Consumo de alimentos ultraprocesados en niños entre 6 y 23 meses según la Segunda Encuesta Nacional de Nutrición y Salud de Argentina / Consumption of ultra-processed foods among children aged 6 to 23 months as per the Second National Survey on Nutrition and Health of Argentina

Introducción. Contar con los datos del consumo de alimentos ultraprocesados en los niños resulta importante para planificar políticas públicas. Objetivos. Describir la prevalencia de consumo de alimentos ultraprocesados en menores de 2 años e identificar factores asociados. Describir la proporción que los alimentos ultraprocesados representan del número total de los alimentos consumidos en el día. Métodos. Análisis secundario de los datos de niños entre 6 y 23 meses de edad con al menos un recordatorio de 24 horas de consumo de alimentos de la Segunda Encuesta Nacional de Nutrición y Salud de Argentina del año 2018. Se estudiaron como variables principales: "consumo de alimentos ultraprocesados" (según el sistema NOVA) categorizada en sí/no y la "proporción de ultraprocesados del total de alimentos consumidos". Los factores asociados explorados fueron lactancia materna, sexo, edad y el número de alimentos no ultraprocesados consumidos. Se realizó un modelo de regresión logística multivariable y se aplicó un factor de expansión para ponderar los datos. Resultados. Se incluyeron 4224 niños (ponderado 908 104). La prevalencia de consumo de ultraprocesados fue del 90,8 % (IC95%: 89,5-92) y fue asociado con mayor edad (OR 3,21; IC95% 2,28-4,52) y con el número de alimentos no ultraprocesados consumidos (OR 1,17; IC95% 1,13-1,23). Los ultraprocesados representaron una mediana del 20 % (RIC: 12,5-28,6 %) del total de alimentos consumidos en el día. Conclusiones. Este estudio señala la alta penetración de los alimentos ultraprocesados en la alimentación complementaria.

Introduction. The availability of data on the consumption of ultra-processed foods among children is important for planning public policies. Objectives. To describe the prevalence of consumption of ultra-processed foods in children under 2 years of age and identify associated factors. To describe the proportion that ultra-processed foods represent out of the total number of foods consumed in a day. Methods. Secondary analysis of data from children aged 6­23 months with at least a 24-hour recall of food consumption based on the Second National Survey on Nutrition and Health of Argentina (2018). The following primary variables were studied: "consumption of ultra-processed foods" (according to the NOVA system) categorized into yes/no and "proportion of ultra-processed out of total foods consumed." The following associated factors were studied: breastfeeding, sex, age, and number of non-ultra-processed foods consumed. A multivariate logistic regression model was developed and an expansion factor was applied to weight the data. Results. A total of 4224 children were included (weighed: 908 104). The prevalence of ultra-processed food consumption was 90.8% (95% CI: 89.5­92) and was associated with an older age (OR: 3.21, 95% CI: 2.28­4.52) and the number of non-ultra-processed foods consumed (OR: 1.17, 95% CI: 1.13­1.23). Ultra-processed foods accounted for a median 20% (IQR: 12.5­28.6%) of all foods consumed in a day. Conclusions. This study highlights the high penetration of ultra-processed foods in complementary feeding.

Alimentação fora do lar: análise do ambiente alimentar de shopping centers de Campo Grande, Mato Grosso do Sul, Brasil / Eating away from home: analysis of the food environment of shopping malls in Campo Grande, Mato Grosso do Sul, Brazil / Alimentación fuera del hogar: análisis del entorno alimentario de los centros comerciales de Campo Grande, Mato Grosso do Sul, Brasil

Objetivo: Caracterizar o ambiente alimentar dos shopping centersde Campo Grande/MS, tendo em vista, a relevância de analisar os produtos que estão disponíveis a este público bem como sua qualidade nutricional. Método: Foram avaliados 124 Unidades de Produção de Refeições (UPR) nos shopping centers, por observação direta do cardápio, bufê ou fachada. Para coleta de dados foi utilizado o instrumento NutritionEnvironmentMeasuresSurveyRestaurants (NEMS-R). As variáveis coletadas a partir do referido instrumento foram tipos de unidades, sistema de gestão, serviços de mesa, tipos de alimentos e bebidas disponíveis, facilitadores e barreiras ao consumo de alimentos saudáveis. Resultados: Foram encontrados 29,0% de restaurantes àla carte; 8,1% de restaurantes tipo autosserviço; 36,3% de lanchonetes e 26,6% dos demais (bares, sorveterias, carrinhos/quiosques). Em relação aos tipos de gestão 77,4% são franquias. Entre os alimentos mais comercializados destaca-se as bebidas açucaradas, acessível em 79,8% das unidades e doces/sobremesas em 50,0%. Grande parte das unidades avaliadas não apresenta facilitadores para a alimentação saudável, sendo que mais de 90,0% das unidades não ofereceram opções de porções reduzidas, trocas saudáveis e opções saudáveis para crianças. A maior barreira encontrada foi a oferta de porções maiores por um pequeno acréscimo de preço (63,7%). Conclusão: O ambiente alimentar encontrado pode dificultar o acesso aos alimentos saudáveis. Assim, sugere-se que políticas públicas de segurança alimentar e nutricional, sejam implementadas, de forma a promover o maior acesso aos alimentos saudáveis que contribuem para a melhoria da qualidade de vida da população.

Objective: To characterize the food environment of shopping centers in Campo Grande/MS, in view the relevance of analyzing the products that are available to this public as well as their nutritional quality. Method: A total of 124 restaurants were evaluated in the shopping malls, by direct observation of the menu, buffet orfacade. For date collection was used the instrument Nutrition Environment Measures Survey Restaurants (NEMS-R). The variables collected were types of units, management system, table services, types of food and drinks available, facilitators and barriers to healthy food consumption. Results: 29.0% of the evaluated restaurants were à la carte; 8.1% self- service; 36.3% snack bars and 26.6% were bars, ice cream parlors or stands/kiosks. Regarding the types of management, 77.4% were franchises. Among the most commercialized foods, sugary drinks stand out, accessible in 79.8% of the units and sweets / desserts in 50.0%. Most of the units evaluated do not have facilitators for healthy eating, and more than 90.0% of the units did not offer reduced portion options, healthy exchanges and healthy options for children. The biggest barrier found was the offer of larger portions for a small price increase (63.7%). Conclusion: The food environment found may hinder access to healthy foods. Thus, it is suggested that public policies for food and nutritional security be implemented in order to promote greater access to healthy foods that contribute to improving the population's quality of life.

