Consumption of ultra-processed foods and eight-year risk of death from all causes and noncommunicable diseases in the ELSA-Brasil cohort.

Increased consumption of ultra-processed foods (UPF) is associated with higher incidences of many noncommunicable diseases (NCDs) and death from all causes. However, the association between UPF and cardiovascular disease (CVD) mortality remains controversial. Our study investigated whether UPF consumption is associated with a higher risk of death from all causes, NCDs, and CVD. This study includes 14,747 participants from the ELSA-Brasil cohort followed up over an eight-year period. The NOVA classification was used to estimate the proportion of UPF (grams/day) in one's diet. Cox regression was also applied. After adjustment for sociodemographic, health, and behavioural factors, a 10% increase in UPF in participants' diets raised the risk of death from all causes and NCDs by 10% (95%CI: 1.01-1.19) and 11% (95%CI:1.02-1.21), respectively. However, UPF consumption was not associated with CVD mortality. The findings support public policies aimed at reducing UPF consumption in an attempt to reduce the NCD burden.

Dairy product consumption reduces cardiovascular mortality: results after 8 year follow-up of ELSA-Brasil.

PURPOSE: To investigate whether the consumption of dairy products and their subgroups is associated with the risk of death from cardiovascular disease (CVD) after 8-year follow-up, and verify if dairy products predict changes in high-sensitivity C-reactive protein (hs-CRP) between two follow-up visits of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHODS: Prospective study with 6671 participants without CVD at baseline. Consumption in grams/day of total dairy, full-fat and low-fat dairy, fermented dairy, and milk was obtained through a food frequency questionnaire and categorized into sex-specific quartiles. Cox regression and linear mixed-effect models were used to estimate associations of dairy products intake with death from CVD and changes in hs-CRP levels, respectively. RESULTS: After adjustments, individuals in the 3rd and 4th quartiles of total dairy consumption presented, respectively, 62% (HR 0.38; 95% CI 0.15-0.99) and 64% (HR 0.36; 95% CI 0.14-0.94) lower hazards of death from CVD compared to the 1st quartile. Also, participants in the 4th quartile of milk consumption had 66% (HR 0.34; 95% CI 0.14-0.86) lower hazard to die from CVD, but only the 2nd quartile of full-fat dairy consumption indicated a lower hazard to die from CVD (HR 0.30; 95% CI 0.10-0.92). No association was observed between low-fat or fermented dairy products and cardiovascular mortality. Consumption of total dairy and their subgroups did not predict changes in hs-CRP levels after 4-year follow-up. CONCLUSION: Results suggest beneficial effects of total dairy and milk, but only low-to-moderate full-fat dairy consumption, on the risk of death from CVD. Assuming true effects, public policies should encourage the consumption of dairy products, especially milk.

Consumption of ultra-processed food and obesity: cross sectional results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort (2008-2010).

OBJECTIVE: To verify if the intake of ultra-processed foods is associated with higher BMI and waist circumference (WC) among participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort. DESIGN: Cross-sectional analysis of the ELSA-Brasil baseline (2008-2010). Dietary information obtained through an FFQ was classified according to characteristics of food processing (NOVA) and used to estimate the percentage energy contribution from ultra-processed foods (i.e. industrial formulations, elaborated from food processing, synthetic constituents and food additives) to individuals' total energy intake. BMI and WC and their respective cut-off points served as response variables. Associations were estimated through linear and multinomial logistic regression models, after adjusting for confounders and total energy intake. SETTING: Six Brazilian capital cities, 2008-2010. SUBJECTS: Active and retired civil servants, aged 35-64 years, from universities and research organizations (n 8977). RESULTS: Ultra-processed foods accounted for 22·7 % of total energy intake. After adjustments, individuals in the fourth quartile of percentage energy contribution from ultra-processed foods presented (ß; 95 % CI) a higher BMI (0·80; CI 0·53, 1·07 kg/m2) and WC (1·71; 1·02, 2·40 cm), and higher chances (OR; 95 % CI) of being overweight (1·31; 1·13, 1·51), obese (1·41; 1·18, 1·69) and having significantly increased WC (1·41; 1·20, 1·66), compared with those in the first quartile. All associations suggest a dose-response gradient. CONCLUSIONS: Results indicate the existence of associations between greater energy contribution from ultra-processed foods and higher BMI and WC, which are independent of total energy intake. These findings corroborate public policies designed to reduce the intake of this type of food.

Sociocultural factors related to the physical activity in boys and girls: PeNSE 2012.

