Evolution of household availability of added sugars and their sources in Brazil: analysis of Household Budget Surveys from 2002 to 2017.

The objective of this study was to describe the evolution of household purchase of added sugars and their main food sources in Brazil. Nationally representative data from the Household Budget Surveys from 2002-2003, 2008-2009 and 2017-2018 were used. Energy and added sugar quantities were estimated by means of per capita food quantities. The items considered as food sources were: (1) table sugar: refined sugar and other energetic sweeteners and (2) processed and ultra-processed foods with added sugar: soft drinks; other drinks; sweets, candies and chocolates; cookies; cakes and pies and other foods. The parameters estimated were: mean share of added sugar in total energy and, for food sources, the share of added sugar in total sugar intake and the impact of variations in sources of added sugar between 2008 and 2017. There was a regular share of energy from added sugar to total energy intake between 2002 and 2008 but a reduced share in 2017. Between 2008 and 2017, there was a decrease in the share of refined sugar and other sweeteners and soft drinks to total sugar intake and an increased share of all other items. High-income households had a lower share of refined sugar and other energetic sweeteners, but a higher share of soft drinks, sweets, candies and chocolates. The decrease in added sugar in 2017 was mainly due to the lower share of soft drinks. In conclusion, Brazilians' total intake of added sugar was decreased, mostly owing to reduced consumption of sugar from soft drinks.

Instruments and indicators for assessing organisational food environments: a scoping review protocol.

INTRODUCTION: Many studies have explored the food environment to characterise it and understand its role in food practices. Assessment of the organisational food environment can contribute to the development of more effective interventions to promote adequate and healthy eating. However, few instruments and indicators have been developed and validated for assessing this type of setting. The systematisation of those can be useful to support the planning of future assessments and the development of wide-ranging instruments. This study aims to conduct a scoping review to systematise evidence on instruments and indicators for assessing organisational food environments. METHODS AND ANALYSIS: This scoping review was planned according to the methodological framework for scoping reviews proposed by Arksey and O'Malley and subsequently enhanced by Levac et al. For the report of the review, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews (PRISMA-ScR) checklist and guidelines will be used. The search will be conducted using PubMed, Embase, Web of Science, PsycINFO, Scopus and Google Scholar databases. The studies to be included were required to have been published in peer-reviewed journals since January 2005. No geographical, population or language restrictions will be applied given the desired breadth of the review. Two researchers will select the articles and extract the data independently. The conceptual model proposed by Castro and Canella will guide the data extraction and analysis. The results will be presented with narrative synthesis for the extracted data accompanying the tabulated and charted results. ETHICS AND DISSEMINATION: This study is based on the analysis of published scientific literature and did not involve patients, medical research, or any type of personal information; therefore, no ethical approval was obtained for this study. The results of this scoping review will be submitted for publication in an international peer-reviewed journal, preferably open access.

Evaluation of food purchasing in the Brazilian School Feeding Programme: feasibility of the requirements and recommendations.

OBJECTIVE: To analyse the purchase of food for school feeding, according to the extent and purpose of industrial processing and variety, exploring the feasibility of achieving the requirements and recommendations of the Brazilian School Feeding Programme, and the variety of unprocessed or minimally processed foods according to the purchase of ultra-processed foods. DESIGN: Secondary data from 2016 from the Accountability Management System of the National Fund for Educational Development, concerning the food items purchased, were used to explore the feasibility of the requirements and recommendations. The foods were grouped according to the NOVA classification system. Variety was assessed by counting different types of unprocessed or minimally processed foods. SETTING: Brazil. PARTICIPANTS: 3698 Brazilian municipalities. RESULTS: Energy share from unprocessed or minimally processed foods was 44·1 % while that of ultra-processed foods was 29·9 %. The average of unprocessed or minimally processed food types purchased annually was 33·8 items. Of the municipalities, 35·8 % were within the limit established for the expenditure of funds for the purchase of processed and ultra-processed foods, while 8·7 % followed the recommendation for variety. The proportion of ultra-processed foods did not influence the variety of food items purchased. CONCLUSIONS: The results showed the feasibility of achieving the requirements and recommendations and underscored the importance of continued efforts to promote the inclusion of unprocessed or minimally processed foods in the school feeding programme while addressing the challenges associated with expenditure limits of processed and ultra-processed foods and enhancing variety, which is strategic to promote adequate and healthy meals.

