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Introdução. Em 2009, foi proposta uma classificação de alimentos, denominada classificação NOVA. Países da América Latina tem se destacado em seu uso nas recomendações nutricionais e agenda regulatória. Objetivo. Avaliar como a produção científica em alimentação e nutrição na América Latina tem incorporado a classificação NOVA. Materiais e métodos. A análise da produção científica foi realizada a partir de trabalhos apresentados no Congresso Latinoamericano de Nutrição (SLAN) nos anos de 2012, 2015 e 2018. Os termos utilizados para a busca foram: NOVA, ultraprocessado, processado, processamento e guia alimentar, nos idiomas português, inglês e espanhol. Após a busca, foram aplicados os critérios de exclusão e inclusão e os resumos selecionados foram descritos de acordo com variáveis analíticas previamente definidas. Resultados. Foram analisados 153, sendo 24 publicados em 2012, 20 em 2015 e 109 em 2018. A maioria dos estudos foram desenvolvidos no Brasil (56,2%) e no México (12,4%) e envolvia adolescentes (28,8%), adultos (21,6%) e alimentos (19,6%) como sujeito/unidade de análise. A maioria dos trabalhos foi classificada na área de Nutrição em Saúde Pública (88,9%), era de natureza observacional (82,3%) e empregava método quantitativo (76,5%). A venda e/ou consumo de alimentos (46,4%) e o ambiente alimentar (24,2%) foram os objetos de estudo mais frequentes. Conclusão. A produção científica que considera a classificação NOVA na América Latina aumentou em 2018, com Brasil e México liderando o desenvolvimento dos estudos. Estudos que explorem a relação da classificação NOVA com o preço dos alimentos, habilidades culinárias e políticas públicas são oportunidades de pesquisa.

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Introduction: In the current eating out of the home scenario, fast-food chains have a major role in people's lives. Bearing this in mind, consumers tend to look for those restaurants for flavor, variety, accessibility, in addition to internal and external influences. Objective: nutritionally analyzing combo meal deals from fast-food chains, evaluating energy and nutrient values. Material and Methods: It was made a cross-sectional, descriptive, and quantitative research in different fast-food food chains, analyzing options available in their online menus. Based on those, carbohydrates, proteins, lipids, saturated fats, sodium, and fibers values were calculated. Results: When evaluating each nutrient mean values, it was observed; inadequate energy supply (926.67 kcal), carbohydrates (130 g), proteins (32.7 g), lipids (44.23 g), saturated fats (16.8 g), and sodium (1283.33 mg). It means that all values are above of the average recommendation for consumption in one meal. Conclusion: According to the obtained results, it is noted that the nutritional compositions of those meal deals analyzed are inadequate, presenting high values, which may reflect on the consumer nutritional status. [ABSTRACT FROM AUTHOR]

Copyright of Archivos Latinoamericanos de Nutrición is the property of Sociedad Latinoamericana de Nutricion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introdução: Há, a nível mundial, um aumento no consumo de alimentos ultraprocessados, inclusive entre crianças pré-escolares. O tempo de exposição a telas demanda atenção quanto às consequências desse hábito. Estudos sobre o consumo de ultraprocessados e o tempo de exposição a telas são escassos na literatura. Objetivo: Analisar a frequência de consumo de refrigerantes, suco industrializado, doces e alimentos fast food e o tempo de exposição a telas de pré-escolares. Métodos: Estudo transversal, com 218 crianças (idade média 2,5±0,9 anos), frequentadoras de uma Organização Não Governamental, no município de São Paulo, Brasil. Os dados foram coletados através de um formulário semiestruturado preenchido pelos responsáveis dos pré-escolares. Dados socioambientais, de frequência alimentar e de exposição a telas foram sistematizados para a realização das análises estatísticas. Resultados: Mais de 30,0% das crianças consomem bebidas açucaradas mais de uma vez por semana, 35,8% consomem doces diariamente e 42,7% alimentos fast food com frequência mensal. Metade dos pré-escolares é exposto a distrações no momento das refeições e 70,0% tem contato por mais de uma hora/dia. O tempo de exposição a telas teve relação significativa (p

Introduction: Food is closely linked with emotions in a complex relationship. The imaginary and symbolic meaning attributed to food has been little studied and the act of eating needs to be better understood. Objective: To analyze the association of adolescents´ feelings to selected foods. Methods: Cross-sectional study with 995 adolescents from public and private schools in Teresina, PI, Brazil. It was a Supplementary Project to the Brazilian national survey ERICA (Estudo de Riscos Cardiovasculares em Adolescentes). Adolescents had to choose one of the following feelings to selected food: well-being/satisfaction, malaise, no feeling, aversion. For the option aversion, the participant had to indicate if it was related to smell, color, appearance, or taste. Adolescents´ feelings to foods were analyzed by type of school, sex, and age range, using Pearson's chi-square (c²) or Fisher's exact tests. Results: There was significant differences regarding the type of school for the feeling to chocolate (p=0.015); vegetables (p=0.003); leafy greens (p=0.005); healthy sandwich/natural fruit juice (p≤0.001); high fat red meat (p=0.046); fruit/natural fruit juice (p≤0.001). For sex, there was significant difrerences for healthy sandwich/natural fruit juice (p=0.001); beans and rice (p=0.021) and high fat red meat (p=0.005). There was significant differences between age groups for sandwich, chips, soda and ice cream (p=0.018); pasta (p=0.047) and high fat red meat (p=0.021). Well-being predominated in almost all foods and aversion was poorly reported. Conclusion: The results suggest that adolescents' feelings are not directed to specific foods.

The obesogenic environment stimulates an inadequate diet by hampering healthy choices. This cross-sectional study evaluated the association between the local food environment and the prevalence of overweight and obesity in a representative sample population of adolescents living in the city of São Paulo, Brazil, using multilevel logistic regression models. Among the adolescents, 29.6% were overweight/obese. There were no significant differences between food environment and adolescents’ weight status. However, the presence of fast food restaurants near their home increased the chances of being overweight or obese (OR = 2.53; 95%CI: 1.02-6.27). Results suggest the need to intensify food and nutrition policies, development of culinary skills, and the reduction in prices of healthy foods to facilitate access to these foods, so that adolescents have options in locations to socialize with friends and family.

