Excessive red and processed meat intake: relations with health and environment in Brazil.

The aims of the present study were to verify the proportion of population that consumed more red and processed meat than the World Cancer Research Fund (WCRF) dietary recommendation, to estimate the environmental impact of beef intake and the possible reduction of greenhouse gas emissions if the dietary recommendation was followed. We used the largest, cross-sectional, population-based survey entitled the National Dietary Survey (34 003 participants aged 10-104 years). The usual meat intake was obtained by two food records completed on 2 non-consecutive days. The usual intake was estimated by the multiple source method. The environmental impact was analysed according to estimates of CO2 equivalent emissions from beef intake as a proxy for beef production in Brazil. The red and processed meat intake mean was 88 g/d. More than 80 % of the population consumed more red and processed meat than the WCRF recommendation. Beef was the type of meat most consumed, accounting to almost 50 %. Each person contributed 1005 kg of CO2 equivalents from beef intake in 2008, the same quantity of CO2 produced if a car travelled a distance between the extreme north and south of Brazil (5370 km). The entire Brazilian population contributed more than 191 million tons of CO2 equivalents, which could have been reduced to more than 131 million tons if the dietary recommendation was followed. The present study shows that the magnitude of the excessive red and processed meat intake in Brazil can impact on health and the environment, pointing to the urgency of promoting a sustainable diet.

Exploring the Nexus between Food Systems and the Global Syndemic among Children under Five Years of Age through the Complex Systems Approach.

The intricate relationship between food systems and health outcomes, known as the food-nutrition-health nexus, intersects with environmental concerns. However, there's still a literature gap in evaluating food systems alongside the global syndemic using the complex systems theory, especially concerning vulnerable populations like children. This research aimed to design a system dynamics model to advance a theoretical understanding of the connections between food systems and the global syndemic, particularly focusing on their impacts on children under five years of age. The framework was developed through a literature review and authors' insights into the relationships between the food, health, and environmental components of the global syndemic among children. The conceptual model presented 17 factors, with 26 connections and 6 feedback loops, categorized into the following 5 groups: environmental, economic, school-related, family-related, and child-related. It delineated and elucidated mechanisms among the components of the global syndemic encompassing being overweight, suffering from undernutrition, and climate change. The findings unveiled potential interactions within food systems and health outcomes. Furthermore, the model integrated elements of the socio-ecological model by incorporating an external layer representing the environment and its natural resources. Consequently, the development of public policies and interventions should encompass environmental considerations to effectively tackle the complex challenges posed by the global syndemic.

Citizen science data on urban forageable plants: a case study in Brazil.

This paper presents two key data sets derived from the Pomar Urbano project. The first data set is a comprehensive catalog of edible fruit-bearing plant species, native or introduced to Brazil. The second data set, sourced from the iNaturalist platform, tracks the distribution and monitoring of these plants within urban landscapes across Brazil. The study includes data from the capitals of all 27 federative units of Brazil, focusing on the ten cities that contributed the most observations as of August 2023. The research emphasizes the significance of citizen science in urban biodiversity monitoring and its potential to contribute to various fields, including food and nutrition, creative industry, study of plant phenology, and machine learning applications. We expect the data sets presented in this paper to serve as resources for further studies in urban foraging, food security, cultural ecosystem services, and environmental sustainability.

Leveraging citizen science for monitoring urban forageable plants.

Urbanization brings forth social challenges in emerging countries such as Brazil, encompassing food scarcity, health deterioration, air pollution, and biodiversity loss. Despite this, urban areas like the city of São Paulo still boast ample green spaces, offering opportunities for nature appreciation and conservation, enhancing city resilience and livability. Citizen science is a collaborative endeavor between professional scientists and nonprofessional scientists in scientific research that may help to understand the dynamics of urban ecosystems. We believe citizen science has the potential to promote human and nature connection in urban areas and provide useful data on urban biodiversity.

Excessive meat consumption in Brazil: diet quality and environmental impacts.

