Eating locations and occasions by energy and nutrients food sources among adolescents and young adultsABSTRACT
Objective This study aimed to estimate the daily energy intake and overconsumed nutrients for adolescents and young adults concerning public health based on the food source, eating location, and occasion.
Methods This study constituted a cross-sectional analysis of the 2015 Health Survey of São Paulo focusing on Nutrition with 707 adolescents (n=554, 12-19 years) and young adults (n=153, 20-30 years). Dietary intake was measured using 24 h recall, and energy, added sugars, sodium, and saturated food sources were calculated. Foods were classified using the “What We Eat in America?” classification system. Eating locations were divided into two categories-at home and away from home-for each main meal (breakfast, lunch, and dinner). Other sociodemographic and weight status variables were included. Descriptive statistics, the Wald test, and proportion rates were applied for analysis.
Results Most meals were consumed at home by 80.5% of adolescents and 66.4% of young adults. Young adults consumed more daily calories and saturated fats than adolescents. Both adolescents and young adults consumed equal daily saturated fatty acids, sodium, and added sugars away from home at dinner. Food consumed at home was consumed both at home and away from home, with the main exception of dinner, which consisted of mainly processed foods rich in saturated fatty acids, sodium, and added sugars consumed away from home.
Conclusion Adolescents and young adults had meals higher in fat, sugar and sodium away from home than those who ate at home when eaten at dinner. Public health policies and behavioral change strategies should be considered independently of where their meals are consumed but with particular attention to eating occasions.
Keywords: Adolescent; Young Adult; Diet; Food; Cross-Sectional Studies
RESUMO
Objetivo Este estudo teve como objetivo estimar a ingestão diária de energia e nutrientes de maior preocupação em saúde pública entre adolescentes e jovens adultos, com base nos alimentos fonte, local e tipo de refeição.
Métodos Este estudo é de delineamento transversal que utilizou dados do Inquérito de Saúde do Município de São Paulo 2015 (ISA-Capital) focado na Nutrição. A amostra compreendeu 707 adolescentes (n=554, 12-19 anos) e adultos jovens (n=153, 20-30 anos). O consumo alimentar foi avaliado por meio do Recordatório Alimentar de 24h (R24H) e a calculou-se as fontes de energia, açúcar de adição, sódio, e gordura saturada. Os alimentos foram classificados pelo sistema de classificação "What We Eat in America?" Os locais de alimentação foram divididos em duas categorias - “em casa” e “fora de casa” - para cada refeição principal (café da manhã, almoço e jantar). Outras variáveis sociodemográficas e antropométricas foram incluídas. Estatísticas descritivas, teste de Wald e proporções foram aplicadas para análise.
Resultados A maioria das refeições era consumida em casa por 80,5% dos adolescentes e 66,4% dos adultos jovens. Os adultos jovens consumiam mais calorias diárias e gorduras saturadas do que os adolescentes. Tanto adolescentes, quanto adultos jovens, consumiam majoritariamente ácidos graxos saturados, sódio e, açúcares de adição fora de casa, no jantar. Os alimentos consumidos em casa eram consumidos tanto em casa quanto fora de casa, com a principal exceção do jantar, que consistia, principalmente, em alimentos processados ricos em ácidos graxos saturados, sódio e açúcares de adição consumidos fora de casa.
Conclusão Adolescentes e adultos jovens apresentaram refeições mais ricas em gordura, açúcares e sódio fora de casa em comparação com aqueles que consomem em casa quando consumidos no jantar. Políticas de saúde pública e estratégias de mudança de comportamento devem ser consideradas independentemente do local onde suas refeições são consumidas, mas com especial atenção ao tipo de refeição.
Palavras-chave: Adolescente; Adulto jovem; Dieta; Alimentação; Estudos Transversal
INTRODUCTION
Food environments have been defined as physical, economic, policy, and socio-cultural spaces and as an opportunity to impact food choices and weight status [1]. Many aspects of food environments, such as eating occasions and location, meal patterns, and overall timing of dietary intake, are influenced by socio-cultural norms [2]. Thus, given the complexity of diverse food choices, eating occasion and location are intrinsically linked. Many studies [3-6] have examined eating occasions, focusing on those socially or culturally described as “breakfast,” “lunch,” “dinner,” and “in-between or smaller meals” (i.e., “snacks”) [7]. Alternatively, few studies have focused on different eating locations, such as eating at home or away from home (including restaurants, fast food, take-out food, and others) [8-12]. Thus, at the physical environmental level, individual eating patterns can be influenced by the location of food preparation and consumption [13], and a deeper understanding of this relationship is needed to guide interventions aiming to improve dietary intake.
Poor dietary intake and unhealthy weight are increasingly common among adolescents and young adults [14,15], and these may be associated with the location of where they eat their meals [7]. For example, a study of over 4,000 US individuals found that eating at home increased the chance of consuming more fruit and vegetables [16]. Conversely, consuming foods away from home was associated with increased saturated fats and decreased overall diet quality scores [17].
