Consumo de alimentos ultraprocesados en niños entre 6 y 23 meses según la Segunda Encuesta Nacional de Nutrición y Salud de Argentina / Consumption of ultra-processed foods among children aged 6 to 23 months as per the Second National Survey on Nutrition and Health of Argentina

Introducción. Contar con los datos del consumo de alimentos ultraprocesados en los niños resulta importante para planificar políticas públicas. Objetivos. Describir la prevalencia de consumo de alimentos ultraprocesados en menores de 2 años e identificar factores asociados. Describir la proporción que los alimentos ultraprocesados representan del número total de los alimentos consumidos en el día. Métodos. Análisis secundario de los datos de niños entre 6 y 23 meses de edad con al menos un recordatorio de 24 horas de consumo de alimentos de la Segunda Encuesta Nacional de Nutrición y Salud de Argentina del año 2018. Se estudiaron como variables principales: "consumo de alimentos ultraprocesados" (según el sistema NOVA) categorizada en sí/no y la "proporción de ultraprocesados del total de alimentos consumidos". Los factores asociados explorados fueron lactancia materna, sexo, edad y el número de alimentos no ultraprocesados consumidos. Se realizó un modelo de regresión logística multivariable y se aplicó un factor de expansión para ponderar los datos. Resultados. Se incluyeron 4224 niños (ponderado 908 104). La prevalencia de consumo de ultraprocesados fue del 90,8 % (IC95%: 89,5-92) y fue asociado con mayor edad (OR 3,21; IC95% 2,28-4,52) y con el número de alimentos no ultraprocesados consumidos (OR 1,17; IC95% 1,13-1,23). Los ultraprocesados representaron una mediana del 20 % (RIC: 12,5-28,6 %) del total de alimentos consumidos en el día. Conclusiones. Este estudio señala la alta penetración de los alimentos ultraprocesados en la alimentación complementaria.

Introduction. The availability of data on the consumption of ultra-processed foods among children is important for planning public policies. Objectives. To describe the prevalence of consumption of ultra-processed foods in children under 2 years of age and identify associated factors. To describe the proportion that ultra-processed foods represent out of the total number of foods consumed in a day. Methods. Secondary analysis of data from children aged 6­23 months with at least a 24-hour recall of food consumption based on the Second National Survey on Nutrition and Health of Argentina (2018). The following primary variables were studied: "consumption of ultra-processed foods" (according to the NOVA system) categorized into yes/no and "proportion of ultra-processed out of total foods consumed." The following associated factors were studied: breastfeeding, sex, age, and number of non-ultra-processed foods consumed. A multivariate logistic regression model was developed and an expansion factor was applied to weight the data. Results. A total of 4224 children were included (weighed: 908 104). The prevalence of ultra-processed food consumption was 90.8% (95% CI: 89.5­92) and was associated with an older age (OR: 3.21, 95% CI: 2.28­4.52) and the number of non-ultra-processed foods consumed (OR: 1.17, 95% CI: 1.13­1.23). Ultra-processed foods accounted for a median 20% (IQR: 12.5­28.6%) of all foods consumed in a day. Conclusions. This study highlights the high penetration of ultra-processed foods in complementary feeding.

Herbal Textual Research on Olibanum in Famous Classical Formulas / 中国实验方剂学杂志

By consulting the ancient and moderm literature， this paper makes a textual research on the name， origin， quality evaluation， harvesting and processing of Olibanum， so as to provide a basis for the development of the famous classical formulas containing this medicinal material. According to the herbal textual research， the results showed that Olibanum was first described as a medicinal material by the name of Xunluxiang in Mingyi Bielu（《名医别录》）， until Ruxiang had been used as the correct name since Bencao Shiyi（《本草拾遗》） in Tang dynasty. The main origin was Boswellia carterii from Burseraceae family. The mainly producing areas in ancient description were ancient India and Arabia， while the modern producing areas are Somalia， Ethiopia and the southern Arabian Peninsula. The medicinal part of Olibanum in ancient and modern times is the resin exuded from the bark， which has been mainly harvested in spring and summer. It is concluded that the better Olibanum has light yellow， granular， translucent， no impurities such as sand and bark， sticky powder and aromatic smell. There were many processing methods in ancient times， including cleansing（water flying， removing impurities）， grinding（wine grinding， rush grinding）， frying（stir-frying， rush frying， wine frying）， degreasing， vinegar processing， decoction. In modern times， the main processing methods are simplified to cleansing， stir-frying and vinegar processing. Nowadays， the commonly used specifications include raw， fried and vinegar-processed products. Among the three specifications， raw products is the Olibanum after cleansing， fried products is a kind of Olibanum processed by frying method， vinegar-processed products is the processed products of pure frankincense mixed with vinegar. Based on the research results， it is recommended to select the resin exuded from the bark of B. carterii for the famous classical formulas such as Juanbitang containing Olibanum， processing method should be carried out in accordance with the processing requirements of the formulas， otherwise used the raw products if the formulas without clear processing requirements.

Ultra-processed food consumption during pregnancy and newborn weight / Consumo de alimentos ultraprocessados durante a gestação e peso ao nascer do recém-nascido

Abstract Objectives: to assess the association between pregnant women's consumption of ultra-processed foods and newborn body weight. Methods: prospective study with pregnant women (n=214) selected from all Basic Health Units in the city of Pinhais, Paraná. Socioeconomic, demographic, and health data were collected. Food consumption data were assessed using a 24-hour dietary recall and tabulated with GloboDiet software. Daily relative energy intake of ultra-processed food was estimated and logistic regression analysis was utilized. The infuence of covariates on the association analysis was also explored (e.g., income and education). Results: ultra-processed foods contributed to 26.9% of pregnant women's total energy intake. About 5.7% of newborns were classifed as small-for-gestational-age and 10.7% as large-for-gestational-age. A borderline statistically signifcant association was observed between large-for-gestational-age newborn weight and maternal consumption of ultra-processed foods (OR= 1.027; p=0.048). Additionally, family income was associated with the consumption of ultra-processed foods (OR= 0.144; p=0.008). With each additional 1% consumption of ultra-processed foods, mothers' likelihood of having large-for-gestational-age babies increased by about 2.7%. Conclusions: the study reveals a trend of positive association between the weight of large-for-gestational-age newborns and the consumption of ultra-processed foods by pregnant women, but not for small-for-gestational-age children.

Resumo Objetivos: avaliar a associação entre o consumo de alimentos ultraprocessados por gestantes e o peso de recém-nascidos. Métodos: estudo prospectivo com gestantes (n=214) selecionadas em Unidades Básicas de Saúde em Pinhais, Paraná. Dados socioeconômicos, demográfcos e de saúde foram coletados. Dados de consumo alimentar foram coletados por recordatório de 24-horas físico e entrados no software GloboDiet. O consumo diário relativo de energia proveniente de alimentos ultraprocessados foi estimado e a análise de regressão logística foi utilizada, considerando covariáveis como renda familiar e escolaridade. Resultados: o consumo de alimentos ultraprocessados pelas gestantes representou 26,9% da energia total. Cerca de 5,7% de recém-nascidos foram classifcados como pequenos para idade gestacional (PIG) e 10,7% como grandes para idade gestacional (GIG). Foi observada uma associação estatisticamente signifcativa limítrofe entre o peso dos recém-nascidos GIG e o consumo materno de alimentos ultraprocessados (OR= 1,027; p=0,048). Além disso, a renda familiar esteve associada com o consumo de alimentos ultraprocessados (OR=0,144; p=0,008). A cada 1% adicional de consumo de alimentos ultraprocessados, a probabilidade de as mães terem recém-nascidos GIG aumentou cerca de 2,7%. Conclusões: o estudo revela uma tendência de associação positiva entre o peso de recém-nascidos GIG e o consumo de alimentos ultraprocessados por mulheres grávidas, mas não para crianças PIG.

