Juliana Araujo Teixeira

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.

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.

Prevalência de omissão do café da manhã e seus fatores associados em adolescentes de São Paulo: estudo ISA-Capital

Objective: To describe the patterns of food intake for breakfast, the prevalence of omission of this meal, its relative share in the total intake of energy and nutrients, and the factors associated with its omission. Methods: A population-based, cross-sectional study (ISA - Capital) with 795 adolescents. The prevalence of omission of breakfast was analyzed using Chi-square test and Poisson regression considering a significance level of 5%. Differences in the intake of energy and nutrients among adolescents who omit and have breakfast was determined by the Student’s t-test and differences in the relative share of breakfast were verified by the test of proportion. The pattern of consumption of breakfast was investigated by factor analysis. Results: The prevalence of omission of breakfast was 38%, higher among female adolescents. The energy contribution of breakfast was 23%, with contribution in vitamins ranging from 17% in vitamin C, for males, up to 37% in vitamin A and D, for females. Through factor analysis, 12 food groups consumed for breakfast were characterized in five factors that demonstrate a pattern of consumption. Conclusion: The results show the need for actions that promote regular consumption and selection of appropriate food for this meal

Calibration of the dietary data obtained from the Brazilian center of the Natural History of HPV Infection in Men study: the HIM Study

The objective of this study was to estimate the regressions calibration for the dietary data that were measured using the quantitative food frequency questionnaire (QFFQ) in the Natural History of HPV Infection in Men: the HIM Study in Brazil. A sample of 98 individuals from the HIM study answered one QFFQ and three 24-hour recalls (24HR) at interviews. The calibration was performed using linear regression analysis in which the 24HR was the dependent variable and the QFFQ was the independent variable. Age, body mass index, physical activity, income and schooling were used as adjustment variables in the models. The geometric means between the 24HR and the calibration-corrected QFFQ were statistically equal. The dispersion graphs between the instruments demonstrate increased correlation after making the correction, although there is greater dispersion of the points with worse explanatory power of the models. Identification of the regressions calibration for the dietary data of the HIM study will make it possible to estimate the effect of the diet on HPV infection, corrected for the measurement error of the QFFQ.

Calibration of Dietary Data: “Folate and Nutrients Involved in the 1-Carbon Cycle in the Pretreatment of Patients for Colorectal Adenocarcinoma in a Referral Center for Oncology in Southeastern Brazil”

Objective: Calibrate the FFQ and evaluate its performance in relation to the consumption of energy, carbohydrate, protein, fat, alcohol, folate, vitamin B2, vitamin B6, vitamin B12, methionine, choline and betaine in the study population “Folate and nutrients involved in the 1-carbon cycle in the pretreatment of patients for colorectal adenocarcinoma in a referral center for oncology in southeastern Brazil.Materials and methods: For calibration, we used three 24-hour dietary recalls (R24s; n=270) and the second FFQ (n=90) collected in a previous study. The R24 data were used as a reference method and subjected to linear regression, with β1 values used as a calibration factor for the FFQ data collected.Results: Comparing the R24 data to observed FFQ data and observed FFQ data to calibrated FFQ data; the means were significantly different for all nutrients. When comparing calibrated FFQ data to R24 values, the means were statistically similar for carbohydrates, vitamin B2, vitamin B6, natural folate, synthetic folate, DFE diet and betaine.Conclusion: The calibration coefficients were low, however the reference method used may not have been the best way to eliminate measurement errors found in the FFQ.