Evidence from high-income countries [8-10,16,17] has shown that eating away from home is associated with food sources of energy and the overconsumption of nutrients that are concerns for public health, namely saturated fats, sodium, and added sugars [18,19]. Eating away from home differs according to a country’s economic status [20]. This is especially true among younger individuals in low- and middle-income countries, who consume more discretionary foods. For example, data from the Brazilian Household Budget Survey 2008-9 regarding adolescents (n=5,266) showed that consuming foods away from home increased adolescents’ intake of baked and deep-fried snacks, soft drinks, sandwiches, pizza, and desserts [21]. Similarly, a study conducted in Santiago, Chile, with children and adolescents showed that most of the added sugars, and fat food sources were consumed at home, with sugar-sweetened beverages (SSBs) as the primary source. This suggests that eating from home can increase the intake of these nutrients instead of foods consumed at school and other venues [22]. These studies suggest that further research is needed in low- and middle-income countries. To fill this gap, this study used nutritional data from a population-based study from Sao Paulo, the largest Brazilian city, to: (i) estimate adolescents’ and young adults’ daily intake of energy and overconsumed nutrients of public health concern (i.e., saturated fats, sodium, and added sugars) by food source and eating location/occasion and (ii) determine the food sources of energy and overconsumed nutrients by eating location/occasion.
METHODS
The 2015 Health Survey of São Paulo (“ISA-Capital” in Portuguese) is a cross-sectional household survey that used two-stage cluster sampling (census tract and households), as well as regional health offices (North, Central-West, Southeast, South, and East), age (12 years or older), and sex, to estimate a representative sample of the residents of São Paulo, Brazil. The 2015 ISA-Capital was conducted according to the guidelines of the Declaration of Helsinki and approved by the Research Ethics Committee of the School of Public Health of the University of São Paulo (protocol code number: 36607614.5.0000.5421) on October 8, 2014.
Study Sample
The survey’s necessary sample size was calculated to be 4250 participants to allow for a 0.50 population proportion to be estimated, with a sampling error of 0.10 considering a 95% confidence level and a design effect 1.5. A total of 4043 participants (56.3% women, 36.3% adolescents, and young adults) agreed to participate in the 2015 ISA-Capital. Of these participants, 1742 were randomly selected to be included in the 2015 ISA-Nutrition subsample. An overview of the 2015 ISA-Capital and ISA-Nutrition, including the purpose, plan, operations, sample design, weighting procedures, analytic guidelines, response rates, and population totals, is available from previous studies [23,24].
The World Health Organization (WHO) defines adolescents as anyone between 10 and 19 years old [25], and previous studies have identified young adults as between 20-30 years old [15]. The Brazilian Statute for Children and Adolescents categorizes the age range for adolescents according to Brazilian law; thus, adolescents are considered individuals aged between 12 and 19 years. Therefore, data from individuals aged 12-30 who participated in the 2015 ISA-Nutrition and answered the 24-h dietary recall (24HR) were used for this analysis (n=707). Sociodemographic information and self-reported weight status and diet were obtained from the 2015 ISA-Capital questionnaire. The ISA-Capital employs protocols and procedures that ensure confidentiality and protect individual participants’ identities [23,24].
Variables
Categorical variables were sex (male/female), race (Caucasian/non-Caucasian), place of birth (born in São Paulo/born elsewhere), marital status (married or living with partner/single or living alone), and educational background (≤high school/college or graduate degree); for adolescents, these variables corresponded to the head of household. Continuous variables were age (years), number of people in the home, family income (Brazilian real [conversation rate: US$1.00=R$4.00]), and number of children in the household. Self-reported weight and height were used to calculate participants’ body mass index (BMI) and classify them accordantly to their weight status categories: (i) young adults’ weight status was determined using WHO cut-off points for ≥20-60-year-olds [26]; and (ii) adolescents (≥12-19 years), sex- and age-specific cut-off points were used as per the WHO BMI Z-scores [27]. A previous study found the ISA-Nutrition’s self-reported measurements valid and reliable [28].
Dietary Data
Dietary intake data were collected via an in-person interview using 24-hour dietary recall as per the automated multiple-pass method [29]. Participants were instructed to report their food consumption in household measures and food item preparation methods, ingredients, and brands to improve consistency and avoid possible bias. In this study, we used a single 24 h dietary recall, which, when administered in a sufficiently large sample, can adequately be used to estimate mean usual dietary intake [30]. Nutrient analysis (including energy, macronutrient, and micronutrient values) for the recorded foods and beverages was done using the Nutrition Data System for Research (NDSR, version 2014, University of Minnesota, USA). The NDSR utilizes the United States Department of Agriculture food database; therefore, a concordance rate of at least 80-120% for energy and macronutrient content was required to establish an equivalence of local foods to NDSR foods. Added sugars included monosaccharides, disaccharides added as caloric sweeteners, and white sugar included in recipes (beverages or foods). Total sodium intake comprises the sodium naturally present in food that is added for flavor during preparation. Saturated fat constitutes the intake of Saturated Fatty Acids (SFAs) (no double bonds) [31].
