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Abstract Longitudinal study, whose objective was to present a better strategy and statistical methods, and demonstrate its use with the data across the 2013-2015 period in schoolchildren aged 7 to 11 years, covered with the same food questionnaire (WebCAAFE) survey in Florianopolis, southern Brazil. Six meals/snacks and 32 foods/beverages yielded 192 possible combinations denominated meal/snack-Specific Food/beverage item (MSFIs). LASSO algorithm (LASSO-logistic regression) was used to determine the MSFIs predictive of overweight/obesity, and then binary (logistic) regression was used to further analyze a subset of these variables. Late breakfast, lunch and dinner were all associated with increased overweight/obesity risk, as was an anticipated lunch. Time-of-day or meal-tagged food/beverage intake result in large number of variables whose predictive patterns regarding weight status can be analyzed by machine learning such as LASSO, which in turn may identify the patterns not amenable to other popular statistical methods such as binary logistic regression.
Resumo Estudo longitudinal cujo objetivo foi apresentar melhores estratégia e métodos estatísticos e demonstrar sua utilização com os dados do período 2013-2015 em escolares de 7 a 11 anos, contemplados com o mesmo questionário alimentar (WebCAAFE) em Florianópolis, Sul do Brasil. Seis refeições/lanches e 32 alimentos/bebidas resultaram em 192 combinações possíveis denominadas item refeição/lanche-alimentos/bebidas específicos (MSFIs). O algoritmo LASSO (LASSO-regressão logística) foi usado para determinar os MSFIs preditivos de sobrepeso/obesidade e, em seguida, a regressão binária (logística) foi usada para analisar um subconjunto dessas variáveis. Café da manhã, almoço e jantar tardios foram todos associados ao aumento do risco de sobrepeso/obesidade, assim como um almoço antecipado. O consumo de alimentos/bebidas marcados na hora do dia ou na refeição resulta em um grande número de variáveis cujos padrões preditivos em relação ao status do peso podem ser analisados por LASSO. Essa análise pode identificar os padrões não passíveis de outros métodos estatísticos populares, como a regressão logística binária.
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Objective@#To evaluate diet quality and related problems among children and adolescents in Yunnan Province, in order to provide a theoretical basis for the formulation of targeted dietary interventions for children and adolescents in this region.@*Methods@#Using a stratified random sampling method, 1 078 primary and secondary school students from six prefecture level cities in Yunnan Province were selected from August to November 2022. Dietary quality was evaluated by applying the China Children s Dietary Index (CCDI-2016) on the basis of a 3 d 24 h dietary survey.@*Results@#The total dietary index score of children and adolescents in Yunnan Province was 62.63(54.57,71.19). The overall recommended intakes were largely achieved by consumption of cereals, eggs and sugary drinks, with dietary index scores of 9.91(8.24,10.00), 5.58(0,8.58) and 9.20(7.38,10.00), respectively; there were inadequate intakes of vegetables, legumes, water, vitamin A and dietary fiber, with scores of 5.63(4.09,7.59), 3.48 (0,9.70), 4.23(2.67,5.50), 2.33(1.56,3.53), 3.19(1.63,5.67), respectively; intake of fruits, dairy and aquatic products were severely deficient, with scores of 0(0,1.74), 0(0,2.37), 0(0,9.85), respectively; excessive intake of meat was found, with a dietary index score of 0(0,2.46). The stratified analysis showed that children and adolescents aged 11-13 years had the highest total dietary scores[65.35(54.29,72.03)], followed by those aged 7-10 years[63.46(56.19,72.63)], while the 14-17 year old age group had the lowest scores[59.07(51.15,68.30), H=32.23, P <0.01]. Girls had higher total dietary scores than that of boys[64.20(56.12,72.56), 59.32(52.60,69.72), Z=-5.16, P <0.01], while urban children and adolescents had higher total dietary scores than rural children and adolescents[65.30(54.84,73.62), 62.17(54.31,70.70), Z=-2.11, P <0.05]. Furthermore, higher total dietary index scores were observed among children and adolescents whose parents had a higher educational level( H=27.68, 22.58, P <0.01). The comparison of ethnic groups revealed that the Wa children and adolescents had the highest total dietary index scores, while the Hani children had the lowest( H=27.51, P <0.01).@*Conclusion@#The overall dietary quality of children and adolescents in Yunnan Province is not high, the imbalance of dietary nutrition is prominent, and the dietary structure needs to be adjusted and optimized. Intervention programs should focus on the problem of insufficient intake of fruits and vegetables, milk and legumes, aquatic products and excessive intake of poultry meat among children and adolescents.
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Objective:To analyze the relationship between dietary composition of residents in endemic fluorosis areas and skeletal fluorosis.Methods:A case-control study was used to analyze the difference of dietary composition between patients with skeletal fluorosis (case group) and residents without skeletal fluorosis (control group). In August 2019, taking the drinking water-borne endemic fluorosis area in Wenshui County, Lvliang City, Shanxi Province as the survey site, a cluster sampling method was adopted to select local residents aged over 18 years old, and a questionnaire survey was conducted by face-to-face interview. The survey contents included gender, age and consumption frequency of various foods. Binary logistic regression was used to analyze the relationship between food consumption frequency and skeletal fluorosis. The diagnosis of skeletal fluorosis was made by using portable digital radiography (DR) to take X-ray films of forearm and lower leg, combining with clinical signs, and according to the Diagnostic Standard for Endemic Skeletal Fluorosis (WS/T 192-2008) to determine.Results:A total of 1 061 subjects were included in this study, including 376 in the case group and 685 in the control group. The age composition of patients in the case group (≤60, > 60 years old: 162, 214 cases) was significantly different from that in the control group (≤60, > 60 years old: 423, 261 cases, χ 2 = 34.52, P < 0.001). There was no statistically significant difference in gender ratio (χ 2 = 1.37, P = 0.251). The proportion of patients in the case group who ate meat and eggs > 1 time/week was lower than that in the control group (χ 2 = 8.06, 5.46, P < 0.05), the proportion of patients who ate milk > 1 time/week was higher than that in the control group (χ 2 = 4.01, P = 0.046), and the proportion of patients who ate seafood ≥1 time/week was lower than that in the control group (χ 2 = 4.16, P = 0.046). The results of binary logistic regression analysis showed that after adjusting for age, sex, and urinary fluoride, the frequency of eating meat, eggs or milk > 1 time/week and the frequency of eating seafood ≥1 time/week were not related to the risk of skeletal fluorosis ( P > 0.05); however, in the group ≤60 years old, the frequency of eating eggs > 1 time/week was associated with the risk of skeletal fluorosis [odds ratio ( OR) = 0.59, 95% confidence interval ( CI): 0.39, 0.88]. Conclusions:The consumption frequency of meat, milk, eggs and seafood is significantly different between the skeletal fluorosis patients and the control people. In the population ≤60 years old, consumption frequency of eggs > 1 time/week may reduce the risk of skeletal fluorosis.
