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Author(s): Lukoye Atwoli 1, Abdullah H. Baqui 2, Thomas Benfield 3, Raffaella Bosurgi 4, Fiona Godlee 5, Stephen Hancocks 6, Richard Horton 7, Laurie Laybourn-Langton 8,*, Carlos Augusto Monteiro 9, [...]

OBJECTIVE: To evaluate sociodemographic factors associated with the consumption of ultraprocessed foods and the temporal evolution of their consumption in Brazil between 2008 and 2018. METHODS: The study used food consumption data of individuals aged = 10 years from 2008-2009 and 2017-2018 Pesquisas de Orçamentos Familiares (POF - Household Budget Surveys), grouping the foods according to the Nova classification. We used crude and adjusted linear regression models to assess the association between sociodemographic characteristics and consumption of ultra-processed foods in 2017-2018 and the temporal variation in their consumption between 2008 and 2018. RESULTS: Ultra-processed foods accounted for 19.7% of calories in 2017-2018. The adjusted analysis showed that their consumption was higher in women (versus men) and the South and Southeast regions (versus North) and lower in blacks (versus whites) and rural areas (versus urban), in addition to decreasing with the increased age and increasing with higher education and income. Consumption of ultra-processed foods increased by 1.02 percentage points (pp) from 2008-2009 to 2017-2018. This increase was significantly higher among men (+1.59 pp), black people (+2.04 pp), indigenous (+5.96 pp), in the rural area (+2.43 pp), those with up to 4 years of schooling (+1.18 pp), in the lowest income quintile (+3.54 pp), and the North (+2.95 pp) and Northeast (+3.11 pp) regions. On the other hand, individuals in the highest level of schooling (-3.30 pp) and the highest income quintile (-1.65 pp) reduced their consumption. CONCLUSIONS: The socioeconomic and demographic segments with the lowest relative consumption of ultra-processed foods in 2017-2018 are precisely those that showed the most significant increase in the temporal analysis, pointing to a trend towards national standardization at a higher level of consumption. DESCRIPTORS: Eating. Ultra-Processed Foods. Socioeconomic Factors. Diet, Food, and Nutrition. [ABSTRACT FROM AUTHOR]

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OBJECTIVE: To estimate beef consumption and its influence on carbon and water footprints, as well as to improve the nutritional quality of the Brazilian diet. METHODS: The amount of beef and other foods consumed was evaluated by two 24-hour food records in a representative sample of the Brazilian population = 10 years of age (n = 32,853) from 2008 to 2009. The environmental impact of the diet considered the coefficients of the carbon footprint (gCO2and/kg) and the water footprint (liters/kg) of the foods, as well as their nutritional quality considering the nutrient composition of each food associated with the prevention of nutritional deficiencies or the increase/decrease in chronic disease risk. Linear and logistic regression models, crude and adjusted for sex, age, education, income, region, and area, were used to respectively study the association of fifths of the caloric contribution of beef with the environmental impacts of the diet and inadequate nutrient intake. RESULTS: Carbon and water footprints and protein, iron, zinc, vitamin B12, saturated fat, and sodium contents were higher in the fraction of the diet composed of beef, whereas fiber and added sugar contents were higher in the fraction composed by the other foods. Dietary beef contribution was directly associated with the carbon and water footprints of the diet and the risk of saturated fat and sodium excess, besides fiber insufficiency, inversely associated with the risk of protein, iron, zinc, and vitamin B12 insufficiency. CONCLUSION: Reducing beef consumption in Brazil would also reduce the carbon and water footprints of the diet, as well as the risk of chronic diseases related to food. Therefore, in order not to increase the risk of nutritional deficiencies, monitoring the increased intake of other foods rich in protein, iron, zinc, and vitamin B12 is suggested. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate the trend of household food acquisition according to the NOVA classification in Brazil between 1987-1988 and 2017-2018. METHODS: We used household food acquisition data from five editions of the Pesquisas de Orçamentos Familiares (Household Budget Surveys), conducted by the Instituto Brasileiro de Geografia e Estatística (Brazilian Institute of Geography and Statistics), in the years 1987-1988, 1995-1996, 2002-2003, 2008-2009, and 2017-2018. All reported foods were categorized according to the NOVA classification. The household availability of food groups and subgroups was expressed through their share (%) in total calories, for all Brazilian families, by household situation (urban or rural), for each of the five geographic regions of the country, by fifths of the household income per capita distribution (2002-2003, 2008-2009 and 2017-2018 surveys), and for the 11 main urban regions of the