Sociodemographic disparities in the consumption of ultra-processed food and drink products in Southern Brazil: a population-based study
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This study aims to describe the distribution of ultra-processed food and drink products (UPP) consumption according to sociodemographic characteristics in adults from southern Brazil, and to investigate which are the most-consumed UPP subtypes in the different social strata.
Cross-sectional analysis of the second wave of a population-based cohort of 1720 adults. The usual caloric intake and the caloric contribution of UPP to total energy intake (%CTEI) were estimated by the application of two 24-h dietary recalls (adjusted by intra- and inter-individual variability). Data were analyzed according to gender, age, marital status, schooling, and family income. Linear regression models were used to estimate the adjusted means.
Consumption data were obtained from 1206 adults (70.1% of the original cohort). Mean UPP consumption was higher in males than females (829.6 kcal vs 694.3 kcal, p value < 0.001), but the %CTEI from UPP increased in females (34.7% vs 39.3%, p value < 0.001), even after adjusting for sociodemographic variables. In the full model, which included all sociodemographic variables, %CTEI from UPP was inversely associated with age (difference between extreme categories 7.1 pp., 95 CI% 7.7–6.5) and directly associated with schooling (difference between extreme categories 6.3 pp., 95 CI% 5.5–7.1). The subtypes of UPP that contributed most to the observed differences were processed breads, fast food, and ultra-processed pies and sweets.
UPP account for a third of the calories normally consumed, with women, young people, and better educated individuals being the most vulnerable groups. These results can help when planning public policies to reduce UPP consumption.
KeywordsFood habits Nutrition Risk factors Population characteristics Nutrition survey Nutritional epidemiology
We would like to express our gratitude to Dr. Nilza Nunes da Silva, Department of Epidemiology, School of Public Health of the University of São Paulo, São Paulo, Brazil, for her advice on sample procedures. We would also like to thank the Brazilian Institute of Geography and Statistics (IBGE) and Florianópolis Health Authority staff for their valuable help with the practical aspects of this study. We are also grateful to Dr. Carlos Augusto Monteiro and his research group “Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde” (NUPENS), for their advice and assistance regarding food group classification. We appreciate the cooperation of Dr. Regina Mara Fisberg and her research group “Grupo de Pesquisa de Avaliação do Consumo Alimentar” (GAC), for facilitating the use of Nutrition Data Software for Research (NDSR) software. The authors conceived and designed this study, performed the experiments, analyzed the data, and wrote the paper jointly.
Author Silvia Giselle Ibarra Ozcariz has participated in the research planning process, field and data entry supervision, conducted the statistical analyses, written, and led this article. Katia Jakovljevic Pudla has participated in the study design and data entry and contributed in revising this article. Ana Paula Bortoletto Martins has contributed to classifying the food groups and revising this article. Marco Peres led the EpiFloripa research and contributed to the revision of this article. David González-Chica contributed to the study design, statistical analysis, writing, and revision of the article.
Compliance with ethical standards
The EpiFloripa Adults 2009 project was approved by the Ethics Committee on Human Research of the Federal University of Santa Catarina (UFSC), under protocol number 351 / 08. The subjects were informed about the objectives of the study and were requested to sign an Informed Consent Form.
The Project was sponsored by the Brazilian National Council for Scientific and Technological Development (CNPq), grant number 485327/2007–4.
Conflict of interest
The authors declare that they have no conflict of interest.
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