Marcadores do consumo de alimentos ultraprocessados em crianças de 06 a 23 meses no brasil, 2015 a 2018 / Markers of ultra-processed food consumption by Brazilian children aged 06 to 23months between the years of 2015 and 2018 / Marcadores de consumo de alimentos ultraprocessadosen niños de 06 a 23meses en Brasil, 2015 a 2018

Introdução:Os dois primeiros anos de vida da criança são de grande importância para a formação dos seus hábitos alimentares, predispondo ao desenvolvimento adequado e favorecendo a saúde a curto e longo prazo. Assim, a introdução de uma alimentação complementar adequada constitui-se como um fator fundamental para favorecer as escolhas alimentares apropriadas no futuro.Objetivo:Analisar os marcadores do consumo de alimentos ultraprocessados em crianças de 06 a 23meses no Brasil entre 2015 e 2018.Metodologia:Trata-se de um estudo ecológico de caráter descritivo. A coleta de dados foi proveniente de base de dados secundários do Sistema de Vigilância Alimentar e Nutricional, cuja população-alvo foram crianças com faixa etária entre 06 e 23meses de idade, abrangendo ambos os sexos e sem distinção de raça/cor. A análise de dados ocorreupor meiode estatística descritiva. Resultados:A região Sul se destacou com as maiores médias de consumo de biscoito recheado, doces ou guloseimas (34%), macarrão instantâneo, salgadinhos de pacote ou biscoitos salgados (21%) ehambúrguer e/ou embutidos (15%). Enquanto que a regiãoNorte apresentou a maior média de consumo de bebidas adoçadas (39%) e a região Nordeste se destacou com as menores médias de consumo desses alimentos. No Brasil, notou-se um consumo maior que 50% de alimentos ultraprocessados em quase todos os anos analisados no presente estudo e em quase todas as regiões e a classe mais consumida foi bebidas adoçadas.Conclusões:Conclui-se que há uma introdução precoce de alimentos ultraprocessados na alimentação de crianças na faixa etária estudada (AU).

Introduction:The first two years of a child's life are of great importance for the formation of their eating habits, predisposing the appropriate development and favoring health in the short and long term. Thus, the introduction of an adequate complementary feeding constitutes a fundamental factor for the person to favor appropriate food in the future. Objective:The authors seek to analyze the ultra-processed food consumption numbers in children aged 06 to 23months in Brazil between 2015 and 2018.Methodology:This paper is a descriptive ecological study. Data collection was taken from secondary databases of the Food and Nutrition Surveillance System and its target population was children aged between 06 and 23months of age, covering both sexes and without distinction of race or color. Data analysis was done through descriptive statistics.Results:The South region stood out with the highest average consumption of sandwich cookies, sweets or treats (34%), instant noodles, packaged snacks or savory cookies (21%) and hamburgers and/or sausages (15%). While. the North region had the highest average consumption of sugary drinks (39%) and the Northeast region stood out with the lowest average consumption of these foods. In Brazil, consumption of more than 50% of ultra-processed foods was observed in almost all years analyzed by the authors, and in almost all regions and the most consumed class was sweetened drinks. Conclusions: The authors observed that there is an early introduction of ultra-processed foods in the diet of children in the studied age group (AU).

Introducción:Los dos primeros años de vida de unniño son de gran importancia para la formación de sus hábitos alimentarios, predisponiéndolo a unadecuado desarrollo y favorecendo la salud a corto y largo plazo. Así, la correcta introducción de la alimentación complementaria es un factor fundamental para favorecer la elección de alimentos en el futuro. Objetivo: Analizar los marcadores de consumo de alimentos ultra procesado en niños de 06 a 23meses en Brasil entre 2015 y 2018. Metodología: Se trata de un estudio ecológico de carácter descriptivo de base de datos secundaria de la Alimentación y Sistema de Vigilancia Nutricional cuya población objetivo fueron los niños de entre 06 y 23meses de edad, abarcando ambos sexos y sin distinción de raza/color. Ocurrieron mediante estadística descriptiva. Resultados: La región Sur se destacó con el promedio más alto consumo de galletas rellenas, dulces o golosinas (34%), fideos instatáneos, botanas envasadas o galletas saladas (21%) y hamburguesas y/o embutidos (15%). Mientras, la región Norte tuvo el mayor consumo promedio de bebidas endulzadas (39%) y la región Nordeste se destacó con el menor consumo promedio de estos alimentos. Todos los años analizados en este estudio y en casi todas las regiones y la clase más consumida fue la de bebidas endulzadas.Conclusiones: Se concluye que existe una introducción temprana de alimentos ultra procesados en la dieta de los niños del grupo de edad estudiado (AU).