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Objective@#To study the consumption of beverages among senior primary school students in rural and pastoral areas of Qinghai Province, China, in order to provide evidence for the development of nutrition and intervention strategies.@*Methods@#A multi stage stratified cluster random sampling method was employed to select 969 primary school students in grades 4 and 5 from 10 schools in Hainan Autonomous Prefecture, Haixi Autonomous Prefecture and Haidong City. All participants completed a questionnaire survey on daily beverage consumption. The Chi square test was performed to compare differences in reported rates of beverage consumption among students in different groups.@*Results@#The proportion of students who consumed beverages at home, school and elsewhere were 96.9%, 64.5% and 84.9%, respectively. The most popular beverages consumed at home were milk and yogurt ( 63.1 %), tea water (53.0%), and tea drinks (52.4%). The most popular beverages consumed at school were tea(29.8%), milk and yogurt (27.8%) and tea drinks (18.4%), while the most popular beverages consumed in other places were tea drinks ( 42.0 %), carbonated drinks (38.1%) and milk and yogurt (35.0%). The top five reasons for choosing a given beverage were taste delicious (81.2%), nutritious (57.6%),healthy and clean(52.6%),many students like to drink(39.6%),family members often drink(37.7%).@*Conclusion@#The consumption of beverages was popular among students, and sugared beverages represented a large proportion of the beverages consumed. Therefore, there is an urgent need to improve the food environment and provide effective nutrition education for students, so as to encourage the consumption of healthy beverages and cultivate healthy eating behaviors.
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Objective@#To study the consumption of beverages among senior primary school students in rural and pastoral areas of Qinghai Province, China, in order to provide evidence for the development of nutrition and intervention strategies.@*Methods@#A multi stage stratified cluster random sampling method was employed to select 969 primary school students in grades 4 and 5 from 10 schools in Hainan Autonomous Prefecture, Haixi Autonomous Prefecture and Haidong City. All participants completed a questionnaire survey on daily beverage consumption. The Chi square test was performed to compare differences in reported rates of beverage consumption among students in different groups.@*Results@#The proportion of students who consumed beverages at home, school and elsewhere were 96.9%, 64.5% and 84.9%, respectively. The most popular beverages consumed at home were milk and yogurt ( 63.1 %), tea water (53.0%), and tea drinks (52.4%). The most popular beverages consumed at school were tea(29.8%), milk and yogurt (27.8%) and tea drinks (18.4%), while the most popular beverages consumed in other places were tea drinks ( 42.0 %), carbonated drinks (38.1%) and milk and yogurt (35.0%). The top five reasons for choosing a given beverage were taste delicious (81.2%), nutritious (57.6%),healthy and clean(52.6%),many students like to drink(39.6%),family members often drink(37.7%).@*Conclusion@#The consumption of beverages was popular among students, and sugared beverages represented a large proportion of the beverages consumed. Therefore, there is an urgent need to improve the food environment and provide effective nutrition education for students, so as to encourage the consumption of healthy beverages and cultivate healthy eating behaviors.
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Abstract: Evidence points to a direct relationship between nutritional quality and food expenditure. However, food expenditure is highly susceptible to changes, and nutritional quality of household food presents limited evidence. The aim of this study was to assess the relationship between nutritional quality available and total food expenditure in Peruvian households, and whether there were differences by area (urban and rural) and between years of the COVID-19 pandemic. For this, we used Peru's National Household Survey (ENAHO) from 2019 and 2020. We assessed total food expenditure in US dollars per day, whereas household nutritional quality available was assessed based on dietary diversity and compliance with the household calorie requirements, percentage of food expenditure, and potential confounders. We used the Student's t-test, analysis of variance (ANOVA), linear regression, and the Wald test to assess the interaction effect. Households with adequate total/partial nutritional quality available by area were found to spend, on average, USD 2.00 more in urban than in rural areas and, by year, they presented 7.1% more percentage of food expenditure in 2020 than in 2019. Despite associations existing between nutritional quality available and total food expenditure by year and study area, the effect modification was only present by study area. In multivariable model, households with adequate total/partial nutritional quality available consistently presented a lower total food expenditure by year, with a lower total food expenditure in urban areas. An inverse relationship was found between nutritional quality available and total food expenditure, in contrast to the direct relationship of studies assessing dietary cost and nutritional quality. Our results reflect the nutritional deficit in the food purchases of Peruvian households.
Resumen: Las evidencian existentes indican una relación directa entre la calidad nutricional y el gasto con alimentos. Sin embargo, los gastos son muy susceptibles a los cambios. Por otro lado, hay pruebas limitadas sobre la calidad nutricional de los alimentos domésticos disponibles. El objetivo de este estudio fue evaluar la relación entre la calidad nutricional disponible y el gasto total en alimentos en los hogares peruanos, y si hubo diferencias por área (urbana y rural) y entre los años de la pandemia del COVID-19. Para ello, se utilizó la Encuesta Nacional de Hogares del Perú (ENAHO) de 2019 y 2020. Se evalúo el gasto total en alimentos en dólares estadounidenses por día, la calidad nutricional disponible por hogar basado en la diversidad dietética y el cumplimiento de los requisitos calóricos por hogar, teniendo en cuenta el porcentaje de gasto alimentario y los posibles factores de confusión. La prueba t de Student, el análisis de varianza (ANOVA), la regresión lineal y la prueba de Wald se utilizaron para evaluar el efecto de interacción. Se encontró que los hogares con la calidad nutricional disponible total/parcial adecuada por área gastan en promedio USD 2,00 más en áreas urbanas que en áreas rurales, y que por año tuvieron el porcentaje de gasto alimentario 7,1% más grande en 2020 que en 2019. Si bien hubo una asociación entre calidad nutricional disponible y gasto total en alimentos por año y área de estudio, la modificación del efecto solo estuvo presente por área de estudio. En el modelo multivariable, los hogares con la calidad nutricional disponible total/parcial adecuada tuvieron consistentemente un gasto total en alimentos más bajo por año, de la misma manera que en áreas urbanas. Se encontró una relación inversa entre calidad nutricional disponible y gasto total en alimentos en contraste con la relación directa de los estudios que evaluaron el costo de la dieta y la calidad nutricional. Los resultados apuntan al déficit nutricional en las compras de alimentos de los hogares peruanos.
