Analysis of the prevalence in sugar consumption in child care consultations / Análise da prevalência do consumo de açúcar em consultas de puericultura

Abstract Objectives: to analyze the prevalence of sugar consumption and associated factors in childcare consultations. Methods: cross-sectional study with 599 children > six months to < 24 months of age, assisted by the Family Health Units. Outcomes: daily consumption of sweetened beverages, sweets/candies, recorded in the Food and Nutrition Surveillance System; independent variables: sociodemographic data. Multiple logistic regression test was applied. Results: 62.10% of the children consume sugary drinks and 42.23%, sweets/candies. Consuming sugary drinks was associated with the age of 12-17 months and 29 days (OR=2.525; CI95%=1.68-3.78) and 18-17 months and 29 days (OR=2.90; CI95%=1.90-4.43); children living with more than four people at home (OR=1.59; CI95%=1.11-2.26), aged 12-17 months and 29 days (OR=2.05; CI95%=1.34-3.13) and 18-23 months and 29 days (OR=2.51; CI95%=1.62-3.87) were more likely to consume sweets/candies than younger children. Maternal aspects, such as age (OR=0.66; CI95%=0.46-0.93), marital status (OR=1.67; CI95%=1.06-2.6), schooling (OR=2.14; CI95%=1.12-4.08), and presence of government assistance (OR=2.03; CI95%=1.41-2.93), were conditions associated with the consumption of sweets. Conclusions: the prevalence of sugar in children's diet was high and was associated with sociodemographic aspects. Health education actions should be carried out in childcare, in order to promote healthy food, minimizing the consumption of sugar.

Resumo Objetivos: analisar a prevalência do consumo de açúcar e fatores associados em consultas de puericultura. Métodos: estudo transversal com 599 crianças >seis a <24 meses de idade, assistidas por Unidades de Saúde da Família. Desfechos: consumo diário de bebidas adoçadas, doces/guloseimas, registrados no Sistema de Vigilância Alimentar e Nutricional; variáveis independentes: dados sociodemográficos. Aplicou-se teste de regressão logística múltipla. Resultados: 62,10% das crianças consomem bebidas açucaradas e 42,23% doces/guloseimas. Consumir bebidas açucaradas associou-se à idade de 12-17 meses e 29 dias (OR=2,525; IC95%=1,68-3,78) e 18-17 meses e 29 dias (OR=2,90; IC95%=1,90-4,43); crianças residirem com mais de quatro pessoas na casa (OR=1,59; IC95%:1,11-2,26), terem idade de 12-17 meses e 29 dias (OR=2,05; IC95%=1,34-3,13) e 18-23 meses e 29 dias (OR=2,51; IC95%=1,62-3,87) apresentaram maior chance de consumir doces/guloseimas que crianças mais novas. Aspectos maternos como idade (OR=0,66; IC95%=0,46-0,93), estado civil (OR=1,67; IC95%=1,06-2,6), escolaridade (OR=2,14; IC95%=1,12-4,08), e presença de auxílio do governo (OR=2,03;IC95%=1,41-2,93), foram condições associadas ao consumo de doces/guloseimas. Conclusão: foi alta a prevalência de açúcar na dieta das crianças e esteve associada a aspectos sociodemográficos. Ações de educação em saúde devem ser realizadas na puericultura, a fim de fomentar a alimentação saudável, minimizando o consumo de açúcar.

Portion Sizes of Ultra-Processed Foods in the United States, 2002 to 2021.

Objectives. To assess the US food industry's response to calls from public health authorities to reduce portion sizes by comparing current with past sizes of selected examples of single-serve ultra-processed packaged and fast foods. Methods. We obtained manufacturers' information about current portion sizes and compared it with sizes when first introduced and in 2002. Results. Few companies in our sample reduced portion sizes since 2002; all still sold portions of ultra-processed foods in up to 5-times-larger sizes than when first introduced. Conclusions. Policies and practices focused on reducing portion size could help discourage the consumption of excessive amounts of ultra-processed foods. (Am J Public Health. 2021;111(12):2223-2226. https://doi.org/10.2105/AJPH.2021.306513).

Chocolate Candy and Incident Invasive Cancer Risk in the Women's Health Initiative: An Observational Prospective Analysis.