Consumption of in natura and ultra-processed foods in adults: an analysis of social, metabolic, and lifestyle determinants / Consumo de alimentos in natura e ultraprocessados em adultos: uma análise dos determinantes sociais, metabólicos e de estilo de vida

ABSTRACT Objective: To assess the social, metabolic, and lifestyle determinants of consumption of fruits, vegetables, and greens (FVG) and ultra-processed food (ULT) in adults from Pernambuco. Methods: Cross-sectional and analytical study, conducted in 2015/2016. In addition to sociodemographic variables, the determinants of lifestyle were level of physical activity, alcohol consumption, tobacco use, and metabolic variables were self-reported hypertension, blood glucose, and Body Mass Index (BMI). Consumption was measured by the Food Frequency Questionnaire, then created the Frequency of Consumption Index (SFI) of the mean intake of ULT and FVG foods. The indices of FVG and ULT consumption were transformed into quartiles and these variables were included in the multinomial logistic regression, considering their determinants when p<0.05. Results: The sample was representative of the state, with 1,067 people being interviewed, whose intake of ULT was higher than that of FVG in the lowest and highest quartile of the consumption index. Consumption of fruit and vegetables was higher in higher consumption of alcoholic beverages (p=0.031) and BMI>25 kg/m2 (p=0.047); and lower in the lowest income (p=0.001). ULT intake was higher in young adults (p=0.005), lower income (p=0.044), and controlled blood glucose (p=0.021). Rural areas were 52% less exposed to medium-high ULT consumption (p<0.006). Conclusion: Higher rate of ULT consumption in relation to fresh foods, with income as a common determinant, inversely associated with ULT intake and directly related to FVG, which demands structuring policies.

RESUMO Objetivo: Avaliar os determinantes sociais, metabólicos e de estilo de vida do consumo de frutas, legumes e verduras (FLV) e ultraprocessados (ULT) em adultos de Pernambuco. Métodos: Estudo transversal e analítico, realizado em 2015/2016. Além de variáveis sociodemográficas, os determinantes do estilo de vida foram nível de atividade física, doses de bebida alcoólica e uso de tabaco e os metabólicos foram hipertensão autorreferida, glicemia e Índice de Massa Corporal (IMC). O consumo foi mensurado por questionário de frequência alimentar, e, em seguida, criou-se Índice da Frequência de Consumo (IFC) da média de ingestão dos alimentos ULT e FVL. Os índices de consumo de FLV e ULT foram transformados em quartis e essas variáveis incluídas na regressão logística multinomial, considerando seus determinantes quando p<0,05. Resultados: A amostra foi representativa do estado, sendo entrevistadas 1.067 pessoas, cuja ingestão de ULT foi superior à de FVL no menor e no maior quartil do índice de consumo. O consumo de FLV foi superior no maior consumo de bebida alcoólica (p=0,031) e IMC>25 kg/m2 (p=0,047); e inferior na menor renda (p=0,001). O consumo de ULT foi maior em adultos jovens (p=0,005), menor renda (p=0,044) e glicemia controlada (p=0,021). A área rural estava 52% menos exposta ao consumo médio-alto de ULT (p<0,006). Conclusão: Maior índice de consumo de ULT em relação aos alimentos in natura, tendo a renda como um determinante comum, inversamente associada à ingestão de ULT e diretamente relacionada a FVL, o que demanda políticas estruturantes.

Fatores maternos associados ao consumo usual de alimentos ultraprocessados na gestação / Maternal factors associated with habitual consumption of ultra-processed foods during pregnancy

Resumo O objetivo do estudo foi investigar a relação entre as características sociodemográficas, obstétricas e de estilo de vida maternas e o consumo usual de alimentos ultraprocessados. Estudo transversal, n = 784 gestantes, assistidas pelo Sistema Único de Saúde. A dieta foi estimada utilizando dois inquéritos recordatórios de 24 horas, pelo método de passagens múltiplas. Os alimentos ultraprocessados foram classificados empregando-se a classificação NOVA e seu consumo usual foi expresso como a contribuição no percentual energético total. Modelos de regressão linear ajustados foram empregados para investigar a relação entre as características maternas e o percentual energético proveniente (%E) de ultraprocessados. O %E de ultraprocessados na dieta foi de 32,1%. A idade materna (-0,45 [-0,62; -0,29] p < 0,001), estrato econômico D+E em relação a A+B (-2,95 [-5,59; -0,32] p = 0,03) e sub-relato energético (-6,95 [-8,86; -5,04] p < 0,001) foram inversamente associados ao %E de ultraprocessados, enquanto o índice de massa corporal (IMC) pré-gestacional (0,41 [0,22; 0,60] p < 0,001) foi diretamente associado. Sugere-se que a idade materna, o estrato econômico, a subnotificação energética e o estado antropométrico pré-gestacional estejam associados ao consumo de alimentos ultraprocessados durante a gestação.

Abstract The scope of the study was to investigate the relationship between maternal sociodemographic, obstetric and lifestyle characteristics and the habitual consumption of ultra-processed foods. It included a cross-sectional study of n = 784 pregnant women attended by the Unified Health System. Diet was estimated using two 24-hour recall surveys, using the multiple-pass method. Ultra-processed foods were classified using the UN NOVA food classification and their habitual consumption was expressed as the contribution to the total energy percentage. Adjusted linear regression models were used to investigate the relationship between maternal characteristics and the percentage of energy (%E) derived from ultra-processed foods. The %E of ultra-processed foods in the diet was 32.1%. Maternal age (-0.45[-0.62; -0.29] p < 0.001), economic bracket D+E in relation to A+B (-2.95[-5.59; -0.32] p = 0.03) and energy underreporting (-6.95[-8.86; -5.04] p < 0.001) were inversely associated with the %E of ultra-processed foods, whereas the pre-pregnancy Body Mass Index (BMI) (0.41[0.22; 0.60] p < 0.001) was directly associated. This would suggest that maternal age, economic status, energy underreporting and pre-gestational anthropometric status are associated with the consumption of ultra-processed foods during pregnancy.

