MARIA ALVIM LEITE
Projetos de Pesquisa
Unidades Organizacionais
LIM/38 - Laboratório de Epidemiologia e Imunobiologia, Hospital das Clínicas, Faculdade de Medicina
18 resultados
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conferenceObject The food environment in school's vicinities of Sao Paulo, Brazil(2020) BARATA, M. F.; LEITE, M. A.; LEVY, R. B.- Inequities in the urban food environment of a Brazilian city(2021) LEITE, Maria Alvim; ASSIS, Maira Macario de; CARMO, Ariene Silva do; NOGUEIRA, Mario Cirio; NETTO, Michele Pereira; MENDES, Larissa LouresFood environment refers to the physical, social, cultural, economic and political contexts in which people engage with food systems in order to acquire, prepare and consume food. In 2016, we investigated the food environment of districts in Juiz de Fora, Minas Gerais, Brazil, according to different socio-economic levels. We proposed a categorization of food establishments according to the NOVA food classification, devised thematic maps, tested the significance of food retailers' agglomerations by univariate K function and detected district clusters using variables of interest. A total of 23 districts (19.1%) presented high or very high vulnerability. Establishments only or mainly selling ultra-processed foods presented higher frequencies (52.7%) in comparison to other categories throughout the city. The downtown district had the most of all types of establishments. Districts of greater vulnerability had fewer establishments. The environmental iniquities we have identified reinforce the need to implement public policies that promote healthy urban food environments.
- Victims, bullies and bully-victims: prevalence and association with negative health outcomes from a cross-sectional study in Sao Paulo, Brazil(2020) LOCH, Ana Paula; ASTOLFI, Roberta Corradi; LEITE, Maria Alvim; PAPA, Cassio Henrique Gomide; RYNGELBLUM, Marcelo; EISNER, Manuel; PERES, Maria Fernanda TourinhoObjectives To estimate the prevalence of self-reported bullying as victims, bullies or bully-victims among 9th grade adolescents in the city of Sao Paulo, Brazil; to investigate association between bullying with negative health outcomes. Methods Cross-sectional data were obtained in 2017 from a sample of Brazilian adolescents (n = 2680) using a structured, self-administered questionnaire. Bivariate and multivariate Poisson regression were employed to assess in which extent the experience of bullying in position of victim, bully or bully-victim affects adolescents' health. Results Prevalence of bullying victimization was 18.3%, while victimization/perpetration and perpetration corresponded to 10.42% and 4.9%, respectively. Adolescents who experienced bullying victimization were more likely to present high levels of internalizing symptoms, to report self-harm, to present negative self-rated health and to use tobacco, when compared with those not involved. Bullies were more likely to use alcohol and to binge drinking. bully-victims presented a higher prevalence of all health outcomes, except for tobacco use. Conclusions Our findings highlight the effect of bullying in adolescents' health, regardless of the position. Planned intersectoral efforts between parents, health and education systems to prevent bullying could therefore reduce negative health outcomes during adolescence.
- Changes in dietary markers during the covid-19 pandemic in Brazil(2023) ANDRADE, Giovanna Calixto; LEVY, Renata Bertazzi; LEITE, Maria Alvim; RAUBER, Fernanda; CLARO, Rafael Moreira; COUTINHO, Janine Giuberti; MAIS, Lais AmaralOBJECTIVE: Evaluate changes in the Brazilian population's diet and its determinants during the covid-19 pandemic.METHODS: We used diet data collected by the Datafolha Institute in 2019 (n = 1,384), 2020 (n =1,214), and 2021 (n = 1,459) from independent and representative samples of the adult population (aged 18 to 55 years) from all socioeconomic classes and geographic regions of Brazil. Food consumption was measured by checking the consumption of 22 sets of food on the day before the survey. The third cycle also included questions about changes in eating habits during the pandemic. We estimated the prevalence of consumption of the food sets in each cycle of the survey and used statistical tests for comparisons of proportions between the three cycles.RESULTS: Between 2019 and 2020, we observed a significant increase in the consumption of cereals, milk, packaged snacks or salty cookies, and industrialized sauces, as opposed to a decrease in the consumption of eggs. Between 2019 and 2021 and between 2020 and 2021, on the other hand, there was a significant decrease in the consumption of cereals, vegetables, fruits, and industrialized fruit juices and an increase in the consumption of soda, sweets, cookies, sausages, industrialized sauces, and ready meals. When asked about the main changes in the purchase and preparation of meals, 46.3% of the respondents reported consuming more food prepared at home during the pandemic. Regarding changes in eating habits, 48.6% of the respondents reported a change in their eating habits during the pandemic. The main reasons for such changes were greater concern with health (39.1%) and self-reported decreased family income (30.2%).CONCLUSIONS: The covid-19 pandemic had a negative impact on the diet of the population, and increased consumption of ultra-processed foods was reported for that period.