The “What We Eat in America” food classification system [32] has been adapted and used to classify all foods consumed in Brazil and seven other Latin American countries [18,33]. For the adaptation, data from over 9,000 individuals were used to create an extensive database listing the energy and nutrient content of all foods and beverages consumed by this population. Under this food classification system, each food code is assigned to one of 131 food categories (e.g., pizza; ready-to-eat cereals, higher in sugar; and milk, whole), which are organized within subgroups (n=46; e.g., mixed dishes-pizza; ready-to-eat cereals; milk, respectively) and significant groups (n=15; e.g., mixed containers; grains; milk and dairy, respectively). Different eating habits are observed as the ISA-Capital targets a representative sample of individuals living in Brazil’s largest city. This yields the need to include new food items in specific mixed-dish categories, such as bean-mixed dishes (e.g., feijoada and acarajé [fried bean cake]), pasta-mixed dishes, and Asian (mainly Japanese)-mixed dishes.
For each food or beverage reported in the 24 h dietary recall, each participant was asked to indicate the location where they ate/drank it. These were classified into two eating locations: (i) at home, including participants’, family members, and friend’s homes, and (ii) away from home, including community centers, work, school, and restaurants (e.g., dining, take-out, and fast-food restaurants). Meals were based on the time when food was consumed: 6-10 am for breakfast, 12-3 pm for lunch, and 6-9 pm for dinner. Eating occasions, focusing on those socially or culturally, was described as “breakfast,” “lunch,” “dinner,” and “in-between or smaller meals” (i.e., “snacks”). Everything that did not comprehend these times was considered “in-between meals” [7].
Data Analysis
All analyses used Stata (version 13.1., 2013, College Station, Texas, USA). Descriptive statistics were calculated for participants’ socio-demographic characteristics. Stratified by age groups, the Wald test was calculated to verify the mean [standard deviation (SD)] differences between eating locations and nutrients consumed. Food energy sources added sugars, sodium, and saturated fats were estimated in the proportions (frequency, percentage) consumed in each eating location. Sample weights, clusters, and strata were considered for the complex study design to ensure the study's representativeness. A significant level of 5% (p<0.05) was considered for all tests.
RESULTS
Table 1 presents adolescents’ and young adults’ sociodemographic and lifestyle characteristics. The majority (52.22%) of participants self-identified as men. Mean (SE) age was 15.61 (0.10) years for adolescents and 23.91 (0.26) years for young adults. Most meals were consumed at home for adolescents (80.5%) and young adults (66.40%). Table 2 shows energy and overconsumed nutrient (i.e., added sugars, sodium, and saturated fats) intake by eating location and occasion. Young adults showed a significantly higher intake of calories and saturated fats than adolescents. Both young adults and adolescents also showed a significantly higher intake of saturated fats, sodium, and added sugars consumed at dinner away from home than at home. Tables 3and4 present the top food contributors of energy and overconsumed nutrients of public health concerns according to different eating locations and occasions.
Regarding total energy consumption, the top five food/beverage sources ranged from 26.54%-75.42% (adolescents) and 23.65-82.65% (young adults) of total energy consumed at home or away from home: rice, yeast bread, beef, excludes ground, chicken, whole pieces and beans, peas, legumes. The top three food energy sources among adolescents at breakfast and lunch were the same at home and away from home (yeast bread, whole milk, margarine for breakfast, rice, beans, peas; legumes; and fruit drinks for lunch). The top three food energy sources among young adults at breakfast were similar at home (sugars and honey [13.85%], margarine [12.96%], and whole milk [12.69%]) and away from home (flavored powder [24.67%], whole milk [14.85%], and margarine [13.48%]). The main difference was what was consumed at home and away from home at dinner: at home, the top three dishes were rice; beans, peas, and legumes; and citrus juice (young adults) or soft drinks (adolescents), while away from home, adolescents ate beef (excluding ground beef), followed by pasta-mixed dishes (excluding macaroni and cheese) and pork, and young adults ate pasta (noodles) and cooked grains, followed by beef (excluding ground beef) and then salad dressing and vegetable oil.
The five ranked food sources consumed at home on relative proportions of saturated fat were 26.66% and 78.98% for adolescents and young adults, respectively. Adolescents and young adults consumed similar saturated fat sources during breakfast at home: margarine, yeast bread, and whole milk. However, there were differences in the foods consumed at breakfast away from home: adolescents consumed pizza (16.65%), yeast bread (13.44%), and butter and animal fats (10.66%), whereas young adults consumed whole milk (15.04%), margarine (9.45%), and crackers (excluding saltines) (7.09%). Foods consumed between age groups were also similar at lunch: the most popular food was beef (excluding ground beef) (adolescents: 16.41%; young adults: 11.18%), followed by chicken (whole pieces) (adolescents: 15.14%; young adults: 10.65%). Differences were found in foods consumed at lunch away from home; adolescents ate chicken (whole pieces) (10.99%), turnovers and other grain-based items (7.05%), and French fries and other fried white potatoes (6.52%). In contrast, young adults ate beef (excluding ground beef) (12.82%), cold cuts and cured meats (6.40%), and chocolate candy (4.78%). For dinner, both adolescents and young adults consumed the same top saturated fat food - beef (excluding ground beef) - at home (adolescents, 9.12%; young adults: 15.21%) and away from home (adolescents: 11.38%; young adults: 28.47%).
