Quality of child anthropometric data from SISVAN, Brazil, 2008-2017.

OBJECTIVE: To evaluate the quality of anthropometric data of children recorded in the Food and Nutrition Surveillance System (SISVAN) from 2008 to 2017. METHOD: Descriptive study on the quality of anthropometric data of children under five years of age admitted in primary care services of the Unified Health System, from the individual databases of SISVAN. Data quality was annually assessed using the indicators: coverage, completeness, sex ratio, age distribution, weight and height digit preference, implausible z-score values, standard deviation, and normality of z-scores. RESULTS: In total, 73,745,023 records and 29,852,480 children were identified. Coverage increased from 17.7% in 2008 to 45.4% in 2017. Completeness of birth date, weight, and height corresponded to almost 100% in all years. The sex ratio was balanced and approximately similar to the expected ratio, ranging from 0.8 to 1. The age distribution revealed higher percentages of registrations from the ages of two to four years until mid-2015. A preference for terminal digits "zero" and "five" was identified among weight and height records. The percentages of implausible z-scores exceeded 1% for all anthropometric indices, with values decreasing from 2014 onwards. A high dispersion of z-scores, including standard deviations between 1.2 and 1.6, was identified mainly in the indices including height and in the records of children under two years of age and residents in the North, Northeast, and Midwest regions. The distribution of z-scores was symmetric for all indices and platykurtic for height/age and weight/age. CONCLUSIONS: The quality of SISVAN anthropometric data for children under five years of age has improved substantially between 2008 and 2017. Some indicators require attention, particularly for height measurements, whose quality was lower especially among groups more vulnerable to nutritional problems.

Maternal and child nutrition programme of investigation within the 100 Million Brazilian Cohort: study protocol.

INTRODUCTION: There is a limited understanding of the early nutrition and pregnancy determinants of short-term and long-term maternal and child health in ethnically diverse and socioeconomically vulnerable populations within low-income and middle-income countries. This investigation programme aims to: (1) describe maternal weight trajectories throughout the life course; (2) describe child weight, height and body mass index (BMI) trajectories; (3) create and validate models to predict childhood obesity at 5 years of age; (4) estimate the effects of prepregnancy BMI, gestational weight gain (GWG) and maternal weight trajectories on adverse maternal and neonatal outcomes and child growth trajectories; (5) estimate the effects of prepregnancy BMI, GWG, maternal weight and interpregnancy BMI changes on maternal and child outcomes in the subsequent pregnancy; and (6) estimate the effects of maternal food consumption and infant feeding practices on child nutritional status and growth trajectories. METHODS AND ANALYSIS: Linked data from four different Brazilian databases will be used: the 100 Million Brazilian Cohort, the Live Births Information System, the Mortality Information System and the Food and Nutrition Surveillance System. To analyse trajectories, latent-growth, superimposition by translation and rotation and broken stick models will be used. To create prediction models for childhood obesity, machine learning techniques will be applied. For the association between the selected exposure and outcomes variables, generalised linear models will be considered. Directed acyclic graphs will be constructed to identify potential confounders for each analysis investigating potential causal relationships. ETHICS AND DISSEMINATION: This protocol was approved by the Research Ethics Committees of the authors' institutions. The linkage will be carried out in a secure environment. After the linkage, the data will be de-identified, and pre-authorised researchers will access the data set via a virtual private network connection. Results will be reported in open-access journals and disseminated to policymakers and the broader public.

Impact of cash transfer programs on birth and child growth outcomes: systematic review.

To investigate the impact of cash transfer (CTs) on birth outcomes, including birth weight, low birth weight and prematurity, as well as child physical growth were included, as assessed by anthropometric indices in children under five years of age. Searching was performed using the PubMed/Medline, Embase, LILACS, Cochrane Library, Scopus and Web of Science databases. Quantitative observational, experimental and quasi-experimental. Eleven studies were included in the review. The majority (81.8%) were carried out in low-and middle-income countries and most involved conditional CTs (63.6%). Four were clinical trials and seven were observational studies. Conditional CTs were found to be associated with a reduction in height-for-age (-0.14; 95%CI -0.27, -0.02); (OR 0.85; 95%CI 0.77-0.94); (OR = 0.44; 95%CI 0.19-0.98), a significantly reduced chance of low weight-for-age (OR = 0.16; 95%CI -0.11-0.43), low weight-for-height (OR = -0.68; 95%CI -1.14, -0.21), and low weight-for-age (OR = 0.27; 95%CI 0.10; 0.71). Unconditional CTs were associated with reduced birth weight (RR = 0.71; 95%CI 0.63-0.81; p < 0.0001) and preterm births (RR = 0.76; 95%CI 0.69-0.84; p < 0.0001). Conditional CTs can positively influence birth outcomes and child growth.

Time trends and social inequalities in infant and young child feeding practices: national estimates from Brazil's Food and Nutrition Surveillance System, 2008-2019.

OBJECTIVE: To describe the time trends and socio-economic inequalities in infant and young child feeding practices in accordance with the Brazilian deprivation index (BDI). DESIGN: This time-series study analysed the prevalence of multiple breast-feeding and complementary feeding indicators based on data from the Brazilian Food and Nutrition Surveillance System, 2008-2019. Prais-Winsten regression models were used to analyse time trends. Annual percent change (APC) and 95 % CI were calculated. SETTING: Primary health care services, Brazil. PARTICIPANTS: Totally, 911 735 Brazilian children under 2 years old. RESULTS: Breast-feeding and complementary feeding practices differed between the extreme BDI quintiles. Overall, the results were more favourable in the municipalities with less deprivation (Q1). Improvements in some complementary feeding indicators were observed over time and evidenced such disparities: minimum dietary diversity (Q1: Δ 47·8-52·2 %, APC + 1·44, P = 0·006), minimum acceptable diet (Q1: Δ 34·5-40·5 %, APC + 5·17, P = 0·004) and consumption of meat and/or eggs (Q1: Δ 59·7-80·3 %, APC + 6·26, P < 0·001; and Q5: Δ 65·7-70·7 %, APC + 2·20, P = 0·041). Stable trends in exclusive breast-feeding and decreasing trends in the consumption of sweetened drinks and ultra-processed foods were also observed regardless the level of the deprivation. CONCLUSIONS: Improvements in some complementary food indicators were observed over time. However, the improvements were not equally distributed among the BDI quintiles, with children from the municipalities with less deprivation benefiting the most.

Influence of Unhealthy Food Environment on Premature Cardiovascular Disease Mortality in Brazil: An Ecologic Approach.

