The current and future costs of colorectal cancer attributable to red and processed meat consumption in Brazil.

BACKGROUND: Compelling evidence supports the association between red and processed meat consumption and increased risk of colorectal cancer. Herein, we estimated the current (2018) and future (2030) federal direct healthcare costs of colorectal cancer in the Brazilian Unified Health System attributable to red and processed meat consumption. Considering reduced red and processed meat consumption, we also projected attributable costs of colorectal cancer in 2040. METHODS: We retrieved information on red and processed meat consumption from two nationally representative dietary surveys, the Household Budget Survey 2008-2009 and 2017-2018; relative risks for colorectal cancer from a meta-analysis; direct healthcare costs of inpatient and outpatient procedures in adults ≥ 30 years with colorectal cancer (C18-C20) from 2008-2019 by sex. RESULTS: Attributable costs of colorectal cancer were calculated via comparative risk assessment, assuming a 10-year lag. In 2018, US$ 20.6 million (8.4%) of direct healthcare costs of colorectal cancer were attributable to red and processed meat consumption. In 2030, attributable costs will increase to US$ 86.6 million (19.3%). Counterfactual scenarios of reducing red and processed meat consumption in 2030 suggested that US$ 2.2 to 11.9 million and US$ 13 to 74 million could be saved in 2040, respectively. CONCLUSION: Red and processed meat consumption has an escalating economic impact on the Brazilian Unified Health System. Our findings support interventions and policies focused on primary prevention and cancer.

The future costs of cancer attributable to excess body weight in Brazil, 2030-2040.

BACKGROUND: Excess body weight (EBW), herein defined as body mass index (BMI) ≥25 kg/m2, is a well-known modifiable risk factor for cancer and a pivotal vector for growing healthcare costs. We estimated the future (2030) federal direct healthcare costs of cancer in the Brazilian Unified Health System (SUS) attributable to EBW. We also projected direct healthcare costs of cancer that could be potentially saved in 2040, considering counterfactual (alternative) scenarios of population-wide reductions in the BMI to be achievedin 2030. METHODS: We developed a macrosimulation model by sex using self-reported BMI data in adults ≥ 20 years who relied exclusively on the public health system from the Brazilian National Health Survey (PNS) 2019; relative risks for 12 types of cancer from the World Cancer Research Fund/American Institute Cancer Research (WCRF/AICR) meta-analysis; and nationwide registries of federal direct healthcare costs of inpatient and outpatient procedures in adults ≥30 years with cancer from 2008-2019. We calculated the attributable costs of cancer via comparative risk assessment, assuming a 10-year lag between exposure and outcome. We used the potential impact fraction (PIF) equation and the Monte Carlo simulation method to estimate the attributable costs and 95% uncertainty intervals, considering the theoretical-minimum-risk exposure and other counterfactual (alternative) scenarios of the EBW prevalence. We assessed the cancer costs attributable to EBW, multiplying PIF by the direct healthcare costs of cancer. RESULTS: In 2030, 2.4% or US$ 62.8 million in direct healthcare costs of cancer may be attributable to EBW. We projected potential savings of approximately US$ 10.3 to 26.6 million in 2040 by reducing the prevalence of EBW in 2030. CONCLUSIONS: We estimated high future costs of cancer attributable to EBW in Brazil. Our findings may support interventions and policies focused on the primary prevention of EBW and cancer.

Boas práticas de higiene e conservação de alimentos em cozinhas residenciais de usuários do programa saúde da família-Lapa / Good hygiene practices and food storage in the home kitchens of users of the family health program - Lapa

Objetivo Verificar a adoção de procedimentos de higiene alimentar em cozinhas residenciais de usuários do Programa Saúde da Família (Lapa, Rio de Janeiro) e comparar com as boas práticas recomendadas. Métodos Foram conduzidas 74 visitas domiciliares e foi aplicada uma lista de verificação de boas práticas de higiene, com ênfase em três temas: higiene ambiental, contaminação cruzada e conservação de alimentos. Os resultados foram expressos como frequências. Para comparar diferentes variáveis foi utilizado o teste Qui-Quadrado. Resultados Os participantes foram predominantemente do gênero feminino (77,0%), com mais de 60 anos de idade (55,4%). As principais falhas higiênicas observadas foram: acesso de animais domésticos à área de preparo de alimentos (20,0%); uso da mesma superfície de corte para diferentes alimentos (73,0%); alimentos crus e prontos não separados no refrigerador (45,0%); armazenamento inadequado de ovos (74,0%) e alimentos prontos expostos em temperatura ambiente (32,0%). O uso de água filtrada foi mais comum em residências de pessoas de maior faixa etária (69,2% vs. 39,3%, p=0,04). Por outro lado, existiu uma tendência de diferentes superfícies de corte serem mais usadas por pessoas mais jovens (75,0% vs. 37,0%, p=0,05). Conclusão Os resultados mostraram importantes falhas de higiene e de conservação de alimentos em cozinhas residenciais de usuários do Programa Saúde da Família (Lapa, Rio de Janeiro), sugerindo a necessidade de educação em saúde sobre higiene alimentar.

