Type and timing of ultra-processed foods consumption and its association with dietary intake and physical activity in women with obesity living in poverty.

BACKGROUND: The present study aimed to investigate the type and timing of ultra-processed foods (UPF) consumption and its association with dietary intake (DI) and physical activity (PA) in women with obesity living in poverty. METHODS: A cross-sectional study was employed. Obesity was defined by at least two criteria (body mass index, waist circumference or % fat mass). Poverty was defined as the three lowest classes of the Brazilian Economic Classification Criterion. PA was measured with triaxial accelerometers and DI was assessed with three 24-h dietary recalls. Foods were categorised according to the NOVA classification, with UPF classified into five subgroups, as well as the timing of consumption into six meals. RESULTS: In total, 56 adult women were included. Overall energy intake was 1653.21 (503.22) kcal/day. UPF intake was 21.62% (11.94%) kcal/day, being higher at breakfast (4.91% kcal/day), afternoon snack (5.39% kcal/day) and dinner (5.01% kcal/day). Only UPF subgroup 4 (sandwich biscuits, sweets, or treats) showed a positive association with energy intake (ß = 54.40 [27.6, 81.10] kcal/day) and a negative association with protein intake (ß = -0.31% [-0.48%, -0.14%] kcal/day). UPF consumption in morning (ß = -0.41% [-0.79%, -0.02%] kcal/day) and afternoon (ß = -0.18% [-0.33%, -0.04%] kcal/day) snacks was associated with lower protein intake. Furthermore, lunchtime UPF consumption was positively associated with walking time (ß = 0.16% [0.02%; 0.30%]) and steps/hour (ß = 8.72 [1.50; 15.94] steps/h). CONCLUSIONS: Women with obesity living in poverty consume more UPF during breakfast, afternoon snack and dinner. Physical activity is positively associated with UPF consumption at lunch. UPF, such as sandwich biscuits, sweets or treats, contribute to increasing energy intake and reducing protein intake.

Longitudinal estimates of resting energy expenditure using predictive equations in individuals with excess weight after weight loss: A systematic review with meta-analysis.

BACKGROUND & AIMS: To determine which resting energy expenditure (REE) predictive equation has the lowest bias in the aggregate level in individuals with excess weight during weight loss interventions. METHODS: Searches were performed in MEDLINE, Web of Science, Scopus, CENTRAL and gray literature databases. Longitudinal studies on weight loss interventions which evaluated REE by predictive equations compared to that measured by indirect calorimetry in adults with excess weight at different follow-up times were included. Meta-analyses were performed with the differences between biases of predictive equations of the REE at the different follow-up times of weight loss. RESULTS: Of the total of 2178 occurrences found in the databases, only eight studies were included. The Harris-Benedict (1919) equation showed the smallest differences between bias up to the third month (MD = 103.33 kcal; 95%CI = -39.01; 245.67), in the sixth month (MD = 59.16 kcal; 95%CI = 8.74; 109.57) and at the 12th month (MD = -71.41 kcal; 95%CI = -150.38; 7.55) of weight loss follow-up. Weight loss does not seem to have an effect on bias at different follow-up times. CONCLUSION: Harris-Benedict (1919) equation seems to be the most adequate to assess the REE of individuals with excess weight during weight loss. However, the finding of large estimated predictive intervals may indicate that predictive equations may not be handy tools for individuals losing and regaining weight due to changes other than body weight.

Use of the activPAL® triaxial accelerometer to estimate total energy expenditure in low-income women: differences between body mass index classifications.

Objective: This study aimed to assess the agreement between the total energy expenditure (TEE) estimated by the activPAL® triaxial accelerometers (ACC) and the TEE measured by the doubly labeled water method (DLW), as well as to assess if these values differ between the classifications of body mass index (BMI). Materials and methods: This is a cross-sectional study. Low-income adult women (19-45y) with BMI ≥ 18.5 kg/m2 were included. Accelerometry data (activPAL® ) were collected over 7 consecutive days, which were used to calculate TEE-ACC and compared with DLW data. The Bland-Altman method, concordance correlation coefficient and root mean square error were used to assess agreement between methods. Results: The sample consisted of 55 women with a mean age of 31 ± 5 years. The agreement between TEE-ACC and TEE-DLW showed a bias of -142.5 kcal (-7.1%). Among the BMI classifications, participants with normal weight show a bias of -417.1 kcal (-21.0%), participants with overweight, -87.5 kcal (-3.9%) and participants with obesity, 97.5 kcal (4.3%). Furthermore, the bias between the methods showed a significant and positive correlation with the body weight (r = 0.49; p < 0.01). Conclusion: The TEE-ACC estimates from activPAL® were reasonably accurate when compared to the TEE-DLW, especially in women with overweight and obesity, being much less accurate in individuals with normal weight.