Objetivo: Caracterizar el entorno alimentario de los centros comerciales de Campo Grande/MS, considerando la relevancia de analizar los productos que están disponibles para este público así como su calidad nutricional. Método: Se evaluaron 124 unidades de producción de comidas (RPU) en centros comerciales mediante la observación directa del menú, el buffet o la fachada. Para la recopilación de datos se utilizó el instrumento NutritionEnvironmentMeasuresSurveyRestaurants (NEMS-R). Las variables cotejadas a partir del referido instrumento fueron los tipos de unidades, el sistema de gestión, los servicios de mesa, los tipos de alimentos y bebidas disponibles, los facilitadores y las barreras al consumo de alimentos sanos. Resultados: Se encontraron un 29,0% de restaurantes a la carta; un 8,1% de restaurantes tipo autoservicio; un 36,3% de bares y un 26,6% de los demás (bares, sorterías, carrinhos/quioscos). En cuanto a los tipos de gestión, el 77,4% son franquicias. Entre los alimentos más vendidos destacan las bebidas azucaradas, accesibles en el 79,8% de las unidades y los dulces/postres en el 50,0%. La mayoría de las unidades evaluadas no presentan facilitadores para una alimentación saludable, y más del 90,0% de las unidades no ofrecen opciones de porciones reducidas, intercambios saludables y opciones saludables para los niños. La mayor barrera encontrada fue la oferta de porciones más grandes por un pequeño aumento de precio (63,7%). Conclusión: El entorno alimentario encontrado puede dificultar el acceso a alimentos saludables. Por ello, se sugiere que se implementen políticas públicas de seguridad alimentaria y nutricional, para promover un mayor acceso a alimentos saludables que contribuyan a mejorar la calidad de vida de la población.

Quality of children's menus in malls in Brazil / Qualidade dos menus infantis em shoppings centers do Brasil

Abstract Objectives: characterize the availability and assess the nutritional quality of children's menus ofered in regular and fast food restaurants in Brazilian malls. Methods: this is an observational and cross-sectional study. Data were collected on the websites of each restaurant and in food sales applications, with a questionnaire consisting of two sections: characterization of the restaurant and characterization of the children's menu. Data collection took place in ten capitals in the fve regions of Brazil. Results: 116 children's menus were evaluated. The study identifed a higher number of regular (n=70, 60%) than fast-food (n=46,40%) restaurants. The cooking methods most used in the main dishes were grilled (n=236, 64%) and boiled (n=74, 20%), and in the side dishes were boiled (n=204, 53%) and fried (n=109, 28%). Only 40% (n=46) of the menus contained vegetables. Less than 10% (n=seven) ofered fruit as dessert, 31% (n = 36) had drinks included in the children's menu and 22% (n=25) ofered gifts associated with the menu. Only 32 (28%) restaurants had the combination of beans and rice. Conclusion: most of the options ofered to children were of low nutritional quality, with low ofer of vegetables, fruits and the traditional beans and rice. The beverages included in the menus, most of them sugary, can contribute to a high-energy intake. There is a need to provide healthy options and encourage these choices.

Resumo Objetivos: caracterizar a disponibilidade e a qualidade nutricional dos menus infantis nos restaurantes e estabelecimentos de fast-foods em Shoppings Centers no Brasil. Métodos: trata-se de um estudo observacional e transversal. Os dados foram coletados nos websites de cada estabelecimento e em aplicativos de vendas de alimentos, com questionário composto por duas seções: Caracterização do estabelecimento e caracterização do menu infantil. A coleta dos dados ocorreu em dez capitais distribuídas nas cinco regiões do Brasil. Resultados: foram avaliados 116 menus infantis. Maior número de estabelecimentos foi classifcado como restaurante do que fast-food. Os métodos de cocção mais utilizados nos pratos principais foram grelhados (n=236, 64%) e cozidos (n=74, 20%), e nos acompanhamentos foram cozidos (n=204, 53%) e fritos (n=109, 28%). Apenas 40% (n=46) dos menus continham hortaliças. Menos de 10% (n=sete) ofertavam fruta como sobremesa; 31% (n=36) constavam bebida inclusa no menu infantil; 22% (n=25) ofereciam brindes associados ao menu. Apenas 32 (28%) estabelecimentos apresentavam a combinação feijão e arroz. Conclusão: a maioria das opções ofertadas às crianças era de baixa qualidade nutricional, com pouca oferta de hortaliças, frutas e do tradicional feijão e arroz. As bebidas incluídas nos menus, a maioria açucaradas, podem contribuir para uma elevada ingestão energética. Constata-se a necessidade de disponibilizar opções saudáveis e incentivar essas escolhas.

Modelo preclínico de obesidad basado en alimentos altamente procesados y de alta palatabilidad / Preclinical model of obesity based on ultra-processed and highly palatable foods

Resumen Introducción: el alarmante incremento de la obesidad en todo el mundo y en Costa Rica responde principalmente a modificaciones en la composición de la dieta habitual de las personas. La presente investigación tuvo como objetivo implementar un protocolo de alimentación formulado a partir de alimentos altamente procesados y de alta palatabilidad (APAP) consumidos por la población costarricense para, luego, evaluar sus efectos en la conducta alimentaria y en parámetros biométricos y bioquímicos. Metodología: ratas adultas macho Wistar se asignaron a dos grupos. Al primero se le administró alimento estándar para roedores (grupo DC) y al segundo, alimentos APAP (grupo APAP), durante ocho semanas. Resultados: a lo largo de ese periodo, los animales expuestos a los APAP exhibieron mayor ingesta y energía, caracterizadas por un alto consumo de grasas y uno menor de proteínas y fibra; además, mostraron un incremento significativo en los diversos parámetros de obesidad (e. g., peso corporal y ganancia de peso, índice de Lee y adiposidad central) y niveles descriptivamente superiores de glucosa y triglicéridos en sangre, pero notablemente menores de colesterol total. Conclusiones: los resultados indican que una dieta basada en los alimentos APAP más frecuentes en la población costarricense es capaz de inducir hiperfagia y obesidad. Así, este modelo constituye una herramienta prometedora para ahondar en el estudio de las factores neurobiológicos y metabólicos relacionados con la obesidad por el sobreconsumo de alimentos APAP.

Abstract Introduction. The alarming increase in obesity both worldwide and in Costa Rica is mainly due to changes in the composition of the usual diet of the population. The goal of our research was to implement a feeding protocol formulated from ultra-processed and highly palatable foods (UPHP) consumed by the Costa Rican population and to evaluate the effects of the UPHP diet on eating behavior and biometric and biochemical parameters. Methods: Adult male Wistar rats were assigned to two groups. One group was given standard rodent chow (DC group) while the other group received UPHP foods (UPHP group) for eight weeks. Results: Throughout this period, animals exposed to the UPHP diet exhibited higher food and energy intake characterized by high consumption of fat and lower consumption of protein and fiber. Animals in the UPHP group also showed a significant increase in obesity parameters (e.g., body weight and bodyweight gain, Lees index, and central adiposity). Furthermore, the UPHP group had descriptively higher levels of blood glucose and triglycerides and significantly lower levels of total cholesterol. Conclusions: Our results indicate that a feeding protocol based on the most frequent food choices of the Costa Rican population is capable of inducing hyperphagia and obesity. This model constitutes a promising tool to delve into the study of the neurobiological and metabolic factors related to obesity induced by overconsumption of UPHP foods.