The five ranked food sources consumed at home on relative proportions of sodium were 37.29% and 93.14% for adolescents and young adults. Adolescents and young adults consumed similar foods during breakfast at home: adolescents ate yeast bread (13.67%), whole milk (13.44%), margarine (12.02%), and flavored powder (9.05%), and young adults consumed whole milk (13.75%), margarine (11.58%), and flavored powder (9.05%). The top three sodium sources for adolescents were the same for lunch and dinner: 1) rice, 2) beans, peas, legumes, and 3) beef (excluding ground beef), with variations in the contribution percentages. Regarding young adults’ lunch and dinner at home, rice and beans, peas, and legumes took first and second place for both meals. However, sodium sources away from home differed; at lunch, they ate tortilla, corn, other chips (18.24%), rice (10.03%), and pasta-mixed dishes (excluding macaroni and cheese) (6.41%), while for dinner, they ate frankfurter sandwiches (17.12%), meat-mixed dishes (13.86%), and pizza (12.36%).
Regarding consumption of added sugar, the top five food/beverage sources of added sugar ranged from 22.78-75.74% (adolescents) and 25.25-65.92% (young adults) at home or away from home on the three eating occasions: white sugar granulated, whole milk, coffee, fruit drinks, and soft drinks. The top added sugar source consumed by adolescents and young adults during breakfast at home and away from home was sugars and honey (18.82%, 17.38%, and 20.83%; 24.39%). At lunch, differences were observed between age groups for food eaten at home and away from home: adolescents consumed soft drinks (18.24%), meat-mixed dishes (13.39%), and tomato-based condiments (8.92%) at home and fruit drinks (11.93%), frankfurter sandwiches (9.13%), and tomato-based sauces (6.72%) away from home. At lunch, young adults consumed meat-mixed dishes (19.56%), citrus juice (17.23%), non-chocolate candy (11.17%) at home and soft drinks (26.38%), sugars and honey (20.21%), and citrus juice (15.17%) away from home. At dinner, mainly sweetened were important sources of added sugar - at home: fruit drinks (adolescents: 7.35%; young adults: 12.25%), away from home: soft drinks (adolescents: 10.46%; young adults 24.1%). The sweets: non-chocolate candy, cakes and pies, cookies and brownies, ice cream, and frozen dairy desserts were top sugar sources at dinner and lunch in both eating locations.
DISCUSSION
This study assessed the food sources of energy and overconsumed nutrients of public health concerns among adolescents and young adults according to their eating locations and occasions. In Brazil, adolescents and young adults consume most meals at home. Results showed that only at dinner, meals away from home tended to be higher in SFAs, sodium, and added sugars than those at home. Overall, young adults had a higher intake of calories and SFAs than adolescents. Even without considering eating occasion, this finding is similar to another study with Brazilian adolescents (n=36,956), which found a relatively large proportion of their daily calories and added sugars came from away-from-home sources [34].
The most significant calorie contributors for both age groups at home and away from home were milk, yeast bread, and margarine, commonly eaten for breakfast [35]. At lunch and dinner, core foods, including rice, beans, and meat, are considered important for dietary habits and are the most consumed foods in Brazil [36]. For dinner, pasta was frequently consumed away from home, while rice and beans were commonly eaten at home. We observed that sodium sources mainly corresponded to breakfast, lunch, and dinner core foods, especially for away-from-home dinner non-core foods such as frankfurter sandwiches, meat-mixed dishes, and pizza. Awareness of sodium in processed foods and controlling sodium use in the food industry is just as important as being conscious of adding salt in food preparation at home [37]. This point is particularly relevant because Brazilians consume, on average, 9.34 g of salt per day - almost double what the WHO recommends (5 g). The perception of high sodium consumption could be higher, suggesting that sodium added while cooking at home may be neglected, and our environment can contribute to this practice [38].
SSBs, soft drinks, and fruit drinks (e.g., artificial fruit juice) were among the top energy sources and added sugars at home and away from home for adolescents and young adults. Furthermore, citrus juice (e.g., natural orange juice and lemonade) was frequently drunk at home. These results are consistent with nationwide studies conducted with Brazilian and Latin American participants aged 12+ who indicated a preference for these beverages [18,39]. In addition to beverages, sugars, and honey were the main sources of added sugars at breakfast. Nonchocolate candy was frequently consumed at dinner, followed by cakes and pies, ice cream and frozen dairy desserts, and cookies and brownies. These results are consistent with a food consumption pattern characteristic of Brazilians in this age group that has already been reported by extensive studies such as the Brazilian Study of Cardiovascular Risks in Adolescents and the Brazilian Household Budget Survey [40,41]. However, emphasizing that poor weight perception is related to unhealthy eating habits is critical [41].
