Exploring the role of the general interest in health on the perceptions of Healthy, Industrialized, and Ultra-processed foods among Brazilians.

Food processing includes operations that transform raw materials into new products, ensuring the preservation and supply of safe food; however, this view is not always understood by consumers who tend to associate any type of processing with something negative and harmful to health. Given this, the objective of this study was to explore the associations of Brazilian consumers in relation to healthy foods, industrialized foods, and ultra-processed foods, as well as to evaluate the role of socio-demographic characteristics and interest in health in these associations. To this end, 512 Brazilians completed a word association task on these three concepts and then answered a questionnaire about interest in health and socio-demographic issues. In general, participants associated "Healthy food" mainly with "Unprocessed products." Conversely, "Industrialized foods" and "Ultra-processed foods" were associated with "Processed products," "Negative perceptions," "Health harm," and "Industry". Despite this, it was found that "Industrialized foods" were also perceived positively, mainly due to convenience. Consumer associations were influenced (p ≤ 0.05) both by interest in health and by socio-demographic profile. Individuals with a high interest in health mainly associated "Industrialized foods" and "Ultra-processed foods" with the presence of preservatives, additives, and pesticides, and with diseases. As for those with low interest in health, there was a greater lack of knowledge of the concepts. Doubts and lack of knowledge were observed for "Industrialized foods" and "Ultra-processed foods," mainly among consumers with low educational level. The results indicate the need to develop communication strategies that reach consumers to facilitate understanding and, in this way, help them to make more conscious food choices.

Publicidade de alimentos direcionada à criança e ao adolescente no Brasil: análise longitudinal de denúncias no CONAR / Food advertising aimed at children and adolescents in Brazil: a longitudinal analysis of denouncements in CONAR

Resumo Evidências científicas mostram que os modelos de autorregulação falham na proteção de crianças e adolescentes da exploração comercial. No Brasil, o Conselho Nacional de Autorregulamentação Publicitária (CONAR) é a entidade que propõe ao setor regulado as diretrizes para a publicidade de produtos e serviços. O objetivo é analisar as denúncias de publicidade de alimentos direcionada à criança e ao adolescente enviadas ao CONAR entre 2010 e 2020. As denúncias foram identificadas quanto ao tipo de produto e serviço, autoria (consumidores/empresas ou CONAR) e decisão do CONAR (arquivamento/penalidades). Foram realizadas análises descritivas e de associação, identificando-se 98 denúncias, 74,8% de alimentos ultraprocessados. Notou-se oscilação no envio de denúncias ao longo dos anos, com tendência geral de redução. Consumidores foram mais frequentes (58,6%) entre os autores das denúncias e 53,3% do total foram penalizadas. As denúncias enviadas pelo CONAR ou empresas foram mais frequentemente penalizadas do que as enviadas pelos consumidores. Houve predominância de denúncias de publicidades de alimentos ultraprocessados e baixa aplicação de penalidades. Notou-se falta de isonomia no padrão de decisão do CONAR sobre as publicidades.

Abstract Scientific evidences show that self-regulation models fail to protect children and adolescents from commercial exploitation. In Brazil, the "Conselho Nacional de Autorregulamentação Publicitária - CONAR" is the entity that proposes guidelines for the products advertising and services to regulated sector. The aim is to analyze the denouncements of food advertising aimed at children and adolescents sent to CONAR between 2010 and 2020. The denouncements were described regarding the type of product and service, authorship (consumers/companies or CONAR), and CONAR decision (archiving/penalties). Descriptive and association analyzes were performed. Ninety-eight denouncements were identified, 74.8% of ultra-processed foods. There was an oscillation in the submission of denouncements over the years, with a general decline trend. Consumers were more frequent among the denouncements (58.6%) and 53.3% of total were penalty. Denouncements sent by CONAR or companies were more frequently penalized than those sent by consumers. There was a predominance of denouncements of advertisements for ultra-processed foods and low application of penalties. There was a lack of isonomy in CONAR decision pattern on advertisements.

Declaración de información nutricional en el etiquetado de bebidas y alimentos procesados y ultraprocesados ofertados en una cadena de supermercados de Lima en el 2022 / Nutritional information on the labels of processed and ultra-processed foods and beverages marketed in a supermarket chain in Lima in 2022

RESUMEN Objetivos. Estimar la cantidad de bebidas y alimentos procesados y ultraprocesados que declaran información nutricional en su empaque y describir las características de esta información, así como determinar la presencia de información nutricional en los productos con octógonos. Materiales y métodos. Se tomaron fotografías del etiquetado de 4404 bebidas y alimentos procesados y ultraprocesados ofertados en supermercados de Lima Metropolitana. La información declarada en la etiqueta se recogió y se registró en la versión móvil y web del Programa de Información de Etiquetas de Alimentos (FLIP por sus siglas en inglés). Se analizaron las variables correspondientes a la declaración de información nutricional, la forma en que se declara dicha información y la declaración de la misma en bebidas y alimentos con octógonos. Resultados. De todos los productos recolectados solo el 71,4% declara algún tipo de información nutricional. De estos, el 13,8% declara la información nutricional en texto y no en tabla, además sólo 56,3% la declara por cada 100 gramos o mililitros. Del total de alimentos con el octógono «Contiene grasas trans¼, sólo 19,2% declara su contenido. Conclusiones. Más de la cuarta parte de bebidas y alimentos envasados expendidos en el mercado peruano no declaran información nutricional de ningún tipo, y de los que declaran, existe una que lo hace en diferentes formatos y unidades. Además, se halló que hay una proporción de bebidas y alimentos para cada tipo de octógono que no declaran la información del nutriente advertido en el mismo.

ABSTRACT Objectives. To estimate the number of processed and ultra-processed beverages and foods that provide nutritional information on their packaging, and to describe the characteristics of this information, as well as to determine the presence of nutritional information on products with octagons. Materials and methods. Photographs were taken of the labels of 4404 processed and ultra-processed beverages and foods marketed in supermarkets in Metropolitan Lima. The information on the label was collected and registered in the mobile and web version of the Food Label Information Program (FLIP). We analyzed variables related to the nutritional information, the way in which such information is declared and the information in beverages and foods with octagons. Results. Only 71.4% of the products had some type of nutritional information. Of these, 13.8% provided the nutritional information as a text and not in a table, and only 56.3% declared it per 100 grams or milliliters. Of the total number of foods with the octagon "Contains trans fats", only 19.2% declared their content. Conclusions. More than a quarter of the beverages and packaged foods in the Peruvian market did not provide nutritional information of any kind, and of those that did, only one did so in different formats and units. In addition, we found that a proportion of beverages and foods for each type of octagon did not declare information of the nutrient that is mentioned in the octagon.

