Adapting a US dietary analysis software and nutrient database for use in Brazil.

In many countries, assessing food and nutrient intake for research and surveillance purposes is difficult due to the lack of comprehensive, country-specific food and nutrient databases and/or a dietary analysis software program. In this case study, we describe the approach used to adapt a United States (US) dietary analysis software and nutrient database (Nutrition Data System for Research [NDSR]) for use in analyzing 24-hour dietary recalls collected for the Brazil Kids Nutrition and Health Study (KNHS). A team of experts that included individuals knowledgeable about Brazil and US eating traditions was assembled to devise solutions for between-country differences in eating habits, food supply, food nomenclature, and language. Solutions devised relied on several key resources, including the Brazilian Food Composition Table (TBCA) and a list of 200 foods commonly consumed in Brazil. These solutions included creating data entry rules that specified how each reported food should be entered into NDSR, creation of User Recipes for foods lacking a close nutritionally matching food in the NDSR database, and adjustment for food fortification differences as part of the analysis of study data. This case study illustrates that NDSR can be adapted for use outside of the United States through a structured process.

Nutrient Intakes among Brazilian Children Need Improvement and Show Differences by Region and Socioeconomic Level.

Brazil is the most populous country in South America. Using 24 h dietary data, we compared the nutrient intakes of 4-13-year-olds to reference values and tested for regional and socioeconomic (SES) differences. A considerable proportion reported intakes below the Estimated Average Requirements (EAR) for vitamins E (78.1%, 96.5%), D (100% for both), and calcium (80.5%, 97.7%) for 4-8 and 9-13-year-olds, respectively. Few exceeded Adequate Intakes (AI) for potassium or fiber. Older children reported greater inadequacies and, while there was regional variability, patterns of inadequacy and excess tended to be similar. For vitamin C, the percent of children below EAR in the Northeast and Southeast was lower than in the South. Most children, regardless of SES, had energy intakes within the Acceptable Macronutrient Distribution Ranges (AMDRs) for carbohydrates and protein. Over a quarter reported total energy from fat less than the AMDR, and inversely associated with SES (low 50.9%, moderate 26.0%, and high 15.0%), but also exceeding the percentage of energy recommendation for saturated fat, increasing with SES (low 18.1%, moderate 38.9%, and high 48.8%). The contrast observed between the diets of young Brazilians and recommendations underscores the need for individual and regional environmental interventions to promote healthier dietary patterns.