Resumo: Evidências revelam uma relação direta entre a qualidade nutricional e os gastos com alimentação. No entanto, essas despesas são altamente suscetíveis a mudanças. Por outro lado, há uma limitação de evidências sobre a qualidade nutricional dos alimentos domésticos disponíveis. O objetivo deste estudo foi avaliar a relação entre a qualidade nutricional disponível e o gasto total com alimentos em domicílios peruanos, e se havia diferenças por área (urbana e rural) e entre os anos da pandemia de COVID-19. Para isso, foi utilizada a Pesquisa Nacional de Domicílios do Peru (ENAHO) de 2019 e 2020. Foram avaliados o gasto total com alimentos em dólares americanos por di e a qualidade nutricional disponível domiciliar com base na diversidade dietética e no cumprimento das necessidades calóricas domiciliares, considerando o percentual de gasto com alimentos e potenciais fatores de confusão. Utilizou-se o teste t de Student, a análise de variância (ANOVA), a regressão linear e o teste de Wald para avaliar o efeito de interação. Os domicílios com a qualidade nutricional disponível total/parcial adequada por área gastaram, em média, USD 2,00 a mais nas áreas urbanas do que nas rurais e tiveram um percentual de gasto com alimentos 7,1% maior em 2020 do que em 2019. Embora tenha sido encontrada uma associação entre a qualidade nutricional disponível e o gasto total com alimentos por ano e área de estudo, a modificação do efeito só estava presente por área de estudo. No modelo multivariável, os domicílios com a qualidade nutricional disponível total/parcial adequada apresentaram consistentemente um gasto total com alimentos menor por ano, assim como em áreas urbanas. Foi encontrada uma relação inversa entre a qualidade nutricional disponível e o gasto total com alimentos, em contraste com a relação direta dos estudos que avaliaram o custo da dieta e a qualidade nutricional. Esses resultados refletem o déficit nutricional nas compras de alimentos das famílias peruanas.
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Abstract Objective: To evaluate the prevalence of ultra-processed food consumption and associated factors among children enrolled in the public school system of the city of Barbacena, Minas Gerais, Brazil. Methods: This is a cross-sectional study conducted with schoolchildren aged 7-9 years, of both sexes, enrolled in state public schools. Food intake was assessed using the Previous Day Food Questionnaire and the level of physical activity by the Previous Day Physical Activity Questionnaire. The listed foods were classified according to the extent and purpose of industrial processing, using the NOVA classification. Pearson's χ2 test, Fisher's exact test, χ2 with Yates correction, and Poisson regression were used in the statistical analysis, estimating the crude and adjusted prevalence ratio, with 95% confidence intervals. Results: The prevalence of daily ultra-processed food consumption was 69.6%. After adjusted analyses, the consumption of ultra-processed food was associated with the omission of breakfast, mid-afternoon snack, supper, low physical activity, and consumption of risk foods. On the other hand, consumption of in natura or minimally processed foods was associated with older age, the consumption of lunch, mid-afternoon snack, dinner, and protective foods. Conclusions: There is a high prevalence of ultra-processed foods consumption, associated with unhealthy dietary habits among schoolchildren. This highlights the need for nutritional counseling and educational actions, favoring healthy eating in childhood.
RESUMO Objetivo Avaliar a prevalência de consumo de alimentos ultraprocessados e fatores associados em crianças matriculadas na rede pública do município de Barbacena, Minas Gerais, Brasil. Métodos Trata-se de um estudo transversal realizado com escolares de 7 a 9 anos de ambos os sexos, matriculados na rede pública estadual de ensino. O consumo alimentar foi avaliado utilizando o Questionário Alimentar do Dia Anterior e o nível de atividade física pelo Questionário de Atividade Física do Dia Anterior. Os alimentos listados foram classificados segundo a extensão e propósito do processamento industrial, conforme proposto pela classificação NOVA. Na análise estatística foram utilizados os testes χ2 de Pearson, Exato de Fisher, χ2 com correção de Yates e regressão de Poisson, estimando-se a razão de prevalência bruta e ajustada, com intervalos de confiança de 95%. Resultados A prevalência de consumo de alimentos ultraprocessados foi de 69,6%. Após análises ajustadas, o consumo de alimentos ultraprocessados foi associado à omissão do café da manhã, lanche da tarde e ceia, baixo nível de atividade física e ao consumo de alimentos de risco. Por outro lado, o consumo de alimentos in natura ou minimamente processados foi associado à maior idade, consumo de almoço, lanche da tarde, jantar e alimentos protetivos. Conclusões Verificamos uma alta prevalência no consumo de alimentos ultraprocessados, associada a hábitos alimentares não saudáveis, em crianças escolares. Isso destaca a necessidade de ações de educação alimentar e nutricional, favorecendo o consumo alimentar saudável na infância.
