GIOVANNA CALIXTO ANDRADE
Projetos de Pesquisa
Unidades Organizacionais
LIM/38 - Laboratório de Epidemiologia e Imunobiologia, Hospital das Clínicas, Faculdade de Medicina
14 resultados
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- Ultra-processed food consumption and NCD-related dietary nutrient profile in a national sample of French children and adolescents(2023) ANDRADE, Giovanna Calixto; JULIA, Chantal; DESCHAMPS, Valerie; SROUR, Bernard; HERCBERG, Serge; KESSE-GUYOT, Emmanuelle; ALLES, Benjamin; CHAZELAS, Eloi; DESCHASAUX, Melanie; TOUVIER, Mathilde; LEVY, Renata BertazziAim The consumption of ultra-processed food (UPF) and its impact on diet quality has been extensively studied and reported in the literature, but only a few studies have focused on children and adolescents. The present study therefore aimed to describe UPF consumption in a representative sample of French children and adolescents and to evaluate its association with diet quality. Methods The study included 1146 children and teenagers (3-17 years old) from the cross-sectional French Nutrition and Health Study 2006/2007 who completed three 24-hour food recalls over a period of 15 days. Food consumption was described using the NOVA classification. Regression models were used to estimate the association between UPF consumption and diet quality. Results The UPF dietary share in children and adolescents represented 44.2% and 44.5% of total energy intake respectively. In both age groups, UPF consumption was positively associated with dietary energy density and total carbohydrate and free sugars content, but negatively associated with dietary contents of protein, fiber, and potassium. UPF consumption also showed a positive association with inadequate intakes of energy density, free sugars, fiber, and potassium among children, and inadequate consumption of fiber and free sugars among teenagers. Conclusion Higher UPF consumption among French children and adolescents is associated with a lower quality diet.
- Promotion of ultra-processed foods in Brazil: combined use of claims and promotional features on packaging(2023) ANDRADE, Giovanna Calixto; MAIS, Lais Amaral; RICARDO, Camila Zancheta; DURAN, Ana Clara; MARTINS, Ana Paula BortolettoOBJECTIVE: To assess the availability of different promotional strategies applied for UPF sales in Brazilian food retailers. METHODS: Information available on food packaging was gathered from all packaged products sold in the five largest food retail chains in Brazil in 2017. UPF were identified using the NOVA food classification system. From this sample, data related to promotional characteristics, nutrition claims and health claims were collected and coded using the INFORMAS methodology. Additional claims referring to the Brazilian Dietary Guidelines were also collected. RESULTS: This study evaluated the packaging of 2,238 UPF, of which 59.8% presented at least one promotional strategy. Almost one third denoted a simultaneous use of different promotional strategies in the same packaging. Nutrition claims were the most commonly found promotional strategy, followed by health claims and the use of characters. The food subgroups comprising the highest prevalence of promotional strategies on their labels were: noncaloric sweeteners (100.0%), breakfast cereals and granola bars (96.2%), juices, nectars and fruit-flavoured drinks (92.9%), other unsweetened beverages (92.9%), and other sweetened beverages (92.6%). CONCLUSIONS: Considering the poor nutritional quality of UPF, the widespread presence of promotional features on their packaging highlights the need for marketing restrictions on this kind of product.
