Rafael Moreira Claro

Estimativa de consumo de sódio pela população brasileira, 2008-2009

OBJECTIVEnTo update estimates of sodium intake in Brazil.nnnMETHODSnWe used data from the Brazilian Household Budget Survey of 2008-2009. Records of food purchases of households were converted into nutrients using food composition tables. Mean sodium availability per person per day and mean adjusted availability for a 2,000 kcal daily energy intake were calculated. The contribution of food groups to the total household sodium availability was calculated and compared to results estimated from the 2002-2003 Household Budget Survey.nnnRESULTSnMean daily sodium available for consumption in Brazilian households was 4.7 g per 2,000 kcal per day, thus still more than twice the recommended levels of intake for this nutrient. Although most of the sodium available for intake is derived from table salt or salt-based condiments (74.4%), the fraction derived from processed foods with added salt showed a strong linear increase with household income (12.3% of total sodium intake in the lower quintile of per capita income distribution and 27.0% in the upper quintile). There was a reduction in the contribution of salt and salt-based condiments (76.2% to 74.4%) and fresh or processed foods without added salt (6.6% to 4.8%) and an increase of processed foods with added salt (15.8% to 18.9%) and ready meals (1.4% to 1.6%), when compared to results estimated from the 2002-2003 Household Budget Survey.nnnCONCLUSIONSnSodium intake in Brazil remains at levels above the recommended maximum for this nutrient in all Brazilian macro regions and income strata. There was stability in the total household sodium availability, and an increase in the fraction from processed foods with addition of salt and ready meals, when comparing 2008-2009 with 2002-2003.OBJETIVO: Atualizar estimativas sobre consumo de sodio no Brasil. METODOS: Foram utilizados dados da Pesquisa de Orcamentos Familiares 2008-2009. Realizou-se a conversao em nutrientes dos registros de aquisicao de alimentos dos domicilios brasileiros por meio de tabelas de composicao de alimentos. Foram calculadas a disponibilidade media de sodio/pessoa/dia e a disponibilidade media ajustada para um consumo energetico diario de 2.000 kcal. Calculou-se a contribuicao de grupos de alimentos selecionados para o total de sodio disponivel para consumo no domicilio e comparou-se com aqueles da Pesquisa de Orcamentos Familiares 2002-2003. RESULTADOS: A quantidade diaria de sodio disponivel para consumo nos domicilios brasileiros foi de 4,7 g para ingestao diaria de 2.000 kcal, mantendo-se mais de duas vezes superior ao limite recomendado de ingestao desse nutriente. A maior parte do sodio disponivel para consumo provem do sal de cozinha e de condimentos a base de sal (74,4%), mas a fracao proveniente de alimentos processados com adicao de sal aumentou linear e intensamente com o poder aquisitivo domiciliar (12,3% do total de sodio no quinto inferior da distribuicao da renda por pessoa e 27,0% no quinto superior). Observou-se reducao na contribuicao de sal e condimentos a base de sal (76,2% para 74,4%) e dos alimentos in natura ou processados sem adicao de sal (6,6% para 4,8%) e aumento dos alimentos processados com adicao de sal (15,8% para 18,9%) e dos pratos prontos (1,4% para 1,6%) na comparacao com a Pesquisa de Orcamentos Familiares 2002-2003. CONCLUSOES: O consumo de sodio no Brasil mantem-se em niveis acima da recomendacao maxima para esse nutriente em todas as macrorregioes e classes de renda brasileiras. Observou-se estabilidade na disponibilidade domiciliar total de sodio e aumento na fracao proveniente dos alimentos processados com adicao de sal e dos pratos prontos, na comparacao de 2008-2009 com 2002-2003.

Sociodemographic and behavioral factors associated with physical activity in Brazilian adolescents

