Smoking and consumption of ultra-processed foods - a combination of risky choices: A cross-sectional study using Vigitel 2018 data.

BACKGROUND: Smoking and unhealthy diet are important risk factors for cardiovascular and metabolic diseases, contributing to public health crises. OBJECTIVE: To evaluate the consumption of natural/minimally processed and ultra-processed foods by Brazilian adults (18-59 years old) according to smoking status. DESIGN AND SETTING: Cross-sectional study of a representative population sample from 26 state capitals and the Federal District (Brazil-2018). METHODS: Data were obtained from Vigitel-Surveillance System for Risk and Protection Factors for Chronic Diseases by Telephone Survey. Participants were categorized as smokers, ex-smokers, and never smokers. Multinomial logistic regression was used for analyses. RESULTS: Of the 30,800 adults evaluated, 9.4% (95%CI: 8.7-10.2) were smokers and 16.5% (95%CI: 15.8-17.3) were ex-smokers. Smokers were less likely to consume fruit and natural juice, and more likely to consume soda or artificial juice (≥ 5 days/week) than ex-smokers and never smokers. Regarding the daily frequency of consumption, smokers were observed to be less likely to eat fruit more than 1 time/day and more likely to drink ≥ 3 cups/cans of soda/day. Compared to never smokers, smokers had a 42% higher chance of consuming ≥ 3 glasses of natural juice/day. On the day before the interview, fruit, milk, tubers, squash, and okra consumption were lower among smokers than non-smokers. Smokers were more likely to report consuming soft drinks, fruit juice, sauces, ready-made dishes, margarine, and sausages. CONCLUSION: Smokers had lower fruit consumption, and higher consumption of natural juices and ultra-processed foods. We highlight the need for strategies that encourage healthy eating and smoking cessation.

Smoking and consumption of ultra-processed foods — a combination of risky choices: A cross-sectional study using Vigitel 2018 data

ABSTRACT BACKGROUND: Smoking and unhealthy diet are important risk factors for cardiovascular and metabolic diseases, contributing to public health crises. OBJECTIVE: To evaluate the consumption of natural/minimally processed and ultra-processed foods by Brazilian adults (18-59 years old) according to smoking status. DESIGN AND SETTING: Cross-sectional study of a representative population sample from 26 state capitals and the Federal District (Brazil-2018). METHODS: Data were obtained from Vigitel—Surveillance System for Risk and Protection Factors for Chronic Diseases by Telephone Survey. Participants were categorized as smokers, ex-smokers, and never smokers. Multinomial logistic regression was used for analyses. RESULTS: Of the 30,800 adults evaluated, 9.4% (95%CI: 8.7-10.2) were smokers and 16.5% (95%CI: 15.8-17.3) were ex-smokers. Smokers were less likely to consume fruit and natural juice, and more likely to consume soda or artificial juice (≥ 5 days/week) than ex-smokers and never smokers. Regarding the daily frequency of consumption, smokers were observed to be less likely to eat fruit more than 1 time/day and more likely to drink ≥ 3 cups/cans of soda/day. Compared to never smokers, smokers had a 42% higher chance of consuming ≥ 3 glasses of natural juice/day. On the day before the interview, fruit, milk, tubers, squash, and okra consumption were lower among smokers than non-smokers. Smokers were more likely to report consuming soft drinks, fruit juice, sauces, ready-made dishes, margarine, and sausages. CONCLUSION: Smokers had lower fruit consumption, and higher consumption of natural juices and ultra-processed foods. We highlight the need for strategies that encourage healthy eating and smoking cessation.

Risk and protective factors for suicide: a populational case-control study, Brazil, 2019.

OBJETIVE: To estimate risk and protection factors associated with suicide in Campinas, Brazil, in 2019. METHODS: This is a populational case-control study analyzing 83 cases of suicide that occurred in 2019 in Campinas, a Brazilian city with about 1.2 million inhabitants. Controls were composed of 716 inhabitants. An adjusted multiple logistic regression was used. Cases and controls were the dichotomous response variables. Sociodemographic and behavioral variables were the predictor variables. RESULTS: The categories which presented higher risk of suicide were: males [OR = 5.26 (p < 0.001)]; people aged 10-29 years [OR = 5.88 (p = 0.002)]; individuals without paid work [OR = 3.06 (p = 0.013)]; individuals presenting problematic use of alcohol [OR = 33.12 (p < 0.001)] and cocaine [14.59 (p < 0.007)]; and people with disabilities [OR = 3.72 (p < 0.001)]. Moreover, the perception of fear was associated with reduced suicide risk [OR = 0.19 (p = 0.015)]. Higher district HDI levels also showed a 4% decrease in risk for each 0.01 increase in district HDI levels [OR = 0.02 (p = 0.008)]. CONCLUSIONS: This study evidenced the association between sociodemographic and behavioral variables and suicide. It also emphasized the complexity in the dynamics between personal, social, and economic factors to this external cause of death.

