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Alves IA, Monteiro LS, Araújo MC, Souza ADM, Hassan BK, Rodrigues PRM, Yokoo EM, Sichieri R, Pereira RA. Use of table sugar and non-caloric sweeteners in Brazil: associated factors and changes across a decade. Br J Nutr 2024; 131:1591-1599. [PMID: 38174420 DOI: 10.1017/s0007114523003057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
This study evaluated changes in the use of sweeteners over one decade and the relationship between socio-demographics, diet and weight status with the type of sweetener. Data came from the Brazilian National Dietary Surveys of 2008-2009 and 2017-2018, including ≥ 10-year-old individuals (n 32 749; n 44 744, respectively, after excluding pregnant and lactating women). The use of table sugar, non-caloric sweeteners (NCS), both or none was reported through a specific question. Food consumption was assessed using two non-consecutive food records (2008-2009) and 24-h recalls (2017-2018). For the last survey, means of energy, macro and micronutrient intake, food groups' contribution (%) to daily energy intake and age- and energy-adjusted nutrient intake were estimated according to the type of sweetener used. Differences in means and proportions across the categories of sweeteners used were evaluated based on the 95 % CI. All analyses were stratified by sex and considered sample design and weights. Over 10 years, the use of table sugar decreased by 8 %, while the habit of not using any sweetener increased almost three times, and the use of NCS remained stable. Larger reductions in the use of table sugar were observed in the highest income level and among men. Regardless of sex, compared with NCS users, table sugar users had greater mean intake of energy, carbohydrates and added sugar and lower micronutrient intake means. Although table sugar is still the most used sweetener, the increased choice of 'no sweetener' is noteworthy in Brazil.
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Affiliation(s)
- Iuna Arruda Alves
- Programa de Pós-graduação em Nutrição, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Luana Silva Monteiro
- Instituto de Alimentação e Nutrição, Universidade Federal do Rio de Janeiro, Macaé, Rio de Janeiro, Brasil
| | - Marina Campos Araújo
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Rio de Janeiro, Brasil
| | - Amanda de Moura Souza
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Bruna Kulik Hassan
- Departamento de Epidemiologia e Bioestatística, Instituto de Saúde Coletiva, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brasil
| | | | - Edna Massae Yokoo
- Departamento de Epidemiologia e Bioestatística, Instituto de Saúde Coletiva, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brasil
| | - Rosely Sichieri
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Rosangela Alves Pereira
- Departamento de Nutrição Social e Aplicada, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
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Mattos P, Moraes CEFD, Sichieri R, Hay P, Faraone SV, Appolinario JC. Adult ADHD Symptoms in a Large Metropolitan Area From Brazil: Prevalence and Associations with Psychiatric Comorbidity, Bullying, Sexual Abuse, and Quality of Life. J Atten Disord 2024; 28:1082-1091. [PMID: 38380531 DOI: 10.1177/10870547241229097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
OBJECTIVE The aim of this study was to investigate the prevalence and psychiatric correlates of symptomatic ADHD in a large metropolitan area of a middle-income country. METHODS An in-person household survey with randomly selected 2,297 adults aged 19 to 60 from Rio de Janeiro, Brazil, assessed by trained lay interviewers. The Adult Self-Rating Scale Screener (ASRS-6) was used. Chi-square and logistic regression were conducted. RESULTS ADHD prevalence was 4.59 (95% CI [3.56, 5.44]). Those with ADHD were younger and more often unemployed; they displayed more psychiatric symptoms (depression, anxiety, and alcohol abuse) and a history of bullying and sexual abuse. They also had worse physical health indicators. Findings remained significant when controlling for socioeconomic variables. CONCLUSION Adults with symptomatic ADHD from a large metropolitan area in Brazil show a pattern of findings consistent with what has been observed in higher-income countries.
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Affiliation(s)
- Paulo Mattos
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Carlos Eduardo Ferreira de Moraes
- Obesity and Eating Disorders Group, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Translational Health Research Institute, School of Medicine, Western Sydney University, NSW, Australia
| | - Rosely Sichieri
- Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, NSW, Australia
- Mental Health Services, SWSLHD, Campbelltown, Sydney, Australia
| | - Stephen V Faraone
- Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Jose Carlos Appolinario
- Obesity and Eating Disorders Group, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Olvera LGT, Martinez LC, Souza BDSND, Sichieri R, de la Torre GSG. Impact of a school-based intervention on sugar-sweetened beverage intake substitution by water in Mexican scholars. Ann Nutr Metab 2024:000538142. [PMID: 38437808 DOI: 10.1159/000538142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/03/2023] [Indexed: 03/06/2024]
Abstract
INTRODUCTION The prevalence of overweight and obesity in children has increased in recent years, associated with substituting plain water intake with sugar-sweetened beverages. To evaluate the impact of a school-based intervention that aimed to replace sugar-sweetened beverages with water in Mexican scholars. METHODS We included 314 children aged 9-11 from three public schools of the State of Hidalgo, Mexico, randomized to intervention (two schools from the municipality of Apan; six classes with 146 participants) or control group (one school from the municipality of Emiliano Zapata; six classes with 168 participants) and followed for six months. The intervention consisted of placing drinking fountains at school and classrooms with nutritional education lessons to increase water consumption and decrease sugar-sweetened beverages. Mixed models for repeated measures were used to assess the impact of the intervention. RESULTS At the end of the study, water consumption was higher (200 mL/day, p=0.005), and flavored milk consumption was lower (94 mL/day, p=0.044) in the intervention group compared with the control group. There was also a statistically significant reduction for energy (p=0.016) and sugar intake (p=0.007). CONCLUSIONS The school-based intervention favorably modified the consumption pattern of sugar-sweetened beverages and water in Mexican students.
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Brandão JM, Sichieri R, Paravidino VB, Ribas SA, Cunha DB. Treatment of childhood obesity based on the reduction of ultra-processed foods plus energy restriction: A randomised controlled trial based on the Brazilian guidelines. Clin Obes 2024:e12648. [PMID: 38400699 DOI: 10.1111/cob.12648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 06/27/2023] [Accepted: 01/31/2024] [Indexed: 02/25/2024]
Abstract
Reducing ultra-processed foods (UPF) improves diet quality and may curb energy consumption. This study aimed to compare an intervention based on the reduction of UPF, according to the Dietary Guideline for the Brazilian Population (DGBP), with and without advice on energy intake. A parallel and randomised controlled trial was carried out with children with obesity from 7 to 12 years old. Both control (CG) and intervention groups (IG) participated monthly in 6 standardised educational activities based on the 10 steps of the DGBP. An individualised food plan was also provided to the IG. The rate of change for body mass index (BMI), waist circumference, body weight, and UPF consumption were investigated based on mixed-effect models. At the end of the study, the BMI declined in the IG (Δ = -0.27 kg/m2 ) compared to the CG (Δ = + 0.53 kg/m2 ) (p = .0002). Both groups showed a decline in grams of UPF until the fourth month and a gradual increase in the following months. Combining the qualitative approach of the DGBP with counselling on energy restriction through the diet plan proved to be effective in reducing childhood obesity. Clinical Trial Registration: This trial is registered at the Brazilian Registry of Clinical Trials (REBEC), under the RBR-3st5sn registry, available at http://www.ensaiosclinicos.gov.br/rg/RBR-3st5sn/. The datasets generated by the current study are not publicly available but are available from the corresponding author on reasonable request.
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Affiliation(s)
- Joana Maia Brandão
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rosely Sichieri
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Vitor Barreto Paravidino
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Physical Education and Sports, Naval Academy-Brazilian Navy, Rio de Janeiro, Brazil
| | - Simone Augusta Ribas
- Departament of Nutrition in Public Health, School of Nutrition, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Diana Barbosa Cunha
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Machado SP, Bezerra IN, Silva MA, D’oran MHL, Cunha DB, Moreno LA, Sichieri R. Evolution of adolescents' dietary patterns in Northeast Brazil from 2008 to 2018. Rev Saude Publica 2024; 58:05. [PMID: 38381895 PMCID: PMC10878684 DOI: 10.11606/s1518-8787.2024058005090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 08/29/2023] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVE To evaluate the evolution of the dietary patterns of adolescents in the northeast region of Brazil. METHODS Secondary analysis of data from the Pesquisa de Orçamentos Familiares (POF - Household Budget Surveys), collected by the Brazilian Institute of Geography and Statistics (IBGE) in the years 2008-2009 and 2017-2018. A total of 3,095 adolescents were evaluated in 2008-2009 and 3,015 in 2017-2018. Food consumption was assessed using two dietary records in 2008-2009 and two 24-hour recalls in 2017-2018, applied on non-consecutive days. Based on these data, principal components factor analysis (PCFA) was performed, followed by orthogonal rotation of the varimax type, to derive dietary patterns, stratified by sex. The results were described as means or percentage frequencies, with their respective 95% confidence intervals. RESULTS Three main dietary patterns were identified among adolescents from the northeast region of Brazil. Among boys, in 2008-2009, the patterns were called snacks, traditional Brazilian, and coffee; and in 2017-2018, traditional Brazilian, snacks, and mixed, in this order of representativeness of the group's eating habits. Among female adolescents, in 2008-2009, the patterns were snacks, traditional Brazilian, and coffee; and in 2017-2018, traditional Brazilian, snacks, and processed meats. CONCLUSION The dietary patterns identified in 2008-2009 and 2017-2018 were similar in both genders; however, the snacks pattern, which explained most of the data variability in 2008-2009, was replaced by the traditional Brazilian.
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Affiliation(s)
- Soraia Pinheiro Machado
- Universidade Estadual do CearáCentro de Ciências da SaúdeFortalezaCEBrazil Universidade Estadual do Ceará. Centro de Ciências da Saúde. Fortaleza, CE, Brazil
| | - Ilana Nogueira Bezerra
- Universidade Estadual do CearáCentro de Ciências da SaúdeFortalezaCEBrazil Universidade Estadual do Ceará. Centro de Ciências da Saúde. Fortaleza, CE, Brazil
| | - Mariane Alves Silva
- Universidade Federal de Mato GrossoFaculdade de NutriçãoCuiabáMTBrazil Universidade Federal de Mato Grosso. Faculdade de Nutrição. Cuiabá, MT, Brazil
| | - Maria Helena Lima D’oran
- Universidade Estadual do CearáCentro de Ciências da SaúdeFortalezaCEBrazil Universidade Estadual do Ceará. Centro de Ciências da Saúde. Fortaleza, CE, Brazil
| | - Diana Barbosa Cunha
- Universidade do Estado do Rio de JaneiroDepartamento de EpidemiologiaRio de JaneiroRJBrazil Universidade do Estado do Rio de Janeiro. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brazil
| | - Luis Alberto Moreno
- Universidad de ZaragozaFacultad de Ciencias de la SaludZaragozaSpain Universidad de Zaragoza. Facultad de Ciencias de la Salud. Zaragoza, Spain
| | - Rosely Sichieri
- Universidade do Estado do Rio de JaneiroDepartamento de EpidemiologiaRio de JaneiroRJBrazil Universidade do Estado do Rio de Janeiro. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brazil
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Rodrigues PRM, Monteiro LS, Vasconcelos TMD, Gomes LEDS, Alves IA, Baltar VT, Gorgulho BM, Yokoo EM, Sichieri R, Pereira RA. How many meals and snacks do Brazilians eat a day? Findings from the 2017-2018 Brazilian National Dietary Survey. CAD SAUDE PUBLICA 2024; 40:e00009923. [PMID: 38381863 PMCID: PMC10877696 DOI: 10.1590/0102-311xen009923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 10/19/2023] [Accepted: 10/24/2023] [Indexed: 02/23/2024] Open
Abstract
The habit of eating specific meals has been addressed in several studies, but the evaluation of meal patterns has received less attention. This study aimed to describe the meal patterns of the Brazilian population. A complex sampling design was used to select the 46,164 ≥ 10-year-old individuals examined in the Brazilian National Dietary Survey. Food consumption was assessed by two non-consecutive 24-hour recalls applied throughout a one-week period. The exploratory data analysis approach was used to determine the meal patterns, i.e., how individuals combined the main meals (breakfast, lunch, dinner) and snacks (morning, afternoon, evening/night) throughout the day. The most common meal patterns were three main meals + one snack, reported by 25.1% of the individuals, and three main meals + two snacks (24.6%). Other meal patterns identified were: three main meals + three snacks (18.5%); three main meals and no snacks (10.9%); one or two main meals + two snacks (7.4%); one or two main meals + one snack (6.9%); one or two main meals + three snacks (4.2%); and one or two main meals and no snacks (2.3%). Meal patterns varied according to gender and age group, and on typical versus atypical food consumption days. We found that eight patterns characterized the daily meal consumption in Brazil. Furthermore, around 80% of the population had three main meals every day and about 13% did not report having any snacks. The characterization of meal habits is important for tailoring and targeting health promotion actions.
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Affiliation(s)
| | | | | | | | - Iuna Arruda Alves
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | | | | | - Edna Massae Yokoo
- Instituto de Saúde Coletiva, Universidade Federal Fluminense, Niterói, Brasil
| | - Rosely Sichieri
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Rosangela Alves Pereira
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
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Antunes ABS, Hassan BK, Pinto RL, Sichieri R, Cunha DB. A choice architecture intervention targeting school meals and water frequency intake: A school-based randomized trial. Appetite 2024; 193:107118. [PMID: 37977257 DOI: 10.1016/j.appet.2023.107118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 10/19/2023] [Accepted: 11/04/2023] [Indexed: 11/19/2023]
Abstract
Our aim was to evaluate the impact of choice architecture on school meals and water intake frequency. We conducted a school-based randomized trial in seven elementary municipal public schools (control = 3; intervention = 4) in Rio de Janeiro, Brazil. The interventions group received the following modifications: (1) banner of the daily school meal menu and two superheroes, (2) waterproof tablecloths, (3) posters on healthy eating habits, (4) displays with playful names, (5) new containers for fruits, and (6) colored footprints for one month. Changes in school meals and daily water frequency consumption were evaluated through intention-to-treat analyses, using generalized estimating equations models for repeated measures, considering the classes' cluster effect. Data from 974 students in the fifth and sixth elementary school grades were analyzed (control = 356; intervention = 618). At baseline, 47.1% of students were female, with a mean age of 12 years (SD = 1.4), 39.2% reported daily consumption of school meals, and 45.7% consumed water from the school drinking fountain three or more times a day. We observed an increase in the odds of daily water intake in the intervention group compared to the control (OR = 1.4 95% CI = 1.1-1.9), no changes in the school meals (OR = 1.2 95% CI = 0.9; 1.6). Low-complexity strategies based on choice architecture applied in the school environment can be promising in increasing water intake frequency among elementary students in public schools. TRIAL REGISTRATION: This study was registered on the Clinicaltrials.gov platform under the number NCT03136016. Access: https://clinicaltrials.gov/ct2/show/NCT03136016.
