Consumption of sugar-sweetened and artificially sweetened beverages and prevalence of hypertension in adults: a population- based study

Systemic Arterial Hypertension is a multifactorial clinical condition associated with severe outcomes such as stroke and death. One of the main modifiable risk factor for hypertension is an unhealthy diet, often characterized by the consumption of ultraprocessed foods such as sweetened beverages. We aimed to investigate the relationship between the consumption of sweetened beverages, both sugar-sweetened and artificially sweetened, and the prevalence of hypertension in adults. A cross-sectional, household, population-based study with 1,162 adults from two Brazilian cities were carried out. The consumption of food groups and sweetened beverages was obtained by food frequency questionnaire and other data were self-reported. Weight, height, and waist circumference were measured. The association between sweetened beverages consumption and hypertension was analyzed using Poisson regression models, expressed as Prevalence Ratio. The prevalence of hypertension was 16.7%, with no significant difference between genders. The prevalence of consumption of sweetened beverages was 70.3% in men and 54.6% in women, being significantly higher in men. Women who consumed sugar-sweetened and artificially sweetened beverages 6 to 7 days per week had 92% higher prevalence of hypertension compared to those who did not consume or consumed at a lower frequency. Furthermore, women who consumed artificially sweetened beverages at least 1 time per week had 3.36 times higher prevalence of hypertension. The habitual consumption of sweetened beverages may be an important risk factor for hypertension, especially the consumption of diet beverages, which are often marketed as healthier than sugar-sweetened beverages.

La Hipertensión Arterial Sistémica es una condición clínica multifactorial asociada a resultados graves como el ictus y la muerte. Uno de los principales factores de riesgo modificables de la hipertensión es una dieta poco saludable, a menudo caracterizada por el consumo de alimentos ultraprocesados como las bebidas endulzadas. Nuestro objetivo fue investigar la relación entre el consumo de bebidas endulzadas, tanto azucaradas como edulcoradas artificialmente, y la prevalencia de hipertensión en adultos. Se realizó un estudio transversal, domiciliario y poblacional con 1,162 adultos de dos ciudades brasileñas. El consumo de grupos de alimentos y bebidas endulzadas se obtuvo mediante cuestionario de frecuencia de alimentos y los demás datos fueron autoinformados. Se midieron el peso, la talla y el perímetro de la cintura. La asociación entre el consumo de bebidas endulzadas y la hipertensión se analizó mediante modelos de regresión de Poisson, expresados como Ratio de Prevalencia. La prevalencia de hipertensión fue del 16,7%, sin diferencias significativas entre géneros. La prevalencia de consumo de bebidas endulzadas fue del 70,3% en los hombres y del 54,6% en las mujeres, siendo significativamente mayor en los hombres. Las mujeres que consumían bebidas azucaradas y edulcoradas artificialmente entre 6 y 7 días a la semana tenían 92% mayor prevalencia de hipertensión que las que no consumían o consumían con una frecuencia menor. Además, las mujeres que consumían bebidas edulcoradas al menos 1 vez por semana tenían una prevalencia de hipertensión 3,36 veces mayor. Así pues, el consumo habitual de bebidas endulzadas puede ser un importante factor de riesgo de hipertensión, especialmente el consumo de bebidas dietéticas, que a menudo se comercializan como más saludables que las bebidas azucaradas.

Avaliação do potencial erosivo de bebidas ácidas / Evaluation of the erosive potential of acid drinks

Objetivo: o presente estudo teve como objetivo avaliar, in vitro, o potencial erosivo para o esmalte dentário de bebidas ácidas, comumente ingeridas pela população e encontradas com frequência no comércio da grande Florianópolis, SC, Brasil. Método: a mensuração do potencial erosivo das bebidas foi realizada através da detecção do potencial hidrogeniônico (pH) e acidez titulável (AT). A amostra foi composta por refrigerantes à base de cola, Coca-Cola® e Pepsi®; isotônicos Gatorade®-morango e maracujá e Powerade®-mix de frutas; Chás industrializados Natural Tea®-limão e Chá Matte Leão®-natural; energéticos Red Bull® e Monster Energy®; sucos naturais de Laranja Pera e de Limão Taiti; água saborizada H2OH!®-sabor limão; e água mineral, para o grupo controle. O pH foi aferido com pHmetro digital (Sensoglass SP1800) e para a AT foi utilizado o método padronizado pelo Instituto Adolfo Lutz, todos os ensaios foram realizados em triplicata. Para a análise estatística descritiva, foram empregados teste t e a ANOVA. Resultados: os menores valores de pH foram encontrados para a bebida Coca-Cola® e suco de limão com 2,3. Para AT, as amostras que apresentaram os maiores valores foram os sucos naturais, com 35,1 para o suco de limão e 13,5 para o suco de laranja. Todas as bebidas analisadas possuem potencial erosivo ao esmalte dental, por apresentarem valores de pH menores que 5,5. Quanto as mensurações de AT, os sucos naturais apresentaram os maiores valores. Conclusão: todas as bebidas do estudo foram consideradas iminentemente erosivas à estrutura dental.(AU)

Objetivo: o presente estudo teve como objetivo avaliar, in vitro, o potencial erosivo para o esmalte dentário de bebidas ácidas, comumente ingeridas pela população e encontradas com frequência no comércio da grande Florianópolis, SC, Brasil. Método: a mensuração do potencial erosivo das bebidas foi realizada através da detecção do potencial hidrogeniônico (pH) e acidez titulável (AT). A amostra foi composta por refrigerantes à base de cola, Coca-Cola® e Pepsi®; isotônicos Gatorade®-morango e maracujá e Powerade®-mix de frutas; Chás industrializados Natural Tea®-limão e Chá Matte Leão®-natural; energéticos Red Bull® e Monster Energy®; sucos naturais de Laranja Pera e de Limão Taiti; água saborizada H2OH!®-sabor limão; e água mineral, para o grupo controle. O pH foi aferido com pHmetro digital (Sensoglass SP1800) e para a AT foi utilizado o método padronizado pelo Instituto Adolfo Lutz, todos os ensaios foram realizados em triplicata. Para a análise estatística descritiva, foram empregados teste t e a ANOVA. Resultados: os menores valores de pH foram encontrados para a bebida Coca-Cola® e suco de limão com 2,3. Para AT, as amostras que apresentaram os maiores valores foram os sucos naturais, com 35,1 para o suco de limão e 13,5 para o suco de laranja. Todas as bebidas analisadas possuem potencial erosivo ao esmalte dental, por apresentarem valores de pH menores que 5,5. Quanto as mensurações de AT, os sucos naturais apresentaram os maiores valores. Conclusão: todas as bebidas do estudo foram consideradas iminentemente erosivas à estrutura dental.(AU)

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.

