Consumption of ultra-processed foods and anthropometric indicators in adolescents, adults, and the elderly in a capital city in northeastern Brazil / Consumo de alimentos ultraprocessados e indicadores antropométricos em adolescentes, adultos e idosos de uma capital do Nordeste do Brasil

ABSTRACT Objective To evaluate the consumption of ultra-processed foods and associate it with anthropometric indicators in adolescents, adults, and the elderly. Methods Cross-sectional, domiciliary, population-based study, comprising adolescents aged 10-19 years, adults aged 20-59 years, and elderly people aged 60 or older, residents of the urban area of the city of Teresina, Piauí. Demographic, socioeconomic, lifestyle, food consumption, and anthropometric data were collected. The analysis of variance test was used along with the Bonferroni post-hoc test and crude and adjusted linear regression with a 95% confidence interval (95% CI). The level of significance adopted was 5%. Results There was no significant association between the consumption of ultra-processed foods and anthropometric variables in adults and the elderly. However, among adolescents, the results showed an inverse association, thus signaling a reduction in anthropometric indicators as the consumption of ultra-processed foods increases. Conclusion There was no association between the consumption of ultra-processed foods and anthropometric indicators in adults and the elderly; however, among adolescents, the results showed an inverse association, which encourages the development of new studies, especially longitudinal ones.

RESUMO Objetivo Avaliar o consumo de alimentos ultraprocessados e associá-lo a indicadores antropométricos em adolescentes, adultos e idosos Métodos Estudo transversal, domiciliar, de base populacional, compreendendo adolescentes de 10-19 anos, adultos de 2059 anos e idosos de 60 anos ou mais, residentes na zona urbana da cidade de Teresina, Piauí. Foram coletados dados demográficos, socioeconômicos, de estilo de vida, consumo alimentar e antropométrico. O teste de análise de variância foi utilizado juntamente com o teste post-hoc de Bonferroni e regressão linear bruta e ajustada com intervalo de confiança de 95% (IC95%). O nível de significância adotado foi de 5%. Resultados Não houve associação significativa entre o consumo de alimentos ultraprocessados e indicadores antropométricos em adultos e idosos, entretanto, entre os adolescentes, os resultados demonstraram uma associação inversa, sinalizando redução dos indicadores antropométricos à medida que se aumenta o consumo de ultraprocessados. Conclusão Não houve associação entre o consumo de alimentos ultraprocessados e indicadores antropométricos em adultos e idosos, entretanto, entre os adolescentes, os resultados demonstraram uma associação inversa, o que incentiva o desenvolvimento de novos estudos, especialmente, longitudinais.

Metabolic syndrome in adolescents and antioxidant nutrient intake: a cross-sectional study

SUMMARY OBJECTIVE: To verify the association between metabolic syndrome and its components, and intake of antioxidant nutrients in adolescents. METHODS: This is a cross-sectional study of the data of 327 adolescents in a high school in Teresina, Piauí, Brazil, pertaining to their socioeconomic background, anthropometric measurements, dietary intake (selenium; copper; zinc; vitamins A, C, and E), hemodynamics, and biochemical tests. The criteria for diagnosing metabolic syndrome in adolescents were applied. Binary logistic regression was used to verify the association between metabolic syndrome and its components, and intake of antioxidants. The level of significance was established at p<0.05. RESULTS: Prevalence of metabolic syndrome was 7.0%, with a significant association between body mass index and blood pressure. Lower tertiles of copper and vitamins A and E intake were associated with high triglyceride and glycemic levels. The association with vitamins A and E remained after adjustment. CONCLUSIONS: A significant association between lower vitamins A and E intake and metabolic syndrome components (altered triglycerides and glycemic levels) was found. Besides further studies on this issue, the need for health interventions was found, which ensures the appropriate intake of antioxidant nutrients during adolescence.

