RENATA BERTAZZI LEVY
Projetos de Pesquisa
Unidades Organizacionais
LIM/38 - Laboratório de Epidemiologia e Imunobiologia, Hospital das Clínicas, Faculdade de Medicina - Líder
191 resultados
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- Consumption of ultra-processed foods and likely impact on human health. Evidence from Canada(2013) MOUBARAC, Jean-Claude; MARTINS, Ana Paula Bortoletto; CLARO, Rafael Moreira; LEVY, Renata Bertazzi; CANNON, Geoffrey; MONTEIRO, Carlos AugustoObjective: To investigate consumption of ultra-processed products in Canada and to assess their association with dietary quality. Design: Application of a classification of foodstuffs based on the nature, extent and purpose of food processing to data from a national household food budget survey. Foods are classified as unprocessed/minimally processed foods (Group 1), processed culinary ingredients (Group 2) or ultra-processed products (Group 3). Setting: All provinces and territories of Canada, 2001. Subjects: Households (n 5643). Results: Food purchases provided a mean per capita energy availability of 8908 (SE 81) kJ/d (2129 (SE 19) kcal/d). Over 61.7% of dietary energy came from ultra-processed products (Group 3), 25.6% from Group 1 and 12.7% from Group 2. The overall diet exceeded WHO upper limits for fat, saturated fat, free sugars and Na density, with less fibre than recommended. It also exceeded the average energy density target of the World Cancer Research Fund/American Institute for Cancer Research. Group 3 products taken together are more fatty, sugary, salty and energy-dense than a combination of Group 1 and Group 2 items. Only the 20% lowest consumers of ultra-processed products (who consumed 33.2% of energy from these products) were anywhere near reaching all nutrient goals for the prevention of obesity and chronic non-communicable diseases. Conclusions: The 2001 Canadian diet was dominated by ultra-processed products. As a group, these products are unhealthy. The present analysis indicates that any substantial improvement of the diet would involve much lower consumption of ultra-processed products and much higher consumption of meals and dishes prepared from minimally processed foods and processed culinary ingredients.
- Greenhouse gas emissions, water footprint, and ecological footprint of food purchases according to their degree of processing in Brazilian metropolitan areas: a time-series study from 1987 to 2018(2021) SILVA, Jacqueline Tereza da; GARZILLO, Josefa Maria Fellegger; RAUBER, Fernanda; KLUCZKOVSKI, Alana; RIVERA, Ximena Schmidt; CRUZ, Gabriela Lopes da; FRANKOWSKA, Angelina; MARTINS, Carla Adriano; LOUZADA, Maria Laura da Costa; MONTEIRO, Carlos Augusto; REYNOLDS, Christian; BRIDLE, Sarah; LEVY, Renata BertazziBackground The consumption of ultra-processed foods has increased worldwide and has been related to the occurrence of obesity and other non-communicable diseases. However, little is known about the environmental effects of ultra processed foods. We aimed to assess the temporal trends in greenhouse gas emissions (GHGE), water footprint, and ecological footprint of food purchases in Brazilian metropolitan areas, and how these are affected by the amount of food processing. Methods In this time-series study, we used data from five Brazilian Household Budget Surveys (1987-88, 1995-96, 2002-03, 2008-09, 2017-18) to calculate GHGE, water footprint, and ecological footprint per 1000 kcal of food and beverages purchased. Food items were classified into NOVA food groups: unprocessed or minimally processed foods (G1); processed culinary ingredients (G2); processed foods (G3); and ultra-processed foods (G4). We calculated the proportion each NOVA food group contributes to daily kcal per person. Linear regression was performed to evaluate trends of the environmental impacts across the years. Findings Between 1987-88 and 2017-18, diet-related GHGE increased by 21% (from 1538.6 g CO2 equivalent [CO(2)e] per 1000 kcal [95% CI 1473.3-1604.0] to 1866.0 g CO(2)e per 1000 kcal [1788.0-1944.0]; p(trend)<0.0001), diet-related water footprint increased by 22% (from 1447.2 L/1000 kcal [95% CI 1400.7-1493.8] to 1769.1 L/1000 kcal [1714.5-1823.7]; ptrend<0.0001), and diet-related ecological footprint increased by 17% (from 9.69 m2/1000 kcal [95% CI 9.33-10.05] to 11.36 m(2)/1000 kcal [10.91-11.81]; ptrend<0.0001). We found that the change in the environmental indicators over time varied between NOVA food groups. We did not find evidence of a change in the environmental indicators for G1 foods over time. GHGE from G2 foods decreased by 18% (ptrend<0.0001), whereas GHGE from G4 foods increased by 245% (p(trend)<0.0001). The water footprint from G2 foods decreased by 17% (ptrend<0.0001) whereas the water footprint from G4 foods increased by 233% (ptrend<0.0001). The ecological footprint from G2 foods decreased by 13% (ptrend<0.0001), whereas the ecological footprint from G3 foods increased by 49% (ptrend<0.0001) and from G4 foods increased by 183% (ptrend<0.0001). We found no significant change in contribution by any other NOVA food groups to any of the three environmental indicators over the study period. Interpretation The environmental effects of the Brazilian diet have increased over the past three decades along with increased effects from ultra-processed foods. This means that dietary patterns in Brazil are becoming potentially more harmful to human and planetary health. Therefore, a shift in the current trend would be needed to enhance sustainable healthy food systems. Funding Science and Technologies Facilities Council-Global Challenges Research Fund.
- Vaccination coverage rates and predictors of HPV vaccination among eligible and non-eligible female adolescents at the Brazilian HPV vaccination public program(2020) FAISAL-CURY, Alexandre; LEVY, Renata Bertazzi; TOURINHO, Maria Fernanda; GRANGEIRO, Alexandre; ELUF-NETO, JoseBackground Since March 2014, the quadrivalent HPV vaccine has been incorporated into the Brazilian Unified Health Care System and began to be offered, without direct costs, for girls from 9 to 13 years of age. Older female adolescents would have the option to be vaccinated at private health care system being responsible for the payment of HPV vaccine. The present study aimed to evaluate the coverage rates and predictors of HPV vaccination in Brazil among two groups of female adolescents: eligible and non-eligible for the HPV vaccination public program. Methods We used data from the 2015 Brazilian National Adolescent School-Based Health Survey, which involved a probabilistic sample of 5404 female adolescents students at public and private schools. Using a questionnaire, we gathered information on sociodemographic characteristics, sexual behavior, and respondent perception of parental supervision and have been vaccinated for HPV. Age-specific vaccination rates were analyzed in girls aged 9 to 13 at the time of public vaccination (eligible for public policy), as well among those 14 to 17 years old not eligible by the Ministry of Health for vaccination. We used Poisson regression models to investigate associated factors. Results HPV vaccine coverage was 83.5 and 21.8% among eligible and non-eligible populations, respectively. In both populations, the chance of being vaccinated decreased with older age. In the eligible population there is a greater chance of being vaccinated among ethnic group ""pardas"" but not with other indicators of socioeconomic status. In the non-eligible population, there was a clear association between higher vaccine coverage and greater maternal education and living with the mother. Conclusion Our findings highlight the importance of public policies to minimize inequities in access to cancer prevention measures in vulnerable adolescents. A public policy of HPV vaccination for older female adolescents would increase coverage with possible reduction of HPV-related diseases in this group of women.