Non-alcoholic beverage and fast-food consumption, among first- and fourth-year nursing students in Madrid

Sugar-sweetened beverages and fast-food consumption have been associated with non-communicable diseases. Objective. Was to analyze consumption of non-alcoholic beverage and fast-food consumption among first- and fourth-year nursing students. Materials and methods. A questionnaire-based survey was conducted among first-and fourth-year nursing students in Madrid, Spain. Anthropometric data (weight and height) and demographic data were collected, as were data on consumption of specific foods and beverages. Results. The survey was completed by 436 students. Mean (SD) age was 22.0 (6.8) years, 84.1 % of were women.26.2 % of the students were underweight; 6.3 % were overweight. Consumption of sugar-sweetened beverages and diet drinks was moderate. Slightly more than three-quarters of the students (75.5 %) purchased fast food in the previous month. Burger bars were the most frequently visited fast-food outlet (77.2 %). A direct relationship was observed between BMI and fast-food consumption (rho = 0.099; p = 0.042) and between BMI and consumption of diet cola or carbonated drinks (rho = 0.120; p = 0.013). Conclusion. We provide new epidemiological data from a specific university population that could be useful to promote more studies that help design appropriate strategies to increase a healthy lifestyle(AU)

Las bebidas azucaradas y el consumo de comida rápida se han asociado con enfermedades no transmisibles. Objetivo. Analizar el consumo de bebidas no alcohólicas y el consumo de comida rápida entre estudiantes universitarios de primer y cuarto curso de enfermería. Materiales y métodos. Cuestionario validado entre estudiantes de enfermería de primer y cuarto año en Madrid, España. Se recopilaron datos antropométricos (peso y altura) y demográficos, así como datos sobre consumo de alimentos y bebidas específicos. Resultados. La encuesta fue completada por 436 estudiantes. La edad media (DE) fue de 22,0 (6,8) años, el 84,1 % eran mujeres; el 26,2 % de los estudiantes tenían bajo peso y el 6,3% mostraban sobrepeso. El consumo de bebidas azucaradas y bebidas dietéticas fue moderado. Más de tres cuartas partes de estudiantes (75,5%) compraron comida rápida en el mes anterior. Las hamburgueserías fueron el restaurante de comida rápida más visitado (77,2%). Se observó una relación directa entre el IMC y el consumo de comida rápida (rho = 0,099; p = 0,042) y entre el IMC y el consumo de refrescos dietéticos o bebidas gaseosas (rho = 0,120; p = 0,013). Conclusión. Aportamos nuevos datos epidemiológicos de una población universitaria concreta, que podrían ser de utilidad para promover más estudios que ayuden a diseñar estrategias adecuadas para incrementar un estilo de vida saludable(AU)

The effect of fast food calorie labels on calories ordered by college students in Quezon City

Background@#There is an increasing trend of obesity in the Philippines with approximately 28.8% of adults considered overweight and 9.6% obese. This is presumably due to a shift in eating patterns towards dining out in restaurants and fast food chains for their convenience. Excess fast food consumption results in diets that are calorie dense yet nutritionally deficient due to their high levels of fat, sugar, and salt leading to increased prevalence of associated diseases such as Type 2 diabetes and cardiovascular diseases. @*Objective@#The researchers determined the effect of presenting the caloric information of fast food items on the total calories ordered among college students in private and public higher education institutions in Quezon City. @*Methodology@#A double-blind experimental research was performed with 179 students by convenience sampling. The participants were randomly assigned to a control group (without caloric labels) and an experimental group (with caloric labels). An online questionnaire was sent to each subject containing their menu and order form along with questions on their demographical data (age, sex, food allowance, BMI, physical activity). @*Results@#Using single linear regression, none of the demographic characteristics were found to be confounding variables. Using multiple linear regression analysis, it was found that the experimental group ordered significantly less calories (p-value = 0.013). @*Conclusion@#The results of the study conclude that those presented with calorie labels ordered less calories than the control.

Food additives in childhood: a review on consumption and health consequences / Aditivos alimentares na infância: uma revisão sobre consumo e consequências à saúde

ABSTRACT OBJECTIVE To discuss the context of scientific publications on the consumption of food additives by children and the possible health consequences in this age group. METHODS A literature review, with a search carried out between April 2020 and April 2021 in the Web of Science, Scopus, PubMed and Google Scholar databases, as well as in websites of Brazilian and foreign official bodies. Official documents and studies published since 2000 were selected. Keywords related to food additives, children, food consumption, and health were used for the search. RESULTS Food additives are substances intentionally added to foods for technological purposes. Processed foods are the main sources of additives in food and their consumption occurs since childhood. It is observed, however, that there are limitations inherent to the scientific method regarding the analysis of consumption and toxicity of food additives in humans, causing scarcity of data in the scientific literature. Additionally, existing data suggest that the additives have a higher toxic potential in children, considering that the body weight in this age group is lower than in adults. This context emphasizes the need to observe the precautionary principle, according to which risks of harm must be prevented. CONCLUSIONS This is a scenario in which the literature points to a risk to people's health and, in particular, to children, about whom the duty of protection must be even greater, with absolute priority. Thus, the relevance of an expanded technical-scientific debate regarding the establishment of specific and stricter parameters for children is considered, regarding the consumption and toxicity of additives, as well as the different sources of exposure to these substances.

