How many meals and snacks do Brazilians eat a day? Findings from the 2017-2018 Brazilian National Dietary Survey / Quantas refeições e lanches os brasileiros fazem por dia? Resultados do Inquérito Nacional de Alimentação de 2017-2018 / ¿Cuántas comidas y meriendas tienen los brasileños por día? Resultados de la Encuesta Nacional de Alimentación 2017-2018

The habit of eating specific meals has been addressed in several studies, but the evaluation of meal patterns has received less attention. This study aimed to describe the meal patterns of the Brazilian population. A complex sampling design was used to select the 46,164 ≥ 10-year-old individuals examined in the Brazilian National Dietary Survey. Food consumption was assessed by two non-consecutive 24-hour recalls applied throughout a one-week period. The exploratory data analysis approach was used to determine the meal patterns, i.e., how individuals combined the main meals (breakfast, lunch, dinner) and snacks (morning, afternoon, evening/night) throughout the day. The most common meal patterns were three main meals + one snack, reported by 25.1% of the individuals, and three main meals + two snacks (24.6%). Other meal patterns identified were: three main meals + three snacks (18.5%); three main meals and no snacks (10.9%); one or two main meals + two snacks (7.4%); one or two main meals + one snack (6.9%); one or two main meals + three snacks (4.2%); and one or two main meals and no snacks (2.3%). Meal patterns varied according to gender and age group, and on typical versus atypical food consumption days. We found that eight patterns characterized the daily meal consumption in Brazil. Furthermore, around 80% of the population had three main meals every day and about 13% did not report having any snacks. The characterization of meal habits is important for tailoring and targeting health promotion actions.

Os hábitos de consumo de refeições específicas têm sido abordados em diversos estudos, no entanto, a avaliação dos padrões refeições tem recebido menos atenção. O objetivo deste estudo foi descrever os padrões de refeições da população brasileira. Um desenho amostral complexo foi utilizado para selecionar os 46.164 indivíduos de ≥ 10 anos examinados no Inquérito Nacional de Alimentação de 2017-2018. O consumo alimentar foi avaliado por meio de dois recordatórios de 24 horas não consecutivos, aplicados durante um período de uma semana. A análise exploratória de dados foi utilizada para determinar os padrões de refeições, ou seja, como os indivíduos combinam as principais refeições (café da manhã, almoço, jantar) e lanches (manhã, tarde, noite) ao longo do dia. Os padrões de refeições mais frequentes foram três refeições principais + um lanche, conforme relatado por 25,1% dos indivíduos, e três refeições principais + dois lanches (24,6%). Outros padrões de refeições identificados foram: três refeições principais + três lanches (18,5%); três refeições principais e nenhum lanche (10,9%); uma ou duas refeições principais + dois lanches (7,4%); uma ou duas refeições principais + um lanche (6,9%); uma ou duas refeições principais + três lanches (4,2%); e uma ou duas refeições principais e nenhum lanche (2,3%). Os padrões de refeições variaram de acordo com o sexo e a faixa etária, e nos dias típicos em comparação com os atípicos de consumo alimentar. Verificou-se que oito padrões caracterizaram o consumo diário de refeições no Brasil. Além disso, cerca de 80% da população realizava três refeições principais diárias e cerca de 13% reportaram não lanchar. A caracterização dos padrões de refeições é importante para adequar e direcionar ações de promoção da saúde.

Los hábitos alimenticios específicos se han abordado en varios estudios, sin embargo, poco se sabe sobre la evaluación de los patrones de alimentación. El objetivo de este estudio fue describir el patrón de alimentación de la población brasileña. Se utilizó un diseño de muestra complejo para seleccionar a 46.164 individuos de ≥ 10 años quienes participaron en la Encuesta Nacional de Alimentación 2017-2018. El consumo alimentario se evaluó mediante dos registros de 24 horas no consecutivos, aplicados durante una semana. Para determinar el patrón de alimentación, se aplicó el análisis exploratorio, es decir, cómo las personas combinan las comidas principales (desayuno, almuerzo, cena) y las meriendas (mañana, tarde, noche) a lo largo del día. Los patrones de alimentación más frecuentes fueron tres comidas principales + una merienda según informan el 25,1% de los individuos, y tres comidas principales + dos meriendas (24,6%). Otros patrones identificados destacaron tres comidas principales + tres meriendas (18,5%); tres comidas principales sin merienda (10,9%); una o dos comidas principales + dos meriendas (7,4%); una o dos comidas principales + una merienda (6,9%); una o dos comidas principales + tres meriendas (4,2%); y una o dos comidas principales sin merienda (2,3%). Los patrones de alimentación tuvieron una variación según el sexo y el grupo de edad, y en días típicos en comparación con los atípicos de consumo de alimentos. Se encontró que ocho patrones caracterizan el consumo diario de comidas en Brasil. Por lo tanto, aproximadamente el 80% de la población tienen tres comidas principales al día y aproximadamente el 13% informan que no tienen merienda. Es importante caracterizar los patrones de alimentación para adaptar y orientar las acciones de promoción de la salud.

Sodium intake according to NOVA food classification in Brazil: trends from 2002 to 2018 / Ingestão de sódio segundo a classificação NOVA no Brasil: tendências de 2002 a 2018 / Ingesta de sodio según la clasificación NOVA en Brasil: tendencias del 2002 al 2018

Abstract: Excessive sodium intake is a major global public health issue and the identification of dietary sources and temporal trends in its consumption are a key to effective sodium reduction policies. This study aims to update estimates of sodium intake and its dietary sources in Brazil according to the NOVA food classification system. Records of 7-day food purchases of households from the Brazilian Household Budgets Survey of 2002-2003, 2008-2009, and 2017-2018 were converted into nutrients using food composition tables and the mean availability was estimated per 2,000kcal/day. Mean daily sodium available for consumption in Brazilian households has increased from 3.9 to 4.7g per 2,000kcal, from 2002-2003 to 2017-2018, over twice the recommended levels of sodium intake. From 2002-2003 to 2017-2018, the processed culinary ingredients, including table salt, represented the largest dietary source of sodium, although their participation in dietary sodium was reduced by 17% (66.6% to 55%), while the percentage of dietary sodium from processed foods increased by 20.3% and from ultra-processed foods increased by 47.6% (11.3% to 13.6% and 17% to 25.1%, respectively). In conclusion, the total household sodium availability remains high and has increased over time in Brazil, yet the participation of different dietary sources of sodium have gradually changed.

