Você costuma verificar o rótulo de alimentos? Estudo de base populacional com adolescentes e adultos de Campinas, SP / Do you usually check the food label? Population-based study with adolescents and adults from Campinas, SP

Resumo Introdução A rotulagem de alimentos é uma importante ferramenta de promoção da saúde e de escolhas alimentares saudáveis. Objetivo Estimar a prevalência do hábito de verificar os rótulos de alimentos e fatores associados em adolescentes e adultos, bem como identificar as informações observadas nos rótulos. Método Estudo transversal de base populacional com amostra probabilística por conglomerados em dois estágios, realizado em Campinas/SP (n = 1.792, 10-59 anos). Foram estimadas razões de prevalência e os respectivos intervalos de confiança de 95% e foi desenvolvido modelo de regressão múltipla de Poisson. Resultados A prevalência do hábito de verificar os rótulos de alimentos foi de 49,4% (IC95%: 45,2-53,6). As prevalências foram superiores no sexo feminino, nos adultos, em indivíduos com maior renda, com maior frequência semanal de consumo de frutas, hortaliças cruas, alimentos integrais, com menor frequência de consumo de refrigerantes e que tinham se pesado há menos de um mês. Data de validade, calorias, sódio e gordura foram as informações mais buscadas nos rótulos. Conclusão Os resultados destacam a necessidade de orientar e estimular o uso da rotulagem nutricional, identificam os segmentos prioritários e contribuem para preencher uma das lacunas científicas brasileiras sobre a prevalência de consulta aos rótulos de alimentos e fatores associados.

Abstract Background Food labeling is an important tool for encouraging health and healthy food choices. Objective To estimate the prevalence of food label consultation and associated factors in adolescents and adults, and to identify the information taken from food labels. Method Cross-sectional study with data from population-based surveys with a probabilistic sample, by clusters and in two-stages, conducted in Campinas, São Paulo, Brazil (n=1.792, 10-59 years). Prevalence ratios and respective 95% confidence intervals were estimated and a Poisson multiple regression model was developed. Results 1,792 individuals aged 10 to 59 years participated in the study. The prevalence of reading food labels was 49.4% (95%CI: 45.2-53.6) for the whole population. Prevalence was higher in females, adults, in those with higher income, with more frequent weekly consumption of fruits, raw vegetables, and whole foods, with less frequent consumption of soft drinks, and those who had weighed themselves less than a month ago. Expiration date, calories, sodium and fat were the most searched for information on food labels. Conclusion The results highlight a need to guide and encourage the use of nutrition labeling, identify priority segments and help to fill a scientific gap in Brazil regarding the prevalence of food label consultation and associated factors.

Sociodemographic, clinical, and dietary characteristics of overweight adults: a secondary analysis of a population study / Caracterização sociodemográfica, clínica e da alimentação de adultos com excesso de peso: análise secundária de um estudo populacional

ABSTRACT Objective: To estimate the prevalence of overweight among Brazilian adults aged 20 to 59, according to sociodemographic characteristics, health-related behaviors, and food consumption. Methods: A cross-sectional study based on data from a population-based survey in a major metropolitan city in the state of São Paulo, Brazil, conducted between 2015-2016. Prevalences and prevalence ratios were estimated using Poisson regression; food consumption means were estimated using linear regression. Results: We analyzed data from 855 adults, 61% of whom were overweight. The prevalence of overweight was significantly higher among males, those aged 30 or older, with 8 to 11 years of education, and those who reported eating more than they should. The body mass index was significantly associated with hypertension, diabetes, high cholesterol, waist-to-height ratio, taking weight-loss medications, overeating, and the habit of checking labels. Overweight adults reported eating meat with visible fat and drinking soda more frequently than those not overweight. Overweight adults reported eating significantly more grams of food daily and had a higher intake of energy, total fat, saturated fats, trans fats, carbohydrates, protein, insoluble dietary fiber, sodium, and potassium. Their diets had a higher glycemic load when compared to participants who were not overweight. Conclusion: Adults with and without overweight differed in their sociodemographic, dietary, and clinical characteristics. Diet quality was similar between both groups, suggesting a need for improving dietary habits in this population regardless of body weight.

RESUMO Objetivo: Estimar a prevalência de excesso de peso entre adultos brasileiros, de 20 a 59 anos, segundo características sociodemográficas, de comportamentos relacionados à saúde e quanto ao consumo alimentar. Métodos: Estudo transversal, de pesquisa de base populacional, em uma cidade metropolitana de São Paulo - Brasil, conduzida entre os anos de 2015 e 2016. Foram estimadas as prevalências e as razões de prevalência por meio da regressão de Poisson, e as médias de consumo alimentar pelo uso da regressão linear. Resultados: Foram analisados dados referentes à 855 adultos, 61% destes apresentavam sobrepeso. A prevalência de excesso de peso foi significativamente maior entre: homens, com 30 anos ou mais, pessoas que possuíam entre 8 e 11 anos de estudo e entre aqueles que acreditavam comer mais do que deveriam. O índice de massa corporal foi significativamente associado à hipertensão, diabetes, colesterol alto, razão cintura-estatura, uso de medicamentos, comer mais do que deveria e o hábito de checar rótulos. Adultos com excesso de peso ingeriam carnes com gordura e refrigerantes em maior frequência quando comparados à adultos com peso saudável. Adultos com excesso de peso consumiam, significativamente, mais gramas de alimentos por dia e apresentaram maior ingestão de calorias, gorduras totais, saturadas e trans, carboidratos, proteína, fibras insolúveis, sódio e potássio. A dieta deles continha uma maior carga glicêmica quando comparada àqueles com peso saudável. Conclusão: Adultos com e sem excesso de peso, diferiram quanto às características sociodemográficas, dietéticas e clínicas. A qualidade da dieta foi similar em ambos os grupos, o que sugere a necessidade de melhora dos hábitos alimentares da população, independentemente do peso corporal.

