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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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Ued FDV, Félix PV, Nogueira-de-Almeida CA, Fisberg M. Intake of Table Sugar and Their Corresponding Food Sources in Adults from the 2017-2018 Brazilian National Dietary Survey. Nutrients 2024; 16:1085. [PMID: 38613118 PMCID: PMC11013856 DOI: 10.3390/nu16071085] [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: 03/11/2024] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024] Open
Abstract
Excessive intake of free sugars is associated with adverse health outcomes. Table sugar is one of the main dietary sources of free sugars; however, the amount added by Brazilian consumers in their culinary preparations is unknown. The aims were to estimate the daily intake of table sugar (g/day), its contribution to total energy intake (E%) and the main food groups that contribute to the intake of this sugar in a nationwide multi-ethnic sample of Brazilian adults (2017-2018 Brazilian National Dietary Survey). Based on two 24-h recalls adjusted for the within-person variation, the overall median table sugar intake was 14.3 g/day, corresponding to 3.2 E%. Males, individuals living in rural areas, with low income, low education and experiencing food insecurity had a higher intake of table sugar. The main food sources of table sugar were coffee (55.8%), juice (33.9%), milk-based preparations and smoothies (3.1%), powdered and processed juice (2.7%), whole milk (1.9%), and tea (1.6%). There are no recommendations regarding the limit of table sugar intake, but considering that the WHO limits the intake of free sugars to <10 E%, it is concluded that table sugar intake by Brazilians corresponds to about 30% of the upper recommended daily intake of free sugars.
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Affiliation(s)
- Fábio da Veiga Ued
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, Brazil
| | - Paula Victória Félix
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil;
| | | | - Mauro Fisberg
- Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo 01227-200, Brazil;
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Silva Júnior JNBD, Freiria CN, Silva GMD, Corona LP. Factors associated with added sugar consumption of older adults from the region of Campinas-SP, Brazil. CIENCIA & SAUDE COLETIVA 2023; 28:1219-1228. [PMID: 37042901 DOI: 10.1590/1413-81232023284.13112022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 10/06/2022] [Indexed: 04/13/2023] Open
Abstract
Adequate nutrition has a profound impact on older adults' health. Therefore, special attention should be given to the dietetic intake of added sugars, which in excess is associated with poorer control of chronic diseases in this phase. The aim of the study was to evaluate the prevalence of consumption of added sugars in older adults in the Campinas-SP region, its associated factors, and its main dietary sources. A cross-sectional study was conducted in the region of Campinas-SP, with a convenience sample of 586 older individuals. Intake was obtained using two 24-hour food recalls, and values >5% of total energy consumption were considered inadequate. The contribution of the groups and foods in relation to the total content of sugars was also calculated. A critical level of p<0.05 was considered. The average intake of added sugars was higher than recommended (7.0%), and this inadequacy was observed in more than half of the sample, being table sugar and honey the main dietary sources. The prevalence of inadequate consumption was higher among women (69.8%; p=0.004) and individuals with low weight (83.7%; p=0.014), and lower in those with diabetes (47.8%; p<0.001). Results indicate that health and nutrition actions should be developed to ensure adequate sugar intake at this stage.
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Affiliation(s)
| | - Carolina Neves Freiria
- Faculdade de Ciências Aplicadas, Universidade Estadual de Campinas. R. Pedro Zaccaria 1300, Jardim Paulista. 13484-350 Limeira SP Brasil.
| | - Graziele Maria da Silva
- Faculdade de Ciências Aplicadas, Universidade Estadual de Campinas. R. Pedro Zaccaria 1300, Jardim Paulista. 13484-350 Limeira SP Brasil.
| | - Ligiana Pires Corona
- Faculdade de Ciências Aplicadas, Universidade Estadual de Campinas. R. Pedro Zaccaria 1300, Jardim Paulista. 13484-350 Limeira SP Brasil.
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Pereira RC, Souza Carneiro JDD, de Angelis Pereira MC. Evaluating nutrition quality of packaged foods carrying claims and marketing techniques in Brazil using four nutrient profile models. JOURNAL OF FOOD SCIENCE AND TECHNOLOGY 2022; 59:1520-1528. [PMID: 35250075 PMCID: PMC8882526 DOI: 10.1007/s13197-021-05162-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 05/24/2021] [Accepted: 05/28/2021] [Indexed: 12/01/2022]
Abstract
The present study aimed to evaluate the nutrient profile of packaged foods marketed in Brazil, giving insights into healthiness of the Brazilian supermarket packaged food environment, considering different food categories and levels of industrial food processing and presence of nutrition and health claims and marketing strategies. A cross-sectional survey was conducted on the labels of pre-packed foods marketed in a home-shopping website. A stratified random sample (n = 335) was obtained to be analysed by four nutrient profile models: Food Standards Australia New Zealand's Nutrient Profiling Scoring Criterion, UK Nutrient Profile from the Food Standards Agency, Nutrient profile model from Pan American Health Organization, and Nutrition Score from Unilever Food & Health Research (Unilever). Overall, the models shown agreement, besides some differences in the levels of approval. Ultra-processed foods were less healthy. Pass rates for products carrying nutrition and/or health claims have evidenced the presence of these claims may be indicative of slightly better nutritional quality. This did not apply for products with and without marketing techniques. These findings highlight the need for improvement of the supermarket packaged food environment in scenarios like Brazil by increasing efforts to reformulate products to make them healthier, together with appropriate food labelling regulation.
