Índice de conicidade como preditor de alterações no perfil lipídico em adolescentes de uma cidade do Nordeste do BrasilConicity index as a predictor of changes in the lipid profile of adolescents in a city in Northeast BrazilÍndice de conicidad como predictor de alteraciones en el perfil lipídico en adolescentes de una ciudad del nordeste de Brasil

Objective To analyse the mortality rate trend due to coronary heart disease (CHD) and stroke in the adult population in Brazil. Methods From 2000 to 2018, a time trend study with joinpoint regression was conducted among Brazilian men and women aged 35 years and over. Age-adjusted and age, sex specific CHD and stroke trend rate mortality were measured. Results Crude mortality rates from CHD decreased in both sexes and in all age groups, except for males over 85 years old with an increase of 1.78%. The most accentuated declining occurred for age range 35 to 44 years for both men (52.1%) and women (53.2%) due to stroke and in men (33%) due to CHD, and among women (32%) aged 65 to 74 years due to CHD. Age-adjusted mortality rates for CHD and stroke decreased in both sexes, in the period from 2000 to 2018. The average annual rate for CHD went from 97.09 during 2000–2008 to 78.75 during 2016–2018, whereas the highest percentage of change was observed during 2008 to 2013 (APC -2.5%; 95% CI). The average annual rate for stroke decreased from 104.96 to 69.93, between 2000–2008 and 2016–2018, and the highest percentage of change occurred during the periods from 2008 to 2013 and 2016 to 2018 (APC 4.7%; 95% CI). Conclusion The downward trend CHD and stroke mortality rates is continuing. Policy intervention directed to strengthen care provision and improve population diets and lifestyles might explain the continued progress, but there is no room for complacency.

The maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) influence maternal and infant outcomes. This study identified patterns of habitual dietary intake in 385 pregnant women in São Paulo and explored their associations with excessive weight gain (EGWG). Weight at the first visit (<14 weeks) was used as a proxy for pre-pregnancy weight. Food consumption was assessed using the 24HR method, administered twice at each gestational trimester, and dietary patterns were identified by principal component analysis. Three dietary patterns were identified: “Vegetables and Fruits,” “Western,” and “Brazilian Traditional.” Descriptive data analysis was performed using absolute and relative frequencies for each independent variable and multilevel mixed-effects logistic regression was used to analyze excessive gestational gain weight (EGWG) and dietary patterns (DP). The Brazilian Traditional dietary pattern showed a protective effect on EGWG (p = 0.04) and age > 35 years (p = 0.03), while subjects overweight at baseline had a higher probability of EGWG (p = 0.02), suggesting that the identification of dietary and weight inadequacies should be observed from the beginning of pregnancy, accompanied by nutritional intervention and weight monitoring throughout the gestational period to reduce risks to the mother and child’s health.

Objective: identify dietary patterns and prospectively evaluated their influence on the BMI z-score of adolescents. Design: a longitudinal study, using data from the Longitudinal Study on Sedentary Behavior, Physical Activity, Eating Habits and Adolescent Health - LONCAAFS. Setting: to obtain data on food consumption, a 24-hour recall survey was conducted; a second 24-hour recall was applied to 30% of the sample in all waves Dietary patterns were identified by exploratory factor analysis using principal components. BMI z-score was determined according to the recommendation of the World Health Organization, based on the body mass index (BMI) for age and sex. Socioeconomic data, sedentary behavior, and physical activity level were obtained. Associations between BMI z-score and dietary patterns and between BMI z-score and variables of interest were determined using Generalized Estimation Equations (GEE). Participants: 1431 adolescents were assessed in 2014, 1,178 in 2015, 959 in 2016, and 773 in 2017, belonging to the public schools of João Pessoa, Northeast Brazil. Results: Were identified three dietary patterns throughout the study: “traditional,” “snacks,” and “western”. The “western” dietary pattern was positively associated with BMI Z-score (β=0.025; 95% CI: 0.002–0.048), regardless of sex and physical activity level, prospectively. Conclusion: A dietary pattern composed of foods with high energy density, high fat and sugars, and low fiber, influence the BMI Z-score of adolescents over time.