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Abstract Background In most cases, atherosclerotic cardiovascular disease (ACVD) is preventable through primary prevention and control of traditional risk factors, such as smoking cessation, regular physical activity, and adherence to healthy dietary patterns. The assessment of diet quality of ACVD patients would be important for a dietary intervention. Objectives This study aimed to evaluate diet quality of ACVD patients and its association with clinical conditions. Methods This cross-sectional study was nested within a randomized clinical trial entitled "Programa Alimentar Cardioprotetor Brasileiro." Baseline data of 80 patients from Pelotas, Brazil, were obtained. Food consumption was assessed using 24-h food recall and the Revised Diet Quality Index (IQD-R). Data on smoking status and comorbidities were reported by the patients during medical history taking. To analyze the associations between IQD-R and clinical variables, unpaired Student's t-test or the analysis of variance was performed. The significance level was 5%. Results Most of the sample consisted of men (66.5%), elderly individuals (52.50%), patients with hypertension (78.75%), dyslipidemia (58.75%), and overweight (73.75%). The average IQD-R score was 56.7 ± 12.6 points. Better quality of diet was observed for patients with diabetes compared to those without diabetes (61.1 ± 11.8 versus 54.0 ± 12.6 points; p=0.014). Conclusion There is a need to improve diet quality of ACVD patients. Patients ACVD and diabetes had better diet quality compared to those without diabetes.
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ABSTRACT Objective: To investigate if the diet quality and its components are associated with breast cancer risk. Methods: A case-control study was conducted with 332 women, 114 who were diagnosed with breast cancer, and 218 control individuals. Groups were matched for age, body mass index, and menopausal status. The quality of diet was assessed using Brazilian Healthy Eating Index Revised (BHEI-R) and its components. Food consumption was measured through three 24-h dietary recalls and assessed using the NDS-R software. For statistical analyses, it was performed an adjusted logistic regression, estimation of the Odds Ratio (OR), and 95% confidence interval (95%CI), with a p-value <0.05. Results: The BHEI-R score, classified into quartiles, did not differ between groups in the lowest quartile of diet quality (p=0.853). The components total cereals (p=0.038), saturated fat (p=0.039) and Gord_AA (fat, alcohol, and added sugar) (p=0.023) had higher scores among the case group. The scores for total fruits (p=0.010) and milk and dairy products (p=0.039) were higher among the control group. The BHEI-R components and the quality of diet were not associated with the outcome. Conclusion: Diet quality, assessed by the BHEI-R and its components, was not associated with breast cancer.
RESUMO Objetivo: Avaliar se a qualidade da dieta e seus componentes estão associados ao desenvolvimento de câncer de mama. Métodos: Trata-se de estudo caso-controle com a participação de 332 mulheres, sendo 114 casos e 218 controles. Os grupos foram pareados por idade, índice de massa corporal e estado menopausal. A qualidade da dieta foi avaliada pelo Índice de Qualidade da Dieta Revisado (IQD-R) e seus componentes. O consumo alimentar foi mensurado por meio da aplicação de três recordatórios alimentares de 24 horas e analisados no software NDS-R. Foi realizada regressão logística ajustada, estimativa de odds ratio (OR) e intervalo de confiança de 95% (IC95%), com valor de p<0,05. Resultados: A pontuação do IQD-R, classificada em quartis, não diferiu entre os grupos no quartil inferior de qualidade da dieta (p=0,853). Os componentes cereais totais (p=0,038), gordura saturada (p=0,039) e Gord_AA (gordura, álcool e açúcar de adição) (p=0,023) tiveram maior pontuação no grupo caso. Já a pontuação de frutas totais (p=0,010) e leites e derivados (p=0,039) foi maior no grupo controle. Os componentes do IQD-R, assim como a qualidade da dieta, não se associaram ao desfecho investigado. Conclusão: A qualidade da dieta, avaliada pelo IQD-R e os seus componentes, não se associou ao câncer de mama.
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This is a cross-sectional population-based study that describes the score of ultra-processed food consumption, applied in the Brazilian National Health Survey performed in 2019, and its association with sociodemographic factors in Brazilian adults (18 years or older). The score of ultra-processed food consumption was calculated by adding up the positive answers about the consumption on the previous day of 10 subgroups of ultra-processed foods frequently consumed in Brazil. The distribution of the score in the population was presented as a count. Poisson regression models were used to evaluate the crude and adjusted associations of scores equal to or higher than five subgroups of ultra-processed foods with urban/rural area, geographic region, sex, age group, schooling level, and wealth index. About 15% of the Brazilian adults reached scores equal to or higher than five. After adjustment for confounders, the prevalence of consuming five or more subgroups of ultra-processed foods decreased linearly with age, increased linearly with wealth quintiles and it was higher in urban areas, in the Southeast and South regions (compared to the others) and in men. Public policies that reduce the consumption of ultra-processed foods with emphasis on strata of the population at the greatest risk are essential and monitoring the score of ultra-processed food consumption across studies and populations will be important to assess the success of these policies.
Estudo transversal de base populacional com objetivo de descrever o escore de consumo de alimentos ultraprocessados, avaliado na Pesquisa Nacional de Saúde em 2019, e sua associação com fatores sociodemográficos em adultos brasileiros (com 18 anos ou mais). O escore de consumo de alimentos ultraprocessados foi calculado, somando as respostas positivas a perguntas sobre o consumo no dia anterior de dez subgrupos de alimentos ultraprocessados, consumidos frequentemente no Brasil. A distribuição da pontuação na população foi apresentada na forma de contagem. Foram utilizados modelos de regressão de Poisson para avaliar as associações brutas e ajustadas para pontuações iguais ou maiores de subgrupos de ultraprocessados, de acordo com situação (urbana/rural), macrorregião, sexo, grupo etário, escolaridade e índice de riqueza. Cerca de 15% dos adultos brasileiros obtiveram pontuações iguais ou superiores a cinco. Após ajustar para fatores de confusão, a prevalência do consumo de cinco ou mais subgrupos de ultraprocessados diminuiu de maneira linear com a idade, aumentou de maneira linear com os quintis de renda e foi mais alta nas áreas urbanas, nas regiões Sul e Sudeste e em homens. São necessárias políticas públicas que reduzam o consumo de alimentos ultraprocessados, com ênfase nos segmentos da população com maior risco. Para avaliar o sucesso dessas políticas, será importante monitorar os níveis de consumo de ultraprocessados entre os diversos estudos e populações.