Síndrome metabólica, consumo de alimentos ultraprocessados e bebidas adoçadas em adolescentes / Metabolic syndrome, consumption of ultra-processed foods and sweetened beverages in adolescents

A síndrome metabólica é caracterizada pela presença concomitante de alteração na glicemia, dislipidemia, elevação da pressão arterial e adiposidade excessiva, os quais elevam o risco cardiovascular. O objetivo deste trabalho foi analisar os parâmetros da síndrome metabólica e a associação com o consumo de alimentos ultraprocessados e bebidas adoçadas em adolescentes com excesso de peso. Realizou-se um estudo transversal, conduzido com 67 adolescentes com excesso de peso, de um ambulatório pediátrico de um hospital público no município de São Paulo. A avaliação antropométrica consistiu na aferição de peso, estatura e circunferência da cintura. Foram coletados dados de glicose, triglicérides, HDL-c, e pressão arterial, e a síndrome metabólica (SM) analisada de acordo com critérios da Associação Brasileira de Nutrologia. O consumo alimentar foi avaliado pelo questionário de frequência alimentar semiquantitativo. A prevalência de síndrome metabólica foi de 56,7%. Os parâmetros mais prevalentes foram redução de HDL-c (71,6%), elevação da pressão arterial sistólica (70,1%) e da glicemia de jejum (64,2%). Observou-se correlação positiva entre a glicemia de jejum e o consumo de alimentos ultra processados e bebidas adoçadas.

Metabolic syndrome is characterized by the concomitant presence of changes in blood glucose, dyslipidemia, elevated blood pressure and excessive adiposity, which increase cardiovascular risk. The objective of this study was to analyze the parameters of metabolic syndrome and the association with the consumption of ultra-processed foods and sweetened beverages in overweight adolescents. A cross-sectional study was carried out with 67 overweight adolescents from a pediatric outpatient clinic of a public hospital in the city of São Paulo. The anthropometric assessment consisted of measuring weight, height and waist circumference. Data on glucose, triglycerides, HDL-c, and blood pressure were collected, and metabolic syndrome (MS) was analyzed according to criteria from the Brazilian Association of Nutrology. Food consumption was assessed using the semi-quantitative food frequency questionnaire. The prevalence of metabolic syndrome was 56.7%. The most prevalent parameters were a reduction in HDL-c (71.6%), and an increase in systolic blood pressure (70.1%) and fasting blood glucose (64.2%). Blood glucose was positively associated with the sweetened beverage consumption score and BMI. It is concluded that there is a high prevalence of metabolic syndrome in adolescents, with glycemia being associated with the consumption of sweetened beverages.

Relationship between family functioning and food consumption during a health and social crisis: A COVID-19 study in Chile

The COVID-19 pandemic and government measures have challenged family functioning (FF) and eating behaviors. In non-pandemic scenarios, FF has shown a protective role in diet quality. This study aimed to explore the role of FF in family members' food consumption during the first wave of the COVID-19 pandemic in Chile. We conducted a cross-sectional, non-probabilistic study. Chilean adults (n= 821) answered an online survey based on the Family Adaptability and Cohesion Evaluation Scales (FACES) IV and a scale of food intake perceptions (non-processed and processed food). The survey also included an open space for comments (n= 147). Most participants had a medium or high FF category. Participants with higher FF had a lower risk of decreasing the consumption of non-processed foods (RR= 0.58 for fruits and RR= 0.45 for legumes) and lower risk of increasing processed foods (RR= 0.37 for sugar-sweetened beverages, RR= 0.46 for snacks, and RR= 0.64 for chocolates) when compared to lower FF participants and controlling for per-capita income. Participants commented on changes in FF: some had more conflicts and others were happy to be together during the pandemic. Most participants indicated that they maintained or increased non-processed and processed food consumption compared to the pre-pandemic period. They perceived having the opportunity of eating healthier during the pandemic. However, the stress they suffered produced them to eat unhealthily. Therefore, FF had a protective role in diet quality during the pandemic. Policymakers should consider FF when promoting healthy diets, especially in health crises.

La pandemia por COVID-19 y las medidas gubernamentales han desafiado el funcionamiento familiar (FF) y los hábitos alimentarios. En escenarios no pandémicos, el FF ha demostrado un papel protector en la calidad de la dieta. Este estudio tuvo como objetivo explorar el papel del FF en el consumo de alimentos de los miembros de la familia durante la primera ola de la pandemia de COVID-19 en Chile. Realizamos un estudio transversal, no probabilístico. Adultos chilenos (n= 821) respondieron una encuesta online basada en la Escala de Evaluación de Cohesión y Adaptabilidad Familiar (FACES) IV y una escala de percepción de consumo de alimentos (alimentos no procesados y procesados). La encuesta también incluyó un espacio abierto para comentarios (n= 147). La mayoría de los participantes tenían una categoría de FF medio o FF alto. Los participantes con mayor FF tenían un menor riesgo de disminuir el consumo de alimentos no procesados (RR= 0,58 para frutas y RR= 0,45 para legumbres) y menor riesgo de aumentar los alimentos procesados (RR= 0,37 para bebidas azucaradas, RR= 0,46 para snacks, y RR= 0,64 para chocolates) en comparación con los participantes de FF más bajos y controlando por ingreso per cápita. Los participantes comentaron cambios en sus FF y teniendo más conflictos, aunque algunos estaban felices de estar juntos durante la pandemia. La mayoría de los participantes indicaron que mantuvieron o aumentaron los alimentos procesados y no procesados en comparación con el período pre-pandemia. Ellos percibieron tener la oportunidad de comer más sano. Sin embargo, el estrés que sufrían les producía comer menos saludable. La FF tuvo un papel protector en la calidad de la dieta durante la pandemia. Quienes formulen políticas públicas deben considerar la AF cuando promuevan dietas saludables, especialmente en crisis de salud.

Consumo de alimentos ultra processados e fatores associados em crianças de seis anos de idade / Consumption of ultra-processed foods and associated factors in six-year-old children

Resumo O objetivo deste artigo é estimar a prevalência e a frequência semanal de consumo de certos alimentos ultra processados por crianças de seis anos e fatores associados em município do Sul do Brasil. Estudo transversal com 956 crianças. Os dados foram coletados por meio de entrevistas com mães nos domicílios. Os desfechos foram o consumo de balas, chicletes, pirulitos e chocolates; bolachas recheadas; sucos artificiais; e refrigerantes por meio do Índice Alimentação do Escolar. As variáveis independentes foram sexo, tipo de escola, escolaridade e ocupação materna, amamentação, tempo de amamentação exclusiva e utilização de mamadeira. A análise bivariada foi realizada pelo qui-quadrado, e a multivariada por meio da regressão de Poisson. Na análise multivariada, a prevalência semanal do consumo de bolacha recheada foi 14% maior nos alunos de escolas públicas e 8% maior em filhos de mães com escolaridade menor do que oito anos. O consumo de suco artificial foi 7% maior entre alunos de escolas públicas e 6% maior nas crianças que fizeram uso de mamadeira. O consumo de refrigerantes foi 8% maior entre alunos de escolas públicas. A maioria dos escolares consumia os alimentos ultra processados estudados de uma a duas vezes na semana. O consumo mostrou-se associado às variáveis independentes estudadas.