The main contributing foods for saturated fat were butter and animal fats, margarine, beef, chicken, milk, bread, and crackers, which were similar to what was found for sodium and added sugars; the major differences corresponded to meals away from home for both lunch and dinner in the type of foods consumed (e.g., French fries, pizza, and chocolate candy). These processed foods are often consumed away from home [42,43].
Adolescents’ overall diet quality needs improvement (mean score=54.46/100 [0.56]), as does their saturated fat intake (mean score=6.50 [0.17] out of 10) and total calorie intake from solid fats, alcohols, and added sugars (SoFAAS) (mean score=7.62/20 [0.29]) according to a previous study of ISA-Capital 2015 data [44]. Similarly, a study using Brazilian Household Budget Survey data showed that people who frequently consumed SoFAAS had a higher intake of SSBs, cookies, cakes, processed meats, chips, candy, chocolate, sandwiches, and snacks than those who moderately consumed SoFAAS [45]. These results underscore the importance of promoting healthy diets both at home and away from home. Family-based interventions that clarify the associations between food choices and health-related problems and multiple-component interventions, including parents’ involvement, cooking classes, and private counseling, may result in improved dietary behaviors in these populations [46-48].
The food environment and the greater availability of places close to home and food marketing may contribute to the consumption of industrialized foods that usually have high amounts of saturated fat, sodium, and added sugars. In this regard, important measures, such as the front labeling of foods was a significant advance for Brazil; the measure that aims to reduce the specific consumption of these three nutrients of most important concern in public health can contribute to consumers making healthy food choices improving diet quality of these populations evaluated [49].
The current study had two unique strengths. First, it targeted a representative sample of individuals living in the most prominent Brazilian city, differentiating it from other studies that have analyzed the dietary intake and consumed foods from non-representative samples in Brazil and other low- and middle-income countries [17,22,42]. Second, the study involved an integrative diet analysis by analyzing food groups through a version of the food classification system adapted to represent foods commonly consumed in the Brazilian context.
Nevertheless, despite these strengths, the study has several limitations. First, the study relied on self-reported measures of food consumption, which may limit the objectivity of the results. Second, participants were recruited from a single Brazilian city, which may limit the generalizability of the study findings to other Brazilian populations and temporal lapse between the data collection and the publication due to possible changes in population profile and food consumption. Finally, some foods were classified as mixed dishes based on standardized recipes, which may underestimate mixed dishes and homemade fast foods outside the standardized recipes. Additionally, the food classification system may need to be revised to better distinguish between ready-to-eat dishes (e.g., frozen meals) and dishes made from scratch. Nevertheless, ready-to-eat dishes are irrelevant energy contributors in the Brazilian diet because they represent less than 5% of the total daily energy consumed.
CONCLUSION
Young adults from São Paulo consumed more calories and saturated fats than adolescents. Adolescents and young adults consumed higher amounts of saturated fats, added sugars, and sodium for dinner away from home than at home. Foods and beverages with the highest energy, saturated fat, and sodium content consumed at home and away from home were similar, except those eaten for dinner. Based on the results, public health policies and behavioral change strategies should be considered in the context of adolescents and young adults regardless of eating location, as these age groups are exposed to large amounts of food sources of sugars, sodium, and saturated fats. Regarding eating occasions, special attention should be paid to the 6-9 pm (dinner) period and main meals outside the home.
REFERENCES
-
1. Swinburn B, Vandevijvere S, Kraak V, Sacks G, Snowdon W, Hawkes C, et al. Monitoring and benchmarking government policies and actions to improve the healthiness of food environments: A proposed Government Healthy Food Environment Policy Index. Obes Rev. 2013;14 Suppl 1:24-37. https://doi.org/10.1111/obr.12073
» https://doi.org/10.1111/obr.12073 -