Prevalence of food addiction determined by the Yale Food Addiction Scale in Latin America: A systematic review with meta-analysis.

OBJECTIVE: Food addiction (FA) has been extensively investigated worldwide; however, the prevalence of FA in the Latin American population has yet to be established and past work has largely neglected the specificities of this region, that includes the most significant economic disparities in the world. Thus, the objective of this study was to assess the prevalence of FA measured by the Yale Food Addiction Scale in Latin America. METHOD: The search was performed on MEDLINE, ScienceDirect, LILACS, IBECS, SciELO, PsycArticles, CENTRAL, and the gray literature. FA prevalence data were collected, and random effects meta-analyses were performed to calculate the overall weighted prevalence, the prevalence by country, and by clinical and non-clinical samples. RESULTS: A total of 10,082 occurrences were identified through database searches, and 23 studies were included (Mexico = 9; Brazil = 7; Chile = 4; Argentina = 1; Peru = 1; Uruguay = 1). The prevalence of FA found in clinical samples was 38% (95% CI: 16%-63%; I2  = 98.67%; 8 studies), while in non-clinical samples, it was 15% (95% CI: 10%-21%; I2  = 98.51%; 15 studies). DISCUSSION: The average prevalence of FA in the Latin American countries included here was in accordance with that reported in other regions worldwide. It is noteworthy that the studies were conducted only in six countries, which are among those with the highest income in the region and do not represent the situation in native populations or those with lower purchasing power. This gap in the data also reflects the effects of economic disparities on the availability of empirical data in the region. PUBLIC SIGNIFICANCE: The prevalence of food addiction in Latin America was similar to that reported in other regions. It was higher among individuals with overweight, whether or not undergoing bariatric surgery, than in non-clinical samples. These findings contribute to aggregate information about this condition that has drawn the attention of clinicians and researchers.

OBJETIVO: La adicción a la comida (FA, por sus siglas en inglés) ha sido ampliamente investigada en todo el mundo; sin embargo, la prevalencia de la FA en la población latinoamericana aún no se ha establecido y el trabajo previo ha descuidado en gran medida las especificidades de esta región, que incluye las disparidades económicas más significativas del mundo. Por lo tanto, el objetivo de este estudio fue evaluar la prevalencia de FA medida por la Escala de Adicción a la Comida de Yale en América Latina. MÉTODO: La búsqueda se realizó en MEDLINE, ScienceDirect, LILACS, IBECS, SciELO, PsycArticles, CENTRAL y la literatura gris. Se recopilaron datos de prevalencia de FA y se realizaron metanálisis de efectos aleatorios para calcular la prevalencia ponderada general, la prevalencia por país y por muestras clínicas y no clínicas. RESULTADO: Se identificaron 10 082 casos mediante búsquedas en bases de datos y se incluyeron 23 estudios (México = 9; Brasil = 7; Chile = 4; Argentina = 1; Perú = 1; Uruguay = 1). La prevalencia de FA encontrada en muestras clínicas fue del 38% (IC95%:16%; 63%; I2 = 98,67%; 8 estudios), mientras que en muestras no clínicas, fue del 15% (IC del 95%: 10%; 21%; I2 = 98,51%; 15 estudios). DISCUSIÓN: La prevalencia promedio de FA en los países latinoamericanos incluidos aquí estuvo de acuerdo con la reportada en otras regiones del mundo. Cabe destacar que los estudios se realizaron solamente en seis países, que se encuentran entre los de mayores ingresos de la región y no representan la situación de las poblaciones nativas o de menor poder adquisitivo. Esta brecha en los datos también refleja los efectos de las disparidades económicas en la disponibilidad de datos empíricos en la región.

