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.

Knowledge, Attitude and Practices Regarding Consumption of Carbonated Soft Drinks Among the Dental Students: A Cross-Sectional Study

Abstract Objective: To assess and evaluate the knowledge, attitude, and practices regarding the consumption of carbonated drinks among dental students. Carbonated drinks are pervaded by carbon dioxide and have more adverse effects since they are acidic in nature. Nowadays, these are consumed more widely globally, causing many systemic diseases; diabetes and obesity are common. Material and Methods: This study includes 204 individuals belonging to the age group of 18-26 years. A self-structured objective type cross-sectional questionnaire survey was conducted to assess the knowledge, attitude, and practice of dental students regarding carbonated drinks. The participants were instructed to mark the most appropriate correct answer from the given list of close-ended type questions. Results: Of 204 dental students, the study population includes 125 female and 79 male students. 98.5% of the students knew about carbonated drinks, while 1.5% were unaware. Conclusion: Most participants preferred to have carbonated drinks even with their awareness about the ill effects of these drinks. Possible implications by the government authorities may probably increase awareness among the population (AU).

Fatores de risco dos beneficiários do gerenciamento clínico por telemonitoramento da saúde suplementar: estudo transversal / Risk factors of the beneficiaries of clinical management through telemonitoring of supplementary health: a cross-sectional study / Factores de riesgo de los beneficiarios del seguimiento clínico por telemonitorización de la salud complementaria: estudio transversal

OBJETIVO: Identificar a prevalência dos fatores de risco modificáveis para doença crônica não transmissível de beneficiários hipertensos e diabéticos. MÉTODO: Estudo transversal, de 2019, com dados do prontuário eletrônico de 109 adultos, independentes para as atividades cotidianas, do gerenciamento clínico por telemonitoramento de operadora de plano de saúde, Paraná-PR. Realizou­se estatística descritiva, teste qui­quadrado e regressão logística binária bruta. RESULTADOS: Homens tiveram menor consumo inadequado de refrigerante (OR =0,37) e peso elevado como fator de risco (OR =3,57). Fatores de proteção dos adultos foram hipertensão arterial (OR =0,14) e boa prontidão para mudança comportamental (OR =0,21) e, dos idosos, hipertensão arterial concomitante ao diabetes mellitus (OR =0,16). Houve associação entre idade, hipertensão arterial (p =0,001; OR =0,14; IC =0,04-0,51) e boa prontidão para a mudança comportamental (p =0,023; OR =0,21; IC =0,06-0,76). CONCLUSÃO: Predominaram idosas com estilo de vida saudável, para as quais são recomendadas intervenções de prevenção secundária.

OBJECTIVE: To identify the prevalence of the modifiable risk factors for chronic non-communicable disease in hypertensive and diabetic beneficiaries. METHOD: A cross-sectional study, from 2019, with data from the electronic medical records of 109adults, independent for the daily activities, of clinical management through telemonitoring of a health plan operator, Paraná-PR. Descriptive statistics, chi-square test and unadjusted binary logistic regression were performed. RESULTS: Men had lower inadequate consumption ofsoft drinks (OR=0.37) and overweight as a risk factor (OR=3.57). Protective factors for adults were arterial hypertension (OR=0.14) and good readiness for behavioral change (OR=0.21) and, for older adults, arterial hypertension concomitant with diabetes mellitus(OR=0.16). There was an association between age, arterial hypertension (p=0.001; OR=0.14; CI=0.04-0.51) and good readiness for behavioral change(p=0.023; OR=0.21; CI=0.06-0.76). CONCLUSION: Aged women with a healthy lifestyle predominated, for whom secondary prevention interventions are recommended.

OBJETIVO: Identificar la prevalencia de factores de riesgo modificables de enfermedades crónicas no transmisibles en beneficiarios hipertensos y diabéticos. MÉTODO: Estudio transversal, de 2019, con datos de historias clínicas electrónicas de 109 adultos, con independencia para las actividades diarias, de seguimiento clínico por telemonitorización de un operador de plan de salud, Paraná-PR. Se realizó estadística descriptiva, prueba de chi-cuadrado y regresión logística binaria bruta. RESULTADOS: Los hombres presentaron menor consumo inadecuado de gaseosas (OR =0,37) y alto peso como factor de riesgo (OR =3,57). Los factores de protección para los adultos fueron hipertensión arterial (OR =0,14) y buena disposición para el cambio de comportamiento (OR =0,21), y para los adultos mayores, hipertensión arterial concomitante con diabetes mellitus (OR =0,16). Hubo una asociación entre edad, hipertensión (p =0,001; OR =0,14; IC =0,04-0,51) y buena disposición para el cambio de comportamiento (p =0,023; OR =0,21; IC =0,06-0,76). CONCLUSIÓN: Predominaron los adultos mayores del sexo femenino con estilo de vida saludable, para quienes se recomiendan intervenciones de prevención secundaria.

Consumo de bebidas açucaradas e imagem corporal de adolescentes na Pandemia de Covid-19 / Consumption of sugary drinks and body image of adolescents in the Covid-19 Pandemic

O isolamento social promovido pela pandemia do COVID-19 alterou os comportamentos da população, principalmente de adolescentes que com o fechamento das escolas passaram a ficar em casa. Neste contexto, o consumo de alimentos e de bebidas açucaradas aumentou, podendo acarretar alterações na composição e na imagem corporal desses jovens. Este estudo avaliou o consumo de bebidas açucaradas, imagem corporal e estado nutricional de adolescentes antes e durante a pandemia do COVID-19. Tratou-se de um estudo quali-quantitativo, que avaliou 62 estudantes de 13 a 18 anos de idade na cidade de Canaã-MG. Investigou-se o consumo de bebidas açucaradas (volume e frequência) por meio do formulário de recordatório alimentar, a imagem corporal usando a escala de silhueta de 9 imagens, e o estado nutricional por meio de parâmetros antropométricos. Os resultados mostram que a maioria dos estudantes era eutrófica e relatou mudar o consumo dos tipos de bebida, a frequência e o volume consumido, sendo suco natural e refrigerante comum as bebidas mais consumidas antes e durante a pandemia. Também relataram alto índice de insatisfação corporal por magreza, que foi reduzido durante a pandemia. O motivo dessa insatisfação relacionou-se à saúde e estética, sendo que as garotas exibiram maiores alterações na insatisfação corporal entre o período antes e durante a pandemia. Os parâmetros antropométricos confirmaram o alto índice de insatisfação corporal dos estudantes, quando comparados a sua classificação por estado nutricional. Conclui-se que durante a pandemia, os estudantes alteraram o consumo de bebidas e a percepção da imagem corporal.