BACKGROUND: Laboratory and animal studies suggest an inverse association between chocolate consumption and the risk of cancer. Epidemiological studies have yielded inconsistent evidence. OBJECTIVE: To assess the association of chocolate candy consumption with incident, invasive total, breast, colorectal, and lung cancers in a large cohort of postmenopausal American women. DESIGN: Prospective cohort study with a mean 14.8-year follow-up. Chocolate candy intake was assessed by food frequency questionnaire. Invasive cancer events were assessed by physician adjudication. PARTICIPANTS/SETTING: The Women's Health Initiative Study enrolled 161,808 postmenopausal women at 40 clinical centers nationwide between 1993 and 1998. Of these women, 114,281 with plausible food frequency or biometric data and no missing data on chocolate candy exposure were selected for analysis. MAIN OUTCOME MEASURES: Cancer risk in quartiles of chocolate candy consumption with the first quartile as referent. STATISTICAL ANALYSES: Multivariable Cox regression was used to calculate hazard ratios and 95% confidence intervals. RESULTS: There were 16,164 documented incident invasive cancers, representing an incidence rate of 17.0 per 100 participants and 12.3 per 1000 person years during follow-up among participants without any preexisting cancers or missing outcome data. There were no statistically significant associations for total invasive cancer (P-linear = .47, P-curvature = .14), or invasive breast cancer (P-linear = .77, P-curvature = .26). For colorectal cancer P-linear was .02, P-curvature was .03, and compared with women eating a 1 oz (28.4 g) chocolate candy serving <1 time per month, the hazard ratio for ≥1.5 times/wk was 1.18 (95% confidence interval: 1.04-1.35). This result may be attributable to the excess adiposity associated with frequent chocolate candy consumption. CONCLUSIONS: In the Women's Health Initiative, there was no significant association between chocolate candy consumption and invasive total or breast cancer. There was a modest 18% higher risk of invasive colorectal cancer for women who ate chocolate candy at least 1.5 times/wk. These results require confirmation.

The extent and nature of television food advertising to children and adolescents in the Russian Federation.

OBJECTIVE: To assess the frequency, healthfulness and promotional techniques of television food advertising to children and adolescents in the Russian Federation. DESIGN: A cross-sectional study was conducted to monitor food and beverage television advertising. For the five most popular TV channels among children and adolescents, TV broadcasts were recorded for two weekdays and two weekends (320 h) during March-May 2017. Recordings were screened for advertisements. Food advertisements were categorised by food categories and as either 'permitted' or 'not permitted' for advertising to children in accordance with World Health Organization Regional Office for Europe Nutrient Profile Model (NPM), and promotional techniques in advertisements were recorded. RESULTS: Overall, 11 678 advertisements were coded. Across all channels, food and drink (19·2 %) were the most frequently advertised product type. The most common food categories advertised were beverages (except juices, milk drinks and energy drinks) (24·1 %); yoghurts and other dairy foods (15 %); and chocolate and confectionery (12·3 %). A majority (64·2 %) of food and drink products advertised should not be permitted for advertising to children according to the NPM. The most frequently used persuasive appeals in the food advertisements were low price (15·4 %), product novelty (11·8 %) and enjoyment (10·0 %). CONCLUSIONS: Children and adolescents in the Russian Federation are likely exposed to a substantial number of unhealthy food advertisements. There is a need to consider policies to restrict children's exposure to unhealthy food advertising on television in the Russian Federation.

Dietary sources of free sugars in the diet of European children: the IDEFICS Study.

OBJECTIVE: To report dietary free sugars consumption and their different types and food sources in European children. METHODS: The present study is based on the IDEFICS study, a European multicenter cohort study in children (2-9 years old) from eight countries, comprising 8308 children (51.4% males). Dietary intake of the previous 24 h was assessed using a computer-assisted 24-h dietary recalls (24-HDR) and the different types of sugars were assessed using the German food composition database. RESULTS: Mean total energy intake was 1720 (SD 477) kcal/d for boys and 1631 (SD 451) kcal/d for girls. Total sugars intake was 98 (SD 52) g/day for boys and 93 (SD 49) g/day for girls. Free sugars intake was 81 (SD 49) g/day for boys and 77 (SD 47) g/day for girls. Girls had significantly lower intakes of energy, total and free sugars compared with than boys but did not differ in terms of percent of energy from total (23%) or free sugars (18%). There were large variations between countries in average % energy from free sugars (ranging from 13% in Italy to 27% in Germany). Less than 20% of children were within the recommended intake of 10% of energy from free sugars. The food groups that contributed substantially to free sugars intakes were "Fruit juices", "Soft drinks", "Dairy" and "Sweets and candies". CONCLUSIONS: The contribution of free sugars to total energy intake in European children is higher than recommendations. The main food contributors to free sugars intake are sweetened beverages ("Fruit juices" and "Soft drinks"). It is especially important to reduce children's intake of free sugars, focusing in target population on certain foods and food groups.