OBJECTIVE To evaluate the consumption of ultra-processed foods, its associated factors, and its influence on nutrient intake in young adults. METHODS In 2004-2005, the individuals belonging to the Pelotas birth cohort of 1982 were identified for a home interview. A total of 4,297 individuals were interviewed and 4,202 individuals were included in the study (follow-up rate of 77.4%). Diet was assessed using a questionnaire on dietary intake and the percentage of daily caloric intake attributed to ultra-processed foods as well as the intake of macro- and micronutrients were estimated. The association between cohort characteristics and the consumption of ultra-processed foods was assessed using linear regression. Analysis of variance and Pearson’s Chi-square test were used to evaluate the association between the quintiles of the consumption of ultra-processed food, nutrient intake and adequacy of nutrient intake, respectively. RESULTS The consumption of ultra-processed foods corresponded to 51.2% of the total caloric intake. The consumption of ultra-processed foods was higher among women, individuals with higher education, and individuals who were never poor and eutrophic. The increased consumption of ultra-processed foods was positively correlated with the consumption of fat, cholesterol, sodium, iron, calcium, and calories (p < 0.001) and was negatively correlated with the consumption of carbohydrates, protein, and dietary fiber (p < 0.001). CONCLUSIONS The high consumption of ultra-processed foods and its positive correlation with the intake of sodium, cholesterol, and fats underscores the need to perform interventions aimed at decreasing the intake of this food group.

Objective: To evaluate sociodemographic factors associated with the consumption of ultra-processed foods and the temporal evolution of their consumption in Brazil between 2008 and 2018., Methods: The study used food consumption data of individuals aged ≥ 10 years from 2008-2009 and 2017-2018 Pesquisas de Orçamentos Familiares (POF - Household Budget Surveys), grouping the foods according to the Nova classification. We used crude and adjusted linear regression models to assess the association between sociodemographic characteristics and consumption of ultra-processed foods in 2017-2018 and the temporal variation in their consumption between 2008 and 2018., Results: Ultra-processed foods accounted for 19.7% of calories in 2017-2018. The adjusted analysis showed that their consumption was higher in women (versus men) and the South and Southeast regions (versus North) and lower in blacks (versus whites) and rural areas (versus urban), in addition to decreasing with the increased age and increasing with higher education and income. Consumption of ultra-processed foods increased by 1.02 percentage points (pp) from 2008-2009 to 2017-2018. This increase was significantly higher among men (+1.59 pp), black people (+2.04 pp), indigenous (+5.96 pp), in the rural area (+2.43 pp), those with up to 4 years of schooling (+1.18 pp), in the lowest income quintile (+3.54 pp), and the North (+2.95 pp) and Northeast (+3.11 pp) regions. On the other hand, individuals in the highest level of schooling (-3.30 pp) and the highest income quintile (-1.65 pp) reduced their consumption., Conclusions: The socioeconomic and demographic segments with the lowest relative consumption of ultra-processed foods in 2017-2018 are precisely those that showed the most significant increase in the temporal analysis, pointing to a trend towards national standardization at a higher level of consumption.

Questions about the safety of food additives and their consumption have been raised in recent years. The increased exposure to these substances, either by intake of ultra-processed foods or by the broad use and combination of various categories of additives, may be related to higher risks to consumer health. This article comments on the results of a study that quantified and characterized food additives found on the labels of 9,856 packaged foods and beverages available in Brazilian supermarkets. The study adopted a field diary method to record and analyze nonconformities in the lists of ingredients. The objective of this article is to discuss the use of additives identified on the labels and the limitations of Brazilian legislation, which should guarantee the right to information and health.

Objective: To evaluate food consumption in Brazil by race/skin color of the population., Methods: Food consumption data from the Pesquisa de Orçamentos Familiares (POF - Household Budget Survey) 2017-2018 were analyzed. Food and culinary preparations were grouped into 31 items, composing three main groups, defined by industrial processing characteristics: 1 - in natura/minimally processed, 2 - processed, and 3 - ultra-processed. The percentage of calories from each group was estimated by categories of race/skin color - White, Black, Mixed-race, Indigenous, and Yellow- using crude and adjusted linear regression for gender, age, schooling, income, macro-region, and area., Results: In the crude analyses, the consumption of in natura/minimally processed foods was lower for Yellow [66.0% (95% Confidence Interval 62.4-69.6)] and White [66.6% (95%CI 66.1-67.1)] groups than for Blacks [69.8% (95%CI 68.9-70.8)] and Mixed-race people [70.2% (95%CI 69.7-70.7)]. Yellow individuals consumed fewer processed foods, with 9.2% of energy (95%CI 7.2-11.1) whereas the other groups consumed approximately 13%. Ultra-processed foods were less consumed by Blacks [16.6% (95%CI 15.6-17.6)] and Mixed-race [16.6% (95%CI 16.2-17.1)], with the highest consumption among White [20.1% (95%CI 19.6-20.6)] and Yellow [24.5% (95%CI 20.0-29.1)] groups. The adjustment of the models reduced the magnitude of the differences between the categories of race/skin color. The difference between Black and Mixed-race individuals from the White ones decreased from 3 percentage points (pp) to 1.2 pp in the consumption of in natura/minimally processed foods and the largest differences remained in the consumption of rice and beans, with a higher percentage in the diet of Black and Mixed-race people. The contribution of processed foods remained approximately 4 pp lower for Yellow individuals. The consumption of ultra-processed products decreased by approximately 2 pp for White and Yellow groups; on the other hand, it increased by 1 pp in the consumption of Black, Mixed-race, and Indigenous peoples., Conclusion: Differences in food consumption according to race/skin color were found and are influenced by socioeconomic and demographic conditions.

This cross-sectional study aimed to analyze the sociodemographic and lifestyle characteristics associated with the consumption of in natura or minimally processed and ultra-processed foods (UPFs) by adolescents in the Metropolitan Region of Greater Vitória, in Espírito Santo, Brazil. The data were obtained between 2016 and 2017. Logistic regression was adopted for the multivariate analysis. A total of 2,285 adolescents aged between 15 and 19 participated in the study. Greater consumption of minimally processed foods was associated with the adolescent doing paid work (OR=1.27; 95%CI=1.04-1.56), a high family income (OR=1.5; 95%CI=1.10-2.17), and engagement in physical activity (OR=1.9; 95%CI=1.45-2.63). Having brown/black skin (OR=1.3; 95%CI=1.02-1.61) and the habit of eating while surfing the web (OR=1.4; 95%CI=1.02-1.88) increased the chances of consuming UPFs. Being enrolled in a private school and being in the third/fourth year of high school reduced UPF consumption by 41.7% and 37.2%, respectively. It is concluded that greater purchasing power and engagement in physical activity influenced the consumption of minimally processed foods. On the other hand, self-reporting as brown/black and internet use increased the chances of greater UPF consumption.