Prevalence of body weight dissatisfaction among adolescents: a systematic review / Prevalência de insatisfação com o peso corporal entre adolescentes: uma revisão sistemática

ABSTRACT Objective: To identify the prevalence of weight dissatisfaction among adolescents aged 10-19 years and stratify the analysis by sex. Data source: A literature review of cross-sectional studies among healthy adolescents was performed. The U.S. National Library of Medicine/National Institutes of Health (PubMed), Ovid® (Wolters Kluwer), The Cumulative Index to Nursing and Allied Health Literature (CINAHL), and American Psychological Association (PsycINFO®) databases were searched between May 2019 and January 2020. Data synthesis: Initially, 3,700 records were identified, and 10 papers were obtained through other sources. After the removal of duplicates, 1,732 records were screened based on the titles and abstracts, and 126 were preselected for full-text analysis. After the application of the eligibility criteria, 34 papers were included in the present review. The studies were published between 1997 and 2020. The sample size ranged from <150 to >103,000 adolescents. The prevalence of weight dissatisfaction ranged from 18.0 to 56.6% in both sexes (10.8-82.5% among boys and 19.2-83.8% among girls). Conclusions: Based on the findings of the present systematic review, the prevalence of weight dissatisfaction is high among adolescents, especially girls. Such information can contribute to the planning of health and education programs addressing the issue of weight in adolescents.

RESUMO Objetivo: Identificar as prevalências de insatisfação com o peso corporal em adolescentes de dez a 19 anos, segundo o sexo. Fontes de dados: Foram selecionados estudos transversais que descreviam as prevalências de insatisfação com o peso em adolescentes saudáveis, nos idiomas inglês, português e espanhol. Não foram estabelecidos limites para o ano de publicação ou país. Utilizaram-se as bases de dados US National Library of Medicine/National Institutes of Health (PubMed), Ovid® (Wolters Kluwer), The Cumulative Index to Nursing and Allied Health Literature (CINAHL) e American Psychological Association (PsycINFO®), entre maio de 2019 e janeiro de 2020. Síntese dos dados: Inicialmente identificaram-se 3.700 registros e dez estudos em outras fontes de dados. Após a remoção dos estudos duplicados, foram rastreados 1.732 registros para a leitura de títulos e resumos, dos quais 126 artigos foram selecionados para avaliação do texto completo. Por fim, foi incluído nesta pesquisa o total de 34 artigos. Os estudos foram publicados entre 1997 e 2020. Os tamanhos amostrais variaram de <150 a >103.000 adolescentes. As prevalências de insatisfação com o peso variaram de 18,0 a 56,6% em ambos os sexos (10,8 a 82,5% no sexo masculino e 19,2 a 83,8% no feminino). Conclusões: Esta revisão identificou elevada prevalência de insatisfação com o peso corporal em adolescentes, superior em meninas. Tais informações podem contribuir para o planejamento de programas de saúde e educação direcionados à questão do peso em adolescentes.

Prevalence of body weight dissatisfaction among adolescents: a systematic review.

OBJECTIVE: To identify the prevalence of weight dissatisfaction among adolescents aged 10-19 years and stratify the analysis by sex. DATA SOURCE: A literature review of cross-sectional studies among healthy adolescents was performed. The U.S. National Library of Medicine/National Institutes of Health (PubMed), Ovid® (Wolters Kluwer), The Cumulative Index to Nursing and Allied Health Literature (CINAHL), and American Psychological Association (PsycINFO®) databases were searched between May 2019 and January 2020. DATA SYNTHESIS: Initially, 3,700 records were identified, and 10 papers were obtained through other sources. After the removal of duplicates, 1,732 records were screened based on the titles and abstracts, and 126 were preselected for full-text analysis. After the application of the eligibility criteria, 34 papers were included in the present review. The studies were published between 1997 and 2020. The sample size ranged from <150 to >103,000 adolescents. The prevalence of weight dissatisfaction ranged from 18.0 to 56.6% in both sexes (10.8-82.5% among boys and 19.2-83.8% among girls). CONCLUSIONS: Based on the findings of the present systematic review, the prevalence of weight dissatisfaction is high among adolescents, especially girls. Such information can contribute to the planning of health and education programs addressing the issue of weight in adolescents.

Diet quality among older adults: What the Index Associated with the Digital Food Guide and the Brazilian Healthy Eating Index-Revised Reveal. / O que revela o Índice de Qualidade da Dieta associado ao Guia Alimentar Digital comparativamente a outro índice, em idosos?

The aim of the present study was to compare the Diet Quality Index-Digital Food Guide (DQI-DFG) to a more widely used measure in the literature: the Brazilian Healthy Eating Index-Revised (BHEI-R). A cross-sectional population-based study was conducted with 822 older adults (≥ 60 years) from the city of Campinas/SP, Brazil. The BHEI-R resulted in a higher overall score compared to DQI-DFG (62.9 vs. 47.7). For the BHEI-R, mean scores increased with age and were worse among smokers and individuals with a higher level of schooling. Regarding the DQI-DFG scores, no significant associations with age, schooling or smoking were detected; however, scores were higher in higher income segments. The components with the worst scores were whole grains, sodium and milk (BHEI-R); fruits, whole grains, roots/tubers, milk, refined cereals and red meat/processed (DQI-DFG). Divergences were found in the global scores and components of the indicators, reflecting important methodological differences. Studies of this nature constitute an opportunity to increase awareness regarding indicators of particular aspects of diet.