ObjectiveEstimate reductions in cardiovascular mortality achievable through improvement in nutrient intakes according to processing level (NOVA classification), that is, reducing consumption of culinary ingredients (G2), processed (G3) and ultra-processed foods (G4) while encouraging consumption of unprocessed and minimally processed foods (G1).DesignModelling study.SettingGeneral adult population of Brazil.ParticipantsMen and women aged 25 or more years (34 003) investigated in the Household Budget Survey 2017–2018, in the consumption data module.Main outcome measuresWe used the IMPACT Food Policy Model to estimate the reduction in deaths from cardiovascular diseases (CVD) up to 2048 in five scenarios with reductions in saturated fat, trans fat, salt and added sugar intakes resulting from changes in NOVA groups. (1) The optimistic scenario modelised an increase in the energy intake provided by G1 and a reduction in the energy intake from G2, G3 and G4, return to previous levels. (2) The minimal scenario modelised a 3.7% increase in the energy intake from G1, and a reduction in the energy intake from G4 to the 2008–2009 level. (3) The modest scenario only modelised a 25.0% reduction of the energy intake from G2 and G3. (4) The intermediary scenario modelised the minimal scenario plus a 25.0% reduction in the energy intake from G2. (5) Finally, the advanced scenario modelised the minimal scenario plus a 25.0% reduction in the energy intake from G2 and G3.ResultsProposed changes in the optimistic scenario could prevent or delay 52.8% CVD-related deaths by 2048. Changes modelled in the minimal, modest, intermediary and advanced scenarios may result in a 10.1%, 28.4%, 31.4% and 38.6% reduction in 2048 CVD mortality, respectively.ConclusionsSubstantial health gains can be achieved by improving the diet, through plausible modifications aimed at the level of processing as a tool for Brazilian food policies.

Objective To identify the association between dietary patterns and nutritional status in adolescent freshmen at a public university in Northeastern Brazil. Methods In this cross-sectional study anthropometric variables, body composition and food intake were collected and assessed using the food frequency questionnaire. Dietary patterns were evaluated through factor analysis using the principal component extraction method. Results Two dietary patterns were identified: “Western” pattern, consisting of foods with high energy density and low nutritional value, and the “traditional Brazilian” pattern, with foods from Brazilian cuisine such as rice, beans, corn, roots and tubers, fruits, greens and vegetables. The multiple regression analysis revealed a negative association between the “traditional Brazilian” pattern and both excess weight and body fat in females. Conclusion A healthy dietary pattern with typical local cuisine foods can offer protection to health and should be encouraged.

Individuals with a history of previous cardiovascular events have an increased risk of mortality and morbidity, so adherence to a healthy dietary pattern is essential. We aimed to evaluate and compare dietary patterns between the control and the experimental group from the BALANCE Program. A total of 2360 individuals aged 45 years or older with previous cardiovascular disease were included. The individuals were randomized into two groups: intervention (dietary prescription with nutritional recommendations, nutritional education program based on playful strategies, suggestions of typical and accessible Brazilian foods and intensive monitoring) and control (conventional nutritional counseling). The dietary patterns were identified using factor analysis with the principal component extraction method, and the t-Student tests and ANOVA test were performed to evaluate the associated factors. Four dietary patterns were identified for both groups: “Traditional”, “Snack”, “Western”, “Cardioprotective”. There was an increase in the variances of the “Cardioprotective” pattern in both groups. Regarding the “Western” pattern, there was a significant reduction in the variances of the experimental group (10.63% vs. 8.14%). Both groups had improvements in eating habits, especially in the first year of follow-up. The greater increase in adherence to the traditional and cardioprotective pattern in the experimental group justifies the initiative of the BALANCE program.

Resumo Objetivou-se identificar padrões alimentares e sua associação com características socioeconômicas, de estilo de vida, estado nutricional, perfil lipídico e inflamatório em adolescentes. Estudo transversal, com amostra probabilística, utilizando dados da linha de base (2014) do Estudo Longitudinal sobre Comportamento Sedentário, Atividade Física, Hábitos Alimentares e Saúde de Adolescentes (LONCAAFS). Participaram 1.438 adolescentes (10 a 14 anos), da rede pública de João Pessoa-PB. Foram obtidos dados socioeconômicos, medidas antropométricas, estilo de vida e exames bioquímicos. Os dados dietéticos foram obtidos por recordatórios de 24h, sendo os padrões alimentares identificados por análise fatorial exploratória e as associações de interesse estimadas por regressão logística múltipla. Foram encontrados três padrões alimentares: “Tradicional”, “Lanches” e “Ocidental” que se associaram com idade, nível socioeconômico, escolaridade dos pais e estilo de vida. O padrão “Tradicional” se mostrou associado a menor adiposidade e melhor perfil lipídico, porém com a maior idade, há maior adesão aos padrões “Lanches” e “Ocidental”. Os resultados da análise do padrão alimentar de adolescentes apontam para necessidade de estratégias que incentivem comportamentos saudáveis.