- The consumption of ultra-processed foods according to eating out occasions(2020) ANDRADE, Giovanna Calixto; GOMBI-VACA, Maria Fernanda; LOUZADA, Maria Laura da Costa; AZEREDO, Catarina Machado; LEVY, Renata BertazziObjective: To describe out-of-home consumption according to the purpose and extent of industrial processing and also evaluate the association between eating out and ultra-processed food consumption, taking account of variance within and between individuals. Design: Cross-sectional study. Setting: Brazil. Participants: The study was based on the Individual Food Intake of the Brazilian Household Budget Survey, carried out with 34 003 individuals aged 10 years or more, between May 2008 and May 2009. All food items were classified according to food processing level. The habit of eating out was evaluated through the frequency of days each individual reported eating out, described according to sociodemographic characteristics. The contribution of food energy per group and subgroup was estimated according to the frequency of eating out. In addition, multilevel modelling was employed to evaluate the association between eating out and ultra-processed food consumption. Results: In Brazil, culinary preparations accounted for most of the energy eaten out. However, it was possible to observe a higher contribution of ultra-processed foods, especially sugary beverages and ready-to-eat meals, as the frequency of out-of-home consumption increased. Compared with food consumption exclusively at home, eating out increased the consumption of ultra-processed foods by 0 center dot 41 percentage points within and between individuals. Conclusion: In Brazil, the same individual and different individuals had greater consumption of ultra-processed foods when they ate out of home compared with when they ate at home. So, it is necessary to implement public policies which discourage the out-of-home consumption of ultra-processed foods and that provide affordable and accessible less-processed food options.
- Whole grain products in Brazil: the need for regulation to ensure nutritional benefits and prevent the misuse of marketing strategies(2023) ANDRADE, Giovanna Calixto; MAIS, Lais Amaral; RICARDO, Camila Zancheta; DURAN, Ana Clara; MARTINS, Ana Paula BortolettoOBJECTIVE: This study aims to evaluate the use of ""whole grains"" claims in food products marketed in Brazil and evaluate the nutrient profile of these products. METHODS: Data from 775 grain-based packaged foods collected in Brazil from April to July 2017 were analyzed. Based on the INFORMAS protocol for food labeling, the prevalence of packaged foods with ""whole grains"" claims was estimated. Information on the list of ingredients was analyzed to evaluate the presence and amount of whole or refined grains in six food groups. The nutrient profiles of the products with and without ""whole grains"" claims were compared using the Pan American Health Organization (PAHO) nutrient profile model. RESULTS: The packages of about 19% of the evaluated products showed ""whole grains"" claims in their front panel. Of these, 35% lacked any whole grains among their top three ingredients. Breakfast cereals, granola bars, bread, cakes and other bakery products, cookies, and pasta had higher amounts of refined flour than whole grain ingredients in their compositions. We found 66% of products with ""whole grains"" claims were high in nutrients of concern according to PAHO's criteria. CONCLUSION: Our results showed that over a third of the products in Brazil with ""whole grains"" claims lacked whole grains as one of their main ingredients. Most had a high content of nutrients associated with noncommunicable chronic disease risk factors, indicating the overestimation of their health benefits.
- Introducing a Suite of Low-Burden Diet Quality Indicators That Reflect Healthy Diet Patterns at Population Level(2021) HERFORTH, Anna W.; WIESMANN, Doris; MARTINEZ-STEELE, Euridice; ANDRADE, Giovanna; MONTEIRO, Carlos A.Background: Few low-burden indicators of diet quality exist to track trends over time at low cost and with low technical expertise requirements. Objective: The aim was to develop and validate a suite of low-burden indicators to reflect adherence to global dietary recommendations. Methods: Using nationally representative, cross-sectional, quantitative dietary intake datasets from Brazil and the United States, we tested the association of food-group scores with quantitative consumption aligned with 11 global dietary recommendations. We updated the Healthy Diet Indicator (HDI) to include current quantifiable recommendations of the WHO (HDI-2020). We developed 3 food-group-based scores-an overall Global Dietary Recommendations (GDR) score as an indicator of all 11 recommendations composed of 2 subcomponents: GDR-Healthy, an indicator of the recommendations on ""healthy"" foods, and GDR-Limit, an indicator of the recommendations on dietary components to limit. We tested associations between these scores and the HDI-2020 and its respective subcomponents. We developed 9 dichotomous food-group-based indicators to reflect adherence to the global recommendations for fruits and vegetables, dietary fiber, free sugars, saturated fat, total fat, legumes, nuts and seeds, whole grains, and processed meats. We conducted receiver operating characteristic and sensitivity-specificity analyses to determine whether the dichotomous indicators were valid to predict adherence to the recommendations in both countries. Results: The GDR score and its subcomponents were moderately to strongly associated with the HDI-2020 and its respective subcomponents (absolute values of rank correlation coefficients ranged from 0.55 to 0.66). Of the 9 dichotomous indicators, 8 largely met the criteria for predicting individual global dietary recommendations in both countries; 1 indicator (total fat) did not perform satisfactorily. Conclusions: Food-group consumption data can be used to indicate adherence to quantitative global dietary recommendations at population level. These indicators may be used to track progress of countries and populations toward meeting WHO guidance on healthy diets.