Dietary habits in Japanese patients with psoriasis and psoriatic arthritis: Low intake of meat in psoriasis and high intake of vitamin A in psoriatic arthritis.

Psoriasis is characterized by T-helper 17 cell-dominant abnormal immunity, and hyperproliferation and abnormal differentiation of epidermal keratinocytes. Some patients are associated with arthritis. Dietary habits can modulate the pathogenesis of psoriasis. Previous studies in Western countries showed higher body mass indices, higher intake of fat and lower intake of fish or vegetables in psoriatic patients compared with the reference groups. We evaluated dietary habits in adult Japanese psoriatic patients, using a validated brief-type self-administered dietary history questionnaire, and compared the results to those of age- and sex-matched healthy controls. The results in psoriatic patients with arthritis were compared with those in the patients without. Japanese psoriatic patients showed higher body mass indices, higher intake of fish/shellfish, pulses, sugar/sweeteners, vitamin B12 and vitamin D, and lower intake of meat, compared with those of healthy controls. The logistic regression analysis showed that psoriasis was associated with high body mass index and low intake of meat. The intake of confection in patients with high Psoriasis Area and Severity Index was higher than that in those with low index. The intake of ß-carotene, vitamin A and green/yellow vegetables in psoriatic patients with arthritis were higher than those in the patients without. The dietary habits in Japanese psoriatic patients are rather different from those in Western patients. This is the first study showing the differences in dietary habits between psoriatic patients with arthritis and those without. Further studies should elucidate the relationships of these results with skin and joint lesions in psoriatic patients.

School-level changes in factors related to oral health inequalities after national recommendation on sweet selling.

Aims: In 2007, Finnish authorities gave a national recommendation that schools should not sell sweet products. This study aimed to determine the effects of the national recommendation on school-level intermediary determinants (factors related to oral health inequalities) and if the changes were different according to school-level socio-economic position (SEP). Methods: This ecological and longitudinal study combined school-level data from two independent studies from Finnish upper comprehensive schools (N = 970): the School Health Promotion study (SHPS) and the School Sweet Selling survey (SSSS). The baseline data (SHPS from 2006-2007 and SSSS from 2007) and the post-intervention data (SHPS and SSSS from 2008-2009) were combined into a longitudinal school-level data set (n = 360 and response rate = 37%). The intermediary determinants were: attitudes and access to intoxicants, school health services, school environment, home environment, schools' health-promoting actions (including sweet product selling) and pupils' eating habits. Three equal-sized school-level SEP group - slow, middle and high - were formed. The changes in the intermediary determinants were analysed using Wilcoxon Signed Ranks test. Differences between school SEP groups were analysed the using Kruskal-Wallis test. Longitudinal linear mixed modelling was used to determine the contribution of intermediary determinants to the changes in pupils' eating habits. Results: The national recommendation was effective in decreasing sweet product selling at schools and the effect was equal in each school-level SEP group. Intermediary determinants contributed differently to eating habits in the three SEP groups. Conclusions: A national recommendation seems to be an effective tool in making the school environment healthier without increasing inequalities.

Reduction in purchases of energy-dense nutrient-poor foods in Mexico associated with the introduction of a tax in 2014.

In 2014, an 8% tax on energy-dense nutrient-poor foods was implemented in Mexico with the aim of reducing its consumption. This paper estimated changes in household purchases of taxed food. We used the latest five waves of the nationally representative Mexican Income and Expenditure Survey (2008, 2010, 2012, 2014 and 2016). The analytic sample comprises 154,777 households. We estimated changes in purchases based on a before and after comparison. Results show a reduction in purchases of taxed food of -5.4 g/week per capita, equivalent to a relative reduction of -5.3% in the 2014 and 2016 waves compared to the 2008, 2010 and 2012 rounds. The largest relative reductions were in urban areas (-6.9%), among households with children (-7.0%), households where the head had an intermediate educational level (-9.9%) and the southern region (-14.8%). We did not find a significant reduction in rural areas. While there is a large heterogeneity, the fiscal instrument has been effective in reducing taxed food purchases and has generated substantial revenue that could be used to finance policies for the prevention and treatment of obesity.

Risk and protection factors for chronic noncommunicable diseases in adolescents in Brazilian capitals. / Fatores de risco e proteção para as doenças crônicas não transmissíveis em adolescentes nas capitais brasileiras.