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Affiliation(s)
- Anna Beatriz Souza Antunes
- Department of Epidemiology, Hesio Cordeiro Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
| | | | - Rafael Lavourinha Pinto
- Department of Epidemiology, Hesio Cordeiro Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rosely Sichieri
- Department of Epidemiology, Hesio Cordeiro Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Diana Barbosa Cunha
- Department of Epidemiology, Hesio Cordeiro Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Garcia MC, Paravidino VB, Lopes CDS, Mediano MFF, Gonçalves TR, de Oliveira AJ, Sichieri R. Sleep duration and quality during the COVID-19 pandemic and the association with physical activity and screen time among Brazilian college students. Am J Hum Biol 2024:e24035. [PMID: 38174842 DOI: 10.1002/ajhb.24035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 09/25/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND As a result of social isolation during the COVID-19 pandemic, changes in sleep patterns have been observed in many countries, as well as changes in physical activity and screen time. The objective was to investigate sleep duration and quality during the COVID-19 pandemic and its association with physical activity and screen time. METHODS Cross-sectional study with students from a University in Rio de Janeiro who answered an online questionnaire between August 2020 and March 2021. Physical activity was assessed using IPAQ-SF. Sleep was investigated based on questions about duration and sleep quality change, and screen time through self-reported questions. Multinomial logistic regression was performed to assess the association between physical activity and screen time with sleep duration and quality. Secondary analyses investigated the influence of the isolation time on this association. The confounding factors used were diagnosis of COVID-19, time of isolation, anxiety, depression, skin color, and gender. RESULTS A total of 771 college students with a mean age of 24.5 years (±8.6) answered the questionnaire. About 75% reported more than 8 h of screen time per day and 49.8% were physically inactive. Regarding sleep, 54.9% had worsening sleep, while 40.6% had inadequate sleep duration during the pandemic. Physical activity was associated with improved sleep quality (Odds ratio (OR) 1.72; confidence interval (95% CI) 1.05-2.97). Also, physically active students who spent more than 14 weeks in social isolation demonstrated improved sleep quality (OR 1.99; 95% CI 1.02-3.78) compared to physically inactive individuals. No association was observed for sleep duration. No association was observed between screen time and sleep quality, or sleep duration. CONCLUSION During the COVID-19 pandemic, there was considerable worsening of sleep quality, and physical activity was positively associated with improved sleep quality.
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Affiliation(s)
- Magno Conceição Garcia
- Department of Epidemiology, Institute of Social Medicine Hésio Cordeiro, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Vitor Barreto Paravidino
- Department of Epidemiology, Institute of Social Medicine Hésio Cordeiro, State University of Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Physical Education and Sports, Naval School, Brazilian Navy, Rio de Janeiro, Brazil
| | - Claudia de Souza Lopes
- Department of Epidemiology, Institute of Social Medicine Hésio Cordeiro, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Tatiana Rehder Gonçalves
- Institute of Public Health Studies, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Aldair José de Oliveira
- Department of Physical Education and Sports, Federal Rural University of Rio de Janeiro, Seropédica, Brazil
| | - Rosely Sichieri
- Department of Epidemiology, Institute of Social Medicine Hésio Cordeiro, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Cardoso LG, Monteiro LS, Sichieri R, Yokoo EM, Pereira RA. Changes in dietary carbohydrate and lipid quality indices between 2008 and 2018: Analysis of the Brazilian dietary surveys. NUTR BULL 2023; 48:546-558. [PMID: 37904632 DOI: 10.1111/nbu.12641] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 09/22/2023] [Accepted: 10/02/2023] [Indexed: 11/01/2023]
Abstract
The aim of the study was to evaluate characteristics and changes over a decade in dietary carbohydrate and lipid quality according to socio-demographic variables. Data was obtained from two Brazilian National Dietary Surveys 2008-2009 (n = 34 003) and 2017-2018 (n = 46 164) examining a nationwide representative sample of individuals ≥10 years old. Food intake was assessed by means of two non-consecutive diet records (2008-2009) and 24 h diet recalls (2017-2018). Carbohydrate Quality Index is a score ranging from 4 to 20 calculated from fibre intake, global dietary glycaemic index, solid/total carbohydrate (CHO) and whole grains/total grains CHO. Lipid Quality Index was estimated by dividing the sum of the dietary content of monounsaturated and polyunsaturated fatty acids by the sum of saturated and trans fatty acids. Indices were categorised into five categories (1 for lowest and 5 for highest quality). Socio-demographic variables were sex, age, income, urban/rural area and place of food consumption. The estimates (95% CI) were generated separately for each survey and then compared to identify changes in time. Our main findings refer to changes in diet quality according to income. At the lowest income level, the proportions of individuals in the best carbohydrate and lipid quality categories reduced from 26.9% to 20.6% and from 30.0% to 24.9%, respectively. Alternatively, at the highest income level, these proportions increased from 22.9% to 26.6% and from 11.9% to 15.7%, respectively. Furthermore, the quality of lipids improved in women and among individuals reporting some away-from-home food consumption, while the quality of carbohydrates was reduced among adolescents and in rural areas.
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Affiliation(s)
- Luciana Guerra Cardoso
- Programa de Pós-graduação em Nutrição, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Luana Silva Monteiro
- Instituto de Alimentação e Nutrição, Universidade Federal do Rio de Janeiro (UFRJ), Macaé, Brazil
| | - Rosely Sichieri
- Departamento de Epidemiologia, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Edna Massae Yokoo
- Departamento de Epidemiologia e Bioestatística, Universidade Federal Fluminense (UFF), Niterói, Brazil
| | - Rosângela Alves Pereira
- Departamento de Nutrição Social e Aplicada, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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De Carli E, Verly E, Palchetti CZ, Sichieri R, Yokoo EM, Pereira RA, Marchioni DML. Dietary iron intake over two post-fortification periods in Brazil: data from the National Dietary Surveys 2008-2009 and 2017-2018. Br J Nutr 2023; 130:1179-1189. [PMID: 36627814 DOI: 10.1017/s0007114523000119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
We aimed to assess the dietary Fe intake and the prevalence of inadequate Fe intake over two post-fortification periods in Brazil. The intake was analysed according to sex, life stage, geographic region and stratum of family income per capita. Excluding pregnant and lactating women, this population-based study included 32 749 and 44 744 participants aged ≥ 10 years from the National Dietary Survey-Brazilian Household Budget Surveys 2008-2009 and 2017-2018, respectively. The National Cancer Institute method was used to predict usual dietary Fe intakes. The prevalence of Fe intake inadequacy was estimated following a probabilistic approach for women of childbearing age or with the Estimated Average Requirement cut-off point method. Over an interval of 10 years, the mean Fe intake remained almost unchanged for most sex-age groups, except for women of childbearing age. In this specific group, the prevalence of Fe intake inadequacy was > 20 % in 2008-2009 and have increased to > 25 % in 2017-2018, with the highest reductions in mean Fe intake found in the highest income strata and richest Brazilian regions. Meanwhile, the highest prevalence of Fe intake inadequacy (> 40 %) occurred among the poorest women aged 31-50 years from the lowest family income stratum, irrespective of the study period. Beans were the main Fe source, while fortified breads, pastas, pizzas, cakes and cookies contributed approximately 40 % of the Fe intake. The results provide important insights into the long-standing dietary impacts of food fortification, which can guide future (re)formulation of effective public health strategies to combat Fe deficiency.
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Affiliation(s)
- Eduardo De Carli
- Department of Nutrition, School of Public Health, University of Sao Paulo (USP), Sao Paulo, Brazil
| | - Eliseu Verly
- Institute of Social Medicine, Rio de Janeiro State University (UERJ), Rio De Janeiro, Brazil
| | - Cecília Zanin Palchetti
- Department of Nutrition, School of Public Health, University of Sao Paulo (USP), Sao Paulo, Brazil
| | - Rosely Sichieri
- Institute of Social Medicine, Rio de Janeiro State University (UERJ), Rio De Janeiro, Brazil
| | - Edna Massae Yokoo
- Department of Epidemiology and Biostatistics, Universidade Federal Fluminense (UFF), Niterói, Rio De Janeiro, Brazil
| | - Rosangela Alves Pereira
- Department of Nutrition, Federal University of Rio de Janeiro (UFRJ), Rio De Janeiro, Brazil
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Naspolini NF, Sichieri R, Barbosa Cunha D, Alves Pereira R, Faerstein E. Dietary patterns, obesity markers and leukocyte telomere length among Brazilian civil servants: cross-sectional results from the Pro-Saude study. Public Health Nutr 2023; 26:2076-2082. [PMID: 37231745 PMCID: PMC10564599 DOI: 10.1017/s1368980023001064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 04/21/2023] [Accepted: 05/15/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Dietary patterns express the combination and variety of foods in the diet. The partial least squares method allows extracting dietary patterns related to a specific health outcome. Few studies have evaluated obesity-related dietary patterns associated with telomeres length. This study aims to identify dietary patterns explaining obesity markers and to assess their association with leukocyte telomere length (LTL), a biological marker of the ageing process. DESIGN Cross-sectional study. SETTING University campuses in the state of Rio de Janeiro, Brazil. PARTICIPANTS 478 participants of a civil servants' cohort study with data on food consumption, obesity measurements (total body fat, visceral fat, BMI, leptin and adiponectin) and blood samples. RESULTS Three dietary patterns were extracted: (1) fast food and meat; (2) healthy and (3) traditional pattern, which included rice and beans, the staple foods most consumed in Brazil. All three dietary patterns explained 23·2 % of food consumption variation and 10·7 % of the obesity-related variables. The fast food and meat pattern were the first factor extracted, explaining 11-13 % variation of the obesity-related response variables (BMI, total body fat and visceral fat), leptin and adiponectin showed the lowest percentage (4·5-0·1 %). The healthy pattern mostly explained leptin and adiponectin variations (10·7 and 3·3 %, respectively). The traditional pattern was associated with LTL (β = 0·0117; 95 % CI 0·0001, 0·0233) after adjustment for the other patterns, age, sex, exercise practice, income and energy intake. CONCLUSION Leukocyte telomere length was longer among participants eating a traditional dietary pattern that combines fruit, vegetables and beans.
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Affiliation(s)
| | - Rosely Sichieri
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ20550-900, Brasil
| | - Diana Barbosa Cunha
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ20550-900, Brasil
| | - Rosangela Alves Pereira
- Universidade Federal do Rio de Janeiro, Departamento de Nutrição Social e Aplicada, Rio de Janeiro, RJ, Brasil
| | - Eduardo Faerstein
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ20550-900, Brasil
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Naspolini NF, Sichieri R, Barbosa Cunha D, Alves Pereira R, Faerstein E. Dietary patterns, obesity markers and leukocyte telomere length among Brazilian civil servants: cross-sectional results from the Pro-Saude study - CORRIGENDUM. Public Health Nutr 2023; 26:2180. [PMID: 37534392 PMCID: PMC10564595 DOI: 10.1017/s1368980023001477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
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13
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Cortes C, Brandão JM, Cunha DB, Paravidino VB, Sichieri R. Blood pressure variation and ultra-processed food consumption in children with obesity. Eur J Pediatr 2023; 182:4077-4085. [PMID: 37401980 DOI: 10.1007/s00431-023-05076-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 06/07/2023] [Accepted: 06/20/2023] [Indexed: 07/05/2023]
Abstract
To investigate the influence of ultra-processed food (UPF) consumption on systolic (SBP) and diastolic (DBP) blood pressure in children with obesity, using dietary and urinary markers. We conducted a secondary analysis of a randomized clinical trial involving children with obesity, aged 7 to 12 years. Over a period of six months, the children and their guardians attended monthly individual consultations and educational activities aimed at promoting a reduction in UPF consumption. During each visit, measurements of blood pressure, body weight, height, and 24-h dietary recall were recorded. Additionally, spot urine samples were collected at baseline, and at the second and fifth-month follow-ups. A total of 96 children were included in the analysis. Energy intake, UPF intake and blood pressure showed a quadratic pattern of change, with a decrease in the first two months and an increase thereafter. There was an association between UPF consumption and DBP. The intake of UPF was correlated with the urinary sodium-to-potassium (Na/K) ratio (r = 0.29; p = 0.008) and the dietary Na/K ratio (r = 0.40; p < 0.001). For every 100 g increase in UPF, DBP increased by 0.28 mmHg (p-value = 0.01). After further adjustment for changes in body mass index (BMI), and physical activity, the increase in DBP was 0.22 mmHg. Conclusion: Our findings indicate that reducing UPF consumption may have an impact on blood pressure in children with obesity. Additional adjustment for BMI and physical activity did not influence the results. Therefore, reducing UPF consumption can be considered as a strategy against hypertension. What is Known: • Ultra-processed food consumption is associated with an increased risk of cardiovascular disease; however, this evidence is still limited in children. • Intake of calories from ultra-processed food in relation to the total calories is increasing worldwide. What is New: • Ultra-processed food consumption has an effect on the diastolic blood pressure, independent of changes in weight. • The intake of ultra-processed food was correlated to the dietary sodium-to-potassium ratio (r = 0.40; p < 0.001).