Association between ultraprocessed food consumption and obesity in US adults: an analysis of NHANES 2009-2018 / Asociación entre consumo de alimentos ultraprocesados y obesidad en US adultos: un análisis de NHANES 2009-2018

We propose the following hypothesis: ultraprocessed foods in the global food supply contribute to the worldwide increase in obesity. Objective. To analyze the association between a higher consumption of ultraprocessed foods and the obesity in adulthood in the United States. Materials and methods. United States National Survey of Health and Nutrition Examination (NHANES) (2009-2018) data were used. We included subjects of both sexes, aged between 18-64 years old, with anthropometric, health, income, race/ethnicity and physical activity (PA) data. The association between the ultraprocessed food intake and obesity was calculated using a binomial logistic regression. In addition, we also evaluated a subsample with subjects who did not consume more than their adequate daily energy requirements. Results. We evaluated 13,310 subjects in total, and 4,788 in our subsample. Of these 33% were committed to obesity, and in the subsample the prevalence was even higher, around 49%. In our analysis, we found five factors (ultraprocessed food consumption, sex, age, race/ethnicity, and sedentary lifestyle) that were positively associated with the development of obesity. Compared to subjects who consumed less than 20% of ultraprocessed foods, subjects who consumed between 20 to 40% of ultraprocessed food had 16% more odds of developing obesity [95%CI:1.06­1.26]. For the subsample, the odds were even higher, being around 27% [95%CI:1.11­1.46]. Conclusions. Our results showed a positive association between obesity and the amount of ultraprocessed food consumption, even though, in those who consumed no more than their adequate daily energy requirements(AU)

La hipótesis planteada es que los alimentos ultraprocesados contribuyen al aumento de la obesidad a nivel global. Objetivo. Analizar la asociación entre un mayor consumo de alimentos ultraprocesados y la obesidad en adultos en Estados Unidos. Materiales y métodos:. Se utilizaron datos de la Encuesta Nacional de Examen de Salud y Nutrición de los Estados Unidos (NHANES) (2009-2018). Se incluyeron individuos de 18 a 64 años de ambos sexos, con datos antropométricos, de salud, ingresos, raza/ etnia y actividad física. La asociación entre la ingesta de alimentos ultraprocesados y la obesidad se calculó utilizando un modelo de regresión logística binomial. Además, evaluamos una submuestra con sujetos que no consumieron más que sus requerimientos energéticos diarios adecuados. Resultados. Evaluamos 13.310 sujetos en total y 4.788 en nuestra submuestra. De estos, el 33% comprometidos con la obesidad, y en la submuestra la prevalencia era aún mayor, alrededor del 49%. En nuestro análisis encontramos cinco factores (consumo de alimentos ultraprocesados, sexo, edad, raza/etnia y sedentarismo) asociados positivamente con el desarrollo de obesidad. En comparación con los sujetos que consumían menos del 20% de los alimentos ultraprocesados, aquellos que consumían entre el 20 y el 40 % de los alimentos ultraprocesados tenían un 16% más de probabilidades de desarrollar obesidad [95%IC: 1,06-1,26]. Para la submuestra, las probabilidades fueron aún mayor, rondando el 27% [95%IC: 1,11-1,46]. Conclusiones. Nuestros resultados mostraron una asociación positiva entre la obesidad y la cantidad de consumo de alimentos ultraprocesados, incluso en aquellos que no superaron sus requerimientos energéticos diarios adecuados(AU)

Asociación entre el consumo de alimentos ultraprocesados y el déficit de atención en escolares de 6 a 12 años de instituciones educativas privadas de Lima Metropolitana y Arequipa, 2022 / Association between the consumption of ultra-processed foods and attention deficit in students aged 6 to 12 years old from private educational institutions in Metropolitan Lima and Arequipa, 2022

Fundamentos: Es importante destacar el fácil acceso que tienen hoy en día los escolares a productos ultraprocesados, y la prevalencia del déficit de atención con hiperactividad (TDAH) también ha ido en aumento en este grupo de edad. El objetivo del presente estudio fue determinar la asociación entre el consumo de alimentos ultraprocesados y el déficit de atención en escolares de 6 a 12 años en instituciones educativas privadas de las ciudades de Lima y Arequipa de Perú en el 2022. Métodos: Estudio tipo analítico transversal. Se realizó un muestreo de tipo no probabilístico, por conveniencia, la muestra recolectada fue de 217 escolares en 4 instituciones educativas privadas de las ciudades de Lima y Arequipa de Perú en el 2022. Resultados: Del total de participantes el 57,1% eran mujeres, el 52,1% tenían TDAH, el 87,1% presentaron un mayor consumo de alimentos ultraprocesados. No se encontró asociación entre las principales características del TDAH y el consumo de alimentos ultraprocesados en los escolares evaluados (p>0,05), pero si existe asociación entre el consumo de piqueos y el TDAH (p<0,05). Asimismo, se encontró que ser hombre brinda un 34% más probabilidades de tener TDAH, no tener antecedentes en los padres representa un 37% menos probabilidad de presentar TDAH, y usar aparatos tecnológicos durante 3-4 horas representa un 42% más probabilidades de tener TDAH. Conclusiones: Existe asociación entre el consumo de piqueos y TDAH en escolares de 6 a 12 años de instituciones educativas privadas de Lima Metropolitana y Arequipa, en el año 2022. (AU)

Background: It is important to highlight the easy access that schoolchildren have today to ultra-processed products, and the prevalence of attention deficit has also been increasing in this age group. The objective of this study was to determine the association between the consumption of ultra-processed foods and attention deficit in schoolchildren from 6 to 12 years of age in private educational institutions in the cities of Lima and Arequipa in Peru in 2022. Methods: Cross-sectional analytical study. A non-probabilistic sampling was carried out, for convenience, the sample collected was 217 schoolchildren in 4 private educational institutions in the cities of Lima and Arequipa in Peru in 2022. Results: Of the total number of participants, 57.1% were women, 52.1% had ADHD, and 87.1% had a higher consumption of ultra-processed foods. No association was found between the main characteristics of ADHD and the consumption of ultra-processed foods in the evaluated schoolchildren (p>0.05), but there is an association between the consumption of snacks and ADHD (p<0.05). Likewise, it was found that being a man provides 34% more probabilities of having ADHD, not having a history in the parents represents a 37% less probability of presenting ADHD, and using technological devices for 3-4 hours represents 42% more probabilities of having ADHD. Conclusions: There is an association between the consumption of snacks and ADHD in schoolchildren from 6 to 12 years of age from private educational institutions in Metropolitan Lima and Arequipa, in the year 2022. (AU)

Ultra-processed food consumption and metabolic syndrome: a cross-sectional study in Quilombola communities of Alagoas, Brazil.