BackgroundPhysical activity in adolescents is associated with short- and long-term health benefits. Physical activity can occur in various domains and is influenced by a complex network of factors. The aims of this study are 1) to describe the physical activity of Brazilian adolescents in physical education classes, during leisure time, and during active commuting and 2) to investigate the socio-demographic and behavioral factors associated with physical activity.MethodsThe representative sample included 109,104 Brazilian students in the final year of elementary school from 2,842 schools. The weekly frequency and duration of physical activity were assessed. A variety of socio-demographic and behavioral factors were studied. A multiple Poisson regression analysis was used to test for associations between physical activity and the socio-demographic and behavioral variables.ResultsMost of the students (97.0%) engaged in physical activity in at least one of the domains studied, especially physical education at school (81.7%) and leisure time physical activity (67.5%). However, only 29% of the adolescents reached the recommended level of physical activity. Among the adolescents who reached the minimum recommended time for physical activity, the various domains contributed the following proportions to total physical activity: leisure time physical activity (PR 12.5; 95% CI 11.17-13.97), active commuting (PR 1.63; 95% CI 1.59-1.67), and physical education at school (PR 1.36; 95% CI 1.29-1.44). The weekly frequency of all activities was greater among boys than among girls. Moreover, nearly two-thirds (61.8%) of students spent more than two hours per day engaging in sedentary behaviors; the prevalence of sedentary behaviors was similar between boys and girls (59.0 and 64.5%, respectively).Total level of physical activity, leisure time physical activity, and active commuting were associated with higher nutritional scores.ConclusionsPhysical activity is important in any health promotion program. Therefore, it is necessary to invest in policies and interagency initiatives that promote all domains and to ensure that the general population helps determine the scope and design of such policies.

Dietary intake of Brazilian adolescents

OBJECTIVEnTo analyse the dietary intake of Brazilian adolescents and investigate its association with sociodemographic factors as well as health-risk and health-protective behaviours.nnnDESIGNnCross-sectional study.nnnSETTINGnThe study was based on data supplied by the National Survey of Schoolchildrens Health (2012) on sociodemographic factors, dietary intake and health-risk and health-protective behaviours of schoolchildren in Brazil. A nutritional scale was elaborated combining markers of healthy and unhealthy diets. Poisson regression analysis was applied to investigate the association between the sociodemographic factors and regular intake (≥5 times/week) of selected foods; linear regression analysis was applied to investigate the association of sociodemographic and behavioural factors with nutritional scale score.nnnSUBJECTSnA total of 109 104 adolescents attending the ninth year of education at 2842 schools in Brazil.nnnRESULTSnFewer than 30 % of the adolescents consumed raw or cooked vegetables on a regular basis, whereas more than one-third reported regular intake of sweets, soft drinks and sweet biscuits. Adolescents from the southern area and the oldest ones were those most exposed to inadequate dietary intake. The nutritional scale average score was higher in the students attending public school and exhibited a positive correlation with protective behaviours, such as being physically active, having meals with parents and eating breakfast, and a negative correlation with risk behaviours such as eating while studying or watching television and having smoked, drunk alcohol or used other drugs in the previous 30 d.nnnCONCLUSIONSnThe results indicate an association between undesirable nutritional habits and other risk behaviours among Brazilian adolescents.

Prevalência de fatores de risco e proteção para doenças crônicas não transmissíveis em adultos: estudo transversal, Brasil 2012

OBJETIVO:descrever as prevalencias de fatores de risco e protecao para doencas cronicas na populacao adulta brasileira e analisar as diferencas segundo variaveis sociodemograficas.METODOS:estudo transversal com dados de 2012 do Sistema de Vigilância de Fatores de Risco e Protecao para Doencas Cronicas por Inquerito Telefonico (Vigitel), incluindo residentes nas capitais brasileiras com idade ≥18 anos; foram calculadas as prevalencias e respectivos intervalos de confianca de 95% (IC95%) segundo sexo, faixa etaria e escolaridade.RESULTADOS:entre 45.448 entrevistados, a prevalencia de tabagismo foi de 12,1% (IC95%: 11,5%-12,8%), inatividade fisica, 14,9% (IC95%: 14,2%-15,5%), consumo abusivo de bebidas alcoolicas, 18,4% (IC95%: 17,7%-19,2%), excesso de peso, 51,0°% (IC95%: 50,1%-51,9%) e obesidade, 17,4°% (IC95%: 16,7%-18,1%); os fatores de risco estudados estiveram associados a maior idade, sexo masculino e menor escolaridade.CONCLUSAO:a prevalencia dos fatores de risco e protecao apresenta diferencas segundo caracteristicas sociodemograficas, a serem consideradas nas estrategias de promocao da saude.