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Affiliation(s)
- Caroline Cortes
- Department of Epidemiology, Hésio Cordeiro Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - Joana Maia Brandão
- Department of Epidemiology, Hésio Cordeiro Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Diana Barbosa Cunha
- Department of Epidemiology, Hésio Cordeiro Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Vitor Barreto Paravidino
- Department of Epidemiology, Hésio Cordeiro Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Department of Physical Education and Sports, Naval Academy - Brazilian Navy, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rosely Sichieri
- Department of Epidemiology, Hésio Cordeiro Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Assemany CG, Cunha DB, Brandão JM, Paravidino VB, Garcia MC, Rêgo ALV, Pereira RA, Sichieri R. A multicomponent family intervention, combined with salt reduction for children with obesity: a factorial randomized study protocol. BMC Public Health 2023; 23:1453. [PMID: 37516844 PMCID: PMC10386775 DOI: 10.1186/s12889-023-16356-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/20/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND Clinical trials to treat childhood obesity show modest results, weight regain and high dropout rates. Children with obesity often live in families with habits that contribute to unhealthy weight gain. This study will test whether a family intervention with a Brazilian-adapted Planetary Healthy Diet (PHD) and reduced portion sizes, along with increased physical activity and reduced sedentary behavior, can reduce excessive weight gain. The protocol promotes the intake of in natura products and water and reduces ultra-processed foods, sugar, and sodium. It encourages family lifestyle changes and physical activities, with randomized allocation to experimental and control groups. The responsible family member will be evaluated during follow-up. The control group will receive a print of the Brazilian dietary guideline. METHODS A factorial crossover design will also allocate families to receive reduced sodium salt plus anti-inflammatory herbs and a placebo salt. Both the control and intervention groups will be randomly assigned to the sequence of both salts. The approach aims to reduce body weight expectations and evaluate salt's impact on blood pressure. It includes a 1-month intervention, 1-month washout, and 1-month intervention with monthly clinic visits and teleservice by health professionals. The primary outcomes will be the variation in the Body Mass Index (BMI) of the children. BMI and the variation in the blood pressure of the pair (child/mother or father) as well as waist circumference (WC) and waist-to-height ratio (WHtR) will also be measured. DISCUSSION The project will test the effectiveness of the use of the recommendations of the PHD, physical activity and a salt-reduced sodium. The results of the present study will allow the refinement of interventions aimed at the treatment of childhood obesity and may help develop guidelines for the treatment of obesity in Brazilian children. TRIAL REGISTRATION The study is registered in the Brazilian Registry of Clinical Trials (RBR-10 mm62vs). Registered 10 February 2023.
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Affiliation(s)
- Cinthia Guimarães Assemany
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, CEP, 20550-013, Rio de Janeiro, Brazil.
| | - Diana Barbosa Cunha
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, CEP, 20550-013, Rio de Janeiro, Brazil
| | - Joana Maia Brandão
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, CEP, 20550-013, Rio de Janeiro, Brazil
| | - Vitor Barreto Paravidino
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, CEP, 20550-013, Rio de Janeiro, Brazil
| | - Magno Conceição Garcia
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, CEP, 20550-013, Rio de Janeiro, Brazil
| | - Ana Lúcia Viégas Rêgo
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, CEP, 20550-013, Rio de Janeiro, Brazil
| | - Rosangela Alves Pereira
- Department of Social and Applied Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rosely Sichieri
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, CEP, 20550-013, Rio de Janeiro, Brazil
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Heriseanu AI, Spirou D, Moraes CEF, Hay P, Sichieri R, Appolinario JC. Grazing Is Associated with ADHD Symptoms, Substance Use, and Impulsivity in a Representative Sample of a Large Metropolitan Area in Brazil. Nutrients 2023; 15:2987. [PMID: 37447311 DOI: 10.3390/nu15132987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 06/28/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Grazing is a clinically relevant eating behaviour, especially when it presents with a sense of loss of control (compulsive grazing). There is evidence that other disordered eating patterns are associated with problematic substance use and impulsivity-related conditions, such as attention-deficit/hyperactivity disorder (ADHD). This overlap contributes to higher psychopathology and treatment complications. Less is known about grazing, and most information originates in high-income countries. Hence, we sought to investigate relationships between grazing, tobacco and alcohol use, ADHD, and impulsivity in a large representative sample from Brazil. Data were collected by trained interviewers from adults (N = 2297) through an in-person household survey based on a stratified and clustered probability sample. We found significant associations between compulsive grazing and problematic alcohol use (OR = 3.02, 95% CI: 1.65, 5.53), ADHD (OR = 8.94, 95% CI: 5.11, 15.63), and smoking (OR = 1.67, 95% CI: 1.12, 2.47), with impulsivity contributing to the first two relationships. The substantial association with ADHD suggests that other executive functions may promote disordered eating, possibly expressed through difficulties in adhering to regular meals. Clinically, these findings highlight the importance of assessing problematic eating patterns, such as compulsive grazing, in those presenting with difficulties with substance use or impulsivity, and vice versa.
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Affiliation(s)
- Andreea I Heriseanu
- eCentreClinic, School of Psychological Sciences, Macquarie University, Wallumattagal Campus, Macquarie Park, NSW 2109, Australia
| | - Dean Spirou
- School of Medicine, Western Sydney University, Sydney, NSW 2214, Australia
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Carlos E F Moraes
- Translational Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia
- Obesity and Eating Disorders Group, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro 22290-140, Brazil
| | - Phillipa Hay
- School of Medicine, Western Sydney University, Sydney, NSW 2214, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia
- Mental Health Service, South West Sydney Local Health District, Campbelltown, NSW 2560, Australia
| | - Rosely Sichieri
- Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro 22290-140, Brazil
| | - Jose C Appolinario
- Obesity and Eating Disorders Group, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro 22290-140, Brazil
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16
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de Souza APA, Paravidino VB, Sichieri R, Pereira RA, da Silva NC, Rodrigues PRM, Muraro AP, Ferreira MG. Effect of the dietary inflammatory potential on the trajectory of body adiposity in a Brazilian cohort of university students. Am J Hum Biol 2023; 35:e23871. [PMID: 36733224 DOI: 10.1002/ajhb.23871] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/18/2022] [Accepted: 01/11/2023] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES University students are vulnerable to unhealthy eating habits that characterize a proinflammatory diet. This study aimed to estimate the dietary inflammatory index (DII) and its association with the trajectory of body adiposity markers in university students. METHODS The study analyzed data from 685 students entering a Brazilian public university in 2016 and 2017 and followed until 2018. DII was estimated from 39 dietary parameters obtained by 24-h dietary recall. Body adiposity was assessed by anthropometric markers and the percentage of body fat. Linear mixed-effects models were used to estimate the trajectory of adiposity markers according to DII tertiles. RESULTS After adjustment for confounding variables, at baseline, DII showed a positive association with increased percentage of body fat among men (β = 0.52; 95% CI: 0.01; 1.03) and waist-to-height ratio (WHtR; β = 0.15; 95% CI: 0.12; 0.18) and among women with all body adiposity markers: BMI (β = 0.68; 95% CI: 0.30; 1.05), percentage of body fat (β = 1.43; 95% CI: 0.74; 2.11), WC (β = 1.15; 95% CI: 0.41; 1.89) and WHtR (β = 0.13; 95% CI:0,10; 0.16). The rate of change of the outcome variables over time was not associated with DII at baseline. CONCLUSIONS The diet of university students in this Brazilian cohort study was characterized as proinflammatory and it was associated with body adiposity markers.
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Affiliation(s)
| | - Vitor Barreto Paravidino
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rosely Sichieri
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rosângela Alves Pereira
- Departament of Social and Applied Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Natália Cardoso da Silva
- Departament of Social and Applied Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Paulo Rogério Melo Rodrigues
- Institute of Public Health, Federal University of Mato Grosso, Cuiabá, Brazil
- Food and Nutrition Department, College of Nutrition, Federal University of Mato Grosso, Cuiabá, Brazil
| | - Ana Paula Muraro
- Institute of Public Health, Federal University of Mato Grosso, Cuiabá, Brazil
- Food and Nutrition Department, College of Nutrition, Federal University of Mato Grosso, Cuiabá, Brazil
| | - Márcia Gonçalves Ferreira
- Institute of Public Health, Federal University of Mato Grosso, Cuiabá, Brazil
- Food and Nutrition Department, College of Nutrition, Federal University of Mato Grosso, Cuiabá, Brazil
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17
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Moraes CEFD, Antunes MML, Mourilhe C, Sichieri R, Hay P, Appolinario JC. Food Consumption during Binge Eating Episodes in Binge Eating Spectrum Conditions from a Representative Sample of a Brazilian Metropolitan City. Nutrients 2023; 15:nu15071573. [PMID: 37049413 PMCID: PMC10096673 DOI: 10.3390/nu15071573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/11/2023] [Accepted: 03/22/2023] [Indexed: 04/14/2023] Open
Abstract
The prevalence of binge eating spectrum conditions (BESC) are increasing globally. However, there is a lack of data from general population samples in low- and middle-income countries. Thus, this study described the food consumption during objective binge eating episodes (OBE) in people with BESC from a metropolitan city in Brazil. Participants comprised 136 adults (18 years old-60 years old) with Binge Eating Disorder (BED), Bulimia Nervosa (BN), or recurrent binge eating (RBE) from a two-phase epidemiological survey. They were interviewed in their homes by trained lay interviewers using the Questionnaire on Eating and Weight Patterns updated for the DSM-5 to assess BESC diagnosis and food consumption during a typical OBE. Overall, participants consumed a mean of 1067 kcal during the episodes. For the most part, these calories were derived from carbohydrates (58%) and lipids (30%), irrespective of the diagnosis. Regarding food item consumption, individuals with BED and RBE consumed staple foods (mainly rice and beans) more frequently than those with BN. Conversely, participants with BN ingested sugar-sweetened beverages more frequently than the BED group. In conclusion, there were differences in the eating patterns of individuals with BESC in Brazil. BED and RBE participants consumed more typical foods, whereas those with BN preferred foods with a high content of energy during their OBE.
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Affiliation(s)
- Carlos Eduardo Ferreira de Moraes
- Group of Obesity and Eating Disorders (GOTA), Psychiatry Institute (IPUB), Federal University of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW 2750, Australia
| | - Marina Maria Leite Antunes
- Group of Obesity and Eating Disorders (GOTA), Psychiatry Institute (IPUB), Federal University of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil
| | - Carla Mourilhe
- Group of Obesity and Eating Disorders (GOTA), Psychiatry Institute (IPUB), Federal University of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil
| | - Rosely Sichieri
- Department of Epidemiology, Social Medicine Institute (IMS), State University of Rio de Janeiro (UERJ), Rio de Janeiro 28625-570, Brazil
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW 2750, Australia
- Mental Health Services, South West Sydney Local Health District (SWSLHD), Campbelltown, NSW 2560, Australia
| | - Jose Carlos Appolinario
- Group of Obesity and Eating Disorders (GOTA), Psychiatry Institute (IPUB), Federal University of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil
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Vasconcelos TMD, Monteiro LS, Sichieri R, Pereira RA. Psychosocial aspects related to fruit and vegetable consumption in adolescents. Cien Saude Colet 2023; 28:609-618. [PMID: 36651411 DOI: 10.1590/1413-81232023282.05112022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 08/22/2022] [Indexed: 01/18/2023] Open
Abstract
This study aimed at assessing the association between psychosocial aspects and fruit and vegetable consumption in adolescents. Cross-sectional study developed with 327 adolescents from a public school in Brazil. A questionnaire developed for adolescents was applied to assess the influence of self-efficacy, family, peers, and body image on the consumption of fruits and vegetables. Specific questions assessed the intake frequency of fruits and vegetables, and the mean consumption was estimated using two 24-hour recalls. Scores related to psychosocial aspects were described as mean and median and the weight status was classified based on the body mass index. The average daily consumption of fruits and vegetables was 36.2 g and 45.4 g, respectively. Self-efficacy and the influence of peers were associated with an increase in the amount and frequency of fruits and vegetables consumption. Adolescents with higher scores of self-efficacy had greater average consumption of fruits and vegetables when compared to those with lower scores. The same was observed for the influence of peers. Self-efficacy and the influence of peers were the factors that most influenced the consumption of fruits and vegetables in adolescents.
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Affiliation(s)
- Thaís Meirelles de Vasconcelos
- Departamento de Nutrição Social e Aplicada, Universidade Federal do Rio de Janeiro. Av. Carlos Chagas Filho 373, Edifício do Centro de Ciências da Saúde, Bloco J, 2º andar, Cidade Universitária. 21941-590 Rio de Janeiro RJ Brasil.
| | | | - Rosely Sichieri
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro. Rio de Janeiro RJ Brasil
| | - Rosângela Alves Pereira
- Departamento de Nutrição Social e Aplicada, Universidade Federal do Rio de Janeiro. Av. Carlos Chagas Filho 373, Edifício do Centro de Ciências da Saúde, Bloco J, 2º andar, Cidade Universitária. 21941-590 Rio de Janeiro RJ Brasil.
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Cavalcante JB, de Vasconcelos TM, Sichieri R, Bezerra IN. Evolution of beverage portion sizes consumed in Brazil between 2008 and 2018. Front Public Health 2023; 10:969045. [PMID: 36711356 PMCID: PMC9874149 DOI: 10.3389/fpubh.2022.969045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 12/19/2022] [Indexed: 01/12/2023] Open
Abstract
Objective To describe the evolution of beverage portion sizes consumed in Brazil between 2008 and 2018. Methods Data from the dietary surveys of 2008-2009 and 2017-2018 Brazilian Household Budget Surveys, conducted with 34,003 and 46,164 individuals, respectively, were used to analyze the portion size of beverages. Food consumption data were used to group beverages according to nutritional characteristics, type and size of portions into eight groups: high-calorie soft drinks, fruit refreshments, alcoholic beverages, coffee/tea, fruit juices, milk and milk substitutes and ultra-processed milk-based beverages. The two-day food record and recall were considered to analyze the consumed portions. Comparisons between the surveys were done using Chi-Square tests and linear regression models. Results Between 2008 and 2018, the average portion consumed showed a significant increase for the group of alcoholic beverages (+29%), flavored juices (+11%), caloric soft drinks (+8%), milk and milk substitutes (+6%) and fruit juices (+5%); and reduction for the coffee/tea group (-11%). Analyzes by age group showed that among individuals between 20 and 40 years of age, the soft drinks and alcoholic beverage groups showed the greatest increase in portion size, +12 and +44%, respectively. Conclusion The beverage portion sizes consumed in Brazil between 2008 and 2018 increased for the group of alcoholic beverages, flavored juices, caloric soft drinks, milk and milk substitutes, and fruit juices.
