Rosangela Alves Pereira

Consumo alimentar de adolescentes com e sem sobrepeso do Município do Rio de Janeiro

This article compares the food intake of overweight and normal-weight adolescents from 12 to 17.9 years of age (71.8% of the original sample). Data were obtained in a survey performed in the city of Rio de Janeiro, Brazil, in 1995-1996. Food intake was assessed by a semi-quantitative food frequency questionnaire, and nutritional status was assessed by body mass index (BMI = weight/stature ). Adolescents classified as overweight reached the 90th percentile of the 1989 Brazilian BMI distribution. Food intake of overweight and non-overweight subjects was similar. Both groups showed below-minimum-recommended food-group intakes and higher intake of high-density food items. These nutritional habits are risk factors for obesity and chronic diseases later in life.

Associação entre fatores socioeconômicos e insegurança alimentar: estudo de base populacional na Região Metropolitana do Rio de Janeiro, Brasil

OBJECTIVE: This work aims to evaluate the prevalence of food insecurity among families from Duque de Caxias, in the Rio de Janeiro Metropolitan Area and the association between socioeconomic indicators and food insecurity. METHODS: A population-based cross-sectional study investigated a probabilistic sample composed of 1,085 households from the district of Campos Eliseos, in the municipality of Duque de Caxias, Rio de Janeiro, Brazil. Information on socioeconomic condition was obtained using a structured questionnaire. Food insecurity was assessed by the Brazilian Food Insecurity Scale, which allows classifying the families into food security, or mild, moderate or severe food insecurity. The analyses took into account the sampling design effect. The food insecurity prevalence was estimated and its association with socioeconomic variables was assessed using the chi-square test (p<0.05). RESULTS: Food insecurity prevalence was 53.8%. The following variables were inversely and significantly associated with food insecurity: family monthly per capita income, head of family educational level, socioeconomic level (classified according to the Brazilian Association of Market Research criteria), number of family members, and having a water filter in the household. CONCLUSION: Family income was the variable that discriminated both food security and insecurity.

Alimentos más consumidos en Brasil: Pesquisa Nacional de Alimentación 2008-2009

OBJETIVO: Caracterizar o consumo alimentar mais frequente da populacao brasileira. METODOS: Foram analisados dados referentes ao primeiro dia de registro alimentar de 34.003 individuos com dez anos ou mais de idade que responderam ao Inquerito Nacional de Alimentacao, composto por amostra probabilistica da Pesquisa de Orcamentos Familiares 2008-2009. O padrao de consumo foi analisado segundo sexo, grupo etario, regiao e faixa de renda familiar per capita. RESULTADOS: Os alimentos mais frequentemente referidos pela populacao brasileira foram arroz (84,0%), cafe (79,0%), feijao (72,8%), pao de sal (63,0%) e carne bovina (48,7%), destacando-se tambem o consumo de sucos e refrescos (39,8%), refrigerantes (23,0%) e menor presenca de frutas (16,0%) e hortalicas (16,0%). Essa configuracao apresenta pouca variacao quando se consideram os estratos de sexo e faixa etaria; contudo, observa-se que os adolescentes foram o unico grupo etario que deixou de citar qualquer hortalica e que incluiu doces, bebida lactea e biscoitos doces entre os itens mais consumidos. Alimentos marcadamente de consumo regional incluem a farinha de mandioca no Norte e Nordeste e o cha na regiao Sul. Houve discrepâncias no consumo alimentar entre os estratos de menor e maior renda: individuos no quarto de renda mais elevada referiram sanduiches, tomate e alface e aqueles no primeiro quarto de renda citaram os peixes e preparacoes a base de peixe e farinha de mandioca entre os alimentos mais referidos. CONCLUSOES: Existe um padrao basico do consumo alimentar no Brasil que inclui entre os alimentos mais consumidos arroz, cafe, feijao, pao de sal e carne bovina, associado ao consumo regional de alguns poucos itens. Particularmente entre os adolescentes, alimentos ricos em gordura e acucar sao tambem de consumo frequente.

Validation and Calibration of a Semiquantitative Food Frequency Questionnaire Designed for Adolescents