Objetivou-se avaliar o Índice de Qualidade da Dieta associado ao Guia Alimentar Digital (IQD-GAD) em comparação a outro mais utilizado e difundido na literatura, o Índice de Qualidade da Dieta Revisado (IQD-R). Estudo transversal de base populacional, com 822 idosos (≥ 60 anos) de Campinas, São Paulo. Utilizaram-se dados de um recordatório de 24 horas para efetuar os indicadores, cujas pontuações globais variam de zero a cem: quanto maior, melhor é a qualidade. Regressão linear simples e múltipla foi aplicada nas análises. O IQD-R resultou em maior pontuação global do que o IQD-GAD (62,9 vs. 47,5). No IQD-R, os escores médios foram melhores nos mais longevos e piores nos mais escolarizados e nos tabagistas. Quanto aos escores do IQD-GAD, não foram detectadas diferenças significativas em idade, escolaridade e tabagismo, mas foram maiores em segmentos de maior renda. Os componentes com piores pontuações: cereais integrais, sódio e leite (IQD-R); frutas, cereais integrais, raízes/tubérculos, leite, cereais refinados e carne vermelha/processada (IQD-GAD). Observaram-se discrepâncias nos escores globais e dos componentes dos indicadores, que refletem importantes diferenças metodológicas. Investigações dessa natureza configuram uma oportunidade de aprimorar a sensibilidade de indicadores a aspectos particulares da alimentação.

O que revela o Índice de Qualidade da Dieta associado ao Guia Alimentar Digital comparativamente a outro índice, em idosos? / Diet quality among older adults: What the Index Associated with the Digital Food Guide and the Brazilian Healthy Eating Index-Revised Reveal

Resumo Objetivou-se avaliar o Índice de Qualidade da Dieta associado ao Guia Alimentar Digital (IQD-GAD) em comparação a outro mais utilizado e difundido na literatura, o Índice de Qualidade da Dieta Revisado (IQD-R). Estudo transversal de base populacional, com 822 idosos (≥ 60 anos) de Campinas, São Paulo. Utilizaram-se dados de um recordatório de 24 horas para efetuar os indicadores, cujas pontuações globais variam de zero a cem: quanto maior, melhor é a qualidade. Regressão linear simples e múltipla foi aplicada nas análises. O IQD-R resultou em maior pontuação global do que o IQD-GAD (62,9 vs. 47,5). No IQD-R, os escores médios foram melhores nos mais longevos e piores nos mais escolarizados e nos tabagistas. Quanto aos escores do IQD-GAD, não foram detectadas diferenças significativas em idade, escolaridade e tabagismo, mas foram maiores em segmentos de maior renda. Os componentes com piores pontuações: cereais integrais, sódio e leite (IQD-R); frutas, cereais integrais, raízes/tubérculos, leite, cereais refinados e carne vermelha/processada (IQD-GAD). Observaram-se discrepâncias nos escores globais e dos componentes dos indicadores, que refletem importantes diferenças metodológicas. Investigações dessa natureza configuram uma oportunidade de aprimorar a sensibilidade de indicadores a aspectos particulares da alimentação.

Abstract The aim of the present study was to compare the Diet Quality Index-Digital Food Guide (DQI-DFG) to a more widely used measure in the literature: the Brazilian Healthy Eating Index-Revised (BHEI-R). A cross-sectional population-based study was conducted with 822 older adults (≥ 60 years) from the city of Campinas/SP, Brazil. The BHEI-R resulted in a higher overall score compared to DQI-DFG (62.9 vs. 47.7). For the BHEI-R, mean scores increased with age and were worse among smokers and individuals with a higher level of schooling. Regarding the DQI-DFG scores, no significant associations with age, schooling or smoking were detected; however, scores were higher in higher income segments. The components with the worst scores were whole grains, sodium and milk (BHEI-R); fruits, whole grains, roots/tubers, milk, refined cereals and red meat/processed (DQI-DFG). Divergences were found in the global scores and components of the indicators, reflecting important methodological differences. Studies of this nature constitute an opportunity to increase awareness regarding indicators of particular aspects of diet.

Neck circumference: cutoff points for Brazilian children / Circunferência do pescoço: proposta de pontos de corte para crianças brasileiras

ABSTRACT Objective The objective of the present study was to propose cutoff points of neck circumference for predicting overweight in Brazilian children. Methods We conducted a cross-sectional study with 875 children from public schools in Brazil. Weight, height, and neck circumference were measured. Nutritional status and the risk of complications were assessed based on the values of body mass index and neck circumference. Receiver operating characteristic curve analysis was used to verify the cutoff points. Results The median age was eight years, and the majority of the children had normal weights by body mass index and had no risk of metabolic complications by neck circumference. There was a correlation between neck circumference and body mass index (k=0.689; p<0.005). The mean values proposed for overweight were 29.2 cm for girls and 29.1 cm for boys. Conclusion Neck circumference had a good correlation with body mass index, and the cutoff points proposed can identify overweight in Brazilian children.