"A consistent stakeholder management process can guarantee the 'social license to operate'": mapping the political strategies of the food industry in Brazil / "Un proceso consistente en la gestión de las partes interesadas puede garantizar la 'licencia social para actuar'": mapeando estrategias políticas de la industria alimentaria en Brasil / "Um processo consistente de gerenciamento dos stakeholders pode garantir a 'licença social para operar'": mapeando as estratégias políticas da indústria alimentícia no Brasil

In the past, food industry actors tried to delay and weaken public health efforts to promote adequate and healthy diets in Brazil. This study aimed to identify the political strategies used by food industry actors in Brazil. We undertook a document analysis of publicly available information and interviews with eighteen key informants in public health nutrition. Data collection and analysis were carried between October 2018 and January 2019. In Brazil, food industry actors interacted with health organizations, communities, and the media. They disseminated information on nutrition and physical activity by scientific events and schools. The food industry also had allies within the government and lobbied high ranking officials. Finally, food industry actors intimidated some public health professionals, including by threats of litigation, which had the effect of silencing them. These strategies were facilitated by the use of arguments, such as the crucial role that the food industry plays in the economy and its support to the United Nations Sustainable Development Goals. Personal responsibility, moderation, and education were cited as solutions to the obesity epidemic, and there was little discussion on the broader issue of inadequate and unhealthy diets. Food industry actors in Brazil used a diverse range of political strategies, which have the potential of negatively influencing public policy, research, and practice in the country. Learning about these strategies is an essential first step, and in response, it is crucial to develop robust mechanisms to address undue influence from corporations.

En el pasado, agentes de la industria alimentaria intentaron retrasar y debilitar los esfuerzos de la salud pública para promover dietas adecuadas y saludables en Brasil. El objetivo de este estudio fue identificar las estrategias políticas usadas por los agentes de la industria alimentaria en Brasil. Realizamos un análisis documental de la información disponible públicamente y entrevistas con 18 informantes clave en nutrición dentro de la salud pública. La recolección de datos y análisis se llevaron a cabo entre octubre de 2018 y enero de 2019. En Brasil, los agentes de la industria alimentaria interactuaron con organizaciones de salud, comunidades y medios. Ellos diseminaron información sobre nutrición y actividad física mediante eventos científicos y en las escuelas. La industria alimentaria tenía también aliados dentro del gobierno y funcionarios de alto rango que hacía lobby a su favor. Finalmente, los agentes de esta industria intimidaron a algunos profesionales públicos de salud, incluso con amenazas de litigios, que tuvieron el efecto de silenciarlos. Estas estrategias se facilitaron mediante el uso de argumentos tales como el papel crucial que desempeñaba la industria alimentaria en la economía y en su apoyo para los Objetivos de Desarrollo Sostenible de la Organización de las Naciones Unidas. Se citaron la responsabilidad personal, moderación, y educación como soluciones para la epidemia de obesidad, y hubo una pequeña discusión sobre un tema tan amplio como el de las dietas inadecuadas e insanas. Los agentes de la industria alimentaria en Brasil usaron un repertorio diverso de estrategias políticas, que tienen el potencial de influenciar negativamente políticas públicas, investigaciones, así como prácticas en el país. Como primer paso es esencial aprender de estas estrategias, y en respuesta, es crucial desarrollar mecanismos robustos para abordar la influencia indebida de las corporaciones alimentarias.

No passado, os agentes da indústria alimentícia tentaram atrasar e enfraquecer os esforços de saúde pública para promoção de dietas adequadas e saudáveis no Brasil. O presente estudo tem como objetivo identificar as estratégias políticas utilizadas pelos agentes da indústria alimentícia no Brasil. Realizamos uma análise documental das informações disponíveis ao público, bem como entrevistas com 18 informantes-chave em saúde pública e nutrição. A coleta e análise de dados foi realizada entre outubro de 2018 e janeiro de 2019. No Brasil, os agentes da indústria alimentícia interagiram com organizações de saúde, comunidades e com a mídia. Difundiram informações sobre nutrição e atividade física em eventos científicos e escolas. A indústria alimentícia também apresentava aliados dentro do governo e fazia lobby junto a altos funcionários. Por fim, os agentes da indústria alimentícia intimidaram alguns profissionais da saúde pública, inclusive com ameaças de litígio, o que teve o efeito de silenciá-los. Essas estratégias foram facilitadas por argumentos como o papel crucial desempenhado pela indústria de alimentos na economia e seu apoio aos Objetivos de Desenvolvimento Sustentável da Organização das Nações Unidas. Responsabilidade pessoal, moderação e educação foram citadas como soluções para a epidemia de obesidade, e houve pouca discussão sobre a problemática mais ampla de dietas inadequadas e insalutares. Os agentes da indústria alimentícia no Brasil utilizaram uma gama diversificada de estratégias políticas com o potencial de influenciar negativamente as políticas públicas, mas também a pesquisa e a prática no país. Conhecer essas estratégias é um primeiro passo essencial e, em resposta, é crucial desenvolver mecanismos robustos para lidar com a influência indevida das corporações.

Evaluación del contenido nutricional de productos lácteos en programa de alimentación venezolano / Evaluation of the nutritional content of dairy products in the Venezuelan food program