El objetivo de este estudio transversal, de base poblacional, es describir la puntuación para el consumo de comida ultraprocesada y su asociación con factores sociodemográficos en adultos brasileños (con 18 años de edad o más). Los datos proceden de la Encuesta Nacional de Salud llevada a cabo en 2019. La puntuación para el consumo de comida ultraprocesada se calculó sumando las respuestas positivas a preguntas sobre el consumo el día previo de 10 subgrupos de comidas ultraprocesadas frecuentemente consumidas en Brasil. La distribución de la puntuación en la población se presentó como un dato de conteo. Fueron utilizados modelos de regressioón de Poison para evaluar las asociaciones crudas y ajustadas de puntuaciones iguales a o superiores a cinco subgrupos de comidas ultraprocesadas con áreas urbanas/rurales, región geográfica, sexo, grupo de edad, nivel de escolaridad, e índice de riqueza. Alrededor de un 15% de los adultos brasileños alcanzaron puntuaciones iguales o mayores que cinco. Tras el ajuste para los factores de confusión, la prevalencia del consumo de cinco o más subgrupos de comidas ultraprocesadas decrecío, aumentando linealmente con los quintiles de riqueza y era superior en las áreas urbanas, en las regiones Sur y Sudeste (comparadas con las otras) y en hombres. Son necesarias políticas públicas para reducir el consumo de comidas ultraprocesadas con enfásis en los estratos poblacionales en mayor riesgo. Monitorear la puntuación del consumo de comida ultraprocesada a través de estudios y poblaciones será importante para evaluar el éxito de estas políticas.
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Humans , Male , Adult , Diet , Sociodemographic Factors , Brazil/epidemiology , Cross-Sectional Studies , Health Surveys , Food HandlingABSTRACT
ABSTRACT Objective Food and nutritional evaluation of children can support public policies to combat early overweight and obesity. This study developed and validated a quantitative food frequency questionnaire for assessing the dietary intake of children. Methods This is a cross-sectional study of the development of a food frequency questionnaire for 130 children of both genders aged 7 to 10 years old. For the food frequency questionnaire list, 81 food items were selected. The validity of the food frequency questionnaire was evaluated by comparison with 24-hour recalls and reproducibility was performed by comparing two food frequency questionnaires. Results Most of the foods with 95% relative contribution were ultra-processed, such as packaged snacks and powdered juice. In validation, correlation coefficients were found between 0.45 (p<0.000) for lipids and 0.37 (p<0.000) for carbohydrates. An adjustment for energy reduced the correlations, but there was an increase in the correlation in calcium (r=0.75) and retinol (r=0.20). In terms of reproducibility, all macronutrients and calcium showed a satisfactory intraclass correlation coefficient (>0.400) and moderate correlations [proteins (0.54; p<0.000) and lipids (0.41; p<0.000)]. Conclusion The food frequency questionnaire developed was valid and able to assess the local food consumption by children from northeastern Brazil.
RESUMO Objetivo A avaliação alimentar e nutricional de crianças pode subsidiar políticas públicas de combate ao sobrepeso e à obesidade precoce. Este estudo desenvolveu e validou um questionário quantitativo de frequência alimentar para avaliação do consumo alimentar de crianças de 7 a 10 anos. Métodos Trata-se de um estudo transversal do desenvolvimento de um questionário de frequência alimentar que avaliou 130 crianças de ambos os sexos com idades entre 7 e 10 anos. Para a lista do questionário, foram selecionados 81 itens alimentares. A validade do instrumento foi avaliada por meio da comparação com recordatórios de 24 horas e a reprodutibilidade foi realizada pela comparação de dois questionários de frequência alimentar. Resultados A maioria dos alimentos com 95% de contribuição relativa foi ultraprocessada, como salgadinhos embalados e suco em pó. Na validação, foram encontrados coeficientes de correlação entre 0,45 (p<0,000) para lipídios e 0,37 (p<0,000) para carboidratos. Um ajuste para energia reduziu as correlações, mas houve um aumento na correlação de cálcio (r=0,75) e retinol (r=0,20). Em termos de reprodutibilidade, todos os macronutrientes e o cálcio apresentaram coeficiente de correlação intraclasse satisfatório (>0,400) e correlações moderadas [proteínas (0,54; p<0,000) e lipídios (0,41; p<0,000)]. Conclusão O questionário de frequência alimentar desenvolvido é válido e foi capaz de avaliar o consumo alimentar local de crianças do Nordeste do Brasil.
Subject(s)
Humans , Male , Female , Child , Nutrients , Diet Surveys/statistics & numerical data , Eating , Nutritional TransitionABSTRACT
Existing methods for assessing food consumption are subject to measurement errors, especially the underreporting of energy intake, characterized by reporting energy intake below the minimum necessary to maintain body weight. This study aimed to compare the identification of energy intake underreporters using different predictive equations and instruments to collect dietary data. The study was conducted with 101 selected participants in the third wave of the Longitudinal Study of Adult Health (ELSA-Brasil) at the University Hospital of the University of São Paulo. For the dietary assessment, we applied a food frequency questionnaire (FFQ), two 24-hour diet recall (24hR) using the GloboDiet software, and two 24hR using the Brasil-Nutri software. The energy intake underreport obtained from the FFQ was 13%, 16%, and 1% using the equations proposed by Goldberg et al. (1991), Black (2000), and McCrory et al. (2002), respectively. With these same equations, the 24hR described an underreport of 9.9%, 14.9%, and 0.9% respectively with the GloboDiet software and 14.7%, 15.8%, and 1.1% respectively with the Brasil-Nutri software. We verified a low prevalence of underreported energy intake among the three self-report-based dietary data collection methods (FFQ, 24hR with GloboDiet, and Brasil-Nutri). Though no statistically significant differences were found among three methods, the equations for each method differed among them. The agreement of energy intake between the methods was very similar, but the best was between GloboDiet and Brasil-Nutri.
