Studies suggest that haem, non-haem iron and total iron intake may be related to non-communicable diseases, especially metabolic syndrome. This study was undertaken to investigate the association of ...haem, non-haem iron and total iron intake with metabolic syndrome and its components. A cross-sectional population-based survey was performed in 2008, enrolling 591 adults and elderly adults living in São Paulo, Brazil. Dietary intake was measured by two 24 h dietary recalls. Metabolic syndrome was defined as the presence of at least three of the following: hypertension, hyperglycaemia, dyslipidaemia and central obesity. The association between different types of dietary iron and metabolic syndrome was evaluated using multiple logistic regression. After adjustment for potential confounders, a higher haem iron intake was positively associated with metabolic syndrome and with elevated triglyceride levels. A higher total iron intake was positively associated with hyperglycaemia. Non-haem iron intake was positively associated with hyperglycaemia in the fourth quintile. In conclusion, this study suggests that the different types of dietary iron are associated with metabolic syndrome, elevated triglyceride levels and hyperglycaemia. In addition, it emphasises the importance of investigating the roles of dietary iron in health outcomes, since its consumption may have different impacts on health.
To associate dietary patterns and food neophobia in low-income preschoolers.
This was a cross-sectional study using a semi-structured questionnaire for socio-demographic data, birth conditions and ...breast-feeding history. Food neophobia was assessed using an adapted version of the Child Food Neophobia Scale. Children's nutritional status was assessed using BMI-for-age and height-for-age Z-scores. Dietary patterns were estimated using a semi-quantitative FFQ through exploratory factor analysis. Multiple linear regression was used to test for an association between food neophobia and dietary pattern adherence.
Philanthropic childhood education schools in Aracaju, an urban community in northeastern Brazil, between July and December 2017.
Two hundred fourteen children aged 3-6 years and their parents.
The percentages of low/medium and high food neophobia among preschoolers were 85·9 % and 11·2 %, respectively. Children with high food neophobia more frequently consumed ultra-processed foods rich in sugars (snacks, filled and unfilled cookies and sweets), as well as protein-rich foods (white meat, cheese and yogurt). Three dietary patterns were identified (traditional, snacks and school snacks). Children with a high level of neophobia had lower adherence to traditional dietary patterns.
A high level of food neophobia among socially vulnerable preschoolers is an eating behaviour related to unhealthy eating and is associated with the poorest diet in typical foods.
The association of obesity and dietary patterns has been well documented in scientific literature; however, information on the impact of meal patterns on obesity is scarce. The objective of this ...study was to investigate the association of adherence to lunch patterns and body mass index (BMI) in a representative sample of individuals aged 20 years or older in Sao Paulo.
Data for 933 participants were retrieved from the Health Survey of São Paulo (ISA-Capital 2008), a cross-sectional population-based survey. The usual dietary intake of individuals with at least one 24-h recall was estimated by the Multiple Source Method. The definition of lunch was self-reported by the participant. Five lunch patterns were derived from twenty-two food groups by exploratory factor analysis: Traditional, Western, Sweetened juice, Salad, and Meats. To estimate the effect of lunch patterns on BMI, we used a generalized linear model with link identity and inverse Gaussian distribution. Analyses were adjusted by age, gender, household income per capita, physical activity levels, smoking status, alcohol consumption, total energy intake, and misreporting status.
The greater adherence to the traditional pattern at the lunch meal was associated with lower BMI, only in insufficiently active individuals (ß = -0.78; 95% CI -1.57; -0.02).
The traditional Brazilian lunch pattern might protect the insufficiently active individuals against obesity.
Excess body weight (EBW: overweight and obesity) has high and rising prevalence in Brazil. Up-to-date information about the distribution and changes in the prevalence of EBW and their associated ...factors are essential to determine target groups and to identify priority actions. The aim of this study was to investigate the associated factors and to determine the prevalence of overweight and obesity in the adolescent and adult population of the city of São Paulo in the years of 2003, 2008, and 2015, as well as to estimate the prediction for the next years.
Individuals aged 12 years and older from three editions of the Health Survey of São Paulo (ISA-Capital), a cross-sectional population-based survey, carried out in 2003 (n = 2144), 2008 (n = 2599), and 2015 (n = 3939), had their socioeconomic, anthropometric, and lifestyle data collected at households. Individuals were classified according to their age and BMI as: without excess body weight, overweight, or obese. Differences were evaluated through Pearson's Chi-square test and comparison of 95% CI. Generalized ordered logit models were used to evaluate factors associated to overweight/obesity and logistic regression models were used to predict their prevalence for the next years.
The prevalence (95% CI) of obesity in total population doubled: from 10% (8.0, 12.5) in 2003 to 19.2% (17.8, 20.6) in 2015. The main increase occurred in female adolescents from 2.5% (1.2, 5.3) to 11.2% (8.4, 14.7) and adults, from 9.2% (6.4, 13.1) to 22.3% (20.0, 24.8). Those with higher chance of having EBW were adults, those with higher income, and former smokers. The prevalence of EBW increased 31% from 2003 to 2008, and 126% from 2003 to 2015, when half of the population had EBW. If this pattern does not change, 77% of the population is expected to have EBW by 2030.