Resumo: A ingestão excessiva de sódio é um dos principais problemas de saúde pública em todo o mundo e a identificação de fontes alimentares e tendências temporais no seu consumo são fundamentais para a elaboração de políticas eficazes de redução de sódio. Este estudo tem como objetivo atualizar as estimativas de ingestão de sódio e suas fontes alimentares no Brasil de acordo com o sistema de classificação NOVA. Os registros de compras de alimentos no período de 7 dias de famílias das Pesquisas de Orçamentos Familiares de 2002-2003, 2008-2009 e 2017-2018 foram convertidos em nutrientes utilizando tabelas de composição de alimentos. A disponibilidade média foi estimada em 2.000kcal/dia. A média diária de sódio disponível para consumo nos domicílios brasileiros aumentou de 3,9 para 4,7g por 2.000kcal, de 2002-2003 a 2017-2018, mais do que o dobro dos níveis recomendados de ingestão desse nutriente. De 2002-2003 a 2017-2018, os ingredientes culinários processados, incluindo o sal de cozinha, representaram a maior fonte de sódio, embora a sua participação no sódio dietético tenha sido reduzida em 17% (de 66,6% para 55%), enquanto a porcentagem de sódio dietético dos alimentos processados aumentou 20,3% e dos alimentos ultraprocessados aumentou 47,6% (11,3% para 13,6% e 17% para 25,1%, respectivamente). Concluindo, a disponibilidade total de sódio nos domicílios permanece alta e tem aumentado ao longo do tempo no Brasil, mas a participação de diferentes fontes dietéticas de sódio mudou gradualmente.

Resumen: La ingesta excesiva de sodio es uno de los principales problemas de salud pública en todo el mundo, y la identificación de las fuentes alimentarias y tendencias temporales en su consumo son esenciales para desarrollar políticas efectivas de reducción de sodio. Este estudio tiene como objetivo actualizar las estimaciones de la ingesta de sodio y sus fuentes alimentarias en Brasil según el sistema de clasificación NOVA. Los registros de compras de alimentos en el período de 7 días de familias de las Encuestas de Presupuestos Familiares de Brasil de 2002-2003, 2008-2009 y 2017-2018 se convirtieron en nutrientes utilizando tablas de composición de alimentos. La disponibilidad media se estimó en 2.000kcal/día. El promedio diario de sodio disponible para el consumo en los hogares brasileños aumentó de 3,9 a 4,7g por 2.000kcal, entre 2002-2003 y 2017-2018, más del doble de los niveles de ingesta recomendados de este nutriente. Entre 2002-2003 y 2017-2018, los ingredientes culinarios procesados, incluida la sal de mesa, representaron la mayor fuente de sodio, aunque su participación en el sodio dietético se redujo en un 17% (del 66,6% al 55%), mientras que el porcentaje de sodio dietético de los alimentos procesados aumentó un 20,3% y de los alimentos ultraprocesados aumentó un 47,6% (11,3% a 13,6% y 17% a 25,1%, respectivamente). En conclusión, la disponibilidad total de sodio en los hogares sigue siendo alta y ha aumentado a lo largo del tiempo en Brasil, pero la proporción de diferentes fuentes dietéticas de sodio ha cambiado gradualmente.

Cuestionario de conocimientos nutricionales aplicados en el deporte: Propuesta inicial de instrumento

El conocimiento nutricional es clave para la formación de hábitos alimentarios y en la modulación del comportamiento alimentario. La alimentación y nutrición son cruciales durante la adolescencia sobre todo en jóvenes deportistas. El objetivo de esta investigación fue analizar la validez teórica y los índices de discriminación y dificultad del cuestionario de conocimientos nutricionales aplicados en el deporte utilizando la teoría de respuesta al ítem en deportistas juveniles de 14 a 19 años. Este estudio instrumental se desarrolló en cinco fases: generación de ítems, revisión por panel de expertos, pilotaje, aplicación y depuración final. Participaron 261 adolescentes de 14 a 19 años e integrantes de disciplinas colectivas en selecciones Nacional y clubes profesionales. Se determinaron los índices de dificultad y de discriminación para cada uno de los ítems. Los ítems 1 (0,354) y 2 (0,285) del factor antes, 3 (0,315) y 6 (0,408) del factor durante, 7 (0,354) y 10 (0,408) del factor después, 3 (0,254) y 9 (0,231) del factor hidratación y, 2 (0,362) y 5 (0,323) del factor suplementación, fueron los que presentaron mayor grado de discriminación. El cuestionario de conocimientos nutricionales aplicados en el deporte está compuesto por 30 ítems divididos en cinco factores cada uno de ellos con seis ítems. La propuesta inicial del cuestionario es una herramienta valida teóricamente y con índices de dificultad y discriminación adecuados para evaluar el conocimiento nutricional en jóvenes deportistas. Su aplicación permite conocer potenciales brechas en conocimientos claves y diseñar estrategias educativas específicas para subsanarlas.

Nutritional knowledge plays a fundamental role in the formation of dietary habits and the modulation of eating behaviour. Nutrition and diet are crucial during adolescence, especially for young athletes. The purpose of this research was to analyse the theoretical validity and indices of discrimination and difficulty of the questionnaire on nutritional knowledge applied in sports using item response theory in youth athletes aged 14 to 19. This instrumental study was conducted in five phases: item generation, expert panel review, pilot testing, application, and final refinement. A total of 261 adolescents aged 14 to 19, who were members of national team and collective disciplines of professional clubs, participated. Difficulty and discrimination indices were determined for each item. Items 1 (0.354) and 2 (0.285) of the before factor, 3 (0.315) and 6 (0.408) of the during factor, 7 (0.354) and 10 (0.408) of the post factor, 3 (0.254) and 9 (0.231) of the hydration factor, and 2 (0.362) and 5 (0.323) of the supplementation factor showed the highest degree of discrimination. The questionnaire on nutritional knowledge applied in sports consists of 30 items divided into five factors, each with six items. The initial questionnaire proposal is a theoretically valid tool and with adequate difficulty and discrimination indices to evaluate nutritional knowledge in young athletes. Its application allows for identifying potential gaps in key knowledge and designing specific educational strategies to address them.