Os métodos existentes para avaliar consumo alimentar estão sujeitos a erros de medição, especialmente à subnotificação de ingestão calórica, que descreve a ingestão calórica abaixo do mínimo necessário para manter o peso corporal. Este estudo buscou comparar a identificação de subnotificações de ingestão calórica através de diferentes equações preditivas e instrumentos para coletar dados dietéticos. Este estudo foi realizado com 101 participantes selecionados na terceira onda do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) do Hospital Universitário da Universidade de São Paulo. A partir da avaliação dietética, aplicamos um questionário de frequência alimentar (QFA), dois recordatórios de 24 horas (24hR) pelo software GloboDiet e dois 24hR utilizando o software Brasil-Nutri. A subnotificação de ingestão calórica obtida pelo QFA foi de 13%, 16% e 1%, utilizando-se as equações propostas por Goldberg et al. (1991), Black (2000) e McCrory et al. (2002), respectivamente. Com essas mesmas equações, o 24hR achou uma subnotificação de 9,9%, 14,9% e 0,9%, respectivamente, com o software GloboDiet e de 14,7%, 15,8% e 1,1%, respectivamente, com o software Brasil-Nutri. Verificou-se baixa prevalência de ingestão calórica subnotificada entre os três métodos de captação de dados dietéticos por autorrelato (FFQ e 24hR com GloboDiet e Brasil-Nutri). As equações para cada método diferem entre si embora não tenhamos encontrado diferenças estatisticamente significativas entre os três métodos. A concordância de ingestão calórica entre os métodos foi muito semelhante, mas a melhor foi entre a GloboDiet e a Brasil-Nutri.
Los métodos existentes para evaluar el consumo de alimentos están sujetos a errores de medición, especialmente la infradeclaración de la ingesta de energía, caracterizada por la notificación de la ingesta de energía por debajo del mínimo necesario para mantener el peso corporal. El objetivo de este estudio era comparar la identificación de las infradeclaraciones de ingesta energética utilizando diferentes ecuaciones de predicción e instrumentos de recogida de datos dietéticos. El estudio se realizó con 101 participantes seleccionados en la tercera ola del Estudio Longitudinal de Salud del Adulto (ELSA-Brasil) en el Hospital Universitario de la Universidad de São Paulo. Para la evaluación de la dieta, se aplicó un cuestionario de frecuencia de alimentos (QFA), dos recordatorios de dieta de 24 horas (24hR) utilizando el software GloboDiet, y dos 24hR utilizando el software Brasil-Nutri. La infradeclaración de la ingesta energética obtenida del QFA fue del 13%, el 16% y el 1,0% utilizando las ecuaciones propuestas por Goldberg et al. (1991), Black (2000) y McCrory et al. (2002), respectivamente. Con estas mismas ecuaciones, el 24hR describió una infradeclaración del 9,9%, el 14,9% y el 0,9% respectivamente con el software GloboDiet y del 14,7%, el 15,8% y el 1,1% respectivamente con el software Brasil-Nutri. Se verificó una baja prevalencia de ingesta de energía subdeclarada entre los tres métodos de recogida de datos dietéticos basados en el autoinforme (QFA, 24hR con GloboDiet y Brasil-Nutri). Aunque no se encontraron diferencias estadísticamente significativas entre los tres métodos, las ecuaciones de cada uno de ellos diferían entre sí. La concordancia de la ingesta de energía entre los métodos fue muy similar, pero la mejor fue entre GloboDiet y Brasil-Nutri.
Subject(s)
Humans , Adult , Energy Intake , Diet , Brazil , Diet Records , Diet Surveys , Surveys and Questionnaires , Longitudinal StudiesABSTRACT
Abstract Longitudinal study, whose objective was to evaluate of the time trend in food consumption across the 2002-2015 period in schoolchildren aged 7 to 11 years, covered five food surveys in Florianopolis, southern Brazil. Methodological differences across the surveys (typical vs. previous day food consumption, pen-and-paper versus computer screen presentation) and some known risk factors, were adjusted for statistically. Offset by maximum food/beverage consumption per day allowed comparability of a varying number of food components in a food group over survey years. Significant reduction in some healthy (fruits and animal proteins) and unhealthy diet markers (sodas, sugary drinks, sweets) was observed over the 2013-2015 period compared with the 2002 and 2007 data. Computer screen presentation of the food questionnaire systematically reduced the reporting frequency compared to the pen-and-paper presentation. Converting frequency reports into rates and using contrast analysis allowed time trend estimation based on food questionnaires with different presentation modes, varying number of items within food group over survey years, and variations in probabilistic sampling procedures.
Resumo Estudo longitudinal cujo objetivo foi avaliar a tendência temporal do consumo alimentar no período 2002-2015 em escolares de 7 a 11 anos, abrangendo cinco inquéritos alimentares em Florianópolis, Sul do Brasil. Foi ajustado para diferenças metodológicas (consumo alimentar típico vs. dia anterior, caneta e papel vs. apresentação no computador) e alguns fatores de risco. A compensação pelo consumo máximo de alimentos/bebidas por dia permitiu a comparabilidade de um número variável de componentes de alimentos em um grupo de alimentos ao longo dos anos da pesquisa. Foi observada redução em alguns marcadores de dieta saudável (frutas e proteínas animais) e não saudáveis (refrigerantes, bebidas açucaradas, doces) no período de 2013-2015, em comparação com os dados de 2002 e 2007. A apresentação do questionário alimentar na tela do computador reduziu sistematicamente a frequência de relatórios em comparação com a apresentação em papel e caneta. A conversão de relatórios de frequência em taxas e o uso de análise de contraste permitiram a estimativa de tendência de tempo com base em questionários de alimentos com diferentes modos de apresentação, número variável de itens dentro do grupo de alimentos ao longo dos anos da pesquisa e variações nos procedimentos de amostragem probabilística.