Our findings present up-to-date information about the distribution of EBW, which increased substantially over a short time and more prominently in specific groups. The factors associated with EBW may provide important information for decision makers and researchers to create or review the existing programs and interventions in order to decrease the trend for the next years.
Identifying which risk groups have a higher intake of branched chain amino acids (BCAA) is important for the planning of public policies. This study was undertaken to investigate BCAA consumption, ...the foods contributing to that consumption and their association with demographic, socioeconomic and lifestyle factors.
Data from the Health Survey of São Paulo, a cross-sectional population-based survey (
= 1662; age range 12-97 years), were used. Dietary intake was measured using 24-h dietary recalls. Baseline characteristics were collected. Associations between BCAA intake and demographic, socioeconomic and lifestyle factors were determined using linear regression.
Total BCAA intake was 217.14 mg/kg·day (Leu: 97.16 mg/kg·day; Ile: 56.44 mg/kg·day; Val: 63.54 mg/kg·day). BCAA intake was negatively associated with female sex in adolescents and adult groups, with no white race in adolescents, and with former smoker status in adults. Conversely, BCAA was positively associated with household per capita income in adolescents and adults. No associations were observed in the older adults group. Main food contributors to BCAA were unprocessed red meat, unprocessed poultry, bread and toast, beans and rice.
Adolescents and adults were the most vulnerable to having their BCCA intake influenced by demographic, socioeconomic and lifestyle factors.
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•Zinc deficiency did not influence the height-for-age or BMI-for-age in children.•Dietary zinc, phytate and phytate:zinc molar ratio is similar between children with or without zinc ...deficiency.•Dietary zinc intake did not influence the ZnT1 and ZIP4 whole blood mRNA.•ZnT1 mRNA expression in whole blood is higher among children with plasma zinc deficiency.•ZIP4 mRNA expression in whole blood is lower among children with plasma zinc deficiency.
Subclinical deficiency of zinc is associated with impairment of immune system function, growth, and cognitive development in children. Although plasma zinc is the best available biomarker of the risk of zinc deficiency in populations, its sensitivity for early detection of deficiency is limited. Therefore, we aimed to investigate zinc deficiency among preschool children and its relationship with whole blood gene expression of zinc transporters ZIP4 and ZnT1.
This cross-sectional study included 139 children aged 32–76 months enrolled in philanthropic day-care centers. We performed an anthropometric evaluation, weighed food record and dietary record for dietary assessment, blood sample collection for zinc, and whole blood gene expression analyses of ZnT1 (SLC30A1) and ZIP4 (SLC39A4).
Zinc deficiency was observed in 26.6 % of the children despite adequate zinc intake and a phytate:zinc molar ratio < 18. Usual zinc intake did not affect whole blood gene expression of zinc transporters, but zinc status influenced ZnT1 and ZIP4 whole blood mRNA. Children with zinc deficiency exhibited 37.1 % higher ZnT1 expression and 45.3 % lower ZIP4 expression than children with adequate zinc (p < 0.05).
Children with plasma zinc deficiency exhibited higher expression of ZnT1 and lower expression of ZIP4 in whole blood mRNA, reinforcing the existence of strong regulation of mineral homeostasis according to the nutritional status, indicating that this analysis may be useful in the evaluation of dietary interventions.
To describe the dietary patterns of children inside and outside school and investigate their associations with sociodemographic factors and nutritional status.
This was a multicenter cross-sectional ...study in which children of both sexes, aged 1–6 years, attending private and public daycare centers and preschools in Brazil, were evaluated (n=2979). Demographic, socioeconomic and dietary data (weighed food records and estimated food records) were collected. Dietary patterns were derived by factor analysis from 36 food groups.
Four dietary patterns were identified inside school, and three outside. Inside school, the “traditional” pattern was associated to low income and presented high nutritional quality. The “dual” pattern was associated with low income and with high intake of added sugar and glycemic load. The “snack” pattern was associated with children enrolled at private schools and with high intake of added sugar and glycemic load. The “bread and butter” pattern was associated with high intake of added sugar and trans fat. Outside school, the “traditional” pattern was associated with high intake of saturated fat, trans fats, sodium, and total fiber. The “bread and butter” pattern was associated with high intake of trans fats and glycemic load, whereas the “snack” pattern was associated with overweight, private schools, high income, and high intake of trans fats, sodium, and total fiber.
There are differences in the nutritional quality of dietary patterns inside and outside school, and heterogeneity in adherence to these patterns were observed across regions and socioeconomic classes.
Descrever os padrões alimentares de crianças dentro e fora da escola e investigar a sua associação com fatores sociodemográficos e estado nutricional.
Trata-se de um estudo multicêntrico transversal, no qual foram avaliadas crianças de 1 a 6 anos de ambos os sexos, atendidas em creches públicas e privadas e pré-escolas no Brasil (n=2979). Foram coletados dados demográficos, socioeconômicos e dietéticos. Os padrões alimentares foram derivados por análise fatorial a partir de 36 grupos de alimentos.