INTRODUCTION: Cardiovascular disease is the main cause of general and premature death of adults aged 30-69 years in Brazil and around the world. Unhealthy food environments have been implicated as one of the factors associated with cardiovascular disease morbimortality because they affect people's health conditions and nutrition. This study aims to explore the association between unhealthy food environments (deserts/swamps) and premature cardiovascular disease mortality in the Brazilian population. METHODS: This is an ecologic study using data from 5,558 Brazilian municipalities in 2016. The cardiovascular disease mortality data were obtained from the Mortality Information System of the Ministry of Health. The study on mapping food deserts in Brazil, developed by the Interministerial Chamber of Food and Nutrition Security, was used to evaluate the physical dimension of food access. The authors calculated the standardized rates of premature general and specific cardiovascular disease (stroke and ischemic heart disease) causes of death in the same period. To characterize food environments, the density of unprocessed and ultraprocessed foods per 10,000 population in tertiles was used. Crude and adjusted negative binomial regression models were used to study the associations of interest. RESULTS: After the necessary adjustments (human development index, gross domestic product per capita, unemployment rate, Gini index and Family Health Strategy coverage), it was found that municipalities with low unprocessed food supply were at the highest risk of increased mortality among women with ischemic heart disease (rate ratio first tertile: 1.08 [95% CI=1.01, 1.15]). Conversely, the municipalities where there was a greater offer of ultraprocessed foods showed a higher risk of death from cardiovascular diseases (rate ratio second tertile: 1.17 [95% CI=1.12, 1.22]; rate ratio third tertile: 1.20 [95% CI=1.14, 1.26]), from strokes (rate ratio second tertile: 1.19 [95% CI=1.13, 1.25]; rate ratio third tertile: 1.22 [95% CI=1.15, 1.30]), and ischemic heart disease (rate ratio second tertile: 1.19 [95% CI=1.12, 1.25]; rate ratio third tertile: 1.22 [95% CI=1.13, 1.29]). CONCLUSIONS: This study's findings show an increase in the risk of cardiovascular disease, stroke, and ischemic heart disease mortality, especially in the municipalities where there was a greater offer of ultraprocessed foods. Initiatives aiming to minimize the effects of these food environments are urgently needed in the Brazilian context.

Quality of child anthropometric data from SISVAN, Brazil, 2008-2017 / Qualidade dos dados antropométricos infantis do Sisvan, Brasil, 2008-2017

ABSTRACT OBJECTIVE To evaluate the quality of anthropometric data of children recorded in the Food and Nutrition Surveillance System (SISVAN) from 2008 to 2017. METHOD Descriptive study on the quality of anthropometric data of children under five years of age admitted in primary care services of the Unified Health System, from the individual databases of SISVAN. Data quality was annually assessed using the indicators: coverage, completeness, sex ratio, age distribution, weight and height digit preference, implausible z-score values, standard deviation, and normality of z-scores. RESULTS In total, 73,745,023 records and 29,852,480 children were identified. Coverage increased from 17.7% in 2008 to 45.4% in 2017. Completeness of birth date, weight, and height corresponded to almost 100% in all years. The sex ratio was balanced and approximately similar to the expected ratio, ranging from 0.8 to 1. The age distribution revealed higher percentages of registrations from the ages of two to four years until mid-2015. A preference for terminal digits "zero" and "five" was identified among weight and height records. The percentages of implausible z-scores exceeded 1% for all anthropometric indices, with values decreasing from 2014 onwards. A high dispersion of z-scores, including standard deviations between 1.2 and 1.6, was identified mainly in the indices including height and in the records of children under two years of age and residents in the North, Northeast, and Midwest regions. The distribution of z-scores was symmetric for all indices and platykurtic for height/age and weight/age. CONCLUSIONS The quality of SISVAN anthropometric data for children under five years of age has improved substantially between 2008 and 2017. Some indicators require attention, particularly for height measurements, whose quality was lower especially among groups more vulnerable to nutritional problems.

RESUMO OBJETIVOS Avaliar a qualidade dos dados antropométricos de crianças registradas no Sistema de Vigilância Alimentar e Nutricional (Sisvan) no período 2008-2017. MÉTODOS Estudo descritivo sobre a qualidade dos dados antropométricos de crianças menores de 5 anos atendidas nos serviços de atenção primária do Sistema Único de Saúde, a partir das bases de dados individuais do Sisvan. A qualidade dos dados foi avaliada anualmente por meio dos indicadores: cobertura, completude, razão entre sexos, distribuição da idade, preferência por dígitos de peso e estatura, valores de escore-z implausíveis, desvio-padrão e normalidade dos escores-z. RESULTADOS No total, 73.745.023 registros e 29.852.480 crianças foram identificados. A cobertura aumentou de 17,7% em 2008 para 45,4% em 2017. A completude da data de nascimento, peso e estatura correspondeu a quase 100% para todos os anos. A razão entre sexos foi equilibrada e aproximadamente similar a razão esperada, variando entre 0,8 e 1. A distribuição da idade revelou maiores percentuais de registros entre as idades de 2 a 4 anos até meados de 2015. Uma preferência pelos dígitos terminais "zero" e "cinco" foi identificada entre os registros de peso e estatura. As porcentagens de escores-z implausíveis excederam 1% para todos os índices antropométricos, com redução dos valores a partir de 2014. Uma alta dispersão dos escores-z, incluindo desvios-padrão entre 1,2 e 1,6, foi identificada principalmente nos índices incluindo estatura e nos registros de crianças menores de 2 anos e residentes das regiões Norte, Nordeste e Centro-Oeste. A distribuição dos escores-z foi simétrica para todos os índices e platicúrtica para estatura/idade e peso/idade. CONCLUSÕES A qualidade dos dados antropométricos do Sisvan para crianças menores de 5 anos melhorou substancialmente entre 2008 e 2017. Alguns indicadores requerem atenção, sobretudo para medidas de estatura, cuja qualidade foi principalmente inferior entre os grupos mais vulneráveis a agravos nutricionais.