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Affiliation(s)
- Jessica Brito Cavalcante
- Programa de Pós-Graduação em Nutrição e Saúde, Centro de Ciências da Saúde, Universidade Estadual do Ceará, Fortaleza, CE, Brazil
| | - Thais Meirelles de Vasconcelos
- Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Universidade Estadual do Ceará, Fortaleza, CE, Brazil
| | - Rosely Sichieri
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Ilana Nogueira Bezerra
- Programa de Pós-Graduação em Nutrição e Saúde, Centro de Ciências da Saúde, Universidade Estadual do Ceará, Fortaleza, CE, Brazil,*Correspondence: Ilana Nogueira Bezerra ✉
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Monteiro LS, Rodrigues PRM, de Vasconcelos TM, Sperandio N, Yokoo EM, Sichieri R, Pereira RA. Snacking habits of Brazilian adolescents: Brazilian National Dietary Survey, 2017-2018. NUTR BULL 2022; 47:449-460. [PMID: 36317893 DOI: 10.1111/nbu.12586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 10/01/2022] [Accepted: 10/03/2022] [Indexed: 11/07/2022]
Abstract
This study was aimed at describing the snack consumption among Brazilian adolescents. The Brazilian National Dietary Survey (2017-2018) is a nationwide representative cross-sectional study that collected food consumption data from 8264 adolescents (10 to 19 years old); data from one 24-h recall were used, in which all foods and beverages consumed throughout the day prior to the interview were described along with the amount, unit of measurement, time, place and occasion of consumption (breakfast, lunch, dinner or snack). Snacks were classified as follows: (a) Morning snack: "Snacks" consumed between 6 AM and 12 PM; (b) Afternoon snack: "Snacks" consumed between 1 PM and 5 PM; (c) Evening snack: "Snacks" consumed between 6 PM and 5 AM. Individuals were categorised according to the number of "Snacks" per day (zero, one, two or three or more). Among the evaluated adolescents, 52.8% were female and 23.0% were overweight. The consumption of at least one snack per day was mentioned by 88.2% of the adolescents, with an average of 2.33 snacks per day. An afternoon snack was consumed by 70.0% of the adolescents. Snack consumption was related to higher mean daily energy intake and a greater contribution of carbohydrates, added sugar and trans fat to the total daily energy intake. 'Cookies & Crackers' and 'Fast Foods' were the groups that contributed the most to the energy intake provided by snacks, showing, therefore, that less healthy foods were relevant components of the snacks consumed. For their important contribution to food intake, snacking habits deserve attention among the topics covered in dietary guidelines.
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Affiliation(s)
- Luana Silva Monteiro
- Instituto de Alimentação e Nutrição, Universidade Federal do Rio de Janeiro, Macaé, Brazil
| | | | | | - Naiara Sperandio
- Instituto de Alimentação e Nutrição, Universidade Federal do Rio de Janeiro, Macaé, Brazil
| | - Edna Massae Yokoo
- Departamento de Epidemiologia e Bioestatística, Universidade Federal Fluminense, Niterói, Brazil
| | - Rosely Sichieri
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rosângela Alves Pereira
- Departamento de Nutrição Social e Aplicada, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Souza ADM, Bezerra IN, de Souza BDSN, Muniz RR, Pereira RA, Sichieri R. Dietary sodium intake remains high in Brazil: Data from the Brazilian National Dietary Surveys, 2008-2009 and 2017-2018. Nutr Res 2022; 107:65-74. [PMID: 36191403 DOI: 10.1016/j.nutres.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 08/22/2022] [Accepted: 08/25/2022] [Indexed: 12/27/2022]
Abstract
Reducing salt intake is considered one of the most cost-effective interventions to decrease morbidity and mortality resulting from noncommunicable diseases. This study aimed to describe changes in sodium intake in the Brazilian population using data from the National Dietary Surveys (NDS) conducted in 2008-2009 and 2017-2018. We hypothesized that over the 10-year period evaluated, sodium intake has remained high in Brazil. Nationwide representative samples of 34,003 and 46,164 individuals (aged ≥10 years) from NDS 2008-2009 and 2017-2018, respectively, were evaluated. Food consumption data were obtained from 2 nonconsecutive food records (NDS 2008-2009) and two 24-hour food recalls (NDS 2017-2018). Trends, percentiles of distribution, and proportions of the population exceeding the age-specific tolerable upper intake level for sodium were estimated. Dietary sodium intake was also estimated as a function of energy intake (mg/1000 kcal). Overall, mean crude daily sodium intake was slightly lower in 2017-2018 than in 2008-2009 (2489 mg/d vs. 2529 mg/d). The decrease in sodium intake (mg/day) was statistically significant (P < .05) only among female adolescents and subjects in the highest income level. Additionally, an overall statistically significant increase in dietary sodium density was observed independent of age, sex, and income level for energy-adjusted data (P < .05). Our findings indicate that sodium intake has not significantly changed over time in the Brazilian population; thus, policies aimed at reducing sodium intake in Brazil are necessary.
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Affiliation(s)
- Amanda de Moura Souza
- Department of Epidemiology and Biostatistics, Institute of Studies in Public Health, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.
| | | | | | - Renata Rodrigues Muniz
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - Rosangela Alves Pereira
- Department of Social and Applied Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - Rosely Sichieri
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
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Sgambato MR, Lignani JDB, Pires CA, Ribeiro ECDSA, Domingos TB, Ferreira AA, Sichieri R, Oliveira LGD, Salles-Costa R. Inequalities in food acquisition according to the social profiles of the head of households in Brazil. Ciênc saúde coletiva 2022; 27:4303-4314. [DOI: 10.1590/1413-812320222711.01582022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 07/06/2022] [Indexed: 12/23/2022] Open
Abstract
Abstract Brazil is characterized by strong social inequalities and differences in access to quality food and sufficient quantities of it, which represent a violation of the human right to adequate food. The aim was to assess food expenditures according to the social profiles of the head of the households. Data from the cross-sectional Brazilian Household Budget Survey (2017/2018) were used with a nationally representative sample of household survey participants (n=52,917). Poisson regression was used to estimate prevalence ratios (PR) to assess the association of different social profiles with the acquisition of food. The profile characterized by woman self-classified as white, with a higher education, which characteristics were positively and significantly associated with more acquisition of fruits (PR=1.22; CI95% 1.09-1.36) and vegetables and greens (PR=1.24; CI95% 1.09-1.41). Black women with low education levels showed a negative association with the consumption of soda (PR=0.53; CI95% 0.45-0.62), and prepared food (PR=0.52; CI95% 0.37-0.74). The results reveal great inequalities in the purchase of food between the social profiles of the heads of the family.
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Moraes ABDVD, Veiga GVD, Azeredo VBD, Sichieri R, Pereira RA. [Healthy diet and adequate calcium intake]. CAD SAUDE PUBLICA 2022; 38:e00142222. [PMID: 36169519 DOI: 10.1590/0102-311xpt142222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 08/04/2022] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | - Rosely Sichieri
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
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24
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Rebouças BVL, Vasconcelos TMD, Sousa MHL, Sichieri R, Bezerra IN. Acquisition of food for away-from-home consumption in Brazil between 2002 and 2018. Cien Saude Colet 2022; 27:3319-3329. [PMID: 35894341 DOI: 10.1590/1413-81232022278.04632022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 05/05/2022] [Indexed: 11/21/2022] Open
Abstract
The aim of the study was to assess the evolution of food acquisition for away from home consumption in Brazil from 2002 to 2018. The trend of food purchases for out-of-home consumption in Brazil was evaluated by comparing food purchase data from the Household Budget Surveys (HBS) of 2002-2003, 2008-2009, and 2017-2018. The frequency of food acquisition was estimated according to sociodemographic variables and the mean cost. In 2002-2003, the frequency of purchase of food for out-of-home consumption was 35.2% (95%CI: 34.4-35.9), increasing to 41.2% (95%CI: 40.4-42.0) in 2008-2009, followed by a decline in 2017-2018 (32.3%; 95%CI: 31.7-32.9). A declining trend was observed in the frequency of purchases of alcoholic beverages and soft drinks and fast foods maintained the frequency between the last two surveys. Spending on this type of food increased between 2002-2003 and 2008-2009, while the mean value of this type of expenditure was maintained between 2008-2009 and 2017-2018. Brazilians increased food purchases for out-of-home consumption between 2002-2003 and 2008-2009, declining in 2017-2018. A consistent fall in the purchase of alcoholic beverages and soft drinks was observed over time, while the group of meals grew significantly.
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Affiliation(s)
- Brenna Virginia Lima Rebouças
- Programa de Pós-Graduação em Nutrição e Saúde, Universidade Estadual do Ceará. Av. Dr. Silas Munguba 1700, Centro de Ciências da Saúde, Campus do Itaperi. 60714-903 Fortaleza CE Brasil.
| | | | - Maria Helena Lima Sousa
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Estadual do Ceará. Fortaleza CE Brasil
| | - Rosely Sichieri
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro. Rio de Janeiro RJ Brasil
| | - Ilana Nogueira Bezerra
- Programa de Pós-Graduação em Nutrição e Saúde, Universidade Estadual do Ceará. Av. Dr. Silas Munguba 1700, Centro de Ciências da Saúde, Campus do Itaperi. 60714-903 Fortaleza CE Brasil.
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25
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Benthroldo RS, Paravidino VB, Cunha DB, Mediano MFF, Sichieri R, Marques ES. Environment modification at school to promote physical activity among adolescents: a cluster randomized controlled trial. Rev Bras Epidemiol 2022; 25:e220019. [PMID: 35894422 DOI: 10.1590/1980-549720220019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 02/06/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To assess the effect of modifications of the school environment on physical activity in Brazilian adolescent students. METHODS Seven public schools in Duque de Caxias (Brazil) were randomized into control and intervention groups. The intervention group underwent modifications in the school environment (painting of hopscotch and school courts) and the provision of sports equipment (balls, basketball table, soccer goalpost, volleyball nets, and others) to stimulate physical activity. Additionally, footsteps towards the court and materials were painted, and a superhero character called Super Active was introduced. Total physical activity was measured using a validated questionnaire for adolescents. Generalized linear models were used to evaluate the effect of the intervention, adjusted by sex. RESULTS The sample consisted of 975 adolescents, with a mean age of 11.52 years (standard deviation - SD 1.43), and 56.7% were boys. After the one-month intervention, both groups' total physical activity time increased. The estimated changes from baseline were not different between the intervention and control groups (Δ=102.75 and Δ=99.76, respectively; p=0.52). CONCLUSION The painting, supply of equipment and other strategies to encourage physical activity in the school environment did not promote a positive effect on improving physical activity among adolescents. Future research is necessary to evaluate the effect of the intervention in the long-term period, particularly in other population contexts in middle-income countries.
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Affiliation(s)
- Raycauan Silva Benthroldo
- Universidade do Rio de Janeiro, Institute of Social Medicine, Department of Epidemiology - Rio de Janeiro (RJ), Brazil
| | - Vitor Barreto Paravidino
- Universidade do Rio de Janeiro, Institute of Social Medicine, Department of Epidemiology - Rio de Janeiro (RJ), Brazil.,Universidade do Estado do Rio de Janeiro, Institute of Social Medicine, Department of Physical Education and Sports, Naval Academy, Brazilian Navy - Rio de Janeiro (RJ), Brazil
| | - Diana Barbosa Cunha
- Universidade do Rio de Janeiro, Institute of Social Medicine, Department of Epidemiology - Rio de Janeiro (RJ), Brazil
| | - Mauro Felippe Felix Mediano
- Fundação Oswaldo Cruz, Evandro Chagas National Institute of Infectious Disease - Rio de Janeiro (RJ), Brazil
| | - Rosely Sichieri
- Universidade do Rio de Janeiro, Institute of Social Medicine, Department of Epidemiology - Rio de Janeiro (RJ), Brazil
| | - Emanuele Souza Marques
- Universidade do Rio de Janeiro, Institute of Social Medicine, Department of Epidemiology - Rio de Janeiro (RJ), Brazil
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Oliveira PS, Levy J, Carli ED, Bensenor IJM, Lotufo PA, Pereira RA, Yokoo EM, Sichieri R, Crispim SP, Marchioni DML. Estimation of underreporting of energy intake using different methods in a subsample of the ELSA-Brasil study. CAD SAUDE PUBLICA 2022; 38:e00249821. [PMID: 35894363 DOI: 10.1590/0102-311xen249821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 05/05/2022] [Indexed: 11/21/2022] Open
Abstract
Existing methods for assessing food consumption are subject to measurement errors, especially the underreporting of energy intake, characterized by reporting energy intake below the minimum necessary to maintain body weight. This study aimed to compare the identification of energy intake underreporters using different predictive equations and instruments to collect dietary data. The study was conducted with 101 selected participants in the third wave of the Longitudinal Study of Adult Health (ELSA-Brasil) at the University Hospital of the University of São Paulo. For the dietary assessment, we applied a food frequency questionnaire (FFQ), two 24-hour diet recall (24hR) using the GloboDiet software, and two 24hR using the Brasil-Nutri software. The energy intake underreport obtained from the FFQ was 13%, 16%, and 1% using the equations proposed by Goldberg et al. (1991), Black (2000), and McCrory et al. (2002), respectively. With these same equations, the 24hR described an underreport of 9.9%, 14.9%, and 0.9% respectively with the GloboDiet software and 14.7%, 15.8%, and 1.1% respectively with the Brasil-Nutri software. We verified a low prevalence of underreported energy intake among the three self-report-based dietary data collection methods (FFQ, 24hR with GloboDiet, and Brasil-Nutri). Though no statistically significant differences were found among three methods, the equations for each method differed among them. The agreement of energy intake between the methods was very similar, but the best was between GloboDiet and Brasil-Nutri.
