Frequency of consumption of fruits, vegetables and soft drinks: a comparative study among adolescents in urban and rural areas

Magnitude of risk factors for chronic noncommunicable diseases in adolescents and young adults in Brazil: A population-based study

AIM OF THE STUDY

Estimate the magnitude and factors associated with risk factors for chronic noncommunicable diseases in adolescents and young adults in Brazil.

METHODS

Cross-sectional study that analyzed data from the 2019 National Health Survey. The population of interest was adolescents and young adults aged 15 to 24 years. Data were collected through individual interviews during home visits. Dependent variables included major risk factors for chronic noncommunicable diseases. Demographic and socioeconomic characteristics were used as independent variables. Multiple Poisson regression models were used to assess the relationship between independent variables and risk factors.

RESULTS

A total of 10,460 individuals (5,001 men and 5,459 women) were included. Regardless of sex, the most prevalent risk factors were insufficient fruit and vegetable consumption (92.6%) and leisure-time physical inactivity (43.3%). The prevalence rates of tobacco smokers, alcohol consumption once a month or more, and alcohol abuse were 8.9%, 28.7%, and 18.5%, respectively. Regular consumption of soft drinks and/or artificial juices was described by 17.2%. The prevalence of overweight was 32.5%. Young adults, males, and individuals with lower educational levels, of black race/skin color, with lower household income, and residents of urban areas had a higher prevalence for most risk factors. Differences in the determinants were found for some factors. Inequalities between Brazilian regions were recorded for seven of the nine factors analyzed. The most socioeconomically developed regions had the highest prevalence of most risk factors. The high magnitude of risk factors indicates a potential increase in the burden of chronic noncommunicable diseases in a future scenario for Brazil.

Contribution of 100% Fruit Juice to Micronutrient Intakes in the United States, United Kingdom and Brazil

The contribution of 100% fruit juice (FJ) to the total daily intakes of energy, sugars, and select vitamins and minerals and to the recommended dietary allowances (RDAs) or adequate intake (AI) of these micronutrients was assessed in individuals reporting the consumption of 100% FJ in the national dietary intake surveys of the United States (U.S.; n = 8661), the United Kingdom (UK; n = 2546) and Brazil (n = 34,003). Associations of 100% FJ intake with the odds of being overweight or obese also were assessed. Data from the U.S. National Health and Nutrition Examination Survey (2013–2014), the UK National Diet and Nutrition Survey (2012–2014), and Brazil’s Pesquisa de Orçamentos Familiares (2008–2009) were used, and all analyses were limited to individuals reporting consumption of 100% FJ on at least one day of the dietary intake survey. Approximately 34%, 37%, and 42% of individuals surveyed reported the consumption of 100% FJ on at least one day of the dietary intake survey in the U.S., UK, and Brazil, respectively, and the average daily intakes of 100% FJ were 184 g, 130 g, and 249 g, respectively. Across the 3 countries, 100% FJ contributed to 3–6% of total energy intakes, 12–31% of total sugar intakes, 21–54% of total vitamin C intakes, 1–12% of total vitamin A intakes, 4–15% of total folate intakes, 7–17% of total potassium intakes, 2–7% of total calcium intakes, and 4–12% of total magnesium intakes. In a multivariate logistic regression model, juice intake was associated with a significant reduction in the odds of being overweight or obese in UK adults (OR = 0.79; 0.63, 0.99), and significant increases in the odds of being overweight or obese in UK children (OR = 1.16; 1.01, 1.33) and Brazilian adults (OR = 1.04; 1.00, 1.09). Nutrient contributions of 100% FJ vary according to regional intake levels. In all three countries studied, 100% FJ contributed to more than 5% of the RDAs for vitamin C and folate. In the U.S. and Brazil, 100% FJ contributed to more than 5% of the RDA for magnesium and more than 5% of the AI for potassium.

Brazilian Children's Dietary Intake in Relation to Brazil's New Nutrition Guidelines: a Systematic Review

PURPOSE OF REVIEW

This systematic review reports the latest scientific evidence, from cross-sectional and cohort studies, describing the dietary intake of children and adolescents from Brazil. The goal of the review was to describe intakes according to Brazil's new food classification system (NOVA) which classifies foods according to the degree of processing, i.e., unprocessed/minimally processed, processed culinary ingredients, processed food, and ultra-processed food. Due to a paucity of data using the NOVA classification system, studies with other intake descriptors were included.

RECENT FINDINGS

Results using the NOVA system showed a somewhat high intake of (ultra-)processed items, than of minimally processed items. Studies using other methods of dietary assessment showed not only high intake of sources rich in fat, sugar, and sodium, most of them processed items (e.g., savory snacks and sweets) but also intake of fruit, vegetables, and whole grains. Overall, the literature was marred by inconsistencies and variation in study definitions and methods making it hard to make firm conclusions regarding the dietary intake of Brazilian children. The development of tools to evaluate the complexities of dietary intake is much needed. Such a tool needs to be accepted and adopted by numerous study groups, to describe dietary status among Brazilian children and devise the most effective, and to evaluate the success of nutrition education programs.