BACKGROUND: The processing of food can cause changes that turn them into risk factors for chronic diseases. A higher degree of food processing is associated with the development of chronic non-communicable diseases (NCDs), including the metabolic syndrome (MetS). The objective of this study was to analyze the relationship between ultra-processed food (UPF) consumption and the prevalence of MetS and its risk factors, focusing on a population group especially subjected to precarious living conditions and food insecurity. METHOD: Cross-sectional population-based study with women (19 to 59 years) from Quilombola communities of Alagoas. The socioeconomic, demographic, anthropometric, health status, lifestyle, and food intake (24-h recall) variables were analyzed. The dependent variable was the MetS, defined using the harmonization criteria of the Joint Interim Statement, and its components. The foods consumed were categorized according to the Nova Classification, assuming the highest UPF consumption as risk exposure. The measure of association was the prevalence ratio (PR) and respective 95%CI, calculated by Poisson regression with robust variance. We also analyzed the association with the Nova score of UPF consumption. RESULTS: We investigated 895 women (38.9 ± 11.0 years), of whom 48.3% had MetS. On average, 15.9% of the total energy intake came from UPF. Lower Nova scores were associated with a lower prevalence of diabetes and low HDL. Higher UPF consumption was associated with a 30% higher prevalence of hypertension (PR = 1.30; 95%CI: 1.06-1.61). CONCLUSION: The highest UPF consumption was positively associated with the prevalence of hypertension, while a lower Nova score was a protective factor against diabetes and low HDL. UPF consumption in Quilombola communities is important but lower than that observed in the Brazilian population in general. It is suggested that public health programs be implemented to promote healthy eating while valuing the existing eating habits and traditions among the remaining Brazilian Quilombola people.

RESUMO: INTRODUçãO: O processamento de alimentos pode causar alterações que os transformam em fatores de risco para doenças crônicas. Um maior grau de processamento de alimentos está associado ao desenvolvimento de doenças crônicas não transmissíveis (DCNT), incluindo a síndrome metabólica (SM). O objetivo deste estudo foi analisar a relação entre o consumo de alimentos ultraprocessados (AUP) e a prevalência de SM e seus fatores de risco, com foco em um grupo populacional especialmente submetido a precárias condições de vida e insegurança alimentar. MéTODO: Estudo transversal de base populacional com mulheres (19 a 59 anos) de comunidades Quilombolas de Alagoas. Foram analisadas as variáveis socioeconômicas, demográficas, antropométricas, estado de saúde, estilo de vida e ingestão alimentar (recordatório de 24 horas). A variável dependente foi a SM, definida a partir dos critérios de harmonização do Joint Interim Statement, e seus componentes. Os alimentos consumidos foram categorizados de acordo com a Classificação Nova, assumindo como exposição de risco o maior consumo de AUP. A medida de associação foi a razão de prevalência (RP) e respectivo IC 95%, calculado por regressão de Poisson com variância robusta. Também analisou-se a associação com o Escore Nova de consumo de AUP. RESULTADOS: Foram investigadas 895 mulheres (38,9 ± 11,0 anos), das quais 48,3% tinham SM. Em média, 15,9% da ingestão total de energia provinham de AUP. Escores Nova mais baixos foram associados a uma menor prevalência de diabetes e HDL baixo. O maior consumo de AUP se associou a uma prevalência 30% maior de hipertensão arterial (RP = 1,30; IC95%: 1,06-1,61). CONCLUSãO: O maior consumo de AUP se associou positivamente à prevalência de hipertensão, enquanto o menor escore Nova foi fator de proteção contra diabetes e baixo HDL. O consumo de AUP nas comunidades Quilombolas é relevante, mas inferior ao observado na população brasileira em geral. Sugere-se a implementação de programas de saúde pública que promovam a alimentação saudável, valorizando os hábitos e tradições alimentares existentes entre os remanescentes Quilombolas brasileiros.

Situação socioeconômica, tempo de tela e de permanência na escola e o consumo alimentar de crianças / Socioeconomic status, screen time, and time spent at school, and children's food consumption

Resumo Este estudo objetivou avaliar a associação de fatores sociodemográficos e estilo de vida com consumo de alimentos in natura ou minimamente processados (INMP), ultraprocessados (AUP) e frutas e hortaliças. Trata-se de estudo transversal com 403 crianças de 4 a 7 anos de uma coorte retrospectiva. Variáveis sociodemográficas e estilo de vida foram investigadas através do questionário sociodemográfico. O consumo alimentar foi avaliado por três registros alimentares. Empregaram-se análises de regressão linear bivariadas e multivariadas para analisar as associações. Crianças com menor renda apresentaram maior consumo de alimentos INMP e menor consumo de AUP. Menor tempo de permanência na escola associou-se ao menor consumo de alimentos INMP e maior consumo de AUP. Crianças com maior tempo de tela e com pais de menor escolaridade, consumiram menos frutas e hortaliças. Fatores sociodemográficos desfavoráveis se associaram ao melhor perfil de consumo de alimentos segundo o nível de processamento, exceto para frutas e hortaliças. O maior tempo de permanência na escola e menor tempo de tela contribuíram para uma alimentação mais saudável.

Abstract The present study aimed to evaluate the association of sociodemographic factors and lifestyle with the consumption of in natura or minimally processed (INMP) foods, ultra-processed foods (UPFs), and fruits and vegetables. This was a cross-sectional study conducted with 403 children, aged 4 to 7 years, from a retrospective cohort. Sociodemographic and lifestyle variables were investigated using a sociodemographic questionnaire. Food consumption was assessed by three food records. Bivariate and multivariate linear regression analyses were used to analyze associations. Children with lower income had a higher consumption of INMP foods and a lower consumption of UPFs. A shorter time spent at school was associated with a lower consumption of INMP foods and a higher consumption of UPFs. Children with more screen time and less educated parents consumed less fruits and vegetables. Unfavorable sociodemographic factors were associated with a better profile of food consumption according to the level of processing, except for fruits and vegetables. The longer time spent at school and a shorter screen time contributed to a healthier diet.

Food advertising on YouTube channels aimed at children in Brazil / Publicidade de alimentos em canais do YouTube direcionados à criança no Brasil

ABSTRACT OBJECTIVE To analyze food advertising on YouTube channels aimed at children in Brazil and the interaction of the public with this type of advertising. METHODS We analyzed the 10 most popular videos from the 25 YouTube most-watched channels with content aimed at children in the country in 2018. The presence of general advertising, food brands and food services was identified. When there was advertising in the videos, the foods and their respective brands were described, the first being classified according to the NOVA system. In cases of advertising of a specific food brand without its product having been displayed or mentioned, the classification was carried out according to the predominance of that company products. The number of visualizations and interactions ("likes" and "dislikes") was also collected. RESULTS General advertising was identified in 45.6% of videos, while food and food service advertising was present in 12.9% and 1.6% of videos, respectively. Food advertisements were mostly represented by ultra-processed products (n = 30; 93.8%). In channels led by Kid YouTubers, there was a higher frequency of general advertising, food and food services in the videos. In these channels, the advertisements of food in general and ultra-processed foods were respectively 2.79 and 2.53 times higher than in videos of channels not led by Kid YouTubers. The number of times videos were tagged "liked" was higher in videos with food advertising (1.67 × 105) compared to videos without food advertising (1.02 × 105), p = 0.0272. CONCLUSION YouTube is a potential medium for children's exposure and interaction with ultra-processed food advertising. The results of this analysis reinforce the importance of enforcing regulations prohibiting children's advertising on this platform.