Evolução temporal de indicadores de consumo alimentar e estado nutricional relacionados às doenças crônicas entre adultos na cidade do Rio de Janeiro e nas demais capitais brasileiras, 2006-2019 / Temporal trend of indicators of food consumption and nutritional status related to noncommunicable diseases in adults from the city of Rio de Janeiro and other Brazilian capitals, 2006 to 2019

Resumo Introdução: Alimentação e estado nutricional inadequados são importantes fatores de risco para doenças crônicas não transmissíveis (DCNT). No Brasil, a cidade do Rio de Janeiro (RJ) tem se destacado pela elevada prevalência de obesidade. Objetivo: Avaliar a evolução temporal de indicadores de consumo alimentar e de estado nutricional, relacionados às DCNT, em adultos da cidade do Rio de Janeiro e das demais capitais brasileiras. Método: Utilizou-se dados do Vigitel de 2006 a 2019. Modelos de regressão de Prais-Winsten foram empregados para avaliar a variação na prevalência dos indicadores de interesse. Esses foram definidos com base nas metas do Plano Nacional de Segurança Alimentar e Nutricional (2016-19) e do Plano de Ações Estratégicas para o Enfrentamento das DCNT no Brasil (2011-22). Resultados: Não houve variação significativa no consumo regular e recomendado de frutas e hortaliças, assim como no consumo regular de doces. O consumo regular de refrigerantes diminuiu no RJ e nas demais capitais no período. A prevalência de excesso de peso e de obesidade aumentou significativamente no RJ e nas demais capitais do país. Conclusões: A evolução dos indicadores revela um cenário desfavorável para a saúde da população e para o alcance das metas dos planos nacionais.

Abstract Background: Inadequate diet and nutritional status are important risk factors for noncommunicable diseases (NCDs). In Brazil, the city of Rio de Janeiro (RJ) has stood out for its high prevalence of obesity. Objective: To evaluate the temporal trend of indicators of food consumption and nutritional status related to NCDs in the adult population of the city of RJ and other Brazilian capitals. Method: Vigitel data between 2006 and 2019 were used. Prais-Winsten regression was used to evaluate the variation in the prevalence of interest indicators. These were defined based on the goals of the National Plan for Food and Nutritional Security (Plano Nacional de Segurança Alimentar e Nutricional - 2016-19) and the Strategic Action Plan to Tackle NCDs in Brazil (Plano de Ações Estratégicas para o Enfrentamento das DCNT no Brasil - 2011-22). Results: Regular and recommended consumption of fruits and vegetables and regular consumption of sweets did not present significant variation, while the regular consumption of soft drinks decreased in RJ and other capitals during the period. The prevalence of excess weight and obesity increased significantly in RJ and in other capitals. Conclusions: The trend of the indicators reveals an unfavorable scenario for the health's population and to achieve the goals proposed in the national plans.

Characteristics of Brazilian school food and physical activity environments: PeNSE 2015.

OBJECTIVE: To characterize the food and physical activity environments in Brazilian public and private schools, and develop indicators to evaluate them. METHODS: This is a cross-sectional study conducted with data from a questionnaire on school characteristics of the 2015 National Adolescent School-based Health Survey, answered by principals or coordinators, referring to 3040 public and private schools throughout the country. The variables related to food and physical activity environments were described in isolation, and an indicator was developed for each environment, with scores ranging from 0 to 100. The frequency and mean score of each variable were described according to the administrative sphere (public or private). RESULTS: The public sector showed a predominance of school meals offer (97.8%), whereas the private sector, of canteens (89.8%). Both had a similar frequency of alternative food outlets in the surroundings. Private schools provided all markers of healthy and unhealthy eating in canteens more frequently. Public schools scored higher in "Food and beverage availability" (64.9) than private schools (55.8). The characteristics of physical activity environments showed that sports courts and sports or games equipment were common in public (69.2% and 90.7%, respectively) and private schools (94.1% and 99.8%, respectively), though at a significantly higher frequency in the second group. Private schools scored higher in "Structures and materials availability" than public schools (63.3 and 41.6, respectively). CONCLUSIONS: Public schools provide a more favorable food environment, whereas private schools, a physical activity environment.

