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Leite JMRS, Ribeiro A, Pereira JL, de Souza CA, Heider D, Soler JMP, Mingroni-Netto RC, Fisberg RM, Rogero MM, Sarti FM. Missense genetic variants in major bitter taste receptors are associated with diet quality and food intake in a highly admixed underrepresented population. Clin Nutr ESPEN 2024; 63:311-321. [PMID: 38964656 DOI: 10.1016/j.clnesp.2024.06.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 06/26/2024] [Accepted: 06/27/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND AND AIMS To investigate associations between Single Nucleotide Polymorphisms (SNPs) in the TAS1R and TAS2R taste receptors and diet quality, intake of alcohol, added sugar, and fat, using linear regression and machine learning techniques in a highly admixed population. METHODS In the ISA-Capital health survey, 901 individuals were interviewed and had socioeconomic, demographic, health characteristics, along with dietary information obtained through two 24-h recalls. Data on 12 components related to food groups, nutrients, and calories was combined into a diet quality score (BHEI-R). BHEI-R, SoFAAs (calories from added sugar, saturated fat, and alcohol) and Alcohol use were tested for associations with 255 TAS2R SNPs and 73 TAS1R SNPs for 637 individuals with regression analysis and Random Forest. Significant SNPs were combined into Genetic taste scores (GTSs). RESULTS Among 23 SNPs significantly associated either by stepwise linear/logistic regression or random forest with any possible biological functionality, the missense variants rs149217752 in TAS2R40, for SoFAAs, and rs2233997 in TAS2R4, were associated with both BHEI-R (under 4% increase in Mean Squared Error) and SoFAAs. GTSs increased the variance explanation of quantitative phenotypes and there was a moderately high AUC for alcohol use. CONCLUSIONS The study provides insights into the genetic basis of human taste perception through the identification of missense variants in the TAS2R gene family. These findings may contribute to future strategies in precision nutrition aimed at improving food quality by reducing added sugar, saturated fat, and alcohol intake.
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Affiliation(s)
- Jean Michel R S Leite
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.
| | - Adèle Ribeiro
- Faculty of Mathematics and Computer Science, Philipps University of Marburg, Germany; Institute for Computer Science, Machine Learning for Medical Data, Heinrich-Heine University Dusseldorf, Germany
| | - Jaqueline L Pereira
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | - Dominik Heider
- Faculty of Mathematics and Computer Science, Philipps University of Marburg, Germany; Institute for Computer Science, Machine Learning for Medical Data, Heinrich-Heine University Dusseldorf, Germany
| | - Júlia M Pavan Soler
- Institute of Mathematics and Statistics, University of São Paulo, São Paulo, Brazil
| | | | - Regina M Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Marcelo M Rogero
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Flavia M Sarti
- School of Arts, Sciences and Humanities, University of São Paulo, Brazil
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Bastos AA, Félix PV, Carnaúba RA, Valentini Neto J, Vicente BM, Ferreira LM, Batista LD, de Melo CM, Fisberg RM, Yannakoulia M, Ribeiro SML. Evaluating the influence of ultra-processed food intake on associations between dietary indices with systemic inflammation in adulthood and old ages. Clin Nutr ESPEN 2024; 61:8-14. [PMID: 38777477 DOI: 10.1016/j.clnesp.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 02/06/2024] [Accepted: 02/15/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND & AIMS Low-grade systemic inflammation (LGSI) is critical to developing many chronic diseases. In turn, it has been shown that the diet can modulate favorably or unfavorably the inflammatory status. Thus, evaluating the diet from appropriate approaches is fundamental; to do so, there are different proposals for dietary indexes. We aimed to: (i) investigate the association between three well-known dietary indexes and LGSI biomarkers; (ii) test these associations individually or in combination with an indicator of ultra-processed foods (UFPs) intake. (iii) as an additional aim, hypothesizing that all the indexes should be capable of identifying the inflammatory potential of diet, we tested the hypothesis that these indexes agree and correlate with each other. METHODS Cross-sectional population-based data of adults and older persons (n = 583). Dietary data were obtained through two non-consecutive 24-h dietary recalls (24HDR) and calculated for Dietary Inflammatory Index (DII), Mediterranean-Style Dietary Pattern Score (MSDPS); Brazilian Healthy Eating Index - Revised (BHEI-R) and energy ingested from UPFs (UPFs ratio). An LGSI score was created from some plasma inflammatory biomarkers [C-Reactive Protein (CRP), tumor necrosis factor-alpha (TNF-α), and adiponectin]. Logistic and linear regression models tested the associations between dietary indexes and LGSI score. RESULTS The MSDPS and DII were significantly associated with our inflammatory score, but the BHEI-R did not. Including UPFs in regression models did not increase the strength of these associations. CONCLUSIONS From the three scores, the dietary inflammatory index and the Mediterranean-style dietary pattern score (MSDPS) were the ones that showed significant association with the inflammatory biomarker. The combination of the indexes with a ratio of UPF intake did not increase the significance of our analyses. The best agreement between the indexes was found between MSDPS and UPFs ratio; the only pair of indexes considered concordant and correlated was the BHEI-R and DII.
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Affiliation(s)
- Amália A Bastos
- Department of Nutrition, Public Health School, University of Sao Paulo (USP), São Paulo, SP, Brazil; Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens (HUA), Athens, Greece.
| | - Paula V Félix
- Department of Nutrition, Public Health School, University of Sao Paulo (USP), São Paulo, SP, Brazil; Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens (HUA), Athens, Greece
| | - Renata A Carnaúba
- School of Pharmaceutical Sciences, University of Sao Paulo (USP), São Paulo, SP, Brazil; Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens (HUA), Athens, Greece
| | - João Valentini Neto
- Department of Nutrition, Public Health School, University of Sao Paulo (USP), São Paulo, SP, Brazil; Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens (HUA), Athens, Greece
| | - Beatriz M Vicente
- Department of Nutrition, Public Health School, University of Sao Paulo (USP), São Paulo, SP, Brazil; Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens (HUA), Athens, Greece
| | - Letícia M Ferreira
- Department of Nutrition, Public Health School, University of Sao Paulo (USP), São Paulo, SP, Brazil; Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens (HUA), Athens, Greece
| | - Lais D Batista
- Department of Nutrition, Public Health School, University of Sao Paulo (USP), São Paulo, SP, Brazil; Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens (HUA), Athens, Greece
| | - Camila M de Melo
- Department of Nutrition, Federal University of Lavras, Lavras, MG, Brazil; Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens (HUA), Athens, Greece
| | - Regina M Fisberg
- Department of Nutrition, Public Health School, University of Sao Paulo (USP), São Paulo, SP, Brazil; Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens (HUA), Athens, Greece
| | - Mary Yannakoulia
- Department of Nutrition, Federal University of Lavras, Lavras, MG, Brazil; Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens (HUA), Athens, Greece
| | - Sandra M L Ribeiro
- Department of Nutrition, Public Health School, University of Sao Paulo (USP), São Paulo, SP, Brazil; Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens (HUA), Athens, Greece
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Bastos AA, Félix PV, Valentini Neto J, Rogero MM, Fisberg RM, Yannakoulia M, Ribeiro SML. High Adherence to the Mediterranean Dietary Pattern Is Inversely Associated with Systemic Inflammation in Older but Not in Younger Brazilian Adults. Nutrients 2024; 16:1385. [PMID: 38732631 PMCID: PMC11085370 DOI: 10.3390/nu16091385] [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: 11/14/2023] [Revised: 12/07/2023] [Accepted: 12/15/2023] [Indexed: 05/13/2024] Open
Abstract
The Mediterranean dietary pattern (MPD) has shown promise in preventing low-grade systemic inflammation (LGSI). This study tested if a high adherence to the MDP by younger and older Brazilian adults is associated with lower LGSI and investigated which Mediterranean food components may contribute to these associations. We performed a secondary study on 2015 ISA-Nutrition (290 younger adults (20-59 years old) and 293 older adults (≥60 years old)), a cross-sectional population-based study in São Paulo, SP, Brazil. The adherence to the MDP was assessed using the Mediterranean Diet Score (MedDietScore), obtained from two non-consecutive 24 h dietary recalls (24HDRs). The LGSI score (from plasma CRP, TNF-α, and adiponectin) identified the inflammatory status. Linear regression models assessed the association between LGSI and the MedDietScore. In older adults only, a high adherence to the MDP signified an 11.5% lower LGSI score. Older adults, classified with high adherence to the MDP, differed by consuming lower meat intake and full-fat dairy. Between older adults, the intake of vegetables and olive oil was inversely associated with the levels of LGSI. Thus, among older adults, the intake of some specific Mediterranean food determined high adherence to the MDP and was associated with decreased LGSI.
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Affiliation(s)
- Amália Almeida Bastos
- Department of Nutrition, Public Health School, University of Sao Paulo, Sao Paulo 01246-904, Brazil; (P.V.F.); (J.V.N.); (M.M.R.); (R.M.F.); (S.M.L.R.)
| | - Paula Victória Félix
- Department of Nutrition, Public Health School, University of Sao Paulo, Sao Paulo 01246-904, Brazil; (P.V.F.); (J.V.N.); (M.M.R.); (R.M.F.); (S.M.L.R.)
| | - João Valentini Neto
- Department of Nutrition, Public Health School, University of Sao Paulo, Sao Paulo 01246-904, Brazil; (P.V.F.); (J.V.N.); (M.M.R.); (R.M.F.); (S.M.L.R.)
| | - Marcelo Macedo Rogero
- Department of Nutrition, Public Health School, University of Sao Paulo, Sao Paulo 01246-904, Brazil; (P.V.F.); (J.V.N.); (M.M.R.); (R.M.F.); (S.M.L.R.)
| | - Regina Mara Fisberg
- Department of Nutrition, Public Health School, University of Sao Paulo, Sao Paulo 01246-904, Brazil; (P.V.F.); (J.V.N.); (M.M.R.); (R.M.F.); (S.M.L.R.)
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17671 Athens, Greece;
| | - Sandra Maria Lima Ribeiro
- Department of Nutrition, Public Health School, University of Sao Paulo, Sao Paulo 01246-904, Brazil; (P.V.F.); (J.V.N.); (M.M.R.); (R.M.F.); (S.M.L.R.)
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Fontanelli MDM, Batista LD, Martinez-Arroyo A, Mozaffarian D, Micha R, Rogero MM, Fisberg RM, Sarti FM. Pragmatic Carbohydrate Quality Metrics in Relation to Glycemic Index, Glycemic Load, and Front-of-Pack Warning Labels in Grain Foods. Foods 2024; 13:1299. [PMID: 38731670 PMCID: PMC11083290 DOI: 10.3390/foods13091299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/15/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
The challenges in the characterization of the nutritional quality of grain foods comprise obstacles to public health actions toward promotion of healthier grain-based foods. The present study investigated how carbohydrate metrics related to glycemic index (GI), glycemic load (GL), and warning labels of grain foods consumed by individuals living in São Paulo, Brazil. Information on intake of grain foods at individual level was obtained using 24 h recalls within a cross-sectional population-based survey conducted in 2015. There were 244 unique grain products reported by individuals in the survey, assessed through four metrics of carbohydrate quality, considering contents per 10 g of total carbohydrate: (1) ≥1 g fiber, (2) ≥1 g fiber and <1 g free sugars, (3) ≥1 g fiber and <2 g free sugars, and (4) ≥1 g fiber, and <2 g free sugars per 1 g of fiber. Outcomes included GI, GL, and inclusion of warning labels proposed by the Brazilian National Health Surveillance Agency (ANVISA), the Chilean Ministry of Health (1st and 3rd stages), and the Pan American Health Organization (PAHO). Metrics identified products with lower mean GI (-12.8 to -9.0 [p-values < 0.001]), and GL (-12.5 to -10.3 [p-values < 0.001]). Warning systems showed a certain degree of discrimination between products according to the metrics (p-value < 0.01 each); however, >50% of products with good nutritional quality according to the carbohydrate metrics still would receive warnings. Findings suggest that carbohydrate metrics identified products with lower GI and GL, and current warning labels may not adequately capture overall nutritional quality of grain foods.