Impact of cash transfer programs on birth and child growth outcomes: systematic review / Impacto dos programas de transferência de renda nos desfechos de nascimento e crescimento infantil: revisão sistemática

Abstract To investigate the impact of cash transfer (CTs) on birth outcomes, including birth weight, low birth weight and prematurity, as well as child physical growth were included, as assessed by anthropometric indices in children under five years of age. Searching was performed using the PubMed/Medline, Embase, LILACS, Cochrane Library, Scopus and Web of Science databases. Quantitative observational, experimental and quasi-experimental. Eleven studies were included in the review. The majority (81.8%) were carried out in low-and middle-income countries and most involved conditional CTs (63.6%). Four were clinical trials and seven were observational studies. Conditional CTs were found to be associated with a reduction in height-for-age (-0.14; 95%CI -0.27, -0.02); (OR 0.85; 95%CI 0.77-0.94); (OR = 0.44; 95%CI 0.19-0.98), a significantly reduced chance of low weight-for-age (OR = 0.16; 95%CI -0.11-0.43), low weight-for-height (OR = -0.68; 95%CI -1.14, -0.21), and low weight-for-age (OR = 0.27; 95%CI 0.10; 0.71). Unconditional CTs were associated with reduced birth weight (RR = 0.71; 95%CI 0.63-0.81; p < 0.0001) and preterm births (RR = 0.76; 95%CI 0.69-0.84; p < 0.0001). Conditional CTs can positively influence birth outcomes and child growth.

Resumo Investigar o impacto dos programas de tranferência de renda (CTs) nos desfechos ao nascer, incluindo peso ao nascer, baixo peso ao nascer e prematuridade, e crescimento físico infantil, avaliado pelos índices antropométricos de crianças menores de cinco anos. Revisão sistemática realizada nas bases de dados PubMed/Medline, Embase, LILACS, Cochrane Library, Scopus e Web of Science. Foram incluídos estudos quantitativos observacionais, experimentais e quasi-experimentais, com um total de 11 estudos na revisão. A maioria (81,8%) foi realizada em países de baixa e média rendas. Também na modalidade CT condicionais (63,6%). Quatro eram ensaios clínicos, e sete observacionais. Os CT condicionais estiveram associados a uma redução nos índices de altura-para-idade (-0,14; IC95% -0,27, -0,02); (OR 0,85; IC95% 0,77-0,94); (OR = 0,44; IC95% 0,19-0,98), redução significativa na chance de baixo peso-para-idade (OR = 0,16; IC95% -0,11-0,43), baixo peso-para-altura (OR = -0,68; IC95% -1,14, -0,21), e redução de peso para idade (OR = 0,27; IC95% 0,10; 0,71). CTs não condicionais foram associados à redução do baixo peso as nascer (RR = 0,71; IC95% 0,63-0,81; p < 0,0001), e de prematuros (RR = 0,76; IC95% 0,69-0,84; p < 0,0001). Os CTs condicionais podem influenciar positivamente os desfechos ao nascer e o crescimento infantil.

[Demographic and socio-environmental factors associated with household food insecurity in different territories of the city of Salvador, Bahia State, Brazil]. / Fatores demográficos e socioambientais associados à insegurança alimentar domiciliar nos diferentes territórios da cidade de Salvador, Bahia, Brasil.

This study aimed to present the prevalence of household food insecurity in different territories of the city of Salvador, Bahia State, Brazil, and to analyze demographic and socio-environmental factors associated with it. The data used are from a larger survey named Quality of the Urban Environment of Salvador - QUALISalvador, carried out from 2018 to 2020 in in the city. Food insecurity was assessed using the Brazilian Food Insecurity Scale. A total of 15,171 households were analyzed. Multinomial logistic regression models were used to analyze the association of demographic and socio-environmental variables with mild food insecurity (MFI) and moderate or severe food insecurity (MSFI) for Salvador and by macrozones. Salvador presented 40.96% of food insecurity. In the macrozones, the prevalence differed: Atlantic Coast (25.8%), Consolidated Urban Area (33%), Suburb (45.7%), and Core (47.9%). All factors analyzed were associated with MFI and/or MSFI in the model for Salvador, namely: household head having schooling ≤ 4 years (MFI: OR = 2.00; 95%CI: 1.61-2.47/MSFI: OR = 4.94; 95%CI: 3.83-6.35), having per capita family income of up to 1/2 minimum wage (MFI: OR = 2.62; 95%CI: 2.37-2.93/MSFI: OR = 4.03; 95%CI: 3.53-4.60), perception of the quality of the urban environment as poor (MFI: OR = 1.57; 95%CI: 1.36-1.81/MSFI: OR = 2.03; 95%CI: 1.73-2.38), with a higher prevalence of food insecurity in scenarios of worse sociodemographic situation. In the Core Macrozone, all factors were also associated with food insecurity. Thus, the factors of social vulnerability are associated with food insecurity in the capital and macrozones, but they are presented in a specific way according to the characteristics of each territory.

O objetivo deste estudo foi apresentar a prevalência da insegurança alimentar domiciliar em diferentes territórios da cidade de Salvador, Bahia, Brasil, e analisar fatores demográficos e socioambientais a ela associados. Os dados utilizados são de uma pesquisa maior denominada Qualidade do Ambiente Urbano de Salvador - QUALISalvador, realizada entre 2018 e 2020 em Salvador. A insegurança alimentar foi avaliada por meio da Escala Brasileira de Insegurança Alimentar. Foram analisados 15.171 domicílios. Modelos de regressão logística multinominal foram utilizados para analisar a associação de variáveis demográficas e socioambientais com insegurança alimentar leve (IAL) e moderada ou grave (IAMG), para Salvador e macrozonas. Salvador apresentou 40,96% de insegurança alimentar. Nas macrozonas, as prevalências se diferenciaram: Orla Atlântica (25,8%), Área Urbana Consolidada (33%), Subúrbio (45,7%) e Miolo (47,9%). Todos os fatores analisados apresentaram associação com IAL e/ou IAMG no modelo para Salvador, entre eles estão o responsável pelo domicílio ter escolaridade ≤ 4 anos (IAL: OR = 2,00; IC95%: 1.61-2,47/IAMG: OR = 4,94; IC95%: 3,83-6,35), renda familiar per capita de até 1/2 salário mínimo (IAL: OR = 2,62; IC95%: 2,37-2,93/IAMG: OR = 4,03; IC95%: 3,53-4,60), percepção sobre a qualidade do ambiente urbano como ruim (IAL: OR = 1,57; IC95%: 1,36-1,81/IAMG: OR = 2,03; IC95%: 1,73-2,38), com maior prevalência de insegurança alimentar em cenários de pior situação sociodemográfica. Na macrozona Miolo todos os fatores também se mantiveram associados à insegurança alimentar. Assim, os fatores de vulnerabilidade social estão associados à insegurança alimentar na capital e macrozonas, mas apresentam-se de formas especificas segundo características de cada território.