RESUMO Objetivo O objetivo do presente estudo foi propor pontos de corte para circunferência do pescoço para predição de excesso de peso em crianças brasileiras. Métodos Estudo transversal realizado com 875 crianças. Foram mensurados peso, estatura e circunferência do pescoço. O diagnóstico do estado nutricional e risco de complicações foi realizado com base nos valores de índice de massa corporal e circunferência de pescoço. Para verificar os pontos de corte foi utilizada a curva Característica de Operação do Receptor. Resultados A mediana de idade foi de oito anos e a maioria das crianças apresentou eutrofia pelo índice de massa corporal e nenhum risco de complicações metabólicas. Observou-se correlação substancial entre a circunferência do pescoço com o índice de massa corporal (k=0,689; p<0,005). Os valores médios de circunferência de pescoço propostos para excesso de peso foi 29,2 cm para meninas e 29,1 cm para meninos. Conclusão A circunferência do pescoço possui boa correlação com o índice de massa corporal e os pontos de corte aqui propostos possuem força para identificar crianças brasileiras com excesso de peso.

[Low intake of dietary fibers among the elderly: 2014/2015 ISACAMP population-based study]. / Baixa ingestão de fibras alimentares em idosos: estudo de base populacional ISACAMP 2014/2015.

The scope of this article is to evaluate the prevalence of inadequate dietary fiber intake and associated factors among elderly adults. A cross-sectional population-based study evaluating participants from the Health Survey of the City of Campinas (ISACAMP) was conducted in 2014/2015, with 1,074 elderly individuals (≥60 years). Dietary fiber intake was obtained using a 24-hour recall, and the prevalence of inadequate fibers was estimated according to the cut-off point of the Institute of Medicine (30 g/day for men and 21 g/day for women). The factors evaluated were sociodemographic conditions (sex, age, schooling, income, marital status), health (number of reported diseases) and lifestyle (physical activity, smoking and alcohol consumption). The prevalence of inadequate dietary fiber intake was 86.6%, being higher in men (RP=1.10), single or divorced (RP=1.09) and physically inactive (PR=1.07). Elderly adults with higher incomes and who reported having 1 to 2 chronic non-communicable diseases had a higher intake of fibers. The high prevalence of inadequate dietary fiber intake in the elderly adults indicates that health and nutrition actions should be developed to ensure adequate dietary intake of these compounds.

O objetivo deste artigo é avaliar a prevalência de inadequação do consumo de fibras alimentares e seus fatores associados em idosos. Estudo transversal de base populacional que avaliou participantes do Inquérito de Saúde do Município de Campinas (ISACAMP) em 2014/2015, com 1.074 idosos (≥60 anos). O consumo de fibras na dieta foi obtido utilizando um recordatório de 24h, e foi estimada a prevalência de inadequação de fibras de acordo com o ponto de corte do Institute of Medicine (30 g/dia para homens e 21 g/dia para mulheres). Os fatores avaliados foram condições sociodemográficas (sexo, idade, escolaridade, renda, estado conjugal), de saúde (número de doenças referidas) e estilo de vida (atividade física, tabagismo e etilismo). A prevalência de inadequação do consumo de fibras alimentares foi de 86,6%, sendo maior em homens (RP=1,10), em solteiros ou divorciados (RP=1,09) e inativos fisicamente (RP=1,07). Idosos de maior renda e que relataram ter de 1 a 2 doenças crônicas não transmissíveis tiveram maior ingestão de fibras. A alta prevalência da inadequação do consumo de fibras alimentares em idosos aponta para que sejam desenvolvidas ações de saúde e nutrição a fim de garantir um consumo alimentar adequado destes compostos.

Contribution of different foods according to the Nova classification to dietary fiber intake in adolescents. / Contribuição dos diferentes alimentos segundo a classificação Nova para a ingestão de fibras alimentares em adolescentes.

The aims of the present study were to evaluate dietary fiber intake and associated factors in adolescents, identify food sources of the nutrient, and determine associations between indicators of dietary patterns (energy/macronutrients/micronutrients) and dietary fiber intake. A population-based cross-sectional study was conducted involving 24-hour recall data. The NOVA classification was used to determine the contribution of foods to dietary fiber intake. Reference values from the World Health Organization (≥12.5 g) and the US Institute of Medicine (14 g) per 1,000 kcal were used to assess intake. The mean intake of dietary fiber/1,000 kcal/day was 6.4 g (1.5 g of soluble fiber and 4.9 g of insoluble fiber) among the 891 adolescents. Fiber intake was low, especially among those who ate fruits, vegetables, and beans less, those who consumed soft drinks and processed meats more, and those who did not eat breakfast every day. Unprocessed/minimally processed foods provided 68.8%, 53.7%, and 72.1% of total, soluble, and insoluble fiber, respectively, whereas ultra-processed products provided 24.8%, 37.9%, and 21.0% respectively. Fiber intake was inversely associated with energy intake, fat, free sugar, and animal protein in the diet. The insufficient fiber intake underscores the need for actions that promote healthy nutrition on the individual and family levels.