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

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

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

Sobrepeso y obesidad en escolares de la Región de Magallanes y Antártica Chilena, Chile, (2009 ­ 2019), y comparación de dos metodologías para el diagnóstico / Overweight and obesity in schoolchildren in the Magallanes and Chilean Antarctica Region, Chile, (2009 - 2019), and comparison of two methodologies for diagnosis

Introducción. En Chile la prevalencia de obesidad total en población escolar alcanza al 31% y la obesidad severa al 10,8%. La Región de Magallanes y Antártica Chilena, es una de las más afectadas por esta epidemia. El diagnóstico nutricional confiable y una intervención oportuna pueden evitar que los niños enfermen y deterioren su calidad de vida. Objetivo: Analizar la tendencia del estado nutricional de escolares de la Región de Magallanes, según datos reportados por la Junta Nacional de Auxilio Escolar y Becas, JUNAEB, entre 2009-2019 y comparar resultados del año 2010 con un estudio propio. Materiales y métodos. Se analizó el estado nutricional de 71.334 escolares de la Región de Magallanes y Antártica Chilena por nivel educacional y variables demográficas, según información de JUNAEB. Luego se compararon los resultados de escolares de 1º básico del año 2010, obtenidos a través de dos metodologías: fuente secundaria, Encuesta JUNAEB, y fuente primaria, estudio antropométrico realizado en la misma región y año. Resultados. Según datos de JUNAEB el exceso ponderal se incrementó en escolares de la región en 4,4 % entre 2009 y 2019, el grupo más afectado fue 1º básico. En el año 2010 la prevalencia de obesidad para escolares de 1º básico según JUNAEB fue 21,8% y según estudio regional propio fue 25,7%. Conclusiones. La malnutrición por exceso afecta al 53,8% de los escolares de la Región de Magallanes y podría ser mayor, considerando que la información censal podría estar subestimando el sobrepeso y obesidad. Es urgente intervenir para evitar perpetuar esta epidemia(AU)

Introduction. In Chile the prevalence of total obesity in school population reaches 31% and severe obesity 10.8%. The Magallanes and Chilean Antarctica Region is one of the most affected by this epidemic. Reliable nutritional diagnosis and timely intervention can prevent children from getting sick and deteriorating their quality of life. Objective. To analyze the trend of nutritional status of schoolchildren in the Magallanes Region, according to data reported by the National Board of School Aid and Scholarships, JUNAEB between 2009-2019 and compare results from 2010 with our own study. Materials and methods. The nutritional status of 71,334 schoolchildren in the Magallanes Region and Chilean Antarctica was analyzed by educational level and demographic variables, according to information from JUNAEB. Then, the results of schoolchildren in 1st grade in 2010 were compared, obtained through two methods: secondary source, JUNAEB survey, and primary source, anthropometric study carried out in the same region and year. Results. According to JUNAEB data, overweight increased in school children in the region by 4.4% between 2009 and 2019, the most affected group was 1st grade. In 2010 the prevalence of obesity for 1st grade schoolchildren according to JUNAEB was 21.8% and according to our own regional study it was 25.7%. Conclusions. Excess malnutrition affects 53.8% of school children in the Magallanes Region and could be higher, considering that census information could be underestimating overweight and obesity. It is urgent to intervene to avoid perpetuating this epidemic(AU)

Comparación entre mediciones e índices antropométricos para evaluar la obesidad general y la abdominal, Colombia ENSIN 2015

Introducción. El exceso de peso representa un problema en la población adulta, el cual aumentó en los últimos años y se asocia con enfermedades no transmisibles. Objetivos. Comparar las mediciones con los índices antropométricos y evaluar su relación con variables individuales y sociodemográficas para generar información sobre el uso de las principales medidas en la evaluación de la obesidad general y la abdominal como indicadores de riesgo cardiovascular. Materiales y métodos. Se hace un análisis secundario de la encuesta ENSIN para Colombia, con datos recolectados entre el 2015 y el 2016. Como marco muestral, se utilizó el Censo de Población y Vivienda del 2005 del Departamento Administrativo Nacional de Estadística (DANE), y la muestra incluyó 44.202 hogares y 151.343 personas de 0 a 64 años; para este análisis, se seleccionaron 70.315 registros de población adulta. Se calcularon proporciones, intervalos de confianza, medidas de tendencia central y dispersión. Resultados. Las medias del índice de masa corporal (IMC) y del índice cintura-estatura fueron más grandes que el punto de corte en ambos sexos, mientras que las medias de la circunferencia de la cintura estuvieron por debajo del corte para los hombres y por encima de aquel para las mujeres (p<0,05). La prevalencia de obesidad por IMC fue de 17,5 %, mientras que la obesidad abdominal, según la circunferencia de la cintura, fue de 50,2 %, y según el índice cintura-estatura, de 62,6 %. Conclusiones. Independientemente del indicador utilizado, la obesidad abdominal es cerca de tres veces más frecuente que la obesidad general por IMC; con el índice cintura- estatura se identifican más personas, en especial hombres, con obesidad abdominal en comparación con la circunferencia de la cintura.

Introduction. Excess weight represents a problem in the adult population, has increased in recent years and is associated with noncommunicable diseases. Objectives. To make comparisons between anthropometric measurements and indices and to evaluate their relationship with individual and sociodemographic variables to generate information on the use of the main measurements in the evaluation of general and abdominal obesity as indicators of cardiovascular risk. Materials and methods . Secondary analysis of the ENSIN survey for Colombia with data collected between 2015 and 2016, the 2005 Population and Housing Census of the Departamento Administrativo Nacional de Estadística (DANE) was used as a sampling frame. The sample was 44,202 households with 151,343 people aged 0 to 64 years; 70,315 records of adult population were selected for this analysis. Proportions, confidence intervals, measures of central tendency and dispersion were calculated. Results. The means of body mass index (BMI) and waist-height index were higher than the cutoff point in both sexes, while the means of waist circumference were below the cutoff point for men and higher for women (p<0.05). The prevalence of obesity by BMI was 17.5%, while abdominal obesity by waist circumference and waist-height index of 50.2% and 62.6% respectively. Conclusions. Abdominal obesity regardless of the indicator used, is about 3 times higher than general obesity by BMI and waist-height index identifies more people, especially men, with abdominal obesity compared to waist circumference.

Evaluation of the effectiveness of healthy school canteen intervention on nutritional literacy and dietary behavior among primary school students / 中国学校卫生

Objective@#To explore the effectiveness of healthy school canteen intervention on nutritional literacy, food consumption, as well as attitude towards school canteen.@*Methods@#A primary school in Taizhou City was selected as the intervention school, and another comparable primary school was selected as the control one. A total of 320 students (163 in the intervention group and 157 in the control group) received a comprehensive intervention based on the construction of a healthy school canteen in the school,incluling healthy dining environment,food impravement,chef training,nutrition and health education, while the control group did not receive any intervention. Questionnaires survey was administered to both groups before and after the intervention.@*Results@#Before the intervention, no significant differences were found in the total scores of skills and nutrition literacy, frequency of food intake, behaviors and attitudes related to canteen construction between the two groups( P >0.05). Daily intake of vegetables, dairy products, fish/poultry/eggs/lean meat increased by 19.63, 15.95 and 19.63 percentage point respectively ( χ 2=15.25，9.14，13.93， P <0.01). The proportion of students reporting have read related intervention materials in the intervention group(95.71%) was higher than the control group(84.71%) ( χ 2= 11.04, P < 0.01 ). The students in favor of low salt, low oil and low sugar dishes in the intervention group (74.85%) was higher than in the control group(48.41%) ( χ 2=23.73, P <0.01).@*Conclusion@#Based on the comprehensive intervention of nutrition and health canteens can improve students nutrition literacy and dietary structure. It is recommended to adopt the form of "home school linkage" to carry out the construction of large sample, multi regional and long term nutrition and health canteens.