RESUMO OBJETIVO Discutir o contexto das publicações científicas sobre consumo de aditivos alimentares por crianças e as possíveis consequências à saúde nessa faixa etária. MÉTODOS Revisão de literatura, com busca realizada entre abril de 2020 e abril de 2021 nas bases de dados Web of Science, Scopus, PubMed e Google Acadêmico, bem como em sites de órgãos oficiais brasileiros e estrangeiros. Foram selecionados documentos oficiais e estudos publicados a partir do ano 2000. Para a busca, foram utilizados unitermos relacionados a aditivos alimentares, crianças, consumo alimentar e saúde. RESULTADOS Aditivos alimentares são substâncias adicionadas intencionalmente aos alimentos para fins tecnológicos. Os alimentos industrializados são as principais fontes de aditivos na alimentação e seu consumo ocorre desde a infância. Observa-se, contudo, que há limitações inerentes ao método científico no que tange à análise de consumo e de toxicidade de aditivos alimentares em humanos, ocasionando escassez de dados na literatura científica. Adicionalmente, dados existentes sugerem que os aditivos apresentam potencial tóxico maior em crianças, considerando que o peso corporal nessa faixa etária é menor em relação ao adulto. Esse contexto ressalta a necessidade de se observar o princípio da precaução, segundo o qual devem-se prevenir os riscos de dano. CONCLUSÕES Trata-se de cenário no qual a literatura aponta risco à saúde das pessoas e, em especial, das crianças, cujo dever de proteção deve ser ainda maior, com absoluta prioridade. Assim, pondera-se a relevância de um debate técnico-científico ampliado quanto ao estabelecimento de parâmetros específicos e mais rígidos para crianças, considerando consumo e toxicidade de aditivos, bem como as diversas fontes de exposição a essas substâncias.

Sponsorship by food and beverage companies in soccer: an analysis of the 2019 Copa América / Patrocínio por empresas de alimentos e bebidas no futebol: análise da Copa América 2019

ABSTRACT OBJECTIVE To identify the sponsorship by food and beverage companies of the teams participating in the 2019 Copa América Soccer Cup and associate this sponsorship with characteristics of the teams and their respective countries. METHODS The sponsors of the 10 teams participating in the 46th edition of the Copa América were identified. These entities were classified into (i) food companies, (ii) alcoholic beverage companies, and (iii) other segments. The food companies were classified according to their products, according to the NOVA classification. In addition, data on the number of titles previously won by the teams in the Copa America and the World Cup were obtained, as well as data on the countries' Human Development Index, annual per capita sales of ultra-processed foods, and annual per capita consumption of alcoholic beverages. RESULTS A total of 89 sponsorships were identified for the 10 teams studied, some of these supporting two or more teams. Eighteen percent of the sponsors were food companies, with 12.4% being ultra-processed foods. The alcoholic beverage category represented 7.9% of the sponsors. Ultra-processed beverage and alcoholic beverage companies sponsored seven of the 10 teams studied. We noted higher participation of ultra-processed foods company sponsors in teams from countries with higher Human Development Index, sales of ultra-processed foods, and number of Copa América and World Cup titles. The sponsorship by alcoholic beverage companies was higher for teams from countries with lower Human Development Index, alcohol consumption, and number of Copa América and World Cup titles. CONCLUSION A significant presence of ultra-processed food and alcoholic beverage companies as sponsors of South American soccer teams was noted, along with the fact that sport performance characteristics of the teams and socioeconomic and market issues of the countries are associated with the occurrence of sponsorship.

RESUMO OBJETIVO Identificar o patrocínio por empresas do setor de alimentos e bebidas das seleções participantes da Copa América de Futebol 2019 e associar esse patrocínio a características das seleções e de seus respectivos países. MÉTODOS Foram identificados os patrocinadores das 10 seleções participantes da 46ª edição da Copa América de Futebol. Essas entidades foram classificadas em empresas i) de alimentos, ii) de bebidas alcoólicas e iii) de outros segmentos. As empresas de alimentos foram classificadas de acordo com seus produtos, segundo a classificação NOVA. Além disso, dados sobre o número de títulos anteriormente conquistados pelas seleções na Copa América e na Copa do Mundo foram obtidos, assim como dados do índice de desenvolvimento humano, de venda anual per capita de alimentos ultraprocessados e de consumo anual per capita de bebidas alcoólicas dos países. RESULTADOS Um total de 89 patrocínios foram identificados para as 10 seleções estudadas, alguns desses apoiando duas ou mais equipes. Dezoito por cento dos patrocinadores eram empresas de alimentos, sendo 12,4% de alimentos ultraprocessados. A categoria de bebidas alcoólicas representou 7,9% dos patrocinadores. As empresas de bebidas ultraprocessadas e as de bebidas alcoólicas patrocinaram sete das 10 seleções estudadas. Notou-se maior participação de patrocinadores de empresas de alimentos ultraprocessados em seleções de países com maior índice de desenvolvimento humano, venda de alimentos ultraprocessados e número de títulos de Copa América e Copa do Mundo. Já o patrocínio por empresas de bebidas alcoólicas foi maior em seleções de países com menor índice de desenvolvimento humano, consumo de álcool e número de títulos em Copa América e Copa do Mundo. CONCLUSÃO Evidenciou-se uma presença significativa de empresas de alimentos ultraprocessados e de bebidas alcoólicas como patrocinadores das seleções sul-americanas de futebol e que as características de desempenho esportivo das seleções e questões socioeconômicas e de mercado dos países se associam à ocorrência do patrocínio.

Consumo de energía y nutrientes críticos según clasificación NOVA en la Argentina, tendencia temporal y diferencias según nivel de ingreso / Intake of energy and critical nutrients according to the NOVA classification in Argentina, time trend and differences according to income / Consumo de energia e nutrientes críticos segundo a classificação NOVA na Argentina: tendência temporal e diferenças por renda familiar

Existe una creciente evidencia de la transición global en los sistemas alimentarios que afectan la disponibilidad, accesibilidad, asequibilidad y conveniencia de los alimentos altamente procesados. El objetivo de este trabajo fue evaluar el consumo aparente de energía, grasas saturadas, azúcares agregados y sodio según el grado de procesamiento de los alimentos en la Argentina entre 1996 y 2018, según el nivel de ingreso. Se trata de un estudio descriptivo y transversal, con datos de gastos de alimentos y bebidas e ingresos de la Encuesta Nacional de Gastos de los Hogares de 1996-1997, 2004-2005, 2012-2013 y 2017-2018, que incluye más de 20.000 hogares en cada período. Se calculó el consumo aparente diario de energía, grasas saturadas, azúcares agregados y sodio por adulto equivalente de: (1) alimentos mínimamente procesados; (2) ingredientes culinarios procesados; (3) alimentos procesados y (4) productos ultraprocesados, para cada periodo y según el quintil de ingresos per cápita del hogar. Fue utilizado análisis estadístico descriptivo. En energía y todos los nutrientes evaluados, se observa la reducción de la proporción proveniente de alimentos mínimamente procesados, ingredientes culinarios y alimentos procesados, y el aumento de productos ultraprocesados. Con una mayor contribución a partir de ultraprocesados, a medida que aumentan los ingresos del hogar, pero con diferencias que disminuyen a lo largo del tiempo. Dados los resultados, las estrategias futuras en Argentina deberían promover el consumo de alimentos mínimamente procesados y desalentar la disponibilidad y accesibilidad de alimentos ultraprocesados, con especial énfasis en los grupos más vulnerados.