- Dietary changes in the NutriNet Brasil cohort during the covid-19 pandemic(2020) STEELE, Euridice Martinez; RAUBER, Fernanda; COSTA, Caroline dos Santos; LEITE, Maria Alvim; GABE, Kamila Tiemann; LOUZADA, Maria Laura da Costa; LEVY, Renata Bertazzi; MONTEIRO, Carlos AugustoOBJECTIVE: To describe the dietary characteristics of participants in the NutriNet Brasil cohort immediately before and during the covid-19 pandemic. METHODS: Our data stem from an adult cohort created to prospectively investigate the relationship between diet and morbidity and mortality from chronic non-communicable diseases in Brazil. For this study, we selected the first participants (n = 10,116) who answered twice to a simplified questionnaire on their diet the day before, the first time when entering the study, between January 26 and February 15, 2020, and the second between May 10 and 19, 2020. The questionnaire inquiries about the consumption of healthy (vegetables, fruits and legumes) and unhealthy (ultra-processed foods) eating markers. Comparisons of indicators based on the consumption of these markers before and during the pandemic are presented for the study population and according to gender, age group, macro-region of residence and schooling. Chi-square tests and t-tests were used to compare proportions and means, respectively, adopting p < 0.05 to identify significant differences. RESULTS: For all participants, we found a modest but statistically significant increase in the consumption of healthy eating markers and stability in the consumption of unhealthy food markers. This favorable pattern of dietary changes during the pandemic occurred in most sociodemographic strata. We observed a less favorable changing pattern, with a tendency to increasing consumption of healthy and unhealthy food markers, in the Northeast and North macro-regions and among people with less schooling, suggesting social inequalities in the response to the pandemic. CONCLUSIONS: If confirmed, the trend of increased consumption of ultra-processed foods in underdeveloped regions and by people with less schooling is concerning, as eating these foods increases the risk of obesity, hypertension and diabetes, whose presence increases the severity and lethality of covid-19.
- EXCESSO DE PESO, AMBIENTE PERCEBIDO E PRIVAÇÃO SOCIAL: UM ESTUDO DA PERCEPÇÃO DE PAIS OU RESPONSÁVEIS(2018) ASSIS, Maíra Macário de; LEITE, Maria Alvim; CôRTES, Alessandra Jordão; CARMO, Ariene Silva do; MATOZINHOS, Fernanda Penido; CÂNDIDO, Ana Paula Carlos; MENDES, Larissa LouresABSTRACT Objective: To investigate parents’ or guardians’ perception of their residential proximity to food retailers, leisure areas, and spaces for physical activity according to neighborhood social deprivation, and test associations between the perceived environment and their children’s overweight. Methods: Cross-sectional study conducted with 408 children and adolescents (6- to 15-year-olds) attending public schools in a medium-sized Brazilian city. Data were collected from 2011 to 2014. A telephone interview using a structured research tool determined the presence of overweight and the walking time between the participants’ home and the places evaluated. The indicator of social deprivation adopted was the Health Vulnerability Index. Logistic regression models were constructed to predict the perception of proximity (social deprivation as an explanatory variable) and evaluate perceived environmental factors (explanatory variables) associated with overweight (outcome). Results: Residents of areas with higher social vulnerability showed a probability of perceived proximity 50 to 71% lower to supermarkets, street/produce markets, parks, recreation areas/community centers, and gyms compared to residents of less vulnerable areas. The perceived proximity to parks reduced the chance of overweight in children and adolescents in 73%, with an odds ratio (OR) of 0.27 (95%CI 0.07-0.95; p<0.05). Conclusions: The perceived environment of the residential area infrastructure might be related to neighborhood social deprivation and the presence of overweight in children and adolescents.