Overweight in Sateré-Mawé indigenous residents of an urban area in Parintins, Amazonas / Sobrepeso em indígenas Sateré-Mawé residentes em área urbana de Parintins, Amazonas

ABSTRACT Objective To verify overweight prevalence in the Sateré-Mawé indigenous population over 18 years of age, residing in the city of Parintins (AM), Brazil, and to assess its associated variables. Methods Household survey performed in the urban area of Parintins in 2017, visiting new households in each interview, completing the census universe. Self-declared Sateré-Mawé, over 18 years of age, residing in the city for a period longer than one year were considered eligible. Overweight was considered for body mass index values ≥ 25 kg/m2 or ≥ 27 kg/m2, for those over 60 years of age. Household information on social assistance, as well as individual information such as speaking the indigenous language, years living in the city and also in the indigenous territory, income, work, schooling, marital status, leisure and transport physical activity level, and time watching television per week were retrieved. The hierarchical logistic model analysis was carried out, calculating the odds ratio and confidence interval (95%). Results A total of 174 subjects participated in the survey, 42% being overweight. Those who spoke the Sateré-Mawé language, number of years living in the city, working outside home and being married had a positive effect on the outcome, but lost significance in the final model. Only transport insufficient physical activity (OR=2.24, 95% CI=1.01-4.98) and being in the age group from 30 to 59 years (OR=8.79, 95% CI=3.41-22.64) maintained statistical significance. Conclusion Efforts to provide visibility to the health situation of urban indigenous populations in Brazil are necessary. Poor transport infrastructure in the city seems to favor transport physical activity levels as a necessity, in addition to age, which is commonly associated with overweight.

RESUMO Objetivo Verificar a prevalência de sobrepeso em indígenas Sateré-Mawé maiores de 18 anos de idade, residentes na cidade de Parintins (AM), Brasil, identificando as variáveis associadas. Métodos Um inquérito domiciliar foi realizado em 2017 na cidade de Parintins e identificou novos domicílios em cada entrevista, alcançando o universo censitário. Foram elegíveis os autodeclarados Sateré-Mawé maiores de 18 anos e residentes há mais de um ano na cidade. O sobrepeso foi considerado para valores de índice de massa corporal ≥25 kg/m2 ou ≥27 kg/m2 para os maiores de 60 anos de idade. Coletou-se informações domiciliares sobre bolsa família, bem como individuais como falar a língua indígena, anos morando na cidade e na terra indígena, renda, trabalho, escolaridade, estado civil, nível de atividade física no lazer e no deslocamento e tempo assistindo televisão na semana. Foi utilizado o modelo logístico hierarquizado, calculando a razão de chances e intervalo de confiança (95%). Resultados Participaram do estudo 174 pessoas no total, sendo que 42% deles estavam com sobrepeso. Falar a língua Sateré-Mawé, a quantidade de anos residindo na cidade, trabalhar fora de casa e ser casado tiveram efeito positivo no desfecho, porém perderam significância no modelo final. Somente atividade física insuficiente no deslocamento (OR=2,24 IC 95%=1,01-4,98) e a faixa etária dos 30 a 59 anos (OR=8,79 IC 95%=3,41-22,64) mantiveram-se significativas. Conclusão Esforços para dar visibilidade à situação de saúde das populações indígenas urbanas no Brasil são necessários. A fraca infraestrutura de transporte na cidade parece favorecer a atividade física no deslocamento como necessidade, além da idade, já comumente associada ao sobrepeso.

Differences in food consumption of the Brazilian population by race/skin color in 2017-2018 / Diferenças no consumo alimentar da população brasileira por raça/cor da pele em 2017-2018

ABSTRACT OBJECTIVE To evaluate food consumption in Brazil by race/skin color of the population. METHODS Food consumption data from the Pesquisa de Orçamentos Familiares (POF - Household Budget Survey) 2017-2018 were analyzed. Food and culinary preparations were grouped into 31 items, composing three main groups, defined by industrial processing characteristics: 1 - in natura/minimally processed, 2 - processed, and 3 - ultra-processed. The percentage of calories from each group was estimated by categories of race/skin color - White, Black, Mixed-race, Indigenous, and Yellow- using crude and adjusted linear regression for gender, age, schooling, income, macro-region, and area. RESULTS In the crude analyses, the consumption of in natura/minimally processed foods was lower for Yellow [66.0% (95% Confidence Interval 62.4-69.6)] and White [66.6% (95%CI 66.1-67.1)] groups than for Blacks [69.8% (95%CI 68.9-70.8)] and Mixed-race people [70.2% (95%CI 69.7-70.7)]. Yellow individuals consumed fewer processed foods, with 9.2% of energy (95%CI 7.2-11.1) whereas the other groups consumed approximately 13%. Ultra-processed foods were less consumed by Blacks [16.6% (95%CI 15.6-17.6)] and Mixed-race [16.6% (95%CI 16.2-17.1)], with the highest consumption among White [20.1% (95%CI 19.6-20.6)] and Yellow [24.5% (95%CI 20.0-29.1)] groups. The adjustment of the models reduced the magnitude of the differences between the categories of race/skin color. The difference between Black and Mixed-race individuals from the White ones decreased from 3 percentage points (pp) to 1.2 pp in the consumption of in natura/minimally processed foods and the largest differences remained in the consumption of rice and beans, with a higher percentage in the diet of Black and Mixed-race people. The contribution of processed foods remained approximately 4 pp lower for Yellow individuals. The consumption of ultra-processed products decreased by approximately 2 pp for White and Yellow groups; on the other hand, it increased by 1 pp in the consumption of Black, Mixed-race, and Indigenous peoples. CONCLUSION Differences in food consumption according to race/skin color were found and are influenced by socioeconomic and demographic conditions.

