OBJECTIVE: To estimate energy and nutrient intake and prevalence of inadequate micronutrient intake among Brazilian adults. METHODS:Data from the National Dietary Survey, from the [2008][2009] Household Budget Survey, were used. Food consumption was evaluated through food record on two non-consecutive days. A total of 21,003 individuals (52.5% women), between 20-59 years old, participated in the survey. Usual nutrient intake was estimated according to the National Cancer Institute method. The Estimated Average Requirement (EAR) cut-off points were used to determine the prevalence of inadequate micronutrient intake. For manganese and potassium, the Adequate Intake (AI) was used as cut-off. Sodium intake was compared with the Tolerable Upper Intake Level (UL). The probability approach was used to determine the prevalence of inadequate iron intake. The data were analyzed according to the location of the household (urban or rural) and macro regions of Brazil. RESULTS:The mean energy intake was 2,083 kcal among men and 1,698 kcal among women. Prevalence of inadequacy equal to or greater than 70% were observed for calcium among men and magnesium, vitamin A, and sodium among both men and women. Prevalence equal to or greater than 90% were found for calcium in women and vitamins D and E in both genders. Prevalence lower than 5% were found for iron in men and for niacin in men and women. In general, prevalence of inadequate intake was higher in the rural area and in the Northeast region. CONCLUSIONS:Energy intake was higher among individuals who live in urban areas and in the North region. The greatest risk groups of inadequate micronutrient intake were women and those living in rural areas and in the Northeast region.

OBJECTIVE: to assess energy and nutrient consumption and the prevalence of inadequate micronutrient intake among Brazilian adolescents. METHODS:A random sample composed of 6,797 adolescents (49.7% girls), between 10 and 18 years old, was evaluated in the fi rst National Dietary Survey, part of the Household Budget Survey carried out in [2008][2009]. Expansion factors, sample complexity design and correction of intraindividual variability were considered. The prevalence of inadequate micronutrient intake was based on the proportion of adolescents with intake below the Estimated Average Requirement. The prevalence of intake above the Tolerable Upper Intake Level (UL) was estimated for sodium. RESULTS:The mean energy intake ranged between 1,869 kcal (10 to 13 year old females) and 2,198 kcal (14 to 18 year old males). Of the total energy intake, 57% came from carbohydrates, 27% from lipids and about 16% from proteins. Inadequacies were higher for calcium (> 95%), phosphorous (54% to 69%) and vitamins A (66% to 85%), E (100%) and C (27% to 49%). More than 70% of adolescents reported sodium intake above the UL. CONCLUSIONS:Mean energy consumption and distribution of macronutrients were adequate, but prevalence of inadequate vitamin and mineral intake were high and notable consumption of sodium above the recommended levels, low levels of calcium consumption and, in 14 to 18 year old females, important inadequacies in iron intake were found.

OBJECTIVE: to assess energy and nutrient consumption and the prevalence of inadequate micronutrient intake among Brazilian adolescents. METHODS:A random sample composed of 6,797 adolescents (49.7% girls), between 10 and 18 years old, was evaluated in the fi rst National Dietary Survey, part of the Household Budget Survey carried out in [2008][2009]. Expansion factors, sample complexity design and correction of intraindividual variability were considered. The prevalence of inadequate micronutrient intake was based on the proportion of adolescents with intake below the Estimated Average Requirement. The prevalence of intake above the Tolerable Upper Intake Level (UL) was estimated for sodium. RESULTS:The mean energy intake ranged between 1,869 kcal (10 to 13 year old females) and 2,198 kcal (14 to 18 year old males). Of the total energy intake, 57% came from carbohydrates, 27% from lipids and about 16% from proteins. Inadequacies were higher for calcium (> 95%), phosphorous (54% to 69%) and vitamins A (66% to 85%), E (100%) and C (27% to 49%). More than 70% of adolescents reported sodium intake above the UL. CONCLUSIONS:Mean energy consumption and distribution of macronutrients were adequate, but prevalence of inadequate vitamin and mineral intake were high and notable consumption of sodium above the recommended levels, low levels of calcium consumption and, in 14 to 18 year old females, important inadequacies in iron intake were found.

