It is time: free meals at schools for all.

The link between school feeding programmes (SFP) and the promotion of healthy eating and health is being explored in studies performed in different countries. The coronavirus disease-19 pandemic has revealed flaws and weaknesses in contemporary food systems, with many school-age children experiencing food insecurity and hunger. There is intense debate among policymakers regarding whether government SFP should be universal or targeted. Countries such as Brazil and India, which have two of the most comprehensive universal free-of-charge programmes, have shown the benefits of SFP, including improved nutritional status, support for more sustainable food systems, attendance and academic performance. Evidence shows and supports actions advocating that it is time to offer healthy and free school meals for all students.

Evolution of household availability of added sugars and their sources in Brazil: analysis of Household Budget Surveys from 2002 to 2017.

The objective of this study was to describe the evolution of household purchase of added sugars and their main food sources in Brazil. Nationally representative data from the Household Budget Surveys from 2002-2003, 2008-2009 and 2017-2018 were used. Energy and added sugar quantities were estimated by means of per capita food quantities. The items considered as food sources were: (1) table sugar: refined sugar and other energetic sweeteners and (2) processed and ultra-processed foods with added sugar: soft drinks; other drinks; sweets, candies and chocolates; cookies; cakes and pies and other foods. The parameters estimated were: mean share of added sugar in total energy and, for food sources, the share of added sugar in total sugar intake and the impact of variations in sources of added sugar between 2008 and 2017. There was a regular share of energy from added sugar to total energy intake between 2002 and 2008 but a reduced share in 2017. Between 2008 and 2017, there was a decrease in the share of refined sugar and other sweeteners and soft drinks to total sugar intake and an increased share of all other items. High-income households had a lower share of refined sugar and other energetic sweeteners, but a higher share of soft drinks, sweets, candies and chocolates. The decrease in added sugar in 2017 was mainly due to the lower share of soft drinks. In conclusion, Brazilians' total intake of added sugar was decreased, mostly owing to reduced consumption of sugar from soft drinks.

Analysis of modified ilib therapy in patients submitted to plastic surgery.

The sample comprised 44 volunteers who had undergone some surgical procedure and were equally divided into four groups. G1 started the therapy 24 h after the surgical procedure with the device off. G2 followed the same time pattern, 24 h, but with the device turned on. G3 and G4 started therapy three days after the surgical procedure; in G3, the device was turned off, and in G4, the device remained on during therapy; each session lasted 30 min, using 660 nm (red), energy 180 J. For all groups, the therapy started with daily use for seven days and followed the interval use of three times a week until completed 21 days. The revaluation was performed after 7 and 21 days. The results found show changes in HR at rest, systolic and diastolic BP, and in peripheral oxygen saturation, which showed a significant difference in the groups that used on-therapy (p < 0.05). In the MCGILL Scale evaluation, the mean total score showed a more accentuated drop in the groups that used ILIB, (p < 0.05). ILIB may have prevented a more significant evolution of firosis levels; however, no changes were observed in the evaluation of sleep and anxiety. The application of the ILIB in patients undergoing plastic surgery was supported in terms of hemodynamics and pain; in addition, starting the ILIB application 24 h after the procedure proved to be more advantageous.

Evaluation of food purchasing in the Brazilian School Feeding Programme: feasibility of the requirements and recommendations.

OBJECTIVE: To analyse the purchase of food for school feeding, according to the extent and purpose of industrial processing and variety, exploring the feasibility of achieving the requirements and recommendations of the Brazilian School Feeding Programme, and the variety of unprocessed or minimally processed foods according to the purchase of ultra-processed foods. DESIGN: Secondary data from 2016 from the Accountability Management System of the National Fund for Educational Development, concerning the food items purchased, were used to explore the feasibility of the requirements and recommendations. The foods were grouped according to the NOVA classification system. Variety was assessed by counting different types of unprocessed or minimally processed foods. SETTING: Brazil. PARTICIPANTS: 3698 Brazilian municipalities. RESULTS: Energy share from unprocessed or minimally processed foods was 44·1 % while that of ultra-processed foods was 29·9 %. The average of unprocessed or minimally processed food types purchased annually was 33·8 items. Of the municipalities, 35·8 % were within the limit established for the expenditure of funds for the purchase of processed and ultra-processed foods, while 8·7 % followed the recommendation for variety. The proportion of ultra-processed foods did not influence the variety of food items purchased. CONCLUSIONS: The results showed the feasibility of achieving the requirements and recommendations and underscored the importance of continued efforts to promote the inclusion of unprocessed or minimally processed foods in the school feeding programme while addressing the challenges associated with expenditure limits of processed and ultra-processed foods and enhancing variety, which is strategic to promote adequate and healthy meals.