Abstract This article aims to estimate the prevalence and weekly frequency of ultra-processed food consumption in six-year-old children and associated factors in a municipality in southern Brazil. Cross-sectional study with 956 children. Data were collected through interviews with mothers in the households. The outcomes were the consumption of candies, chewing gum, lollipops and chocolates; stuffed cookies; artificial juices; and soft drinks using the Índice de Alimentação Escolar (School Feeding Index). The independent variables were gender, type of school, education and maternal occupation, breastfeeding, duration of exclusive breastfeeding and the use of bottle. Bivariate analysis was performed using the chi-square test and the multivariate analysis using Poisson regression. In the multivariate analysis, the weekly prevalence of stuffed cookies consumption was 14% higher in students from public schools and 8% higher in children of mothers with less than eight years of schooling. Artificial juice and soft drink consumption was 7% and 8% higher in public school students respectively and 6% higher in bottle-fed children. Most schoolchildren consumed the ultra-processed foods assessed once or twice a week. Consumption was associated with the independent variables assessed.

Descripción de la ingesta de energía según grado de procesamiento de los alimentos. Encuesta Nacional de Nutrición y Salud 2018-19 / Description of energy intake by degree of food processing. National Survey on Nutrition and Health of 2018­2019

Introducción. A nivel mundial los niños, niñas y adolescentes lideran el consumo de productos ultraprocesados. El objetivo de este trabajo fue caracterizar la ingesta de energía según el grado de procesamiento de los alimentos por grupo etario, en la población urbana mayor de 2 años de la Argentina. Población y métodos. Estudio transversal, con datos de la 2da Encuesta Nacional de Nutrición y Salud 2018-19, en una muestra probabilística polietápica de localidades urbanas de Argentina. A partir de la información recopilada con el recordatorio de 24 horas, se analizó la ingesta diaria de energía, para cada grupo etario, de 1) alimentos sin procesar o mínimamente procesados; 2) ingredientes culinarios procesados; 3) alimentos procesados, y 4) productos ultraprocesados. Se realizó análisis estadístico descriptivo. Resultados. En 15 444 individuos mayores de 2 años, los alimentos mínimamente procesados representaron el 34,5 % de la energía diaria; los productos ultraprocesados, el 26,0 %; los alimentos procesados, el 23,0 %, y los ingredientes culinarios, el 16,6 %. El porcentaje de energía aportada por ultraprocesados es mayor en niños, niñas y adolescentes que en los adultos (p <0,01), mientras que para alimentos procesados e ingredientes culinarios la tendencia es opuesta (p <0,01). Las galletitas, los amasados de pastelería, las bebidas azucaradas y las golosinas representaron dos tercios de la energía aportada por ultraprocesados. Conclusión. Los niños, niñas y adolescentes de entornos urbanos de la Argentina presentan la mayor ingesta de energía a partir de productos ultraprocesados. Las políticas alimentarias deben contemplar la situación de cada grupo etario para promover una alimentación más saludable.

Introduction. Worldwide, children and adolescents lead the consumption of ultra-processed foods. The objective of this study was to describe the energy intake by the degree of food processing by age group in the urban population over 2 years of age in Argentina. Population and methods. Cross-sectional study based on data from the 2nd National Survey on Nutrition and Health of 2018­2019 conducted using a multistage probability sample from urban areas of Argentina. Data were collected from a 24-hour recall and were analized, for each age group, the daily energy intake from 1) unprocessed or minimally processed foods; 2) processed culinary ingredients; 3) processed foods; and 4) ultra-processed foods. A descriptive, statistical analysis was performed. Results. In 15 444 individuals older than 2 years, minimally processed foods accounted for 34.5% of daily energy; ultra-processed foods, 26.0%; processed foods, 23.0%; and culinary ingredients, 16.6%. The percentage of energy from ultra-processed foods is higher in children and adolescents than in adults (p < 0.01), while the trend is the opposite from processed foods and culinary ingredients (p < 0.01). Cookies, pastries, sweetened beverage and confectionery accounted for two-thirds of the energy contributed by ultra-processed foods. Conclusion. Children and adolescents in urban areas in Argentina showed the highest energy intake from ultra-processed. Food policies should consider the characteristics of each age group to promote a healthier diet.

Momentos alimentarios y consumo de productos ultraprocesados durante el día, Antioquia, Colombia / Food moments and comsumption of ultraprocessed products during the day, Antioquia, Colombia

Introducción. La acelerada transición nutricional en Latinoamérica ha modificado los patrones alimentarios, favoreciendo dietas con mayor participación de productos industrializados y alto aporte de nutrientes relacionados con enfermedades crónicas como grasas (saturadas, trans), sodio, azúcar libre y densidad de energía. Objetivo. Describir los momentos alimentarios de consumo de productos comestibles ultraprocesados (PCUP) durante el día en Antioquia, Colombia. Materiales y métodos. Estudio descriptivo transversal, usando datos de consumo de alimentos del Perfil Alimentario y Nutricional de Antioquia 2019 y del Perfil de Seguridad Alimentaria y Nutricional de Medellín 2015, en población general, muestra de 13494 individuos. Los alimentos se clasificaron según NOVA y se agruparon en subcategorías. Se calculó la media de energía consumida y su desviación estándar (confianza del 95%) para las categorías NOVA y subcategorías, además su distribución en los momentos alimentarios. Resultados. Para la población de Medellín (capital de Antioquia), en promedio el 54,7% de la energía venia de alimentos no procesados, 17,3% de ingredientes culinarios, y 20,4% de PCUP. En la población de Antioquia, 56,0% de la energía se obtuvo de alimentos no procesados, 18,8% de ingredientes culinarios y 17,0% de PCUP. En los momentos alimentarios principales (desayuno, almuerzo y cena) los alimentos no procesados tienen mayor aporte energético. Mientras que los momentos alimentarios con mayor porcentaje de energía proveniente de PCUP fueron la media mañana, el algo y la merienda. Conclusiones. Para los antioqueños el mayor riesgo de consumo de PCUP relacionados con la obesidad y las enfermedades crónicas se presenta entremedio de las comidas principales(AU)

Introduction. The accelerated nutritional transition in Latin America has modified dietary patterns, favoring diets with a greater participation of industrialized products and a high contribution of nutrients related to chronic diseases such as fats (saturated, trans), sodium, free sugar, and energy density. Objective. To describe the dietary moments of consumption of ultra-processed foods (UPF) during the day in Antioquia, Colombia. Materials and methods. Cross-sectional descriptive study using food consumption data from the Food and Nutrition Profile of Antioquia 2019 and the Food and Nutrition Security Profile of Medellín 2015, in general population, sample of 13,494 individuals. Foods were classified according to NOVA and grouped into subcategories. The mean energy consumed and its standard deviation (95% confidence), were calculated for the NOVA categories and subcategories, as well as its distribution at feeding times. Results. for the population of Medellín (capital of Antioquia), on average 54.7% of the energy came from unprocessed foods, 17.3% from culinary ingredients, and 20.4% from UPF. In the population of Antioquia, 56.0% of the energy was obtained from unprocessed foods, 18.8% from culinary ingredients, and 17.0% from UPF. At the main eating moments (breakfast, lunch, and dinner) unprocessed foods have a greater energy contribution. While the food moments with the highest percentage of energy coming from UPF were mid-morning snacks and snacks. Conclusions. For Antioqueños the greatest risk of consuming UPFs related to obesity and chronic diseases occurs between main meals(AU)

