Disability and costs of IHD attributable to the consumption of trans-fatty acids in Brazil.

OBJECTIVE: To estimate the disability and costs of the Brazilian Unified Health System for IHD attributable to trans-fatty acid (TFA) consumption in 2019. DESIGN: This ecological study used secondary data from the Global Burden of Disease (GBD) Study 2019 to estimate the years lived with disability from IHD attributable to TFA in Brazil in 2019. Data on direct costs (purchasing power parity: 1 Int$ = R$ 2·280) were obtained from the Hospital and Ambulatory Information Systems of the Brazilian Unified Health System. Moreover, the total costs in each state were divided by the resident population in 2019 and multiplied by 10 000 inhabitants. The relationship between the socio-demographic index, disease and economic burden was investigated. SETTING: Brazil and its twenty-seven states. PARTICIPANTS: Adults aged ≥ 25 years of both sexes. RESULTS: IHD attributable to TFA consumption resulted in 11 165 years lived with disability (95 % uncertainty interval 932­18 462) in 2019 in Brazil. A total of Int$ 54 546 227 (95 % uncertainty interval 4 505 792­85 561 810) was spent in the Brazilian Unified Health System in 2019 due to IHD attributable to TFA, with the highest costs of hospitalisations, for males and individuals aged ≥ 50 years or over. The highest costs were observed in Sergipe (Int$ 6508/10 000; 95 % uncertainty interval 576­10 265), followed by the two states from the South. Overall, as the socio-demographic index increases, expenditures increase. CONCLUSIONS: TFA consumption results in a high disease and economic IHD burden in Brazil, reinforcing the need for more effective health policies, such as industrial TFA elimination, following the international agenda.

Characteristics of the obesogenic environment around schools are associated with body fat and low-grade inflammation in Brazilian children.

OBJECTIVE: To assess the association of obesogenic environmental characteristics around schools with body adiposity and adipokine concentrations in Brazilian children. DESIGN: Cross-sectional study. Body adiposity was assessed using the dual-energy X-ray absorptiometry. Concentrations of leptin, adiponectin, retinol-binding protein 4 (RBP4) and chemerin were measured. Predominantly ultra-processed food (UPF) stores, public physical activity (PA) facilities, green spaces, walkability, traffic accidents and crime were evaluated. The neighbourhood unit was the 400 m (0·25 miles) road network buffer around schools. The association of environmental characteristics with body adiposity and adipokine concentrations was assessed by linear regression models using generalised estimating equations. SETTING: Urban schools (n 24), Viçosa, Minas Gerais, Brazil. PARTICIPANTS: Children aged 8 and 9 years (n 378). RESULTS: A higher density of predominantly UPF stores and a lower percentage of green space were associated with higher total (ß: 0·12; 95 % CI 0·06, 0·18 and ß: -0·10; 95 % CI -0·16, -0·04, respectively) and android body fat (ß: 0·28; 95 % CI 0·13, 0·43 and ß: -0·18; 95 % CI -0·32, -0·04, respectively). In addition, the densities of PA facilities and crime were inversely associated with leptin concentrations. Traffic accidents density and percentage of green spaces around schools had, respectively, a positive and an inverse association with concentrations of adiponectin and RBP4. CONCLUSIONS: Obesogenic environmental characteristics around schools were associated with total and android body fat, as well as with pro-inflammatory adipokine concentrations in Brazilian children from a medium-sized city.

Obesogenic neighborhood environment is associated with body fat and low-grade inflammation in Brazilian children: could the mother's BMI be a mediating factor?

OBJECTIVE: To evaluate the direct and indirect associations of obesogenic and leptogenic neighborhood environments with body fat, and pro- and anti-inflammatory adipokines in Brazilian children. DESIGN: Cross-sectional study. The body fat distribution was assessed using dual-energy X-ray absorptiometry (DXA). Concentrations of leptin and adiponectin were measured. Four hundred meters (0·25 miles) road network buffer was the neighborhood unit used to assess the environmental characteristics around households. Obesogenic and leptogenic environments were the latent variables obtained from the observed characteristics. The mother's BMI, ultra-processed food consumption, and physical activity before and after school, were tested as mediating variables. A hybrid model of structural equations was used to test the direct and indirect associations of obesogenic and leptogenic environments with body fat, leptin and adiponectin concentrations. SETTING: Urban area of Viçosa, Minas Gerais, Brazil. PARTICIPANTS: Children aged 8- and 9-years (n 367). RESULTS: Obesogenic environment was directly associated with the mother's BMI (ß: 0·24, P = 0·02) and the child's body fat (ß: 0·19, P = 0·02). The mother's BMI and body fat mediated the association of the obesogenic environment with leptin concentrations (ß: 0·05, P = 0·02). CONCLUSIONS: Obesogenic neighborhood environment was directly associated with body fat and mother's BMI, and indirectly associated with leptin concentrations in Brazilian children, mediated by the mother's BMI and body fat.