Digital marketing of online food delivery services in a social media platform before and during COVID-19 pandemic in Brazil.

OBJECTIVE: To describe the promotion of food and beverage and marketing strategies used by online food delivery services (OFDS) in a social media platform before and during the pandemic in Brazil. DESIGN: Publicly available data were extracted from OFDS Instagram accounts. Posts published 6 months immediately before and after the first case of COVID-19 in Brazil were randomly sampled. Two independent authors coded the posts' content. Food and beverage items featured in posts were classified according to the NOVA food system classification. Marketing strategies were coded according to protocols from previous studies. SETTING: Top three OFDS Instagram accounts in Brazil. PARTICIPANTS: Posts published in the period studied (n 304). RESULTS: During the pandemic, the proportion of posts featuring at least one food item decreased from 71·6 % to 40·2 %, and the proportion of ultra-processed foods decreased from 57·6 % to 27·9 %. Before the pandemic, the most widely used marketing strategies were branding elements (80·7 %), product imagery (unbranded) (48·9 %) and partnerships/sponsorship (35·2 %). While during the pandemic, branding elements (62·2 %) continued to be the most applied, but were followed by the use of videos/graphics interchange format/boomerangs (34·1 %) and corporate social responsibility (31·7 %). The most frequent COVID-19 marketing strategies were 'social responsibility in the pandemic' (30·5 %), 'combatting the pandemic' (28·0 %) and 'accelerating digitalisation' (20·7 %). CONCLUSIONS: OFDS advertisements on a social media platform placed less emphasis on food items, but improved the nutritional quality of foods and beverages featured in posts. A COVID-washing approach was highlighted, especially through the use of social responsibility marketing during the pandemic.

Scientific research on food environments in Brazil: a scoping review.

OBJECTIVE: To map the scientific research on food environments in Brazil, based on the following questions: How many studies have addressed food environments?; What study designs and methodological approaches were applied?; What is the geographic scope of the studies?; What scenarios and dimensions of food environments were studied?; Which population groups were studied?; How were food environments conceptualised?; What are the main limitations of the studies? DESIGN: Scoping review conducted in four databases, from January 2005 to December 2022, using different food environment-related terms to cover the main types and dimensions proposed in the literature. The studies were independently selected by two authors. A narrative synthesis was used to summarise the findings. SETTING: Brazil. PARTICIPANTS: 130 articles. RESULTS: Scientific research on Brazilian food environments has been increasing. The analytical quantitative approach and the cross-sectional design were the most frequently used. Most articles were published in English. The majority of studies evaluated the community food environment, addressed aspects of the physical dimension, sampled the adult population, had food consumption as an outcome, used primary data, and were carried out in capital cities in the Southeast region. Furthermore, in most articles, no conceptual model was explicitly adopted. CONCLUSIONS: Gaps in literature are related to the need for conducting studies in the Brazilian countryside, the support for the formulation of research questions based on conceptual models, the use of valid and reliable instruments to collect primary data, in addition to the need for a greater number of longitudinal, intervention and qualitative studies.

Maternal Knowledge of Oral Health During Pregnancy and Childbirth.