En Venezuela se distribuyen productos lácteos en polvo a través de los Comité Locales de Abastecimiento y Producción (CLAP). Con el objetivo de evaluar la composición nutricional de catorce marcas de productos lácteos provenientes de industrias mexicanas y distribuidos en Venezuela, se realizó un estudio descriptivo y transversal, con muestreo a conveniencia de 14 marcas de lácteos obtenidas en hogares beneficiados del área metropolitana de Caracas-Venezuela. Se cotejó la información presentada en el rotulado del producto y se efectuó un análisis químico de la composición nutricional. Los valores obtenidos se compararon utilizando como referencia a la norma COVENIN. En el etiquetado se encontró que sólo 2 marcas se denominan producto lácteo y el 43% de las marcas expresan el mismo contenido nutricional en el rótulo. En la analítica química se encontró inexactitud con la información presentada en el etiquetado nutricional. El análisis de componentes principales seguido de un conglomerado jerárquico permitió diferenciar 4 clúster o grupos: 2 reales y 2 ideales. La mayoría de los productos analizados son significativamente más altos en carbohidratos y sodio (p<0,05), además de bajos en proteínas y calcio (p<0,05). En conclusión, todas las muestras evaluadas incumplen la normativa correspondiente, al presentar irregularidades en la denominación del producto e informar valores que no se corresponden con el contenido nutricional resultante de los análisis químicos(AU)

In Venezuela, powdered milk products are distributed through the Local Supply and Production Committee (CLAP). The objective was to evaluate the nutritional composition of fourteen brands of dairy products from Mexican industries distributed in Venezuela, a descriptive and cross-sectional study was conducted, with convenience sampling of 14 brands of dairy products obtained in households benefiting from the Caracas Metropolitan area - Venezuela. The information presented in the product labeling was checked and a chemical analysis of the nutritional composition was performed. The values obtained were compared using the COVENIN standard as a reference. In the labeling, it was found that only 2 brands are called dairy products and 43% of the brands express the same nutritional content on the label. The chemical analysis showed inaccuracy with the information presented in the nutritional labeling. The analysis of principal components followed by a hierarchical conglomerate allowed us to differentiate 4 clusters or groups: 2 real and 2 ideal. Most of the products analyzed are significantly higher in carbohydrates and sodium (p <0.05), as well as low in protein and calcium (p <0.05). In conclusion, all the samples evaluated fail to comply with the corresponding regulations, presenting irregularities in the product name and reporting values that do not correspond to the nutritional content resulting from chemical analyzes(AU)

Conocimiento y uso del etiquetado nutrimental de alimentos y bebidas industrializados en México / Knowledge and use of nutrient labelling of industrialized foods and beverages in Mexico

Resumen: Objetivo: Documentar el conocimiento y uso de la información de las diferentes etiquetas colocadas en los productos industrializados en México. Material y métodos: En una submuestra de la Encuesta Nacional de Salud y Nutrición de Medio Camino 2016, se aplicó un cuestionario semiestructurado, desarrollado por investigadores libres de conflicto de interés, previamente validado y piloteado en población de diferentes estratos socioeconómicos, grupos de edad y regiones del país. Resultados: Se entrevistó a 8 667 adultos ≥20 años de edad. El etiquetado más utilizado para la elección de alimentos y bebidas industrializados fue la "tabla nutrimental" 41.5% (IC95% 36.9-46.3) y el de menor uso el "sello nutrimental" 4.3% (IC95% 3.1-5.7). Conclusiones: Es de suma importancia que las instancias reguladoras, en coordinación con la Secretaría de Salud, implementen un etiquetado frontal rápido de leer y de fácil comprensión con criterios nutrimentales que garanticen el cumplimiento de lo expuesto en los documentos oficiales, así como la estandarización del porcentaje de consumo de azúcar al recomendado por la OMS o a una menor cantidad dada la alerta epidemiológica por diabetes que experimenta el país.

Abstract: Objective: To keep record of the knowledge and use of information of the different food labels on industrialized products in Mexico. Materials and methods: We administered a semi-structured survey-developed by researchers free of conflict interest-in a subsample of the National Health and Nutrition Survey, 2016. This survey was previously validated and piloted in different populations of varying socioeconomic levels and age and country regions. Results: Data was collected from a total of 8 667 individuals ≥20 years of age. The most frecuent type of label on industrialized foods and beverages was the nutrient table, with 41.5% (95%CI 36.9-46.3) and the least used was the nutrient seal, 4.3% (95%CI 3.1-5.7). Conclusions: It is of critical importance that the regulating authorities and the Ministry of Health, implement criteria that guarantee the compliance of recommendations promulgated in official documents. As well as the standarization of the percentage of recommended sugar intake based on WHO standards or lower considering the epidemiological alert for diabetes that the country is experiencing.

Política e medidas regulatórias para a eliminação gradual de gorduras trans de origem industrial nos alimentos / Policy and regulatory measures for the phasing out of trans fats of industrial origin in foods

Fomentar nos Estados Partes e Associados a adoção de medidas regulatórias para a eliminação gradual de gorduras trans de origem industrial nos alimentos em um prazo preferencialmente inferior a quatro anos.

Processed and ultra-processed food consumption among children aged 13 to 35 months and associated factors / Consumo de alimentos processados e ultraprocessados e fatores associados em crianças entre 13 e 35 meses de idade / Consumo de alimentos procesados y ultraprocesados y factores asociados en niños entre 13 y 35 meses de edad

Abstract: The aim of this study was to evaluate the consumption of processed and ultra-processed foods among children aged 13-35 months and its associated factors. We studied 1,185 children within the BRISA cohort in São Luís, Maranhão State, Brazil. The food consumption was investigated using a 24-hour recall, and the percentages of daily caloric intake and nutrients were estimated by food groups according to "NOVA" classification. We chose to categorize children belonging to the upper tertile of the distribution as having a high consumption of processed and ultra-processed food products. The Poisson regression model with robust variance estimation using a hierarchical modeling approach was used to calculate the prevalence ratios (PRs) of variables associated with high consumption of processed and ultra-processed food products. The mean energy intake was 1,226Kcal/day. After adjustments, there was a higher proportion of high consumption of processed and ultra-processed food products among children whose mothers had < 12 years of education and among children who were older than 16 months. Mothers with low schooling and children older than 16 months should be the targets of interventions aimed at reducing consumption of these food products and preventing adverse health outcomes in later life.