Social and Racial Disparities in Food Consumption Among Brazilian College Students: a Nationwide Study.

This study aims to assess the association between economic class, race/skin color, and food consumption among Brazilian college students. A cross-sectional web-based survey was conducted with college students from all over Brazil. Demographic data, economic class, self-reported race/skin color, anthropometry, and food consumption markers from the Brazilian Food and Nutrition Surveillance System were collected. The final sample comprised 5843 participants with a mean age of 24.1 (SD: 6.3) years, 4292 (73.5%) were female, and 810 (13.9%) in the highest economic stratum. We observed a progressive decrease in the frequency of fresh fruits and vegetables consumption from higher to lower economic classes (p < 0.01 for both). Contrarily, there was a progressive increase in the frequency of consumption of beans from higher to lower economic classes (p < 0.01). The frequency consumption of vegetables was also associated with race/skin color (p < 0.01), being lower in brown (PR: 0.94; CI 95%: 0.90; 0.98), and black (PR: 0.91; 95% CI: 0.85; 0.98) individuals, compared to white individuals. Brown individuals showed higher frequency consumption of beans (PR: 1.10; 95% CI: 1.05; 1.15) than whites. When compared to individuals of white race/skin color, brown (PR: 1.07; 95% CI: 1.01; 1.13) and black (PR: 1.15; 95% CI: 1.07; 1.23) individuals showed higher frequency consumption of sweetened beverages. Economic class and race/skin color were independent factors associated with the food consumption of Brazilian college students.

Prevalence of food addiction and its association with anxiety, depression, and adherence to social distancing measures in Brazilian university students during the COVID-19 pandemic: a nationwide study.

The study's objective was to determine the prevalence of food addiction (FA) in Brazilian university students and to verify whether there is an association with anxiety, depression, and adherence to the social distancing measures adopted during the COVID-19 pandemic. This is a nationwide cross-sectional study carried out through the application of online questionnaires. Self-reported data on age, sex, economic class, race/skin color, anthropometric data, depression diagnosis, anxiety, modified Yale Food Addiction Scale 2.0 (mYFAS 2.0), and adherence to social distancing measures were collected. 5368 participants were included, with a mean age was 24.1 ± 6.3 years, the majority were female (n = 3990; 74.3%), and the mean BMI in our sample was 24.5 ± 5.3 kg/m2. The prevalence of FA was 19.1% (95%CI: 18.0; 20.0%). An association was observed between FA with depression (PR: 1.60; 95%CI: 1.43; 1.78; p < 0.01), and anxiety (3.13; 95%CI: 2.74; 3.58; p < 0.01), but not with adherence to social distancing measures (p = 0.70). In conclusion, there was a higher prevalence of FA in Brazilian university students. Besides, university students with anxiety, depression, overweight, or obesity and females are more prone to FA.Level of evidence Level V, Opinions of authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

Racial Differences in Generalized Anxiety Disorder During the COVID-19 Pandemic among Brazilian University Students: a National Survey.

There is evidence that during the COVID-19 pandemic, there was an increase in anxiety and depression rates among college students. However, little is known about how generalized anxiety disorder (GAD) developed among individuals of different race/skin color. This study aimed to determine whether there are racial differences in GAD in Brazilian university students during the COVID-19 pandemic. This is a nationwide cross-sectional study, carried out through the application of online questionnaires to university students from 94 Brazilian universities. Self-reported data on age, sex, economic class, race/skin color, anthropometric data, and adherence to social distancing measures were collected. To determine the GAD, the Generalized Anxiety Disorder 7-item scale was applied. A total of 5879 participants were included, with a mean age of 24.1 ± 6.4 years, and the majority were female (n = 4324, 73.5%), most self-declared to be whites (n = 2945, 50.1%), followed by browns (n = 2185, 37.2%) and blacks (n = 749, 12.7%). The prevalence of GAD among black Brazilian university students (47.3% [95% CI 43.7, 50.8]) was significantly higher than that of browns (38.6% [95% CI 36.6, 40.7]) and whites (44.1% [95% CI 42.3, 45.9]), even after multivariable adjustment by other sociodemographic factors. The findings of the present study suggest a possible racial difference in GAD among Brazilian university students, in which those who declared their race/skin color as black showed a greater risk for GAD than those who declared themselves as white or brown.