RESUMO OBJETIVO Avaliar o consumo alimentar no Brasil por raça/cor da pele da população. MÉTODOS Foram analisados dados de consumo alimentar da Pesquisa de Orçamentos Familiares 2017-2018. Alimentos e preparações culinárias foram agrupados em 31 itens, compondo três grupos principais, definidos por características do processamento industrial: 1 - in natura/minimamente processados, 2 - processados e 3 - ultraprocessados. O percentual de calorias de cada grupo foi estimado por categorias de raça/cor da pele - branca, preta, parda, indígena e amarela -, utilizando-se regressão linear bruta e ajustada para sexo, idade, escolaridade, renda, macrorregião e área. RESULTADOS Nas análises brutas, o consumo de alimentos in natura/minimamente processados foi menor para amarelos [66,0% (Intervalo de Confiança 95% 62,4-69,6)] e brancos [66,6% (IC95% 66,1-67,1)] que para pretos [69,8% (IC95% 68,9-70,8)] e pardos [70,2% (IC95% 69,7-70,7)]. Amarelos consumiram menos alimentos processados, com 9,2% das calorias (IC95% 7,2-11,1) enquanto os demais consumiram aproximadamente 13%. Ultraprocessados foram menos consumidos por pretos [16,6% (IC95% 15,6-17,6)] e pardos [16,6% (IC95% 16,2-17,1)], e o maior consumo ocorreu entre brancos [20,1% (IC95% 19,6-20,6)] e amarelos [24,5% (IC95% 20,0-29,1)]. O ajuste dos modelos reduziu a magnitude das diferenças entre as categorias de raça/cor da pele. A diferença entre pretos e pardos em relação aos brancos diminuiu, de 3 pontos percentuais (pp), para 1,2 pp no consumo de alimentos in natura/minimamente processados e as maiores diferenças remanescentes foram no consumo de arroz e feijão, com maior percentual na alimentação de pretos e pardos. A participação de alimentos processados permaneceu aproximadamente 4 pp menor para amarelos. O consumo de ultraprocessados diminuiu aproximadamente 2 pp para brancos e amarelos; por outro lado, aumentou 1 pp no consumo de pretos, pardos e indígenas. CONCLUSÃO Diferenças no consumo alimentar segundo raça/cor da pele foram encontradas e são influenciadas por condições socioeconômicas e demográficas.

Edentulism and number of medications are associated with nutritional status in older adults: a population-based cross-sectional study / Edentuslimo e número de medicações estão associados com estado nutricional em idosos: um estudo transversal de base populacional

ABSTRACT Objective: This study evaluated the nutritional status and associated factors among older adults of a southern Brazilian city. Methods: A cross-sectional home-based study, with a probabilistic sample per cluster, was carried out with 282 older adults aged ≥60 years in the city of Veranópolis, Brazil. Through a structured questionnaire, socioeconomic, general and behavioral health aspects were assessed. Nutritional status was assessed using the Mini Nutritional Assessment (MAN®) instrument, categorizing the sample into eutrophic or nutritional risk (risk of malnutrition + malnourished). Oral health was assessed by counting teeth and the use of and need for dental prosthesis. Two independent multivariate models were constructed, using number of daily medication and polypharmacy (≥2 daily medications). Logistic regression was used to verify associations. Results: The prevalence of nutritional risk was 14.5% (N=41). In the final multivariate analysis, users of ≥6 daily medications demonstrated a greater odds ratio (OR) of being at nutritional risk when compared to those who did not use medication daily (OR: 12.16; 95% confidence interval [95%CI]: 1.47 - 100.82). Non-edentulous older adults had 67.7% (p = 0.006) lower OR for nutritional risk when compared to edentulous. Conclusion: The prevalence of nutritional risk was low among this sample, and it was associated with edentulism and number of daily medications.

RESUMO Objetivo: Esse estudo avaliou o estado nutricional e fatores associados em idosos de uma cidade do Sul do Brasil. Métodos: Um estudo transversal de base populacional, com amostragem probabilística por cluster, foi realizado com 282 idosos com idade ≥60 anos na cidade de Veranópolis, Brasil. Por meio de um questionário estruturado, aspectos socioeconômicos, comportamentais e de saúde geral foram aferidos. Estado nutricional foi verificado usando a Mini Avaliação Nutricional (MAN), categorizando a amostra em eutróficos e risco nutricional (risco de desnutrição + desnutridos). Saúde bucal foi verificada pela contagem dos dentes e uso e necessidade de prótese dentária. Dois modelos multivariados independentes foram construídos, utilizando o número de medicações diárias e polifarmácia (≥2 medicamentos por dia). Regressão logística foi utilizada para verificar as associações. Resultados: A prevalência de risco nutricional foi de 14,5% (N=41). Na análise multivariada final, usuários de ≥6 medicamentos por dia demonstraram uma maior razão de chance (RC) de terem risco nutricional quando comparados com aqueles que não utilizaram medicamento diariamente (RC: 12,164; intervalo de confiança de 95% [IC95%]: 1,468 - 100,821). Idosos não edêntulos tiveram 67,7% (p=0,006) menor RC para risco nutricional quando comparados com não edêntulos. Conclusão: A prevalência de risco nutricional foi baixa nessa amostral, ela foi associada com edentulismo e número diário de medicações.

Fast food consumption behaviors among senior primary school students in agricultural and pastoral areas of Qinghai Province / 中国学校卫生

Objective@#To investigate fast food consumption behaviors among 4th and 5th grade primary school students in agricultural and pastoral areas in Qinghai Province, and to provide scientific basis for nutrition education and intervention measures for school age children in agricultural and pastoral areas.@*Methods@#Using multi stage stratified cluster random sampling method, a total of 969 fourth and fifth grade students were selected from 10 primary schools in 4 counties and districts in 3 cities of Haidong City, Hainan Prefecture and Haixi Prefecture from Qinghai Province. Self administered questionnaires were used to investigate the fast food consumption behaviors of participants.@*Results@#The proportions of senior primary school students in agricultural and pastoral areas of Qinghai Province who had consumed western fast food and traditioal fast food in the past week were 45.8% and 75.6%, respectively, with statistically significant differences ( χ 2=290.24, P <0.05). The times of traditional fast food consumption in the past week among boarding students were higher than that of non boarding students( Z =6.44,5.84, P <0.05). The main reasons for senior primary school students in agricultural and pastoral areas of Qinghai Province to choose to consume western fast food were that it was delicious (84.7%), nutritious (62.6%), clean and hygienic (57.4%), and a better environment (57.0%). The top 4 reasons for chousing Chinese fast food were yummy(83.8%),nutritious(82.8%),clean and healthy(67.4%),and good environment(53.5%). Among the surveyed primary school students, 64.7% believed that diet structure of Chinese fast food was reasonable, 43.0% believed that the nutritional value of Chinese fast food was high, and 39.4% believed that the energy content of western fast food was high.@*Conclusion@#Fast food consumption is a common dietary behavior of senior primary school students in agricultural and pastoral areas of Qinghai Province. Relevant departments should strengthen the nutrition education related to fast food, promote the dissemination of health knowledge, enable students to develop a good lifestyle and reduce fast food consumption.