OBJECTIVE: This cohort study was to investigate maternal knowledge of the oral health of woman and children during pregnancy and after childbirth, and the associated factors. METHODS: Groups of women participating in a public prenatal dental care programme in Brazil were assessed, in two different stages. In the first stage, pregnant women were assessed for their own oral health. In the second stage, after childbirth, women were assessed for the oral health of their child. The examiner assigned a maternal knowledge score to the questionnaires, considering the ideal alternatives within the context of oral health promotion as correct answers. Statistical analysis included the Kruskal-Wallis and multiple linear regression tests, considering a level of significance of P < 0.05. RESULTS: Ninety-eight women were included in the study, with a mean age 26.27 years (SD 6.51). In the regression analysis, the maternal knowledge score was associated with the presence of myths about oral health (P < 0.01), the children first dental appointment in the first year of life (P = 0.07), the presence of a non-nutritious sucking habit (P < 0.01), considering dental treatment to be important during pregnancy (P < 0.01), and having been instructed on oral health during pregnancy (P < 0.01) and after the children birth (P = 0.02). CONCLUSION: This study suggests that the women showed a regular score of knowledge about their oral health and that of their children, as they still believed in some myths about oral health and the risks of dental treatment during pregnancy. Women who received guidance on oral health in pregnancy and after birth showed higher knowledge of their oral health and that of their children, demonstrating the importance of carrying out health promotion actions during pregnancy and the first years of the child's life.

Food environments and the COVID-19 pandemic in Brazil: analysis of changes observed in 2020.

Evidence of changes caused by the COVID-19 pandemic in food security and nutrition conditions, as well as in different food environments, has called researchers' attention to substantial changes taking place in individuals' dietary habits. The aim of this study is to present and address changes that have already happened in food environments, during the first COVID-19 pandemic year, in a middle-income country. Multiple changes were observed and had direct impact on the population, among them, worsened health and nutrition indicators and advanced dietary inequalities, as well as on its food profile in different life cycles, if one takes into consideration aspects such as food availability, financial access and dietary quality.

Obesity and health service utilization in Brazil: data from the National Health Survey.

BACKGROUND: Obesity, a complex public health problem, is generally associated with other chronic diseases. The association of obesity with health service utilization has been little investigated in low- and middle-income countries. This study aimed to analyze the association between obesity and health service utilization (considering those services related to hypertension and/or diabetes). METHODS: A cross-sectional, nationally-representative, study of Brazilians aged ≥18 years was conducted. Data from the National Health Survey (2013) for 59,402 individuals were analyzed, including measured weight and height. The association between body mass index (BMI) category (under/normal weight, overweight, and obesity) and health service utilization due to hypertension and/or diabetes was investigated using Poisson regression models (crude and adjusted). To analyze the health services utilization, the following variables were considered: 1) routine visits to a general doctor or health service; 2) referrals/consultations with a specialist; 3) prescribed exams done; and 4) hospital admission due to the disease or related complication. All analyses were stratified by sex. RESULTS: Compared with under/normal-weight individuals, subjects with obesity (both male and female) made roughly double the use of all health care services assessed. Men with hypertension that had obesity had a higher risk of hospital admission (adjusted PR = 2.55; 95%CI 1.81-3.61), than those with under/normal weight. Women with diabetes that had obesity had more referrals/consultations with specialists (adjusted PR = 2.56; 95%CI 1.94-3.38), than those with under/normal weight. CONCLUSIONS: The presence of obesity was associated with increased use of health care services for hypertension and/or diabetes, indicating greater demand for human resources and materials, and a greater burden on the national health system.

Antifungal Effect and Inhibition of the Virulence Mechanism of D-Limonene against Candida parapsilosis.

Yeasts from the Candida parapsilosis complex are clinically relevant due to their high virulence and pathogenicity potential, such as adherence to epithelial cells and emission of filamentous structures, as well as their low susceptibility to antifungals. D-limonene, a natural compound, emerges as a promising alternative with previously described antibacterial, antiparasitic, and antifungal activity; however, its mechanisms of action and antivirulence activity against C. parapsilosis complex species have not been elucidated. Therefore, in the present study, we aimed to evaluate the antifungal and antivirulence action, as well as the mechanism of action of D-limonene against isolates from this complex. D-limonene exhibited relevant antifungal activity against C. parapsilosis complex yeasts, as well as excellent antivirulence activity by inhibiting yeast morphogenesis and adherence to the human epithelium. Furthermore, the apoptotic mechanism induced by this compound, which is not induced by oxidative stress, represents an important target for the development of new antifungal drugs.

