[Food consumption according to the level of processing among adolescents from the rural area of a municipality in the south of Brazil]

Adequate Food and Nutrition in School: Acceptability and Consumption by Students of a Brazilian Municipality

OBJECTIVE

This study aimed to evaluate the acceptability of a specific menu preparation based on minimally processed foods and the factors associated with the consumption of school meals by students in Brazilian public schools.

METHODS

A hedonic scale was employed to assess the acceptability of a milk preparation with 100% cocoa and sugar. A structured questionnaire was used to evaluate school food consumption, addressing consumption frequency, dietary habits, environmental conditions, and consumption of competing foods. A binomial logistic regression model was conducted to verify the association between individual variables and conditions of meal supply and consumption. Data analyses were performed using the Jamovi 2022 software.

RESULTS

A total of 1080 students participated, with 630 taking part in the acceptability test, and 450 completing the consumption questionnaire. The study highlighted acceptance below the minimum PNAE standards (79.68%) for the tested preparation, indicating a need for further investigation into student preferences. Pleasant taste was the most frequently cited reason (53.2%) for consumption. Disliking the served lunch increased the likelihood of not consuming school meals by 2.73% (p = 0.03). Bringing snacks from home showed no significant impact on consumption (p = 0.677). Using inadequate cutlery increased the likelihood of not consuming school meals by 6.44% (p = 0.009).

CONCLUSIONS

The study underscored the low acceptance of milk prepared with 100% cocoa and sugar, along with irregular school meal consumption, emphasizing the need for strategies to align students' taste preferences with healthier menu options. While PNAE ensures nutrient-rich meals, improving flavor, variety, and dining conditions, alongside permanent food and nutrition education, is essential to enhance adherence and support students' health. Although snacks do not affect the consumption of school meals, controlling snack intake is important from a health perspective.

Heterogeneity in the consumption of fresh and ultra-processed foods by the Brazilian population ≥10 years of age

OBJECTIVE

To evaluate the heterogeneity in the consumption of fresh or minimally processed foods (FMPF) and ultra-processed foods (UPF) in the Brazilian population ≥10 years of age.

METHODS

Cross-sectional study that used data from the food consumption and resident module from the 2017-2018 edition of the Family Budget Survey. Variables relating to sex, region of residence, household status and per capita family income in minimum wages were used. The outcomes were dietary participation in percentage of FMPF and UPF. Heterogeneity was assessed using random effects produced by linear mixed-effects models.

RESULTS

Thirty-two random effects were obtained for the consumption of FMPF and 34 for UPF. Living in the urban area of the South and Southeast regions, as well as having a higher income were driving factors in the consumption of UPF and reducing the consumption of FMPF. Living in a rural area and having low income were mainly reducing factors in the consumption of UPF and driving factors in the consumption of FMPF.

CONCLUSIONS

The consumption of UPF and FMPF was determined by the set of factors that represented easy access to these foods, whether geographic or economic such as income.

Multiple behavioral risk factors for non-communicable diseases among the adolescent population in Brazil: the analysis derived from the Brazilian national survey of school health 2019

BACKGROUND

Health risk behaviors often emerge or intensify during adolescence and tend to co-occur, exposing individuals to an even greater risk for the development of non-communicable diseases (NCDs). The likelihood of exhibiting multiple health risk factors also increases throughout life and is associated with sociodemographic characteristics contributing to their escalation and severity. In this context, the objective of this study was to analyze the association between sociodemographic characteristics and multiple behavioral risk factors for non-communicable diseases among the adolescent population in Brazil.

METHODS

This cross-sectional study utilized data from the Brazilian National Survey of School Health 2019. The sample comprised 121,580 adolescents aged 13 to 17. The analyzed variables included irregular intake of fruits and vegetables, regular consumption of soft drinks and treats, insufficient physical activity, sedentary lifestyle, cigarette smoking, and alcohol consumption. To analyze MBRFs, a classification ranging from zero to five was created, and associations were estimated using Odds Ratio (OR) with the respective 95% confidence interval (CI). The Backward method was employed for the multivariate regression model, utilizing ordinal logistic regression.

RESULTS

Adolescents without behavioral risk factors for NCDs constituted only 3.9% (95% CI 3.7-4.1). The most prevalent categories were two and three MBRFs, accounting for 28.3% (95% CI: 27.7-28.8) and 27.0% (95% CI: 26.5-27.5), respectively. Adolescents aged 16 and 17 (ORadj: 1.39; 95% CI: 1.32-1.48), residing in the Brazilian Southeast (ORadj: 1.66; 95% CI: 1.52-1.81), and those reporting poor or very poor self-rated health (ORadj: 2.05; 95% CI: 1.87-2.25) were more likely to exhibit multiple behavioral risk factors. Conversely, male adolescents (adjusted OR: 0.65; 95% CI: 0.62-0.69), those of mixed race (adjusted OR: 0.92; 95% CI: 0.87-0.97), and residents of rural areas (adjusted OR: 0.76; 95% CI: 0.70-0.84) were less likely to manifest MBRFs for NCDs.