Preparation of a probiotic quinoa beverage by enzymatic hydrolysis of its starches and subsequent lactic acid fermentation / Elaboración de una bebida probiótica de quinua por hidrólisis enzimática de sus almidones y posterior fermentación ácido láctica

Background: The concern about consuming healthy foods has increased in recent years. Not only are they expected to comply with essential feeding functions, but they also provide health benefits. Probiotics are one of the main functional components expected to be present in functional foods and beverages. They provide many health benefits and stand out due to their metabolic capacities and adaptability to different habitats. In addition, Quinoa seeds contain valuable quantities of quality protein and nutritional values of carbohydrates, proteins, fats, fibers, and mineral substances for which they are considered an ideal dietary alternative. Objectives: This research aimed to elaborate on a probiotic quinoa beverage, which combines the effect of enzymatic hydrolysis of the starches obtained from its seeds with lactic acid fermentation using probiotic cultures, seeking to enhance its nutritional properties and converting it into a functional beverage. Methods: For this, fermentations were carried out in three different concentrations of probiotic cultures (inoculum): 10%, 5%, 1%, and three other different fermentation times: 8, 10, and 12 hours. pH, Total titrable acidity expressed as lactic acid (%), reducing sugars, and soluble solids were measured. After that, the beverage was formulated with honey, carob, preservatives, and mango flavoring. Results: Statistical analysis indicated optimal conditions were achieved with 10% probiotic cultures and 10 hours of fermentation. The microbiological analysis confirmed the presence of probiotic microorganisms at a concentration of 108 CFU/mL. Proximal analysis indicated that the composition contained 84.6 Kcal, 19.3 g of carbohydrates, and 1.4 g of protein per 100 g of beverage. Conclusions: The probiotic quinoa beverage was produced and can be considered in the group of plant-based foods, as well as a functional beverage, since the probiotic cultures it contains contribute to maintaining the intestinal microbiota and prevent the onset of chronic diseases.

Antecedentes: La preocupación por el consumo alimentos saludables ha aumentado en los últimos años. No solo se espera que cumplan con las funciones esenciales de alimentación, sino que también brinden beneficios para la salud. Los probióticos son uno de los principales componentes funcionales que se espera que estén presentes en los alimentos y bebidas funcionales. Aportan múltiples beneficios para la salud y destacan por sus capacidades metabólicas y adaptabilidad a diferentes hábitats. Además, las semillas de quinua contienen valiosas cantidades de proteína de notable calidad, valores nutricionales de carbohidratos, proteínas, grasas, fibras y sustancias minerales por lo que se consideran una alternativa dietética ideal. Objetivos: Esta investigación tuvo como objetivo elaborar una bebida probiótica de quinua, que combina el efecto de la hidrólisis enzimática de los almidones obtenidos de sus semillas con la fermentación láctica utilizando cultivos probióticos, buscando potenciar sus propiedades nutricionales y convertirla en una bebida funcional. Métodos: Para ello se realizaron fermentaciones en tres concentraciones diferentes de cultivos probióticos (inóculo): 10%, 5%, 1%, y tres distintos tiempos de fermentación: 8, 10 y 12 horas. Se midió pH, Acidez titulable total expresada como ácido láctico (%), azúcares reductores y sólidos solubles. Posteriormente, se formuló la bebida con miel, algarrobina, conservantes y saborizante de mango. Resultados: El análisis estadístico indicó que se lograron condiciones óptimas con 10% de cultivos probióticos y 10 horas de fermentación. El análisis microbiológico confirmó la presencia de microorganismos probióticos a una concentración de 108 UFC/mL. El análisis proximal indicó que la composición contenía 84,6 Kcal, 19,3 g de carbohidratos y 1,4 g de proteína por 100 g de bebida. Conclusiones: la bebida probiótica de quinua fue elaborada y puede ser considerada en el grupo de alimentos de origen vegetal, así como una bebida funcional, ya que los cultivos probióticos que contiene contribuyen al mantenimiento de la microbiota intestinal y previenen la aparición de enfermedades crónicas.

A Comparative Study of the Cytohistomorphological and Biochemical Effect of Alcoholic Beverages (Brandy, Beer, Sour Wine, Dry Gin) on the Testes of Adult Male Wistar Rats

This study was designed to evaluate the cytohistomorphological and biochemical effect of alcoholic beverages on the prostate gland of adult male Wistar rats. Sixty-five (65) rats weighing between 180-230g were used for this experiment. They were randomly divided into 13 groups of five (5) animals each. Group 1 was the normal control. Group 2-13 were the experiment groups. Group 2, 3 and 4 were treated with 1.23mg/kg, 2.45mg/kg and 3.68mg/kg bodyweight of brandy respectively. Group 5, 6 and 7 were treated with 17.32mg/kg, 34.64mg/ kg and 51.96mg/kg body weight of beer respectively. Group 8, 9 and 10 were treated with 12.25mg/kg, 24.96mg/kg and 36.74mg/kg bodyweight of soured wine respectively. Group 11, 12 and 13 were treated with 1.73mg/kg, 3.46mg/kg and 5.20mg/kg bodyweight of dry gin respectively. Administration was done daily for 28 days and orally using orogastric tube. On the 29th day, the animals were sacrificed using chloroform inhalation anaesthesia. The blood samples were aspirated via cardiac puncture and centrifuged for biochemical analysis, and testicular tissues were harvested, fixed in 10% buffered formalin, processed, and stained with haematoxylin and eosin. Body weight showed significant (p<0.05) increase in brandy administered groups compared to control. For testicular weight, there was an insignificant increase in all the treated groups except the group administered with 3.69mg/kg which showed insignificant decrease compared to control. Results for TT showed a general significant (p<0.001) decrease in all administered groups compared to control. FSH showed significant (p<0.05;0.01;0.001) decrease in group administered 3.69mg/kg of brandy, all administered groups of soured wine and group administered 5.20mg/kg of dry gin compared to control. Histology showed narrowed and elongated lumen of seminiferous tubule, hypertrophied sertoli cells, destroyed interstitial cells of leydig, distorted seminiferous tubules with degenerating spermatogenic cells in the administered groups compared to control. In conclusion, alcohol beverages pose adverse effects on the testes.

