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de Faria NC, Andrade GMDP, Ruas CM, Claro RM, Braga LVM, Nilson EAF, Anastácio LR. Impact of implementation of front-of-package nutrition labeling on sugary beverage consumption and consequently on the prevalence of excess body weight and obesity and related direct costs in Brazil: An estimate through a modeling study. PLoS One 2023; 18:e0289340. [PMID: 37566577 PMCID: PMC10420370 DOI: 10.1371/journal.pone.0289340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 07/18/2023] [Indexed: 08/13/2023] Open
Abstract
RATIONALE Intake of sugary beverages has been associated with obesity and chronic non-communicable diseases, thereby increasing the direct health costs related to these diseases. Front-of-package nutrition labeling (FoPNL) aims to help consumers understand food composition, thereby improving food choices and preventing the development of such diseases. OBJECTIVE To estimate, over five years, the impact of implementing FoPNL in Brazil on the prevalence of excess body weight and obesity in adults who consume sugary beverages and the direct costs related to such problems. METHODS A simulation study to performed to estimate the effect of FoPNL implementation on the prevalence of excess body weight and obesity. The VIGITEL research database (2019), published in the 2020 report, was used in this study (the final sample consisted of 12,471 data points representing 14,380,032 Brazilians). The scenarios were considered: base (trend in sugary beverage intake); 1 (base scenario associated with the changes in energy content of the purchased beverages observed after the first phase of the Chilean labeling law (-9.9%); and 2 (scenario 1 associated with reformulation of beverages, total energy reduction of -1.6%). Changes in body weight were estimated using the simulation model of Hall et al. (2011) over five years. A linear trend in the prevalence of obesity and excess body weight in the Brazilian population was considered. The impact of the prevalence of obesity and excess body weight on body mass index was estimated. In addition, the direct health costs related to obesity were estimated. RESULTS Energy consumption from sugary beverages after FoPNL implementation is expected to be reduced by approximately 28 kcal/day (95% CI, -30 to -27) considering scenario 1. In scenarios 1 and 2, without FoPNL, the prevalence of obesity and excess body weight over five years was estimated to be 25.3% and 25.2%, and 64.4% and 64.2%, respectively. By extrapolating the results to the entire Brazilian population, it was observed that the implementation of FoPNL may reduce the prevalence of obesity by -0.32 percentage points and -0.35 percentage points (scenario 1 and 2, respectively) and excess body weight by -0.42 percentage points and -0.48 percentage points (scenarios 1 and 2, respectively) in five years. It is estimated that after five years of implementation, it will be possible to save approximately US$ 5,5 millions (95% CI 4,7 to 8,8) in scenario 1, reaching approximately US$ 6,1 millions (95% CI 5,3 to 9,8) in scenario 2. CONCLUSION The results of this modeling study indicate that FoPNL may reduce prevalence of excess body weight and obesity, representing strategic public policies for obesity prevention.
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Affiliation(s)
- Natália Cristina de Faria
- Post-Graduate Program in Food Science, Faculty of Pharmacy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | - Cristina Mariano Ruas
- Department of Social Pharmacy, Faculty of Pharmacy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Rafael Moreira Claro
- Department of Nutrition, School of Nursing, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
- Centre for Epidemiological Research in Nutrition and Health (NUPENS), University of Sao Paulo, Sao Paulo, Brazil
| | - Luíza Vargas Mascarenhas Braga
- Post-Graduate Program in Food Science, Faculty of Pharmacy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Eduardo Augusto Fernandes Nilson
- Centre for Epidemiological Research in Nutrition and Health (NUPENS), University of Sao Paulo, Sao Paulo, Brazil
- Oswaldo Cruz Foundation (Fiocruz) Brasília, Brasilia, Brazil
| | - Lucilene Rezende Anastácio
- Post-Graduate Program in Food Science, Faculty of Pharmacy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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Tomaz LA, Pereira CG, Braga LVM, Prates SMS, Silva ARCS, Soares APDC, de Faria NC, Anastácio LR. From the most to the least flexible nutritional profile: Classification of foods marketed in Brazil according to the Brazilian and Mexican models. Front Nutr 2022; 9:919582. [PMID: 36204372 PMCID: PMC9531871 DOI: 10.3389/fnut.2022.919582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/10/2022] [Indexed: 11/16/2022] Open
Abstract
