Características individuais e ambientais relacionadas ao consumo de alimentos ultraprocessados (Projeto CUME)
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2019-07-30
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Universidade Federal de Viçosa
Resumo
A transição nutricional, marcada principalmente pelo aumento do consumo de alimentos ultraprocessados, já é uma realidade nos países do Sul Global, incluindo o Brasil. Estudar as características individuais e, principalmente, ambientais que se relacionam a este consumo é crucial para a elaboração de novas políticas públicas que promovam hábitos alimentares saudáveis da população. Com isso, o objetivo deste trabalho foi avaliar como características individuais e do ambiente construído e social se relacionam com o consumo alimentar de egressos de universidades mineiras. Trata-se de um estudo transversal, conduzido com 4.987 adultos graduados e/ou pós-graduados na Universidade Federal de Viçosa (UFV) e/ou Universidade Federal de Minas Gerais (UFMG) entre os anos 1994 e 2014, que preencheram o questionário de linha de base da Coorte de Universidades Mineiras (CUME) no período de março a agosto de 2016. A variável dependente foi o maior consumo de alimentos ultraprocessados, obtido por meio de um questionário de frequência de consumo alimentar e pela classificação dos itens alimentares baseando-se no grau de processamento proposto pela classificação NOVA. Dados sobre as práticas alimentares, características socioeconômicas, e de estilo de vida foram obtidos por meio de um questionário online auto respondido. Os respondentes que relataram residir em Viçosa (Minas Gerais) foram convidados a comparecer em uma etapa de coleta de dados presencial, e compuseram assim uma sub amostra do estudo. Na etapa presencial, duas escalas sobre a percepção do ambiente social e construído foram aplicadas. Ademais, os dados geográficos dos endereços residenciais e profissionais dos participantes foram obtidos. Para caracterizar o ambiente alimentar, os endereços dos estabelecimentos bares/lanchonetes, alimentícios (varejos bares/restaurantes, de açaí, restaurantes, sorveterias, feiras açougues, livres, peixarias, varejistas de hortifrutigranjeiros, mercearias, padarias, varejistas de produtos naturais, varejistas de laticínios e frios, supermercados e serviços ambulantes de alimentação) foram coletados em listagens disponibilizadas pela Vigilância Sanitária, com posterior verificação in loco, utilizando o aplicativo ColetAPP (versão 1.0). O buffer euclidiano de 200 metros foi utilizado como unidade de medida. No Software QGIS ® (versão 3.4.7), realizou-se a contagem dos estabelecimentos alimentícios e das ocorrências policiais para cada buffer que continha como centroide o endereço residencial ou profissional dos participantes. Para todos os participantes da etapa online, análises univariadas de regressão logística multinomial foram conduzidas para estimar as razões de chance (OR) associadas ao maior consumo de alimentos ultraprocessados em um intervalo de confiança de 95%, usando o primeiro quartil de consumo como referência. As análises foram ajustadas pelas covariáveis sexo, idade e renda individual e conduzidas no software STATA® (versão 12). Para comparar a distribuição dos estabelecimentos alimentícios, obtida pela contagem dentro dos buffers, entre os tercis de consumo de alimentos ultraprocessados, o teste de Kruskal-Wallis foi conduzido no software estatístico SPSS ® (versão 23.0), com α adotado de 5%. Para a amostra total, percepção negativa do estado de saúde (OR 2.12, 95% CI 1.41 – 3.20), maior tempo gasto no computador (OR 1.65, 95% CI 1.19 – 2.26) ou na TV (OR 2.25, 95% CI 1.50 – 3.37), inatividade física (OR 1.83, 95% CI 1.36 – 2.45), o hábito de adicionar açúcar nas bebias (OR 1.34, 95% CI 1.03 – 1.74) e sal na salada (OR 1.43, 95% CI 1.10 – 1.85), não ter o hábito de consumir alimentos prebióticos (OR 1.81, 95% CI 1.40 – 2.32), ou orgânicos (OR 2.03, 95% CI 1.59 – 2.59), ou vegetais refogados (OR 1.61, 95% CI 1.25 – 2.07), alto consumo de alimentos fritos (OR 2.62, 95% CI 2.01 – 3.41) e almoçar em restaurantes fastfood (OR 4.04, 95% CI 2.60 – 6.27) se associaram ao maior consumo de alimentos ultraprocessados. A prevalência do maior consumo de alimentos ultraprocessados aumentou 1,89 vezes (95% CI: 1,10 – 3,25) entre aqueles que almoçam em restaurante universitário e diminuiu 0,41 vezes (RP: 0,59; 95% CI: 0,37 – 0,94) entre aqueles que almoçam em casa. A distribuição dos estabelecimentos alimentícios e de ocorrências policiais não diferiu entre os tercis de consumo para os endereços residenciais, enquanto menor distribuição de bares/lanchonetes, restaurantes e estabelecimentos de aquisição de ultraprocessados foi encontrada no maior tercil de consumo de alimentos ultraprocessados para os endereços profissionais. Os fatores mais associados ao maior consumo de alimentos ultraprocessados foram relacionados ao estilo de vida e às práticas alimentares, e avaliar apenas a exposição alimentar em áreas residenciais subestima a exposição total a qual os indivíduos estão submetidos, comprometendo estimativas das reais associações entre indivíduos e seus ambientes. Além disso, refeições realizadas em ambiente domiciliar se apresentaram como fator protetor ao consumo de alimentos ultraprocessados. Palavras-chave: Estilo de vida. Ambiente obesogênico. Ambiente social. Ambiente alimentar. Classificação NOVA.
