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Doctoral Thesis
DOI
https://doi.org/10.11606/T.6.2013.tde-02042013-092319
Document
Author
Full name
Ágatha Nogueira Previdelli
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2013
Supervisor
Committee
Fisberg, Regina Mara (President)
Bandoni, Daniel Henrique
Damasceno, Nágila Raquel Teixeira
Pereira, Rosângela Alves
Sartorelli, Daniela Saes
Title in Portuguese
Padrões da dieta de adolescentes do município de São Paulo e fatores associados: estudo de base populacional
Keywords in Portuguese
Adolescentes
Análise Fatorial
Dieta
Índice de Qualidade da Dieta Revisado (IQD-R)
Padrão Alimentar
Abstract in Portuguese
Introdução: Padrões alimentares estabelecidos na adolescência têm sido associados a fatores de risco para o desenvolvimento de doenças crônicas, tais como diabetes, doenças cardiovasculares e câncer. Objetivo: Avaliar os padrões da dieta de adolescentes e seus fatores associados. Metodologia: Utilizaram-se dados de adolescentes provenientes do estudo de base populacional do município de São Paulo. Foram utilizadas duas abordagens distintas na identificação dos padrões da dieta: o Índice de Qualidade da Dieta Revisado (IQD-R) e a análise fatorial. Para estimar a ingestão usual, foram coletados de um a cinco Recordatório de 24 horas (R24h), sendo o primeiro obtido no domicílio, juntamente com o Questionário de Frequência Alimentar (QFA), e os demais por telefone. Na primeira abordagem, o método proposto pelo National Cancer Institute estimou a distribuição da pontuação dos componentes do IQD-R, com base na ingestão usual e nas características da população. Na identificação dos padrões da dieta pela análise fatorial, primeiramente estimou-se o consumo usual pelo Multiple Source Method. Neste, além dos R24h, foram utilizadas informações complementares dos QFA, melhorando o modelo de probabilidade e consumo. Posteriormente à análise fatorial, modelos de regressão multivariada identificaram os fatores associados aos padrões da dieta. Resultados: A pontuação média do IQD-R (47,1), ajustada por sexo e escolaridade do chefe da família, foi semelhante entre homens (46,3) e mulheres (48,0). Observou-se um baixo consumo de Cereais integrais (0,3), Vegetais totais (1,0), Frutas totais (1,3) e inteiras (0,4); e um elevado consumo de Sódio (2,2), Gordura saturada (5,8) e GordAA (4,5), que representa as calorias provenientes de gordura sólida, álcool e açúcar de adição. Na análise fatorial, os dois padrões dietéticos retidos explicaram 17,1 por cento da variância total da ingestão. O padrão Tradicional, caracterizado pelo consumo de feijões, arroz, café/chá, açúcar, manteiga/margarina, carne bovina e bolacha doce, se associou negativamente ao sexo masculino, maior renda familiar e maior escolaridade do chefe da família. O padrão Dual, caracterizado pelo consumo de achocolatado, vegetais, leite integral, temperos (salada), queijo, carne processada/frios, pães/torradas, bala, suco e carne branca, se associou positivamente ao estado matrimonial (com companheiro) e maior escolaridade do chefe da família e à maior renda. Conclusão: Os adolescentes apresentam baixo consumo de fibras, principalmente sob a forma de frutas e cereais integrais, e alta ingestão de sódio, gorduras e açúcares. As duas abordagens forneceram informações consistentes e complementares sobre o comportamento alimentar dos adolescentes, podendo ser utilizadas para o desenvolvimento de programas de saúde pública que visem previnir e tratar doenças crônicas relacionadas com a dieta e que ocorrem ao longo da vida
Title in English
Dietary patterns among adolescents living in the municipally of São Paulo and associated factors: population based study
Keywords in English
Adolescents
Brazilian Healthy Eating Index Revised (BHEI-R)
Diet
Dietary Patterns
Factor Analysis
Abstract in English
Background: Adolescent dietary patterns have been associated with increased risk factors for chronic diseases, including diabetes, coronary heart disease and cancer. Objectives: To evaluate the dietary patterns among adolescents living in the municipally of São Paulo. Methods: Data of adolescents from a cross-sectional survey were analyzed. Two different approaches were used to evaluate the dietary patterns: the Brazilian Healthy Eating Index Revised (BHEI-R) and the factors analysis. To estimate the usual intake, it was collected a minimum of one and a maximum of five 24-hour dietary recall (24HR), in which the first one was obtained in the adolescents home, together with a Food Frequency Questionnaire (FFQ), and the others records were collected by phone. In the first approach, the method proposed by the American National Cancer Institute was used to estimate the distribution of the components of the BHEI-R, according to the usual intake and adjusted by the sociodemographic, anthropometric and lifestyle characteristics. To access the dietary patterns using the factor analysis, initially, the usual intake that was estimated by the Multiple Source Method. Beside the 24HR data, the FFQ was used as covariate information to improve the modeling of consumption probability and intake amount. After the factor analysis, multivariate linear regressions models identified the characteristics associated with the dietary patterns. Results: The estimated mean BHEI-R score (47.1 points), adjusted for gender and family heads schooling, was, being similar between males (46.3) and females (48.0). The results indicated lower consumption of Whole grains (0.3), Total vegetables (1.0), Total fruit (1.3) and Whole fruit (0.4); and higher intake Sodium (2.2), Saturated fat (5.8) and; SoFAAS (4.5), that comprise the calories from solid fat, alcohol intake and added sugar. The factor analysis identified two dietary patterns that together explained 17.1 per cent of the total variation in food intake. The Traditional diet, characterized by the consumption of beans, rice, coffee/tea, sugar, butter/margarine, beef and cookies, was inversely associated with be male, higher income and higher family heads schooling. The Dual diet, characterized by the consumption chocolate powder, vegetables, whole milk, salada dressings, cheeses, processed meats/cold cuts, breads/toasts/crackers, candies, juices and white meat (chicken and fish), was directly associated with higher income, family heads marital status (living with someone) and higher family heads schooling. Conclusion: The adolescents have lower dietary fiber intake, especially fruits and whole grains and higher intake of sodium, fats and sugars. Thus, the results of the two approaches provide consistent and complementary information about the adolescent dietary behavior that can be used to the development of public health programs, in order to prevent and treat dietrelated chronic diseases throughout the life course
 
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Publishing Date
2013-05-22
 
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