To investigate the consumption of foods with voluntary fortification of vitamins and minerals (FVFVM) according to demographic, socio-economic and health characteristics.

A cross-sectional population-based study.

The investigated food groups were selected in two stages according to availability of food in the local market and prevalence of food consumption in a recent national survey. The research instruments included a questionnaire and a photographic catalogue. The FVFVM consumption covered a period of one week prior to the interview date. Statistical analyses were performed using Stata 12·0 statistical software package, considering the design effect and a hierarchical model. A multinomial logistic regression was applied to estimate the prevalence ratios. All tests were two-tailed, with a 5·0 % significance level.

Adults (≥20 years old) living in a southern city of Brazil.

Between February and June 2012, 2925 individuals were interviewed. Losses and refusals corresponded to 13·4 % of the sample. The overall prevalence of FVFVM consumption was 73·3 (95 % CI 71·7, 75·9) %. The total number of FVFVM reported exhibited a distribution with a median of two and a maximum of fifteen, inflated by the FVFVM categorized in the ‘juice’ group. The micronutrients most consumed were vitamin C, followed by Fe and thiamin. Young adults, females, those of higher socio-economic status and those who perceived their health positively were more likely to consume FVFVM.

Prevalence of FVFVM consumption in southern Brazil, occurring concurrently with the decline in consumption of unprocessed and minimally processed foods, and the way voluntary fortification is being employed trigger a warning sign to primary prevention.

To evaluate the adequacy and accuracy of cut-off values currently recommended by the WHO for assessment of cardiovascular risk in southern Brazil.

Population-based study aimed at determining the predictive ability of waist circumference for cardiovascular risk based on the use of previous medical diagnosis for hypertension, diabetes mellitus and/or dyslipidaemia. Descriptive analysis was used for the adequacy of current cut-off values of waist circumference, receiver operating characteristic curves were constructed and the most accurate criteria according to the Youden index and points of optimal sensitivity and specificity were identified.

Pelotas, southern Brazil.

Individuals (n 2112) aged ≥20 years living in the city were selected by multistage sampling, since these individuals did not report the presence of previous myocardial infarction, angina pectoris or stroke.

The cut-off values currently recommended by WHO were more appropriate in men than women, with overestimation of cardiovascular risk in women. The area under the receiver operating characteristic curve showed moderate predictive ability of waist circumference in men (0·74, 95 % CI 0·71, 0·76) and women (0·75, 95 % CI 0·73, 0·77). The method of optimal sensitivity and specificity showed better performance in assessing the accuracy, identifying the values of 95 cm in men and 87 cm in women as the best cut-off values of waist circumference to assess cardiovascular risk.

The cut-off values currently recommended for waist circumference are not suitable for women. Longitudinal studies should be conducted to evaluate the consistency of the findings.

To estimate the prevalence of episodes of binge eating and to assess potential associations with nutritional status, satisfaction with current body weight, self-rated health status and self-rated body weight.

A cross-sectional population-based study. Binge eating was assessed using adapted questions from the Brazilian Portuguese version of the Questionnaire on Eating and Weight Patterns and was defined as binging one or more times over the last 3 months before the interview.

City of Pelotas, southern Brazil.

Individuals (n 2097) aged 20–59 years.

The prevalence of binge eating and recurrent binge eating was 7·9 % and 2·7 %, respectively. In the adjusted analysis, obesity, fair/poor self-rated health status and body dissatisfaction remained strongly associated with binge eating.

The study showed a high prevalence of binge eating among adults in Pelotas, being higher among younger women, the obese and those who desired to weigh less. The current results are informative, but longitudinal studies would be needed to demonstrate the causal relationship between these events.

To investigate the predictors of change in physical activity (PA) from early to mid adolescence in a cohort of adolescents.

Prospective, population-based birth cohort study. PA level was evaluated by means of questionnaire, and was analysed in continuous form (min/week) and as a trajectory (inactive–inactive, inactive–active, active–inactive, active–active) based on the cut-off point of 300 min/week.

Pelotas, a city of 340 000 inhabitants in southern Brazil.

Adolescents (n 4120) followed from 11 to 15 years of age.

Maternal PA change and more exposure to outdoors were directly associated with a positive change in PA level (min/week) for both genders. Higher maturation status (among boys) and later menarche were also associated with positive PA change in min/week. Predictors to remain inactive were: maternal PA change (inverse association), more exposure to outdoors, higher socio-economic level, fear of living in the neighbourhood and non-overweight girls. Predictors to become inactive were higher socio-economic level among boys and increase in screen time among girls.

The study demonstrates that social, family, biological, behavioural and environmental factors exert an important role in the PA change among youngsters as they move into adolescence. These findings may be relevant to the design of policies and intervention programmes aimed at promoting PA in teenagers.

To investigate the association of family income at birth with BMI among young adults who have been followed since birth.

A birth cohort study.

