Publications by authors named "Paula Martins Horta"

20 Publications

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Social inequalities in the surrounding areas of food deserts and food swamps in a Brazilian metropolis.

Int J Equity Health 2021 07 21;20(1):168. Epub 2021 Jul 21.

Departamento de Nutrição, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena,190, Santa Efigênia, Belo Horizonte, 30130-090, Brazil.

Background: Food deserts are neighborhoods with little or no access to healthy food, whereas food swamps are neighborhoods where unhealthy food options prevail over healthy ones. The main aims of the current study are to feature and compare the neighborhoods of food deserts and food swamps based on social inequality.

Methods: Ecological study carried out in Belo Horizonte City, Minas Gerais State, Brazil. Information about commercial food establishments derived from two different databases. It was measured by secondary governmental databases, which were virtually conferred in the present study. Census tracts were considered as analysis units and classified as food deserts and food swamps, based on the Brazilian methodology. Take into consideration the density of establishments classified as selling fresh or minimally-processed food, mixed establishments, and establishments selling ultra-processed food. The Brazilian methodology evaluates food deserts by the density of healthy establishments (establishments classified as mostly selling fresh or minimally-processed food and mixed establishments) per 10 thousand inhabitants. And the metric to evaluate food swamps considers the density of unhealthy establishments (establishments mostly selling ultra-processed food) per 10 thousand inhabitants. Information about social inequalities comprised aspects such as income, population count, number of households, number of literate individuals, race, water and energy supply, and garbage collection. The Health Vulnerability Index (HVI) was used as a synthetic social vulnerability indicator.

Results: Neighborhoods of food deserts presented worse essential service availability, lower income per capita, and smaller mean number of literate individuals. Census tracts classified as food swamps presented better socio-demographic conditions than those areas food deserts. Neighborhoods simultaneously classified as food deserts and food swamps presented lower income per capita and were more often observed in census sectors presenting medium and high HVI.

Conclusion: The food environment in Belo Horizonte was featured by the strong presence of food deserts and food swamps. However, the potential influence of these areas on food intake has changed depending on social inequalities.
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http://dx.doi.org/10.1186/s12939-021-01501-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8293554PMC
July 2021

The quality and inflammatory index of the diet of patients with migraine.

Nutr Neurosci 2021 Jun 19:1-8. Epub 2021 Jun 19.

Departamento de Nutrição, Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.

Background: The association between diet and migraine has been reported in the literature, but only a few studies have evaluated whether the diet consumed by patients with migraine differs from individuals without migraine.

Objective: Herein, we aimed to investigate whether the quality and the Dietary Inflammatory Index (DII) of diet consumed by migraine patients differ from that consumed by healthy controls. We also evaluated whether the severity of migraine and headache frequency were associated with these parameters.

Methods: Patients of both sexes, aged between 18 and 65, with episodic migraine and healthy controls were enrolled in this cross-sectional study. Disability and impact caused by migraine and depressive symptoms were evaluated. Dietary intake was assessed using a 24-hour dietary recall and a three-day non-consecutive food record. The quality of the diet was calculated using the Healthy Eating Index (HEI)-2015 adapted to the Brazilian population, and DII was calculated based on the method developed by Shivappa et al. (2014).

Results: Ninety patients with migraine and 62 individuals without migraine were included in this study. The groups did not differ regarding age, sex, marital status, years of schooling, anthropometric characteristics, and depressive symptoms. Patients with migraine had lower HEI total score than controls, indicating that these patients have a lower quality of the diet. Patients with migraine also had higher DII than controls. Nevertheless, HEI and DII scores did not correlate with migraine frequency and severity.

Conclusion: This study corroborates the view that the characteristics of the diet might be involved in migraine pathophysiology.
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http://dx.doi.org/10.1080/1028415X.2021.1939935DOI Listing
June 2021

[Sponsorship by the food and beverage industries in Brazilian professional soccer: an obstacle to the promotion of healthy eating].

Cad Saude Publica 2021 11;36(12):e00219719. Epub 2021 Jan 11.

Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.