The present study aimed to evaluate the association of sociodemographic factors and lifestyle with the consumption of in natura or minimally processed (INMP) foods, ultra-processed foods (UPFs), and fruits and vegetables. This was a cross-sectional study conducted with 403 children, aged 4 to 7 years, from a retrospective cohort. Sociodemographic and lifestyle variables were investigated using a sociodemographic questionnaire. Food consumption was assessed by three food records. Bivariate and multivariate linear regression analyses were used to analyze associations. Children with lower income had a higher consumption of INMP foods and a lower consumption of UPFs. A shorter time spent at school was associated with a lower consumption of INMP foods and a higher consumption of UPFs. Children with more screen time and less educated parents consumed less fruits and vegetables. Unfavorable sociodemographic factors were associated with a better profile of food consumption according to the level of processing, except for fruits and vegetables. The longer time spent at school and a shorter screen time contributed to a healthier diet.

Objective: To describe the distribution of restaurants, bars and snack bars in the city of São Paulo-SP, Brazil; and to evaluate the correlation between the density of these establishments and the public transport network, used as a proxy of circulation of people. Methods: Cross-sectional study in which were audited all restaurants, bars and snack bars and the like, found in 52 census tracts assessed, belonging to 13 different administrative districts of São Paulo. Descriptive analysis was performed on data and correlation between the density of establishments and public transportation network, adjusted for family income in the administrative district where each establishment was located. Results and Discussion: A total of 472 restaurants, bars and snack bars, mostly found in intermediate income areas. The total density of establishments was positively correlated with the public transport network density, adjusted for family income. Similar results were found when only snack bars were included in the analysis. In other countries, the relationship between public transport and food environment has been explored only in relation to access to supermarkets and hypermarkets and the resulting improved access to healthy foods. Conclusion: A higher density of restaurants, bars and coffee shops in areas with greater coverage of the public transport network and focused interventions in the food environment should prioritize areas with the highest density of public transport in order to reach a large number of people and properties, ensuring the applicability of resources. [ABSTRACT FROM AUTHOR]

The Food Guide for the Brazilian Population (GAPB) is an official document that addresses principles and recommendations for an adequate and healthy diet, and it is configured as a support tool for food and nutrition education actions. This article aims to analyze the guide content, which is one of the main instruments of public policies related to food in Brazil, in the light of the concepts of social theory, especially theories of modernity, identity, and risks. In the detailed analysis of the guide content, we found that the document considered the cultural and biological food diversity of Brazilian regions. It is based on food not on nutrients, making illustrative recommendations easy to public understanding. It avoided food risks, considering the issue of acquiring adequate and healthy food. However, two risks were not addressed: the problem of processed and ultra-processed foods (PU); and the omission of warnings regarding transgenic foods (GMOs). Although the guide has been designed in an innovative way, stimulating time, attention, and companionship at the table, the GAPB needs revision.

Objective: Assessing the regular consumption of ultra-processed foods by children at 24 months of age from the 2015 Pelotas Birth Cohort and the main demographic, socioeconomic, and behavioral factors related to the consumption of these products., Methods: Population-based cohort in the city of Pelotas, RS, where 4,275 children were assessed at birth and 95.4% of them were followed up until 24 months of age. Food consumption was assessed by a questionnaire on regular consumption of ultra-processed foods, which collected information regarding sex, household income, maternal skin color, schooling level, and age, the child attending day care and having siblings, breastfeeding status, and obesity. The outcome was the sum of ultra-processed foods regularly consumed by a child. A multivariate Poisson regression analysis was used to calculate the association between the regular consumption of ultra-processed foods and exposure variables., Results: The mean number of ultra-processed foods consumed was 4.8 (SD = 2.3). The regular consumption of ultra-processed foods was positively associated with black skin color and having siblings, and negatively associated with household income and maternal schooling level and age., Conclusion: The mean regular consumption of ultra-processed foods by children from the 2015 Pelotas Birth Cohort is high, which can negatively affect the children's diet. The risk of consuming this kind of food was higher among children from families of lower socioeconomic status, whose mothers present lower education level, black skin color, and younger age.

Objective: To evaluate the trend of household food acquisition according to the NOVA classification in Brazil between 1987-1988 and 2017-2018., Methods: We used household food acquisition data from five editions of the Pesquisas de Orçamentos Familiares (Household Budget Surveys), conducted by the Instituto Brasileiro de Geografia e Estatística (Brazilian Institute of Geography and Statistics), in the years 1987-1988, 1995-1996, 2002-2003, 2008-2009, and 2017-2018. All reported foods were categorized according to the NOVA classification. The household availability of food groups and subgroups was expressed through their share (%) in total calories, for all Brazilian families, by household situation (urban or rural), for each of the five geographic regions of the country, by fifths of the household income per capita distribution (2002-2003, 2008-2009 and 2017-2018 surveys), and for the 11 main urban regions of the country (1987-1988, 1995-1996, 2002-2003, 2008-2009 and 2017-2018 surveys). Linear regression models were used to assess the trend of increasing or decreasing food purchases., Results: The diet of the Brazilian population is still composed predominantly of foods in natura or minimally processed and processed culinary ingredients. However, our findings point to trends of increasing share of ultra-processed foods in the diet. This increase of 0.4 percentage points per year between 2002 and 2009 slowed down to 0.2 percentage points between 2008 and 2018. The consumption of ultra-processed food was higher among households with higher income, in the South and Southeast regions, in urban areas, and in metropolitan regions., Conclusion: Our results indicate an increase in the share of ultra-processed foods in the diet of Brazilians. This is a worrisome scenario, since the consumption of such foods is associated with the development of diseases and the loss of nutritional quality of the diet.

This article aims to characterize the advertising appeals present in the food environment to market ultra-processed foods and to analyze the nutritional profile of these foods according to PAHO criteria and the presence of food additives. Cross-sectional study, with data audited in 20 small supermarkets in São Paulo. The INFORMAS protocol was used to classify the advertising messages. The foods were classified according to NOVA. The PAHO profile model was used to classify foods high in critical nutrients. Advertising patterns were identified by factor analysis. The association between patterns and food groups was investigated by linear regression. More than 95% of the ultraprocessed foods had at least 1 critical nutrient in excess. There was a positive association between the new brand, fun and advantageous pattern with snacks, ready-made products, dairy products and cookies; between the new brand and suggested use pattern with dairy products. The standardization of food advertising in small retail stores is associated with offering snacks, dairy products, ready-to-eat foods and cookies, products that exceed critical nutrients.

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.