RESUMO OBJETIVO Analisar a publicidade de alimentos em canais do YouTube direcionados à criança no Brasil e a interação do público com esse tipo de publicidade. MÉTODOS Foram analisados os 10 vídeos mais populares dos 25 canais do YouTube com conteúdo dirigido ao público infantil mais assistidos no país em 2018. Identificou-se a presença de publicidade geral, de marcas de alimentos e de serviços de alimentação. Quando houve publicidade nos vídeos, os alimentos e suas respectivas marcas foram descritos, sendo os primeiros classificados segundo o sistema NOVA. Nos casos de publicidade de uma marca de alimentos específica, sem que o seu produto tenha sido exibido ou mencionado, a classificação foi realizada segundo a predominância dos produtos dessa empresa. Coletou-se, também, o número de visualizações e de interações ("gostei" e "não gostei"). RESULTADOS A publicidade geral foi identificada em 45,6% dos vídeos, enquanto a publicidade de alimentos e de serviços de alimentação esteve presente em 12,9% e 1,6% dos vídeos, respectivamente. Os anúncios de alimentos foram representados em sua maioria por produtos ultraprocessados (n = 30; 93,8%). Em vídeos de canais liderados por youtubers mirins, observou-se uma maior frequência de publicidade geral, de alimentos e de serviços de alimentação. Nesses canais, as veiculações de publicidade de alimentos em geral e de alimentos ultraprocessados foram respectivamente 2,79 e 2,53 vezes maior do que nos vídeos de canais não liderados por youtubers mirins. O número de vezes em que os vídeos foram marcados com "gostei" foi maior nos vídeos com publicidade de alimentos (1,67 × 105) em comparação aos vídeos sem publicidade de alimentos (1,02 × 105), p = 0,0272. CONCLUSÃO O YouTube é um potencial meio de exposição e interação de crianças com a publicidade de alimentos ultraprocessados. Os resultados desta análise reforçam a importância de fazer cumprir a regulamentação de proibição de publicidade infantil nessa plataforma.

Prevalência de aditivos alimentares em produtos industrializados e a tendência clean label / The impact of food additive intake on human health and the clean label trend

Introdução: A ingestão de aditivos por meio dos alimentos industrializados pode impactar a saúde humana. Diante disso, surge à tendência clean label visando produtos mais saudáveis e naturais. Objetivo: Analisar a proporção de produtos clean label e dos principais aditivos presentes em alimentos industrializados, comparando-os aos análogos clean label. Métodos: Estudo transversal, descritivo, onde compilou-se aditivos presentes nas listas de ingredientes de três categorias de alimentos (hambúrgueres de carne, iogurtes e pós para o preparo de gelatina). As informações foram extraídas de um banco de dados de 2021, por meio de coleta em supermercados de Belo Horizonte-Minas Gerais (MG). Resultados e Discussão: Atingiu-se um número final de 157 produtos: hambúrgueres de carne (n=14), pós para o preparo de gelatina (n=51) e iogurtes (n=92). Apenas 16 produtos (10,2%) foram considerados clean label ou similares. A categoria de pós para o preparo de gelatina apresentou maior média de aditivos (7,3). Os principais aditivos encontrados foram: Tripolifosfato de Sódio (100%; n=12) nos hambúrgueres de carne, Sorbato de Potássio (92%; n=77) nos iogurtes e Acessulfame de Potássio (89%; n=40) nos pós para o preparo de gelatina. Após levantamento dos aditivos mais frequentes, uma discussão sobre o impacto na saúde foi realizada. Conclusão: Os resultados indicaram que a maioria dos produtos avaliados possui 5 ou mais aditivos em sua composição e que os aditivos mais frequentes podem ter efeito negativo à saúde, logo a alternativa de alimentos clean label pode oferecer um mesmo aporte nutricional sem os riscos inerentes à ingestão de aditivos químicos. (AU)

Introduction: The ingestion of food additives in processed foods can impact human health. Considering this, the clean label trend arises with healthier and more natural ingredients. Objective: To analyze the proportion of clean label products and the main additives present in industrialized foods, comparing them to their clean label analogues. Methods: A cross-sectional, descriptive study, in which the additives present in the ingredients lists of three categories of industrialized foods (meat-based hamburgers, yogurts and powders for gelatin) were compiled. The information was extracted from a database built in 2021, through collection in supermarkets in Belo Horizonte-MG. Results and Discussion: A final number of 157 products was reached: meat-based hamburgers (n=14), powders for gelatin (n=51) and yogurts (n=92). Only 16 products (10.2%) were considered clean label or similar. The category of powders for gelatin had the highest average of additives per product (7.3). The main additives found were: Sodium Tripolyphosphate (100%; n=12) in meat-based hamburgers, Potassium Sorbate (92%; n=77) in yogurts and Acesulfame Potassium (89%; n=40) in powders for gelatin. After surveying the most frequent additives, a discussion about their impact on health was held. Conclusion: The results indicated that most of the evaluated products have 5 or more additives in their composition and that the most frequent additives can have a negative effect on health, so the clean label food alternative can offer the same nutritional contribution without the risks inherent to the ingestion of chemical additives. (AU)

Approach to food processing in the main messages of food-based dietary guidelines: A qualitative analysis / Abordagem sobre o processamento de alimentos nas mensagens principais de guias alimentares mundiais: uma análise qualitativa

ABSTRACT Objective: Analyze the content of the main messages of the world food guides, identifying the approach regarding the food processing level. Methods: This qualitative exploratory study was conducted through documentary research based on analyzing the main messages of 96 consumption guides selected from the database provided by the Food and Agriculture Organization of the United Nations. The unit of analysis consisted of segments of the main messages whose content was scrutinized using the document analysis technique. Recommendations that referred to food processing were identified after repeated readings. Data were extracted according to the developed protocol, including terms used, consumption guidance, scope of approach, and complementary information (definition, justification, exemplification, and advice on the recommended consumption amount). Results: We identified 21 Food Guides (21.88%) with recommendations related to the food processing level in their main messages, primarily published after 2012 (76.19%). The analyzed guides used terms "highly processed", "ultra-processed", "processed", "minimally processed", and "non-processed". Guidelines regarding limiting consumption were primarily used by the guides, and few specified the related food. The messages did not define the terms used. When identified, the justifications were of a nutritional or health nature. Conclusion: We observed a lack of agreement and standardization concerning the terms used, the guidelines for consumption, and the scope of the identified recommendations, with little or no additional information to explain or justify the approach adopted regarding the food processing level.

