Dietary exposure to low-calorie sweeteners in a sample of Brazilian pregnant women.

The dietary exposure to low-calorie sweeteners (LCS) was estimated in a sample of pregnant Brazilian women. Consumption data were obtained with a 24-h Dietary Recall interview. Because of the uncertainty in assessing foods with LCS, they were classified into three scenarios to ensure inclusion of the 15 LCS allowed for use in Brazil: ranging from a less to a more conservative scenario. The concentration of LCS was estimated using the amount declared on the label or the maximum permitted levels and analytical determination data for table-top sweeteners. The frequency of consumption was higher for acesulfame-K, aspartame, and cyclamate. The food groups contributing the most to the consumption of LCS were non-alcoholic beverages, table-top sweeteners, confectionary and desserts. The level of dietary exposure to LCS was within the safety limit. However, continued efforts to monitor their dietary exposure are necessary given the limitations highlighted in this study.

Food swamps in Campinas, Brazil. / Mapeamento de pântanos alimentares em Campinas, Brasil.

The characteristics of the food environment can interfere with physical access to healthy foods and accentuate health inequalities. The presence of food swamps, i.e., the greater availability of ultra-processed food and commercial establishments compared to those that sell healthier options, are associated with the consumption of unhealthy foods. This study identified the spatial distribution of these establishments in Campinas, São Paulo. Fast-food restaurants, open-air organic/agroecological food markets and supermarkets were geocoded. Regional administrations (RAs) with greater social vulnerability according to the 2010 Census and with a greater availability of fast-food restaurants in relation to open-air food markets and supermarkets were considered food swamps. The less vulnerable neighborhoods had a higher concentration of all types of commercial food establishments compared to the most vulnerable regions. In Campinas, of eighteen RAs, five were considered food swamps. The findings reinforce the need for actions to improve exposure to healthy foods in more vulnerable neighborhoods.

As características do ambiente alimentar podem interferir no acesso físico a alimentos saudáveis e acentuar as desigualdades em saúde. A presença de pântanos alimentares, ou seja, a maior disponibilidade de estabelecimentos de comercialização de alimentos ultraprocessados em relação aos que comercializam opções mais saudáveis, associado a características de vulnerabilidade da vizinhança, pode estar relacionado ao consumo de alimentos não saudáveis. Esse estudo identificou a distribuição espacial desses estabelecimentos e verificou se há e onde se localizam os pântanos alimentares em Campinas, São Paulo. Foram geocodificados restaurantes de comida rápida, feiras livres e supermercados/hipermercados. Administrações Regionais (ARs) com maior vulnerabilidade social de acordo com o Censo de 2010, e com maior disposição de restaurantes de comida rápida em relação a feiras livres e supermercados/hipermercados foram considerados pântanos alimentares. Os bairros menos vulneráveis apresentaram maior concentração de todos os tipos de estabelecimentos de comercialização de alimentos em relação às regiões mais vulneráveis. Em Campinas, de dezoito ARs, cinco foram consideradas pântanos alimentares. Os achados reforçam a necessidade de ações que melhorem a exposição a alimentos saudáveis em bairros mais vulneráveis.

Lessons Learned for Emergency Feeding During Modifications to 11 School Feeding Programs in Latin America and the Caribbean During the COVID-19 Pandemic.

BACKGROUND: School feeding programs (SFPs) can play a crucial role in the emergency food and nutrition response, but there is a dearth of information on how SFPs operate during emergencies. DESIGN AND METHODS: A rapid comparative assessment of 11 SFPs throughout Latin America and the Caribbean during the COVID-19 pandemic. Data from (1) systematic document search and (2) surveys with key informants (n = 23) about barriers/facilitators to modifications were systematically analyzed using a multiple case study approach. RESULTS: During the pandemic, all SFPs continued (although continuation plans varied from a few days in Chile to > 1 month in Puerto Rico) via food kits, food vouchers, and/or grab n' go meals. The SFP implementation was highly dependent on the programs' autonomy and financial support, which impacted their logistics to acquire and distribute foods during the pandemic. The types of foods offered in some SFPs suggest that established nutritional guidelines were not always followed. Key informants expressed concerns about the deterioration of the nutritional quality of foods offered during the pandemic and lack of community engagement that impeded distribution to the neediest. CONCLUSIONS: Results underscore the urgency for clear implementation guidance on how to modify SFP during emergencies. Public health implications include (1) allocation of autonomous resources to an intersectoral working group to safeguard nutritional benefits during emergencies, (2) strengthening efforts of SFP community engagement before and during emergencies, and (3) establishing guidelines of the types of foods that can be distributed to meet the nutritional needs of beneficiaries during emergencies.

