Aline Martins de Carvalho

Excessive meat consumption in Brazil: diet quality and environmental impacts.

OBJECTIVE To evaluate red and processed meat intake, and the impact meat consumption has on diet quality and the environment. DESIGN A large cross-sectional health survey performed in São Paulo, Brazil. SETTING Diet was assessed by two 24 h dietary recalls. Usual intakes were calculated using the Multiple Source Method. The World Cancer Research Fund recommendation of an average of 71.4 g/d was used as the cut-off point to estimate excessive red and processed meat consumption. To investigate the relationship between meat consumption and diet quality we used the Brazilian Healthy Eating Index Revised. The environmental impact was analysed according to estimates of CO2 equivalent emissions from meat consumption. SUBJECTS Brazilians (n 1677) aged 19 years and older were studied. RESULTS The mean red and processed meat intake was 138 g/d for men and 81 g/d for women. About 81% of men and 58% of women consumed more meat than recommended. Diet quality was inversely associated with excessive meat intake in men. In Brazil alone, greenhouse gas emissions from meat consumption, in 2003, were estimated at approximately 18,071,988 tonnes of CO2 equivalents, representing about 4% of the total CO2 emitted by agriculture. CONCLUSIONS The excessive meat intake, associated with poorer diet quality observed, support initiatives and policies advising to reduce red and processed meat intake to within the recommended amounts, as part of a healthy and environmentally sustainable diet.

Meat Consumption in Sao Paulo – Brazil: Trend in the Last Decade

Objective To characterize trends in meat consumption, and verify the percentage of excessive red and processed meat consumption in the last decade in São Paulo, Brazil. Design Cross-sectional weighted data from the Health Survey for São Paulo, conducted in São Paulo, Brazil among people aged 12 years and older. Setting Diet was assessed by two 24-hour recalls in each survey. Usual meat consumption was estimated by Multiple Source Method. Wald tests were used to compare means across survey years. Data were collected from adolescents, adults, and elderly using a representative, complex, multistage probability-based survey in 2003 and in 2008 in São Paulo, southeast of Brazil. Subjects 2631 Brazilians were studied in 2003 and 1662 in 2008. Results Daily mean of red and processed meat consumption was 100 g/day in 2003, and 113 g/day in 2008. Excessive red and processed meat consumption was observed in almost 75% of the subjects, especially among adolescents in both surveys. Beef represented the largest proportion of meat consumed, followed by poultry, pork and fish in both surveys. Conclusions Daily red and processed meat consumption was higher in 2008 than in 2003, and almost the entire population consumed more than what is recommended by World Cancer Research Fund. Public health strategies are needed, in order to reduce red and processed meat consumption to the recommended amounts, for a healthy diet.

Validation and calibration of self-reported weight and height from individuals in the city of São Paulo

OBJECTIVE To evaluate the validity of self-reported weight and height measurements among residents of São Paulo, as well as the accuracy of these measurements for determining nutritional status, and to present calibration coefficients. METHODS A cross-sectional, population-based study was performed with a sample of 299 adolescents, adults and elderly of both genders, in São Paulo in 2008. Bland-Altman difference plot and intraclass correlation were used to determine agreement between measured and self-reported parameters. Sensitivity and specificity were assessed for overweight, and calibration coefficients were estimated for correction of weight, height and body mass index data. RESULTS The intraclass correlation was high between self-reported and measured parameters for weight (r > 0,94) and body mass index (BMI) (r > 0,85). The agreement between measured and self-reported weight, height and BMI was good. Sensibility was > 91% and specificity was > 83%. CONCLUSION Self-reported weight measurements can substitute measured parameters in this population, in both genders and in the age groups studied. Self-reported height measurements should be used with caution. Calibration coefficients can be used to adjust self-reported measurements.

Validity and reproducibility of a food frequency questionnaire for adults of São Paulo, Brazil.

OBJECTIVES To assess the validity and reproducibility of a food frequency questionnaire developed for estimating the food consumption of adults in São Paulo, Brazil, based population study. METHODS A sample of individuals aged above 20 years, of both genders, living in São Paulo, was used for the validation study (n = 77) and reproducibility study (n = 74) of the food frequency questionnaire. To verify the validity and reproducibility of energy and 19 nutrients were applied two food frequency questionnaires (60 items) and three 24-hour dietary recalls (24HR - reference method). The validity was verified by Spearman correlation coefficient (crude and de-attenuated) and weighted Kappa, and reproducibility by intraclass correlation coefficients and weighted kappa. RESULTS In analyzes of validity de-attenuated correlation coefficients ranged from 0.21 (carbohydrate) to 0.74 (energy), and weighted kappa exceeded 0.40 for 30% of the nutrients. Polyunsaturated fat and folate did not show significant correlation and weighted kappa. In reproducibility correlation coefficients ranged from 0.36 (polyunsaturated fat) to 0.69 (calcium), and weighted kappa exceeded 0.40 for 80% of the nutrients. CONCLUSION The food frequency questionnaire analyzed has good validity and reproducibility for estimating the food consumption of adults in São Paulo compared to the reference method, so it is an appropriate instrument to be used in epidemiological studies on similar populations. Estimates of polyunsaturated fat and folate should be interpreted with caution.