country (1987-1988, 1995-1996, 2002-2003, 2008-2009 and 2017-2018 surveys). Linear regression models were used to assess the trend of increasing or decreasing food purchases. RESULTS: The diet of the Brazilian population is still composed predominantly of foods in natura or minimally processed and processed culinary ingredients. However, our findings point to trends of increasing share of ultra-processed foods in the diet. This increase of 0.4 percentage points per year between 2002 and 2009 slowed down to 0.2 percentage points between 2008 and 2018. The consumption of ultra-processed food was higher among households with higher income, in the South and Southeast regions, in urban areas, and in metropolitan regions. CONCLUSION: Our results indicate an increase in the share of ultra-processed foods in the diet of Brazilians. This is a worrisome scenario, since the consumption of such foods is associated with the development of diseases and the loss of nutritional quality of the diet. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To study the association between ultra-processed food consumption and carbon and water footprints of the Brazilian diet. METHODS: Cross-sectional analysis on data collected in 2008-2009 on a probabilistic sample of the Brazilian population aged = 10 years (n = 32,886). Individual food intake was assessed using two 24-hour food records, on non-consecutive days. The environmental impact of individual diets was calculated by multiplying the amount of each food by coefficients that quantify the atmospheric emissions of greenhouse gases in grams of carbon dioxide equivalent (carbon footprint) and freshwater use in liters (water footprint), both per gram or milliliter of food. The two coefficients consider the food life cycle 'from farm to fork.' Crude and adjusted linear regression models and tests for linear trends assessed the association between the ultraprocessed food contribution to total energy intake (quintiles) and the diet carbon and water footprints. Potential confounders included age, sex, education, income, and region. Total energy intake was assessed as a potential mediation variable. RESULTS: In the crude models, the dietary contribution of ultra-processed foods was linearly associated with the carbon and water footprints of the Brazilian diet. After adjustment for potential confounders, the association remained significant only regarding the diet water footprint, which increased by 10.1% between the lowest and highest quintile of the contribution of ultra-processed foods. Additional adjustment for total energy intake eliminated this association indicating that the dietary contribution of ultra-processed foods increases the diet water footprint by increasing energy intake. CONCLUSIONS: The negative impact of ultra-processed foods on the diet water footprint, shown for the first time in this study, adds to the negative impacts of these foods, already demonstrated regarding dietary nutrient profiles and the risk for several chronic noncommunicable diseases. This reinforces the recommendation to avoid ultra-processed foods made in the official Brazilian Dietary Guidelines and increasingly in dietary guidelines of other countries. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Saúde Pública is the property of Faculdade de Educacao da Universidade de Sao Paulo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Saúde Pública is the property of Faculdade de Educacao da Universidade de Sao Paulo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Saúde Pública is the property of Faculdade de Educacao da Universidade de Sao Paulo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Saúde Pública is the property of Faculdade de Educacao da Universidade de Sao Paulo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Saúde Pública is the property of Faculdade de Educacao da Universidade de Sao Paulo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Agrobiodiversity is key for promoting healthy diets and moving towards more sustainable food systems. Conversely, monocultures and homogenous diets threaten the diversity of species available for human food. Objectives: This study aimed to investigate the diversity of plant species mobilized by household food acquisitions in Brazil. Methods: Data from the 2017-18 National Household Budget Survey were used to quantify the total amount of foods (kilograms) and beverages (litres) purchased per person per year by household aggregates (n=575). Food items were classified according to the Nova classification system. Those items classified as Nova groups 1 and 2 were directly identified at the species level by using taxonomical classification from four data sources. Ingredient lists from the UNC/IDEC/NUPENS national food label database were used to determine the composition of processed and ultra-processed foods. The percent composition of the ingredients was estimated and classified at the species level. The total amount of animalsourced foods acquired by households were proportionally converted into the plant species utilized as feed inputs in their production. The Shannon