Objective: The aim of this study was to evaluate allergenic labeling components of packaged foods for "What is the quality of food labels?" and "What is the group of Brazilian Food Pyramid that 'May contain' is predominant?.", Methods: The photographs of 916 products were obtained, of which 518 were analyzed. Data from each label were evaluated according to Brazilian Food Pyramid Groups (i.e., Cereals, Fruits, & Vegetables; Soybean & products; Milk & dairy products; Meat & eggs; Fats & oils; and Sugars & sweets). Ten items were analyzed in each label, namely, the presence of a list of ingredients, alert phrase for allergy sufferers, grouping of the alert phrase, phrase location, uppercase phrase, the phrase in bold, the color of alert phrase contrasting to the background, adequate font size, do not claim the absence for any allergen with the ingredients, and others factors that make it difficult to read. For the second question, a structured questionnaire was completed, and products were classified into two categories, namely, "Contain" and "May contain.", Results: The quality of the label was appropriate, and 69% of packaged foods had at least one allergen. The information "May contain" were higher in cow's milk (Cereals and Meat & eggs), soy (Soybean & products), and egg protein (Cereals). Soybean & products were the highest insecurity group., Conclusions: Brazilian health professionals can count on good-quality labeling of packaged products. Consequently, they could promote patients' and parents/caregivers' education to consult the labels and manage the risks in processed foods about precautionary allergen labeling. Soybean & products were the most significant insecurity for food choices between Brazilian Pyramid Groups.

Objective: To identify the sponsorship by food and beverage companies of the teams participating in the 2019 Copa América Soccer Cup and associate this sponsorship with characteristics of the teams and their respective countries., Methods: The sponsors of the 10 teams participating in the 46th edition of the Copa América were identified. These entities were classified into (i) food companies, (ii) alcoholic beverage companies, and (iii) other segments. The food companies were classified according to their products, according to the NOVA classification. In addition, data on the number of titles previously won by the teams in the Copa America and the World Cup were obtained, as well as data on the countries' Human Development Index, annual per capita sales of ultra-processed foods, and annual per capita consumption of alcoholic beverages., Results: A total of 89 sponsorships were identified for the 10 teams studied, some of these supporting two or more teams. Eighteen percent of the sponsors were food companies, with 12.4% being ultra-processed foods. The alcoholic beverage category represented 7.9% of the sponsors. Ultra-processed beverage and alcoholic beverage companies sponsored seven of the 10 teams studied. We noted higher participation of ultra-processed foods company sponsors in teams from countries with higher Human Development Index, sales of ultra-processed foods, and number of Copa América and World Cup titles. The sponsorship by alcoholic beverage companies was higher for teams from countries with lower Human Development Index, alcohol consumption, and number of Copa América and World Cup titles., Conclusion: A significant presence of ultra-processed food and alcoholic beverage companies as sponsors of South American soccer teams was noted, along with the fact that sport performance characteristics of the teams and socioeconomic and market issues of the countries are associated with the occurrence of sponsorship.

Objective: To evaluate the quality of children's menus in restaurants located in shopping malls., Methods: To select the sample, restaurants from 30% of shopping malls in each region of the city of São Paulo were included and, after considering only one restaurant per chain, the total was limited to 151 restaurants, 30.2% of which (n=35) presented a children's menu. Data were collected through a form on Google Forms., Results: Of the restaurants with children's menu, 60% (n=21) were conventional restaurants and 40% (n=14) takeaway/fast-food. The large number of chains present in most visited malls showed a democratization of the way of eating, with popular and accessible menus, regardless of social status. Most of the analyzed foods were cooked (41.5%). Most preparations did not use grease in their preparation and there was a notable lack of fruit and vegetables (FV) (4%). Sweet desserts were offered in 11.4% of the places and 20% included gifts with meals., Conclusions: The scarce offer of children's menus, few options and low FV offer indicate the need for a new look at the development of children's menus and a greater integration between the possibilities of restaurants and the expectations of parents and children, in the challenge of integrating the relationship between the supply of new foods that promote healthier habits and their consumption.

Objective: To discuss the context of scientific publications on the consumption of food additives by children and the possible health consequences in this age group., Methods: A literature review, with a search carried out between April 2020 and April 2021 in the Web of Science, Scopus, PubMed and Google Scholar databases, as well as in websites of Brazilian and foreign official bodies. Official documents and studies published since 2000 were selected. Keywords related to food additives, children, food consumption, and health were used for the search., Results: Food additives are substances intentionally added to foods for technological purposes. Processed foods are the main sources of additives in food and their consumption occurs since childhood. It is observed, however, that there are limitations inherent to the scientific method regarding the analysis of consumption and toxicity of food additives in humans, causing scarcity of data in the scientific literature. Additionally, existing data suggest that the additives have a higher toxic potential in children, considering that the body weight in this age group is lower than in adults. This context emphasizes the need to observe the precautionary principle, according to which risks of harm must be prevented., Conclusions: This is a scenario in which the literature points to a risk to people's health and, in particular, to children, about whom the duty of protection must be even greater, with absolute priority. Thus, the relevance of an expanded technical-scientific debate regarding the establishment of specific and stricter parameters for children is considered, regarding the consumption and toxicity of additives, as well as the different sources of exposure to these substances.

The scope of this study was to assess the prevalence and associated factors with the introduction of ultra-processed food (UPF) among children under six months of age living in the southwest of Bahia state. This is an excerpt from a prospective cohort study conducted with pairs of mothers/babies. The introduction of UPF was defined by the intake of at least one UPF before the age of six months. Socioeconomic, maternal, paternal, gestational, and child-related information was gathered by the application of questionnaires. To analyze the factors associated with the outcome, Poisson regression was performed according to a hierarchical model. P-value<0.05 and 95% confidence interval are considered. A total of 300 mother/baby pairs were evaluated. Before 6 months, 31.3% of children have already received UPF. With greater introduction of cookies/biscuits (23.3%) and yogurt (14.3%). The introduction of UPF before six months of age was higher among families with lower income (p=0.038), lower maternal education (p=0.031), lower maternal (p=0.017) and paternal (p=0.013) age, among children who had cow's milk <6 months (p<0.001) and tea <30 days (p=0.005). The results demonstrate the need for interventions aimed at reducing the introduction of UPF, especially for low-income families, with less education and among younger parents.

The Dietary Guidelines for the Brazilian Population is acknowledged as a powerful inducer of public food and nutrition policies. In this perspective, this article presents the methodological path and evidence that supported the elaboration of the new parameters of food acquisition of the Brazilian National School Feeding Program (PNAE). This elaboration involved the analyses of: (1) participation of federal resources used to purchase food, grouped according to the NOVA classification, used in Dietary Guidelines for the Brazilian Population, by the set of Brazilian municipalities and according to the classification of the execution (positive or negative); (2) monthly reference menus that were prepared following Dietary Guidelines for the Brazilian Population recommendations; (3) analysis of food acquisition by the sampling of 525 municipalities, involving the relative participation of food groups (according to NOVA) in total expenditures and energy and nutritional quality of purchased foods; and (4) analysis of ultra-processed foods that should not be offered in the school environment. We proposed the adoption of the following parameters for the participation of food groups in relation to the total federal resources used in the purchase of food: ≥ 75% of resources for fresh or minimally processed foods; < 20% for processed or ultra-processed foods and < 5% for processed culinary ingredients, as well as the expansion of the list of foods whose acquisition with federal resources from PNAE is prohibited. This process supported the elaboration of Resolution CD/FNDE n. 6 of May 8, 2020, which provides for the attendance of school feeding to primary education students within the PNAE.

