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Canella DS, Louzada MLDC, Oliveira N, Azevedo ABCD, Levy RB. Evolution of household availability of added sugars and their sources in Brazil: analysis of Household Budget Surveys from 2002 to 2017. Br J Nutr 2024:1-8. [PMID: 38634261 DOI: 10.1017/s0007114524000813] [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: 04/19/2024]
Abstract
The objective of this study was to describe the evolution of household purchase of added sugars and their main food sources in Brazil. Nationally representative data from the Household Budget Surveys from 2002-2003, 2008-2009 and 2017-2018 were used. Energy and added sugar quantities were estimated by means of per capita food quantities. The items considered as food sources were: (1) table sugar: refined sugar and other energetic sweeteners and (2) processed and ultra-processed foods with added sugar: soft drinks; other drinks; sweets, candies and chocolates; cookies; cakes and pies and other foods. The parameters estimated were: mean share of added sugar in total energy and, for food sources, the share of added sugar in total sugar intake and the impact of variations in sources of added sugar between 2008 and 2017. There was a regular share of energy from added sugar to total energy intake between 2002 and 2008 but a reduced share in 2017. Between 2008 and 2017, there was a decrease in the share of refined sugar and other sweeteners and soft drinks to total sugar intake and an increased share of all other items. High-income households had a lower share of refined sugar and other energetic sweeteners, but a higher share of soft drinks, sweets, candies and chocolates. The decrease in added sugar in 2017 was mainly due to the lower share of soft drinks. In conclusion, Brazilians' total intake of added sugar was decreased, mostly owing to reduced consumption of sugar from soft drinks.
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Affiliation(s)
- Daniela Silva Canella
- Department of Applied Nutrition, Institute of Nutrition, Rio de Janeiro State University, Rio de Janeiro, Brazil
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
| | - Maria Laura da Costa Louzada
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Natália Oliveira
- Postgraduate Program in Food, Nutrition and Health, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | | | - Renata Bertazzi Levy
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
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Aguiar-Bloemer AC, Japur CC, Francisco LV, Diez-Garcia RW. Dietary quality differences between women with and without weight loss in nutritional treatment. Clin Nutr ESPEN 2019; 34:110-115. [PMID: 31677700 DOI: 10.1016/j.clnesp.2019.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 05/17/2019] [Accepted: 08/05/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND & AIMS The obesity nutritional treatment is structured to weight loss and diet is considered an important indicator of treatment effectiveness. The purpose of this study is to compare the diet quality among women who lost weight to women who maintained or gained weight during the nutritional treatment. METHODS This is a retrospective study that included 66 obese women in nutritional treatment for weight loss, over six months, divided in tercile according to their weight loss. The diet quality was evaluated by score, which was obtained with a food frequency questionnaire. RESULTS The diet quality comparison was made among the group with weight loss (GL; n = 22) and the group that maintained or gained weight during the nutritional treatment (GG; n = 22) showed that both groups had improvement in their diet quality scores from pre-treatment to post-treatment. Nevertheless, the GG had higher sugar consumption than the GL in the pre-treatment (p = 0.02) and in the post-treatment (p 0.01) periods. In the post-treatment, GL increased their scores for leafy vegetables (0.013), fruit (0.004), sweets (p 0.03), and soft drinks (p 0.02). GL improved their scores for fried food (p 0.01) and sweets (p 0.008). CONCLUSION This indicates that in the weight loss treatment special attention should be given to the incentive to the fruit and leafy vegetables consumption and, to reduce the consumption of sweets.
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Affiliation(s)
- Ana Carolina Aguiar-Bloemer
- Laboratory of Food Practices and Behavior - PrátiCA, Division of Nutrition and Metabolism, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, SP, Brazil.
| | - Camila Cremonezi Japur
- Laboratory of Food Practices and Behavior - PrátiCA, Division of Nutrition and Metabolism, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, SP, Brazil; Division of Nutrition and Metabolism, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, SP, Brazil.
| | - Lucas Vieira Francisco
- Laboratory of Food Practices and Behavior - PrátiCA, Division of Nutrition and Metabolism, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, SP, Brazil.
| | - Rosa Wanda Diez-Garcia
- Laboratory of Food Practices and Behavior - PrátiCA, Division of Nutrition and Metabolism, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, SP, Brazil; Division of Nutrition and Metabolism, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, SP, Brazil.