Subject(s)
Diet , Feeding Behavior , Brazil , Surveys and Questionnaires , Longitudinal Studies , FruitABSTRACT
A difusão de padrões alimentares ditos "não saudáveis" são fatores de risco independentes para as Doenças Crônicas Não Transmissíveis. Considerando essa importância, foi realizada uma revisão integrativa com o objetivo de analisar as evidências científicas atuais que retratam a qualidade da dieta do idoso no Brasil e seus fatores associados. O levantamento bibliográfico abrangeu publicações brasileiras, no período de 2011 a 2020, nas bases de dados LILACS e Pubmed, sendo selecionados ao final da pesquisa documental 18 documentos originais. Os resultados apontaram que a dieta da população idosa brasileira encontra-se monótona e pobre em nutrientes, sendo um potencial fator de risco para o desenvolvimento e/ou agravamento de doenças. Deve-se, portanto, enfatizar a importância do desen-volvimento de novos estudos, principalmente nas regiões Norte, Nordeste e Centro-oeste, a fim de subsidiar o planejamento de políticas públicas voltadas à alimentação e nutrição desse grupo populacional. Ações concentradas nesse sentido poderão contribuir, sobremaneira, com a promoção da saúde e melhoria da qualidade de vida da população envelhecida.(AU)
The propagation of unhealthy eating patterns is an independent risk factor for Chronic Noncommunicable diseases. Given this importance, an integrative review was conducted, and has as aim to analyze the current scientific evidence that portrays the quality of the elderly's diet in Brazil and its associated factors. The biblio-graphic survey covered Brazilian publications, from 2011 to 2020, in the LILACS and Pubmed databases; 18 original documents were selected after the review. The articles showed that the diet of the elderly Brazilian is monotonous and poor in nutrients, being a poten-tial risk factor for the development and/or worsening of diseases. Therefore, it is necessary to emphasize the importance of developing new es, mainly in the North, Northeast and Midwest regions for the purpose of subsidizing the planning of public policies for food and nutrition for this population group. Targeted actions in this direc-tion may contribute, significantly, with the promotion of health and improvement of the quality of life of elderly.(AU)
Subject(s)
Aged , Diet Surveys , EatingABSTRACT
Resumo O objetivo deste estudo foi caracterizar a quantidade e a variedade de frutas e hortaliças adquiridas nos domicílios brasileiros em 2008-09 e 2017-18 e segundo regiões e classes de rendimento em 2017-18. Foram utilizados dados das Pesquisas de Orçamentos Familiares referentes a disponibilidade domiciliar de frutas e hortaliças. A quantidade anual per capita adquirida de cada item alimentar foi transformada em valores diários. Foram descritas as médias da quantidade absoluta (grama/per capita/dia) e relativa de cada tipo de fruta e hortaliça para o Brasil (nos dois períodos) e segundo regiões e renda (em 2017-18). Verificou-se baixa aquisição de frutas e hortaliças para o Brasil (54,4 g e 42,7 g em 2008-09; 49,7 g e 37,4 g em 2017-18, respectivamente), e em todas as regiões e classes de renda analisadas. O Sul apresentou a maior aquisição e o Norte a menor; a quantidade adquirida aumentou com o aumento da renda. Seis tipos de frutas (banana prata, maçã, banana d'água, laranja pera, melancia e mamão) e três de hortaliças (tomate, cebola e cenoura) representaram mais de 50% da aquisição total no Brasil, sendo semelhante em todos os estratos analisados. A aquisição de frutas e hortaliças no Brasil foi baixa e apresentou pouca variação. Esse cenário se reproduziu em todas as regiões e faixas de renda.
Abstract The objective of this study was to establish the quantity and variety of fruit and vegetables (FV) available in Brazilian households in 2008-09 and 2017-18, and according to regions and income classes in 2017-18. Data from the Household Budget Surveys were used regarding household availability of fruit and vegetables. The annual per capita amount of each food item purchased was transformed into daily amounts. The absolute (gram/per capita/day) and the relative average quantities of each type of FV in Brazil (in both periods), and according to region and income (in 2017-18), were analyzed. An insufficient quantity of fruit and vegetables purchased in Brazil (54.4 g and 42.7 g in 2008-09; 49.7 g and 37.4 g in 2017-18, respectively) in all regions and income classes was verified. The South represented the highest amount purchased, while the North revealed the lowest; the quantity of FV increased as income increased. Six varieties of fruit (banana, apple, plantain, orange, watermelon, and papaya) and three types of vegetables (tomato, onion, and carrot) represented more than 50% of the total acquisition in Brazil, which was similar for all strata analyzed. The acquisition of fruit and vegetables in Brazil was low and featured little variation. This scenario was the same for all regions and income brackets.
Subject(s)
Humans , Vegetables , Fruit , Brazil , Diet , Feeding BehaviorABSTRACT
RESUMEN Los Cuestionarios de Frecuencia de Consumo de Alimentos son herramientas de investigación ampliamente utilizadas a nivel poblacional para evaluar la ingesta alimentaria, especialmente en niños. Los objetivos de este estudio fueron construir y determinar la validez relativa del Cuestionario de Frecuencia de Consumo de Alimentos (CFCA) para la evaluación de la ingesta entre niños ecuatorianos en edad escolar. Fueron incluidos 100 niños entre 6 y 8 años de edad de zonas costeras rurales del Ecuador. Las madres completaron 1 CFCA y 2 Recordatorios de 24 horas (R24h, estándar oro). Se utilizaron correlaciones de Pearson, Kappa ponderado y el método de Bland Altman para evaluar su validez. Se aplicaron modelos de regresión lineal incluyendo el R24h como variable dependiente y CFCA como variable independiente para derivar factores de calibración. Los coeficientes de Pearson oscilaron entre -0,03 y 0,24. Los valores de Kappa variaron entre -0,05 y 0,24, los gráficos de Bland-Altman se encuentran entre los límites cerca de la línea media y los factores de calibración oscilaron entre -0,01 a 0,16. Después de aplicar los factores de calibración, las ingestas medias de energía, macro y micro nutrientes fueron similares a las obtenidas en el R24h. El CFCA fue considerado apropiado para evaluar consumo de energía y nutrientes, sin embargo, debido a su concordancia débil a moderada este debe ser corregido mediante los valores de calibración. Asimismo, este CFCA es una herramienta útil para la evaluación de la dieta y la relación entre la dieta y la enfermedad en este grupo poblacional.