Resumo: O estudo teve como objetivo avaliar o consumo de alimentos processados e ultraprocessados por crianças entre 13 e 35 meses de idade e fatores associados. Estudamos 1.185 crianças da coorte BRISA em São Luís, Maranhão, Brasil. O consumo alimentar foi investigado com um recordatório de 24 horas, e os percentuais de ingestão diária de calorias e nutrientes foram estimados por grupos de alimentos de acordo com a classificação "NOVA". Optamos por categorizar as crianças pertencentes ao tercil superior da distribuição como tendo consumo elevado de produtos alimentícios processados e ultraprocessados. Foi utilizado um modelo de regressão Poisson com estimativa robusta de variância com modelagem hierárquica para calcular as razões de prevalência (RPs) das variáveis associadas ao consumo elevado de produtos alimentícios processados e ultraprocessados. A ingestão calórica média era 1.226Kcal/dia. Após os ajustes, houve uma proporção maior de consumo elevado de produtos alimentícios processados e ultraprocessados entre crianças cujas mães tinham menos de 12 anos de escola e entre crianças com mais de 16 meses de idade. As mães com baixa escolaridade e crianças acima de 16 meses devem ser alvos de intervenções para reduzir o consumo desses produtos alimentícios e prevenir os desfechos de saúde adversos na adolescência e idade adulta.

Resumen: El objetivo de este estudio fue evaluar el consumo de alimentos procesados y ultraprocesados por parte de niños entre 13 y 35 meses de edad y sus factores asociados. Estudiamos a 1.185 niños de la cohorte BRISA en São Luís, Maranhão, Brasil. El consumo alimentario fue investigado con un recordatorio de 24 horas, y los porcentajes de ingesta diaria de calorías y nutrientes fueron estimados por grupos de alimentos, de acuerdo con la clasificación "NOVA". Optamos por categorizar a los niños pertenecientes al tercil superior de la distribución como de consumo elevado de productos alimenticios procesados y ultraprocesados. Se utilizó un modelo de regresión Poisson de estimativa robusta de variancia con modelaje jerárquico para calcular las razones de prevalencia (RPs) de las variables asociadas al consumo elevado de productos alimenticios procesados y ultraprocesados. La ingesta calórica media era 1.226Kcal/día. Tras los ajustes, hubo una proporción mayor de consumo elevado de productos alimenticios procesados y ultraprocesados entre niños, cuyas madres contaban con menos de 12 años de escuela y entre niños con más de 16 meses de edad. Las madres con baja escolaridad y niños por encima de 16 meses deben ser objetivo de intervenciones para reducir el consumo de esos productos alimenticios y prevenir desenlaces de salud adversos en la adolescencia y edad adulta.

Semáforo nutricional de alimentos procesados: estudio cualitativo sobre conocimientos, comprensión, actitudes y prácticas en el Ecuador / Nutritional traffic light system for processed foods: qualitative study of awareness, understanding, attitudes, and practices in Ecuador

RESUMEN Objetivos. Analizar los conocimientos, comprensión, actitudes y prácticas relacionadas al semáforo nutricional (SN) en envases de alimentos procesados en el Ecuador. Materiales y métodos. Se realizaron 21 discusiones de grupos focales, en poblaciones de diverso tamaño de las regiones de costa, sierra y oriente. Se condujeron nueve entrevistas a informantes claves (IC) con representantes de empresas grandes, medianas y pequeñas que producían o comercializaban productos procesados. Resultados. Fueron 171 participantes de GF; en su mayoría reconocían y comprendían el SN. Hubo cierta disociación entre los conocimientos del SN y la actitud de compra, pues también se consideraba otros factores como el sabor, la marca o la accesibilidad. Las actitudes fueron diferentes entre grupos etarios: mientras que el grupo de 5 a 9 años conocía poco sobre el SN y prefería alimentos caseros, el grupo de 15 a 19 años era indiferente a la información del SN y daba más valor a otras características como el gusto. Las prácticas relacionadas a la compra y el consumo de alimentos procesados revelaron, siete estrategias diferentes que iban del reemplazo del producto a ignorar la información del SN. Los IC no concordaban con la política, pero reconocían haber modificado el contenido de algunos productos para reducir las concentraciones de grasa, azúcar y sal. Conclusiones. El SN ha tenido un efecto positivo en el conocimiento y comprensión del contenido de los productos procesados. Las prácticas relacionadas a la compra y consumo de alimentos procesados mejorarían a través de la promoción de la política del etiquetado nutricional, control de la comercialización, y el monitoreo y la vigilancia de su implementación.