Quatro padrões alimentares foram identificados dentro da creche e três fora da creche. Dentro da creche, o padrão “tradicional” foi associado a menor renda e apresentou melhor qualidade nutricional. O padrão “dual” associou-se a menor renda e maior ingestão de açúcar de adição e carga glicêmica. O padrão “lanches” foi associado a crianças matriculadas em escolas privadas e com maior ingestão de açúcar de adição e carga glicêmica. O padrão “pão com manteiga” associou-se a maior ingestão de açúcar de adição e gordura trans. Fora da creche, o padrão “tradicional” foi associado a maior ingestão de gordura saturada, trans, sódio e fibra. O padrão “pão com manteiga” associou-se a maior ingestão de gordura trans e carga glicêmica, enquanto o padrão “lanches” associou-se às crianças com excesso de peso, de creches privadas, maior renda e com maior ingestão de gordura trans, sódio e fibra.
Houve diferença na qualidade nutricional dos padrões dentro e fora da escola e a aderência a esses ocorreu de forma heterogênea nas regiões e classes socioeconômicas.
To assess Fe intake, calculate the prevalence of inadequate Fe intake and identify food contributors to Fe intake during 2003 and 2008 in a population-based study, reflecting before and after the ...mandatory fortification of flour with Fe.
Two cross-sectional population-based studies conducted in 2003 and 2008. Dietary intake was evaluated by 24 h recall and the Software for Intake Distribution Estimation (PC-SIDE) was used to estimate within-person variance and prevalence of inadequate Fe intake. The statistical analysis was conducted considering the complex survey design.
São Paulo, Brazil.
Adolescents, adults and elderly adults of both sexes, interviewed in 2003 (n 2386) and 2008 (n 1661).
The Fe intake mean increased in all populations in the post-fortification period. A reduction of over 90 % was observed in the prevalence of inadequate Fe intake among men for all age groups analysed. When evaluating women, despite the substantial reduction (over 63 %), prevalence of inadequate Fe intake remained high (34 %) in those aged 19-50 years. Major food contributors to Fe intake before fortification were beans, beef, vegetables and dairy. There was an alteration in the contributors in the post-fortification period, with bread, beef, beans and biscuits as main contributors.
The mandatory fortification with Fe significantly furthered the reduction in the prevalence of inadequacy, except among women of reproductive age, and changed the main contributors to this nutrient in the studied population. Therefore, monitoring of Fe addition in flour is essential to assess compliance to the fortified flour policy and to guarantee a safe Fe intake for all the population.
Physical activity levels during the COVID-19 pandemic have been decreasing and this may be a risk factor for development of emotional eating and its associated factors. The aim of the study was to ...analyze the factors associated with emotional eating among individuals with different physical activity levels during the COVID-19 pandemic. Data relating to the pandemic on physical activity, emotional eating, sociodemographic data, perceptions about lifestyle habits, body satisfaction, and perceptions about eating habits and food consumption were collected. Factors associated with emotional eating in the group of active and inactive individuals were observed using multiple linear regression controlled for age, sex, BMI, and monthly income. Emotional eating for the active group was associated with perceived stress, body dissatisfaction, and increased consumption of sweets and desserts. In addition to these factors found among the active group, working or studying >8 h/day, sleep worsening, increased amount of food consumed, increased purchase of food through delivery, and increased vegetable consumption were also associated with emotional eating for the inactive group. These findings suggest a potential protective role of physical activity in the appearance of factors associated with emotional eating during the COVID-19 pandemic.
Introduction: the simultaneous increase in the prevalence of cardiometabolic diseases and in the consumption of ultraprocessed foods (UPF) suggests a possible relationship between UPF and ...cardiometabolic risk (CMR). Objective: to evaluate the association between food consumption, according to the degree of processing, and CMR in young adults. Methods: this is a comparative cross-sectional study in 120 Brazilian young adults aged 18-25 years, categorized by the presence of CMR. Food consumption was investigated using a semi-quantitative food frequency questionnaire, and classified according to the extent of food processing. Food groups and tertiles in grams of unprocessed, minimally processed (MPF), processed and ultra-processed foods (UPF) were compared using the Kruskal-Wallis test. The associations of food consumption, according to level of processing (MPF and UPF), with CMR components were evaluated using logistic regression models. Results: a high caloric contribution of UPF was observed in the diet of this study population. The total energy intake from lipids in all foods (p = 0.04) and in UPF (p = 0.03) was greater in the group with CMR. A greater consumption of UPF was a risk factor for abdominal obesity (OR = 1.09; 95 % CI = 1.00-1.18) while a greater consumption of MPF was protective for LDL-c alterations independently of sex, physical activity, and alcohol intake (OR = 0.70; 95 % CI = 0.50-0.98). Conclusions: UPF contributed to a greater caloric intake from fat in the CMR, and was a risk factor for abdominal obesity. MPF was an independent protective factor for LDL-c alterations.