OBJECTIVE: To estimate energy and nutrient intake and prevalence of inadequate micronutrient intake among Brazilian adults. METHODS:Data from the National Dietary Survey, from the [2008][2009] Household Budget Survey, were used. Food consumption was evaluated through food record on two non-consecutive days. A total of 21,003 individuals (52.5% women), between 20-59 years old, participated in the survey. Usual nutrient intake was estimated according to the National Cancer Institute method. The Estimated Average Requirement (EAR) cut-off points were used to determine the prevalence of inadequate micronutrient intake. For manganese and potassium, the Adequate Intake (AI) was used as cut-off. Sodium intake was compared with the Tolerable Upper Intake Level (UL). The probability approach was used to determine the prevalence of inadequate iron intake. The data were analyzed according to the location of the household (urban or rural) and macro regions of Brazil. RESULTS:The mean energy intake was 2,083 kcal among men and 1,698 kcal among women. Prevalence of inadequacy equal to or greater than 70% were observed for calcium among men and magnesium, vitamin A, and sodium among both men and women. Prevalence equal to or greater than 90% were found for calcium in women and vitamins D and E in both genders. Prevalence lower than 5% were found for iron in men and for niacin in men and women. In general, prevalence of inadequate intake was higher in the rural area and in the Northeast region. CONCLUSIONS:Energy intake was higher among individuals who live in urban areas and in the North region. The greatest risk groups of inadequate micronutrient intake were women and those living in rural areas and in the Northeast region.

The greatest health hazards related to poor sanitation were found in the microregions with a high concentration of low-income population with limited education. The general sanitation conditions and other factors related to dwelling quality and infrastructure are major determinants of mortality. Coverage of the water services, which reach 90% of households in Brazil, was not in itself found to be an important factor in the reduction of the mortality studied.

The National Cancer Institute (NCI) method allows the distributions of usual intake of nutrients and foods to be estimated. This method can be used in complex surveys. However, the user must perform additional calculations, such as balanced repeated replication (BRR), in order to obtain standard errors and confi dence intervals for the percentiles and mean from the distribution of usual intake. The objective is to highlight adaptations of the NCI method using data from the National Dietary Survey. The application of the NCI method was exemplifi ed analyzing the total energy (kcal) and fruit (g) intake, comparing estimations of mean and standard deviation that were based on the complex design of the Brazilian survey with those assuming simple random sample. Although means point estimates were similar, estimates of standard error using the complex design increased by up to 60% compared to simple random sample. Thus, for valid estimates of food and energy intake for the population, all of the sampling characteristics of the surveys should be taken into account because when these characteristics are neglected, statistical analysis may produce underestimated standard errors that would compromise the results and the conclusions of the survey. 172SUsual dietary intake in complex sample Barbosa FS et al For most epidemiological diet analyses, usual intake is required, and in many situations, such as in large surveys, only one or two 24-hour recalls (24HR) or food records are collected. These methods yield an excessive amount of within-person variation, 4 and early attempts to compensate for this limitation by averaging over a small number of days 1 do not adequately represent usual individual intakes. Thus, more sophisticated methods based on statistical modelling were developed, 2 paying special attention to the problems that are inherent in modelling usual intake of foods or food groups that are episodically consumed. Challenges for the statistical modelling of usual intake include the following: the ratio of within-person and between-person variation; the reported days that are without consumption or the consumption-day amounts that are positively skewed, with extreme values in the upper tail; the correlation between the probability of consumption and the consumption-day amount; and covariate information on usual intake.The National Cancer Institute (NCI) method was designed to meet all of these challenges by allowing effi cient estimation of the usual intake distributions of daily and episodically consumed items. 13 The method also allows the prediction of individual intakes to be used in a model to assess the relationship between diet and disease or another variable 6 and by performing an assessment of the effects of individual covariates on consumption.12 An extension of the NCI method has also been used to estimate the population distributions of the ratios of usual intakes of dietary components. 5 RESUMOO objetivo do estudo foi indicar uma adaptação do método do Instituto Nacional do Câncer (INC), ut...