ABSTRACT Objectives. To analyze awareness, understanding, attitudes, and practices related to the nutritional traffic light system (NTLS) on processed food packaging in Ecuador. Materials and methods. 21 discussions were held in focus groups (FG) in populations of various sizes in the coastal, mountainous, and eastern regions. Nine interviews were conducted with key informants (KI) representing large, medium, and small enterprises producing or selling processed foods. Results. There were 171 FG participants, the majority of whom recognized and understood the NTLS. There was a certain amount of discussion around awareness of the NTLS and purchasing attitudes, and other factors such as taste, brand, or accessibility were considered. Attitudes were different between age groups: while the group of five- to nine-year-olds knew little about the NTLS and preferred homemade foods, the group of 15- to 19-year-olds was indifferent to the NTLS information and placed more value on other features, such as taste. Practices related to the purchase and consumption of processed foods highlighted seven different strategies that ranged from replacing the product to ignoring the NTLS information. The KIs did not agree with the policy, but they acknowledged having amended the content of some products to reduce fat, sugar, and salt. Conclusions. The NTLS has had a positive effect on awareness and understanding of the content of processed products. Practices related to purchasing and consuming processed foods would be improved by promotion of the nutritional labeling policy, trade control, and the monitoring and surveillance of its implementation.

Occupational exposure to hydrogen cyanide during large-scale cassava processing, in Alagoas State, Brazil / Exposição ocupacional ao cianeto de hidrogênio durante a produção industrial da farinha de mandioca no Estado de Alagoas, Brasil / Exposición ocupacional al cianuro de hidrógeno durante la producción industrial de la harina de mandioca en el estado de Alagoas, Brasil

Abstract: The cassava roots used for flour production contain high amounts of cyanogenic glycosides and are, therefore, potential hydrogen cyanide (HCN) releasers. This fact is the cause of an increasing health concern in the sector of cassava processing. Brazilian workers engaged in the flour production may be chronically exposed to HCN in levels above the safety limits. This hypothesis is based on the drastic reduction in cyanide content of cassava roots during a traditional Brazilian method of processing and in the physical properties of the compound, which makes it very susceptible to volatilization and air contamination. As an attempt to explore this issue, HCN exposure in Brazilian "flour houses" was evaluated in this study through environmental and biological monitoring. Four flour houses placed in Alagoas State, Brazil, were investigated. The results indicated that the cassava processors are chronically exposed to HCN at average levels between 0.464 and 3.328mg/m3 (TWA), in the work environment. This range is below the TLV-C of 5mg/m3 but not below the Action Level of 2.5mg/m3. These data may be interpreted as a possible risk to susceptible individuals. Additionally, the biological monitoring indicated a high cyanide exposure in the population study, considering urinary thiocyanate (SCN-) levels.

Resumo: As raízes da mandioca utilizadas na produção de farinha contêm altos teores de glicosídeos cianogênicos; portanto, representam fontes potenciais de liberação de cianeto de hidrogênio. Esse fato causa preocupação crescente quanto à saúde dos trabalhadores na indústria de processamento da mandioca. Os trabalhadores brasileiros na produção da farinha de mandioca podem estar cronicamente expostos ao cianeto de hidrogênio em níveis acima dos limites seguros. Essa hipótese é baseada na redução drástica do nível de cianeto nas raízes da mandioca durante o método tradicional de processamento no Brasil, e nas propriedades físicas do composto, fazendo com que seja altamente suscetível à volatilização e à contaminação atmosférica. Para explorar essa questão, o estudo avaliou a exposição ao cianeto de hidrogênio em casas de farinha brasileiras através da monitorização ambiental e biológica. Foram estudadas quatro casas de farinha localizadas no Estado de Alagoas. Os resultados mostraram que os trabalhadores no processamento da mandioca estão expostos cronicamente ao cianeto de hidrogênio em níveis médios entre 0,464 e 3,328mg/m3 (TWA). Essa faixa é abaixo do TLV-C de 5mg/m3, mas não abaixo do Nível de Ação de 2,5mg/m3. Os dados podem ser interpretados como de risco potencial para os indivíduos suscetíveis. Além disso, a monitorização biológica indicou exposição elevada ao cianeto na população do estudo, considerando os níveis urinários de tiocianato.

Resumen: Las raíces de la mandioca, utilizadas en la producción de harina contiene altas proporciones de glucósidos cianogénicos; por tanto, representan fuentes potenciales de liberación de cianuro de hidrógeno. Este hecho causa una preocupación creciente, en cuanto a la salud de los trabajadores en la industria de procesamiento de la mandioca. Los trabajadores brasileños en la producción de harina de mandioca pueden estar crónicamente expuestos al cianuro de hidrógeno a niveles superiores de los límites seguros. Esta hipótesis está basada en la reducción drástica del nivel de cianuro en las raíces de la mandioca durante el método tradicional de procesamiento en Brasil, y en las propiedades físicas del compuesto, provocando que sea altamente susceptible a la volatilización y a la contaminación atmosférica. Para explorar esta cuestión, el estudio evalúo la exposición al cianuro de hidrógeno en fábricas de harina brasileñas, a través de la monitorización ambiental y biológica. Se estudiaron cuatro fábricas de harina localizadas en el estado de Alagoas. Los resultados mostraron que los trabajadores en el procesamiento de la mandioca están expuestos crónicamente al cianuro de hidrógeno en niveles medios entre 0,464 y 3,328mg/m3 (TWA). Esta franja está por debajo del TLV-C de 5mg/m3, pero no por debajo del nivel de acción de 2,5mg/m3. Los datos pueden ser interpretados como de riesgo potencial para los individuos susceptibles. Además, la monitorización biológica indicó exposición elevada al cianuro en la población del estudio, considerando los niveles urinarios de tíocianato.