¿Qué necesita nuestra región para fortalecer políticas públicas sobre bebidas azucaradas? diálogo de decisores / What does our region need in order to strengthen public policies on sugar-sweetened beverages? decision-makers' dialogue

Con el objetivo de priorizar políticas públicas para disminuir el consumo de bebidas azucaradas en Argentina, Brasil, El Salvador y Trinidad y Tobago e identificar las necesidades de información relacionadas con la carga de enfermedad atribuible a su consumo se realizó un diálogo de políticas en el que participaron miembros de gobierno, organizaciones de la sociedad civil, investigadores y comunicadores de países de Latinoamérica y el Caribe. Se llevaron a cabo exposiciones y talleres deliberativos utilizándose herramientas de recolección de datos semiestructuradas y discusiones grupales facilitadas. Las intervenciones priorizadas fueron el incremento de impuestos, el etiquetado frontal, la restricción de la publicidad, promoción y patrocinio y las modificaciones del entorno escolar. La principal barrera percibida fue la interferencia de la industria alimentaria. La realización de este diálogo de decisores permitió la identificación de las políticas públicas prioritarias para disminuir el consumo de bebidas azucaradas en la región.

In order to prioritize public policies to reduce the consumption of sugar-sweetened beverages in Argentina, Brazil, El Salvador and Trinidad and Tobago and to identify information gaps related to the burden of disease attributable to their consumption, a policy dialogue was held with government members, civil society organizations, researchers and communicators from Latin American and Caribbean countries. Presentations and deliberative workshops were conducted using semi-structured data collection tools and group discussions. The prioritized interventions were tax increases, front labeling, restriction of advertising, promotion and sponsorship, and modifications regarding the school environment. The main perceived barrier was the interference from the food industry. This dialogue among decision-makers led to the identification of priority public policies to reduce the consumption of sugar-sweetened beverages in the region.

A introdução precoce de sucos pode influenciar desfechos antropométricos e consumo alimentar em idade pré-escolar? / Does early fruit juice introduction influence anthropometric outcomes and food consumption at preschool age?

Resumo Objetivou-se avaliar o impacto do consumo de sucos antes dos 6 meses de idade no Índice de Massa Corporal para Idade (IMC/I) e no consumo alimentar em pré-escolares. Estudo longitudinal com amostra composta por mães e seus filhos (n=103) entre 6 meses e 3 a 6 anos. Peso e estatura foram aferidos e convertidos para o escore z de IMC/I. Para avaliar o consumo alimentar, foi utilizado o Questionário de Frequência Alimentar Infantil. Testes de Qui-Quadrado e t de Student foram utilizados para comparação entre os grupos. Não houve diferença nos parâmetros antropométricos entre pré-escolares que receberam ou não suco antes dos seis meses. Aquelas que tiveram introdução de suco mais precoce (≤150 dias de vida) apresentaram consumo mais frequente (≥1x/dia) de suco artificial (63,8% versus 35,7%; p=0,028) e biscoito recheado (21,3% versus 14,3%; p=0,001) na idade pré-escolar. Crianças que receberam suco do tipo artificial antes dos 6 meses tiveram maior prevalência de consumo de refrigerante entre 1 e 4x/semana (69,2% versus 27,4%; p=0,014) e menor prevalência de consumo de achocolatado pelo menos 1x/dia (38,5% versus 69,4%; p=0,027). Sendo assim, crianças com introdução precoce de suco apresentaram maior consumo de alimentos doces e bebidas açucaradas em fase pré-escolar.

Abstract The aim of this study was to evaluate the impact of fruit juice consumption before 6 months of age on Body Mass Index-for-age (BMI-for-age) and food consumption in preschoolers. We conducted a longitudinal study with mothers and their children (n=103) at 6 months and 3-6 years. Weight and height were measured and converted into BMI-for-age z-scores. Food consumption was analyzed using the Food Frequency Questionnaire for Children. Groups were compared using the chi-squared and Student's t-tests. No differences in anthropometric measurements were found at preschool age between children who had been given fruit juice before 6 months and those who had not. Consumption of artificial juice (≥once/day) and sandwich cookies at preschool age was higher in children with early introduction of fruit juice (≤150 days of life) (63.8% versus 35.7%; p=0.028 and 21.3% versus 14.3%; p=0.001, respectively). The prevalence of the consumption of soda (1 to 4 times/week) and chocolate milk (at least once/day) was higher in children who had been given artificial juice before 6 months (69.2% versus 27.4%; p=0.014 and 38.5% versus 69.4%; p=0.027, respectively). It can be concluded that the consumption of sweet foods and sugary beverages was higher in children with early introduction of fruit juice.

Estabilidade de cor de diferentes sistemas cerâmicos fresados no CAD/CAM e polidos com diferentes métodos / Color stability of different ceramic systems milled in CAD/CAM and polished with different methods

A descoloração ou perda de translucidez dos materiais cerâmicos usados em odontologia ainda hoje é um problema, especialmente pelo comprometimento estético. Com o objetivo de comparar a estabilidade de cor, blocos de dissilicato de lítio (IPS e.max CAD HT) e de silicato de lítio reforçado com zircônia (Vita Suprinity HT) fresados no desenho de um disco com dimensões de 1,5 × 7 × 12 mm3 (n = 120) foram preparados usando 3 procedimentos de acabamento de superfície: glaze, polimento mecânico e coloração externa e glaze. Em seguida, cada grupo foi dividido em 2 subgrupos de armazenamento, chá preto e café (n = 10/grupo). As mensurações de cor foram medidas com espectrofotômetro (VITA Easyshade) no estágio inicial e após 1 semana, 2 semanas, 1 mês, 2 meses de armazenamento. As alterações de cor (ΔE) foram calculadas e analisadas estatisticamente usando ANOVA (α < 0,05). Observamos que, para ambos os materiais cerâmicos, o procedimento de glaze apresentou valores de mudança de cor estatisticamente menores do que os outros grupos (p < 0,05) após o armazenamento em ambas as bebidas. Os grupos de dissilicato de lítio apresentaram valores de alteração de cor estatisticamente menores em relação aos grupos de silicato de lítio reforçados com zircônia. Conclui-se que, o glaze sozinho levou a uma maior estabilidade de cor em relação ao polimento mecânico e coloração externa o dissilicato de lítio apresentou maior estabilidade de cor em comparação com o silicato de lítio reforçada com zircônia.