RESUMO Objetivo: Analisar o conteúdo das mensagens principais dos guias alimentares mundiais identificando a abordagem quanto ao nível de processamento dos alimentos. Métodos: Estudo exploratório qualitativo, realizado por meio de pesquisa documental, com base na análise das mensagens principais de 96 guias alimentares selecionadas no banco de dados disponibilizado pela Food and Agriculture Organization of the United Nations. A unidade de análise consistiu em segmentos das mensagens principais cujo conteúdo foi analisado através da técnica de análise documental. Após repetidas leituras foram identificadas as recomendações que faziam referência ao processamento dos alimentos. Os dados foram extraídos segundo protocolo desenvolvido, contemplando: termos utilizados; orientação de consumo; abrangência da abordagem; presença de informações complementares (definição; justificativa; exemplificação; e orientação sobre quantidade recomendada de consumo). Resultados: Constatou-se que 21 guias alimentares (21,88%) faziam recomendações relacionadas ao nível de processamento do alimento em suas mensagens principais, a maioria (76,19%) publicado após 2012. Os guias analisados utilizaram os termos: altamente processado, ultraprocessado, processado, minimamente processado e não processado. Orientações referentes à limitação de consumo foram as mais utilizadas pelos guias e poucos especificavam o alimento relacionado. As mensagens não apresentavam definição para os termos utilizados. Quando presentes, as justificativas eram de cunho nutricional ou de saúde. Conclusão: Foi observada falta de consenso e padronização no que se refere aos termos utilizados, às orientações de consumo e à abrangência das recomendações apresentadas, além de pouca ou nenhuma informação complementar capaz de explicar ou justificar a abordagem realizada em relação ao nível de processamento dos alimentos.

Consumption of ultra-processed foods and associated factors in children from Barbacena (MG), Brazil / Consumo de alimentos ultraprocessados e fatores associados em crianças de Barbacena (MG), Brasil

Abstract Objective: To evaluate the prevalence of ultra-processed food consumption and associated factors among children enrolled in the public school system of the city of Barbacena, Minas Gerais, Brazil. Methods: This is a cross-sectional study conducted with schoolchildren aged 7-9 years, of both sexes, enrolled in state public schools. Food intake was assessed using the Previous Day Food Questionnaire and the level of physical activity by the Previous Day Physical Activity Questionnaire. The listed foods were classified according to the extent and purpose of industrial processing, using the NOVA classification. Pearson's χ2 test, Fisher's exact test, χ2 with Yates correction, and Poisson regression were used in the statistical analysis, estimating the crude and adjusted prevalence ratio, with 95% confidence intervals. Results: The prevalence of daily ultra-processed food consumption was 69.6%. After adjusted analyses, the consumption of ultra-processed food was associated with the omission of breakfast, mid-afternoon snack, supper, low physical activity, and consumption of risk foods. On the other hand, consumption of in natura or minimally processed foods was associated with older age, the consumption of lunch, mid-afternoon snack, dinner, and protective foods. Conclusions: There is a high prevalence of ultra-processed foods consumption, associated with unhealthy dietary habits among schoolchildren. This highlights the need for nutritional counseling and educational actions, favoring healthy eating in childhood.

RESUMO Objetivo Avaliar a prevalência de consumo de alimentos ultraprocessados e fatores associados em crianças matriculadas na rede pública do município de Barbacena, Minas Gerais, Brasil. Métodos Trata-se de um estudo transversal realizado com escolares de 7 a 9 anos de ambos os sexos, matriculados na rede pública estadual de ensino. O consumo alimentar foi avaliado utilizando o Questionário Alimentar do Dia Anterior e o nível de atividade física pelo Questionário de Atividade Física do Dia Anterior. Os alimentos listados foram classificados segundo a extensão e propósito do processamento industrial, conforme proposto pela classificação NOVA. Na análise estatística foram utilizados os testes χ2 de Pearson, Exato de Fisher, χ2 com correção de Yates e regressão de Poisson, estimando-se a razão de prevalência bruta e ajustada, com intervalos de confiança de 95%. Resultados A prevalência de consumo de alimentos ultraprocessados foi de 69,6%. Após análises ajustadas, o consumo de alimentos ultraprocessados foi associado à omissão do café da manhã, lanche da tarde e ceia, baixo nível de atividade física e ao consumo de alimentos de risco. Por outro lado, o consumo de alimentos in natura ou minimamente processados foi associado à maior idade, consumo de almoço, lanche da tarde, jantar e alimentos protetivos. Conclusões Verificamos uma alta prevalência no consumo de alimentos ultraprocessados, associada a hábitos alimentares não saudáveis, em crianças escolares. Isso destaca a necessidade de ações de educação alimentar e nutricional, favorecendo o consumo alimentar saudável na infância.

Avaliação do microambiente alimentar em estabelecimentos fornecedores de alimentos em um município do trairí do Rio Grande do Norte / Evaluation of the food microenvironment in establishments supplying foods in acity of Trairi ofRio Grande do Norte / Evaluación del microambiente alimentario en provedores de alimentos en unmunicipio de Trairi doRio Grande do Norte

Introdução:As pessoas passaram a consumir alimentos prontos e ultraprocessados cada vez mais e diminuíram o consumo de alimentos naturais. Consequentemente, têm aumentado o desenvolvimento de obesidade e outras doenças crônicas não transmissíveis. Esse processo de transição nutricional e epidemiológico tem sido influenciado pelo ambiente alimentar. Objetivo:avaliar o microambiente alimentar em mercados e restaurantes do município de Santa Cruz, Rio Grande do Norte. Metodologia:Trata-se deuma pesquisa transversal e descritiva, de abordagem quantitativa, realizada em 60 estabelecimentos comerciais fornecedores de alimentos naturais, industrializados e refeições prontas. Foram aplicados questionários, de acordo com a classificação do tipo deestabelecimento para verificação da disponibilidade, variedade, preço e qualidade de alimentos naturais e ultraprocessados. Resultados:A maior parte dos estabelecimentos participantes eram mercados locais ou de bairros, localizados no centro da cidade, evidenciando as desigualdades territoriais.Foi visto que a disponibilidade de frutas e hortaliças era inferior aos ultraprocessados. Os alimentos apresentaram qualidade satisfatória e os menores preços de frutas foram encontrados nos supermercados e mercadinhos, enquanto os das hortaliças na feira livre. Conclusões:ficou evidente a necessidade de políticas públicas de incentivo a descentralização do comércio de alimentos e o incentivo à venda de alimentos mais saudáveis e acessíveis física e financeiramente (AU).

Introduction:People have started to consume more and more ready-to-eat foods and have reduced their consumption of fruit and vegetables. Consequently, the prevalence of overweight and chronic non-communicable diseases have increased over the years. This dietary and epidemiological transition process has been influenced by the food environment in which they are inserted. Objective:to evaluate the food microenvironment in markets and restaurants in the city of Santa Cruz, Rio Grande do Norte.Methodology:This is a cross-sectional and descriptive research, with a quantitative approach, carried out in 60 commercial establishments supplying natural and processed foods and ready-to-eat meals. Questionnaires were applied, according to the classification of the type of establishment, to check the availability, variety, price and quality of natural and ultra-processed foods.Results:Most of the participating establishments were local or neighborhood markets,located in the downtown, highlighting territorial inequalities. It was noted that the availability of fruits and vegetables is lower than the ultra-processed foods. All foods showed satisfactory quality, and the lowest prices for fruits were found in supermarkets and grocery stores, while vegetables were found in the street market. Conclusions:the need for public policies to encourage the decentralization of the food trade and the incentive to sell healthier and more affordable foodsphysically and financially became evident (AU).