Effects of a nutritional intervention using pictorial representations for promoting knowledge and practices of healthy eating among Brazilian adolescents

This study aimed to evaluate the effect of a nutritional intervention involving a problem-raising approach and the use of pictorial representations on the promotion of knowledge and practices of healthy eating among adolescents. This randomized study included 461 adolescents from public schools in Brasilia, Federal District, Brazil (intervention group: 273 students from four schools; control group: 188 students from three schools). Mean age was 14.8±1.0, and 52.9% were boys. The intervention consisted of three meetings with interactive activities about principles of healthy eating, food classification, importance of reading labels and analyzing food advertising critically, and representations of healthy and unhealthy meals and their sugar, salt, and fat content. Pictorial materials consisted of food drawings, food models, and a food packaging model. Controls were not exposed to any activity. Dietary knowledge, consumption, and behaviors were the variables of interest. The intervention group showed a higher mean score of correct answers to questions about dietary knowledge than the control group (p = 0.0006), with higher odds of correctly answering questions about in natura (OR: 3.7; 95% CI: 1.9–6.6), minimally processed (OR: 3.6; 95% CI: 1.9–6.4), processed (OR: 2.2; 95% CI: 1.1–4.3), and ultra-processed foods (OR: 3.5; 95% CI: 1.8–6.6) and composition of ultra-processed foods (OR: 2.4; 95% CI: 1.3–4.4). Participants in the intervention group were also 2.5 times more likely to correctly answer questions about the importance of the dietary environment (95% CI: 1.1–5.5) and caution with food advertising (95% CI: 1.2–5.3) than controls. Increased weekly consumption of vegetables (p = 0.0077; OR: 2.4; 95% CI: 1.26–4.51) and reduced consumption of soft drinks (p = 0.0212; OR: 0.36; 95% CI: 0.15–0.86) were observed in the intervention group compared to the control group. The proposed intervention increased adolescents’ knowledge and improved some of their dietary habits. Educational activities using a problem-raising approach and pictorial representations of food appear to be effective in promoting healthy eating practices among adolescents.

Prevalence and Factors Associated with Metabolic Syndrome among Brazilian Adult Population: National Health Survey - 2013

Background

In Brazil, population-based researches analyzing prevalence and factors associated with metabolic syndrome (MS), a recognized predictor of cardiovascular diseases (CVD), and an important cause of disability and death in the country are scarce.

Objective

To evaluate prevalence of MS and its associated factors in Brazilian population.

Methods

Secondary analysis of the 2013 National Health Survey, a cross-sectional survey with national representativeness of Brazilian adult population (n = 59,402). MS was the outcome variable, defined from harmonization of cardiology international consensus as load ≥ 3 of the following components: self-reported diabetes and hypercholesterolemia, high blood pressure and high waist circumference. Analysis were stratified by sex and prevalence ratios, with their respective 99% confidence intervals (PR [CI 99%]) calculated by simple and multiple Poisson regression models.

Results

MS prevalence was 8.9%, being significantly higher among women compared to men; in general, this pattern was maintained in relation to exposure variables studied. Additionally, less than 25% of population did not present any MS component. In final multiple models, sociodemographic, behavioral and comorbidity variables were associated with MS, however, while low schooling (1.46 [1.23-1.74], cerebrovascular accident (1.36 [1], 00] (1.28 [1.03-1.62]) were associated among women, chronic renal failure (1.85 [2.23-2.76]) was associated exclusively among men.

Conclusion

We identified MS high prevalence in Brazilian population; on the other hand, factors associated with this condition were different depending on sex.

[Nutrition, physical activity and substance use in children and adolescents : Representative results of the federal state module Thuringia in KiGGS wave 1]

The term health behaviour combines both health-promoting and health-risk components. In this study, the health behaviour of children and adolescents in Thuringia is analysed. The database was a representative subsample of the federal state module Thuringia, which was conducted by the Robert Koch Institute as part of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) wave 1 (2010-2012; n = 4,096; 3-17 years). Health behaviour was described based on nine indicators: fruit and vegetable consumption, soft drink consumption, breakfast at home, physical activity, sport, swimming ability, alcohol consumption, smoking and water pipe consumption (shisha smoking). Prevalence and mean values with 95 % confidence intervals were reported, and based on logistic or linear regression, the significance of the group differences was examined. The results show that 43.4 % of children and adolescents in Thuringia ate fruits and vegetables daily, 44.5 % consumed soft drinks less than once a week, and 67.9 % had breakfast at home every weekday. In addition, 31.0 % of children and adolescents in Thuringia were physically active at least 60 min a day, 69.8 % did sports for at least 2 h a week, and 81.5 % can swim. Additionally, 15.9 % of adolescents in Thuringia had hazardous alcohol consumption, 14.4 % currently smoked, and 20.0 % smoked a water pipe. Differences existed with regard to gender, age, socio-economic status (SES) of the family and residence (urban/rural). In summary, many of the children and adolescents in Thuringia demonstrate relatively positive health behaviour. However, the results also indicate groups at higher risk of unhealthy behaviour, such as children and adolescents from families with low SES.