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Affiliation(s)
- Rafaela Corrêa Pereira
- Department of Agricultural Science, Federal Institute of Minas Gerais, Bambuí, MG Brazil
- Department of Nutrition, Federal University of Lavras, PO box 3037, Lavras, MG 37200-900 Brazil
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Petrus RR, do Amaral Sobral PJ, Tadini CC, Gonçalves CB. The NOVA classification system: A critical perspective in food science. Trends Food Sci Technol 2021. [DOI: 10.1016/j.tifs.2021.08.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Henriques P, Alvarenga CRTD, Ferreira DM, Dias PC, Soares DDSB, Barbosa RMS, Burlandy L. Food environment surrounding public and private schools: an opportunity or challenge for healthy eating? CIENCIA & SAUDE COLETIVA 2020; 26:3135-3145. [PMID: 34378704 DOI: 10.1590/1413-81232021268.04672020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 06/01/2020] [Indexed: 11/22/2022] Open
Abstract
The study analyzed and compared the types of food sold in the surroundings of 30 private and 26 public elementary schools in the city of Niterói, Rio de Janeiro. Data were collected by audit using a checklist instrument to characterize establishments (formal or informal) and identify the types of food and beverages sold, which were classified by processing level (fresh, processed, and ultraprocessed). Mann-Whitney statistical tests were used to verify the difference in the type of trade outlets d the categories of food sold between schools. The Kruskal-Wallis test was used to verify the difference in the amount of food traded between the categories. The amount of ultraprocessed food in the surroundings of public and private schools was statistically higher (p=0.0001) than the other categories. Some culinary preparations had a high rate of energy contribution from ultraprocessed foods (above 15%). There was no statistically significant difference (p = 0.478) in the categories of food sold between public and private schools. The sale of ultraprocessed products predominates around public and private schools, favoring the exposure of children to an environment that encourages the consumption of these products.
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Affiliation(s)
- Patrícia Henriques
- Programa de Pós-Graduação em Ciências da Nutrição, Departamento de Nutrição, Universidade Federal Fluminense. Niterói, Rio de Janeiro, Brasil. Rua Mario Santos Braga 30, Valonguinho. 24020-150 Niterói RJ Brasil.
| | | | - Daniele Mendonça Ferreira
- Programa de Pós-Graduação em Ciências da Nutrição, Departamento de Nutrição, Universidade Federal Fluminense. Niterói, Rio de Janeiro, Brasil. Rua Mario Santos Braga 30, Valonguinho. 24020-150 Niterói RJ Brasil.
| | - Patricia Camacho Dias
- Programa de Pós-Graduação em Ciências da Nutrição, Departamento de Nutrição, Universidade Federal Fluminense. Niterói, Rio de Janeiro, Brasil. Rua Mario Santos Braga 30, Valonguinho. 24020-150 Niterói RJ Brasil.
| | - Daniele da Silva Bastos Soares
- Programa de Pós-Graduação em Ciências da Nutrição, Departamento de Nutrição, Universidade Federal Fluminense. Niterói, Rio de Janeiro, Brasil. Rua Mario Santos Braga 30, Valonguinho. 24020-150 Niterói RJ Brasil.
| | - Roseane Moreira Sampaio Barbosa
- Programa de Pós-Graduação em Ciências da Nutrição, Departamento de Nutrição, Universidade Federal Fluminense. Niterói, Rio de Janeiro, Brasil. Rua Mario Santos Braga 30, Valonguinho. 24020-150 Niterói RJ Brasil.
| | - Luciene Burlandy
- Programa de Pós-Graduação em Ciências da Nutrição, Departamento de Nutrição, Universidade Federal Fluminense. Niterói, Rio de Janeiro, Brasil. Rua Mario Santos Braga 30, Valonguinho. 24020-150 Niterói RJ Brasil. .,Programa de Estudos Pós-Graduados em Política Social, Universidade Federal Fluminense. Niterói RJ Brasil
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Lopes WC, Pinho LD, Caldeira AP, Lessa ADC. CONSUMPTION OF ULTRA-PROCESSED FOODS BY CHILDREN UNDER 24 MONTHS OF AGE AND ASSOCIATED FACTORS. ACTA ACUST UNITED AC 2020; 38:e2018277. [PMID: 32074226 PMCID: PMC7025446 DOI: 10.1590/1984-0462/2020/38/2018277] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 11/27/2018] [Indexed: 11/22/2022]
Abstract
Objective: To evaluate the intake of ultra-processed foods by children under 24 months
of age from the city of Montes Claros and identify factors associated with
this consumption. Methods: This is a population-based cross-sectional study with data collected from
households through interviews. A questionnaire assessed the sociodemographic
conditions of the family, maternal and child characteristics, and food
consumption. We adopted a multivariate model to identify factors associated
with the intake of ultra-processed foods. Results: A total of 545 children participated in this study, of whom 74.3% consumed
some kind of ultra-processed food. The factors most strongly associated with
this consumption were children older than six months, infants who were not
breastfed, households with up to three residents, and the main caregiver of
the child being someone other than the mother. Conclusions: Children under 24 months start consuming ultra-processed products at an
early age, replacing foods considered natural and healthy. This study can
contribute to guide health professionals in counseling families about
feeding in the first years of life, emphasizing the proper introduction of
complementary feeding and discouraging the consumption of ultra-processed
products.
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Monteiro LS, Rodrigues PRM, Sichieri R, Pereira RA. Intake of saturated fat, trans fat, and added sugars by the Brazilian population: an indicator to evaluate diet quality. Eur J Clin Nutr 2020; 74:1316-1324. [PMID: 32047290 DOI: 10.1038/s41430-020-0582-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 01/29/2020] [Accepted: 01/31/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVE In recent decades, changes in the diet of Brazilians have been characterized by increased consumption of high energy-dense foods, rich in fat and sugar. This study was aimed at assessing diet quality based on the intake of foods with high content of solid fat and added sugars (SoFAS). SUBJECTS/METHODS The first Brazilian National Dietary Survey (2008-2009) is a nationwide representative cross-sectional study that collected food records from 34,003 ≥ 10-year-old individuals. A receiver-operating characteristic curve was used to determine the limit that would identify diets with high SoFAS content. RESULTS The limit of 45% of total dietary energy provided by SoFAS was adopted to classify diets with excessive content. The SoFAS provided 53% of daily energy intake to adolescents, 49% to adults, and 48% to the elderly. A high intake of SoFAS was found in 64.7% of adolescents, 59.1% of adults, and 57.8% of the elderly. The contribution of SoFAS to daily energy intake increased with income in all age groups. Those with high consumption of SoFAS had higher intakes of sugar-sweetened beverages, cookies and cakes, processed meats, chips, candy and chocolate, and sandwiches and snacks, when compared with those that had moderate SoFAS intake (<45% of daily energy). CONCLUSIONS The 45% cutoff point for the contribution of SoFAS foods to total energy intake, utilized to classify low-quality diets, allowed to point out the high-risk profile of the Brazilian diet.