index was used to assess the diversity of plant species. Linear regression models were used to test associations between sociodemographic characteristics and the Shannon index. Results: Six species accounted for more than 90% of the total amount of plant species mobilized by Brazilian households through their food purchases. This was reflected by a low average value of the Shannon index for the Brazilian population (H=0.87; 95%CI 0.85; 0.88), indicating low diversity. Mean values of this index tended to increase with income and were significantly lower in the North and Midwest regions and in urban areas. Conclusions: Our findings demonstrate a low diversity of plant species mobilized by Brazilian households through their food purchases in 2017-18. This is in line with previous studies demonstrating increasing homogeneity of global food supplies. [ABSTRACT FROM AUTHOR]

Background & aims: few longitudinal studies have been conducted on ultra-processed food (UPF) and weight gain in low- to middle-income countries (LMIC), especially with young adults and with an innovative appropriate instrument to capture UPF consumption. We aim to evaluate the prospective associations between UPF consumption and incidence of 10% or more gain in body mass index (BMI) in Brazilian young adults. Methods: the study population are 18-29 years old Brazilians enrolled at NutriNet-Brasil study, an open web-based cohort for volunteers that started enrollment in January 2020. All variables were self-reported. UPF consumption (percentage of caloric contribution in diet) was assessed by two 24-hour food recalls and categorized into quartiles. The participants had 1-3 measures of weight at follow-up. Multivariable cox regression models were performed to examine the association between the exposure and the incidence of 10% or more gain in BMI. Included covariates were sex, age, housing macro-region, years of schooling, goods and services score, skin color, leisure physical activity, smoking, sleep, leisure screen time, alcohol consumption, lower than usual caloric intake and BMI at baseline. Participants who reported pregnancy at any time point of follow-up or who had implausible measurements of weight, height, age, and caloric intake were excluded. Results: 2,105 young adults were included in the analyses. With a mean follow-up of 17.2 months, there were 234 outcome cases. The higher the UPF consumption, the greater the chance for weight gain in the adjusted models for the total sample and of women (p-trend < 0.05). Using the first quartile of UPF consumption as a reference, in the last quartile the risk of weight gain increased by 65% for the total sample, and in 72% for women. Conclusions: The results confirm the direct relationship between the consumption of ultraprocessed foods and weight gain and reinforce the need to implement and/or strengthen public policies that discourage UPF consumption. [ABSTRACT FROM AUTHOR]

Introduction and Objective: Both ultra-processed foods (UPF) and animal-based foods have been associated with cardiovascular disease in some studies. Our study aims to examine the prospective association of two dietary factors (UPF and animal-based foods), adjusted for each other, with cardiovascular-related mortality using the UK Biobank cohort. Methods: Participants of the UK Biobank from England, Scotland, and Wales with at least two 24-h dietary recall completed between 2009 and 2012 were included. The exposure of interest was 2 dietary factors: 1) proportion of dietary energy from UPF and 2) proportion of dietary energy from animal-based foods (red meat, poultry/fish, and eggs/dairy). The main outcome was cardiovascular-cause mortality, identified through data linkage to mortality registries. Prospective association was assessed using multivariable Cox proportional hazards models adjusted for baseline sociodemographic and lifestyle characteristics. Results: Among 126,639 participants followed for a mean of 9.2 years, there were 1,327 cardiovascular deaths. In mutually adjusted models of both dietary factors (UPF and animal-based foods), the hazard ratio for the 5th compared with the 1st quintile of the proportion of dietary energy from UPF was 1.47 (95% CI: 1.22, 1.76, comparing 41.5% with 9.4% dietary energy), whereas for animal-based food intake (meats, dairy, eggs) it was 1.10 (95% CI: 0.93, 1.32, comparing 45.3% with 16.8% dietary energy). There was no evidence of interaction (P = 0.51). Among animalbased foods, none of the subgroups was associated with CVD mortality. Conclusion: Greater consumption of UPF was associated with higher cardiovascular-cause mortality in this UK population. The total of animal-based food consumption (meat, dairy, eggs) was not associated with cardiovascular mortality, neither red meat intake. These findings suggest that the proportion of UPF in the diet may be more important with respect to cardiovascular mortality than the proportion of animal-based foods. Funding Cancer Research UK and World Cancer Research Fund. [ABSTRACT FROM AUTHOR]