Growing evidence of the global transition in food systems exists, affecting the availability, accessibility, affordability, and convenience of highly processed foods. This study aimed to evaluate the apparent consumption of energy, saturated fat, added sugars, and sodium according to the degree of food processing in Argentina from 1996 to 2018 and according to income level. This is a descriptive and cross-sectional study with data on food and beverage expenditures and income from the National Household Expenditure Survey for years 1996-1997, 2004-2005, 2012-2013, and 2017-2018, including more than 20,000 households in each period. The apparent daily consumption of energy, saturated fat, added sugars, and sodium per adult for: (1) minimally processed foods; (2) processed culinary ingredients; (3) processed foods; and (4) ultra-processed products, was calculated for each period and according to per capita income quintile in each household. Descriptive statistical analysis was performed. Reductions in the proportion of energy and all nutrients evaluated from minimally processed foods, culinary ingredients and processed foods were observed, as well as an increase in the consumption of ultra-processed products. One also observes a greater share from ultra-processed foods as household income increases but with decreasing differences over time. Therefore, future strategies in Argentina should promote the consumption of minimally processed foods and discourage the availability and accessibility of ultra-processed ones, especially for the most vulnerable groups.

Cada vez mais há evidências sobre a mudança global nos sistemas alimentares, que envolvem disponibilidade, acessibilidade, custo e pertinência dos alimentos ultraprocessados. O objetivo deste trabalho foi analisar o consumo aparente de energia, gorduras saturadas, açúcar e sódio conforme o nível de processamento de alimentos e a renda familiar na Argentina no período entre 1996 e 2018. Estudo descritivo e transversal, realizado com dados sobre o consumo de alimentos e bebidas e a renda familiar obtidos da Pesquisa Nacional de Consumo Domiciliar de 1996-1997, 2004-2005, 2012-2013 e 2017-2018, que inclui mais de 20.000 residências em cada período. Foi calculado o consumo diário de energia, gordura saturada, açúcar e sódio por adulto equivalente a partir de: (1) alimentos minimamente processados; (2) ingredientes culinários processados; (3) alimentos processados e (4) alimentos ultraprocessados, para cada período e de acordo com o quintil de renda familiar per capita. Foi aplicada análise estatística descritiva. Em relação à energia e aos nutrientes analisados, foi encontrada uma redução na proporção de alimentos minimamente processados, ingredientes culinários e alimentos processados, e um aumento de alimentos ultraprocessados. O consumo de alimentos ultraprocessados é maior conforme aumenta a renda familiar, mas com diferenças que diminuem ao longo do tempo. Esses resultados evidenciam a necessidade de promover estratégias na Argentina quanto ao consumo de alimentos minimamente processados e desestimular a disponibilidade e o acesso a alimentos ultraprocessados, especialmente para os grupos mais vulneráveis.

Consumo de alimentos ultraprocessados e fatores associados no primeiro ano de vida em Cruzeiro do Sul, Acre, Brasil / Consumption of ultra-processed foods during the first year of life and associated factors in Cruzeiro do Sul, Brazil

Resumo O objetivo deste artigo é avaliar o consumo de alimentos ultraprocessados (AUP) e fatores associados no primeiro ano de vida. Trata-se da análise de dados do seguimento de um ano da coorte de nascimentos MINA-Brasil. Foram coletados dados socioeconômicos, demográficos e obstétricos na maternidade e no seguimento de um ano (n = 774), investigando consumo alimentar do dia anterior à entrevista, a fim de avaliar o consumo de AUP. A razão de prevalência (RP) e o intervalo de confianças (IC 95%) para consumo ≥ 3 AUP foram estimados em modelo de regressão múltiplo de Poisson com variância robusta. A prevalência de consumo ≥ 1 AUP foi 87,5%; e ≥ 3 AUP de 40,5%, estando associado a: menor escolaridade materna (≤ 9 anos [RP: 1,97 IC 95% 1,38; 2,80] e entre 10-12 anos [RP: 1,58, IC 95% 1,13; 2,20) comparados com > 12 anos de escolaridade, índice de riqueza abaixo da média (RP: 1,26, IC 95% 1,04; 1,53) e ter mãe adolescente (RP: 1,28, IC 95% 1,06; 1,55). A ausência de diversidade da dieta foi inversamente associada ao desfecho (RP: 0,65, IC 95% 0,51; 0,81). O consumo ≥ 3 AUP se associou às características maternas de menores escolaridade, índice de riqueza e idade materna, e a diversidade da dieta ao maior consumo de AUP.

Abstract This article aims to assess the consumption of ultra-processed foods (UPFs) during the first year of life and associated factors. We analyzed data from the one-year follow-up of the MINA-Brazil birth cohort. Socioeconomic, demographic and obstetric data were collected in the baseline study and at one-year follow-up (n = 774). Dietary intake during the previous day was assessed using a food frequency questionnaire to determine UPF consumption. Multiple Poisson regression with robust variance was performed to estimate prevalence ratios (PR) and confidence intervals (95%CI) for factors associated with the consumption of ≥ 3 UPFs. Prevalence of UPF consumption and consumption of ≥ 3 UPFs was 87.5% and 40.5%, respectively. Consumption of ≥ 3 UPFs was associated with lower maternal education (≤ 9 years of schooling [PR: 2.02 95%CI 1.42; 2.87] and between 10-12 years of schooling [PR: 1.55, 95%CI 1, 11; 2.14]), below-average wealth index (PR: 1.26, 95%CI 1.04; 1.53), and having a teenage mother (PR:1.19, 95%CI 1.00; 1.49). Lack of dietary diversity was inversely associated with the outcome (RP: 0,65, IC95% 0,51; 0,81). The consumption of ≥ 3 UPFs was associated with lower wealth index, education and maternal age. Dietary diversity was associated with higher levels of UPF consumption.

Ultra-processed food intake and diet carbon and water footprints: a national study in Brazil

ABSTRACT OBJECTIVE To study the association between ultra-processed food consumption and carbon and water footprints of the Brazilian diet. METHODS Cross-sectional analysis on data collected in 2008-2009 on a probabilistic sample of the Brazilian population aged ≥ 10 years (n = 32,886). Individual food intake was assessed using two 24-hour food records, on non-consecutive days. The environmental impact of individual diets was calculated by multiplying the amount of each food by coefficients that quantify the atmospheric emissions of greenhouse gases in grams of carbon dioxide equivalent (carbon footprint) and freshwater use in liters (water footprint), both per gram or milliliter of food. The two coefficients consider the food life cycle 'from farm to fork.' Crude and adjusted linear regression models and tests for linear trends assessed the association between the ultra-processed food contribution to total energy intake (quintiles) and the diet carbon and water footprints. Potential confounders included age, sex, education, income, and region. Total energy intake was assessed as a potential mediation variable. RESULTS In the crude models, the dietary contribution of ultra-processed foods was linearly associated with the carbon and water footprints of the Brazilian diet. After adjustment for potential confounders, the association remained significant only regarding the diet water footprint, which increased by 10.1% between the lowest and highest quintile of the contribution of ultra-processed foods. Additional adjustment for total energy intake eliminated this association indicating that the dietary contribution of ultra-processed foods increases the diet water footprint by increasing energy intake. CONCLUSIONS The negative impact of ultra-processed foods on the diet water footprint, shown for the first time in this study, adds to the negative impacts of these foods, already demonstrated regarding dietary nutrient profiles and the risk for several chronic non-communicable diseases. This reinforces the recommendation to avoid ultra-processed foods made in the official Brazilian Dietary Guidelines and increasingly in dietary guidelines of other countries.