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Del-Ponte B, Anselmi L, Assunção MCF, Tovo-Rodrigues L, Munhoz TN, Matijasevich A, Rohde LA, Santos IS. Sugar consumption and attention-deficit/hyperactivity disorder (ADHD): A birth cohort study. J Affect Disord 2019; 243:290-296. [PMID: 30257225 PMCID: PMC6193136 DOI: 10.1016/j.jad.2018.09.051] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 07/31/2018] [Accepted: 09/15/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is characterized by persistent symptoms of lack of attention, impulsivity and hyperactivity. The association between nutritional exposures and ADHD has been investigated and some studies have identified adverse effects from higher intake of sugar. The objective of the present study was to evaluate the association between change in sugar consumption between 6 and 11 years of age and incidence of attention-deficit/hyperactivity disorder (ADHD). METHODS Pelotas 2004 Birth Cohort Study in Brazil. A food frequency questionnaire (FFQ) was used to estimate sugar consumption and the Development and Well-Being Assessment (DAWBA) was applied to mothers to assess the presence of ADHD. RESULTS Only children without ADHD at 6 years and with complete information from FFQ and DAWBA at 6 and 11 years were included in the analyses (n = 2924). Odds ratios with 95% confidence intervals were calculated. Incidence of ADHD between 6 and 11 years was 4.6% (3.6-5.6%) among boys and 1.8% (1.2-2.5%) among girls. Adjusted analyses showed no association between always high sucrose consumption between 6 and 11 years and incidence of ADHD, compared with individuals who always presented low consumption, both among boys (OR = 0.66; 0.21-2.04) and girls (OR = 2.71; 0.24-30.35). LIMITATIONS Reflect those that are inherent to use of FFQs, such as memory bias and lack of precision in quantifying the diet. CONCLUSIONS The results suggest that there is no association between sucrose consumption between 6 and 11 years of age and incidence of ADHD.
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Affiliation(s)
- Bianca Del-Ponte
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
| | - Luciana Anselmi
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | | | - Tiago N. Munhoz
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Iná S. Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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AGUIAR-BLOEMER AC, AGLIUSSI RG, PINHO TMP, FURTADO EF, DIEZ-GARCIA RW. Eating behavior of schizophrenic patients. REV NUTR 2018. [DOI: 10.1590/1678-98652018000100002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
ABSTRACT Objective To assess the eating behavior, food practices, nutritional and metabolic profiles of patients with schizophrenia undergoing treatment. Methods Cross-sectional exploratory descriptive qualitative study used a semi-structured questionnaire on the eating behavior, food practices, and perception of changes after the initiation of drug therapy and a quantitative method using anthropometric and body composition measurements, metabolic parameters, and 5-day dietary records to analyze nutrient ingestion of patients with schizophrenia in an outpatient clinic at a tertiary hospital (n=33). The qualitative data were analyzed and coded by three researchers and quantitative data were analyzed using descriptive exploratory statistics. Results The results of this study showed that schizophrenic patients presented high prevalence of excess weight (71.0%), metabolic syndrome (42.0%), dyslipidemia (62.0%), changes in appetite (76.0%), and increase in energy intake (74.2%), associated with important irregularities in eating behavior and food practices (such as irregularity of meals, emotional intake, high carbohydrate and fat intake, and low energy expenditure) and lifestyle (changes in social and work routines). Conclusion This eating profile may interact synergistically with psychotropic drugs to contribute to weight gain and metabolic changes in schizophrenia. Nutrition education may prevent and monitor the risk of metabolic and nutrition problems, irrespective of the medications used.
