Energy and macronutrient intakes in Brazil: results of the first nationwide individual dietary survey

Abstract

Objective: To characterize energy and macronutrient intakes in Brazil and to describe the top food items contributing to energy and macronutrient intakes. Design: Two non-consecutive 24 h dietary records were collected and energy and macronutrient data were adjusted for usual intake distribution. Descriptive statistics and ANOVA with the Bonferroni post hoc test were analysed using SAS version 9·1. Means and standard deviations were estimated for sex, age and income strata. Setting: Nationwide cross-sectional survey, [2008][2009]. Subjects: Nationally representative sample of individuals ≥10 years old (n 32 749), excluding pregnant and lactating women (n 1254). Results: The average energy intake was 7958 kJ/d (1902 kcal/d) and mean energy density was 6·82 kJ/g (1·63 kcal/g). Added sugar represented 13 % of total energy intake and animal protein represented 10 %. The mean contribution of total fat to energy intake was 27 %, while the mean saturated fat contribution was 9 %. Compared with the lowest quartile of income, individuals in the highest income quartile had greater mean intakes of energy, added sugar, alcohol, animal protein, total fat, saturated fat, monounsaturated fat and trans fat. Rice, beans, beef, bread and coffee were among the top five foods contributing most to the intakes of energy, carbohydrates, protein, fat and fibre. Conclusions: In general, Brazilians' dietary intake is compatible with a high risk of obesity and non-communicable chronic diseases, being characterized by high intakes of added sugar and saturated fat. Income may be a major determinant of diet nutritional characteristics. Keywords Food consumption Dietary survey Food records Energy intakeSimilar to many other countries, the dietary patterns in Brazil have changed rapidly and drastically in recent decades. These changes are characterized by the increased intake of processed foods and consequently of saturated fats and simple sugars. The excessive consumption of these foods has been linked to the development of excessive weight gain and to an increased risk CVD(1) as obesity is a leading risk factor for many adverse health outcomes including dyslipidaemia, hypertension, type 2 diabetes, CVD and certain types of cancer (2) . In 2007, 72 % of deaths in Brazil were attributed to non-communicable diseases, especially stroke, CVD and cancer (3) . Additionally, the prevalence of overweight and obesity in Brazil has increased steadily since 1974 in both females and males, as well as across all income quintiles. In the 35 years elapsed from 1974-1975 to 2008-2009, the prevalence of overweight in adults almost tripled among males (18·5 % to 50·1 %) and almost doubled among females (from 28·7 % to 48·0 %). In the same period, the prevalence of obesity more than quadrupled among males (from 2·8 % to 12·4 %) and doubled among females (from 8·0 % to 16·9 %) (4) . Despite the importance of diet in the development of these diseases, which are among the main causes of mortality in Brazil (3) , and the accelerated progression of overweigh...

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