Effects of time-restricted feeding on body weight, body composition and vital signs in low-income women with obesity: A 12-month randomized clinical trial.

BACKGROUND & AIMS: Time-restricted feeding (TRF) studies usually are of short-term, involving heterogeneous populations, without a control group with similar energy restriction. Besides, it seldom assess vital signs such as body temperature and heart rate, which may be influenced by the fasting state. In this investigation, we assessed the long-term effects of TRF on body weight, body composition and vital signs of low-income women with obesity undergoing diets with the same energy deficit. METHODS: Low-income women with obesity were randomly allocated to a group with a hypoenergetic diet and 12 h of TRF or to a group with only a hypoenergetic diet, for 12 months. Body fat and waist circumference were estimated using a tetrapolar electrical bioimpedance and an inelastic measuring tape, respectively, at baseline and after 4, 6 and 12 months of intervention. Systolic and diastolic blood pressure, heart rate, and axillary temperature were measured at baseline and 12 months of intervention. The energy content of the diets was determined based on the women's resting metabolic rate (by indirect calorimetry) and level of physical activity (by triaxial accelerometers). Effects were analyzed using an intention-to-treat approach. RESULTS: Fifty-eight women were randomized and 31 (53.44%) were lost to follow-up at 12 months. Dropout rates were similar between groups. In the intention-to-treat analysis, there were no significant changes in the body weight after 12 months (Differences in changes from baseline between groups: -0.05 95%CI [-2.34; 2.24] Kg; p = 0.96). An increase in axillary temperature (0.40 °C, 95% CI [-0.14; 0.67]°C, p < 0.01), a reduction in the percentage of body fat (-1.64%, 95% CI [-3.08; -0.19]%, p = 0.02) and waist circumference (-2.57 cm, 95% CI [-5.73; 0.58] cm, p = 0.03 in the mixed model involving 4 measurements) were observed in the intervention group, when compared to the control group. CONCLUSIONS: TRF showed no effects on weight loss. Nevertheless the findings on waist circumference and body fat, although not clinically meaningful, suggest that this strategy may help in the long-term management of obesity in this population, since it is an easy to apply intervention. Axillary temperature findings warrants further investigation. Registered under www.ensaiosclinicos.gov.br Identifier no. RBR-387v6v. TRIAL REGISTRATION: http://www.ensaiosclinicos.gov.br/rg/RBR-387v6v/.

Premature birth, low birth weight, small for gestational age and chronic non-communicable diseases in adult life: A systematic review with meta-analysis.

BACKGROUND: Individuals who were born prematurely (PT), with low birth weight (LBW), or small for gestational age (SGA) appear to present a set of permanent changes that make them more susceptible to develop chronic non-communicable diseases (CNCD) in adult life. AIM: Investigating the association between PT birth, LBW or SGA at birth and CNCD incidence in adult life. METHODS: Systematic review with meta-analysis of studies available in three databases - two of them are official (PubMed and Web of Science) and one is gray literature (OpenGrey) - based on pre-established search and eligibility criteria. RESULTS: Sixty-four studies were included in the review, 93.7% of them only investigated one of the exposure variables (46.7% LBW, 35.0% PT and 18.3% SGA at birth), whereas 6.3% investigated more than one exposure variable (50.0% LBW and PT; 50.0% SGA and PT). There was association among all exposure variables in the following outcomes: cardiometabolic (CMD) and glycidic metabolism (GMD) disorders, changes in body composition and risk of developing metabolic syndrome (MS). Female sex was identified as risk factor in the exposure-outcome association. Eighteen (18) articles were included in the meta-analysis. There was positive association between LBW and incidence of CMD (OR: 1.25 [95%CI: 1.11; 1.41]; 07 studies), GMD (OR: 1.70 [95%CI: 1.25; 2.30]; 03 studies) and MS (OR: 1.75 [95%CI: 1.27; 2.40]; 02 studies) in adult life. PT was positively associated with CMD (OR: 1.38 [95%CI: 1.27; 1.51]; 05 studies). CONCLUSIONS: LBW and PT are associated with CMD and GMD development, as well as with the risk of developing MS in adult life.