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Macedo DM, Diez-Garcia RW. Sweet craving and ghrelin and leptin levels in women during stress. Appetite 2014; 80:264-70. [DOI: 10.1016/j.appet.2014.05.031] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 05/05/2014] [Accepted: 05/26/2014] [Indexed: 12/21/2022]
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Pereira RA, Duffey KJ, Sichieri R, Popkin BM. Sources of excessive saturated fat, trans fat and sugar consumption in Brazil: an analysis of the first Brazilian nationwide individual dietary survey. Public Health Nutr 2014; 17:113-21. [PMID: 23190560 PMCID: PMC3883959 DOI: 10.1017/s1368980012004892] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Revised: 08/22/2012] [Accepted: 10/09/2012] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine the patterns of consumption of foods high in solid fats and added sugars (SoFAS) in Brazil. DESIGN Cross-sectional study; individual dietary intake survey. Food intake was assessed by means of two non-consecutive food records. Foods providing >9·1% of energy from saturated fat, or >1·3% of energy from trans fat, or >13% of energy from added sugars per 100 g were classified as high in SoFAS. SETTING Brazilian nationwide survey, 2008-2009. SUBJECTS Individuals aged ≥10 years old. RESULTS Mean daily energy intake was 8037 kJ (1921 kcal), 52% of energy came from SoFAS foods. Contribution of SoFAS foods to total energy intake was higher among women (52%) and adolescents (54%). Participants in rural areas (43%) and in the lowest quartile of per capita family income (43%) reported the smallest contribution of SoFAS foods to total energy intake. SoFAS foods were large contributors to total saturated fat (87%), trans fat (89%), added sugar (98%) and total sugar (96%) consumption. The SoFAS food groups that contributed most to total energy intake were meats and beverages. Top SoFAS foods contributing to saturated fat and trans fat intakes were meats and fats and oils. Most of the added and total sugar in the diet was supplied by SoFAS beverages and sweets and desserts. CONCLUSIONS SoFAS foods play an important role in the Brazilian diet. The study identifies options for improving the Brazilian diet and reducing nutrition-related non-communicable chronic diseases, but also points out some limitations of the nutrient-based criteria.
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Affiliation(s)
- Rosangela A Pereira
- Department of Social and Applied Nutrition, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho 373, CCS – Bloco J – 2° andar, Cidade Universitaria, Rio de Janeiro – RJ, CEP 21.941-902, Brazil
- Department of Nutrition, University of North Carolina at Chapel Hill, NC, USA
| | - Kiyah J Duffey
- Department of Nutrition, University of North Carolina at Chapel Hill, NC, USA
| | - Rosely Sichieri
- Department of Epidemiology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Barry M Popkin
- Department of Nutrition, University of North Carolina at Chapel Hill, NC, USA
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Gragnani JG, Garavello MEPE, Silva RJ, Nardoto GB, Martinelli LA. Can stable isotope analysis reveal dietary differences among groups with distinct income levels in the city of Piracicaba (southeast region, Brazil)? J Hum Nutr Diet 2013; 27:270-9. [DOI: 10.1111/jhn.12148] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J. G. Gragnani
- CENA; Universidade de São Paulo; Campus de Piraciaba; Piracicaba SP Brazil
| | | | - R. J. Silva
- ESALQ; Universidade de São Paulo; Campus de Piracicaba; Piracicaba SP Brazil
| | - G. B. Nardoto
- Universidade de Brasília; Campus de Planaltina; Brasília DF Brazil
| | - L. A. Martinelli
- CENA; Universidade de São Paulo; Campus de Piraciaba; Piracicaba SP Brazil
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Vandevijvere S, Monteiro C, Krebs-Smith SM, Lee A, Swinburn B, Kelly B, Neal B, Snowdon W, Sacks G. Monitoring and benchmarking population diet quality globally: a step-wise approach. Obes Rev 2013; 14 Suppl 1:135-49. [PMID: 24074217 DOI: 10.1111/obr.12082] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
INFORMAS (International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support) aims to monitor and benchmark the healthiness of food environments globally. In order to assess the impact of food environments on population diets, it is necessary to monitor population diet quality between countries and over time. This paper reviews existing data sources suitable for monitoring population diet quality, and assesses their strengths and limitations. A step-wise framework is then proposed for monitoring population diet quality. Food balance sheets (FBaS), household budget and expenditure surveys (HBES) and food intake surveys are all suitable methods for assessing population diet quality. In the proposed 'minimal' approach, national trends of food and energy availability can be explored using FBaS. In the 'expanded' and 'optimal' approaches, the dietary share of ultra-processed products is measured as an indicator of energy-dense, nutrient-poor diets using HBES and food intake surveys, respectively. In addition, it is proposed that pre-defined diet quality indices are used to score diets, and some of those have been designed for application within all three monitoring approaches. However, in order to enhance the value of global efforts to monitor diet quality, data collection methods and diet quality indicators need further development work.