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Affiliation(s)
| | - Jéssica Levy
- Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brasil
| | - Eduardo De Carli
- Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brasil
| | | | | | - Rosangela Alves Pereira
- Departamento de Nutrição Social e Aplicada, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Edna Massae Yokoo
- Centro de Ciências Médicas, Universidade Federal Fluminense, Niterói, Brasil
| | - Rosely Sichieri
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
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27
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da Rocha CMM, Gama VPM, de Moura Souza A, Massae Yokoo E, Verly Junior E, Bloch KV, Sichieri R. Comparison of Quality of Carbohydrate Metrics Related to Fasting Insulin, Glycosylated Hemoglobin and HOMA-IR in Brazilian Adolescents. Nutrients 2022; 14:nu14122544. [PMID: 35745274 PMCID: PMC9227805 DOI: 10.3390/nu14122544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 06/04/2022] [Accepted: 06/13/2022] [Indexed: 12/02/2022] Open
Abstract
Low glycemic index (GI) and glycemic load (GL) diets are effective for glycemic control (GC) associated with a carbohydrate-controlled meal plan. However, whether GI and GL peaks are related to GC is unknown. Objective: To compare the daily GI (DGI)/GL (DGL) and average GI (AvGI)/GL (AvGL) of meals (accounting for peaks) related to GC markers (GCM) in Brazilian adolescents. Methods: A representative national school-based (public/private) sample of students without diabetes, 12−17 years of age, was evaluated. Food intake was based on a 24 h recall. The models for complex cluster sampling were adjusted (sex, sexual maturation, age, and physical activity). Results: Of 35,737 students, 74% were from public schools, 60% girls, 17% overweight, and 8% obese. The minimum DGI and DGL were observed at lunch, with higher values at night. Fasting insulin was 1.5 times higher in overweight/obese (OW) girls, and 1.7 times higher in OW boys than in normal-weight (NW) girls. The same trend was observed for the homeostatic model assessment for insulin resistance (HOMA-IR) (OW = 2.82 vs. NW = 1.84 in girls; OW = 2.66 vs. NW = 1.54 in boys; p < 0.05). The daily and average metrics were greater for NW adolescents. Glycosylated hemoglobin was not associated with these metrics, except for AvGL. Insulin and HOMA-IR were associated with all metrics in NW adolescents, with greater coefficients associated with AvGL. Among overweight/obese adolescents, only GI metrics were associated (β = 0.23; AvGI and insulin) and appeared to have the best association with GCM. Conclusions: Among NW adolescents, GL is a better measure of carbohydrate quality, but for those with overweight/obesity, carbohydrate consumption is more associated with GC, probably because they eat/report small amounts of carbohydrates.
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Affiliation(s)
- Camilla Medeiros Macedo da Rocha
- Instituto de Alimentação e Nutrição, Centro Mutidisciplinar UFRJ—Macaé, Universidade Federal do Rio de Janeiro, Av. Aluizio da Silva Gomes 50, Novo Cavaleiros, Macaé 27930-560, RJ, Brazil
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524, Pavilhão João Lyra Filho, 7º Andar, Rio de Janeiro 20550-900, RJ, Brazil;
- Correspondence: (C.M.M.d.R.); (R.S.)
| | - Vanessa Proêza Maciel Gama
- Instituto Federal de Educação, Ciência e Tecnologia Fluminense, Av. Souza Mota 350, Parque Fundão, Campos dos Goytacazes 28060-010, RJ, Brazil;
- Departamento de Epidemiologia e Bioestatística, Universidade Federal Fluminense, Rua Marques de Paraná 303, 3º Andar, Centro, Niterói 24030-210, RJ, Brazil;
- Curso de Especialização em Nutrição Clínica, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373—Bloco J 2º Andar, Ilha do Fundão, Rio de Janeiro 21941-902, RJ, Brazil
| | - Amanda de Moura Souza
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Avenida Horácio Macedo s/n, Ilha do Fundão, Rio de Janeiro 21941-598, RJ, Brazil; (A.d.M.S.); (K.V.B.)
| | - Edna Massae Yokoo
- Departamento de Epidemiologia e Bioestatística, Universidade Federal Fluminense, Rua Marques de Paraná 303, 3º Andar, Centro, Niterói 24030-210, RJ, Brazil;
| | - Eliseu Verly Junior
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524, Pavilhão João Lyra Filho, 7º Andar, Rio de Janeiro 20550-900, RJ, Brazil;
| | - Katia Vergetti Bloch
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Avenida Horácio Macedo s/n, Ilha do Fundão, Rio de Janeiro 21941-598, RJ, Brazil; (A.d.M.S.); (K.V.B.)
| | - Rosely Sichieri
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524, Pavilhão João Lyra Filho, 7º Andar, Rio de Janeiro 20550-900, RJ, Brazil;
- Correspondence: (C.M.M.d.R.); (R.S.)
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Moraes ABDVD, Veiga GVD, Azeredo VBD, Sichieri R, Pereira RA. High dietary calcium intake and low adiposity: findings from a longitudinal study in Brazilian adolescents. CAD SAUDE PUBLICA 2022; 38:e00144521. [PMID: 35703666 DOI: 10.1590/0102-311xen144521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 03/10/2022] [Indexed: 11/21/2022] Open
Abstract
Epidemiological studies have supported the hypothesis that dietary calcium intake is protective for adiposity. This study aimed to estimate the association of dietary calcium with adiposity indicators during adolescence. This is a cohort study with high school adolescents (n = 962) from selected schools of the Metropolitan Region of Rio de Janeiro, Brazil, which were followed from 2010 to 2012. Calcium intake was assessed by a validated self-reported food frequency questionnaire. Cross-sectional and longitudinal analyses of dietary calcium intake were performed regarding body mass index (BMI), waist circumference (WC), body fat percentage (%BF), fat mass (FM), fat-free mass (FFM), fat mass index (FMI), and fat-free mass index (FFMI). The analysis of variance was used for cross-sectional analysis with baseline data and linear mixed models applied to assess changes across the follow-up. At baseline, BMI, %BF, fat mass, and FMI (p for trend < 0.05) had lower means at the highest quintile of calcium intake whereas FFM and FFMI had higher means (p for trend < 0.05), especially for boys. During follow-up, boys had decreased FMI at the 4th and 5th quintiles of calcium intake (p < 0.05); among girls, only WC was significantly lower at the 4th quintile than in the 1st. These results support the hypothesis that low calcium intake increases adiposity among adolescents.
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Affiliation(s)
| | | | | | - Rosely Sichieri
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
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Abstract
Obesity and undernutrition are manifestations of malnutrition that affect many people worldwide. A lack of access to food may explain the association of food insecurity (FI) with both undernutrition and obesity, but there are other factors that are specifically related to obesity. Studies have also found that FI is related to both overweight and obesity among women but not among men. The present study aimed to evaluate the association between FI and weight status among adults from a nationally representative sample of Brazil and to consider the impacts of sex. Data from the 2017/2018 Household Budget Survey (n=28,112), a national cross-sectional study, were analyzed using the Brazilian Household FI Scale (EBIA) and body mass index (BMI; measured in kg/m2) by individual self-reported weight and height. Associations were estimated by odds ratios (ORs) with 95% confidence intervals (CIs) considering a multinomial logistic regression model. Women with severe FI were more than twice (OR=2.36) as likely to be underweight and had a higher frequency of obesity (OR=1.39). Among men, severe FI status was a protective factor for overweight (OR=0.58) and obesity (OR=0.61). In conclusion, FI was a risk factor for underweight and obesity among women but not among men.
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Affiliation(s)
- Talita Barbosa Domingos
- Institute of Nutrition, Josué de Castro, University of Rio de Janeiro, Rio de Janeiro, RJ 21941-590, Brazil
| | - Rosely Sichieri
- Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
| | - Rosana Salles-Costa
- Institute of Nutrition, Josué de Castro, University of Rio de Janeiro, Rio de Janeiro, RJ 21941-590, Brazil
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30
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Martins HX, Siqueira JH, Oliveira AMAD, Jesus HCD, Pereira TSS, Sichieri R, Mill JG, Molina MDCB. Multimorbidity and health care of community health workers in Vitória, Espírito Santo, Brazil, 2019: a cross-sectional study. Epidemiol Serv Saude 2022; 31:e2021543. [PMID: 35352760 DOI: 10.1590/s1679-49742022000100006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 11/12/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To assess health conditions, health care and lifestyle habits of community health workers (CHW) in Vitória, Espírito Santo, Brazil. METHODS This was a cross-sectional study using baseline data from an intervention study. Biochemical, anthropometric and hemodynamic examinations and interviews were carried out between October 2018 and March 2019 in Vitória. Appropriate statistical tests, in accordance with the sample design, were performed using SPSS software version 21.0, adopting p<0.05. RESULTS We assessed 262 CHWs with a mean age of 46.1±9.3 years. High prevalence of prediabetes (22.9%), diabetes mellitus (17.2%), hypertension (37.0%), obesity (39.8%), hypercholesterolemia (57.3%), hypertriglyceridemia (27.1%), multimorbidity (40.8%), physical inactivity (60.9%) and use of anxiolytics/antidepressants (22.5%) was found. Some 40% of the CHWs had three or more morbidities. CONCLUSION High percentages of chronic diseases, multimorbidity, sedentary lifestyle and use of anxiolytics/antidepressants were found in CHWs in Vitória.
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Affiliation(s)
- Haysla Xavier Martins
- Universidade Federal do Espírito Santo, Programa de Pós-Graduação em Saúde Coletiva, Vitória, ES, Brasil
| | - Jordana Herzog Siqueira
- Universidade Federal do Espírito Santo, Programa de Pós-Graduação em Saúde Coletiva, Vitória, ES, Brasil
| | | | - Hanna Carolina de Jesus
- Universidade Federal do Espírito Santo, Programa de Pós-Graduação em Nutrição e Saúde, Vitória, ES, Brasil
| | | | - Rosely Sichieri
- Universidade do Estado do Rio de Janeiro, Instituto de Medicina Social, Rio de Janeiro, RJ, Brasil
| | - José Geraldo Mill
- Universidade Federal do Espírito Santo, Programa de Pós-Graduação em Saúde Coletiva, Vitória, ES, Brasil
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31
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da Cruz VL, Mediano MFF, Paravidino VB, Neves FA, de Oliveira Malafaia T, Rodrigues Junior LF, Moura AS, Sichieri R. Insulin sensitivity as a predictor of longitudinal changes on body mass index in Brazilian adolescents. Am J Hum Biol 2022; 34:e23745. [PMID: 35294067 DOI: 10.1002/ajhb.23745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/24/2022] [Accepted: 03/05/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES We aimed to investigate the effect of insulin sensitivity and insulin resistance status at baseline on longitudinal body mass index, and the possible effect modification by sex. METHODS This is a secondary analysis of a randomized intervention community trial, in which a subgroup of 84 adolescents, aged between 10 and 12 years, were analyzed. Body weight, height, and body mass index (BMI) were determined before and after 8 months of follow-up. Glucose and serum insulin were examined at baseline and IR was defined based on the homeostasis model assessment-insulin resistance (HOMA-IR), with a cutoff >2.5 for both genders. Linear mixed-effects models were performed to evaluate the influence of HOMA-IR at baseline on BMI changes over time. Models were adjusted for age, pubertal stage, and stratified by sex. RESULTS The sample comprised 65.4% of girls and the prevalence of overweight/obesity was 54.7% among girls and 50.0% among boys. The overall prevalence of IR was 75.3%, of which 60.7% for boys and 83.0% for girls. We found an interaction effect by sex (p = .004) for HOMA-IR as a continuous variable, with a decreased BMI rate of change among boys (β = -0.13; p = .03) but not for girls (β = +0.03; p = .36). Longitudinal BMI changes considering IR status at baseline (IR vs. non-IR) did not demonstrate any statistically significant difference for both boys (-0.1 vs. +0.4; p = .28) and girls (+0.7 vs. +1.0; p = .44). CONCLUSION Increased HOMA-IR values at baseline were associated with greater BMI reduction over time among boys but not girls, with no influence of IR status.
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Affiliation(s)
- Valéria Lima da Cruz
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mauro Felippe Felix Mediano
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.,Department of Research and Education, National Institute of Cardiology, Rio de Janeiro, Brazil
| | - Vitor Barreto Paravidino
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil.,Department of Physical Education and Sports, Naval Academy - Brazilian Navy, Rio de Janeiro, Brazil
| | - Fabiana Alves Neves
- Laboratory of Nutrition Physiology and Development, Department of Physiological Sciences, Institute of Biology, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tayanne de Oliveira Malafaia
- Laboratory of Nutrition Physiology and Development, Department of Physiological Sciences, Institute of Biology, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Anibal Sanchez Moura
- Laboratory of Nutrition Physiology and Development, Department of Physiological Sciences, Institute of Biology, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rosely Sichieri
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Appolinario JC, Sichieri R, Lopes CS, Moraes CE, da Veiga GV, Freitas S, Nunes MAA, Wang YP, Hay P. Correlates and impact of DSM-5 binge eating disorder, bulimia nervosa and recurrent binge eating: a representative population survey in a middle-income country. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1491-1503. [PMID: 35044479 PMCID: PMC9246799 DOI: 10.1007/s00127-022-02223-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 01/06/2022] [Indexed: 12/11/2022]
Abstract
PURPOSE Binge eating disorder (BED), bulimia nervosa (BN) and recurrent binge eating (RBE) are binge eating spectrum conditions causing a significant impact in individual's health and functioning. Information regarding those conditions came mostly from high-income countries. The objective of this study was to assess the prevalence of DSM-5 BED, BN and RBE and correlates in a representative sample from a metropolitan area of a middle-income country. METHODS The data were obtained from a cross-sectional population-based household survey in two stages in Rio de Janeiro, Brazil. Noninstitutionalized residents aged 18-60 years were assessed by lay interviewers using the Questionnaire of Eating and Weight Patterns-5 (QEWP-5). Positive cases and a paired sample screen-negative cases were reassessed by phone with the Eating Disorders Section of SCID-I-P (adapted for DSM-5). The data were collected from September 2019 to February 2020. RESULTS Overall, 2297 individuals were interviewed. Prevalence of BED was 1.4%, BN 0.7%, RBE 6.2%. Psychiatric comorbidities, such as depression, anxiety and ADHD were significantly more prevalent in people with BED, BN and RBE than in people without these eating problems. Several medical conditions, when controlling for body mass index, were significantly more prevalent in people with BED, BN and RBE. People with BED and BN had marked impairments in work/school, social and family life, reduced mental and physical HRQoL and under half had sought treatment. CONCLUSION As in high income countries, in Rio de Janeiro, Brazil, BED, BN and RBE are prevalent conditions and are associated with elevated BMI, functional impairment, psychiatric and medical comorbidity and poorer HRQoL.