Reducing ultra-processed foods and increasing diet quality in affordable and culturally acceptable diets: a study case from Brazil using linear programming.

The aim was to design culturally acceptable and healthy diets with reduced energetic share of ultra-processed foods (UPF%) at no cost increment and to evaluate the impact of the change in the UPF% on diet quality. Food consumption and price data were obtained from the Household Budget Survey (n 55 970 households) and National Dietary Survey (n 32 749 individuals). Linear programming models were performed to design diets in which the mean population UPF% was reduced up to 5 % with no cost increment relative to the observed costs. The models were isoenergetic or allowed the energy content to vary according to the UPF%, and they were not constrained to nutritional goals (nutrient-free models) or maximised the compliance with dietary recommendations (nutrient-constrained models). Constraints regarding food preference were introduced in the models to obtain culturally acceptable diets. The mean population UPF% was 23·8 %. The lowest UPF% attained was approximately 10 %. The optimised diet cost was up to 20 % cheaper than the observed cost, depending on the model and the income level. In the optimised diets, the reduction in the UPF% was followed by an increase in fruits, vegetables, beans, tubers, dairy products, nuts, fibre, K, Mg, vitamin A and vitamin C in the nutrient-constrained models, compared with the observed consumption in the population. There was little variation in most nutrients across the UPF% reduction. The UPF% reduction in the nutrient-free models impacted only trans-fat and added sugar content. UPF% reduction and increase in diet quality are possible at no cost increment.

Social inequalities in the surrounding areas of food deserts and food swamps in a Brazilian metropolis.

BACKGROUND: Food deserts are neighborhoods with little or no access to healthy food, whereas food swamps are neighborhoods where unhealthy food options prevail over healthy ones. The main aims of the current study are to feature and compare the neighborhoods of food deserts and food swamps based on social inequality. METHODS: Ecological study carried out in Belo Horizonte City, Minas Gerais State, Brazil. Information about commercial food establishments derived from two different databases. It was measured by secondary governmental databases, which were virtually conferred in the present study. Census tracts were considered as analysis units and classified as food deserts and food swamps, based on the Brazilian methodology. Take into consideration the density of establishments classified as selling fresh or minimally-processed food, mixed establishments, and establishments selling ultra-processed food. The Brazilian methodology evaluates food deserts by the density of healthy establishments (establishments classified as mostly selling fresh or minimally-processed food and mixed establishments) per 10 thousand inhabitants. And the metric to evaluate food swamps considers the density of unhealthy establishments (establishments mostly selling ultra-processed food) per 10 thousand inhabitants. Information about social inequalities comprised aspects such as income, population count, number of households, number of literate individuals, race, water and energy supply, and garbage collection. The Health Vulnerability Index (HVI) was used as a synthetic social vulnerability indicator. RESULTS: Neighborhoods of food deserts presented worse essential service availability, lower income per capita, and smaller mean number of literate individuals. Census tracts classified as food swamps presented better socio-demographic conditions than those areas food deserts. Neighborhoods simultaneously classified as food deserts and food swamps presented lower income per capita and were more often observed in census sectors presenting medium and high HVI. CONCLUSION: The food environment in Belo Horizonte was featured by the strong presence of food deserts and food swamps. However, the potential influence of these areas on food intake has changed depending on social inequalities.

Evaluation of the food environment of public hospitals in a Brazilian metropolis.

