Dietary guidelines for Brazilian population: an analysis from the cultural and social dimensions of food

Food-Based Dietary Guidelines for Infants in Latin America and the Caribbean: A Systematic Review

Food-based dietary guidelines (FBDGs) are tools for promoting healthy eating habits. For the population of children under two years old in Latin America and the Caribbean (LAC), there is a lack of reviews analyzing the quality of these guidelines. The objective of this systematic review is to evaluate publicly available FBDGs for the population under two years old in LAC until mid-2023. Guidelines aimed at caregivers of children were included, sourced from government websites in LAC countries and the Food and Agriculture Organization (FAO) portal. Documents targeted at healthcare professionals were excluded. For qualitative analysis, the Agree II guidelines assessment tool and the FAO guide principles for developing healthy and sustainable diets were used. The results showed that more recently released and revised FBDGs with a greater number of pages obtained better scores in both assessments. Additionally, out of the 32 LAC countries, only 13 had these FBDGs available on websites for public access. As a limitation, this study faced challenges in standardizing the searches on government websites. The authors emphasize the need to develop FBDGs for the population under two years old that align with current health and sustainability needs and promote health education.

Complementary feeding indicators from the World Health Organization and the Ministry of Health: agreement analysis and comparison of estimated prevalence in a cohort of children in southwestern Bahia, Brazil, 2018

OBJECTIVE

To assess the agreement between complementary feeding indicators established by the World Health Organization (WHO) and the Ministry of Health (MOH) and to compare the prevalence of these indicators in the first year of a child's life.

METHODS

: This was a cross-sectional study in a cohort of 286 children from Vitória da Conquista, state of Bahia, Brazil; agreement between indicators and comparison between prevalences were analyzed using the Kappa coefficient and McNemar's test; the prevalence of the indicators "introduction of complementary feeding" (ICF), "minimum dietary diversity" (MDD), "minimum meal frequency" (MMF) and "minimum acceptable diet" (MAD) were calculated.

RESULTS

: Three indicators showed poor agreement, with only one demonstrating moderate agreement; prevalence of WHO indicators was higher than that of the MOH (ICF, 94.3% vs. 20.7%; MDD, 75.2% vs. 50.7%; MMF, 97.2% vs. 44.8%; MAD, 96.8% vs. 26.9%).

CONCLUSION

The majority of indicators showed poor agreement and the prevalence of WHO indicators exceeded that of the Ministry of Health.

Nutrition Literacy Level in Bank Employees: The Case of a Large Brazilian Company

Nutrition Literacy (NL) positively impacts diet quality and has the potential to promote health and prevent nutrition-related chronic diseases. Brazil is one of the countries with the highest rates of nutrition-related chronic diseases. Nevertheless, in Brazil, few studies have explored the NL levels of its population. To provide remote access to the Nutrition Literacy Assessment Instrument for Brazilians (NLit-Br) and assess Brazilian bank employees, we conducted a study to estimate the validity of the NLit-Br online and to investigate whether bank employees have an adequate NL level. In the first step, we randomly assigned 21 employees from three financial institution branches to two groups to complete NLit-Br paper and online versions. After an interval period, both groups completed the NLit-Br with an opposite delivery method (paper vs. online). We compared the validity of the digital and paper versions of the NLit-Br by the Intraclass Correlation Coefficient (ICC), and the reliability by Kuder-Richardson formula 20. Second, we evaluated 1174 bank employees using the NLit-Br online version. We found an excellent absolute agreement (ICC ≥ 0.75) between the paper and online versions. The questionnaire had good internal consistency (KR-20 = 0.64). The sample was characterized as mostly male (61.0%), married/cohabitant (73.8%), and white (69.8%), with high household income (85.2%), and graduated or postgraduate (97.4%). The mean age of the population was 42.1 (SD = 7.6) years. Subjects predominantly had possibly inadequate NL (62.3%). The online NLit-Br total score was significantly associated with gender, age, and household income (p < 0.05). Women and individuals with higher incomes had a higher degree of NL. Subjects over 50 years old had a lower degree of NL. There was no significant association between the NLit-Br score and the participants' education. The NLit-Br online is a valid instrument to assess NL remotely. The population studied showed a high prevalence of inadequacy of the NL. Therefore, there is a need for targeted actions to improve the NL of bank employees.

