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Lopes MS, dos Santos PLC, Lopes ACS. Food Consumption Inequalities in Primary Care in a Large Metropolis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:935. [PMID: 39063511 PMCID: PMC11276611 DOI: 10.3390/ijerph21070935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 07/15/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024]
Abstract
The aim of this study was to examine the association between health vulnerability and food consumption according to the NOVA classification within primary care in a major Brazilian city. A cross-sectional study was conducted among adults over 20 years old. These participants were part of a representative sample from the Health Academy Program (PAS) in Belo Horizonte, Brazil. We evaluated socio-demographic variables, self-reported illnesses, perceived health and quality of life, and the length of participation in PAS. Health vulnerability was gauged through the Health Vulnerability Index (HVI), which is calculated for each census sector and classified as low, medium, and high/very high. On the other hand, food consumption was determined by evaluating the average consumption described in a 24 h diet recall (24HR) and categorizing it under the NOVA classification: culinary preparations, processed foods, and ultra-processed foods (UPFs). The average calorie intake was 1429.7 kcal, primarily from culinary preparations (61.6%) and UPFs (27.4%). After adjustments, individuals residing in high/very high-HVI areas consumed more culinary preparations (β = 2.7; 95%CI: 4.7; 0.7) and fewer UPFs (β = -2.7; 95%CI: -4.7; -0.7) compared to those from low-vulnerability areas. PAS participants residing in more vulnerable areas reported healthier dietary habits, consuming more homecooked meals and fewer UPFs. These findings underscore the importance of concentrating efforts on promoting and preserving healthy eating habits and emphasizing the value of home cooking in the most vulnerable regions.
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Affiliation(s)
- Mariana Souza Lopes
- Nutrition Department, Health Sciences Center, Campus I, Universidade Federal da Paraíba, João Pessoa 58051-900, Brazil;
| | | | - Aline Cristine Souza Lopes
- Nutrition Department, School of Nursing, Health Campus, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil;
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Costa RM, Oliveira AG, Torres KG, Souza AM, Pereira GS, Bezerra IWL. Quantitative Assessment of the Inadequate Intake of Macronutrients, Minerals, and Vitamins Associated with Ultra-Processed Food Consumption. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:888. [PMID: 39063465 PMCID: PMC11276910 DOI: 10.3390/ijerph21070888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 06/27/2024] [Accepted: 07/05/2024] [Indexed: 07/28/2024]
Abstract
Studies indicate that ultra-processed food (UP) consumption correlates negatively with essential vitamin and mineral intake and positively with sodium and lipid intake. The objective of this study was to explore the relationship between UP consumption and deviations from nutritional guidelines. An observational, cross-sectional analytical study was conducted on a probability sample of manufacturing workers in the state of Rio Grande do Norte, Brazil. Food consumption was assessed with a 24 h recall survey, and nutrient intake inadequacies were calculated as the difference between individuals' intake of energy, macronutrients, minerals and vitamins, and the dietary reference intakes for individuals of the same sex and age group, and then analyzed for trends across the percentage contribution of UP to total energy intake with nonparametric multiple regression adjusted for covariates. The study included 921 workers from 33 industries, 55.9% male, with a mean age of 32 years. Overall, the study population exhibited deficits in energy, all macronutrients, and in some micronutrients. With increasing UP contribution to total energy intake, there is a trend towards a greater intake of energy (p < 0.001), total, saturated, monounsaturated, and trans fats (p < 0.001), n6-polyunsaturated fatty acids (p = 0.03), carbohydrates (p < 0.001), calcium (p = 0.008), and manganese (p < 0.001), thiamin (p < 0.001), and vitamin B6 (p = 0.01); however, this comes with a negative consequence in terms of reducing the protein consumption (p = 0.037), fiber (p = 0.035), copper (p = 0.033), and vitamin E (p = 0.002) intake. The results show that correcting energy and micronutrient deficiencies by increasing UP consumption can also lead to a decrease in diet quality.
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Affiliation(s)
- Raiane M. Costa
- Postgraduate Program in Health Sciences, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal 59012-570, RN, Brazil; (R.M.C.); (A.G.O.); (K.G.T.); (A.M.S.); (G.S.P.)
| | - Antonio G. Oliveira
- Postgraduate Program in Health Sciences, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal 59012-570, RN, Brazil; (R.M.C.); (A.G.O.); (K.G.T.); (A.M.S.); (G.S.P.)