CONCLUSION

The majority of adolescents displayed MBRFs for NCDs, positively associated with age, region, and perceived health status. This underscores the necessity for healthcare promotional interventions throughout the life cycle, as these behaviors may persist into adulthood.

Consumption of ultra-processed foods and associated factors in children from Barbacena (MG), Brazil

OBJECTIVE

To evaluate the prevalence of ultra-processed food consumption and associated factors among children enrolled in the public school system of the city of Barbacena, Minas Gerais, Brazil.

METHODS

This is a cross-sectional study conducted with schoolchildren aged 7-9 years, of both sexes, enrolled in state public schools. Food intake was assessed using the Previous Day Food Questionnaire and the level of physical activity by the Previous Day Physical Activity Questionnaire. The listed foods were classified according to the extent and purpose of industrial processing, using the NOVA classification. Pearson's χ2 test, Fisher's exact test, χ2 with Yates correction, and Poisson regression were used in the statistical analysis, estimating the crude and adjusted prevalence ratio, with 95% confidence intervals.

RESULTS

The prevalence of daily ultra-processed food consumption was 69.6%. After adjusted analyses, the consumption of ultra-processed food was associated with the omission of breakfast, mid-afternoon snack, supper, low physical activity, and consumption of risk foods. On the other hand, consumption of in natura or minimally processed foods was associated with older age, the consumption of lunch, mid-afternoon snack, dinner, and protective foods.

CONCLUSIONS

There is a high prevalence of ultra-processed foods consumption, associated with unhealthy dietary habits among schoolchildren. This highlights the need for nutritional counseling and educational actions, favoring healthy eating in childhood.

Qualidade da dieta de adolescentes da rede pública de ensino de um município do sul do Brasil: estudo transversal, 2019

Resumo Objetivo Identificar os fatores associados à qualidade da dieta de estudantes do 9º ano da rede municipal de ensino de Pelotas, Rio Grande do Sul, Brasil. Métodos Estudo transversal, realizado em 2019. As informações alimentares foram coletadas por formulário de frequência alimentar, e a qualidade da dieta foi avaliada mediante índice desenvolvido pelos autores. A dieta foi classificada como de baixa, intermediária ou alta qualidade. A associação foi avaliada por regressão logística multinomial. Resultados Os 808 adolescentes avaliados obtiveram média de 16,0 pontos (desvio-padrão=4,1) no índice desenvolvido. A alta qualidade da dieta mostrou-se associada a experimentação de tabaco [razão de chances, ou odds ratio (OR) 2,92; intervalo de confiança de 95% (IC95%) 1,74;4,92] e prática de atividade física no lazer (OR=1,65; IC95% 1,15;2,38). Conclusão Destaca-se a importância do incentivo à prática de atividade física, monitoramento de comportamentos de riscos nos adolescentes e promoção do consumo de alimentos considerados saudáveis.

A Systematic Review of Worldwide Consumption of Ultra-Processed Foods: Findings and Criticisms

A debate is ongoing on the significance and appropriateness of the NOVA classification as a tool for categorizing foods based on their degree of processing. As such, the role of ultra-processed food (UPF) on human health is still not completely understood. With this review, we aimed to investigate the actual level of consumption of UPF across countries and target populations to determine the impact in real contexts. Suitable articles published up to March 2021 were sourced through the PubMed and SCOPUS databases. Overall, 99 studies providing data on the level of UPF consumption expressed as the percentage of total energy intake were identified, for a total of 1,378,454 participants. Most of them were published in Brazil (n = 38) and the United States (n = 15), and the 24 h recall was the most-used tool (n = 63). Analysis of the results revealed that the United States and the United Kingdom were the countries with the highest percent energy intake from UPF (generally >50%), whereas Italy had the lowest levels (about 10%); the latter was inversely associated with adherence to the Mediterranean diet. High variability was also observed based on sex, age, and body mass index, with men, young people, and overweight/obese subjects generally having higher levels of consumption compared to older subjects. Overall, our findings underline the large differences in UPF intake. Since most of the observations derived from studies conducted with food questionnaires are not specifically validated for UPF, further efforts are essential to confirm the results previously obtained and to investigate further the association between UPF consumption and health status, also considering the actual contribution within different dietary patterns, which has been less investigated to date.