Consumption of fruits and vegetables associated with other risk behaviors among adolescents in Northeast Brazil

Objective:

To determine the prevalence of consumption of fruits and vegetables and identify the association with low level of physical activity, exposure to sedentary behavior, consumption of soft drinks and overweight/obesity in adolescents.

Methods:

This is a cross-sectional school-based study with a representative sample of 3992 students aged 14–19 years from the state of Sergipe, Brazil. The outcome was low consumption of fruits and vegetables (<5servings/day). Independent variables were: level of physical activity, sedentary behavior, consumption of soft drinks, and overweight/obesity. Global Student Health Survey questionnaire and body mass and height measurements were used, as well as chi-square test and crude and adjusted binary logistic regression. The significance level adopted was 5%.

Results:

The prevalence of inadequate consumption of fruits and vegetables was high – 88.6% (95%CI=87.6–89.5). Higher likelihood of low consumption of fruits and vegetables was verified among boys who were exposed to sedentary behavior (OR=1.63; 95%CI=1.18–2.24), who consumed soft drinks (OR=3.04; 95%CI=2.10–4.40), with insufficiently physical activity (OR=1.98; 95%CI=1.43–2.73) and girls who consumed soft drinks (OR=1.88; 95%CI=1.43–2.47) and those with overweight/obesity (OR=1.63; 95%CI=1.19–2.23).

Conclusions:

There is a need of public policies aimed at encouraging the consumption of healthy foods among adolescents.

Weight concerns and food habits of adolescent girls in two contrasting ecological regions: A comparative study in India

OBJECTIVE

To compare the incidence of weight concerns and food habits between two ethnically different groups of adolescent girls residing in two distinct ecological settings: the plains of Kolkata and the mountains of Sikkim.

METHODS

Two separate cross-sectional studies were conducted within a period of five years in urban hilly areas of Sikkim and the city of Kolkata, India. A total of 506 girls aged 14-19 years were selected from the study areas of Sikkim (n=224) and Kolkata (n=282). Girls were interviewed for weight concerns and food habits along with socio-demographic characteristics. Weight concerns were assessed with four variables such as, perceptions about own body weight, felt dissatisfied with own body weight, urge for dieting and use of weight reduction diet. Food habits included consumption of major foods during the past one week.

RESULTS

Bivariate analyses showed that Kolkata girls perceived themselves as overweight, remained dissatisfied with body weight, expressed perceived need for dieting and followed weight reduction diet more compared to the girls of Sikkim. Food habits indicated that all Sikkimese girls preferred to consume cereals regularly, while Kolkata girls consumed vegetables, pulses, fish, fruits, bread and butter and fried foods more than Sikkimese girls. Multivariate analyses showed that place of residence was significantly (p<0.05) associated with both weight concerns and food habits of girls.

CONCLUSION

Diversity in culture, ethnicity and socio-economic standard perhaps develop the disparity in food habits and weight concerns between girls of urban hilly areas of Sikkim and the city of Kolkata.

[Prevalence and factors associated with the co-occurrence of health risk behaviors in adolescents]

OBJECTIVE

To analyze the prevalence and factors associated with the co-occurrence of health risk behaviors in adolescents.

METHODS

A cross-sectional study was performed with a sample of high school students from state public schools in Pernambuco, Brazil (n=4,207, 14-19 years old). Data were obtained using a questionnaire. The co-occurrence of health risk behaviors was established based on the sum of five behavioral risk factors (low physical activity, sedentary behavior, low consumption of fruits/vegetables, alcohol consumption and tobacco use). The independent variables were gender, age group, time of day attending school, school size, maternal education, occupational status, skin color, geographic region and place of residence. Data were analyzed by ordinal logistic regression with proportional odds model.

RESULTS

Approximately 10% of adolescents were not exposed to health risk behaviors, while 58.5% reported being exposed to at least two health risk behaviors simultaneously. There was a higher likelihood of co-occurrence of health risk behaviors among adolescents in the older age group, with intermediate maternal education (9-11 years of schooling), and who reported living in the driest (semi-arid) region of the state of Pernambuco. Adolescents who reported having a job and living in rural areas had a lower likelihood of co-occurrence of risk behaviors.

CONCLUSIONS

The findings suggest a high prevalence of co-occurrence of health risk behaviors in this group of adolescents, with a higher chance in five subgroups (older age, intermediate maternal education, the ones that reported not working, those living in urban areas and in the driest region of the state).