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Affiliation(s)
| | - Lais Duarte Batista
- School of Public Health, University of São Paulo, São Paulo 05508-030, SP, Brazil; (L.D.B.); (M.M.R.); (R.M.F.)
| | - Angela Martinez-Arroyo
- Food Behavior Research Center (CEIC), Faculty of Pharmacy, School Nutrition and Dietetics, University of Valparaíso, Valparaíso 2381850, Chile;
| | - Dariush Mozaffarian
- Food is Medicine Institute, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA; (D.M.); (R.M.)
| | - Renata Micha
- Food is Medicine Institute, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA; (D.M.); (R.M.)
- Department of Food Science and Nutrition, University of Thessaly, 38334 Volos, Greece
| | - Marcelo Macedo Rogero
- School of Public Health, University of São Paulo, São Paulo 05508-030, SP, Brazil; (L.D.B.); (M.M.R.); (R.M.F.)
| | - Regina Mara Fisberg
- School of Public Health, University of São Paulo, São Paulo 05508-030, SP, Brazil; (L.D.B.); (M.M.R.); (R.M.F.)
| | - Flavia Mori Sarti
- School of Arts, Sciences and Humanities (EACH), University of São Paulo, São Paulo 03828-000, SP, Brazil;
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Felix PV, Pereira JL, Fisberg RM. Associations between Four Diet Quality Indexes and High Blood Pressure among Adults: Results from the 2015 Health Survey of Sao Paulo. Nutrients 2024; 16:629. [PMID: 38474757 DOI: 10.3390/nu16050629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/14/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
Several dietary quality indexes (DQIs) have been proposed to investigate adherence to a healthy diet. However, only a few studies have been conducted to investigate their association with high blood pressure (BP) in Brazil. In the present work, we examine the association between four established DQIs-2020 Healthy Eating Index (HEI-2020), Dietary Approaches to Stop Hypertension (DASH), Alternative Healthy Eating Index (AHEI), and Brazilian Healthy Eating Index (BHEI)-and high BP in a cross-sectional sample of Brazilian adults from the 2015 Health Survey of São Paulo with Focus on Nutrition. Based on two 24 h recalls adjusted for the within-person variation, higher HEI-2020 and BHEI total scores were inversely related to elevated BP (HEI-2020: OR 0.94, BHEI: OR 0.95). Individuals at the second quartile (OR 0.33) and the fourth quartile of BHEI (OR 0.35), as well as individuals with higher scores on dairy components (HEI-2020: OR 0.80, BHEI: OR 0.83, DASH: OR 0.75), and fruit components (AHEI: OR 0.82, HEI-2020: OR 0.72, BHEI: OR 0.77, DASH: OR 0.79) also presented lower odds for the occurrence of elevated BP. In conclusion, healthier diet quality using the HEI-2020 and BHEI indexes and the fruit and dairy components were identified as protective factors for high BP.
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Affiliation(s)
- Paula Victoria Felix
- Department of Nutrition, School of Public Health, University of São Paulo, Sao Paulo 01246-904, Brazil
| | - Jaqueline Lopes Pereira
- Department of Nutrition, School of Public Health, University of São Paulo, Sao Paulo 01246-904, Brazil
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, Sao Paulo 01246-904, Brazil
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Leite JMRS, Pereira JL, Damasceno NRT, Soler JMP, Fisberg RM, Rogero MM, Sarti FM. Association of dyslipidemia with single nucleotide polymorphisms of the cholesteryl ester transfer protein gene and cardiovascular disease risk factors in a highly admixed population. Clin Nutr ESPEN 2023; 58:242-252. [PMID: 38057013 DOI: 10.1016/j.clnesp.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/04/2023] [Accepted: 10/04/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND AND AIMS Cardiovascular diseases (CVD) are major causes of mortality worldwide, leading to premature deaths, loss of quality of life, and extensive socioeconomic impacts. Alterations in normal plasma lipid concentrations comprise important risk factors associated with CVD due to mechanisms involved in the pathophysiology of atherosclerosis. Genetic markers such as single nucleotide polymorphisms (SNPs) are known to be associated with lipid metabolism, including variants in the cholesteryl ester transfer protein (CETP) gene. Thus, the study's objective was to assess the relationship among lipid profile, socioeconomic and demographic characteristics, health status, inflammatory biomarkers, and CETP genetic variants in individuals living in a highly admixed population. METHODS The study comprises an analysis of observational cross-sectional data representative at the population level from a highly admixed population, encompassing 901 individuals from three age groups (adolescents, adults, and older adults). Socioeconomic, demographic, health, and lifestyle characteristics were collected using semi-structured questionnaires. In addition, biochemical markers and lipid profiles were obtained from individuals' blood samples. After DNA extraction, genotyping, and quality control according to Affymetrix's guidelines, information on 15 SNPs in the CETP gene was available for 707 individuals. Lipid profile and CVD risk factors were evaluated by principal component analysis (PCA), and associations between lipid traits and those factors were assessed through multiple linear regression and logistic regression. RESULTS There were low linear correlations between lipid profile and other individuals' characteristics. Two principal components were responsible for 80.8 % of the total variance, and there were minor differences in lipid profiles among individuals in different age groups. Non-HDL-c, total cholesterol, and LDL-c had the highest loadings in the first PC, and triacylglycerols, VLDL-c and HDL-c were responsible for a major part of the loading in the second PC;, whilst HDL-c and LDL-c/HDL-c ratio were significant in the third PC. In addition, there were minor differences between groups of individuals with or without dyslipidemia regarding inflammatory biomarkers (IL-1β, IL- 6, IL-10, TNF-α, CRP, and MCP-1). Being overweight, insulin resistance, and lifestyle characteristics (calories from solid fat, added sugar, alcohol and sodium, leisure physical activity, and smoking) were strong predictors of lipid traits, especially HDL-c and dyslipidemia (p < 0.05). The CETP SNPs rs7499892 and rs12691052, rs291044, and rs80180245 were significantly associated with HDL-c (p < 0.05), and their inclusion in the multiple linear regression model increased its accuracy (adjusted R2 rose from 0.12 to 0.18). CONCLUSION This study identified correlations between lipid traits and other CVD risk factors. In addition, similar lipid and inflammatory profiles across age groups in the population suggested that adolescents might already present a significant risk for developing cardiovascular diseases in the population. The risk can be primarily attributed to decreased HDL-c concentrations, which appear to be influenced by genetic factors, as evidenced by associations between SNPs in the CETP gene and HDL-c concentrations, as well as potential gene-diet interactions. Our findings underscore the significant impact of genetic and lifestyle factors on lipid profile within admixed populations in developing countries.
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Affiliation(s)
- Jean Michel R S Leite
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.
| | - Jaqueline L Pereira
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Nágila R T Damasceno
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Júlia M Pavan Soler
- Institute of Mathematics and Statistics, University of São Paulo, São Paulo, Brazil
| | - Regina M Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Marcelo M Rogero
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Flavia M Sarti
- School of Arts, Sciences and Humanities, University of São Paulo, Brazil
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Carvalho GB, Payolla TB, Brandão-Lima PN, Sarti FM, Fisberg RM, Rogero MM. Association between circulating micro-ribonucleic acids and metabolic syndrome in older adults from a population-based study. Clin Nutr ESPEN 2023; 58:320-325. [PMID: 38057022 DOI: 10.1016/j.clnesp.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 10/14/2023] [Accepted: 10/19/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND AND AIMS Aging is a major factor in development of chronic non-communicable diseases (NCD). Epigenetic causes are risk factors in NCD development since studies indicate that the expression of micro-ribonucleic acids (miRs) is altered under different clinical conditions. This study aimed to analyze the expression profile of circulating miRs and investigate their association with biomarkers of cardiometabolic risk in older adults living in São Paulo municipality, Brazil. METHODS A cross-sectional study was conducted based on the analysis of data from 200 older adults, with a mean age of 69.1 (0.5) years old participating in the ISA-Nutrition. The expression profiles of 21 plasma miRs related to glycemic and lipid metabolism, adiposity, and inflammation were evaluated in relation to cardiometabolic risk. Individuals were distributed into groups according to diagnosis of metabolic syndrome (MetS). The Stata Somersd module was used to calculate confidence intervals for Kendall's tau-a to estimate the correlations among variables. RESULTS Differences in the plasma expression were observed in two of the 21 miRs evaluated according to the MetS presence in participants. Individuals with MetS showed higher expression of miR-30a and miR-122 than individuals without MetS. CONCLUSIONS Considering that miR-30, and miR-122 were altered due to MetS, these miRs may be potential biomarkers for MetS in older adults.
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Affiliation(s)
- Gabrielli B Carvalho
- Department of Nutrition, School of Public Health, University of São Paulo, 715 Dr Arnaldo Avenue, Pacaembu, ZIP Code 01246-904, São Paulo, SP, Brazil
| | - Tanyara B Payolla
- Department of Nutrition, School of Public Health, University of São Paulo, 715 Dr Arnaldo Avenue, Pacaembu, ZIP Code 01246-904, São Paulo, SP, Brazil
| | - Paula N Brandão-Lima
- Department of Nutrition, School of Public Health, University of São Paulo, 715 Dr Arnaldo Avenue, Pacaembu, ZIP Code 01246-904, São Paulo, SP, Brazil
| | - Flávia M Sarti
- School of Arts, Sciences and Humanities, University of São Paulo, 1000 Arlindo Bettio Avenue, ZIP Code 03828-000, São Paulo, SP, Brazil
| | - Regina M Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, 715 Dr Arnaldo Avenue, Pacaembu, ZIP Code 01246-904, São Paulo, SP, Brazil
| | - Marcelo M Rogero
- Department of Nutrition, School of Public Health, University of São Paulo, 715 Dr Arnaldo Avenue, Pacaembu, ZIP Code 01246-904, São Paulo, SP, Brazil.
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Carvalho GB, Brandão-Lima PN, Payolla TB, Lucena SEF, Sarti FM, Fisberg RM, Rogero MM. Circulating MiRNAs Are Associated With Low-grade Systemic Inflammation and Leptin Levels in Older Adults. Inflammation 2023; 46:2132-2146. [PMID: 37464054 DOI: 10.1007/s10753-023-01867-6] [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: 05/10/2023] [Revised: 06/17/2023] [Accepted: 06/27/2023] [Indexed: 07/20/2023]
Abstract
Inflammaging refers to the low-grade systemic inflammation that occurs with aging present in chronic non-communicable diseases. MicroRNAs (miRNAs) are potential biomarkers for these diseases in older adults. This study aimed to assess the expression of 21 circulating miRNAs and their associations with inflammatory biomarkers in older adults. This cross-sectional study was performed with 200 individuals participating in ISA-Nutrition. The systemic low-grade inflammation score (SIS) was calculated from the plasma concentration of 10 inflammatory biomarkers. Circulating miRNA expression was assessed using the Fluidigm method. Wilcoxon-Mann-Whitney test was employed to determine differences in SIS among groups distributed according to sex and presence of MetS. Spearman's correlation was used to estimate correlations among SIS, leptin levels, miRNA expression, and variables of interest. Analyses were performed using software R version 4.2.3, with a significance level of 0.05. The final sample consisted of 193 individuals with a mean age of 69.1 (SE = 0.5) years, being 64.7% individuals with metabolic syndrome (MetS). Positive correlations were observed between leptin concentration and metabolic risk factors, and leptin concentration was higher in individuals with MetS compared to those without MetS. The expression of 15 circulating miRNAs was negatively correlated with leptin concentration. GLMs showed negative associations between miRNAs (miR-15a, miR-16, miR-223, miR-363, miR-532), leptin, and/or SIS values; and only miR-21 showed positive association with SIS values. The results suggest the presence of peripheral leptin resistance associated with low-grade inflammation and plasma expression of miRNAs in older adults. These findings suggest the potential role of miRNAs as biomarkers for cardiometabolic risk.
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Affiliation(s)
- Gabrielli B Carvalho
- Department of Nutrition, School of Public Health, University of São Paulo, 715 Dr. Arnaldo Avenue, São Paulo, SP, 01246-904, Brazil
| | - Paula N Brandão-Lima
- Department of Nutrition, School of Public Health, University of São Paulo, 715 Dr. Arnaldo Avenue, São Paulo, SP, 01246-904, Brazil
| | - Tanyara B Payolla
- Department of Nutrition, School of Public Health, University of São Paulo, 715 Dr. Arnaldo Avenue, São Paulo, SP, 01246-904, Brazil
| | - Sadraque E F Lucena
- Department of Statistics and Actuarial Sciences, Federal University of Sergipe, Marechal Rondon Avenue, São Cristóvão, SE, 49100-000, Brazil
| | - Flávia M Sarti
- School of Arts, Sciences and Humanities, University of São Paulo, 1000 Arlindo Bettio Avenue, São Paulo, SP, 03828-000, Brazil
| | - Regina M Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, 715 Dr. Arnaldo Avenue, São Paulo, SP, 01246-904, Brazil
| | - Marcelo M Rogero
- Department of Nutrition, School of Public Health, University of São Paulo, 715 Dr. Arnaldo Avenue, São Paulo, SP, 01246-904, Brazil.