OBJECTIVE: To evaluate red and processed meat intake, and the impact meat consumption has on diet quality and the environment. DESIGN: A large cross-sectional health survey performed in São Paulo, Brazil. SETTING: Diet was assessed by two 24 h dietary recalls. Usual intakes were calculated using the Multiple Source Method. The World Cancer Research Fund recommendation of an average of 71.4 g/d was used as the cut-off point to estimate excessive red and processed meat consumption. To investigate the relationship between meat consumption and diet quality we used the Brazilian Healthy Eating Index Revised. The environmental impact was analysed according to estimates of CO2 equivalent emissions from meat consumption. SUBJECTS: Brazilians (n 1677) aged 19 years and older were studied. RESULTS: The mean red and processed meat intake was 138 g/d for men and 81 g/d for women. About 81% of men and 58% of women consumed more meat than recommended. Diet quality was inversely associated with excessive meat intake in men. In Brazil alone, greenhouse gas emissions from meat consumption, in 2003, were estimated at approximately 18,071,988 tonnes of CO2 equivalents, representing about 4% of the total CO2 emitted by agriculture. CONCLUSIONS: The excessive meat intake, associated with poorer diet quality observed, support initiatives and policies advising to reduce red and processed meat intake to within the recommended amounts, as part of a healthy and environmentally sustainable diet.

Biodiversity is overlooked in the diets of different social groups in Brazil.

Food biodiversity is essential for improving nutrition and reducing hunger in populations worldwide. However, in middle and low-income countries, the biodiversity of food production does not necessarily represent food consumption patterns by population. We used Brazil, one of the world's megabiodiverse countries, as a case study to investigate the following questions: what is the prevalence of consumption of biodiverse foods in Brazil, and what are the socioeconomic factors that influence their consumption throughout the country? We used data from a Brazilian representative national dietary survey to estimate the frequency of food consumption of unconventional food plants, edible mushrooms, and wild meat, in according to socioeconomic variables. Thus, we investigated the socioeconomic predictors of Unconventional Food Plants consumption using methods of Machine Learning (ML) and multiple zero-inflated Poisson (ZIP) regression. We showed that biodiverse food consumption in Brazil is low, just related by 1.3% of the population, varying in according to area, ethnicity, age, food insecurity, sex, and educational level. Our findings of low utilization of biodiversity suggest an important mismatch between the rich biodiversity of the country and its representation in the human diet.

Low Adherence to the EAT-Lancet Sustainable Reference Diet in the Brazilian Population: Findings from the National Dietary Survey 2017-2018.

Diets are simultaneously connected with population health and environment. The EAT-Lancet Commission proposed a sustainable reference diet to improve population health and respect the planetary boundaries. Recently, the Planetary Health Diet Index (PHDI) has been developed to assess the adherence to this reference diet. In the present study, we aimed to evaluate the adherence to the EAT-Lancet diet through the PHDI in a nationwide population-based study carried out in Brazil. We used data from the National Dietary Survey conducted through the Household Budget Survey in 2017-2018, with 46,164 Brazilians aged over 10 years old. Food consumption was evaluated with a 24 h dietary recall. The average PHDI total score in the Brazilian population was 45.9 points (95% CI 45.6:46.1) on a total score that can range from 0 to 150 points. The adherence to EAT-Lancet diet was low among all Brazilian regions. Women, elderly, those overweighed/obese, with higher per capita income and living in the urban area had higher scores in the PHDI. In general, the Brazilian population presented low adherence to a healthy and sustainable dietary pattern and seems far from meeting the EAT-Lancet recommendations.

The cost of eating more sustainable diets: A nutritional and environmental diet optimisation study.

We aim to identify the dietary changes to improve nutrition and reduce diet-related greenhouse gas emission (GHGE) simultaneously in Brazil, taking into account the heterogeneity in food habits and prices across the country. Food consumption and prices were obtained from two nationwide surveys (n = 55,970 households and 34,003 individuals). Linear programming models were performed to design optimised diets most resembling the observed diets, and meeting different sets of constraints: (i) nutritional, for preventing chronic diseases and meeting nutrient adequacy; (ii) socio-cultural: by respecting food preferences; and (iii) environmental: by reducing GHGE by steps of 10%. Moving toward a diet that meets nutritional recommendations led to a 14% to 24% cost increase and 10% to 27% GHGE reduction, depending on the stringency of the acceptability constraints. Stronger GHGE reductions were achievable (up to about 70%), with greater departure from the current diet, but not achieving calcium and potassium goals. Diet cost increment tended to be mitigated with GHGE reduction in most models, along with reductions in red meat, chicken, eggs, rice, and high-fat sugar sodium foods.

Development and Validation of an Index Based on EAT-Lancet Recommendations: The Planetary Health Diet Index.