Objetivou-se avaliar a ingestão de fibra alimentar e fatores associados em adolescentes; identificar as fontes alimentares do nutriente; e verificar a relação de indicadores de práticas alimentares (energia/macro/micronutrientes) com o consumo de fibras. Trata-se de estudo transversal de base populacional com dados de Recordatório de 24 Horas. Utilizou-se a classificação NOVA e foi avaliada a contribuição dos alimentos para o teor de fibras da dieta. Valores de referência da Organização Mundial da Saúde (≥12,5 g) e do Institute of Medicine (14 g) por 1.000 kcal foram usados para avaliar o consumo. A ingestão média foi de 6,4 g de fibra alimentar/1.000 kcal/dia, 1,5 g de solúvel e 4,9 g de insolúvel, para os 891 adolescentes. O consumo de fibras foi baixo, principalmente entre os que ingeriam menos frutas, hortaliças, feijão, mais refrigerante, embutidos, e nos que não consumiam o café da manhã diariamente. Os alimentos in natura forneceram 68,0%, 53,7% e 72,1% da fibra total, solúvel e insolúvel, e os ultraprocessados 24,8%, 37,9% e 21,0%, respectivamente. O consumo de fibras foi inversamente associado ao teor de energia, gordura, açúcar livre e proteína animal da dieta. A ingestão insuficiente de fibras sinaliza a necessidade de promover a alimentação saudável e adequada em nível individual e familiar.

Complete androgen insensitivity syndrome and risk of gonadal malignancy: systematic review.

Complete androgen insensitivity syndrome (CAIS) is a rare condition characterized by 46,XY karyotype, female external genitalia, absence of uterus, and testes located intra-abdominally, in the inguinal ring or in the labia majora. In the present study, the frequency of testicular malignancy in prepubertal and pubertal patients with CAIS who underwent gonadectomy or gonadal biopsy were evaluated. Systematic review was performed using electronic databases according to the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) guidelines. The samples included 15 articles published between 1998 and 2019. From a total of 456 patients who underwent gonadectomy or gonadal biopsy, 6.14% had a premalignant lesion and most were postpubertal (82.14%). A malignant lesion was found in 1.3% and all were postpubertal. Because the risk of malignancy is very low in prepubertal patients with CAIS, gonadectomy may be delayed until puberty is complete, allowing it to progress naturally; however, close follow-up of the patient is required.

Weight self-perception in adolescents: evidence from a population-based study.

OBJECTIVE: To evaluate weight misperception among adolescents and determine associations between self-perceived weight and socio-demographic characteristics, BMI, screen time, self-rated food quantity and diet quality, weekly frequency of breakfast and the consumption of healthy and unhealthy foods. DESIGN: A cross-sectional, two-stage, probabilistic population-based study was conducted in Campinas, Brazil. Multinomial logistic regressions were run to estimate weight self-perception. SETTING: Data from the Campinas Health Survey (ISACamp) and Campinas Food Consumption Survey (ISACamp-Nutri). PARTICIPANTS: A total of 911 adolescents aged 10-19 years. RESULTS: Nearly half (47·7 %) of the adolescents with overweight/obesity did not evaluate their weight properly. Weight self-perception as thin and excess weight was associated with the female gender, overweight/obesity, self-rated diet quality as poor/very poor and eating snacks ≥3 times/week. Adolescents who did not consume breakfast daily were less likely to perceive themselves as thin. Adolescents who ate excessively were more likely and those who consumed cookies/crackers ≥3 times/week were less likely to perceive themselves as having excess weight. CONCLUSIONS: Greater weight misperception was found in overweight/obese adolescents. Gender, BMI, self-rated food quantity/diet quality, weekly frequency of breakfast and some unhealthy foods were associated with self-perceived weight. The present findings could contribute to health promotion strategies targeting adolescents.

Do adults and older people follow current guidelines for milk consumption?

OBJECTIVE: To estimate the prevalence of frequent milk consumption (≥five times/week), the consumption of low-fat/skimmed milk and associated factors in adults and older people, evaluating adherence to current Brazilian guideline. DESIGN: Population-based cross-sectional study involving the analysis of data from the 2015 Campinas Food Intake and Nutritional Status and 2015 Campinas Health Survey. The prevalence of milk consumption was analysed according to socio-economic characteristics, morbidities and health-related behaviours. SETTING: City of Campinas, state of São Paulo, Brazil. PARTICIPANTS: A sample of 1710 participants of the 2015 Campinas Nutritional and Health Surveys. RESULTS: A total of 73·8 % of the population consumed milk, but the prevalence of frequent consumption was only 44·0 %. Frequent milk consumption was higher among women, older people and individuals with better diet quality. A total of 18·4 % of the individuals who consumed milk reported consuming low-fat/skimmed milk; this prevalence was higher among women, individuals with a higher socio-economic status, those with better diet quality and those with chronic diseases. CONCLUSION: Despite the high nutritional quality of milk and the different types available on the market, adults and older people do not follow current recommendations regarding its consumption. Information on the nutritional quality of milk and current recommendations should be disseminated more at healthcare services.

Sociodemographic inequalities in eating practices and concerns.

OBJECTIVE: To evaluate associations between selected dietary concerns and eating practices and determine the association of these concerns/practices with demographic and socio-economic characteristics in a population from a large Brazilian city. DESIGN: Population-based cross-sectional study. We investigated concerns regarding salt intake, the use of highly processed seasoning and the custom of reading the Na content on food labels. We also analysed concerns regarding the use of pesticides on food products and the practice of consuming organic foods. These variables were analysed according to sex, age group, schooling and income. Multivariate Poisson regression analysis was performed for the estimation of prevalence ratios. SETTING: Campinas, state of São Paulo, Brazil. PARTICIPANTS: The representative sample consisted of 1710 adults and seniors. RESULTS: A total 62·3 % of the population were concerned with salt intake, 34·7 % did not use highly processed seasoning and 10·6 % checked the Na content on food labels; 27·5 % were concerned with pesticides and 26·5 % consumed organic foods. The practices analysed were associated with the respective concerns. Women and seniors had a better profile, except for reading Na content in both groups and the consumption of organic foods among seniors. The frequency of checking the Na content and consuming organic foods increased with the level of schooling. The higher income group had a better profile, except for concern with salt intake. CONCLUSIONS: Considerable social differences were found regarding the dietary practices, and the practices were associated with concerns. The present findings underscore the need for different dietary counseling strategies targeting specific groups.