2. Bronfenbrenner U. Ecology of the family as a context for human development: Research perspectives. Dev Psychol. 1986;22(6):723-42. https://doi.org/10.1037/0012-1649.22.6.723
» https://doi.org/10.1037/0012-1649.22.6.723 -
3. Nishi SK, Jessri M, L'Abbé M. Assessing the dietary habits of Canadians by eating location and occasion: Findings from the Canadian Community Health Survey, Cycle 2.2. Nutrients. 2018;10(6):682. https://doi.org/10.3390/nu10060682
» https://doi.org/10.3390/nu10060682 -
4. Myhre JB, Loken EB, Wandel M, Andersen LF. The contribution of snacks to dietary intake and their association with eating location among Norwegian adults - results from a cross-sectional dietary survey. BMC Public Health. 2015;15:369. https://doi.org/10.1186/s12889-015-1712-7
» https://doi.org/10.1186/s12889-015-1712-7 -
5. Rauber F, Martins CA, Azeredo CM, Leffa PS, Louzada MLC, Levy RB. Eating context and ultra-processed food consumption among UK adolescents. Br J Nutr. 2021;127(1):112-22. https://doi.org/10.1017/S0007114521000854
» https://doi.org/10.1017/S0007114521000854 -
6. Hammons A, Olvera N, Teran-Garcia M, Villegas E, Fiese B. Mealtime resistance: Hispanic mothers' perspectives on making healthy eating changes within the family. Appetite. 2021;159:105046. https://doi.org/10.1016/j.appet.2020.105046
» https://doi.org/10.1016/j.appet.2020.105046 -
7. Leech RM, Worsley A, Timperio A, McNaughton SA. Understanding meal patterns: Definitions, methodology, and impact on nutrient intake and diet quality. Nutr Res Rev. 2015;28(1):1-21. https://doi.org/10.1017/S0954422414000262
» https://doi.org/10.1017/S0954422414000262 -
8. Matsumoto M, Saito A, Okada C, Okada E, Tajima R, Takimoto H. Consumption of meals prepared away from home is associated with inadequate dietary fiber, vitamin C and mineral intake among Japanese adults: Analysis from the 2015 National Health and Nutrition Survey. Nutr J. 2021;20(1):40. https://doi.org/10.1186/s12937-021-00693-6
» https://doi.org/10.1186/s12937-021-00693-6 -
9. Du Y, Rong S, Sun Y, Liu B, Wu Y, Snetselaar LG, et al. Association between frequency of eating away-from-home meals and risk of all-cause and cause-specific mortality. J Acad Nutr Diet. 2021;121(9):1741-9. https://doi.org/10.1016/j.jand.2021.01.012
» https://doi.org/10.1016/j.jand.2021.01.012 -
10. Auchincloss AH, Li J, Moore KAB, Franco M, Mujahid MS, Moore LV. Are neighborhood restaurants related to the frequency of restaurant meals and dietary quality? Prevalence and changes over time in the Multi-Ethnic Study of Atherosclerosis. Public Health Nutr. 2021;24(14):4630-41. https://doi.org/10.1017/S1368980021002196
» https://doi.org/10.1017/S1368980021002196 -
11. Mandracchia F, Tarro L, Llaurado E, Valls RM, Sola R. Interventions to promote healthy meals in full-service restaurants and canteens: A systematic review and meta-analysis. Nutrients. 2021;13(4):1350. https://doi.org/10.3390/nu13041350
» https://doi.org/10.3390/nu13041350 -
12. Kelly C, Callaghan M, Gabhainn SN. 'It's Hard to Make Good Choices, and It Costs More': Adolescents' perception of the external school food environment. Nutrients. 2021;13(4):1043. https://doi.org/10.3390/nu13041043
» https://doi.org/10.3390/nu13041043 -
13. Story M, Kaphingst KM, Robinson-O'Brien R, Glanz K. Creating healthy food and eating environments: Policy and environmental approaches. Annu Rev Public Health. 2008;29 1 ):253-72. https://doi.org/10.1146/annurev.publhealth.29.020907.090926
» https://doi.org/10.1146/annurev.publhealth.29.020907.090926 -
14. Livingstone KM, Abbott G, Lamb KE, Dullaghan K, Worsley T, McNaughton SA. Understanding meal choices in young adults and interactions with demographics, diet quality, and health behaviors: A discrete choice experiment. J Nutr. 2021;151(8):2361-71. https://doi.org/10.1093/jn/nxab106
» https://doi.org/10.1093/jn/nxab106 -
15. Leme ACB, Haines J, Tang L, Fisberg M, Ferrari G, Silva VA, et al. Association between weight control behaviors and diet quality among Brazilian adolescents and young adults: Health Survey of São Paulo with focus on nutrition, 2015. Eat Weight Disord. 2022;27(2):605-18. https://doi.org/10.1007/s40519-021-01198-1
» https://doi.org/10.1007/s40519-021-01198-1 -
16. Kegler MC, Hermstad A, Haardorfer R. Home food environment and associations with weight and diet among U.S. adults: A cross-sectional study. BMC Public Health . 2021;21(1):1032. https://doi.org/10.1186/s12889-021-11102-2
» https://doi.org/10.1186/s12889-021-11102-2 -
17. Moyeda-Carabaza AF, Githinji P, Nguyen B, Murimi M. The influence of frequent consumption of foods away from home on the total diet quality and weight status among faculty and staff. J Am Coll Health. 2021;71(1):292-9. https://doi.org/10.1080/07448481.2021.1891081