BACKGROUND Epidemiologic studies must have a reliable method for evaluating food intake; therefore, valid, precise, and practical instruments are essential. OBJECTIVE To assess the relative validity and estimate the calibration factors of a semiquantitative food frequency questionnaire (FFQ) for adolescents. DESIGN Validation and calibration study. SUBJECTS/SETTINGS This study enrolled 169 adolescents from Rio de Janeiro, Brazil. A set of three food records was used as the reference method. STATISTICAL ANALYSES PERFORMED The relative validity was analyzed according to weighted kappa values for the quartile categorization of energy and nutrient intakes, Pearson correlation coefficients, and the Bland-Altman method. To estimate the calibration factors for the FFQ, linear regression models, including the food record means as dependent variables and the FFQ estimations as independent variables were developed for boys and girls. RESULTS The weighted kappa values ranged from 0.28 to 0.44 for the raw data and from 0.16 to 0.39 for the deattenuated and energy-adjusted data. The Pearson correlation coefficients ranged from 0.33 to 0.46, and the mean agreement varied from 62% to 143%. The calibration factors estimated for boys ranged from 0.15 to 0.48, and the factors estimated for girls ranged from 0.14 to 0.47. The mean energy and nutrient intakes estimated by the calibrated FFQ were similar to the means estimated by the food records; however, the standard deviations were smaller for the calibrated FFQ estimations. CONCLUSIONS The tested FFQ is a suitable tool for ranking energy and nutrients intake in the studied group. Calibration factors are needed to estimate energy and nutrient intake means and should be used to correct raw data as well as association measurements based on FFQ data.

Meal consumption patterns and anthropometric measurements in adolescents from a low socioeconomic neighborhood in the metropolitan area of Rio de Janeiro, Brazil.

We investigated the association between meal consumption and anthropometric measurements in a probabilistic sample of 528 12-18-year-old adolescents assessed in a population-based cross-sectional study developed in the Rio de Janeiro Metropolitan Area, Brazil. A score ranging from zero to nine according to the frequency of meal consumption (breakfast, lunch and dinner) assessed meal patterns which were defined as satisfactory or unsatisfactory. Nutritional status was defined by the sex- and age-specific body mass index cut-offs. Underweight was observed in 5.7% of the adolescents (8.6% boys, 2.5% girls) and overweight in 20.9%. The omission of breakfast was observed in 4.5% of the boys and 12.4% of the girls. Unsatisfactory meal consumption pattern was more frequent among girls (38.7% vs. 29.2%), and among teenagers over 15 years of age (40.0% vs. 25.4%). Boys with unsatisfactory patterns of meal consumption presented higher means of BMI and of waist and hip circumferences than the ones with satisfactory patterns. The higher values of anthropometric measurement observed among adolescents with an unsatisfactory meal pattern indicate that they may be at risk for overweight or obesity.

Prevalence and energy intake from snacking in Brazil: analysis of the first nationwide individual survey

Background/Objectives:Snacking has increased globally. We examine snacking patterns and common snack foods in Brazil.Subjects/Methods:Data from the first of two non-consecutive food diaries from 34 003 individuals (aged ⩾10 years) in the first Brazillian nationally representative dietary survey (2008–2009) were used. Meals were defined as the largest (kcal) eating event reported during select times of the day (Breakfast, 0600–1000 hours; Lunch, 1200–1500 hours; Dinner, 1800–2100 hours); all other eating occasions were considered snacks. We estimate daily energy intake, percentage of persons consuming snacks, number of daily snacks and per capita and per consumer energy from snacks (kcal/day, kcal/snack and % of daily energy from snacks).Results:In all, 74% of Brazilians (⩾10 years) snacked, reporting an average 1.6 snacks/day. Also, 23% of the sample were heavy snackers (⩾3 snacks/day). Snacking accounted for 21% of daily energy intake in the full sample but 35.5% among heavy snackers. Compared with non-snackers (1548 kcal/day), light (1–2 snacks/day) and heavy snackers consumed more daily energy (1929 and 2334 kcal/day, respectively). Taking into account time of day, the largest percentage of persons reported afternoon/early evening snacking (1501–1759 hours, 47.7%). Sweetened coffee and tea, sweets and desserts, fruit, sugar-sweetened beverages, and high-calorie salgados (fried/baked dough with meat/cheese/vegetable) were the top five most commonly consumed snacks. Differences were observed by age groups. Trends in commercial sales were observed, especially for sugar-sweetened beverages.Conclusions:Many commonly consumed snack foods in Brazil are classified, in the US, as being high in solid fats and added sugars. The public health impact of snacking in Brazil requires further exploration.

Sources of excessive saturated fat, trans fat and sugar consumption in Brazil: an analysis of the first Brazilian nationwide individual dietary survey.

OBJECTIVE To examine the patterns of consumption of foods high in solid fats and added sugars (SoFAS) in Brazil. DESIGN Cross-sectional study; individual dietary intake survey. Food intake was assessed by means of two non-consecutive food records. Foods providing >9·1% of energy from saturated fat, or >1·3% of energy from trans fat, or >13% of energy from added sugars per 100 g were classified as high in SoFAS. SETTING Brazilian nationwide survey, 2008-2009. SUBJECTS Individuals aged ≥10 years old. RESULTS Mean daily energy intake was 8037 kJ (1921 kcal), 52% of energy came from SoFAS foods. Contribution of SoFAS foods to total energy intake was higher among women (52%) and adolescents (54%). Participants in rural areas (43%) and in the lowest quartile of per capita family income (43%) reported the smallest contribution of SoFAS foods to total energy intake. SoFAS foods were large contributors to total saturated fat (87%), trans fat (89%), added sugar (98%) and total sugar (96%) consumption. The SoFAS food groups that contributed most to total energy intake were meats and beverages. Top SoFAS foods contributing to saturated fat and trans fat intakes were meats and fats and oils. Most of the added and total sugar in the diet was supplied by SoFAS beverages and sweets and desserts. CONCLUSIONS SoFAS foods play an important role in the Brazilian diet. The study identifies options for improving the Brazilian diet and reducing nutrition-related non-communicable chronic diseases, but also points out some limitations of the nutrient-based criteria.