Lunch quality and sociodemographic conditions between Brazilian regions

The objective of this study was to assess the quality of lunch consumed by adults in Brazil and its sociodemographic determinants in each Brazilian region. A cross-sectional study was carried out and a representative sample of regional populations was used. The sample comprised of 16,096 adults from the Brazilian National Dietary Survey, part of the Brazilian Household Budget Survey (POF). The lunch quality was evaluated by applying the main meal quality index (MMQI), comprised of 10 items of equal weights that resulted in a score that ranged from zero to 100 points. Linear regression models measured the association between lunch quality and sociodemographic factors. The average energy consumption at lunch was 704kcal (SD = 300), and the meal quality score mean was 57 points (SE = 0.30). The North Region had the worst MMQI score (56 points, SE = 0.07), while the Central had the best MMQI adjusted score (59 points, SE = 0.05). The MMQI final score was positively associated with male gender and ages between 20-39 years, and was inversely associated with having eight years or more of education, per capita income of at least three minimum wages, and with the consumption of meals prepared away from home. Despite differences among sociodemographic factors, all Brazilian regions had a lunch composed of foods rich in sugars and fats, with insufficient portions of fruits and vegetables, resulting in a low meal quality.

Dietary patterns in internal migrants in a continental country: A population-based study

Objective The objective of this study was to assess the differences and similarities in dietary patterns among migrants and natives. Methods A population-based, cross-sectional study was conducted in the city of São Paulo. The study population included internal migrants, defined as individuals born outside São Paulo city who had lived in the city for ten years or longer. The final population (n = 999) was divided into three groups: natives of São Paulo (n = 354), migrants from the Southeast (n = 349) and migrants from the Northeast (n = 296). Factor and principal component analysis was employed to derive dietary patterns. The standardized scores were compared among groups using linear regression. Results Differences in income per capita, years of education, self-reported race, smoking habits, alcohol consumption, nutritional status and prevalence of hypertension were found for place of birth. Three dietary patterns were identified: prudent (salad dressings, vegetables, natural flavorings, fruits, whole-grain bread, white cheeses and juices), traditional (rice, beans, bread/toast/crackers, butter/margarine, whole milk, coffee/teas, sugar), and modern (sodas, pastries/sandwiches/pizzas, yellow cheeses, pastas, sauces, alcoholic beverages, sweets, processed meats). Compared to natives, migrants from the Southeast had an inversely proportional adherence to the modern pattern whereas migrants from the Northeast had an inverse association with the prudent and modern patterns and a positive association with the traditional pattern. Conclusions São Paulo natives and internal migrants from other regions of Brazil exhibited different dietary patterns. The results presented here add perspectives to be considered in the study of non-communicable diseases and its different incidences among migrants and natives.

Dietary intake of selected nutrients and persistence of HPV infection in men

Human papillomavirus (HPV) infection is a common sexually transmitted disease. Although often transitory, persistent oncogenic HPV infection may progress to a precursor lesion and, if not treated, can further increase the risk of cancer. The purpose of this study was to investigate the relation between dietary intake and HPV persistent infection in men of a Brazilian cohort. The study population consisted of 1,248 men from the Brazilian cohort of the HIM (HPV in Men) Study, ages 18 to 70 years, who completed a quantitative food frequency questionnaire. U Mann‐Whitney test was used to assess differences in median nutrient intake of selected nutrients. The association of dietary intake and persistent HPV infection was assessed in multivariate logistic models. The prevalence of any HPV infection at baseline was 66.6%. Of 1,248 participants analyzed, 1,211 (97.0%) were HPV positive at one or more times during the 4 years of follow‐up and 781 (62.6%) were persistently HPV positive. Men with nonpersistent oncogenic HPV infections had higher median intake of retinol (p = 0.008), vitamin A (p < 0.001) and folate (DFE; p = 0.003) and lower median intake of energy (p = 0.005) and lycopene (p = 0.008) in comparison to men with persistent oncogenic infections. No significant association was found between selected nutrients and persistent oncogenic HPV infection. For nononcogenic persistent infections, only vitamin B12 intake was significantly associated (p = 0.003, test for trend). No association was observed between dietary intake and persistent oncogenic‐type HPV infection; however, vitamin B12 intake was inversely associated with nononcogenic HPV persistence.