» https://doi.org/10.1080/07448481.2021.1891081 -
18. Fisberg RM, Leme ACB, Previdelli AN, Mello AV, Martinez AG, Sales CH, et al. Contribution of food groups to energy, grams, and nutrients-to-limit: The Latin American study of nutrition and health/Estudio Latino Americano de Nutricion y Salud (ELANS). Public Health Nutr. 2021;24(9):2424-36. https://doi.org/10.1017/S136898002100152X
» https://doi.org/10.1017/S136898002100152X -
19. Leme AC, Baranowski T, Thompson D, Philippi S, O'Neil C, Fulgoni V, et al. Top food sources of the percentage of energy, nutrients to limit and total gram amount consumed among US adolescents: National Health and Nutrition Examination Survey 2011-2014. Public Health Nutr . 2019;22(4):661-71. https://doi.org/10.1017/S1368980018002884
» https://doi.org/10.1017/S1368980018002884 -
20. Leme ACB, Hou S, Fisberg RM, Fisberg M, Haines J. Adherence to food-based dietary guidelines: A systemic review of high-income and low- and middle-income countries. Nutrients. 2021;13(3):1038. https://doi.org/10.3390/nu13031038
» https://doi.org/10.3390/nu13031038 -
21. Cunha DB, Bezerra IN, Pereira RA, Sichieri R. At-home and away-from-home dietary patterns and BMI z-scores in Brazilian adolescents. Appetite. 2018;120:374-80. https://doi.org/10.1016/j.appet.2017.09.028
» https://doi.org/10.1016/j.appet.2017.09.028 -
22. Rebolledo N, Reyes M, Corvalán C, Popkin BM, Smith Taillie L. Dietary intake by food source and eating location in low- and middle-income Chilean preschool children and adolescents from southeast Santiago. Nutrients. 2019;11(7):1695. https://doi.org/10.3390/nu11071695
» https://doi.org/10.3390/nu11071695 -
23. Alves M, Escuder MML, Goldbaum M, Barros MBA, Fisberg RM, Cesar CLG. Sampling plan in health surveys, São Paulo, Brazil, 2015. Rev Saúde Pública. 2018;52:81. https://doi.org/10.11606/s1518-8787.2018052000471
» https://doi.org/10.11606/s1518-8787.2018052000471 -
24. Fisberg RM, Sales CH, Fontanelli MM, Pereira JL, Alves MCGP, Escuder MML, et al. 2015 health survey of São Paulo with focus in nutrition: Rationale, design, and procedures. Nutrients. 2018;10(2):169. https://doi.org/10.3390/nu10020169
» https://doi.org/10.3390/nu10020169 - 25. World Health Organization. Adolescence health: Overview. Switzerland: World Health Organization; 2021.
- 26. World Health Organization. Body mass index - BMI. Switzerland: World Health Organization ; 2010.
-
27. Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007;85(9):660-7. https://doi.org/10.2471/blt.07.043497
» https://doi.org/10.2471/blt.07.043497 -
28. Teixeira IP, Pereira JL, Barbosa JPAS, Mello AV, Onita BM, Fisberg RM, et al. Validity of self-reported body mass and height: relation with sex, age, physical activity, and cardiometabolic risk factors. Rev Bras Epidemiol. 2021;24:e210043. https://doi.org/10.1590/1980-549720210043
» https://doi.org/10.1590/1980-549720210043 -
29. Moshfegh AJ, Rhodes DG, Baer DJ, Murayi T, Clemens JC, Rumpler WV, et al. The US department of agriculture's automated multiple-pass method reduces bias in the collection of energy intakes. Am J Clin Nutr. 2008;88(2):324-32. https://doi.org/10.1093/ajcn/88.2.324
» https://doi.org/10.1093/ajcn/88.2.324 -
30. Naska A, Lagiou A, Lagiou P. Dietary assessment methods in epidemiological research: Current state of the art and prospects. F1000Res. 2017;6:926. https://doi.org/10.12688/f1000research.10703.1
» https://doi.org/10.12688/f1000research.10703.1 -
31. Nutrition Coordinating Center. Nutrition data system for research 2014 user manual. University of Minnesota; 2014 [cited 2023 Jan 15]. Available from: Available from: http://www.ncc.umn.edu/products/ndsr-user-manual/
» http://www.ncc.umn.edu/products/ndsr-user-manual/ -
32. Rhodes DG, Adler ME, Clemens JC, Moshfegh AJ. What we eat in America food categories and changes between survey cycles. J Food Compos Anal. 2017;64:107-11. https://doi.org/10.1016/j.jfca.2017.07.018
» https://doi.org/10.1016/j.jfca.2017.07.018 -
33. Leme ACB, Fisberg RM, Mello AV, Sales CH, Ferrari G, Haines J, et al. Food Sources of Shortfall Nutrients among Latin Americans: Results from the Latin American Study of Health and Nutrition (ELANS). Int J Environ Health Res Pub Health. 2021;18(9):4967. https://doi.org/10.3390/ijerph18094967
» https://doi.org/10.3390/ijerph18094967 -
34. Morais SR, Bezerra IN, Souza AM, Vergara C, Sichieri R. Eating away from home and biomarkers for chronic noncommunicable diseases in Brazilian adolescents. Cad Saúde Pública. 2021;37(1):e00219619. https://doi.org/10.1590/0102-311X00219619
» https://doi.org/10.1590/0102-311X00219619 -