The relationship between the consumption of ultra-processed food products and the increase in obesity and the risk of noncommunicable diseases (NCDs) has prompted international organizations to mobilize governments to regulate the reduction of the levels of sugars, fats and sodium in such products. The article analyzes the understanding of different strategic subjects about the health risks associated with the ultra-processed food products, and the public intervention adopted to modify their composition, in compliance with the Brazilian National Food and Nutrition Policy (PNAN). This is a qualitative empirical investigation, in which representatives of 12 institutions were interviewed. The theoretical framework of Depth Hermeneutics was adopted in conjunction with Discourse Analysis. This study focused on the generic theme "Agreement and Regulation" and the stated matrix "Consent Regulation" Considering a scenario of global circulation of the ultra-processed food products, not disciplined by international standards, the measure of public intervention was to establish Agreements with some food corporations, in opposition to the compulsory regulation. This measure was criticized by the subjects of the Public Sector and Civil Society, as the relevance of the topic to public health requires clear rules for the reduction of key nutrients as well as sanctions. Contrarily, the subjects of the Regulated Sector consider this measure sensible and of the government's understanding. Although there are differences among the subjects, it appears that the Agreements, as opposed to regulation, disregard the provisions of PNAN 2012 and represent a setback in view of their particular characteristics, whose results will slowly interfere in the nutritional improvement of the ultra-processed food products.

Chronic non-communicable diseases correspond to the main cause of death in the world and have inadequate nutrition as one of its main modifiable risk factors, highlighting the excessive consumption of sodium and its association with cardiovascular diseases, mediated by blood pressure. This study evaluated the impact of different policy scenarios for reducing sodium consumption from processed and ultra-processed foods in the prevention of deaths due to cardiovascular outcomes in the adult population in Brazil. We used secondary data from public reports and databases of the Brazilian Unified National Health System (SUS) and population surveys. We analyzed the impacts, up to 2027, of three scenarios: maintenance of the current voluntary targets, and two mandatory scenarios, considering the lowest targets in the Americas and the lowest global targets. The Preventable Risk Integrated ModEl (PRIME) analyzed the deaths prevented or delayed from sodium consumption in such scenarios. In 2027, more than 72,000 deaths would be attributed to excess sodium; the voluntary goals would result in the prevention or postponement of up to 4,001 (95% uncertainty intervals - 95%UI: 1,611-6,563) deaths, while the mandatory scenarios would result in the prevention of 9,704 (95%UI: 3,955-15,665) and 15,561 (95%UI: 6,350-25,096) deaths from cardiovascular diseases, considering the lower regional and international targets, respectively. The findings suggest that the maintenance of voluntary targets has limited impact when compared to possible and more restrictive scenarios of reducing sodium content in processed and ultra-processed foods and reinforce the need to adopt measures with greater effectiveness in the country.

Ultra-processed foods are markers of unhealthy eating patterns, and their consumption is high among adolescents. Characteristics of the school eating environment associate with student eating practices. This study aims to investigate the association between the presence of school canteens and the availability of ultra-processed foods in school canteens with the consumption of these foods, inside the school, among adolescents of the 9th grade (14 years) of the public and private schools of the city of São Paulo, Brazil. We conducted a cross-sectional study with SP-Proso data, in a sample of 2,680 adolescents. We elaborated multilevel linear regression models to evaluate associations between the exposures: presence of school canteens and availability of ultra-processed foods with outcomes of consumption frequency of ultra-processed foods in the school. We found an association between the presence of school canteens and the higher frequency of consumption of sausages (0.46; 95%CI: 0.24; 0.68), package snacks (0.50; 95%CI: 0.19; 0.80), goodies (0.82; 95%CI: 0.55; 1.09), and sugary drinks (0.34; 95%CI: 0.06; 0.62), as well as a score of consumption frequency of ultra-processed foods (2.37; 95%CI: 1.25; 3.48). The availability of package snacks, goodies, and sugary drinks in school canteens increased the frequency of consumption of these foods. We observed a dose-response effect between the diversity of ultra-processed foods in canteens and the frequency of consumption of these foods. A school food environment with greater availability of ultra-processed products is associated with their higher consumption in school, indicating the need to regulate the sale of food within these institutions.

This article aims to assess the consumption of ultra-processed foods (UPFs) during the first year of life and associated factors. We analyzed data from the one-year follow-up of the MINA-Brazil birth cohort. Socioeconomic, demographic and obstetric data were collected in the baseline study and at one-year follow-up (n = 774). Dietary intake during the previous day was assessed using a food frequency questionnaire to determine UPF consumption. Multiple Poisson regression with robust variance was performed to estimate prevalence ratios (PR) and confidence intervals (95%CI) for factors associated with the consumption of ≥ 3 UPFs. Prevalence of UPF consumption and consumption of ≥ 3 UPFs was 87.5% and 40.5%, respectively. Consumption of ≥ 3 UPFs was associated with lower maternal education (≤ 9 years of schooling [PR: 2.02 95%CI 1.42; 2.87] and between 10-12 years of schooling [PR: 1.55, 95%CI 1, 11; 2.14]), below-average wealth index (PR: 1.26, 95%CI 1.04; 1.53), and having a teenage mother (PR:1.19, 95%CI 1.00; 1.49). Lack of dietary diversity was inversely associated with the outcome (RP: 0,65, IC95% 0,51; 0,81). The consumption of ≥ 3 UPFs was associated with lower wealth index, education and maternal age. Dietary diversity was associated with higher levels of UPF consumption.

The study aimed to analyze the economic impact of the adoption of optimized and nutritionally balanced diets to Brazilian families, considering the Brazilian dietary guidelines and the economic disparities of the population. Data from the Brazilian Household Budget Survey from 2008-2009 (550 strata; 55,970 households) were used. About 1,700 foods and beverages purchased by the Brazilians were classified into 4 groups according to NOVA system. Linear programming models estimated isoenergetic diets preserving the current diet as baseline and optimizing healthier diets gradually based on the "golden rule" of the Brazilian dietary guidelines, respecting nutritional restrictions for macronutrients and micronutrients (based on international recommendations) and food acceptance limits (10th and 90th percentiles of the per capita calorie distribution from the population). The diet cost was defined based on the sum of the average cost of each food group, both in the current and optimized diets (BRL per 2,000Kcal/person/day). The economic impact of the Brazilian dietary guidelines to Brazilian household budget was analyzed by comparison the cost of the optimized diets to the cost of the current diet, calculated for the total population and by income level. Three healthier diets were optimized. Current diet cost was BRL 3.37, differed among low- and high-income strata (BRL 2.62 and BRL 4.17, respectively). Regardless of income, diet cost decreased when approaching the guidelines. However, low-income strata compromised their household budget more than two times the high-income strata (20.2% and 7.96%, respectively). Thus, the adoption of healthier eating practices can be performed with the same or lower budget.