OBJECTIVE: To verify in male and female Brazilian adolescents the association of demographic, psychosocial, behavioral and sociocultural characteristics with the regular practice of physical activity. METHODS: The sample consisted of 109,104 adolescents from all Brazilian states attending the 9th year of elementary education in 2012. The response variable was the regular practice of physical activity (300+ minutes/week). The explanatory variables were grouped into four fields: demographic, psychosocial, behavioral and sociocultural. The Poisson regression was stratified by sex to evaluate the association. RESULTS: The prevalence of active adolescents was 20.2%, higher in boys (27.9%) than in girls (13.1%). It was observed a greater practice of physical activity in boys of lower age group, children of mothers with higher schooling, who consumed healthy foods such as beans, fruits, vegetables, and milk, as well as among those with family supervision. At the same time, unhealthy habits such as insomnia and alcohol consumption were also positively associated with physical activity. In girls, greater physical activity was observed among those who lived with mothers and whose mothers had higher schooling. In addition to family supervision, the practice of physical activity in girls was also positively associated with the frequency of meals with their parents. However, as in boys, insomnia and alcohol consumption were associated with an increase in the practice of physical activity. CONCLUSIONS: One-fifth of adolescents practice physical activity regularly, demonstrating the need for specific public policies to increase the percentage of active young people in the country. Maternal schooling, healthy eating habits and family supervision were associated with regular physical activity in boys and girls, evidencing the importance of the family for the acquisition of healthy habits in this age group.

Sociocultural factors related to the physical activity in boys and girls: PeNSE 2012 / Fatores socioculturais associados à atividade física de meninos e meninas: PeNSE 2012

ABSTRACT OBJECTIVE: To verify in male and female Brazilian adolescents the association of demographic, psychosocial, behavioral and sociocultural characteristics with the regular practice of physical activity. METHODS: The sample consisted of 109,104 adolescents from all Brazilian states attending the 9th year of elementary education in 2012. The response variable was the regular practice of physical activity (300+ minutes/week). The explanatory variables were grouped into four fields: demographic, psychosocial, behavioral and sociocultural. The Poisson regression was stratified by sex to evaluate the association. RESULTS: The prevalence of active adolescents was 20.2%, higher in boys (27.9%) than in girls (13.1%). It was observed a greater practice of physical activity in boys of lower age group, children of mothers with higher schooling, who consumed healthy foods such as beans, fruits, vegetables, and milk, as well as among those with family supervision. At the same time, unhealthy habits such as insomnia and alcohol consumption were also positively associated with physical activity. In girls, greater physical activity was observed among those who lived with mothers and whose mothers had higher schooling. In addition to family supervision, the practice of physical activity in girls was also positively associated with the frequency of meals with their parents. However, as in boys, insomnia and alcohol consumption were associated with an increase in the practice of physical activity. CONCLUSIONS: One-fifth of adolescents practice physical activity regularly, demonstrating the need for specific public policies to increase the percentage of active young people in the country. Maternal schooling, healthy eating habits and family supervision were associated with regular physical activity in boys and girls, evidencing the importance of the family for the acquisition of healthy habits in this age group.

RESUMO OBJETIVO: Verificar em adolescentes brasileiros dos sexos masculino e feminino a associação de características demográficas, psicossociais, comportamentais e socioculturais com a prática regular de atividade física. MÉTODOS: A amostra foi constituída por 109.104 adolescentes de todos estados do Brasil cursando o 9° ano do ensino fundamental em 2012. A variável resposta foi a prática regular de atividade física (300+ minutos/semana). As variáveis explicativas foram agrupadas em quatro domínios: demográfico, psicossocial, comportamental e sociocultural. Para avaliar a associação, foi realizada a regressão de Poisson, estratificada por sexo. RESULTADOS: A prevalência de adolescentes ativos foi de 20,2%, maior em meninos (27,9%) do que em meninas (13,1%). Constatou-se maior prática de atividade física em meninos de menor faixa etária, filhos de mães com maior escolaridade, que consumiam alimentos saudáveis como feijão, frutas, verduras, legumes e leite, assim como entre aqueles com supervisão familiar. Ao mesmo tempo, hábitos não saudáveis como insônia e consumo de álcool também se associaram positivamente à prática de atividade física. Em meninas, foi observada maior prática de atividade física entre aquelas que viviam com as mães e cujas mães tinham maior escolaridade. Além da supervisão familiar, a prática da atividade física nas meninas também esteve associada positivamente com a frequência de realização das refeições com os pais. Entretanto, assim como nos meninos, a insônia e consumo de álcool se associaram ao aumento da prática da atividade física. CONCLUSÕES: Um quinto dos adolescentes praticam atividade física regularmente, demonstrando a necessidade de políticas públicas específicas para aumentar o percentual de jovens ativos do país. A escolaridade materna, hábitos alimentares saudáveis e supervisão familiar foram associados à prática regular de atividade física em meninos e meninas, evidenciando a importância da família para a aquisição de hábitos saudáveis nessa faixa etária.