Sponsorship by ultra-processed food and beverage companies is a common marketing practice in sports, capable of influencing consumers, with unknown effects in Brazil. The study aimed to identify the profile of food and beverage companies sponsoring professional soccer teams in Brazil and to associate the occurrence of this sponsorship with the teams' characteristics. The sample included companies from these industries sponsoring 20 major league soccer teams competing in the Brazilian Championship in 2018. The food companies were identified according to the products based on the NOVA classification, and information was obtained on the number of championships they had won in Copa Libertadores, the Brazilian Championship, and the state championships; time since the club was founded; region of Brazil; number of fans; and revenues from sponsorship/advertising and sale of TV rights. A total of 280 sponsors were identified, with repeat sponsors between teams, of which 11.5% were from the food industry, featuring ultra-processed products (9.4%) and 6.7% of ultra-processed beverages. Sponsorship by ultra-processed producers was more prevalent among teams that had won more championships in the Brazilian National Cup and Copa Libertadores and among those with more fans and higher revenues from sponsorship/advertising and sale of TV rights. The study revealed the significant presence of manufacturers of ultra-processed foods and beverages as soccer team sponsors, especially for the more popular teams that had won more championships, thus posing an obstacle to the promotion of healthy eating.
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http://dx.doi.org/10.1590/0102-311X00219719DOI Listing
March 2021

The COVID-19 pandemic and its implications for the food information environment in Brazil.

Public Health Nutr 2021 02 23;24(2):321-326. Epub 2020 Nov 23.

Departamento de Nutrição, Universidade Federal de Minas Gerais, Av. Alfredo Balena 190, Escola de Enfermagem, 3º andar, sala 312, Belo Horizonte, 30130-100Minas Gerais, Brazil.

The food information environment includes food advertising disseminated in various media. With the COVID-19 pandemic and the shutdown of schools, universities, non-essential commerce, public leisure areas, bars, restaurants, among others, the food information environment has changed in Brazil. People spent more time at home which led to greater exposure to television and internet advertising content. During the COVID-19 pandemic, the food production sector has invested in new ways to advertise their products that include advertising messages of support, empathy and solidarity, as well as social responsibility campaigns looking for self-promotion such as food donation and financial aids. Sponsoring online events promoted by Brazilian musicians on social media was also enhanced during the pandemic and allowed food companies to become part of the consumer's leisure and entertainment moments. The advertising strategies adopted by the food industry during the COVID-19 pandemic are used to generate market demands, influence the consumer purchase decision and increase their loyalty to the supplier brands. Consequently, individuals may have been more vulnerable to excessive consumption of ultra-processed foods during this health crisis. This commentary aims to describe the changes in the food information environment during the COVID-19 pandemic in Brazil and propose a pathway to promote a healthier food information environment after this health crisis. Perspectives for promoting a healthier food information environment after the pandemic are also discussed, focusing on regulating food advertising with a shared responsibility between government, the food industry, the academy and civil society.
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http://dx.doi.org/10.1017/S1368980020004747DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7737163PMC
February 2021

Digital food environment during the coronavirus disease 2019 (COVID-19) pandemic in Brazil: an analysis of food advertising in an online food delivery platform.

Br J Nutr 2021 09 19;126(5):767-772. Epub 2020 Nov 19.

Departamento de Nutrição, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil.

Online food delivery (OFD) platforms guarantee access to food during the coronavirus disease 2019 (COVID-19) pandemic when commercial food establishments are closed and access to food retail is controlled. The present study aimed to describe the advertisements published in an OFD platform in Brazilian capitals, during the 13th and 14th weeks of the pandemic. Data collection occurred on 1 d of the week and 1 d of the weekend and during lunch and dinner time. A random sample of 25 % of the advertisements (n 1754) published in this period was classified in accordance with the presence of food groups and to the use of marketing strategies. Sandwiches, ultra-processed beverages, traditional meals or pasta were the most common food groups shown in the advertisements. Free delivery prevailed in advertisements of ice cream, candies or salty packages snacks and pizza (P < 0·01). Combos were more frequently shown in the advertising of natural juices or smoothies, ultra-processed beverages, sandwiches and pizzas (P < 0·01). Messages about healthiness were more seen among natural juices or smoothies, vegetables and traditional meals and pasta advertisements (P < 0·01) and less seen in sandwiches (P = 0·02) and pizza advertisements (P < 0·01). Economy messages were rare in advertisements of traditional meals or pasta (P < 0·01) and more common in ultra-processed beverages (P = 0·03) and ice cream, candies or salty packages snacks (P < 0·01) advertisements. The OFD platform promoted unhealthy eating during the COVID-19 pandemic in Brazil due to the expressive presence of unhealthy foods advertising.
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http://dx.doi.org/10.1017/S0007114520004560DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7737114PMC
September 2021

Reducing ultra-processed foods and increasing diet quality in affordable and culturally acceptable diets: a study case from Brazil using linear programming.