High intake of heterocyclic amines from meat is associated with oxidative stress.

High meat intake has been related to chronic diseases such as cancer and CVD. One hypothesis is that heterocyclic amines (HCA), which are formed during the cooking process of meat, can generate reactive species. These compounds can cause oxidation of lipids, proteins and DNA, resulting in oxidative stress, cell damage and loss of biological function. This association has been seen in vitro; however, it remains unclear in vivo. The aim of the present study was to investigate the association between oxidative stress and HCA intake, and oxidative stress and meat intake. Data were from the Health Survey for Sao Paulo--ISA-Capital (561 adult and elderly). Food intake was estimated by one 24-h dietary recall (24HR) complemented by a detailed FFQ with preferences of cooking methods and level of doneness for meat. HCA intake was estimated linking the meat from the 24HR to a database of HCA. Oxidative stress was estimated by malondialdehyde (MDA) concentration in the plasma, after derivatisation with thiobarbituric acid and quantification by HPLC/diode array. Analyses were performed using multivariate logistic regressions adjusted for smoking, sex, age, BMI, skin colour, energy intake, fruit and vegetable intake, and physical activity. A positive association between HCA intake and MDA concentration (OR 1·17; 95% CI 1·01, 1·38) was observed, showing that HCA from meat may contribute to increase oxidative stress, and may consequently increase the risk of chronic diseases.

Adesao ao guia alimentar para populacao brasileira

OBJECTIVE : To analyze adherence to the Food Guide for the Brazilian Population. METHODS : Sample composed of participants in the Health Survey for Sao Paulo (n = 1,661) who completed two non-consecutive 24-hour recalls. A bivariate mixed model was created for the ratio of energy from a food group and total energy intake. The estimated ratio was used to calculate the percentage of individuals with intake above or below the recommendation. RESULTS : At least 80.0% of the individuals consume below the recommendation for milk and dairy; fruit and fresh juice; and cereals, tubers and roots; about 60.0% for vegetables; 30.0% for beans; and 8.0% for meat and eggs. Adolescents had the greatest inadequacy for vegetables (90.0%), and the highest income group had the lowest inadequacy for oils, fat and seeds (57.0%). CONCLUSIONS : The intake of food groups related to increased risk of chronic diseases were found to be inadequate.OBJECTIVE To analyze adherence to the Food Guide for the Brazilian Population. METHODS Sample composed of participants in the Health Survey for Sao Paulo (n = 1,661) who completed two non-consecutive 24-hour recalls. A bivariate mixed model was created for the ratio of energy from a food group and total energy intake. The estimated ratio was used to calculate the percentage of individuals with intake above or below the recommendation. RESULTS At least 80.0% of the individuals consume below the recommendation for milk and dairy; fruit and fresh juice; and cereals, tubers and roots; about 60.0% for vegetables; 30.0% for beans; and 8.0% for meat and eggs. Adolescents had the greatest inadequacy for vegetables (90.0%), and the highest income group had the lowest inadequacy for oils, fat and seeds (57.0%). CONCLUSIONS The intake of food groups related to increased risk of chronic diseases were found to be inadequate.

Thyroid hormone treatment decreases hepatic glucose production and renal reabsorption of glucose in alloxan‐induced diabetic Wistar rats

The thyroid hormone (TH) plays an important role in glucose metabolism. Recently, we showed that the TH improves glycemia control by decreasing cytokines expression in the adipose tissue and skeletal muscle of alloxan‐induced diabetic rats, which were also shown to present primary hypothyroidism. In this context, this study aims to investigate whether the chronic treatment of diabetic rats with T3 could affect other tissues that are involved in the control of glucose homeostasis, as the liver and kidney. Adult Male Wistar rats were divided into nondiabetic, diabetic, and diabetic treated with T3 (1.5 μg/100 g BW for 4 weeks). Diabetes was induced by alloxan monohydrate (150 mg/kg, BW, i.p.). Animals showing fasting blood glucose levels greater than 250 mg/dL were selected for the study. After treatment, we measured the blood glucose, serum T3, T4, TSH, and insulin concentration, hepatic glucose production by liver perfusion, liver PEPCK, GAPDH, and pAKT expression, as well as urine glucose concentration and renal expression of SGLT2 and GLUT2. T3 reduced blood glucose, hepatic glucose production, liver PEPCK, GAPDH, and pAKT content and the renal expression of SGLT2 and increased glycosuria. Results suggest that the decreased hepatic glucose output and increased glucose excretion induced by T3 treatment are important mechanisms that contribute to reduce serum concentration of glucose, accounting for the improvement of glucose homeostasis control in diabetic rats.