Food environment of the economic capital of the Northeast: social and territorial disparities in the availability of food stores / Ambiente alimentar da capital econômica do Nordeste: disparidades sociais e territoriais da disponibilidade dos comércios de alimentos

ABSTRACT Objective Characterize the community food environment through the different types of food outlets in the city of Fortaleza and associate their distribution according to sociodemographic indicators. Methods This is an ecological study carried out in the city of Fortaleza in which data from the Health Surveillance Service were used with the location of all licensed food stores in the city in the years 2018 and 2019. Georeferenced maps were set up to illustrate the spatial distribution of the establishments. Correlation analyses were performed to verify the association between food outlets and socioeconomic data. Values of p≤0.005 were considered significant. Results We identified a greater concentration of food stores in the neighborhoods with better socioeconomic levels. Snack bars (n=2051; 27.7%) and restaurants (n=1945; 26.3%), were in greater quantity and exhibited a positive correlation with the Human Development Index and average income. Supermarkets and hypermarkets (n=288; 3.9%) and street markets (n=81; 1.1%) were in a smaller number and had the worst spatial distribution. Conclusion We observed socioeconomic inequalities in the distribution of different types of food outlets. The little diversity and the limited number of establishments in peripheral neighborhoods, besides the centralization of outlets that sell food that is harmful to health, constitute obstacles for the population to make healthy food choices.

RESUMO Objetivo Caracterizar o ambiente alimentar comunitário por meio dos diferentes tipos de estabelecimentos de venda de alimentos existentes na cidade de Fortaleza e relacionar sua distribuição de acordo com indicadores sociodemográficos. Métodos Trata-se de um estudo ecológico realizado na cidade de Fortaleza em que foram utilizados dados da Vigilância Sanitária com a localização de todos os comércios de alimentos licenciados para funcionamento no município nos anos de 2018 e 2019. Foram construídos mapas georreferenciados para ilustrar a distribuição espacial dos estabelecimentos. Análises de correlação foram realizadas para verificar associação entre os estabelecimentos de venda de alimentos e dados socioeconômicos. Consideraram-se significativos valores de p≤0,005. Resultados Foi possível identificar maior concentração de comércios de alimentos nos bairros com melhores níveis socioeconômicos. Lanchonetes (n=2051; 27,7%) e restaurantes (n=1945; 26,3%) apresentaram-se em maior quantidade e obtiveram correlação positiva com o Índice de Desenvolvimento Humano e a renda média. Supermercados e hipermercados (n = 288; 3,9%) e feiras livres (n=81; 1,1%) existiam em menor proporção e apresentaram a pior distribuição espacial. Conclusão Desigualdades socioeconômicas foram observadas na distribuição dos diferentes tipos de pontos de venda de alimentos. A pouca diversidade e a limitada quantidade de estabelecimentos em bairros periféricos, além da centralização da oferta de comércios que vendem alimentos prejudiciais à saúde, constituem-se obstáculos para que a população faça escolhas alimentares saudáveis.

Effect of the coronavirus pandemic on nutrition and health of adults in Calabar, Nigeria: A post-lockdown analysis

Background: The food security and nutrition of millions of people around the world is currently being threatened by the coronavirus disease 2019 (COVID-19) pandemic, an evolving health crisis. Aim: To evaluate the effect of the COVID-19 pandemic on nutrition and health of adults in Calabar, especially after the hard lockdown.Setting: Online cross-sectional survey in Calabar, Nigeria. Method: After sample size determination, an online questionnaire was designed, content-validated by nutrition experts and piloted on 20 respondents. The questionnaire link was circulated for 6 weeks (April­May, 2021). The questionnaire was structured to gather socio-economic data, lifestyles of the participants (especially younger adults) and changes in dietary intake and health. Descriptive statistics and Pearson's correlation were used to define the proportion of responses for each question and check for association. Results: No glaring nutrition or health problems was observed in the surveyed population (385 respondents), but many (50%) earned very low monthly income (< 50 000 naira). A drop in finances seemed to have indirectly caused a decrease in food consumption post-lockdown. A strong association between age and health risks was observed; similarly, alcohol intake was significantly affected by income and age. Conclusion: The pandemic caused many changes in people's dietary habits and lifestyles, including financial setbacks. Apparently, education and proper enlightenment play a major role in food choices (despite limited resources), thus ensuring adequate nutrition and reducing health risks in the face of a pandemic. Contribution: This study has affirmed the efficacy of nutrition education and proper awareness in ensuring healthy dietary choices, optimal health and reduced risks of diseases.

Perceptions of healthy food, and perceived facilitators and barriers to buying and consuming healthy food, among female caregivers in Soweto, South Africa

Background. Obesity poses a continuous health challenge in South Africa and disproportionately affects black African households. To target obesity in these settings, it is crucial to have an in-depth understanding of food choices made by affected households. Objectives. To explore how healthy food is perceived by women living in Soweto, and the facilitators of and barriers to buying and consuming this food. Methods. This was a qualitative study that utilized semi-structured interviews. Ten participants were recruited using purposive sampling. Interviews were audio-recorded, transcribed verbatim and analyzed using thematic analysis. The study took place in Soweto, South Africa, and was conducted from February to May 2019. Results. Six themes were developed from the data: perceptions of healthy food; protecting family members from unhealthy food; learning about healthy food; appreciation by the family; home-cooked food v. food bought on the street; and budgetary restrictions. The first three themes were grouped by the overarching theme 'consciousness of healthfulness of food', and the last three themes were grouped by the theme 'influences of the family and environment on food choice'. Conclusions. A focus on the whole family's dietary behaviours is recommended and, in future interventions, guidance communicated in intervention materials should be tailored to existing knowledge of healthy eating.