Trends in spending on eating away from home in Brazil, 2002-2003 to 2008-2009

The study aims to describe trends in food consumption away from home in Brazil from 2002-2003 to 2008-2009 and to analyze the influence of income on this behavior. The authors used data collected by the Household Budget Surveys conducted by the Brazilian Institute of Geography and Statistics (IBGE) in 2002-2003 and 2008-2009. The information analyzed in this study involves records of food and beverage purchases for consumption away from home. Trends in eating away from home were estimated for the total population and according to demographic and economic strata. The association between the share of food consumed away from home and income was studied using regression models to estimate income elasticity coefficients. The share of eating away from home increased 25% during the period, reaching 28% of total spending on food. Each 10% increase in mean per capita income leads to a 3.5% increase in the share of food consumed away from home. This suggests that income growth will result in future increases in the share of eating away from home.Abstract The study aims to describe trends in food con -sumption away from home in Brazil from 2002-2003 to 2008-2009 and to analyze the influence of income on this behavior. The authors used data collected by the Household Budget Sur-veys conducted by the Brazilian Institute of Ge-ography and Statistics (IBGE) in 2002-2003 and 2008-2009. The information analyzed in this study involves records of food and beverage pur-chases for consumption away from home. Trends in eating away from home were estimated for the total population and according to demo-graphic and economic strata. The association between the share of food consumed away from home and income was studied using regression models to estimate income elasticity coefficients. The share of eating away from home increased 25% during the period, reaching 28% of total spending on food. Each 10% increase in mean per capita income leads to a 3.5% increase in the share of food consumed away from home. This suggests that income growth will result in future increases in the share of eating away from home.Food Consumption; Nutrition Surveys; Income

Estimated sodium intake for the Brazilian population, 2008-2009

OBJECTIVEnTo update estimates of sodium intake in Brazil.nnnMETHODSnWe used data from the Brazilian Household Budget Survey of 2008-2009. Records of food purchases of households were converted into nutrients using food composition tables. Mean sodium availability per person per day and mean adjusted availability for a 2,000 kcal daily energy intake were calculated. The contribution of food groups to the total household sodium availability was calculated and compared to results estimated from the 2002-2003 Household Budget Survey.nnnRESULTSnMean daily sodium available for consumption in Brazilian households was 4.7 g per 2,000 kcal per day, thus still more than twice the recommended levels of intake for this nutrient. Although most of the sodium available for intake is derived from table salt or salt-based condiments (74.4%), the fraction derived from processed foods with added salt showed a strong linear increase with household income (12.3% of total sodium intake in the lower quintile of per capita income distribution and 27.0% in the upper quintile). There was a reduction in the contribution of salt and salt-based condiments (76.2% to 74.4%) and fresh or processed foods without added salt (6.6% to 4.8%) and an increase of processed foods with added salt (15.8% to 18.9%) and ready meals (1.4% to 1.6%), when compared to results estimated from the 2002-2003 Household Budget Survey.nnnCONCLUSIONSnSodium intake in Brazil remains at levels above the recommended maximum for this nutrient in all Brazilian macro regions and income strata. There was stability in the total household sodium availability, and an increase in the fraction from processed foods with addition of salt and ready meals, when comparing 2008-2009 with 2002-2003.OBJETIVO: Atualizar estimativas sobre consumo de sodio no Brasil. METODOS: Foram utilizados dados da Pesquisa de Orcamentos Familiares 2008-2009. Realizou-se a conversao em nutrientes dos registros de aquisicao de alimentos dos domicilios brasileiros por meio de tabelas de composicao de alimentos. Foram calculadas a disponibilidade media de sodio/pessoa/dia e a disponibilidade media ajustada para um consumo energetico diario de 2.000 kcal. Calculou-se a contribuicao de grupos de alimentos selecionados para o total de sodio disponivel para consumo no domicilio e comparou-se com aqueles da Pesquisa de Orcamentos Familiares 2002-2003. RESULTADOS: A quantidade diaria de sodio disponivel para consumo nos domicilios brasileiros foi de 4,7 g para ingestao diaria de 2.000 kcal, mantendo-se mais de duas vezes superior ao limite recomendado de ingestao desse nutriente. A maior parte do sodio disponivel para consumo provem do sal de cozinha e de condimentos a base de sal (74,4%), mas a fracao proveniente de alimentos processados com adicao de sal aumentou linear e intensamente com o poder aquisitivo domiciliar (12,3% do total de sodio no quinto inferior da distribuicao da renda por pessoa e 27,0% no quinto superior). Observou-se reducao na contribuicao de sal e condimentos a base de sal (76,2% para 74,4%) e dos alimentos in natura ou processados sem adicao de sal (6,6% para 4,8%) e aumento dos alimentos processados com adicao de sal (15,8% para 18,9%) e dos pratos prontos (1,4% para 1,6%) na comparacao com a Pesquisa de Orcamentos Familiares 2002-2003. CONCLUSOES: O consumo de sodio no Brasil mantem-se em niveis acima da recomendacao maxima para esse nutriente em todas as macrorregioes e classes de renda brasileiras. Observou-se estabilidade na disponibilidade domiciliar total de sodio e aumento na fracao proveniente dos alimentos processados com adicao de sal e dos pratos prontos, na comparacao de 2008-2009 com 2002-2003.