OBJECTIVE: To characterise the food environment of public hospitals in a Brazilian metropolis. DESIGN: A cross-sectional study involving the audit of mini-kitchens, non-commercial food services, commercial food services and vending machines within hospitals and interviews with workers and managers. Environmental dimensions assessed included: availability, accessibility, affordability, convenience, nutrition information, promotion and advertising, infrastructure for food and ambience, in addition to decisions-level aspects. SETTING: Rio de Janeiro, Brazil. PARTICIPANTS: 24 public hospitals in the municipal health network. RESULTS: Of the hospitals assessed, 92·0 % had a non-commercial food service, 87·5 % had mini-kitchens (facilities to consume food taken from home), 37·5 % had commercial food services and 25·0 % had vending machines. Mini-kitchens were available in most but not all hospitals, a key facility given that few commercial or non-commercial food services were open 24 h a day. The food availability in the hospitals surveyed did not promote healthy eating. A wide variety of ultra-processed foods and drinks was found and advertising promoting their consumption, even in non-commercial food services with menus planned by nutritionists. Water filters/fountains were present in around 50 % of mini-kitchens and non-commercial food services but were unavailable in commercial food services. According to workers interviewed, the temperature of the environment was the worst-rated aspect of mini-kitchens, non-commercial food services and commercial food services. Nutrition service managers reported little involvement in producing biddings and proposals for hiring outside companies to run non-commercial food services or commercial food services. CONCLUSION: The food environment of the hospitals studied did not promote healthy eating habits.

Genetic polymorphisms in interleukin-6 and interleukin-1-beta were associated with dental caries and gingivitis.

OBJECTIVE: Evaluate the association between single nucleotide polymorphisms (SNPs) in Interleukin-6 (IL-6) gene (rs1800795) and in Interleukin-1-beta (IL-1ß) gene (rs1143627 and rs1143629) with dental caries and gingivitis in Brazilian children. MATERIAL AND METHODS: Three hundred and fifty-three children aged 8-11 years were included. Visible biofilm and gingival bleeding were evaluated by Community Periodontal Index. The International System for Detection and Assessment of Carious Lesions (ICDAS) was used to investigate dental caries. Real-time PCR evaluated SNPs in the DNA. Chi-square test, haplotype analysis and logistic regression were applied (alpha of 5%). RESULTS: The GG genotype in rs1800795 (IL-6) decreases the risk of gingivitis in a co-dominant model (p = .05; OR = 0.64). The GG genotype in rs1143627 (IL-1ß) reduces the risk of dental caries (Co-dominant model: ICDAS0 versus ICDAS1-6: p = .05; OR = 0.55. ICDAS0-2 versus ICDAS3-6: p = .02; OR = 0.49. Recessive model: ICDAS0 versus ICDAS1-6: p = .005; OR = 0.48. ICDAS0-2 versus ICDAS3-6: p = .004; OR = 0.45. Logistic regression: ICDAS0-2 versus ICDAS3-6: p = .05; OR = 0.24; CI 95%= 0.05-1.00). The GG genotype in rs1143629 was more frequent in ICDAS0 (p = .05; OR: 0.60). In the haplotype analysis, IL-1ß was associated with gingivitis. CONCLUSION: The rs1800795 in IL-6 gene was associated with gingivitis. The rs1143627 and rs1143629 in IL-1ß were associated with dental caries and gingivitis.

Tobacco Use, Attitudes, Knowledge, and Perception About Smoking Cessation Counseling Among Brazilian Dental Students: a Cross-Sectional Study.

The aim of this study was to evaluate the prevalence of tobacco use, exposure to secondhand smoke, and knowledge and perception about smoking cessation counseling among dental students in Brazil. A cross-sectional study was performed at the School of Dentistry, Universidade Federal de Pernambuco, Brazil. The Global Health Professions Student Survey (GHPSS) research instrument was used. In the second half of 2017, students from the 5th to the 10th semester were recruited to answer the anonymous and self-administered survey in classrooms. The data were tabulated and analyzed, and information about the variables was presented using descriptive statistics. The association between the variables was determined through the Chi-square test and binary logistic regression. Two hundred and twenty-four students answered the survey. More than 40% of the students had tried cigarettes at least once and 8.9% were current smokers. About 28% of the participants reported having been exposed to secondhand smoke in their home and 57.1% in other environments. Most students recognized that they are role models for society and believed they should receive training in smoking cessation counseling. However, only 12.5% of the students reported having received some formal training in this subject. In conclusion, although dental students are aware of the harmful effects of tobacco, there is still a lack of training in smoking prevention and control among these future professionals.