Objective The objective of this study was to verify hygiene practices in home kitchens of users of the Family Health Program (Lapa, Rio de Janeiro, Brazil) and compare them with the recommended good practices. Methods A total of 74 home visits were done and a list of good hygiene practices was verified regarding the environment, cross contamination and food storage. The results were expressed as frequencies. The chi-square test was used to compare the different variables. Results The participants were mostly females (77.0%) aged 60 or more years (55.4%). The most common poor hygiene practices were: pets with access to food preparation areas (20%), using the same surface to cut different foods (73.0%), raw and cooked foods not separated in the refrigerator (45.0%), inadequate egg storage (74.0%), and ready-to-eat foods under room temperature (32.0%). Filtered water was used more commonly by older individuals (69.2% vs. 39.3%, p=0.04) whereas there was a tendency different cutting surfaces were used more commonly by younger individuals (75.0% vs. 37.0%, p=0.05). (Obs. da tradutora: geralmente existe diferença quando p<0.05, e não quando p=0.05). Conclusion The results showed important lack of hygiene and poor food storage practices in the home kitchens of users of the Family Health Program of Lapa, Rio de Janeiro, suggesting that education in food hygiene is needed.

[Waist-to-hip ratio and dietary factors in adults]. / Relação cintura-quadril e fatores de dieta em adultos.

OBJECTIVES: To assess the association between diet factors and abdominal fat accumulation. METHODS: A household survey carried out in the city of Rio de Janeiro during 1995-1996. The usual diet of a sample of 2,441 individuals (42.8% men and 57.2% women), aged 20 to 60 years, was investigated using a food frequency questionnaire and data about height, weight, waist and hip perimeter was collected. The cut-off points for inadequate waist-to-hip ratio (WHR) for men and women were 0.95 and 0.80, respectively. RESULTS: Inadequate WHR was positively associated with age, cigarette smoking, body mass index, and inversely associated with education level, income and leisure physical activity in both men and women (p<0.05). Inadequate WHR was not associated with lipids, carbohydrates and total fiber intake. Positive association was found with inadequate WHR and spirits consumption among menopause women (p<0.001), and the consumption of four or more glasses of beer per day in men (p<0.001). CONCLUSION: In agreement with other studies, alcohol intake was associated with abdominal fat accumulation.

Relaçäo cintura-quadril e fatores de dieta em adultos / Waist-to-hip ratio and dietary factors in adults

OBJETIVO: Avaliar as associaçöes entre fatores de dieta e acúmulo de tecido adiposo na regiäo abdominal. MÉTODOS: A partir de um inquérito de base domiciliar realizado no Município do Rio de Janeiro, RJ, em 1995 e 1996, foi investigada a dieta usual em 2.441 pessoas (42,8por cento homens e 57,2por cento mulheres) entre 20 anos e 60 anos. Para tanto, utilizou-se um questionário semiquantitativo de freqüência de consumo alimentar, e aferiram-se altura, peso e perímetros de cintura e quadril. Considerou-se a relaçäo cintura-quadril (RCQ) inadequada para os homens que apresentassem RCQ acima de 0,95 e, para as mulheres, acima de 0,80. RESULTADOS: A RCQ inadequada associou-se positivamente a idade, tabagismo, índice de massa corporal e inversamente a escolaridade, renda e atividade física de lazer para ambos os sexos (p<0,05). Näo foi verificada associaçäo entre RCQ elevada e consumo de lipídios, carboidratos e fibras totais. Foi encontrada associaçäo positiva entre RCQ inadequada e consumo de bebidas destiladas entre mulheres na menopausa (p<0,001) e consumo de quatro ou mais copos por dia de cerveja entre os homens (p<0,001). CONCLUSAO: Em concordância a outros estudos similares, somente o consumo de álcool parece estar associado ao acúmulo de gordura abdominal