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To evaluate the association of ultra-processed food (UPF) consumption with gains in weight and waist circumference, and incident overweight/obesity, in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort.
We applied FFQ at baseline and categorized energy intake by degree of processing using the NOVA classification. Height, weight and waist circumference were measured at baseline and after a mean 3·8-year follow-up. We assessed associations, through Poisson regression with robust variance, of UPF consumption with large weight gain (1·68 kg/year) and large waist gain (2·42 cm/year), both being defined as ≥90th percentile in the cohort, and with incident overweight/obesity.
Civil servants of Brazilian public academic institutions in six cities (n 11 827), aged 35–74 years at baseline (2008–2010).
UPF provided a mean 24·6 (sd 9·6) % of ingested energy. After adjustment for smoking, physical activity, adiposity and other factors, fourth (>30·8 %) v. first (<17·8 %) quartile of UPF consumption was associated (relative risk (95 % CI)) with 27 and 33 % greater risk of large weight and waist gains (1·27 (1·07, 1·50) and 1·33 (1·12, 1·58)), respectively. Similarly, those in the fourth consumption quartile presented 20 % greater risk (1·20 (1·03, 1·40)) of incident overweight/obesity and 2 % greater risk (1·02; (0·85, 1·21)) of incident obesity. Approximately 15 % of cases of large weight and waist gains and of incident overweight/obesity could be attributed to consumption of >17·8 % of energy as UPF.
Greater UPF consumption predicts large gains in overall and central adiposity and may contribute to the inexorable rise in obesity seen worldwide.
To identify generational differences in the dietary patterns of Brazilian adults born between 1934 and 1975.
A cross-sectional study from the baseline of the multicentre Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort. Year of birth was categorized into three birth generations: Traditionalists (born between 1934 and 1945); Baby Boomers (born between 1946 and 1964); and Generation X (born between 1965 and 1975). Food consumption was investigated using an FFQ. Latent class analysis (LCA) was used to identify data-driven dietary patterns.
Individuals (n 15 069) aged 35–74 years.
A three-class model was generated from the LCA for each birth generation. Generation X presented higher energy intakes (kJ/kcal) from soft drinks (377·4/90·2) and sweets (1262·3/301·7) and lower energy intakes from fruit (1502·5/359·1) and vegetables (311·3/74·4) than Baby Boomers (283·7/67·8, 1047·7/250·4, 1756·0/419·7 and 365·3/87·3, respectively) and Traditionalists (186·2/44·5, 518·8/124·0, 1947·7/465·5 and 404·6/96·7, respectively). For Baby Boomers and Generation X, we found food patterns with similar structures: mixed pattern (22·7 and 29·7 %, respectively), prudent pattern (43·5 and 34·9 %, respectively) and processed pattern (33·8 and 35·4 %, respectively). Among Traditionalists, we could also identify mixed (30·9 %) and prudent (21·8 %) patterns, and a third pattern, named restricted dietary pattern (47·3 %).
The younger generation presented higher frequencies of consuming a pattern characterized by a low nutritional diet, compared with other generations, indicating that they may age with a greater burden of chronic diseases. It is important to develop public health interventions promoting healthy foods, focusing on the youngest generations.
To verify if the intake of ultra-processed foods is associated with higher BMI and waist circumference (WC) among participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort.
Cross-sectional analysis of the ELSA-Brasil baseline (2008–2010). Dietary information obtained through an FFQ was classified according to characteristics of food processing (NOVA) and used to estimate the percentage energy contribution from ultra-processed foods (i.e. industrial formulations, elaborated from food processing, synthetic constituents and food additives) to individuals’ total energy intake. BMI and WC and their respective cut-off points served as response variables. Associations were estimated through linear and multinomial logistic regression models, after adjusting for confounders and total energy intake.
Six Brazilian capital cities, 2008–2010.
Active and retired civil servants, aged 35–64 years, from universities and research organizations (n 8977).
Ultra-processed foods accounted for 22·7 % of total energy intake. After adjustments, individuals in the fourth quartile of percentage energy contribution from ultra-processed foods presented (β; 95 % CI) a higher BMI (0·80; CI 0·53, 1·07 kg/m2) and WC (1·71; 1·02, 2·40 cm), and higher chances (OR; 95 % CI) of being overweight (1·31; 1·13, 1·51), obese (1·41; 1·18, 1·69) and having significantly increased WC (1·41; 1·20, 1·66), compared with those in the first quartile. All associations suggest a dose–response gradient.
Results indicate the existence of associations between greater energy contribution from ultra-processed foods and higher BMI and WC, which are independent of total energy intake. These findings corroborate public policies designed to reduce the intake of this type of food.
In the present study we investigated gender-specific associations of low birth weight (LBW) and shorter relative leg length with metabolic syndrome (MetS) after adjusting for sociodemographic characteristics and health-related behaviours. We also investigated whether these associations are independent of age at menarche and BMI at 20 years old.
Baseline data from 12 602 participants (35–74 years) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), 2008–2010.
MetS was defined according to the revised National Cholesterol Education Program Adult Treatment Panel III guidelines. LBW (<2·5 kg) and age- and sex-standardized relative leg length (high, medium and low) were the explanatory variables studied. The strength of the associations between the explanatory variables and MetS was estimated by Poisson regression with robust variance.
MetS prevalence was 34·2 %; it was more prevalent in men (36·8 %) than in women (32·2 %). In multivariate analysis, LBW was associated (prevalence ratio; 95 % CI) with MetS only in women (1·28; 1·24, 1·45). Shorter leg length was associated with MetS in both men (1·21; 1·09, 1·35 and 1·46; 1·29, 1·65 for low and medium lengths, respectively) and women (1·12; 1·00, 1·25 and 1·40; 1·22, 1·59 for low and medium lengths, respectively). Additional adjustments for age at menarche and BMI at 20 years old did not change the associations.
Poor nutritional status as estimated by LBW and lower leg length in childhood was associated with a higher prevalence of MetS, although LBW was a significant factor only among women.
To evaluate the performance of waist-to-height ratio (WHtR) in predicting
cardiometabolic outcomes and compare cut-off points for Brazilian
Cross-sectional study. WHtR areas under the curve (AUC) were compared with
those for BMI, waist circumference (WC) and waist-to-hip ratio (WHR). The
outcomes of interest were hypertension, diabetes, hypertriacylglycerolaemia
and presence of at least two components of metabolic syndrome (≥2
MetS). Cut-offs for WHtR were compared and validity measures were estimated
for each point.
Teaching and research institutions in six Brazilian state capitals,
Women (n 5026) and men (n 4238) aged
35–54 years who participated in the Brazilian Longitudinal Study of
Adult Health (ELSA-Brasil) at baseline.
WHtR age-adjusted AUC ranged from 0·68 to 0·72 in men and
0·69 to 0·75 in women, with smaller AUC for
hypertriacylglycerolaemia and the largest for ≥2 MetS. WHtR performed
better than BMI for practically all outcomes; better than WHR for
hypertension in both sexes; and displayed larger AUC than WC in predicting
diabetes mellitus. It also offered better discriminatory power for ≥2
MetS in men; and was better than WC, but not WHR, in women. Optimal cut-off
points of WHtR were 0·55 (women) and 0·54 (men), but they
presented high false-negative rate compared with 0·50.
We recommend using WHtR (which performed similarly to, or better than, other
available indices of adiposity) as an anthropometric index with good
discriminatory power for cardiometabolic outcomes in Brazilian adults,
indicating the already referenced limit of WHtR≥0·50.
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