Knowledge of Oral Cancer by a Brazilian Population.

The aim of the present study was to investigate the knowledge about oral cancer in a Brazilian population, including initial clinical signs, causal factors, and the health professional of first choice when suspected of the disease. A total of 2261 participants were interviewed in a cross-sectional study, to investigate associations between sociodemographic descriptive variables and knowledge of oral cancer, risk factors, disease precursor lesions, and health professional of choice for diagnosis. The variables were descriptively analyzed and possible associations investigated considering p values < 0.05. A total of 83.4% of participants reported knowing about oral cancer, and 59.5% reported knowing about potentially malignant lesions; both variables were associated (p < 0.0001). Tobacco was identified as the main risk factor (83.6%), followed by family history (66.2%), and poor oral hygiene (54.5%). Interviewees with higher education level had greater knowledge about cancer (p < 0.0001), and the dentist was the health professional of choice for 43.1% of those who knew about the disease (p = 0.007), with the generalist being the most sought specialist. The population evaluated had a low knowledge of oral cancer given the lack of specific clarifications on etiological factors and risk situations. Health education initiatives are necessary to increase population awareness of potentially malignant oral lesions and improve early diagnosis and recognition of the dentist as a qualified professional for diagnosis of the disease.

Ectonucleotidases from trypomastigotes from different sources and various genetic backgrounds of Trypanosoma cruzi potentiate their infectivity and host inflammation.

Distinct populations of Trypanosoma cruzi interact with mammalian cardiac muscle cells causing different inflammation patterns and low heart functionality. During T. cruzi infection, the extracellular ATP is hydrolyzed to tri- and/or diphosphate nucleotides, based on the infectivity, virulence, and regulation of the inflammatory response. T. cruzi carries out this hydrolysis through the T. cruzi ectonucleotidase, NTPDase-1 (TcNTPDase-1). This study aimed to evaluate the role of TcNTPDase-1 in culture rich in metacyclic trypomastigote forms (MT) and cell culture-derived trypomastigote forms (CT) from Colombiana (discrete typing unit - DTU I), VL-10 (DTU II), and CL (DTU VI) strains of T. cruzi. For this, we measured TcNTPDase-1 activity in suramin-treated and untreated parasites and infected J774 cells and C57BL/6 mice with suramin pre-treated parasites to assess parasitic and inflammatory cardiac profile in the acute phase of infection. Our data indicated a higher TcNTPDase-1 activity for ATP in culture rich in metacyclic trypomastigote forms from Colombiana strain in comparison to those from VL-10 and CL strains. The cell culture-derived trypomastigote forms from CL strain presented higher capacity to hydrolyze ATP than those from Colombiana and VL-10 strains. Suramin inhibited ATP hydrolysis in all studied parasite forms and strains. Suramin pre-treated parasites reduced J774 cell infection and increased nitrite production in vitro. In vivo studies showed a reduction of inflammatory infiltrate in the cardiac tissues of animals infected with cell culture-derived trypomastigote forms from suramin pre-treated Colombiana strain. In conclusion, TcNTPDase-1 activity in trypomastigotes forms drives part of the biological characteristics observed in distinct DTUs and may induce cardiac pathogenesis during T. cruzi infection.

Transcranial Direct Current Stimulation (tDCS) Induces Analgesia in Rats with Neuropathic Pain and Alcohol Abstinence.