Impact of the use of food ingredients and additives on the estimation of ultra-processed foods and beverages.

Introduction: Increasing consumption of ultra-processed foods (UPF), defined by the NOVA classification, has been associated with obesity and other health outcomes. However, some authors have criticized the UPF definition because it is somewhat subjective. Most studies identify UPF using food descriptions; nevertheless, NOVA developers described a list of ingredients, including substances not commonly used for cooking and "cosmetic additives" that could be used to identify UPF. Assessing the impact of the use of different UPF definitions is particularly relevant with respect to children's diet, because several dietary policies target this age group. Thus, our study compared the frequency of UPF among foods and beverages and their share in the diet of Chilean preschoolers using three different methods of identifying UPF. Methods: We used cross-sectional 24-h dietary recall data from 962 preschoolers enrolled in the Food and Environment Chilean Cohort (FECHIC) in 2016. All foods and beverages consumed were classified according to NOVA, considering their description (classic method), the presence of ingredients markers of UPF (ingredient marker method), and the presence of markers plus all cosmetic additives (food additive method). We also estimated the caloric share and quintiles of UPF consumption using the three methods. We used kappa coefficients, consistency-of-agreement intra-class correlation (CA-ICC), absolute agreement intra-class correlation (AA-ICC), and weighted kappa coefficients for assessing agreement between methods. Results: The proportion of UPF products were 65% in the "classic," 67% in the "ingredient marker," and 73% in the "food additive" method, and kappa coefficients between methods varied from 0.79 to 0. 91. The caloric share of UPF was 47, 52, and 58% with "classic," "ingredient marker," and "food additive" methods, respectively. Consistency-of-agreement was higher than the absolute agreement between the methods (CA-ICC = 0.81; AA-ICC = 0.74). For quintiles of UPF consumption, we found weighted kappa of 0.65 as measure of agreement between "classic" and "ingredient marker," and 0.51 between "classic" and "food additive" methods. Conclusion: Searching for all possible markers of UPF in the list of ingredients increased the proportion of food products identified as UPF compared to the classic method. These differences affected the estimated caloric share of UPF in Chilean preschoolers' diets.

Mapeamento de pântanos alimentares em Campinas, Brasil / Food swamps in Campinas, Brazil

Resumo As características do ambiente alimentar podem interferir no acesso físico a alimentos saudáveis e acentuar as desigualdades em saúde. A presença de pântanos alimentares, ou seja, a maior disponibilidade de estabelecimentos de comercialização de alimentos ultraprocessados em relação aos que comercializam opções mais saudáveis, associado a características de vulnerabilidade da vizinhança, pode estar relacionado ao consumo de alimentos não saudáveis. Esse estudo identificou a distribuição espacial desses estabelecimentos e verificou se há e onde se localizam os pântanos alimentares em Campinas, São Paulo. Foram geocodificados restaurantes de comida rápida, feiras livres e supermercados/hipermercados. Administrações Regionais (ARs) com maior vulnerabilidade social de acordo com o Censo de 2010, e com maior disposição de restaurantes de comida rápida em relação a feiras livres e supermercados/hipermercados foram considerados pântanos alimentares. Os bairros menos vulneráveis apresentaram maior concentração de todos os tipos de estabelecimentos de comercialização de alimentos em relação às regiões mais vulneráveis. Em Campinas, de dezoito ARs, cinco foram consideradas pântanos alimentares. Os achados reforçam a necessidade de ações que melhorem a exposição a alimentos saudáveis em bairros mais vulneráveis.

Abstract The characteristics of the food environment can interfere with physical access to healthy foods and accentuate health inequalities. The presence of food swamps, i.e., the greater availability of ultra-processed food and commercial establishments compared to those that sell healthier options, are associated with the consumption of unhealthy foods. This study identified the spatial distribution of these establishments in Campinas, São Paulo. Fast-food restaurants, open-air organic/agroecological food markets and supermarkets were geocoded. Regional administrations (RAs) with greater social vulnerability according to the 2010 Census and with a greater availability of fast-food restaurants in relation to open-air food markets and supermarkets were considered food swamps. The less vulnerable neighborhoods had a higher concentration of all types of commercial food establishments compared to the most vulnerable regions. In Campinas, of eighteen RAs, five were considered food swamps. The findings reinforce the need for actions to improve exposure to healthy foods in more vulnerable neighborhoods.