Chronic diseases attributable to a diet rich in processed meat in Brazil: Burden and financial impact on the healthcare system

Background

The consumption of processed meat causes negative impacts on health; however, this burden for the population living in developing countries is less explored. This study aimed to describe the burden of chronic noncommunicable diseases (NCDs) attributed to a diet rich in processed meat between 1990 and 2019 in Brazil and its federative units and the financial burden on the Unified Health System (SUS) in 2019.

Methods

Secondary data from the Global Burden of Disease (GBD) and SUS Information Systems were used in this ecological study. The metrics to assess the burden of NCDs attributable to processed meat consumption were disability-adjusted life years (DALYs) and deaths. The age-standardized rates were presented per 100,000 inhabitants with 95% uncertainty intervals (95% UI). The cost of hospitalizations and outpatient procedures covered by SUS for the treatment of NCDs attributable to processed meat consumption was estimated using the population-attributable fraction. Both burdens were estimated for both sex and stratified by sex, specific cause, and federative units.

Results

The age-standardized DALY rates attributable to a diet rich in processed meat increased between 1990 (75.31/100,000 [95% UI: 34.92–139.65]) and 2019 (79.35/100,000 [95% UI: 42.84–126.25]); while mortality rates remained stable between 1990 (2.64/100,000 [95% UI: 1.17–5.21) and 2019 (2.36/100,000 [95% UI: 1.22–4.09]). The cost of hospitalization and outpatient procedures in Brazil for NCDs attributable to the consumption of processed meat was approximately US$ 9,4 million, of which US$ 6,1 million was spent on ischemic heart disease, US$ 3,1 million on colorectal cancer, and US$ 200 thousand on type 2 diabetes mellitus.

Conclusion

The NCD burden did not decrease during the years evaluated, while the financial burden was high in 2019, with higher treatment costs for ischemic heart disease. These results can guide political, economic, and health education interventions to advance the fight against NCDs.

O Guia Alimentar para População Brasileira (GAPB): uma análise à luz da teoria social

Resumo O Guia Alimentar para a População Brasileira (GAPB) é um documento oficial que aborda princípios e recomendações de uma alimentação adequada e saudável e se configura como um instrumento de apoio às ações de educação alimentar e nutricional (EAN). O objetivo deste artigo é analisar o conteúdo do guia, que é um dos principais instrumentos das políticas públicas relacionadas à alimentação no Brasil, à luz de conceitos da teoria social, em especial teorias da modernidade, da identidade e dos riscos. Na análise minuciosa do conteúdo do guia, foi constatado que o texto considerou a diversidade alimentar cultural e biológica das regiões brasileiras. Teve base de referência os alimentos e não os nutrientes, tornando a compreensão das recomendações ilustrativas fáceis de serem assimiladas pelo público. Preocupou-se em evitar os riscos alimentares, levando em consideração a questão da aquisição de alimentos adequados e saudáveis. Entretanto, identificou-se dois riscos não abordados: o problema dos alimentos processados e ultraprocessados (UP); e a omissão de alerta referente aos alimentos transgênicos (OGMs). Embora construído de forma inovadora, estimulando tempo, atenção e companhia à mesa, o GAPB necessita uma revisão.

The Food Guide for The Brazilian Population: an analysis in the light of social theory

Abstract The Food Guide for the Brazilian Population (GAPB) is an official document that addresses principles and recommendations for an adequate and healthy diet, and it is configured as a support tool for food and nutrition education actions. This article aims to analyze the guide content, which is one of the main instruments of public policies related to food in Brazil, in the light of the concepts of social theory, especially theories of modernity, identity, and risks. In the detailed analysis of the guide content, we found that the document considered the cultural and biological food diversity of Brazilian regions. It is based on food not on nutrients, making illustrative recommendations easy to public understanding. It avoided food risks, considering the issue of acquiring adequate and healthy food. However, two risks were not addressed: the problem of processed and ultra-processed foods (PU); and the omission of warnings regarding transgenic foods (GMOs). Although the guide has been designed in an innovative way, stimulating time, attention, and companionship at the table, the GAPB needs revision.