Ultra-processed food consumption and nutritional status in Uruguayan and Brazilian children between three to five years / Consumo de alimentos ultraprocesados y estado nutricional en niños de tres a cinco años uruguayos y brasileños

Introduction. There is growing consensus globally that the consumption of ultra- processed food (UPF) can negatively affect the nutritional status of children. Objective. The present study aims to evaluate associations between the consumption of UPF and the nutritional status in a sample of Uruguayan and Brazilian preschoolers belonging to two studies: the ENDIS Study and the Pelotas 2015 Birth Cohort. Materials and methods. We conducted a cross-sectional analysis. The main outcome measure was obesity defined as BMI for age and sex ≥ +3 z-scores. The score of UPF consumption was the main exposure measured. Each positive answer of habitual intake was added up to create a UPF score ranging from zero to six or more UPF. Crude and adjusted logistic regressions were performed for the associations between UPF consumption and nutritional status in preschoolers. Results. The final sample consisted of 8,687 preschool children, 50.8% belonging to the Uruguayan study, while the remaining 49.2% belonged to the Brazilian study. Nearly 5% of the sample of young children were obese. We didn't observe a relationship between the score of UPF consumption and obesity, the odds ratio (OR) was 1.04 (95% CI, 1.00­1.09). Adjustments resulted in modest attenuation of the relationship and a lack of statistical significance. However, in children under 48 months, the score of UPF consumption was directly associated with childhood obesity. Conclusions. Results suggest that higher consumption of UPF is associated with obesity in Uruguayan and Brazilian preschool children under 4 years of age. These findings suggest that actions to reduce ultra- processed food consumption could lead to diminish obesity patterns and bring important public health benefits(AU)

Introducción. Existe creciente consenso a nivel mundial de que el consumo de alimentos ultraprocesados puede afectar negativamente el estado nutricional de los niños. Objetivo. El presente estudio tiene como objetivo evaluar asociaciones entre el consumo de ultraprocesados y el estado nutricional en una muestra de preescolares uruguayos y brasileños pertenecientes a dos estudios: el Estudio ENDIS y la Cohorte de Nacimiento de Pelotas 2015. Materiales y métodos. Se realizó un análisis transversal. La principal medida de resultado fue la obesidad definida como el IMC/edad y sexo ≥ +3 puntuaciones z. La puntuación del consumo de ultraprocesados fue la principal exposición. Cada respuesta positiva de la ingesta habitual se sumó para crear una puntuación de ultraprocesados que oscilaba entre cero y seis o más. Se realizaron regresiones logísticas crudas y ajustadas. Resultados. La muestra final estuvo constituida por 8.687 niños, de los cuales el 50,8% pertenecía al estudio uruguayo, mientras que el 49,2% restante pertenecía al estudio brasileño. Casi el 5% de la muestra de niños pequeños eran obesos. No observamos relación entre la puntuación del consumo de ultraprocesados y la obesidad, el odds ratio (OR) fue de 1,04 (IC 95%, 1,00-1,09). Los ajustes dieron lugar a modesta atenuación de la relación y falta de significación estadística. Sin embargo, en menores de 48 meses la puntuación de consumo de ultraprocesados se asoció directamente con la obesidad infantil. Conclusiones. Los resultados sugieren que un mayor consumo de ultraprocesados se asocia con obesidad en prescolares uruguayos y brasileños menores de 4 años. Estos hallazgos sugieren que las acciones para reducir el consumo de alimentos ultraprocesados podrían conducir a una disminución de los patrones de obesidad y traer importantes beneficios para la salud pública(AU)

Educación alimentaria en pacientes en dialisis / Nutritional education in dialysis patients

La enfermedad renal crónica terminal aumenta el riesgo cardiovascular y puede ocasionar defectos en la mineralización ósea. Para prevenir esto, se debe mantener el fósforo plasmático normal, que depende de la diálisis, los quelantes y la ingesta de fósforo, principalmente de origen inorgánico, incorporado mediante aditivos alimentarios. Las intervenciones nutricionales son pilares en el tratamiento de estos pacientes. El objetivo es facilitar estrategias alimentarias a un grupo de pacientes pediátricos en diálisis, mediante educación alimentaria nutricional, para aumentar el consumo de alimentos naturales, disminuyendo la ingesta de fósforo inorgánico especialmente de los productos cárnicos procesados. Materiales y métodos: se estudió una población pediátrica en diálisis. Se preparó un programa educativo con atención personalizada, instrucción alimentaria y seguimiento mensual, seguido de un taller. Resultados: n: 17 pacientes, edad decimal media de 12,3, 53% sexo masculino, 88% en hemodiálisis. Previo a la intervención el 64,7% consumía productos cárnicos procesados. Luego del taller el 58,8% disminuyó su consumo, el 41,2% aumentó la ingesta de preparaciones caseras, el 53% incorporó nuevos condimentos, de los cuales el 89% presentó al incorporarlos, mejor aceptación a las preparaciones. Conclusiones: la hiperfosfatemia está presente en alrededor del 50% de los pacientes en diálisis asociándose a un incremento entre 20% al 40% del riesgo de mortalidad. La presencia de fósforo oculto en los alimentos y la falta de adherencia hacen prioritario trabajar en programas educativos que favorezcan el aprendizaje colaborativo, centralizados en prácticas culinarias, para brindar herramientas que faciliten una alimentación natural, disminuyendo el consumo de ultraprocesados (AU)

Chronic end-stage renal disease increases the risk of cardiovascular disease and may lead to defects in bone mineralization. In order to prevent these risks, normal plasma phosphorus levels should be maintained. Achieving this goal depends on dialysis, chelators, and phosphorus intake, mainly of inorganic origin, incorporated through food supplements. Nutritional interventions are crucial in the treatment of these patients. The objective is to facilitate nutritional strategies to a group of pediatric dialysis patients, through food education, to increase the consumption of natural foods, decreasing the intake of inorganic phosphorus, especially from processed meat products. Materials and methods: a pediatric population undergoing dialysis was studied. An educational program was prepared with personalized care, nutritional instruction, and monthly follow-up visits, followed by a workshop. Results: n: 17 patients, mean age 12.3 years, 53% male, 88% on hemodialysis. Prior to the intervention, 64.7% consumed processed meat products. After the workshop, 58.8% decreased their consumption, 41.2% increased the intake of homemade food, 53% incorporated new seasonings, of whom 89% reported better acceptance of the preparations when they were incorporated. Conclusions: hyperphosphatemia is observed in around 50% of patients undergoing dialysis and is associated with a 20% to 40% increased risk of mortality. The presence of hidden phosphorus in food and the lack of adherence point to the need for the development of educational programs that promote collaborative learning, focusing on food-preparation practices. These programs should provide tools that facilitate a natural diet, reducing the consumption of ultra-processed food (AU)

Ingesta de alimentos ultraprocesados y circunferencia de cintura según área de residencia en adultos peruanos / Ultra-processed food consumption and waist circumference by residence setting in Peruvian adults

