Maylla Luanna Barbosa Martins Bragança

Introdução: As Doenças e Agravos Não Transmissíveis (DANT) representam um dos maiores desafios da saúde pública no Brasil, com impactos significativos sobre a morbimortalidade e a qualidade de vida da população. Alinhado aos Objetivos do Desenvolvimento Sustentável (ODS) da Organização das Nações Unidas, este estudo teve como objetivo identificar desafios e barreiras na execução das políticas relacionadas ao Plano DANT no estado do Estado. Metodologia: Trata-se de um estudo qualitativo vinculado ao projeto Fortalecimento e Interiorização da Agenda 2030 dos ODS junto à Vigilância de Doenças e Agravos não Transmissíveis da Amazônia Legal, aprovado pelo Comitê de Ética da UFT. A pesquisa combinou análise documental, indicadores dos ODS e do Plano DANT, além de entrevista semiestruturada com uma servidora da Secretaria Estadual de Saúde do Estado, participante da construção e implementação do plano. A análise de conteúdo categorial temática contemplou quatro eixos: desafios, articulação, políticas relacionadas e resultados. Resultados: Os achados apontaram dificuldades na articulação entre a Vigilância em Saúde, a Atenção Primária à Saúde (APS) e as políticas intersetoriais, consideradas fundamentais para o alcance das metas do Plano DANT e dos ODS. Foram evidenciadas barreiras estruturais, limitações de recursos e lacunas na integração entre setores e níveis de gestão. Conclusão: Os achados revelam que, embora avanços tenham sido alcançados, ainda há grandes desafios a serem superados para que as metas do Plano DANT e dos ODS sejam plenamente atingidas. A experiência maranhense evidencia que o caminho para a redução da morbimortalidade por DANT depende de maior integração intersetorial, fortalecimento da vigilância e da atenção primária, bem como da valorização contínua da educação permanente em saúde. Isto porque a formação continuada é imprescindível para a implementação de ações coerentes com os princípios do SUS e com os objetivos pactuados em âmbito global, como os do ODS 3. PALAVRAS-CHAVE: Objetivos do Desenvolvimento Sustentável; Saúde; Determinantes sociais em Saúde; Atenção primária.

Objetivo: identificar os padrões alimentares e avaliar sua associação com fatores socioeconômicos em adolescentes de São Luís, Maranhão. Métodos: Realizou-se um estudo transversal com a aplicação de um Questionário de Frequência Alimentar para avaliação do consumo alimentar e posterior extração de padrões alimentares por Análise de Componentes Principais. Foi utilizada modelagem hierarquizada e regressão de Poisson para avaliação dos fatores associados. Resultados: Foram avaliados 2496 adolescentes, sendo 52,4% do sexo feminino, 63,6% de cor parda e 53,7% pertencentes a classe-C. Foram identificados cinco padrões alimentares: denso em energia, prudente, tradicional brasileiro, bebidas com açúcar e bebidas alcóolicas/energéticas. As variáveis sexo, situação socioeconômica, raça, ser universitário e a situação conjugal foram associadas aos padrões alimentares encontrados. Conclusão: Os aspectos socioeconômicos foram determinantes na aderência aos padrões alimentares, tornando-se necessária implementação de políticas públicas que incentivem escolha de alimentos saudáveis, levando em consideração esses aspectos.

Objetivo: Selecionar os indicadores dos Objetivos do Desenvolvimento Sustentável (ODS) determinantes da desnutrição infantil (DI) no Brasil e monitorar o alcance das metas da DI, por região, no ano de 2022.

Objective: To select indicators of the Sustainable Development Goals (SDGs) that determine child malnutrition (CM) in Brazil and to monitor the achievement of SDG targets by region in 2022.

This study aimed to identify the dietary patterns (DPs) of adolescents and assess indicators of subclinical inflammation. It was a cross-sectional study aligned with the RPS cohort with data from São Luís, Maranhão, Brazil. We evaluated 511 adolescents between 18–19 years old. DPs were identified with a factor analysis of the principal components. Nutritional status was assessed with body mass index and body fat percentages. Hierarchical modeling was performed using a linear regression to estimate the beta coefficient (β) of the independent variables with the dependent variables interleukin-6 and high-sensitivity C-reactive protein (hs-CRP). Five DPs were identified: energy-dense, sugar-sweetened beverages and breakfast cereals, prudent, traditional Brazilian and alcoholic and energy beverages. Greater adherence to the prudent DP was associated with a lower concentration of interleukin-6 (β = −0.11; p value = 0.040). Greater adherence to the DP “traditional Brazilian” and “alcoholic and energy beverages” were associated with increased IL-6, mediated by the nutritional status. A higher BMI (β = 0.36; p value = p value = 0.014) were associated with higher hs-CRP concentrations. The nutritional status and “prudent” pattern were associated with inflammatory biomarkers. These findings show that a higher consumption of fresh and minimally processed foods and the adequacy of the nutritional status are protective factors for the inflammatory process.

Background: Ultra-processed Food (UPF) consumption can play a role in the pathogenesis and progression of asthma. The aim of this study was to evaluate the association between the consumption of UPF and asthma. Methods: This cross-sectional study included 1857 adults aged 23–25 years from the Ribeirão Preto-SP birth cohort (1978/1979). The exposure variable was the consumption of UPF (expressed as their percentage contribution to energy intake—% total caloric value [%TCV] and their percentage contribution to the amount of food ingested—%grams), which was assessed with a food frequency questionnaire. Asthma was the outcome and was defined based on a positive methacholine challenge test and the presence of wheezing, chest tightness, or shortness of breath over the last 12 months. Poisson regression with robust variance was used to estimate the association between these variables. Unadjusted analyses and analyses adjusted for sex, age, household income, smoking, and physical activity level were performed. Results: The prevalence of asthma in the sample was 13.2%. The mean total consumption of UPF was 37.9 ± 11.2% TCV (corresponding to 35.1 ± 15.1% grams). There was no association between the consumption of UPF and asthma in adults. Conclusion: This study provides no evidence for an association between the consumption of UPF and asthma in young adults.

