FERNANDA RAUBER
Projetos de Pesquisa
Unidades Organizacionais
LIM/38 - Laboratório de Epidemiologia e Imunobiologia, Hospital das Clínicas, Faculdade de Medicina
11 resultados
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- The burden of excessive saturated fatty acid intake attributed to ultra-processed food consumption: a study conducted with nationally representative cross-sectional studies from eight countries(2021) STEELE, Euridice Martinez; BATIS, Carolina; CEDIEL, Gustavo; LOUZADA, Maria Laura da Costa; KHANDPUR, Neha; MACHADO, Priscila; MOUBARAC, Jean-Claude; RAUBER, Fernanda; JEDLICKI, Marcela Reyes; LEVY, Renata Bertazzi; MONTEIRO, Carlos A.Cross-sectional nutritional survey data collected in eight countries were used to estimate saturated fatty acid intakes. Our objective was to estimate the proportion of excessive saturated fatty acid intakes (>10 % of total energy intake) that could be avoided if ultra-processed food consumption was reduced to levels observed in the first quintile of each country. Secondary analysis was performed of 24 h dietary recall or food diary/record data collected by the most recently available nationally representative cross-sectional surveys carried out in Brazil (2008-9), Chile (2010), Colombia (2005), Mexico (2012), Australia (2011-12), the UK (2008-16), Canada (2015) and the US (2015-16). Population attributable fractions estimated the impact of reducing ultra-processed food consumption on excessive saturated fatty acid intakes (above 10 % of total energy intake) in each country. Significant relative reductions in the percentage of excessive saturated fatty acid intakes would be observed in all countries if ultra-processed food consumption was reduced to levels observed in the first quintile's consumption. The reductions in excessive intakes ranged from 10.0 % (95 % CI 6.2-13.6 %) in Canada to 35.0 % (95 % CI 28.7-48.0 %) in Mexico. In all eight studied countries, all presenting more than 30 % of intakes with excessive saturated fatty acids, lowering the dietary contribution of ultra-processed foods to attainable, context-specific levels was shown to be a potentially effective way to reduce the percentage of intakes with excessive saturated fatty acids, which may play an important role in the prevention of non-communicable diseases, particularly cardiovascular diseases.
- Dietary Patterns in Portuguese Children and Adolescent Population: The UPPER Project(2021) MORAES, Milena Miranda de; OLIVEIRA, Bruno; AFONSO, Claudia; SANTOS, Cristina; TORRES, Duarte; LOPES, Carla; MIRANDA, Renata Costa de; RAUBER, Fernanda; ANTONIAZZI, Luiza; LEVY, Renata Bertazzi; RODRIGUES, SaraConsidering the nature, extent, and purpose of food processing, this study aims to identify dietary patterns (DPs) and their associations with sociodemographic factors and diet quality in Portuguese children and adolescents. Cross-sectional data were obtained from the National Food, Nutrition and Physical Activity Survey (2015-2016) of the Portuguese population. Dietary intake was obtained from two non-consecutive days and food items were classified according to the NOVA system. The proportion (in grams) of foods in the total daily diet was considered to identify DPs by latent class analysis, with age and sex as concomitant variables. Associations of DPs with sociodemographic characteristics were assessed using multinomial logistic regression. Linear regressions adjusted by sociodemographic characteristics tested associations of DPs with diet quality. DPs identified were: ""Unhealthy "" (higher sugar-sweetened beverages, industrial breads, and sausages intake), ""Traditional "" (higher vegetables, fish, olive oil, breads, ultra-processed yogurts, and sausages intake), and ""Dairy "" (higher intake of milk, yogurt, and milk-based beverages). ""Unhealthy "" was associated with older ages and lower intake of dietary fibre and vitamins and the highest free sugars and ultra-processed foods (UPF), although all DPs presented significant consumption of UPF. These findings should be considered for the design of food-based interventions and school-feeding policies in Portugal.
conferenceObject Dietary patterns and diet quality of Portuguese children and adolescents: the UPPER project(2021) MORAES, Milena; OLIVEIRA, Bruno; AFONSO, Claudia; SANTOS, Cristina; TORRES, Duarte; LOPES, Carla; MIRANDA, Renata; RAUBER, Fernanda; ANTONIAZZI, Luiza; LEVY, Renata; RODRIGUES, Sara- Risk and protective behaviors for chronic non-communicable diseases among Brazilian adults(2021) CARVALHO, R. B. N. de; RAUBER, F.; CLARO, R. M.; LEVY, R. B.Objectives: This study aimed to analyze behavioral patterns of protective and risk factors for chronic non-communicable diseases (NCDs) among adults and to explore the association between these patterns and sociodemographic characteristics using data from the National Health Survey 2013. Study design: This was a cross-sectional study. Methods: This is a population-based study, nationwide, of individuals aged >= 18 years (n = 60,202). The sampling process used was grouping with three selection stages: census sector, households, and individuals. The factor analysis by principal component was used to identify behavioral patterns of protective and risk factors for NCDs. Linear regression was used to explore the association between patterns and sociodemographic characteristics. Results: Two behavioral patterns were identified: a 'protective pattern' featured by consumption of vegetable, fruits/natural fruit juice, and low-fat milk and recommended physical activity practice during leisure time; and a 'risk pattern' characterized by consumption of high-fat meat and soft drinks, alcohol abuse, and smoking habit. Adherence to the protective pattern was associated with older White women who had higher levels of education, were economically active, and lived in the urban areas of the country. Younger, economically active men living in the urban areas were associated with the risk patterns. Conclusions: Two behavioral patterns for NCDs have been identified and are distributed non-randomly in the adult Brazilian population. These findings are expected to contribute to better targeting health promotion and prevention of NCDs.