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Affiliation(s)
- Luana Silva Monteiro
- Curso de Nutrição. Universidade Federal do Rio de Janeiro, Av. Aluizio da Silva Gomes, 50-Novo Cavaleiros, CEP 27930-560, Macaé, Rio de Janeiro, Brazil.
| | - Paulo Rogério Melo Rodrigues
- Faculdade de Nutrição. Universidade Federal de Mato Grosso, Avenida Fernando Corrêa da Costa, 2367. Bairro Boa Esperança, CEP 78060-900, Cuiabá, Mato Grosso, Brazil
| | - Rosely Sichieri
- Instituto de Medicina Social-Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier, 524, Pavilhão João Lyra Filho, 7° andar, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rosangela Alves Pereira
- Departamento de Nutrição Social e Aplicada, Universidade Federal do Rio de Janeiro, Avenida Carlos Chagas Filho, 373. Edifício do Centro de Ciências da Saúde, Bloco J, 2° andar, Cidade Universitária, CEP 21941-590, Rio de Janeiro, Rio de Janeiro, Brazil
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Camargo DFM, Belon AP, Marín-León L, Souza BFDNJD, Pérez-Escamilla R, Segall-Corrêa AM. Comparing food environment and food purchase in areas with low and high prevalence of obesity: data from a mapping, in-store audit, and population-based survey. CAD SAUDE PUBLICA 2019; 35:e00247218. [PMID: 31508702 DOI: 10.1590/0102-311x00247218] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 03/22/2019] [Indexed: 11/21/2022] Open
Abstract
Our study aimed to compare key aspects of the food environment in two low-income areas in the city of Campinas, São Paulo State, Brazil: one with low and the other with high prevalence of obesity. We compared the availability of retail food establishments, the types of food sold, and the residents' eating habits. Demographic and socioeconomic data and eating habits were obtained from a population-based health survey. We also analyzed local food environment data collected from remote mapping of the retail food establishments and audit of the foods sold. For comparison purposes, the areas were selected according to obesity prevalence (body mass index - BMI ≥ 30kg/m²), defined as low prevalence (< 25%) and high prevalence (> 45%). Only 18 out of the 150 points of sale for food products sold fruits and vegetables across the areas. Areas with high obesity prevalence had more grocery stores and shops specialized in fruits and vegetables, as well as more supermarkets that sold fruits and vegetables. With less schooling, residents in the areas with high obesity prevalence reported purchasing food more often in supermarket chains and specialized shops with fruits and vegetables, although they consumed more sodas when compared with residents of areas with low obesity prevalence. Our results suggest interventions in low-income areas should consider the diverse environmental contexts and the interaction between schooling and food purchase behaviors in settings less prone to healthy eating.
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Affiliation(s)
| | | | - Leticia Marín-León
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, Brasil
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de Sousa JR, Botelho RBA, Akutsu RDCCA, Zandonadi RP. Nutritional Quality of Breakfast Consumed by the Low-Income Population in Brazil: A Nationwide Cross-Sectional Survey. Nutrients 2019; 11:nu11061418. [PMID: 31238519 PMCID: PMC6628221 DOI: 10.3390/nu11061418] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 06/15/2019] [Accepted: 06/20/2019] [Indexed: 01/02/2023] Open
Abstract
Objective: This study aimed to characterize the nutritional quality of breakfast consumed by the low-income Brazilian population. Methods: A cross-sectional study was conducted with a sample of 1547 low-income individuals attending 36 Community Restaurants (CRs) in Brazil. Food consumption was analyzed by the frequency of food groups presented in the 24 h recall for three days. The nutritional consumption consisted of the analysis of the total energetic value (TEV) and the macronutrients, fibers, monounsaturated fatty acids, saturated fatty acids, trans fatty acids, calcium, and sodium. The nutrients were evaluated considering the percentage of contribution concerning the daily recommendation of consumption. Results: Among the 4641 breakfasts expected to be consumed and reported, 17.2% (n = 797) of the consumers did not consume breakfast. Therefore, we analyzed the 3844 breakfasts. The analysis of food groups showed a high consumption of dairy and cereals, and low consumption of fruits, roots/tubers, and meat/eggs. The percentages of energy contribution of the macronutrients in the TEV were adequate for a balanced diet. The mean intake of monounsaturated fatty acids was low, and the contribution percentages of saturated fatty acids and trans fatty acids were within the recommendations. The mean fiber intake of the breakfast was low, agreeing with the result of low fruit consumption. Calcium intake covered 73.49% of that expected for this meal, and sodium intake was adequate in breakfast. Conclusion: The individuals studied consumed a nutritionally balanced breakfast. Although dairy was one of the most consumed groups, calcium consumption was low, indicating the need to consume higher portions of food sources of this nutrient.
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Affiliation(s)
- Janice Ramos de Sousa
- Department of Nutrition, Faculty of Health Sciences, University of Brasilia, Brasilia 70910-900, Brazil
| | - Raquel B A Botelho
- Department of Nutrition, Faculty of Health Sciences, University of Brasilia, Brasilia 70910-900, Brazil.
| | - Rita de Cássia C A Akutsu
- Department of Nutrition, Faculty of Health Sciences, University of Brasilia, Brasilia 70910-900, Brazil.
| | - Renata Puppin Zandonadi
- Department of Nutrition, Faculty of Health Sciences, University of Brasilia, Brasilia 70910-900, Brazil.