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9
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Bastos AA, Félix PV, de Castro MA, Fisberg RM, Yannakoulia M, Ribeiro SML. Response to the critical analysis of the article 'Comparison and convergent validity of five Mediterranean dietary indexes applied to Brazilian adults and older adults: data from a population-based study (2015 ISA-Nutrition)'. J Nutr Sci 2023; 12:e77. [PMID: 37528830 PMCID: PMC10388441 DOI: 10.1017/jns.2023.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 08/03/2023] Open
Affiliation(s)
- Amália Almeida Bastos
- Department of Nutrition, Public Health School, University of Sao Paulo, São Paulo, Brazil
| | - Paula Victória Félix
- Department of Nutrition, Public Health School, University of Sao Paulo, São Paulo, Brazil
| | | | - Regina Mara Fisberg
- Department of Nutrition, Public Health School, University of Sao Paulo, São Paulo, Brazil
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Sandra Maria Lima Ribeiro
- Department of Nutrition, Public Health School, University of Sao Paulo, São Paulo, Brazil
- School of Arts, Sciences and Humanities, University of Sao Paulo, São Paulo, Brazil
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Hermes Sales C, de Mello Fontanelli M, Macedo Rogero M, Mori Sarti F, Fisberg RM. Dietary inadequacies overestimate the blood deficiencies of magnesium, zinc, and vitamins A, C, E, and D among residents of Sao Paulo. Clin Nutr ESPEN 2023; 53:196-205. [PMID: 36657914 DOI: 10.1016/j.clnesp.2022.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 11/03/2022] [Accepted: 12/10/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND & AIMS We aimed to estimate the prevalence of the inadequate intake and status of magnesium, zinc, and vitamins A, C, E, and D and identify factors associated with micronutrient deficiency in serum/plasma among residents of São Paulo, Brazil. METHODS Data from 824 individuals aged ≥14 years were obtained from the 2015 ISA-Nutrition, a population-based, cross-sectional survey. Dietary and supplement intakes were assessed using two 24-h dietary recalls, and the micronutrient inadequacies were estimated using the National Cancer Institute method. Micronutrient status was measured in serum or plasma, and deficiency was established according to the lower limit of the reference values. Receiver operating characteristic curve analysis was used to identify the effect of intake on the micronutrient status in serum/plasma. Logistic regression analysis was applied to assess the association between micronutrient status and individual characteristics. RESULTS More than 80% of the population had an inadequate dietary intake of magnesium, vitamin E, and vitamin D. Males had a high prevalence of inadequate dietary intake of vitamin A and zinc. A high-to-moderate prevalence of inadequate vitamin C intake was observed. Vitamin D was the only nutrient with a deficient status comparable to its dietary inadequacy. The other nutrients demonstrated a lower deficiency prevalence compared to dietary inadequacy, and vitamin A demonstrated the lowest prevalence of deficiency in plasma. Generally, dietary intake showed a non-notable association with micronutrient deficiency in serum/plasma. Individuals with fasting glucose concentrations ≥100 mg/dL and those using diuretic drugs had a higher risk of serum magnesium deficiency. Those using lipid-lowering drugs and those with high plasma adiponectin concentrations had a higher risk of serum zinc deficiency. Individuals who smoked and those with hypertension showed a higher risk of plasma vitamin C deficiency. Individuals with average leptin concentrations had a higher risk of plasma vitamin E deficiency. Finally, those with sufficient leisure-time physical activity had a lower risk of serum vitamin D deficiency. CONCLUSIONS Residents of the urban areas of São Paulo demonstrated substantially inadequate intakes of most of the assessed micronutrients; however, micronutrient deficiency in serum/plasma was not associated with dietary inadequacy, and it usually demonstrated a lower prevalence than dietary indicators. Thus, using micronutrient intake to determine the serum/plasma profile should be done with caution. The status of the micronutrients varied according to individual characteristics, indicating the interplay of complex mechanisms underlying micronutrient balance.
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Affiliation(s)
- Cristiane Hermes Sales
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil.
| | | | - Marcelo Macedo Rogero
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil.
| | - Flávia Mori Sarti
- School of Arts, Sciences and Humanities, University of Sao Paulo, São Paulo 03828-000, Brazil.
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil.
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11
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Batista LD, Valentini Neto J, Grande de França NA, Lima Ribeiro SM, Fisberg RM. Body composition affects the accuracy of predictive equations to estimate resting energy expenditure in older adults: An exploratory study. Clin Nutr ESPEN 2023; 53:80-86. [PMID: 36657934 DOI: 10.1016/j.clnesp.2022.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/25/2022] [Accepted: 11/27/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND To investigate the accuracy of ten different predictive equations to estimate resting energy expenditure (REE) in a sample of Brazilian older adults and develop a predictive equation for estimating REE based on body composition data. METHODS A cross-sectional study with thirty-eight Brazilian older adults aged 60-84 years, who had their REE measured by indirect calorimetry (IC) and BC assessed by dual-energy x-ray absorptiometry (DXA). REE was compared to the estimation of ten predictive equations, and the differences between BC and anthropometric-based equations were investigated using Bland-Altman plots and Lin's concordance correlation. Accuracy was evaluated considering ±10% of the ratio between estimated and measured REE. RESULTS The sample was composed of 57.9% men, with a mean age of 68.1 (5.8) years, and a mean REE by IC of 1528 (451) kcal. The highest accuracy was 47.4% obtained by Luhrmann and Fredrix equations, and the lowest accuracy was 13.2% reached by Weigle equation. In general, the proportion of underestimation was higher than overestimation. All anthropometric-based equations presented a good agreement with REE from IC. For those equations derived from BC, however, three of them reached only a moderate agreement. In terms of accuracy, all equations presented lower than 50% of accurate prediction of REE. CONCLUSIONS In this sample of older adults, previous predictive equations to estimate REE did not show good accuracy, and those based on BC presented even worse results, showing that changes in BC related to aging could impact the accuracy of these equations.
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Affiliation(s)
- Lais Duarte Batista
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo, 715, Cerqueira Cesar, São Paulo, SP, Brazil.
| | - João Valentini Neto
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo, 715, Cerqueira Cesar, São Paulo, SP, Brazil.
| | - Natasha Aparecida Grande de França
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo, 715, Cerqueira Cesar, São Paulo, SP, Brazil.
| | - Sandra Maria Lima Ribeiro
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo, 715, Cerqueira Cesar, São Paulo, SP, Brazil.
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo, 715, Cerqueira Cesar, São Paulo, SP, Brazil.
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12
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Bastos AA, Félix PV, Castro MA, Fisberg RM, Silva AAM, Yannakoulia M, Ribeiro SML. Comparison and convergent validity of five Mediterranean dietary indexes applied to Brazilian adults and older adults: data from a population-based study (2015 ISA-Nutrition). J Nutr Sci 2023; 12:e12. [PMID: 36843964 PMCID: PMC9947597 DOI: 10.1017/jns.2022.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 01/27/2023] Open
Abstract
Different dietary indexes are proposed to investigate adherence to the Mediterranean diet (MD). However, they are based on different methodologies, and limited research has compared them to each other, particularly in non-Mediterranean populations. We aimed to compare five indexes intended to measure adherence to the MD. The sample was composed of adults and older adults (n 1187) from 2015 ISA-Nutrition, a cross-sectional population-based study in São Paulo, SP, Brazil. Dietary data obtained through two 24-h dietary recalls (24HDR) from which the Mediterranean diet scale (MDS), Mediterranean diet Score (MedDietscore), Mediterranean dietary pattern (MDP), Mediterranean Adequacy Index (MAI) and Mediterranean-Style Dietary Pattern Score (MSDPS) were calculated. The correlations and agreements between them were analysed by Spearman's correlation and linearly weighted Cohen's Kappa coefficients, respectively. Confirmatory factor analyses (CFAs) were applied to investigate their convergent validity. The highest correlations were found between MDP and MAI (r = 0⋅76; 95% CI 0⋅74-0⋅79) and between MDP and MDS (r = 0⋅72; 95% CI 0⋅69-0⋅75). The greatest agreements observed were moderate, between MDP v. MAI (κ = 0⋅57, P < 0⋅001) and MDP v. MDS (κ = 0⋅48, P < 0⋅001). The goodness-of-fit of CFA for MedDietscore (RMSEA = 0⋅033, 90% CI 0⋅02-0⋅042; SRMR = 0⋅042) and MSDPS (RMSEA = 0⋅028, 90% CI 0⋅019-0⋅037; SRMR = 0⋅031) had acceptable values for absolute fit indices. Vegetables, olive oil, MUFA:SFA ratio and cereals with legumes were more relevant to characterise the MD (factor loadings ≥0⋅50). The MDS, MAI and MDP classified the population similarly, but the MedDietscore showed better performances in evaluating adherence to the MD. These results provided guidance for the most appropriate Mediterranean dietary index to be applied in non-Mediterranean populations.
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Affiliation(s)
- Amália A. Bastos
- Department of Nutrition, Public Health School, University of Sao Paulo, São Paulo, Brazil
| | - Paula V. Félix
- Department of Nutrition, Public Health School, University of Sao Paulo, São Paulo, Brazil
| | | | - Regina M. Fisberg
- Department of Nutrition, Public Health School, University of Sao Paulo, São Paulo, Brazil
| | - Antônio A. M. Silva
- Department of Public Health, Federal University of Maranhão, São Luís, Brazil
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Sandra M. L. Ribeiro
- Department of Nutrition, Public Health School, University of Sao Paulo, São Paulo, Brazil
- School of Arts, Sciences and Humanities, University of Sao Paulo, São Paulo, Brazil
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13
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de Mello AV, Sarti FM, Barros MBDA, Goldbaum M, Cesar CLG, Fisberg RM. Differences in Cost-Effectiveness of Adherence to Nutritional Recommendations: Why, Where, and What? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:772. [PMID: 36613092 PMCID: PMC9819702 DOI: 10.3390/ijerph20010772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/16/2022] [Accepted: 12/28/2022] [Indexed: 06/17/2023]
Abstract
Cost-effectiveness analysis of diets may comprise an important tool to promote food security; however, studies show divergent evidence regarding the relationship between diet quality and cost in diverse populations. Thus, this study assesses differences in cost-effectiveness ratios regarding adherence to nutritional recommendations using data representative of the population level in Sao Paulo municipality, Brazil. Information from adolescents and adult individuals (n = 1742) was used to estimate diet quality and cost in 2015. Differences in cost-effectiveness ratios were investigated through application of two diet quality indexes and exploration of individuals' personal and contextual characteristics. Results indicated that higher diet cost was associated with higher adherence to nutritional recommendations at the national level and inversely associated with adherence to international recommendations. Purchasing foods in street markets was linked to healthier diets at lower costs, and protein consumption was associated with higher diet cost regardless of diet quality; however, diet quality was linked to type of protein consumed by individuals. Differences in cost-effectiveness ratios were attributable to methodological choices in measuring dietary quality (why); individuals' personal and contextual characteristics, in particular, access to retail equipment (where); and certain food choices (what). Therefore, cost-effectiveness analyses should be tailored to policy goals and local environments to ensure proper assessment of nutrition programs and to foster improvements in nutritional diet quality at lower cost.