Nutrient profiling is the science of classifying or ranking foods according to their nutritional composition, for reasons related to disease prevention and health promotion. To be effective, policies such as front-of-pack nutrition labeling (FoPNL) must have an adequate nutritional profile model, since it will determine which products will be eligible to receive a FoPNL. This study aimed to determine the percentage of packaged food and drink products available in Brazil that would be subject to FoPNL under two different legislations: Brazilian and Mexican. This is a cross-sectional study in which we collected information on food products (photos of the ingredients list, the front label, the barcode, and the nutrition facts table) from one of the largest stores of a supermarket chain in the city of Belo Horizonte-MG, Brazil, from March to May 2021 (~6 months after the publication of the Brazilian legislation about FoPNL and a year and a half before the legislation came into force). The products were classified in relation to the BNPM (added sugars, saturated fats, and sodium) and the MNPM (energy, free sugars, saturated fats, trans fats, sodium, non-sugar sweeteners, and caffeine). A total of 3384 products were collected and, after applying the exclusion criteria, 3,335 products were evaluated. Of these, 2,901 would be eligible to receive FoPNL in Brazil and 2,914 would be eligible to receive FoPNL in Mexico. According to the BNPM, 56.7% (95% CI 54.9; 58.5%) of the products were “high in” critical nutrients, 27.1% (95% CI 25.5; 28.7%) of the products in added sugars, 26.7% (95% CI 25.2; 28.4%) of the products in saturated fats, and 21.4% (95% CI 19.9; 22.9%) of the products in sodium. As for the MNPM, 96.8% (95% CI 96.1; 97.4%) of them were “high in” up to five critical nutrients and up to two warning rectangles (caffeine and non-sugar sweeteners), 45.8% (95% CI 44.0; 47.6%) of them in free sugars, 43.7% (95% CI 41.9; 45.5%) of them in saturated fats, and 47.9% (95% CI 46.1; 49.7%) of them in sodium. We concluded that the eligibility to receive FoPNL by BNPM and MNPM was relatively similar between products; however, almost all products would have at least one FoPNL and/or warning rectangles according to Mexican legislation, and nearly half of them would have at least one FoPNL, considering BNPM. The MNPM is much more restrictive than the BNPM. The Nutrient Profile Model (NPM) that regulates FoPNL, and other health policies, must be carefully defined to ensure that foods are properly classified according to their healthiness.
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Soares APDC, de Faria NC, Graciano GF, Dos Santos ALS, Valenzuela VDC, Toulson Davisson Correia MI, Cosenza GP, Anastácio LR. Cinnamon Infusion Reduces Satiety and Increases Energy Intake: A Randomized Crossover Trial. Ann Nutr Metab 2022; 78:265-272. [PMID: 35830848 DOI: 10.1159/000525949] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 07/01/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS This study aimed to evaluate the effects of the intake of a single dose of cinnamon infusion on energy metabolism, appetite responses and food intake in healthy individuals. METHODS This was an open randomized crossover clinical trial, with a minimum washout of seven days, which was conducted in which two standardized breakfasts were served randomly: one with cinnamon infusion (2g, Cinnamomum sp.) And one with water (control). The study included 21 healthy volunteers. Energy expenditure (EE), diet-induced thermogenesis (DIT), respiratory quotient (RQ), substrate oxidation and appetite responses were evaluated, as well as prospective food intake. RESULTS Ingestion of cinnamon infusion did not alter EE, DIT, RQ or substrate oxidation. The incremental area under the curve for hunger, satiety and desire to eat did not differ between the treatment with cinnamon infusion and water, however, there was a reduction in the feeling of satiety (p=0.021) compared to the control treatment. The energy consumption of the first meal after treatment was higher (p=0.05) in the treatment with cinnamon infusion than in the control treatment. Regarding macronutrients or food intake throughout the day, there was no difference between treatments. CONCLUSIONS Although it did not affect energy metabolism, consuming a single dose of cinnamon infusion promoted less feeling of satiety and increased energy intake in the first meal after treatment. The study protocol was registered at the Brazilian Clinical Trials Registry Platform (RBR-5ftg3z).
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Affiliation(s)
- Ana Paula da Costa Soares
- Food Science Post-Graduation Program, Pharmacy School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Natália Cristina de Faria
- Food Science Post-Graduation Program, Pharmacy School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Guilherme Fonseca Graciano
- Postgraduate Program in Sciences Applied to Adult Health, Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ana Luiza Soares Dos Santos
- Food Science Post-Graduation Program, Pharmacy School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Gustavo Pereira Cosenza
- Food Science Department, Pharmacy School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lucilene Rezende Anastácio
- Food Science Post-Graduation Program, Pharmacy School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Food Science Department, Pharmacy School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Cristina de Faria N, Paula da Costa Soares A, Graciano GF, Toulson Davisson Correia MI, Valenzuela VDCT, Anastácio LR. Acute green tea infusion ingestion effect on energy metabolism, satiety sensation and food intake: a randomized crossover trial. Clin Nutr ESPEN 2022; 48:63-67. [DOI: 10.1016/j.clnesp.2022.01.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 01/21/2022] [Accepted: 01/27/2022] [Indexed: 11/27/2022]