- Impact of ultra-processed food consumption on metabolic health(2021) MIRANDA, Renata Costa de; RAUBER, Fernanda; LEVY, Renata BertazziPurpose of review Ultra-processed foods (UPF) have been associated with poor diet quality and adverse health outcomes. Our aim in this review is to summarize recent research assessing the impact of UPF consumption, classified according to the NOVA system, on outcomes related to metabolic health. Recent findings Thirty recent studies with different design, quality and target population have investigated the impact of UPF consumption on parameters related to metabolic health, which were organized into: metabolic syndrome; body weight change and obesity indicators; blood pressure and hypertension; glucose profile, insulin resistance and type 2 diabetes; other metabolic risks and cardiovascular diseases and mortality. Most of the studies demonstrated adverse associations between high UPF consumption and metabolic health, mainly those with robust design and involving adults. Most of the latest findings have revealed an adverse impact of high UPF consumption on metabolic health, including cardiovascular diseases and mortality. Scientific evidence is accumulating towards the necessity of curbing UPF consumption worldwide at different life stages. Nevertheless, other studies are needed to confirm the causality between UPF consumption and metabolic health in diverse scenarios and to better elucidate all likely mechanisms involved in this relationship.
- Healthy, ""usual"" and ""convenience"" cooking practices patterns: How do they influence children's food consumption?(2021) MARTINS, Carla Adriano; ANDRADE, Giovanna Calixto; OLIVEIRA, Mariana Fernandes Brito de; RAUBER, Fernanda; CASTRO, Ines Rugani Ribeiro de; COUTO, Marcia Thereza; LEVY, Renata BertazziThis study identified adults' cooking practices patterns and tested their associations with children's consumption of ultra-processed foods. Cross-sectional study conducted with 551 adult-child pairs from Sao Paulo, Brazil. Children's food consumption was collected through dietary recalls. Adults' cooking practices were identified using a questionnaire developed for the Brazilian's context. Principal Component Analysis has been employed to identify cooking patterns and linear regression models (crude and adjusted for sociodemographic variables) have been used to test associations between pattern's scores and contribution of ultra-processed foods to total energy at dinners. Three cooking patterns were identified: ""Healthy"", ""Usual"" and ""Convenience"". The first two patterns reflected behaviors of people who mostly cook ""from scratch"". Only the Healthy pattern (confidence to cook several meals using fresh foods and natural seasonings; healthier cooking techniques) was inversely associated with ultra-processed food consumption (beta = -4.1; p = 0.002), whereas the Convenience pattern (less frequency and time to cook, using microwave and ready-to-heat meals) was positively associated with (beta = 3.6; p = 0.008). Our results suggest that cooking at home, as an isolated action, is not enough to protect the consumption of ultraprocessed foods. To promote healthy eating among children, the adults' cooking practices should be aligned with the preparation of meals made ""from scratch"", taking into account the healthiness of what is being cooked.
- Eating context and its association with ultra-processed food consumption by British children(2021) ONITA, Bianca M.; AZEREDO, Catarina M.; JAIME, Patricia C.; LEVY, Renata B.; RAUBER, FernandaThis study aimed to investigate the patterns of eating context and its association with ultra-processed food consumption by British children. This cross-sectional study was conducted with a representative sample of UK children aged 4-10 years old (n = 1772) from the National Diet and Nutrition Survey 2008/2014. Data on food consumption, meal context and ultra-processed food consumption were assessed through a four-day food diary. Exploratory factor analysis was used to identify the patterns of eating context and these patterns' association with the daily consumption of ultra-processed food was verified by linear regression analyses. Ultra-processed foods comprised 65.4% of the total daily energy intake. At lunch, higher ultra-processed food consumption was associated with the patterns ""Eating with family while watching TV"" (64.9% in the lowest tertile to 68.1% in the highest tertile) and ""Eating away from home"" (65.2%-67.7%, respectively), while the eating pattern ""Eating at school with friends"" was associated with lower ultra-processed food consumption (66.6%-64.7%, respectively). At dinner, higher ultra-processed food consumption was associated with the patterns ""Eating with family while watching TV"" (64.6%-67.1%, respectively) and ""Eating alone in the bedroom"" (63.9%-66.5%, respectively). Eating alone, eating whilst watching TV, and eating away from home stood out as patterns of eating context associated with the increased consumption of ultra-processed food.