Hábito alimentar de adultos brasileiros segundo a condição na força de trabalho / Eating behavior of Brazilian adults according to workforce position / Hábitos alimentarios de los adultos brasileños según su situación laboral

Resumo O objetivo desse artigo é avaliar o hábito alimentar da população adulta no Brasil segundo a condição na força de trabalho. Realizou-se estudo transversal com dados de 63.782 adultos (18 a 59 anos), participantes da Pesquisa Nacional de Saúde (PNS) 2019. A condição na força de trabalho - ocupado, desocupado ou fora da força - foi relacionada com marcadores de consumo alimentar saudável e não saudável. Estimaram-se razões de chance (odds ratio) ajustadas com regressão logística multinomial. Os resultados apontam que, entre os adultos brasileiros, 71,3% estavam ocupados, 6,7% desocupados e 21,9% encontravam-se fora da força de trabalho. Os ocupados apresentaram maior frequência de consumo de frutas, hortaliças e carne vermelha, e menor de feijão. O consumo de frango, bebidas de frutas, cereais, ovos, margarina e pratos prontos/semiprontos foi mais frequente para os desocupados versus ocupados, enquanto o de peixes e tubérculos foi menos frequente. Os adultos fora da força de trabalho, comparados aos ocupados, mostraram menor frequência de consumo de refrigerantes, embutidos, pães de pacote, oleaginosas, assim como do costume de substituir o almoço por lanches. Observaram-se discrepâncias na alimentação segundo a condição de trabalho, sobretudo no consumo de hortaliças, frutas, carnes e feijão, denotando a necessidade de iniciativas de promoção da alimentação adequada e saudável voltadas para a saúde do trabalhador.

Abstract Objective: To evaluate eating habits of the adult population in Brazil according to workforce status. Methods: Cross-sectional study with data from 63,782 adults (18-59 years old) participating in the National Health Interview Survey, PNS 2019. Workforce status - employed, unemployed or not part of the workforce - was related to markers of healthy and unhealthy food intake. Adjusted odds ratios were estimated with multinomial logistic regression. Results: Of Brazilian adults, 71.3% were employed, 6.7% were unemployed and 21.9% were outside the workforce. Employed adults showed a higher frequency of fruit, vegetable and red meat intake, and a lower frequency of beans consumption. The consumption of chicken, fruit drinks, cereals, eggs, margarine and ready-made/semi-ready meals was more frequent among the unemployed versus the employed, while fish and root vegetables were less frequently consumed. Adults outside the workforce, compared to the employed, showed a lower frequency of consumption of soft drinks, sausages, packaged bread, oilseeds, as well as the habit of replacing lunch for snacks. Conclusion: Discrepancies in diet were observed according to working condition, especially in the consumption of vegetables, fruits, meat, and beans, denoting the need for initiatives to promote adequate and healthy eating habits to improve workers' health.

Resumen Objetivo: Evaluar hábitos alimentarios de la población adulta según su situación laboral. Métodos: Estudio transversal con datos de 63.782 adultos brasileros (18-59 años), participantes de la Encuesta Nacional de Salud, PNS-2019. La situación en la población activa, ocupada, desocupada o fuera de ella, estaba relacionada con marcadores de ingesta de alimentos saludables y no saludables. Las odds ratio ajustadas (odds ratio) se estimaron con regresión logística multinomial. Resultados: De los adultos, 71,3% estaban ocupados, 6,7% desocupados y 21,9% fuera de la población activa. Los empleados mostraron mayor frecuencia de consumo de frutas, verduras y carne roja, y una menor de frijoles. El consumo de pollo, bebidas de frutas, cereales, huevos, margarina y platos preparados/semipreparados era más frecuente entre los desocupados frente a los ocupados, mientras que el pescado y los tubérculos eran menos frecuentes. Los adultos fuera de la fuerza de trabajo, en comparación con los empleados, mostraron menor frecuencia de consumo de refrescos, embutidos, pan envasado, semillas oleaginosas, así como el hábito de sustituir el almuerzo por bocadillos. Conclusión: Se observaron discrepancias en la alimentación según la condición de trabajo, especialmente en el consumo de hortalizas, frutas, carnes, frijol, denotando la necesidad de iniciativas de promoción de alimentación saludable dirigida a la salud de los trabajadores.

