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Background: Consumption of ultra-processed foods (UPFs) is a risk factor for several cardiovascular diseases and mortality, with potential physiological mechanisms including elevated serum cholesterol levels. Objectives: To analyze the association between hypercholesterolemia and the isolated and simultaneous consumption of UPFs in older adults. Methods: This is a cross-sectional epidemiological study conducted with 1322 Brazilian older adults (mean age of 70.4 years; 55.0% females) from the state of Roraima. The data was obtained from the Department of Epidemiological Surveillance of the State of Roraima. Hypercholesterolemia was diagnosed based on nosology criteria. Food consumption patterns were assessed using a nationally standardized instrument comprising four categories of UPFs. Binary logistic regression models were employed to explore potential associations. Results: The prevalence of hypercholesterolemia was high (54.4%, 95% CI 51.7-56.6). While the simultaneous consumption of all UPFs types was lower (15.2%), over half of the older adults reported consuming at least one type of UPFs (71.8%). Isolated consumption of UPFs was associated with approximately twice the odds of hypercholesterolemia. Older adults who consumed two (OR 1.75, 95% CI 1.26-2.43), three (OR 2.28, 95% CI 1.58-3.29), or all four types of UPF (OR 6.65, 95% CI 4.35-9.44) had a higher likelihood of having hypercholesterolemia. Conclusions: Isolated consumption of UPFs is a risk factor for hypercholesterolemia, which can increase up to sixfold when older adults consume multiple UPFs simultaneously. Prioritizing nutritional education and raising awareness regarding the reduction of UPFs consumption is crucial.
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Given the aging global population, identifying heart failure (HF) phenotypes has become crucial, as distinct disease characteristics can influence treatment and prognosis in older adults. This study aimed to analyze the association between clustering of cardiovascular risk factors and HF in older adults. A cross-sectional epidemiological study was conducted with 1322 older adults (55% women, mean age 70.4) seen in primary health care. Diagnosis of HF was performed by a cardiologist based on diagnostic tests and medical history. Cardiovascular risk factors included hypertension, diabetes, hypercholesterolemia, and smoking. Using logistic regression, potential associations were tested. Individual risk factor analysis showed that older adults with hypertension, diabetes, or hypercholesterolemia had up to 7.6 times higher odds to have HF. The cluster where older adults had only one risk factor instead of none increased the odds of HF by 53.0%. Additionally, the odds of older patients having HF ranged from 3.59 times for the two-risk factor cluster to 20.61 times for the simultaneous presence of all four factors. The analysis of clusters substantially increasing HF risk in older adults revealed the importance of individualizing subgroups with distinct HF pathophysiologies. The clinical significance of these clusters can be beneficial in guiding a more personalized therapeutic approach.
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Resumo Objetivo Estimar a prevalência de insuficiência cardíaca (IC) e explorar sua possível associação com o consumo de alimentos ultraprocessados (AUP) em idosos. Método Este estudo transversal utilizou prontuários médicos de 1.322 idosos (55% mulheres; idade média de 70,4 anos) tratados na atenção primária à saúde no estado de Roraima, Brasil. Um cardiologista diagnosticou a IC com base em testes diagnósticos como ecocardiografia, avaliação clínica e análise do histórico médico. Nutricionistas avaliaram o consumo de AUP utilizando um formulário nacional comumente utilizado nas unidades de saúde primária brasileiras. Resultados Os achados revelaram que 15,4% dos idosos tinham IC. Observaram-se associações significativas entre grupos de AUP e IC, com a probabilidade de IC variando de OR=1,97 (IC 95% =1,36-2,84) para o consumo de hambúrgueres e/ou salsichas a OR=2,59 (IC 95% =1,73-3,74) para o consumo de biscoitos, doces e guloseimas. Conclusão O consumo de AUP foi associado a uma alta prevalência de IC nessa amostra de idosos brasileiros. Formuladores de políticas e profissionais de saúde diretamente envolvidos com essa população devem colaborar em ações direcionadas e orientações para reduzir o consumo de AUP e aumentar a ingestão de alimentos não processados.
Abstract Objective To estimate the prevalence of heart failure (HF) and explore its potential association with the consumption of ultra-processed foods (UPF) in older adults. Method This cross-sectional study utilized medical records of 1,322 older adults (55% women; mean age of 70.4 years) treated in primary health care facilities in the state of Roraima, Brazil. A cardiologist diagnosed HF based on diagnostic tests such as echocardiography, clinical evaluation, and analysis of medical history. Nutritionists assessed UPF consumption using a nationally standardized form commonly employed in Brazilian primary health care units. Results The findings revealed that 15.4% of older adults had HF. Significant associations were observed between UPF groups and HF, with the probability of HF ranging from OR=1.97 (95% CI=1.36-2.84) for the consumption of hamburgers and/or sausages to OR=2.59 (95% CI=1.73-3.74) for the consumption of filled biscuits, sweets, and treats. Conclusion The consumption of UPF was associated with a high prevalence of HF in this sample of Brazilian older adults. Policymakers and healthcare professionals directly involved with this population should collaborate on targeted interventions and guidelines to reduce UPF consumption and increase the intake of unprocessed foods.
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PURPOSE: Childhood obesity has become a concern for the Brazilian Unified Health System, which has recently started to investigate children's eating habits in basic health units. This study examined the trends and ultra-processed foods (UPF) consumption in Brazilian children. DESIGN AND METHODS: This repeated cross-sectional study included 492,630 children (2-9 years old), from different Brazilian regions, in the years 2015 and 2019. The children's food consumption was assessed by nurses using a nationally standardized instrument. Information was provided by the Food and Nutrition Surveillance System Brazilian. RESULTS: The UPF consumption in Brazilian children is generally high and was higher among children in the South and Midwest regions. The consumption of sweetened beverages was more prevalent among all the UPF assessed and continues to increase among children in the Northeast region. Declining trends in UPF consumption were observed in children from all regions, except for the Northeast region, whose trends increased in almost all evaluated foods. PRACTICE IMPLICATIONS: Nurses, especially, have a primary role in guiding the reduction of UPF consumption, as they are the first health professionals to have access to this information. Increasing trends in UPF consumption can be mitigated by the inclusion of nutritionists in basic health units. Brazilian children need to be assisted by public policies that promote food education.