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Affiliation(s)
- Jose C. Appolinario
- Obesity and Eating Disorders Group, Institute of Psychiatry, Federal University of Rio de Janeiro, Av. Professor Gastão Bahiana, 496 ap1809, Rio de Janeiro, 22071-030 Brazil
| | - Rosely Sichieri
- Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Claudia S. Lopes
- Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carlos E. Moraes
- Obesity and Eating Disorders Group, Institute of Psychiatry, Federal University of Rio de Janeiro, Av. Professor Gastão Bahiana, 496 ap1809, Rio de Janeiro, 22071-030 Brazil
| | - Gloria V. da Veiga
- Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Silvia Freitas
- State Institute of Diabetes and Endocrinology, Rio de Janeiro, Brazil
| | | | - Yuan-Pang Wang
- Instituto de Psiquiatria (LIM-23), Universidade de São Paulo, São Paulo, Brazil
| | - Phillipa Hay
- Translational Health Research Institute, Western Sydney University, Penrith, Australia ,Camden and Campbelltown Hospitals, SWSLHD, Campbelltown, Australia
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Rodrigues RM, Carli ED, Araújo MC, Verly Junior E, Marchioni DML, Bezerra IN, Souza ADM, Yokoo EM, Pereira RA, Sichieri R. Limitations in the comparison of the Brazilian National Dietary Surveys of 2008-2009 and 2017-2018. Rev Saude Publica 2021; 55:3s. [PMID: 34910053 PMCID: PMC9586432 DOI: 10.11606/s1518-8787.2021055003365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 05/04/2021] [Indexed: 11/30/2022] Open
Abstract
OBJETIVE: To present particular characteristics of two Brazilian National Dietary Surveys (Inquéritos Nacionais de Alimentação - INA) and the methodology used to better compare their data. METHODS: This study details the differences between both INA conducted by the Brazilian Institute of Geography and Statistics (IBGE) in 2008–2009 and 2017–2018. We present the alterations in data collecting methods and food composition tables as well as the analysis strategies recommended to obtain such data. A validation study with 95 participants of the third wave of the Longitudinal Study of Adult Health assessed the measurement error associated with the procedures adopted in the 24-hours dietary recall of INA 2017–2018. The reference standards were urinary protein recovery, sodium, and potassium biomarkers. Different strategies were used in the analysis of INA to compare two essential dietary items that had their collection method changed: fats and sugars. RESULTS: The validation study indicated lower underreport in the most recent survey with higher means of energy intake. The correlation of means for the 24-hours recalls with their respective biomarkers was 0.58 for proteins, 0.31 for potassium, and 0.30 for sodium. Comparing the food composition tables used in both surveys with the data obtained by INA 2008-2009, the mean variation of energy, macronutrients, and minerals was lower than 15%, except for trans fats and selenium, which had means 40% and 52% lower in the Tabela Brasileira de Composição de Alimentos (TBCA - Brazilian Food Composition Table). INA 2017–2018 presents lower means for added sugar, using a generic question about the frequency of sugar consumption as a measure for sugar as an additional item. CONCLUSION: The methodological changes promoted in the most recent INA enhanced food groups and nutrients intake estimation, adding detailed and specific data in dietary habits reports.
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Affiliation(s)
- Renata Muniz Rodrigues
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Rio de Janeiro, RJ, Brasil
| | - Eduardo De Carli
- Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Nutrição. São Paulo, SP, Brasil
| | - Marina Campos Araújo
- Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Departamento de Epidemiologia e Métodos Quantitativos em Saúde. Rio de Janeiro, RJ, Brasil
| | - Eliseu Verly Junior
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Rio de Janeiro, RJ, Brasil
| | | | | | - Amanda de Moura Souza
- Universidade Federal do Rio de Janeiro. Instituto de Estudos em Saúde Coletiva. Rio de Janeiro, RJ, Brasil
| | - Edna Massae Yokoo
- Universidade Federal Fluminense. Departamento de Epidemiologia e Bioestatística. Niterói, RJ, Brasil
| | - Rosangela Alves Pereira
- Universidade Federal do Rio de Janeiro. Departamento de Nutrição Social e Aplicada. Rio de Janeiro, RJ, Brasil
| | - Rosely Sichieri
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Rio de Janeiro, RJ, Brasil
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Sichieri R. Importance of national data on food consumption and changes in the diet of Brazilians from 2008 to 2018. Rev Saude Publica 2021; 55:2s. [PMID: 34910052 DOI: 10.11606/s1518-8787.2021055supl1ap] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Rosely Sichieri
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social Hesio Cordeiro. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
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Verly E, Marchioni DM, Araujo MC, Carli ED, de Oliveira DCRS, Yokoo EM, Sichieri R, Pereira RA. Evolution of energy and nutrient intake in Brazil between 2008-2009 and 2017-2018. Rev Saude Publica 2021; 55:5s. [PMID: 34910054 PMCID: PMC9586436 DOI: 10.11606/s1518-8787.2021055003343] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 05/08/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To assess the evolution of energy and nutrient intake and the prevalence of inadequate micronutrients intakes according to sociodemographic characteristics and Brazilian regions. METHODS The food consumption of 32,749 individuals from the National Dietary Survey of the Household Budget Survey 2008-2009 was analyzed by two food registries, as well as 44,744 subjects from two 24-hour recalls in 2017-2018. Usual intake and percentage of individuals with consumption below the average recommendation for calcium, magnesium, phosphorus, copper and zinc, vitamins A, C, D, E, thiamine, riboflavin, pyridoxine and cobalamin were estimated. Sodium intake was compared to the reference value to reduce the risk of chronic diseases. Analyses were stratified by sex, age group, region and income. RESULTS Mean daily energy intake was 1,753 kcal in 2008-2009 and 1,748 kcal in 2017-2018. The highest prevalence of inadequacy (> 50%) in the two periods were calcium; magnesium; vitamins A, D and E; pyridoxine and, only among adolescents, phosphorus. There was an increase in the prevalence of inadequate vitamin A, riboflavin, cobalamin, magnesium, and zinc among women, and riboflavin among men. The prevalence of inadequacy decreased for thiamine. Sodium intake was excessive in approximately 50% of the population in both periods. The highest variations (about 50%) in the prevalence of inadequacy between the lowest and highest income (< 0.5 minimum wage and > 2 minimum wages per capita) were observed for vitamin B12 and C in both periods. The North and Northeast regions had the highest prevalence of inadequacy. CONCLUSION Both surveys found high prevalence of inadequate nutrient intake and excessive sodium intake. The inadequacy varies according to income strata, increasing in the poorest regions of the country.
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Affiliation(s)
- Eliseu Verly
- Universidade do Estado do Rio de JaneiroInstituto de Medicina SocialDepartamento de EpidemiologiaRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Dirce Maria Marchioni
- Universidade de São PauloFaculdade de Saúde PúblicaDepartamento de NutriçãoSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. Departamento de Nutrição. São Paulo, SP, Brasil
| | - Marina Campos Araujo
- Fundação Oswaldo CruzEscola Nacional de Saúde Pública Sérgio AroucaDepartamento de Epidemiologia e Métodos Quantitativos em SaúdeRio de JaneiroRJBrasilFundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Departamento de Epidemiologia e Métodos Quantitativos em Saúde. Rio de Janeiro, RJ, Brasil
| | - Eduardo De Carli
- Universidade de São PauloFaculdade de Saúde PúblicaDepartamento de NutriçãoSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. Departamento de Nutrição. São Paulo, SP, Brasil
| | - Dayan Carvalho Ramos Salles de Oliveira
- Universidade do Estado do Rio de JaneiroInstituto de Medicina SocialDepartamento de EpidemiologiaRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Edna Massae Yokoo
- Universidade Federal FluminenseInstituto de Saúde ColetivaDepartamento de Epidemiologia e BioestatísticaNiteróiRJBrasilUniversidade Federal Fluminense. Instituto de Saúde Coletiva. Departamento de Epidemiologia e Bioestatística. Niterói, RJ, Brasil
| | - Rosely Sichieri
- Universidade do Estado do Rio de JaneiroInstituto de Medicina SocialDepartamento de EpidemiologiaRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Rosangela Alves Pereira
- Universidade Federal do Rio de JaneiroInstituto de Nutrição Josué de CastroDepartamento de Nutrição Social e AplicadaRio de JaneiroRJBrasilUniversidade Federal do Rio de Janeiro. Instituto de Nutrição Josué de Castro. Departamento de Nutrição Social e Aplicada. Rio de Janeiro, RJ, Brasil
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Bezerra IN, Vasconcelos TM, Cavalcante JB, Yokoo EM, Pereira RA, Sichieri R. Evolution of out-of-home food consumption in Brazil in 2008-2009 and 2017-2018. Rev Saude Publica 2021; 55:6s. [PMID: 34852163 PMCID: PMC8627152 DOI: 10.11606/s1518-8787.2021055003221] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/21/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To describe the evolution of out-of-home food consumption in Brazil in 2008–2018. METHODS We used the 2008–2009 and 2017–2018 data from the Inquéritos Nacionais de Alimentação (INA - National Food Surveys), conducted amid 34,003 and 46,164 individuals, to estimate the frequency of out-of-home food consumption and the contribution of this consumption to specific foods. Food consumption was analyzed using food records in the 2008–2009 INA and 24-hour recalls in 2017–2018. Estimates were generated for Brazil in general, for urban and rural areas, for age groups (adolescent, adult, elderly), and for income bracket. RESULTS The frequency of out-of-home consumption decreased by 8.8% between the two surveys, with no change in the rural area, in the Northeast and South regions, and for the lowest income brackets. We observed a slight increase among the elderly and in the Midwest region. The contribution of out-of-home food consumption to daily energy intake also decreased (16.3% vs. 12.7%), excepting the rural area, where there was a reduction in the difference in relation to the urban area between the two surveys. For most items evaluated, the out-of-home food consumption decreased. The most consumed out-of-home food were alcoholic beverages, fried and baked snacks, soft drinks, pizza, sweets, and sandwiches in both surveys. CONCLUSION In 10 years, the prevalence of food consumption and the percentage of contribution of out-of-home food decreased in Brazil, but ultra-processed foods still figure as the most consumed food group outside the home.
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Affiliation(s)
- Ilana Nogueira Bezerra
- Universidade Estadual do Ceará. Centro de Ciências da Saúde. Programa de Pós-Graduação em Nutrição e Saúde e Programa de Pós-Graduação em Saúde Coletiva. Fortaleza, CE, Brasil
| | - Thaís M Vasconcelos
- Universidade Estadual do Ceará. Programa de Pós-Graduação em Saúde Coletiva. Fortaleza, CE, Brasil
| | - Jessica Brito Cavalcante
- Universidade Estadual do Ceará. Programa de Pós-Graduação em Nutrição e Saúde. Fortaleza, CE, Brasil
| | - Edna Massae Yokoo
- Universidade Federal Fluminense. Departamento de Epidemiologia e Bioestatística. Niterói, RJ, Brasil
| | - Rosângela A Pereira
- Universidade Federal do Rio de Janeiro. Departamento de Nutrição Social e Aplicada. Rio de Janeiro, RJ, Brasil
| | - Rosely Sichieri
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
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Antunes ABS, Cunha DB, Baltar VT, Steluti J, Pereira RA, Yokoo EM, Sichieri R, Marchioni DM. Dietary patterns of Brazilian adults in 2008-2009 and 2017-2018. Rev Saude Publica 2021; 55:8s. [PMID: 34852165 PMCID: PMC8647980 DOI: 10.11606/s1518-8787.2021055003437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/30/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To identify dietary patterns among Brazilian adults based on the National Dietary Surveys (INA - Inquéritos Nacionais de Alimentação) in 2008-2009 and 2017-2018, and to verify in the second period the adherence to the patterns according to sociodemographic factors and Brazilian regions. METHODS We analyzed the first of two days of adults' food consumption (19-59 years) in INA data from 2008-2009 (n = 21,630) and 2017-2018 (n = 28,901). Dietary patterns were derived by exploratory factor analysis from 19 food groups, considering the complexity of the sample design. We evaluated the factor scores according to sex, age group, region, per capita income, and education for the INA data in 2017-2018. RESULTS We identified three patterns in the two surveys: (1) "traditional", characterized by rice, beans, and meat; (2) "breads and butter/margarine", characterized by breads, oils, and fats (including margarine/butter) and, coffee and teas in 2008-2009; and (3) "western", characterized by sodas, pizzas, snacks, flour, pasta, and sweets in 2017-2018. The "traditional" pattern had greater adherence among men, residents of the Midwest region and individuals with incomplete primary education. "Bread and butter/margarine" pattern had greater adherence among males, individuals aged between 40 and 59 years, from the Southeast region, and with income between 1 and 2 minimum wages per capita. Male individuals, aged between 19 and 39 years, from the South region, with per capita income greater than two minimum wages, and education level equal to or greater than primary education showed greater adherence to the "western" pattern. CONCLUSION The dietary patterns identified in 2008-2009 and 2017-2018 were similar, and we observed the maintenance of the "traditional" pattern, which includes rice, beans, and meat. Adherence to the dietary patterns varies according to sex, age group, region, per capita income, and education level.
