest variety in food retail is in high HVI areas, and large food retail chains prevail around private schools, especially in low HVI areas.
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Affiliation(s)
| | | | | | - Juliana Souza Oliveira
- Universidade Federal de Pernambuco. Av. Professor Moraes Rego 1.235. 50670-901 Recife PR Brasil.
| | - Raquel Canuto
- Universidade Federal de Pernambuco. Av. Professor Moraes Rego 1.235. 50670-901 Recife PR Brasil.
- Universidade Federal do Rio Grande do Sul. Porto Alegre RS Brasil
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López-González ÁA, Albaladejo Blanco M, Vidal Ribas C, Tomás-Gil P, Riutord Sbert P, Ramírez-Manent JI. Determination of the Level of Cardiovascular Risk in 172,282 Spanish Working Women. Diagnostics (Basel) 2023; 13:2734. [PMID: 37685272 PMCID: PMC10487210 DOI: 10.3390/diagnostics13172734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/17/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
Introduction, objectives: Although cardiovascular events have been traditionally associated mainly with men, some data reflect an increase in women, which may even exceed their male counterparts, constituting the leading cause of death in working women in Spain. The objective of this present study was to analyze the level of cardiovascular risk in Spanish working women by assessing the influence of age, type of work, and tobacco consumption. MATERIAL, METHODS A descriptive cross-sectional study was carried out in 172,282 working women from different Spanish geographical areas and from different companies between January 2018 and June 2020. A range of variables and risk factors were assessed and various cardiovascular risk scales were used to analyze the data. RESULTS An increase in cardiovascular risk was observed in the least qualified work groups, mainly corresponding to blue-collar workers, when using the SCORE or REGICOR risk equation. The prevalence of altered values for all the parameters analyzed (overweight and obesity, hypertension, dyslipidemia, diabetes, fatty liver, hepatic fibrosis, atherogenic indexes, and cardiovascular risk scales) was higher among blue-collar women. Age was the only factor that influenced all the cardiovascular risk scales studied, increasing risk when comparing the group of women aged 50 years and older with the others. CONCLUSIONS Aging and belonging to the blue-collar job category meant worse results in the cardiovascular risk scales and in all the parameters analyzed. This is in line with numerous studies that argue that age and zip code are more influential than genetic code.
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Affiliation(s)
- Ángel Arturo López-González
- Faculty of Odontology, ADEMA University School, 07009 Palma, Spain; (Á.A.L.-G.); (P.R.S.)
- IdisBa (Balearic Islands Health Research Institute), 07004 Palma, Spain;
- Investigation Group ADEMA SALUD IUNICS, 07003 Palma, Spain
| | | | | | | | - Pere Riutord Sbert
- Faculty of Odontology, ADEMA University School, 07009 Palma, Spain; (Á.A.L.-G.); (P.R.S.)
| | - José Ignacio Ramírez-Manent
- IdisBa (Balearic Islands Health Research Institute), 07004 Palma, Spain;
- Investigation Group ADEMA SALUD IUNICS, 07003 Palma, Spain
- Balearic Islands Health Service, 07003 Palma, Spain; (M.A.B.); (C.V.R.)
- Department of Medicine, University of the Balearic Islands, 07120 Palma, Spain
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12
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Prescott SL, D’Adamo CR, Holton KF, Ortiz S, Overby N, Logan AC. Beyond Plants: The Ultra-Processing of Global Diets Is Harming the Health of People, Places, and Planet. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6461. [PMID: 37569002 PMCID: PMC10419141 DOI: 10.3390/ijerph20156461] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023]
Abstract
Global food systems are a central issue for personal and planetary health in the Anthropocene. One aspect of major concern is the dramatic global spread of ultra-processed convenience foods in the last 75 years, which is linked with the rising human burden of disease and growing sustainability and environmental health challenges. However, there are also calls to radically transform global food systems, from animal to plant-derived protein sources, which may have unintended consequences. Commercial entities have moved toward this "great plant transition" with vigor. Whether motivated by profit or genuine environmental concern, this effort has facilitated the emergence of novel ultra-processed "plant-based" commercial products devoid of nutrients and fiber, and sometimes inclusive of high sugar, industrial fats, and synthetic additives. These and other ingredients combined into "plant-based" foods are often assumed to be healthy and lower in calorie content. However, the available evidence indicates that many of these products can potentially compromise health at all scales-of people, places, and planet. In this viewpoint, we summarize and reflect on the evidence and discussions presented at the Nova Network planetary health meeting on the "Future of Food", which had a particular focus on the encroachment of ultra-processed foods into the global food supply, including the plant-sourced animal protein alternatives (and the collective of ingredients therein) that are finding their way into global fast-food chains. We contend that while there has been much uncritical media attention given to the environmental impact of protein and macronutrient sources-meat vs. novel soy/pea protein burgers, etc.-the impact of the heavy industrial processing on both human and environmental health is significant but often overlooked, including effects on cognition and mental health. This calls for a more nuanced discourse that considers these complexities and refocuses priorities and value systems towards mutualistic solutions, with co-benefits for individuals, local communities, and global ecology.
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Affiliation(s)
- Susan L. Prescott
- Nova Institute for Health, Baltimore, MD 21231, USA; (C.R.D.); (A.C.L.)
- Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
- Medical School, University of Western Australia, Nedlands, WA 6009, Australia
- The ORIGINS Project, Telethon Kids Institute, Nedlands, WA 6009, Australia
| | - Christopher R. D’Adamo
- Nova Institute for Health, Baltimore, MD 21231, USA; (C.R.D.); (A.C.L.)
- Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Kathleen F. Holton
- Departments of Health Studies and Neuroscience, Center for Neuroscience and Behavior, American University, Washington, DC 20016, USA;
| | - Selena Ortiz
- Department of Health Policy and Administration, The Pennsylvania State University, State College, PA 16802, USA;
| | - Nina Overby
- Department of Nutrition and Public Health, Centre for Lifecourse Nutrition, University of Agder, 4630 Kristiansand, Norway;
| | - Alan C. Logan
- Nova Institute for Health, Baltimore, MD 21231, USA; (C.R.D.); (A.C.L.)
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13
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Coletro HN, de Menezes-Júnior LAA, Mendonça RDD, Meireles AL, Machado-Coelho GLL, de Menezes MC. The combined consumption of fresh/minimally processed food and ultra-processed food on food insecurity: COVID Inconfidentes, a population-based survey. Public Health Nutr 2023; 26:1414-1423. [PMID: 36919847 PMCID: PMC10346086 DOI: 10.1017/s136898002300054x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 11/11/2022] [Accepted: 03/03/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVE To investigate whether the combined consumption of fresh/minimally processed and ultra-processed food is associated with food insecurity (FI) during the COVID-19 pandemic. DESIGN Cross-sectional observational study was derived from a survey using a population-based search of a complex sample. FI was assessed using the validated Brazilian Food Insecurity Scale. Food consumption was assessed using a qualitative FFQ and the NOVA classification for fresh/minimally processed food and ultra-processed food. A scoring system was used to evaluate combined food consumption according to the extent and purpose of processing, considering the weekly consumption of the two groups (according to the NOVA classification). Higher punctuation reflects worse diet quality (higher consumption of ultra-processed foods and lower consumption of fresh/minimally processed foods). A theoretical causality model was constructed using a directed acyclic graph, and multivariate analysis was performed using Poisson regression to test the association between FI and food consumption. SETTING Ouro Preto and Mariana, Brazil, between October and December 2020. PARTICIPANTS An epidemiological household survey was conducted with 1753 individuals selected through a stratified and clustered sampling design in three stages. RESULTS Those with food consumption scores in the fourth quartile had a 60 % higher prevalence ratio (PR) for FI (PR: 1·60 and 95 % CI: 1·06 - 2·40). Also, the increased consumption of fresh/minimally processed foods and low consumption of ultra-processed foods presented a 45 % lower prevalence ratio of FI (PR: 0·55 and 95 % CI: 0·40 - 0·80). CONCLUSION These results indicate an inverse association between FI and diet quality.
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Affiliation(s)
- Hillary Nascimento Coletro
- Universidade Federal de Ouro Preto, Research and Study Group on Nutrition and Public Health (GPENSC), School of Nutrition, Ouro Preto, Minas Gerais, Brazil
| | - Luiz Antônio Alves de Menezes-Júnior
- Universidade Federal de Ouro Preto, Research and Study Group on Nutrition and Public Health (GPENSC), School of Nutrition, Ouro Preto, Minas Gerais, Brazil
| | - Raquel de Deus Mendonça
- Universidade Federal de Ouro Preto, Department of Clinical and Social Nutrition, Research and Study Group on Nutrition and Public Health (GPENSC), School of Nutrition, Ouro Preto, Minas Gerais, Brazil
| | - Adriana Lúcia Meireles
- Universidade Federal de Ouro Preto, Department of Clinical and Social Nutrition, Research and Study Group on Nutrition and Public Health (GPENSC), School of Nutrition, Ouro Preto, Minas Gerais, Brazil
| | | | - Mariana Carvalho de Menezes
- Universidade Federal de Ouro Preto, Department of Clinical and Social Nutrition, Research and Study Group on Nutrition and Public Health (GPENSC), School of Nutrition, Ouro Preto, Minas Gerais, Brazil
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Neves ACM, de Menezes Junior LAA, Canuto R, Bruno TCV, Carvalho de Menezes M, de Deus Mendonça R, Meireles AL, Carraro JCC. Racial disparities in lifestyle habits and dietary patterns in university students during the COVID-19 pandemic. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023:1-11. [PMID: 37361280 PMCID: PMC10249555 DOI: 10.1007/s10389-023-01946-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/11/2023] [Indexed: 06/28/2023]
Abstract
Objectives To evaluate lifestyle habits and dietary patterns among university students during the COVID-19 pandemic and their association with skin color. Methods This cross-sectional study was conducted with 1315 undergraduate students from a public higher education institution. Sociodemographic characteristics, lifestyle habits, and food consumption were collected. Factor analysis was used to identify dietary patterns and multivariate logistic regression was conducted to estimate the associations between race/skin color and outcomes. Results Black individuals were less likely to show behaviors associated with the use of cigarettes or tobacco products (OR = 0.61; 95% CI 0.42-0.89). However, black individuals with higher income (greater than, or equal to one minimum wage per person) were less likely to show behaviors associated with illicit drug use (OR = 0.54; 95% CI 0.31-0.96), use of cigarettes or tobacco products (OR = 0.46; 95% CI 0.24-0.87) and alcohol consumption (OR = 0.64; CI 95% 0.42-0.98). In addition, individuals of race/skin color black with lower income (less than one minimum wage per person) showed decreased consumption of vegetables (OR = 0.68; CI 95% 0.48-0.96). Conclusions Black college students with higher income were less likely to show undesirable behaviors related to the use of psychoactive substances. In contrast, individuals with lower income had lower consumption of foods from the vegetable group, which can be considered an unfavorable health-related behavior.