Food environments in schools and in the immediate vicinity are associated with unhealthy food consumption among Brazilian adolescents.

BACKGROUNDnEvidence of the influence of the school food environment on adolescent diet is still little explored in low- and middle-income countries. We aimed to evaluate the association between food environment in schools and the immediate vicinity and the regular consumption of unhealthy food among adolescents.nnnMETHODSnWe used cross-sectional data collected by the Brazilian National Survey of School Health (PeNSE) from a representative sample of adolescents attending 9th grade public and private schools in Brazil, in 2012. We estimated students regular consumption (>5days/week) of unhealthy food (soft drinks, bagged salty snacks, deep fried salty snacks and sweets) and school availability, in the cafeteria or an alternative outlet, of the same food plus some healthy options (fruit and natural fruit juice). We performed multilevel logistic regression models.nnnRESULTSnHaving a cafeteria inside school selling soft drinks (private schools OR=1.23; 95% CI=1.14-1.33; public schools OR=1.13; 95% CI=1.06-1.20) and deep fried salty snacks (private schools OR=1.41 95% CI=1.26-1.57; public schools OR=1.16 95% CI=1.08-1.24) was associated with a higher consumption of these unhealthy foods of among students. In private schools, cafeteria selling fruit and natural fruit juice was associated with lower student consumption of bagged salty snacks (OR=0.86; 95% CI 0.77-0.96) and soft drinks (OR=0.85; 95% CI=0.76-0.94). In addition, eating meals from the Brazilian School Food Program in public schools was associated with a lower consumption of unhealthy foods.nnnCONCLUSIONSnFoods available in the school food environment are associated with the consumption of unhealthy food among adolescents in Brazil.

Fatores de risco e proteção para doenças crônicas por inquérito telefônico nas capitais brasileiras, Vigitel 2014

Objective: To describe the prevalence of risk and protective factors for chronic diseases in Brazilian adult population in 2014 and investigate the associated sociodemographic factors. Methods: Analyses were performed based on data from telephone interviews (Vigitel 2014) on probabilistic samples of adult population (≥ 18 years old) from the capitals of the 26 Brazilian States and the Federal District, living in households with landline phones. Prevalence is presented by gender, age and educational level, and adjusted prevalence ratios (PR) are estimated using Poisson Regression model. Results: Among the 40.853 adults who were interviewed, 10.8% were smokers and 21.2% ex-smokers. Among the respondents, 16.5% reported alcohol abuse and 52.5% were overweight, factors that were more frequent among men. The prevalence of recommended intake of fruits and vegetables was 24%, intake of sweets was 18.1% and replacements of main meals for snacks was 16.2%, factors that were higher among women. Leisure time physical activity reached 35.3% and increased with the level of education. Hypertension was the most frequent disease achieving 24.8%, which was higher among women and increased with age. Conclusion: The results from Vigitel 2014 indicate that risk factors are, in general, more frequent among men, older adults and less educated individuals, characterizing the socioeconomic and cultural dimensions in determining chronic diseases.OBJECTIVEnTo describe the prevalence of risk and protective factors for chronic diseases in Brazilian adult population in 2014 and investigate the associated sociodemographic factors.nnnMETHODSnAnalyses were performed based on data from telephone interviews (Vigitel 2014) on probabilistic samples of adult population (≥ 18 years old) from the capitals of the 26 Brazilian States and the Federal District, living in households with landline phones. Prevalence is presented by gender, age and educational level, and adjusted prevalence ratios (PR) are estimated using Poisson Regression model.nnnRESULTSnAmong the 40.853 adults who were interviewed, 10.8% were smokers and 21.2% ex-smokers. Among the respondents, 16.5% reported alcohol abuse and 52.5% were overweight, factors that were more frequent among men. The prevalence of recommended intake of fruits and vegetables was 24%, intake of sweets was 18.1% and replacements of main meals for snacks was 16.2%, factors that were higher among women. Leisure time physical activity reached 35.3% and increased with the level of education. Hypertension was the most frequent disease achieving 24.8%, which was higher among women and increased with age.nnnCONCLUSIONnThe results from Vigitel 2014 indicate that risk factors are, in general, more frequent among men, older adults and less educated individuals, characterizing the socioeconomic and cultural dimensions in determining chronic diseases.