Introducción: Las personas pasaron a consumir alimentos listos y ultraprocessados cada vez más y disminuyeron el consumo de alimentos naturales. Consecuentemente, las prevalencias de sobrepeso y enfermedades crónicas no transmisibles han aumentado con los años. Este proceso de transición alimentaria y epidemiológica ha sido influenciado por el entorno alimentario en el que se encuentran. Objetivo: evaluar el microambiente alimentario en mercados y restaurantes del municipio de Santa Cruz, Rio Grande do Norte.Metodología: Se trata de una investigación transversal y descriptiva, de abordaje cuantitativo, realizada en 60 establecimientos comerciales proveedores de alimentos naturales, industrializados y comidas preparadas. Se aplicaron cuestionarios de acuerdo con la clasificación del tipo de establecimiento para verificar la disponibilidad, variedad, precio y calidad de los alimentos naturales y ultraprocesados. Resultados: La mayor parte de los establecimientos participantes eran mercados locales o de barrios, localizada en el centro de la ciudad, destacando las desigualdades territoriales. Se ha visto que la disponibilidad de frutas y hortalizas es inferior a los ultraprocesados. Los alimentos presentaron calidad satisfactoria y los menores precios de frutas fueron encontrados en los supermercados y mercadillos, mientras que las hortalizas en la feria libre.Conclusiones: quedó evidente la necesidad de políticas públicas de incentivo a la descentralización del comercio de alimentos y el incentivo a la venta de alimentos más saludablesy asequibles física y financieramente (AU).

The association between maternal ultra-processed food consumption during pregnancy and child neuropsychological development: A population-based birth cohort study.

BACKGROUND & AIMS: Maternal ultra-processed food (UPF) consumption during pregnancy may adversely affect child development. Pregnancy sugar-sweetened beverage consumption (as a part of UPF) has been associated with child cognitive dysfunction in the general population, but the role of total UPF consumption during pregnancy in later child neuropsychological development has not been studied. We aimed to analyse the association between maternal pregnancy UPF consumption and child neurodevelopment. METHODS: This study involved 2377 pairs of pregnant women and their offspring from a Spanish birth cohort (recruitment period: 2004-2008, INMA project). Dietary intake was estimated using a 101-item food frequency questionnaire in the third trimester of pregnancy. The NOVA classification was used to identify UPFs, and their consumption was calculated as the daily percentage of total food consumption and categorized into tertiles. Child neuropsychological development was assessed with the Bayley Scales of Infant and Toddler Development (1-year-old, n = 1929) and the McCarthy Scales of Children's Abilities (4-5 years-old, n = 1679). Potential associations were analysed using multivariate linear regression models adjusted for a range of family and child characteristics. RESULTS: UPF consumption among pregnant women represented an average of 17% of the total diet, with sugar-sweetened beverages being the most commonly consumed type of UPF (40%). Children born to mothers in the highest tertile of UPF consumption (28.9% or more of the total diet) vs the lowest tertile (7.2% or less), showed a lower score (B = -2.29 [95% Confidence Interval (CI), -4.13; -0.46]) in the Verbal Scale of the McCarthy Scales (p-for-trend = 0.02). No associations were observed with the McCarthy Scales assessing other cognitive domains or with the Bayley Scales. CONCLUSION: Of the seven cognitive domains studied, we observed an adverse association between maternal consumption of UPF during pregnancy and verbal functioning in early childhood, which is an important cognitive domain of neurodevelopment.

Association between ultra-processed food consumption and nutrient intake among low-risk pregnant women / Associação entre o consumo de alimentos ultraprocessados e a ingestão de nutrientes em gestantes de risco habitual

Abstract Objectives: to analyze the ultra-processed foods (UPF) consumption in pregnant women's diets associated with nutrient intake. Methods: a cross-sectional study using socioeconomic, anthropometric and food consumption data from low-risk pregnant women. Consumption of energy, macro and micronutrient were obtained through two 24-hour recalls (R24h). The UPF were identified using the NOVA classification, and the percentage of energy from this food was classified in quartiles and associated with nutrient intake. So, the ANCOVA test adjusted for age and per capita income were adopted. Results: a total of 60 pregnant women with a mean of age of 28.44 (CI95%=27.20-29.69) years old were evaluated. The average percentage of UPF in the diet was 20.68 (CI95%=17.88-23.47). Pregnant women in the highest quartile of UPF consumption had lower protein intake (13.48g vs. 18.84g; p=0.031) and lower zinc intake (4.52mg vs. 6.18mg; p=0.045) when compared to those in the lowest quartile. Conclusions: the results showed a negative relationship between the participation of UPF in pregnant women's diets and the intake of protein and zinc, important nutrients for the gestational period. Such findings reinforce the importance of promoting healthy eating habits during pregnancy to ensure an adequate supply of nutrients in this phase.

Resumo Objetivos: analisar o consumo de alimentos ultraprocessados (AUP) e sua associação com a ingestão de nutrientes entre gestantes de risco habitual. Métodos: estudo transversal com dados socioeconômicos, antropométricos e de consumo alimentar de gestantes de risco habitual. O consumo de energia, macro e micronutrientes foi obtido através de dois Recordatórios 24 horas (R24h). Os AUP foram identificados através da classificação NOVA, e o percentual de calorias proveniente destes alimentos foi classificado em quartis e associado à ingestão de nutrientes. Para tal, adotou-se o teste ANCOVA ajustado segundo a idade e a renda per capita. Resultados: foram avaliadas 60 gestantes com média de idade de 28,44 (IC95%=27,20-29,69) anos. O percentual médio de AUP na dieta foi de 20,68 (IC95%=17,88-23,47). Gestantes no maior quartil de consumo de AUP apresentaram menor ingestão de proteína (13,48g vs. 18,84g; p=0,031) e zinco (4,52mg vs. 6,18mg; p=0,045) quando comparadas ao menor quartil. Conclusão: os resultados evidenciaram uma relação desfavorável entre a participação de AUP na dieta e a ingestão de proteínas e zinco, nutrientes importantes para o período gestacional. Tais achados reforçam a importância da promoção de hábitos alimentares saudáveis durante a gestação para garantir o aporte adequado de nutrientes nessa fase.

Trans-Fat Labeling in Packaged Foods Sold in Brazil Before and After Changes in Regulatory Criteria for Trans-Fat-Free Claims on Food Labels.