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Faria NCD, Soares APDC, Graciano GF, Correia MITD, Pires MC, Valenzuela VDCT, Anastácio LR. Hibiscus sabdariffa tea affects diet-induced thermogenesis and subjective satiety responses in healthy men, but not in women: a randomized crossover trial. Appl Physiol Nutr Metab 2021; 47:429-438. [PMID: 34370964 DOI: 10.1139/apnm-2021-0051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study was to investigate the effect of Hibiscus sabdariffa tea on energy expenditure, satiety response and food intake. This is an open-label, crossover, randomized clinical trial (RBR-5HZ86T), including 21 subjects (11 women, 10 men). The individuals were evaluated at acute moments (fasting and after eating standardized breakfast accompanied by water or Hibiscus sabdariffa tea). Resting energy expenditure was measured by indirect calorimetry, subjective satiety responses were evaluated with a visual analogue scale and food intake was assessed by using food records. The volunteers who drank the Hibiscus sabdariffa tea had lower perception of hunger (p=0.002) and greater feeling of satiety (p=0.010) and fullness (p=0.009) compared to control. Men who ingested the Hibiscus sabdariffa tea had an increase in nitrogen energy expenditure (water: 1501±290.7kcal, Hibiscus sabdariffa tea: 1619±288.9kcal; p=0.029). In comparison to control, men presented less perception of hunger (p=0.003) and desire to eat (p=0.016), increased satiety (p=0.021) and fullness (p=0.010), and women oxidized more fat (p=0.034) when they drank Hibiscus sabdariffa tea. There was no difference between treatments regarding the energy and macronutrient intake from the first meal and throughout the day (p>0.050) for all participants. The Hibiscus sabdariffa tea only affected energy expenditure and satiety responses in men. Clinical trial registry: ReBEC Platform of the Brazilian Clinical Trials Registry - RBR-5HZ86T Novelty bullets • Hibiscus sabdariffa tea promoted an increase in energy expenditure and caused less perception of hunger/desire to eat in men. • Hibiscus sabdariffa tea intake increased postprandial fat oxidation in women.
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Affiliation(s)
- Natália Cristina de Faria
- Universidade Federal de Minas Gerais, 28114, Departamento de Alimentos, 6627 Antônio Carlos Avenue, Pampulha Campus, Belo Horizonte, Minas Gerais, Brazil, 31270-901;
| | | | | | | | - Magda Carvalho Pires
- Universidade Federal de Minas Gerais, Department of Statistics; Institute of Exact Sciences, Belo Horizonte, Minas Gerais, Brazil;
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Silva I, de Faria NC, Ferreira ÁRS, Anastácio LR, Ferreira LG. Risk factors for critical illness and death among adult Brazilians with COVID-19. Rev Soc Bras Med Trop 2021; 54:e0014 2021. [PMID: 33950121 PMCID: PMC8083890 DOI: 10.1590/0037-8682-0014-2021] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 03/25/2021] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Severe acute respiratory syndrome coronavirus 2 has infected more than 9,834,513 Brazilians up to February 2021. Knowledge of risk factors of coronavirus disease among Brazilians remains scarce, especially in the adult population. This study verified the risk factors for intensive care unit admission and mortality for coronavirus disease among 20-59-year-old Brazilians. METHODS A Brazilian database on respiratory illness was analyzed on October 9, 2020, to gather data on age, sex, ethnicity, education, housing area, and comorbidities (cardiovascular disease, diabetes, and obesity). Multivariate logistic regression analysis was performed to identify the risk factors for coronavirus disease. RESULTS Overall, 1,048,575 persons were tested for coronavirus disease; among them, 43,662 were admitted to the intensive care unit, and 34,704 patients died. Male sex (odds ratio=1.235 and 1.193), obesity (odds ratio=1.941 and 1.889), living in rural areas (odds ratio=0.855 and 1.337), and peri-urban areas (odds ratio=1.253 and 1.577) were predictors of intensive care unit admission and mortality, respectively. Cardiovascular disease (odds ratio=1.552) was a risk factor for intensive care unit admission. Indigenous people had reduced chances (odds ratio=0.724) for intensive care unit admission, and black, mixed, East Asian, and indigenous ethnicity (odds ratio=1.756, 1.564, 1.679, and 1.613, respectively) were risk factors for mortality. CONCLUSIONS Risk factors for intensive care unit admission and mortality among adult Brazilians were higher in men, obese individuals, and non-urban areas. Obesity was the strongest risk factor for intensive care unit admission and mortality.
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Affiliation(s)
- Isabela Silva
- Universidade Federal de Lavras, Departamento de Nutrição, Programa de Pós-Graduação em Nutrição e Saúde, Lavras, MG, Brasil
| | - Natália Cristina de Faria
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Alimentos, Programa de Pós-Graduação em Ciência de Alimentos, Belo Horizonte, MG, Brasil
| | - Álida Rosária Silva Ferreira
- Universidade Federal de Minas Gerais, Ciências Econômicas, Programa de Pós-Graduação em Demografia, Belo Horizonte, MG, Brasil
| | - Lucilene Rezende Anastácio
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Alimentos, Programa de Pós-Graduação em Ciência de Alimentos, Belo Horizonte, MG, Brasil
| | - Lívia Garcia Ferreira
- Universidade Federal de Lavras, Departamento de Nutrição, Programa de Pós-Graduação em Nutrição e Saúde, Lavras, MG, Brasil
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