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      How many meals and snacks do Brazilians eat a day? Findings from the 2017-2018 Brazilian National Dietary Survey Translated title: Quantas refeições e lanches os brasileiros fazem por dia? Resultados do Inquérito Nacional de Alimentação de 2017-2018 Translated title: ¿Cuántas comidas y meriendas tienen los brasileños por día? Resultados de la Encuesta Nacional de Alimentación 2017-2018

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          Abstract

          The habit of eating specific meals has been addressed in several studies, but the evaluation of meal patterns has received less attention. This study aimed to describe the meal patterns of the Brazilian population. A complex sampling design was used to select the 46,164 ≥ 10-year-old individuals examined in the Brazilian National Dietary Survey. Food consumption was assessed by two non-consecutive 24-hour recalls applied throughout a one-week period. The exploratory data analysis approach was used to determine the meal patterns, i.e., how individuals combined the main meals (breakfast, lunch, dinner) and snacks (morning, afternoon, evening/night) throughout the day. The most common meal patterns were three main meals + one snack, reported by 25.1% of the individuals, and three main meals + two snacks (24.6%). Other meal patterns identified were: three main meals + three snacks (18.5%); three main meals and no snacks (10.9%); one or two main meals + two snacks (7.4%); one or two main meals + one snack (6.9%); one or two main meals + three snacks (4.2%); and one or two main meals and no snacks (2.3%). Meal patterns varied according to gender and age group, and on typical versus atypical food consumption days. We found that eight patterns characterized the daily meal consumption in Brazil. Furthermore, around 80% of the population had three main meals every day and about 13% did not report having any snacks. The characterization of meal habits is important for tailoring and targeting health promotion actions.

          Translated abstract

          Os hábitos de consumo de refeições específicas têm sido abordados em diversos estudos, no entanto, a avaliação dos padrões refeições tem recebido menos atenção. O objetivo deste estudo foi descrever os padrões de refeições da população brasileira. Um desenho amostral complexo foi utilizado para selecionar os 46.164 indivíduos de ≥ 10 anos examinados no Inquérito Nacional de Alimentação de 2017-2018. O consumo alimentar foi avaliado por meio de dois recordatórios de 24 horas não consecutivos, aplicados durante um período de uma semana. A análise exploratória de dados foi utilizada para determinar os padrões de refeições, ou seja, como os indivíduos combinam as principais refeições (café da manhã, almoço, jantar) e lanches (manhã, tarde, noite) ao longo do dia. Os padrões de refeições mais frequentes foram três refeições principais + um lanche, conforme relatado por 25,1% dos indivíduos, e três refeições principais + dois lanches (24,6%). Outros padrões de refeições identificados foram: três refeições principais + três lanches (18,5%); três refeições principais e nenhum lanche (10,9%); uma ou duas refeições principais + dois lanches (7,4%); uma ou duas refeições principais + um lanche (6,9%); uma ou duas refeições principais + três lanches (4,2%); e uma ou duas refeições principais e nenhum lanche (2,3%). Os padrões de refeições variaram de acordo com o sexo e a faixa etária, e nos dias típicos em comparação com os atípicos de consumo alimentar. Verificou-se que oito padrões caracterizaram o consumo diário de refeições no Brasil. Além disso, cerca de 80% da população realizava três refeições principais diárias e cerca de 13% reportaram não lanchar. A caracterização dos padrões de refeições é importante para adequar e direcionar ações de promoção da saúde.

          Translated abstract

          Los hábitos alimenticios específicos se han abordado en varios estudios, sin embargo, poco se sabe sobre la evaluación de los patrones de alimentación. El objetivo de este estudio fue describir el patrón de alimentación de la población brasileña. Se utilizó un diseño de muestra complejo para seleccionar a 46.164 individuos de ≥ 10 años quienes participaron en la Encuesta Nacional de Alimentación 2017-2018. El consumo alimentario se evaluó mediante dos registros de 24 horas no consecutivos, aplicados durante una semana. Para determinar el patrón de alimentación, se aplicó el análisis exploratorio, es decir, cómo las personas combinan las comidas principales (desayuno, almuerzo, cena) y las meriendas (mañana, tarde, noche) a lo largo del día. Los patrones de alimentación más frecuentes fueron tres comidas principales + una merienda según informan el 25,1% de los individuos, y tres comidas principales + dos meriendas (24,6%). Otros patrones identificados destacaron tres comidas principales + tres meriendas (18,5%); tres comidas principales sin merienda (10,9%); una o dos comidas principales + dos meriendas (7,4%); una o dos comidas principales + una merienda (6,9%); una o dos comidas principales + tres meriendas (4,2%); y una o dos comidas principales sin merienda (2,3%). Los patrones de alimentación tuvieron una variación según el sexo y el grupo de edad, y en días típicos en comparación con los atípicos de consumo de alimentos. Se encontró que ocho patrones caracterizan el consumo diario de comidas en Brasil. Por lo tanto, aproximadamente el 80% de la población tienen tres comidas principales al día y aproximadamente el 13% informan que no tienen merienda. Es importante caracterizar los patrones de alimentación para adaptar y orientar las acciones de promoción de la salud.

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          Algorithm AS 136: A K-Means Clustering Algorithm

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            The US Department of Agriculture Automated Multiple-Pass Method reduces bias in the collection of energy intakes.