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Malta DC, Bernal RTI, Vieira Neto E, Curci KA, Pasinato MTDM, Lisbôa RM, Cachapuz RF, Coelho KSC. Trends in risk and protective factors for non-communicable diseases in the population with health insurance in Brazil from 2008 to 2015. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2018; 21:e180020. [PMID: 30517471 DOI: 10.1590/1980-549720180020.supl.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 11/16/2017] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To analyze trends in risk and protective factors for non-communicable diseases (NCD) and access to preventive tests in the population with health insurance in Brazilian state capitals between 2008 and 2015. METHODS This is a cross-sectional study that analyzed data collected from the Surveillance of Risk and Protective Factors for non-communicable diseases (NCD) Telephone Survey (Sistema Nacional de Vigilância de Doenças Crônicas por Inquérito Telefônico - Vigitel) on adults aged 18 years and older. We analyzed trends in NCD indicators among health insurance users in approximately 30 thousand interviews done between 2008 and 2015. We used the simple linear regression model to calculate the trends. RESULTS Health insurance users showed an increase in the prevalence of protective factors such as fruit and vegetable consumption, and physical activity in leisure time. Also, there was a decrease in risk factors such as smoking and soft drink consumption, increase in mammography coverage, and a drop in smoking prevalence. However, overweight, obesity, and diabetes increased. CONCLUSION There are differences according to gender, and, in general, women accumulate more protective factors and men, more risk factors.
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Affiliation(s)
- Deborah Carvalho Malta
- Departamento de Enfermagem Materno Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil
| | - Regina Tomie Ivata Bernal
- Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil
| | - Eduardo Vieira Neto
- Diretoria de Normas e Habilitação dos Produtos, Agência Nacional de Saúde Suplementar - Rio de Janeiro (RJ), Brasil
| | - Katia Audi Curci
- Diretoria de Normas e Habilitação dos Produtos, Agência Nacional de Saúde Suplementar - Rio de Janeiro (RJ), Brasil
| | | | - Raquel Medeiros Lisbôa
- Diretoria de Normas e Habilitação dos Produtos, Agência Nacional de Saúde Suplementar - Rio de Janeiro (RJ), Brasil
| | - Renata Fernandes Cachapuz
- Diretoria de Normas e Habilitação dos Produtos, Agência Nacional de Saúde Suplementar - Rio de Janeiro (RJ), Brasil
| | - Karla Santa Cruz Coelho
- Diretoria de Normas e Habilitação dos Produtos, Agência Nacional de Saúde Suplementar - Rio de Janeiro (RJ), Brasil
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Trends in sweetened beverages consumption among adults in the Brazilian capitals, 2007–2016. Public Health Nutr 2018; 21:3307-3317. [DOI: 10.1017/s1368980018002161] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveTo analyse trends in sweetened beverages consumption among adults in Brazil between 2007 and 2016.DesignA time-series analysis, with data from the Surveillance System of Risk and Protection Factors for Chronic Diseases by Telephone Survey (VIGITEL). The prevalence of regular consumption (≥5 d/week), the average daily consumption (millilitres) and the prevalence of non-consumption of these beverages were analysed. The temporal variations of the indicators were calculated by linear regression. The analyses were performed for the complete set of the evaluated population and stratified by sociodemographic characteristics.SettingBrazilian capitals and Federal District.SubjectsBrazilian adults aged ≥18 years (n 519 641).ResultsThere was a reduction in both regular and average daily consumption of sugar- and artificially sweetened beverages (−1·28 percentage points (pp)/year, P=0·001 and −9·63 ml/year, P=0·001, respectively). The same result regarding regular consumption was found when only sugar-sweetened beverages were analysed (−1·11 pp/year, P=0·011). Similar trends were identified in the stratified analyses, with a greater magnitude of reduction among males, young adults, those with higher schooling and residents of more developed regions. Coincidentally, there was an increase in the prevalence of adults who did not consume sweetened beverages (1·54 pp/year, P=0·005).ConclusionsThe consumption of sweetened beverages decreased during the period. However, a significant portion of the population still referred a daily consumption of these beverages.
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Popkin BM, Reardon T. Obesity and the food system transformation in Latin America. Obes Rev 2018; 19:1028-1064. [PMID: 29691969 PMCID: PMC6103889 DOI: 10.1111/obr.12694] [Citation(s) in RCA: 240] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 03/01/2018] [Accepted: 03/16/2018] [Indexed: 02/06/2023]
Abstract
The Latin America and the Caribbean (LAC) region faces a major diet-related health problem accompanied by enormous economic and social costs. The shifts in diet are profound: major shifts in intake of less-healthful low-nutrient-density foods and sugary beverages, changes in away-from-home eating and snacking and rapid shifts towards very high levels of overweight and obesity among all ages along with, in some countries, high burdens of stunting. Diet changes have occurred in parallel to, and in two-way causality with, changes in the broad food system - the set of supply chains from farms, through midstream segments of processing, wholesale and logistics, to downstream segments of retail and food service (restaurants and fast food chains). An essential contribution of this piece is to marry and integrate the nutrition transition literature with the literature on the economics of food system transformation. These two literatures and debates have been to date largely 'two ships passing in the night'. This review documents in-depth the recent history of rapid growth and transformation of that broad food system in LAC, with the rapid rise of supermarkets, large processors, fast food chains and food logistics firms. The transformation is the story of a 'double-edged sword', showing its links to various negative diet side trends, e.g. the rise of consumption of fast food and highly processed food, as well as in parallel, to various positive trends, e.g. the reduction of the cost of food, de-seasonalization, increase of convenience of food preparation reducing women's time associated with that and increase of availability of some nutritious foods like meat and dairy. We view the transformation of the food system, as well as certain aspects of diet change linked to long-run changes in employment and demographics (e.g. the quest for convenience), as broad parameters that will endure for the next decades without truly major regulatory and fiscal changes. We then focus in on what are the steps that are being and can be taken to curb the negative effects on diet of these changes. We show that countries in LAC are already among the global leaders in initiating demand-related solutions via taxation and marketing controls. But we also show that this is only a small step forward. To shift LAC's food supply towards prices that incentivize consumption of healthier diets and demand away from the less healthy component is not simple and will not happen immediately. We must be cognizant that ultimately, food industry firms must be incentivized to market the components of healthy diets. This will primarily need to be via selective taxes and subsidies, marketing controls, as well as food quality regulations, consumer education and, in the medium term, consumers' desires to combine healthier foods with their ongoing quest for convenience in the face of busy lives. In the end, the food industry in LAC will orient itself towards profitable solutions, ie those demanded by the broad mass of consumers.