Br J Nutr 2021 Aug 4;126(4):572-581. Epub 2020 Nov 4.

Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rio de Janeiro, 20550-013, Brazil.

The aim was to design culturally acceptable and healthy diets with reduced energetic share of ultra-processed foods (UPF%) at no cost increment and to evaluate the impact of the change in the UPF% on diet quality. Food consumption and price data were obtained from the Household Budget Survey (n 55 970 households) and National Dietary Survey (n 32 749 individuals). Linear programming models were performed to design diets in which the mean population UPF% was reduced up to 5 % with no cost increment relative to the observed costs. The models were isoenergetic or allowed the energy content to vary according to the UPF%, and they were not constrained to nutritional goals (nutrient-free models) or maximised the compliance with dietary recommendations (nutrient-constrained models). Constraints regarding food preference were introduced in the models to obtain culturally acceptable diets. The mean population UPF% was 23·8 %. The lowest UPF% attained was approximately 10 %. The optimised diet cost was up to 20 % cheaper than the observed cost, depending on the model and the income level. In the optimised diets, the reduction in the UPF% was followed by an increase in fruits, vegetables, beans, tubers, dairy products, nuts, fibre, K, Mg, vitamin A and vitamin C in the nutrient-constrained models, compared with the observed consumption in the population. There was little variation in most nutrients across the UPF% reduction. The UPF% reduction in the nutrient-free models impacted only trans-fat and added sugar content. UPF% reduction and increase in diet quality are possible at no cost increment.
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http://dx.doi.org/10.1017/S0007114520004365DOI Listing
August 2021

Digital food environment of a Brazilian metropolis: food availability and marketing strategies used by delivery apps.

Public Health Nutr 2021 02 9;24(3):544-548. Epub 2020 Sep 9.

Departamento de Nutrição, Universidade Federal de Minas Gerais, Av. Alfredo Balena 190, 30130-100 Escola de Enfermagem, 3º andar, Belo Horizonte, MG, Brasil.

Objective: Food delivery apps represent an important and emerging dimension of the digital food environment. This study aimed to examine food availability and the use of marketing strategies by two food delivery apps in a Brazilian metropolis.

Design: An exploratory study was conducted in the city of Belo Horizonte, Minas Gerais. Food groups were identified and the use of price discounts and photos by the apps was observed.

Setting: Eighteen neighbourhoods and the ten best rated restaurants in each app.

Participants: Three hundred sixty-two commercial food establishments.

Results: The proportion of ultra-processed beverages on offer in the apps (78·45 %) was much higher in comparison with water (48·89 %), natural juices or smoothies (27·07 %). Ultra-processed ready-to-eat meals represented almost 70 % of the food offered in the establishments' menus, while traditional meals and vegetables represented just over 30 % of the offering. Ice cream, candies and salty packaged snacks were nine times more frequently presented than fruits. The use of photos and price discounts prevailed predominantly among ultra-processed beverages, sandwiches and ice cream, candies and salty packaged snacks. These marketing strategies were least used for promoting fruits and vegetables.

Conclusions: Restaurants registered on food delivery apps offered a significant amount of ultra-processed foods with price discounts and photos in comparison with unprocessed and minimally processed foods.
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http://dx.doi.org/10.1017/S1368980020003171DOI Listing
February 2021

Ultra-processed food and beverage advertising on Brazilian television by International Network for Food and Obesity/Non-Communicable Diseases Research, Monitoring and Action Support benchmark.

Public Health Nutr 2020 10 29;23(15):2657-2662. Epub 2020 May 29.

Federal University of Minas Gerais (Universidade Federal de Minas Gerais - UFMG), Department of Nutrition, Belo Horizonte, MG30130-100, Brazil.