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Affiliation(s)
| | - Flavia Mori Sarti
- School of Public Health, University of Sao Paulo, Sao Paulo 01246-904, Brazil
| | | | - Moises Goldbaum
- School of Medicine, University of Sao Paulo, Sao Paulo 01246-903, Brazil
| | | | - Regina Mara Fisberg
- School of Public Health, University of Sao Paulo, Sao Paulo 01246-904, Brazil
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Circulating microRNAs Showed Specific Responses according to Metabolic Syndrome Components and Sex of Adults from a Population-Based Study. Metabolites 2022; 13:metabo13010002. [PMID: 36676927 PMCID: PMC9861536 DOI: 10.3390/metabo13010002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
MicroRNAs (miRNAs) regulate several metabolic pathways and are potential biomarkers for early risk prediction of metabolic syndrome (MetS). Our aim was to evaluate the levels of 21 miRNAs in plasma according to MetS components and sex in adults. We employed a cross-sectional study of 192 adults aged 20 to 59 years old from the 2015 Health Survey of São Paulo with Focus in Nutrition. Data showed reduced levels of miR-16 and miR-363 in women with MetS; however, men with one or more risk factors showed higher levels of miR-let-7c and miR-30a. Individuals with raised waist circumference showed higher levels of miR-let-7c, miR-122, miR-30a, miR-146a, miR-15a, miR-30d and miR-222. Individuals with raised blood pressure had higher miR-30a, miR-122 and miR-30a levels. Plasma levels of four miRNAs (miR-16, miR-363, miR-375 and miR-486) were lower in individuals with low HDL-cholesterol concentrations. In addition, plasma levels of five miRNAs (miR-122, miR-139, miR-let-7c, miR-126 and miR-30a) were increased in individuals with high fasting plasma glucose and/or insulin resistance. Our results suggest that the pattern of miRNA levels in plasma may be a useful early biomarker of cardiometabolic components of MetS and highlight the sex differences in the plasma levels of miRNAs in individuals with MetS.
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15
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Mello AVD, Sarti FM, Fisberg RM. Associations among diet costs, food prices and income: Elasticities of risk and protection food groups for cardiometabolic diseases in Sao Paulo, Brazil (2003-2015). Nutr Health 2022:2601060221104579. [PMID: 35673763 DOI: 10.1177/02601060221104579] [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: 11/15/2022]
Abstract
Background: Economic dimension comprises important determinants of food choices, particularly income and prices. Aim: Identification of the influence of food prices and diet costs on the consumption of food groups considered protection and risk factors for cardiometabolic diseases. Methods: Food groups classification follows the proposal of "What we eat in America?" from the National Health and Nutrition Examination Survey (NHANES), adapted to Latin America. Data on food consumption from the Health Survey of Sao Paulo (2003, 2008, and 2015), representative at population level, was used. Log-linear regressions were estimated for food groups, controlling for endogeneity through augmented regression-test Results: Results showed increase in prices per calorie of whole grains and red meat from 2003-2015 and a decrease in prices per calorie of fruits, vegetables, beans, legumes, oilseeds and fish/seafood. Food groups had price elasticities between -0.01 and -1.6, i.e., decrease in consumption associated with increase in prices. Results showed statistically significant effects of substitution and complementarity, particularly substitution between sweetened beverages and fruits (2003, β = 0.606; 2008: β = 0.683; 2015, β = 0.848), complementarity between nuts and seeds and whole grains (2003, β = -0.646; 2008, β = -0.647; 2015,β = -0.901), and vegetables and processed meat (2003, β = -1.379; 2015, β = -1.685). Conclusion: Findings of the study represent relevant evidence for design strategies towards the adoption of healthier diets, particularly through subsidies to protection food groups, promoting lower prices and higher diet quality. The evidence may be useful for policymakers and researchers in fields of nutrition and health in diverse countries worldwide, especially due to absence of robust evidence in literature.
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Affiliation(s)
- Aline Veroneze de Mello
- Nutrition Department, School of Public Health, 28133University of São Paulo, São Paulo, Brazil
| | - Flávia Mori Sarti
- Nutrition Department, School of Public Health, 28133University of São Paulo, São Paulo, Brazil
| | - Regina Mara Fisberg
- Nutrition Department, School of Public Health, 28133University of São Paulo, São Paulo, Brazil
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Misreporting of dietary energy intake obtained by 24 h recalls in older adults: a comparison of five previous methods using doubly labeled water. Eur J Clin Nutr 2022; 76:535-543. [PMID: 34462557 DOI: 10.1038/s41430-021-00998-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 07/28/2021] [Accepted: 08/06/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND/OBJECTIVE To test five different methods to detect misreporting in comparison to doubly labeled water in a sample of older adults. SUBJECTS/METHODS A cross-sectional study with thirty-eight Brazilian community-dwelling older adults aged 60-84 years, who had their total energy expenditure measured by doubly labeled water (TEEDLW). Dietary data were collected by two 24 h recalls. Misreporting was compared with estimates obtained by the methods proposed by: Goldberg et al. [1, 2], Black [3], McCrory et al. [4], Huang et al [5], and Rennie et al [6]. Bland-Altman plots with 95% limits of agreement were constructed to assess the agreement between rEI and TEEDLW. Weighted kappa coefficients, sensitivity and specificity analyses, and area under the receiving operator characteristic curve (AUC) were used to test the performance of each method. RESULTS The prevalence of under-reporters (UR) and over-reporters (OR) obtained by the reference (DLW) were 57.9% (n = 22) and 5.3% (n = 2), respectively. Black [3] presented the worst agreement and McCrory et al. [4] the best one to accurately classify individuals in the three categories of energy reporting. McCrory et al. [4] had the best performance in the sensitivity and specificity analyses detecting UR and plausible reporters. CONCLUSIONS There was a high prevalence of misreporting, especially underreporting, in this sample of community-dwelling Brazilian older adults. The study showed a wide variation in the accuracy of predictive methods to handle misreporting, with none of the equations showing outstanding agreement with the reference. When DLW is not available, a valid method should be chosen to address energy intake reporting.
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Palchetti CZ, Steluti J, Sales CH, Fisberg RM, Marchioni DML. Folate and vitamin B12 status: temporal evaluation after mandatory fortification in Brazil. Eur J Clin Nutr 2022; 76:1266-1272. [PMID: 35318452 DOI: 10.1038/s41430-022-01096-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 01/27/2022] [Accepted: 02/04/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To perform temporal evaluation of folate and vitamin B12 status and their associated factors in a Brazilian population exposed to mandatory fortification. METHODS Data from the cross-sectional population-based studies 2008 and 2015 Health Surveys of São Paulo, including individuals ≥ 20 years, both sexes, N = 549 in 2008 and N = 610 in 2015. Folate and vitamin B12 biomarkers status, B-complex supplements and medications use, and dietary intake were assessed. RESULTS Serum folate concentrations increased in the entire population, adults and older adults in 2015 compared to 2008, while serum vitamin B12 concentration increased only in older adults. B-complex supplement use raised in 2015, reflecting in serum vitamins status. Overall serum vitamin B12 deficiencies (<200 pg/mL) were 23.2% and 21.2%, while serum folate deficiencies (<4 ng/mL) were 4.1% and 1.5% in 2008 and 2015, respectively. The lowest quintile of serum folate (≤8.7 ng/mL) was positively associated with smoking and oral contraceptive use, while the highest quintile (≥17.8 ng/mL) was inversely associated with smoking and positively with B-complex supplement use. The odds of having vitamin B12 deficiency was inversely associated with B-complex supplement use, higher serum folate median, higher dietary vitamin B12 intake and positively associated with using oral contraceptive. CONCLUSION Overall deficiency of folate has decreased in 2015, being almost non-existent. Low vitamin B12 status presented similar proportions in the overall population comparing both periods, except for older adults. Different predictive variables were identified to better understand vitamins status outcomes in the most recent period of the study.
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Affiliation(s)
- Cecília Zanin Palchetti
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, 01246-904, Brazil.
| | - Josiane Steluti
- Public Policies and Collective Health Department, Health and Society Institute, Federal University of Sao Paulo, Santos, 11015-020, Brazil
| | - Cristiane Hermes Sales
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, 01246-904, Brazil
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, 01246-904, Brazil
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Leme ACB, Haines J, Tang L, Fisberg M, Ferrari G, da Silva VA, Fisberg RM. Association between weight control behaviors and diet quality among Brazilian adolescents and young adults: Health Survey of São Paulo with Focus on Nutrition, 2015. Eat Weight Disord 2022; 27:605-618. [PMID: 33929700 DOI: 10.1007/s40519-021-01198-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/16/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Little is known about how behaviors to control weight are associated with diet quality among youth from low- and middle-income countries. The aim of this study was to examine associations between efforts to control weight (ECW) and diet quality among Brazilian adolescents and young adults. METHODS Data from 731 participants (17.89 ± 4.92 years, 51.1% female) of the 2015 Health Survey of São Paulo were used for this cross-sectional study. Dietary intake was assessed using a 24 h dietary recall and diet quality was calculated using the Brazilian Healthy Eating Index-Revised (BHEI-R). Participants reported their ECW, weight satisfaction, and socio-demographics. Descriptive statistics and linear regressions were calculated to investigate associations between ECW and diet quality. RESULTS Approximately 47.7% of participants were dissatisfied with their current weight, and 41.0% reported ECW. Reported strategies to control weight included increased physical activity, taking care of what they eat, and dieting (8.2, 3.1, and 2.5%, respectively). After adjusting for age, sex, race/ethnicity, and body mass index, reporting at least one ECW (ß = 0.08; 95% CI 0.02, 0.13), taking care of what to eat (ß = 0.15; 0.08, 0.22) and being satisfied with their weight (0.08; 0.02, 0.13) were all associated with a higher overall BHEI-R score. CONCLUSION Overall diet quality score showed a small increase in participants reporting ECW. Further studies should be conducted to provide strategies used by adolescents from low- and middle-income countries to control their weight. Thus, developing public health policies, and behavioral-change strategies. LEVEL V Cross-sectional descriptive study.
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Affiliation(s)
- Ana Carolina Barco Leme
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada. .,Center of Excellence in Nutrition and Feeding Difficulties, PENSI Institute, Children's Hospital Sabará, São Paulo, Brazil. .,Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.
| | - Jess Haines
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada
| | - Lisa Tang
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada
| | - Mauro Fisberg
- Escuela de Ciências de la Actividad Física, El Deporte y la Salud, Universidad de Santiago de Chile, USACH, 71783-5, Santiago, Chile
| | - Gerson Ferrari
- Laboratorio de Ciencias de la Actividad Física, Facultad de Ciencias Médicas, El Deporte y la Salud, Universidad de Santiago de Chile, USACH, 71783-5, Santiago, Chile
| | | | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
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Pereira JL, de Castro MA, Leite JMRS, Rogero MM, Sarti FM, César CLG, Goldbaum M, Fisberg RM. Overview of Cardiovascular Disease Risk Factors in Adults in São Paulo, Brazil: Prevalence and Associated Factors in 2008 and 2015. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2021. [DOI: 10.36660/ijcs.20210076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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de Mello AV, Sarti FM, Fisberg RM. How to Estimate Food Prices and Diet Costs in Population-Based Studies? Front Nutr 2021; 8:728553. [PMID: 34746204 PMCID: PMC8568763 DOI: 10.3389/fnut.2021.728553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 09/20/2021] [Indexed: 01/04/2023] Open
Abstract
Health and nutrition surveys usually comprise detailed information on health characteristics and food consumption of certain population groups; however, the lack of data collection on the food prices may pose challenges for the estimation of the diet costs for the comprehensive analysis of food demand. The Household Budget Survey (HBS) represents an opportunity to obtain the data on the food prices for the nutrition surveys in the diverse countries worldwide. Although the HBS and the health and nutrition surveys may correspond to different periods, the application of the appropriate Consumer Price Index (CPI) allows to address the changes in the relative prices to perform the linkage between the data of food consumption with information on the food prices. Therefore, the aim of this study was to present the methods for the extraction and linkage of the food prices data from the Brazilian HBS (2002–2003 and 2008–2009) by using the pairing features related to the household characteristics to match the Health Survey of São Paulo [Inquérito de Saúde de São Paulo (ISA-Capital)] conducted in 2003, 2008, and 2015. Data referring to the household characteristics and food prices acquired by the household members living in São Paulo municipality were selected from the HBS datasets for integration with the ISA-Capital dataset. Specific deflators referring to the food items surveyed in São Paulo were obtained from the datasets of the Brazilian Broad Consumer Price Index (BCPI). Therefore, the pairing criteria referring to time, location, and household characteristics were adopted to allow linking foods consumed by the individuals in the ISA-Capital with the prices from the foods acquired by household members interviewed in the HBS. Matching data on the key pairing criteria (location/year/household income per capita/number of residents/family profile) resulted in the linkage of 94.4% (2003), 92.6% (2008), and 81.2% of the cases (2015). Following the data linkage, it was possible to estimate diet costs per gram and per calorie including application of cooking and conversion factors. Data were presented in the International Monetary Unit under the purchasing power parity (PPP) to allow the comparison at the international level. The mean diet costs identified in the population of São Paulo municipality were $8.45 (dp = 0.38) per capita per day in 2003, $8.72 (dp = 0.24) per capita per day in 2008, and $9.62 (dp = 0.23) per capita per day in 2015. Thus, it was possible to estimate the diet costs based on the prices of food items through pairing linkage of information from the household surveys, such as the Brazilian HBS, with the health and nutrition surveys lacking information on the expenditures or prices such as the ISA-Capital. Similar procedures may be used in the diverse countries with availability of the datasets of the household expenditures and health and nutrition surveys, allowing the researchers worldwide to associate the diet quality with food demand.