The social isolation promoted by the COVID-19 pandemic changed the behavior of the population, especially teenagers who, with the closing of schools, started to stay at home. In this context, the consumption of sugary foods and beverages increased, which may lead to changes in the composition and body image of these young people. This study evaluated the consumption of sugary drinks, body image, and nutritional status of adolescents before and during the COVID-19 pandemic. It was a quali-quantitative study, which evaluated 62 students from 13 to 18 years old in the city of Canaã-MG. The consumption of sugary drinks (volume and frequency) was investigated using the dietary recall form, the 9-image silhouette scale for body image, and anthropometric parameters for measuring nutritional status. The results show that most students were eutrophic and reported changing their consumption of types of beverages, frequency, and volume consumed. Natural juice and common soft drinks were the most consumed beverages before and during the pandemic. They also reported a high rate of body dissatisfaction due to thinness, which was reduced during the pandemic. The reason for this dissatisfaction was related to health and aesthetics, with girls exhibiting greater changes in body dissatisfaction between the period before and during the pandemic. Anthropometric parameters confirmed the high rate of body dissatisfaction among students, when compared to their classification by nutritional status. It is concluded that during the pandemic, students changed their consumption of beverages and their perception of their body image.

Food insecurity, food expenses and consumption of sugar and soft drinks in households with and without children and/or adolescents / Insegurança alimentar, gasto com alimentos e consumo de açúcar e refrigerante em domicílios com e sem crianças e/ou adolescentes

ABSTRACT Objectives To estimate the frequency of food insecurity in households with and without children/adolescents; compare food expenses, sugar and soft drinks consumption in these households; and to analyze the relationship between food insecurity and demographic/socioeconomic variables with food expenses, and sugar and soft drinks consumption in households with and without children/adolescents. Methods Cross-sectional study with 628 households in Campinas, SP, Brazil. Food insecurity was estimated by the Brazilian Household Food Insecurity Measurement Scale. The dependent variables were the proportion of food expenses, and consumption of sugar and soft drinks; and the independent ones included food security/insecurity condition, monthly family income, gender, age and education of the household head. Results The frequency of food insecurity was higher in households with children/adolescents than in households without minors (41.4% vs. 27.9%). The proportion of food expenses was higher in households with children/adolescents and in all households it was associated with lower family income and, in households with minors, to the presence of a female householder. Soft drinks consumption was higher in households with children/adolescents; and was related to higher income in all households, and to the presence of male householder in households with minors. Sugar consumption in households with children/adolescents was associated with higher income, male gender and education level of the household head (<12 years). In households without children/adolescents, the higher sugar consumption was associated with food insecurity and the household head's education (<8 years). Conclusion In households with children/adolescents there was a greater frequency of food insecurity and a greater commitment of income with food. Food insecurity was associated with increased sugar consumption in households without children/adolescents.

RESUMO Objetivos Estimar a frequência de insegurança alimentar em domicílios com e sem crianças/adolescentes; comparar o gasto com alimentos e o consumo de açúcar e de refrigerante nestes domicílios; e analisar a relação da insegurança alimentar e de variáveis demográficas/socioeconômicas com o gasto com alimentos e com o consumo de açúcar e de refrigerante em domicílios com e sem crianças/adolescentes. Métodos Estudo transversal com 628 domicílios de Campinas, SP, Brasil. A insegurança alimentar foi estimada pela Escala Brasileira de Insegurança Alimentar. As variáveis dependentes foram proporção de gasto com alimentos e consumo de açúcar e refrigerante; as independentes incluíram condição de segurança/insegurança alimentar, renda familiar mensal, sexo, idade e escolaridade do chefe da família. Resultados A frequência de insegurança alimentar foi maior nos domicílios com crianças/adolescentes do que nos domicílios sem menores (41,4% vs. 27,9%). A proporção de gasto com alimentos foi superior nos domicílios com crianças/adolescentes; em todos esteve associada ao menor rendimento familiar e, nos domicílios com menores, à presença de chefe da família do sexo feminino. O consumo de refrigerante foi maior em domicílios com crianças/adolescentes, relacionou-se à maior renda em todos os domicílios e à presença de chefe da família do sexo masculino em domicílios com menores. O consumo de açúcar nos domicílios com crianças/adolescentes associou-se à maior renda, sexo masculino e escolaridade do chefe <12 anos. Nos domicílios sem crianças/adolescentes, o maior consumo de açúcar esteve associado à insegurança alimentar e à escolaridade do chefe da família <8 anos. Conclusão Nos domicílios com crianças/adolescentes, houve maior frequência de insegurança alimentar e maior comprometimento da renda com a alimentação. A insegurança alimentar associou-se ao aumento do consumo de açúcar em domicílios sem crianças/adolescentes.

Década da Ação em Nutrição e tributação de bebidas açucaradas no Brasil: onde estamos? / Decade of Action on Nutrition and sugary drinks taxation in Brazil: where are we? / Década de la Acción en Nutrición y tributación de bebidas azucaradas en Brasil: ¿dónde estamos?

Resumo: O Brasil foi o primeiro país a comprometer-se com a Década da Ação em Nutrição da Organização das Nações Unidas, com metas ambiciosas relativas ao controle da obesidade e à redução do consumo de bebidas açucaradas. Neste estudo, descrevemos as iniciativas legislativas relacionadas à tributação de bebidas açucaradas apresentadas no Congresso Nacional durante os primeiros quatro anos da Década e a situação do processo decisório. Foram buscadas, nas bases de dados da Câmara dos Deputados e do Senado Federal, todas as propostas apresentadas entre 2016 e 2019 que tratassem do tema, sendo apresentados os resultados de forma narrativa, descrevendo-se o conteúdo dos projetos e a situação da tramitação. Ao todo, foram identificadas dez propostas. Seis delas visam ao aumento da tributação e ainda se encontram em apreciação de Comissões na Câmara dos Deputados. Quatro propostas buscavam sustar um ato normativo que resultou no aumento da tributação sobre concentrados de refrigerantes e foram rejeitadas e arquivadas. Ainda há um longo caminho a ser percorrido para o aumento da tributação das bebidas açucaradas no país. A complexidade e a morosidade do processo decisório no Congresso Nacional impõem dois riscos: que nenhum projeto seja convertido em lei ou, caso o seja, que não cause qualquer impacto na saúde pública até 2025.