El objetivo de este estudio fue estimar la prevalencia de la inseguridad alimentaria familiar en diferentes territorios de la ciudad de Salvador (Bahía, Brasil) y analizar sus factores demográficos y socioambientales asociados. Los datos provienen de la encuesta Calidad del Ambiente Urbano de Salvador - QUALISalvador, realizada entre 2018 y 2020 en Salvador. La inseguridad alimentaria se evaluó mediante la Escala Brasileña de Inseguridad Alimentaria. Se analizaron 15.171 domicilios. Se utilizaron los modelos de regresión logística multinomial para analizar la asociación de variables demográficas y socioambientales con la inseguridad alimentaria leve (IAL) y moderada o severa (IAMG) para Salvador, por macrozonas. Salvador presentó el 40,96% de inseguridad alimentaria. En las macrozonas, las prevalencias fueron diferentes: Orla Atlântica (25,8%), Área Urbana Consolidada (33%), Subúrbio (45,7%) y Miolo (47,9%). Todos los factores analizados se asociaron con IAL e/o IAMG en el modelo para Salvador, entre ellos destacan el responsable del hogar con nivel de estudios ≤ 4 años (IAL: OR = 2,00; IC95%: 1,61-2,47/IAMG: OR = 4,94; IC95%: 3,83-6,35), con renta familiar per cápita de hasta 1/2 salario mínimo (IAL: OR = 2,62; IC95%: 2,37-2,93/IAMG: OR = 4,03; IC95%: 3,53-4,60), percepción de mala calidad del medio urbano (IAL: OR = 1,57; IC95%: 1,36-1,81/IAMG: OR = 2,03; IC95%: 1,73-2,38) y mayor prevalencia de inseguridad alimentaria en escenarios con peor situación sociodemográfica. En la macrozona Miolo, todos los factores también estuvieron asociados con la inseguridad alimentaria. Por tanto, los factores de vulnerabilidad social se asocian a la inseguridad alimentaria en la capital y en las macrozonas, pero son específicos según las características de cada territorio.

[The color and gender of hunger: analysis of food insecurity from an intersectional gaze]. / A cor e o sexo da fome: análise da insegurança alimentar sob o olhar da interseccionalidade.

The aim of this study is to analyze home food (in)security via intersectionality. The data are from the cross-sectional study Quality of the Urban Environment of Salvador - QUALISalvador, conducted from 2018 to 2020 in Salvador, Bahia State, Brazil. A structured questionnaire and the Brazilian Food Insecurity Scale were used. A total of 14,713 households were analyzed. The outcome variable was the situation of food security: mild, moderate, or severe food insecurity. The exposure of interest variable was the intersection of the variables self-declared race/color and gender: white man, white woman, black man, black woman. Multinominal logistic regression models were used to estimate the association between exposure of interest and outcome, adjusted for socioeconomic variables and stratified according to education level and per capita family income. Households lead by black women had a higher chance of experiencing mild (OR = 1.39; 95%CI: 1.15-1.68; p = 0.001) and moderate or severe (OR = 1.94; 95%CI: 1.49-2.52; p < 0.001) food insecurity in relation to households lead by white men. They also had a higher chance of experiencing moderate or severe food insecurity in all levels of education and in the ranges of up to 1/2 minimum wage and > 1 minimum wage. When the person responsible for the household was a black man, the greatest chance for this condition was in the > 1 minimum wage. Food insecurity in households lead by black women, even in socioeconomically favorable conditions, is revealed as one of the consequences of the structural interaction of racism and sexism.

Este trabalho objetiva analisar a (in)segurança alimentar domiciliar sob o olhar da interseccionalidade. Para isso, foram analisados 14.713 domicílios, utilizando-se um questionário estruturado e a Escala Brasileira de Insegurança Alimentar, além dos dados do estudo transversal Qualidade do Ambiente Urbano de Salvador - QUALISalvador, realizado entre 2018 e 2020 em Salvador, Bahia, Brasil. A variável desfecho foi a situação de segurança alimentar (insegurança alimentar leve, moderada ou grave) e a variável exposição de interesse foi o cruzamento de raça/cor e sexo autodeclarado (homem branco, mulher branca, homem negro, mulher negra). Modelos de regressão logística multinominal foram usados para estimar a associação entre a exposição de interesse e o desfecho, ajustada a partir de questões socioeconômicas estratificadas segundo escolaridade e renda familiar per capita. Diante disso, concluiu-se que domicílios chefiados por mulheres negras apresentaram maior chance de insegurança alimentar leve (OR = 1,39; IC95%: 1,15-1,68; p = 0,001) e moderada ou grave (OR = 1,94; IC95%: 1,49-2,52; p < 0,001) em relação aos domicílios chefiados por homens brancos, além de maior chance de insegurança alimentar moderada ou grave em todos os níveis de escolaridade e nas faixas de até 1/2 salário mínimo e > 1 salário mínimo. Quando os responsáveis foram homens negros, a maior chance se apresentou na faixa > 1 salário mínimo. A insegurança alimentar nos domicílios chefiados por mulheres negras, mesmo em condições socioeconomicamente favoráveis, revela-se como uma das consequências da interação estrutural do racismo e do sexismo.

El objetivo de este estudio fue analizar la (in)seguridad alimentaria de los hogares desde la perspectiva de la interseccionalidad. Los datos son del estudio transversal Calidad del Medio Ambiente Urbano de Salvador - QUALISalvador, realizado entre el 2018 y el 2020 en Salvador, Bahía, Brasil. Se utilizó un cuestionario estructurado y la Escala Brasileña de Inseguridad Alimentaria. Se analizaron 14.713 hogares. La variable desenlace fue la situación de seguridad alimentaria, inseguridad alimentaria leve, moderada o severa. La variable de exposición de interés fue el cruce de las variables autoinformadas raza/color y sexo: hombre blanco, mujer blanca, hombre negro, mujer negra. Se utilizaron modelos de regresión logística multinomial para estimar la asociación entre la exposición de interés y el desenlace, ajustados por variables socioeconómicas y estratificadas, según la escolaridad y la renta familiar per cápita. Los hogares encabezados por mujeres negras presentaron una mayor probabilidad de inseguridad alimentaria leve (OR = 1,39; IC95%: 1,15-1,68; p = 0,001) y moderada o severa (OR = 1,94; IC95%: 1,49-2,52; p < 0,001) con relación a los hogares encabezados por hombres blancos. También presentaron una mayor probabilidad de inseguridad alimentaria moderada o severa en todos los niveles de escolaridad y en los rangos de hasta 1/2 salario mínimo y > 1 salario mínimo. Cuando el responsable era un hombre negro, la mayor probabilidad para esta condición se presentó en el rango > 1 salario mínimo. La inseguridad alimentaria en los hogares encabezados por mujeres negras, incluso en condiciones socioeconómicamente favorables, se revela como una de las consecuencias de la interacción estructural del racismo y del sexismo.