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Affiliation(s)
- B M Popkin
- Department of Nutrition, Gillings School of Global Public Health, Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - T Reardon
- Department of Agricultural, Food, and Resource Economics, Michigan State University, East Lansing, MI, USA
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Souto DL, Dantas JR, Oliveira MMDS, Rosado EL, Luiz RR, Zajdenverg L, Rodacki M. Does sucrose affect the glucose variability in patients with type 1 diabetes? a pilot crossover clinical study. Nutrition 2018; 55-56:179-184. [PMID: 30086487 DOI: 10.1016/j.nut.2018.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 05/26/2018] [Accepted: 05/28/2018] [Indexed: 10/14/2022]
Abstract
OBJECTIVE The aim of this study was to compare the effects of a sucrose-free diet with a sucrose-added diet on glucose variability in patients with type 1 diabetes. METHODS This was a two-way crossover design study in which patients with type 1 diabetes were monitored by blinded continuous glucose monitoring and were selected to receive a sucrose-free diet (<30 g/d), followed by a sucrose-added diet (>80 g/d) for 2 d each. Intra-day glucose variability was assessed by the mean amplitude of glycemic excursions (MAGE), the M-value, J-index, glycemic risk assessment in diabetes equation (GRADE), and continuous overlapping net glycemic action (CONGA1-3). Between-day variability was determined by mean of daily difference (MODD). Statistical analyses were performed with a significance level of 5%. RESULTS Ten patients with type 1 diabetes were evaluated. The participants were a mean of 26.1 ± 7.1 y of age. The mean duration of disease was 16.5 ± 10.5 y, and patients' mean glycated hemoglobin was 7.4% ± 0.8%. The intra- and inter-day glucose variability indexes did not differ between the diet periods (MAGE: 10.2 ± 5.1 and 10.4 ± 6.8mmol/L, P = 0.98; M-value: 12.9 ± 2 and 15.6 ± 1.3mmol/L, P = 0.29; J-index: 50.9 ± 4.4 and 57.7 ± 3.3mmol/L, P = 0.41; GRADE: 7.2 ± 1 and 4.7 ± 5.3mmol/L, P = 0.07; and MODD: 3.9 ± 1 and 4.3 ± 1.5mmol/L, P = 0.28; for the sucrose-free and sucrose-added diets, respectively). CONGA1-3 were similar for both diet periods (P > 0.05). CONCLUSIONS The use of a moderate amount of sucrose, as part of a balanced diet, did not affect the glucose variability or insulin requirements in patients with type 1 diabetes.
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Affiliation(s)
- Débora Lopes Souto
- Department of Internal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Joana Rodrigues Dantas
- Department of Internal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Eliane Lopes Rosado
- Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ronir Raggio Luiz
- Institute of Public Health Studies, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lenita Zajdenverg
- Department of Internal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Melanie Rodacki
- Department of Internal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Carrijo ADP, Botelho RBA, Akutsu RDCCDA, Zandonadi RP. Is What Low-Income Brazilians Are Eating in Popular Restaurants Contributing to Promote Their Health? Nutrients 2018; 10:nu10040414. [PMID: 29584659 PMCID: PMC5946199 DOI: 10.3390/nu10040414] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 02/28/2018] [Accepted: 03/05/2018] [Indexed: 11/16/2022] Open
Abstract
This study evaluates the healthfulness of the meals offered to and consumed by low-income Brazilians in Popular Restaurants (PR). It is a cross-sectional, exploratory study. The final sample includes 36 PRs, respecting the stratification criteria for each of the five Brazilian regions. To identify the quantity and quality of food consumption, consumers’ meals are evaluated. The sample calculation uses a minimum of 41 consumers in each PR. Consumption evaluation is carried out by weighing and direct observation of the meal that each consumer served to his plate. Each dish of the meals had its Technical preparation files (TPF) developed by observing the production and weighing all the ingredients. Evaluations of Energy density (ED), meal’s weight components and sodium composition are conducted. Plate’s composition is compared to “My plate” guidelines United States Department of Agriculture (USDA). The final sample includes 1771 low-income Brazilians consumers. The plate of PRs consumers is adequate only for the “protein group” in comparison to “My plate”. Rice and beans compose more than 50% of the plate’s weight, as expected, since it is a Brazilian habit of consumption at lunch. Thus, grains are the major group consumed by PRs consumers. The average ED for all PRs is 1.34 kcal/g. Regarding sodium content, rice and main courses presented the highest values and are classified as high, according to Food and Drug Administration (FDA). Concerning sodium, PRs are putting Brazilian low-income population at risk for chronic diseases. However, in general, PRs are good choices because they promote access to cheap and quality traditional Brazilian foods.
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Affiliation(s)
- Alinne de Paula Carrijo
- Research Group in Nutritional and Nourishment Quality, Department of Nutrition, University of Brasilia, Brasilia DF 70910-900, Brazil.
| | - Raquel Braz Assunção Botelho
- Research Group in Nutritional and Nourishment Quality, Department of Nutrition, University of Brasilia, Brasilia DF 70910-900, Brazil.
| | | | - Renata Puppin Zandonadi
- Research Group in Nutritional and Nourishment Quality, Department of Nutrition, University of Brasilia, Brasilia DF 70910-900, Brazil.