- Pharmacy Department, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal 59012-570, RN, Brazil
| | - Karina G. Torres
- Postgraduate Program in Health Sciences, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal 59012-570, RN, Brazil; (R.M.C.); (A.G.O.); (K.G.T.); (A.M.S.); (G.S.P.)
| | - Anissa M. Souza
- Postgraduate Program in Health Sciences, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal 59012-570, RN, Brazil; (R.M.C.); (A.G.O.); (K.G.T.); (A.M.S.); (G.S.P.)
| | - Gabriela S. Pereira
- Postgraduate Program in Health Sciences, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal 59012-570, RN, Brazil; (R.M.C.); (A.G.O.); (K.G.T.); (A.M.S.); (G.S.P.)
| | - Ingrid W. L. Bezerra
- Nutrition Department, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal 59078-970, RN, Brazil
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Béjar LM, Mesa-Rodríguez P, García-Perea MD. Short-Term Effect of a Health Promotion Intervention Based on the Electronic 12-Hour Dietary Recall (e-12HR) Smartphone App on Adherence to the Mediterranean Diet Among Spanish Primary Care Professionals: Randomized Controlled Clinical Trial. JMIR Mhealth Uhealth 2024; 12:e49302. [PMID: 38190226 PMCID: PMC10804253 DOI: 10.2196/49302] [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: 05/24/2023] [Revised: 09/14/2023] [Accepted: 12/20/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND The World Health Organization has called for addressing the growing burden of noncommunicable diseases (NCDs) by promoting healthy lifestyles among the population. Regarding patient health, primary care professionals (PCPs) are the first line of care who can positively influence patients' behavior and lifestyle habits. However, a significant percentage of PCPs do not lead a healthy lifestyle. Therefore, addressing their health behaviors may be the key to substantially increasing health promotion advice in general practice. The Mediterranean diet has been extensively studied, and there is strong evidence of it being a dietary pattern for the prevention of NCDs, in addition to its significant environmental, sociocultural, and local economics benefits. OBJECTIVE This study focused only on the dietary aspect of the PCPs' lifestyle. The primary objective was to evaluate the effect of using the Electronic 12-Hour Dietary Recall (e-12HR) smartphone app to improve diet, specifically to promote adherence to the Mediterranean diet (AMD), among PCPs. The secondary objectives were to establish the usability of the e-12HR app and to determine AMD among PCPs. METHODS An individual-level randomized, controlled, and single-blind clinical trial was conducted with 2 parallel groups: a control group (CG), using the nonfeedback version of the e-12HR app, and an intervention group (IG), using the feedback version of the e-12HR app. The level of human involvement was fully automated through the use of the app. There was a 28-day follow-up period. Participants were PCPs (medicine or nursing) recruited offline at one of the selected primary care centers (Andalusia, Spain, Southern Europe), of both sexes, over 18 years old, possessing a smartphone, and having smartphone literacy. RESULTS The study response rate was 73% (71 of 97 PCPs), with 27 (38%) women and 44 (62%) men: 40 (56%) PCPs in the CG and 31 (44%) in the IG. At baseline, AMD was medium (mean Mediterranean Diet Serving Score [MDSS] index 9.45, range 0-24), with 47 (66%) PCPs with a medium/high MDSS index. There were significant statistical improvements (CG vs IG, in favor of the IG) at week 4 (no significant statistical differences at baseline): +25.6% for the MDSS index (P=.002) and +213.1% for the percentage with a medium/high MDSS index (P=.001). In relation to specific food groups, there were significant statistical improvements for fruits (+33.8%, P=.02), vegetables (+352%, P=.001), nuts (+184%, P=.02), and legumes (+75.1%, P=.03). The responses to the usability rating questionnaire were satisfactory. CONCLUSIONS The results support recommending the use of the e-12HR app as a tool to contribute to improving diet and preventing NCDs among PCPs, while positively influencing patient dietary behavior and preventing diet-related NCDs among patients. TRIAL REGISTRATION ClinicalTrials.gov NCT05532137; https://clinicaltrials.gov/study/NCT05532137.