Objective: To analyse the extent and nature of food and beverage advertising on the three major Brazilian free-to-air television (TV) channels.

Design: Cross-sectional study. A protocol developed for the International Network for Food and Obesity/Non-Communicable Diseases Research, Monitoring and Action Support was applied for data collection. A total of 432 h of TV programming was recorded from 06.00 to 24.00 hours, for eight non-consecutive and randomly selected days, in April 2018. All TV advertisements (ads) were analysed, and food-related ads were classified according to the NOVA classification system. Descriptive analyses were used to describe the number and type of ads, food categories and the distribution of ads throughout the day and time of the day.

Setting: The three most popular free-to-air channels on Brazilian TV.

Participants: The study did not involve human subjects.

Results: In total, 14·2 % (n 1156 out of 7991) of ads were food related (858 were specific food items). Approximately 91 % of food items ads included ultra-processed food (UPF) products. The top three most promoted products were soft drinks, alcoholic beverages and fast-food meals. Alcoholic beverage ads were more frequently broadcast in the evening.

Conclusion: The high risk of exposure of the Brazilian population to UPF ads should be considered a public health concern given the impact of unhealthy food advertising on people's food choices and health.
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http://dx.doi.org/10.1017/S1368980020000518DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7477364PMC
October 2020

Diet Quality among the Brazilian Population and Associated Socioeconomic and Demographic Factors: Analysis from the National Dietary Survey 2008-2009.

J Acad Nutr Diet 2019 11 24;119(11):1866-1874. Epub 2019 Jun 24.

Background: Evaluating diet quality is a way to monitor a population's adherence to dietary guidelines.

Objective: To adapt the Healthy Eating Index-2015 (HEI-2015) to the Brazilian population, to evaluate the validity and reliability of the adapted HEI-2015, and to assess diet quality of Brazilian adults as well as socioeconomic and demographic factors associated with diet quality.

Design: In this cross-sectional study, two dietary records from nonconsecutive days were used to obtain food intake information. The collected socioeconomic and demographic data included sex, age, education, per capita income, and residence area.

Participants/setting: A representative sample (n=27,760) of the Brazilian adult population participated in the Nutrition Dietary Survey 2008-2009.

Main Outcome Measures: Total and component scores for the adapted HEI-2015. The validity and reliability of the index were tested.

Statistical Analysis Performed: Mean total and component scores were estimated for the adapted HEI-2015. Also, the proportion of subjects that achieved the maximum score for each component was calculated. Regarding validity and reliability analysis, principal components analysis examined the number of dimensions; Pearson correlations were estimated between total score, components, and energy, and Cronbach's coefficient α was estimated. Diet quality was compared among socioeconomic and demographic categories.

Results: The mean total score for the adapted HEI-2015 was 45.7 (95% CI: 45.4 to 46.0). Women had higher diet quality scores (46.4; 95% CI: 46.1 to 46.7) than men (44.9; 95% CI: 44.6 to 45.3). Age, education, and per capita income were directly associated with the adapted HEI-2015 total score. Greater than or equal to 50% of subjects received the maximum adapted HEI-2015 component scores for "total protein foods," "seafood and plant proteins," "fatty acids," and "sodium." In contrast, less than 30% of subjects received the maximum component scores for "total vegetables," "dairy," and "saturated fats." Higher percentages of women received the maximum component scores for "total fruits," "whole fruits," "total vegetables," "greens," "dairy," and "sodium," whereas higher percentages of men received the maximum component scores for "total protein foods," "seafood and plant proteins," "fatty acids," "added sugars," and "saturated fats" components. Finally, validity analysis revealed weak correlations between component scores and energy and weak to moderate correlations with total scores; six dimensions were responsible for the total variance in diet quality and the standardized Cronbach's coefficient α was .65 (unstandardized=.64).

Conclusions: Brazilian adults have suboptimal diet quality as assessed by the adapted HEI-2015. Diet quality varied by socioeconomic and demographic factors. Results support the validity and the reliability of the index.
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http://dx.doi.org/10.1016/j.jand.2019.04.014DOI Listing
November 2019

Consuming school meals improves Brazilian children's diets according to their social vulnerability risk.

Public Health Nutr 2019 10 26;22(14):2714-2719. Epub 2019 Jun 26.