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Affiliation(s)
- Aline Veroneze de Mello
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Flavia Mori Sarti
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
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Lucchesi I, Fisberg RM, Sales CH. [Quality of diet is associated with water intake among residents in São Paulo, Brazil]. CIENCIA & SAUDE COLETIVA 2021; 26:3875-3883. [PMID: 34468680 DOI: 10.1590/1413-81232021269.2.21052019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 11/08/2019] [Indexed: 11/21/2022] Open
Abstract
The scope of the study was to evaluate the probability of the adequacy of water intake among residents of São Paulo, and to investigate if the quality of diet differs according to the adequacy of water intake. Data were extracted from the Health Survey of São Paulo, a cross-sectional, population-based study. Water intake (drinking water beverages and food) was evaluated using two 24-hours dietary recalls and a supplementary dietary intake questionnaire. Adequacy and classification of water intake was assessed using the corresponding Adequate Intake for sex and age of the individual. Dietary quality was evaluated using the revised Brazilian Healthy Eating Index (BHEI). The associations were tested using the Theil-Sen median test and logistic regression models. A low probability of adequate water intake was observed, and this decreased with advancing age. Except among the elderly, among whom no association was observed, a positive association between water intake and the BHEI was observed, and for the total and integral fruit components, which was maintained after confusion adjustments. Among adults, it was observed that those who ingested less water had even lower scores for saturated fats. The residents of São Paulo have low water intake, and the quality of diet is worse among those who drink less water.
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Affiliation(s)
- Isabella Lucchesi
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo. Av. Dr. Arnaldo 715, Cerqueira César. 01246-904 São Paulo SP Brasil.
| | - Regina Mara Fisberg
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo. Av. Dr. Arnaldo 715, Cerqueira César. 01246-904 São Paulo SP Brasil.
| | - Cristiane Hermes Sales
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo. Av. Dr. Arnaldo 715, Cerqueira César. 01246-904 São Paulo SP Brasil.
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22
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Diet quality, excess body weight and cardiometabolic risk factors in adolescents living in São Paulo, Brazil and in the USA: differences and similarities. Public Health Nutr 2021; 24:4091-4101. [PMID: 32907665 PMCID: PMC8501489 DOI: 10.1017/s1368980020002736] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To compare diet quality and its association with excess body weight (EBW: overweight/obesity), central adiposity (CA) and CVD risk factors (CVDR) among adolescents from Brazil and USA. DESIGN Data from two cross-sectional surveys: Health Survey of São Paulo (ISA-Nutrition) and Hispanic Community Health Study/Study of Latino Youth (SOL-Youth). Dietary intake was assessed from 24-h recalls, and diet quality using the Alternate Healthy Eating Index-2010 (AHEI) developed in the USA and the Revised Brazilian Healthy Eating Index (BHEI-R). CVDR was defined as ≥3 of: obesity, elevated blood pressure, dyslipidaemia, high plasma glucose and insulin resistance. Adjusted OR for EBW, CA and CVDR by diet quality were tested using logistic regression. SETTING São Paulo, Brazil; and Chicago, IL; Miami, FL; Bronx, NY; San Diego, CA. PARTICIPANTS Adolescents (12-16 years) living in São Paulo (n 189) and USA (n 787). RESULTS ISA-Nutrition individuals with EBW (v. without) had marginally lower (unhealthier) scores for whole grains using BHEI-R and sugary beverages using AHEI. SOL-Youth individuals with EBW had lower scores of nuts/legumes using AHEI, and Na using BHEI-R, but higher scores of whole grains and dairy using BHEI-R. In ISA-Nutrition, BHEI-R was inversely associated with EBW (OR = 0·87; 95 % CI 0·80, 0·95) and CVDR (OR = 0·89; 95 % CI 0·80, 0·98). In SOL-Youth, AHEI was inversely associated with EBW (OR = 0·93; 95 % CI 0·87, 0·99). CONCLUSIONS Dietary improvements should be made by adolescents in both USA and Brazil. Healthier diet quality as measured with the country-specific index was associated with lower odds of EBW in Brazilian and USA-Hispanic/Latino adolescents, and with lower CVDR in Brazilian adolescents.
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23
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Lopes TDS, Mello AVD, Nogueira LR, Leme ACB, Fisberg RM. Energy, nutrients and food sources in snacks for adolescents and young adults. ACTA ACUST UNITED AC 2021; 40:e2020148. [PMID: 34346990 PMCID: PMC8331068 DOI: 10.1590/1984-0462/2022/40/2020148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 09/20/2020] [Indexed: 11/22/2022]
Abstract
Objective: To evaluate associations between snacking and energy, nutrients and food source, and to identify the contribution of snacking across age, sex, weight status and lifestyle behaviors among adolescents and young adults. Methods: A sub-sample was calculated from the population-based cross-sectional study 2015-Health Survey of São Paulo (ISA-Capital). The survey “ISA-Nutrição” used a sample of non-institutionalized individuals aged >15 years. For this study, only adolescents (12-18 years old; n=418) and young adults (19-29 years old; n=218) were included. Snacks were identified, and their contribution to energy, nutrients, and food sources were calculated. Descriptive statistics and logistic regressions were used. Results: Participants experienced an average of 2.9±0.6 snacking occasions per day. Young adults consumed more energy from morning and night snacks, and adolescents, from afternoon snacks. The top three food sources on snacking contributed to 30.5% of energy: cookies (11.8%), sugar sweetened beverages (9.4%), sweets and other desserts (9.3%). Although results were non-significant, being a female (Odds Ratio [OR] 0.93; 95% confidence interval [95%CI] 0.36-1.49), meeting the physical activity recommendations (OR 0.75; 95%CI 0.25-1.25), and scoring higher for the healthy eating index (OR 0.88; 95%C 0.24-1.52) were all factors related to increased intake of snacks. Alternatively, overweight individuals (OR -0.54; 95%CI -1.00 to -0.08) consumed less snacks. Conclusions: Improving the quality of snacks should be considered in behavior-change strategies.
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Affiliation(s)
| | | | - Luana Romão Nogueira
- Centro de Excelência em Dificuldades Alimentares, Instituto de Pesquisa e Ensino em Saúde Infantil, São Paulo, SP, Brazil
| | - Ana Carolina Barco Leme
- Universidade de São Paulo, São Paulo, SP, Brazil.,Centro de Excelência em Dificuldades Alimentares, Instituto de Pesquisa e Ensino em Saúde Infantil, São Paulo, SP, Brazil.,Family Relations and Applied Nutrition, University of Guelph, Canada
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24
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Healthful grain foods consumption by São Paulo residents: a 12-year analysis and future trends. Public Health Nutr 2021; 24:2987-2997. [PMID: 32605681 PMCID: PMC9884746 DOI: 10.1017/s1368980020001342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Understanding trends in grain consumption is essential to tackle the low consumption of healthful grain foods. This study aimed to evaluate trends and determinants of grain foods meeting the ≤10:1 carbohydrate:fibre ratio (≤10:1 ratio) in Brazil and to estimate this intake for the next years. DESIGN Three editions of the cross-sectional, population-based study Health Survey of São Paulo (2003, 2008 and 2015). SETTING Urban area of São Paulo, Brazil. PARTICIPANTS The sample included 5801 participants aged 12 years or more. RESULTS A growing trend in the intake of these foods (0·9 percentage of energy (%E) in 2003 to 1·5 %E in 2015) was observed. Also, the proportion of the population consuming at least one grain food meeting the ≤10:1 ratio increased from 8·7 % in 2003 to 15·8 % in 2015, and 20·3 % of the population would be consuming some kind of healthful grain food by 2030. Sociodemographic factors associated with the consumption of grain foods meeting the ≤10:1 ratio changed according to study edition, but overall, older individuals (+79 %), females (+28 %), those with higher education (+138 %) and higher family income (+135 %) were more likely to consume grain foods meeting the ratio, whereas participants who self-reported black, brown or indigenous ethnicity were less likely to consume these foods (-30 %). CONCLUSIONS There was a growing trend to consume grain foods meeting the ≤10:1 ratio from 2003 to 2015, but this consumption continues to be far from recommended levels. Intersectoral changes are urgently needed in order to increase the intake of healthful grain foods.
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Sales CH, Rogero MM, Sarti FM, Fisberg RM. Prevalence and Factors Associated with Iron Deficiency and Anemia among Residents of Urban Areas of São Paulo, Brazil. Nutrients 2021; 13:1888. [PMID: 34072813 PMCID: PMC8226555 DOI: 10.3390/nu13061888] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/23/2021] [Accepted: 05/28/2021] [Indexed: 12/23/2022] Open
Abstract
Anemia is a worldwide concern. This cross-sectional population-based study examined the prevalence of iron-deficiency anemia (IDA) among residents of São Paulo (n = 898; 12-93 years), considering sociodemographic factors, dietary iron inadequacy, and food contributors to iron intake. Blood cell count and iron biomarkers were quantified. Dietary iron intake was measured using two 24-h dietary recalls. Iron intake inadequacy was estimated using a probabilistic approach. The prevalence of anemia was 6.7%, depleted iron stores 5.1%, and IDA 1.1%. Women of all age groups, older adults, and those who were underweight or obese had the highest prevalence of anemia, and female adolescents had the highest prevalence of depleted iron stores. Female adolescents and adults were more vulnerable to depleted iron stores. Male adults and older adults had a considerable prevalence of iron overload. Except for female adolescents and adults, all groups had mild probabilities of inadequate iron intake. The main food iron contributor was wheat flour. Hemoglobin concentrations were directly associated with being an adult, having a higher income, and inversely associated with being female. Serum ferritin concentrations were directly associated with age and inversely correlated with female sex. Residents of São Paulo had a low prevalence of anemia, iron deficiency, and IDA, and sociodemographic factors interfered with these parameters.
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Affiliation(s)
- Cristiane Hermes Sales
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil; (M.M.R.); (R.M.F.)
| | - Marcelo Macedo Rogero
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil; (M.M.R.); (R.M.F.)
| | - Flávia Mori Sarti
- School of Arts, Sciences and Humanities, University of São Paulo, São Paulo 03828-000, Brazil;
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil; (M.M.R.); (R.M.F.)
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26
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Opportunities for diet quality improvement: the potential role of staple grain foods. Public Health Nutr 2021; 24:6145-6156. [PMID: 33843545 DOI: 10.1017/s1368980021001531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Given the high disease burden associated with the low intake of whole grains, modelling studies that estimate the impact of dietary strategies to increase more healthful grain foods consumption are essential to inform evidence-based and culturally specific policies. The current study investigated the potential nutritional impact of replacing staple grain foods with more healthful options. DESIGN Based on the 2015 Health Survey of São Paulo, a cross-sectional, population-based study, we modelled the substitution of white rice and white bread with brown rice and whole-wheat bread. Outcomes included changes in more healthful grain foods, energy and nutrient intakes. SETTING Urban area of São Paulo, Brazil. PARTICIPANTS Participants aged over 12 years who completed a semi-structured questionnaire and one 24-h recall (n 1741). RESULTS The substitution of all white rice and white bread with brown rice and whole-wheat bread, respectively, would result in more than 5 % increases in Zn (+9·1 %), Ca (+9·3 %), vitamin E (+18·8 %), dietary fibre (+27·0 %) and Mg (+52·9 %) intake, while more than a 5 % decrease would be seen for total carbohydrate (-6·1 %), folate (-6·6 %), available carbohydrate (-8·5 %), Fe (-8·6 %), vitamin B6 (-12·5 %), vitamin B2 (-17·4 %), and vitamin B1 (-20·7 %). A substantial increase in the amount of more healthful grain foods consumed would be seen (10 g/d to 220 g/d, or from 4 % to 69 % of total grain intake). CONCLUSIONS Replacing white rice and white bread with their whole-grain versions has the potential to improve diet quality, suggesting they are prime targets for policy actions aiming at increasing intake of more healthful grain foods.