The influence of ultra-processed food consumption in anthropometric and atherogenic indices of adolescents / Influência do consumo de alimentos ultraprocessados em índices antropométricos e aterogênicos de adolescentes

ABSTRACT Objective To investigate the influence of ultra-processed food consumption on anthropometric and atherogenic indices. Methods A cross-sectional study was conducted with 327 adolescents aged 14 to 19 years. Sociodemographic, anthropometric, biochemical, and food consumption data were evaluated. The ratios of atherogenic indices were calculated using the Castelli I (Total Cholesterol/High Density Lipoprotein Cholesterol), Castelli II (Low Density Lipoprotein Cholesterol/High Density Lipoprotein Cholesterol), and estimated Low Density Lipoprotein Cholesterol particle size (Atherogenic Index of Plasma=Triglycerides/High-Density Lipoprotein Cholesterol) indices. Logistic regression was used for the unadjusted and adjusted analysis between ultra-processed foods consumption, anthropometric, and atherogenic indices. The level of significance was 5%. Results Most participants were female (59.3%). Girls had a higher consumption of ultra-processed foods (26.6% vs. 20.5%). Of the total number of adolescents, 16.5% were overweight and 65.7% were from public schools. Adolescents with altered values for the Castelli I and II Index, and for the Atherogenic Index of Plasma had significantly higher weights, Waist Circumference, Waist Circumference/ Height and Body Mass Index/ Age values. The adjusted analysis identified a significant association (Odds ratio=2.29; 95% Confidence interval: 1.23-4.28) between the high consumption of ultra-processed foods and the Castelli II index. Conclusion The associations between atherogenic indices and anthropometric indices and the consumption of ultra-processed foods highlight the negative influence of these foods on adolescents' cardiovascular health.

RESUMO Objetivo Verificar a influência do consumo de alimentos ultraprocessados em índices antropométricos e de aterogenicidade. Métodos Estudo transversal com 327 adolescentes na faixa etária de 14 a 19 anos. Avaliaram-se dados sociodemográficos, antropométricos, bioquímicos e de consumo alimentar. As razões dos índices de aterogenicidade foram calculadas por meio do Índice de Castelli I (Colesterol Total/Lipoproteína de Alta Densidade), Índice de Castelli II (Lipoproteína de Baixa Densidade/Lipoproteína de Alta Densidade) e da estimativa do tamanho da partícula de Lipoproteína de Baixa Densidade (Índice Aterogênico do Plasma=Triglicerídeos/Lipoproteína de Alta Densidade). A regressão logística foi utilizada para a análise bruta e ajustada entre consumo de alimentos ultraprocessados, indicadores antropométricos e índice de aterogenicidade. O nível de significância foi de 5%. Resultados A maioria dos adolescentes que participaram do estudo era do sexo feminino (59,3%). As meninas apresentaram maior consumo de alimentos ultraprocessados (26,6% vs. 20,5%). Do total de participantes, 16,5% estavam com excesso de peso e 65,7% eram de escolas públicas. Adolescentes com valores alterados para o Índice Castelli I e II e para o Índice Aterogênico do Plasma apresentaram valores de peso, Circunferência da Cintura, Circunferência da Cintura/Altura e Índice de Massa Corporal/Idade significantemente superiores. A análise ajustada identificou associação significante (Razão de possibilidades=2,29; Intervalo de confiança 95%:1,23-4,28) entre o elevado consumo de alimentos ultraprocessados e o índice de Castelli II. Conclusão As associações entre os índices aterogênicos com os índices antropométricos e com o consumo de alimentos ultraprocessados ressaltam a influência negativa desses alimentos na saúde cardiovascular de adolescentes.

Associação entre o consumo de alimentos ultraprocessados e parâmetros lipídicos em adolescentes / Association between ultra-processed food consumption and lipid parameters among adolescents

