The environmental impact of beef and ultra-processed food consumption in Brazil.

OBJECTIVE: This study evaluated the independent and combined environmental impacts of the consumption of beef and ultra-processed foods in Brazil. DESIGN: Cross-sectional study. SETTING: Brazil. PARTICIPANTS: We used food purchases data from a national household budget survey conducted between July 2017 and July 2018, representing all Brazilian households. Food purchases were converted into energy, carbon footprints and water footprints. Multiple linear regression models were used to assess the association between quintiles of beef and ultra-processed foods in total energy purchases and the environmental footprints, controlling for sociodemographic variables. RESULTS: Both beef and ultra-processed foods had a significant linear association with carbon and water footprints (P < 0·01) in crude and adjusted models. In the crude upper quintile of beef purchases, carbon and water footprints were 47·7 % and 30·8 % higher, respectively, compared to the lower quintile. The upper quintile of ultra-processed food purchases showed carbon and water footprints 14·4 % and 22·8 % higher, respectively, than the lower quintile. The greatest reduction in environmental footprints would occur when both beef and ultra-processed food purchases are decreased, resulting in a 21·1 % reduction in carbon footprint and a 20·0 % reduction in water footprint. CONCLUSIONS: Although the environmental footprints associated with beef consumption are higher, dietary patterns with lower consumption of beef and ultra-processed foods combined showed the greatest reduction in carbon and water footprints in Brazil. The high consumption of beef and ultra-processed foods is harmful to human health, as well as to the environment; thus, their reduction is beneficial to both.

Segurança alimentar e consumo de frutas e vegetais entre pré-escolares: estudo exploratório durante a pandemia da COVID-19 / Food security and fruit and vegetable consumption among preschoolers: an exploratory study during the COVID-19 pandemic

Estudos que avaliem a insegurança alimentar e sua associação com o consumo de frutas, legumes e verduras (FLV) podem auxiliar na identificação de grupos e fatores de risco para um consumo alimentar inadequado, a fim de propor intervenções nutricionais assertivas. O objetivo deste estudo foi descrever o consumo de FLV por crianças em diferentes situações de segurança alimentar. Trata-se de um estudo exploratório de caráter transversal, conduzido com pais/ responsáveis de 44 crianças de zero a quatro anos. A versão curta da Escala Brasileira de Insegurança Alimentar e um Questionário de Frequência Alimentar foram aplicados aos pais/responsáveis via entrevista telefônica. As crianças tinham em média 2,6 anos, 56,8% eram do sexo feminino, 67,5% estavam eutróficas, e 70,5% das famílias estavam em situação de insegurança alimentar. Para os domicílios em situação de segurança alimentar, a mediana de consumo de FLV foi 213,4 g/dia (P25=97,89; P75=425,91). Já aqueles em situação de insegurança alimentar, a mediana de FLV foi de 105,4 g/dia (P25=33,58; P75=205,16). Concluiu-se que o consumo de FLV pelas crianças de famílias em situação de segurança alimentar é superior ao das crianças em situação de insegurança alimentar, as quais são fortemente influenciadas pela oferta de alimentos baratos e de baixa qualidade nutricional. Políticas públicas são necessárias para favorecer a garantia de acesso à FLV de qualidade e com custo acessível a todas as famílias.

Studies that assess food insecurity and its association with the consumption of fruits, legumes, and vegetables (FLV) can help identify groups and risk factors of inadequate food consumption, in order to propose assertive nutritional interventions. The aim of this study was to describe FLV consumption by children in different food security situations. This is an exploratory cross-sectional study, conducted with parents/guardians of 44 children from zero to four years old. The short version of the Brazilian Food Insecurity Scale and a Food Frequency Questionnaire were applied to parents/guardians via a telephone interview. The children were 2.6 years old on average, 56.8% were female, 67.5% were eutrophic, and 70.5% of the families were in a situation of food insecurity. For households in a situation of food security, the median consumption of FLV was 213.4 g/day (P25=97.89; P75=425.91). As for those in a situation of food insecurity, the median FLV was 105.4 g/day (P25=33.58; P75=205.16). It was concluded that the consumption of FLV by children from families in a situation of food security is higher than that of children in a situation of food insecurity, who are strongly influenced by the offer of cheap food with low nutritional quality. Public policies are needed to favor the guarantee of access to FLV of quality and at an affordable cost for all families.