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Affiliation(s)
- Anna Beatriz Souza Antunes
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Programa de Pós-Graduação em Saúde Coletiva. Rio de Janeiro, RJ, Brasil
| | - Diana Barbosa Cunha
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Valéria Troncoso Baltar
- Universidade Federal Fluminense. Instituto de Saúde Coletiva. Departamento de Epidemiologia e Bioestatística. Niterói, RJ, Brasil
| | - Josiane Steluti
- Universidade Federal de São Paulo. Instituto de Saúde e Sociedade. Departamento de Políticas Públicas e Saúde Coletiva. Santos, SP, Brasil
| | - Rosangela Alves Pereira
- Universidade Federal do Rio de Janeiro. Instituto de Nutrição Josué de Castro. Departamento de Nutrição Social e Aplicada. Rio de Janeiro, RJ, Brasil
| | - Edna Massae Yokoo
- Universidade Federal Fluminense. Instituto de Saúde Coletiva. Departamento de Epidemiologia e Bioestatística. Niterói, RJ, Brasil
| | - Rosely Sichieri
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Dirce Maria Marchioni
- Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Nutrição. São Paulo, SP, Brasil
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Abstract
OBJECTIVE To estimate the lowest cost of a healthy and culturally acceptable diet and to assess the evolution of its cost in the periods 2008-2009 and 2017-2018. METHODS We used data on the individual food consumption and food prices from the Pesquisas de Orçamentos Familiares (Household Budget Surveys), in the 2008-2009 and 2017-2018. The sample strata of each period were aggregated, forming 108 new strata with geographic and economic homogeneity. Linear programming models generated diets for each new stratum, considering the constraints in two models: model 1 (≥ 400g of fruits and vegetables); and model 2 (≥ 400g of fruits and vegetables, < 2300mg of sodium, sodium/potassium ratio < 1, ≥ 500mg of calcium). Each food could progressively deviate 5g from the observed consumption averages until the models found a solution in each of the strata. The objective function was to minimize the total cost of the diet. RESULTS The average observed and optimized costs were R$4.96, R$4.62 (model 1) and R$5.08 (model 2) in 2008-2009, and R$9.18, R$8.69 and R$9.87 in 2017-2018. Models 1 and 2 resulted in an increase of up to 6% and 11% in 2008-2009, and of up to 25% and 34% in 2017-2018 in the lowest income strata. The main changes observed in the two models include the reduction in the amounts of sweetened beverages, sweets, sauces, ready-to-eat foods, and an increase in fruits and vegetables, flour, and tubers. CONCLUSION The adequate amount of fruits and vegetables resulted in an increase in costs to some population strata. When the adequacy of calcium, sodium, and potassium was considered, we observed a more significant increase in cost, especially in 2017-2018.
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Affiliation(s)
- Eliseu Verly
- Universidade do Estado do Rio de JaneiroInstituto de Medicina SocialDepartamento de EpidemiologiaRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Dayan Carvalho Ramos Salles de Oliveira
- Universidade do Estado do Rio de JaneiroInstituto de Medicina SocialDepartamento de EpidemiologiaRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Rosely Sichieri
- Universidade do Estado do Rio de JaneiroInstituto de Medicina SocialDepartamento de EpidemiologiaRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
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Rodrigues RM, Souza ADM, Bezerra IN, Pereira RA, Yokoo EM, Sichieri R. Most consumed foods in Brazil: evolution between 2008-2009 and 2017-2018. Rev Saude Publica 2021; 55:4s. [PMID: 34852162 PMCID: PMC8659613 DOI: 10.11606/s1518-8787.2021055003406] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 05/04/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To describe the evolution of food consumption by the Brazilian population in 2008-2009 to 2017-2018. METHODS Data from the National Dietary Surveys of 2008-2009 and 2017-2018 were used. Both surveys estimated food consumption of two non-consecutive days of individuals aged 10 years or older. The first survey collected consumption data from 34,003 individuals through food records; the second, obtained data from 46,164 individuals, through 24-hour recalls. The twenty most frequently reported food groups in the two surveys were identified. The probability of consumption of each food group in the two surveys was estimated according to sex, age and income. This study presents the foods that had a change in the frequency of consumption of 5% or higher between the two surveys. The probability of consumption was corrected for intra-individual variability using the method developed by the National Cancer Institute. RESULTS Rice, beans, coffee, bread, vegetables and beef remained the staple Brazilian diet, ranking as the six most consumed items in both surveys. Ultra-processed foods such as sweet/stuffed cookies, savory cookies, processed meats and carbonated drinks also remained among the 20 most consumed foods. Trend analyses showed, regardless of gender, age and income range, a decrease in the consumption of rice, beans, beef, bread, fruit, milk and dairy, processed meats and carbonated drinks, and an increase in the consumption of sandwiches. CONCLUSION The Brazilian diet is still characterized by consumption of traditional foods, such as rice and beans, and by high frequency of consumption of ultra-processed foods, such as cookies and carbonated drinks. However, between the years of 2008-2009 and 20172018, there was a decrease in the consumption of rice, beans, beef, bread, fruit, milk and dairy, processed meats and carbonated drinks, but an increase in the consumption of sandwiches. The results show a decrease in quality in the Brazilian diet.
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Affiliation(s)
- Renata Muniz Rodrigues
- Universidade do Estado do Rio de JaneiroInstituto de Medicina SocialRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Rio de Janeiro, RJ, Brasil
| | - Amanda de Moura Souza
- Universidade Federal do Rio de JaneiroInstituto de Estudos em Saúde ColetivaRio de JaneiroRJBrasilUniversidade Federal do Rio de Janeiro. Instituto de Estudos em Saúde Coletiva. Rio de Janeiro, RJ, Brasil
| | - Ilana Nogueira Bezerra
- Universidade Estadual do CearáCentro de Ciências da SaúdeFortalezaCEBrasilUniversidade Estadual do Ceará. Centro de Ciências da Saúde. Fortaleza, CE, Brasil
| | - Rosangela Alves Pereira
- Universidade Federal do Rio de JaneiroDepartamento de Nutrição Social e AplicadaRio de JaneiroRJBrasilUniversidade Federal do Rio de Janeiro. Departamento de Nutrição Social e Aplicada. Rio de Janeiro, RJ, Brasil
| | - Edna Massae Yokoo
- Universidade Federal FluminenseDepartamento de Epidemiologia e BioestatísticaNiteróiRJBrasilUniversidade Federal Fluminense. Departamento de Epidemiologia e Bioestatística. Niterói, RJ, Brasil
| | - Rosely Sichieri
- Universidade do Estado do Rio de JaneiroInstituto de Medicina SocialRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Rio de Janeiro, RJ, Brasil
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Vieira FDST, Muraro AP, Rodrigues PRM, Sichieri R, Pereira RA, Ferreira MG. Lifestyle-related behaviors and depressive symptoms in college students. CAD SAUDE PUBLICA 2021; 37:e00202920. [PMID: 34644759 DOI: 10.1590/0102-311x00202920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 01/08/2021] [Indexed: 12/15/2022] Open
Abstract
This study sought to examine the association between lifestyle-related behaviors and depressive symptoms among college students. This cross-sectional study analyzed baseline data of a dynamic-cohort study from a public university in Central-Western Brazil, in all 21 undergraduate full-time courses. Students up to 25 years old who were enrolled for the first time in a university were included in the study, except pregnant and/or nursing women. All students who met the eligibility criteria were invited to participate in the study. From a total of 1,212 eligible students, 1,038 were included (85.6%). All participants answered a self-administered questionnaire on smoking, alcohol consumption, screen time, sleep duration, and meal patterns. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Multivariate Poisson regression models stratified by sex were used to estimate the associations. Depressive symptoms was observed in 31.6% (males 23.6%; females 39.9%; p-value chi-square test = 0.01) of the students. Smoking, drinking spirits, and having irregular meal habits were directly associated with depressive symptoms in both males and females. The co-occurrence of two risk behaviors (men: aPR = 2.23, 95%CI: 1.25; 3.99; women: aPR = 1.54, 95%CI: 1.03; 2.30) and three or more risk behaviors (men: aPR = 3.42, 95%CI: 1.90; 6.16; women: aPR = 2.09, 95%CI: 1.39; 3.15) increased the occurrence of depressive symptoms among the students. Lifestyle-related unhealthy behaviors were associated with an increased occurrence of depressive symptoms among college students. These findings suggest the need of interventions encouraging changes in lifestyle to promote mental health and to improve the quality of life in this group.
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Affiliation(s)
| | - Ana Paula Muraro
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| | | | - Rosely Sichieri
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Rosangela Alves Pereira
- Departamento de Nutrição Social e Aplicada, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
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Paravidino VB, Sichieri R, Gomes DCK, Silva GAE. High discrepancies in the mortality of hospitalized patients with COVID-19 in the two most economically important states in Brazil. Rev Bras Epidemiol 2021; 24:e210056. [PMID: 34877997 DOI: 10.1590/1980-549720210056] [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] [Received: 07/27/2021] [Accepted: 09/22/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare the proportion of deaths among hospitalized cases of COVID-19 in São Paulo and Rio de Janeiro, stratified by private and public services. METHODS Hospitalization data for severe acute respiratory syndrome (SARS) were obtained using the SIVEP-Gripe Database. All hospitalized adults who were diagnosed as COVID-19 or unspecified SARS, between January and December 2020, were included in the analysis. Logistic regression models were fitted to evaluate the risk of death between Rio de Janeiro and São Paulo, adjusted for age, sex, and comorbidities. RESULTS A total of 388,657 hospital registers for Rio de Janeiro and São Paulo (91,532 and 297,125, respectively) were analyzed. Missing data are frequent in the database and it was greater in Rio de Janeiro, at the state and capital levels. Adjusting for confounders, the odds ratio of dying by COVID-19, comparing the state of Rio de Janeiro with São Paulo, was 2.51 in the private hospitals and 2.29 in the public ones. For the capitals, the scenario is worse. The lethality among hospitalized patients with COVID-19 is at least twice in Rio de Janeiro than São Paulo, both at the states and capitals. The public or private services showed important differences, with odds ratios of 2.74 and 3.46, respectively. CONCLUSION It appears that the worst governance in the health sector in Rio de Janeiro, more than lack of resources, explains the excess mortality of hospitalized COVID-19 patients in Rio de Janeiro.
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Affiliation(s)
- Vitor Barreto Paravidino
- Department of Epidemiology, Institute of Social Medicine, Universidade do Estado do Rio de Janeiro - Rio de Janeiro (RJ), Brazil.,Department of Physical Education and Sports, Naval School, Marinha do Brasil - Rio de Janeiro (RJ), Brazil
| | - Rosely Sichieri
- Department of Epidemiology, Institute of Social Medicine, Universidade do Estado do Rio de Janeiro - Rio de Janeiro (RJ), Brazil
| | - Danilo Cosme Klein Gomes
- Department of Epidemiology, Institute of Social Medicine, Universidade do Estado do Rio de Janeiro - Rio de Janeiro (RJ), Brazil
| | - Gulnar Azevedo E Silva
- Department of Epidemiology, Institute of Social Medicine, Universidade do Estado do Rio de Janeiro - Rio de Janeiro (RJ), Brazil
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Morais LDC, Paravidino VB, Mediano MFF, Benthroldo R, Gonçalves TR, Sgambato MR, de Souza BDSN, Junior EV, Marques ES, Pereira RA, Sichieri R, Cunha DB. Effectiveness of a school-based randomized controlled trial aimed at increasing physical activity time in adolescents. Eur J Public Health 2021; 31:367-372. [PMID: 33846735 DOI: 10.1093/eurpub/ckab025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND This study aimed to evaluate the effectiveness of obesity prevention educational activities, isolated or combined with the modification of the school environment on total physical activity time. METHODS This is a school-based randomized controlled trial, conducted with 2511 students from fifth and sixth-grade in Brazil, that employed a parallel, three-group experimental arms: control group (CG), PAAPPAS group (PG) and PAAPPAS-environment group (PEG). During the 2016 school year, the PG received educational activities in the classroom, providing a general basis for a healthy lifestyle. The PEG received the same educational activities and also modifications in the school environment to stimulate physical activity practice during one month. Physical activity was evaluated through a validated physical activity questionnaire. Intention-to-treat analysis was performed to evaluate the rate of change of physical activity time between groups using PROC GENMOD procedure. All analyses were performed using SAS. RESULTS Total physical activity time increased by 22% in PEG compared with CG (P = 0.003). No difference was observed between PEG and PG (Δ = 60.20 vs. 36.37, respectively; P = 0.27) and between PG and CG (Δ = 36.37 vs. 9.70, respectively; P = 0.23). The proportion of individuals who attended at least 150 min week-1 of physical activity increased in PEG compared with PG (P = 0.04); however, no difference was observed between PEG and CG (P = 0.19) and between PG and CG (P = 0.26). For 300 min week-1, no difference was observed between groups. CONCLUSION A school-based multi-component intervention including modification of the school environment was effective for increasing physical activity time among adolescents.
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Affiliation(s)
- Lidiane da C Morais
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Vitor Barreto Paravidino
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil.,Department of Physical Education and Sports, Naval Academy, Brazilian Navy, Rio de Janeiro, Brazil
| | - Mauro F F Mediano
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Raycauan Benthroldo
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tatiana R Gonçalves
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Michele R Sgambato
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Eliseu V Junior
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Emanuele S Marques
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rosângela A Pereira
- Department of Social and Applied Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rosely Sichieri
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Diana B Cunha
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Batista DRR, Rodrigues PRM, Souza AM, Sichieri R, Muraro AP. [Nutritional status of children of Haitian descent and their demographic, socioeconomic and health characteristics in Cuiabá, State of Mato Grosso (MT), Brazil]. Cien Saude Colet 2021; 25:2571-2582. [PMID: 32667541 DOI: 10.1590/1413-81232020257.28552018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 11/26/2018] [Indexed: 11/21/2022] Open
Abstract
The scope of this study was to analyze the distribution of anthropometric variables according to demographic, socioeconomic, and health characteristics among children of Haitian descent between 0 and 5 years of age living in Cuiabá-MT. It consists of a cross-sectional and census-based study with data collected between August 2016 and February 2017. The dependent variables were body mass index (BMI) and height-for-age z-score, using Student's t-Test and ANOVA in the statistical analysis. A total of 67 children, 73.2% to 24 months of age and 34.3% being male, were evaluated. There was a significant proportion of families with per capita income of less than 1/4 of the minimum wage (65.6%), with no home monitoring for the family health strategy (88.1%), and long working hours for mothers (43.3%). The onset of prenatal care until the third month of pregnancy and female sex were associated with higher BMI averages. For height-for-age, an association with lower mean values was found for households with more than one resident per room, higher age range of the child, and child-care in daycare centers. Thus, although few factors have an association with the anthropometric indications evaluated, it is necessary to consider the precarious socioeconomic conditions in which these children find themselves.
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Affiliation(s)
- Delma Riane Rebouças Batista
- Instituto de Saúde Coletiva, Departamento de Saúde Coletiva, Universidade Federal de Mato Grosso (UFMT). Av. Fernando Corrêa da Costa 2367, Boa Esperança. 78060-900 Cuiabá MT Brasil.
| | | | - Amanda Moura Souza
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro. Rio de Janeiro RJ Brasil
| | - Rosely Sichieri
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro. Rio de Janeiro RJ Brasil
| | - Ana Paula Muraro
- Instituto de Saúde Coletiva, Departamento de Saúde Coletiva, Universidade Federal de Mato Grosso (UFMT). Av. Fernando Corrêa da Costa 2367, Boa Esperança. 78060-900 Cuiabá MT Brasil.