Determinantes do nascimento prematuro: proposta de um modelo teórico hierarquizado / Determinants of preterm birth: proposal for a hierarchical theoretical model

Resumo O nascimento prematuro (NP) é uma síndrome resultante de uma complexa relação entre múltiplos fatores que não possuem relações e causalidade totalmente compreendidas. Esse artigo traz uma discussão de um modelo teórico hierarquizado dos determinantes de NP, considerando características maternas como aspectos sociodemográficos, psicossociais, nutricionais, comportamentais e biológicos, tradicionalmente associados ao risco aumentado de NP. As variáveis foram distribuídas em seis dimensões, alocadas em três níveis hierárquicos (distal, intermediário e proximal). Nesse modelo, os determinantes socioeconômicos da mãe, da família, do domicílio e do bairro exercem efeitos indiretos sobre o NP por meio de variáveis no nível intermediário, que por sua vez afetam fatores biológicos de risco no nível proximal, os quais apresentam um efeito direto sobre o NP. O estudo adota um modelo teórico hierarquizado dos fatores envolvidos na cadeia de determinação do NP e suas inter-relações. O entendimento dessas inter-relações é um passo importante na tentativa de interromper a cadeia causal que torna algumas mulheres vulneráveis ao parto prematuro.

Abstract Preterm birth (PB) is a syndrome resulting from a complex relationship between multiple factors which do not have fully understood relationships and causality. This article discusses a hierarchical theoretical model of PB determinants, considering maternal characteristics such as sociodemographic, psychosocial, nutritional, behavioral and biological aspects, traditionally associated with increased risk of PB. The variables were distributed in six dimensions within three hierarchical levels (distal, intermediate and proximal). In this model, the socioeconomic determinants of the mother, family, household and neighborhood play indirect effects on PB through variables at the intermediate level, which in turn affect biological risk factors at the proximal level that have a direct effect on PB. The study presents a hierarchical theoretical model of the factors involved in the PB determination chain and their interrelationships. Understanding these interrelationships is an important step in trying to break the causal chain that makes some women vulnerable to preterm birth.

Determinants of preterm birth: proposal for a hierarchical theoretical model. / Determinantes do nascimento prematuro: proposta de um modelo teórico hierarquizado.

Preterm birth (PB) is a syndrome resulting from a complex relationship between multiple factors which do not have fully understood relationships and causality. This article discusses a hierarchical theoretical model of PB determinants, considering maternal characteristics such as sociodemographic, psychosocial, nutritional, behavioral and biological aspects, traditionally associated with increased risk of PB. The variables were distributed in six dimensions within three hierarchical levels (distal, intermediate and proximal). In this model, the socioeconomic determinants of the mother, family, household and neighborhood play indirect effects on PB through variables at the intermediate level, which in turn affect biological risk factors at the proximal level that have a direct effect on PB. The study presents a hierarchical theoretical model of the factors involved in the PB determination chain and their interrelationships. Understanding these interrelationships is an important step in trying to break the causal chain that makes some women vulnerable to preterm birth.

O nascimento prematuro (NP) é uma síndrome resultante de uma complexa relação entre múltiplos fatores que não possuem relações e causalidade totalmente compreendidas. Esse artigo traz uma discussão de um modelo teórico hierarquizado dos determinantes de NP, considerando características maternas como aspectos sociodemográficos, psicossociais, nutricionais, comportamentais e biológicos, tradicionalmente associados ao risco aumentado de NP. As variáveis foram distribuídas em seis dimensões, alocadas em três níveis hierárquicos (distal, intermediário e proximal). Nesse modelo, os determinantes socioeconômicos da mãe, da família, do domicílio e do bairro exercem efeitos indiretos sobre o NP por meio de variáveis no nível intermediário, que por sua vez afetam fatores biológicos de risco no nível proximal, os quais apresentam um efeito direto sobre o NP. O estudo adota um modelo teórico hierarquizado dos fatores envolvidos na cadeia de determinação do NP e suas inter-relações. O entendimento dessas inter-relações é um passo importante na tentativa de interromper a cadeia causal que torna algumas mulheres vulneráveis ao parto prematuro.

Health managers and professionals' perception on the care of child and adolescent obesity in Brazil's Unified Health System / Percepção de gestores e profissionais de saúde sobre o cuidado da obesidade infanto-juvenil no Sistema Único de Saúde

The study aimed to analyze the perception of health managers and professionals on the care of children and adolescents with overweight and obesity in the Unified Health System of Sergipe, Brazil. This is a qualitative and exploratory study with sample composed of 46 actors and semi-structured interviews as data collection method. The existing care was perceived as poor and fragmented, regardless of the health care level. The main difficulties were the professionals' work process, care management and organization, family support and insufficient resources. Potentialities related to management, teams and professionals, which could contribute to the implementation of a comprehensive care line, were also identified. However, the organization of care for child obesity still requires the connectivity of different actors' roles and tasks, with the agreement and co-responsibility between services, professionals and family. Key words: Obesity. Child. Adolescent. Comprehensive Health Care. Unified Health System.

O estudo teve como objetivo analisar a percepção de gestores e profissionais de saúde sobre o cuidado disponível para crianças e adolescentes com sobrepeso e obesidade no Sistema Único de Saúde em Sergipe, Brasil. Trata-se de um estudo qualitativo e exploratório, com amostra composta por 46 atores e coleta por meio de entrevistas semiestruturadas. O cuidado existente foi percebido como falho e fragmentado, independente do nível de atenção. As principais dificuldades abrangeram o processo de trabalho, a gestão e organização do cuidado, a adesão familiar e a insuficiência de recursos. Potencialidades relacionadas à gestão, equipes e profissionais, que poderiam contribuir para implantação de uma linha de cuidado integral, foram também identificadas. Contudo, a organização do cuidado à obesidade infantil ainda requer uma conectividade dos papéis e tarefas dos diversos atores, por meio da pactuação e corresponsabilização entre os serviços, profissionais e a família. Palavras-chave: Obesidade. Criança. Adolescente. Assistência Integral à Saúde. Sistema Único de Saúde.