35. Pereira JL, Castro MA, Hopkins S, Gugger C, Fisberg RM, Fisberg M. Prevalence of consumption and nutritional content of breakfast meal among adolescents from the Brazilian National Dietary Survey. J Pediatr. 2018;94(6):630-41. https://doi.org/10.1016/j.jped.2017.10.004
» https://doi.org/10.1016/j.jped.2017.10.004 -
36. Souza AM, Pereira RA, Yokoo EM, Levy RB, Sichieri R. Most consumed foods in Brazil: National dietary survey 2008-2009. Rev Saúde Pública . 2013;47 Suppl 1:190S-9S. https://doi.org/10.1590/s0034-89102013000700005
» https://doi.org/10.1590/s0034-89102013000700005 -
37. Mello AV, Fisberg M, Previdelli AN, Ferrari GLM, França NAG, Kovalskys I. Dietary sources of sodium among Brazilian population: Data from Latin American Nutrition and Health Study (ELANS). Nutr Clín Diet Hosp. 2019;39(1):14-21. https://doi.org/10.12873/391veroneze
» https://doi.org/10.12873/391veroneze -
38. Mill JG, Malta DC, Machado IE, Pate A, Pereira CA, Jaime PC, et al. Estimativa do consumo de sal pela população brasileira: Resultado da Pesquisa Nacional de Saúde 2013. Rev Bras Epidemiol . 2019;22 Suppl 2:E190009.SUPL.2. https://doi.org/10.1590/1980-549720190009.supl.2
» https://doi.org/10.1590/1980-549720190009.supl.2 -
39. Rocha LL, Pessoa MC, Gratao LHA, Carmo AS, Cunha CF, Oliveira TRPR, et al. Health behavior patterns of sugar-sweetened beverage consumption among Brazilian adolescents in a nationally representative school-based study. PLos One. 2021;16(1):e0245203. https://doi.org/10.1371/journal.pone.0245203
» https://doi.org/10.1371/journal.pone.0245203 -
40. Borges CA, Marchioni DML, Levy RB, Slater B. Dietary patterns associated with overweight among Brazilian adolescents. Appetite. 2018;123:402-9. https://doi.org/10.1016/j.appet.2018.01.001
» https://doi.org/10.1016/j.appet.2018.01.001 -
41. Silva SU, Alves MA, Vasconcelos FAG, Gonçalves VSS, Barufaldi LA, Carvalho KMB. Association between body weight misperception and dietary patterns in Brazilian adolescents: Cross-sectional study using ERICA data. PLos One . 2021;16(9):e0257603. https://doi.org/10.1371/journal.pone.0257603
» https://doi.org/10.1371/journal.pone.0257603 -
42. Bezerra IN, Sichieri R. Characteristics and spending on out-of-home eating in Brazil. Rev Saúde Pública . 2010;44(1):221-9. https://doi.org/10.1590/s0034-89102010000200001
» https://doi.org/10.1590/s0034-89102010000200001 -
43. Bezerra IN, Medeiros HB, Moura Souza A, Sichieri R. Contribution of away-from-home food to the energy and nutrient intake among Brazilian adolescents. Public Health Nutr . 2021;24(11):3371-8. https://doi.org/10.1017/S1368980020001573
» https://doi.org/10.1017/S1368980020001573 -
44. Mello AV, Sarti FM, Pereira JL, Goldbaum M, Cesar CLG, Alves MCGP, et al. Determinants of inequalities in the quality of Brazilian diet: Trends in a 12-year population-based study (2003-2015). Int J Equity Health. 2018;17(1):72. https://doi.org/10.1186/s12939-018-0784-2
» https://doi.org/10.1186/s12939-018-0784-2 -
45. Monteiro LS, Rodrigues PRM, Sichieri R, Pereira RA. Intake of saturated fat, trans fat, and added sugars by the Brazilian population: An indicator to evaluate diet quality. Eu J Clin Nutr. 2020;74(9):1316-24. https://doi.org/10.1038/s41430-020-0582-y
» https://doi.org/10.1038/s41430-020-0582-y -
46. Leme ACB, Philippi ST, Thompson D, Nicklas T, Baranowski T. "Healthy Habits, Healthy Girls-Brazil": An obesity prevention program with added focus on eating disorders. Eat Weight Disord . 2019;24(1):107-19. https://doi.org/10.1007/s40519-018-0510-5
» https://doi.org/10.1007/s40519-018-0510-5 -
47. Leme AC, Philippi ST. The "Healthy Habits, Healthy Girls" randomized controlled trial for girls: Study design, protocol, and baseline results. Cad Saúde Pública . 2015;31(7):1381-94. https://doi.org/10.1590/0102-311X00136014
» https://doi.org/10.1590/0102-311X00136014 -
48. Tang L, Broad J, Lewis R, Ma DWL, Haines J; Guelph Family Health S. Transitioning a home-based, motivational interviewing intervention among families to remote delivery during the COVID-19 pandemic: Key lessons learned. Patient Educ Couns. 2021;104(9):2286-91. https://doi.org/10.1016/j.pec.2021.02.043
» https://doi.org/10.1016/j.pec.2021.02.043 -
49. Sousa IC, Mucinhato RMD, Prates CB, Zanin LM, Cunha DT, Capriles VD, et al. Do Brazilian consumers intend to use food labels to make healthy food choices? An assessment before the front-of-package labeling policy. Food Res Int. 2023;172:113107. https://doi.org/10.1016/j.foodres.2023.113107
» https://doi.org/10.1016/j.foodres.2023.113107
Publication Dates
-
Publication in this collection
20 Sept 2024 -
Date of issue
2024
History
-
Received
31 Mar 2023 -
Reviewed
21 July 2023 -
Accepted
20 Feb 2024