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27
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Florindo AA, Teixeira IP, Barrozo LV, Sarti FM, Fisberg RM, Andrade DR, Garcia LMT. Study protocol: health survey of Sao Paulo: ISA-Physical Activity and Environment. BMC Public Health 2021; 21:283. [PMID: 33541300 PMCID: PMC7859902 DOI: 10.1186/s12889-021-10262-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 01/18/2021] [Indexed: 11/18/2022] Open
Abstract
Background Many studies have investigated the association between the built environment and physical activity behavior in urban settings. However, most of the studies conducted in low- and middle-income countries were cross-sectional, which are limited to identify behavioral determinants. We propose a prospective cohort study to verify the relationship between built environment features and leisure-time and transport-related physical activity in adults from Sao Paulo city, Brazil. Methods Prospective multilevel cohort, denominated “ISA-Physical Activity and Environment”. It will build on the Health Survey of Sao Paulo in 2015 (“Inquérito de Saúde de São Paulo (ISA)” in Portuguese). The Health Survey of Sao Paulo, originally designed as a cross-sectional survey, had a multi-stage sample, covering 150 census tracts distributed in five health administrative areas. Data collection was performed by face-to-face interviews until December 2015 and the sample comprised 4043 individuals aged 12 years or more. The ISA-Physical Activity and Environment study will reassess people who are aged 18 years or more in 2020, including telephone and household interviews. The primary outcome will be leisure-time and transport-related physical activity, assessed through the International Physical Activity Questionnaire long version. Exposure variables will be built environment features in the areas participants live and work in the follow-up. Data analysis will include multivariate multilevel linear and logistic models. We will also conduct cost-effectiveness analysis and develop agent-based models to help inform decision-makers. The study will be conducted by an interdisciplinary research team specialized in physical activity epidemiology, nutritional epidemiology, georeferencing applied to health, statistics, agent-based modeling, public health policy, and health economics. Discussion There are few longitudinal studies on the relationship between the built environment and physical activity behavior in low- and middle-income countries. We believe that the ISA-Physical Activity and Environment study will contribute with important results for the progress of the knowledge in this field and for the implementation of policies that promote leisure-time physical activity and active travel in Sao Paulo and similar cities across the world.
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Affiliation(s)
- Alex Antonio Florindo
- School of Arts, Sciences and Humanities, University of Sao Paulo, Rua Arlindo Bettio, 1000, Sao Paulo, SP, 03828-000, Brazil. .,Graduate Program in Nutrition in Public Health, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil. .,Physical Activity Epidemiology Group, University of Sao Paulo, Sao Paulo, Brazil.
| | - Inaian Pignatti Teixeira
- School of Arts, Sciences and Humanities, University of Sao Paulo, Rua Arlindo Bettio, 1000, Sao Paulo, SP, 03828-000, Brazil.,Physical Activity Epidemiology Group, University of Sao Paulo, Sao Paulo, Brazil
| | - Ligia Vizeu Barrozo
- Department of Geography, School of Philosophy, Literature and Human Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Flávia Mori Sarti
- School of Arts, Sciences and Humanities, University of Sao Paulo, Rua Arlindo Bettio, 1000, Sao Paulo, SP, 03828-000, Brazil.,Graduate Program in Nutrition in Public Health, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Regina Mara Fisberg
- Graduate Program in Nutrition in Public Health, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil.,Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Douglas Roque Andrade
- School of Arts, Sciences and Humanities, University of Sao Paulo, Rua Arlindo Bettio, 1000, Sao Paulo, SP, 03828-000, Brazil.,Physical Activity Epidemiology Group, University of Sao Paulo, Sao Paulo, Brazil
| | - Leandro Martin Totaro Garcia
- Physical Activity Epidemiology Group, University of Sao Paulo, Sao Paulo, Brazil.,Centre for Public Health, Queen's University Belfast, Belfast, UK
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28
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Garcez MR, de Castro MA, César CLG, Goldbaum M, Fisberg RM. A chrononutrition perspective of diet quality and eating behaviors of Brazilian adolescents in associated with sleep duration. Chronobiol Int 2021; 38:387-399. [PMID: 33441036 DOI: 10.1080/07420528.2020.1851704] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
It is well recognized that sleep and food intake exhibit 24-h patterns and disturbances of these patterns can lead to health problems. Cross-sectional and prospective studies suggest that diet quality and eating behaviors are negatively affected by short sleep duration. Adolescence is a particularly vulnerable period for the emergence of inadequate sleep and diet patterns. The aim of the study was to investigate associations, from a chrononutrition perspective, of diet quality, nutrients intake, and eating behaviors (eating frequency, eating period, and time-interval between eating occasions) in relation to sleep duration among a multi-ethnic cohort of Brazilian adolescents. Data were collected by the 2015 ISA-Capital survey, a population-based cross-sectional study comprising 419 adolescents of both sexes (12-19 years old) of São Paulo, Brazil. Demographic, socioeconomic, anthropometric, and lifestyle, including sleep duration, data were obtained from an interviewer-administered structured questionnaire. Dietary data were obtained by 24-h dietary recall (24-HDR), and diet quality was assessed by the Brazilian Healthy Eating Index - Revised (BHEI-R), validated for the Brazilian population. The independent associations between sleep duration categories (i.e., <8 h as short sleep and 8-10 h as adequate sleep), and dietary variables were assessed after adjustments for covariates. Multiple linear, logistic, and Poison regression models were used, depending on the variable. Diet quality, nutrients intake, and eating behaviors differed according to adolescents' sleep duration. Approximately 36% of adolescents were sleep deprived. They presented poorer diet quality (53 points, p = .034) and eating behaviors characterized by lower probability of having lunch (88%, p < .001) and dinner (71%, p < .001) and higher probabilities of eating breakfast (87%, p < .001) and morning snack (26%, p = .001). These adolescents compared to those with adequate sleep duration also had, from snacks and in the 24-h cycle, higher contribution of available carbohydrates (8%, p < .001; 50%, p = .024) and total sugar (6%, p < .001; 21%, p < .001) and added sugar (3%, p < .001; 15%, p < .001). The chrononutrition characteristics of sleep-deprived adolescents were marked by longer eating periods (12 h, p < .001) and time-interval between eating occasions (3 h, p < .001) than adolescents with adequate sleep duration. These differences point to the relevance of the interrelation between sleep and diet, i.e., disruption of circadian cycles and consequent metabolic health problems, to inform public health policies and clinical interventions.
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Affiliation(s)
| | | | | | - Moisés Goldbaum
- Department of Preventive Medicine, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
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Obesity Associated with Low Lean Mass and Low Bone Density Has Higher Impact on General Health in Middle-Aged and Older Adults. J Obes 2020. [DOI: 10.1155/2020/8359616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
It is believed that the phenomenon of simultaneous changes in body composition could have a higher negative impact on general health. Thus, we aimed to investigate the prevalence of concomitant body composition disturbances and evaluate the association with dietary intake, sedentary behaviour, muscle strength, and performance. This is a cross-sectional study with 218 community-dwelling adults, aged 63 (59–69) years, both sexes (52% female) recruited from the Health Survey of the City of São Paulo. Assessments include appendicular lean mass (LM), fat mass and bone mineral density (BMD) by DXA, grip strength, time spent sitting, and dietary intake. Subjects were clustered into 8 groups: (1) normal, (2) osteopenia (OP), (3) low LM, (4) obesity, (5) OP + low LM, (6) obesity + OP, (7) obesity + low LM, and (8) obesity + OP + low LM. Statistical analyses include ANCOVA, the chi-square test, and linear regression models. 52 (23%) individuals presented obesity associated with another body composition change, with 14 (6%) having the combination of the 3 conditions (obesity + OP + low LM). All groups with obesity showed lower protein intake (
); however, those with obesity or obesity + low LM spent more time in a sitting position (
), and the group with obesity + OP + low LM had the lowest grip strength. The combination of obesity with low LM and OP presented the aggravating factor of being associated with lower grip strength. In a context of demographic and nutrition transition, the findings represent a demand for longitudinal investigations.
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30
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Batista LD, De França NAG, Pfrimer K, Fontanelli MDM, Ferriolli E, Fisberg RM. Estimating total daily energy requirements in community-dwelling older adults: validity of previous predictive equations and modeling of a new approach. Eur J Clin Nutr 2020; 75:133-140. [PMID: 32814851 DOI: 10.1038/s41430-020-00717-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 07/08/2020] [Accepted: 08/04/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Accurate estimation of energy requirements is crucial for health maintenance and prevention of malnutrition in older adults. This study aimed to assess the accuracy of predictive equations for estimating energy requirements in older adults and to test the validity of new predictive equations for this age group. SUBJECTS/METHODS This is a cross-sectional study including 38 Brazilian community-dwelling older adults aged 60-84 years, who had their total energy expenditure measured by doubly labeled water (TEEDLW). The energy expenditure was compared to the Institute of Medicine (Dietary Reference Intake (DRI)) and Vinken et al. previous predictive equations and three predictive models developed in a modeling sample. The agreement was assessed using intra-class correlation coefficient, Bland-Altman plots, and Lin's concordance correlation. Accuracy was evaluated considering ±10% of the ratio between estimated and measured energy expenditure. RESULTS The mean (standard deviation) TEEDLW was 2656.7 (405.6) kcal/day for men and 2168.9 (376.9) for women. Vinken et al. and both DRI equations presented moderate to good degree of agreement, while the developed models vary from fair to very good agreement in comparison to DLW. The accuracy rate was the same for both DRI equations and Vinken et al. equation (60.53%). The new equations developed in this study had accuracy in predicting TEE for Brazilian older adults varying from 43.11% to 73.68%. CONCLUSIONS The results corroborate the use of previous predictive equations for estimating energy requirements in Brazilian older adults. Further studies have the potential to explore the use of the developed models to assess energy needs in this population.
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Affiliation(s)
- Lais Duarte Batista
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, Cerqueira Cesar, São Paulo, SP, Brazil
| | - Natasha Aparecida Grande De França
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, Cerqueira Cesar, São Paulo, SP, Brazil.,Centro Universitário de Rio Preto (UNIRP), R. Ivete Gabriel Atique, 45-Vila Maria, São José do Rio Preto, SP, Brazil
| | - Karina Pfrimer
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Mariane de Mello Fontanelli
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, Cerqueira Cesar, São Paulo, SP, Brazil
| | - Eduardo Ferriolli
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, Cerqueira Cesar, São Paulo, SP, Brazil.
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31
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dos Santos EA, Giudici KV, de França NAG, Peters BSE, Fisberg RM, Martini LA. Correlations among vitamin K intake, body fat, lipid profile and glucose homeostasis in adults and the elderly. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2020; 64:436-444. [PMID: 32267358 PMCID: PMC10522088 DOI: 10.20945/2359-3997000000230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 10/01/2019] [Indexed: 11/23/2022]
Abstract
Objective Recent research has investigated the possible inverse relationship between vitamin K intake and body fat. In addition, an increasing number of studies are supporting a key role for this vitamin in improving lipid profile and insulin sensitivity and reducing the risk of type 2 diabetes mellitus, but little is known about what mechanisms would be involved. Thus, the objective of this study was to investigate the relationship between vitamin K intake (in the form of phylloquinone - PK), body fat, lipid profile and markers of glucose homeostasis in adults and the elderly. Subjects and methods A cross-sectional study with 298 participants (46% men) in the São Paulo Health Survey 2014-2015. Spearman correlations were performed to evaluate the associations between vitamin K intake and the biochemical and body composition measures. Results Among normal-weight male adults (n = 15), PK intake presented a positive correlation with the quantitative insulin sensitivity check index (QUICKI) (r = 0.525; p = 0.045). Among men with high fat mass index (FMI) (n = 101), PK intake had a negative correlation with homeostasis model assessment estimate for β-cell function (HOMA-β) (r = -0.227; p = 0.022). In women with high FMI (n = 122), PK intake had a negative correlation with HOMA-β (r = -0.199, p = 0.032) and insulin (r = -0.207, p = 0.026). No correlations were found between PK intake and lipid profile. Conclusions Our findings support a potential relationship among PK intake, body fat and markers of glucose homeostasis in adults and the elderly.