The EAT-Lancet Commission has proposed a planetary health diet. We propose the development of the Planetary Health Diet Index (PHDI) based on this proposed reference diet. We used baseline dietary data obtained through a 114-item FFQ from 14,779 participants of the Longitudinal Study on Adult Health, a multicenter cohort study conducted in Brazil. The PHDI has 16 components and a score from 0 to 150 points. Validation and reliability analyses were performed, including principal component analyses, association with selected nutrients, differences in means between groups (for example, smokers vs. non-smokers), correlations between components and total energy intake, Cronbach's alpha, item-item correlations, and linear regression analysis between PHDI with carbon footprint and overall dietary quality. The mean PHDI was 60.4 (95% CI 60.2:60.5). The PHDI had six dimensions, was associated in an expected direction with the selected nutrients and was significantly (p < 0.001) lower in smokers (59.0) than in non-smokers (60.6). Cronbach's alpha value was 0.51. All correlations between components were low, as well as between components and PHDI with total energy intake. After adjustment for age and sex, the PHDI score remained associated (p < 0.001) with a higher overall dietary quality and lower carbon footprint. Thus, we confirmed the PHDI validity and reliability.

The role of the Brazilian Unified Health System in combating the global syndemic and in the development sustainable food systems. / O papel do Sistema Único de Saúde no combate à sindemia global e no desenvolvimento de sistemas alimentares sustentáveis.

The undernutrition and obesity pandemics associated with climate change are a global syndemic. They have a point of convergence, which is the unsustainable current food systems. This paper aims to discuss the role of public health policies, particularly the Brazilian Unified Health System (SUS) in the context of Primary Health Care, in combating the global syndemic and in the development of sustainable food systems. In this scenario, the National Food and Nutrition Policy is a leading intersectoral tool for an adequate and healthy diet and food and nutrition security. Also, the Dietary Guidelines for the Brazilian population is a strategic tool to support food and nutrition education. We highlight the need to articulate health, agriculture, and environmental policies to achieve sustainable development. Thus, SUS can be the arena to promote the main discussions on this topic, potentiating individual, group, and institutional actions to provide a fairer, healthy, and sustainable food system.

As pandemias de desnutrição e obesidade, em conjunto com as mudanças climáticas, constituem uma sindemia global e apresentam um importante ponto de convergência, que é a insustentabilidade dos sistemas alimentares atuais. O objetivo deste artigo é discutir o papel de políticas públicas de saúde, particularmente do Sistema Único de Saúde (SUS) no âmbito da Atenção Primária à Saúde, no combate à sindemia global e no desenvolvimento de sistemas alimentares sustentáveis. Nesse contexto, a Política Nacional de Alimentação e Nutrição se destaca como uma importante ferramenta intersetorial para a alimentação adequada e saudável e à segurança alimentar e nutricional. Além disso, o Guia Alimentar se apresenta como um instrumento estratégico de apoio às ações de educação alimentar e nutricional. De modo essencial, destaca-se a necessidade de articulação das políticas de saúde, agricultura e meio ambiente para que o desenvolvimento sustentável possa ser efetivado. Assim, o SUS tem capacidade de ser palco das principais discussões sobre essa temática, atuando como um potencializador de ações individuais, coletivas e institucionais para promover um sistema alimentar mais justo, saudável e sustentável.

Plasma metabolomics are associated with metabolic syndrome: A targeted approach.

OBJECTIVES: Advances in metabolomic tools have allowed us to gain a more comprehensive understanding of metabolic syndrome (MetS). The aim of this study was to evaluate the association between plasma metabolomic profiles and MetS. METHODS: For this study, adults without diabetes, chronic kidney disease, stroke, heart disease, or cancer and with full metabolomics, biochemical, and dietetic data available, representing a subsample of the Health Survey of Sao Paulo study (ISA-Capital; N = 130), were included. The joint interim statement consensus criteria were used for diagnosing MetS. Absolute quantification (µmol/L) of blood metabolites was achieved by targeted quantitative profiling of annotated metabolites by electrospray ionization tandem mass spectrometry in plasma samples. Mean differences in the compounds for MetS were evaluated by linear regression adjusted for confounding factors. RESULTS: Serine was inversely associated with MetS (ß = -15.04; P = 0.014). In glycerophospholipids with acyl-alkyl bonds, there was an inverse association with MetS, including phosphatidylcholine (PC) ae C42:5 (ß = -0.15; P = 0.040), PC ae C44:5 (ß = -0.15; P = 0.046), PC ae C40:4 (ß = -0.21; P = 0.014) and PC ae C44:4 (ß = -0.04; P = 0.032). CONCLUSION: Plasma metabolomic profiles were associated with MetS, especially the amino acid serine and some acyl-alkyl PCs.