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Affiliation(s)
- Luis María Béjar
- Department of Preventive Medicine and Public Health, Institute of Anatomy, School of Medicine, University of Seville, Seville, Spain
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de Souza GR, Ribeiro-Silva RDC, Felisbino-Mendes MS, Silva NDJ, de Andrade RDCS, Pedroso J, Spaniol AM, Bortolini GA, Nilson EAF, da Silva SA, Lourenço BH, Rocha ADS, Falcão IR, Ichihara MYT, Farias DR, Barreto ML. Time trends and social inequalities in infant and young child feeding practices: national estimates from Brazil's Food and Nutrition Surveillance System, 2008-2019. Public Health Nutr 2023; 26:1731-1742. [PMID: 37231823 PMCID: PMC10478053 DOI: 10.1017/s1368980023001039] [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: 08/10/2022] [Revised: 04/26/2023] [Accepted: 05/12/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To describe the time trends and socio-economic inequalities in infant and young child feeding practices in accordance with the Brazilian deprivation index (BDI). DESIGN This time-series study analysed the prevalence of multiple breast-feeding and complementary feeding indicators based on data from the Brazilian Food and Nutrition Surveillance System, 2008-2019. Prais-Winsten regression models were used to analyse time trends. Annual percent change (APC) and 95 % CI were calculated. SETTING Primary health care services, Brazil. PARTICIPANTS Totally, 911 735 Brazilian children under 2 years old. RESULTS Breast-feeding and complementary feeding practices differed between the extreme BDI quintiles. Overall, the results were more favourable in the municipalities with less deprivation (Q1). Improvements in some complementary feeding indicators were observed over time and evidenced such disparities: minimum dietary diversity (Q1: Δ 47·8-52·2 %, APC + 1·44, P = 0·006), minimum acceptable diet (Q1: Δ 34·5-40·5 %, APC + 5·17, P = 0·004) and consumption of meat and/or eggs (Q1: Δ 59·7-80·3 %, APC + 6·26, P < 0·001; and Q5: Δ 65·7-70·7 %, APC + 2·20, P = 0·041). Stable trends in exclusive breast-feeding and decreasing trends in the consumption of sweetened drinks and ultra-processed foods were also observed regardless the level of the deprivation. CONCLUSIONS Improvements in some complementary food indicators were observed over time. However, the improvements were not equally distributed among the BDI quintiles, with children from the municipalities with less deprivation benefiting the most.
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Affiliation(s)
- Giesy Ribeiro de Souza
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Rita de Cássia Ribeiro-Silva
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
- School of Nutrition, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Mariana Santos Felisbino-Mendes
- School of Nursing, Department of Mother-Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Natanael de Jesus Silva
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
- Barcelona Institute for Global Health, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | | | - Jéssica Pedroso
- General Coordination of Food and Nutrition, Ministry of Health, Federal District, Brasília, Brazil
| | - Ana Maria Spaniol
- General Coordination of Food and Nutrition, Ministry of Health, Federal District, Brasília, Brazil
| | - Gisele Ane Bortolini
- General Coordination of Food and Nutrition, Ministry of Health, Federal District, Brasília, Brazil
| | - Eduardo Augusto Fernandes Nilson
- Food, Nutrition and Culture Program (PALIN), Brasília Regional Management, Oswaldo Cruz Foundation, Federal District, Brasília, Brazil
| | - Sara Araújo da Silva
- General Coordination of Food and Nutrition, Ministry of Health, Federal District, Brasília, Brazil
| | | | - Aline dos Santos Rocha
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
- School of Nutrition, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Ila Rocha Falcão
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
| | - Maria Yury Travassos Ichihara
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
| | - Dayana Rodrigues Farias
- Nutritional Epidemiology Observatory, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maurício Lima Barreto
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
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Campos SF, Lopes MS, dos Santos LC, de Freitas PP, Lopes ACS. Evaluation of Nutrient Consumption for the Prevention of Chronic Diseases in Health Promotion Services: A Controlled and Randomized Community Trial to Promote Fruits and Vegetables. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6267. [PMID: 37444114 PMCID: PMC10341051 DOI: 10.3390/ijerph20136267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/19/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023]
Abstract
To evaluate the effectiveness of a collective intervention to encourage the consumption of fruits and vegetables on the nutrients intake for the prevention of chronic non-communicable diseases (NCDs), a randomized controlled community trial was conducted with a representative sample from the Health Academy Program. While the individuals in the control group (CG) participated in regular physical exercise, those in the intervention group (IG) also participated in a collective intervention. After 12 months, IG and CG showed a reduction in energy, omega 3 and sodium intake and an increase in the consumption of carbohydrates, fiber, vitamins, and minerals. Individuals from the CG showed an increase in phosphorus consumption and, in the IG, a reduction in the consumption of total, saturated, and polyunsaturated fats as well as an increase in the consumption of monounsaturated fats was seen. In both groups, there was an increase in the prevalence of adequate nutrients. Participation in the nutritional intervention was associated with lower consumption of energy and protein in the diet. The results pointed to the importance of individuals' participation in the program, which, associated with nutritional intervention, promoted an improvement in the nutrient profile of the diet and the prevention and control of NCDs.