- Comparison between household food purchase and individual food consumption in Brazil(2019) OLIVEIRA, Dayan Carvalho Ramos Salles de; SOUZA, Amanda de Moura; LEVY, Renata Bertazzi; SICHIERI, Rosely; VERLY-JR, EliseuOBJECTIVE: The present study aimed to compare Household Budget Survey (HBS) data on food purchasing and individual food consumption, collected in the same nationwide survey. DESIGN: Food purchase information for each household was collected by a seven-day collective acquisition diary, applied to 55 970 households. Food consumption information was obtained from household members over 10 years old by the application of two non-consecutive food records in a sub-sample of the HBS. Cooking and correction factors were applied when necessary, and all food items reported were grouped into twelve main food groups. Food purchase and consumption data were presented as absolute weight (g/person per d) and as relative contribution to energy intake (%) for the overall study population, which was stratified according to household income. SETTING: Brazil.ParticipantsNational estimates of food consumption and purchase for Brazil. RESULTS: The greatest differences between purchase and consumption data (purchase minus consumption) were observed for meat (-168 g), beans/legumes (-48 g), roots/tubers (-36 g) and fruits (-31 g). When expressed in terms of energy contribution, the highest differences were found for cereals (13 %) and oils and fats (11 %). Differences between purchase and consumption data were generally lower in the highest compared with the lowest household income quintile; and were lower for most main food groups when considering only foods reported as being eaten at home. CONCLUSIONS: With few exceptions, food purchase expressed as relative energy contribution, as opposed to absolute weight, can provide a good picture of actual consumption in the Brazilian population
- Postpartum bonding at the beginning of the second year of child's life: the role of postpartum depression and early bonding impairment(2020) FAISAL-CURY, Alexandre; LEVY, Renata Bertazzi; KONTOS, Alexandra; TABB, Karen; MATIJASEVICH, AliciaBackground: We evaluated the association between mother-child bonding and maternal depression at 6-8months after birth with bonding impairment at 12-15months in a sample of mothers at high risk of postnatal depression.Methods: A prospective cohort study with 346 low-income postpartum women with antenatal depression. The Postpartum Bonding Questionnaire (PBQ) and the Patient Health Questionnaire-9 (PHQ-9) were used, at 6-8 and 12-15months after delivery, to assess the mother-infant bonding and postnatal depression (PPD), respectively.Results: The percentage of the main outcome, bonding impairment (BI) at 12-15months, was 9.9% (95% CI 6.6-13.7). Using logistic regression models, BI was associated with: having an occupation (OR=2.82; 95% CI 1.00-7.94, p=.049), unplanned pregnancy (OR=3.46; 95% CI 1.01-11.8, p=.047), and presence of BI at 6-8months (OR= 13.0; 95% CI 3.76-45.4, p <= .001). Maternal depression was marginally associated with BI at 12-15months.Conclusions: BI affects 1 in 10 mothers, and although BI and PPD are strongly associated at 6-8 and 12-15months after delivery, BI at 6-8months is the main predictor of later BI. Based on the study findings, PPD screening in combination with BI assessment is highly recommended during the first year of child's life.
conferenceObject The food environment in school's vicinities of Sao Paulo, Brazil(2020) BARATA, M. F.; LEITE, M. A.; LEVY, R. B.- Food environments in schools and in the immediate vicinity are associated with unhealthy food consumption among Brazilian adolescents(2016) AZEREDO, Catarina Machado; REZENDE, Leandro Fornias Machado de; CANELLA, Daniela Silva; CLARO, Rafael Moreira; PERES, Maria Fernanda Tourinho; LUIZ, Olinda do Carmo; FRANCA-JUNIOR, Ivan; KINRA, Sanjay; HAWKESWORTH, Sophie; LEVY, Renata BertazziBackground. Evidence of the influence of the school food environment on adolescent diet is still little explored in low-and middle-income countries. We aimed to evaluate the association between food environment in schools and the immediate vicinity and the regular consumption of unhealthy food among adolescents. Methods. We used cross-sectional data collected by the Brazilian National Survey of School Health (PeNSE) from a representative sample of adolescents attending 9th grade public and private schools in Brazil, in 2012. We estimated students' regular consumption (>5 days/week) of unhealthy food (soft drinks, bagged salty snacks, deep fried salty snacks and sweets) and school availability, in the cafeteria or an alternative outlet, of the same food plus some healthy options (fruit and natural fruit juice). We performed multilevel logistic regression models. Results. Having a cafeteria inside school selling soft drinks (private schools OR = 1.23; 95% CI = 1.14-1.33; public schools OR = 1.13; 95% CI = 1.06-1.20) and deep fried salty snacks (private schools OR = 1.41 95% CI = 1.26-1.57; public schools OR = 1.16 95% CI = 1.08-1.24) was associated with a higher consumption of these unhealthy foods of among students. In private schools, cafeteria selling fruit and natural fruit juice was associated with lower student consumption of bagged salty snacks (OR = 0.86; 95% CI 0.77-0.96) and soft drinks (OR = 0.85; 95% CI = 0.76-0.94). In addition, eating meals from the Brazilian School Food Program in public schools was associated with a lower consumption of unhealthy foods. Conclusions. Foods available in the school food environment are associated with the consumption of unhealthy food among adolescents in Brazil.