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Paravidino VB, Mediano MFF, Sichieri R. Physical Exercise, Energy Expenditure and Weight Loss: An Assumption not Always Observed in Practice. International Journal of Cardiovascular Sciences 2021. [DOI: 10.36660/ijcs.20200090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Morais SRD, Bezerra IN, Souza ADM, Vergara CMAC, Sichieri R. [Eating away from home and biomarkers for chronic noncommunicable diseases in Brazilian adolescents]. CAD SAUDE PUBLICA 2021; 37:e00219619. [PMID: 33534874 DOI: 10.1590/0102-311x00219619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 06/15/2020] [Indexed: 11/21/2022] Open
Abstract
The study aimed to assess the relationship between food consumption away from home and alterations in biomarkers for chronic noncommunicable diseases in Brazilian adolescents. This cross-sectional study used data from the Study of Cardiovascular Risk Factors in Adolescents (ERICA), conducted in 36,956 adolescents in 2013/2014. The relationship between food consumption away from home and each target outcome (hypertriglyceridemia, hypercholesterolemia, hyperglycemia, high glycated hemoglobin, and hyperinsulinemia) was tested with logistic regression models adjusted for age, school system (public versus private), physical activity, and screen time. Data on food consumption were obtained with a 24-hour diet recall (24HR), analyzing consumption of energy, added sugar, sodium, potassium, fiber, fruits, vegetables, rice, beans, sandwiches, cakes, dessert, chocolates, and sodas. The results showed that 53.2% of adolescents consumed foods away from home. Eating away from home showed an inverse relationship with hyperinsulinemia (OR = 0.65; 95%CI: 0.46-0.92) and hyperglycemia (OR = 0.46; 95%CI: 0.30-0.71) in boys and hypertension (OR = 0.71; 95%CI: 0.55-0.92) and hyperglycemia (OR = 0.57; 95%CI: 0.34-0.96) in girls. However, the consumption of calories, added sugar, sandwiches, desserts, and sodas was higher in adolescents that consumed foods away from home. The protective role of eating away from home, as measured by biochemical indicators in adolescents, may be a function of higher consumption of school meals, which was more frequent among adolescents that consumed food away from home, thus highlighting the importance of encouraging consumption of school meals.
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Affiliation(s)
| | | | | | | | - Rosely Sichieri
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
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Paravidino VB, Mediano MFF, Crochemore-Silva I, da Cruz VL, Antunes MML, Beaulieu K, Gibbons C, Finlayson G, Blundell JE, Sichieri R. The compensatory effect of exercise on physical activity and energy intake in young men with overweight: The EFECT randomised controlled trial. Physiol Behav 2020; 229:113249. [PMID: 33221391 DOI: 10.1016/j.physbeh.2020.113249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 10/03/2020] [Accepted: 11/16/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND The compensatory effect of exercise on total volume of physical activity and food intake has been described as a possible explanation for the limited body weight loss observed during exercise interventions. OBJECTIVE To investigate the effect of different exercise intensities on total volume of physical activity and energy intake amongst active men with overweight. DESIGN Young men with overweight from a naval academy (n = 72; mean ± SD, age 21 ± 2 years, BMI 27.9 ± 2.13 kg/m2) were randomised to a control group (CG), moderate-intensity (MEG), or vigorous-intensity exercise group (VEG). MEG and VEG performed exercise sessions three times per week, for 60 min, during a 2-week period. Physical activity was assessed using triaxial accelerometers for 13 days. Energy intake was assessed at four time-points by 24-hour food recall. Intention-to-treat analyses were performed using linear mixed effect models. RESULTS MEG and VEG presented a greater compensatory effect in the total volume of physical activity over time compared to CG, with a significant difference in the rate of change between VEG and CG (∆ = -250,503 counts vs. ∆ = -61,306 counts, respectively; p = 0.01), and MEG and CG (∆ = -253,336 counts vs. ∆ = -61,306 counts, respectively; p = 0.01). There was no difference between MEG and VEG (p = 0.97). Changes in energy intake were not different between groups (p = 0.18); however, MEG presented greater energy intake compared to CG (β=491 kcal/day; p = 0.01) and VEG (β=319 kcal/day; p = 0.07). VEG presented a greater reduction in body weight compared to MEG (-1.3 kg vs. -0.4 kg; p = 0.03) and CG (-1.3 kg vs. -0.6 kg; p = 0.07). CONCLUSIONS Two weeks of exercise promoted a compensatory effect in total volume of physical activity in active men with overweight, regardless of exercise intensity. The compensatory effect was not observed for energy intake, although there was a trend for higher absolute energy intake in the MEG. Consequently, individuals in the VEG showed greater reduction in body weight over the intervention period.
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Affiliation(s)
- Vitor Barreto Paravidino
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil; Department of Physical Education and Sports, Naval Academy - Brazilian Navy, Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Mauro Felippe Felix Mediano
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Inácio Crochemore-Silva
- Post-graduate Program in Epidemiology and Post-graduate Program in Physical Education, Federal University of Pelotas, Brazil.
| | - Valéria Lima da Cruz
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Marina Maria Leite Antunes
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Kristine Beaulieu
- School of Psychology, Faculty of Medicine & Health, University of Leeds, Leeds, UK.
| | - Catherine Gibbons
- School of Psychology, Faculty of Medicine & Health, University of Leeds, Leeds, UK.
| | - Graham Finlayson
- School of Psychology, Faculty of Medicine & Health, University of Leeds, Leeds, UK.
| | - John Edward Blundell
- School of Psychology, Faculty of Medicine & Health, University of Leeds, Leeds, UK.
| | - Rosely Sichieri
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
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Tavares AKMM, Ribas SA, Paravidino VB, Sgambato MR, Rodrigues RDRM, da Rocha CMM, Sichieri R, Cunha DB. Effect of phytosterol capsule supplementation associated with the National Cholesterol Education Program Step 2 diet on low-density lipoprotein in children and adolescents with dyslipidemia: A double-blind crossover trial. Nutrition 2020; 82:111051. [PMID: 33290971 DOI: 10.1016/j.nut.2020.111051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 08/21/2020] [Accepted: 10/28/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the effect of phytosterol capsule supplementation associated with the National Cholesterol Education Program (NCEP) Step 2 diet on LDL-C levels in children and adolescents with dyslipidemia. METHODS This is a randomized, double-blind, crossover trial conducted with children and adolescents (n = 31; mean ± SD, age 9.0 ± 2.22 years, BMI zscore 1.65 ± 1.47 kg/m2) with dyslipidemia. After a run-in period, the participants were randomly allocated to control or intervention groups. The intervention group received capsules containing 1.5 g/day of phytosterols, and the control group received capsules containing 2 g/day of sunflower oil for 8 weeks. Patients in both groups were instructed to follow the NCEP Step 2 diet during the study. The primary outcome was LDL-C and secondary outcomes were total cholesterol (TC), HDL-C, triglyceride, insulin, blood pressure, and anthropometric measures. Intention-to-treat analyses were performed using the proc mixed procedure in SAS. RESULTS The rate of change for LDL-C was not different between intervention and control groups (p=0.30). No significant reduction was also observed for TC (p=0.47), HDL-C (p=0.97), insulin (p=0.27), triglycerides (p=0.38), systolic blood pressure (p=0.11), and diastolic blood pressure (p=0.57) compared to control group. Although we observed a high adherence to the capsule intake (95.7% in phytosterol and 93.8% in the control group), the low adherence to the diet may have contributed to explaining the results. CONCLUSION Daily phytosterol capsules supplementation associated with the NCEP Step 2 diet did not reduce LDL-cholesterol concentrations in children and adolescents with dyslipidemia.
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Affiliation(s)
| | - Simone Augusta Ribas
- Department of Nutrition in Public Health, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Vitor Barreto Paravidino
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil; Department of Physical Education and Sports, Naval Academy - Brazilian Navy, Rio de Janeiro, Brazil
| | - Michele Ribeiro Sgambato
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Rosely Sichieri
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Diana Barbosa Cunha
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Santana DD, Cunha DB, Sichieri R, Veiga GVD. Association of body image dissatisfaction with body mass index trajectory: the Adolescent Nutritional Assessment Longitudinal Study cohort. J bras psiquiatr 2020. [DOI: 10.1590/0047-2085000000279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Objective To examine the association of body image dissatisfaction (BID) with body mass index (BMI) trajectory among students from a metropolitan area of Rio de Janeiro. Methods Data were analyzed for 809 middle school students followed from 2010 to 2013, and 1131 high school students followed from 2010 to 2012. BID was assessed using a body silhouettes scale. Type of school (public and private) was used as a proxy of socioeconomic status. Results In the middle school cohort, girls from private schools who wanted to have smaller and bigger silhouettes gained fewer BMI units than those who were satisfied with their body image ( p < 0.05). In the high school, girls from private schools who wished to have bigger and smaller silhouettes experienced greater BMI increase than girls who were satisfied with their body image ( p < 0.05). Also, in the high school cohort, boys from public schools who wished to have smaller and bigger silhouettes experienced smaller BMI increase than boys who were satisfied ( p < 0.05). Conclusion BID may be related to the BMI trajectory in girls from private schools and in boys from public schools.
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Brandao JM, Sichieri R, Ribas SA, Verly-Jr E, Pereira RA, Castro IRRD, Hassan BK, Oliveira ASDD, Marques ES, Cunha DB. Treatment of Childhood Obesity Based on Brazilian Dietary Guidelines Plus Energy Restriction (PAPPAS HUPE Study): Protocol for a Randomized Clinical Trial. JMIR Res Protoc 2020; 9:e16170. [PMID: 32502969 PMCID: PMC7308900 DOI: 10.2196/16170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 11/13/2019] [Accepted: 11/13/2019] [Indexed: 11/24/2022] Open
Abstract
Background The Food Guide for the Brazilian Population relies on natural or minimally processed foods mainly of plant origin such as beans and rice with low oil, salt, and sugar content and limited consumption of ultraprocessed foods. Reduction of ultraprocessed foods improves diet quality and energy consumption. Objective The goal of this study is to evaluate the effectiveness of an intervention for the treatment of obesity in children, with counseling based on the Brazilian Food Guide plus control of total energy intake. Methods A parallel, randomized clinical trial will include children aged 7 to 12 years. Randomization will be performed in blocks of 10 individuals using computer-generated random sequence numbers. Both the control and intervention groups will participate in 6 standardized educational activities based on the 10 steps of the Brazilian Food Guide. These activities will be conducted at the University Hospital Toy Library, located in the pediatric outpatient clinic. For the intervention group, in addition to the educational activities, an individualized food plan based on the nutritional recommendations of the Brazilian Society of Pediatrics will be prescribed and discussed with the mothers and fathers. The primary outcome of the study will be variations in body mass index, and secondary outcomes will include analysis of insulin resistance, blood pressure, body fat percentage, and waist and neck circumference. Results This project was funded by the National Council for Scientific and Technological Development in December 2017 (grant no 408333/2017-0). Recruitment began in August 2018 and by September 2019, we had enrolled the 101 participants. In addition to the patients referred by the national system of regulation, recruitment was made by medical outpatient referral and external indication. This is an ongoing study. We expect the results to be published in November 2020. Conclusions At the end of the project, in case of a positive result, a protocol for the treatment of obesity based on the Brazilian Food Guide will be proposed to the Unified Health System. A successful method to reduce childhood obesity is expected. Trial Registration Brazilian Registry of Clinical Trials RBR-3st5sn; http://www.ensaiosclinicos.gov.br/rg/RBR-3st5sn International Registered Report Identifier (IRRID) DERR1-10.2196/16170
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Affiliation(s)
- Joana Maia Brandao
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rosely Sichieri
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Simone Augusta Ribas
- Department of Nutrition and Public Health, School of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Eliseu Verly-Jr
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rosangela Alves Pereira
- Department of Social and Applied Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Bruna Kulik Hassan
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Emanuele Souza Marques
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Diana Barbosa Cunha
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Steluti J, Crispim SP, Araujo MC, Peralta AM, Pereira RA, Sichieri R, Yokoo EM, Marchioni DM. Technology in Health: Brazilian version of the GloboDiet program for dietary intake assessment in epidemiological studies. Rev Bras Epidemiol 2020; 23:e200013. [PMID: 32159624 DOI: 10.1590/1980-549720200013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 01/10/2019] [Indexed: 11/22/2022] Open
Abstract
The 24-hour recall (R24h) has been the method for dietary assessment in surveys. Technological advances have allowed the development of a program for the collection of R24h data. International Agency for Research on Cancer-World Health Organization (IARC-WHO) developed a standardized interview and computer-based 24-hour dietary recall program called GloboDiet, aimed at using it in research and nutrition surveillance. Brazil was included in a project for the global expansion of this methodology for developing and adapting a version for national use. The adaptation followed the procedures established by the IARC-WHO that considered the translation and adaptation of approximately 70 databases. For the development of the food list, national databases of food consumption from national surveys were consulted obtaining a final list of 2113 foods and recipes. GloboDiet program guides an interview in five steps: general information of the participant; quick list of foods and recipes; details of food / recipes and quantities consumed using mainly a picture book; control of the amount of food and nutrients; and information on dietary supplements. The Brazilian version of the GloboDiet program will provide a more accurate assessment of food intake based on a standardized method for nutrition surveillance and investigation of the relationship between diet and health outcomes, as well as comparisons of dietary intakes within and between countries.
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Affiliation(s)
- Josiane Steluti
- Instituto de Saúde e Sociedade, Universidade Federal de São Paulo - Santos (SP), Brasil.,Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil
| | | | - Marina Campos Araujo
- Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz, Ministério da Saúde - Rio de Janeiro (RJ), Brasil
| | - Aline Mendes Peralta
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil
| | - Rosangela Alves Pereira
- Departamento de Nutrição Social e Aplicada, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro - Rio de Janeiro (RJ), Brasil
| | - Rosely Sichieri
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro - Rio de Janeiro (RJ), Brasil
| | - Edna Massae Yokoo
- Departamento de Saúde da Comunidade, Faculdade de Medicina, Universidade Federal Fluminense - Niterói (RJ), Brasil
| | - Dirce Maria Marchioni
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil
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