Abstract: Brazil was the first country to commit to the United Nations' Decade of Action on Nutrition with ambitious goals related to controlling obesity and reducing the intake of sugar-sweetened beverages. In this study, we describe legislative efforts related to sugar-sweetened beverage taxation introduced in the Brazilian Legislature throughout the first four years of this decade as well as the status of the decision-making process. We searched databases within the Chamber of Deputies and the Federal Senate for legislative proposals introduced between 2016 and 2019 that addressed sugary drinks taxation. The results are presented narratively. The content of the bills and status of the legislative process are described. Ten bills were identified. Six of them are aimed at raising taxes and are currently under consideration in the Committees by the first legislative House. Four bills had been aimed at repealing an act which increased taxes on soft drink concentrates, but they have since been rejected and archived. There still seems to be a long road ahead before taxes on sugar-sweetened beverages are raised in Brazil. The lawmaking process in the Brazilian Legislature is complex and slow. This poses two risks: no law being passed; or enacted legislation not being capable to cause significant impact on public health by 2025.

Resumen: Brasil fue el primer país en comprometerse con la Década de la Acción en Nutrición de la Organización de las Naciones Unidas, con metas ambiciosas relativas al control de la obesidad y a la reducción del consumo de bebidas azucaradas. En este estudio, describimos las iniciativas legislativas relacionadas con la tributación de bebidas azucaradas, presentadas en el Congreso Nacional durante los primeros cuatro años de la Década, y la situación del proceso decisorio. Se buscaron en las bases de datos de la Cámara de los Diputados y del Senado Federal todas las propuestas presentadas entre 2016 y 2019 que tratasen el tema. Se presentan los resultados de forma narrativa, describiéndose el contenido de los proyectos y la situación de la tramitación. Se identificaron en total diez propuestas. Seis de ellas tienen como objetivo el aumento de la tributación e incluso se encuentran en apreciación de Comisiones en la Cámara de los Diputados. Cuatro propuestas buscaban demorar un acto normativo que resultó en el aumento de la tributación sobre concentrados y refrescos, que fueron rechazadas y archivadas. Todavía hay un largo camino por recorrer para el aumento de la tributación de las bebidas azucaradas en el país. La complejidad y la tardanza del proceso decisivo en el Congreso Nacional imponen dos riesgos: que ningún proyecto sea convertido en ley o, en caso de que lo sea, que no cause cualquier impacto en la salud pública hasta 2025.

Relação entre ganho de peso e consumo de refrigerantes em adolescentes brasileiros do ensino médio / Relationship between weight gain and the consumption of soft drinks in Brazilian adolescents of secondary education

A adolescência é um período de diversas transformações, sendo observadas mudanças em relação à nutrição, que podem resultar em excesso de peso corporal. Assim, o estudo teve como objetivo verificar a associação entre excesso de peso corporal e consumo de refrigerante em adolescentes escolares estratificado por sexo. Trata-se de um estudo transversal, realizado com estudantes do ensino médio. Utilizou-se um questionário autoaplicável. A variável desfecho foi a mediana do escore de IMC (eutrófico e excesso de peso) e o consumo de refrigerante foi a variável de exposição principal. Foi utilizado o modelo de Poisson, estratificado por sexo. Participaram do estudo 1.225 adolescentes, 53,4% do sexo feminino e 15,6% consumiam refrigerante diariamente. Nos adolescentes eutróficos não houve associação de consumo de refrigerantes e zIMC. Nos meninos com excesso de peso e consumo de refrigerante mais de duas vezes na semana apresentaram maior chance de estarem acima da mediana de zIMC. Os resultados apontaram que o consumo diário de refrigerantes por adolescentes do sexo masculino com excesso de peso pode aumentar as chances de ter zIMC ainda mais alto, reforçando assim, a necessidade de medidas que visem a redução do consumo de refrigerante(AU)

Adolescence is a period of several changes, with changes related to nutrition, which can result in excess body weight. Thus, the study aimed to verify the association between excess body weight and soft drink consumption in school adolescents stratified by sex. This is a cross-sectional study, carried out with high school students. A self-administered questionnaire was used. The outcome variable was the median BMI score (eutrophic and overweight) and soft drink consumption was the main exposure variable. The Poisson model, stratified by sex, was used. The sample consisted of 1,225 adolescents, which 53.4% were female and 15.6% consumed soft drinks daily. In eutrophic adolescents, there was no association between consumption of soft drinks and the BMI Z-score. In overweight boys and soda consumption more than twice a week, they were more likely to be above the BMI Z-score median. The results showed that the daily consumption of soft drinks by overweight male adolescents may increase the chances of having even higher BMI Z-score, thus reinforcing the need for measures aimed at reducing the consumption of soft drinks(AU)

Consumo de bebidas açucaradas e estado nutricional em adultos: um estudo de intervenção / Sugary drink consumption and nutritional status in adults: an intervention study

Objetivou-se avaliar mudanças no consumo de bebidas açucaradas e estado nutricional de adultos vinculados a uma instituição federal de ensino localizada em Vitória (ES), após um programa de intervenção. Foram coletadas medidas antropométricas e dados de consumo de bebidas açucaradas de todos os participantes, os quais foram randomizados e alocados em dois grupos, intervenção (ações mHealth) e controle. Posteriormente, foi realizada uma reavaliação. Os desfechos foram avaliados em relação aos grupos e aos momentos inicial e final com auxílio do software SPSS versão 21.0, adotando-se valor de p < 0,05. Foram avaliados 200 indivíduos com média de idade de 33,8±11,3 anos. As médias de circunferência da cintura e índice de massa corporal em cada momento do grupo controle foram estatisticamente diferentes, havendo aumento das medidas. A respeito do consumo de bebidas açucaradas não foram observadas diferenças estatisticamente significativas em ambos os grupos.

