The INFORMAS healthy food environment policy index in Brazil: Benchmarking, current policies, and determining priorities for the future Elisabetta Recine, Paulo Cesar Pereira de Castro Junior, Andrea Sugai, Patricia Chaves Gentil, Ana Carolina Feldenheimer da Silva Obesity Reviews, 2024 SummaryIntroductionObesity and non‐communicable diseases are the most important cause of death and inability in Brazil and worldwide. Public policies are an important strategy to prevent obesity. This study analysed the scope of Brazilian public policies for preventing and controlling obesity using the INFORMAS/Food‐EPI protocol.MethodsThe public policies evaluation was conducted based on the INFORMAS/Food‐EPI protocol. Experts from academia, civil society, and government assessed the level of implementation of food policies compared with international best practices and proposed new actions to be developed nationally. The protocol consisted of five phases: (1) A comprehensive review of the implementation of food environment‐related public policies; (2) validation with experts; (3) comparison of the national actions with the international best practice and due to the level of implementation; (4) list a set of actions to improve the current policies; and (5) evaluation of the actions due to their importance and achievability.ResultsBrazilian actions were focused on monitoring, leadership, governance, and resources and financing domains.ConclusionThe results will provide elements to support and improve the national policies that aim at the promotion of a healthy food environment and obesity prevention.
Food Consumption of People with Sickle Cell Anemia in a Middle-Income Country Tamara Vilhena Teixeira, Ana Carolina Feldenheimer Da Silva, Cláudia dos Santos Cople Rodrigues, Flávia dos Santos Barbosa Brito, Daniela Silva Canella, et al. Nutrients, 2023 Sickle cell anemia (SCA) is a genetic and hemolytic disease globally characterized by social vulnerability. Food consumption has been insufficiently analyzed in SCA. Secondary iron overload is often observed. This leads to unreliable recommendations for dietary iron restriction. We assessed food consumption and iron intake among adults with SCA. Considering the guidelines for healthy eating, foods were grouped according to the NOVA classification. This transversal study included 74.4% of eligible patients who were registered in the reference center for SCA treatment in Rio de Janeiro, Brazil, in 2019. Data on food consumption were collected through 24 h recall. The monthly household income of 82.3% of patients was less than $770. The consumption of fresh or minimally processed foods was directly associated with monthly household income (p < 0.0001; η2 = 0.87). Ultra-processed foods provided more than one-third of the total energy intake (35.2%). The prevalence of inadequate iron intake was about 40% among women, while that of iron intake above the tolerable upper limit was 0.8%. People from lower socioeconomic classes had the lowest iron intake. Strategies to encourage the consumption of fresh or minimally processed foods are needed considering the requirement of an antioxidant diet in SCA. These findings highlight the need for health equity to ensure food security and healthy eating in SCA.
Relative validity and reproducibility of WHO indicators for assessment of feeding practices in children under two years of age Juliana Martins Oliveira, Ana Carolina Feldenheimer da Silva, Milena Miranda de Moraes, Letícia de Oliveira Cardoso, Inês Rugani Ribeiro de Castro Ciencia E Saude Coletiva, 2023 The study aimed to evaluate relative validity and reproducibility of seven WHO indicators of dietary practices in children aged 6-23.9 months. Data from probabilistic sample of children who used primary healthcare services in Rio de Janeiro, Brazil were collected using a 24h dietary recall (24HR) and a closed questionnaire (Q1) on feeding in the day before the study. The last one was reapplied (Q2) around 16 days later. Validity was assessed by comparing the prevalence rates estimated by 24HR and Q1 and calculating the positive (PPV) and negative (NPV) predictive values, sensitivity (Se), specificity (Sp), and accuracy index (AI) for the resulting indicators. For reproducibility, estimated prevalence rates based on Q1 and Q2 were compared and the kappa index and prevalence-adjusted bias-adjusted kappa were estimated. Of the seven estimated indicators, the prevalence of two was overestimated (Continued breastfeeding: 50.0% vs 40.0%; Sweet beverage consumption: 65.1% vs 52.7%) and the prevalence of one was underestimated (Zero vegetable or fruit consumption: 6.5% vs 18.1%). For most indicators, Se and PPV were higher than Sp and NPV. The prevalence rates determined with Q1 and Q2 were similar for 6 indicators. More than half showed good, very good or excellent agreement.