INTRODUÇÃO A agrobiodiversidade global está em declínio, especialmente a diversidade genética de plantas utilizadas para consumo humano. Das mais de 7 mil espécies de plantas comestíveis identificadas e utilizadas para alimentação humana desde a origem da agricultura, menos de 200 espécies tiveram produção significativa em 2014 e, apenas 9 culturas representaram mais de 66% em peso de toda a produção agrícola. Tal homogeneidade no sistema alimentar global tem sido associada às epidemias da desnutrição, obesidade e mudanças climáticas, também denominada Sindemia Global. Um dos potenciais determinantes para o declínio da agrobiodiversidade são mudanças nos padrões de alimentação das sociedades humanas que levam à demanda por um número reduzido de espécies vegetais. No entanto, estudos que investiguem tal aspecto ainda são escassos. O objetivo deste estudo foi descrever a diversidade de espécies vegetais mobilizadas pela aquisição domiciliar de alimentos no Brasil no período de 2017-18. MÉTODOS Agregados de domicílios correspondentes aos estratos amostrais da Pesquisa de Orçamentos Familiares (POF) 2017-18 (n=575) foram utilizados como unidade de análise do estudo. Alimentos e bebidas adquiridos ao longo de doze meses pelos agregados de domicílios estudados foram classificados em quatro grupos segundo a classificação Nova. O total em quilogramas aportado por cada item de consumo foi distribuído segundo as espécies vegetais mobilizadas na sua produção. A métrica ‘Índice de diversidade de Shannon’ foi aplicada para investigar a agrobiodiversidade mobilizada pela aquisição domiciliar de alimentos para o conjunto dos agregados de domicílios brasileiros e segundo unidades federativas. RESULTADOS Mais de 90% da quantidade total de espécies vegetais mobilizadas pela aquisição domiciliar de alimentos no Brasil em 2017-18 foram provenientes de apenas seis espécies vegetais: braquiária, milho, soja, arroz, cana-de-açúcar e trigo. O valor médio do índice de Shannon relativo à diversidade de espécies vegetais mobilizadas por agregados de domicílios brasileiros foi de 0,87 (0,85;0,88). As unidades federativas do Tocantins e do Acre e Tocantins apresentaram os valores mais baixos do índice de Shannon, enquanto Minas Gerais, Espírito Santo e São Paulo apresentaram os valores mais elevados. Os resultados deste estudo demonstram uma baixa diversidade de espécies vegetais mobilizadas por agregados de domicílios brasileiros, com alta concentração em um número muito reduzido de espécies. Além disso, observou-se diferenças na diversidade de espécies vegetais mobilizadas segundo unidades federativas do país, sendo que as unidades federativas localizadas nas regiões Norte e Centro-Oeste foram as que mobilizaram uma diversidade de espécies vegetais mais baixa, enquanto que as localizadas na região sudeste mobilizaram uma maior diversidade de espécies. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Saúde Pública is the property of Faculdade de Educacao da Universidade de Sao Paulo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective. To describe the prevalence of "active" (self-propelled, human-powered) transportation in the Latin America and Caribbean (LAC) region over the past decade. Methods. MEDLINE, Excerpta Medica (Embase), SportDiscus, Lilacs, MediCarib, Web of Science, OVID, CINAHL, Scopus, Google Scholar, National Transportation Library, and TRIS/TRID were searched for articles on active transportation published between January 2003 and December 2014 with (at least) a title and abstract in English, Portuguese, or Spanish. Research was included in the study if the two reviewing authors agreed it 1) was conducted in an adult sample (≥ 18 years old), 2) was designed to be representative of any LAC area, and 3) reported at least one measure of active transportation. Reference lists of included papers and retrieved reviews were also checked. A total of 129 key informants (87 scientific experts and 42 government authorities) were contacted to identify additional candidate publications. Two other authors extracted the data independently. Results. A total of 10 459 unique records were found; the full texts of 143 were reviewed; and a total of 45 studies were included in the study, yielding estimates for 72 LAC settings, most of which were in Argentina, Brazil, and Colombia. No eligible studies were found for the years 2003-2004, resulting in a 10-year study time frame. Estimates were available for walking, cycling, or the combination of both, with a high degree of heterogeneity (heterogeneity index (I2) ≥ 99%). The median prevalence of active transportation (combining walking and cycling) was 12.0%, ranging from 5.1% (in Palmas, Brazil) to 58.9% (in Rio Claro, Brazil). Men cycled more than women in all regions for which information was available. The opposite was true for walking. Conclusions. Prevalence of active transportation in LAC varied widely, with great heterogeneity and uneven distribution of studies across countries, indicating the need for efforts to build comprehensive surveillance systems with standardized, timely, and detailed estimates of active transportation in order to support policy planning and evaluation. [ABSTRACT FROM AUTHOR]