The nutritional transition, characterized mainly by the increase of ultra processed foods consumption, is already a reality in Global South countries, including Brazil.To study individual and environmental characteristics related to this consumption is crucial for public policies development that reflect in eating behavior. Thus, the objective was to evaluate how individual and environmental characteristics relate to food consumption in adults who graduated from federal higher education institutions located in the state of Minas Gerais, Brazil. This is a cross-sectional study, conducted with 4,987 adults graduated and / or postgraduated at the Federal Universidade Federal de Viçosa (UFV) and / or Universidade Federal de Minas Gerais (UFMG) between 1994 and 2014, who completed Coorte de Universidades Mineiras (CUME) baseline questionnaire, from March to August 2016. The high consumption of ultra-processed foods was defined as an outcome, which was obtained by a semi-quantitative Food Frequency Questionnaire and by the classification of food items based on degree of processing proposed by NOVA classification. Dietary practices, socioeconomic characteristics, and lifestyle data were obtained by an online questionnaire.Participants who reported living in Viçosa were invited to attend a data collection phase, and thus composed a sub sample of the study. In this stage, two scales about perception of the social and constructed environment were applied.In addition, geographical data of the residential and professional addresses of the participants were obtained.In order to characterize the food environment, the addresses of food establishments (açaí retailers, ice cream shops, butchery shops, fishmongers, snack bar, bars / restaurants, restaurants, market, vegetable retailers, grocery stores, bakeries, natural products retailers, supermarkets and trailers) were collected in lists provided by Sanitary Surveillance, and subsequent verification in loco, using the application ColetAPP (version 1.0). The 200-meter buffer was used as measurement. Food retail and police occurrences were counted for each buffer of participants' residential or professional address, in QGIS® software (version 3.4.7). For all participants in the online stage, univariate multinomial logistic regression analyses were conducted to estimate the odds ratio (OR) associated with higher consumption of ultra-processed foods at a 95% confidence interval using the first quartile of consumption as a reference. Analyzes were adjusted for covariates gender, age and individual income and conducted in STATA® software (version 12).Kruskal-Wallis test was conducted in the statistical software SPSS® (version 23.0), in order to compare the distribution of food establishments among tercis of consumption of ultra processed foods. The significant p was ≤ 0.05. Negative health status perception (OR 2.12, 95% CI 1.41 – 3.20), long screen time on computer (OR 1.65, 95% CI 1.19 – 2.26) or TV (OR 2.25, 95% CI 1.50 – 3.37), physical inactivity (OR 1.83, 95% CI 1.36 – 2.45), sweetening beverages with sugar (OR 1.34, 95% CI 1.03 – 1.74), seasoning salad with salt (OR 1.43, 95% CI 1.10 – 1.85), not consuming prebiotics foods (OR 1.81, 95% CI 1.40 – 2.32), or organic foods (OR 2.03, 95% CI 1.59 – 2.59), or sautéed leafy greens (OR 1.61, 95% CI 1.25 – 2.07), consuming deep fried foods (OR 2.62, 95% CI 2.01 – 3.41), and having lunch in fast food restaurants (OR 4.04, 95% CI 2.60 – 6.27) increased the chance of eating ultra-processed foods. In addition, the prevalence of higher consumption of ultra- processed foods increased 1,89 times (95% CI: 1,10 – 3,25) for whose have lunch in university restaurants, and decrease 41 times (RP: 0,59; 95% CI: 0,37 – 0,94) for whose have lunch at home. Food establishments and police occurrences distribution did not differ between tercis of consunmtion of ultra-processed food for residential addresses. On the other hand, lower distribution of bars / snack bars, restaurants and ultra-processed food retail establishments was found in the higher tercil of consumption of ultra-processed food for professional addresses.The mainly factors associated with higher consumption of ultra- processed foods were related to lifestyle and eating practices. To evaluate only food exposure in residential areas underestimates the total exposure to which individuals are subjected, implicating on associations between individuals and their environments.In addition, home- made meals were presented as a protective factor for the consumption of ultra processed foods. Keywords: Lifestyle. Obesogenic environment. Social environment. Food environment. NOVA classification.
