Consumption of in natura and ultra-processed foods in adults: an analysis of social, metabolic, and lifestyle determinants.

OBJECTIVE: To assess the social, metabolic, and lifestyle determinants of consumption of fruits, vegetables, and greens (FVG) and ultra-processed food (ULT) in adults from Pernambuco. METHODS: Cross-sectional and analytical study, conducted in 2015/2016. In addition to sociodemographic variables, the determinants of lifestyle were level of physical activity, alcohol consumption, tobacco use, and metabolic variables were self-reported hypertension, blood glucose, and Body Mass Index (BMI). Consumption was measured by the Food Frequency Questionnaire, then created the Frequency of Consumption Index (SFI) of the mean intake of ULT and FVG foods. The indices of FVG and ULT consumption were transformed into quartiles and these variables were included in the multinomial logistic regression, considering their determinants when p<0.05. RESULTS: The sample was representative of the state, with 1,067 people being interviewed, whose intake of ULT was higher than that of FVG in the lowest and highest quartile of the consumption index. Consumption of fruit and vegetables was higher in higher consumption of alcoholic beverages (p=0.031) and BMI>25 kg/m2 (p=0.047); and lower in the lowest income (p=0.001). ULT intake was higher in young adults (p=0.005), lower income (p=0.044), and controlled blood glucose (p=0.021). Rural areas were 52% less exposed to medium-high ULT consumption (p<0.006). CONCLUSION: Higher rate of ULT consumption in relation to fresh foods, with income as a common determinant, inversely associated with ULT intake and directly related to FVG, which demands structuring policies.

Consumption of in natura and ultra-processed foods in adults: an analysis of social, metabolic, and lifestyle determinants / Consumo de alimentos in natura e ultraprocessados em adultos: uma análise dos determinantes sociais, metabólicos e de estilo de vida

ABSTRACT Objective: To assess the social, metabolic, and lifestyle determinants of consumption of fruits, vegetables, and greens (FVG) and ultra-processed food (ULT) in adults from Pernambuco. Methods: Cross-sectional and analytical study, conducted in 2015/2016. In addition to sociodemographic variables, the determinants of lifestyle were level of physical activity, alcohol consumption, tobacco use, and metabolic variables were self-reported hypertension, blood glucose, and Body Mass Index (BMI). Consumption was measured by the Food Frequency Questionnaire, then created the Frequency of Consumption Index (SFI) of the mean intake of ULT and FVG foods. The indices of FVG and ULT consumption were transformed into quartiles and these variables were included in the multinomial logistic regression, considering their determinants when p<0.05. Results: The sample was representative of the state, with 1,067 people being interviewed, whose intake of ULT was higher than that of FVG in the lowest and highest quartile of the consumption index. Consumption of fruit and vegetables was higher in higher consumption of alcoholic beverages (p=0.031) and BMI>25 kg/m2 (p=0.047); and lower in the lowest income (p=0.001). ULT intake was higher in young adults (p=0.005), lower income (p=0.044), and controlled blood glucose (p=0.021). Rural areas were 52% less exposed to medium-high ULT consumption (p<0.006). Conclusion: Higher rate of ULT consumption in relation to fresh foods, with income as a common determinant, inversely associated with ULT intake and directly related to FVG, which demands structuring policies.

RESUMO Objetivo: Avaliar os determinantes sociais, metabólicos e de estilo de vida do consumo de frutas, legumes e verduras (FLV) e ultraprocessados (ULT) em adultos de Pernambuco. Métodos: Estudo transversal e analítico, realizado em 2015/2016. Além de variáveis sociodemográficas, os determinantes do estilo de vida foram nível de atividade física, doses de bebida alcoólica e uso de tabaco e os metabólicos foram hipertensão autorreferida, glicemia e Índice de Massa Corporal (IMC). O consumo foi mensurado por questionário de frequência alimentar, e, em seguida, criou-se Índice da Frequência de Consumo (IFC) da média de ingestão dos alimentos ULT e FVL. Os índices de consumo de FLV e ULT foram transformados em quartis e essas variáveis incluídas na regressão logística multinomial, considerando seus determinantes quando p<0,05. Resultados: A amostra foi representativa do estado, sendo entrevistadas 1.067 pessoas, cuja ingestão de ULT foi superior à de FVL no menor e no maior quartil do índice de consumo. O consumo de FLV foi superior no maior consumo de bebida alcoólica (p=0,031) e IMC>25 kg/m2 (p=0,047); e inferior na menor renda (p=0,001). O consumo de ULT foi maior em adultos jovens (p=0,005), menor renda (p=0,044) e glicemia controlada (p=0,021). A área rural estava 52% menos exposta ao consumo médio-alto de ULT (p<0,006). Conclusão: Maior índice de consumo de ULT em relação aos alimentos in natura, tendo a renda como um determinante comum, inversamente associada à ingestão de ULT e diretamente relacionada a FVL, o que demanda políticas estruturantes.

Modulation of hypothalamic AMPK and hypothalamic neuropeptides in the control of eating behavior: A systematic review.

Eating behavior is regulated by central and peripheral signals, which interact to modulate the response to nutrient intake. Central control is mediated by the hypothalamus through neuropeptides that activate the orexigenic and anorexigenic pathways. Energy homeostasis depends on the efficiency of these regulatory mechanisms. This neuroendocrine regulation of hunger and appetite can be modulated by nutritional sensors such as adenosine monophosphate-activated protein kinase (AMPK). Thus, this systematic review discusses the literature on correlations between AMPK and hypothalamic neuropeptides regarding control of eating behavior. Lilacs, PubMed/Medline, ScienceDirect, and Web of Science were searched for articles published from 2009 to 2021 containing combinations of the following descriptors: "eating behavior," "hypothalamus," "neuropeptide," and "AMPK." Of the 1330 articles found initially, 27 were selected after application of the inclusion and exclusion criteria. Of the selected articles, 15 reported decreased AMPK activity, due to interventions using angiotensin II infusion, fructose, glucose, cholecystokinin, leptin, or lipopolysaccharide (LPS) injection; dietary control through a low-protein diet or a high-fat diet (60 % fat); induction of hyperthyroidism; or injection of AMPK inhibitors. Seven studies showed a decrease in neuropeptide Y (NPY) through CV4 AICAR administration; fructose, glucose, leptin, or angiotensin II injections; or infusion of LPS from Escherichia coli and liver kinase B1 (LKB1) overexpression. Eleven studies reported a decrease in food consumption due to a decrease in AMPK activity and/or hypothalamic neuropeptides such as NPY. The results indicate that there is a relationship between AMPK and the control of eating behavior: a decrease in AMPK activity due to a dietary or non-dietary stimulus is associated with a consequent decrease in food intake. Furthermore, AMPK activity can be modulated by glucose, thyroid hormones, estradiol, leptin, and ghrelin.