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Affiliation(s)
- Suellen Fabiane Campos
- Department of Nutrition, Nursing School, Federal University of Minas Gerais, Belo Horizonte 30130-100, Brazil; (S.F.C.); (L.C.d.S.); (P.P.d.F.)
| | - Mariana Souza Lopes
- Department of Nutrition, Health Science Center, Federal University of Paraíba, João Pessoa 58051-900, Brazil;
| | - Luana Caroline dos Santos
- Department of Nutrition, Nursing School, Federal University of Minas Gerais, Belo Horizonte 30130-100, Brazil; (S.F.C.); (L.C.d.S.); (P.P.d.F.)
| | - Patrícia Pinheiro de Freitas
- Department of Nutrition, Nursing School, Federal University of Minas Gerais, Belo Horizonte 30130-100, Brazil; (S.F.C.); (L.C.d.S.); (P.P.d.F.)
| | - Aline Cristine Souza Lopes
- Department of Nutrition, Nursing School, Federal University of Minas Gerais, Belo Horizonte 30130-100, Brazil; (S.F.C.); (L.C.d.S.); (P.P.d.F.)
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Haghighatdoost F, Atefi M, Mohammadifard N, Daryabeygi-Khotbehsara R, Khosravi A, Mansourian M. The relationship between ultraprocessed food consumption and obesity indicators in Iranian adults. Nutr Metab Cardiovasc Dis 2022; 32:2074-2085. [PMID: 35843797 DOI: 10.1016/j.numecd.2022.05.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 05/23/2022] [Accepted: 05/23/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND AIMS Food processing changes the nature of foods, and it is growing globally due to its availability and affordability and its effects on the palatability of foods. Consumption of ultraprocessed foods (UPFs) may adversely affect weight gain. The purpose of the current study is to examine the association between UPFs consumption and adiposity among Iranian adults. METHODS AND RESULTS A cross-sectional study was conducted on 1459 Iranian adults (≥19 years). Dietary intakes were assessed using a validated 136-item food frequency questionnaire (FFQ), and foods were classified based on the NOVA system. Overweight, obesity, and abdominal obesity were defined as body mass index (BMI) ≥25 and < 30, ≥30, respectively, and waist circumference (WC) ≥91 for women and WC ≥ 89 for men. The odds of general and abdominal obesity across the quartiles of UPFs were assessed by binary logistic regression. UPFs consumption contributed to 20.17% of daily energy intake. After adjustment for potential confounders, UPFs consumption was not associated with general or abdominal obesity. However, in the fully adjusted model, men in the top quartile of UPFs were twice as likely to be overweight compared with those in the bottom quartile (OR = 2.06, 95% CI: 1.03, 4.10; P = 0.047). No association was found in women or stratified analysis by age. CONCLUSION The present findings suggest a sex-specific association between UPFs consumption and overweight. UPFs consumption might be associated with an increased risk of overweight in men, but no such association was found in women. Future cohort studies are required to confirm these results.
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Affiliation(s)
- F Haghighatdoost
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - M Atefi
- Food and Drug Deputy, Shahroud University of Medical Sciences, Shahroud, Iran
| | - N Mohammadifard
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| | | | - A Khosravi
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - M Mansourian
- Biostatistics and Epidemiology Department, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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Lopes MS, Martiniano MO, Freitas PPD, Carvalho MCRD, Sales DM, Lopes ACS. Sources of food ready to consume around the Health Academy Program units: an analysis according to inequality. CIENCIA & SAUDE COLETIVA 2022; 27:3283-3294. [PMID: 35894338 DOI: 10.1590/1413-81232022278.02232022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 04/26/2022] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to spatially examine the distribution of establishments for the acquisition of food that is ready to consume around the Health Academy Program (PAS) in Belo Horizonte, Minas Gerais, Brazil, according to the Municipal Human Development Index (IDH-M).This is an ecological study with the PAS as the unit of analysis. The establishments contained in a circular buffer with a radius of 900 meters from the 77 units of the PAS in operation were evaluated. Address and type of establishment data were obtained from a public list and verified in a virtual audit. Thematic kernel maps were used. A total of 3,050 establishments were identified around the PAS units. Higher densities were observed around units located in the city's south-central region and in areas with high and very high IDH-M. There was a high density of establishments selling ready-to-consume foods around the PAS units, especially in the wealthier parts of the city. These results are useful in supporting the planning of actions aimed at strengthening the PAS as a promoter of healthy eating environments. Further, it reinforces the need for equitable public policies for supply and regulation, aiming to promote access to adequate and healthy food for all.