Introducción. La circunferencia de cintura (CC) es indicador de obesidad abdominal y riesgo cardiovascular en adultos. En Perú, la obesidad ha aumentado a diferente magnitud por área de residencia y poco se sabe de la influencia del consumo de alimentos ultraprocesados (AUP) sobre este fenómeno en población adulta. Objetivo. Evaluar la asociación entre ingesta de AUP y circunferencia de cintura en adultos peruanos por área de residencia. Materiales y métodos. Estudio transversal de datos secundarios de 745 adultos con información de ingesta dietaria (un recordatorio de 24 horas) de la Encuesta Nacional Vigilancia Alimentaria y Nutricional por Etapas de Vida 2017-2018. Los AUP fueron caracterizados según la clasificación NOVA. La ingesta AUP como el porcentaje relativo de la ingesta energética total (%), dividida en terciles. La CC medida como punto medio entre última costilla y cresta iliaca. Se usó regresión lineal múltiple ponderada y análisis estratificado según área de residencia. Resultados. La edad promedio fue 37,2 años. La ingesta de AUP promedio fue 14,7% (IC95%: 14,2 ­ 15,3). Comparado con adultos en el menor tercil de ingesta de AUP, aquellos en tercil medio tuvieron mayor CC ( 0,73; IC95%: 0,22 ­ 1,24; valor p= 0,007). Al estratificar por área de residencia, adultos rurales del tercil medio tuvieron mayor CC en comparación con primer tercil ( : 1,85; IC95%: 1,17 ­ 2,53, valor p < 0,001). Conclusiones. En adultos peruanos, la ingesta de AUP se asoció a CC en áreas rurales, aunque no de forma lineal. Más estudios son necesarios para entender la naturaleza de esta asociación(AU)

Introduction. Waist circumference (WC) is an abdominal obesity and cardiovascular risk indicator among adults. In Peru, obesity prevalence has been increasing unequally between residence areas, and the influence of ultra- processed food (UPF) consumption on WC in Peruvian adults remains unclear. Objective. Evaluate the association between UPF consumption and waist circumference by residence setting among Peruvian adults. Materials and methods. A cross-sectional secondary analysis of dietary intake data (single 24-hour recall) from 745 adults aged 18 and 59 years old from the "Vigilancia Alimentaria y Nutricional por Etapas de Vida 2017-2018" National Surveys was performed. The NOVA system was used to characterize the UPFs, and the exposure was the percentage of total energy consumed from UPF per day (%), in quantiles. WC (cm) was assessed at the middle point between the last rib and the iliac crest. Weighted linear regression analysis stratified by residence areas were conducted. Results. The mean age was 37.2 years. The mean percent of total energy consumed from UPF was 14.7% (95%CI: 14.2 ­ 15.3). Those in the middle tertile of UPF consumption, had higher WC ( 0.73; 95%CI: 0.22 ­ 1.24; p-value = 0.007) compared with those in the lower tertile. In the stratified analysis, those in the second tertile in rural areas have more WC compared with the first tertile ( 1.85; 95%CI: 1.17 ­ 2.53, p-value< 0.001). Conclusions. In rural areas, UPF consumption was associated with waist circumference, but it does not follow a linear association. Further studies are needed to understand the rationale behind these results(AU)

Aplicación del perfil de nutrientes de la OPS en productos ultraprocesados, inclusive en alimentos fortificados / Application of PAHO's nutrient profile in ultra-processed products, including fortified foods

Resumen Introducción: en la actualidad se recomienda limitar el consumo de productos ultraprocesados por su alto contenido en azúcar, grasas totales, grasas saturadas, grasas trans y sodio. El etiquetado frontal es una estrategia destinada a fortalecer en el consumidor su capacidad de elegir, pero la estrategia de adición de micronutrientes realizada por la industria alimentaria contribuye a que los consumidores sobrestimen su calidad nutricional. El objetivo de este estudio fue analizar según el modelo del Perfil de Nutrientes (PN) de la Organización Panamericana de la Salud (OPS), un grupo de productos ultraprocesados disponibles en el mercado argentino y aplicar el modelo de forma diferenciada en productos fortificados por la industria alimentaria. Materiales y método: estudio de campo, transversal, descriptivo. Se aplicó el perfil de nutrientes considerando: azúcares libres, grasas totales, grasas saturadas, grasas trans y sodio, en productos fortificados y sin fortificación. Cada una de las categorías generales de alimentos: galletitas dulces, alfajores, chocolates, golosinas, helados, cereales, bebidas, dulces untables, snacks salados y lácteos, fueron divididas en subcategorías, integradas por diferentes productos. Se realizó un análisis estadístico descriptivo por subcategorías. Resultados: la muestra se conformó por 682 productos y todos superaron el punto de corte de al menos un nutriente en cantidad excesiva. El 100% de los productos fortificados (n=146) presentó cantidad excesiva de algún nutriente, el 41,1% tuvo un nutriente en cantidad excesiva y el 50,7% dos nutrientes. 95,7-100% de los productos de los grupos cereales de desayuno, chocolatadas, yogures bebibles y en pote, se categorizaron como con cantidad excesiva de azúcares libres. Conclusiones: todos los productos analizados presentaron al menos un nutriente del PN de referencia, en cantidad excesiva. Los mismos productos tenían adición de vitaminas, minerales o fibra. Se visibiliza la necesidad de realizar estudios que investiguen si esta estrategia induce confusión en el consumidor al momento de elegir.

Abstract Introduction: it is currently recommended to limit the consumption of ultra-processed products because of their high content of sugar, total fats, saturated fats, trans fats and sodium. Front labelling is a strategy aimed at strengthening consumer choice, but the micronutrient addition strategy carried out by the food industry contributes to consumers overestimating their nutritional quality. The objective of this study was to analyze, following the model of the Nutrient Profile (PN) of the Pan American Health Organization (PAHO), a group of ultra-processed products available in the Argentine market and apply the model in a differentiated way in products fortified by the food industry. Materials and method: field study, cross-sectional, descriptive. The nutrient profile was applied considering: free sugars, total fats, saturated fats, trans fats and sodium, both in fortified and unfortified products. Each of the general food categories: sweet cookies, alfajores, chocolates, sweets, ice cream, cereals, beverages, spreadable sweets, salty snacks and dairy products, were divided into subcategories, made up of different products. A descriptive statistical analysis by subcategories was performed. Results: the sample consisted of 682 products and all exceeded the cut-off point of at least one nutrient in excessive quantity. 100% of the fortified products (n=146) had an excessive amount of some nutrient, 41.1% had an excess nutrient and 50.7% two nutrients. 95.7-100% of the products of the breakfast cereals, chocolate, drinking and potted yogurts groups were categorized as having excessive amounts of free sugars. Conclusions: all the products analyzed presented at least one nutrient from the reference NP, in excessive quantity. The same products had added vitamins, minerals or fiber. The need for studies to research whether this strategy induces confusion in the consumer when choosing is made visible.