Fatores demográficos e socioambientais associados à insegurança alimentar domiciliar nos diferentes territórios da cidade de Salvador, Bahia, Brasil / Demographic and socio-environmental factors associated with household food insecurity in different territories of the city of Salvador, Bahia State, Brazil / Factores demográficos y socioambientales asociados a la inseguridad alimentaria domiciliar en los diferentes territorios de la ciudad de Salvador, Bahía, Brasil

O objetivo deste estudo foi apresentar a prevalência da insegurança alimentar domiciliar em diferentes territórios da cidade de Salvador, Bahia, Brasil, e analisar fatores demográficos e socioambientais a ela associados. Os dados utilizados são de uma pesquisa maior denominada Qualidade do Ambiente Urbano de Salvador - QUALISalvador, realizada entre 2018 e 2020 em Salvador. A insegurança alimentar foi avaliada por meio da Escala Brasileira de Insegurança Alimentar. Foram analisados 15.171 domicílios. Modelos de regressão logística multinominal foram utilizados para analisar a associação de variáveis demográficas e socioambientais com insegurança alimentar leve (IAL) e moderada ou grave (IAMG), para Salvador e macrozonas. Salvador apresentou 40,96% de insegurança alimentar. Nas macrozonas, as prevalências se diferenciaram: Orla Atlântica (25,8%), Área Urbana Consolidada (33%), Subúrbio (45,7%) e Miolo (47,9%). Todos os fatores analisados apresentaram associação com IAL e/ou IAMG no modelo para Salvador, entre eles estão o responsável pelo domicílio ter escolaridade ≤ 4 anos (IAL: OR = 2,00; IC95%: 1.61-2,47/IAMG: OR = 4,94; IC95%: 3,83-6,35), renda familiar per capita de até 1/2 salário mínimo (IAL: OR = 2,62; IC95%: 2,37-2,93/IAMG: OR = 4,03; IC95%: 3,53-4,60), percepção sobre a qualidade do ambiente urbano como ruim (IAL: OR = 1,57; IC95%: 1,36-1,81/IAMG: OR = 2,03; IC95%: 1,73-2,38), com maior prevalência de insegurança alimentar em cenários de pior situação sociodemográfica. Na macrozona Miolo todos os fatores também se mantiveram associados à insegurança alimentar. Assim, os fatores de vulnerabilidade social estão associados à insegurança alimentar na capital e macrozonas, mas apresentam-se de formas especificas segundo características de cada território.

This study aimed to present the prevalence of household food insecurity in different territories of the city of Salvador, Bahia State, Brazil, and to analyze demographic and socio-environmental factors associated with it. The data used are from a larger survey named Quality of the Urban Environment of Salvador - QUALISalvador, carried out from 2018 to 2020 in in the city. Food insecurity was assessed using the Brazilian Food Insecurity Scale. A total of 15,171 households were analyzed. Multinomial logistic regression models were used to analyze the association of demographic and socio-environmental variables with mild food insecurity (MFI) and moderate or severe food insecurity (MSFI) for Salvador and by macrozones. Salvador presented 40.96% of food insecurity. In the macrozones, the prevalence differed: Atlantic Coast (25.8%), Consolidated Urban Area (33%), Suburb (45.7%), and Core (47.9%). All factors analyzed were associated with MFI and/or MSFI in the model for Salvador, namely: household head having schooling ≤ 4 years (MFI: OR = 2.00; 95%CI: 1.61-2.47/MSFI: OR = 4.94; 95%CI: 3.83-6.35), having per capita family income of up to 1/2 minimum wage (MFI: OR = 2.62; 95%CI: 2.37-2.93/MSFI: OR = 4.03; 95%CI: 3.53-4.60), perception of the quality of the urban environment as poor (MFI: OR = 1.57; 95%CI: 1.36-1.81/MSFI: OR = 2.03; 95%CI: 1.73-2.38), with a higher prevalence of food insecurity in scenarios of worse sociodemographic situation. In the Core Macrozone, all factors were also associated with food insecurity. Thus, the factors of social vulnerability are associated with food insecurity in the capital and macrozones, but they are presented in a specific way according to the characteristics of each territory.

El objetivo de este estudio fue estimar la prevalencia de la inseguridad alimentaria familiar en diferentes territorios de la ciudad de Salvador (Bahía, Brasil) y analizar sus factores demográficos y socioambientales asociados. Los datos provienen de la encuesta Calidad del Ambiente Urbano de Salvador - QUALISalvador, realizada entre 2018 y 2020 en Salvador. La inseguridad alimentaria se evaluó mediante la Escala Brasileña de Inseguridad Alimentaria. Se analizaron 15.171 domicilios. Se utilizaron los modelos de regresión logística multinomial para analizar la asociación de variables demográficas y socioambientales con la inseguridad alimentaria leve (IAL) y moderada o severa (IAMG) para Salvador, por macrozonas. Salvador presentó el 40,96% de inseguridad alimentaria. En las macrozonas, las prevalencias fueron diferentes: Orla Atlântica (25,8%), Área Urbana Consolidada (33%), Subúrbio (45,7%) y Miolo (47,9%). Todos los factores analizados se asociaron con IAL e/o IAMG en el modelo para Salvador, entre ellos destacan el responsable del hogar con nivel de estudios ≤ 4 años (IAL: OR = 2,00; IC95%: 1,61-2,47/IAMG: OR = 4,94; IC95%: 3,83-6,35), con renta familiar per cápita de hasta 1/2 salario mínimo (IAL: OR = 2,62; IC95%: 2,37-2,93/IAMG: OR = 4,03; IC95%: 3,53-4,60), percepción de mala calidad del medio urbano (IAL: OR = 1,57; IC95%: 1,36-1,81/IAMG: OR = 2,03; IC95%: 1,73-2,38) y mayor prevalencia de inseguridad alimentaria en escenarios con peor situación sociodemográfica. En la macrozona Miolo, todos los factores también estuvieron asociados con la inseguridad alimentaria. Por tanto, los factores de vulnerabilidad social se asocian a la inseguridad alimentaria en la capital y en las macrozonas, pero son específicos según las características de cada territorio.

Percepção de gestores e profissionais de saúde sobre o cuidado da obesidade infanto-juvenil no Sistema Único de Saúde / Health managers and professionals' perception on the care of child and adolescent obesity in Brazil's Unified Health System

Resumo O estudo teve como objetivo analisar a percepção de gestores e profissionais de saúde sobre o cuidado disponível para crianças e adolescentes com sobrepeso e obesidade no Sistema Único de Saúde em Sergipe, Brasil. Trata-se de estudo qualitativo e exploratório, com amostra composta por 46 atores e coleta de dados por meio de entrevistas semiestruturadas. O cuidado existente foi percebido como falho e fragmentado, independentemente do nível de atenção à saúde. As principais dificuldades abrangeram o processo de trabalho, a gestão e organização do cuidado, a adesão familiar e a insuficiência de recursos. Potencialidades relacionadas à gestão, equipes e profissionais, que poderiam contribuir para a implantação de uma linha de cuidado integral, foram também identificadas. Contudo, a organização do cuidado à obesidade infantil ainda requer uma conectividade dos papéis e tarefas dos diversos atores, por meio da pactuação e corresponsabilização entre os serviços, profissionais e a família.