The nutritional transition, characterized mainly by the increase of ultra processed foods consumption, is already a reality in Global South countries, including Brazil.To study individual and environmental characteristics related to this consumption is crucial for public policies development that reflect in eating behavior. Thus, the objective was to evaluate how individual and environmental characteristics relate to food consumption in adults who graduated from federal higher education institutions located in the state of Minas Gerais, Brazil. This is a cross-sectional study, conducted with 4,987 adults graduated and / or postgraduated at the Federal Universidade Federal de Viçosa (UFV) and / or Universidade Federal de Minas Gerais (UFMG) between 1994 and 2014, who completed Coorte de Universidades Mineiras (CUME) baseline questionnaire, from March to August 2016. The high consumption of ultra-processed foods was defined as an outcome, which was obtained by a semi-quantitative Food Frequency Questionnaire and by the classification of food items based on degree of processing proposed by NOVA classification. Dietary practices, socioeconomic characteristics, and lifestyle data were obtained by an online questionnaire.Participants who reported living in Viçosa were invited to attend a data collection phase, and thus composed a sub sample of the study. In this stage, two scales about perception of the social and constructed environment were applied.In addition, geographical data of the residential and professional addresses of the participants were obtained.In order to characterize the food environment, the addresses of food establishments (açaí retailers, ice cream shops, butchery shops, fishmongers, snack bar, bars / restaurants, restaurants, market, vegetable retailers, grocery stores, bakeries, natural products retailers, supermarkets and trailers) were collected in lists provided by Sanitary Surveillance, and subsequent verification in loco, using the application ColetAPP (version 1.0). The 200-meter buffer was used as measurement. Food retail and police occurrences were counted for each buffer of participants' residential or professional address, in QGIS® software (version 3.4.7). For all participants in the online stage, univariate multinomial logistic regression analyses were conducted to estimate the odds ratio (OR) associated with higher consumption of ultra-processed foods at a 95% confidence interval using the first quartile of consumption as a reference. Analyzes were adjusted for covariates gender, age and individual income and conducted in STATA® software (version 12).Kruskal-Wallis test was conducted in the statistical software SPSS® (version 23.0), in order to compare the distribution of food establishments among tercis of consumption of ultra processed foods. The significant p was ≤ 0.05. Negative health status perception (OR 2.12, 95% CI 1.41 – 3.20), long screen time on computer (OR 1.65, 95% CI 1.19 – 2.26) or TV (OR 2.25, 95% CI 1.50 – 3.37), physical inactivity (OR 1.83, 95% CI 1.36 – 2.45), sweetening beverages with sugar (OR 1.34, 95% CI 1.03 – 1.74), seasoning salad with salt (OR 1.43, 95% CI 1.10 – 1.85), not consuming prebiotics foods (OR 1.81, 95% CI 1.40 – 2.32), or organic foods (OR 2.03, 95% CI 1.59 – 2.59), or sautéed leafy greens (OR 1.61, 95% CI 1.25 – 2.07), consuming deep fried foods (OR 2.62, 95% CI 2.01 – 3.41), and having lunch in fast food restaurants (OR 4.04, 95% CI 2.60 – 6.27) increased the chance of eating ultra-processed foods. In addition, the prevalence of higher consumption of ultra- processed foods increased 1,89 times (95% CI: 1,10 – 3,25) for whose have lunch in university restaurants, and decrease 41 times (RP: 0,59; 95% CI: 0,37 – 0,94) for whose have lunch at home. Food establishments and police occurrences distribution did not differ between tercis of consunmtion of ultra-processed food for residential addresses. On the other hand, lower distribution of bars / snack bars, restaurants and ultra-processed food retail establishments was found in the higher tercil of consumption of ultra-processed food for professional addresses.The mainly factors associated with higher consumption of ultra- processed foods were related to lifestyle and eating practices. To evaluate only food exposure in residential areas underestimates the total exposure to which individuals are subjected, implicating on associations between individuals and their environments.In addition, home- made meals were presented as a protective factor for the consumption of ultra processed foods. Keywords: Lifestyle. Obesogenic environment. Social environment. Food environment. NOVA classification.
Descrição
Palavras-chave
Obesidade - Aspectos ambientais, Estilo de vida, Influência social, Hábitos alimentares - Aspectos ambientais, NOVA (Classificação de alimentos)
Citação
MATTAR, Jéssica Bevenuto. Características individuais e ambientais relacionadas ao consumo de alimentos ultraprocessados (Projeto CUME). 2019. 116 f. Dissertação (Mestrado em Ciência da Nutrição) - Universidade Federal de Viçosa, Viçosa. 2019.