This study aimed to evaluate changes in the consumption of sugar sweetened soft drinks and nutritional status of adults linked to a federal educational institution located in Vitória (ES), after an intervention program. Anthropometric measurements and sugary drink intake data were collected from all participants, who were randomized and allocated into two groups, intervention (mHealth actions) and control. After that, a reevaluation was performed. The outcomes were evaluated in relation to the groups and the initial and final moments, using SPSS version 21.0, adopting p <0.05. We evaluated 200 individuals with a mean age of 33.8 ± 11.3 years. The means for waist circumference and body mass index at each moment, for the control group, were statistically different, with an increase in measurements. Regarding the consumption of sugary drinks, there were no statistically significant differences in the two groups.

Association of Carbonated Drinks intake with Dental Erosion among Dental Students: A Comparison between Day Scholars and Hostel Residents

Introduction: Coronary artery disease (CAD) contributessignificantly to the development of Heart failure in bothdeveloped and developing countries. Recognition of CAD inthese patients significantly alters the management strategy.This study was aimed at assessing the prevalence of coronarydisease in the patient with Left Ventricular systolic dysfunctionof unknown causeMaterial and Methods: This prospective study enrolledall the consecutive patients with LV systolic dysfunction ofunknown cause and Status of coronary arteries of eligiblepatients was assessed with coronary angiogram.Results: A total of 145 patients were enrolled in this study.Mean age of the patients was 53.4±7.43 years. There were91(62.8%) males and 54(37.2%) females. Dyspnea on exertion(DOE) was presenting symptom in 71(51.7%), Angina onexertion (AOE) in 15(10.3%), DOE & AOE in 47(32%), andUnstable angina (UA) in 08(5.5%) of cases. Hypertensionwas the risk factor in 88(60.7%), diabetes in 35(24.13%),smoking in 60(41.4%) and dyslipidemia in 32(22.06%)cases. Echocardiography of study patients revealed, mild LVdysfunction (EF=40%-49%) in 57 (39.7%) patients, moderateLV dysfunction (EF=30%-39%) in 71 (49%) patients andsever LV dysfunction (EF<30%) in 17 (11.7%) patients.Conclusion: coronary artery disease contributes significantlyto development of LV systolic dysfunction of unknown causeand its presence significantly alters the management andprognosis in these patients.

Efeito do treinamento concorrente na composição corporal de animais submetidos ao consumo de refrigerante / Effect of concurrent in the body composition of animals submitted to refrigerant consumption

Objetivo ­ Analisar as alterações impostas pelo treinamento concorrente na composição corporal de ratos submetidos ao consumo de refrigerante. Métodos ­ 32 ratos machos da raça Wistar, distribuídos em quatro grupos: Controle (C); Controle Refrigerante (CR); Treinamento Concorrente (TC) e Treinamento Concorrente e Refrigerante (TCR). Os grupos CR e TCR receberam a bebida (0,41 cal/g) do trigésimo ao nonagésimo dia de vida. Foram submetidos a um protocolo de treinamento concorrente, 3x/semana, pelo período de quatro semanas. O protocolo de treino foi composto por 30 minutos de treinamento aeróbio, à 80% do limiar anaeróbio, seguido do treinamento resistido, composto por 4 séries de 10 saltos e sobrecarga de 50% do peso corporal de cada animal. Após 48 horas da última sessão de treinamento, os animais foram submetidos a procedimentos cirúrgicos e mensuraram-se as variáveis de peso corporal, Índice de Massa Corporal (IMC) e Índice de Lee (Lee). Além disso, foi coletado o tecido adiposo epididimal. Resultados ­ Não foram verificadas diferenças significativas entre os índices antropométricos (p>0,05). Houve aumento do peso corporal e gordura visceral nos animais que consumiram refrigerantes. Apenas a variável peso corporal demonstrou diferença estatisticamente significativa (p<0,05). Foi verificado que a glicose sanguínea de jejum se apresentou mais baixa nos grupos que receberam refrigerantes (p<0,05). Conclusão ­ O refrigerante alterou de forma significativa as variáveis de peso corporal, glicose sanguínea de jejum e consumo de água e ração

Objective ­ To analyze the changes imposed by concurrent training on the body composition of rats submitted to the consumption of soda. Methods ­ 32 male Wistar rats, divided into four groups: Control (C); Refrigerant Control (CR); Concurrent Training (TC) and Concurrent Training and Refrigerant (TCR). The CR and TCR groups received the beverage (0.41cal/g) from the 30th to the 90th day of life. They underwent a concurrent training protocol, 3x / week, for a period of four weeks. The training protocol consisted of 30 minutes of aerobic training at 80% of the anaerobic threshold, followed by resistance training consisting of 4 sets of 10 jumps and 50% overload of each animal's body weight. 48 hours after the last training session, the animals underwent surgical procedures and the variables body weight, body mass index (BMI) and Lee index (Lee) were measured. In addition, epididymal adipose tissue was collected. Results ­ No significant differences were found between anthropometric indices (p> 0.05). There was an increase in body weight and visceral fat in animals that consumed soda. Only the body weight variable showed a statistically significant difference (p <0.05). It was found that fasting blood glucose was lower in the groups that received soda (p <0.05). Conclusion ­ The soda significantly changed the variables of body weight, fasting blood glucose and water and feed intake

Nutritional profile of sugar-sweetened beverages destined to the youngsters marketed in Brazil and Portugal / Perfil nutricional de bebidas açucaradas destinadas ao público infantojuvenil comercializadas no Brasil e em Portugal

ABSTRACT Objective To analyze and compare the sugar content in sugar sweetened beverages in Brazil and Portugal, according to the Pan American Health Organization nutritional profile model. Methods One hundred six equivalent sugary beverages were selected in the markets of São Paulo, Brazil and Porto, Portugal. Nutritional information reported on the labels was reviewed, according to the Pan American Health Organization nutritional profile model, regarding the critical content of free sugars, salt, total saturated fats and trans fatty acids. Results The Brazilian nectars presented higher amounts of sugar and vitamin C compared to Portuguese nectars that contained more protein. The juices in Portugal contained a higher content of vitamin C and Portuguese dairy beverages had higher levels of protein and sodium, while the Brazilian ones had more total fats. According to the critical nutrients proposed by the Pan American Health Organization, Brazil had excess sodium in dairy beverages and soft drinks, while in Portugal excess sodium was found in nectars and dairy beverages. In both countries, excess free sugars were present in all beverages. Conclusion The amount of sugar in the beverages represents an important contribution of added sugar, especially in the Brazilian nectars. The identification of this component in sugary beverages is fundamental for the adoption of strategies of food education to control obesity.