Department of Nutrition, Federal University of Minas Gerais, Avenida Professor Alfredo Balena 190, 3 andar - sala 324, Belo Horizonte, MG 303130-100, Brazil.

Objective: To estimate usual diets among Brazilian children regarding the consumption of school meals and social vulnerability risks.

Design: A cross-sectional study. School meal consumers were considered those children who reported consuming school meals ≥3 times/week. Social vulnerability risk was classified by an index. Dietary intake was evaluated by one 24 h dietary recall for the whole sample; a second 24 h dietary recall was administered in a sub-sample (38·6 %). The National Cancer Institute's method was used to estimate children's usual intake of nutrients and food groups.

Setting: Municipal public schools from Belo Horizonte, Brazil.

Participants: Children (n 1357) aged 8-12 years.

Results: Half of the sample lived in low/medium social vulnerability risk areas and 27·9 % were school meal non-consumers. School meal consumers more frequently lived in high/very high social vulnerability risk areas (76·2 v. 68·7 %). Children with low/medium social vulnerability risk had a higher mean intake of thiamin (1·13 v. 1·04 mg) and a lower mean intake of candy (1·35 v. 1·42 g). Consumption of school meals among children under high/very high social vulnerability risk was associated with higher mean consumption of vitamin C (31·9 v. 24·1 mg), unprocessed/minimally processed foods (956·3 v. 851·9 g), fruits (128·5 v. 90·9 g) and vegetables (58·2 v. 47·1 g). Ultra-processed food product consumption was lower among school meal consumers (136·2 v. 187·7 g), especially ultra-processed beverages (252·5 v. 305·7 g).

Conclusions: Consuming school meals was associated with a better usual diet quality, particularly among those with higher social vulnerability risk.
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http://dx.doi.org/10.1017/S1368980019001459DOI Listing
October 2019

Usual diet quality among 8- to 12-year-old Brazilian children.

Cad Saude Publica 2019 02 11;35(2):e00044418. Epub 2019 Feb 11.

Departamento de Nutrição, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.

Nutritional surveys are important information sources for public policy in the food and nutrition field. They focus on assessing usual dietary patterns, because health outcomes result from the long-term intake. Here we aimed to evaluate diet quality adjusted for day-to-day variance among Brazilian children. Data were collected between March 2013 and August 2015. The sample included 8- to 12-year-old children (n = 1,357) from public schools from all administrative regions of a Brazilian city. One 24-h dietary recall (24HR) was collected for the whole sample and two 24HR for two non-consecutive days of the same week for a subsample. The Healthy Eating Index-2010 (HEI-2010) was adapted to Brazilian food habits and the Brazilian dietary guidelines were used to evaluate diet quality. Statistical analysis included a multipart, nonlinear mixed model with correlated random effects proposed by the U.S. National Cancer Institute to correct diet quality for day-to-day variance. The adapted HEI-2010 total score was 51.8. Children with poorer diet quality (< 10th percentile) scored less than 41.1, and children with higher diet quality (> 90th percentile) scored more than 62.4. The overall adequacy of adapted HEI-2010 components was low. Higher adequacy percentages were identified for total protein foods (94.9%), greens (62.3%), and seafood and plant proteins (52.2%). Seven components showed less than 10% of adequacy: refined grains, fatty acids, dairy, sodium, total vegetable, whole grains, and empty calories. This study identified the main inadequacies among children's diet quality, which can guide promotion actions for healthy eating.
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http://dx.doi.org/10.1590/0102-311X00044418DOI Listing
February 2019

Perception of food consumed at home and dietary intake: A nationwide study from Brazil.

Appetite 2017 09 24;116:487-492. Epub 2017 May 24.

Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rua São Francisco Xavier, 524, 7° Andar, Bloco E, 20550-900, Rio de Janeiro, RJ, Brazil.