Resumo O objetivo do estudo foi analisar a associação entre o consumo de alimentos ultraprocessados (AUP) e parâmetros lipídicos. Estudo transversal realizado com adolescentes de ensino médio. O consumo alimentar foi analisado por meio de recordatório alimentar de 24h, sendo os AUP identificados de acordo com a NOVA classificação de alimentos. Os níveis de colesterol total, HDL-c e triglicérides, foram determinados por colorimetria enzimática e a fração de LDL-c estimada por fórmula. Utilizou-se o teste t de Student ou Mann-Whitney para comparação de médias e regressão linear para realizar associações entre as variáveis. Os resultados mostram que o consumo de AUP foi mais frequente nas adolescentes do sexo feminino, entre a faixa etária 17 a 19 anos, com renda familiar superior a dois salários mínimos e de escolas particulares. Nota-se que os indivíduos no maior tercil de consumo de AUP apresentaram maior ingestão energética, de carboidratos e de sódio, com menor ingestão de proteínas e de fibras. Observou-se, ainda, que o maior consumo de AUP foi associado negativamente aos níveis de HDL-c e positivamente aos níveis de triglicerídeos e dislipidemia. Portanto, os AUP estão associados a uma piora no perfil nutricional da dieta e alterações negativas nos parâmetros lipídicos de jovens.

Abstract The scope of this study was to analyze the association between ultra-processed food (UPF) consumption and lipid parameters. It was a cross-sectional study performed with high school adolescents. Food consumption was analyzed by means of a 24-hour food recall form, where UPF were identified in line with the NOVA system of food classification. The total cholesterol levels, HDL-c and triglycerides were determined by enzymatic colorimetry and the LDL-c fraction estimated by formula. The Student's t-test or Mann-Whitney was used to compare averages, and linear regression to make associations among the variables. The results show that UPF consumption was more frequent in female adolescents between 17 and 19 years of age, with a family income above two minimum wages and from private schools. It was observed that individuals in the upper third of UPF consumption had a higher energetic, carbohydrate and sodium intake, with a lower intake of proteins and fibers. Moreover, it was found that a higher UPF intake was negatively associated with HDL-c levels and positively associated with triglyceride levels and dyslipidemia. Therefore, UPF is associated with a worsening of the nutritional profile of the diet and contributes to negative changes in the lipid parameters of young individuals.

Factors associated with the lipid profile of adolescents / Factores asociados con el perfil lipídico de adolescentes

ABSTRACT There is a high prevalence of dyslipidemia in adolescence. The aim of this study was to determine the lipid profile of adolescents and associated factors. We conducted a cross-sectional study with male and female adolescents from public and private schools in Teresina, aged 14 to 19 years. Body mass index (BMI) z-score was obtained and adjusted for age, in addition to waist circumference (WC) percentile values. Lipid profile was determined by enzymatic colorimetric method; LDL-C was calculated. The statistical tests Mann-Whitney U, Student's t, and odds ratio were used. The sample was comprised of 327 adolescents with a mean age of 16.5 years, 59.6% were female and 65.7% from public schools. The prevalence of dyslipidemia was 85.6%, especially hypoalphalipoproteinemia. TG levels were significantly higher and HDL levels were lower among participants who attended public schools (P< 0.05). BMI and WC were associated with dyslipidemia; a higher mean BMI and overweight was observed in girls with dyslipidemia. In the adjusted regression, being from a public school increased the odds for low HDL-C and dyslipidemia, while overall higher BMI and abdominal excess weight represented a risk for higher triglycerides. Thus, overweight increased the chances of hypertriglyceridemia and studying in a public school increased the odds for dyslipidemia and hypoalphalipoproteinemia.

RESUMEN Las dislipidemias tienen una elevada prevalencia en la adolescencia. Nuestro objetivo fue determinar el perfil lipídico de adolescentes y sus factores asociados. Realizamos un estudio transversal que abarcó adolescentes de escuelas públicas y privadas de Teresina, con edad entre 14 y 19 años, de los dos sexos. El índice de masa corporal (escore-z, IMC-Z) se obtuvo conforme a la edad, y la circunferencia de la cintura (CC) en percentil. La determinación del perfil lipídico se realizó por método enzimático colorimétrico; LDL-C fue calculado. Las pruebas estadísticas Mann-Whitney U, T de Student y odds ratio fueran utilizadas. La muestra comprendió 327 adolescentes con edad media de 16,5 años, siendo 59,6% del sexo femenino y el 65,7% de escuelas públicas. La prevalencia de dislipidemia fue 85,6%, destacándose la hipo-alfa-lipoproteinemia. Los niveles de TC fueron significativamente mayores y los de HDL menores en las escuelas públicas (P< 0,05). Al asociar IMC y CC con dislipidemia, se observó mayores valores medios de IMC en las niñas con dislipidemia y sobrepeso. En la regresión ajustada, ser de escuela pública aumentó las posibilidades de bajo HDL-C y dislipidemia, mientras que el exceso de peso global y abdominal fueron factores de riesgo de cambios en los triglicéridos. Así, el exceso de peso elevó las posibilidades de hipertrigliceridemia, y estudiar en escuela pública elevó las posibilidades de dislipidemia e hipo-alfa-lipoproteinemia.