Risk and protective factors for suicide: a populational case-control study, Brazil, 2019

ABSTRACT OBJETIVE To estimate risk and protection factors associated with suicide in Campinas, Brazil, in 2019. METHODS This is a populational case-control study analyzing 83 cases of suicide that occurred in 2019 in Campinas, a Brazilian city with about 1.2 million inhabitants. Controls were composed of 716 inhabitants. An adjusted multiple logistic regression was used. Cases and controls were the dichotomous response variables. Sociodemographic and behavioral variables were the predictor variables. RESULTS The categories which presented higher risk of suicide were: males [OR = 5.26 (p < 0.001)]; people aged 10-29 years [OR = 5.88 (p = 0.002)]; individuals without paid work [OR = 3.06 (p = 0.013)]; individuals presenting problematic use of alcohol [OR = 33.12 (p < 0.001)] and cocaine [14.59 (p < 0.007)]; and people with disabilities [OR = 3.72 (p < 0.001)]. Moreover, the perception of fear was associated with reduced suicide risk [OR = 0.19 (p = 0.015)]. Higher district HDI levels also showed a 4% decrease in risk for each 0.01 increase in district HDI levels [OR = 0.02 (p = 0.008)]. CONCLUSIONS This study evidenced the association between sociodemographic and behavioral variables and suicide. It also emphasized the complexity in the dynamics between personal, social, and economic factors to this external cause of death.

Eating Behavior of Older Adults with and Without Diabetes: The Vigitel Survey, Brazil, 2016. / Hábito Alimentar de Idosos Diabéticos e não Diabéticos: Vigitel, Brasil, 2016.

BACKGROUND: A healthy diet is a protection factor against type 2 diabetes and plays an important role in the treatment of the disease, as well as associated comorbidities. OBJECTIVE: Characterize the eating habits of older adults (≥ 65 years) with and without diabetes residing in capital cities and the Federal District of Brazil. METHODS: A cross-sectional study was conducted using data from the Surveillance of Risk and Protection Factors for Chronic Diseases Through a Telephone Survey (Vigitel, 2016). The prevalence of diabetes mellitus was estimated according to sociodemographic variables, physical inactivity level, self-rated health status and body mass index. Dietary habits were assessed based on the frequency (weekly and daily) of consumption of healthy and unhealthy foods and the replacement of food by snacks. Differences were determined using Pearson's chi-square test (Rao-Scott), with the significance level set at 5%. RESULTS: A total of 13,649 older adults were interviewed. The prevalence of self-reported diabetes was 27.2% (95% CI: 25.5; 29.0). Compared to non-diabetics, diabetic individuals had a higher consumption of raw vegetables (32.1% vs. 26.5%/3-4 days/week) and lower consumption of chicken (3.8% vs. 6.4%/hardly ever/never), fruit juice (24.0% vs. 29.6%) and sweets (6.8% vs. 16.2%) ≥ 5 days/week. Compared to non-diabetics, diabetic individuals consumed more skim milk (51.5% vs. 44.6%) and diet soda (60.0% vs. 17.3%) ≥ 5 days/week, raw vegetables (9.1% vs. 2.5%/at dinner) and sweets (37.7% vs. 20.5%/twice/day) 3-4 days/week. CONCLUSION: The observed differences emphasize the need for healthy eating interventions for all older adults, as well as specific counseling for those with diabetes.

FUNDAMENTOS: A alimentação saudável é um fator de proteção contra o diabetes tipo 2 e desempenha importante papel no tratamento do diabetes e das comorbidades associadas. OBJETIVO: Caracterizar o hábito alimentar de idosos diabéticos e não diabéticos com 65 anos ou mais, residentes nas capitais brasileiras e no Distrito Federal. MÉTODOS: Estudo transversal com dados da pesquisa Vigilância de Fatores de Risco e Proteção para as Doenças Crônicas por Inquérito Telefônico (Vigitel, 2016). Foram estimadas as prevalências de diabetes melito segundo variáveis sociodemográficas, inatividade física, autoavaliação da saúde e índice de massa corporal (IMC). O hábito alimentar foi avaliado pela frequência (semanal e diária) de consumo de alimentos saudáveis e não saudáveis, e pela substituição da comida por lanches. As diferenças foram verificadas por meio do teste Qui-quadrado de Pearson (Rao-Scott) com nível de significância de 5%. RESULTADOS: Foram entrevistados 13.649 idosos, e a prevalência de diabetes autorreferido foi de 27,2% (IC95%:25,5; 29,0). Nos pacientes diabéticos, observou-se maior consumo de hortaliças cruas (32,1% vs. 26,5%/3-4 dias/semana) e menor de frango (3,8% vs. 6,4%/quase nunca/nunca), suco (24,0% vs. 29,6%) e doces (6,8% vs. 16,2%) ≥5 dias/semana. Os percentuais de idosos com consumo de leite desnatado (51,5% vs. 44,6%) e refrigerante dietético (60,0% vs. 17,3%) ≥5 dias/semana, hortaliças cruas (9,1% vs. 2,5%/no jantar) e doces (37,7% vs. 20,5%/2 vezes/dia) 3-4 dias/semana foram maiores nos diabéticos, comparados aos não diabéticos. CONCLUSÃO: As diferenças observadas sinalizam a necessidade de promover intervenções para alimentação saudável entre todos os idosos, bem como orientações específicas para os diabéticos.