Correlation analysis between children and adolescents watching food TV advertising and fast food consumption / 中华预防医学杂志

Based on the open data of China Health and Nutrition Survey (CHNS), 249 children, adolescents and 249 heads of families who completed two rounds of surveys in 2011 and 2015 were selected in this study. According to the fast food consumption of children and adolescents, they were divided into fast food consumption group and non-fast food consumption group. Logistic regression model was used to analyze the relationship between children and adolescents watching Food TV advertising and fast food consumption. After adjusting relevant factors, the results showed that children and adolescents requiring their parents to buy food in TV advertisements (OR=3.122, P=0.001), parents buying food for their children in TV advertisements (OR=4.717, P=0.036), children and adolescents buying food in TV advertisements themselves (OR=3.728, P=0.041), children and adolescents' preference for food in TV advertisements (OR=2.946, P=0.044) and the frequency of children and adolescents reported by their parents asking their parents to buy food in TV advertisements (OR=3.113, P=0.002) were associated with children and adolescents' fast food consumption.

Spatial influence on qualitative food consumption in Colombia / Influência espacial sobre o consumo alimentar qualitativo em Colômbia

Abstract Spatial location is a factor that may facilitate the consumption of processed foods due to the ease of access, especially in highly urbanized, high density populations. This study presents the differences in food consumption in populations with different densities and urban and rural characteristics, and income above and below ten dollars a day. A sample of 2,130 subjects was used from 9 populations that included the Capital of Colombia, outlying medium-sized municipalities, metropolitan-area municipalities and small villages. The results confirm that processed and ultra-processed foods are consumed more in cities and urban areas than in smaller and rural populations, and that there are differences in consumption generated by income.

Resumo A localização espacial é um fator que pode facilitar o consumo de alimentos processados devido à facilidade de acesso, principalmente em populações altamente urbanizadas e com alta densidade populacional. Este estudo apresenta as diferenças no consumo alimentar em populações com diferentes densidades, características urbanas e rurais e renda maior ou menor de 10 dólares. A amostra foi de 2.130 indivíduos em 9 populações que incluíam a capital da Colômbia, municípios médios próximos à capital, municípios da área metropolitana e cidades rurais pequenas. Os resultados confirmam que os alimentos processados e ultraprocessados são mais consumidos nas cidades e áreas urbanas em relação aos municípios rurais e pequenos, além disso há diferenças no consumo geradas pela renda.

Duração do sono, excesso de peso e consumo de alimentos ultraprocessados em adolescentes / Sleep duration, overweight and consumption of ultra-processed foods among adolescents

Resumo O objetivo deste artigo é analisar a relação entre duração insuficiente do sono, sobrepeso/obesidade e o consumo de alimentos ultraprocessados em adolescentes de 10 a 14 anos. Trata-se de um estudo transversal, com avaliação de 1.384 adolescentes de escolas públicas de João Pessoa-PB, participantes do Estudo Longitudinal sobre Comportamento Sedentário, Atividade Física, Hábitos Alimentares e Saúde de Adolescentes (LONCAAFS). Foram mensuradas variáveis sociodemográficas, duração do sono, turno de aula, estado nutricional antropométrico, comportamento sedentário e consumo alimentar. Foram realizadas regressão linear e logística por meio do Software Stata 13.0. Prevalência de curta duração do sono de 29,5% (<9h/noite). Associação significativa entre a curta duração do sono e o excesso de peso somente para adolescentes <12 anos. Quanto à relação entre a duração do sono e o consumo de alimentos ultraprocessados, quanto maior a duração do sono, menor o consumo de lanches pelos adolescentes menores de 12 anos, com associação positiva para ≥12 anos apenas com ajuste pela variável atividade física. Não houve associação com os grupos "bebidas açucaradas" e "biscoitos" para nenhuma das faixas etárias analisadas.

Abstract The scope of this article is to analyze the relationship between insufficient sleep duration, overweight/obesity and the consumption of ultra-processed foods among adolescents aged 10 to 14 years. This is a cross-sectional study, with an evaluation of 1,384 adolescents from public schools in João Pessoa-PB, participating in the Longitudinal Study on Sedentary Behavior, Physical Activity, Diet and Adolescent Health (LONCAAFS). Sociodemographic variables, sleep duration, class shift, anthropometric nutritional status, sedentary behavior and food consumption were measured. Linear and logistic regression of the following were performed using Stata 13.0 Software: the prevalence of short sleep duration of 29.5% (<9h/night); a significant association between short sleep duration and excess weight only for adolescents <12 years old. With respect to the relationship between sleep duration and the consumption of ultra-processed foods, the longer the sleep duration, the lower the consumption of snacks by adolescents under 12 years old, with a positive association for ≥12 years old only with adjustment by the physical activity variable. There was no association with the "sugary drinks" and "cookies" groups for any of the age groups analyzed.

El consumo de productos ultraprocesados y su impacto en el perfil alimentario de los escolares uruguayos / Consumption and impact of ultra-processed food products on the nutritional profile of Uruguayan schoolchildren / O consumo e impacto de produtos ultra processados no perfil nutricional de escolares uruguaios

Objetivos: estimar la ingesta calórica y de nutrientes vinculados con enfermedades no transmisibles, según el nivel de procesamiento de los alimentos, en escolares de 4 a 12 años de la ciudad de Montevideo. Método: estudio transversal a partir de recordatorios de 24 horas realizados en 21 escuelas públicas con servicio de comedor escolar de la ciudad de Montevideo en 2018, en el marco de la evaluación nacional del Programa de Alimentación Escolar (PAE) de la Administración Nacional de Educación Pública. Para esto se analizó el aporte calórico, grasas totales, grasas saturadas, sodio, potasio, fibra dietética y azúcares libres en la dieta de los niños según su origen alimentario. Se utilizó el software PC SIDE para estimar la distribución de la ingesta de nutrientes y ajustar las varianzas interindividuales e intraindividuales. Resultados: en promedio la adecuación calórica alcanzó el 113% del requerimiento para el grupo y el 54% de los escolares consume calorías en forma excesiva. El 28% de las calorías provienen de productos ultraprocesados (PUP) y el 18,9% proviene de azúcares libres, equivalente prácticamente a 100 gramos de consumo diario. El consumo de PUP se constató en prácticamente todos los escolares estudiados y se asoció a un perfil alimentario más desfavorable, lo que se incrementa a medida que aumenta su ingesta. Conclusiones: los datos hallados permiten afirmar que el consumo de PUP es generalizado, de inicio en edades tempranas y que su mayor consumo se asocia a un perfil alimentario desfavorable.