Analysis on the nutritional composition of prepackaged foods commonly consumed by children aged 6-12 in Chengdu / 中国学校卫生

Objective@#To analyze the current nutritional composition of commonly consumed prepackaged foods among children in Chengdu and to provide a scientific basis for health education among children and adolescents.@*Methods@#Based on the 3 day and 24 hour dietary data of children aged 6-12 in Chengdu of the Southwest China Childhood Nutrition and Growth Cohort from 2021 to 2022, the nutritional information of prepackaged foods was collected by combining offline and online methods. All foods were classified step by step, and the nutrient content of each 100 g or 100 mL food was counted and graded.@*Results@#A total of 1 902 children s prepackaged foods in 23 sub categories of 10 major categories were investigated. Nuts and seeds, snack foods, instant foods and other dairy products had higher total energy(2 476, 2 027, 1 728, 1 816 kJ/100 g), with the nutrient reference value percentage(NRV%) exceeding 20%. Fish, poultry, meat, eggs and their products had the highest protein content(22.8 g/ 100 g ) with an NRV% of 38%, nuts and seeds had the highest fat content(47.5 g/100 g) with an NRV% of 79%, confectionery and jelly had the highest carbohydrate content(82.1 g/100 g) with an NRV% of 27%, and seasoning flour products had the highest sodium content with an NRV% up to 118%. Seasoning flour products and instant foods were mostly high sodium, high fat and high carbohydrate food. Baked and puffed foods were almost high fat and high carbohydrate. Fish, poultry, meat, eggs, beans and their products were rich in protein but mostly high in sodium. Beverages and cold drinks were low in other nutrients except carbohydrate.@*Conclusion@#The nutrient content of various prepackaged foods commonly consumed by children in Chengdu are quite different. Most of the foods consumed by children are high sodium, high fat and/or high carbohydrate. Nutrition education should be strengthened to help children choose healthy foods.

Acquisition of food for away-from-home consumption in Brazil between 2002 and 2018 / Aquisição de alimentos para consumo fora do domicílio no Brasil entre 2002 e 2018

Abstract The aim of the study was to assess the evolution of food acquisition for away from home consumption in Brazil from 2002 to 2018. The trend of food purchases for out-of-home consumption in Brazil was evaluated by comparing food purchase data from the Household Budget Surveys (HBS) of 2002-2003, 2008-2009, and 2017-2018. The frequency of food acquisition was estimated according to sociodemographic variables and the mean cost. In 2002-2003, the frequency of purchase of food for out-of-home consumption was 35.2% (95%CI: 34.4-35.9), increasing to 41.2% (95%CI: 40.4-42.0) in 2008-2009, followed by a decline in 2017-2018 (32.3%; 95%CI: 31.7-32.9). A declining trend was observed in the frequency of purchases of alcoholic beverages and soft drinks and fast foods maintained the frequency between the last two surveys. Spending on this type of food increased between 2002-2003 and 2008-2009, while the mean value of this type of expenditure was maintained between 2008-2009 and 2017-2018. Brazilians increased food purchases for out-of-home consumption between 2002-2003 and 2008-2009, declining in 2017-2018. A consistent fall in the purchase of alcoholic beverages and soft drinks was observed over time, while the group of meals grew significantly.

Resumo O objetivo desse estudo foi avaliar a evolução da aquisição de alimentos para consumo fora de casa no Brasil de 2002 a 2018. A tendência de compra de alimentos para consumo fora de casa no Brasil foi avaliada pela comparação de dados de compra de alimentos das Pesquisas de Orçamentos Familiares (POF) de 2002-2003, 2008-2009 e 2017-2018. A frequência de aquisição de alimentos foi estimada de acordo com variáveis sociodemográficas e o custo médio. Em 2002-2003, a frequência de compra de alimentos para consumo fora do domicílio foi de 35,2% (IC95%: 34,4-35,9), aumentando para 41,2% (IC95%: 40,4-42,0) em 2008-2009, seguido por um declínio em 2017-2018 (32,3%; IC95%: 31,7-32,9). Foi observada tendência de queda na frequência de compras de bebidas alcoólicas e refrigerantes, enquanto fast food manteve a frequência entre as duas últimas pesquisas. Os gastos com esse tipo de alimentação aumentaram entre 2002-2003 e 2008-2009, enquanto o valor médio desse tipo de gasto se manteve entre 2008-2009 e 2017-2018. Os brasileiros aumentaram as compras de alimentos para consumo fora de casa entre 2002-2003 e 2008-2009, diminuindo em 2017-2018. Uma queda consistente na compra de bebidas alcoólicas e refrigerantes foi observada ao longo do tempo, enquanto o grupo das refeições apresentou aumento significativo.

Dietary intake of the Mexican population: comparing food group contribution to recommendations, 2012-2016 / Ingesta dietética de la población mexicana: contribución de grupos de alimentos vs. recomendaciones, 2012-2016

Abstract: Objective: To estimate energy contribution (EC) of food groups in 2016, to compare consumption against Mexican Dietary Guidelines, and to examine changes in EC from 2012 to 2016. Materials and methods: We analyzed 24-hour dietary recalls from the 2012 and 2016 National Health and Nutrition Surveys (Ensanut). Foods and beverages were classified into eight food groups: cereals, legumes, dairy, meats, fruit and vegetables, fats and oils, sugar-sweetened beverages, and high in saturated fat and added sugar (HSFAS) products. Results: Cereals had the highest EC (30.1%), followed by meats (15.9%), HSFAS products (15.5%), and SSBs (10.5%). Fruits and vegetables, and legumes had the lowest contribution with 6.4 and 3.8%, respectively. SSBs, meats, and HSFAS products were 250, 59 and 55% above the recommended intake, respectively. Conclusions: This analysis confirms the need to generate a food environment conducive to a healthier diet.