The association between multiple cardiovascular risk factors and overweight in Brazilian adolescents: an analysis based on the grade of membership / A associação entre múltiplos fatores de risco cardiovascular e o excesso de peso em adolescentes brasileiros: uma análise baseada no grade of membership

Abstract The aim of the current research is to analyze the coexistence of modifiable risk behaviors for cardiovascular disease (CVD) in 12-to-17-year-old adolescents living in Brazil and their influence on overweight. National, cross-sectional, school-based epidemiological study focused on estimating the prevalence of cardiovascular risk factors and metabolic syndrome in 12 to 17 year old adolescents enrolled in public and private schools in Brazilian counties accounting for more than 100 thousand inhabitants. The grade of membership method was used to identify the coexistence of risk factors among adolescents. The analytical sample comprised 71,552 adolescents. According to the two herein generated profiles, adolescents classified under Profile 2 have shown behaviors such as smoking, alcohol consumption and diet rich in Ultra-processed food intake ≥ 80% of the percentage of total caloric value. In addition, adolescents presenting CVD risk profile have shown increased likelihood of being overweight. The study has found coexistence of risk factors for CVD in Brazilian adolescents, with emphasis on tobacco smoking and alcoholic beverage intake. In addition, it heads towards the analysis of the association between CVD risk factors and health outcomes, such as overweight.

Resumo O objetivo desta pesquisa é analisar a coexistência de comportamentos de risco modificáveis para doenças cardiovasculares (DCV) em adolescentes de 12 a 17 anos residentes no Brasil e sua influência no excesso de peso. Estudo epidemiológico nacional, transversal, de base escolar, com foco em estimar a prevalência de fatores de risco cardiovascular e síndrome metabólica em adolescentes de 12 a 17 anos matriculados em escolas públicas e privadas de municípios brasileiros que somam mais de 100 mil habitantes. O grade of membership foi utilizado para identificar a coexistência de fatores de risco entre os adolescentes. A amostra analítica foi composta por 71.552 adolescentes. De acordo com os dois perfis gerados, os adolescentes classificados no Perfil 2 mostraram comportamentos como fumar, consumo de álcool e dieta rica em alimentos ultraprocessados ≥ 80% da porcentagem do valor calórico total. Além disso, adolescentes com perfil de risco para DCV mostraram maior probabilidade de apresentar excesso de peso. O estudo encontrou coexistência de fatores de risco para DCV em adolescentes brasileiros, com destaque para tabagismo e consumo de bebidas alcoólicas. Além disso, demonstra associação entre fatores de risco para DCV e desfechos de saúde, como o excesso de peso.

Cambios en la microbiota por ultraprocesados: obesidad, cáncer y muerte prematura / Changes in the microbiota due to ultra-processed foods: obesity, cancer and premature death

Resumen Los alimentos ultraprocesados son formulaciones industriales que están omnipresentes en todos los hoga res y las góndolas de los supermercados. Este grupo de alimentos incluye gaseosas, snacks, comidas listas para calentar como las pizzas, hamburguesas, nuggets, hasta los panes comerciales. Múltiples estudios de cohortes a largo plazo han demostrado que su consumo se asocia al aumento de la incidencia de obesidad, diabetes tipo 2, enfermedades cardiovasculares, cáncer colorrectal y mortalidad global. Además, generan huella de carbono e hídrica, con un impacto negativo en el medio am biente. La microbiota tendría un rol central generando inflamación metabólica (metainflamación). Necesitamos políticas públicas activas para reducir su consumo y promover hábitos alimenticios saludables y accesibles.

Abstract Ultra-processed foods (UPFs) are industrial formula tions that are ubiquitous in every home and supermar ket aisle. This food group includes snacks, soft drinks, ready-to-eat products like pizzas, nuggets, burger till commercial breads. Multiple long cohort studies have shown a relationship between their consumption and the rise in the incidence of obesity, type 2 diabetes, cardiovascular diseases, colorectal cancer and all-cause mortality. In addition, UPFs generate carbon and water footprints with a negative impact in our environment. The intestinal microbiota would play a central role as a trigger of metabolic inflammation (metainflammation). We need to reduce consumption of UPFs and promote healthier and accessible eating habits. Official public policies are needed.

Main results and public health implications of the National School Health Survey (ENSE), Colombia 2017

Introduction: The school population represents a fundamental group for health promotion actions, given that the foundations of healthy behaviors in adult life are established in children and adolescents, who can be greatly influenced by the school. Objective: To describe the health-related behavioral factors of schoolchildren between 13 and 17 years of age in secondary and middle school in Colombia. Methods: A national cross-sectional study was conducted (i.e., School Health Survey -ENSE-) that recorded information on dietary practices, physical activity, alcohol and drug consumption, injuries and bullying, and oral, visual and hearing health. Sampling was probabilistic, cluster and multistage. Results: Schoolchildren have low consumption of fruits, vegetables (13.1%) and dairy (76.5 %), high consumption of ultra-processed foods (82.4 %), sugary drinks (74.0 %) and fast foods (14.8 %), frequent addition of salt at the table (43.3 %), low compliance with physical activity recommendations (15.0 %) and high sedentary lifestyle (46.3 %), frequent consumption of alcohol (44.7 %) and psychoactive substances (14.7 %), in addition to prevalent situations of bullying (15.4 %), rejection (8.2 %) and verbal aggression (42.7 %). Conclusions: The ENSE shows critical inequalities by gender, ethnicity and social class, throughout the country. The indicators observed in schoolchildren are precursors of various chronic and degenerative diseases and mental illness, which requires the urgent attention of the different social actors in the country.

Introducción: La población escolar es un grupo fundamental para las intervenciones de promoción de la salud, ya que en los niños y adolescentes se sientan las bases de un comportamiento saludable en la vida adulta, que puede ser muy influenciado por la escuela. Objetivo: Describir los factores comportamentales relacionados con la salud de los escolares de 13 a 17 años de edad que cursan educación básica secundaria y media en Colombia. Métodos: Se realizó una encuesta nacional transversal (Encuesta de Salud en Escolares -ENSE-) con los lineamientos de Global School-based Student Health Survey para recolectar información sobre prácticas alimentarias, actividad física, consumo de alcohol y drogas, lesiones e intimidación, y salud bucal, visual y auditiva. El muestreo fue probabilístico, por conglomerados y polietápico. Resultados: Se incluyeron 79.640 escolares de 298 municipios. Los escolares presentaron bajo consumo de frutas, verduras (13.1%) y productos lácteos (76.5 %), alto consumo de alimentos ultraprocesados (82.4 %), bebidas azucaradas (74.0 %) y comidas rápidas (14.8 %); alto uso de sal añadida en la mesa (43.3 %), actividad física inferior a la recomendada (15.0 %) y sedentarismo (46.3 %). Fue frecuente el consumo de alcohol (44.7 %) y sustancias psicoactivas (14.7 %) y reportaron situaciones de intimidación (15.4 %), rechazo (8.2 %) y agresiones verbales (42.7 %). Conclusiones: La ENSE muestra desigualdades por género, etnia y clase social en todo el país. Los hallazgos observados en los escolares son factores de riesgo de enfermedades crónico-degenerativas y mentales, y requieren la atención urgente de los actores sociales del país.