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Use of Table Sugar and Artificial Sweeteners in Brazil: National Dietary Survey 2008-2009. Nutrients 2018; 10:nu10030295. [PMID: 29494539 PMCID: PMC5872713 DOI: 10.3390/nu10030295] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 02/17/2018] [Accepted: 02/23/2018] [Indexed: 02/02/2023] Open
Abstract
The study aimed to describe the use of table sugar and artificial sweeteners (AS) in Brazil. A representative sample (n = 32,749) of individuals aged > 10 years was examined from the Brazilian National Dietary Survey (2008–2009). Participants reported whether they use table sugar, AS, both, or none as sweeteners for their foods and beverages. Energy intake and the contribution of selected food groups to energy intake were evaluated according to the type of sweetener reported. Sample weights and design effects were considered in the analysis. The majority of the population (85.7%) used sugar to sweeten foods and beverages, 7.6% used AS, and 5.1% utilized both products. The use of AS was more frequent among the elderly (20%), women (10% versus 5.5%), overweight individuals (10% versus 6%), those who live in urban areas (8.5% versus 3%), and those who belong to the highest income quartile (14% versus 1.6%), compared with men, normal weight individuals, those who live in rural areas, and those who belong to the first income quartile, respectively. Overall, the mean daily energy intake of individuals using only sugar was approximately 16% higher than those who used AS exclusively. The contribution of staple foods to daily energy intake was higher in individuals who used sugar than those who used AS.
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Ultra-processed food product brands on Facebook pages: highly accessed by Brazilians through their marketing techniques. Public Health Nutr 2018; 21:1515-1519. [DOI: 10.1017/s1368980018000083] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveTo analyse the content and extent of marketing of ultra-processed food products (UPP) and their brand pages on Facebook, which are highly accessed by Brazilians.DesignDescriptive.SettingSixteen UPP brand pages on Facebook were selected from 250 pages that were the most liked by Brazilians in October 2015.SubjectsWe analysed the frequency of ‘likes’ and members ‘talking about’ each one of the pages, in addition to fifteen marketing techniques used in the previous year (September 2014 to October 2015). The number of posts, likes, ‘shares’ and ‘commentaries’, and the mean number of likes, shares and commentaries per post, were collected for one month, from 23 September to 23 October 2015.ResultsThe two most liked pages were: Coke® (93 673 979 likes) and McDonald’s® (59 749 819 likes). Regarding the number of people talking about the pages, McDonald’s led with 555 891 commentaries, followed by Coke (287 274), Burger King® (246 148) and Kibon® (244 523). All pages used marketing techniques, which included photos, user conversations, presence of brand elements and links. Videos were observed on 93·8 % of the pages; promotions on 68·8 %; and celebrities on 62·5 %. In one month, Garoto®, Outback® and Coke were brands that published more than one post per day. Kibon achieved the highest ratio of likes per post (285 845·50) and Burger King had the highest mean shares per post (10 083·93), including commentaries per post (7958·13).ConclusionsUPP marketing is extensively used on Facebook pages and is highly accessed by Brazilians, with UPP companies employing a diversity of marketing strategies.
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Braz M, Assumpção DD, Barros MBDA, Barros Filho ADA. Added sugar intake by adolescents: A population-based study. CIENCIA & SAUDE COLETIVA 2018; 24:3237-3246. [PMID: 31508744 DOI: 10.1590/1413-81232018249.24692017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 02/13/2018] [Indexed: 01/09/2023] Open
Abstract
The aim of the present study was to estimate the prevalence of added sugar intake within the maximum limit of 5% of the total energy of the diet and test associations with demographic/socioeconomic characteristics, health-related behaviors and nutritional status in adolescents. A population-based, cross-sectional study was conducted with two-stage cluster sampling. The amount of free sugar in the diet was estimated using a 24-hour dietary recall. Among the 924 adolescents evaluated, only 20.1% (95% CI: 16.8-23.9) met the recommendation of not exceeding 5% of total calories with added sugar. Higher prevalence rates of adherence to the recommendation were found among males (22.0%), adolescents aged 15 to 19 years (24.3%), those born outside the state of São Paulo (30.4%), those with less screen time (27.5%), those with a lower number of household appliances (0-7: 29.5%; 8-15: 20.3%) and those with higher diet quality scores (2nd tertile: 17.7%; 3rd tertile: 37.2%). The findings demonstrate factors associated with added sugar intake from an epidemiological perspective, revealing the simultaneity of inappropriate behaviors, that is, the adolescents who consume more sugar also have longer screen time and worse overall diet quality.
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Affiliation(s)
- Marici Braz
- Departamento de Pediatria, Universidade Estadual de Campinas (Unicamp). R. Tessália Vieira de Camargo 126, Zeferino Vaz. 13083-887 Campinas SP Brasil.
| | - Daniela de Assumpção
- Departamento de Pediatria, Universidade Estadual de Campinas (Unicamp). R. Tessália Vieira de Camargo 126, Zeferino Vaz. 13083-887 Campinas SP Brasil.
| | | | - Antonio de Azevedo Barros Filho
- Departamento de Pediatria, Universidade Estadual de Campinas (Unicamp). R. Tessália Vieira de Camargo 126, Zeferino Vaz. 13083-887 Campinas SP Brasil.