OBJECTIVE: To analyze trend estimates on the prevalence of risk and protective behaviors for chronic noncommunicable diseases in adolescents, according to data from the National School Health Survey in 2009, 2012 and 2015. METHODS: Data from the three cross-sectional studies in Brazilian capitals and the Federal District were used. In total, 173,310 adolescents enrolled in the ninth grade of elementary school were interviewed, with average age of 14 years. The prevalence of indicators of protective (consumption of beans and fruit; physical education classes at school; practice of physical activity for 60 minutes or more) and risk factors (consumption of candies and soft drinks; use of cigarettes and alcohol in the last 30 days; drug testing) were estimated through linear regression. RESULTS: There was a significant increase (p < 0.05) in the prevalence of fruit consumption and in the reduction of bean, soft drinks and candies consumption, as well as the consumption of alcoholic beverages and cigarettes. However, an increase in the prevalence of illicit drug experimentation was observed. Discussion: Despite the tendency to reduce risk factors, prevalences are high when compared with other sociocultural realities. CONCLUSION: The school is an important area of access to the adolescent public, and it is necessary to encourage school health promotion programs to reduce health risk behaviors, as well as to stimulate protective ones.

OBJETIVO: Analisar as estimativas de tendência sobre a prevalência de comportamentos de risco e proteção para doenças crônicas não transmissíveis em adolescentes, segundo dados da Pesquisa Nacional de Saúde do Escolar em 2009, 2012 e 2015. MÉTODOS: Foram utilizados dados dos três estudos transversais nas capitais brasileiras e no Distrito Federal. No total, entrevistaram-se 173.310 adolescentes matriculados no 9º ano do ensino fundamental, com idade média de 14 anos. Foram estimadas pelo modelo de regressão linear as prevalências dos indicadores de fatores de proteção (consumo de feijão e frutas; aulas de educação física na escola; prática de 60 minutos ou mais de atividade física) e de risco (consumo de guloseimas e refrigerantes; uso de cigarro e álcool nos últimos 30 dias; experimentação de drogas). RESULTADOS: Houve aumento significativo (p < 0,05) da prevalência do consumo de frutas e redução de consumo de feijão, refrigerantes e guloseimas, assim como do uso de bebidas alcoólicas e cigarro, entretanto foi observado aumento na prevalência de experimentação de drogas ilícitas. DISCUSSÃO: Apesar da tendência de redução em alguns fatores de risco, as prevalências encontradas são altas ao comparar com outras realidades socioculturais. CONCLUSÃO: A escola é um importante espaço de acesso ao público adolescente, e faz-se necessário estimular programas de promoção da saúde escolar para reduzir comportamentos de risco à saúde, assim como incentivar comportamentos protetores.

Fatores de risco e proteção para as doenças crônicas não transmissíveis em adolescentes nas capitais brasileiras / Risk and protection factors for chronic noncommunicable diseases in adolescents in Brazilian capitals

RESUMO: Objetivo: Analisar as estimativas de tendência sobre a prevalência de comportamentos de risco e proteção para doenças crônicas não transmissíveis em adolescentes, segundo dados da Pesquisa Nacional de Saúde do Escolar em 2009, 2012 e 2015. Métodos: Foram utilizados dados dos três estudos transversais nas capitais brasileiras e no Distrito Federal. No total, entrevistaram-se 173.310 adolescentes matriculados no 9º ano do ensino fundamental, com idade média de 14 anos. Foram estimadas pelo modelo de regressão linear as prevalências dos indicadores de fatores de proteção (consumo de feijão e frutas; aulas de educação física na escola; prática de 60 minutos ou mais de atividade física) e de risco (consumo de guloseimas e refrigerantes; uso de cigarro e álcool nos últimos 30 dias; experimentação de drogas). Resultados: Houve aumento significativo (p < 0,05) da prevalência do consumo de frutas e redução de consumo de feijão, refrigerantes e guloseimas, assim como do uso de bebidas alcoólicas e cigarro, entretanto foi observado aumento na prevalência de experimentação de drogas ilícitas. Discussão: Apesar da tendência de redução em alguns fatores de risco, as prevalências encontradas são altas ao comparar com outras realidades socioculturais. Conclusão: A escola é um importante espaço de acesso ao público adolescente, e faz-se necessário estimular programas de promoção da saúde escolar para reduzir comportamentos de risco à saúde, assim como incentivar comportamentos protetores.