Fatores associados ao consumo de açúcares de adição de idosos da região de Campinas-SP, Brasil / Factors associated with added sugar consumption of older adults from the region of Campinas-SP, Brazil

Resumo A alimentação adequada tem profundo impacto na saúde dos idosos, e uma especial atenção deve ser dada ao consumo de açúcares de adição na dieta, que em excesso está associado a pior controle das doenças crônicas nesta fase. O objetivo do estudo foi avaliar a prevalência do consumo de açúcares de adição de idosos da região de Campinas-SP, seus fatores associados e suas principais fontes alimentares. Trata-se de estudo transversal realizado na região de Campinas-SP, com amostra de conveniência de 586 idosos. O consumo foi obtido por meio de dois recordatórios de 24 horas, sendo inadequado se >5% do consumo energético total. Também foi calculada a contribuição dos alimentos em relação ao teor total de açúcares. Considerou-se nível crítico de p<0,05. O consumo médio de açúcares de adição estava acima do recomendado (7,0%), inadequado em mais da metade da população estudada, sendo o açúcar de mesa e o mel as principais fontes dietéticas. A prevalência de inadequação do consumo foi maior entre mulheres (69,8%; p=0,004) e em indivíduos com baixo peso (83,7%; p=0,014), e o consumo foi menor em portadores de diabetes (47,8%; p<0,001). Os resultados apontam para que sejam elaboradas ações de saúde e nutrição a fim de garantir um consumo adequado de açúcares nesta fase.

Abstract Adequate nutrition has a profound impact on older adults' health. Therefore, special attention should be given to the dietetic intake of added sugars, which in excess is associated with poorer control of chronic diseases in this phase. The aim of the study was to evaluate the prevalence of consumption of added sugars in older adults in the Campinas-SP region, its associated factors, and its main dietary sources. A cross-sectional study was conducted in the region of Campinas-SP, with a convenience sample of 586 older individuals. Intake was obtained using two 24-hour food recalls, and values >5% of total energy consumption were considered inadequate. The contribution of the groups and foods in relation to the total content of sugars was also calculated. A critical level of p<0.05 was considered. The average intake of added sugars was higher than recommended (7.0%), and this inadequacy was observed in more than half of the sample, being table sugar and honey the main dietary sources. The prevalence of inadequate consumption was higher among women (69.8%; p=0.004) and individuals with low weight (83.7%; p=0.014), and lower in those with diabetes (47.8%; p<0.001). Results indicate that health and nutrition actions should be developed to ensure adequate sugar intake at this stage.

Ultra-processed foods in institutional food services: what are diners eating?

Introduction. Frequent use of ultra-processed foods (UPF) leads to poor health outcomes, and the population must avoid their consumption. Objective. To assess the occurrence of ultra-processed foods (UPFs) in culinary lunch menus from various institutional food services. Materials and methods. Over one month, the five institutional food services analyzed served 1,128 culinary preparations; and a total of 3,863 ingredients were classified according to the extent and purpose of processing using the NOVA classification system. Associations between the occurrence of UPFs and the type, size, and management of food service establishments were analyzed. Five institutional food services in three municipalities (Bauru, Limeira, and Campinas), Brazil. Results. We found 8.4 % up to 12.6 % UPF ingredients used in culinary preparations. The highest frequency of UPFs was associated with private cafeterias (p = 0.002). Most UPFs were part of the recipe or the main ingredient in protein dishes and desserts (p < 0.05) and in university and hospital food services, respectively. UPF use was associated with food service size and type of management (p ≤ 0.003) and was more prevalent in protein dishes (p = 0.003) and large-size institutional food services (28.8 %). Self-managed units (p = 0.03) also use high amounts of UPFs in protein dishes (20.3 %). Conclusions. The presence of UPF rounded 10%; the validity of this value needs further studies. There are no comparative data in the scientific literature regarding the use of these ingredients in institutional food service culinary preparations. Therefore, it is necessary to stimulate reflection to promote healthy food habits and adequate nutrition for diners(AU)

Introducción. El uso frecuente de alimentos ultraprocesados (UPF) conduce a complicaciones de salud, y la población debe evitar su consumo. Objetivo. Evaluar la presencia de alimentos ultraprocesados (UPFs) en los menús de almuerzos de diversos servicios de alimentación institucionales. Materiales y métodos. Durante un mes, los cinco servicios de alimentación institucionales analizados sirvieron 1.128 preparaciones culinarias; y se clasificaron un total de 3.863 ingredientes según el alcance y el propósito del procesamiento, utilizando el sistema de clasificación NOVA. Se analizaron las asociaciones entre la ocurrencia de UPFs y el tipo, tamaño y gestión de los establecimientos de servicio de alimentos. Cinco servicios institucionales de alimentación en tres municipios (Bauru, Limeira y Campinas), Brasil. Resultados. Se encontró entre un 8,4 % hasta un 12,6 % de ingredientes UPF utilizados en las preparaciones culinarias. La mayor frecuencia de UPF se asoció a cafeterías privadas (p = 0,002). La mayoría de los UPFs formaban parte de la receta o eran el ingrediente principal en platos proteicos y postres (p < 0,05) y en los servicios de alimentación universitarios y hospitalarios, respectivamente. El uso de UPFs se asoció con el tamaño del servicio de alimentación y el tipo de gestión (p≤ 0,003) y fue más frecuente en platos proteicos (p = 0,003) y servicios de alimentación institucional de gran tamaño (28,8 %). Las unidades autogestionadas (p = 0,03) también utilizan altas cantidades de UPF en platos proteicos (20,3 %). Conclusiones. La presencia de UPF ronda el 10 %; la validez de este valor necesita más estudios. No existen datos comparativos en la literatura científica sobre el uso de estos ingredientes en las preparaciones culinarias de los servicios de alimentación institucional. Por ello, es necesario estimular la reflexión para promover hábitos alimentarios saludables y una adecuada nutrición de los comensales(AU)

Chemical components of Magnoliae Officinalis Cortex of different origins and with different tree ages before and after being processed with ginger juice:a qualitative and quantitative analysis / 中国中药杂志

This study aimed to investigate the impact of ginger juice on chemical profile of Magnoliae Officinalis Cortex(MOC) when they were processed together. Ultra-high-performance liquid chromatography coupled to quadrupole-orbitrap high-resolution mass spectrometry(UHPLC-Q-Orbitrap HRMS) was used for qualitative analysis of the chemical component of MOC samples before and after being processed with ginger juice. UPLC was performed to observe the content variation of eight main components in processed MOC. A total of 174 compounds were identified or tentatively deduced from processed and unprocessed MOC samples according to MS data obtained in positive and negative ion mode. After MOC was processed with ginger juice, the peak areas of most phenolics increased, while the peak areas of most phenylethanoid glycosides decreased; as for neolignans, oxyneolignans, other lignans and alkaloids, changes in the peak area were variable, and the peak areas of terpenoid-lignans varied little. Additionally, gingerols and diarylheptanoids were only detected in the processed MOC sample. The contents of syringin, magnoloside A, and magnoloside B decreased significantly in the processed MOC sample while no significant difference was observed in the contents of magnoflorine, magnocurarine, honokiol, obovatol, and magnolol. This study comprehensively explored the content variation of chemical components in processed and unprocessed MOC samples derived from different regions and with different tree ages using UPLC and UHPLC-Q-Orbitrap HRMS, and summarized the variation characteristics of various compounds. The results provide a data foundation for further research on pharmacodynamic substances of MOC processed with ginger juice.