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Affiliation(s)
- Ana Cláudia Morito Neves
- Postgraduate Program in Health and Nutrition, School of Nutrition, Universidade Federal de Ouro Preto (UFOP), University Campus, s/n - Morro do Cruzeiro., Ouro Preto, MG CEP 35400-000 Brazil
| | - Luiz Antônio Alves de Menezes Junior
- Postgraduate Program in Health and Nutrition, School of Nutrition, Universidade Federal de Ouro Preto (UFOP), University Campus, s/n - Morro do Cruzeiro., Ouro Preto, MG CEP 35400-000 Brazil
| | - Raquel Canuto
- Department of Nutrition and coordinator of the Program in Food, Nutrition and Health, Faculty of Medicine, Universidade Federal Do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul Brazil
| | - Thaís Calcagno Vidon Bruno
- Postgraduate Program in Health and Nutrition, School of Nutrition, Universidade Federal de Ouro Preto (UFOP), University Campus, s/n - Morro do Cruzeiro., Ouro Preto, MG CEP 35400-000 Brazil
| | - Mariana Carvalho de Menezes
- Department of Clinical and Social Nutrition, School of Nutrition, Universidade Federal de Ouro Preto (UFOP), Ouro Preto, MG Brazil
| | - Raquel de Deus Mendonça
- Department of Clinical and Social Nutrition, School of Nutrition, Universidade Federal de Ouro Preto (UFOP), Ouro Preto, MG Brazil
| | - Adriana Lúcia Meireles
- Department of Clinical and Social Nutrition, School of Nutrition, Universidade Federal de Ouro Preto (UFOP), Ouro Preto, MG Brazil
| | - Júlia Cristina Cardoso Carraro
- Department of Clinical and Social Nutrition, School of Nutrition, Universidade Federal de Ouro Preto (UFOP), Ouro Preto, MG Brazil
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15
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Bennett E, Topp SM, Moodie AR. National Public Health Surveillance of Corporations in Key Unhealthy Commodity Industries - A Scoping Review and Framework Synthesis. Int J Health Policy Manag 2023; 12:6876. [PMID: 37579395 PMCID: PMC10425693 DOI: 10.34172/ijhpm.2023.6876] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 01/02/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Corporations in unhealthy commodity industries (UCIs) have growing influence on the health of national populations through practices that lead to increased consumption of unhealthy products. The use of government-led public health surveillance is best practice to better understand any emerging public health threat. However, there is minimal systematic evidence, generated and monitored by national governments, regarding the scope of UCI corporate practices and their impacts. This study aims to synthesise current frameworks that exist to identify and monitor UCI influence on health to highlight the range of practices deployed by corporations and inform future surveillance efforts in key UCIs. METHODS Seven biomedical, business and scientific databases were searched to identify literature focused on corporate practices that impact human health and frameworks for monitoring or assessment of the way UCIs impact health. Content analysis occurred in three phases, involving (1) the identification of framework documents in the literature and extraction of all corporate practices from the frameworks; (2) initial inductive grouping and synthesis followed by deductive synthesis using Lima and Galea's 'vehicles of power' as a heuristic; and (3) scoping for potential indicators linked to each corporate practice and development of an integrated framework. RESULTS Fourteen frameworks were identified with 37 individual corporate practices which were coded into five different themes according the Lima and Galea 'Corporate Practices and Health' framework. We proposed a summary framework to inform the public health surveillance of UCIs which outlines key actors, corporate practices and outcomes that should be considered. The proposed framework draws from the health policy triangle framework and synthesises key features of existing frameworks. CONCLUSION Systematic monitoring of the practices of UCIs is likely to enable governments to mitigate the negative health impacts of corporate practices. The proposed synthesised framework highlights the range of practices deployed by corporations for public health surveillance at a national government level. We argue there is significant precedent and great need for monitoring of these practices and the operationalisation of a UCI monitoring system should be the object of future research.
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Affiliation(s)
- Elizabeth Bennett
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, VIC, Australia
| | - Stephanie M. Topp
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, VIC, Australia
| | - Alan Rob Moodie
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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Giacomello L, Bordignon S, Salm D, Donatello N, Belmonte LA, Bobinski F, Tourinho Dos Santos CF, Traebert JL, Piovezan AP, Martins DF. RETRACTED: Effects of the application of a food processing-based classification system in obese women: A randomized controlled pilot study. Nutr Health 2023:2601060231153947. [PMID: 36751033 DOI: 10.1177/02601060231153947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- Leandro Giacomello
- Experimental Neuroscience Laboratory (LaNEx), University of Southern Santa Catarina at Palhoça, Palhoca, Santa Catarina, Brazil
- Postgraduate Program in Health Sciences, University of Southern Santa Catarina at Palhoça, Palhoca, Brazil
| | - Silvana Bordignon
- Experimental Neuroscience Laboratory (LaNEx), University of Southern Santa Catarina at Palhoça, Palhoca, Santa Catarina, Brazil
| | - Daiana Salm
- Experimental Neuroscience Laboratory (LaNEx), University of Southern Santa Catarina at Palhoça, Palhoca, Santa Catarina, Brazil
- Postgraduate Program in Health Sciences, University of Southern Santa Catarina at Palhoça, Palhoca, Brazil
| | - Nathalia Donatello
- Experimental Neuroscience Laboratory (LaNEx), University of Southern Santa Catarina at Palhoça, Palhoca, Santa Catarina, Brazil
- Postgraduate Program in Health Sciences, University of Southern Santa Catarina at Palhoça, Palhoca, Brazil
| | - Luiz Augusto Belmonte
- Experimental Neuroscience Laboratory (LaNEx), University of Southern Santa Catarina at Palhoça, Palhoca, Santa Catarina, Brazil
- Postgraduate Program in Health Sciences, University of Southern Santa Catarina at Palhoça, Palhoca, Brazil
| | - Franciane Bobinski
- Experimental Neuroscience Laboratory (LaNEx), University of Southern Santa Catarina at Palhoça, Palhoca, Santa Catarina, Brazil
- Postgraduate Program in Health Sciences, University of Southern Santa Catarina at Palhoça, Palhoca, Brazil
| | | | - Jefferson Luiz Traebert
- Postgraduate Program in Health Sciences, University of Southern Santa Catarina at Palhoça, Palhoca, Brazil
- School of Medicine, University of Southern Santa Catarina at Palhoça, Palhoca, Santa Catarina, Brazil
| | - Anna Paula Piovezan
- Experimental Neuroscience Laboratory (LaNEx), University of Southern Santa Catarina at Palhoça, Palhoca, Santa Catarina, Brazil
- Postgraduate Program in Health Sciences, University of Southern Santa Catarina at Palhoça, Palhoca, Brazil
- School of Medicine, University of Southern Santa Catarina at Palhoça, Palhoca, Santa Catarina, Brazil
- School of Pharmacy, University of Southern Santa Catarina at Palhoça, Palhoca, Santa Catarina, Brazil
| | - Daniel Fernandes Martins
- Experimental Neuroscience Laboratory (LaNEx), University of Southern Santa Catarina at Palhoça, Palhoca, Santa Catarina, Brazil
- Postgraduate Program in Health Sciences, University of Southern Santa Catarina at Palhoça, Palhoca, Brazil
- School of Medicine, University of Southern Santa Catarina at Palhoça, Palhoca, Santa Catarina, Brazil
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Valmorbida JL, Sangalli CN, Leffa PS, Baratto PS, Rauber F, Mennella JA, Vitolo MR. Sodium Intake Tracked from Infancy and Salt Taste Preference during Adolescence: Follow-up of a Randomized Controlled Field Trial in Brazil. Curr Dev Nutr 2023; 7:100011. [PMID: 37181123 PMCID: PMC10100944 DOI: 10.1016/j.cdnut.2022.100011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 10/25/2022] [Accepted: 10/30/2022] [Indexed: 12/24/2022] Open
Abstract
Background Effective interventions to promote healthy sodium intakes require understanding factors driving liking for salt taste. Objectives To examine effects of an early feeding intervention among low-income mothers on their children's energy and sodium intake and salt taste preferences at 12 years; and to identify age-related changes in dietary sodium sources. Methods Secondary analyses were conducted on dietary intake and taste preference data collected from children in a longitudinal trial (NCT00629629). Mothers randomized to the intervention group received counseling on healthy eating practices for 1 year postpartum; the control group received no counseling. Two-day dietary recalls were obtained at 1 year (intervention end) and at 4-, 8-, and 12-year follow-up visits, from which foods were categorized as unprocessed, processed, or ultra-processed. At the 12-year visit, children's most preferred concentration of salt was measured using a validated, forced-choice, paired-comparison tracking method, and pubertal stage was self-assessed. Results The intervention group had reduced energy intake compared with controls in all food categories at 1 year (P = 0.04) but not at the other time points. Sodium intake from processed foods increased from 4 to 12 years and from ultra-processed foods from 1 to 4; intake from unprocessed foods decreased from 1 to 8 year (all P < 0.01). At 12 years, children in early stages of puberty (Tanner stages 1-3; P = 0.04) or in the ≥75th percentile of sodium intake (P < 0.01) preferred significantly higher concentrations of salt than the other children. Conclusions Both dietary intake of sodium and early puberty were associated with preferences for higher salt concentrations. Childhood and adolescence are important periods for understanding how experience and growth shape diet by changing salt taste. Clinical Trial Registration This manuscript reports secondary analysis of data collected in trial NCT00629629 (2001-3) and follow-up [https://clinicaltrials.gov/ct2/show/NCT00629629?term=NCT00629629&draw=2&rank=1].
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Affiliation(s)
- Julia L. Valmorbida
- Nutrition Research Center, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
- Graduate Program in Pediatrics, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Caroline N. Sangalli
- Nutrition Research Center, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Paula S. Leffa
- Nutrition Research Center, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Paola S. Baratto
- Nutrition Research Center, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
- Graduate Program in Pediatrics, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Fernanda Rauber
- Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Marcia R. Vitolo
- Nutrition Research Center, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
- Graduate Program in Pediatrics, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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18
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Coyle DH, Huang L, Shahid M, Gaines A, Di Tanna GL, Louie JCY, Pan X, Marklund M, Neal B, Wu JHY. Socio-economic difference in purchases of ultra-processed foods in Australia: an analysis of a nationally representative household grocery purchasing panel. Int J Behav Nutr Phys Act 2022; 19:148. [PMID: 36503612 PMCID: PMC9742014 DOI: 10.1186/s12966-022-01389-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/25/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Consumption of ultra-processed foods is associated with increased risk of obesity and non-communicable diseases. Little is known about current patterns of ultra-processed foods intake in Australia. The aim of this study was to examine the amount and type of ultra-processed foods purchased by Australian households in 2019 and determine whether purchases differed by socio-economic status (SES). We also assessed whether purchases of ultra-processed foods changed between 2015 and 2019. METHODS: We used grocery purchase data from a nationally representative consumer panel in Australia to assess packaged and unpackaged grocery purchases that were brought home between 2015 to 2019. Ultra-processed foods were identified according to the NOVA system, which classifies foods according to the nature, extent and purpose of industrial food processing. Purchases of ultra-processed foods were calculated per capita, using two outcomes: grams/day and percent of total energy. The top food categories contributing to purchases of ultra-processed foods in 2019 were identified, and differences in ultra-processed food purchases by SES (Index of Relative Social Advantage and Disadvantage) were assessed using survey-weighted linear regression. Changes in purchases of ultra-processed foods between 2015 to 2019 were examined overall and by SES using mixed linear models. RESULTS In 2019, the mean ± SD total grocery purchases made by Australian households was 881.1 ± 511.9 g/d per capita. Of this, 424.2 ± 319.0 g/d per capita was attributable to purchases of ultra-processed foods, which represented 56.4% of total energy purchased. The largest food categories contributing to total energy purchased included mass-produced, packaged breads (8.2% of total energy purchased), chocolate and sweets (5.7%), biscuits and crackers (5.7%) and ice-cream and edible ices (4.3%). In 2019, purchases of ultra-processed foods were significantly higher for the lowest SES households compared to all other SES quintiles (P < 0.001). There were no major changes in purchases of ultra-processed foods overall or by SES over the five-year period. CONCLUSIONS Between 2015 and 2019, ultra-processed foods have consistently made up the majority of groceries purchased by Australians, particularly for the lowest SES households. Policies that reduce ultra-processed food consumption may reduce diet-related health inequalities.