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Affiliation(s)
- Elizabete A. dos Santos
- Departamento de NutriçãoFaculdade de Saúde PúblicaUniversidade de São PauloSão PauloSPBrasilDepartamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo (USP), São Paulo, SP, Brasil
| | - Kelly V. Giudici
- Departamento de NutriçãoFaculdade de Saúde PúblicaUniversidade de São PauloSão PauloSPBrasilDepartamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo (USP), São Paulo, SP, Brasil
| | - Natasha A. G. de França
- Departamento de NutriçãoFaculdade de Saúde PúblicaUniversidade de São PauloSão PauloSPBrasilDepartamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo (USP), São Paulo, SP, Brasil
| | - Barbara S. Emo Peters
- Departamento de NutriçãoFaculdade de Saúde PúblicaUniversidade de São PauloSão PauloSPBrasilDepartamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo (USP), São Paulo, SP, Brasil
| | - Regina Mara Fisberg
- Departamento de NutriçãoFaculdade de Saúde PúblicaUniversidade de São PauloSão PauloSPBrasilDepartamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo (USP), São Paulo, SP, Brasil
| | - Lígia A. Martini
- Departamento de NutriçãoFaculdade de Saúde PúblicaUniversidade de São PauloSão PauloSPBrasilDepartamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo (USP), São Paulo, SP, Brasil
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32
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Norde MM, Tabung FK, Giovannucci EL, Fisberg RM, Rogero MM. Validation and adaptation of the empirical dietary inflammatory pattern across nations: A test case. Nutrition 2020; 79-80:110843. [PMID: 32563770 DOI: 10.1016/j.nut.2020.110843] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 02/19/2020] [Accepted: 04/10/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The empirical dietary inflammatory pattern (EDIP) assesses the inflammatory potential of diet in the US population. The aim of this study was to assess the applicability of the EDIP to a Brazilian population. METHODS Data from 19- to 75-y-old participants of two editions of the cross-sectional population-based Health Survey of Sao Paulo (HS-SP) were used to validate the EDIP (n = 269; HS-SP 2008), develop an EDIP adapted to a Sao Paulo population, the EDIP-SP (n = 441; HS-SP 2008), and replicate EDIP-SP results in an independent sample (n = 501; HS-SP 2015). Dietary data was assessed through two 24-h recalls and one validated food frequency questionnaire. Plasma C-reactive protein (CRP), and nine other inflammatory biomarkers were determined. EDIP was tested for its association with the 10 inflammatory biomarkers. For development of the EDIP-SP, 21 food groups and their contributions to plasma CRP levels were modeled using a stepwise multiple linear regression adjusted for age and sex. RESULTS The EDIP was not associated with concentrations of inflammatory biomarkers in a Brazilian population. The components of EDIP-SP were processed meats (β = 0.27; P = 0.082), fruits and vegetables (β = -0.12; P = 0.018), and rice and beans (β = -0.27; P = 0.007). EDIP-SP significantly predicted dietary quality (β = -6.1; P < 0.001) and its inflammatory potential was replicated among men (β = 0.36; P = 0.01), but not among women (β = 0.05; P = 0.82). CONCLUSION EDIP was adapted to the Sao Paulo population. EDIP-SP, composed of high processed meat intake and low intake of fruits and vegetables, and rice and beans, constitutes an important tool to investigate dietary quality based on its inflammatory potential, in Brazilian populations.
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Affiliation(s)
- Marina M Norde
- Department of Nutrition, School of Public Health of the University of Sao Paulo, Sao Paulo, Brazil; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States
| | - Fred K Tabung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States; Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, and Comprehensive Cancer Center; Columbus, Ohio, United States
| | - Edward L Giovannucci
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States
| | - Regina M Fisberg
- Department of Nutrition, School of Public Health of the University of Sao Paulo, Sao Paulo, Brazil
| | - Marcelo M Rogero
- Department of Nutrition, School of Public Health of the University of Sao Paulo, Sao Paulo, Brazil.
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Bastos AA, Nogueira LR, Neto JV, Fisberg RM, Yannakoulia M, Ribeiro SML. Association between the adherence to the Mediterranean dietary pattern and common mental disorders among community-dwelling elders: 2015 Health Survey of São Paulo, SP, Brazil. J Affect Disord 2020; 265:389-394. [PMID: 32090764 DOI: 10.1016/j.jad.2020.01.100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/22/2019] [Accepted: 01/20/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND Some questions regarding the benefits of the Mediterranean Dietary Pattern (MDP) are still unanswered, especially in non-Mediterranean areas. As such, this study intends to evaluate the association between the adherence to the MDP with the presence of Common Mental Disorders (CMD) in Brazilian older adults, adopting two different concepts of MDP. METHODS The sample included 545 elders from 2015 Health Survey of São Paulo City (cross-sectional population-based study). CMD were identified through the Self Reporting Questionnaire-20 (SRQ-20). Data from two 24-hour dietary recall were used to construct two concepts of MDP according to the Mediterranean-diet score (MDS): Traditional MDP (included only foods with characteristics of the original MDP) and Brazilian-MDP (included foods with non-Mediterranean characteristics). The analyses included two different models (crude model and adjusted model for potential confounders) of logistic regression. RESULTS Moderate and high adherence to Traditional MDP were associated with a lower prevalence of CMD (OR: 0.59; 95% CI: 0.35-0.98 and OR: 0.42, 95% CI: 0.18-0.96, respectively), after adjustment for sociodemographic, lifestyle and health status variables. In turn, the presence of CMD was not significantly associated with any level of adherence to the Brazilian-MDP. LIMITATIONS due to the cross-sectional feature of the study, we cannot determine a cause-effect relationship; some covariates were self-reported; the results cannot apply to the elderly from other regions. CONCLUSION Moderate and high adherence to the traditional MDP was found to reduce the risk of mental disorders in Brazilian elderly. Nevertheless, an increased intake of non-Mediterranean food components can limit this effect.
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Affiliation(s)
- Amália Almeida Bastos
- University of Sao Paulo, School of Public Health, Av. Dr. Arnaldo, 715, São Paulo, CEP 01246-904 SP, Brazil.
| | - Luana Romão Nogueira
- University of Sao Paulo, School of Public Health, Av. Dr. Arnaldo, 715, São Paulo, CEP 01246-904 SP, Brazil
| | - João Valentini Neto
- University of Sao Paulo, School of Public Health, Av. Dr. Arnaldo, 715, São Paulo, CEP 01246-904 SP, Brazil
| | - Regina Mara Fisberg
- University of Sao Paulo, School of Public Health, Av. Dr. Arnaldo, 715, São Paulo, CEP 01246-904 SP, Brazil
| | - Mary Yannakoulia
- Harokopio University, School of Health Sciences and Education, Athens, Greece
| | - Sandra Maria Lima Ribeiro
- University of Sao Paulo, School of Public Health, Av. Dr. Arnaldo, 715, São Paulo, CEP 01246-904 SP, Brazil; University of Sao Paulo, School of Arts, Science and Humanities, São Paulo, SP, Brazil
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Nogueira LR, Fontanelli MDM, Aguiar BSD, Failla MA, Florindo AA, Leme AC, Barbosa JPDAS, Fisberg RM. Is the local food environment associated with excess body weight in adolescents in São Paulo, Brazil? CAD SAUDE PUBLICA 2020; 36:e00048619. [DOI: 10.1590/0102-311x00048619] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 08/02/2019] [Indexed: 11/21/2022] Open
Abstract
The obesogenic environment stimulates an inadequate diet by hampering healthy choices. This cross-sectional study evaluated the association between the local food environment and the prevalence of overweight and obesity in a representative sample population of adolescents living in the city of São Paulo, Brazil, using multilevel logistic regression models. Among the adolescents, 29.6% were overweight/obese. There were no significant differences between food environment and adolescents’ weight status. However, the presence of fast food restaurants near their home increased the chances of being overweight or obese (OR = 2.53; 95%CI: 1.02-6.27). Results suggest the need to intensify food and nutrition policies, development of culinary skills, and the reduction in prices of healthy foods to facilitate access to these foods, so that adolescents have options in locations to socialize with friends and family.
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Fontanelli MDM, Micha R, Sales CH, Liu J, Mozaffarian D, Fisberg RM. Application of the ≤ 10:1 carbohydrate to fiber ratio to identify healthy grain foods and its association with cardiometabolic risk factors. Eur J Nutr 2019; 59:3269-3279. [PMID: 31865421 DOI: 10.1007/s00394-019-02165-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 12/13/2019] [Indexed: 02/05/2023]
Abstract
PURPOSE Optimal metrics to assess healthfulness of carbohydrate-rich products are not well established. We investigated how the content per 10 g of carbohydrate of at least 1 g of fiber (≤ 10:1-ratio) related to nutritional quality in grain foods as well as cardiometabolic risk factors in São Paulo, Brazil. METHODS Data were from the cross-sectional population-based study 2015 Health Survey of São Paulo, including a probabilistic sample of urban residents in the city. Participants (n = 1188) aged 20 + years completed a 24-h dietary recall and a subsample of 603 participants had blood samples, anthropometrics, and blood pressure measurements collected, and answered a second 24-h recall. Energy and nutrient contents of grain foods meeting or not meeting the ≤ 10:1-ratio were evaluated using linear regression models. The association between consumption (percent energy, %E) of grain foods meeting the ≤ 10:1-ratio and cardiometabolic risk factors were investigated using linear regression models. RESULTS Foods meeting the ≤ 10:1-ratio had less available carbohydrate (- 3.0 g/serving), total sugar (- 7.4 g/serving), added sugar (- 7.2 g/serving) and saturated fat (- 0.7 g/serving), and more dietary fiber (+ 3.5 g/serving), protein (+ 2.1 g/serving), potassium (+ 100.1 mg/serving), iron (+ 0.9 mg/serving), selenium (+ 4.2 µg/serving), magnesium (+ 38.7 mg/serving), and zinc (+ 1.1 mg/serving). Each increase in 1%E consumption of grain foods meeting the ≤ 10:1-ratio was associated with lower levels of blood triacylglycerol (- 10.7%), the triacylglycerol/high-density lipoprotein cholesterol ratio (- 14.9%), fasting insulin (- 13.6%), and homeostasis model assessment for insulin resistance (- 14.0%). CONCLUSION The ≤ 10:1-ratio identified grain foods with higher nutritional quality and higher intakes of these foods were associated with cardiometabolic risk factors related to atherogenic dyslipidemia and insulin resistance.
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Affiliation(s)
- Mariane de Mello Fontanelli
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo, 715, Cerqueira Cesar, São Paulo, SP, 01246-904, Brazil
| | - Renata Micha
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA, 02111, USA
| | - Cristiane Hermes Sales
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo, 715, Cerqueira Cesar, São Paulo, SP, 01246-904, Brazil
| | - Junxiu Liu
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA, 02111, USA
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA, 02111, USA
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo, 715, Cerqueira Cesar, São Paulo, SP, 01246-904, Brazil.
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Social determinants, lifestyle and diet quality: a population-based study from the 2015 Health Survey of São Paulo, Brazil. Public Health Nutr 2019; 23:1766-1777. [DOI: 10.1017/s1368980019003483] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
AbstractObjective:To investigate the association among social determinants, lifestyle variables and diet quality in São Paulo, Brazil.Design:Cross-sectional study, 2015 Health Survey of São Paulo (Inquérito de Saúde de São Paulo (2015 ISA-Capital)) with Focus on Nutrition Study (2015 ISA-Nutrition).Setting:Population-based study, with a representative sample of adults living in São Paulo, Brazil.Participants:Adults (aged 20–59 years, n 643) and older adults (aged ≥60 years, n 545).Results:We observed differences in the Brazilian Healthy Eating Index-Revised (BHEI-R) by education, income, occupation, sex and race. Whole grains (0·63 points, 12·6 % of the maximum score), sodium (2·50 points, 25·0 %) and solid fat, alcohol and added sugars (9·28 points, 46·4 %) components had the lowest BHEI-R scores. Factors positively associated with diet quality included the presence of one disease or more (e.g. diabetes mellitus, hypertension, cancer, hypercholesterolaemia: β = 0·636, P < 0·001), income (middle income: β = 0·478, P < 0·001; high income: β = 0·966, P < 0·001) and occupation (other: β = 1·418, P < 0·001). Energy (β = –0·001, P < 0·001), alcohol consumption (β = –0·207, P = 0·027), education level (middle education: β = –0·975, P < 0·001; high education: β = –1·376, P < 0·001), races other than white (β = –0·366, P < 0·001) and being unemployed (β = –0·369, P < 0·046) were negatively associated with diet quality.Conclusions:Groups affected by socio-economic inequalities need better diet quality. Governmental actions should be implemented to reduce the consumption of energy-dense and sodium-rich foods, facilitate access and information on healthy eating, and conduct nutritional education.