The discoloration or loss of translucency of ceramic materials used in dentistry is still a problem today, especially due to aesthetic compromise. In order to compare color stability, lithium disilicate (IPS e.max CAD HT) and zirconia-reinforced lithium silicate (Vita Suprinity HT) blocks were milled into a disc design with dimensions of 1.5 × 7 × 12 mm3 (n = 120). The specimens were prepared using 3 surface finishing procedures: glaze, mechanical polishing and external staining and glaze. Then, each group was divided into 2 storage subgroups, black tea and coffee (n = 10/group). Color measurements were measured with a spectrophotometer (VITA Easyshade) at the initial stage and after 1 week, 2 weeks, 1 month, 2 months of storage. Color changes (ΔE) were calculated and statistically analyzed using ANOVA (α < 0.05). We observed that, for both ceramic materials, the glaze procedure presented statistically lower color change values ​​than the other groups (p < 0.05) after storage in both beverages. The lithium disilicate groups showed statistically lower color change values ​​than the zirconia-reinforced lithium silicate groups. It is concluded that, glaze alone led to greater color stability compared to mechanical polishing and external staining, lithium disilicate showed greater color stability compared to zirconia-reinforced lithium silicate.

Knowledge level and influencing factors of sugar-sweetened beverages among Chinese adults aged 18-64 years in 2021 / 环境与职业医学

Background Excessive intake of sugar-sweetened beverages (SSBs) is harmful to health. In recent decades, the consumption of SSBs by Chinese residents has increased rapidly, increasing the risk of death and burden of disease. Objective To analyze the knowledge level and influencing factors of SSBs for Chinese residents aged 18-64 years in 2021. Methods A multi-stage cluster random sampling approach was used to conduct a questionnaire survey among residents aged 18-64 years in 302 survey sites across the country in 2021, and 98567 valid questionnaires were obtained. Four questions are about SSBs among the questionnaire's 5 dimensions. Respondents who answered 3 or more questions correctly were considered to have a basic understanding of SSBs. Frequency and weighted proportion were used for description. With individual as level 1 and resident council (village council) as level 2, a two-level logistic regression model was applied to examine the influencing factors. A null model was used to determine whether the two-level logistic regression model was appropriate. Results The knowledge awareness rate of SSBs was 57.0% among the Chinese residents aged 18-64 years in 2021. The knowledge point with the lowest correct rate was "It is best to consume no more than 25 grams of added sugar per day" (22.6%), while the one with the highest correct rate was "Excessive intake of SSBs can increase the risk of obesity and diabetes" (81.1%). The results of the null model showed that SSBs knowledge level had a clustering effect at resident council (village council) level (t=25.00, P<0.0001), so a two-level model fit better than a one-level model. The results of the two-level logistic model revealed that residents who were female (OR=1.14, 95%CI: 1.11, 1.18) or working in medical and health (OR=1.36, 95%CI: 1.27, 1.45) and education institutions (OR=1.16, 95%CI: 1.07, 1.24) had a higher knowledge level compared to males or residents of other occupations. The knowledge level was lower among residents in central (OR=0.87, 95%CI: 0.77, 0.97) and western (OR=0.85, 95%CI: 0.75, 0.94) areas than in eastern areas. Those with chronic diseases (OR=0.81, 95%CI: 0.78, 0.84) and who did not know if they had a chronic disease (OR=0.75, 95%CI: 0.72, 0.78) had a lower knowledge level than those without chronic diseases. Compared with 18-24 years, the knowledge level was higher in ages 35-44 years (OR=1.07, 95%CI: 1.02, 1.12) and lower in ages 55-64 years (OR=0.92, 95%CI: 0.86, 0.97), and not different from the ages 25-34 years and 45-54 years. The knowledge level increased with the level of education, the trend was statistically significant (P＜0.001). Conclusion Only about half of Chinese adults aged 18-64 years had a basic understanding of SSBs in 2021. The awareness rate of added sugar intake was low in particular. The knowledge levels of male, central and western, or less educated populations were even lower. Awareness of the negative health outcomes of SSBs was high among the population.

Beverage behaviors of senior primary school students in agricultrual and pastoral areas of Qinghai Province / 中国学校卫生

Objective@#To study the consumption of beverages among senior primary school students in rural and pastoral areas of Qinghai Province, China, in order to provide evidence for the development of nutrition and intervention strategies.@*Methods@#A multi stage stratified cluster random sampling method was employed to select 969 primary school students in grades 4 and 5 from 10 schools in Hainan Autonomous Prefecture, Haixi Autonomous Prefecture and Haidong City. All participants completed a questionnaire survey on daily beverage consumption. The Chi square test was performed to compare differences in reported rates of beverage consumption among students in different groups.@*Results@#The proportion of students who consumed beverages at home, school and elsewhere were 96.9%, 64.5% and 84.9%, respectively. The most popular beverages consumed at home were milk and yogurt ( 63.1 %), tea water (53.0%), and tea drinks (52.4%). The most popular beverages consumed at school were tea(29.8%), milk and yogurt (27.8%) and tea drinks (18.4%), while the most popular beverages consumed in other places were tea drinks ( 42.0 %), carbonated drinks (38.1%) and milk and yogurt (35.0%). The top five reasons for choosing a given beverage were taste delicious (81.2%), nutritious (57.6%),healthy and clean(52.6%),many students like to drink(39.6%),family members often drink(37.7%).@*Conclusion@#The consumption of beverages was popular among students, and sugared beverages represented a large proportion of the beverages consumed. Therefore, there is an urgent need to improve the food environment and provide effective nutrition education for students, so as to encourage the consumption of healthy beverages and cultivate healthy eating behaviors.

