Objective: To evaluate the association of ultra-processed food (UPF) consumption with gains in weight and waist circumference, and incident overweight/obesity, in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort. Design: We applied FFQ at baseline and categorized energy intake by degree of processing using the NOVA classification. Height, weight and waist circumference were measured at baseline and after a mean 3·8-year follow-up. We assessed associations, through Poisson regression with robust variance, of UPF consumption with large weight gain (1·68 kg/year) and large waist gain (2·42 cm/year), both being defined as ≥90th percentile in the cohort, and with incident overweight/obesity. Setting: Brazil. Participants: Civil servants of Brazilian public academic institutions in six cities (n 11 827), aged 35-74 years at baseline (2008)(2009)(2010). Results: UPF provided a mean 24·6 (SD 9·6) % of ingested energy. After adjustment for smoking, physical activity, adiposity and other factors, fourth (>30·8 %) v. first (<17·8 %) quartile of UPF consumption was associated (relative risk (95 % CI)) with 27 and 33 % greater risk of large weight and waist gains (1·27 (1·07, 1·50) and 1·33 (1·12, 1·58)), respectively. Similarly, those in the fourth consumption quartile presented 20 % greater risk (1·20 (1·03, 1·40)) of incident overweight/obesity and 2 % greater risk (1·02; (0·85, 1·21)) of incident obesity. Approximately 15 % of cases of large weight and waist gains and of incident overweight/obesity could be attributed to consumption of >17·8 % of energy as UPF. Conclusions: Greater UPF consumption predicts large gains in overall and central adiposity and may contribute to the inexorable rise in obesity seen worldwide. Keywords Ultra-processed food Obesity Weight gain Food handlingThe world has witnessed a progressive, major increase in the burden of obesity over recent decades. Since 1980, the prevalence has doubled in more than seventy out of 195 countries (1) and obesity has become a major problem not only in high-income but also in low-and middleincome countries (2) .

Results indicate the existence of associations between greater energy contribution from ultra-processed foods and higher BMI and WC, which are independent of total energy intake. These findings corroborate public policies designed to reduce the intake of this type of food.

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Objetivo: Descrever a série temporal das internações por condições sensíveis à atenção primária (ICSAP) no estado do Espírito Santo, no período de 2000 a 2014, segundo sexo, faixa etária, porte municipal, macrorregiões e grupos de causa, e investigar os fatores associados à ocorrência dessas hospitalizações. Métodos: Estudo ecológico de série temporal das ICSAP ocorridas de 2000 a 2014. A análise da série temporal foi realizada pelo método Cochrane-Orcutt, e para a análise de regressão multivariável multinível usou-se o modelo de regressão binomial negativa. Resultados: As ICSAP diminuíram 28,79% no período. As maiores taxas foram observadas entre os idosos e as crianças menores de cinco anos, e reduziram mais entre idosos e adultos. Os principais grupos de causas foram as gastroenterites infecciosas e complicações, a infecção no rim e trato urinário, e a insuficiência cardíaca. Houve redução das taxas de ICSAP na medida em que cresceu a taxa de cobertura da estratégia saúde da família (0,60, IC: 0,56-0,66), a proporção de médicos (0,90, IC: 0,84-0,96), de pretos e pardos (0,88, IC: 0,83-0,93) e de pessoas com ensino médio (0,87, IC: 0,76-0,99), enquanto houve acréscimo dessas hospitalizações a cada aumento do produto interno bruto per capita, do índice de Gini, da taxa de urbanização, dos leitos hospitalares e dos planos de saúde. Conclusão: A expansão e consolidação da estratégia saúde da família são importantes para a redução das ICSAP no estado dentre outros fatores, como recursos de saúde e fatores socioeconômicos. (39)1546 www.rbmfc.org.br ARTIGOS DE PESQUISAS Panorama de las hospitalizaciones por condiciones sensibles a la atención primaria en Espírito Santo, Brasil, 2000 a 2014Objective: To describe the time series of hospitalizations due to ambulatory care sensitive conditions (ACSC) in Espirito Santo, from 2000 to 2014, according to sex, age, municipal size, regions and cause groups, and investigate the factors associated with the occurrence of these hospitalizations. Method: Ecological study of time series of ACSC hospitalizations occurred from 2000 to 2014. The analysis of the time series was performed by the Cochrane-Orcutt method, and for the multivariable regression analysis the negative binomial regression model was used. Results: ACSC hospitalizations decreased 28.79% in the period. The highest rates were observed among the elderly and children under five, and decreased more among the elderly and adults. The main groups of causes were gastroenteritis and complications, infection in the kidney and urinary tract, and heart failure. There was a reduction in the ACSC hospitalizations rates as the coverage rate of family health strategy increased ( não se aplica. Conflito de interesses:declaram não haver.

BackgroundPrevention and reduction of excessive use of alcohol represents damages to society in general. In turn, arterial hypertension is the main attributable risk factor premature life lost years and disability.ObjectiveTo investigate the relationship between alcohol consumption and high blood pressure in participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).MethodologyA baseline data of total of 7,655 participants volunteers between 35 and 74 years of age, of both genders, in six educational and research institutions of three different regions of the country were interviewed between 2008–2010. Socioeconomic, haemodynamic, anthropometric and health data were collected in the research centers of ELSA-Brasil. The presence of high blood pressure was identified when the systolic blood pressure was ≥140 mm Hg and/or the diastolic was ≥90 mm Hg. Alcohol consumption was estimated and categorized regarding consumption and pattern of ingestion. The Student’s t-test, chi-squared and logistic regression tests were used for analysis, including potential co-variables of the model, and a 5% significance level was adopted.ResultsA dose-response relation was observed for the consumption of alcohol (g/week) in systolic blood pressure and diastolic blood pressure. Alcohol consumption was associated with high blood pressure in men who reported moderate (OR = 1.69; 95%CI 1.35–2.11) and excessive (OR = 2.70; 95%CI 2.04–3.59) consumption. Women have nearly three times more chance of presenting elevated blood pressure when presenting excessive consumption (OR = 2.86, 95%CI 1.77–4.63), and binge drinkers who drink more than 2 to 3 times a month have approximately 70% more chance of presenting with elevated blood pressure, after adjusting for consumption of drinks with meals.ConclusionThe consumption of alcohol beverages increases the odds of elevated blood pressure, especially among excessive drinkers. Therefore alcohol consumption needs a more robust regulation in view of its impact on population health.