Cardiometabolic risk profile and diet quality among internal migrants in Brazil: a population-based study.

PURPOSE: Studies of migrants can improve understanding of the environmental influence on the risk of chronic diseases. In continental countries, internal migration has been associated with changes in diet and health status. The objective of this study is to assess differences in diet quality and the cardiometabolic risk profile between migrants and the host population. METHODS: A cross-sectional, population-based study was conducted in the city of São Paulo. The study population included internal migrants, defined as individuals born outside São Paulo city who had lived in the city for ten years or longer. The final population (n = 537) was divided into three groups: natives of São Paulo (45.5%), migrants from the Southeast (26.9%) and migrants from the Northeast (27.5%). The joint interim statement consensus criteria were used for diagnosing MetSyn. Diet quality was estimated using the revised version of the Brazilian Healthy Eating Index (BHEI-R). Comparisons between the data of BHEI-R, cardiometabolic risk factors and MetSyn in migrants and natives were performed using generalized linear models adjusted for confounding factors, respectively. RESULTS: Southeastern and Northeastern migrants younger than 60 years had a higher average of for whole fruit and oil components, respectively. Northeastern migrants older than 60 years had higher systolic and diastolic blood pressure, atherogenic ratio concentrations, lower HDL-C and were more likely to present metabolic syndrome compared to those born in São Paulo of the same age group. CONCLUSION: Native and internal migrants from Brazil resident in São Paulo exhibited differences in diet quality and cardiometabolic risk factors.

The relationship between carbohydrate quality and the prevalence of metabolic syndrome: challenges of glycemic index and glycemic load.

PURPOSE: To estimate the prevalence of metabolic syndrome (MetS) and its components in adults and older adults residents of São Paulo, the association of MetS with the glycemic index (GI) and glycemic load (GL) and the foods that contribute to dietary GI and GL in this population. METHODS: Data from 591 adults and older adults participants in the Health Survey of São Paulo were used. This is a cross-sectional, population-based study with a complex multistage sample design of residents in the urban area of the municipality. Dietary consumption data, anthropometric measurements, blood pressure and blood samples were collected. The associations between GI, GL and MetS and its components were tested using logistic regression models, considering the sample design of the study. RESULTS: The prevalence of MetS in the adult and older adults residents of São Paulo was 30.3%. There was no association between GI, GL and MetS. GI and GL were positively associated with low high-density lipoprotein cholesterol (HDL-c), OR = 1.113 (95% CI 1.007-1.230) and OR = 1.019 (95% CI 1.002-1.037), respectively. GL was inversely associated with high blood pressure and this association differed by age group (OR = 0.981; 95% CI 0.964-0.998). Foods that most contributed to dietary GI and GL were sugar, white rice and French bread. CONCLUSIONS: Considering the high prevalence of low HDL-c in the population of São Paulo, GI and GL may contribute to the nutritional therapy of this dyslipidemia. However, findings should be treated with caution, considering several conflicting results between studies.

Dietary inadequacies overestimate the blood deficiencies of magnesium, zinc, and vitamins A, C, E, and D among residents of Sao Paulo.

BACKGROUND & AIMS: We aimed to estimate the prevalence of the inadequate intake and status of magnesium, zinc, and vitamins A, C, E, and D and identify factors associated with micronutrient deficiency in serum/plasma among residents of São Paulo, Brazil. METHODS: Data from 824 individuals aged ≥14 years were obtained from the 2015 ISA-Nutrition, a population-based, cross-sectional survey. Dietary and supplement intakes were assessed using two 24-h dietary recalls, and the micronutrient inadequacies were estimated using the National Cancer Institute method. Micronutrient status was measured in serum or plasma, and deficiency was established according to the lower limit of the reference values. Receiver operating characteristic curve analysis was used to identify the effect of intake on the micronutrient status in serum/plasma. Logistic regression analysis was applied to assess the association between micronutrient status and individual characteristics. RESULTS: More than 80% of the population had an inadequate dietary intake of magnesium, vitamin E, and vitamin D. Males had a high prevalence of inadequate dietary intake of vitamin A and zinc. A high-to-moderate prevalence of inadequate vitamin C intake was observed. Vitamin D was the only nutrient with a deficient status comparable to its dietary inadequacy. The other nutrients demonstrated a lower deficiency prevalence compared to dietary inadequacy, and vitamin A demonstrated the lowest prevalence of deficiency in plasma. Generally, dietary intake showed a non-notable association with micronutrient deficiency in serum/plasma. Individuals with fasting glucose concentrations ≥100 mg/dL and those using diuretic drugs had a higher risk of serum magnesium deficiency. Those using lipid-lowering drugs and those with high plasma adiponectin concentrations had a higher risk of serum zinc deficiency. Individuals who smoked and those with hypertension showed a higher risk of plasma vitamin C deficiency. Individuals with average leptin concentrations had a higher risk of plasma vitamin E deficiency. Finally, those with sufficient leisure-time physical activity had a lower risk of serum vitamin D deficiency. CONCLUSIONS: Residents of the urban areas of São Paulo demonstrated substantially inadequate intakes of most of the assessed micronutrients; however, micronutrient deficiency in serum/plasma was not associated with dietary inadequacy, and it usually demonstrated a lower prevalence than dietary indicators. Thus, using micronutrient intake to determine the serum/plasma profile should be done with caution. The status of the micronutrients varied according to individual characteristics, indicating the interplay of complex mechanisms underlying micronutrient balance.

Family income per capita, age, and smoking status are predictors of low fiber intake in residents of São Paulo, Brazil.

We hypothesized that dietary total fiber intake may be less than recommendations and that the intake of total, soluble, and insoluble fiber may be associated with demographic, lifestyle, and socioeconomic factors. Data were drawn from the Health Survey of São Paulo, a cross-sectional population-based study. Adolescents, adults, and elderly persons living in São Paulo city were included. Demographic, lifestyle, and anthropometric data were collected from households. Dietary intake was measured using two 24-hour dietary recalls. All analyses were conducted based on the sample design of the study. The proportion of individuals who met the adequate intake (AI) for total fiber intake was examined, and foods that contributed to the intake of fiber and fractions were evaluated. The relationship of total, soluble, and insoluble fiber intake with demographic, socioeconomic, and lifestyle characteristics was determined using multiple linear regression models. A low proportion of individuals met the AI for dietary fiber. The foods that most contributed to total fiber intake were beans, French bread, and rice. Total fiber intake was negatively associated with former and current smokers and positively associated with family income per capita and age. Soluble fiber intake was negatively associated with current smokers and positively associated with female sex, age, and family income per capita. Insoluble fiber intake was negatively associated with former or current smokers and positively associated with age. In summary, residents in the city of São Paulo had a low fiber intake, and demographic, socioeconomic, and lifestyle factors were associated with dietary fiber and intake of its fractions.