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Affiliation(s)
- S Vandevijvere
- School of Population Health, University of Auckland, Auckland, New Zealand
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Prevalence and energy intake from snacking in Brazil: analysis of the first nationwide individual survey. Eur J Clin Nutr 2013; 67:868-74. [PMID: 23486510 DOI: 10.1038/ejcn.2013.60] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Revised: 02/07/2013] [Accepted: 02/08/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND/OBJECTIVES Snacking has increased globally. We examine snacking patterns and common snack foods in Brazil. SUBJECTS/METHODS Data from the first of two non-consecutive food diaries from 34,003 individuals (aged ≥ 10 years) in the first Brazillian nationally representative dietary survey (2008-2009) were used. Meals were defined as the largest (kcal) eating event reported during select times of the day (Breakfast, 0600-1000 hours; Lunch, 1200-1500 hours; Dinner, 1800-2100 hours); all other eating occasions were considered snacks. We estimate daily energy intake, percentage of persons consuming snacks, number of daily snacks and per capita and per consumer energy from snacks (kcal/day, kcal/snack and % of daily energy from snacks). RESULTS In all, 74% of Brazilians (≥ 10 years) snacked, reporting an average 1.6 snacks/day. Also, 23% of the sample were heavy snackers (≥ 3 snacks/day). Snacking accounted for 21% of daily energy intake in the full sample but 35.5% among heavy snackers. Compared with non-snackers (1548 kcal/day), light (1-2 snacks/day) and heavy snackers consumed more daily energy (1929 and 2334 kcal/day, respectively). Taking into account time of day, the largest percentage of persons reported afternoon/early evening snacking (1501-1759 hours, 47.7%). Sweetened coffee and tea, sweets and desserts, fruit, sugar-sweetened beverages, and high-calorie salgados (fried/baked dough with meat/cheese/vegetable) were the top five most commonly consumed snacks. Differences were observed by age groups. Trends in commercial sales were observed, especially for sugar-sweetened beverages. CONCLUSIONS Many commonly consumed snack foods in Brazil are classified, in the US, as being high in solid fats and added sugars. The public health impact of snacking in Brazil requires further exploration.
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Spolidoro JV, Pitrez Filho ML, Vargas LT, Santana JC, Pitrez E, Hauschild JA, Bruscato NM, Moriguchi EH, Medeiros AK, Piva JP. Waist circumference in children and adolescents correlate with metabolic syndrome and fat deposits in young adults. Clin Nutr 2012; 32:93-7. [PMID: 22841400 DOI: 10.1016/j.clnu.2012.05.020] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2011] [Revised: 05/28/2012] [Accepted: 05/31/2012] [Indexed: 01/28/2023]
Abstract
BACKGROUND & AIMS To determine the relevance of waist circumference (WC) measurement and monitoring in children and adolescents as an early indicator of overweight, metabolic syndrome (MS) and cardiovascular problems in young adults in comparison with visceral and subcutaneous adiposity. METHODS A cohort study with 159 subjects (51.6% female) started in 1999 with an average age of 13.2 years. In 1999, 2006 and 2008 weight, height, and WC were evaluated. In 2006 blood samples for laboratory diagnosis of MS were added. In 2008 abdominal computed tomography (ACT) to quantify the fat deposits were also added. RESULTS The WC measured in children and adolescents was strongly correlated with body mass index (BMI) measured simultaneously. A strong correlation was established between WC in 1999 with measures of WC and BMI as young adults. WC strongly correlated with fat deposits in ACT. The WC in 1999 expressed more subcutaneous fat (SAT), while the WC when young adults expressed strong correlation with both visceral fat (VAT) and SAT. The correlation of WC with fat deposits was stronger in females. WC and not BMI in 1999 was significantly higher in the group that evolved to MS. CONCLUSIONS The WC in children and adolescents was useful in screening patients for MS. WC expressed the accumulation of abdominal fat; especially subcutaneous fat.
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Affiliation(s)
- Jose Vicente Spolidoro
- Medical School of the Pontifícia Universidade Católica do RS, Moinhos de Vento Hospital, Porto Alegre, RS, Brazil.