The effect of the a regional cardioprotective nutritional program on inflammatory biomarkers and metabolic risk factors in secondary prevention for cardiovascular disease, a randomised trial

BACKGROUND & AIMS: To evaluate the effect of the Brazilian Cardioprotective Diet Program (BALANCE Program) on inflammatory biomarkers, involved in the pathophysiology of the atherosclerosis, on inflammatory biomarkers, cardiovascular risk factors, and on plasma fatty acids in cardiovascular disease secondary prevention patients. METHODS: In this substudy of the BALANCE Program randomized clinical trial, a total of 369 patients aged 45 years or older, who have experienced cardiovascular disease in the previous 10 years, were included. These patients were randomized into two groups and followed up for six months: BALANCE Program group and control group (conventional nutrition advice). In the initial and six-month final visits, anthropometry (body weight, height and waist circumference), food intake evaluation by 24-h dietary recall, plasma inflammatory biomarkers (IL-6, IL-8, IL-10, IL-12, tumor necrosis factor-a, adiponectin, and C-reactive protein levels), blood pressure, glycemia, insulinemia, lipid profile, and plasma fatty acids levels were evaluated. RESULTS: The BALANCE Program group showed increased plasma alpha-linolenic acid levels (P » 0.008), reduction in waist circumference (P » 0.049) and BMI (P » 0.032). No difference was observed among plasma inflammatory biomarkers and clinical data. CONCLUSION: After six months of follow-up, BALANCE Program led to a significant reduction on BMI and waist circumference in individuals in secondary prevention for cardiovascular disease. Although plasmatic alpha-linolenic acid has increased, there was no impact on plasma inflammatory biomarkers. Clinical trial registration: NCT01620398.

Association between plasma fatty acids and inflammatory markers in patients with and without insulin resistance and in secondary prevention of cardiovascular disease, a cross-sectional study

BACKGROUND: Proinflammatory biomarkers levels are increased among patients with cardiovascular disease, and it is known that both the presence of insulin resistance and diet may influence those levels. However, these associations are not well studied among patients with established cardiovascular disease. Our objective is to compare inflammatory biomarker levels among cardiovascular disease secondary prevention patients with and without insulin resistance, and to evaluate if there is any association between plasma fatty acid levels and inflammatory biomarker levels among them. METHODS: In this cross-sectional sub-study from the balance Program Trial, we collected data from 359 patients with established cardiovascular disease. Plasma fatty acids and inflammatory biomarkers (interleukin (IL)-1ß, IL-6, IL-8, IL-10, IL-12, high sensitive C-reactive protein (hs-CRP), adiponectin, and tumor necrosis factor (TNF)-alpha) were measured. Biomarkers and plasma fatty acid levels of subjects across insulin resistant and not insulin resistant groups were compared, and general linear models were used to examine the association between plasma fatty acids and inflammatory biomarkers. RESULTS: Subjects with insulin resistance had a higher concentration of hs-CRP (p = 0.002) and IL-6 (p = 0.002) than subjects without insulin resistance. Among subjects without insulin resistance there was a positive association between stearic fatty acid and IL-6 (p = 0.032), and a negative association between alpha-linolenic fatty acid and pro-inflammatory biomarkers (p < 0.05). Among those with insulin resistance there was a positive association between monounsaturated fatty acids and arachidonic fatty acid and adiponectin (p < 0.05), and a negative association between monounsaturated and polyunsaturated fatty acids and pro-inflammatory biomarkers (p < 0.05), as well as a negative association between polyunsaturated fatty acids and adiponectin (p < 0.05). Our study has not found any association between hs-CRP and plasma fatty acids.

Desenvolvimento de um índice dietético baseado na dieta do Programa Alimentar Cardioprotetor Brasileiro (DICA Br) / Development of a dietary index based on the Brazilian Cardioprotective Nutritional Program

Introdução: Índices dietéticos (ID) têm sido utilizados para estudar associações entre alimentação e doenças cardiovasculares (DCV). Um ID combina e resume aspectos de uma recomendação ou guia alimentar. Esses aspectos geralmente são a quantidade de nutrientes, alimentos ou grupos de alimentos a serem consumidos em um período de tempo (dia - semana - mês). A dieta do Programa Alimentar Brasileiro Cardioprotetor (DICA Br) classificou os alimentos em quatro grupos e definiu a quantidade diária a ser consumida. Uma vez que os aspectos nutricionais do DICA Br são diferentes de outras recomendações alimentares, não é possível utilizar os ID existentes para associar essa dieta com as DCV. Por isso, faz-se necessário o desenvolvimento de ID que considere as características da DICA Br. Objetivo: Descrever o desenvolvimento do ID DICA Br, avaliar a sua consistência interna, validade de constructo e as características da população associadas ao índice. Métodos: Foram utilizados dados de baseline do ensaio clínico randomizado DICA Br (www.clinicaltrials.gov; NCT01620398). Os quatro grupos alimentares da dieta estudada foram adotados como componentes do índice. Os critérios para atribuir pontos foram definidos a priori com base nos princípios e recomendações da DICA Br. Cada componente do índice recebeu pontos que variam de 0 a 10, portanto a pontuação total variou de 0 a 40.

Background: The diet of the Brazilian Cardioprotective Nutritional Programme (BALANCE) classified food into four groups and set the daily amount to be consumed. The nutritional aspects of BALANCE are different from other dietary recommendations, therefore it is not possible to use existing diet indexes (DI) to associate this diet with cardiovascular disease. Objective: To describe the development of BALANCE DI, evaluate its internal consistency, construct validity and population characteristics associated with the index. Methods: We analyzed baseline data from BALANCE randomized clinical trial (www.clinicaltrials.gov, NCT01620398). The four food groups of the studied diet were adopted as index components. Each index component received points ranging from 0 to 10 and the total score ranged from 0 to 40.