FODMAP project: Development, validation and reproducibility of a short food frequency questionnaire to estimate consumption of fermentable carbohydrates.

BACKGROUND & AIMS: Irritable bowel syndrome (IBS) is a functional disorder that is characterized by gastrointestinal symptoms and that has a major impact on quality of life, resulting in direct and indirect health care costs. The majority of patients with IBS suffer from food intolerances, most commonly related to the consumption of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs). This study aimed to develop and verify the validity and reproducibility of a short food frequency questionnaire (FFQ) to assess typical FODMAP consumption in adults with IBS. METHODS: The primary FFQ list consisted of source foods of FODMAPs that contributed at least 10% to the frequency of consumption among 855 adults from a population-based study in the municipality of Campinas in 2014/2015. In addition, source foods of FODMAPs (according to the Monash University Low FODMAP Diet application) and foods commonly consumed by the Brazilian population (according to the FFQ for adults validated in the city of São Paulo) were included. One hundred and five (n = 105) healthy subjects were recruited to respond to the FFQ twice and to respond the 24-h dietary recall (24HR) three times during a 3-month period. The relative validity of the proposed instrument was compared with the average of the three 24HRs, and the reproducibility of the instrument was assessed by comparing both FFQ applications. The following statistical analyses were used for validation and reproducibility: Wilcoxon's test, Spearman's correlation analysis, weighted kappa, Bland Altman's plot and index, and interclass correlation coefficient. RESULTS: The final list of items for the short FFQ included 54 different foods. The foods were organized by FODMAP groups: free fructose, lactose, total oligosaccharides and total polyols, with variations of categories of responses for consumption frequency between 0 and 10 times and the unit of time in days, weeks or months. In the validity analyses, the correlation coefficients ranged from 0.209 (polyols) to 0.652 (lactose) (p < 0.05). There was no correlation between the methods in the fructose and oligosaccharide groups. The lactose group presented good agreement, and the remaining groups had a lack of agreement, with a mean of 15.7%. The Bland-Altman index values were 4.7% (fructose), 3.8% (lactose), 5.7% (oligosaccharides) and 6.6% (polyols). Regarding reproducibility, the interclass and Spearman's correlation coefficients varied from ICC = 0.781 and r = 0.725 (oligosaccharides) to ICC = 0.913 and r = 0.807 (lactose) (p < 0.05), showing strongly reproducible results for lactose and polyols and good results for fructose and oligosaccharides. Accurate agreement between FFQ applications had a mean of 67.3%, and 3.0% showed disagreement between FFQ1 and FFQ2. The weighted kappa coefficient ranged from 0.576 (polyols) to 0.645 (lactose). CONCLUSION: The semi-quantitative short FFQ was developed to evaluate the consumption of FODMAPs in adults in São Paulo. The instrument presents good reproducibility for all groups of FODMAPs, good validity for lactose and weaker validity for fructose, polyols and oligosaccharides. As the short FFQ was carefully designed for the study population, its estimates are relatively reliable at the population group level. A future reanalysis of this questionnaire would be useful when the chemical composition data of FODMAPs are available.

Vitamin e intake and food sources in adolescent diet: a cross-sectional population-based study / Consumo de vitamina e e fontes alimentares na dieta de adolescentes: um estudo transversal de base populacional

ABSTRACT Objective: To assess vitamin E intake and its relationship with sociodemographic variables, and to identify the main dietary sources of the nutrient in the diet of adolescents. Methods: This is a population-based cross-sectional study that used data from 891 adolescents living in Campinas, SP, participating in ISACamp 2014/15 (Health Survey) and ISACamp-Nutri 2015/16 (Food Consumption and Nutritional Status Survey). The nutrient intake averages were estimated using the Generalized Linear Model, adjusted for the total energy of the diet. Dietary sources of vitamin E were identified from the calculation of the relative contribution. Results: The average vitamin E intake was 3.2 mg for adolescents aged 10 to 13 years and 3.5 mg for those aged 14 to 19 years, results far below the recommended values of 9 and 12 mg, respectively. The prevalence of inadequacy was 92.5%. ­Ten ­foods/­food groups represented 85.7% of vitamin E present in the adolescents' diet; the vegetable oils group accounted for more than a quarter of the contribution (25.5%), followed by cookies (9.1%) and beans (8.9%). Conclusions: There were a low intake and a high prevalence of inadequate vitamin E intake among adolescents in Campinas, with vegetable oil as the main source. For the total number of adolescents, almost 33% of the nutrient content was derived from foods of poor nutritional quality such as cookies, packaged snacks, and margarine. The results of this study can guide public health actions that aim to improve the quality of adolescents' diets.