Obesity is a recognized risk factor for the development of cardiometabolic outcomes. Therefore, it is essential to evaluate anthropometric and body composition indicators used for its diagnosis. This study aimed to assess the diagnostic performance of body fat percentage (BF%), fat mass index (FMI) and body mass index (BMI) for detecting cardiometabolic outcomes in adults. A cross-sectional study was conducted involving adults at 30 years of age from Pelotas, RS (n = 3517) and at 37–39 years from Ribeirão Preto, SP (n = 1696). Receiver operating characteristic (ROC) curves were used to determine the cut-off points for predicting cardiometabolic risk factors, including altered blood pressure, blood glucose, triglycerides, total cholesterol, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDDL-c), C-reactive protein and glycated hemoglobin. The cut-off points of BF% ranged from 25.2 to 27.8 in men and from 37.4 to 39.7 in women at 30 years, and from 26.1 to 27.8 in men and from 38.5 to 42.2 in women at 37–39 years. For FMI (kg/m²), the cut-off points ranged from 6.3 to 7.5 in men and from 9.5 to 10.8 in women at 30 years, and from 7.3 to 7.8 in men and from 10.2 to 12.2 in women at 37–39 years. The BMI cut-off points (kg/m²) ranged from 26.3 to 27.3 in men and from 25.4 to 27.2 in women at 30 years, and from 28.3 to 29.0 in men and from 27.2 to 29.6 in women at 37–39 years. The areas under the curve were similar for the three indicators, ranging from 0.523 to 0.746. BMI showed a performance similar to that of the body fat-based indicators in identifying cardiometabolic outcomes. The cut-off points of the three indicators showed acceptable discriminatory power in subjects with cardiometabolic risk factors.

Sugar-sweetened beverages (SSB) consumption may be associated with a reduction in bone mineral density (BMD). The aim of this study was to evaluate the association between the consumption of SSB and BMD among young people. We performed a cross-sectional study that evaluated 6620 young people (18–23 years of age) from three Brazilian birth cohorts (Ribeirão Preto, Pelotas, and São Luís). We analyzed the daily frequency and the amount and energy contribution of the SSB, which were obtained through a food frequency questionnaire. Total body and lumbar spine BMD (g/cm²), measured by dual-energy X-ray absorptiometry, were the outcomes. Unadjusted linear regression models, adjusted for sex, socioeconomic class, physical activity, smoking, alcohol consumption, and body mass index were used. The highest tertile of SSB consumption frequency (2.1–16.7 times/day) was associated with a lower lumbar spine BMD (β = −0.009; 95% CI: −0.017; −0.001; standardized β = −0.03). This association persisted after adjustment for confounders (β = −0.008; 95% CI: −0.016; −0.001; standardized β = −0.03). No association was observed between SSB consumption frequency and total body BMD or between the amount and energy contribution of SSB and total body or lumbar spine BMD. A high frequency of SSB consumption was associated with a low lumbar spine BMD.

Objective: Daily fruit and vegetable consumption is a critical factor in health, especially aging. This study aimed to evaluate the association between socioeconomic factors and daily fruit and vegetable consumption in men and women aged ≥ 50 years. Methods: This cross-sectional study used 2015–2016 data from the Brazilian longitudinal study of aging (ELSI-Brazil), which included 8665 individuals aged ≥ 50 years. Daily fruit and vegetable consumption was the dependent variable, and income, education, sex, age, and race were the independent variables. Associations between fruit and vegetable consumption and the independent variables were determined using Poisson regression. Results: Individuals who had completed higher education (OR 2.40; 95% CI 2.07–2.78), whose income was > 3 times the minimum wage (OR 2.42; 95% CI 2.18–2.68), and those aged > 80 years (OR 1.44; 95% CI 1.27–1.63) were more likely to consume fruits and vegetables. However, men (OR 0.63; 95% CI 0.58–0.67), Blacks (OR 0.74; 95% CI 0.65–0.84), and people of mixed race (OR 0.68; 95% CI 0.63–0.73), were less likely to consume fruits and vegetables. Conclusions: The results show inequality in fruit and vegetable consumption among people aged ≥ 50 years, which was lower among men, people of Black or mixed race, people with low income and education, and those with younger age. Interventions are needed to promote fruit and vegetable consumption, and thus healthy aging, among these groups.

Resumo Introdução A pandemia do novo coronavírus intensificou a violação do direito humano à alimentação e nutrição adequadas e elevou a insegurança alimentar e nutricional na população brasileira. Objetivo Analisar as estratégias das políticas e programas de segurança alimentar e nutricional adotadas pelo governo brasileiro durante a pandemia (ano de 2020) para promoção da segurança alimentar e nutricional e combate à insegurança alimentar e nutricional no país. Método Realizou-se busca nos sites oficiais para análise das ações propostas. Resultados Apesar de algumas proposições pontuais, como a distribuição do auxílio emergencial, estratégias mais enérgicas, como o fortalecimento do Programa de Aquisição de Alimentos, encorajamento de pequenos agricultores, facilitação do transporte e da comercialização de alimentos e a garantia da continuidade de programas assistenciais que facilitem acesso à renda e à alimentação durante a pandemia, precisam ser urgentemente adotadas. Conclusão Essas estratégias requerem atuação das três esferas de governo em prol do combate dos impactos da pandemia do novo coronavírus nos índices de insegurança alimentar e nutricional no Brasil.