- Ultra-processed food consumption and type 2 diabetes incidence: A prospective cohort study(2021) LEVY, Renata B.; RAUBER, Fernanda; CHANG, Kiara; LOUZADA, Maria Laura da C.; MONTEIRO, Carlos A.; MILLETT, Christopher; VAMOS, Eszter P.Background: Ultra-processed foods account for more than 50% of daily calories consumed in several high-income countries, with sales of ultra-processed foods soaring globally, especially in middle-income countries. The objective of this study is to investigate the association between ultra-processed food (UPF) consumption and risk of type 2 diabetes (T2D) in a UK-based prospective cohort study. Methods: Participants of the UK Biobank (2007-2019) aged 40-69 years without diabetes at recruitment who provided 24-h dietary recall and follow-up data were included. UPFs were defined using the NOVA food classification. Multivariable Cox proportional hazards regression models were used to evaluate the association between UPF consumption and the risk of T2D adjusting for socio-demographic, anthropometric and lifestyle characteristics. Results: A total of 21,730 participants with a mean age of 55.8 years and mean UPF intake of 22.1% at baseline were included. During a mean follow-up of 5.4 years (116,956 person-years), 305 incident T2D cases were identified. In the fully adjusted model, compared with the group in the lowest quartile of UPF intake, the hazard ratio for T2D was 1.44, 1.04-2.02 in the group with the highest quartile of UPF consumption. A gradient of elevated risk of T2D associated with increasing quartiles of UPF intake was consistently observed (p value for trend < 0.028). A significantly increased risk of T2D was observed per 10 percentage points increment in UPF consumption ([adjusted HR]: 1.12, 95% confidence interval [CI]: 1.04-1.20). Conclusions: Our findings demonstrate that a diet high in UPFs is associated with a clinically important increased risk of T2D. Identifying and implementing effective public health actions to reduce UPF consumption in the UK and globally are urgently required.
- An Ultra-Processed Food Dietary Pattern Is Associated with Lower Diet Quality in Portuguese Adults and the Elderly: The UPPER Project(2021) MORAES, Milena Miranda de; OLIVEIRA, Bruno; AFONSO, Claudia; SANTOS, Cristina; TORRES, Duarte; LOPES, Carla; MIRANDA, Renata Costa de; RAUBER, Fernanda; ANTONIAZZI, Luiza; LEVY, Renata Bertazzi; RODRIGUES, SaraThis study aimed to identify dietary patterns (DPs) and their associations with sociodemographic factors and diet quality in Portuguese adults and the elderly. Cross-sectional data were obtained from the National Food, Nutrition and Physical Activity Survey (2015-2016), with two non-consecutive dietary 24 h recalls. Food items were classified according to the NOVA system and its proportion (in grams) in the total daily diet was considered to identify DPs by latent class analysis, using age and sex as concomitant variables. Multinomial logistic and linear regressions were performed to test associations of DPs with sociodemographic characteristics and diet quality, respectively. Three DPs were identified: ""Traditional "" (higher vegetables, fish, olive oil, breads, beer and wine intake), ""Unhealthy "" (higher pasta, sugar-sweetened beverages, confectionery and sausages intake) and ""Diet concerns "" (lower intake of cereals, red meat, sugar-sweetened and alcoholic beverages). ""Unhealthy "" was associated with being younger and lower intake of dietary fiber and vitamins and the highest free sugars and ultra-processed foods (UPF). ""Diet concerns "" was associated with being female and a more favorable nutrient profile, but both DPs presented a higher contribution of UPF than the ""Traditional "" DP. These findings should be considered for the design of food-based interventions and public policies for these age groups in Portugal.
- Body weight changes in the NutriNet Brasil cohort during the covid-19 pandemic(2021) COSTA, Caroline dos Santos; STEELE, Euridice Martinez; LEITE, Maria Alvim; RAUBER, Fernanda; LEVY, Renata Bertazzi; MONTEIRO, Carlos AugustoThis study describes body weight changes among participants of the NutriNet Brasil cohort (n = 14,259) during the covid-19 pandemic. We analyzed data reported before the pandemic onset (01/26/2020 to 03/18/2020) and about six months after (09/14/2020 to 10/19/2020). Our results show that 19.7% of the participants gained >= 2 kg. Weight gain was directly associated with male gender, lower education, and previous presence of overweight, and inversely associated with age. In turn, 15.2% lost >= 2kg, being directly associated with male gender and previous presence of overweight and inversely associated with age.