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Affiliation(s)
- Daisy H. Coyle
- grid.1005.40000 0004 4902 0432Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042 Australia
| | - Liping Huang
- grid.1005.40000 0004 4902 0432Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042 Australia
| | - Maria Shahid
- grid.1005.40000 0004 4902 0432Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042 Australia
| | - Allison Gaines
- grid.1005.40000 0004 4902 0432Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042 Australia ,grid.7445.20000 0001 2113 8111Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Public Health, Imperial College London, London, SW7 2AZ UK
| | - Gian Luca Di Tanna
- grid.1005.40000 0004 4902 0432Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042 Australia
| | - Jimmy Chun Yu Louie
- grid.1005.40000 0004 4902 0432Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042 Australia ,grid.194645.b0000000121742757School of Biological Science, Faculty of Science, The University of Hong Kong, Hong Kong, 999077 China
| | - Xiongfei Pan
- grid.461863.e0000 0004 1757 9397Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, 610041 Sichuan China
| | - Matti Marklund
- grid.1005.40000 0004 4902 0432Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042 Australia
| | - Bruce Neal
- grid.1005.40000 0004 4902 0432Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042 Australia ,grid.7445.20000 0001 2113 8111Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Public Health, Imperial College London, London, SW7 2AZ UK
| | - Jason H. Y. Wu
- grid.1005.40000 0004 4902 0432Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042 Australia
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Crepaldi BVC, Okada LM, Claro RM, Louzada MLDC, Rezende LFM, Levy RB, Azeredo CM. Educational inequality in consumption of in natura or minimally processed foods and ultra-processed foods: The intersection between sex and race/skin color in Brazil. Front Nutr 2022; 9:1055532. [PMID: 36570160 PMCID: PMC9774479 DOI: 10.3389/fnut.2022.1055532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/17/2022] [Indexed: 12/13/2022] Open
Abstract
Background It remains uncertain how the intersection between educational, gender, and race/skin color inequalities influences food consumption in Brazil. In this study, we examined the educational inequality in the consumption of in natura/minimally processed and ultra-processed foods by Brazilians with an intersectional perspective between sex and race/color. Methods We used cross-sectional data from the Telephone Surveillance System (VIGITEL 2019), comprising 52,443 participants ≥ 18 years. Daily food consumption was considered high when consumption of ≥5 foods for each food group was reported the day before the survey. Educational inequality in food consumption was assessed by the slope index of inequality (SII) and the relative index of inequality (RII) according to sex and race/color (White; Black/Brown). Positive SII and RII values > 1.0 indicate higher food consumption among more educated participants. Results The consumptions of in natura/minimally processed and ultra-processed foods were more prevalent in those with the highest level of education (≥12 years) and intermediate education (9-11 years), respectively. However, highly educated White women had higher consumption of in natura/minimally processed foods than Black women with the same education level, and White men in low and intermediate school levels had higher consumption of these foods than Black men with the same education levels. We found higher absolute educational inequality for in natura/minimally processed foods among White women (SII 21.8, 95% CI 15.3, 28.4) and Black/Brown men (SII 19.3, 95% CI 12.5, 26.1). Black/Brown men (SII 7.3, 95% CI 0.5, 14.0) and Black/Brown women (SII 5.6, 95% CI 1.0, 10.2) had higher absolute educational inequality than White men (SII -3.3, 95% CI -10.9, 4.3; P = 0.04) in the consumption of ultra-processed foods. Conclusion Educational inequalities influenced the consumption of in natura/minimally processed more than ultra-processed foods, and, for the latter, inequalities were greater among Black/Brown men and women than among White men.
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Affiliation(s)
| | - Letícia Martins Okada
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Rafael Moreira Claro
- Departamento de Nutrição, Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Leandro F. M. Rezende
- Departamento de Medicina Preventiva, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Renata Bertazzi Levy
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Catarina Machado Azeredo
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil,*Correspondence: Catarina Machado Azeredo,
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20
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Haghighatdoost F, Hajihashemi P, Mohammadifard N, Najafi F, Farshidi H, Lotfizadeh M, Kazemi T, Karimi S, Shirani S, Solati K, Sarrafzadegan N. Association between ultra-processed foods consumption and micronutrient intake and diet quality in Iranian adults: a multicentric study. Public Health Nutr 2022; 26:1-9. [PMID: 36274641 DOI: 10.1017/s1368980022002038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To identify ultra-processed foods (UPF) contribution to daily energy and nutrient intake in Iranians and examine whether UPF intake is associated with nutrient profile and diet quality. DESIGN In this cross-sectional study, a validated FFQ was used to evaluate usual dietary intake over the preceding year. NOVA system was applied to categorise foods based on their levels of processing. Diet quality was evaluated using the nutrient adequacy ratio (NAR), Nutrient Rich Food Index (NRF) and hybrid nutrient density. SETTING The LIPOKAP study conducted in five cities of Iran (Isfahan, Birjand, Bandar Abbas, Kermanshah and Shahrekord). PARTICIPANTS A total of 1994 adults aged ≥18 years were recruited using stratified multistage random cluster sampling method. RESULTS UPF were responsible for 8·5 % of daily energy intake. In the adjusted model, UPF consumption was inversely associated with carbohydrate, protein, refined and whole grains, fibre, fruit and meat, but was positively linked to energy, total fat, saturated and trans fatty acids and cholesterol. Compared with those in the lowest tertile, individuals in the highest tertile of UPF had smaller NAR for Ca, Mg, Zn, Fe, phosphorus, thiamin, niacin, folate and vitamin C. Both NRF and hybrid nutrient density decreased when the share of daily energy intake from UPF increased. CONCLUSION The higher consumption of UPF is associated with poorer diet quality and lower nutrient intake. It is recommended that UPF be replaced with minimally processed foods to improve diet quality and nutrient profile.
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Affiliation(s)
- Fahimeh Haghighatdoost
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parisa Hajihashemi
- Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, P. O. Box 81745-15, Isfahan, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hossein Farshidi
- Hormozgan Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandarabbas, Iran
| | - Masoud Lotfizadeh
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Tooba Kazemi
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Simin Karimi
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahin Shirani
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Kamal Solati
- Department of Psychiatry, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, P. O. Box 81745-15, Isfahan, Iran
- Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, Canada
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21
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Mendoza-Velázquez A, Lara-Arévalo J, Siqueira KB, Guzmán-Rodríguez M, Drewnowski A. Affordable Nutrient Density in Brazil: Nutrient Profiling in Relation to Food Cost and NOVA Category Assignments. Nutrients 2022; 14:nu14204256. [PMID: 36296940 PMCID: PMC9611234 DOI: 10.3390/nu14204256] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/10/2022] [Accepted: 10/10/2022] [Indexed: 11/23/2022] Open
Abstract
Affordable nutrient density is provided by low-cost and nutrient-rich foods. We explored nutrient density, cost, and NOVA category assignments within and across food groups in Brazil. The nutrient density of the foods (n = 591) was assessed using the Nutrient Rich Food Index (NRF9.3) based on protein, fiber, vitamin A (RAE), vitamin C, vitamin E (mg), Ca, Fe, K and Mg; and NRF6.3 score for priority nutrients: Ca, Fe, Zn, vitamin A, vitamin B12, and folate. Nutrients to limit (LIM) were saturated fat, added sugar, and sodium. Affordability was defined as the ratio of energy and/or nutrient density of foods and retail price per 100 kcal. Foods were classified as minimally processed (n = 106), processed (n = 188), ultra-processed (n = 286), and culinary ingredients (n = 11). Nutrient density was positively linked to per 100 kcal food cost. Ultra-processed foods (UPF) contained more energy, fat, sugar, and salt and had lower NRF scores compared to minimally processed (MPF) foods. UPF was also less expensive than MPF foods. Nutrient-rich foods below the median per 100 kcal costs included MPF foods, but also processed foods (PF) and UPF. Affordable nutrient-rich foods can be found in the different categories of the NOVA classification.
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Affiliation(s)
- Alfonso Mendoza-Velázquez
- Center for Public Health Nutrition, University of Washington, Seattle, WA 98195, USA
- Centro de Investigación e Inteligencia Económica, Universidad Popular Autónoma del Estado de Puebla (UPAEP), Puebla 72410, Mexico
| | - Jonathan Lara-Arévalo
- Center for Public Health Nutrition, University of Washington, Seattle, WA 98195, USA
- Correspondence:
| | | | - Mariano Guzmán-Rodríguez
- Centro de Investigación e Inteligencia Económica, Universidad Popular Autónoma del Estado de Puebla (UPAEP), Puebla 72410, Mexico
| | - Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, WA 98195, USA
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22
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Ramírez-Manent JI, Altisench Jané B, Tomás Salvà M, Arroyo Bote S, González San Miguel HM, López-González ÁA. Influence of Educational Level and Healthy Habits on the Prevalence of Diabesity in a Spanish Working Population. Nutrients 2022; 14:nu14194101. [PMID: 36235753 PMCID: PMC9573222 DOI: 10.3390/nu14194101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 11/05/2022] Open
Abstract
Background: Diabesity is a growing problem internationally. Taking into account the importance of physical activity and diet in its prevention and treatment, the objective of this study was to delve into the impact of healthy habits on diabesity. Methods: A descriptive, cross-sectional study was carried out in 386,924 Spanish adult workers. Obesity was determined according to eleven different formulas. Life habits were also valued; sociodemographic variables; and educational level; as well as analytical and clinical variables such as blood pressure and blood glucose levels. The association between the different variables was performed using the chi-square and the Student’s t-tests when the samples were independent. A multivariate analysis was performed using the multinomial logistic regression test by calculating the odds ratio and a 95% confidence interval. The Hosmer–Lemeshow goodness-of-fit test was also performed. Results: The overall prevalence of diabesity ranged between 0.3% (95% CI 0.3–0.4) when obesity was assessed according to the abdominal volume index and 8.3% (95% CI 8.2–8.4) when evaluated according to the CUN-BAE (Clínica Universitaria de Navarra Body Adiposity Estimator) formula. The prevalence of diabesity was also higher in workers with a non-heart-healthy diet and in those who did not exercise regularly. Conclusions: The most disadvantaged socioeconomic classes are those with the highest prevalence of diabesity. It is important to prioritise prevention in populations and communities with the most unfavourable social and environmental conditions to reduce the burden of diabesity.