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Affiliation(s)
- Mariana Souza Lopes
- Departamento de Nutrição, Grupo de Pesquisa de Intervenções em Nutrição, Universidade Federal de Minas Gerais (UFMG). Av. Prof. Alfredo Balena 190, Sala 316, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Mariana Oliveira Martiniano
- Departamento de Nutrição, Grupo de Pesquisa de Intervenções em Nutrição, Universidade Federal de Minas Gerais (UFMG). Av. Prof. Alfredo Balena 190, Sala 316, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Patrícia Pinheiro de Freitas
- Departamento de Nutrição, Grupo de Pesquisa de Intervenções em Nutrição, Universidade Federal de Minas Gerais (UFMG). Av. Prof. Alfredo Balena 190, Sala 316, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | | | - Denise Marques Sales
- Programa de Pós-Graduação em Geografia, Instituto de Geociências, UFMG. Belo Horizonte MG Brasil
| | - Aline Cristine Souza Lopes
- Departamento de Nutrição, Grupo de Pesquisa de Intervenções em Nutrição, Universidade Federal de Minas Gerais (UFMG). Av. Prof. Alfredo Balena 190, Sala 316, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
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Lopes MS, Martiniano MO, Freitas PPD, Carvalho MCRD, Sales DM, Lopes ACS. Sources of food ready to consume around the Health Academy Program units: an analysis according to inequality. CIENCIA & SAUDE COLETIVA 2022. [DOI: 10.1590/1413-81232022278.02232022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract The aim of this study was to spatially examine the distribution of establishments for the acquisition of food that is ready to consume around the Health Academy Program (PAS) in Belo Horizonte, Minas Gerais, Brazil, according to the Municipal Human Development Index (IDH-M).This is an ecological study with the PAS as the unit of analysis. The establishments contained in a circular buffer with a radius of 900 meters from the 77 units of the PAS in operation were evaluated. Address and type of establishment data were obtained from a public list and verified in a virtual audit. Thematic kernel maps were used. A total of 3,050 establishments were identified around the PAS units. Higher densities were observed around units located in the city’s south-central region and in areas with high and very high IDH-M. There was a high density of establishments selling ready-to-consume foods around the PAS units, especially in the wealthier parts of the city. These results are useful in supporting the planning of actions aimed at strengthening the PAS as a promoter of healthy eating environments. Further, it reinforces the need for equitable public policies for supply and regulation, aiming to promote access to adequate and healthy food for all.
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Abstract
Dramatically increasing trends in consumption of ultra-processed foods have been reported across the globe. Public concern about the health consequences of ultra-processed foods is high. This manuscript provides a comprehensive review of trends in global consumption of ultra-processed foods, dietary nutrient profile of ultra-processed foods, demographic, socioeconomic, psychological, and behavioral characteristics of ultra-processed food consumers, current evidence from longitudinal studies at the population level on the association between ultra-processed foods consumption and major health outcomes (including all-cause and cause-specific mortality, cardiovascular disease, overweight and obesity, body composition and fat deposition, diabetes, cancer, and gastrointestinal and other diseases), potential mechanisms linking ultra-processed foods with these outcomes (nutrient displacement, factors that influence adiposity, and processing), and challenges and future research directions. The global trends in consumption of ultra-processed foods, the generally unfavorable nutrient profile of ultra-processed foods, the characteristics of ultra-processed food consumers, the accumulating longitudinal studies associating ultra-processed foods with major health outcomes, and the uncertainties and complexities in putative mechanisms all highlight the need for future high-quality epidemiologic and mechanistic investigations on this topic. It is critical to interpret findings in the light of the totality of evidence.
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Affiliation(s)
- Yin Zhang
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Edward L Giovannucci
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
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