ABSTRACT: Objective: To analyze trend estimates on the prevalence of risk and protective behaviors for chronic noncommunicable diseases in adolescents, according to data from the National School Health Survey in 2009, 2012 and 2015. Methods: Data from the three cross-sectional studies in Brazilian capitals and the Federal District were used. In total, 173,310 adolescents enrolled in the ninth grade of elementary school were interviewed, with average age of 14 years. The prevalence of indicators of protective (consumption of beans and fruit; physical education classes at school; practice of physical activity for 60 minutes or more) and risk factors (consumption of candies and soft drinks; use of cigarettes and alcohol in the last 30 days; drug testing) were estimated through linear regression. Results: There was a significant increase (p < 0.05) in the prevalence of fruit consumption and in the reduction of bean, soft drinks and candies consumption, as well as the consumption of alcoholic beverages and cigarettes. However, an increase in the prevalence of illicit drug experimentation was observed. Discussion: Despite the tendency to reduce risk factors, prevalences are high when compared with other sociocultural realities. Conclusion: The school is an important area of access to the adolescent public, and it is necessary to encourage school health promotion programs to reduce health risk behaviors, as well as to stimulate protective ones.

Association between dietary patterns and mental disorders in pregnant women in Southern Brazil

Objective: To evaluate the association between dietary patterns and mental disorders among pregnant women in southern Brazil. Methods: Cross-sectional study with 712 pregnant women recruited from the Study of Food Intake and Eating Behaviors in Pregnancy (ECCAGe). Food intake assessment was performed using the Food Frequency Questionnaire. Dietary patterns were identified by cluster analysis. The Primary Care Evaluation of Mental Disorders (PRIME-MD) was used to evaluate participants' mental health. Poisson regression models with robust variance were fitted to estimate prevalence ratios (PR). Results: In the adjusted models, there was a high prevalence of major depressive disorder among women with low fruit intake (43%, PR 1.43, 95%CI 1.04-1.95) and high sweets and sugars intake (91%, PR 1.91, 95%CI 1.19-3.07). Women with a common-Brazilian dietary pattern had higher prevalence of major depressive disorder compared to those with a varied consumption pattern (PR 1.43, 95%CI 1.01-2.02). Low intake of beans was significantly associated with generalized anxiety disorder (PR 1.40, 95%CI 1.01-1.93). Conclusions: Low consumption of fruits and beans and intake of the common-Brazilian dietary pattern during pregnancy were associated with higher prevalence of mental disorders. These results reinforce the importance of an adequate dietary intake to ensure better mental health in pregnancy.

[Household purchase of sodas and cookies reduces the effect of an intervention to promote the consumption of fruits and vegetables]. / Aquisição domiciliar de refrigerantes e de biscoitos reduz o efeito de uma intervenção de promoção de frutas e hortaliças.

This study examines the influence of increasing household availability of sodas and cookies on the effects of an intervention to promote the consumption of fruits and vegetables. The study analyzed data from 70 families living in low-income communities in the city of Rio de Janeiro, Brazil, selected in a stratified probabilistic sample, and who completed a 30-day food record before and after the intervention. The intervention contributed to a significant increase in the household availability of fruit and vegetables (+2.7 p.p.; 95%CI: 1.5; 4.0), contrary to the trend towards stagnation of such availability in the general population in Brazil. Meanwhile, the purchase of sodas and cookies, which was not the intervention's target, mirrored the upward trend in the consumption of these products (+5.8 p.p.; 95%CI: 3.3; 8.4). Families that increased their purchase of sodas and cookies showed lower increases, or even decreases, in the purchase of fruits and vegetables (p < 0.05), and had nearly fourfold lower odds of experiencing any increase in the household availability of fruits and vegetables.

Association between dietary patterns and mental disorders in pregnant women in Southern Brazil.

OBJECTIVE:: To evaluate the association between dietary patterns and mental disorders among pregnant women in southern Brazil. METHODS:: Cross-sectional study with 712 pregnant women recruited from the Study of Food Intake and Eating Behaviors in Pregnancy (ECCAGe). Food intake assessment was performed using the Food Frequency Questionnaire. Dietary patterns were identified by cluster analysis. The Primary Care Evaluation of Mental Disorders (PRIME-MD) was used to evaluate participants' mental health. Poisson regression models with robust variance were fitted to estimate prevalence ratios (PR). RESULTS:: In the adjusted models, there was a high prevalence of major depressive disorder among women with low fruit intake (43%, PR 1.43, 95%CI 1.04-1.95) and high sweets and sugars intake (91%, PR 1.91, 95%CI 1.19-3.07). Women with a common-Brazilian dietary pattern had higher prevalence of major depressive disorder compared to those with a varied consumption pattern (PR 1.43, 95%CI 1.01-2.02). Low intake of beans was significantly associated with generalized anxiety disorder (PR 1.40, 95%CI 1.01-1.93). CONCLUSIONS:: Low consumption of fruits and beans and intake of the common-Brazilian dietary pattern during pregnancy were associated with higher prevalence of mental disorders. These results reinforce the importance of an adequate dietary intake to ensure better mental health in pregnancy.