Beverage behaviors of senior primary school students in agricultrual and pastoral areas of Qinghai Province / 中国学校卫生

Objective@#To study the consumption of beverages among senior primary school students in rural and pastoral areas of Qinghai Province, China, in order to provide evidence for the development of nutrition and intervention strategies.@*Methods@#A multi stage stratified cluster random sampling method was employed to select 969 primary school students in grades 4 and 5 from 10 schools in Hainan Autonomous Prefecture, Haixi Autonomous Prefecture and Haidong City. All participants completed a questionnaire survey on daily beverage consumption. The Chi square test was performed to compare differences in reported rates of beverage consumption among students in different groups.@*Results@#The proportion of students who consumed beverages at home, school and elsewhere were 96.9%, 64.5% and 84.9%, respectively. The most popular beverages consumed at home were milk and yogurt ( 63.1 %), tea water (53.0%), and tea drinks (52.4%). The most popular beverages consumed at school were tea(29.8%), milk and yogurt (27.8%) and tea drinks (18.4%), while the most popular beverages consumed in other places were tea drinks ( 42.0 %), carbonated drinks (38.1%) and milk and yogurt (35.0%). The top five reasons for choosing a given beverage were taste delicious (81.2%), nutritious (57.6%),healthy and clean(52.6%),many students like to drink(39.6%),family members often drink(37.7%).@*Conclusion@#The consumption of beverages was popular among students, and sugared beverages represented a large proportion of the beverages consumed. Therefore, there is an urgent need to improve the food environment and provide effective nutrition education for students, so as to encourage the consumption of healthy beverages and cultivate healthy eating behaviors.

Sugar sweetened beverages knowledge and associated factors among primary and middle school students in Shenzhen / 中国学校卫生

Objective@#To explore the status of sugar sweetened beverages(SSBs) and its associated factors among primary and middle school students in Shenzhen, providing reference for nutrition and health education.@*Methods@#A random number table and convenience sampling method was used to select 40 135 primary and middle school students aged 6-18 years in Shenzhen. Data was collected to investigate their SSBs knowledge and associated factors.@*Results@#The proportion of SSBs knowledge score less than 60 points, between 60-79 points and 80-100 points were 5.6%, 41.9% and 52.4%. Multivariate analysis showed that age(4-6 grade, junior middle and high school), gender(female), parents education(high school or vocational schools, colleges and universities as bachelors, masters or doctors), students pay attention to the ingredient list (seldom, none), parental dissuasion or reward behavior (only forced dissuasion, giving no dissuasion, occasional reward, no reward), and the storing beverages at home (seldom, none) were associated with total SSBs knowledge score and milk containing beverage knowledge score ( β =-0.79，-1.19，-1.74，0.58， 1.20 ，1.81，2.98，3.13，2.70，4.85，6.34,6.41，-0.99，-0.78，-1.81，-2.40，5.85，6.26，0.61，1.92， P <0.05). Age(4-6 grade, junior middle and high school), gender(female), father s education background(with colleges and universities as bachelor, masters or doctors), mother s education background(high schools or vocational schools, colleges and universities as bachelors, masters or doctors), parents dissuation behaviors(giving no dissuation), parents rewarding behavior(seldom, none), storing beverages at home(seldom, none) were associated with the total SSBs knowledge score and milk containing beverage knowledge score( β =-0.68， -0.92 ，-0.49，0.26，0.51，1.05，1.09，0.90，1.93，2.62，2.55，-0.68，0.93，1.13，0.21，0.92， P <0.05).@*Conclusion@#Primary and middle school students have moderate to high level of SSBs knowledge. It is necessary for students and their parents to learn more SSBs related nutrition healthy knowledge, and to reduce home availability of SSBs.

Sugar sweetened beverages knowledge and associated factors among primary and middle school students in Shenzhen / 中国学校卫生

Objective@#To explore the status of sugar sweetened beverages(SSBs) and its associated factors among primary and middle school students in Shenzhen, providing reference for nutrition and health education.@*Methods@#A random number table and convenience sampling method was used to select 40 135 primary and middle school students aged 6-18 years in Shenzhen. Data was collected to investigate their SSBs knowledge and associated factors.@*Results@#The proportion of SSBs knowledge score less than 60 points, between 60-79 points and 80-100 points were 5.6%, 41.9% and 52.4%. Multivariate analysis showed that age(4-6 grade, junior middle and high school), gender(female), parents education(high school or vocational schools, colleges and universities as bachelors, masters or doctors), students pay attention to the ingredient list (seldom, none), parental dissuasion or reward behavior (only forced dissuasion, giving no dissuasion, occasional reward, no reward), and the storing beverages at home (seldom, none) were associated with total SSBs knowledge score and milk containing beverage knowledge score ( β =-0.79，-1.19，-1.74，0.58， 1.20 ，1.81，2.98，3.13，2.70，4.85，6.34,6.41，-0.99，-0.78，-1.81，-2.40，5.85，6.26，0.61，1.92， P <0.05). Age(4-6 grade, junior middle and high school), gender(female), father s education background(with colleges and universities as bachelor, masters or doctors), mother s education background(high schools or vocational schools, colleges and universities as bachelors, masters or doctors), parents dissuation behaviors(giving no dissuation), parents rewarding behavior(seldom, none), storing beverages at home(seldom, none) were associated with the total SSBs knowledge score and milk containing beverage knowledge score( β =-0.68， -0.92 ，-0.49，0.26，0.51，1.05，1.09，0.90，1.93，2.62，2.55，-0.68，0.93，1.13，0.21，0.92， P <0.05).@*Conclusion@#Primary and middle school students have moderate to high level of SSBs knowledge. It is necessary for students and their parents to learn more SSBs related nutrition healthy knowledge, and to reduce home availability of SSBs.