013 THE INFORMAS HEALTHY FOOD ENVIRONMENT POLICY INDEX (FOOD-EPI) IN BRAZIL: BENCHMARKING, CURRENT POLICIES AND DETERMINING PRIORITIES FOR THE FUTURE Archivos Latinoamericanos De Nutricion, 2023
Healthy eating in supermarket circulars: reflections according to the food classification adopted in dietary guidelines for the Brazilian population Caroline Camila Moreira, Ana Carolina Feldenheimer da Silva, Amanda de Oliveira Requena Leme, Thais Santos Silva, Flávia dos Santos Barbosa Brito, et al. Ciencia E Saude Coletiva, 2023 The present study evaluated the promotion of natural/minimally processed foods (N/MPF) subgroups advertised in supermarket circulars by considering supermarket features and circular typology. We analyzed circulars published by five supermarket chains in the metropolitan region of Rio de Janeiro (June/2019-May/2020) and present data on the socioeconomic coverage and profile of the supermarkets and the types of circulars. Of the 68,110 types of foods, 30.6% were N/MPF. Meat/eggs were the most promoted ones (42.3%), followed by fruits/vegetables (20.2%), which were more often advertised by produce shop circulars. Dairy products, cereals/flours/pasta and beverages/infusions made up around 10.0% of the ads. Legumes (3.8%), spices and mushrooms (0.2%) and oilseeds (0.1%) were rarely promoted. Statistically significant differences were found in the promotion of subgroups according to supermarket coverage and their socioeconomic profiles. Fruits/vegetables were more often advertised by national chains and aimed at a high-income public than by local companies and aimed at a low/middle-income public. Promotion of N/MPF subgroups was disproportional due to differences among chains and types of circulars. As a result, a discussion on the regulation of food promotion in food retail is required.
Effectiveness of nutritional interventions to prevent nonprogressive congenital and perinatal brain injuries: a systematic review and meta-analysis of randomized trials Cintia C Curioni, Michel C Mocellin, Marina dos S Tavares, Ana C F da Silva, Patricia C de Velasco, et al. Nutrition Reviews, 2022 ContextNutritional interventions for newborns with brain injury are scarce, and there are gaps in the knowledge of their mechanisms of action in preventing the occurrence of cerebral palsy (CP) or the incidence of other developmental disabilities.ObjectiveThe objective of this review was to assess the effect of nutritional interventions in preventing nonprogressive congenital or perinatal brain injuries, or in improving outcomes related to neurological development.Data SourcesRandomized trials on any nutritional intervention for pregnant women at risk of preterm delivery, or for children with low birth weight, preterm, or with confirmed or suspected microcephaly, CP, or fetal alcohol syndrome disorders (FASDs) were retrieved from MEDLINE, Embase, Scopus, Web of Science, LILACS, and CENTRAL databases from inception to September 17, 2020.Data ExtractionData extraction, risk of bias (Cochrane Risk of Bias tool 2), and quality of evidence (GRADE approach) were assessed by 2 authors.Data AnalysisPooled risk ratios (RRs) with 95% confidence intervals were calculated using a random-effects meta-analysis. Seventeen studies were included on intravenous interventions (magnesium sulfate [n = 5], amino acids [n = 4], vitamin A [n = 1], and N-acetylcysteine [n = 1]); enteral interventions (vitamin D [n = 1], prebiotic [n = 1], nutrient-enriched formula [n = 1], and speed of increasing milk feeds [n = 1]); and oral interventions (choline [n = 1] and docosahexaenoic acid, choline, and uridine monophosphate [n = 1]). All studies assessed CP, except 1 on FASDs. Eight studies were judged as having high risk of bias. Five studies (7413 babies) with high-quality evidence demonstrated decreased risk of childhood CP (RR = 0.68, 95% CI: 0.52–0.88) with magnesium sulfate. Interventions with amino acids had no effect on CP prevention or other outcomes. Except for 1 study, no other intervention decreased the risk of CP or FASDs.ConclusionAlthough different types of nutritional interventions were found, only those with antenatal magnesium sulfate were effective in decreasing CP risk in preterm infants. Well-designed, adequately powered randomized clinical trials are required.