ABSTRACT Food frequency questionnaires are research tools widely used at the population level to assess food intake, especially in childhood. The objectives of this study were to develop and determine the relative validity of the Food Frequency Questionnaire (FFQ) for the evaluation of food intake among Ecuadorian schoolchildren. One hundred children from rural coastal areas of Ecuador, aged 6 to 8 years, were included. Mothers completed 1 FFQ frequency and two 24-hour recalls (R24h gold standard). Pearson correlation, weighted Kappa and the Bland Altman method were used to assess validity. Linear regression models were used including R24h as a dependent variable and FFQ as an independent variable to derive calibration factors. The Pearson coefficients ranged between -0.03 and 0.24. The Kappa values varied between -0.05 and 0.24, the Bland-Altman plots were between the limits near the midline and the calibration factors ranged from -0.01 to 0.16. The FFQ was considered appropriate to evaluate energy and nutrient consumption, however, due to its weak to moderate agreement this must be corrected using calibration values. This FFQ is a useful tool for evaluating diet and the relationship between diet and disease in this population group.
ABSTRACT
Objective@#To understand the level of radius speed of sound (SOS) in female college students and explore the effect of dietary on their bone health,so as to provide a reference for effective prevention fracture and osteoporosis among college students.@*Methods@#A total of 363 female college students were selected by multistage stratified random sampling method. Dietary intake was assessed with a self-administered food frequency questionnaire, principal component analysis was used to derive dietary patterns. Speed of sound was measured by ultrasonic bone densitometer.@*Results@#In all, the mean SOS of female college students was(4 138.0±114.3)m/s, 26.7% of female college students had low bone mass. Three dietary patterns were identified by factor analysis, explaining 55.4% of the diet variation: "snack" "plant" "high protein and high fat" patterns, respectively. Multiple linear regression analysis showed that with the increase of age, the level of SOS in radius increased significantly; and snacks consumption was negatively associated with the level of SOS(β=13.23, -0.47, P<0.05).@*Conclusion@#University stage is still the critical period of bone mass accumulation for female, snacks consumption may have a negative impact on bone health, so it is necessary to carry out nutrition education to help improve health awareness, promote health eating, and lead health lives to prevent osteoporosis.
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Objective@#To investigate lunch supply of public primary school canteens in Zhejiang Province, and to provide a basis for the scientific guidance of school lunch.@*Methods@#During May to Jun. and Sept. to Oct. in 2019, lunch food supply was weighed and recorded and the number of diners in 44 public primary school canteens were summarized. Each investigation lasted for one week.@*Results@#Food was mainly based on the taste of the students (40.91%) in the school canteen. About 45.45% of the schools referred to the Nutrition Guidelines of School Meals for students meals when making recipes in the school canteen. The supplies of cereals, vegetables, fruits, livestock and poultry meat, fish and shrimp, eggs, milk, soybean nuts, vegetable oil and salt were 109.05, 118.01, 0, 63.96, 9.25, 11.31, 0, 10.68, 10.47, 2.54 g. The supply of vegetable oil was basically the same as the recommended amount ( P >0.05). The supplies of energy, protein, calcium, iron, zinc, vitamin A, vitamin B 1, vitamin B 2, vitamin C, dietary fiber were 820.84 kcal, 32.79 g, 164.18 mg, 7.84 mg, 4.71 mg, 23.07 μgRAE, 0.41 mg, 0.35 mg, 20.47 mg, 2.34 g, 37.56% of energy from fat and 48.47% of energy from carbohydrate. The supply of vitamin B 1 was basically the same as the recommended amount ( P >0.05). There were no significant differences in all kinds of food and nutrients between urban and rural primary schools ( P >0.05).@*Conclusion@#Lunch supply is not optimistic in public primary school canteens in Zhejiang Province, with unreasonable structure and fails to agree with current nutritional recommendations. It is suggested that the scientific guidance of students meals should be carried out according to the survey results combined with the characteristics of local diet.
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Objective@#To evaluate the nutritional status, food intake, eating behavior and physical activity level of college students in a medical college in Guangzhou, and to explore its association with dietary behavior.@*Methods@#A total of 263 students selected using stratified random sampling method from a medical college in Guangzhou were investigated by questionnaire from October to December in 2019. Chi square test and Wilcoxon test were used to analyze group differences. Multivariate Logistic regression was used to analyze associated factors with thinness, overweight and obesity.@*Results@#The rate of thinness was 25.5%, and the rate of overweight and obesity was 11.8%. The intake of cereals, fruits, eggs, livestock, fried foods and carbonated drinks varied significantly by gender (U=3 278.00，5 224.50，5 981.00，6 663.00，5 460.00，3 873.00，P＜0.05). There was significant difference in total physical activity level in different grades (U=4 239.50，P＜0.05). Multivariate analysis showed that egg intake was negatively correlated with emaciation (OR=0.20, P＜0.01). Picky eating and partial eating were positively correlated with emaciation (OR=2.96, P＜0.01). Eating fast was positively correlated with overweight and obesity (OR=5.35, P＜0.05).@*Conclusion@#The detection rate of malnutrition among college students in this college is relatively high, and dietary behavior is associated with thinness, overweight and obesity.
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Objective@#To understand nutrient intake and dietary structure among migrant children in primary schools in Hongshan District of Wuhan, so as to carry out dietary nutrition intervention and evaluate the effectiveness of the intervention.@*Methods@#Stratified random sampling was used to select children in grade 3-6 who were randomly assigned to the intervention group (n=218) and the control group (n=222) from primary schools with a large number of migrant children in Hongshan District of Wuhan. After the baseline survey, the intervention group was given a two month diet intervention with "nutrition class" and knowledge lecture, and the caregivers of the intervention group were also given an intervention.@*Results@#At baseline, both groups had inadequate nutrient intake, with adequate intake rate of calcium, selenium, vitamin B 1 and vitamin B 2 less than 5%; children were lack of dietary diversity with adequate intake of vegitable, milk and milk product less than 5%. After intervention, the intake of energy, three main macronutrients, calcium, vitamin A, and vitamin C in the intervention group were higher than that of before intervention, as well as than the control group, differences were statistically significant (Z=2.22-8.65，2.62-8.46，P<0.05). In terms of dietary structure, adequate intake rate of cereals and miscellaneous beans increased from 55.5% to 68.8%, livestock and poultry meat increased from 45.9% to 56.4%, which were higher than that of the control group (56.3% and 44.6%) (χ 2=5.29-13.25，4.39-14.13，P<0.05).@*Conclusion@#Inadequate nutrient intake and unreasonable dietary structure of migrant children can be improved through short term dietary intervention including nutrition education to both parents and children.