Consumption of industrially produced trans-fat acids (TFA) is a public health concern. Therefore, it is important that information on TFA in packaged foods be clearly informed to consumers. This study aimed to assess the evolution of TFA information presented in packaged foods sold in Brazil in 2010 and 2013, before and after the introduction of stricter regulatory requirements for TFA-free claims on food labels. A repeated cross-sectional study was performed through food label censuses of all packaged foods available for sale in two stores from the same supermarket chain, totaling 2,327 foods products in 2010 and 3,176 in 2013. TFA-free claims and information indicating TFA in the ingredients list and nutrition facts label were analyzed by descriptive statistics and Pearson's chi-square test. There was a 14% decrease in the use of ingredients containing or potentially containing industrially produced TFA (i-TFA), according to analysis of the ingredients list. However, when analyzing foods by groups, it was found that this decrease was significant only for group A (bakery goods, bread, cereals, and related products; from 59 to 35%, p < 0.001). By contrast, food group F (gravies, sauces, ready-made seasonings, broths, soups, and ready-to-eat dishes) showed a 5% increase in i-TFA. The use of specific terms for i-TFA decreased between 2010 and 2013, but there was an increase in the use of alternative terms, such as vegetable fat and margarine, which do not allow consumers to reliably identify whether a food product is a possible source of i-TFA. There was an 18% decrease in the use of TFA-free claims in products containing or potentially containing i-TFA. However, almost one-third of foods sold in 2013 were false negatives, that is, foods reported to contain 0 g of TFA in the nutrition facts label or with TFA-free claims but displaying specific or alternative terms for i-TFA in the ingredients list. The results indicate that adoption of stricter requirements for TFA-free claims on food labels in Brazil helped reduce the prevalence of such claims but was not sufficient to decrease i-TFA in industrialized foods sold in supermarkets.

Introdução de alimentos ultraprocessados e fatores associados em crianças menores de seis meses no sudoeste da Bahia, Brasil / Introduction of ultra-processed foods and associated factors among children under six months of age in the Southwest of the state of Bahia, Brazil

Resumo O objetivo do estudo foi avaliar a frequência e os fatores de risco para a introdução de alimentos ultraprocessados (AUP) em crianças menores de seis meses residentes em um município do sudoeste da Bahia. Trata-se de um recorte de um estudo coorte prospectiva realizado com duplas de mães/bebês. A introdução de AUP foi definida pela ingestão de pelo menos um AUP antes dos seis meses de vida. As informações socioeconômicas, maternas, paternas, gestacionais e relacionadas a criança foram obtidas por meio da aplicação de questionários. Para análise dos fatores associados ao desfecho foi realizada regressão de Poisson de acordo com um modelo hierárquico. Foram avaliadas 300 duplas de mães/bebês. Antes dos 6 meses, 31,3% das crianças já haviam recebido AUP. Houve maior frequência de introdução de bolacha/biscoito (23,3%) e petit suísse (14,3%). A introdução de AUP antes dos seis meses de vida foi maior entre famílias com menor renda (p=0,038), menor escolaridade materna (p=0,031), menor idade materna (p=0,017) e paterna (p=0,013), em criança que receberam leite de vaca antes dos 6 meses (p<0,001) e chá antes dos 30 dias (p=0,005). Os resultados demonstram a necessidade de intervenções voltadas para redução da introdução de AUP, principalmente para famílias de baixa renda, com menor grau de instrução e entre pais mais jovens.

Abstract The scope of this study was to assess the prevalence and associated factors with the introduction of ultra-processed food (UPF) among children under six months of age living in the southwest of Bahia state. This is an excerpt from a prospective cohort study conducted with pairs of mothers/babies. The introduction of UPF was defined by the intake of at least one UPF before the age of six months. Socioeconomic, maternal, paternal, gestational, and child-related information was gathered by the application of questionnaires. To analyze the factors associated with the outcome, Poisson regression was performed according to a hierarchical model. P-value<0.05 and 95% confidence interval are considered. A total of 300 mother/baby pairs were evaluated. Before 6 months, 31.3% of children have already received UPF. With greater introduction of cookies/biscuits (23.3%) and yogurt (14.3%). The introduction of UPF before six months of age was higher among families with lower income (p=0.038), lower maternal education (p=0.031), lower maternal (p=0.017) and paternal (p=0.013) age, among children who had cow's milk <6 months (p<0.001) and tea <30 days (p=0.005). The results demonstrate the need for interventions aimed at reducing the introduction of UPF, especially for low-income families, with less education and among younger parents.

Tipos de processamento no consumo alimentar de alunos universitários / Types of processing in the food consumption of university students

Objetivo Avaliar universitários através de questionário de frequência alimentar (quantitativo e qualitativo) e classificar a ingestão de alimentos de acordo com o tipo de processamento. Métodos Trata-se de um estudo transversal observacional, em que foi enviado um questionário para os alunos dos cursos de Nutrição, Educação Física, Enfermagem, Administração, Farmácia, Psicologia, Engenharia Civil e Fisioterapia da Instituição de Ensino Superior Universidade Salgado de Oliveira, Rio de Janeiro. Foram coletadas as seguintes informações: curso, sexo e o consumo alimentar nas refeições diárias, separadas por porções: desjejum, colação, almoço, lanche da tarde, jantar e ceia. Em seguida, os alimentos que os estudantes relataram consumir foram separados em quatro categorias: in natura; minimamente processado; processado e ultraprocessado, baseando-se nas nomenclaturas do Guia Alimentar Brasileiro. Resultados Foram coletados dados de 201 alunos, o equivalentes a 5% dos alunos matriculados nos cursos de Nutrição, Educação Física, Enfermagem, Administração, Farmácia, Psicologia, Engenharia Civil e Fisioterapia da Universidade Salgado de Oliveira. Observou-se um alto consumo de alimentos processados na amostra como um todo, porém de forma mais expressiva pelos alunos do curso de Engenharia Civil. Em contrapartida, o maior consumo de alimentos in natura e minimamente processados foi declarado pelos alunos do curso de Educação Física. Conclusão As análises mostraram que o consumo alimentar dos alunos do curso de Educação Física era mais saudável em termos de processamento, possivelmente devido ao cuidado maior desses alunos com a saúde física. Já os alunos do curso de Engenharia Civil consumiam mais alimentos ultraprocessados. O consumo prolongado de alimentos ultraprocessados e processados aumenta o risco de desenvolvimento de doenças crônicas não transmissíveis, levando a um maior risco de mortalidade em longo prazo.

Objective To evaluate university students with a food frequency questionnaire (quantitative and qualitative), and classify the intake according to food processing. Methods This is a cross-sectional observational study, in which a questionnaire was sent to students from the following undergraduate courses: Nutrition, Physical Education, Nursing, Business Management, Pharmacy, Psychology, Civil Engineering and Physiotherapy of the Higher Education Institution at Salgado de Oliveira University, in Rio de Janeiro. The following information was collected: the undergraduate course, gender and food consumption separated by portions in daily meals: breakfast, mid-morning snack, lunch, afternoon snack, dinner and supper. Then, the foods were separated into four categories: fresh; minimally processed; processed; ultra-processed, based on the nomenclatures of the "Brazilian Food's Guide". Results The data were collected from 201 students, equivalent to 5% of the courses in Nutrition, Physical Education, Nursing, Business Management, Pharmacy, Psychology, Civil Engineering and Physiotherapy at Salgado de Oliveira University. It was observed a higher consumption of processed foods in the sample as a whole, however, the highest intake was in the Civil Engineering Course. On the other hand, the highest consumption of fresh and minimally processed foods was found in Physical Education Course students. Conclusion The analyzes showed that food consumption of Physical Education students proved to be healthier in terms of processing, possibly due to the greater care with the physical health of these students, while the students of Civil Engineering course consumed a worrisome diet with more ultra-processed and less fresh foods. The prolonged consumption of ultra-processed and processed foods increases the risk of developing chronic non-communicable diseases, worsening the population's quality of life, leading to a higher risk of long-term mortality.