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Affiliation(s)
- José Ignacio Ramírez-Manent
- Faculty of Medicine, University Balearic Islands, 07009 Palma, Balearic Islands, Spain
- IDISBA, Balearic Islands Health Research Institute Foundation, 07004 Palma, Balearic Islands, Spain
- General Practitioner Department, Balearic Islands Health Service, 07003 Palma, Balearic Islands, Spain
| | - Bárbara Altisench Jané
- General Practitioner Department, Balearic Islands Health Service, 07003 Palma, Balearic Islands, Spain
- Correspondence:
| | - Matías Tomás Salvà
- Investigation Group ADEMA SALUD IUNICS, 07003 Palma, Balearic Islands, Spain
- Faculty of Dentistry, University School ADEMA, 07009 Palma, Balearic Islands, Spain
| | - Sebastiana Arroyo Bote
- Investigation Group ADEMA SALUD IUNICS, 07003 Palma, Balearic Islands, Spain
- Faculty of Dentistry, University School ADEMA, 07009 Palma, Balearic Islands, Spain
| | - Hilda María González San Miguel
- Investigation Group ADEMA SALUD IUNICS, 07003 Palma, Balearic Islands, Spain
- Faculty of Dentistry, University School ADEMA, 07009 Palma, Balearic Islands, Spain
| | - Ángel Arturo López-González
- IDISBA, Balearic Islands Health Research Institute Foundation, 07004 Palma, Balearic Islands, Spain
- Investigation Group ADEMA SALUD IUNICS, 07003 Palma, Balearic Islands, Spain
- Faculty of Dentistry, University School ADEMA, 07009 Palma, Balearic Islands, Spain
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23
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Carvalho CMPD, Johns P, Albiero M, Martins APB, Mais LA, Ralston R, Collin J. "Private and personal": Corporate political activity, informal governance, and the undermining of marketing regulation in Brazil. Glob Public Health 2022; 17:1902-1912. [PMID: 34648410 DOI: 10.1080/17441692.2021.1988128] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Few studies have investigated corporate political activity by unhealthy commodity industries in low- and middle-income countries, and the significance of social and political context has been largely neglected. This study aimed to explore the stalled development of marketing restriction policies in Brazil with an analysis of strategies used to undermine the Legal Framework for Early Childhood. Using a constructivist approach based on a typology of corporate political strategies, decision-making processes were assessed to understand interference by food companies in the Legal Framework, and how this was perceived by policy actors. Semi-structured interviews were conducted with public health advocates, academics and legislature officials. Three broad strategies that contributed to the stalling of marketing restrictions in the Legal Framework were identified: relational approaches to policy influence; collective participation in formal decision-making; and specific strategy choices (information and financial incentives). Key opportunities for policy influence through informal social networks in the 'backstage' of policy making are found to privilege commercial sector actors. Informal policy making may have a critical function in obstructing the development of health-focused regulation in Brazil. This highlights the need for a better understanding of non-codified and hidden corporate efforts to shape the policy environment.
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Affiliation(s)
- Camila Maranha Paes de Carvalho
- ACT Health Promotion (ACT Promoção da Saúde), Rio de Janeiro, Brazil.,Social Nutrition Department, Faculty of Nutrition Emília de Jesus Ferreiro, Fluminense Federal University (Departamento de Nutrição Social, Faculdade de Nutrição Emília de Jesus Ferreiro, Universidade Federal Fluminense - UFF), Rio de Janeiro, Brazil
| | - Paula Johns
- ACT Health Promotion (ACT Promoção da Saúde), Rio de Janeiro, Brazil
| | - Marília Albiero
- ACT Health Promotion (ACT Promoção da Saúde), Rio de Janeiro, Brazil
| | - Ana Paula Bortoletto Martins
- Brazilian Institute for Consumer Defense (Instituto Brasileiro de Defesa do Consumidor - Idec), São Paulo, Brazil.,Center for Epidemiological Research in Nutrition and Health, University of São Paulo (Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo - Nupens/USP), São Paulo, Brazil
| | - Laís Amaral Mais
- Brazilian Institute for Consumer Defense (Instituto Brasileiro de Defesa do Consumidor - Idec), São Paulo, Brazil
| | - Rob Ralston
- Global Health Policy Unit, University of Edinburgh, Edinburgh, UK.,Shaping Public Health Policies to Reduce Inequalities and Harm, SPECTRUM Consortium, Edinburgh, UK
| | - Jeff Collin
- Global Health Policy Unit, University of Edinburgh, Edinburgh, UK.,Shaping Public Health Policies to Reduce Inequalities and Harm, SPECTRUM Consortium, Edinburgh, UK
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24
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Ferreira ACM, Silva AGD, Sá ACMGND, Oliveira PPVD, Felisbino-Mendes MS, Pereira CA, Malta DC. Fatores de risco e proteção para as doenças crônicas não transmissíveis entre escolares brasileiros. REME: REVISTA MINEIRA DE ENFERMAGEM 2022. [DOI: 10.35699/2316-9389.2022.38620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
Objetivo: Descrever as prevalências de fatores de risco e de proteção para as doenças crônicas não transmissíveis (DCNT) em adolescentes brasileiros em 2019 e compará-las às de 2015. Método: Estudo transversal com dados da Pesquisa Nacional de Saúde do Escolar. Estimou-se as prevalências e intervalos de confiança de 95% (IC95%) dos indicadores de alimentação, atividade física e uso de drogas, segundo sexo, instituição de ensino e Unidade da Federação. Resultados: Em 2019, o consumo de frutas foi 26,9% (IC95% 26,3-27,6), de verduras e legumes 28,8% (IC95% 28,2-29,4), de ultraprocessados 97,3% (IC95% 97,1-97,6) e de guloseimas 32,8% (IC95% 32,1-33,4). Apenas 28,3% (IC95% 27,4-28,8) praticaram atividade física. O fumo entre os adolescentes totalizou 6,8% (IC95% 6,3-7,3) e o consumo de álcool 28,1% (IC95% 27,3-28,8). Ao comparar 2015 com 2019, observou uma redução do consumo de frutas (2015: 30,9% - IC95% 29,6-32,3; 2019: 26,9% - IC95% 26,3-27,6), refrigerante (2015: 27,2% - IC95% 25,6-28,9; 2019: 17,2% - IC95% 16,6-17,8), guloseimas (2015: 40,6% - IC95% 39,0-42,1; 2019: 32,8% - IC95% 32,1-33,4), de atividade física (2015: 31,6% - IC95% 30,1-33,2; 2019: 28,1% - IC95% 27,4-28,8) e aumento da embriaguez (2015: 27,2% - IC95% 25,4-28,9; 2019: 47,0% - IC95% 46,0-47,9). Conclusão: Os adolescentes estão expostos aos fatores de risco para as DCNT. Esses resultados reforçam a importância das estratégias e ações para promoção da saúde dos adolescentes, especialmente por ser um grupo em fase de grandes transformações psicobiológicas e sociais.
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25
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Meller FDO, Santos LPD, Miranda VIA, Tomasi CD, Soratto J, Quadra MR, Schäfer AA. [Inequalities in risk behaviors for chronic noncommunicable diseases: Vigitel, 2019]. CAD SAUDE PUBLICA 2022; 38:e00273520. [PMID: 35766632 DOI: 10.1590/0102-311xpt273520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 03/25/2022] [Indexed: 11/22/2022] Open
Abstract
This study analyzes the economic, racial, and geographic inequalities in risk behaviors for chronic non-communicable diseases of Brazilian adults. This is a cross-sectional study conducted with data from the 2019 Vigitel (Risk and Protective Factors Surveillance System for Chronic Noncomunicable Diseases Through Telephone Interview). The analyzed risk behaviors were smoking, alcohol abuse, physical inactivity, overweight, regular consumption of soft drinks or artificial juice drinks, and non-regular consumption of fruits, legumes, and vegetables. Inequalities in risk behaviors were assessed considering Brazilian's schooling level and their dwelling region, via the slope index of inequality (SII). Equiplots graphs were also built to better illustrate the inequalities. Stata svy command was used for all analyses due to the complexity of the sampling process. In total, 52,395 patients were evaluated. Significant inequalities in risk behaviors for chronic non-communicable diseases were observed: most risk behaviors were concentrated in those with low schooling. Smoking and soft drinks consumption were more observed in the Southern region of Brazil. Public policies are necessary to reduce the inequalities found, allowing for improvement in health indicators of the Brazilian population.
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Affiliation(s)
| | | | | | | | - Jacks Soratto
- Universidade do Extremo Sul Catarinense, Criciúma, Brasil
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26
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Lourenção LFDP, de Paula NC, Cardoso MA, Santos PR, de Oliveira IRC, Fonseca FLA, da Veiga GL, Alves BDCA, Graciano MMDC, Pereira-Dourado SM. Biochemical markers and anthropometric profile of children enrolled in public daycare centers. J Pediatr (Rio J) 2022; 98:390-398. [PMID: 34774468 PMCID: PMC9432236 DOI: 10.1016/j.jped.2021.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The nutritional status resultant from dietary habits along with socioeconomic conditions and the school environment are directly related to the individual's health condition not only in their childhood but also throughout adulthood. The aim of this study was to evaluate the effects of socioeconomic factors on the anthropometric profile and to analyze a probable association between this profile and biochemical markers in children attending public daycare centers. METHODS It is a transversal study developed in a probability sample of clusters of children from 6 months to 5 years old. Anthropometric and socioeconomic data were gathered at the CMEIs, questionnaires on the nutritional status were applied and blood was collected at the Family Health Units (USFs). RESULTS Female children are three times more likely to be underweight; in families with five members, it is 1/3 more likely that children of higher-educated parents are overweight. Among the results of the biochemical tests, hypervitaminosis A was a relevant aspect, positively correlating with copper (p=0.005) and zinc (p=0.008). CONCLUSION Therefore, since the influence of the family is an important predictor of overweight and its future outcomes related to nutritional deficiencies and inadequate dietary intake, educational interventions are vital as a way to pave the path to prevention.
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Affiliation(s)
| | | | | | | | | | - Fernando Luiz Affonso Fonseca
- Universidade Federal de São Paulo (UNIFESP), Departamento de Ciências Farmacêuticas, Diadema, SP, Brazil; Centro Universitário Saúde ABC, Laboratório de Análises Clínicas, Santo André, SP, Brazil.
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27
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Moriguchi Watanabe L, Bernardes Pereira Delfino H, Augusta de Souza Pinhel M, Noronha NY, Maria Diani L, Cintra do Prado Assumpção L, Ferreira Nicoletti C, Barbosa Nonino C. Food and Nutrition Public Policies in Brazil: From Malnutrition to Obesity. Nutrients 2022; 14:nu14122472. [PMID: 35745202 PMCID: PMC9227558 DOI: 10.3390/nu14122472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/06/2022] [Accepted: 06/09/2022] [Indexed: 02/04/2023] Open
Abstract
“Nutrition transition” describes the shifts in dietary consumption and energy expenditure influenced by economic, demographic, and epidemiological changes at a population level. This phenomenon has been associated with rising obesity rates worldwide, especially in developed countries. In Brazil, the historical analysis of temporal trends between malnutrition and obesity characterized the nutrition transition in the country and interweaved it with the formulation and implementation of public food and nutrition policies. Such analysis is crucial for understanding certain principles in each context. Thus, this review contextualized the consolidation of obesity as a critical health and public policy issue in Brazil. Our review suggested that the country may still be at the initial stage of care for obesity, and more efforts are needed to contain the advance of the disease in Brazil.
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Affiliation(s)
- Ligia Moriguchi Watanabe
- Department of Health Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirão Preto 14049-900, Brazil; (L.C.d.P.A.); (C.B.N.)