Effect of dietary fat intake and genetic risk on glucose and insulin-related traits in Brazilian young adults

PURPOSE

The development of metabolic diseases such as type 2 diabetes (T2D) is closely linked to a complex interplay between genetic and dietary factors. The prevalence of abdominal obesity, hyperinsulinemia, dyslipidaemia, and high blood pressure among Brazilian adolescents is increasing and hence, early lifestyle interventions targeting these factors might be an effective strategy to prevent or slow the progression of T2D.

METHODS

We aimed to assess the interaction between dietary and genetic factors on metabolic disease-related traits in 200 healthy Brazilian young adults. Dietary intake was assessed using 3-day food records. Ten metabolic disease-related single nucleotide polymorphisms (SNPs) were used to construct a metabolic-genetic risk score (metabolic-GRS).

RESULTS

We found significant interactions between the metabolic-GRS and total fat intake on fasting insulin level (Pinteraction = 0.017), insulin-glucose ratio (Pinteraction = 0.010) and HOMA-B (Pinteraction = 0.002), respectively, in addition to a borderline GRS-fat intake interaction on HOMA-IR (Pinteraction = 0.051). Within the high-fat intake category [37.98 ± 3.39% of total energy intake (TEI)], individuals with ≥ 5 risk alleles had increased fasting insulin level (P = 0.021), insulin-glucose ratio (P = 0.010), HOMA-B (P = 0.001) and HOMA-IR (P = 0.053) than those with < 5 risk alleles.

CONCLUSION

Our study has demonstrated a novel GRS-fat intake interaction in young Brazilian adults, where individuals with higher genetic risk and fat intake had increased glucose and insulin-related traits than those with lower genetic risk. Large intervention and follow-up studies with an objective assessment of dietary factors are needed to confirm our findings.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40200-021-00863-7.

Ultra-processed food intake and all-cause and cause-specific mortality in individuals with cardiovascular disease: the Moli-sani Study

AIMS 

To evaluate the association of ultra-processed food (UPF) intake and mortality among individuals with history of cardiovascular disease (CVD) and analyse some biological pathways possibly relating UPF intake to death.

METHODS AND RESULTS 

Longitudinal analysis on 1171 men and women (mean age: 67 ± 10 years) with history of CVD, recruited in the Moli-sani Study (2005-10, Italy) and followed for 10.6 years (median). Food intake was assessed using a food frequency questionnaire. UPF was defined using the NOVA classification according to degree of processing and categorized as quartiles of the ratio (%) between UPF (g/day) and total food consumed (g/day). The mediating effects of 18 inflammatory, metabolic, cardiovascular, and renal biomarkers were evaluated using a logistic regression model within a counterfactual framework. In multivariable-adjusted Cox analyses, higher intake of UPF (Q4, ≥11.3% of total food), as opposed to the lowest (Q1, UPF <4.7%), was associated with higher hazards of all-cause (hazard ratio [HR]: 1.38; 95% confidence interval (CI): 1.00-1.91) and CVD mortality (HR: 1.65; 95% CI: 1.07-2.55). A linear dose-response relationship of 1% increment in UPF intake with all-cause and CVD mortality was also observed. Altered levels of cystatin C explained 18.3% and 16.6% of the relation between UPF (1% increment in the diet) with all-cause and CVD mortality, respectively.

CONCLUSION 

A diet rich in UPF is associated with increased hazards of all-cause and CVD mortality among individuals with prior cardiovascular events, possibly through an altered renal function. Elevated UPF intake represents a major public health concern in secondary CVD prevention.