Goals: estimate the caloric and nutritional intake associated with non-communicable diseases, according to the level of food processing in schoolchildren aged 4 to 12 in the city of Montevideo. Method: cross-sectional study based on 24-hour reminders carried out in 21 public schools with a school canteen service in the city of Montevideo in 2018, within the framework of the national evaluation of the School Food Program of the National Public Education Administration. With this purpose, the children's diet source was analyzed in terms of caloric intake, total fat, saturated fat, sodium, potassium, dietary fiber and free sugars. We used PC SIDE software to estimate the distribution of nutrient intake and adjust for interindividual and intraindividual variances. Results: on average, caloric adequacy reached 113% of the group's requirement and 54% of schoolchildren consume calories excessively. 28% of the calories come from Ultra-Processed Products (UPP) and 18.9% come from free sugars, equivalent to practically 100 grams of daily consumption. UPP consumption was found in practically all the schoolchildren studied and was associated with a more unfavorable dietary profile, which increases intake does. Conclusions: these findings enable us to state that the consumption of UPP is generalized, starts at an early age and that its higher consumption is associated with an unfavorable dietary profile.

Objetivos: estimar a ingestão calórica e de nutrientes associada às doenças não transmissíveis, segundo o nível de processamento de alimentos em escolares de 4 a 12 anos na cidade de Montevidéu. Método: estudo transversal com base em lembretes 24 horas realizados em 21 escolas públicas com serviço de cantina escolar na cidade de Montevidéu em 2018, no âmbito da avaliação nacional do Programa de Alimentação Escolar da Administração Nacional de Educação Pública. Para isso, foi analisada a ingestão calórica, gordura total, gordura saturada, sódio, potássio, fibra alimentar e açúcares livres na dieta das crianças, de acordo com a origem alimentar. O software PC SIDE foi usado para estimar a distribuição da ingestão de nutrientes e ajustar as variâncias interindividuais e intraindividuais. Resultados: em média, a adequação calórica atingiu 113% da necessidade do grupo e 54% dos escolares consomem calorias em excesso. 28% das calorias vêm de Produtos Ultraprocessados (PUP) e 18,9% vêm de açúcares livres, o que equivale a praticamente 100 gramas de consumo diário. O consumo de PUPs foi encontrado em praticamente todos os escolares estudados e esteve associado a um perfil alimentar mais desfavorável, que aumenta à medida que aumenta o consumo. Conclusões: os dados encontrados permitem afirmar que o consumo de PUPs é generalizado, acontece a partir de idade precoce e que seu maior consumo está associado a um perfil alimentar desfavorável.

Alimentos ultraprocessados e o consumo de fibras alimentares no Brasil / Ultra-processed foods and dietary fiber consumption in Brazil

Resumo Foi avaliado o consumo de fibras alimentares no Brasil e sua relação com a ingestão de alimentos ultraprocessados. Foram utilizados dados de consumo alimentar, via registro alimentar de 24 horas, com indivíduos de idade ≥10 anos (n=34.003) oriundos da Pesquisa de Orçamentos Familiares 2008-2009. Os alimentos foram divididos em grupos: in natura ou minimamente processados, ingredientes culinários processados, processados e ultraprocessados, estimando-se sua contribuição para o consumo de fibras. Verificou-se a relação entre quintos de consumo de ultraprocessados (avaliado pelo % do total de energia consumida) e teor médio de fibras na dieta (g/1.000kcal), e a prevalência de inadequação no consumo de fibras. Alimentos in natura ou minimamente processados apresentaram densidade de fibras significativamente maior do que os ultraprocessados e corresponderam à majoritária contribuição percentual de fibras na dieta, notavelmente a partir do arroz e feijão. Indivíduos do maior quintil de consumo de ultraprocessados tiveram 1,5 vez mais chance de apresentar ingestão de fibras inadequada. O consumo de ultraprocessados impactou negativamente na ingestão de fibras. Reduzir o consumo desses alimentos pode trazer benefícios à qualidade da dieta brasileira.

Abstract The consumption of dietary fiber in Brazil and its relationship with the intake of ultra-processed foods was evaluated. The analysis used food consumption data, with a 24-hour food record of residents aged ≥10 years (n=34.003) from the 2008-2009 Family Budgets Survey. The food products were divided into groups: in natura or minimally processed ingredients; processed culinary ingredients; processed and ultra-processed ingredients. The contribution of each food group and selected subgroups to the total fiber intake, the relation between quintiles of ultra-processed foods (evaluated by the % of total energy intake), average dietary fiber content (g/1,000kcal), and the prevalence of inadequate fiber consumption, was estimated. In natura or minimally processed foods revealed significantly higher fiber density than ultra-processed foods and corresponded to the majority percentile contribution of dietary fiber, notably derived from rice and beans. Individuals in the largest quintile of ultra-processed consumption were 1.5 times more likely to ingest inadequate fiber intake. The consumption of ultra-processed foods had a negative impact on fiber intake. Reducing the consumption of these foods can bring benefits to the quality of the Brazilian diet.

Ambiente alimentar de estações de metrô: um estudo no município de São Paulo, Brasil / Food environment at subway stations: a study in the municipality of São Paulo, Brazil

Resumo Os objetivos deste estudo foram caracterizar o ambiente alimentar no interior de estações de metrô da cidade de São Paulo e descrever a disponibilidade de alimentos e bebidas segundo vulnerabilidade social da área onde as estações se localizam. Foi realizado um estudo transversal envolvendo 19 estações de metrô. Para a auditoria dos pontos comerciais e das vending machines foram utilizados instrumentos do tipo checklist. Para caracterização do local onde as estações estavam inseridas, utilizou-se o Índice Paulista de Vulnerabilidade Social. Foram encontrados 66 pontos comerciais. A mediana de pontos comerciais por estação foi a mesma em todas as categorias de vulnerabilidade social do território (mediana=2 estabelecimentos/estação). Os tipos de alimentos comercializados mais frequentes foram os de conveniência, presentes em 100% dos pontos comerciais. A vulnerabilidade do território não resultou em diferença na disponibilidade de alimentos marcadores saudáveis e não saudáveis. O ambiente alimentar das estações de metrô é marcado pela grande disponibilidade de alimentos e bebidas ultraprocessados em todos os pontos comerciais.

Abstract This study aimed to characterize the food environment within subway stations in São Paulo and describe the availability of food and drinks according to the social vulnerability of the area where the stations are located. A cross-sectional study was carried out involving 19 subway stations, and checklist instruments were used to audit outlets and vending machines. The São Paulo Social Vulnerability Index was adopted to characterize the location of the stations. Sixty-six outlets were found. The median of outlets per station was the same in all categories of the territory's social vulnerability (median=2 establishments/station). The most frequent types of food sold were convenience foods, present in all of the outlets. The territory's vulnerability did not result in a difference in the availability of healthy and unhealthy marker foods. The food environment at subway stations is marked by the high availability of ultra-processed food and drinks at all outlets.