- Correspondence:
| | - Heitor Bernardes Pereira Delfino
- Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirão Preto 14049-900, Brazil; (H.B.P.D.); (M.A.d.S.P.); (N.Y.N.); (L.M.D.)
| | - Marcela Augusta de Souza Pinhel
- Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirão Preto 14049-900, Brazil; (H.B.P.D.); (M.A.d.S.P.); (N.Y.N.); (L.M.D.)
- Department of Molecular Biology, Sao Jose do Rio Preto Medical School, Sao Jose do Rio Preto 15090-000, Brazil
| | - Natália Yumi Noronha
- Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirão Preto 14049-900, Brazil; (H.B.P.D.); (M.A.d.S.P.); (N.Y.N.); (L.M.D.)
| | - Luisa Maria Diani
- Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirão Preto 14049-900, Brazil; (H.B.P.D.); (M.A.d.S.P.); (N.Y.N.); (L.M.D.)
| | - Lucca Cintra do Prado Assumpção
- Department of Health Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirão Preto 14049-900, Brazil; (L.C.d.P.A.); (C.B.N.)
| | - Carolina Ferreira Nicoletti
- Applied Physiology & Nutrition Research Group, Rheumatology Division, Medical School FMUSP, University of Sao Paulo, Sao Paulo 01246-903, Brazil;
| | - Carla Barbosa Nonino
- Department of Health Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirão Preto 14049-900, Brazil; (L.C.d.P.A.); (C.B.N.)
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Menezes-Júnior LAAD, Andrade ACDS, Coletro HN, Mendonça RDD, Menezes MCD, Machado-Coelho GLL, Meireles AL. Food consumption according to the level of processing and sleep quality during the COVID-19 pandemic. Clin Nutr ESPEN 2022; 49:348-356. [PMID: 35623836 PMCID: PMC8942582 DOI: 10.1016/j.clnesp.2022.03.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Consumption of ultra-processed foods is negatively associated with health outcomes, however, the contribution to sleep quality is limited. Therefore, the objective of this study was to evaluate the association between food intake by frequency and degree of processing and sleep quality in adults during the covid-19 pandemic. METHODS Population-based survey of adults from October to December 2020 in the Iron Quadrangle region, Brazil. The exposure variable was a food intake score that considered the frequency of consumption and food processing degree. The total score ranged from 0 (best) to 48 points (worst food quality), categorized into quartiles. Furthermore, we also evaluated whether individuals replaced their lunch and/or dinner based mostly on fresh/minimally processed foods for ultra-processed foods, for five or more days in the week. The outcome variable was sleep quality assessed with the Pittsburgh Sleep Quality Index. We constructed a contrasting directed acyclic graph (DAG) model to estimate the adjusted odds ratio of the association between score eating and sleep, by logistic regression. RESULTS Most of the 1762 individuals evaluated had poor sleep quality (52.5%). The minimum and maximum food scores were 0 and 30 points (mean 9.16; 95% CI 8.50, 9.81). The higher values of the score corresponded to lower consumption of fresh and minimally processed foods and higher consumption of ultraprocessed foods. In multivariate analysis, individuals in the third food consumption score had 71% greater odds of poor sleep quality (OR = 1.71; 95% CI: 1.03, 2.85) and in the fourth quartile 144% greater odds (OR = 2.44; 95% CI: 1.32, 2.44). Besides, replacing the dinner meal with ultra-processed foods five days or more in the week was also associated with poor sleep quality (OR = 2.01; 95%CI: 1.14, 3.57). CONCLUSION Higher consumption of ultra-processed foods concomitant with lower consumption of fresh and minimally processed foods is associated with a higher chance of poor sleep quality.
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Affiliation(s)
- Luiz Antônio Alves de Menezes-Júnior
- Postgraduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil,Research and Study Group on Nutrition and Public Health (GPENSC), Federal University of Ouro Preto, Brazil
| | | | - Hillary Nascimento Coletro
- Postgraduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil,Research and Study Group on Nutrition and Public Health (GPENSC), Federal University of Ouro Preto, Brazil
| | - Raquel de Deus Mendonça
- Postgraduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil,Research and Study Group on Nutrition and Public Health (GPENSC), Federal University of Ouro Preto, Brazil,Department of Clinical and Social Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Mariana Carvalho de Menezes
- Postgraduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil,Research and Study Group on Nutrition and Public Health (GPENSC), Federal University of Ouro Preto, Brazil,Department of Clinical and Social Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - George Luiz Lins Machado-Coelho
- Postgraduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil,School of Medicine, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Adriana Lúcia Meireles
- Postgraduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil,Research and Study Group on Nutrition and Public Health (GPENSC), Federal University of Ouro Preto, Brazil,Department of Clinical and Social Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil,Corresponding author. Federal University of Ouro Preto, R. Diogo de Vasconcelos, 122, Ouro Preto - MG, Brazil
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Vasconcelos Leitão Moreira P, da Costa Pereira de Arruda Neta A, Leite de Lima Ferreira FE, de Araújo JM, da Costa Louzada ML, Lira Formiga Cavalcanti de Lima R, Pinheiro de Toledo Vianna R, Moreira da Silva Neto J, Colombet Z, O'Flaherty M. Projected impact of change in the percentage of energy from each NOVA group intake on cardiovascular disease mortality in Brazil: a modelling study. BMJ Open 2022; 12:e057953. [PMID: 35473748 PMCID: PMC9045117 DOI: 10.1136/bmjopen-2021-057953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 04/07/2022] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE Estimate reductions in cardiovascular mortality achievable through improvement in nutrient intakes according to processing level (NOVA classification), that is, reducing consumption of culinary ingredients (G2), processed (G3) and ultra-processed foods (G4) while encouraging consumption of unprocessed and minimally processed foods (G1). DESIGN Modelling study. SETTING General adult population of Brazil. PARTICIPANTS Men and women aged 25 or more years (34 003) investigated in the Household Budget Survey 2017-2018, in the consumption data module. MAIN OUTCOME MEASURES We used the IMPACT Food Policy Model to estimate the reduction in deaths from cardiovascular diseases (CVD) up to 2048 in five scenarios with reductions in saturated fat, trans fat, salt and added sugar intakes resulting from changes in NOVA groups. (1) The optimistic scenario modelised an increase in the energy intake provided by G1 and a reduction in the energy intake from G2, G3 and G4, return to previous levels. (2) The minimal scenario modelised a 3.7% increase in the energy intake from G1, and a reduction in the energy intake from G4 to the 2008-2009 level. (3) The modest scenario only modelised a 25.0% reduction of the energy intake from G2 and G3. (4) The intermediary scenario modelised the minimal scenario plus a 25.0% reduction in the energy intake from G2. (5) Finally, the advanced scenario modelised the minimal scenario plus a 25.0% reduction in the energy intake from G2 and G3. RESULTS Proposed changes in the optimistic scenario could prevent or delay 52.8% CVD-related deaths by 2048. Changes modelled in the minimal, modest, intermediary and advanced scenarios may result in a 10.1%, 28.4%, 31.4% and 38.6% reduction in 2048 CVD mortality, respectively. CONCLUSIONS Substantial health gains can be achieved by improving the diet, through plausible modifications aimed at the level of processing as a tool for Brazilian food policies.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Zoe Colombet
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Martin O'Flaherty
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
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Alathari BE, Cruvinel NT, da Silva NR, Chandrabose M, Lovegrove JA, Horst MA, Vimaleswaran KS. Impact of Genetic Risk Score and Dietary Protein Intake on Vitamin D Status in Young Adults from Brazil. Nutrients 2022; 14:1015. [PMID: 35267990 PMCID: PMC8912678 DOI: 10.3390/nu14051015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/21/2022] [Accepted: 02/24/2022] [Indexed: 01/27/2023] Open
Abstract
Given the relationship between vitamin D deficiency (VDD) and adverse outcomes of metabolic diseases, we investigated the interplay of dietary and genetic components on vitamin D levels and metabolic traits in young adults from Brazil. Genetic analysis, dietary intake, and anthropometric and biochemical measurements were performed in 187 healthy young adults (19−24 years). Genetic risk scores (GRS) from six genetic variants associated with vitamin D (vitamin D-GRS) and 10 genetic variants associated with metabolic disease (metabolic-GRS) were constructed. High vitamin D-GRS showed a significant association with low 25(OH)D concentrations (p = 0.001) and high metabolic-GRS showed a significant association with high fasting insulin concentrations (p = 0.045). A significant interaction was found between vitamin D-GRS and total protein intake (g/day) (adjusted for non-animal protein) on 25(OH)D (pinteraction = 0.006), where individuals consuming a high protein diet (≥73 g/d) and carrying >4 risk alleles for VDD had significantly lower 25(OH)D (p = 0.002) compared to individuals carrying ≤4 risk alleles. Even though our study did not support a link between metabolic-GRS and vitamin D status, our study has demonstrated a novel interaction, where participants with high vitamin D-GRS and consuming ≥73 g of protein/day had significantly lower 25(OH)D levels. Further research is necessary to evaluate the role of animal protein consumption on VDD in Brazilians.
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Affiliation(s)
- Buthaina E. Alathari
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Harry Nursten Building, Pepper Lane, Reading RG6 6DZ, UK; (B.E.A.); (J.A.L.)
- Department of Food Science and Nutrition, Faculty of Health Sciences, The Public Authority for Applied Education and Training, P.O. Box 14281, AlFaiha 72853, Kuwait
| | - Nathália Teixeira Cruvinel
- Nutritional Genomics Research Group, Faculty of Nutrition, Federal University of Goiás (UFG), Goiânia 74690-900, Brazil; (N.T.C.); (N.R.d.S.)
| | - Nara Rubia da Silva
- Nutritional Genomics Research Group, Faculty of Nutrition, Federal University of Goiás (UFG), Goiânia 74690-900, Brazil; (N.T.C.); (N.R.d.S.)
| | - Mathurra Chandrabose
- Department of Psychology and Clinical Language Sciences, University of Reading, Harry Pitt Building, Earley Gate, Reading RG6 6ES, UK;
| | - Julie A. Lovegrove
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Harry Nursten Building, Pepper Lane, Reading RG6 6DZ, UK; (B.E.A.); (J.A.L.)
- Institute for Food, Nutrition and Health, University of Reading, Reading RG6 6AH, UK
- Institute of Cardiovascular and Metabolic Research, University of Reading, Reading RG6 6AA, UK
| | - Maria A. Horst
- Nutritional Genomics Research Group, Faculty of Nutrition, Federal University of Goiás (UFG), Goiânia 74690-900, Brazil; (N.T.C.); (N.R.d.S.)
| | - Karani S. Vimaleswaran
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Harry Nursten Building, Pepper Lane, Reading RG6 6DZ, UK; (B.E.A.); (J.A.L.)