- Ultra-processed food intake in association with BMI change and risk of overweight and obesity: A prospective analysis of the French NutriNet-Sante cohort(2020) BESLAY, Marie; SROUR, Bernard; MEJEAN, Caroline; ALLES, Benjamin; FIOLET, Thibault; DEBRAS, Charlotte; CHAZELAS, Eloi; DESCHASAUX, Melanie; WENDEU-FOYET, Meyomo Gaelle; HERCBERG, Serge; GALAN, Pilar; MONTEIRO, Carlos A.; DESCHAMPS, Valerie; ANDRADE, Giovanna Calixto; KESSE-GUYOT, Emmanuelle; JULIA, Chantal; TOUVIER, MathildeBackground Ultra-processed food (UPF) consumption has increased drastically worldwide and already represents 50%-60% of total daily energy intake in several high-income countries. In the meantime, the prevalence of overweight and obesity has risen continuously during the last century. The objective of this study was to investigate the associations between UPF consumption and the risk of overweight and obesity, as well as change in body mass index (BMI), in a large French cohort. Methods and findings A total of 110,260 adult participants (>= 18 years old, mean baseline age = 43.1 [SD 14.6] years; 78.2% women) from the French prospective population-based NutriNet-Sante cohort (2009-2019) were included. Dietary intakes were collected at baseline using repeated and validated 24-hour dietary records linked to a food composition database that included >3,500 different food items, each categorized according to their degree of processing by the NOVA classification. Associations between the proportion of UPF in the diet and BMI change during follow-up were assessed using linear mixed models. Associations with risk of overweight and obesity were assessed using Cox proportional hazard models. After adjusting for age, sex, educational level, marital status, physical activity, smoking status, alcohol intake, number of 24-hour dietary records, and energy intake, we observed a positive association between UPF intake and gain in BMI (beta Time x UPF = 0.02 for an absolute increment of 10 in the percentage of UPF in the diet, P < 0.001). UPF intake was associated with a higher risk of overweight (n= 7,063 overweight participants; hazard ratio (HR) for an absolute increase of 10% of UPFs in the diet = 1.11, 95% CI: 1.08-1.14; P < 0.001) and obesity (n = 3,066 incident obese participants; HR10% = 1.09 (1.05-1.13); P < 0.001). These results remained statistically significant after adjustment for the nutritional quality of the diet and energy intake. Study limitations include possible selection bias, potential residual confounding due to the observational design, and a possible item misclassification according to the level of processing. Nonetheless, robustness was tested and verified using a large panel of sensitivity analyses. Conclusions In this large observational prospective study, higher consumption of UPF was associated with gain in BMI and higher risks of overweight and obesity. Public health authorities in several countries recently started to recommend privileging unprocessed/minimally processed foods and limiting UPF consumption.