RESUMO Objetivo Este estudo buscou analisar e comparar o teor de açúcar presente em bebidas prontas para consumo no Brasil e em Portugal, segundo o modelo de perfil nutricional da Organização Pan-Americana de Saúde. Métodos Selecionaram-se 106 bebidas açucaradas comercializadas nos mercados das cidades de São Paulo e do Porto. Analisaram-se informações nutricionais nos rótulos, conforme o modelo de perfil nutricional da Organização Pan-Americana de Saúde, quanto ao teor crítico de açúcares livres, sal, gorduras totais, saturados e ácidos graxos trans. Resultados Os néctares brasileiros apresentaram maior quantidade de açúcar e vitamina C; os portugueses evidenciaram maior valor proteico. Os sucos em Portugal continham maior teor de vitamina C, e as bebidas lácteas portuguesas demonstraram ter maior teor de proteína e sódio; já as brasileiras, maior quantidade de gorduras totais. De acordo com os nutrientes críticos propostos pela Organização Pan-Americana de Saúde, o Brasil possuiu excesso de sódio nas bebidas lácteas e refrigerantes, enquanto Portugal, nos néctares e nas bebidas lácteas. Em ambos os países, o excesso de açúcares livres esteve presente em todas as bebidas. Conclusão A quantidade de açúcar nas bebidas representa uma expressiva contribuição de açúcar adicionado, destacando-se os néctares brasileiros. A identificação desse componente em bebidas açucaradas é fundamental para a adoção de estratégias de educação alimentar contra a obesidade.

Are laws restricting soft drinks sales in Brazilian schools able to lower their availability?

ABSTRACT OBJECTIVE To describe students protected by laws and exposed to soft drinks sales and assess whether forbidding laws are associated with lower availability of these beverages. METHODS We identified laws forbidding non-government administered cafeterias or sales of soft drinks in schools in the 27 Brazilian state capitals. Data on soft drinks sales were obtained from Pesquisa Nacional de Saúde do Escolar 2015 (PeNSE - National Survey of School Health 2015), for a representative sample of 9th graders from public and private schools. Students were attributed with the status of their school regarding the law and sale of soft drinks. Co-variables were school status (public or private), school size, geographic regions, mother's educational level, score of goods and services. We performed multivariate analyses using Poisson regression. RESULTS The total of 23 laws forbidding sales of soft drinks covered 63.0% of capitals, comprising 56.9% of students. Law coverage was higher among students from more developed regions (67.6%) and in public schools (60.6%), compared with those from less developed regions (38.0%) and private schools (45.8%). Soft drinks were available for 33.9% of students. Students attending public schools in less developed regions had the lowest availability of soft drinks, regardless of law coverage (14.8%; 12.0%); while students attending private schools in these regions had a high availability, regardless of law coverage (82.1%; 73.4%). Restrictive laws were associated with lower sales of soft drinks in more developed regions, and restrictions had a greater association with the availability of soft drinks in public schools (PR = 0.25; 95%CI = 0.15-0.41), compared with private schools (PR = 0.48; 95%CI = 0.35-0.66). CONCLUSION Laws restricting soft drinks in schools were associated with fewer sales in more developed regions. Private schools were less compliant with the law than public schools. A broadly enforced national law could reduce the availability of soft drinks in schools.

Prevalencia del consumo de estimulantes por parte de estudiantes universitarios y factores asociados / Prevalence of stimulant use among university students and associated factors / Prevalência de uso de estimulantes por estudantes universitários e fatores associados

RESUMEN Objetivo Identificar la prevalencia de consumo de sustancias estimulantes en la población estudiantil de la Universidad Latina de Costa Rica, sede San Pedro, y algunos factores asociados a estos hábitos. Materiales y Métodos La investigación es un estudio transversal de tipo observacional y analítico en la Universidad Latina de Costa Rica Sede San Pedro. Donde se utilizó como instrumento de recolección de información encuestas dirigidas a estudiantes de las diferentes carreras universitarias. El análisis estadístico se realizó con el software SPSS 19. Resultados La edad promedio de los estudiantes universitarios es de 20,6 años y las sustancias estimulantes de mayor consumo por parte de estos son las bebidas gaseosas y el café. Existe una diferencia significativa entre el consumo productos que contienen nicotina entre hombre y mujeres. Más del 50% de la población universitaria encuestada pertenece a carreras del área de ciencias de la salud. Conclusiones El sexo, el estado civil, el estado laboral, el nivel académico, la facultad en la que se estudia y la provincia de residencia, no son factores que influyan de en el consumo de sustancias estimulantes dentro de la población universitaria de la Universidad Latina de Costa Rica, siendo la única excepción el consumo de nicotina y su relación con el sexo del sujeto.

ABSTRACT Objective To identify the prevalence of stimulant use among the student population at the Universidad Latina de Costa Rica, San Pedro Campus, and some factors associated with these habits. Materials and Methods This is an analytical observational cross-sectional study conducted at the Universidad Latina de Costa Rica, San Pedro Campus. Surveys aimed at students of the different university careers were used as an instrument to collect information. The statistical analysis was carried out with SPSS 19 software. Results The average age of university students was 20.6 years, and the most commonly used stimulants were soft drinks and coffee. There is a significant difference among men and women regarding the consumption of nicotine-containing products. More than 50% of the university population surveyed was enrolled in Health Sciences programs. Conclusions Sex, marital status, work status, academic level, the faculty in which the students are enrolled, and the province of residence are not factors that influence the use of stimulants by the university population of the Universidad Latina de Costa Rica. The only exception was nicotine consumption and its relationship to the sex of the individual.