Characteristics of Brazilian school food and physical activity environments: PeNSE 2015 / Características do ambiente escolar relativas à alimentação e atividade física: PeNSE 2015

ABSTRACT OBJECTIVE To characterize the food and physical activity environments in Brazilian public and private schools, and develop indicators to evaluate them. METHODS This is a cross-sectional study conducted with data from a questionnaire on school characteristics of the 2015 National Adolescent School-based Health Survey, answered by principals or coordinators, referring to 3040 public and private schools throughout the country. The variables related to food and physical activity environments were described in isolation, and an indicator was developed for each environment, with scores ranging from 0 to 100. The frequency and mean score of each variable were described according to the administrative sphere (public or private). RESULTS The public sector showed a predominance of school meals offer (97.8%), whereas the private sector, of canteens (89.8%). Both had a similar frequency of alternative food outlets in the surroundings. Private schools provided all markers of healthy and unhealthy eating in canteens more frequently. Public schools scored higher in "Food and beverage availability" (64.9) than private schools (55.8). The characteristics of physical activity environments showed that sports courts and sports or games equipment were common in public (69.2% and 90.7%, respectively) and private schools (94.1% and 99.8%, respectively), though at a significantly higher frequency in the second group. Private schools scored higher in "Structures and materials availability" than public schools (63.3 and 41.6, respectively). CONCLUSIONS Public schools provide a more favorable food environment, whereas private schools, a physical activity environment.

RESUMO OBJETIVO Caracterizar o ambiente alimentar e o ambiente para a prática de atividade física em escolas brasileiras públicas e privadas, bem como desenvolver indicadores-síntese de avaliação desses ambientes. MÉTODOS Estudo transversal, realizado com dados oriundos de questionário sobre características da escola da Pesquisa Nacional de Saúde do Escolar 2015 respondido pelo diretor ou responsável pelas escolas, referentes a 3.040 escolas públicas e privadas de todo o território nacional. As variáveis relacionadas aos ambientes alimentar e de prática de atividades físicas foram descritas isoladamente e, adicionalmente, foi desenvolvido um indicador-síntese para cada um dos ambientes, com pontuação variando de 0 a 100. A frequência de cada variável e a pontuação média dos escores foi descrita segundo a esfera administrativa (pública ou privada). RESULTADO A oferta de alimentação escolar foi predominante na rede pública (97,8%) e a presença de cantinas na rede privada (89,8%). A presença de pontos alternativos de venda foi similar nas duas esferas. A disponibilidade de todos os marcadores de alimentação saudável e não saudável nas cantinas foi mais frequente nas escolas privadas. A pontuação do escore "Disponibilidade de alimentos e bebidas" foi maior para as escolas públicas (64,9), comparada à das privadas (55,8). A caraterização do ambiente para a prática de atividade física mostrou que a presença de quadra de esporte e de material esportivo foi frequente em escolas públicas (69,2% e 90,7%, respectivamente) e em escolas privadas (94,1% e 99,8%, respectivamente), ainda que em frequência significativamente maior no segundo grupo. A pontuação do escore "Disponibilidade de estruturas e materiais" foi maior entre escolas privadas do que entre as públicas (63,3 e 41,6, respectivamente). CONCLUSÕES O ambiente alimentar de escolas públicas foi mais favorável à promoção da alimentação saudável que o de escolas privadas, sendo que o oposto foi verificado para o ambiente para a prática de atividade física.