Analysis of a voluntary initiative to reduce sodium in processed and ultra-processed food products in Argentina: the views of public and private sector representatives / Análisis de una iniciativa voluntaria para reducir el sodio en productos procesados y ultra-procesados en Argentina: perspectivas de los representantes del sector público y privado / Análise de uma iniciativa voluntária para reduzir o teor de sódio em produtos alimentícios processados e ultra-processados na Argentina: as perspectivas de representantes dos setores público e privado

Abstract: The Less Salt, More Life program was the first voluntary salt reduction initiative in Argentina. This article analyzes the perspectives of the stakeholders involved in this voluntary agreement between the Ministry of Health and the food industry to gradually reduce sodium content in processed foods. This exploratory case study used a qualitative approach including 29 in-depth interviews with stakeholders from the public and private sectors and identified the role of the different stakeholders and their perceptions regarding the challenges encountered in the policy process that contribute to the debate on public-private partnerships in health policies. The article also discusses the initiative's main challenges and controversies.

El programa Menos Sal, Más Vida fue la primera iniciativa voluntaria para la reducción de la sal en Argentina. Este artículo analiza las perspectivas de los representantes del sector público y privado involucrados en este acuerdo voluntario, entre el Ministerio de Salud y la industria alimentaria, para reducir gradualmente el contenido de sodio en las comidas procesadas. Este estudio de caso se basó en una aproximación cualitativa, incluyendo 29 entrevistas en profundidad, con las partes interesadas del sector público y privado e identificó el papel de los mismos y sus percepciones respecto a los desafíos enfrentados durante el proceso, con el fin de contribuir al debate de las colaboraciones público-privadas en políticas de salud. El artículo también discute los principales desafíos y controversias.

O programa Menos Sal, Mais Vida foi a primeira iniciativa voluntária para reduzir o teor de sal em produtos alimentícios na Argentina. O artigo analisa as perspectivas dos atores envolvidos nesse acordo voluntário entre o Ministério da Saúde e a indústria alimentícia para reduzir gradualmente o teor de sódio nos alimentos processados. O estudo de caso exploratório utilizou uma abordagem qualitativa com 29 entrevistas em profundidade com representantes dos setores público e privado, e identificou o papel dos diversos atores e suas percepções quanto aos desafios enfrentados no processo político, contribuindo para o debate sobre parcerias público-privadas em políticas de saúde. O artigo também discute os principais desafios e controvérsias dessa iniciativa.

Multidrug resistance and ESBL-producing Salmonella spp. isolated from broiler processing plants

Abstract The aim of this study was to investigate the occurrence of multidrug-resistant, extended spectrum beta-lactamase (ESBL) producing Salmonella spp. isolated from conveyor belts of broiler cutting rooms in Brazilian broiler processing plants. Ninety-eight strains of Salmonella spp. were analyzed. Multidrug resistance was determined by the disk diffusion test and the susceptibility of the isolated bacteria was evaluated against 18 antimicrobials from seven different classes. The double disk diffusion test was used to evaluate ESBL production. Of the 98 strains tested, 84 were multidrug resistant. The highest rates of resistance were against nalidixic acid (95%), tetracycline (91%), and the beta-lactams: ampicillin and cefachlor (45%), followed by streptomycin and gentamicin with 19% and 15% of strain resistance, respectively. By contrast, 97% of the strains were sensitive to chloramphenicol. 45% of the strains were positive for the presence of ESBL activity. In this study, high rates of multidrug resistance and ESBL production were observed in Salmonella spp.

Impacto da redução do teor de sódio em alimentos processados no consumo de sódio no Brasil / Impacto de la reducción del contenido de sodio en los alimentos procesados en la ingestión de sodio en Brasil / The impact of the reduction of sodium content in processed foods in salt intake in Brazil

Resumo: O objetivo do presente estudo foi avaliar o potencial impacto da redução do teor de sódio em alimentos processados no consumo médio de sódio na população brasileira. Um total de 32.900 participantes do primeiro Inquérito Nacional de Alimentação (2008-2009), com 10 anos e mais de idade, que forneceram dados de dois dias de consumo foram avaliados. As metas de redução de sódio pactuadas pelo Ministério da Saúde em 2010 e 2013 foram utilizadas como referência para determinar o teor máximo de sódio em 21 grupos de alimentos processados. Os resultados indicam que as metas de redução de sódio em alimentos processados têm pequeno impacto no consumo médio de sódio na população brasileira. Em 2017, a redução média esperada é de 1,5%, ficando os valores de consumo médio de sódio ainda acima do limite máximo recomendado de 2.000mg/dia. Portanto, dificilmente será possível alcançar a redução necessária no consumo de sódio no Brasil a partir de acordos voluntários nos moldes dos que aconteceram até o momento.