RESUMO: Objetivo Identificar a prevalência do consumo de substâncias estimulantes na população estudantil da Universidade Latina da Costa Rica, campus de San Pedro, e alguns fatores associados a esses hábitos. Materiais e métodos A pesquisa é um estudo transversal observacional e analítico da Universidade Latina da Costa Rica, campus de San Pedro. Onde pesquisas destinadas a estudantes de diferentes carreiras universitárias foram usadas como um instrumento para coletar informações. A análise estatística foi realizada com o software SPSS 19. Resultados A idade média dos estudantes universitários é de 20,6 anos e as substâncias estimulantes mais consumidas por eles são refrigerantes e café. Existe uma diferença significativa entre o consumo de produtos que contêm nicotina entre homens e mulheres. Mais de 50% da população universitária pesquisada pertence a carreiras na área das ciências da saúde. Conclusões Sexo, estado civil, emprego, nível acadêmico, escola em que é estudado e província de residência não são fatores que influenciam o consumo de substâncias estimulantes na população universitária da Universidade Latina de Costa Rica, a única exceção é o consumo de nicotina e sua relação com o sexo do sujeito.(AU)

Bebidas azucaradas y patrocinio de eventos deportivos: El derecho a la salud de niños, niñas y adolescentes en juego / Sugar-sweetened beverages and sports sponsorship: The right to health of children and adolescents at stake

La publicidad de alimentos y bebidas no saludables a la que se encuentran expuestos/as niños, niñas y adolescentes ha sido identificada como un factor de gran relevancia en la génesis, expansión y persistencia de la obesidad. Este artículo aborda el patrocinio de eventos deportivos por parte de las empresas productoras de bebidas azucaradas y su influencia en las preferencias de hidratación, intención de compra y hábitos de consumo. Se destacan las consecuencias negativas en la salud del consumo de bebidas azucaradas (gaseosas y deportivas) y su asociación con la obesidad y el riesgo de enfermedades metabólicas y cardiovasculares. Se plantea la necesidad de apelar al principio jurídico de "interés superior del niño" para exigir la protección del derecho a la salud, en línea con las recomendaciones de organismos de salud internacionales para la restricción de la publicidad de alimentos y bebidas no saludables dirigida a niños/as y adolescentes.

Advertising of unhealthy foods and beverages to which children and adolescents are exposed has been identified as a factor of great relevance in the genesis, expansion and persistence of obesity. This article deals with sports sponsorship by companies producing sugar-sweetened drinks and their influence on the preferences of hydration, purchasing, intention and consumption habits. It highlights the negative health consequences from the consumption of sugary drinks (soft drinks and sports beverages) and their association with obesity and risk of metabolic and cardiovascular diseases. There is a need to apply the legal principle of "best interests of the child" to demand the protection of the right to health, in line with the recommendations of international health organizations for the restriction of advertising of unhealthy foods and beverages targeted at children and adolescents.

Posicionamiento sobre los impuestos a alimentos no básicos densamente energéticos y bebidas azucaradas / Position paper on taxes to non-basic energy-dense foods and sugar-sweetened beverages

Resumen: En 2014, el gobierno mexicano implementó una política fiscal para disminuir el consumo de bebidas azucaradas y alimentos no básicos con alta densidad energética. Este documento resume y analiza los estudios que han evaluado el impacto observado y esperado de los impuestos a alimentos y bebidas no saludables en México. La implementación de impuestos ha logrado disminuir las compras de bebidas azucaradas en 7.6% y alimentos no básicos con alta densidad energética en 7.4%. La reducción de consumo de bebidas azucaradas podría reducir la obesidad en 2.5%, prevenir 20 000 casos de enfermedad cardiovascular y 189 000 casos de diabetes al año 2022, así como prevenir 2 000 muertes. Además, se espera que estos impuestos ayuden a reducir en 1 173 millones de dólares los costos de atención a la salud. Los impuestos a alimentos no saludables deben fortalecerse y permanecer como parte integral de la estrategia nacional dirigida a reducir la obesidad y las enfermedades crónicas en México.

Abstract: In 2014 the Mexican government implemented taxes to reduce the consumption of sugar-sweetened beverages and nonessential energy-dense foods. In this manuscript, we analyze the scientific evidence linking the consumption of these products to chronic diseases, and summarize the studies that have evaluated the observed and expected impact of food taxes in Mexico. The implementation of taxes to unhealthy foods has reduced purchases of sugar-sweetened beverages in 7.6% and nonessential energy-dense foods in 7.4%. A reduction in consumption could decrease obesity prevalence by 2.5%; prevent 20 000 cardiovascular disease events; 189 000 diabetes cases; and 20 000 cardiovascular deaths. Additionally, this impact could save nearly 1 173 million dollars from healthcare costs. Taxes to unhealthy foods should be strengthened up and remain as an integral part of the national strategy to reduce obesity and chronic diseases in Mexico.

Prevalencia de uso de loncheras saludables en escolares peruanos del nivel primario / Prevalence of healthy lunchboxes in Peruvian elementary schoolchildren / Prevalência de uso de lancheiras saudáveis ​​em alunos do ensino fundamental peruano

RESUMEN Objetivo Determinar la prevalencia de loncheras saludables en escolares peruanos del nivel primario. Material y Métodos Estudio transversal que incluyó a 8 185 escolares de colegios públicos y privados. Muestreo probabilístico, estratificado y multietápico. El tamaño de muestra calculado fue 8 628 escolares. Se definió lonchera saludable, la inclusión de una fruta, bebida y complemento saludable (bajo en azúcar, sal y aceite) según normatividad peruana, se evalúo por observación. El análisis se realizó mediante muestras complejas ajustado por factor de ponderación. Se calculó, porcentajes, intervalo de confianza de 95% y Chi-cuadrado. Se solicitó la autorización formal al director, maestros y padres, adicionalmente se pidió el asentimiento verbal a los estudiantes ≥ con 9 o más años. Resultados Se evaluaron 8 185 escolares, la prevalencia del uso de loncheras fue 58,7% (IC 95%:56.5;61.0). La prevalencia de loncheras saludables fue 5,4% (IC95%:4,6;6,3). Del total de niños, 5,6% tuvieron loncheras saludables y 5,2% del total de niñas tuvieron loncheras saludables. El 6,3% de los niños que residieron en la zona urbana tuvieron lonchera saludable y 0,8% en la zona rural. Los niños que residieron en Lima Metropolitana (8,1%) y la selva (8,1%) tuvieron loncheras saludables. Los departamentos con mayor prevalencia de loncheras saludables fueron: Arequipa (13,6%), Moquegua (9,4%), Tacna (9,3%), Lima (7,5%) y Lambayeque (6,5%). Conclusiones La prevalencia de loncheras saludables en los escolares peruanos es muy baja.(AU)

