Ultra-processed food consumption and metabolic syndrome: a cross-sectional study in Quilombola communities of Alagoas, Brazil.

BACKGROUND: The processing of food can cause changes that turn them into risk factors for chronic diseases. A higher degree of food processing is associated with the development of chronic non-communicable diseases (NCDs), including the metabolic syndrome (MetS). The objective of this study was to analyze the relationship between ultra-processed food (UPF) consumption and the prevalence of MetS and its risk factors, focusing on a population group especially subjected to precarious living conditions and food insecurity. METHOD: Cross-sectional population-based study with women (19 to 59 years) from Quilombola communities of Alagoas. The socioeconomic, demographic, anthropometric, health status, lifestyle, and food intake (24-h recall) variables were analyzed. The dependent variable was the MetS, defined using the harmonization criteria of the Joint Interim Statement, and its components. The foods consumed were categorized according to the Nova Classification, assuming the highest UPF consumption as risk exposure. The measure of association was the prevalence ratio (PR) and respective 95%CI, calculated by Poisson regression with robust variance. We also analyzed the association with the Nova score of UPF consumption. RESULTS: We investigated 895 women (38.9 ± 11.0 years), of whom 48.3% had MetS. On average, 15.9% of the total energy intake came from UPF. Lower Nova scores were associated with a lower prevalence of diabetes and low HDL. Higher UPF consumption was associated with a 30% higher prevalence of hypertension (PR = 1.30; 95%CI: 1.06-1.61). CONCLUSION: The highest UPF consumption was positively associated with the prevalence of hypertension, while a lower Nova score was a protective factor against diabetes and low HDL. UPF consumption in Quilombola communities is important but lower than that observed in the Brazilian population in general. It is suggested that public health programs be implemented to promote healthy eating while valuing the existing eating habits and traditions among the remaining Brazilian Quilombola people.

RESUMO: INTRODUçãO: O processamento de alimentos pode causar alterações que os transformam em fatores de risco para doenças crônicas. Um maior grau de processamento de alimentos está associado ao desenvolvimento de doenças crônicas não transmissíveis (DCNT), incluindo a síndrome metabólica (SM). O objetivo deste estudo foi analisar a relação entre o consumo de alimentos ultraprocessados (AUP) e a prevalência de SM e seus fatores de risco, com foco em um grupo populacional especialmente submetido a precárias condições de vida e insegurança alimentar. MéTODO: Estudo transversal de base populacional com mulheres (19 a 59 anos) de comunidades Quilombolas de Alagoas. Foram analisadas as variáveis socioeconômicas, demográficas, antropométricas, estado de saúde, estilo de vida e ingestão alimentar (recordatório de 24 horas). A variável dependente foi a SM, definida a partir dos critérios de harmonização do Joint Interim Statement, e seus componentes. Os alimentos consumidos foram categorizados de acordo com a Classificação Nova, assumindo como exposição de risco o maior consumo de AUP. A medida de associação foi a razão de prevalência (RP) e respectivo IC 95%, calculado por regressão de Poisson com variância robusta. Também analisou-se a associação com o Escore Nova de consumo de AUP. RESULTADOS: Foram investigadas 895 mulheres (38,9 ± 11,0 anos), das quais 48,3% tinham SM. Em média, 15,9% da ingestão total de energia provinham de AUP. Escores Nova mais baixos foram associados a uma menor prevalência de diabetes e HDL baixo. O maior consumo de AUP se associou a uma prevalência 30% maior de hipertensão arterial (RP = 1,30; IC95%: 1,06-1,61). CONCLUSãO: O maior consumo de AUP se associou positivamente à prevalência de hipertensão, enquanto o menor escore Nova foi fator de proteção contra diabetes e baixo HDL. O consumo de AUP nas comunidades Quilombolas é relevante, mas inferior ao observado na população brasileira em geral. Sugere-se a implementação de programas de saúde pública que promovam a alimentação saudável, valorizando os hábitos e tradições alimentares existentes entre os remanescentes Quilombolas brasileiros.

Prevalence of IGFBP3, NOS3 and TCF7L2 polymorphisms and their association with hypertension: a population-based study with Brazilian women of African descent.

OBJECTIVE: African ancestry seems to be a risk factor for hypertension; however, few genetic studies have addressed this issue. This study aimed to investigate the prevalence of polymorphisms NOS3; rs1799983, IGFBP3; rs11977526 and TCF7L2; rs7903146 in Brazilian women of African descent and their association with hypertension. RESULTS: The prevalences of the less frequent genotypes were 26.5% TT genotype of NOS3; rs1799983, 16.7% AA genotype of IGFBP3; rs11977526, and 18.3% TT genotype of TCF7L2; rs7903146. For these conditions, the prevalence of hypertension and PR (adjusted) relatively to the ancestral genotype were, respectively: 52.0% vs 24.5% (PR = 1.54; p < 0.001), 62.0% vs 24.1% (PR = 1.59; p < 0.001), and 38.9% vs 27.9% (PR = 0.86; p = 0.166). Associations with hypertension were statistically significant, except for the TCF7L2; rs7903146 polymorphism, after adjusted analysis. Brazilian Afro-descendant women with the TT genotype for the NOS3 gene and the AA genotype for the IGFBP3 gene are more susceptible to hypertension. The understanding of underlying mechanisms involving the pathogenesis of hypertension can motivate research for the development of new therapeutic targets related to nitric oxide metabolism and the management of oxidative stress.

Factors associated with childhood anaemia in Afro-descendant communities in Alagoas, Brazil.

OBJECTIVE: To investigate factors associated with anaemia in preschool children. DESIGN: A home survey was conducted in 2018. Anaemia in children (capillary blood Hb level < 110 g/l) was the outcome, and socio-economic, demographic and health factors of the mother and child were the independent variables. The measure of association was the prevalence ratio, and its 95 % CI was calculated using Poisson's regression with robust variance and hierarchical selection of independent variables. SETTING: Afro-descendants communities living in the state of Alagoas, northeast Brazil. PARTICIPANTS: Children aged 6-59 months and their mothers (n 428 pairs). RESULTS: The prevalence of child anaemia was 38·1 % (95 % CI 33·5, 42·7). The associated factors with child anaemia were male sex, age < 24 months, larger number of residents at home (> 4), relatively taller mothers (highest tertile) and higher z-score of BMI for age, after further adjustment for wealth index, vitamin A supplementation in the past 6 months and clinical visit in the last 30 d. CONCLUSIONS: The high prevalence of anaemia observed reveals a relevant public health problem amongst children under five from the quilombola communities of Alagoas. Considering the damage caused to health and multiplicity of risk factors associated with anaemia, the adoption of intersectoral strategies that act on modifiable risk factors and increase vigilance concerning those that are not modifiable becomes urgent.