Resumen: Objetivo: Estimar la contribución energética (CE) de grupos de alimentos al compararla con las Guías Alimentarias y examinar los cambios de 2012 a 2016. Material y métodos: Se analizaron recordatorios de 24 horas de las Encuestas Nacionales de Salud y Nutrición de 2012 y 2016. Los alimentos y bebidas se clasificaron en ocho grupos: cereales, leguminosas, lácteos, carnes, frutas y verduras, grasas, bebidas azucaradas, y productos altos en grasa saturada y/o azúcares añadidos. Resultados: Los cereales tuvieron la CE más alta (30.1%), seguidos por carnes (15.9%), productos altos en grasa saturada y azúcares añadidos (15.5%) y bebidas azucaradas (10.5%). Frutas y verduras y leguminosas tuvieron la menor CE con 6.4 y 3.8%, respectivamente. Las bebidas azucaradas, carnes y productos altos en grasa saturada y azúcares añadidos superaron en 250, 59 y 55% la recomendación, respectivamente. Conclusión: Este análisis confirma la necesidad de generar un ambiente alimentario que propicie una dieta más saludable.

Availability of foods according to the degree of processing in families with young elderly and oldest-old (POF 2017-2018) / Disponibilidade de alimentos de acordo com o grau de processamento em famílias com idosos jovens e longevos (POF 2017-2018)

ABSTRACT Objective To compare the availability of healthy and unhealthy foods in families with and without elderly and oldest-old people. Methods This is an observational, cross-sectional study with secondary data from the Household Budget Survey, conducted by the Brazilian Institute of Geography and Statistics between 2017 and 2018. Families were characterized based on the oldest member: Control (without elderly and oldest-old) or with elderly and oldest-old. The sociodemographic characteristics of the families and the foods purchased by the families were obtained, according to the Nova classification (in natura, processed and ultra-processed foods, in addition to culinary ingredients). Results Families with elderly and oldest-old people had greater availability of fresh foods and fewer ultra-processed foods. In contrast, young families showed greater acquisition of all ultra-processed food items. Conclusion The unfavorable nutritional transition process with fewer in natura foods seemed to be less evident in families with higher age groups. It is concluded that the presence of the elderly and oldest-old in the family could be related to a better quality of the family diet, with a greater presence of fresh foods and a lower acquisition of ultra-processed foods.

RESUMO Objetivo Comparar a disponibilidade de alimentos saudáveis e não saudáveis nas famílias com e sem idosos e longevos. Métodos É um estudo observacional, transversal com dados secundários da Pesquisa de Orçamento Familiar, realizada pelo Instituto Brasileiro de Geografia e Estatística entre 2017-2018. As famílias foram caracterizadas pelo integrante com maior idade: controle (sem idosos e longevos), com idosos e longevos. Foram obtidas características sociodemográficas das famílias e itens alimentares adquiridos pelas famílias, segundo a classificação Nova (alimentos in natura, processados e ultraprocessados, além de ingredientes culinários). Resultados As famílias com idosos e longevos apresentaram maior disponibilidade de alimentos in natura e menor em ultraprocessados. Enquanto que as famílias jovens apresentaram maior aquisição em todos os itens alimentares ultraprocessados. Conclusão O processo de transição nutricional desfavorável com menos alimentos in natura pareceu ser menos evidente em famílias com maiores faixas-etárias. Conclui-se que a presença de idosos e longevos na família pode estar relacionada à melhor qualidade alimentar familiar, com maior presença de alimentos in natura e menor aquisição de ultraprocessados.

Deficiency of vitamins C and E in women of childbearing age in Brazil: a systematic review and meta-analysis

ABSTRACT BACKGROUND: Despite the several options available for supplements containing vitamins C and E, evidence regarding the prevalence of deficiency or insufficiency of these vitamins is weak. OBJECTIVES: To estimate the prevalence of deficiency or insufficiency of vitamins C and E and associated factors among women of childbearing age, in Brazil. DESIGN AND SETTING: Systematic review and meta-analysis conducted at a Brazilian public university. METHODS: A search from index inception until May 2020 was conducted. Meta-analyses were performed using inverse variance for fixed models, with summary proportions calculation using Freeman-Tukey double arcsine (base case). Reporting and methodological quality were assessed using the Joanna Briggs Institute tool for prevalence studies. RESULTS: Our review identified 12 studies, comprising 1,316 participants, especially breastfeeding women. There was at least one quality weakness in all studies, mainly regarding sampling method (i.e. convenience sampling) and small sample size. The prevalence of vitamin C deficiency ranged from 0% to 40%. Only vitamin E deficiency was synthetized in meta-analyses, with mean prevalences of 6% regardless of the alpha-tocopherol cutoff in plasma, and 5% and 16% for cutoffs of < 1.6-12.0 mmol/l and < 16.2 mmol/l, respectively. The cumulative meta-analysis suggested that a trend to lower prevalence of vitamin E deficiency occurred in recent studies. CONCLUSIONS: Although the studies identified in this systematic review had poor methodological and reporting quality, mild-moderate vitamin C and E deficiencies were identified, especially in breastfeeding women. Thus, designing and implementing policies does not seem to be a priority, because the need has not been properly dimensioned among women of childbearing age in Brazil. REGISTRATION NUMBER IN PROSPERO: CRD42020221605.

Aislamiento ante síntomas sugestivos de Covid-19 o contacto con un caso: cumplimiento, prevalencia y factores asociados. Ensanut 2020 Covid-19 / Isolation in the fase of symptoms suggestive of Covid-19 or contact with a case: compliance, prevalence, and associated factors. Ensanut 2020 Covid-19

Resumen: Objetivo: Investigar el cumplimiento de las recomendaciones de aislamiento ante síntomas de Covid-19 o contacto con un caso. Material y métodos: Estudio transversal basado en la Encuesta Nacional de Salud y Nutrición 2020 sobre Covid-19. Se describió la prevalencia de aislamiento y su asociación con factores del nivel individual, hogar y contexto utilizando modelos de regresión log-binomial. Resultados: El 48.1% de la población >10 años reportó quedarse en casa ante síntomas o contacto con un caso. La prevalencia de aislamiento fue menor entre población ocupada vs. no-ocupada (RP 0.81; IC95% 0.73-0.89), mayor entre personas con alto nivel socioeconómico vs. bajo (RP 1.22; IC95% 1.08-1.38) y menor entre personas viviendo en estados sin un mensaje específico sobre aislamiento vs. estados con mensaje específico (RP 0.76; IC95% 0.63-0.91). Conclusiones: El cumplimiento de las recomendaciones de aislamiento durante la pandemia de Covid-19 estuvo asociado con factores socioeconómicos individuales y con la calidad de los mensajes de salud pública de los estados.

