ObjectiveTo evaluate the effectiveness of a school-based intervention involving the families and teachers that aimed to promote healthy eating habits in adolescents; the ultimate aim of the intervention was to reduce the increase in body mass index (BMI) of the students.DesignPaired cluster randomized school-based trial conducted with a sample of fifth graders.SettingTwenty classes were randomly assigned into either an intervention group or a control group.ParticipantsFrom a total of 574 eligible students, 559 students participated in the study (intervention: 10 classes with 277 participants; control: 10 classes with 282 participants). The mean age of students was 11 years.InterventionStudents attended 9 nutritional education sessions during the 2010 academic year. Parents/guardians and teachers received information on the same subjects.Main Outcome MeasurementChanges in BMI and percentage of body fat.ResultsIntention-to-treat analysis showed that changes in BMI were not significantly different between the 2 groups (β = 0.003; p = 0.75). There was a major reduction in the consumption of sugar-sweetened beverages and cookies in the intervention group; students in this group also consumed more fruits.ConclusionEncouraging the adoption of healthy eating habits promoted important changes in the adolescent diet, but this did not lead to a reduction in BMI gain. Strategies based exclusively on the quality of diet may not reduce weight gain among adolescents.Trial RegistrationClinicaltrials.gov NCT01046474.

Traditional analysis of food intake usually fails to show an association between energy and nutrient intake and indicators of obesity. The analysis of food patterns can contribute to the understanding of the association between eating habits and anthropometric indicators. A population-based cross-sectional study was carried out on a low-income neighbourhood in the Rio de Janeiro metropolitan area, and 1009 subjects between 20 and 65 years of age completed an FFQ. Dietary patterns were identified by means of factor analysis, and their associations with BMI and waist circumference (WC) were ascertained by applying a linear regression analysis. Three main dietary patterns were identified: a mixed pattern, which included cereals, fish and shrimp, vegetables, roots, fruits, eggs, meat and caffeinated beverages; a Western pattern, which consisted of 'fast foods', soft drinks, juices, cakes, cookies, milk and dairy, sweets and snacks; a traditional pattern, which included rice, beans, bread, sugar, fats and salad dressings. After adjusting for age and energy intake, we found that the traditional dietary pattern was inversely associated with BMI (b ¼ 21·14, P, 0·001) and WC (b ¼ 214·9, P¼ 0·002) among females. Additionally, a positive association between the Western pattern and WC (b ¼ 12·8, P¼ 0·02) was observed for females. A diet based on rice and beans may have a protective role against weight gain in women.

OBJECTIVE To analyze if dietary patterns during the third gestational trimester are associated with birth weight.METHODS Longitudinal study conducted in the cities of Petropolis and Queimados, Rio de Janeiro (RJ), Southeastern Brazil, between 2007 and 2008. We analyzed data from the first and second follow-up wave of a prospective cohort. Food consumption of 1,298 pregnant women was assessed using a semi-quantitative questionnaire about food frequency. Dietary patterns were obtained by exploratory factor analysis, using the Varimax rotation method. We also applied the multivariate linear regression model to estimate the association between food consumption patterns and birth weight.RESULTS Four patterns of consumption – which explain 36.4% of the variability – were identified and divided as follows: (1) prudent pattern (milk, yogurt, cheese, fruit and fresh-fruit juice, cracker, and chicken/beef/fish/liver), which explained 14.9% of the consumption; (2) traditional pattern, consisting of beans, rice, vegetables, breads, butter/margarine and sugar, which explained 8.8% of the variation in consumption; (3) Western pattern (potato/cassava/yams, macaroni, flour/farofa/grits, pizza/hamburger/deep fried pastries, soft drinks/cool drinks and pork/sausages/egg), which accounts for 6.9% of the variance; and (4) snack pattern (sandwich cookie, salty snacks, chocolate, and chocolate drink mix), which explains 5.7% of the consumption variability. The snack dietary pattern was positively associated with birth weight (β = 56.64; p = 0.04) in pregnant adolescents.CONCLUSIONS For pregnant adolescents, the greater the adherence to snack pattern during pregnancy, the greater the baby’s birth weight.