- Institute for Food, Nutrition and Health, University of Reading, Reading RG6 6AH, UK
- Institute of Cardiovascular and Metabolic Research, University of Reading, Reading RG6 6AA, UK
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Coletro HN, Mendonça RDD, Meireles AL, Machado-Coelho GLL, Menezes MCD. Ultra-processed and fresh food consumption and symptoms of anxiety and depression during the COVID – 19 pandemic: COVID Inconfidentes. Clin Nutr ESPEN 2022; 47:206-214. [PMID: 35063203 PMCID: PMC8710821 DOI: 10.1016/j.clnesp.2021.12.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/01/2021] [Accepted: 12/15/2021] [Indexed: 12/17/2022]
Abstract
Background & aim Psychological disorders are an important health problem worldwide. A healthy diet is recommended as one of the measures to prevent and control mental disorders. Epidemiological studies have shown important associations between the consumption of diets rich in nutrients and a lower risk of developing anxiety and depression. Therefore, the aim of this study was to evaluate the association between the prevalence of anxiety and depression symptoms and food consumption, according to the degree of processing, during the COVID-19 pandemic. Methods An epidemiological household survey was conducted in two cities in Brazil. Anxiety and depression symptoms were assessed using validated scales (Generalized Anxiety Disorder 7-item/Patient Health Questionnaire-9), and food consumption was assessed using a qualitative food frequency questionnaire referring to consumption within the last 3 months. The foods were categorized according to the NOVA classification for fresh/minimally processed food and ultra-processed food, using the average weekly consumption as the cutoff. For data analysis, adjusted Poisson regression with robust variance was utilized to estimate the prevalence ratio and 95% confidence interval (CI). Results The consumption of fresh/minimally processed foods above the weekly average frequency was associated with a lower prevalence of symptoms of depression (PR: 0.5, 95% CI: 0.3; 0.7). Consumption above the weekly average of ultra-processed foods was associated with a higher prevalence of anxiety (PR: 1.5 and 95% CI: 1.03; 2.3) and depression symptoms (PR: 1.5, 95% CI: 1.0; 2.1, P = 0.034). Conclusion Increased consumption of ultra-processed foods is associated with a higher occurrence of anxiety and depression symptoms; therefore, we recommend an increase in the consumption of fresh/minimally processed foods, as endorsed by the Dietary Guidelines for the Brazilian Population.
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Araújo MLD, Silva GB, Rocha LL, Novaes TG, Lima CAMD, Mendes LL, Pessoa MC. Características do ambiente alimentar comunitário e do entorno das residências das famílias beneficiárias do Programa Bolsa Família. CIENCIA & SAUDE COLETIVA 2022; 27:641-651. [DOI: 10.1590/1413-81232022272.38562020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 01/07/2021] [Indexed: 11/22/2022] Open
Abstract
Resumo Conhecer o ambiente alimentar a que as famílias beneficiárias do Programa Bolsa Família (PBF) estão expostas é necessário para identificar a exposição a ambientes que favoreçam piores escolhas alimentares. O objetivo deste trabalho foi caracterizar o ambiente alimentar comunitário da zona urbana do município de Ouro Preto e do entorno das residências das famílias beneficiárias do PBF. Trata-se de um estudo ecológico, conduzido com dados do Sistema de Cadastro Único e da Secretaria Estadual da Fazenda, ambos de 2014, e do Censo 2010. Foram realizadas análises espaciais para avaliar as aglomerações de famílias beneficiárias e de estabelecimentos. Os setores censitários (SC) periféricos e com menor renda per capita apresentaram pouco ou nenhum local de venda de alimentos, bem como maior aglomeração de famílias beneficiárias do PBF, que estão mais próximas a estabelecimentos considerados não saudáveis (mediana: 65,73 metros). Verificou-se maior concentração de locais de venda de alimentos, sobretudo não saudáveis, nos SC de localização central e de maior renda per capita (59,2%). Nesse caso, torna-se relevante o diálogo com outras políticas públicas interrelacionadas com a nutrição, visando reduzir as iniquidades e contribuir para melhorar o acesso físico a estabelecimentos de venda de alimentos saudáveis.
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RETONDARIO A, ALVES MADO, FERREIRA SMR. Contribution of ultra-processed food to the nutritional dietary profile of young children school feeding. REV NUTR 2022. [DOI: 10.1590/1678-9865202235e210106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective To investigate the contribution of ultra-processed food to the nutritional dietary profile of school feeding in public child day-care centers. Methods Cross-sectional study carried out from June-November/2013. Samples from six daily meals were collected in twenty non-consecutive days. A total of 117 school meals (123 food items) were offered to children from 12-36 months of age. The served portions were determined by direct weighting. Physicochemical analyses were performed to establish the nutritional composition. School meals were classified according to the processing degree: (A) unprocessed/minimally processed/culinary preparations, (B) processed food, or (C) ultra-processed food. The contribution of each group to the quantity of energy, macronutrients and sodium was calculated. Student’s t test was applied for comparison between groups. Results Ultra-processed meals contributed to 45.8% of energy, 33.9% of lipids, 42.8% of proteins, 48.9% of carbohydrates, and 20.9% of sodium. All lunches and 90% of dinners were classified as unprocessed/minimally processed/culinary preparations. 39.0% of the meals were ultra-processed (mainly breakfast and snacks). Ultra-processed meals had a greater quantity of energy (p=0.026) and carbohydrates (p<0.001) per serving, while unprocessed/minimally processed/culinary preparations offered more sodium per serving (p<0.001). Conclusion Although most meals were classified as unprocessed/minimally processed/culinary preparations, ultra-processed food, which should be avoided at this stage of life, are offered daily, contributing with higher energy and carbohydrates offer per serving. The municipality need to improve the quality of the meals offered to children in these child day-care centers, observing the new Resolution nº 6/2020 that came into effect in 2021.
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Association between dietary related factors and central obesity among married women: China Health and Nutrition Survey. Appetite 2022; 168:105785. [PMID: 34728248 DOI: 10.1016/j.appet.2021.105785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 10/25/2021] [Accepted: 10/29/2021] [Indexed: 12/31/2022]
Abstract
Waist-to-height ratio (WHtR) with a cut-off value of 0.5 has been recognized as an anthropometric indicator of central obesity to predict the risk of the chronic disease. The aim of our study was to identify dietary related risk factors of central obesity based on WHtR. We used cross-sectional data from the China Health and Nutrition Survey (CHNS) in 2011 obtained from 2881 married women aged 19-55. The association of dietary related factors and central obesity was analyzed using binary logistic regression and back-propagation artificial neural network. Overall, central obesity prevalence was 48.4% (1394/2881). Compared to the population of women without central obesity, the population of women with central obesity had an older average age (41.84 ± 6.89 years vs 38.45 ± 7.91 years, P < 0.001), and meanwhile an average lower per capita annual income (13904 ± 15916 CNY vs 16753 ± 19163 CNY, P < 0.001). Our analysis indicated that the score of dietary knowledge (adjusted odds ratio (aOR), 0.956; 95% confidence interval (CI), 0.936-0.976) and the score of food preferences (aOR, 0.961; 95% CI, 0.926-0.997) were significantly associated with lower risk of central obesity; whereas fast food (aOR, 1.002; 95% CI, 1.000-1.003) was associated with higher risk of central obesity. The study showed the score of dietary knowledge (15.5%), fast foods (10.2%), and the score of food preferences (8.8%) were the most important modifiable factors for central obesity. In summary, aging, fast food intake, and lower per capita annual income were positively associated with higher prevalence of central obesity, while higher scores of dietary knowledge and food preferences were negatively correlated. More nutrition education programs should be implemented by the government to strengthen the pro-healthy dietary behaviors.
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Delpino FM, Figueiredo LM, Bielemann RM, da Silva BGC, Dos Santos FS, Mintem GC, Flores TR, Arcêncio RA, Nunes BP. Ultra-processed food and risk of type 2 diabetes: a systematic review and meta-analysis of longitudinal studies. Int J Epidemiol 2021; 51:1120-1141. [PMID: 34904160 DOI: 10.1093/ije/dyab247] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 10/26/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The consumption of some food groups is associated with the risk of diabetes. However, there is no evidence from meta-analysis which evaluates the consumption of ultra-processed products in the risk of diabetes. This study aimed to review the literature assessing longitudinally the association between consumption of ultra-processed food and the risk of type 2 diabetes and to quantify this risk through a meta-analysis. METHODS We conducted a systematic review and meta-analysis with records from PubMed, Latin American and Caribbean Literature in Health Sciences (LILACS), Scielo, Scopus, Embase, and Web of Science. We included longitudinal studies assessing ultra-processed foods and the risk of type 2 diabetes. The review process was conducted independently by two reviewers. The Newcastle Ottawa scale assessed the quality of the studies. A meta-analysis was conducted to assess the effect of moderate and high consumption of ultra-processed food on the risk of diabetes. RESULTS In total 2272 records were screened, of which 18 studies, including almost 1.1 million individuals, were included in this review and 72% showed a positive association between ultra-processed foods and the risk of diabetes. According to the studies included in the meta-analysis, compared with non-consumption, moderate intake of ultra-processed food increased the risk of diabetes by 12% [relative risk (RR): 1.12; 95% confidence interval (CI): 1.06-1.17, I2 = 24%], whereas high intake increased risk by 31% (RR: 1.31; 95% CI: 1.21-1.42, I2 = 60%). CONCLUSIONS The consumption of ultra-processed foods increased the risk for type 2 diabetes as dose-response effect, with moderate to high credibility of evidence.
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Affiliation(s)
- Felipe Mendes Delpino
- Postgraduate Program in Nursing, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil.,Postgraduate Program in Public Health Nursing, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Renata Moraes Bielemann
- Postgraduate Program in Nutrition and Food, Faculty of Nutrition, Federal University of Pelotas, Pelotas, Brazil
| | | | - Francine Silva Dos Santos
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.,Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Gicele Costa Mintem
- Postgraduate Program in Nutrition and Food, Faculty of Nutrition, Federal University of Pelotas, Pelotas, Brazil
| | - Thaynã Ramos Flores
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | - Bruno Pereira Nunes
- Postgraduate Program in Nursing, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil.,Faculty of Nursing, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
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Abstract
AbstractFood systems that deliver healthy diets without exceeding the planet’s resources are essential to achieve the worlds’ ambitious development goals. Healthy diets need to be safe, accessible, and affordable for all, including for disadvantaged and nutritionally vulnerable groups such as of smallholder producers, traders, and consumers in low- and middle-income countries. Globally, food systems are experiencing rapid and drastic changes and are failing to fulfil these multiple duties simultaneously. The international community therefore calls for rigorous food systems transformations and policy solutions to support the achievement of healthy diets for all. Most strategies, however, are essentially supply- and market-oriented. Incorporation of a healthy diet perspective in food system transformation is essential to enable food systems to deliver not only on supplying nutritious foods but also on ensuring that consumers have access can afford and desire healthy, sustainable, and culturally acceptable diets. This paper argues that this should be guided by information on diets, dietary trends, consumer motives, and food environment characteristics. Transformational approaches and policies should also take into account the stage of food system development requiring different strategies to ensure healthier diets for consumers. We review current knowledge on drivers of consumer choices at the individual and food environment level with special emphasis on low- and middle income countries, discuss the converging and conflicting objectives that exist among multiple food-system actors, and argue that failure to strengthen synergies and resolve trade-offs may lead to missed opportunities and benefits, or negative unintended consequences in food system outcomes. The paper proposes a menu of promising consumer- and food-environment- oriented policy options to include in the food systems transformation agenda in order to shift LMIC consumer demand towards healthier diets in low- and middle income countries.