Association between sugar-sweetened beverage consumption and physical fitness index among college students / 中国学校卫生

Objective@#To understand the association between sugar sweetened beverage consumption with physical fitness index among college students, so as to provide a reference for the improvement and intervention of college students physical fitness.@*Methods@#From September to December 2021, a total of 5 520 college students from universities in Jilin, Anhui, Jiangxi, Xinjiang, and Shanghai, were surveyed with sugar sweetened beverage consumption and physical fitness using stratified cluster sampling. One way ANOVA and Logistic regression analysis were used to analyze the association between sugary drink consumption and physical fitness index (PFI).@*Results@#The frequencies of sugar-sweetened beverage consumption among college students were 10.3% , 67.2%, 13.9% , and 8.6% for 0, 1-3, 4-5, and ≥ 6 times/week, respectively. The differences in waist circumference, grip strength, standing long jumping, sit and reach, 50-meter running, and 1 000/800 meter running performance were statistically significant among college students with varying sugar-sweetened beverage consumption ( F =8.67, 7.22, 11.20, 13.47, 3.98, 2.86 , P <0.05). Logistic regression analysis showed that those who had sugary drinks 4-5 times/week, ≥ 6 times/week had a higher risk of low PFI compared to those who reported no sugary drinks ( OR =1.48, 1.56, P <0.05). With respect to gender, the risk of low PFI was also higher among male students who consumed sugary drinks ≥6 times/week ( OR =2.01, P <0.05), while there was no significant difference among female students.@*Conclusion@#Sugar-sweetened beverage consumption is negatively associated with the physical fitness index among college students with significant gender differences. College students, especially males, should be targeted to improve health literacy, reduce the consumption of sugar-sweetened beverages, so as to improve physical fitness.

Food safety and risk assessment for prepared beverage around the campus in Wuxi / 中国学校卫生

Objective@#To investigate the use of additives and microbiologic contamination in prepared beverages around campus in Wuxi City, so as to provide reference for ensuring the physical health of primary and secondary school students.@*Methods@#From August to September 2022, 108 prepared beverage were randomly collected from beverage stores around campus in four districts of Wuxi City. The food additives and microbiologic contamination were detected by the national standard method and evaluated according to the National Food Safety Standards for the Use of Food Additives and Local Food Safety Standards for Ready made Beverages. Chi squared test was used for statistical analysis.@*Results@#The use of 13 additives in prepared beverages didn t exceed the limits specified in relevant standards. The detection rate of preservatives in fruit juice (52.78%) was higher than that in tea (16.67%), and milk tea (27.78%), while the detection rate of pigments in milk tea (16.67%) was lower than that in tea (52.78%) and fruit juice (47.22%)( χ 2=11.24, 11.46, P <0.05). The overlapping use of the same functional additive did not exceed the specified limit. The exceeding rate of total bacterial count was 9.26%, and Escherichia coli was 14.81%.@*Conclusion@#There are certain food safety risks in prepared beverages around the campus in Wuxi City. Relevant enterprises and shops should strengthen supervision and management to ensure food safety for students.

Modifiable behavioral risk factors for NCDs and sleep in Brazilian adolescents / Fatores de risco comportamentais modificáveis para DNT e sono em adolescentes brasileiros

ABSTRACT OBJECTIVE To analyze the association between modifiable behavioral risk factors for non-communicable diseases and sleep parameters in Brazilian adolescents. METHODS This was a cross-sectional study that used data from the RPS Cohort Consortium, São Luís, Brazil for the follow-up of adolescents aged 18-19 years (n = 2,515). The outcomes were excessive daytime sleepiness (Epworth Sleepiness Scale - ESS) and sleep quality (Pittsburgh Sleep Quality Index - PSQI). The exposures of interest were the behavioral risk factors for non-communicable diseases (NCDs): screen time, physical inactivity, alcohol, smoking, illicit drugs, caffeine intake, and consumption of sugar-sweetened beverages. Excess weight was considered a possible mediator of this association between the exposures of interest and the outcomes. The models were analyzed by modeling with structural equations. RESULTS Physical inactivity (standardized coefficient, SC = 0.112; p = 0.001), higher consumption of alcohol (SC = 0.168; p = 0.019) and of sugar-sweetened beverages (SC = 0.128; p < 0.001) were associated with excessive daytime sleepiness in adolescents; better socioeconomic status was also associated with this outcome (SC = 0.128; p < 0.001). Physical inactivity (SC = 0.147; p < 0.001) and higher consumption of sugar-sweetened beverages (SC = 0.089; p = 0.003) were also associated with poor sleep quality. Overweight was neither a mediator nor associated with sleep quality or excessive daytime sleepiness. CONCLUSIONS The main modifiable behavioral risk factors for NCDs are associated with worse sleep parameters already in adolescence, which serves as a warning toward the accumulation of risks for sleep disorders in the future.

RESUMO OBJETIVO Analisar a associação entre fatores de risco comportamentais modificáveis para doenças não transmissíveis e parâmetros do sono em adolescentes brasileiros. MÉTODOS Estudo transversal que utilizou dados do Consórcio de Coortes RPS, São Luís, Brasil para o seguimento de adolescentes de 18-19 anos (n = 2.515). Os desfechos foram a sonolência diurna excessiva (Escala de Sonolência de Epworth - ESE) e a qualidade do sono (Índice de Qualidade do Sono de Pittsburgh - IQSP). As exposições de interesse foram os fatores de risco comportamentais para doenças não transmissíveis (DNT): tempo de tela, inatividade física, álcool, cigarro, drogas ilícitas, consumo de cafeína, consumo de bebidas adoçadas com açúcar. O excesso de peso foi considerado um possível mediador dessa associação entre as exposições de interesse e os desfechos. Os modelos foram analisados por modelagem com equações estruturais. RESULTADOS A inatividade física (Coeficiente padronizado, CP = 0,112; p = 0,001), maior consumo de álcool (CP = 0,168; p = 0,019) e de bebidas adoçadas com açúcar (CP = 0,128; p < 0,001) foram associados a sonolência diurna excessiva nos adolescentes; a melhor situação socioeconômica também foi associada a este desfecho (CP = 0,128; p < 0,001). A inatividade física (CP = 0,147; p < 0,001) e o maior consumo de bebidas adoçadas com açúcar (CP = 0,089; p = 0,003) também se associaram com a qualidade do sono ruim. O excesso de peso não foi mediador e nem associado à qualidade do sono ou à sonolência diurna excessiva. CONCLUSÕES Os principais fatores de risco comportamentais modificáveis para DNT estão associados a piores parâmetros do sono já na adolescência; alertando para um quadro de acúmulos de riscos para distúrbios de sono no futuro.