To ascertain the association of BMI and obesity with short stature, a cross-sectional telephone survey was conducted in 2006, using a multilevel approach, adjusting for individual-and city-level measures of socio-economic status. The study probabilistic sample consisted of 54 369 adults (. 18 years) living in households with access to telephone lines in each urban area of the twenty-six Brazilian state capitals and federal district. Odds of being currently obese and obese at age 20 years were compared between short stature individuals (5th percentile) and those with normal stature. After controlling for individual-and city-level sociodemographic characteristics and behaviours, high BMI was strongly associated with short stature individuals (P¼ 0·001). Among short stature women the adjusted OR of being obese was 3·0 (95 % CI 2·2, 4·2) compared with those with stature greater than the 5th percentile. Among men this adjusted OR was 2·0 (95 % CI 1·5, 2·6). When comparisons were made for BMI at age 20 years the OR were even larger (6 for men and 8 for women). Despite the growing body of evidence that environmental factors such as poor food choices and physical inactivity are the main determinants of the worldwide obesity epidemic, the greater difference in BMI and prevalence of obesity in the Brazilian capitals was explained mainly by individual factors. We found a strong association between obesity and short stature after adjustment for diet, physical activity, and many environmental factors. Intra-and inter-generational consequences of undernutrition are an alternative explanation for the regional disparities in obesity in Brazil. Short stature: Obesity: BMI: Telephone interviewsUndernutrition early in life has been associated with adulthood obesity in some (1 -4) , but not all, studies (5 -7) . According to Prentice (8) whether malnutrition in childhood predisposes to later obesity is difficult to analyse owing to the lack of prospective cohorts in developing countries.Cross-sectional studies in Brazil have shown that short adult stature, a marker for early undernutrition, is a risk factor for obesity among women, but not men, even after adjusting for contemporary differences in socio-economic status (3,9) . In addition, associations among women have only been observed in studies conducted in the developed regions of the country, suggesting that a minimum of food availability or the kind of food availability present in developed urban centres would be required for the expression of a possible metabolic programming at an early age (10) . In a recent study, a more accurate marker of early undernutrition -the ratio of height to sitting height -was also associated with a high percentage of fat and obesity in a survey of Brazilian women (11) .A possible physiological mechanism to explain these associations is low energy expenditure among women exposed to energy restriction during development, as shown for Brazilian adolescents with stunting (12,13) . A complementary rather than alternative hypothesis in explaining the...

The National Cancer Institute (NCI) method allows the distributions of usual intake of nutrients and foods to be estimated. This method can be used in complex surveys. However, the user must perform additional calculations, such as balanced repeated replication (BRR), in order to obtain standard errors and confi dence intervals for the percentiles and mean from the distribution of usual intake. The objective is to highlight adaptations of the NCI method using data from the National Dietary Survey. The application of the NCI method was exemplifi ed analyzing the total energy (kcal) and fruit (g) intake, comparing estimations of mean and standard deviation that were based on the complex design of the Brazilian survey with those assuming simple random sample. Although means point estimates were similar, estimates of standard error using the complex design increased by up to 60% compared to simple random sample. Thus, for valid estimates of food and energy intake for the population, all of the sampling characteristics of the surveys should be taken into account because when these characteristics are neglected, statistical analysis may produce underestimated standard errors that would compromise the results and the conclusions of the survey. 172SUsual dietary intake in complex sample Barbosa FS et al For most epidemiological diet analyses, usual intake is required, and in many situations, such as in large surveys, only one or two 24-hour recalls (24HR) or food records are collected. These methods yield an excessive amount of within-person variation, 4 and early attempts to compensate for this limitation by averaging over a small number of days 1 do not adequately represent usual individual intakes. Thus, more sophisticated methods based on statistical modelling were developed, 2 paying special attention to the problems that are inherent in modelling usual intake of foods or food groups that are episodically consumed. Challenges for the statistical modelling of usual intake include the following: the ratio of within-person and between-person variation; the reported days that are without consumption or the consumption-day amounts that are positively skewed, with extreme values in the upper tail; the correlation between the probability of consumption and the consumption-day amount; and covariate information on usual intake.The National Cancer Institute (NCI) method was designed to meet all of these challenges by allowing effi cient estimation of the usual intake distributions of daily and episodically consumed items. 13 The method also allows the prediction of individual intakes to be used in a model to assess the relationship between diet and disease or another variable 6 and by performing an assessment of the effects of individual covariates on consumption.12 An extension of the NCI method has also been used to estimate the population distributions of the ratios of usual intakes of dietary components. 5 RESUMOO objetivo do estudo foi indicar uma adaptação do método do Instituto Nacional do Câncer (INC), ut...