Aquisição domiciliar de refrigerantes e de biscoitos reduz o efeito de uma intervenção de promoção de frutas e hortaliças / Household purchase of sodas and cookies reduces the effect of an intervention to promote the consumption of fruits and vegetables / La adquisición domiciliaria de refrescos y galletas reduce el efecto de una intervención de promoción de frutas y hortalizas

Resumo: O presente estudo examina a influência do aumento da disponibilidade intradomiciliar de refrigerantes e biscoitos sobre os efeitos de uma intervenção de promoção do consumo de frutas e hortaliças. Foram analisados os dados de 70 famílias que viviam em comunidades de baixa renda na cidade do Rio de Janeiro, Brasil, que foram selecionadas por meio de uma amostra probabilística estratificada e completaram registro alimentar de 30 dias antes e depois da intervenção. A intervenção contribuiu para um aumento significativo na disponibilidade intradomiciliar de frutas e hortaliças (+2,7 p.p.; IC95%: 1,5; 4,0), superando a tendência de estagnação na população brasileira. Já a aquisição de refrigerantes e biscoitos, que não foi objeto da intervenção, acompanhou a tendência crescente de consumo destes produtos (+5,8 p.p.; IC95%: 3,3; 8,4). As famílias que aumentaram a aquisição de refrigerantes e biscoitos apresentaram menores aumentos, ou decréscimos, na aquisição de frutas e hortaliças (p < 0,05) e tiveram uma chance quase quatro vezes menor de experimentar algum aumento na disponibilidade intradomiciliar de frutas e hortaliças.

Abstract: This study examines the influence of increasing household availability of sodas and cookies on the effects of an intervention to promote the consumption of fruits and vegetables. The study analyzed data from 70 families living in low-income communities in the city of Rio de Janeiro, Brazil, selected in a stratified probabilistic sample, and who completed a 30-day food record before and after the intervention. The intervention contributed to a significant increase in the household availability of fruit and vegetables (+2.7 p.p.; 95%CI: 1.5; 4.0), contrary to the trend towards stagnation of such availability in the general population in Brazil. Meanwhile, the purchase of sodas and cookies, which was not the intervention's target, mirrored the upward trend in the consumption of these products (+5.8 p.p.; 95%CI: 3.3; 8.4). Families that increased their purchase of sodas and cookies showed lower increases, or even decreases, in the purchase of fruits and vegetables (p < 0.05), and had nearly fourfold lower odds of experiencing any increase in the household availability of fruits and vegetables.

Resumen: El presente estudio examina la influencia del aumento de la disponibilidad intradomiciliaria de refrescos y galletas, sobre los efectos de una intervención de promoción del consumo de frutas y hortalizas. Se analizaron los datos de 70 familias que vivían en comunidades de baja renta en la ciudad de Río de Janeiro, Brasil, que fueron seleccionadas mediante una muestra probabilística estratificada, y completaron un registro alimentario de 30 días antes y después de la intervención. La intervención contribuyó a un aumento significativo en la disponibilidad intradomiciliaria de frutas y hortalizas (+2,7 p.p.; IC95%: 1,5; 4,0), superando la tendencia de estancamiento en la población brasileña. Ya la adquisición de refrescos y galletas, que no fue objeto de la intervención, acompañó la tendencia creciente de consumo de estos productos (+5,8 p.p.; IC95%: 3,3; 8,4). Las familias que aumentaron la adquisición de refrescos y galletas presentaron menores aumentos, o decrementos, en la adquisición de frutas y hortalizas (p < 0,05) y tuvieron una probabilidad casi cuatro veces menor de experimentar algún aumento en la disponibilidad intradomiciliaria de frutas y hortalizas.

Television food advertising to children in Slovenia: analyses using a large 12-month advertising dataset.

OBJECTIVES: The marketing of energy-dense foods is recognised as a probable causal factor in children's overweight and obesity. To stimulate policymakers to start using nutrient profiling to restrict food marketing, a harmonised model was recently proposed by the WHO. Our objective is to evaluate the television advertising of foods in Slovenia using the above-mentioned model. METHODS: An analysis is performed using a representative dataset of 93,902 food-related advertisements broadcast in Slovenia in year 2013. The advertisements are linked to specific foods, which are then subject to categorisation according to the WHO and UK nutrient profile model. RESULTS: Advertising of chocolate and confectionery represented 37 % of food-related advertising in all viewing times, and 77 % in children's (4-9 years) viewing hours. During these hours, 96 % of the food advertisements did not pass the criteria for permitted advertising according to the WHO profile model. CONCLUSIONS: Evidence from Slovenia shows that, in the absence of efficient regulatory marketing restrictions, television advertising of food to children is almost exclusively linked to energy-dense foods. Minor modifications of the proposed WHO nutrient profile model are suggested.