Validade de indicadores de atividade física e comportamento sedentário da Pesquisa Nacional de Saúde do Escolar entre adolescentes do Rio de Janeiro, Brasil

This study evaluated the relative validity of physical activity indicators from the questionnaire used in the Brazilian National School-Based Health Survey (PeNSE) in the city of Rio de Janeiro, Brazil, based on a sample of 174 students. The following indicators of weekly physical activity were evaluated: ACTIVE-300MIN (≥ 300 minutes/week); ACTIVE-150MIN (≥ 150 minutes), INACTIVE (no physical activity). Additionally, indicators of sedentary behavior were also assessed, as daily screen time (TV, videogames, and computer). The results from the questionnaire were compared with three 24-hour recalls. The results of ACTIVE-300MIN, ACTIVE-150MIN, and INACTIVE generated by PeNSE showed high accuracy. These indicators performed better than those of sedentary behavior in relation to frequency estimates as well as sensitivity, specificity, and correct classification rate. The indicators of physical activity from PeNSE showed satisfactory relative validity.Analisou-se a validade relativa dos indicadores de atividade fisica do questionario utilizado na Pesquisa Nacional de Saude do Escolar (PeNSE) entre adolescentes da cidade do Rio de Janeiro, Brasil. Foram estudados 174 alunos. Avaliaram-se os seguintes indicadores referentes ao tempo semanal acumulado com a pratica de atividade fisica: ATIVO-300MIN (acumulou 300 minutos ou mais); ATIVO-150MIN (acumulou 150 minutos ou mais); INATIVO (nao praticou atividade fisica). Tambem foram estudados os indicadores de comportamento sedentario referentes ao tempo diario despendido assistindo TV, jogando videogame e usando computador. Foram comparados os resultados do questionario e dos tres recordatorios de 24 horas. Os resultados de ATIVO-300MIN, ATIVO-150MIN e INATIVO gerados pela PeNSE apresentaram alta acuracia. Esses indicadores tiveram melhor desempenho que os de comportamento sedentario, tanto em relacao as estimativas de frequencia quanto em relacao a sensibilidade, especificidade e indice de acuracia. Os indicadores de atividade fisica da PeNSE apresentaram validade relativa satisfatoria.

Dietary patterns of Brazilian adolescents: results of the Brazilian National School-Based Health Survey (PeNSE)

The objectives of this study were to identify dietary patterns in Brazilian adolescents, describe their distributions in Brazils State capitals and Federal District, and analyze the correlations with the Municipal Human Development Index (HDI-M). The study analyzed a sample of 60,954 ninth-graders from public and private schools who participated in the National School-Based Health Survey (PeNSE) in 2009. Cluster analysis was used to characterize dietary patterns. Three patterns were identified: healthy (27.7%), unhealthy (34.6%), and mixed (37.7%). Adolescents in the countrys Southeast, South, and Central West regions showed a higher proportion of the healthy eating pattern. HDI-M showed a positive correlation with the healthy pattern and a negative correlation with the mixed pattern. The identification of different dietary patterns within and between regions and according to HDI-M highlights the need for better knowledge of each local context in terms of both the magnitude of events and the examination of determinants within these different realities.Abstract The aims of this study were to identify the dietary patterns of adolescents, describe their distribu-tion in the 26 Brazilian capitals and Federal District and analyze its association with the Mu-nicipal Human Development Index (IDH-M). Were studied 60.954 students from public and private schools, which were in the last year of the elementary education and attended the Brazil-ian National School-Based Adolescent Health Survey (PeNSE) conducted in 2009. To character-ize the dietary pattern cluster analysis was used. Three dietary patterns were identified: healthy (27.7%), unhealthy (34.6%) and mixed (37.7%). It was observed a higher proportion of healthy pat-tern in the capitals of the Southeast, South and Midwest. The IDH-M was positively correlated with the healthy pattern and negatively with the mixed pattern. The identification of differenti-ated dietary patterns intra and between regions and according to IDH-M indicates the need to better understand each local context either with respect to the magnitude of the event either the examination of the determinants of the different realities.Feeding Behavior; Adolescent; Students