- Is neighbourhood social deprivation in a Brazilian city associated with the availability, variety, quality and price of food in supermarkets?(2019) LEITE, Maria Alvim; ASSIS, Maira Macario de; CARMO, Ariene Silva do; COSTA, Bruna Vieira de Lima; CLARO, Rafael Moreira; CASTRO, Ines Rugani de; CARDOSO, Leticia de Oliveira; NETTO, Michele Pereira; MENDES, Larissa LouresObjective: To verify differences in the availability, variety, quality and price of unprocessed and ultra-processed foods in supermarkets and similar establishments in neighbourhoods with different social deprivation levels at Juiz de Fora, Minas Gerais, Brazil. Design: Cross-sectional study. Setting: The Obesogenic Environment Study in Sao Paulo's Food Store Observation Tool (ESAO-S) was applied in thirty-three supermarket chains, wholesale and retail supermarkets. Results: Fruits, vegetables and ultra-processed foods were available in almost all establishments, without differences according to Health Vulnerability Index (HVI; which varies from 0 to 1 point and the higher the worse; P > 0 center dot 05). Most establishments were concentrated in low vulnerability areas and offered healthy foods with greater variety and quality, despite higher prices. The Healthy Food Store Index (HFSI; which varies from 0 to 16 points and the higher the best) was calculated from the ESAO-S and the mean score was 8 center dot 91 (sd 1 center dot 51). The presence and variety of unprocessed foods count as positive points, as do the absence of ultra-processed products. When HFSI was stratified by HVI, low HVI neighbourhoods presented higher HFSI scores, compared with medium, high and very high HVI neighbourhoods (P = 0 center dot 001). Conclusions: Supermarkets and similar establishments are less dense in areas of greater social deprivation and have lower prices of healthy foods, but the variety and quality of those foods are worse, compared with areas of low vulnerability. We found worse HFSI for supermarkets located in areas with greater vulnerability. Those findings can guide specific public policies improving the urban food environment.
- Malnutrition in mother-child dyads in the Brazilian National Survey on Child Nutrition (ENANI-2019)(2023) FARIAS, Dayana Rodrigues; ANJOS, Luiz Antonio dos; FREITAS, Maiara Brusco de; BERTI, Talita Lelis; ANDRADE, Pedro Gomes; ALVES-SANTOS, Nadya Helena; LEITE, Maria Alvim; RAYMUNDO, Carlos Eduardo; LACERDA, Elisa Maria de Aquino; BOCCOLINI, Cristiano Siqueira; CASTRO, Ines Rugani Ribeiro de; KAC, GilbertoMalnutrition affects billions of individuals worldwide and represents a global health challenge. This study aimed to determine the prevalence of malnutri-tion (undernutrition or overweight) among mother-child dyads in children under 5 years old in Brazil in 2019 and to estimate changes in this preva-lence from 2006 to 2019. Individual-level data from the Brazilian National Survey on Child Nutrition (ENANI-2019) and the Brazilian National Survey of Demography and Health of Women and Children carried out in 2006 (PNDS 2006) were analyzed. Malnutrition outcomes in mother-child dyads included overweight mother and child, undernourished mother and child, and the double burden of malnutrition, i.e., overweight mother and child having any form of undernourishment (stunting, wasting, or underweight). Prevalence and 95% confidence intervals (95%CI) were estimated. Most women (58.2%) and 9.7% of the children were overweight, 6.9% were stunted, and 3.1% of mothers and 2.9% of the children were underweight. The preva-lence of overweight in the mother-child dyad was 7.8% and was statistically higher in Southern Brazil (9.7%; 95%CI: 7.5; 11.9) than in the Central-West (5.4%; 95%CI: 4.3; 6.6). The prevalence of overweight mother and stunted child was 3.5%, with statistically significant difference between the extremes of the mother's education [0-7 vs. >= 12 years, 4.8% (95%CI: 3.2; 6.5) and 2.1%, (95%CI: 1.2; 3.0), respectively]. Overweight in the dyad increased from 5.2% to 7.8%, and the double burden of malnutrition increased from 2.7% to 5.2% since 2006. Malnutrition in Brazilian mother-child dyads seems to be a grow-ing problem, and dyads with lower formal education, higher maternal age, and from the South Region of Brazil were more vulnerable.