The scope of this article is to analyze the relationship between insufficient sleep duration, overweight/obesity and the consumption of ultra-processed foods among adolescents aged 10 to 14 years. This is a cross-sectional study, with an evaluation of 1,384 adolescents from public schools in João Pessoa-PB, participating in the Longitudinal Study on Sedentary Behavior, Physical Activity, Diet and Adolescent Health (LONCAAFS). Sociodemographic variables, sleep duration, class shift, anthropometric nutritional status, sedentary behavior and food consumption were measured. Linear and logistic regression of the following were performed using Stata 13.0 Software: the prevalence of short sleep duration of 29.5% (<9h/night); a significant association between short sleep duration and excess weight only for adolescents <12 years old. With respect to the relationship between sleep duration and the consumption of ultra-processed foods, the longer the sleep duration, the lower the consumption of snacks by adolescents under 12 years old, with a positive association for ≥12 years old only with adjustment by the physical activity variable. There was no association with the "sugary drinks" and "cookies" groups for any of the age groups analyzed.

Objective: To describe the evolution of out-of-home food consumption in Brazil in 2008-2018., Methods: We used the 2008-2009 and 2017-2018 data from the Inquéritos Nacionais de Alimentação (INA - National Food Surveys), conducted amid 34,003 and 46,164 individuals, to estimate the frequency of out-of-home food consumption and the contribution of this consumption to specific foods. Food consumption was analyzed using food records in the 2008-2009 INA and 24-hour recalls in 2017-2018. Estimates were generated for Brazil in general, for urban and rural areas, for age groups (adolescent, adult, elderly), and for income bracket., Results: The frequency of out-of-home consumption decreased by 8.8% between the two surveys, with no change in the rural area, in the Northeast and South regions, and for the lowest income brackets. We observed a slight increase among the elderly and in the Midwest region. The contribution of out-of-home food consumption to daily energy intake also decreased (16.3% vs. 12.7%), excepting the rural area, where there was a reduction in the difference in relation to the urban area between the two surveys. For most items evaluated, the out-of-home food consumption decreased. The most consumed out-of-home food were alcoholic beverages, fried and baked snacks, soft drinks, pizza, sweets, and sandwiches in both surveys., Conclusion: In 10 years, the prevalence of food consumption and the percentage of contribution of out-of-home food decreased in Brazil, but ultra-processed foods still figure as the most consumed food group outside the home.

Objective: To describe the evolution of food consumption by the Brazilian population in 2008-2009 to 2017-2018., Methods: Data from the National Dietary Surveys of 2008-2009 and 2017-2018 were used. Both surveys estimated food consumption of two non-consecutive days of individuals aged 10 years or older. The first survey collected consumption data from 34,003 individuals through food records; the second, obtained data from 46,164 individuals, through 24-hour recalls. The twenty most frequently reported food groups in the two surveys were identified. The probability of consumption of each food group in the two surveys was estimated according to sex, age and income. This study presents the foods that had a change in the frequency of consumption of 5% or higher between the two surveys. The probability of consumption was corrected for intra-individual variability using the method developed by the National Cancer Institute., Results: Rice, beans, coffee, bread, vegetables and beef remained the staple Brazilian diet, ranking as the six most consumed items in both surveys. Ultra-processed foods such as sweet/stuffed cookies, savory cookies, processed meats and carbonated drinks also remained among the 20 most consumed foods. Trend analyses showed, regardless of gender, age and income range, a decrease in the consumption of rice, beans, beef, bread, fruit, milk and dairy, processed meats and carbonated drinks, and an increase in the consumption of sandwiches., Conclusion: The Brazilian diet is still characterized by consumption of traditional foods, such as rice and beans, and by high frequency of consumption of ultra-processed foods, such as cookies and carbonated drinks. However, between the years of 2008-2009 and 20172018, there was a decrease in the consumption of rice, beans, beef, bread, fruit, milk and dairy, processed meats and carbonated drinks, but an increase in the consumption of sandwiches. The results show a decrease in quality in the Brazilian diet.

Objective: To identify the prevalence and factors associated with the consumption of ultra-processed foods by Brazilian adolescents., Methods: The sample was representative of adolescents and participants in the cross-sectional population-based study National Survey of School Health, 2015 edition (PeNSE-2015). A self-administered questionnaire was used for data collection. The variable weekly consumption of ultra-processed foods was considered, and consumption more than seven times a week was considered excessive. Descriptive and inferential analyses of demographic, socioeconomic, behavioral and environmental characteristics potentially associated with the outcome were performed. Poisson's multiple regression model was adjusted to control for confounding factors., Results: The prevalence of excessive consumption of ultra-processed foods among 16,324 adolescents in Brazil was 75.4%. Nine factors independently associated with this outcome were identified: age under 15 years (RR 1.08; p<0.001), daily sitting time greater than four hours (RR 1.13; p<0.001), eating while watching TV or studying more than four days a week (RR 1.09; p<0.001), daily TV time greater than three hours (RR 1.08; p<0.001), breakfast frequency less than four days a week (RR 1,03; p=0.001), having a cell phone (RR 1.12; p<0.001), absent maternal education (RR 0.88; p<0.001), being enrolled in a private school (RR 1.05; p=0.002) located in the urban area (RR 1.13; p=0.002)., Conclusions: The results express the multifactorial characteristic of excessive consumption of ultra-processed foods and suggest the need for the development and implementation of health policies to guide the consumption of these foods and the importance of adopting healthy behaviors for this population group in both school and home environments.

The consumption of dietary fiber in Brazil and its relationship with the intake of ultra-processed foods was evaluated. The analysis used food consumption data, with a 24-hour food record of residents aged ≥10 years (n=34.003) from the 2008-2009 Family Budgets Survey. The food products were divided into groups: in natura or minimally processed ingredients; processed culinary ingredients; processed and ultra-processed ingredients. The contribution of each food group and selected subgroups to the total fiber intake, the relation between quintiles of ultra-processed foods (evaluated by the % of total energy intake), average dietary fiber content (g/1,000kcal), and the prevalence of inadequate fiber consumption, was estimated. In natura or minimally processed foods revealed significantly higher fiber density than ultra-processed foods and corresponded to the majority percentile contribution of dietary fiber, notably derived from rice and beans. Individuals in the largest quintile of ultra-processed consumption were 1.5 times more likely to ingest inadequate fiber intake. The consumption of ultra-processed foods had a negative impact on fiber intake. Reducing the consumption of these foods can bring benefits to the quality of the Brazilian diet.