RESUMO Objetivo: Avaliar a ingestão de vitamina E e sua relação com variáveis sociodemográficas, e identificar as principais fontes alimentares do nutriente na dieta de adolescentes. Métodos: Trata-se de estudo transversal de base populacional que utilizou dados de 891 adolescentes residentes em Campinas, SP, participantes do ISACamp 2014/15 (Inquérito de Saúde) e ISACamp-Nutri 2015/16 (Inquérito de Consumo Alimentar e Estado Nutricional). As médias de ingestão do nutriente foram estimadas por meio de modelo linear generalizado, ajustado pela energia total da dieta. As fontes alimentares de vitamina E foram identificadas pelo cálculo de contribuição relativa. Resultados: A ingestão média de vitamina E foi de 3,2 mg para os adolescentes de 10 a 13 anos e de 3,5 mg para os de 14 a 19 anos, resultados bem inferiores aos valores recomendados de 9 e 12 mg, respectivamente. A prevalência de inadequação foi de 92,5%. Dez alimentos/grupos alimentares representaram 85,7% da vitamina E presente na dieta dos adolescentes; o grupo dos óleos vegetais totalizou mais de um quarto da contribuição (25,5%), seguido dos biscoitos (9,1%) e dos feijões (8,9%). Conclusões: Observou-se baixa ingestão e elevada prevalência de inadequação do consumo de vitamina E nos adolescentes de Campinas, apontando o óleo vegetal como principal fonte. Para o total de adolescentes, quase 33% do teor do nutriente derivava de alimentos de má qualidade nutricional como biscoitos, salgadinhos de pacote e margarina. Os resultados deste estudo podem direcionar ações de saúde pública que objetivem melhorar a qualidade da dieta dos adolescentes.

VITAMIN E INTAKE AND FOOD SOURCES IN ADOLESCENT DIET: A CROSS-SECTIONAL POPULATION-BASED STUDY.

OBJECTIVE: To assess vitamin E intake and its relationship with sociodemographic variables, and to identify the main dietary sources of the nutrient in the diet of adolescents. METHODS: This is a population-based cross-sectional study that used data from 891 adolescents living in Campinas, SP, participating in ISACamp 2014/15 (Health Survey) and ISACamp-Nutri 2015/16 (Food Consumption and Nutritional Status Survey). The nutrient intake averages were estimated using the Generalized Linear Model, adjusted for the total energy of the diet. Dietary sources of vitamin E were identified from the calculation of the relative contribution. RESULTS: The average vitamin E intake was 3.2 mg for adolescents aged 10 to 13 years and 3.5 mg for those aged 14 to 19 years, results far below the recommended values of 9 and 12 mg, respectively. The prevalence of inadequacy was 92.5%. -Ten -foods/-food groups represented 85.7% of vitamin E present in the adolescents' diet; the vegetable oils group accounted for more than a quarter of the contribution (25.5%), followed by cookies (9.1%) and beans (8.9%). CONCLUSIONS: There were a low intake and a high prevalence of inadequate vitamin E intake among adolescents in Campinas, with vegetable oil as the main source. For the total number of adolescents, almost 33% of the nutrient content was derived from foods of poor nutritional quality such as cookies, packaged snacks, and margarine. The results of this study can guide public health actions that aim to improve the quality of adolescents' diets.

Self-rated diet quality according to adolescents: ISACamp-Nutri results. / Qualidade da dieta segundo a autoavaliação de adolescentes: resultados do ISACamp-Nutri.

The aim was to estimate the prevalence of categories of self-rated diet quality according to adolescents, identify the reasons for not considering the diet very good/good as well as calculate the global Revised Brazilian Healthy Eating Index Revised (BHEI-r) score and component scores according to the self-assessment categories. A cross-sectional population-based study with two-stage stratified cluster sampling was conducted in Campinas-SP. A total of 891 adolescents were analyzed. The proportions of very good/good, fair and poor/very poor self-rated diet quality were 57.3%, 34.6% and 8.1%, respectively. Fair/poor/very poor self-rated diet quality was associated with the consumption of candy/sweets, snacks/cookies, whole grains (10-14 years) and fast food (15-19 years). Among those classified as having poor diet quality (1st tertile of BHEI-r scores), 52.5% considered their diet to be very good/good and only 13.1% considered their diet to be poor/very poor. The BHEI-r score was significantly lower among those who thought their diet was poor (50.0 points) compared to those who thought their diet was very good/good (55.4 points). Those who considered their diet to be poor had lower intakes of fruit and whole grains as well as higher intakes of solid fats and sugars. The findings reveal incoherence between self-rated diet quality and the observed unsatisfactory diet scores.

Objetivou-se estimar as prevalências de autoavaliação da qualidade da dieta de adolescentes e identificar os motivos de não a considerar muito boa/boa; calcular o escore global e de cada componente do Índice de Qualidade da Dieta Revisado (IQD-R) segundo as categorias de autoavaliação. Estudo transversal de base populacional com amostra por conglomerados e em dois estágios, realizado em Campinas-SP. Foram analisadas 891 entrevistas. As prevalências de autoavaliação da qualidade da dieta foram de 57,3% como muito boa/boa, 34,6% como regular e 8,1% como ruim/muito ruim. A autoavaliação como regular ou ruim foi associada ao consumo de doces, salgadinhos/biscoitos, cereais integrais (10-14 anos) e de fast-food (15-19 anos). Para os que foram classificados com pior qualidade da dieta (1º tercil dos escores do IQD-R), 52,5% consideravam a alimentação muito boa/boa e apenas 13,1% como ruim/muito ruim. O escore do IQD-R revelou-se significativamente menor nos que achavam a alimentação ruim (50,0 pontos) comparados aos que disseram muito boa/boa (55,4 pontos). Os que consideravam a alimentação ruim apresentaram consumo inferior de frutas, cereais integrais, e superior de gorduras sólidas e açúcares. Os achados revelam incoerência na autoavaliação da qualidade da dieta em relação aos escores insatisfatórios observados.

