OBJETIVO Descrever características da alimentação dos participantes da coorte NutriNet Brasil imediatamente antes e na vigência da pandemia de covid-19. MÉTODOS Os dados deste estudo provêm de coorte de adultos criada para investigar prospectivamente a relação entre alimentação e morbimortalidade por doenças crônicas não transmissíveis no Brasil. Para este estudo, foram selecionados os primeiros participantes (n = 10.116) que responderam por duas vezes a questionário simplificado sobre sua alimentação no dia anterior, a primeira vez ao ingressar no estudo, entre 26 de janeiro e 15 de fevereiro de 2020, e a segunda entre 10 e 19 de maio de 2020. O questionário indaga sobre o consumo de marcadores de alimentação saudável (hortaliças, frutas e leguminosas) e não saudável (alimentos ultraprocessados). Comparações de indicadores baseados no consumo desses marcadores antes e na vigência da pandemia são apresentadas para o conjunto da população estudada e segundo sexo, faixa etária, macrorregião de residência e escolaridade. Testes qui-quadrado e testes t foram utilizados para comparar proporções e médias, respectivamente, adotando-se p < 0,05 para identificar diferenças significantes. RESULTADOS Para o conjunto dos participantes, identificou-se aumento modesto, porém estatisticamente significante, no consumo de marcadores de alimentação saudável e estabilidade no consumo de marcadores de alimentação não saudável. Esse padrão favorável de mudanças na alimentação com a pandemia se repetiu na maior parte dos estratos sociodemográficos. Padrão menos favorável de mudanças, com tendência de aumento no consumo de marcadores de alimentação saudável e não saudável, foi observado nas macrorregiões Nordeste e Norte e entre pessoas com menor escolaridade, sugerindo desigualdades sociais na resposta à pandemia. CONCLUSÕES Caso confirmada, a tendência de aumento no consumo de alimentos ultraprocessados nas regiões economicamente menos desenvolvidas e por pessoas com menor escolaridade preocupa, pois a ingestão desses alimentos eleva o risco de obesidade, hipertensão e diabetes, cuja presença aumenta a gravidade e a letalidade da covid-19.
The findings reinforce the need for public policies that promote equality in the food environments of the city. Also, further investigations into the influence of the presence of supermarkets on the nutritional status of children and adolescents are required.
OBJECTIVE: To describe students protected by laws and exposed to soft drinks sales and assess whether forbidding laws are associated with lower availability of these beverages. METHODS: We identified laws forbidding non-government administered cafeterias or sales of soft drinks in schools in the 27 Brazilian state capitals. Data on soft drinks sales were obtained from Pesquisa Nacional de Saúde do Escolar 2015 (PeNSE – National Survey of School Health 2015), for a representative sample of 9th graders from public and private schools. Students were attributed with the status of their school regarding the law and sale of soft drinks. Co-variables were school status (public or private), school size, geographic regions, mother’s educational level, score of goods and services. We performed multivariate analyses using Poisson regression. RESULTS: The total of 23 laws forbidding sales of soft drinks covered 63.0% of capitals, comprising 56.9% of students. Law coverage was higher among students from more developed regions (67.6%) and in public schools (60.6%), compared with those from less developed regions (38.0%) and private schools (45.8%). Soft drinks were available for 33.9% of students. Students attending public schools in less developed regions had the lowest availability of soft drinks, regardless of law coverage (14.8%; 12.0%); while students attending private schools in these regions had a high availability, regardless of law coverage (82.1%; 73.4%). Restrictive laws were associated with lower sales of soft drinks in more developed regions, and restrictions had a greater association with the availability of soft drinks in public schools (PR = 0.25; 95%CI = 0.15-0.41), compared with private schools (PR = 0.48; 95%CI = 0.35-0.66). CONCLUSION: Laws restricting soft drinks in schools were associated with fewer sales in more developed regions. Private schools were less compliant with the law than public schools. A broadly enforced national law could reduce the availability of soft drinks in schools.
Objective:To verify differences in the availability, variety, quality and price of unprocessed and ultra-processed foods in supermarkets and similar establishments in neighbourhoods with different social deprivation levels at Juiz de Fora, Minas Gerais, Brazil.Design:Cross-sectional study.Setting:The Obesogenic Environment Study in São Paulo’s Food Store Observation Tool (ESAO-S) was applied in thirty-three supermarket chains, wholesale and retail supermarkets.Results:Fruits, vegetables and ultra-processed foods were available in almost all establishments, without differences according to Health Vulnerability Index (HVI; which varies from 0 to 1 point and the higher the worse; P > 0·05). Most establishments were concentrated in low vulnerability areas and offered healthy foods with greater variety and quality, despite higher prices. The Healthy Food Store Index (HFSI; which varies from 0 to 16 points and the higher the best) was calculated from the ESAO-S and the mean score was 8·91 (sd 1·51). The presence and variety of unprocessed foods count as positive points, as do the absence of ultra-processed products. When HFSI was stratified by HVI, low HVI neighbourhoods presented higher HFSI scores, compared with medium, high and very high HVI neighbourhoods (P = 0·001).Conclusions:Supermarkets and similar establishments are less dense in areas of greater social deprivation and have lower prices of healthy foods, but the variety and quality of those foods are worse, compared with areas of low vulnerability. We found worse HFSI for supermarkets located in areas with greater vulnerability. Those findings can guide specific public policies improving the urban food environment.
Este estudo descreve modificações no peso corporal de participantes da coorte NutriNet Brasil (n = 14.259) ocorridas durante a pandemia de covid-19. Foram analisados dados informados em período anterior ao início da pandemia (26/01/2020 a 18/03/2020) e cerca de 6 meses após (14/09/2020 a 19/10/2020). O ganho de peso ≥ 2 kg alcançou 19,7% dos participantes, mostrando-se diretamente associado ao sexo masculino, à menor escolaridade e à presença prévia de excesso de peso, sendo inversamente associado à idade. A perda de peso ≥ 2kg alcançou 15,2% dos participantes, mostrando-se diretamente associada ao sexo masculino e à presença prévia de excesso de peso, sendo inversamente associada à idade.
Objective: To investigate the association between ultra-processed food (UPF) consumption and Internalizing Symptoms (IS) among adolescents. Design: It is a cross-sectional study. Paper-pencil survey was completed in classroom with information on UPF consumption, IS and selected covariates. IS were assessed with the Internalizing Symptoms sub-scale from the Social Behaviour Questionnaire (ISs-SBQ). UPF was evaluated with a food frequency questionnaire extracted from the Brazilian National School Health Survey. Crude and adjusted association between UPF and IS was investigated with Structural Equation Models. Setting: São Paulo, SP, Brazil. Participants: n= 2,680 students, Mage= 14.85; CI95% 14.81-14.88. Results: UPF consumption was associated with higher scores in IS in the crude (ß=0.14; p<0.001) and adjusted (ß=0.12; p<0.001) models. The higher the consumption of UPF, the higher the IS score. The following variables were associated with a lower risk of UPF consumption: male gender, public school and having more meals with parents. The change in the magnitude of the standardized score was almost negligible, but the model was significantly improved with the inclusion of covariates. Conclusions: Our results provide evidence about the positive association between UPF consumption and IS among adolescents. The association, despite its low magnitude, remained significant after adjusting for potential confounders. These results are relevant considering the increase in UPF consumption worldwide and in low- and middle-income countries. Also, our study emphasizes the importance of a healthy diet with a reduction in UPF consumption among adolescents.
The information found on the sites is largely in disagreement with the Ministry of Health recommendations, which can lead to misconceptions in the nutritional care of the children younger than two years.
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