Perception of food consumed is a key factor in acknowledging the need for behavioral change to improve diet quality. We analyzed family dietary intake according to the head of household's perception of satisfaction with food consumed by the family. Households (n = 13,351) that participated in the Brazilian Household Budget Survey and the National Dietary Survey were classified as satisfied or dissatisfied with the food consumed in the home. We compared the family dietary intake of the two groups considering their socio-demographic characteristics. Satisfied families (n = 4429) reported statistically higher intake (in grams/1000 kcal) of vegetables (47.3 vs 33.7), fruits (46.9 vs 21.4), sugar-sweetened beverages (118 vs 71.7), milk and dairy (57.9 vs 34.6), and ultra-processed products (18.6 vs 9.8); and lower intake of rice (86.2 vs 112), beans (91.7 vs 136), and meat (76.5 vs 84.0) when compared to dissatisfied families (n = 1717). Among satisfied families, in the youngest group we found lower consumption of fruits and higher intake of sugar-sweetened beverages and ultra-processed products when compared to the oldest group. Also among satisfied families, those in the highest per capita income group presented higher intake of fruits and lower intake of beans than those in the lowest income group. Satisfied families in the highest income group also consumed more fruits and less beans than dissatisfied families in the same income group. Socio-demographic characteristics may influence perception of satisfaction with food consumed and potentially influence the success of public health efforts to offer nutrition guidance for families satisfied with diets that may or may not be comprised of healthy food and beverages.
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http://dx.doi.org/10.1016/j.appet.2017.05.036DOI Listing
September 2017

Fatty acid intake and metabolic syndrome among overweight and obese women.

Rev Bras Epidemiol 2015 Oct-Dec;18(4):930-42

Instituto de Pesquisa e Ensino em Saúde Infantil PENSI, Hospital Infantil Sabará, São Paulo, SP, Brazil.

Objective: To examine relations between fatty acids intake and metabolic syndrome (MetS) status among overweight and obese women (n = 223).

Methods: This was a cross-sectional study. The physical and laboratory tests included anthropometry, body composition evaluation and measurements of blood pressure, fasting blood glucose, insulinemia and lipid profiles. A three-day food diary was used to evaluate fatty acids consumption. Statistical analysis included χ2 test and odds ratio measurements.

Results: The women had 35.2 (6.9) years old and 15.2% presented MetS. Women with MetS presented higher serum levels of very low-density lipoprotein cholesterol, triglycerides, glucose and insulin in addition to higher diastolic blood pressure in comparison to women without MetS. Overweight women with MetS consumed higher amounts of monounsaturated fatty acids - 24.3 g (24.7 - 36.4) versus overweight women without MetS - 23.9 g (23.8 - 26.8), polyunsaturated fatty acids - 16.7 g (14.6 - 21.1) versus overweight women without MetS - 13.6 g (13.8 - 15.8) and linoleic fatty acids - 15.9 g (6.5) versus overweight women without MetS - 13.1 g (5.1). Among obese women with MetS, higher intake of linoleic fatty acids was also noted - 17.6 g (6.1) versus obese women without MetS - 14.3 g (6.6) in addition to higher consumption of trans fatty acids - 4.7 g (4.8 - 6.3) versus obese women without MetS - 3.9 g (2.9 - 4.6). Increased quartiles of monounsaturated, polyunsaturated, linoleic and trans fatty acid intake were significantly associated with a greater occurrence of MetS.

Conclusion: Lipid intake may be related to MetS, although other factors also need to be considered, such as lifestyle, genetics and metabolism.
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http://dx.doi.org/10.1590/1980-5497201500040020DOI Listing
September 2017

[Consumption of fruit and vegetables and the health conditions of men and women attended in the primary healthcare network].

Cien Saude Colet 2015 Aug;20(8):2313-22

Departamento de Nutrição, Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil,

This cross-sectional study sought to analyze the associations between health conditions and the inadequate consumption of fruit and vegetables (FV) of 1,255 men and women attended in Primary Healthcare Units in Belo Horizonte (State of Minas Gerais). Data collection included FV consumption, socioeconomic status and health conditions. Results are presented by prevalence ratio (PR) with a confidence interval of 95% (CI 95%). A 77.5% (CI 95%: 75.1%-79.8%) of inadequacy of consumption (< 5 daily servings) was found and it was more prevalent among men (83.8%, CI 95%: 79.0%-88.5% than among women: 76.0%, CI 95%: 73.4%-78.6%). For women, the inadequate consumption of FV was higher among those with poor perception of health quality (PR: 1.37; CI 95%: 1.19-1.59) and among those who consider their dietary habits as being unhealthy (PR: 1.15; CI 95%: 1.07-1.24). For men, the inadequate consumption was higher between individuals that reported 2 to 4 visits to the doctor in the year prior to the interview (PR: 1.21; CI 95%: 1.06-1.21). The conclusions showed that the consumption of FV among the population under study is below the recommendations and the health conditions are associated differently for each gender.
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http://dx.doi.org/10.1590/1413-81232015208.18272014DOI Listing
August 2015

The dietary profile of socially vulnerable participants in health promotion programs in a brazilian metropolis.