Association between the consumption of antioxidant nutrients with lipid alterations and cardiometabolic risk in adolescents / Associação entre o consumo de nutrientes antioxidantes com alterações lipídicas e risco cardiometabólico em adolescentes

ABSTRACT Objective This study aimed at validating the associations between the consumption of antioxidant nutrients as well as lipid alterations and cardiometabolic risks in adolescents. Methods This cross-sectional study included 327 adolescents aged 14-19 years. Sociodemographic and dietary information, anthropometric and blood pressure measurements, and biochemical data were obtained. Cardiometabolic risk was calculated by aggregating the risk factors, which were expressed as the sum of Z-scores. Poisson regression was performed to estimate the prevalence ratios. Results In boys, low intake of zinc was associated with elevated total cholesterol and triglyceride levels, whereas it was associated with low high-density lipoprotein cholesterol levels and high low-density lipoprotein cholesterol and total cholesterol levels in girls, thus indicating a cardiometabolic risk. Furthermore, low intake of copper was associated with high triglyceride levels and cardiometabolic risk in girls. The high prevalence ratios of high low-density lipoprotein cholesterol and total cholesterol levels and cardiometabolic risk were higher in those with low intake of vitamin A. Among girls, associations were also observed between lower intake of vitamin A and high triglyceride levels. Low intake of vitamin C among boys was associated with elevated high low-density lipoprotein cholesterol and triglyceride levels. Among girls, the intake of this vitamin was associated with lower low high-density lipoprotein cholesterol levels. In girls, low intake of vitamin E was associated with low low high-density lipoprotein cholesterol levels and high total cholesterol levels. Conclusion The associations between antioxidant micronutrients as well as lipid alterations and cardiometabolic risk emphasize the importance of encouraging the consumption of foods that are rich in these nutrients to modulate lipid alterations and cardiometabolic risk.

RESUMO Objetivo Esta pesquisa teve como objetivo verificar as associações entre o consumo de nutrientes antioxidantes e as alterações lipídicas e o risco cardiometabólico em adolescentes. Métodos Trata-se de estudo transversal com 327 adolescentes de 14 a 19 anos de idade. Investigaram-se dados sociodemográficos, antropométricos, pressóricos, bioquímicos e de consumo alimentar. O risco cardiometabólico foi calculado por meio da agregação dos fatores de risco, expressa pela soma dos escores Z. Realizou-se a regressão de Poisson para estimar as razões de prevalência. Resultados O baixo consumo de zinco associou-se a elevados níveis de CT e triglicérides para os meninos, e a níveis baixos de HDL-c e elevados de LDL-c e CT para as meninas, demonstrando risco. Além disso, a baixa ingestão de cobre associou-se a altos níveis de triglicérides e risco cardiometabólico para as meninas. A razão de prevalência nos níveis elevados de LDL-c, CT e risco cardiometabólico foi maior entre os adolescentes que apresentavam baixa ingestão de vitamina A. Foram observadas também associações, no sexo feminino, da menor ingestão de vitamina A com altos níveis de triglicérides. A baixa ingestão de vitamina C nos meninos mostrou associações com LDL-c e triglicérides elevado, enquanto nas meninas essa vitamina associou-se com menores níveis de HDL-c. O baixo consumo de vitamina E, para as meninas, apresentou associações com níveis baixos de HDL-c e elevados de CT. Conclusão As associações entre os micronutrientes antioxidantes e as alterações lipídicas e risco cardiometabólico ressaltam a importância de estimular o consumo de alimentos que sejam fonte desses nutrientes, com o objetivo de modular as alterações lipídicas e o risco cardiometabólico.