Folate and nutrients involved in the 1-carbon cycle in the pretreatment of patients for colorectal cancer

To assess the ingestion of folate and nutrients involved in the 1-carbon cycle in non-treated patients with colorectal adenocarcinoma in a reference center for oncology in southeastern Brazil. In total, 195 new cases with colorectal adenocarcinoma completed a clinical evaluation questionnaire and a Food Frequency Questionnaire (FFQ). Blood samples from 161 patients were drawn for the assessment of serum folate. A moderate correlation was found between serum concentrations of folate, folate intake and the dietary folate equivalent (DFE) of synthetic supplements. Mulatto or black male patients with a primary educational level had a higher intake of dietary folate. Of patients obtaining folate from the diet alone or from dietary supplements, 11.00% and 0.10%, respectively, had intake below the recommended level. Of the patients using dietary supplements, 35% to 50% showed high levels of folic acid intake. There was a prevalence of inadequacy for vitamins B2, B6 and B12, ranging from 12.10% to 20.18%, while 13.76% to 22.55% of patients were likely to have adequate choline intake. The considerable percentage of patients with folate intake above the recommended levels deserves attention because of the harmful effects that this nutrient may have in the presence of established neoplastic lesions.

Adherence to the food guide for the Brazilian population

OBJECTIVE : To analyze adherence to the Food Guide for the Brazilian Population. METHODS : Sample composed of participants in the Health Survey for Sao Paulo (n = 1,661) who completed two non-consecutive 24-hour recalls. A bivariate mixed model was created for the ratio of energy from a food group and total energy intake. The estimated ratio was used to calculate the percentage of individuals with intake above or below the recommendation. RESULTS : At least 80.0% of the individuals consume below the recommendation for milk and dairy; fruit and fresh juice; and cereals, tubers and roots; about 60.0% for vegetables; 30.0% for beans; and 8.0% for meat and eggs. Adolescents had the greatest inadequacy for vegetables (90.0%), and the highest income group had the lowest inadequacy for oils, fat and seeds (57.0%). CONCLUSIONS : The intake of food groups related to increased risk of chronic diseases were found to be inadequate.OBJECTIVE To analyze adherence to the Food Guide for the Brazilian Population. METHODS Sample composed of participants in the Health Survey for Sao Paulo (n = 1,661) who completed two non-consecutive 24-hour recalls. A bivariate mixed model was created for the ratio of energy from a food group and total energy intake. The estimated ratio was used to calculate the percentage of individuals with intake above or below the recommendation. RESULTS At least 80.0% of the individuals consume below the recommendation for milk and dairy; fruit and fresh juice; and cereals, tubers and roots; about 60.0% for vegetables; 30.0% for beans; and 8.0% for meat and eggs. Adolescents had the greatest inadequacy for vegetables (90.0%), and the highest income group had the lowest inadequacy for oils, fat and seeds (57.0%). CONCLUSIONS The intake of food groups related to increased risk of chronic diseases were found to be inadequate.

Excessive red and processed meat intake: relations with health and environment in Brazil

The aims of the present study were to verify the proportion of population that consumed more red and processed meat than the World Cancer Research Fund (WCRF) dietary recommendation, to estimate the environmental impact of beef intake and the possible reduction of greenhouse gas emissions if the dietary recommendation was followed. We used the largest, cross-sectional, population-based survey entitled the National Dietary Survey (34 003 participants aged 10-104 years). The usual meat intake was obtained by two food records completed on 2 non-consecutive days. The usual intake was estimated by the multiple source method. The environmental impact was analysed according to estimates of CO2 equivalent emissions from beef intake as a proxy for beef production in Brazil. The red and processed meat intake mean was 88 g/d. More than 80 % of the population consumed more red and processed meat than the WCRF recommendation. Beef was the type of meat most consumed, accounting to almost 50 %. Each person contributed 1005 kg of CO2 equivalents from beef intake in 2008, the same quantity of CO2 produced if a car travelled a distance between the extreme north and south of Brazil (5370 km). The entire Brazilian population contributed more than 191 million tons of CO2 equivalents, which could have been reduced to more than 131 million tons if the dietary recommendation was followed. The present study shows that the magnitude of the excessive red and processed meat intake in Brazil can impact on health and the environment, pointing to the urgency of promoting a sustainable diet.