Abstract The study aimed to analyze the perception of health managers and professionals on the care of children and adolescents with overweight and obesity in the Unified Health System of Sergipe, Brazil. This is a qualitative and exploratory study with sample composed of 46 actors and semi-structured interviews as data collection method. The existing care was perceived as poor and fragmented, regardless of the health care level. The main difficulties were the professionals' work process, care management and organization, family support and insufficient resources. Potentialities related to management, teams and professionals, which could contribute to the implementation of a comprehensive care line, were also identified. However, the organization of care for child obesity still requires the connectivity of different actors' roles and tasks, with the agreement and co-responsibility between services, professionals and family.

A cor e o sexo da fome: análise da insegurança alimentar sob o olhar da interseccionalidade / The color and gender of hunger: analysis of food insecurity from an intersectional gaze / El color y el sexo del hambre: análisis de la inseguridad alimentaria desde la perspectiva de la interseccionalidad

Este trabalho objetiva analisar a (in)segurança alimentar domiciliar sob o olhar da interseccionalidade. Para isso, foram analisados 14.713 domicílios, utilizando-se um questionário estruturado e a Escala Brasileira de Insegurança Alimentar, além dos dados do estudo transversal Qualidade do Ambiente Urbano de Salvador - QUALISalvador, realizado entre 2018 e 2020 em Salvador, Bahia, Brasil. A variável desfecho foi a situação de segurança alimentar (insegurança alimentar leve, moderada ou grave) e a variável exposição de interesse foi o cruzamento de raça/cor e sexo autodeclarado (homem branco, mulher branca, homem negro, mulher negra). Modelos de regressão logística multinominal foram usados para estimar a associação entre a exposição de interesse e o desfecho, ajustada a partir de questões socioeconômicas estratificadas segundo escolaridade e renda familiar per capita. Diante disso, concluiu-se que domicílios chefiados por mulheres negras apresentaram maior chance de insegurança alimentar leve (OR = 1,39; IC95%: 1,15-1,68; p = 0,001) e moderada ou grave (OR = 1,94; IC95%: 1,49-2,52; p < 0,001) em relação aos domicílios chefiados por homens brancos, além de maior chance de insegurança alimentar moderada ou grave em todos os níveis de escolaridade e nas faixas de até 1/2 salário mínimo e > 1 salário mínimo. Quando os responsáveis foram homens negros, a maior chance se apresentou na faixa > 1 salário mínimo. A insegurança alimentar nos domicílios chefiados por mulheres negras, mesmo em condições socioeconomicamente favoráveis, revela-se como uma das consequências da interação estrutural do racismo e do sexismo.

The aim of this study is to analyze home food (in)security via intersectionality. The data are from the cross-sectional study Quality of the Urban Environment of Salvador - QUALISalvador, conducted from 2018 to 2020 in Salvador, Bahia State, Brazil. A structured questionnaire and the Brazilian Food Insecurity Scale were used. A total of 14,713 households were analyzed. The outcome variable was the situation of food security: mild, moderate, or severe food insecurity. The exposure of interest variable was the intersection of the variables self-declared race/color and gender: white man, white woman, black man, black woman. Multinominal logistic regression models were used to estimate the association between exposure of interest and outcome, adjusted for socioeconomic variables and stratified according to education level and per capita family income. Households lead by black women had a higher chance of experiencing mild (OR = 1.39; 95%CI: 1.15-1.68; p = 0.001) and moderate or severe (OR = 1.94; 95%CI: 1.49-2.52; p < 0.001) food insecurity in relation to households lead by white men. They also had a higher chance of experiencing moderate or severe food insecurity in all levels of education and in the ranges of up to 1/2 minimum wage and > 1 minimum wage. When the person responsible for the household was a black man, the greatest chance for this condition was in the > 1 minimum wage. Food insecurity in households lead by black women, even in socioeconomically favorable conditions, is revealed as one of the consequences of the structural interaction of racism and sexism.

El objetivo de este estudio fue analizar la (in)seguridad alimentaria de los hogares desde la perspectiva de la interseccionalidad. Los datos son del estudio transversal Calidad del Medio Ambiente Urbano de Salvador - QUALISalvador, realizado entre el 2018 y el 2020 en Salvador, Bahía, Brasil. Se utilizó un cuestionario estructurado y la Escala Brasileña de Inseguridad Alimentaria. Se analizaron 14.713 hogares. La variable desenlace fue la situación de seguridad alimentaria, inseguridad alimentaria leve, moderada o severa. La variable de exposición de interés fue el cruce de las variables autoinformadas raza/color y sexo: hombre blanco, mujer blanca, hombre negro, mujer negra. Se utilizaron modelos de regresión logística multinomial para estimar la asociación entre la exposición de interés y el desenlace, ajustados por variables socioeconómicas y estratificadas, según la escolaridad y la renta familiar per cápita. Los hogares encabezados por mujeres negras presentaron una mayor probabilidad de inseguridad alimentaria leve (OR = 1,39; IC95%: 1,15-1,68; p = 0,001) y moderada o severa (OR = 1,94; IC95%: 1,49-2,52; p < 0,001) con relación a los hogares encabezados por hombres blancos. También presentaron una mayor probabilidad de inseguridad alimentaria moderada o severa en todos los niveles de escolaridad y en los rangos de hasta 1/2 salario mínimo y > 1 salario mínimo. Cuando el responsable era un hombre negro, la mayor probabilidad para esta condición se presentó en el rango > 1 salario mínimo. La inseguridad alimentaria en los hogares encabezados por mujeres negras, incluso en condiciones socioeconómicamente favorables, se revela como una de las consecuencias de la interacción estructural del racismo y del sexismo.

Time trends and social inequalities in child malnutrition: nationwide estimates from Brazil's food and nutrition surveillance system, 2009-2017.

OBJECTIVE: In Brazil, national estimates of childhood malnutrition have not been updated since 2006. The use of health information systems is an important complementary data source for analysing time trends on health and nutrition. This study aimed to examine temporal trends and socio-demographic inequalities in the prevalence of malnutrition in children attending primary health care services between 2009 and 2017. DESIGN: Time trends study based on data from Brazil's Food and Nutrition Surveillance System. Malnutrition prevalence (stunting, wasting, overweight and double burden) was annually estimated by socio-demographic variables. Prais-Winsten regression models were used to analyse time trends. Annual percent change (APC) and 95 % CI were calculated. SETTING: Primary health care services, Brazil. PARTICIPANTS: Children under 5 years old. RESULTS: In total, 15,239,753 children were included. An increase in the prevalence of overweight (APC = 3·4 %; P = 0·015) and a decline in the prevalence of wasting (-6·2 %; P = 0·002) were observed. The prevalence of stunting (-3·2 %, P = 0·359) and double burden (-1·4 %, P = 0·630) had discrete and non-significant reductions. Despite the significant reduction in the prevalence of undernutrition among children in the most vulnerable subgroups (black, conditional cash transfer's recipients and residents of poorest and less developed areas), high prevalence of stunting and wasting persist alongside a disproportionate increase in the prevalence of overweight in these groups. CONCLUSIONS: The observed pattern in stunting (high and persistent prevalence) and increase in overweight elucidate setbacks in advances already observed in previous periods and stresses the need for social and political strategies to address multiple forms of malnutrition.

