ObjectiveData from household food budget surveys were examined in order to describe the regional and socio-economic distribution of household food availability in Brazil ResultsAdequate protein content and a high proportion of animal protein were found in all regions and income strata. These were the most important positive aspects identified in the household food availability in Brazil. On the other hand, all regions and socioeconomic strata showed excess calories from sugar and little availability of fruits and vegetables. An excessive proportion of calories came from total and saturated fat in the more economically developed regions and in the urban milieu, as well as among higher-income families. Time-trends in metropolitan areas indicated a decline in the consumption of basic, traditional foods, such as rice and beans; notable increases (up to 400%) in the consumption of processed food items, such as cookies and soft drinks; maintenance of the excessive consumption of sugar; and a continuous increase in total fat and saturated fat content in the diet. Conclusions Patterns and trends regarding household food availability in Brazil are consistent with the increasing participation of chronic non-communicable diseases in morbidity and mortality and with the continuous increase in the prevalence of obesity.

Objective: To determine whether an educational programme aimed at discouraging students from drinking sugar-sweetened beverages could prevent excessive weight gain. Design: Forty-seven classes in twenty-two schools were randomised as intervention or control. Subjects: Participants were 1140, 9-12-year-old fourth graders (435 in the intervention group and 608 in the control group). Sugar-sweetened beverages and juice intake were measured through one 24 h recall at baseline and another at the end of the trial. The main outcome was the change in BMI (BMI 5 weight (kg)/height (m 2 )), measured at the beginning and at the end of the school year. Intentionto-treat analysis was performed taking into account the cluster (classes) effect. Results: A statistically significant decrease in the daily consumption of carbonated drinks in the intervention compared to control (mean difference 5 256 ml; 95 % CI 2119, 27 ml) was followed by a non-significant overall reduction in BMI, P 5 0?33. However, among those students overweight at baseline, the intervention group showed greater BMI reduction (20?4 kg/m 2 compared with 20?2 kg/m 2 in the control group (P 5 0?11)), and this difference was statistically significant among girls (P 5 0?009). Fruit juice consumption was slightly increased in the intervention group (P 5 0?08), but not among girls. Conclusion: Decreasing sugar-sweetened beverages intake significantly reduced BMI among overweight children, and mainly among girls. Efforts to reduce energy intake through liquids need to emphasise overall sweetened beverages and addition of sugar on juices.

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SICHIERI, ROSELY. Dietary patterns and their associations with obesity in the Brazilian city of Rio de Janeiro. Obes Res. 2002;10:42-48. Objective: To evaluate the dietary patterns of adults living in the city of Rio de Janeiro, Brazil and their associations with body mass index (BMI). Research Methods and Procedures:A survey was conducted in 1996 in a probabilistic sample of 2040 households. Weight and height were measured and food intake was based on an 80-item semi-quantitative food frequency questionnaire. Dietary patterns were identified through factor analysis. Results: More than one-third of the adult population (20 to 60 years old) was overweight (BMI ϭ 25 to 29.9 kg/m 2 ), and 12% were obese (BMI Ն 30 kg/m 2 ). Three major dietary patterns were identified: mixed pattern when all food groups and items had about the same factor loading, except for rice and beans; one pattern that relies mainly on rice and beans, which was called a traditional diet; and a third pattern, termed a Western diet, where fat (butter and margarine) and added sugar (sodas) showed the highest positive loading and rice and beans were strong negative components. Among men, the Western diet also included deep-fried snacks and milk products with high positive values. The traditional diet was associated with lower risk of overweight/obesity in logistic models adjusted for dieting, age, leisure physical activity, and occupation (13% reduction in men and 14% reduction in women comparing the traditional and Western diets). Discussion: Factors contributing to the effects of the Brazilian traditional diet may include low-energy density, highdietary fiber content, incorporation of low glycemic index foods such as beans, or a relatively low food variety.

Eating outside of the home environment on a frequent basis has been associated with weight gain. Food choices when eating out are usually high in energy content, which contributes to excessive energy intake; however, the available data on out-of-home eating and obesity are far from conclusive. This systematic review assesses the association between out-of-home eating and body weight in adults over 18 years of age. The literature databases searched included Medline, Embase, Lilacs, The Cochrane Library, and the ISI Web of Knowledge. The review includes a comprehensive quality assessment of all included observational studies, 20 cross-sectional studies, and 8 prospective cohort studies. All but one of the prospective cohort studies and about half of the cross-sectional analyses found a positive association between out-of-home eating and body weight. However, many methodological differences among the studies were found, such as the definition of out-of-home eating and its assessment, which limits comparisons. The results of the present analysis suggest that in future studies fast-food restaurants and other out-of-home dining venues should be analyzed separately, assessments based on a single 24-h recall should be avoided, and controls for at-home choices (which were not included in any of the studies reviewed) are necessary to evaluate this association.

There is a basic food intake pattern in Brazil based on rice, beans, coffee, bread, and beef with small but consistent regional variation. The consumption of items rich in fat and sugar is also frequent, particularly among adolescents.

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.

Resumo IntroduçãoA obesidade na adolescência é um fator preditivo da obesidade no adulto. Assim, foram avaliados os fatores associados à obesidade e o uso do índice de massa morporal (IMC). MétodoForam avaliados 391 estudantes aferindo-se: consumo de alimentos, hábitos alimentares, características antropométricas dos pais e atividade física. O IMC foi a variável dependente utilizada na regressão linear multivariada. ResultadosA prevalência de sobrepeso foi 23,9% para meninos e 7,2% para meninas. Fazer dieta para emagrecer foi 7 vezes mais freqüente entre meninas do que entre meninos com sobrepeso. Nos meninos, idade, uso de dieta, omissão de desjejum, horas de televisão/"vídeo-game" e obesidade familiar apresentaram associação positiva e significante com IMC. Nas meninas, associaram-se positivamente: uso de dieta, omissão de desjejum e obesidade familiar e negativamente idade da menarca. A correlação do IMC com medidas antropométricas foi maior que 0,7. ConclusõesUm padrão estético de magreza parece predominar entre meninas e elas o atingem com hábitos e consumo alimentar inadequados. Obesidade. Índice de massa corporal. Estado nutricional Abstract Introduction