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Claro RM, Levy RB, Popkin BM, Monteiro CA. Sugar-sweetened beverage taxes in Brazil. Am J Public Health 2011; 102:178-83. [PMID: 22095333 DOI: 10.2105/ajph.2011.300313] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
OBJECTIVES We investigated whether taxing sugar-sweetened beverages (SSBs) would improve the diets of households in Brazil. METHODS We used household food consumption data that the Brazilian Institute of Geography and Statistics collected in 2002-2003 from a nationally representative sample of 48,470 Brazilian households. The consumption of SSBs is expressed as the total SSB calories consumed and as the SSB percentage of the total calories purchased. We investigated price elasticity with regression models, controlling for demographic variables, income, and prices of all other foods and drinks. RESULTS Increases in the price of SSBs led to reductions in consumption. A 1.00% increase in the price of SSBs led to a 0.85% reduction of SSB calories consumed (1.03% reduction for the poor and 0.63% for the nonpoor). Increased income had a positive effect on SSB consumption, but the effect was less than half the size of the price elasticity (0.41% increase in SSB calories consumed for every 1.00% increase in income). CONCLUSIONS High SSB price elasticity in Brazil indicates that a tax on purchased weight or volume would lead to reductions in SSB consumption.
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Affiliation(s)
- Rafael M Claro
- Center for Epidemiological Studies in Health and Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.
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Schmidt MI, Duncan BB, Azevedo e Silva G, Menezes AM, Monteiro CA, Barreto SM, Chor D, Menezes PR. Chronic non-communicable diseases in Brazil: burden and current challenges. Lancet 2011; 377:1949-61. [PMID: 21561658 DOI: 10.1016/s0140-6736(11)60135-9] [Citation(s) in RCA: 710] [Impact Index Per Article: 54.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Non-communicable diseases (NCDs) have become a major health priority in Brazil--72% of all deaths were attributable to NCDs in 2007. They are also the main source of disease burden, with neuropsychiatric disorders being the single largest contributor. Morbidity and mortality due to NCDs are greatest in the poor population. Although the crude NCD mortality increased 5% between 1996 and 2007, age-standardised mortality declined by 20%. Declines were primarily for cardiovascular and chronic respiratory diseases, in association with the successful implementation of health policies that lead to decreases in smoking and the expansion of access to primary health care. Of note, however, the prevalence of diabetes and hypertension is rising in parallel with that of excess weight; these increases are associated with unfavourable changes of diet and physical activity. Brazil has implemented major policies for the prevention of NCDs, and its age-adjusted NCD mortality is falling by 1·8% per year. However, the unfavourable trends for most major risk factors pose an enormous challenge and call for additional and timely action and policies, especially those of a legislative and regulatory nature and those providing cost-effective chronic care for individuals affected by NCDs.
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Levy RB, Claro RM, Monteiro CA. Aquisição de açúcar e perfil de macronutrientes na cesta de alimentos adquirida pelas famílias brasileiras (2002-2003). CAD SAUDE PUBLICA 2010; 26:472-80. [DOI: 10.1590/s0102-311x2010000300005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2010] [Indexed: 11/22/2022] Open
Abstract
Avaliou-se a influência exercida pela aquisição de calorias de açúcar sobre a participação calórica dos demais macronutrientes da dieta. As estimativas deste estudo são baseadas em dados da Pesquisa de Orçamentos Familiares realizada no Brasil pelo Instituto Brasileiro de Geografia e Estatística entre julho de 2002 e junho de 2003. Modelos de regressão linear múltiplos foram utilizados para estudar a influência das calorias de açúcar sobre a participação calórica de cada um dos macronutrientes na aquisição domiciliar de alimentos com o controle do valor calórico total da aquisição de alimentos e variáveis sócio-demográficas. Cada caloria adquirida de açúcar eleva em 0,3 caloria a participação de gorduras na aquisição domiciliar de alimentos e diminui em 0,07 a participação de proteínas. Cada caloria de açúcar procedente de alimentos processados aumenta em 1,6 caloria a participação de gorduras e em 0,4 caloria de ácidos graxos saturados e diminui em 0,8 caloria a participação de outros carboidratos que não o açúcar. Os resultados encontrados trazem novas evidências sobre o papel prejudicial do açúcar à saúde humana.
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