            The US Department of Agriculture Automated Multiple-Pass Method (AMPM) is used for collecting 24-h dietary recalls in What We Eat In America, the dietary interview component of the National Health and Nutrition Examination Survey. Because the data have important program and policy applications, it is essential that the validity of the method be tested. The accuracy of the AMPM was evaluated by comparing reported energy intake (EI) with total energy expenditure (TEE) by using the doubly labeled water (DLW) technique. The 524 volunteers, aged 30-69 y, included an equal number of men and women recruited from the Washington, DC, area. Each subject was dosed with DLW on the first day of the 2-wk study period; three 24-h recalls were collected during the 2-wk period by using the AMPM. The first recall was conducted in person, and subsequent recalls were over the telephone. Overall, the subjects underreported EI by 11% compared with TEE. Normal-weight subjects [body mass index (in kg/m(2)) 30). Although the AMPM accurately reported EIs in normal-weight subjects, research is warranted to enhance its accuracy in overweight and obese persons.
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              Ultra‐processed foods and the nutrition transition: Global, regional and national trends, food systems transformations and political economy drivers

              Understanding the drivers and dynamics of global ultra-processed food (UPF) consumption is essential, given the evidence linking these foods with adverse health outcomes. In this synthesis review, we take two steps. First, we quantify per capita volumes and trends in UPF sales, and ingredients (sweeteners, fats, sodium and cosmetic additives) supplied by these foods, in countries classified by income and region. Second, we review the literature on food systems and political economy factors that likely explain the observed changes. We find evidence for a substantial expansion in the types and quantities of UPFs sold worldwide, representing a transition towards a more processed global diet but with wide variations between regions and countries. As countries grow richer, higher volumes and a wider variety of UPFs are sold. Sales are highest in Australasia, North America, Europe and Latin America but growing rapidly in Asia, the Middle East and Africa. These developments are closely linked with the industrialization of food systems, technological change and globalization, including growth in the market and political activities of transnational food corporations and inadequate policies to protect nutrition in these new contexts. The scale of dietary change underway, especially in highly populated middle-income countries, raises serious concern for global health.
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                Author and article information

                Contributors
                Role: contributed to the study conception and designRole: data analysis and interpretation, and writingRole: approved the final version
                Role: contributed to the study design, data analysisRole: interpretation, and writingRole: approved the final version
                Role: contributed to the study design, data analysisRole: interpretation, and writingRole: approved the final version
                Role: contributed to the data analysis and interpretationRole: approved the final version
                Role: contributed to data analysis and data interpretationRole: approved the final version
                Role: contributed to data analysis and interpretationRole: approved the final version
                Role: contributed to the study conception, data interpretationRole: approved the final version
                Role: contributed to the study conception, data interpretationRole: approved the final version
                Role: contributed to the study conception and design, data analysisRole: approved the final version
                Role: contributed to the study conception and design, data analysisRole: approved the final version
                Journal
                Cad Saude Publica
                Cad Saude Publica
                csp
                Cadernos de Saúde Pública
                Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz
                0102-311X
                1678-4464
                19 February 2024
                2024
                : 40
                : 2
                : e00009923
                Affiliations
                [1 ] Faculdade de Nutrição, Universidade Federal de Mato Grosso, Cuiabá, Brasil.
                [2 ] Universidade Federal do Rio de Janeiro, Macaé, Brasil.
                [3 ] Programa de Pós-graduação em Saúde Coletiva, Universidade Estadual do Ceará, Fortaleza, Brasil.
                [4 ] Instituto de Matemática, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil.
                [5 ] Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil.
                [6 ] Instituto de Saúde Coletiva, Universidade Federal Fluminense, Niterói, Brasil.
                [7 ] Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil.
                Author notes
                [Correspondence ] P. R. M. Rodrigues Faculdade de Nutrição, Universidade Federal de Mato Grosso. Av. Fernando Corrêa da Costa 2367, Cuiabá, MT 78060-900, Brasil. prmr84@ 123456gmail.com

                Additional information: ORCID: Paulo Rogério Melo Rodrigues (0000-0002-4213-0685); Luana Silva Monteiro (0000-0003-3599-6947); Thaís Meirelles de Vasconcelos (0000-0003-0108-8991); Luiz Eduardo da Silva Gomes (0000-0001-8968-5947); Iuna Arruda Alves (0000-0002-4872-314X); Valéria Troncoso Baltar (0000-0002-8152-8565); Bartira Mendes Gorgulho (0000-0002-1714-3548); Edna Massae Yokoo (0000-0002-3513-2084); Rosely Sichieri (0000-0001-5286-5354); Rosangela Alves Pereira (0000-0002-9886-9796).

                Author information
                http://orcid.org/0000-0002-4213-0685
                http://orcid.org/0000-0003-3599-6947
                http://orcid.org/0000-0003-0108-8991
                http://orcid.org/0000-0001-8968-5947
                http://orcid.org/0000-0002-4872-314X
                http://orcid.org/0000-0002-8152-8565
                http://orcid.org/0000-0002-1714-3548
                http://orcid.org/0000-0002-3513-2084
                http://orcid.org/0000-0001-5286-5354
                http://orcid.org/0000-0002-9886-9796
                Article
                01404
                10.1590/0102-311XEN009923
                10877696
                47dd41d5-ea7f-4daf-9049-8a4660c05933

                This is an open-access article distributed under the terms of the Creative Commons Attribution License

                History
                : 10 January 2023
                : 19 October 2023
                : 24 October 2023
                Page count
                Figures: 0, Tables: 3, Equations: 0, References: 39
                Categories
                Article

                meals,food consumption,food habits,nutrition surveys,refeições,consumo alimentar,hábitos alimentares,inquéritos nutricionais,comidas,consumo alimentario,conducta alimentaria,encuestas nutricionales

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