- The relationship between ultra-processed food consumption and internalising symptoms among adolescents from Sao Paulo city, Southeast Brazil(2022) FAISAL-CURY, Alexandre; LEITE, Maria Alvim; ESCUDER, Maria Mercedes Loureiro; LEVY, Renata Bertazzi; PERES, Maria Fernanda TourinhoObjective: To investigate the association between ultra-processed food (UPF) consumption and internalising symptoms (IS) among adolescents. Design: It is a cross-sectional study. Paper-pencil survey was completed in classroom with information on UPF consumption, IS and selected covariates. IS were assessed with the Internalizing Symptoms sub-scale from the Social Behaviour Questionnaire (IS-SBQ). UPF was evaluated with a FFQ extracted from the Brazilian National School Health Survey. Crude and adjusted association between UPF and IS was investigated with structural equation models. Setting: Sao Paulo, SP, Brazil. Participants: A total of 2680 students, M-age = 14 center dot 85; (95 % CI 14 center dot 81, 14 center dot 88). Results: UPF consumption was associated with higher scores in IS in the crude (beta = 0 center dot 14; P < 0 center dot 001) and adjusted (beta = 0 center dot 12; P < 0 center dot 001) models. The higher the consumption of UPF, the higher is the IS score. The following variables were associated with a lower risk of UPF consumption: male sex, public school and having more meals with parents. The change in the magnitude of the standardised score was almost negligible, but the model was significantly improved with the inclusion of covariates. Conclusions: Our results provide evidence about the positive association between UPF consumption and IS among adolescents. The association, despite its low magnitude, remained significant after adjusting for potential confounders. These results are relevant considering the increase in UPF consumption worldwide and in low- and middle-income countries. Also, our study emphasises the importance of a healthy diet with a reduction in UPF consumption among adolescents.
- Availability and consumption of ultra-processed foods in schools in the municipality of Sao Paulo, Brazil: results of the SP-Proso(2021) LEITE, Maria Alvim; AZEREDO, Catarina Machado; PERES, Maria Fernanda Tourinho; ESCUDER, Maria Mercedes Loureiro; LEVY, Renata BertazziUltra-processed foods are markers of unhealthy eating patterns, and their consumption is high among adolescents. Characteristics of the school eating environment associate with student eating practices. This study aims to investigate the association between the presence of school canteens and the availability of ultra-processed foods in school canteens with the consumption of these foods, inside the school, among adolescents of the 9th grade (14 years) of the public and private schools of the city of Sao Paulo, Brazil. We conducted a cross-sectional study with SP-Proso data, in a sample of 2,680 adolescents. We elaborated multilevel linear regression models to evaluate associations between the exposures: presence of school canteens and availability of ultra-processed foods with outcomes of consumption frequency of ultra-processed foods in the school. We found an association between the presence of school canteens and the higher frequency of consumption of sausages (0.46; 95%CI: 0.24; 0.68), package snacks (0.50 95%CI: 0.19; 0.80), goodies (0.82; 95%CI: (155; L09), and sugary drinks (a 34; 95%Cl: (106; 0.62), as well as a score of consumption frequency of ultra-processed foods (2.37: 95%CI: 1.25; 3.48). The availability of package snacks, goodies, and sugary drinks in school canteens increased the frequency of consumption of these foods. We observed a dose-response effect between the diversity of ultra-processed foods in canteens and the frequency of consumption of these foods. A school food environment with greater availability of ultra-processed products is associated with their higher consumption in school, indicating the need to regulate the sale of food within these institutions.