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Campos SF, dos Santos LC, Lopes MS, de Freitas PP, Lopes ACS. Consumption of ultra-processed foods and nutritional profile in a health promotion service of primary care. Public Health Nutr 2021; 24:5113-5126. [PMID: 34034849 PMCID: PMC11082804 DOI: 10.1017/s1368980021002202] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 04/29/2021] [Accepted: 05/12/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Describing the consumption of ultra-processed foods (UPF) and their association with the nutritional profiles among users of a health promotion service in a Brazilian city. DESIGN Cross-sectional study. SETTING Public health promotion service of Primary Health Care in Belo Horizonte, Minas Gerais, Brazil. PARTICIPANTS Totally, 3372 participants. RESULTS UPF were found to contribute to 27·7 % of the diet's total energy. The highest consumption was associated with higher values for energy intake (1561·8 v. 1331·8 kcal/d; P < 0·01), energy density (1·7 v. 1·4 kcal/g; P < 0·01), total (32·5 v. 27·3 %; P < 0·01) and trans-fats (2·1 v. 1·2 %; P < 0·01) and Na (1001·6 v. 758·9 mg/1000 kcal; P < 0·01) and with lower values for proteins (14·9 v. 19·6 %; P < 0·01), mono-unsaturated fats (16·1 v. 20·1 %; P = 0·02), n-3 (0·9 v. 1·1 %; P < 0·01) and some vitamins and minerals when comparing individuals in the last quintile of energy contribution from UPF in relation to the first one. The prevalence rate of nutrient inadequacy aimed at preventing non-communicable diseases increased between 30 % and 100 % when compared with the values of the fifth to the first quintile of UPF consumption (P < 0·001). However, the participants had lower energy intake, energy density and Na and higher fibre consumption when compared to Brazilian population. CONCLUSIONS Participants showed a high consumption of UPF, but also positive diet characteristics when compared with the national data. The results suggest the importance of health promotion services to promote healthy food and the need to include approaches to reduce UPF consumption.
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Affiliation(s)
- Suellen F Campos
- Nutrition Department, Nursing School, Universidade Federal de Minas Gerais, Center for Studies in Food and Nutrition in Life Cycles, Research Group on Nutrition Interventions, 190 Alfredo Balena Avenue, Santa Efigênia, Belo Horizonte, MG30130-100, Brazil
| | - Luana Caroline dos Santos
- Nutrition Department, Nursing School, Universidade Federal de Minas Gerais, Center for Studies in Food and Nutrition in Life Cycles, Research Group on Nutrition Interventions, 190 Alfredo Balena Avenue, Santa Efigênia, Belo Horizonte, MG30130-100, Brazil
| | - Mariana S Lopes
- Nutrition Department, Nursing School, Universidade Federal de Minas Gerais, Center for Studies in Food and Nutrition in Life Cycles, Research Group on Nutrition Interventions, 190 Alfredo Balena Avenue, Santa Efigênia, Belo Horizonte, MG30130-100, Brazil
| | - Patrícia P de Freitas
- Nutrition Department, Nursing School, Universidade Federal de Minas Gerais, Center for Studies in Food and Nutrition in Life Cycles, Research Group on Nutrition Interventions, 190 Alfredo Balena Avenue, Santa Efigênia, Belo Horizonte, MG30130-100, Brazil
| | - Aline CS Lopes
- Nutrition Department, Nursing School, Universidade Federal de Minas Gerais, Center for Studies in Food and Nutrition in Life Cycles, Research Group on Nutrition Interventions, 190 Alfredo Balena Avenue, Santa Efigênia, Belo Horizonte, MG30130-100, Brazil
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Mariath AB, Martins APB. [Decade of Action on Nutrition and sugary drinks taxation in Brazil: where are we?]. CAD SAUDE PUBLICA 2021; 37:e00157220. [PMID: 34287585 DOI: 10.1590/0102-311x00157220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 11/27/2020] [Indexed: 11/22/2022] Open
Abstract
Brazil was the first country to commit to the United Nations' Decade of Action on Nutrition with ambitious goals related to controlling obesity and reducing the intake of sugar-sweetened beverages. In this study, we describe legislative efforts related to sugar-sweetened beverage taxation introduced in the Brazilian Legislature throughout the first four years of this decade as well as the status of the decision-making process. We searched databases within the Chamber of Deputies and the Federal Senate for legislative proposals introduced between 2016 and 2019 that addressed sugary drinks taxation. The results are presented narratively. The content of the bills and status of the legislative process are described. Ten bills were identified. Six of them are aimed at raising taxes and are currently under consideration in the Committees by the first legislative House. Four bills had been aimed at repealing an act which increased taxes on soft drink concentrates, but they have since been rejected and archived. There still seems to be a long road ahead before taxes on sugar-sweetened beverages are raised in Brazil. The lawmaking process in the Brazilian Legislature is complex and slow. This poses two risks: no law being passed; or enacted legislation not being capable to cause significant impact on public health by 2025.
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Affiliation(s)
- Aline Brandão Mariath
- Departamento Médico, Câmara dos Deputados, Brasília, Brasil.,Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
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Xu K, Shi L, Zhang B, Mi B, Yang J, Sun X, Liao X, Dai X, Zeng L, Liu X, Yan H. Distinct metabolite profiles of adiposity indices and their relationships with habitual diet in young adults. Nutr Metab Cardiovasc Dis 2021; 31:2122-2130. [PMID: 34053831 DOI: 10.1016/j.numecd.2021.03.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/13/2021] [Accepted: 03/25/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND AIMS Obesity is characterized as overall or regional adiposity accumulation. However, the metabolic status underlying fat accumulation was not well understood. We sought to identify metabolite profiles based on their correlations with body mass index (BMI), body fat percentage (BFP), waist circumference (WC), and visceral adiposity index (VAI) in young Chinese adults (19-37 years old), and their associations with dietary consumption were also explored. METHODS AND RESULTS A total of 86 plasma samples were analyzed using untargeted lipidomics and metabolomics approaches. Metabolite profiles of adiposity indices were identified using random forest modelling. Ridge regression was used to generate metabolite scores. Overall, 30, 46, 30, and 20 metabolites correlated with BMI, BFP, WC, and VAI, respectively, which resulted in metabolite scores for each index. Top three enriched categories of the identified metabolites were glycerophospholipids, glycerolipids, and sphingolipids, with some specific metabolites (such as phosphatidylserine (37:2), phatidylethanolamine (42:4), and ceramide (40:0)) exclusively associated with overall adiposity, and some other metabolites exclusively associated with abdominal adiposity indices, e.g., triradylglycerol (45:0, 52:4, and 35:0) and diacylglycerol (38:4, 36:3, and 36:5). Moreover, metabolite scores were negatively associated with the intake of food rich in protein or fiber, while they were positively associated with food rich in carbohydrate, with similar results for adiposity indices. CONCLUSION We observed unique metabolite profiles of regional or overall fat deposition in young adults. Glycerophospholipids, glycerolipids, or sphingolipids may be involved in the regulation of adiposity accumulation, affected by dietary exposures.
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Affiliation(s)
- Kun Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, 710061, Xi'an, Shaanxi, China
| | - Lin Shi
- School of Food Engineering and Nutritional Science, Shaanxi Normal University, Xi' an, 710062, China; Xi'an Key Laboratory of Characteristic Fruit Storage and Fresh-keeping, Xi'an, Shaanxi, China
| | - Baoming Zhang
- Hospital of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, China; School of Public Health, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, 710061, Xi'an, Shaanxi, China
| | - Baibing Mi
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, 710061, Xi'an, Shaanxi, China
| | - Jiaomei Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, 710061, Xi'an, Shaanxi, China
| | - Xiaomin Sun
- Global Health Institute, Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Xia Liao
- Department of Nutrition, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xiaoshuang Dai
- BGI Institute of Applied Agriculture, BGI-Agro, Shenzhen, 518083, China
| | - Lingxia Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, 710061, Xi'an, Shaanxi, China
| | - Xin Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, 710061, Xi'an, Shaanxi, China.
| | - Hong Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, 710061, Xi'an, Shaanxi, China; Nutrition and Food Safety Engineering Research Center of Shaanxi Province, Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, 76 West Yanta Road, 710061, Xi'an, Shaanxi, China.
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Watanabe LM, Navarro AM, Seale LA. Intersection between Obesity, Dietary Selenium, and Statin Therapy in Brazil. Nutrients 2021; 13:2027. [PMID: 34204631 PMCID: PMC8231251 DOI: 10.3390/nu13062027] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/07/2021] [Accepted: 06/10/2021] [Indexed: 01/14/2023] Open
Abstract
Obesity is among the most alarming health concerns, impacting public health and causing a socioeconomic challenge, especially in developing countries like Brazil, where approximately one quart of the population presents obesity. As an established risk factor for numerous comorbidities with a multifactorial etiology, obesity is a consequence of energy-dense overfeeding, however with significant undernourishment, leading to excessive adipose tissue accumulation and dysfunction, dyslipidemia, and micronutrient deficiencies. About 60% of patients with obesity take statins, a cholesterol-lowering medication, to curb dyslipidemia, with ~10% of these patients presenting various myopathies as side effects. Statins act upon the rate-limiting enzyme of cholesterol biosynthesis in the liver, which is a pathway providing intermediates to the synthesis of selenoproteins, i.e., enzymes containing the micronutrient selenium. Statins have been postulated to negatively impact selenoprotein synthesis, particularly in conditions of selenium deficiency, and potentially implicated in the myopathies occurring as side effects of statins. The Brazilian population is prone to selenium deficiency, hence could be considered more susceptible to statin side effects. This review examines the specific consequences to the Brazilian population of the harmful intersection between obesity development and concomitant micronutrient deficiencies, particularly selenium, combined with statin treatment in the context of nutrition in Brazil.
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Affiliation(s)
- Ligia M. Watanabe
- Department of Health Sciences, Division of Nutrition and Metabolism, Ribeirão Preto Medical School, University of São Paulo—FMRP/USP, Ribeirão Preto 14040-900, SP, Brazil; (L.M.W.); (A.M.N.)
| | - Anderson M. Navarro
- Department of Health Sciences, Division of Nutrition and Metabolism, Ribeirão Preto Medical School, University of São Paulo—FMRP/USP, Ribeirão Preto 14040-900, SP, Brazil; (L.M.W.); (A.M.N.)
| | - Lucia A. Seale
- Pacific Biosciences Research Center, School of Ocean and Earth Science and Technology, University of Hawaii at Manoa, Honolulu, HI 96822, USA
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Conde-Caballero D, Rivero-Jimenez B, Mariano-Juarez L. Memories of hunger, continuities, and food choices: An ethnography of the elderly in extremadura (Spain). Appetite 2021; 164:105267. [PMID: 33933550 DOI: 10.1016/j.appet.2021.105267] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/15/2021] [Accepted: 04/11/2021] [Indexed: 11/18/2022]
Abstract
Food choices are a complex subject of study. This study reviews existing literature on the topic, while also offering new perspectives. It introduces empirical materials that suggest the existence of continuities between childhood memories of food insecurity and current nutritional choices and practices among older adults. This is a qualitative study, based on grounded theory, which explores memories of hunger in the aftermath of the Spanish Civil War through ethnographic fieldwork conducted in 12 rural localities in Extremadura (Spain) - analysing current food practices and ideologies among surviving post-war children and tracing continuities between the past and the present. It provides results in the field of food continuities and shows how experiences and memories of hunger have an impact on food choices many decades later Data analysis and interpretation revealed three main categories: food memories of the so-called "years of hunger"; present-day food practices; and continuities between past and present. The inductive-deductive analysis revealed enduring memories that shaped present-day attitudes towards food - i.e. maximisation of ingredients and "zero-waste" practices; conspicuous consumption at particular times of the year; the central role of bread; and even certain food taboos. More than seventy years later, memories of deprivation and hunger are still pervasive and permeate present-day dietary practices and choices.