Hábito Alimentar de Idosos Diabéticos e não Diabéticos: Vigitel, Brasil, 2016 / Eating Behavior of Older Adults with and Without Diabetes: The Vigitel Survey, Brazil, 2016

Resumo Fundamentos A alimentação saudável é um fator de proteção contra o diabetes tipo 2 e desempenha importante papel no tratamento do diabetes e das comorbidades associadas. Objetivo Caracterizar o hábito alimentar de idosos diabéticos e não diabéticos com 65 anos ou mais, residentes nas capitais brasileiras e no Distrito Federal. Métodos Estudo transversal com dados da pesquisa Vigilância de Fatores de Risco e Proteção para as Doenças Crônicas por Inquérito Telefônico (Vigitel, 2016). Foram estimadas as prevalências de diabetes melito segundo variáveis sociodemográficas, inatividade física, autoavaliação da saúde e índice de massa corporal (IMC). O hábito alimentar foi avaliado pela frequência (semanal e diária) de consumo de alimentos saudáveis e não saudáveis, e pela substituição da comida por lanches. As diferenças foram verificadas por meio do teste Qui-quadrado de Pearson (Rao-Scott) com nível de significância de 5%. Resultados Foram entrevistados 13.649 idosos, e a prevalência de diabetes autorreferido foi de 27,2% (IC95%:25,5; 29,0). Nos pacientes diabéticos, observou-se maior consumo de hortaliças cruas (32,1% vs. 26,5%/3-4 dias/semana) e menor de frango (3,8% vs. 6,4%/quase nunca/nunca), suco (24,0% vs. 29,6%) e doces (6,8% vs. 16,2%) ≥5 dias/semana. Os percentuais de idosos com consumo de leite desnatado (51,5% vs. 44,6%) e refrigerante dietético (60,0% vs. 17,3%) ≥5 dias/semana, hortaliças cruas (9,1% vs. 2,5%/no jantar) e doces (37,7% vs. 20,5%/2 vezes/dia) 3-4 dias/semana foram maiores nos diabéticos, comparados aos não diabéticos. Conclusão As diferenças observadas sinalizam a necessidade de promover intervenções para alimentação saudável entre todos os idosos, bem como orientações específicas para os diabéticos.

Abstract Background A healthy diet is a protection factor against type 2 diabetes and plays an important role in the treatment of the disease, as well as associated comorbidities. Objective Characterize the eating habits of older adults (≥ 65 years) with and without diabetes residing in capital cities and the Federal District of Brazil. Methods A cross-sectional study was conducted using data from the Surveillance of Risk and Protection Factors for Chronic Diseases Through a Telephone Survey (Vigitel, 2016). The prevalence of diabetes mellitus was estimated according to sociodemographic variables, physical inactivity level, self-rated health status and body mass index. Dietary habits were assessed based on the frequency (weekly and daily) of consumption of healthy and unhealthy foods and the replacement of food by snacks. Differences were determined using Pearson's chi-square test (Rao-Scott), with the significance level set at 5%. Results A total of 13,649 older adults were interviewed. The prevalence of self-reported diabetes was 27.2% (95% CI: 25.5; 29.0). Compared to non-diabetics, diabetic individuals had a higher consumption of raw vegetables (32.1% vs. 26.5%/3-4 days/week) and lower consumption of chicken (3.8% vs. 6.4%/hardly ever/never), fruit juice (24.0% vs. 29.6%) and sweets (6.8% vs. 16.2%) ≥ 5 days/week. Compared to non-diabetics, diabetic individuals consumed more skim milk (51.5% vs. 44.6%) and diet soda (60.0% vs. 17.3%) ≥ 5 days/week, raw vegetables (9.1% vs. 2.5%/at dinner) and sweets (37.7% vs. 20.5%/twice/day) 3-4 days/week. Conclusion The observed differences emphasize the need for healthy eating interventions for all older adults, as well as specific counseling for those with diabetes.