Intervenção interdisciplinar reduz o consumo de alimentos ultraprocessados em adolescentes com sobrepeso ou obesidade / Interdisciplinary intervention reduces the consumption of ultra-processed foods in adolescents with overweight or obesity

Este estudo objetivou avaliar o efeito da intervenção interdisciplinar com abordagem motivacional sobre o consumo de alimentos ultraprocessados em adolescentes com sobrepeso ou obesidade. O método utilizado foi um ensaio clínico randomizado no qual os participantes distribuíram-se em grupo controle (GC) e grupo intervenção (GI). A coleta de dados do consumo alimentar ocorreu mediante o recordatório de 24 horas, obtido no início e ao final das intervenções. Os alimentos consumidos foram categorizados nos quatro grupos da classificação alimentar NOVA conforme o grau de processamento a qual são submetidos. Participaram 42 adolescentes com média de idade de 16,5±1,3 anos, a maioria do gênero feminino (69%). No GI, a média de quilocalorias de alimentos ultraprocessados diminuiu 37,5% após a intervenção; em contrapartida, aumentou o consumo de alimentos processados em ambos os grupos. Concluiu-se que a intervenção interdisciplinar com abordagem motivacional foi eficaz na redução do consumo de alimentos ultraprocessados na população estudada.

The aim of this study was to evaluate the effect of interdisciplinary intervention with motivational approach on the consumption of ultra-processed foods in overweight or obese adolescents. The method used was a randomized clinical trial in which participants were allocated to control group (CG) and intervention group (IC). The data collection of food consumption occurred through the 24-hour food record, obtained at the beginning and end of interventions. The foods consumed were classified into the four NOVA groups according to the degree of processing which they are submitted. Forty-two adolescents with a mean age of 16.5±1.3 years, mostly female (69%), participated in the study. In IG, the average kcal of ultra-processed foods decreased by 37.5% after intervention. In contrast, there was an increase in the consumption of processed foods in both groups. It was concluded that the interdisciplinary intervention with a motivational approach was effective in reducing the consumption of ultra-processed foods in the studied population.

Degree of food processing and association with overweight and abdominal obesity in adolescents

ABSTRACT Objective To evaluate the association between the degree of food processing, overweight, and abdominal obesity in adolescents. Methods This is a cross-sectional study, with 576 adolescents aged 10 to 17 years, of both sexes. Food consumption was collected using the Food Frequency Questionnaire and foods classified as in natura or minimally processed, processed foods associated with culinary ingredients, and ultraprocessed foods. Sociodemographic data, body mass index, waist circumference and waist-to-height ratio were collected. The analysis was evaluated by the Mann-Whitney test and prevalence ratio with 95% confidence interval, considering p<0.05. Results An intake above the third quartile of processed foods associated with culinary ingredients (prevalence ratio of 1.64; 95%CI: 1.12-2.42) and ultraprocessed (prevalence ratio of 1.58; 95%CI: 1.07-2.34) was associated with a higher prevalence of overweight. Consumption above the third quartile of ultraprocessed foods was associated with a higher prevalence of abdominal obesity, assessed by waist circumference (prevalence ratio of 2.48; 95%CI: 1.41-4.36), and waist-height ratio (prevalence ratio of 2.09; 95%CI: 1.11-3.92). Conclusion A higher consumption of processed foods associated with culinary ingredients was related to being overweight, and ultraprocessed foods with overweight and abdominal obesity.

Food additives in childhood: a review on consumption and health consequences / Aditivos alimentares na infância: uma revisão sobre consumo e consequências à saúde

ABSTRACT OBJECTIVE To discuss the context of scientific publications on the consumption of food additives by children and the possible health consequences in this age group. METHODS A literature review, with a search carried out between April 2020 and April 2021 in the Web of Science, Scopus, PubMed and Google Scholar databases, as well as in websites of Brazilian and foreign official bodies. Official documents and studies published since 2000 were selected. Keywords related to food additives, children, food consumption, and health were used for the search. RESULTS Food additives are substances intentionally added to foods for technological purposes. Processed foods are the main sources of additives in food and their consumption occurs since childhood. It is observed, however, that there are limitations inherent to the scientific method regarding the analysis of consumption and toxicity of food additives in humans, causing scarcity of data in the scientific literature. Additionally, existing data suggest that the additives have a higher toxic potential in children, considering that the body weight in this age group is lower than in adults. This context emphasizes the need to observe the precautionary principle, according to which risks of harm must be prevented. CONCLUSIONS This is a scenario in which the literature points to a risk to people's health and, in particular, to children, about whom the duty of protection must be even greater, with absolute priority. Thus, the relevance of an expanded technical-scientific debate regarding the establishment of specific and stricter parameters for children is considered, regarding the consumption and toxicity of additives, as well as the different sources of exposure to these substances.

RESUMO OBJETIVO Discutir o contexto das publicações científicas sobre consumo de aditivos alimentares por crianças e as possíveis consequências à saúde nessa faixa etária. MÉTODOS Revisão de literatura, com busca realizada entre abril de 2020 e abril de 2021 nas bases de dados Web of Science, Scopus, PubMed e Google Acadêmico, bem como em sites de órgãos oficiais brasileiros e estrangeiros. Foram selecionados documentos oficiais e estudos publicados a partir do ano 2000. Para a busca, foram utilizados unitermos relacionados a aditivos alimentares, crianças, consumo alimentar e saúde. RESULTADOS Aditivos alimentares são substâncias adicionadas intencionalmente aos alimentos para fins tecnológicos. Os alimentos industrializados são as principais fontes de aditivos na alimentação e seu consumo ocorre desde a infância. Observa-se, contudo, que há limitações inerentes ao método científico no que tange à análise de consumo e de toxicidade de aditivos alimentares em humanos, ocasionando escassez de dados na literatura científica. Adicionalmente, dados existentes sugerem que os aditivos apresentam potencial tóxico maior em crianças, considerando que o peso corporal nessa faixa etária é menor em relação ao adulto. Esse contexto ressalta a necessidade de se observar o princípio da precaução, segundo o qual devem-se prevenir os riscos de dano. CONCLUSÕES Trata-se de cenário no qual a literatura aponta risco à saúde das pessoas e, em especial, das crianças, cujo dever de proteção deve ser ainda maior, com absoluta prioridade. Assim, pondera-se a relevância de um debate técnico-científico ampliado quanto ao estabelecimento de parâmetros específicos e mais rígidos para crianças, considerando consumo e toxicidade de aditivos, bem como as diversas fontes de exposição a essas substâncias.