Short stature and hypertension in the city of Rio de Janeiro, Brazil.

OBJECTIVE Stature is a powerful indicator of poor nutrition early in life in nations where undernutrition is a public health problem. Hypertension in adults has been associated with factors present early in life such as low birth weight. We tested the hypothesis that short stature is associated with hypertension among adults. DESIGN AND SETTING A household survey of representative adults in Rio de Janeiro city, Brazil was carried out in 1996. SUBJECTS Blood pressure and anthropometric measures were collected from 2802 adults in their own households. Prevalence estimates and modelling incorporated the sample design and weights. RESULTS Age-adjusted prevalence of hypertension for both sexes was lower in the third quartile of stature distribution. In women, but not in men, the odds ratio comparing the first quartile of stature with the fourth quartile was statistically significant with an odds ratio of 1.68 (95%CI 1.02-2.76). Adjusting for known risk factors for hypertension such as age, income, smoking, sodium and alcohol intake and race, the association among women, comparing the first with the fourth quartile for stature, was 1.84 (95%CI 1.03-3.30). With further adjustment for residual of weight on height the ratio reduced to 1.76 (95% CI 0.97-3.19, P value of trend = 0.03). Systolic blood pressure showed a U-shaped association with quartiles of stature, mainly among women, with a beta-coefficient significantly lower at the third quartile. CONCLUSIONS This association of stature with hypertension supports the theory of an important ontogenetic dependence of adult blood pressure, at least among women.

Effectiveness of a Randomized School-Based Intervention Involving Families and Teachers to Prevent Excessive Weight Gain among Adolescents in Brazil

Objective To evaluate the effectiveness of a school-based intervention involving the families and teachers that aimed to promote healthy eating habits in adolescents; the ultimate aim of the intervention was to reduce the increase in body mass index (BMI) of the students. Design Paired cluster randomized school-based trial conducted with a sample of fifth graders. Setting Twenty classes were randomly assigned into either an intervention group or a control group. Participants From a total of 574 eligible students, 559 students participated in the study (intervention: 10 classes with 277 participants; control: 10 classes with 282 participants). The mean age of students was 11 years. Intervention Students attended 9 nutritional education sessions during the 2010 academic year. Parents/guardians and teachers received information on the same subjects. Main Outcome Measurement Changes in BMI and percentage of body fat. Results Intention-to-treat analysis showed that changes in BMI were not significantly different between the 2 groups (β = 0.003; p = 0.75). There was a major reduction in the consumption of sugar-sweetened beverages and cookies in the intervention group; students in this group also consumed more fruits. Conclusion Encouraging the adoption of healthy eating habits promoted important changes in the adolescent diet, but this did not lead to a reduction in BMI gain. Strategies based exclusively on the quality of diet may not reduce weight gain among adolescents. Trial Registration Clinicaltrials.gov NCT01046474.

Macronutrient consumption and inadequate micronutrient intake in adults

OBJECTIVE To estimate energy and nutrient intake and prevalence of inadequate micronutrient intake among Brazilian adults. METHODS Data from the National Dietary Survey, from the 2008-2009 Household Budget Survey, were used. Food consumption was evaluated through food record on two non-consecutive days. A total of 21,003 individuals (52.5% women), between 20-59 years old, participated in the survey. Usual nutrient intake was estimated according to the National Cancer Institute method. The Estimated Average Requirement (EAR) cut-off points were used to determine the prevalence of inadequate micronutrient intake. For manganese and potassium, the Adequate Intake (AI) was used as cut-off. Sodium intake was compared with the Tolerable Upper Intake Level (UL). The probability approach was used to determine the prevalence of inadequate iron intake. The data were analyzed according to the location of the household (urban or rural) and macro regions of Brazil. RESULTS The mean energy intake was 2,083 kcal among men and 1,698 kcal among women. Prevalence of inadequacy equal to or greater than 70% were observed for calcium among men and magnesium, vitamin A, and sodium among both men and women. Prevalence equal to or greater than 90% were found for calcium in women and vitamins D and E in both genders. Prevalence lower than 5% were found for iron in men and for niacin in men and women. In general, prevalence of inadequate intake was higher in the rural area and in the Northeast region. CONCLUSIONS Energy intake was higher among individuals who live in urban areas and in the North region. The greatest risk groups of inadequate micronutrient intake were women and those living in rural areas and in the Northeast region.