Satisfaction with body weight among adolescents with excess weight: findings from a cross-sectional population-based study.

BACKGROUND: Individuals who are overweight or obese often underestimate their size, and they are less likely to consider their weight status to be a health problem and consequently to make lifestyle changes. OBJECTIVES: To estimate the proportion of satisfaction with weight among adolescents classified as overweight/obese, according to sociodemographic factors, morbidities and health-related behaviors. DESIGN AND SETTING: Cross-sectional population-based study conducted among adolescents aged 10 to 19 years in the city of Campinas (SP), Brazil. METHODS: The sample (n = 217) included participants with self-reported weight and height who were classified as overweight or obese, based on body mass index (BMI) according to age-specific cutoff points recommended by the World Health Organization. Participants whose answer to the question: "Would you like to gain or lose weight?" was "no" (i.e. no change) were deemed to be satisfied with their body weight. Odds ratios and 95% confidence intervals (95% CI) were calculated using logistic regression. RESULTS: The proportions of the respondents who were satisfied with their weight were 75.8% (95% CI: 65.3-83.9) among the overweight adolescents and 24.2% (95% CI: 16.1-34.7) among the obese adolescents (P < 0.01). Satisfaction was lower among individuals aged 15 to 19 years (versus 10 to 14 years), those born outside of Campinas (versus in Campinas), those with ≥ 8 household appliances (versus < 8), and those reporting ≥ two health complaints (versus none). CONCLUSIONS: More than half of the overweight adolescents and almost a quarter of the obese adolescents were satisfied with their weight. These results support the need for strategies for healthy weight management among Brazilian adolescents.

Geometric indices of femur bone strength in female handball players.

The practice of sports during the growth phase has a positive influence on bone mineral accrual. However, the effects of different sports are still not fully understood. The aim of this study was to evaluate the bone geometry in adolescent handball players. This is a cross-sectional study in which 53 female adolescents (12-17 years old) were divided into two groups: handball players (HG: n = 26), who must have had at least six months of participation in official competitions, and a control group (CG: n = 27). Bone geometry properties, such as cross-sectional area (CSA), cross-sectional moment of inertia (CSMI), section modulus (Z), and femoral strength index (FSI) were measured using DXA. Tanner's sexual maturity, menarche, peak height velocity, sun exposure, and calcium intake were assessed. An unpaired Student's t test or the Mann-Whitney test and multivariate analyzes were used to compare variables differences between groups. The HG group showed a significantly higher body mass index, weight and lean mass (LST), CSA, CSMI, Z, and FSI than the CG group. When the values were adjusted for LST, the differences disappeared. The LST has been shown to be relevant to the strength and bone stiffness of the femurs of female adolescents, and the competitive practice in handball may have contributed to its increase.

Dissatisfaction with body weight and nutritional status among adolescents: population-based study in the city of Campinas, São Paulo, Brazil. / Insatisfação com o peso corporal e estado nutricional de adolescentes: estudo de base populacional no município de Campinas, São Paulo, Brasil.

The aim of this study was to investigate nutritional status and estimate the prevalence of weight dissatisfaction among adolescents 10 to 19 years. Population-based cross-sectional study was conducted in two-stage in Campinas, Brazil. Nutritional status was classified based on percentiles of body mass index for age recommended by the World Health Organization. Weight dissatisfaction was determined by desire to gain or lose weight. Prevalence rates and 95% confidence intervals were calculated for nutritional status and weight (dis)satisfaction. The Rao-Scale chi-squared test was used for the determination of associations with sociodemographic variables. 822 adolescents were analyzed with mean age of 14.1 years. 64.7% of the boys and 75.4% of the girls were classified as normal weight, whereas 30.5% and 22.2% with excess weight, respectively. Among the boys dissatisfied with their weight, 34.5% were normal weight, 45.3% were classified as overweight and 77.1% with obesity. Whereas the girls dissatisfied with their weight, 52.0% were classified as normal weight, 63.6% as overweight and 75.2% with obesity. The prevalence of excess weight was high, especially among the boys and younger adolescents (10-14 years). Weight dissatisfaction was more prevalent among the girls and older adolescents (15-19 years).

O objetivo deste artigo é estimar as prevalências do estado nutricional e da insatisfação com o peso, em adolescentes de 10-19 anos. Estudo transversal de base populacional com amostra em dois estágios, realizado em Campinas, SP. O estado nutricional foi classificado pelos percentis de IMC para idade, da Organização Mundial da Saúde. A insatisfação com o peso foi obtida pelo relato dos que gostariam de ganhar ou perder peso. Calcularam-se as prevalências e os intervalos de confiança de 95% do estado nutricional e da (in)satisfação com o peso. As associações com as variáveis sociodemográficas foram verificadas pelo teste de χ2 de Rao Scott. Analisaram-se 822 adolescentes com idade média de 14,1 anos. Foram classificados com eutrofia 64,7% dos meninos e 75,4% das meninas e com excesso de peso 30,5% e 22,2%, respectivamente. Comparados aos meninos satisfeitos, 34,5% dos insatisfeitos eram eutróficos, 45,3% tinham sobrepeso e 77,1% obesidade. Comparadas às meninas satisfeitas, as insatisfeitas tinham 52,0% de eutrofia, 63,6% de sobrepeso e 75,2% de obesidade. Observaram-se elevadas prevalências de excesso de peso, principalmente nos meninos e nos mais jovens (10-14 anos), e maiores prevalências de insatisfação com o peso nas meninas e nos adolescentes de 15-19 anos.