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Collese TS, De Moraes ACF, Rendo-Urteaga T, Luzia LA, Rondó PHDC, Marchioni DML, Carvalho HB. The Validity of Children's Fruit and Vegetable Intake Using Plasma Vitamins A, C, and E: The SAYCARE Study. Nutrients 2019; 11:E1815. [PMID: 31390803 PMCID: PMC6722842 DOI: 10.3390/nu11081815] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 07/30/2019] [Accepted: 08/02/2019] [Indexed: 01/29/2023] Open
Abstract
Despite that fruits and vegetables are key elements for health promotion, there are limited studies validating their intake in children. We aimed to validate the SAYCARE (South American Youth/Child Cardiovascular and Environmental) Study Food Frequency Questionnaire (FFQ) and the combination of the FFQ frequency of intake with the 24 h-dietary-recall (24 h-DR) (mean of 3 days), for children's fruit and vegetable intake. The reference methods were plasma dosages of β-carotene, retinol, ascorbic acid, and α-tocopherol, which were collected in the school environment. It is a validity study in a subsample of 45 children aged 6-10 years participating in the SAYCARE Study, from São Paulo (Brazil). The FFQ was answered by the parents/guardians over the previous 3 months; the 24 h-DR was answered three times (two weekdays by nutritionists, one weekend day by parents/guardians). The mean fruit and vegetable intake (combined with frequency of intake) was calculated using the multiple source method (MSM). Multiple linear regression showed pooled correlation coefficients of 0.29 to 0.35 for the reported fruit and vegetable intake estimated by the FFQ and the MSM, respectively. The SAYCARE FFQ is an accurate and useful tool for ranking fruit and vegetable intake in children between 6-10 years from the SAYCARE Study.
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Affiliation(s)
- Tatiana Sadalla Collese
- YCARE (Youth/Child cArdiovascular Risk and Environmental) Research Group, Department of Preventive Medicine, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 01246-903, Brazil.
| | - Augusto César Ferreira De Moraes
- YCARE (Youth/Child cArdiovascular Risk and Environmental) Research Group, Department of Preventive Medicine, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 01246-903, Brazil
- Department of Epidemiology, School of Public Health, University of Sao Paulo, Sao Paulo 01246-904, Brazil
| | - Tara Rendo-Urteaga
- YCARE (Youth/Child cArdiovascular Risk and Environmental) Research Group, Department of Preventive Medicine, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 01246-903, Brazil
- Facultad de Ciencias de la Salud, Universidad Isabel I, 09001 Burgos, Spain
| | - Liania Alves Luzia
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo 1246-904, Brazil
| | | | | | - Heráclito Barbosa Carvalho
- YCARE (Youth/Child cArdiovascular Risk and Environmental) Research Group, Department of Preventive Medicine, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 01246-903, Brazil
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Castro MAD, Garcez MR, Pereira JL, Fisberg RM. Eating behaviours and dietary intake associations with self-reported sleep duration of free-living Brazilian adults. Appetite 2019; 137:207-217. [PMID: 30844412 DOI: 10.1016/j.appet.2019.02.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 02/17/2019] [Accepted: 02/26/2019] [Indexed: 11/29/2022]
Abstract
Sleep duration in modern societies has been decreasing over the past decades and many environmental and behaviour factors contribute with. Evidence have shown that individuals with short sleep duration have worse eating behaviours and dietary intakes than those with adequate sleep. This study aimed to describe eating behaviours and dietary intakes of Brazilian adults and investigate their associations with self-reported sleep duration encompassing aspects of chrono-nutrition. Demographic, socioeconomic, anthropometric, lifestyle, sleep duration and dietary data were obtained from an interviewer-administered structured questionnaire of the cross-sectional population-based study, 2015 ISA-Capital, (n = 1081 adults, ≥20y). The independent associations between sleep duration (categories: ≤6 h, 7-8 h, and ≥9 h) and dietary variables were assessed after adjustment for covariates. Employment status, physical activity, number of chronic diseases and day of recalled intake were significantly associated with sleep duration categories (p < 0.05). Short duration sleepers (≤6 h) showed the largest probabilities of eating breakfast and snacks. Snacks contributed to 23% of total energy intake and provided the largest amounts of total and added sugar than other eating occasions among short duration sleepers. Long duration sleepers (≥9 h) exhibited lower probability of consumption of the three main meals, lower energy and nutrient intakes in the morning, lower eating frequency and shorter eating period. Irrespective of sleep duration, the largest contribution to total energy intake was in the afternoon (43-46%), followed by the evening (30-32%) and morning (22-25%) periods. In conclusion, sleep duration was associated with different dietary intakes and eating behaviours among Brazilian adults. The largest energy intakes in the afternoon and evening periods signalize the relevance to consider the timing of food consumption aside sleep duration as a target to nutritional counseling for prevention of circadian misalignment and related metabolic disturbances.
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Affiliation(s)
| | | | | | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, Brazil.
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Pereira JL, Vieira DADS, Alves MCGP, César CLG, Goldbaum M, Fisberg RM. Excess body weight in the city of São Paulo: panorama from 2003 to 2015, associated factors and projection for the next years. BMC Public Health 2018; 18:1332. [PMID: 30509223 PMCID: PMC6276135 DOI: 10.1186/s12889-018-6225-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 11/16/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Excess body weight (EBW: overweight and obesity) has high and rising prevalence in Brazil. Up-to-date information about the distribution and changes in the prevalence of EBW and their associated factors are essential to determine target groups and to identify priority actions. The aim of this study was to investigate the associated factors and to determine the prevalence of overweight and obesity in the adolescent and adult population of the city of São Paulo in the years of 2003, 2008, and 2015, as well as to estimate the prediction for the next years. METHODS Individuals aged 12 years and older from three editions of the Health Survey of São Paulo (ISA-Capital), a cross-sectional population-based survey, carried out in 2003 (n = 2144), 2008 (n = 2599), and 2015 (n = 3939), had their socioeconomic, anthropometric, and lifestyle data collected at households. Individuals were classified according to their age and BMI as: without excess body weight, overweight, or obese. Differences were evaluated through Pearson's Chi-square test and comparison of 95% CI. Generalized ordered logit models were used to evaluate factors associated to overweight/obesity and logistic regression models were used to predict their prevalence for the next years. RESULTS The prevalence (95% CI) of obesity in total population doubled: from 10% (8.0, 12.5) in 2003 to 19.2% (17.8, 20.6) in 2015. The main increase occurred in female adolescents from 2.5% (1.2, 5.3) to 11.2% (8.4, 14.7) and adults, from 9.2% (6.4, 13.1) to 22.3% (20.0, 24.8). Those with higher chance of having EBW were adults, those with higher income, and former smokers. The prevalence of EBW increased 31% from 2003 to 2008, and 126% from 2003 to 2015, when half of the population had EBW. If this pattern does not change, 77% of the population is expected to have EBW by 2030. CONCLUSIONS Our findings present up-to-date information about the distribution of EBW, which increased substantially over a short time and more prominently in specific groups. The factors associated with EBW may provide important information for decision makers and researchers to create or review the existing programs and interventions in order to decrease the trend for the next years.
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Affiliation(s)
- Jaqueline Lopes Pereira
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | | | | | - Moisés Goldbaum
- Department of Preventive Medicine, Medical School, University of São Paulo, São Paulo, Brazil
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
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Fontanelli MDM, Nogueira LR, Garcez MR, Sales CH, Corrente JE, César CLG, Goldbaum M, Fisberg RM. [Validity of self-reported high cholesterol in the city of São Paulo, Brazil, and factors associated with this information's sensitivity]. CAD SAUDE PUBLICA 2018; 34:e00034718. [PMID: 30517313 DOI: 10.1590/0102-311x00034718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 08/17/2018] [Indexed: 11/22/2022] Open
Abstract
The study aimed to validate self-report of high cholesterol in São Paulo, Brazil, and verify factors associated with this information's sensitivity. Data were used from the Health Survey of the City of São Paulo 2015, a cross-sectional population-based study with a probabilistic sample of the city's residents. The sample included 886 individuals with information from the structured questionnaire, blood measurements of total cholesterol and fractions or who reported being on medication for high cholesterol. The validity of self-reported information on high cholesterol was measured according to sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and kappa index, considering total cholesterol and LDL-c and pharmacological treatment as the gold standard. Logistic regression models were developed to investigate factors associated with the sensitivity of this information. The sensitivity of information on high cholesterol using total cholesterol as the reference was 50.6%, specificity 90.19%, PPV 51.64%, NPV 89.82%, and kappa 0.41. Taking LDL-c as the gold standard, sensitivity was 53.52%, specificity 89.93%, PPV 49.22%, NPV 91.39%, and kappa 0.43. Using total cholesterol as the reference, age (OR = 1.69; 95%CI: 1.24-2.29) and having a private health plan (OR = 2.91; 95%CI: 1.06-7.99) were associated with the information's sensitivity. With LDL-c as the gold standard, age (OR = 1.71; 95%CI: 1.13-2.57), smoking (OR = 3.33; 95%CI: 1.08-10.27), and having a private health plan (OR = 3.64; 95%CI: 1.10-12.08) were associated with the information's sensitivity. The results suggest low sensitivity and low PPV of self-reported high cholesterol in residents of São Paulo.
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Affiliation(s)
| | | | | | | | | | | | - Moisés Goldbaum
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
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Pereira JL, Félix PV, Mattei J, Fisberg RM. Differences over 12 Years in Food Portion Size and Association with Excess Body Weight in the City of São Paulo, Brazil. Nutrients 2018; 10:E696. [PMID: 29848971 PMCID: PMC6024366 DOI: 10.3390/nu10060696] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 05/24/2018] [Accepted: 05/28/2018] [Indexed: 12/21/2022] Open
Abstract
Although changes in Brazilian diet have occurred over the last decades, there is no evidence about differences in food portion sizes (FPS) over time. Therefore, we aimed to evaluate the association of FPS with excess body weight (EBW), and to monitor differences in the population from São Paulo, Brazil, from 2003 to 2015. Data came from three cross-sectional population-based studies with 5270 individuals aged ≥12 years in 2003, 2008, and 2015. Dietary data were obtained from 24-h recalls. Logistic regression models were used to evaluate the association between FPS and EBW. Over the years, there was a diverse variation in FPS, with an increase in some groups (white meat, salted snacks, coffee/tea, eggs) and decrease in others (rice, red meat, sweets, pasta, sandwiches, cold cuts). The percentage of people reporting the intake of six food groupings (rice, white meat, sweets, fruits, commercial juices, toasts/biscuits) increased in the period. In this population, EBW was associated with larger FPS of 11 of the 30 food groupings investigated (cold cuts, fried snacks, fruit and commercial juices, pizza, red meat, rice, salted snacks, soft drinks, soups, sugar). These findings could support future interventions and policies for optimal food intake in Brazil.
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Affiliation(s)
- Jaqueline Lopes Pereira
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo SP 01246-904, Brazil.
| | - Paula Victória Félix
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo SP 01246-904, Brazil.
| | - Josiemer Mattei
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo SP 01246-904, Brazil.
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Access to Street Markets and Consumption of Fruits and Vegetables by Adolescents Living in São Paulo, Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018. [PMID: 29538324 PMCID: PMC5877062 DOI: 10.3390/ijerph15030517] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Food environment and income act as determinants of diet, and consequently, of the consumption of fruits and vegetables. The objective of this study is to investigate the association between fruit and vegetable consumption, income, and street market density in adolescents living in São Paulo, Brazil. Data from 521 adolescents (12 to 19 years) participating in the 2015 Health Survey of São Paulo were used. Buffers (500, 1000, and 1500 m) were drawn around the households and the street markets were counted in each zone. Multilevel logistic regression models were used to evaluate the association between fruit and vegetable consumption, income, and street market density. The main results showed that the presence of a street market in the zone closest to the households (500 m) was associated with higher consumption of fruits and vegetables (OR: 1.73; CI 95% 1.01-3.00). Higher family income was associated with a higher consumption of fruits and vegetables for models of 500 m buffer (OR: 2.56; CI 95% 1.47-4.45), 1000 m (OR: 2.30; CI 95% 1.33-3.96), and 1500 m (OR: 2.32; CI 95% 1.35-4.00). These results support the implementation of public policies that jointly consider income and the availability of street markets or healthy food environments.
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