ABSTRACT Objective To determine the prevalence of healthy lunchboxes in Peruvian elementary schoolchildren. Material and Methods Cross-sectional study including a sample of 8 185 children of public and private schools. Probabilistic, stratified and multistage sampling. Healthy lunchbox was defined as that composed of a fruit, a drink and a healthy complement (low in sugar, salt and oil) according to the Peruvian law; it was evaluated by observation. The analysis was performed using complex samples adjusted by weighting factor. Percentages, 95% confidence interval and chi square were calculated. Formal authorization was requested from the principal and the teachers and fathers; additionally, written consent was requested from students aged ≥9 years or older. Results 8 185 schoolchildren were evaluated; the prevalence was 58.7% of lunchboxes (CI95%: 56.5;61.0). The prevalence of lunchbox use was 5.4% (CI95%: 4.6;6.3). A figure of 5.6% healthy lunchboxes was found in boys and 5.2% in girls. 6.3% of the children residing in the urban area had healthy lunch boxes, in contrast to 0.8% in the rural area. Children residing in Metropolitan Lima (8.1%) and the jungle (8.1%) had healthy lunchboxes. The departments with the highest prevalence of healthy lunchboxes were: Arequipa (13.6%), Moquegua (9.4%), Tacna (9.3%), Lima (7.5%) and Lambayeque (6.5%). Conclusions The prevalence of healthy lunchboxes in Peruvian schoolchildren is very low.(AU)

RESUMO Objetivo Determinar a prevalência de lancheiras saudáveis ​​em alunos do ensino fundamental peruano. Material e Métodos Estudo transversal que incluiu 8.185 escolares de escolas públicas e privadas. Amostragem probabilística, estratificada e multiestágios. O tamanho da amostra calculada foi de 8.628 escolares. Foi definida uma lancheira saudável, a inclusão de uma fruta, bebida e complemento saudável (baixo teor de açúcar, sal e óleo) de acordo com a regulamentação peruana, avaliada por observação. A análise foi realizada usando amostras complexas ajustadas para fator de ponderação. Foram calculados os percentuais, intervalo de confiança de 95% e qui-quadrado. Foi solicitada autorização formal do diretor, professores e pais, além do consentimento verbal dos alunos com idade igual ou superior a 9 anos. Resultados Foram avaliados 8 185 escolares, a prevalência de uso de lancheira foi de 58,7% (IC 95%: 56,5; 61,0). A prevalência de lancheiras saudáveis ​​foi de 5,4% (IC 95%: 4,6, 6,3). Do total de meninos, 5,6% tinham lancheiras saudáveis ​​e 5,2% de todas as meninas tinham lancheiras saudáveis. 6,3% das crianças que moravam na zona urbana tinham lancheira saudável e 0,8% na zona rural. As crianças que residiam na região metropolitana de Lima (8,1%) e na selva (8,1%) tinham lancheiras saudáveis. Os departamentos com maior prevalência de lancheiras saudáveis ​​foram: Arequipa (13,6%), Moquegua (9,4%), Tacna (9,3%), Lima (7,5%) e Lambayeque (6,5%). Conclusões A prevalência de lancheiras saudáveis ​​em escolares peruanos é muito baixa.(AU)

Potencial erosivo de jugos naturales, jugos industrializados y gaseosas: Revisión de Literatura / Erosive potential of natural juices, industrialized and carbonated beverages: Literature review

El estudio de las lesiones dentales de origen no carioso ha ganado un gran terreno en el último siglo, siendo cada vez más frecuente encontrar lesiones como erosión, abfracción, atrición, y abrasión. El consumo cotidiano de jugos naturales, jugos industrializados o de gaseosas postula como un factor preponderante en la etiología de la erosión dental. Existe literatura muy amplia que aborda supotencial erosivo, características de estas bebidas, la frecuencia de ingesta, edad de la persona, entre otros. El objetivo de esta revisión de literatura es presentar evi- dencia científica sobre el potencial erosivo en la dentición humana de los jugos naturales, jugos industrializados y gaseosas.

The study of dental lesions of non-carious origin has gained a lot of ground in the last century, being increasingly frequent to find injuries such as erosion, abfraction, attrition, and abrasion. The daily consumption of natural juices, industrialized juices orcarbonated juices postulates as a preponderant factor in the etiology of dental erosion. There is a very broad literature that addresses its erosive potential, characteristics of these drinks, the frequency of intake, age of the person, among others. The objective of this literature review is to present scien- tific evidence on the erosive potential in human dentition of natural juices, industrialized and carbonated juices.

Comparison of the Erosive Potential of Commercially Available Beverages on Human Enamel: An in vitro Study

Objective: To assess and compare the erosive potential of commercially available beverages and to evaluate the relationship between mineral loss and physiochemical properties (pH and titratable acidity) of different beverages. Material and Methods: Seven commercially available beverages [4 soft drinks, 1 chlorhexidine mouthwash and 2 controls (Amul milk and human saliva)] were tested. The pH and tritratable acidity of the beverages was determined. Fifty-six human premolars were sectioned into enamel and root surface (total 112 specimens) by using diamond-cutting machine. The specimens were immersed in each beverage for 24-hour intervals at 370C. The weight loss of the specimens and mineral loss (calcium, phosphorus and fluoride) was determined at pre and post immersion and was subjected to statistical analysis at p<0.05 level of significance. Results: All beverages included in this were acidic. Nimbooz exhibited significant (p<0.05) weight loss compared to all other beverages. Fanta shows significantly (p<0.05) high loss of phosphorus and calcium for enamel and root surface respectively. There was a week correlation with pH and tritratable acidity and loss of minerals. Conclusion: The erosive potential of Fanta and Nimbooz was significant compared to other beverages. However, it must be considered that there are numerous factors, which may influence the erosion rate in the intra oral environment; hence the result of this in vitro study should be applied with caution.