Abstract: Objective: To examine compliance to isolation and quarantine recommendations during the early phase of the Covid-19 epidemic in Mexico. Materials and methods: Cross-sectional population-based study (National Health and Nutrition Survey 2020 Covid-19). We estimated the prevalence of compliance with recommendations and assessed its association with individual, household and context level variables using log-binomial models. Results: 48.1% of the population over 10 years old reported staying at home when faced with symptoms or a potential contact with a case. The prevalence was lower in employed vs unemployed population (PR 0.81; 95%IC 0.73-0.89), higher among higher socioeconomic position groups vs lower (RP 1.22; 95%IC 1.08-1.38), and lower among people living in states with an unspecific public health message regarding isolation and quarantine (RP 0.76; 95%IC 0.63-0.91). Conclusions: Compliance to isolation and quarantine recommendations was associated with socioeconomic factors and the quality of public health messages during the Covid-19 pandemic in Mexico.

Metodología de la Encuesta Nacional de Salud y Nutrición 2021 / National Health and Nutrition Survey 2021 methodology

Resumen: Objetivo: Describir el diseño de la Encuesta Nacional de Salud y Nutrición 2021 (Ensanut 2021). Material y métodos: La Ensanut 2021 es una encuesta probabilística de hogares que forma parte de la serie de Ensanut Continua 2020-2024. En esta ocasión se describen el alcance, el muestreo, la medición y la organización logística. Resultados: Se planea obtener al menos 12 060 entrevistas de hogar completas a nivel nacional y 9 837 muestras para determinar seropositividad a SARS-CoV-2 a nivel nacional. Conclusiones: La Ensanut 2021 permitirá realizar inferencias regionales sobre la prevalencia de seropositividad a SARS-CoV-2 y también acumular información para realizar inferencias estatales en el año 2024.

Abstract: Objective: To describe the design of the Mexican 2021 National Health and Nutrition Survey (Ensanut 2021). Materials and methods: The Ensanut 2021 is a probabilistic household survey that is part of the continuous Ensanut 2020-2024; survey outreach, sampling, measurement and logistic organization are described. Results: It is planned to obtain at least 12 060 complete household interviews and 9 837 samples to determine SARS-CoV-2 seropositivity at the national level. Conclusions: Ensanut 2021 will allow to estimate the seroprevalence of SARS-CoV-2 antibodies at regional and national level; also, it will accumulate information to make state inferences for the year 2024.

Factores asociados con el cambio en la inseguridad alimentaria en México: Ensanut 2012 y 2018-19 / Related factors to changes in food insecurity in Mexico: Ensanut 2012 and 2018-19

Resumen Objetivo: Evaluar los factores asociados con el cambio en la inseguridad alimentaria (IA) con las Encuestas Nacionales de Salud y Nutrición (Ensanut) 2012 y 2018-19. Material y métodos: Se obtuvo información de la Escala Latinoamericana y Caribeña de Seguridad Alimentaria en ambas encuestas. Mediante modelos de regresión logística ordinal se evaluó la contribución de ser beneficiario de programas sociales y otras variables sociodemográficas sobre el nivel de IA entre las dos encuestas. Resultados: La IA disminuyó 4.8 puntos porcentuales (p<0.0001). Los beneficiarios de programas presentaron mayor IA que los no beneficiarios (ß=0.258, IC95%: 0.192-0.325). Los hogares con estufa/horno para cocinar y con agua en la vivienda presentaron mayor seguridad alimentaria. Conclusiones: La IA persiste en México como problema severo de salud pública en uno de cada cinco hoga- res con mayores carencias. Se requieren acciones integrales del Estado para fortalecer factores estructurales y mejorar el acceso económico de los sectores sociales empobrecidos.

Abstract Objective: To assess factors related to changes in food insecurity (FI), based on information from the National Health and Nutrition Surveys 2012 and 2018-19. Materials and methods: The Latin American and Caribbean Food Security Scale was applied in both surveys. Using ordinal logistic regression models was evaluated the contribution of social programs and other sociodemographic variables on FI level among both surveys. Results: FI decreased 4.8 percentage points (p<0.0001), in the period. Beneficiaries of social programs showed higher FI levels than non-beneficiaries (ß=0.258, 95%CI: 0.192-0.325). Households with greater infrastructure (stove or oven and water service) presented greater food security. Conclusions: FI persists as a severe public health problem in 1 out of 5 households in Mexico, where deficiencies are greater. State comprehensive actions are required to strengthen structural factors and improve economic access for impoverished social sectors.

Iron deficiency is not the main contributor to anemia in older Mexican adults: results from the National Health and Nutrition Survey 2018-19 / La deficiencia de hierro no es el principal contribuyente a la anemia en adultos mayores participantes en la Ensanut 2018-19

Abstract Objective: To describe the current status of anemia and iron deficiency (ID), as well as associated sociodemographic characteristics, in older adults (OA). Materials and methods: Serum and capillary blood samples from a sample of OA participants (n=2 902) from the Ensanut 2018-19 were analyzed. ID was defined as s-ferritin<15 μg/L, and anemia was defined according to World Health Organization standards. Logistic regression models were used to associate the characteristics of OA with anemia and ID. Results: Of the OA analyzed, anemia was present in 28.4%, ID in 5% and iron deficiency anemia in 2.07%. Diabetes (OR=2.14), renal insufficiency (OR=10.4), higher age, and urban dwelling (OR=1.35) were conditions associated with higher odds for anemia (p<0.05). Belonging to the 70-79 year age group was the only condition associated with higher odds for ID (OR=1.86, p<0.05). Conclusions: Anemia affects a high proportion of OA, and ID is not the main contributor to anemia. Chronic comorbidities help explain the anemia problem in OA.

Resumen Objetivo: Describir la situación actual de deficiencia de hierro (DH), anemia y características asociadas en adultos mayores (AM). Material y métodos: Se analizó información de 2 902 AM de la Ensanut 2018-19. Deficiencia de hierro se definió: s-ferritina<15 μg/L y anemia de acuerdo con el criterio de la Organización Mundial de la Salud. Se emplearon modelos de regresión logística para identificar las características asociadas con la DH y anemia en los AM. Resultados: La prevalencia de anemia fue de 28.4%, DH 5% y anemia por DH 2.07%. Diabetes (RM=2.14), insuficiencia renal (RM=10.4), la mayor edad y habitar en localidades urbanas (RM=1.35) se asociaron a mayor momio para anemia (p<0.05). El grupo de edad de 70-79 años fue la única característica asociada a mayor probabilidad de DH (RM=1.86, p<0.05). Conclusiones: La anemia afecta a una proporción de los AM sin tener como principal causa a la DH. Algunas comorbilidades crónicas explican el problema de la anemia en esta población.