The politics of ultra-processed foods and beverages regulatory policy in upper-middle-income countries: Industry and civil society in Mexico and Brazil

ABSTRACTAddressing the politics of corporate political activity and policy interference in response to non-communicable diseases (NCDs) is a new area of scholarly research. The objective of this article is to explain how, in Mexico and Brazil, the ultra-processed foods and beverages industry succeeded in creating the political and social conditions conducive for their on-going regulatory policy influence and manipulation of scientific research. In addition to establishing partnerships within and outside of government, industry representatives have succeeded in hampering civic opposition by establishing allies within academia and society. Ministries of Health have simultaneously neglected to work closely with civil society, while legislative representatives have continued to benefit from industry campaign contributions. Findings from this article suggest that ultra-processed foods and beverages industries wield on-going regulatory policy influence in Mexico and Brazil, and that government is still not fully committed to working with civil society on these issues.

Post-Harvest Quality and Sensory Evaluation of Mini Sweet Peppers

Sweet pepper (Capsicum annuum L.) is one of the most consumed vegetables in the world, being recognized as a food with high nutritional value. Recently, the market for sweet and colorful mini peppers has increased, especially among the most demanding consumers in the novelties in vegetables and functional foods. In this sense, we evaluated mini sweet peppers genotypes (Akamu, Kaiki, Kalani, Kaolin e Moke from Isla® seeds) regarding the physical-chemical, nutritional and sensory analysis aspects. A wide variability was observed among genotypes, highlighting the Kalani genotype for total carotenoids, and the genotypes Akamu, Kaiki and Kaolin for phenolic totals content and antioxidant activity. Moke and Kaolin showed higher vitamin C content and fruit firmness. Based on sensory analysis, Kalani, Kaiki, Kaolin and Akamu obtained greater global acceptance. The genotypes can be considered an important marketing strategy of mini sweet peppers trade, associating different shapes, colors and nutritional quality.

A Critical Review on New Approaches for Chronic Disease Prevention in Brazil and Canada: From Wholistic Dietary Guidelines to Physical Activity Security

In light of new evidence on the prevention of chronic diseases and the elevated rates of overweight and obesity in Brazil and Canada, this critical review aims to interpret and synthesize current aspects regarding dietary and physical activity initiatives in both countries and make future recommendations. The pioneering work presented in the last Brazilian dietary guidelines has been called a model that can be applied globally, given its conceptualization of healthy eating that translates easily to practical guidance. The new Canadian Food Guide has incorporated similar aspects, also putting the country as a leader in dietary guidance. With these new recommendations, citizens in both Brazil and Canada have access to impactful evidence-informed nutritional guidelines. Both documents propose eating patterns that focus not only on health benefits, such as chronic disease prevention, but also incorporate well-being concerning cultural, economic, sociodemographic, biological, and ecological dimensions. A similar approach is required for physical activity to allow individuals to have attainable health and life goals and thereby fully enjoy their lives, regardless of geographical location, health status, and socioeconomic condition, a concept recently described as physical activity security. The wholistic dietary guidelines from both countries represent a change in paradigm in public health. Likewise, national evidence-based policies are warranted to reduce disparities in physical activity, allowing healthier and more active lifestyles for everyone.

Intersection between Obesity, Dietary Selenium, and Statin Therapy in Brazil

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.

Autistic children and adolescents and their parents: being and having meals together

ABSTRACT Objective his study analyzed collective activities, involving eating with autistic children and adolescents, their families and professionals and included walks to street-food markets, picnics and participating in Festa Junina, aiming at investigating feeding in the perspective of commensality. Methods Ethnographic research carried out, based on participant observation during a walk to the street-food market, picnic and Festa Junina, conducted with 19 children and 13 adolescents of an Institution for autistic people. The data recorded were analyzed within the phenomenology framework. Results The activities showed the interaction of autistic children/adolescents with space, people and food, revealing the way autistic people relate, belong and position themselves. The investigators highlighted commensality, emphasizing food as a mediator of relationships, considering a scenario that may present contradictions and power relationships, and allows new possibilities of being together with this audience, outside home and beyond therapeutic care. Conclusion Staying and eating in a group influences the autistic child/adolescent and the activities were configured as an invitation to shared meals, with unexpected behaviors that went beyond institutional therapeutic purposes.