Consumption of sugar-rich food products among Brazilian students:National School Health Survey (PeNSE 2012) / Consumo de alimentos ricos em açúcar entre estudantes brasileiros:Pesquisa Nacional de Saúde do Escolar (PeNSE 2012) / Consumo de alimentos ricos en azúcar entre estudiantes brasileños:Encuesta Nacional de Salud Escolar (PeNSE 2012)

Abstract This study aimed to analyze the consumption of high-sugar foods by Brazilian schoolchildren and to identify associated factors, based on data from the National School Health Survey (PeNSE 2012). Consumption of these foods was classified as: do not consume sweets and soft drinks regularly; consume sweets or soft drinks regularly; and consume sweets and soft drinks regularly. Its association with sociodemographic information, eating habits, and family contexts were investigated via multiple ordinal regressions. Regular consumption of sweets and/or soft drinks was reported by 19.2% and 36.1% of adolescents, respectively, and higher prevalence was associated with female gender, age 14-15 years, higher maternal education, not living with the mother and father, not eating meals with the parents, eating while watching TV, and longer TV time. Nearly one-fifth of adolescents regularly consumed sweets and soft drinks, which was associated with socio-demographic and behavioral factors that should be targeted in order to improve their food consumption.

Resumo Objetivou-se analisar o consumo de alimentos ricos em açúcar entre estudantes brasileiros e identificar seus fatores associados. Utilizaram-se dados da Pesquisa Nacional de Saúde do Escolar (PeNSE 2012). O consumo desses alimentos foi classificado como: não consomem guloseimas/refrigerantes regularmente; consomem guloseimas ou refrigerantes regularmente; consomem guloseimas e refrigerantes regularmente. Fatores sociodemográficos, alimentares e familiares associados foram avaliados por regressão ordinal múltipla. O consumo regular de guloseimas e/ou refrigerantes foi relatado por 19,2% e 36,1% dos adolescentes, respectivamente, sendo mais prevalente entre estudantes do sexo feminino, com 14-15 anos de idade, com maior escolaridade materna, que não viviam com a mãe e o pai, que não realizam as refeições com os pais, que comiam assistindo TV e que passavam mais tempo diante da TV. Quase 1/5 dos adolescentes consumia guloseimas e refrigerantes regularmente, condição associada a fatores sociodemográficos e comportamentais, os quais devem ser priorizados visando a melhorar seu consumo alimentar.

Resumen Se tuvo como objetivo analizar el consumo de alimentos ricos en azúcar entre estudiantes brasileños e identificar sus factores asociados. Se utilizaron datos de la Encuesta Nacional de Salud Escolar (PeNSE 2012). El consumo de estos alimentos fue clasificado como: no consumen golosinas/refrescos regularmente; consumen golosinas o refrescos regularmente; consumen golosinas y refrescos regularmente. Factores sociodemográficos, alimentarios y familiares asociados fueron evaluados por regresión ordinal múltiple. El consumo regular de golosinas y/o refrescos fue relatado por 19,2% y 36,1% de los adolescentes, respectivamente, siendo más prevalente entre estudiantes del sexo femenino, con 14-15 años de edad, con mayor escolaridad materna, que no vivían con la madre y el padre, que no realizan las comidas con los padres, que comían viendo TV y que pasaban más tiempo viendo TV. Casi 1/5 de los adolescentes consumía golosinas y refrescos regularmente, condición asociada a factores sociodemográficos y de comportamiento, que deben ser observados como prioridad para mejorar el consumo alimenticio.

Dental Erosion and its Associated Factors In 11-16-Year Old School Children.

UNLABELLED: Dental erosion currently stands as a great challenge for the clinician, regarding the diagnosis, identification of the etiological factors, prevention and execution of an adequate treatment. AIMS: To evaluate the prevalence, severity, and associated factors on dental erosion in 11-16-years old. STUDY DESIGN: A cross sectional study was conducted among 2000 school children who were randomly selected. A questionnaire was given to the children that included personal demographic details and habit of consuming acidic foods and drinks. An index specific for dental erosion given by O Sullivan was used to assess every affected tooth. The values were subjected to chi-square test and multivariate logistic regression analysis. RESULTS: The prevalence of dental erosion was found to be 1.4%. Females (1.6%) were slightly more affected than males (1.3%). Public school children (2.1%) were found to be affected a little more than private children (0.7%). Chi square test showed significant association between type of school and erosion prevalence (p = 0.015). Most commonly affected teeth were lateral incisor (59.72%). CONCLUSION: The prevalence of dental erosion was found to be low when compared to various studies done all over the world.