Background/objectivesIn Brazil, the increase in obesity rates has been accompanied by increased consumption of ultra-processed food (UPF). The objective of this paper was to evaluate body mass index (BMI) and body fat percentage (%BF) trajectories in adolescents over a 3-year follow-up according to the frequency of UPF consumption.Subjects/methodsData of three consecutive years (2010, 2011, and 2012) were obtained from the Adolescent Nutritional Assessment Longitudinal Study (ELANA) that aimed to assess changes in anthropometric indicators of nutritional status, and 1035 adolescents enrolled in the 1st year of high school from six schools (four private and two public) in the metropolitan area of Rio de Janeiro, Brazil were included. At three follow-ups, they had their weights and heights measured. Body composition was measured at the first and second follow-ups. Mixed linear regression models were used to estimate BMI and %BF trajectories based on quartiles of UPF intake, adjusting for type of school, sex, physical activity, and underreporting.ResultsCompared to their counterparts in the 1st quartile, adolescents in the 4th quartile of UPF consumption had a lower daily intake of fruits, cooked vegetables, and raw vegetables and a higher intake of total sugar and physical activity levels (p < 0.001). There was an inverse association between UPF consumption and BMI both at baseline and at follow-up. Values for %BF followed the same trend. Adolescents in the 4th quartile had the greatest level of physical activity and lowest total energy intake.ConclusionThis study confirmed that greater intake of UPF is a marker of an unhealthy diet, but did not support the hypothesis of a high rate of change in BMI associated with greater UPF consumption, even after adjusting for physical activity.

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Objective: To identify dietary patterns among adolescents and to assess their association with socioeconomic and lifestyle characteristics and nutritional status. Methods: A probabilistic clustered two-stage sample of students between 14 and 19 years old from public and private high schools from Cuiabá, Mato Grosso, Brazil, was investigated (n = 1.139). A selfadministered food frequency questionnaire was used to obtain information on food intake. Nutritional status was classified according to the Body Mass Index (BMI = weight/height 2 ) z-score. Socioeconomic status was inferred by the education level of head of household and by the presence of electrical appliances in the household. Dietary patterns were identified by applying exploratory factor analysis (extraction method: principal component analysis) and their relationship with socioeconomic conditions, lifestyle variables, and nutritional status was estimated by mutually adjusted multilinear regression models. Results: "Western", "traditional" and "mixed" dietary patterns were identified. Studying in the morning hours and reporting the intake of alcoholic beverages were associated with greater adherence to the "Western" pattern. Male low-income students from public schools who have a BMI in the normal range preferred the "traditional" pattern. The "mixed" pattern was adopted by boys from public schools reporting physical activity. Conclusion: Several factors were associated with dietary patterns of adolescents and the Brazilian traditional diet was associated with normal weight.

Introduction:The Study of Cardiovascular Risk in Adolescents (ERICA) is a national multicenter study whose purpose is to describe the cardiovascular risk profile, including obesity, changes in lipid and glucose metabolism, and blood pressure, of about 75,000 Brazilian adolescents. Objective: To describe the development of a tool for data collection of 24-hour food recall (REC24h) in ERICA and to report its performance in the pilot study. Methods: The Multiple Pass Method was used for the development of the computer program that guides REC24h interview. REC24h-ERICA uses a database composed of 1,626 food items including preparation methods and units of predefined portion sizes. Food consumption data are obtained through interviews and entered directly into REC24h-ERICA, avoiding the use of paper. Results: The pilot study included 1,367 adolescents, of which 1,047 (77%) responded to REC24h. The researchers did not report difficulties in program use, the average duration of interviews was 20 minutes and the interviewers inserted 50 new food items. Conclusion: The program developed was proven suitable for use in large-population studies, even in a country like Brazil, where there is great diversity in eating habits.

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