Neuromodulatory techniques have been studied to treat drug addiction or compulsive eating as well as different chronic pain conditions, such as neuropathic and inflammatory pain in the clinical and preclinical settings. In this study, we aimed to investigate the effect of transcranial direct current stimulation (tDCS) on the association of alcohol withdrawal with neuropathic pain based on nociceptive and neurochemical parameters in rats. Thirty-six adult male Wistar rats were randomized into five groups: control, neuropathic pain, neuropathic pain + tDCS, neuropathic pain + alcohol, and neuropathic pain + alcohol + tDCS. The neuropathic pain model was induced by chronic constriction injury (CCI) to the sciatic nerve. Rats were then exposed to alcohol (20%) by oral gavage administration for 15 days (beginning 24 h after CCI). tDCS was started on the 17th day after surgery and lasted for 8 consecutive days. The nociceptive test (hot plate) was performed at baseline, 16 days after CCI, and immediately and 24 h after the last session of tDCS. Rats were killed by decapitation, and structures were removed and frozen for biochemical analysis (nerve growth factor and interleukin (IL-1α, IL-1ß, and IL-10 measurements). Neuropathy-induced thermal hyperalgesia was reversed by tDCS, an effect that was delayed by alcohol abstinence. In addition, tDCS treatment induced modulation of central levels of IL-1α, IL-1ß, and IL-10 and neurotrophic growth factor. We cannot rule out that the antinociceptive effect of tDCS could be related to increased central levels of IL-1α and IL-10. Therefore, tDCS may be a promising non-pharmacological therapeutic approach for chronic pain treatment.

Malnutrition in all its forms and social inequalities in Brazil.

OBJECTIVE: To describe malnutrition (undernutrition and excess weight) by income, education and race/ethnicity in the Brazilian population. DESIGN: Cross-sectional study. SETTING: Brazil. PARTICIPANTS: Children aged <5 years (n 14 580), adolescents aged 11-19 years (n 31 892) and adults aged 20-49 years (n 84 660). RESULTS: Among children, prevalence of excess weight, wasting and stunting was 16·9, 2·8 and 6·0 %, respectively. Differences related to income, education and race/ethnicity were verified, except for prevalence of wasting by education level. Girls and boys presented 18·4 and 20·5 % of excess weight, 2·8 and 3·7 % of underweight and 5·5 and 7·3 % of stunting, respectively. Prevalence of excess weight was lower among poorer, lower-educated (only for boys) and white adolescents, while stunting was lower among higher-income, higher-educated and white adolescents. Over three-quarters of women and almost half of men presented excess weight. Among adults, 3·9 % of women and 1·7 % of men were underweight, and 5·7 % of women and 0·2 % of men presented short stature. Prevalence of excess weight for women was higher among lower education and black, while for men it was higher among higher income and education and white. Short stature was more prevalent among black and mixed-race, low-educated and low-income women. Underweight prevalence was higher among low-educated, black and mixed-race women. CONCLUSIONS: In Brazil, the prevalence of excess weight was at least threefold higher than that of undernutrition for children and adolescents and at least sevenfold higher for adults. Social inequalities were observed in the distribution of malnutrition across the lifespan and by gender.

Association of body image (dis)satisfaction and perception with food consumption according to the NOVA classification: Pró-Saúde Study.

The literature on body image and food consumption has generally focused on isolated food items, while overlooking the growing role of ultra-processed foods in the overall diet. The objective of this study was to assess the association of body image (dis)satisfaction and perception with food consumption, according to the NOVA classification, which takes into account the extent and purpose of industrial food processing. A silhouette scale developed considering the Brazilian adults' Body Mass Index was used to assess body image (dis)satisfaction and perception. Food consumption was evaluated using a Food Frequency Questionnaire, and its items were categorized into three groups: unprocessed or minimally-processed foods and culinary preparations; processed foods; ultra-processed foods. The association was assessed using linear regression models. A total of 514 of Brazilian university employees were evaluated. Women dissatisfied due to excess weight consumed less unprocessed or minimally-processed foods and culinary preparations (-6.6, 95% CI: -10.7; -2.5) and more ultra-processed foods (3.7, 95% CI: 0.1; 7.2) compared to satisfied. Women that overestimated their body size consumed less unprocessed or minimally-processed food and culinary preparations (-4.2, 95% CI: -7.3; -1.1), compared to those who had not distorted body image. Food consumption appears to be more strongly associated with body image (dis)satisfaction than with perception. An association was established between body image dissatisfaction and unhealthy eating habits. This relation deserves public health attention since it may contribute to the development of chronic diseases and reduce the quality of life and body image assessment could be adopted by nutritionists and other health professionals in their practice.