Chocolate-candy consumption and 3-year weight gain among postmenopausal U.S. women.

OBJECTIVE: To test the hypothesis that greater chocolate-candy intake is associated with more weight gain in postmenopausal women. METHODS: A prospective cohort study involved 107,243 postmenopausal American women aged 50-79 years (mean = 60.7) at enrollment in the Women's Health Initiative, with 3-year follow-up. Chocolate-candy consumption was assessed by food frequency questionnaire, and body weight was measured. Linear mixed models, adjusted for demographic, socio economic, anthropomorphic, and behavioral variables, were used to test our main hypotheses. RESULTS: Compared with women who ate a 1 oz (∼28 g) serving of chocolate candy <1 per month, those who ate this amount 1 per month to <1 per week, 1 per week to < 3 per week and ≥3 per week showed greater 3-year prospective weight gains (kg) of 0.76 (95% CI: 0.66, 0.85), 0.95 (0.84, 1.06), and 1.40 (1.27, 1.53), respectively, (P for linear trend<0.0001). Each additional 1 oz/day was associated with a greater 3-year weight gain (kg) of 0.92 (0.80, 1.05). The weight gain in each chocolate-candy intake level increased as BMI increased above the normal range (18.5-25 kg/m(2)), and was inversely associated with age. CONCLUSIONS: Greater chocolate-candy intake was associated with greater prospective weight gain in this cohort of postmenopausal women.

The role of behaviour in inequality in increments of dental caries among Finnish adults.

BACKGROUND: Evidence from cross-sectional studies implies that dental behaviours partially explain inequalities in oral health. OBJECTIVE: To assess whether dental behaviours completely eliminate inequality in increments of dental caries in a sample of Finnish adults. METHODS: The baseline data were collected from the Health 2000 survey, a nationally representative survey of 8,028 individuals aged 30 years or older living in mainland Finland. Four years later, 1,248 subjects were invited for oral re-examination, and 1,049 agreed to participate (84% response rate). At baseline, participants provided information on demographics, education and dental behaviours (dental attendance, tooth brushing with fluoride toothpaste, sugar consumption and daily smoking). Oral examinations at baseline and follow-up were identical. RESULTS: Adults with basic education had significantly greater increments of DMFT (incidence rate ratio 1.41, 95% CI 1.07-1.85) and DT (incidence rate ratio 2.23, 95% CI 1.27-3.90) than those with high education. Adjusting for single behaviours attenuated but did not eliminate education inequality in DMFT and DT increments, tooth brushing having the greatest impact on inequality. Simultaneous adjustment for all behaviours eliminated the significant relationship between education and caries increment. CONCLUSIONS: Accounting for important dental behaviours appears to explain all education inequality in dental caries in Finnish adults. The results should be interpreted with caution when applied to less egalitarian populations.

Effect of national recommendation on sweet selling as an intervention for a healthier school environment.

AIMS: In 2007, the Finnish National Board of Education (FNBE) and the National Institute for Health and Welfare (THL) gave a national recommendation that Finnish upper comprehensive schools should not sell sweet products. The aim was to find out how the national recommendation changed the schools' selling of sweet products. METHODS: This longitudinal survey was conducted in Finnish upper comprehensive school classes 7-9 (13-15-year-old pupils) in 2007 and 2010. All the schools (N=970) were invited to answer the questionnaire and 237 schools answered in both years (response rate 24%). The questionnaires contained questions concerning the selling of sweet and healthy products and school policy on sweet selling guidelines. Of the nine items in the questionnaire, three weighted sum scores were formed for oral health promotion: Exposure, enabling and policy (higher score indicating better actions). These sum scores were also trichotomized. Statistical significances of the changes were analyzed using nonparametric Wilcoxon's test, McNemar's test, and McNemar-Bowker's test. RESULTS: Schools had decreased exposure of pupils to sweet products (p<0.001), more often provided oral health protecting items (p=0.047) and had improved their oral health-promoting policy (p<0.001). The selling of some sweet products, candies and soft drinks had decreased (p<0.001) whereas the selling of other sweet products had not changed (p=0.665). Schools tended to improve their exposure and policy status (p<0.001). CONCLUSION: It is possible to improve school environments by means of a national recommendation. Other actions are needed both inside and outside schools in order to decrease the total consumption of sweet products among adolescents.