Psychosocial Factors and Alcohol Consumption among Students at a Public Technological Higher Education Institute in Peru / Factores psicosociales y consumo de alcohol en estudiantes de un Instituto de Educación Superior Tecnológica Público, Perú

Objective: To analyze the relationship between psychosocial factors and alcohol consumption among third-year students at a public technological higher education institute in Huaraz, Peru. Methods: The study utilized a quantitative approach with a cross-sectional and correlational design. A total of 232 students were assessed using an instrument adapted for this study, which demonstrated adequate levels of reliability (Cronbach's alpha = 0.82) and validity (Aiken's V = 0.92). Results: Regarding the main findings related to alcohol consumption, it was observed that 61.21 percent of the participants reported occasional alcohol consumption. In contrast, 31.48 percent reported no alcohol consumption, and 4.31 percent reported frequent consumption. In this regard, a significant relationship was identified between psychosocial factors and alcohol consumption among third-year students at a public technological higher education institute in Huaraz, Peru. Conclusions: The study concludes by examining the significant relationship between psychosocial factors, including sociodemographic, socioeconomic, sociocultural, and family variables, and alcohol consumption. Based on these findings, it is crucial to direct future research efforts towards addressing this issue(AU)

Objetivo: Analizar la relación entre los factores psicosociales y el consumo de alcohol entre estudiantes de tercer año en un Instituto de Educación Superior Tecnológica público en Huaraz, Perú. Métodos: El estudio utilizó un enfoque cuantitativo con un diseño transversal y correlacional. Se evaluó a un total de 232 estudiantes utilizando un instrumento adaptado para este estudio, el cual demostró niveles adecuados de confiabilidad (alfa de Cronbach = 0.82) y validez (V de Aiken = 0.92). Resultados: En cuanto a los principales hallazgos relacionados con el consumo de alcohol, se observó que el 61.21 por ciento de los participantes reportó un consumo ocasional de alcohol. En contraste, el 31.48% reportó no consumir alcohol y el 4.31 por ciento reportó un consumo frecuente. En ese sentido, se identificó una relación significativa entre los factores psicosociales y el consumo de alcohol entre estudiantes de tercer año en Instituto de Educación Superior Tecnológica público en Huaraz, Perú. Conclusiones: El estudio concluye examinando la relación significativa entre los factores psicosociales, incluyendo variables sociodemográficas, socioeconómicas, socioculturales y familiares, y el consumo de alcohol. Con base en estos hallazgos, es crucial dirigir futuras investigaciones para contrarrestar esta problemática(AU)

Prevalência de uso de álcool na gestação, Brasil, 2011-2012 / Prevalencia del consumo de alcohol durante el embarazo en Brasil, 2011-2012 / Prevalence of alcohol use during pregnancy, Brazil, 2011-2012

Resumo: Estudo transversal, de base hospitalar, nacional, com entrevista de 23.894 puérperas, em 2011-2012, com os objetivos de estimar a prevalência de consumo de álcool na gestação e identificar grupos mais vulneráveis. O uso de álcool na gestação foi identificado por meio da escala TWEAK, sendo classificadas como "diagnóstico presumível de uso inadequado de álcool" mulheres com pontuação ≥ 2. Calculou-se a prevalência nacional de uso de álcool e em subgrupos de acordo com características maternas, com respectivos intervalos de 95% de confiança (IC95%). Foram encontradas, de forma gráfica, coexistência de tabagismo, inadequação de consultas pré-natais e ingestão de bebidas alcoólicas na gestação. A prevalência de uso de álcool foi de 14% (IC95%: 13,3-14,7), com 10% (IC95%: 9,3-10,6) das mulheres apresentando diagnóstico presumível de uso inadequado de álcool na gestação. Maiores prevalências de uso de álcool e de diagnóstico presumível de uso inadequado foram observadas em mulheres pretas, com 12-19 anos de idade, com menor índice de escolaridade, de classe econômica mais baixa, sem companheiro, sem trabalho remunerado, com mais de três partos anteriores, que não queriam engravidar, com assistência pré-natal inadequada, com parto em serviços públicos e que referiram tabagismo na gestação. Estima-se que 1,2% das mulheres entrevistadas apresentavam concomitância dos três fatores de risco para desfechos perinatais negativos: fumo, álcool e assistência pré-natal inadequada. Os resultados demonstraram alta prevalência de uso de álcool na gestação e de diagnóstico presumível de uso inadequado, principalmente por mulheres em situação de vulnerabilidade social. São relevantes a elaboração de políticas públicas que contemplem ações de prevenção do uso de bebidas alcoólicas e a prestação de serviços de apoio para cessação do uso de álcool na gravidez.

Resumen: Estudio transversal, de base hospitalaria, nacional, con entrevistas a 23.894 puérperas, en 2011-2012, con el objetivo de estimar la prevalencia de consumo de alcohol durante el embarazo e identificar grupos más vulnerables. El consumo de alcohol durante el embarazo se identificó mediante la escala TWEAK, y las mujeres con puntuación ≥ 2 fueron clasificadas como "diagnóstico presumible de uso inadecuado de alcohol¨. Se calculó la prevalencia nacional de consumo de alcohol y subgrupos según características maternas, con sus respectivos intervalos de 95% de confianza (IC95%). Se identificó gráficamente la coexistencia de tabaquismo, consultas prenatales inadecuadas y consumo de alcohol durante el embarazo. La prevalencia de consumo de alcohol fue del 14% (IC95%: 13,3-14,7), siendo el 10% (IC95%: 9,3-10,6) de mujeres con diagnóstico presumible de uso inadecuado durante el embarazo. Se observaron mayores prevalencias de consumo de alcohol y diagnóstico presumible de uso inadecuado en mujeres de color/raza negra, de 12-19 años, con menos años de escolaridad, de clase económica más baja, sin pareja, sin trabajo remunerado, con más de tres partos previos, que no querían quedar embarazadas, con control prenatal inadecuado, con parto en el sistema público de salud y que relataron fumar durante el embarazo. Se estima que el 1,2% de las mujeres entrevistadas presentaron la concomitancia de tres factores de riesgo en resultados perinatales negativos: tabaquismo, alcohol y atención prenatal inadecuada. Los resultados demuestran una alta prevalencia de consumo de alcohol durante el embarazo y de diagnóstico presumible de uso inadecuado, especialmente en mujeres con las peores condiciones sociales, siendo relevante para la elaboración de políticas públicas que incluyan acciones de prevención del consumo de alcohol y servicios de apoyo para el cese del consumo de alcohol en el embarazo.