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Monteiro LS, Hassan BK, Estima CCP, Souza ADM, Verly E, Sichieri R, Pereira RA. Food Consumption According to the Days of the Week - National Food Survey, 2008-2009. Rev Saude Publica 2017; 51:93. [PMID: 29020121 PMCID: PMC5676750 DOI: 10.11606/s1518-8787.2017051006053] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 10/02/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Evaluate the variations in energy, nutrients, and food groups intake between days of the week and weekend days in the Brazilian population. METHODS We used data from the first National Food Survey (2008-2009) of a one-day food log of a representative sample of the Brazilian population aged 10 years or older (n = 34,003). For the analyses, we considered the sample weights and the effect of the study design. The mean (and standard deviations) and frequencies (%) of energy, nutrients, and food groups consumption were estimated for weekdays (Monday to Friday) and weekend (Saturday and Sunday), we then estimated the differences according to the days of the week for the population strata analyzed. RESULTS The average daily energy intake for the weekend was 8% higher than the one observed for weekdays. The average percentage contribution of carbohydrate to the daily energy intake was higher during the week compared to Saturday and Sunday (56.3% versus 54.1%, p < 0.01). The inverse was observed for averages of the contribution to the daily intake of energy from total fat (26.8% versus 28.4%), saturated fat (9.1% versus 9.9%) and trans fat (1.4% versus 1.6%). The most significant changes between weekdays and weekend days were observed for eggs, sugar-added beverages, puff snacks and chips, beans, and pasta. During weekends, the frequency of beverage with added sugar consumption increased by 34%, the amount consumed increased by 42%, and the contribution to energy intake increased by 62% when compared to weekdays. CONCLUSIONS The Brazilian population increases energy intake and unhealthy food markers on weekends compared to weekdays.
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Affiliation(s)
| | - Bruna Kulik Hassan
- Programa de Pós-Graduação em Saúde Coletiva. Instituto de Medicina Social. Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil
| | - Camilla Chermont Prochnik Estima
- Programa de Pós-Graduação em Saúde Coletiva. Instituto de Medicina Social. Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil
| | - Amanda de Moura Souza
- Instituto de Estudos em Saúde Coletiva. Universidade Federal do Rio de Janeiro. Rio de Janeiro, RJ, Brasil
| | - Eliseu Verly
- Departamento de Epidemiologia. Instituto de Medicina Social. Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil
| | - Rosely Sichieri
- Departamento de Epidemiologia. Instituto de Medicina Social. Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil
| | - Rosangela Alves Pereira
- Departamento de Nutrição Social Aplicada. Instituto de Nutrição Josué de Castro. Universidade Federal do Rio de Janeiro. Rio de Janeiro, RJ, Brasil
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Effects of reducing processed culinary ingredients and ultra-processed foods in the Brazilian diet: a cardiovascular modelling study. Public Health Nutr 2017; 21:181-188. [PMID: 28885137 DOI: 10.1017/s1368980017002063] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To estimate the impact of reducing saturated fat, trans-fat, salt and added sugar from processed culinary ingredients and ultra-processed foods in the Brazilian diet on preventing cardiovascular deaths by 2030. DESIGN A modelling study. SETTING Data were obtained from the Brazilian Household Budget Survey 2008/2009. All food items purchased were categorized into food groups according to the NOVA classification. We estimated the energy and nutrient profile of foods then used the IMPACT Food Policy model to estimate the reduction in deaths from CVD up to 2030 in three scenarios. In Scenario A, we assumed that the intakes of saturated fat, trans-fat, salt and added sugar from ultra-processed foods and processed culinary ingredients were reduced by a quarter. In Scenario B, we assumed a reduction of 50 % of the same nutrients in ultra-processed foods and processed culinary ingredients. In Scenario C, we reduced the same nutrients in ultra-processed foods by 75 % and in processed culinary ingredients by 50 %. RESULTS Approximately 390 400 CVD deaths might be expected in 2030 if current mortality patterns persist. Under Scenarios A, B and C, CVD mortality can be reduced by 5·5, 11·0 and 29·0 %, respectively. The main impact is on stroke with a reduction of approximately 6·0, 12·6 and 32·0 %, respectively. CONCLUSIONS Substantial potential exists for reducing the CVD burden through overall improvements of the Brazilian diet. This might require reducing the penetration of ultra-processed foods by means of regulatory policies, as well as improving the access to and promotion of fresh and minimally processed foods.
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Borges MC, Louzada ML, de Sá TH, Laverty AA, Parra DC, Garzillo JMF, Monteiro CA, Millett C. Artificially Sweetened Beverages and the Response to the Global Obesity Crisis. PLoS Med 2017; 14:e1002195. [PMID: 28045913 PMCID: PMC5207632 DOI: 10.1371/journal.pmed.1002195] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Christopher Millett and colleagues argue that artificially sweetened beverages should not be promoted as part of a healthy diet.
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Affiliation(s)
- Maria Carolina Borges
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Maria Laura Louzada
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
| | - Thiago Hérick de Sá
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
| | - Anthony A. Laverty
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Diana C. Parra
- Washington University in St. Louis School of Medicine, Program in Physical Therapy, St. Louis, Missouri, United States of America
| | - Josefa Maria Fellegger Garzillo
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
- PhD Program on Global Health and Sustainability, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Carlos Augusto Monteiro
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
| | - Christopher Millett
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
- * E-mail:
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Muniz VM, Cavalcanti DS, Lima NMD, Osório MM. Food consumption of sugarcane workers' families in the Brazilian Northeast. REV NUTR 2015. [DOI: 10.1590/1415-52732015000200006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE: To analyze the food intake of sugarcane workers' family members. METHODS: The food intake of 159 family members of sugarcane workers from Gameleira, Pernambuco, Brazilian Northeast, was investigated by directly weighing the foods on three non-consecutive days. The percent risk of inadequate macro- and micronutrient intakes was analyzed according to the Reference Dietary Intakes. The macronutrients were analyzed in relation to acceptable distribution intervals. The energy consumed from the various food groups was expressed as a ratio of the total energy intake. RESULTS: The median intake of carbohydrates and proteins remained above the Estimated Average Requirement, and all age groups presented a low risk of inadequate carbohydrate and protein intakes. The median intakes of riboflavin, niacin, thiamin, and iron remained above the Estimated Average Requirement for all age groups, but children aged 1-3 years presented a high percent risk of inadequate iron intake. All age groups presented high percent risk of inadequate zinc, calcium, vitamin A, and vitamin C intakes. Grains and derivatives had a greater participation in the total energy intake, especially in men aged 19-30 years. The group "milk and dairy products" had a greater participation in the diet of children aged 1-3 years. CONCLUSION: The low percent risk of inadequate carbohydrate and protein intakes in all age groups was opposed to the high risk of inadequate mineral and vitamin intakes, making the population vulnerable to nutritional disorders caused by excess macronutrient intake and inadequate micronutrient intake.
