Food intake and prevalence of obesity in Brazil: an ecological analysis

Abstract

Objective: To investigate the correlation between the consumption of refined carbohydrates and fats and the prevalence of obesity in the state capitals of Brazil. Design: An ecological evaluation of obesity and dietary risk factors was carried out in twenty-six state capitals of Brazil. Setting: Analysis was based on the age-standardized prevalence of obesity (BMI $ 30?0 kg/m 2 ) among adults aged 20-59 years. Both intake and obesity prevalence were obtained from the last National Family Household Budget Survey (HBS). The survey was conducted from July 2002 to June 2003, based on a probabilistic national sample of 48 470 households. In each household, during seven consecutive days, all monetary and non-monetary expenses for food and beverages for family consumption were transformed into energy. The relative contribution of foods and food groups was expressed as the proportion (%) of total energy. Fruits and vegetables were also measured by the quantity bought in grams. Results: Prevalence of obesity varied from 5?1 % to 13?6 % among women and from 5?2 % to 17?6 % among men. For women, there were statistically significant correlations between obesity and intake of sugar and soft drinks (r S 5 0?60; P 5 0?001), ready-to-eat meals (r S 5 0?39; P 5 0?05) and potatoes (r S 5 0?40; P 5 0?04). For men there were no such associations. Conclusions: Increasing intake of refined carbohydrates, mainly soft drinks, may play a role in the prevalence of obesity among women in Brazil. Effecting changes in family purchase patterns may be a strategy to reduce obesity. Keywords Ecological study Obesity Food intake Household budget surveyThe whole world is experiencing an obesity epidemic, affecting individuals of all ages, in all social strata and ethnic groups (1,2) . Although obesity is related to genetic, metabolic, behavioural and environmental influences, its rapid increase suggests that behavioural and environmental influences, rather than biological changes, are the major underlying cause (1-3) .There has been a marked shift recently in the composition of the diet, with an increase in per capita energy availability, higher consumption of soft drinks and larger portion sizes (2) , as well as higher intakes of fat and added sugar, accompanied by a dramatic fall in total cereal and fibre intakes (1,4) .Rice and beans used to be the staple foods in Brazil, but recent data show a decrease in their intake, whereas there has been a 400 % increase in the consumption of industrialized products such as soft drinks (5) . Trends between 1974 and 2003 in Brazil also indicated high consumption of sugar, total fat and saturated fat, and insufficient intakes of vegetables and fruits (5) . During the same period, the prevalence of obesity in Brazil rose from 2?8 % to 8?8 % among adult men, and from 7?8 % to 12?7 % among women (6) .Ecological studies in the USA have found a strong positive association between the intake of refined carbohydrates in the form of corn syrup and the prevalence of type 2 diabetes and obesity, and a negativ...

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