The aim of the present study was to evaluate the consumption of ultra-processed (UP) foods and associated factors among adults. We used cross-sectional data on 947 adults from the 2008-2009 Campinas Health Survey. Food consumption data were collected using the 24-h dietary recall method and food items were classified according to NOVA classification based on the nature, extent and purpose of industrial processing. Linear regression models were run to evaluate the association between the consumption UP foods and predictor variables with a 5% significance level. The average daily energy intake per capita was 2000.6 kcal and UP foods represented 24.1% of this intake. UP food consumption was higher among women and increased with the increase in schooling. Consumption was also higher among young adults between 20 and 29 years old as well as ex-smokers and individuals who were physically active at leisure. The results show that there is still time to intervene in favor of the health of the adult population. Thus, studies dedicated to the investigation of food intake from the perspective of the NOVA classification, the possible repercussions for health and the evaluation of food and nutrition actions and policies should be prioritized in the current context of Brazil.

Objective: To develop a quantitative Food Frequency Questionnaire (FFQ) for adults in the Northeast region of Brazil, in order to identify the frequency of consumption of foods considered to be of protection and risk for chronic non-communicable diseases (NCDs), grouping food items by processing level., Methods: To develop the FFQ, data from 7,516 adults from Northeastern Brazil were used, extracted from the 2008-2009 Household Budget Survey. The food lists were elaborated according to the methodology of the relative contribution of each item, identifying foods with the highest relative contribution for macronutrients, fiber, saturated fat, trans fat, sodium and potassium. All foods whose contribution sum was up to 90% composed such lists. The final structure of the FFQ organized the food items in order to respect the mental image of the meals., Result: The FFQ resulted in 83 food items, distributed in minimally processed, processed and ultra-processed. We chose the previous year as the time to estimate food consumption, and frequency options ranged from "never" to "10 times". The instrument includes guidelines for filling and collects data on serving sizes (small, medium, large and extra-large), as well as additional information on culinary preparations. There was a high percentage of people who were overweight (44.1%)., Conclusion: The study culminated in an FFQ to identify the frequency of consumption of foods considered protective and risk for NCDs. The instrument can support epidemiological studies that evaluate outcomes related to the diet of adults considering the level of food processing, in accordance with the Guia alimentar para a população brasileira .

Objective: To describe the magnitude of consumption of ultra-processed foods in the adult population (≥ 18 years old) in the capitals of the 27 federative units of Brazil, as well as its association with sociodemographic variables., Methods: Data used in this study stem from participants (n = 52,443) of the 2019 wave of the annual survey of the "National surveillance system for risk and protective factors for chronic diseases by telephone survey" (Vigitel). The consumption of ultra-processed foods was described based on a score, corresponding to the sum of positive responses to questions about consumption on the previous day of thirteen subgroups of ultra-processed foods frequently consumed in Brazil. Poisson regression models were used to describe the crude and adjusted associations between high consumption of ultra-processed foods (scores ≥ 5) and sex, age group, and level of education., Results: The frequency of high consumption of ultra-processed foods was 18.2% (95% CI 17.4-19.0). With or without adjustment for other sociodemographic variables, this frequency was significantly lower in females and decreased linearly with age. In the crude analysis, there was an increase in the frequency of high consumption from the lower level to the intermediate level of education and a decrease in this consumption from the intermediate level to the upper level. In the analysis adjusted for sex and age, the frequency of high consumption of ultra-processed foods was significantly lower at the higher level of education (12 or more years of study), with no differences between the other levels., Conclusion: Ultra-processed foods are consumed with high frequency in the adult Brazilian population in the 27 capitals of the federation. Being male, younger and having less education than university are conditions that increase, independently, the consumption of these foods.

The aims of the present study were to evaluate dietary fiber intake and associated factors in adolescents, identify food sources of the nutrient, and determine associations between indicators of dietary patterns (energy/macronutrients/micronutrients) and dietary fiber intake. A population-based cross-sectional study was conducted involving 24-hour recall data. The NOVA classification was used to determine the contribution of foods to dietary fiber intake. Reference values from the World Health Organization (≥12.5 g) and the US Institute of Medicine (14 g) per 1,000 kcal were used to assess intake. The mean intake of dietary fiber/1,000 kcal/day was 6.4 g (1.5 g of soluble fiber and 4.9 g of insoluble fiber) among the 891 adolescents. Fiber intake was low, especially among those who ate fruits, vegetables, and beans less, those who consumed soft drinks and processed meats more, and those who did not eat breakfast every day. Unprocessed/minimally processed foods provided 68.8%, 53.7%, and 72.1% of total, soluble, and insoluble fiber, respectively, whereas ultra-processed products provided 24.8%, 37.9%, and 21.0% respectively. Fiber intake was inversely associated with energy intake, fat, free sugar, and animal protein in the diet. The insufficient fiber intake underscores the need for actions that promote healthy nutrition on the individual and family levels.

This study aimed to characterize the food environment within subway stations in São Paulo and describe the availability of food and drinks according to the social vulnerability of the area where the stations are located. A cross-sectional study was carried out involving 19 subway stations, and checklist instruments were used to audit outlets and vending machines. The São Paulo Social Vulnerability Index was adopted to characterize the location of the stations. Sixty-six outlets were found. The median of outlets per station was the same in all categories of the territory's social vulnerability (median=2 establishments/station). The most frequent types of food sold were convenience foods, present in all of the outlets. The territory's vulnerability did not result in a difference in the availability of healthy and unhealthy marker foods. The food environment at subway stations is marked by the high availability of ultra-processed food and drinks at all outlets.

Our aim was to explore the feeding practices of indigenous children younger than two years old, living in Cruzeiro do Sul and Mâncio Lima, in Acre, Brazil. A cross-sectional study was conducted with indigenous children of the Katukina (Cruzeiro do Sul), Nukini, Nawa and Poyanawa (Mâncio Lima) ethnicities in October 2013. We used a structured questionnaire on the food consumption of the day before the collection, based on the food indicators proposed by the Ministry of Health. A total of 94 children (50% Katukina, 27% Poyanawa, 13% Nukini, and 10% Nawa) were studied. Among children under 6 months of age, although the majority was breastfed, 42.1% drank water, 15.8%, savory food, and 11.1%, local cuisine. In the age groups of 6 to 12 months and 13 to 23 months, a high consumption of ultra-processed foods was identified (52.6% and 28.6% respectively), while the consumption of complementary food was insufficient (33% of fruits and 25% of savory food between 6 and 13 months, and 41.2% of fruits and 19.6% of savory food between 13 and 23 months). The feeding profile of these indigenous children was inadequate for their age, revealing a concerning situation for this population.