Plasma fatty acids: Biomarkers of dietary intake?

OBJECTIVE: To our knowledge, there is currently no consensus in the literature on the association between dietary fatty acids and circulating levels in plasma. The aim of this study was to assess the association of the intake of fatty acids with their relative plasma concentrations. METHODS: We conducted a study with 300 adults from the population-based health survey in São Paulo city (ISA-Capital 2008). We assessed demographic, lifestyle and anthropometric data, biochemical measurements, and two 24-h dietary recalls collected on non-consecutive days. Intake distribution was adjusted for intrapersonal variance to give usual dietary intake using the multiple source method (MSM). Percentage of fatty acids in plasma were analyzed by gas chromatography. The κ statistic, Spearman's correlation, and multiple linear regression (adjusted for confounders) and ratio limits of agreement were employed to determine the relationship between plasma and dietary measurements. RESULTS: Low correlation and agreement were found between dietary and plasma fatty acids. Docosahexaenoic acid (ß = 0.25; P < 0.001) and saturated (ß = 0.19; P = 0.048) fatty acids exhibited an association for means of intake adjusted by the MSM and for confounding variables. A large mean difference, with a large variation of "ratio limits," were observed between the measurements. CONCLUSION: Plasma and dietary polyunsaturated and saturated fatty acids exhibited low correlation and agreement, as well as weak association between each other. No association between intake and plasma concentrations of monounsaturated fat was found. Plasma fatty acids are not good biomarkers of food intake.

Arginine intake is associated with oxidative stress in a general population.

OBJECTIVE: The aim of this study was to assess the association between protein and arginine from meat intake and oxidative stress in a general population. METHODS: Data came from the Health Survey for Sao Paulo (ISA-Capital), a cross-sectional population-based study in Brazil (N = 549 adults). Food intake was estimated by a 24-h dietary recall. Oxidative stress was estimated by malondialdehyde (MDA) concentration in plasma. Analyses were performed using general linear regression models adjusted for some genetic, lifestyle, and biochemical confounders. RESULTS: MDA levels were associated with meat intake (P for linear trend = 0.031), protein from meat (P for linear trend = 0.006), and arginine from meat (P for linear trend = 0.044) after adjustments for confounders: age, sex, body mass index, smoking, physical activity, intake of fruit and vegetables, energy and heterocyclic amines, C-reactive protein levels, and polymorphisms in GSTM1 (glutathione S-transferase Mu 1) and GSTT1 (glutathione S-transferase theta 1) genes. Results were not significant for total protein and protein from vegetable intake (P > 0.05). CONCLUSIONS: High protein and arginine from meat intake were associated with oxidative stress independently of genetic, lifestyle, and biochemical confounders in a population-based study. Our results suggested a novel link between high protein/arginine intake and oxidative stress, which is a major cause of age-related diseases.

The MC4R genotype is associated with postpartum weight reduction and glycemic changes among women with prior gestational diabetes: longitudinal analysis.

The genetic variants near the Melanocortin-4 receptor gene (MC4R), a key protein regulating energy balance and adiposity, have been related to obesity and glucose metabolism. We aimed to assess whether the MC4R genotype affected longitudinal changes in body weight and glucose metabolism biomarkers among women with prior gestational diabetes mellitus (GDM). The MC4R genotype, postpartum weight reduction, and glycemic changes between after delivery and pregnancy were assessed in a cohort of 1208 Chinese women who had experienced GDM. The adiposity-increasing allele (C) of the MC4R variant rs6567160 was associated with greater postpartum increase of HbA1c (ß = 0.08%; P = 0.03) and 2-hour OGTT glucose concentrations (ß = 0.25 mmol/L; P = 0.02). In addition, we found an interaction between the MC4R genotype and postpartum weight reduction on changes in fasting plasma glucose (P-interaction = 0.03). We found that the MC4R genotype was associated with postpartum glycemic changes; and the association with fasting glucose were significantly modified by postpartum weight reduction in women who had experienced GDM.

Joint association of fruit, vegetable, and heterocyclic amine intake with DNA damage levels in a general population.

