Physical inactivity is a cardinal feature of chronic obstructive pulmonary disease (COPD), and is associated with increased morbidity and mortality. Pedometers, which have been used in healthy populations, might also increase physical activity in patients with COPD.COPD patients taking part in a 3-month individualised programme to promote an increase in their daily physical activity were randomised to either a standard programme of physical activity encouragement alone, or a pedometer-based programme. Assessments were performed by investigators blinded to treatment allocation. Change in average 1-week daily step count, 6-min walking distance (6MWD), modified Medical Research Council scale, St George’s respiratory questionnaire (SGRQ) and COPD assessment test (CAT) were compared between groups.102 patients were recruited, of whom 97 completed the programme (pedometer group: n=50; control group: n=47); 60.8% were male with a mean±sd age of 68.7±8.5 years, and forced expiratory volume in 1 s (FEV1) 66.1±19.4% and FEV1/forced vital capacity 55.2±9.5%. Both groups had comparable characteristics at baseline. The pedometer group had significantly greater improvements in: physical activity 3080±3254 steps·day−1 versus 138.3±1950 steps·day−1 (p<0.001); SGRQ −8.8±12.2 versus −3.8±10.9 (p=0.01); CAT score −3.5±5.5 versus −0.6±6.6 (p=0.001); and 6MWD 12.4±34.6 versus −0.7±24.4 m (p=0.02) than patients receiving activity encouragement only.A simple physical activity enhancement programme using pedometers can effectively improve physical activity level and quality of life in COPD patients.

The present study aimed to investigate counseling content provided by healthcare professional for primary healthcare users, as well as users' difficulties in adhering to the counseling, through a cross-sectional study design. Interviews were conducted with 499 users at a primary healthcare unit and 59.3% of them said that counseling had been provided especially by physicians (93.6%), and it was based on healthy nutrition and physical activity practice (48.9%). Counseling was more frequently to users with greater numbers of morbid conditions (p = 0.001). The main factors that made adherence difficult for users were lack of time (27.5%) and the need to change habits (23%). It was identified that counseling is still at initial stage within primary care, and there is a need for healthcare professionals, especially the nurse of the family health team to be more proactive in this process,focusing mainly on health promotion.

Food delivery apps guarantee access to food during the COVID-19 pandemic when commercial establishments are closed and access to food retail is controlled. This study aimed to describe the ads published in a food delivery app in Brazilian capitals, during 13th and 14th week of the pandemic. Data collection occurred on one day of the week and one day of the weekend and during lunch and dinner time. A random sample of 25% of the ads (n=1,754) published in this period was classified in accordance to the presence of healthy and unhealthy eating markers and to the use of marketing strategies. Almost 50% of the ads contained at least one unhealthy eating marker and 29.3% at least one healthy eating marker. Ads containing healthy eating markers were more frequent on the weekday (34.2% vs. 24.1% at the weekend) and at lunch (47.5% vs. 16.1% at dinner). Ads containing unhealthy eating markers were more common at the weekend (54.7% vs. 47.8% on the weekday) and at dinner (63.3% vs. 34.2% at lunch). The most common marketing strategies in the ads were: price discounts (91.7%), use of photos (94.0%) and free shipping (45.7%). Combos were frequent on weekday (2.1% vs. 26.4% at the weekend) in addition to photo use (95.2% vs. 92.7% at the weekend). Free shipping and combo strategies prevailed at dinner: 48.0% vs. 42.4% at lunch and 33.4% vs. 23.6% at lunch, respectively. In sum, food delivery app proved to be an obesogenic food environment during the COVID-19 pandemic.

UPP marketing is extensively used on Facebook pages and is highly accessed by Brazilians, with UPP companies employing a diversity of marketing strategies.