Rev Bras Epidemiol 2015 Apr-Jun;18(2):454-65

Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

Objectives: To analyze the dietary profile of participants who used two health promotion services located in socially vulnerable areas in a Brazilian metropolis.

Methods: A cross-sectional comparative study was conducted with participants (n = 370) aged ≥ 20 years who joined two services of the Academias da Cidade program in Belo Horizonte, Minas Gerais, Brazil. The study participants engaged in physical activity and nutritional education actions directed by the services from 2009 to 2010. The sociodemographic and economic conditions and health and nutrition profiles of each individual were assessed.

Results: Participants from a high social-risk who used the service did not demonstrate adequate intake of vegetables (54.6 versus 43.6%; p = 0.038), sweets (33.5 versus 23.2%; p = 0.030), soft drinks (28.5 versus 11.9%; p < 0.001), artificial juice (34.7 versus 22.6%; p = 0.011), and processed meat (48.8 versus 32.7; p = 0.002). However, in the other service, lower social vulnerability, a higher prevalence of abdominal adiposity (60.7 versus 43.0%; p = 0.004) and consumption of high-fat meat products (53.0 versus 36.5%; p = 0.002) was observed.

Conclusion: Participants who used both services demonstrated inadequate food intake compatible with the development of chronic disease profiles. However, the participants in each service were distinct from each other. This suggests that promotion of healthy eating should to contemplate the territory and its interface with people health.
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http://dx.doi.org/10.1590/1980-5497201500020013DOI Listing
November 2016

Dietary quality maintained among overweight Brazilian women enrolled in a primary healthcare service.

J Health Popul Nutr 2014 Dec;32(4):608-14

The present study aimed to evaluate the dietary quality maintained among 113 overweight [body mass index (BMI) > or =25.0 kg/m2] women aged > or =20 years, who were enrolled in a Brazilian primary healthcare service in 2009. Dietary quality was evaluated using the Healthy Eating Index (HEI)-1995, which was adapted in the Brazilian context. Statistical analysis included linear regression adjusted by self-reporting energy intake. The prevalence of obesity (BMI > or = 30.0 kg/m2), elevated waist-circumference, and excessive body-fat were 85.8%, 98.2%, and 100% respectively. Data on dietary quality indicated an HEI score of 66.6 (11.3), with low mean scores for 'milk and dairy products' (2.6) and 'vegetables' (3.1). The calcium (beta=0.40) and vitamin C (beta=0.27) intake was positively associated with the HEI score. Fat (13 = -0.38) and sodium (beta = -0.21) intake and protein adequacy (beta = -18.17) were inversely associated with the dietary quality. We found that the dietary quality in this study population needs improvement, demonstrating the importance of nutritional counselling within the primary healthcare service.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4438691PMC
December 2014

[Quality of life among overweight women with chronic non-communicable diseases].

Rev Gaucha Enferm 2013 Dec;34(4):121-9

This study aimed to identify quality of life and its associated factors within women who are overweight and have noncommunicable diseases. It was a cross sectional study with a convenience sample of 50 adult and elderly women enrolled in an "Academia da Cidade" in Belo Horizonte, MG, Brazil. For quality of life assessment, the WHOQOL-bref was used. A descriptive analysis in addition to uni and multivariate linear regression were conducted. "Social relations" was the domain which most have contributed to quality of life, followed by "physical" domain. Worse quality of life was associated with self-reported presence of gastritis/ulcer (beta = -11.980, p = 0.011), medication use (beta = -7.730, p = 0.035), high per capita consumption of sugar (beta = -0.092, 0.045), elevated body mass index (beta= -1.218, p = 0.048) and high carbohydrate intake (beta = -0.388, p = 0.042). Many factors are associated to quality of life, that should be considered in health programs.
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http://dx.doi.org/10.1590/s1983-14472013000400016DOI Listing
December 2013

Analysis of television food advertising on children's programming on "free-to-air" broadcast stations in Brazil.