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[Introduction of soft drinks and processed juice in the diet of infants attending public day care centers]. REVISTA PAULISTA DE PEDIATRIA 2015; 33:34-41. [PMID: 25662561 PMCID: PMC4436954 DOI: 10.1016/j.rpped.2014.06.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 06/10/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Identifying at what age infants enrolled in public day care centers are introduced to soft drinks and industrialized juice, as well as comparing the nutritional composition of these goods with natural fruit juice. METHODS A cross-sectional study with the mothers of 636 children (aged 0 to 36 months) from nurseries of day care centers, who were asked questions about the age of feeding introduction. This study evaluated the proximate composition of soft drinks and artificial juice, comparing them with those of natural fruit juice regarding energy, sugar, fiber, vitamin C, and sodium values. The chemical composition of fruit juice was obtained by consulting the Table of Food Composition and, for industrialized drinks, the average nutritional information on the labels of the five most consumed product brands. RESULTS The artificial drinks were consumed before the first year of life by more than half of the children studied, however, approximately 10% consumed them before the age of 6 months. With regard to the comparison among the drinks, artificial fruit juice beverages and soft drinks proved to contain from nine to 13 times higher amounts of sodium, and 15 times less vitamin C than natural juices. CONCLUSIONS The introduction of soft drinks and industrialized juice in the diet of infants was inopportune and premature. When compared to natural fruit juice, these have inferior nutritional composition, which suggests the urgent need for measures based on strategies for food and nutrition education in order to promote awareness and the maintenance of healthy eating habits.
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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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Gonçalves MM, Leles CR, Freire MDCM. Associations between Caries among Children and Household Sugar Procurement, Exposure to Fluoridated Water and Socioeconomic Indicators in the Brazilian Capital Cities. Int J Dent 2013; 2013:492790. [PMID: 24307900 PMCID: PMC3838834 DOI: 10.1155/2013/492790] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 09/06/2013] [Accepted: 09/23/2013] [Indexed: 11/18/2022] Open
Abstract
The objective of this ecological study was to investigate the association between caries experience in 5- and 12-year-old Brazilian children in 2010 and household sugar procurement in 2003 and the effects of exposure to water fluoridation and socioeconomic indicators. Sample units were all 27 Brazilian capital cities. Data were obtained from the National Surveys of Oral Health; the National Household Food Budget Survey; and the United Nations Program for Development. Data analysis included correlation coefficients, exploratory factor analysis, and linear regression. There were significant negative associations between caries experience and procurement of confectionery, fluoridated water, HDI, and per capita income. Procurement of confectionery and soft drinks was positively associated with HDI and per capita income. Exploratory factor analysis grouped the independent variables by reducing highly correlated variables into two uncorrelated component variables that explained 86.1% of total variance. The first component included income, HDI, water fluoridation, and procurement of confectionery, while the second included free sugar and procurement of soft drinks. Multiple regression analysis showed that caries is associated with the first component. Caries experience was associated with better socioeconomic indicators of a city and exposure to fluoridated water, which may affect the impact of sugars on the disease.
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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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Contiero P, Berrino F, Tagliabue G, Mastroianni A, Di Mauro MG, Fabiano S, Annulli M, Muti P. Fasting blood glucose and long-term prognosis of non-metastatic breast cancer: a cohort study. Breast Cancer Res Treat 2013; 138:951-9. [PMID: 23568483 DOI: 10.1007/s10549-013-2519-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 04/01/2013] [Indexed: 10/27/2022]
Abstract
High circulating glucose has been associated with increased risk of breast cancer (BC). There may also be a link between serum glucose and prognosis in women treated for BC. We assessed the effect of peridiagnostic fasting blood glucose and body mass index (BMI) on long-term BC prognosis. We retrospectively investigated 1,261 women diagnosed and treated for stage I-III BC at the National Cancer Institute, Milan, in 1996, 1999 and 2000. Data on blood tests and follow-up were obtained by linking electronic archives, with follow-up to end of 2009. Multivariate Cox modelling estimated hazard ratios (HR) with 95 % confidence intervals (CI) for distant metastasis, recurrence and death (all causes) in relation to categorized peridiagnostic fasting blood glucose and BMI. Mediation analysis investigated whether blood glucose mediated the BMI-breast cancer prognosis association. The risks of distant metastasis were significantly higher for all other quintiles compared to the lowest glucose quintile (reference <87 mg/dL) (respective HRs: 1.99 95 % CI 1.23-3.24, 1.85 95 % CI 1.14-3.0, 1.73 95 % CI 1.07-2.8, and 1.91 95 % CI 1.15-3.17). The risk of recurrence was significantly higher for all other glucose quintiles compared to the first. The risk of death was significantly higher than reference in the second, fourth and fifth quintiles. Women with BMI ≥ 25 kg/m(2) had significantly greater risks of recurrence and distant metastasis than those with BMI < 25 kg/m(2), irrespective of blood glucose. The increased risks remained invariant over a median follow-up of 9.5 years. Mediation analysis indicated that glucose and BMI had independent effects on BC prognosis. Peridiagnostic high fasting glucose and obesity predict worsened short- and long-term outcomes in BC patients. Maintaining healthy blood glucose levels and normal weight may improve prognosis.
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Affiliation(s)
- Paolo Contiero
- Cancer Registry and Environmental Epidemiology Division, Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy.
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