Objective: Food delivery apps represent an important and emerging dimension of the digital food environment. This study aimed to examine food availability and the use of marketing strategies by two food delivery apps in a Brazilian metropolis. Design: An exploratory study was conducted in the city of Belo Horizonte, Minas Gerais. Food groups were identified and the use of price discounts and photos by the apps was observed. Setting: Eighteen neighbourhoods and the ten best rated restaurants in each app. Participants: Three hundred sixty-two commercial food establishments. Results: The proportion of ultra-processed beverages on offer in the apps (78·45 %) was much higher in comparison with water (48·89 %), natural juices or smoothies (27·07 %). Ultra-processed ready-to-eat meals represented almost 70 % of the food offered in the establishments’ menus, while traditional meals and vegetables represented just over 30 % of the offering. Ice cream, candies and salty packaged snacks were nine times more frequently presented than fruits. The use of photos and price discounts prevailed predominantly among ultra-processed beverages, sandwiches and ice cream, candies and salty packaged snacks. These marketing strategies were least used for promoting fruits and vegetables. Conclusions: Restaurants registered on food delivery apps offered a significant amount of ultra-processed foods with price discounts and photos in comparison with unprocessed and minimally processed foods.

Anemia and iron deficiency were associated with low levels of serum retinol in children aged 1 to 5 years, and a positive correlation was verified between serum retinol and serum ferritin and hemoglobin levels. These results indicate the importance of initiatives encouraging the development of new treatments and further research regarding retinol deficiency.

The food information environment includes food advertising disseminated in various media. With the COVID-19 pandemic and the shutdown of schools, universities, non-essential commerce, public leisure areas, bars, restaurants, among others, the food information environment has changed in Brazil. People spending more time at home which led to greater exposure to television (TV) and internet advertising content. During the COVID-19 pandemic, the food production sector has invested in new ways to advertise their products that include advertising messages of support, empathy, and solidarity, as well as social responsibility campaigns looking for self-promotion such as food donation and financial aids. Sponsoring online events promoted by Brazilian musicians on social media was also enhanced during the pandemic and allowed food companies to become part of the consumer’s leisure and entertainment moments. The advertising strategies adopted by the food industry during the COVID-19 pandemic are used to generate market demands, influence the consumer purchase decision, and increase their loyalty to the supplier brands. Consequently, individuals may have been more vulnerable to excessive consumption of ultra-processed foods during this health crisis. This commentary aims to describe the changes in the food information environment during the COVID-19 pandemic in Brazil and propose a pathway to promote a healthier food information environment after this health crisis. Perspectives for promoting a healthier food information environment after the pandemic are also discussed, focusing on regulating food advertising with a shared responsibility between government, the food industry, the academy, and civil society.

Objective: To analyze the content of television food advertising on Brazilian 'free-to-air' broadcast stations during children's programming. Methods: This is a descriptive study which evaluated the content of food advertising between 08:00 a.m. and 06:00 p.m. on three Brazilian 'free-to-air' broadcast stations (A, B and C). Data collection was performed during 10 week days and weekends. Food advertising was organized according to the food group classification from the Food Guide for the Brazilian Population. The annual exposure to food advertising was obtained considering the national children average exposure to television of five daily hours. The χ 2 and Fisher's exact test were conducted in order to identify differences in the content of television advertising in the morning and in the afternoon and between broadcast stations. Results: One hundred and twenty six hours of programming were recorded, totalizing 1,369 commercials -13.8% of food. There was major participation of 'sugars and sweets' (48.1%) and 'oils and fats' (29.1%) among food advertising and much food publicity in the afternoon (15.7%; morning: 12.2%, p = 0.037). Moreover, the broadcast with more audience was the one that advertised more food (A: 63.5%; B: 12.2%; C: 24.3%), especially 'sugar and sweets' (A: 59.2%; B: 43.5%; C: 21.7%). Finally, an annual average exposure to 2,735.5 commercials was obtained for Brazilian children, totalizing 2,106.3 of food rich in sugar and fat publicity. Conclusion: Food advertising is focused on poor nutritionally food, emphasizing the need for specific intervention strategies. Keywords