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Affiliation(s)
- David Conde-Caballero
- Department of Nursing, Faculty of Nursing and Occupational Therapy, Avenida de La Universidad S/n, 10003, Cáceres, Spain.
| | - Borja Rivero-Jimenez
- Department of Computer Systems and Telematics Engineering, Polytechnic School, Avenida de La Universidad S/n, 10003, Cáceres, Spain.
| | - Lorenzo Mariano-Juarez
- Department of Nursing, Faculty of Nursing and Occupational Therapy, Avenida de La Universidad S/n, 10003, Cáceres, Spain.
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Silva LESD, Oliveira MMD, Stopa SR, Gouvea EDCDP, Ferreira KRD, Santos RDO, Valença Neto PDF, Macário EM, Sardinha LMV. Temporal trend of overweight and obesity prevalence among Brazilian adults, according to sociodemographic characteristics, 2006-2019. ACTA ACUST UNITED AC 2021; 30:e2020294. [PMID: 33605396 DOI: 10.1590/s1679-49742021000100008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 09/08/2020] [Indexed: 11/22/2022]
Abstract
OBJETIVO To analyze the temporal trend of overweight and obesity prevalence rates among adults in the Brazilian state capitals and Federal District between 2006 and 2019. METHODS This was a time series study using data from the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey, 2006-2019 (n=730,309). Prevalence of overweight and obesity for each of the years was analyzed, according to combined sex, age, and schooling. Temporal variation trend was analyzed using Prais-Winsten regression. RESULTS Variations in overweight prevalence were observed, mainly among males 18-24 years old with up to 8 years of schooling (3.17%/year) and among women between 18-24 years old with more than 12 or more years of schooling (6.81% /year). Variations in obesity prevalence were found mainly among women 18-24 years old with more than 12 years of schooling (10.79%/year). CONCLUSION There was an increase in overweight and obesity in most of the socio-demographic strata studied, especially among more educated young people.
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Pelegrini A, Bim MA, Souza FUD, Kilim KSDS, Pinto ADA. Prevalence of overweight and obesity in Brazilian children and adolescents: a systematic review. REVISTA BRASILEIRA DE CINEANTROPOMETRIA E DESEMPENHO HUMANO 2021. [DOI: 10.1590/1980-0037.2021v23e80352] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
abstract It is important to know about overweight and obesity situation of Brazilian children and adolescents. The present study aims to update scientific production, through a systematic review, on the prevalence and factors associated with overweight and obesity in Brazilian children and adolescents. Nine databases were verified, and 1,316 references were examined from 2018 to 2019. The electronic search was conducted by three independent researchers. All review steps followed a strategy based on PRISMA. 40 studies were included in this systematic review. Most studies use the World Health Organization classification criteria. The prevalence of overweight in Brazilian children and adolescents varies from 8.8% to 22.2% (boys: 6.2% to 21%; girls: 6.9% to 27.6%). The prevalence of obesity varied from 3.8% to 24% (boys: 2.4% to 28.9%; girls: 1.6% to 19.4%). It was observed that the socioeconomic factors (sex, skin color, economic level, region, mother's educational level, living in a rented house and without access to the internet), hereditary/genetic (family history of dyslipidemia and overweight and rs9939609 genotype) and behavioral (physical activity, screen time, eating habits, perceived body weight, health vulnerability, presence of a result close to home, alcoholic beverages, cigarette consumption) were associated with the outcome. It is concluded that the prevalence of overweight and obesity among Brazilian children and adolescents are worrisome and most of the factors associated with the outcomes are subject to change from the adoption of a healthy lifestyle.
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SILVA LESD, CALDEIRA TCM, CLARO RM. Food consumption, overweight, obesity, and sociodemographic profile in a Brazilian capital: a time trend analysis between 2006 and 2018. REV NUTR 2021. [DOI: 10.1590/1678-9865202134e200159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective To analyze the time trend of sociodemographic characteristics and the prevalence of food consumption, overweight, and obesity variables among adults in the city of Belo Horizonte, Brazil, between 2006 and 2018. Methods A time series study involving data from the Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (Vigitel, Surveillance System of Risk and Protective Factors for Chronic Diseases by Telephone Survey), between 2006 and 2018 in Belo Horizonte (n=25,443). The annual prevalence of the population’s sociodemographic characteristics (sex, age groups, and years of schooling), and risk and protective factors for chronic diseases related to food consumption and nutritional status were estimated. Prais-Winsten regression models were used to investigate the temporal variation of each variable. Results From 2006 to 2018, there was a significant increase in the age and educational level of the adult population of Belo Horizonte. In the same period, the prevalence of recommended consumption of fruits and vegetables increased (from 23.0% to 29.2%), while that of consumption of fat-rich meat and regular consumption of soft drinks decreased (respectively, from 41.9% to 38.0%; from 35.3% to 15.2%). In parallel, the prevalence of overweight and obesity increased (respectively, from 38.5% to 53.3%; from 9.8% to 17.2%). Conclusions An important change in the population’s sociodemographic profile was noted. There are also favorable changes regarding the investigated aspects of food consumption, without these being sufficient to prevent the significant increase in the prevalence of overweight and obesity in the population.
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SILVA DCGD, FERREIRA FG, PEREIRA DLM, MAGALHÃES ELGD, LONGO GZ. Degree of food processing and its relationship with overweight and body adiposity in Brazilian adults. REV NUTR 2021. [DOI: 10.1590/1678-9865202134e200135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective To check the relationship of the degree of food processing with overweight and body adiposity in Brazilian adults. Methods Cross-sectional study with 670 adults (334 women and 336 men) aged 20-59 years in Viçosa, Minas Gerais, Brazil, based on population data collected using a questionnaire, 24-hour dietary recall interview, and anthropometric evaluation. Consumed foods were categorized into four groups: unprocessed or minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods. Poisson regression models were used to assess the relationship between degree of food processing and overweight and body adiposity. Results The contribution of unprocessed or minimally processed foods to total energy intake was a protective factor for overweight in all quartiles. The contribution of ultra-processed foods to total energy intake was a risk factor for overweight in the highest quartile (prevalence ratio, 1.308; 95% confidence interval, 1.085-1.577). High energy intake from ultra-processed foods was a risk factor for excess adiposity in the highest quartiles. Conclusion Consumption of ultra-processed foods is associated with overweight and excess adiposity, whereas consumption of unprocessed and minimally processed foods is a protective factor for overweight.
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Freeman T, Gesesew HA, Bambra C, Giugliani ERJ, Popay J, Sanders D, Macinko J, Musolino C, Baum F. Why do some countries do better or worse in life expectancy relative to income? An analysis of Brazil, Ethiopia, and the United States of America. Int J Equity Health 2020; 19:202. [PMID: 33168040 PMCID: PMC7654592 DOI: 10.1186/s12939-020-01315-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 10/29/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND While in general a country's life expectancy increases with national income, some countries "punch above their weight", while some "punch below their weight" - achieving higher or lower life expectancy than would be predicted by their per capita income. Discovering which conditions or policies contribute to this outcome is critical to improving population health globally. METHODS We conducted a mixed-method study which included: analysis of life expectancy relative to income for all countries; an expert opinion study; and scoping reviews of literature and data to examine factors that may impact on life expectancy relative to income in three countries: Ethiopia, Brazil, and the United States. Punching above or below weight status was calculated using life expectancy at birth and gross domestic product per capita for 2014-2018. The scoping reviews covered the political context and history, social determinants of health, civil society, and political participation in each country. RESULTS Possible drivers identified for Ethiopia's extra 3 years life expectancy included community-based health strategies, improving access to safe water, female education and gender empowerment, and the rise of civil society organisations. Brazil punched above its weight by 2 years. Possible drivers identified included socio-political and economic improvements, reduced inequality, female education, health care coverage, civil society, and political participation. The United States' neoliberal economics and limited social security, market-based healthcare, limited public health regulation, weak social safety net, significant increases in income inequality and lower levels of political participation may have contributed to the country punching 2.9 years below weight. CONCLUSIONS The review highlighted potential structural determinants driving differential performance in population health outcomes cross-nationally. These included greater equity, a more inclusive welfare system, high political participation, strong civil society and access to employment, housing, safe water, a clean environment, and education. We recommend research comparing more countries, and also to examine the processes driving within-country inequities.
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Affiliation(s)
- Toby Freeman
- Southgate Institute for Health, Society, and Equity, Flinders University, Adelaide, Australia.
| | - Hailay Abrha Gesesew
- Department of Public Health, Flinders University, Adelaide, Australia
- Department of Epidemiology, Mekelle University, Mekelle, Ethiopia
| | - Clare Bambra
- Institute of Population Health Sciences, Newcastle University, Newcastle, UK
| | | | - Jennie Popay
- Division of Health Research, Lancaster University, Lancashire, UK
| | - David Sanders
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - James Macinko
- Departments of Health Policy and Management and Community Health Sciences, UCLA, Los Angeles, CA, USA
| | - Connie Musolino
- Southgate Institute for Health, Society, and Equity, Flinders University, Adelaide, Australia
| | - Fran Baum
- Southgate Institute for Health, Society, and Equity, Flinders University, Adelaide, Australia
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The Cost of Diets According to Their Caloric Share of Ultraprocessed and Minimally Processed Foods in Belgium. Nutrients 2020; 12:nu12092787. [PMID: 32933051 PMCID: PMC7551888 DOI: 10.3390/nu12092787] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/01/2020] [Accepted: 09/09/2020] [Indexed: 12/30/2022] Open
Abstract
Background: This study estimated the monetary cost of diets with higher and lower caloric shares of ultraprocessed food products (UPF) and unprocessed/minimally processed foods (MPF) in Belgium for various sociodemographic groups. Methods: Data from the latest nationally representative Food Consumption Survey (FCS) 2014–2015 (n = 3146; 3–64 years) were used. Dietary data were collected through two nonconsecutive 24-hour recalls (food diaries for children). Average prices for >2000 food items (year 2014) were derived from GfK ConsumerScan panel data and linked with foods consumed in the FCS. Foods eaten were categorized by their extent of processing using the NOVA classification. The average caloric share (percentage of daily energy intake) of UPF and MPF were calculated. The mean diet cost was compared across the UPF and MPF contribution tertiles, using linear regression. Results: The average price per 100 kcal for UPF was significantly cheaper (EUR 0.55; 95%CI = 0.45–0.64) than for MPF (EUR 1.29; 95% CI = 1.27–1.31). UPF contributed between 21.9% (female adults) and 29.9% (young boys), while MPF contributed between 29.5% (male adolescents) and 42.3% (female adults) to the daily dietary cost. The contribution of MPF to the daily dietary cost was significantly higher for individuals with a higher household education level compared to those with a lower household education level (p < 0.01). Adjusted for covariates, the average dietary cost per 2000 kcal was significantly lower for individuals in the highest compared to the lowest tertile for the proportion of daily energy consumed from UPF (EUR −0.37 ± 0.13; p = 0.006), and significantly higher for individuals in the highest compared to the lowest tertile for proportion of daily energy consumed from MPF (EUR 1.18 ± 0.12, p < 0.001). Conclusion: Diets with a larger caloric share of UPF were significantly cheaper than those with a lower contribution of these products, while the opposite was found for MPF. Policies that improve relative affordability and accessibility of MPF are recommended.
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