Rev Bras Epidemiol 2013 Dec;16(4):976-83

Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

Objective: To analyze the content of television food advertising on Brazilian 'free-to-air' broadcast stations during children's programming.

Methods: This is a descriptive study which evaluated the content of food advertising between 08:00 a.m. and 06:00 p.m. on three Brazilian 'free-to-air' broadcast stations (A, B and C). Data collection was performed during 10 week days and weekends. Food advertising was organized according to the food group classification from the Food Guide for the Brazilian Population. The annual exposure to food advertising was obtained considering the national children average exposure to television of five daily hours. The χ2 and Fisher's exact test were conducted in order to identify differences in the content of television advertising in the morning and in the afternoon and between broadcast stations.

Results: One hundred and twenty six hours of programming were recorded, totalizing 1,369 commercials - 13.8% of food. There was major participation of 'sugars and sweets' (48.1%) and 'oils and fats' (29.1%) among food advertising and much food publicity in the afternoon (15.7%; morning: 12.2%, p = 0.037). Moreover, the broadcast with more audience was the one that advertised more food (A: 63.5%; B: 12.2%; C: 24.3%), especially 'sugar and sweets' (A: 59.2%; B: 43.5%; C: 21.7%). Finally, an annual average exposure to 2,735.5 commercials was obtained for Brazilian children, totalizing 2,106.3 of food rich in sugar and fat publicity.

Conclusion: Food advertising is focused on poor nutritionally food, emphasizing the need for specific intervention strategies.
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http://dx.doi.org/10.1590/s1415-790x2013000400017DOI Listing
December 2013

[Nutrition and physical activity counseling practice and adherence of primary care users].

Rev Gaucha Enferm 2012 Dec;33(4):14-21

Nutricionista pelo Centro Universitário de Belo Horizonte, Belo Horizonte, Minas Gerais, Brasil.

The present study aimed to investigate counseling content provided by healthcare professional for primary healthcare users, as well as users' difficulties in adhering to the counseling, through a cross-sectional study design. Interviews were conducted with 499 users at a primary healthcare unit and 59.3% of them said that counseling had been provided especially by physicians (93.6%), and it was based on healthy nutrition and physical activity practice (48.9%). Counseling was more frequently to users with greater numbers of morbid conditions (p = 0.001). The main factors that made adherence difficult for users were lack of time (27.5%) and the need to change habits (23%). It was identified that counseling is still at initial stage within primary care, and there is a need for healthcare professionals, especially the nurse of the family health team to be more proactive in this process,focusing mainly on health promotion.
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http://dx.doi.org/10.1590/s1983-14472012000400002DOI Listing
December 2012

Food advertising and television exposure: influence on eating behavior and nutritional status of children and adolescents.

Arch Latinoam Nutr 2012 Mar;62(1):53-9

Department of Physiology and Pharmacology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.

This study aimed to evaluate the influence of food advertising and television exposure on eating behaviour and nutritional status of children and adolescents. It was a cross sectional study developed among 116 students from a private school in Brazil. Socio-demographic and health conditions were evaluated. Anthropometric data, food consumption, physical activity, television viewing habits and behaviour in relation to food advertising were also investigated. Among the results, a 1:2 relationship was identified between the number of televisions and residents per household. Excessive weight was present in 25.8% of subjects and 66.4% of children watched television while eating. Children were exposed to television for a median of 3.0 hours daily (95% CI: 2.9 to 3.6). There was a direct association between attraction to foods advertised and purchasing the product (p < 0.001) and a positive relationship between the number of televisions per household and body weight (r = 0.246, p = 0.015) and the amount of liquid consumed during meals (r = 0.277, p = 0.013). Findings also highlighted the association between watching television while eating and the reduced probability of fruit consumption (p = 0.032), contrasted with a greater likelihood of daily artificial juice intake (p = 0.039). In conclusion, watching television is associated with lower probability of daily consumption of fruits and the number of television at household is positively related to BMI in children and adolescents.
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March 2012
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