Objective: To analyze association between exclusive breastfeeding (EBF) and the introduction of ultra-processed foods in children under 12 months old., Methods: This was a Cohort study, conducted with children in Vitória da Conquista, Bahia, Brazil. The main exposure was EBF (days: <120; 120-179; ≥180). The outcome variable was the introduction of four or more types of ultra-processed foods in the first year of life. Poisson regression analysis was used., Results: 286 children were evaluated, of whom 40.2% received four or more ultra-processed foods and 48.9% EBF for less than 120 days. EBF for less than 120 days (RR=2.94 - 95%CI 1.51;5.71) and for 120-179 days (RR=2.17 - 95%CI 1.09;4.30) was associated with the outcome after adjustment by socioeconomic, maternal, paternal and child variables., Conclusion: EBF for less than 180 days increased the risk of introducing four or more ultra-processed foods in the first year of life.

Objective: To describe the Nova score for the consumption of ultra-processed foods (UPF) and evaluate its potential in reflecting the dietary share of UPF in Brazil., Methods: This study was conducted in São Paulo with a convenience sample of 300 adults. Using a tablet, participants answered a 3-minute electronic self-report questionnaire on the consumption of 23 subgroups of UPF commonly consumed in Brazil, regarding the day prior the survey. Each participant score corresponded to the number of subgroups reported. The dietary share of UPF on the day prior to the survey, expressed as a percentage of total energy intake, was calculated based on data collected on a 30-minute complete 24-hour dietary recall administered by trained nutritionists. The association between the score and the dietary share of UPF was evaluated using linear regression models. The Pabak index was used to assess the agreement in participants' classification according to the fifths of Nova score and the fifths of dietary share of UPF., Results: The average dietary share of UPF increased linearly and significantly with the increase of the Nova score for the consumption of ultra-processed foods. We found a substantial agreement in participants' classification according to the fifths of the distribution of scores and the fifths of the dietary share of UPF (Pabak index = 0.67). Age was inversely associated with a relatively high frequency of UPF consumption (upper fifth of the distribution) for both score and dietary share of UPF., Conclusion: The Nova score for the consumption of ultra-processed foods, obtained in a quick and practical manner, shows a good potential in reflecting the dietary share of UPF in Brazil.

This study analyzed the role of ultra-processed foods (UPFs) in the food and nutritional profile of pregnant women's diet. This was a cross-sectional study conducted in a representative sample of pregnant women attending primary healthcare units in Maceió, capital of the State of Alagoas, Brazil. Food consumption was assessed with the application of two 24-hour food recalls on nonconsecutive days, and the consumption items were grouped according to the NOVA classification. Overall estimates were expressed as absolute dietary consumption (mean calorie intake) and relative consumption (percentage of total energy intake according to food groups and consumption items). Analysis of variance was used to compare mean energy and nutrient intake according to food groups. The association between quintiles of the energy share from UPFs (exposure variable) and (1) consumption items and food groups, (2) percentage of total energy from macronutrients, and (3) micronutrient density was analyzed via adjusted linear regression models. Mean energy intake in pregnant women was 1,966.9Kcal/day, 22% of which from UPFs. A direct relationship was observed between the percentage of energy from UPFs and total energy consumption (β = 228.78Kcal; SE = 21.26). In addition, an increase in the share of UPFs was associated with a statistically significant reduction in the intake of protein, fiber, magnesium, iron, potassium, zinc, selenium, folate, and vitamins D and E, as well as in the consumption of traditional foods such as protein, beans, roots, and tubers. Our data thus indicate that the consumption of UPFs reduces the overall nutritional and food quality of diet in pregnant women.

The objective of this study was to assess the provision of information on the amount of sugar and identify the position of sugar in the list of ingredients of processed foods. A cross-sectional study was conducted to analyze all processed traditional and diet/light/zero food products sold in a hypermarket containing the word sugar or sucrose in the list of ingredients. The food labels were read and the position of sugar on the list of ingredients and presence, or absence, of information on the amount of sugar in the nutrition facts table were recorded. Information on the amount of sugar was also requested from the manufacturers by e-mail or telephone. A total of 2,200 food products were assessed, 2,164 (98.4%) of which were traditional foods and 36 (1.6%) diet/light/zero foods. The amount of sugar was declared in only 14.4% and 13.9% of these products, respectively (p=0.84). Only 7.7% (n=12) of the 156 companies contacted provided the requested information. Sugar was present in the first three positions of the list of ingredients in 75.8% of the traditional foods and 77.8% of the diet/light/zero foods (p=0.93). The data show that sugar was the main ingredient in the majority of the food products analyzed and that the level of provision of information on the amount of sugar is low.

The scope of the study was to assess food consumption according to the level of processing and the ingestion of nutrients among adolescents in the rural areas of Pelotas-RS. It involved a cross-sectional census-type study with 462 students in grades 6 through 9 of elementary school from 21 municipal schools in the rural area. Food consumption was evaluated by 24-hour dietary recall (24HR), with food products being classified into four groups according to the level of processing in line with the NOVA classification. The average daily energy intake was 1,921 calories, namely 48.2% from in natura or minimally processed food and 31.9% from ultra-processed food. The products that contributed most to the total daily calory intake were rice, meat, legumes, sugar, homemade bread, cookies, candies, soda, and artificial juices. A higher proportion of macro and micronutrients was observed from ingestion of in natura or minimally processed food, although carbohydrates, fat and iron contents derived from ultra-processed food was also high. The results of the study indicate that adolescents in rural areas have a higher energy intake from fresh or minimally processed food, however, it is observed that ultra-processed food is also part of their diet, thereby revealing the nutritional transition.

The increase in the input of ultra-processed ingredients in the food of children and adolescents is related to the development of noncommunicable diseases such as dyslipidemia. The scope of this study was to conduct a systematic review of the literature on the relationship of consumption of ultra-processed foods in the lipid profile of children and adolescents. A search in the PubMed, Scopus, Cochrane and LILACS databases was carried out to locate cross-sectional and longitudinal studies, with or without intervention, in apparently healthy children and/or adolescents, who had the intake of ultra-processed food as an exposure variable and the lipid profile as an outcome. After screening, 14 studies were included, of which nine demonstrated that ultra-processed food consumption was related to increased LDL-c, total cholesterol, triglycerides and a reduction in HDL-c. Three studies found no relationship and two demonstrated that the increased intake of ready-to-eat cereals was related to the decrease in total cholesterol and LDL-c. There was a high consumption of ultra-processed foods and positive relation with blood lipids among children and adolescents, which calls attention to interventions, such as nutritional education, with a view to reducing the intake of these foods.