Abstract: This is a national cross-sectional, hospital-based study, which interviewed 23,894 postpartum women in 2011-2012 aiming to estimate the prevalence of alcohol use during pregnancy and identifying more vulnerable groups. Alcohol use during pregnancy was identified using the TWEAK scale, and women with a score of ≥ 2 were classified as having a "presumable diagnosis of inadequate alcohol use". The national prevalence of alcohol use and the prevalence in subgroups were calculated according to maternal characteristics, with respective 95% confidence intervals (95%CI). Coexistence of smoking, inadequate prenatal consultations, and alcohol use during pregnancy were graphically identified. The prevalence of alcohol use was 14% (95%CI: 13.3-14.7), with 10% (95%CI: 9.3-10.6) of women presenting presumable diagnosis of inadequate alcohol us during pregnancy. Higher prevalence of alcohol use and presumable diagnosis of inadequate alcohol us was observed in black women, aged 12-19 years, with lower educational level, from a lower economic class, without a partner, without paid work, with more than three previous births, who did not want to get pregnant, with inadequate prenatal care, with previous delivery in public services, and who reported smoking during pregnancy. Among the interviewees, 1.2% presented all three risk factors for negative perinatal outcomes at the same time: smoking, alcohol use, and inadequate prenatal care. The results showed a high prevalence of alcohol use during pregnancy and presumable diagnosis of inadequate alcohol us, especially among women with worse social conditions. These data are relevant for the formulation of public policies to prevent alcohol use and provide support services to help this population stop alcohol use during pregnancy.

Carga de enfermedad y económica atribuible al consumo de bebidas azucaradas en El Salvador / Burden of disease and economic burden attributable to the consumption of sugar-sweetened beverages in El Salvador / Carga de morbidade e econômica atribuível ao consumo de bebidas açucaradas em El Salvador

RESUMEN Objetivo. Estimar la carga de enfermedad y económica atribuible al consumo de bebidas azucaradas en El Salvador. Métodos. Se utilizó un modelo de riesgos comparativos para estimar los efectos en muertes, eventos de salud, años perdidos por muerte prematura y discapacidad (AVAD), y costos médicos directos atribuibles al consumo de bebidas azucaradas. Resultados. Un total de 520 muertes (8 cada 100 000 individuos), 214 082 eventos en salud (3 220 cada 100 000 individuos) y 16 643 AVAD podrían ser atribuibles al consumo de bebidas azucaradas en El Salvador, lo que representa $69,35 millones (dólar americano) en costos médicos directos para el año 2020. En particular, los eventos de diabetes tipo 2 (DBT2) atribuibles al consumo de bebidas azucaradas podrían llegar a representar más del 20% del total de casos de DBT2 para el país. Conclusión. Un elevado número de muertes, eventos y costos podrían atribuirse al consumo de bebidas azucaradas en El Salvador.

ABSTRACT Objective. To estimate the burden of disease and economic burden attributable to the consumption of sugar-sweetened beverages in El Salvador. Methods. A comparative risk model was used to estimate the effects on deaths, health events, disability-adjusted life years (DALYs), and direct medical costs attributable to the consumption of sugar-sweetened beverages. Results. A total of 520 deaths (8 per 100 000 individuals), 214 082 health events (3 220 per 100 000 individuals) and 16 643 DALYs could be attributable to the consumption of sugar-sweetened beverages in El Salvador, representing US$69.35 million in direct medical costs for the year 2020. In particular, type 2 diabetes (T2DM) events attributable to the consumption of sugar-sweetened beverages could represent more than 20% of total T2DM cases in the country. Conclusion. A high number of deaths, events, and costs could be attributed to the consumption of sugar-sweetened beverages in El Salvador.

RESUMO Objetivo. Estimar a carga de morbidade e econômica atribuível ao consumo de bebidas açucaradas em El Salvador. Métodos. Foi utilizado um modelo de risco comparativo para estimar os efeitos sobre óbitos, eventos de saúde, anos perdidos devido a morte prematura ou vividos com incapacidade (AVAI) e custos médicos diretos atribuíveis ao consumo de bebidas açucaradas. Resultados. Um total de 520 mortes (8 por 100 00 indivíduos), 214 082 eventos de saúde (3 220 por 100 000 indivíduos) e 16 643 AVAI podem ser atribuídos ao consumo de bebidas açucaradas em El Salvador, o que representa US$ 69,35 milhões em custos médicos diretos para o ano de 2020. Os eventos de diabetes mellitus tipo 2 (DM2) atribuíveis ao consumo de bebidas açucaradas, em especial, podem representar mais de 20% do total de casos de DM2 no país. Conclusões. Um número elevado de mortes, eventos de saúde e custos pode ser atribuído ao consumo de bebidas açucaradas em El Salvador.

Use of bacaba peel for the development of hydroelectrolytic beverages and their consumer acceptance

Abstract The hydroelectrolytic beverages segment has been expading its market and introducing new flavors in order to meet the demand for new products. However, experimental studies find concerns about the chemical compositions of these drinks. The aim of this study was to develop a drink without synthetic coloring or flavoring, with functional attributes based on the bacaba (Oenocarpus bacaba Mart.) peel extract. Two hydroelectrolytic drinks were developed, one hypotonic and the other isotonic, containing 0.5 and 1.0% of bacaba peel extract. Physicochemical characterization, determination of total phenolic compounds, anthocyanins, and antioxidant capacity were perfomed, in addition to color evaluation, as well as sensory analysis by means of preference tests. The developed formulations showed potential antioxidant activity and natural red coloring due to the phenolic compounds and anthocyanins present in the beverages. The sensory evaluation indicated positive acceptance by the tasters regarding the addition of the bacaba peel extract to the beverage formulations. The developed formulations demonstrated that the use of the bacaba peel is a viable option for the production of sports drinks, acting as a natural dye and offering health benefits due to its bioactive compounds.