Consumption of healthy food and ultra-processed products: comparison between pregnant and non-pregnant women, Vigitel 2018 / Consumo de alimentos saudáveis e produtos ultraprocessados: comparação entre gestantes e não gestantes, Vigitel 2018

Abstract Objectives: to characterize pregnant women's eating habits and compare them to women of reproductive age, and to analyze the association between pregnancy and eating habits. Methods: a cross-sectional study with 13,108 women aged 18 to 50 years (179 pregnant women), included in the Vigitel 2018 telephone survey. Eating habits were assessed by the frequency of food consumption considered as food quality markers and by food eaten in previous day. NOVA classification was used to categorize food into: natural/minimally processed, and ultra-processed food products. The differences were verified by Pearson's Chi-square test and Poisson multiple regression. Results: in pregnant women, we observed lower percentages of natural juice intake (27.5%) and fruit (10.1%) 0-2 times/week, and higher percentages of juice (36.4%) 3-4 times and fruit (74.2%) ≥ 5 times/week compared to non-pregnant women. No differences were detected in the daily frequencies of food intake among the women. The day before the interview, almost 95% of the pregnant women consumed ultra-processed products. Pregnant women reported a lower frequency of soft drink consumption (12.3%) and sauces (7.4%) than non-pregnant women. Conclusion: pregnant women and non-pregnant women had high consumption of ultraprocessed products, highlighting the necessity of interventions, aiming to promote healthy eating.

Resumo Objetivos: caracterizar o hábito alimentar de gestantes e compará-lo ao de mulheres em idade fértil, e analisar a associação entre gestação e hábito alimentar. Métodos: estudo transversal com 13.108 mulheres de 18 a 50 anos (179 gestantes), incluídas no inquérito telefônico Vigitel 2018. O hábito alimentar foi avaliado pela frequência de consumo de alimentos considerados marcadores de qualidade alimentar e por alimentos ingeridos no dia anterior. Utilizou-se a classificação NOVA para categorizar os alimentos em: in natura/minimamente processados e ultraprocessados. As diferenças foram verificadas pelo teste Qui-quadrado de Pearson e regressão múltipla de Poisson. Resultados: nas gestantes, observaram-se menores percentuais de ingestão de suco natural (27,5%) e frutas (10,1%) de 0-2 vezes/semana, e maiores percentuais de suco (36,4%) de 3-4 vezes e frutas (74,2%) ≥5 vezes/semana, comparadas às mulheres não gestantes. Não foram detectadas diferenças nas frequências diárias de ingestão de alimentos entre as mulheres. No dia anterior à entrevista, quase 95% das gestantes consumiram produtos ultraprocessados. As gestantes referiram menor frequência de consumo de refrigerante (12,3%) e molhos (7,4%) do que as não gestantes. Conclusão: as gestantes e as não gestantes apresentaram elevado consumo de produtos ultraprocessados, destacando a necessidade de intervenções voltadas à promoção da alimentação saudável.

Can Meals Outside Homes Impact Sodium Intake?

BACKGROUND: The WHO currently recommends a daily sodium intake of 2 g and has established the goal of a 30% reduction in mean salt intake by 2025. OBJECTIVE: We sought to estimate sodium intake in study participants according to the locations of where they consumed meals and their demographic and socioeconomic characteristics and practices related to salt consumption. METHODS: A population-based, cross-sectional study was conducted with a sample of 2574 individuals aged ≥10 y who answered the 2015 Campinas-Brazil Nutrition Survey. Mean sodium intake was estimated using a 24-h recall log and associations with the independent variables were tested using generalized regression analysis stratified by age group. RESULTS: Sodium intake was higher in male participants as well as adolescents and adults who reported eating ≥1 meal outside the home (6.07% and 7.06% increase, respectively). Per meal, sodium was consumed more outside the home at breakfast, during an afternoon snack, and at dinner among adolescents. No significant differences were found in the analysis by type of meal among the adults and seniors. CONCLUSIONS: Sodium intake exceeded the WHO recommendation in all age groups analyzed. Having ≥1 meal outside the home was associated with greater sodium intake among adolescents and adults. Measures to regulate the food industry and dietary/nutritional education strategies targeting consumers are important to reducing the sodium intake of the population.