Combined association of obesity and other cardiometabolic diseases with severe COVID-19 outcomes: a nationwide cross-sectional study of 21 773 Brazilian adult and elderly inpatients.

OBJECTIVES: To investigate the combined association of obesity, diabetes mellitus (DM) and cardiovascular disease (CVD) with severe COVID-19 outcomes in adult and elderly inpatients. DESIGN: Cross-sectional study based on registry data from Brazil's influenza surveillance system. SETTING: Public and private hospitals across Brazil. PARTICIPANTS: Eligible population included 21 942 inpatients aged ≥20 years with positive reverse transcription-PCR test for SARS-CoV-2 until 9 June 2020. MAIN OUTCOME MEASURES: Severe COVID-19 outcomes were non-invasive and invasive mechanical ventilation use, intensive care unit (ICU) admission and death. Multivariate analyses were conducted separately for adults (20-59 years) and elders (≥60 years) to test the combined association of obesity (without and with DM and/or CVD) and degrees of obesity with each outcome. RESULTS: A sample of 8848 adults and 12 925 elders were included. Among adults, obesity with DM and/or CVD showed higher prevalence of invasive (prevalence ratio 3.76, 95% CI 2.82 to 5.01) and non-invasive mechanical ventilation use (2.06, 1.58 to 2.69), ICU admission (1.60, 1.40 to 1.83) and death (1.79, 1.45 to 2.21) compared with the group without obesity, DM and CVD. In elders, obesity alone (without DM and CVD) had the highest prevalence of ICU admission (1.40, 1.07 to 1.82) and death (1.67, 1.00 to 2.80). In both age groups, obesity alone and combined with DM and/or CVD showed higher prevalence in all outcomes than DM and/or CVD. A dose-response association was observed between obesity and death in adults: class I 1.32 (1.05 to 1.66), class II 1.41 (1.06 to 1.87) and class III 1.77 (1.35 to 2.33). CONCLUSIONS: The combined association of obesity, diabetes and/or CVD with severe COVID-19 outcomes may be stronger in adults than in elders. Obesity alone and combined with DM and/or CVD had more impact on the risk of COVID-19 severity than DM and/or CVD in both age groups. The study also supports an independent relationship of obesity with severe outcomes, including a dose-response association between degrees of obesity and death in adults.

Contribution of minimally processed and ultra-processed foods to the cardiometabolic risk of Brazilian young adults: a cross-sectional study / Contribución de los alimentos mínimamente procesados y ultraprocesados al riesgo cardiometabólico de adultos jóvenes brasileños: un estudio transversal

INTRODUCTION: the simultaneous increase in the prevalence of cardiometabolic diseases and in the consumption of ultraprocessed foods (UPF) suggests a possible relationship between UPF and cardiometabolic risk (CMR). OBJECTIVE: to evaluate the association between food consumption, according to the degree of processing, and CMR in young adults. METHODS: this is a comparative cross-sectional study in 120 Brazilian young adults aged 18-25 years, categorized by the presence of CMR. Food consumption was investigated using a semi-quantitative food frequency questionnaire, and classified according to the extent of food processing. Food groups and tertiles in grams of unprocessed, minimally processed (MPF), processed and ultra-processed foods (UPF) were compared using the Kruskal-Wallis test. The associations of food consumption, according to level of processing (MPF and UPF), with CMR components were evaluated using logistic regression models. RESULTS: a high caloric contribution of UPF was observed in the diet of this study population. The total energy intake from lipids in all foods (p = 0.04) and in UPF (p = 0.03) was greater in the group with CMR. A greater consumption of UPF was a risk factor for abdominal obesity (OR = 1.09; 95 % CI = 1.00-1.18) while a greater consumption of MPF was protective for LDL-c alterations independently of sex, physical activity, and alcohol intake (OR = 0.70; 95 % CI = 0.50-0.98). CONCLUSIONS: UPF contributed to a greater caloric intake from fat in the CMR, and was a risk factor for abdominal obesity. MPF was an independent protective factor for LDL-c alterations

INTRODUCCIÓN: la alta prevalencia de enfermedades cardiometabólicas y el avance de los alimentos ultraprocesados en la dieta sugieren una posible relación entre ellos. OBJETIVO: valorar la asociación entre el consumo de alimentos clasificado por el grado de procesamiento y el riesgo cardiometabólico en adultos jóvenes. MÉTODOS: estudio transversal con una muestra compuesta por 120 jóvenes brasileños de 18 a 25 años, que fueron categorizados según el riesgo cardiometabólico (presencia o ausencia). El consumo de alimentos se evaluó mediante un cuestionario semicuantitativo de frecuencias a partir del que se clasificó la ingesta de acuerdo con el grado de procesamiento. Estos resultados se dividieron en terciles de gramos de alimentos (procesados y mínimamente procesados, procesados y ultraprocessados). Las diferencias de consumo diario de alimentos entre los terciles se compararon por medio del test de Kruskal-Wallis. Se realizó una regresión logística para asociar el grado de procesamiento con los componentes del riesgo cardiometabólico. RESULTADOS: se observó una alta contribución energética de los alimentos ultraprocesados en la dieta de la muestra estudiada. La ingestión de grasas totales (p = 0,04) y alimentos ultraprocesados (p = 0,03) fue mayor entre el grupo con riesgo cardiometabólico. El consumo de alimentos ultraprocesados fue un factor de riesgo de obesidad abdominal (OR = 1,09; IC 95 %: 1,00-1,18), mientras que el consumo de los mínimamente procesados fue protector frente a las alteraciones del LDL-c, independientemente del sexo, la actividad física y la ingesta de alcohol (OR = 0,70; IC 95 % = 0,50-0,98). CONCLUSIÓN: los alimentos ultraprocesados contribuyeron a aumentar la ingesta de grasas y a la obesidad abdominal; en cambio, los alimentos no procesados y mínimamente procesados redujeron los niveles de LDL-c