OBJECTIVE: To assess joint effects of heterocyclic amine (HCA), fruit, and vegetable intake on DNA damage in a general population. METHODS: A cross-sectional survey (ISA-Capital) was performed among adults and older adults in Brazil. We selected 73 participants with high HCA intake and 73 sex- and age-matched participants with non-HCA intake (n = 146) for the present study. Diet was assessed by a 24-h dietary recall and a structured questionnaire with cooking methods and levels of meat doneness. DNA damage was measured by 8-oxo-2'-deoxyguanosine (8-OHdG). The association between DNA damage and dietary intake was analyzed by linear regression models. RESULTS: Fruit intake showed significantly inverse association with 8-OHdG (ß, -0.787; P = 0.035), whereas HCA intake was significantly associated with increased DNA damage (ß, 1.621; P = 0.036) after adjusting for covariates, including sex, age, body mass index, energy intake, smoking, physical activity, and C-reactive protein. Vegetable intake was not significantly associated with 8-OHdG. We also found a significant association between joint fruit and HCA intake and DNA damage, and the difference in 8-OHdG levels was significantly higher between participants with the lowest fruit intake and highest HCA intake and those with the highest fruit intake and non-HCA intake (P = 0.049). CONCLUSIONS: Lower intake of fruits and higher intake of HCAs were associated with higher DNA damage levels and showed an additive effect pattern.

O papel do Sistema Único de Saúde no combate à sindemia global e no desenvolvimento de sistemas alimentares sustentáveis / The role of the Brazilian Unified Health System in combating the global syndemic and in the development sustainable food systems

Resumo As pandemias de desnutrição e obesidade, em conjunto com as mudanças climáticas, constituem uma sindemia global e apresentam um importante ponto de convergência, que é a insustentabilidade dos sistemas alimentares atuais. O objetivo deste artigo é discutir o papel de políticas públicas de saúde, particularmente do Sistema Único de Saúde (SUS) no âmbito da Atenção Primária à Saúde, no combate à sindemia global e no desenvolvimento de sistemas alimentares sustentáveis. Nesse contexto, a Política Nacional de Alimentação e Nutrição se destaca como uma importante ferramenta intersetorial para a alimentação adequada e saudável e à segurança alimentar e nutricional. Além disso, o Guia Alimentar se apresenta como um instrumento estratégico de apoio às ações de educação alimentar e nutricional. De modo essencial, destaca-se a necessidade de articulação das políticas de saúde, agricultura e meio ambiente para que o desenvolvimento sustentável possa ser efetivado. Assim, o SUS tem capacidade de ser palco das principais discussões sobre essa temática, atuando como um potencializador de ações individuais, coletivas e institucionais para promover um sistema alimentar mais justo, saudável e sustentável.

Abstract The undernutrition and obesity pandemics associated with climate change are a global syndemic. They have a point of convergence, which is the unsustainable current food systems. This paper aims to discuss the role of public health policies, particularly the Brazilian Unified Health System (SUS) in the context of Primary Health Care, in combating the global syndemic and in the development of sustainable food systems. In this scenario, the National Food and Nutrition Policy is a leading intersectoral tool for an adequate and healthy diet and food and nutrition security. Also, the Dietary Guidelines for the Brazilian population is a strategic tool to support food and nutrition education. We highlight the need to articulate health, agriculture, and environmental policies to achieve sustainable development. Thus, SUS can be the arena to promote the main discussions on this topic, potentiating individual, group, and institutional actions to provide a fairer, healthy, and sustainable food system.

Folate and nutrients involved in the 1-carbon cycle in the pretreatment of patients for colorectal cancer.

To assess the ingestion of folate and nutrients involved in the 1-carbon cycle in non-treated patients with colorectal adenocarcinoma in a reference center for oncology in southeastern Brazil. In total, 195 new cases with colorectal adenocarcinoma completed a clinical evaluation questionnaire and a Food Frequency Questionnaire (FFQ). Blood samples from 161 patients were drawn for the assessment of serum folate. A moderate correlation was found between serum concentrations of folate, folate intake and the dietary folate equivalent (DFE) of synthetic supplements. Mulatto or black male patients with a primary educational level had a higher intake of dietary folate. Of patients obtaining folate from the diet alone or from dietary supplements, 11.00% and 0.10%, respectively, had intake below the recommended level. Of the patients using dietary supplements, 35% to 50% showed high levels of folic acid intake. There was a prevalence of inadequacy for vitamins B2, B6 and B12, ranging from 12.10% to 20.18%, while 13.76% to 22.55% of patients were likely to have adequate choline intake. The considerable percentage of patients with folate intake above the recommended levels deserves attention because of the harmful effects that this nutrient may have in the presence of established neoplastic lesions.