In 1982, all children born in Pelotas, southern Brazil, were included in a perinatal survey and visited at ages 1, 2, 4, 15, 18–19 and 23 years.

Cohort members (n 4297) were traced and interviewed in 2004–2005. In all follow-ups, participants were weighed and measured, and BMI and prevalence of obesity were calculated for each age. Family income was obtained in minimum wages in 1982 and as a continuous variable, in reais, in later follow-ups. Skin colour was self-reported in 2004–2005.

Mean BMI and prevalence of obesity differed between males and females. In males, a direct relationship was found throughout life and among females this relationship was modified by age. During childhood, BMI was higher among girls from higher income groups and this association was inversed at age 23 years. At this same age, mean BMI among black women was 1·3 kg/m2 higher than among white women, even after adjustment for current family income.

The findings show in men that the relationship between income and BMI is similar to that seen in less developed areas, whereas among adult women the relationship is similar to that observed in developed countries. In addition to the effect of socio-economic status, skin colour also has an influence on the BMI of adult women.

To verify the impact of flour fortification on anaemia in Brazilian children. The survey also investigated the role of Fe deficiency as a cause of anaemia and estimated the bioavailability of the Fe in the children's diet. This local study was complemented by a nationwide survey of the types of Fe compounds added to flour.

Series of population-based surveys conducted in 2004 (baseline study), 2005, 2006 and 2008.

Pelotas, Rio Grande do Sul, Brazil.

Children under 6 years of age residing in the urban area of the city of Pelotas, Southern Brazil (n 507 in 2004; n 960 in 2005; n 893 in 2006; n 799 in 2008). In 2008, a sub-sample of children (n 114) provided venous blood samples to measure body Fe reserve parameters (ferritin and transferrin saturation).

We found no impact of fortification, with an increase in anaemia prevalence among children under 24 months of age. Hb levels decreased by 0·9 g/dl in this age group between 2004 and 2008 (10·9 g/dl to 10·0 g/dl; P < 0·001). Roughly 50 % of cases of anaemia were estimated to be due to Fe deficiency. Half of the mills surveyed used reduced Fe to fortify wheat flour. Total Fe intake from all foodstuffs was adequate for 88·6 % of the children, but its bioavailability was only 5 %.

The low bioavailability of the Fe compounds added to flours, combined with the poor quality of children's diets, account for the lack of impact of mandatory fortification.

To identify dietary patterns among young adults and the relationships with socio-economic, demographic and lifestyle characteristics.

Population-based, cross-sectional analysis of a cohort study. Food intake was assessed by a frequency questionnaire, and dietary patterns were identified using principal components analysis.

Southern Brazil.

A total of 4202 men and women aged 23 years, who participated in the 1982 Pelotas Birth Cohort Study.

Five dietary patterns were identified: common Brazilian, processed food, vegetable/fruit, dairy/dessert and tubers/pasta. Subjects who had low own or maternal educational levels, low social position or who were always poor throughout life had high adherence to the common Brazilian dietary pattern. In contrast, the processed food pattern was more likely to be followed by those belonging to middle and high social position and who were never poor. Men and smokers showed high adherence to the processed food and common Brazilian dietary patterns. Vegetable/fruit pattern was more likely to be followed by women and subjects engaged in physical activity. Women also showed high adherence to the dairy/dessert pattern.

Our study among young Brazilian adults has identified distinct dietary patterns that are clearly influenced by socio-economic and lifestyle characteristics, which have important policy implications in a country with marked social and economic inequalities.

To study risk factors associated with overweight and obesity among adolescents enrolled in private high schools in the city of Pelotas, southern Brazil.

This was a case–control study. The subjects were 264 overweight (body mass index (BMI) ≥85th percentile of the National Center for Health Statistics (NCHS) reference population) and 264 non-overweight (BMI > 5th and <85th NCHS percentiles) adolescents identified by means of an anthropometric survey which included 1608 students. The adolescents were weighed, measured and interviewed about food habits and physical activity at school. Parents provided their own weights and heights when contacted by telephone, and parental BMI was calculated.

Hierarchical multiple conditional logistic regression showed that overweight and obesity were positively associated with mother's (odds ratio (OR) 2.86, 95% confidence interval (Cl) 1.43–5.74) and father's (OR 2.43, 95% Cl 1.37–4.30) BMI ≥ 30 kg m−2, being overweight before 10 years of age (OR 2.26, 95% Cl 1.30–3.90) and the habit of dieting (OR 3.53, 95% Cl 1.76–7.22). Having more than three meals per day was found to be a protective factor against overweight and obesity (OR 0.54, 95% Cl 0.29–1.00).

The present study showed that a family history of obesity, overweight during childhood and the habit of dieting for weight-loss purposes are factors associated with obesity during adolescence. The habit of having more than three daily meals turned out to be a protective factor against overweight. These results suggest the necessity for early intervention at the family and general community levels aimed at the prevention of obesity through actions directed towards the modification of established behaviours.