conferenceObject TIME TRENDS CHANGES IN THE CONSUMPTION OF PROCESSED AND ULTRA-PROCESSED FOOD AND DRINK PRODUCTS DURING THE 20TH CENTURY IN CANADA(2013) MOUBARAC, J. C.; BATAL, M.; MARTINS, A. P. Bortoletto; CLARO, R.; LEVY, R. B.; CANNON, G.; MONTEIRO, C.- Characterization of the degree of food processing in the European Prospective Investigation into Cancer and Nutrition: application of the Nova classification and validation using selected biomarkers of food processing (vol 9, 1035580 , 2022)(2023) HUYBRECHTS, Inge; RAUBER, Fernanda; NICOLAS, Genevieve; CASAGRANDE, Corinne; KLIEMANN, Nathalie; WEDEKIND, Roland; BIESSY, Carine; SCALBERT, Augustin; TOUVIER, Mathilde; ALEKSANDROVA, Krasimira; JAKSZYN, Paula; SKEIE, Guri; BAJRACHARYA, Rashmita; BOER, Jolanda M. A.; BORNE, Yan; CHAJES, Veronique; DAHM, Christina C.; DANSERO, Lucia; GUEVARA, Marcela; HEATH, Alicia K.; IBSEN, Daniel B.; PAPIER, Keren; KATZKE, Verena; KYRO, Cecilie; MASALA, Giovanna; MOLINA-MONTES, Esther; ROBINSON, Oliver J. K.; PABLOS, Carmen Santiuste de; SCHULZE, Matthias B.; SIMEON, Vittorio; SONESTEDT, Emily; TJONNELAND, Anne; TUMINO, Rosario; SCHOUW, Yvonne T. van der; VERSCHUREN, W. M. Monique; VOZAR, Beatrice; WINKVIST, Anna; GUNTER, Marc J.; MONTEIRO, Carlos A.; MILLETT, Christopher; LEVY, Renata Bertazzi
- Ultra-processing. An odd 'appraisal'(2018) MONTEIRO, Carlos A.; CANNON, Geoffrey; MOUBARAC, Jean-Claude; LEVY, Renata B.; LOUZADA, Maria Laura C.; JAIME, Patricia C.It is now generally agreed that the impact of the current nature, purpose and extent of food processing on human well-being, health and disease needs to be better understood and explained, in order to improve public health. The special issue of Public Health Nutrition devoted to the concept of ultra-processing of food, and the NOVA classification of which ultra-processed foods are one category, is a great step forward in this work. Coincidentally, a polemical 'critical appraisal' of ultra-processing was recently published in another journal. Debate and discussion are an essential part of the scientific endeavour. In this commentary, we correct inaccurate statements made about NOVA in the 'appraisal,' rebut points raised, and discuss the larger issue of scientific responsibility for publishing opposing views on controversial topics.