Association between beverage intake and obesity in children: The Korea National Health and Nutrition Examination Survey (KNHANES) 2013–2015

BACKGROUND/OBJECTIVES: Numerous researches have studied the association between sugar intake and obesity of children in many countries. This study was undertaken to investigate the association between beverage intake and obesity of children by reviewing a database for total sugar contents established in all foods and presented in a nutrition survey by the Korea National Health and Nutrition Examination Survey (KNHANES). SUBJECTS/METHODS: Data of 1,520 children aged 6–11 years in the 6th KNHANES (2013–2015) were analyzed for this study. A database for total sugar intake comprises the total sugar contents of all foods included in the results of a nutrition survey using the 24-hour recall method of 6th KNHANES. Beverages were categorized into carbonated beverages, fruit & vegetable drinks, other drinks, tea, and coffee. RESULTS: The average daily beverage intake of all children was 131.75 g/day, and the average daily total sugar intake in beverages was 13.76 g/day. Carbonated beverages had the highest intake rate (58.85 g/day) and also ranked highest for sugar intake (6.36 g/day). After adjusting for confounding variables, the odds ratio for obesity in children with beverage intake of ≥ 200 mL/day significantly increased by 1.83 times (95% CI, 1.11–3.00) as compared to children with beverage intake of < 200 mL/day. Also, a significant increase was observed in the odds ratio for obesity in total children (2.41 times; 95% CI, 1.35–4.33) and boys (3.15 times; 95% CI, 1.53–6.49) with carbonated beverage intake of ≥ 200 mL/day when compared with children who consumed < 200 mL/day. CONCLUSION: A positive association is observed between beverage intake and obesity in Korean children. In particular, an intake of carbonated beverages has a positive correlation with childhood obesity in boys. This study can therefore be used as scientific evidence for reducing sugar, and for the continuous management and research on beverages.

Efecto del etiquetado de semáforo en el contenido nutricional y el consumo de bebidas gaseosas en Ecuador / Effect of traffic-light labeling on nutritional content and on consumption of carbonated beverages in Ecuador / Efeito da rotulagem nutricional com modelo de semáforo no consumo de refrigerantes no Equador

RESUMEN Objetivo El objetivo de este estudio fue evaluar el efecto del etiquetado de semáforo nutricional en las compras de bebidas gaseosas y en su contenido nutricional en Ecuador. Métodos Se utilizaron dos bases de datos: la primera fue proporcionada por la Agencia Nacional de Regulación, Control y Vigilancia Sanitaria del Ecuador y la segunda se obtuvo de la empresa internacional de investigación de mercados Kantar World Panel. Se hizo un análisis antes-después de la introducción del etiquetado de semáforo con pruebas t de Student para evaluar cambios en las medias del contenido nutricional y de las compras de bebidas gaseosas y se usaron métodos de regresión lineal múltiple para evaluar cambios en las compras debido a la introducción del etiquetado de semáforo. Resultados El consumo promedio per capita de bebidas gaseosas se redujo después del etiquetado en 0,003 L/mes, que es un valor de pequeña magnitud en relación con el consumo promedio per capita (1,678 L/mes). Los resultados de las pruebas t de Student indicaron que esta diferencia no fue estadísticamente diferente de cero. Además, con los análisis de regresión tampoco se encontraron pruebas empíricas de que el etiquetado de semáforo haya afectado el consumo de bebidas gaseosas. Con relación al contenido de azúcar, se observó una reducción promedio de 0,93 gr/100 ml de bebida. Conclusiones No se encontraron pruebas empíricas de que la implementación del etiquetado de semáforo haya cambiado los hábitos de compra de bebidas gaseosas en Ecuador, pero sí de que disminuyó el contenido de azúcar de las bebidas gaseosas en el país.

SUMMARY Objective To evaluate the effect of "traffic-light" nutritional labeling on the purchase of soft drinks and on their nutritional content in Ecuador. Methods Two databases were used: the first was provided by Ecuador's National Agency for Health Regulation, Control, and Surveillance; the second was obtained from the international market research company Kantar World Panel. A before/after study was conducted of introducing traffic-light labeling, using Student's t-tests to evaluate changes in average nutritional content and the purchase of soft drinks. Multiple linear regression methods were used to evaluate changes in purchases resulting from the introduction of traffic-light labeling. Results After labeling, average per capita consumption of soft drinks declined by 0.003 L/month--a small change with respect to average per capita consumption of 1.678 L/month. The results of the Student's t-tests indicated that this difference was not statistically significant. Furthermore, the regression analyses found no empirical evidence that traffic-light labeling affected soft drink consumption. With regard to sugar content, an average reduction of 0.93 gm/100 ml of beverage was observed. Conclusions No empirical evidence was found that implementation of traffic-light labeling changed soft-drink purchase habits in Ecuador, but there is evidence that it reduced sugar content in carbonated beverages in the country.

RESUMO Objetivo Avaliar o efeito da rotulagem nutricional com modelo de semáforo na compra e no teor nutricional dos refrigerantes no Equador. Métodos As informações foram obtidas do banco de dados da Agência Nacional de Regulamentação, Controle e Vigilância Sanitária do Equador e do banco de dados da Kantar World Panel, empresa internacional de pesquisa de mercado. Foi feita uma análise do tipo antes-depois da introdução da rotulagem com modelo de semáforo. Foram usados testes t de Student para avaliar a variação nas médias do teor nutricional e na compra de refrigerantes e métodos de regressão linear multivariada para avaliar a variação na compra com a introdução da rotulagem com modelo de semáforo. Resultados Foi observada uma redução de 0,003 litro/mês no consumo médio per capita de refrigerantes com a introdução da rotulagem, que representa um valor pequeno em relação ao consumo médio per capita (1,678 litro/mês). Os resultados dos testes t de Student indicaram que esta diferença não foi estatisticamente diferente de zero. As análises de regressão também não forneceram evidências empíricas de que a rotulagem com modelo de semáforo tenha influído no consumo de refrigerantes. Com relação ao teor de açúcar, foi verificada uma redução média de 0,93 g por 100 ml de bebida. Conclusões Não foram observadas evidências empíricas de que a implantação da rotulagem nutricional com modelo de semáforo alterou os hábitos de compra de refrigerantes, porém houve uma diminuição no teor de açúcar destas bebidas no Equador.