Resumen: El objetivo del presente estudio fue evaluar el potencial impacto de la reducción del contenido en sodio en alimentos procesados en el consumo medio de sodio de la población brasileña. Un total de 32.900 participantes de la primera Encuesta Nacional de Alimentación (2008-2009), con 10 años y más de edad, proporcionaron datos sobre dos días de consumo, que fueron evaluados. Las metas de reducción de sodio, indicadas por el Ministerio de Salud en 2010 y 2013, fueron utilizadas como referencia para determinar el contenido máximo de sodio en 21 grupos de alimentos procesados. Los resultados indican que las metas de reducción de sodio en alimentos procesados tiene un pequeño impacto en el consumo medio de sodio en la población brasileña. En 2017, la reducción media esperada es de un 1,5%, quedando los valores de consumo medio de sodio todavía por encima del límite máximo recomendado de 2.000mg/día. Por tanto, difícilmente será posible alcanzar la reducción necesaria en el consumo de sodio en Brasil, a partir de acuerdos voluntarios en los términos de los que se han ido sucediendo hasta el momento.

Abstract: This study aimed at assessing the potential impact of the reduction of sodium content in processed foods in the average salt intake in the Brazilian population. A total of 32,900 participants of the first National Dietary Survey (NDS 2008-2009), age 10 years and older who provided information about food intake over two days were evaluated. The sodium reduction targets established by the Brazilian Ministry of Health in 2010 and 2013 were used as the reference to determine the maximum content of sodium in 21 groups of processed food. The results show that sodium reduction targets in processed food have small impact in mean Brazilian population intake of salt. For 2017, the expected mean reduction is of 1.5%, the average sodium intake being still above the recommended 2,000mg/day maximum. Therefore, it will hardly be possible to reach the necessary reduction in salt intake in Brazil from volunteer agreements like the ones made so far.

Avian influenza virus in various environments and risk factors for the contamination of live poultry markets during winter and spring season in Zhejiang province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To evaluate the prevalence of avian influenza virus in various environment and the influence factors for subtype H7 prevalence in live poultry markets.</p><p><b>METHODS</b>We collected environmental samples from various environments across 11 cities of Zhejiang province between October 2014 and March 2015. Cage surface swabs, chopping board surface swabs, feces, water for cleaning, drinking water and swabs of other surfaces were collected. A total of 6 457 samples were collected, including 4 487 samples from poultry markets, 820 samples from poultry farms, 715 samples from backyard poultry pens, 118 samples from poultry processing factories, 118 samples from wild bird habitats and 86 samples from other sites. The chi-squared test was used to compare virus prevalence among sample types, sites types, and poultry markets types. Binary logistic regression was used to analyze factors on H7 subtype prevalence in poultry markets.</p><p><b>RESULTS</b>Of 6 457 samples, 32.54% (2 101) samples were positive for avian influenza, with 3.67% (237) positive for H5 subtype, 12.02%(776) positive for H7 subtype, 11.77%(760) positive for H9 subtype. Of 237 live poultry markets, 33.8% (80) were positive for H7 subtype. The prevalence of influenza A in poultry processing factories was the highest at 43.72% (101/231) (χ(2)=737.80, P<0.001). Poultry markets were contaminated most seriously by subtype H5/H7/H9 with the prevalence of 27.55% (1 236/4 487) (χ(2)=436.37, P<0.001). Compared with markets with 1 type of poultry, OR was 4.58 (95%CI: 1.63-12.87) for markets with ≥2 types of poultry.</p><p><b>CONCLUSION</b>Live poultry markets and poultry processing factories were contaminated most seriously by avian influenza. The types of poultry might be the factor which influenced the subtype H7 prevalence in poultry markets.</p>

El desafío de controlar las enfermedades transmitidas por alimentos: bacteriófagos como una nueva herramienta biotecnológica / The challenge of controlling foodborne diseases: bacteriophages as a new biotechnological tool

Foodborne diseases are an increasing public health issue, in which bacterial pathogens have a transcendental role. To face this situation, the food industry has implemented several control strategies, using in the last decade some biotechnological tools, such as direct application of bacteriophages on food, to effectively control bacterial pathogens. Their bactericidal and safe properties to humans and animals have been widely described in the literature, being nowadays some bacteriophage-based products commercially available. Despite this, there are so many factors that can interfere in their biocontrol effectiveness on food, therefore is essential to consider these factors before their application. Thus, the optimal bacterial reduction will be achieved, which would produce a safer food. This review discusses some factors to consider in the use of bacteriophages as biocontrol agents of foodborne pathogens, including historical background, taxonomy and biological description of bacteriophages, and also advantages, disadvantages, and considerations of food applications.

Las enfermedades transmitidas por alimentos son un creciente problema de salud pública, donde los agentes patógenos bacterianos juegan un rol trascendental. La industria alimentaria ha implementado diversas medidas de control para enfrentar esta situación, utilizando en la última década algunas herramientas biotecnológicas, como es la aplicación de bacteriófagos directamente en los alimentos. Sus propiedades exclusivamente bactericidas e inocuas para el hombre y los animales han sido descritas ampliamente en la literatura científica, existiendo a la fecha algunos productos comerciales disponibles en el mercado internacional. A pesar de esto, diversos son los factores que pueden influir en su efectividad bio-controladora en alimentos, por lo que conocer dichos factores resulta fundamental antes de considerar su aplicación. De esta manera, se logrará obtener la máxima actividad reductora de la carga bacteriana, generando así un alimento más seguro. Esta revisión aborda ciertos factores a considerar para el uso de bacteriófagos como agentes bio-controladores de patógenos alimentarios, incluyendo antecedentes históricos, taxonomía y descripción biológica de bacteriófagos, así como ventajas, desventajas y consideraciones de su aplicación en alimentos.