- Consumption of ultra-processed foods and the eating location: can they be associated?(2022) SOUZA, Thays Nascimento; ANDRADE, Giovanna Calixto; RAUBER, Fernanda; LEVY, Renata Bertazzi; LOUZADA, Maria Laura da CostaStudies indicate that eating locations can influence food choices. However, the relationship with ultra-processed foods has been little explored. The objective was to assess the association between eating locations and ultra-processed foods consumption in the UK in 2014-2016. Data from 2,449 individuals aged 4 years or older from the NDNS were analysed cross-sectionally. Food consumption information was collected through 4-day food diaries. Recorded foods were classified into NOVA system. The eating locations were grouped into nine categories (home, institutional places, sit-down restaurants, on the go, coffee shops, leisure and sports clubs, fast food, friends and relatives' house, and other places). Linear regression models were carried out. The coefficients represent the increment in the contribution of ultra-processed foods to total energy intake for each percentage point increase in the contribution of each eating location to total energy intake. Among children, consumption at home was inversely associated with ultra-processed foods consumption (beta: -0.10; 95% CI -0.17, -0.03), while in leisure and sports places (0.47; 0.20, 0.73) directly associated. For adolescents, eating at home (-0.12; -0.19, -0.05) was inversely associated with the consumption of ultra-processed foods, as well as sit-down restaurants (-0.21; -0.38, -0.03). Fast food (0.29; 0.12, 0.47) were directly associated with the consumption of ultra-processed foods for adolescents. Finally, for adults, sit-down restaurants (-0.13; -0.22, -0.03) showed to be inversely associated with the consumption of ultra-processed foods while in fast food restaurants (0.77; 0.38, 1.17) it was directly associated. Our results showed that the eating locations have different impacts on diet quality.
- Out-of-Home Food Consumers in Brazil: What Do They Eat?(2018) ANDRADE, Giovanna Calixto; LOUZADA, Maria Laura da Costa; AZEREDO, Catarina Machado; RICARDO, Camila Zancheta; MARTINS, Ana Paula Bortolleto; LEVY, Renata BertazziConsidering the increased contribution of foods consumed outside home and their potential impact on diet, this study aims to identify eating out patterns and their association with nutritional dietary quality in Brazil. We used the Individual Food Intake Survey 2008-2009, conducted with 34,003 individuals aged 10 and up. We used factor analysis by principal component to identify out-of-home eating patterns and linear regression to explore the association between patterns scores and dietary quality. We identified three food patterns. The Traditional meal pattern carried more rice, beans, meat, roots and tubers, pasta, vegetables and eggs. The typical Brazilian breakfast/tea pattern carried more fresh bread, margarine, milk, cheese and butter. The Ultra-processed food pattern carried more ready-to-eat meals and soft drinks. The traditional meal pattern was positively associated with calories from proteins, fiber, iron, potassium and sodium densities, whereas typical Brazilian breakfast/tea and ultra-processed food patterns were positively associated with energy density, the percentage of calories from lipids or carbohydrates, trans fat and free sugar. Out-of-home eating may have a negative impact on nutritional dietary quality when based on ultra-processed food. However, it is possible to maintain a healthy out-of-home diet with adherence to traditional Brazilian cuisine.
- 'We must have a sufficient level of profitability': food industry submissions to the French parliamentary inquiry on industrial food(2020) MIALON, Melissa; MIALON, Jonathan; ANDRADE, Giovanna Calixto; JEAN-CLAUDE, MoubaracIn March 2018, the French parliament launched an inquiry into industrial food and its 'nutritional quality, role in the emergence of chronic diseases, and the social and environmental impact of its origin'. Our aim was to analyse the food industry's submissions to the inquiry, particularly discussions around the role that the food industry has played in the non-communicable disease (NCD) epidemic. We studied the submissions of 23 food industry actors. We generated three main themes from our analysis: i) a redefinition of the nature and activities of the food industry, where food industry actors, for example presented themselves as part of the French culture and as experts on the science of diet and health; ii) an industry framing of the problem, with, for example, a focus on other actors in the industry and on consumers; and iii) industry preferred solutions in response to the NCD epidemic, such as reformulation, education or personal responsibility. We conclude that food industry actors' rhetoric in their submissions to the inquiry could have a potentially negative influence on the development of public health policies in France: it could slow the policy-making process and could lead to the adoption of ineffective solutions. Our findings could help policy makers, public health professionals and the public to better distinguish between the narratives that are of valid relevance for public health from those that merely serve the interests of food industry actors.
conferenceObject FOOD-BASED DIETARY PATTERNS AND NUTRITIONAL QUALITY OF MEALS IN BRAZIL (2008-2009)(2017) MACHADO, Priscila Pereira; LOUZADA, Maria Laura da Costa; ANDRADE, Giovanna; RICARDO, Camila; LEVY, Renata