Neutralising antibodies for Mayaro virus in Pantanal, Brazil

The Pantanal hosts diverse wildlife species and therefore is a hotspot for arbovirus studies in South America. A serosurvey for Mayaro virus (MAYV), eastern (EEEV), western (WEEV) and Venezuelan (VEEV) equine encephalitis viruses was conducted with 237 sheep, 87 free-ranging caimans and 748 equids, including 37 collected from a ranch where a neurologic disorder outbreak had been recently reported. Sera were tested for specific viral antibodies using plaque-reduction neutralisation test. From a total of 748 equids, of which 264 were immunised with vaccine composed of EEEV and WEEV and 484 had no history of immunisation, 10 (1.3%) were seropositive for MAYV and two (0.3%) for VEEV using criteria of a ≥ 4-fold antibody titre difference. Among the 484 equids without history of immunisation, 48 (9.9%) were seropositive for EEEV and four (0.8%) for WEEV using the same criteria. Among the sheep, five were sero- positive for equine encephalitis alphaviruses, with one (0.4%) for EEEV, one (0.4%) for WEEV and three (1.3%) for VEEV. Regarding free-ranging caimans, one (1.1%) and three (3.4%), respectively, had low titres for neutralising antibodies to VEEV and undetermined alphaviruses. The neurological disorder outbreak could not be linked to the alphaviruses tested. Our findings represent strong evidence that MAYV and all equine encephalitis alphaviruses circulated in the Pantanal.

BAY 41-2272 activates host defence against local and disseminated Candida albicans infections

In our previous study, we have found that 5-cyclopropyl-2-[1-(2-fluoro-benzyl)-1H-pyrazolo[3,4-b]pyridine-3-yl]-pyrimidin-4-ylamine (BAY 41-2272), a guanylate cyclase agonist, activates human monocytes and the THP-1 cell line to produce the superoxide anion, increasing in vitro microbicidal activity, suggesting that this drug can be used to modulate immune functioning in primary immunodeficiency patients. In the present work, we investigated the potential of the in vivo administration of BAY 41-2272 for the treatment of Candida albicans and Staphylococcus aureus infections introduced via intraperitoneal and subcutaneous inoculation. We found that intraperitoneal treatment with BAY 41-2272 markedly increased macrophage-dependent cell influx to the peritoneum in addition to macrophage functions, such as spreading, zymosan particle phagocytosis and nitric oxide and phorbol myristate acetate-stimulated hydrogen peroxide production. Treatment with BAY 41-2272 was highly effective in reducing the death rate due to intraperitoneal inoculation of C. albicans, but not S. aureus. However, we found that in vitro stimulation of peritoneal macrophages with BAY 41-2272 markedly increased microbicidal activities against both pathogens. Our results show that the prevention of death by the treatment of C. albicans-infected mice with BAY 41-2272 might occur primarily by the modulation of the host immune response through macrophage activation. .

Bats and zoonotic viruses: can we confidently link bats with emerging deadly viruses?

An increasingly asked question is 'can we confidently link bats with emerging viruses?'. No, or not yet, is the qualified answer based on the evidence available. Although more than 200 viruses - some of them deadly zoonotic viruses - have been isolated from or otherwise detected in bats, the supposed connections between bats, bat viruses and human diseases have been raised more on speculation than on evidence supporting their direct or indirect roles in the epidemiology of diseases (except for rabies). However, we are convinced that the evidence points in that direction and that at some point it will be proved that bats are competent hosts for at least a few zoonotic viruses. In this review, we cover aspects of bat biology, ecology and evolution that might be relevant in medical investigations and we provide a historical synthesis of some disease outbreaks causally linked to bats. We provide evolutionary-based hypotheses to tentatively explain the viral transmission route through mammalian intermediate hosts and to explain the geographic concentration of most outbreaks, but both are no more than speculations that still require formal assessment.

Genetic variability in G2 and F2 region between biological clones of human respiratory syncytial virus with or without host immune selection pressure

Human respiratory syncytial virus (HRSV) is an important respiratory pathogens among children between zero-five years old. Host immunity and viral genetic variability are important factors that can make vaccine production difficult. In this work, differences between biological clones of HRSV were detected in clinical samples in the absence and presence of serum collected from children in the convalescent phase of the illness and from their biological mothers. Viral clones were selected by plaque assay in the absence and presence of serum and nucleotide sequences of the G2 and F2 genes of HRSV biological clones were compared. One non-synonymous mutation was found in the F gene (Ile5Asn) in one clone of an HRSV-B sample and one non-synonymous mutation was found in the G gene (Ser291Pro) in four clones of the same HRSV-B sample. Only one of these clones was obtained after treatment with the child's serum. In addition, some synonymous mutations were determined in two clones of the HRSV-A samples. In conclusion, it is possible that minor sequences could be selected by host antibodies contributing to the HRSV evolutionary process, hampering the development of an effective vaccine, since we verify the same codon alteration in absence and presence of human sera in individual clones of BR-85 sample.