Diet energy density and cardiovascular risk: population-based survey of São Paulo - ISA-Capital study

Author(s)

Aline Mendes Peralta

• Document type: Master's Dissertation
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Faculdade de Saúde Pública (FSP/CIR)
• Defense date: 2014-02-07

Examining board members

Dirce Maria Lobo Marchioni; Nágila Raquel Teixeira Damasceno; Eliseu Verly Junior

• Advisor: Dirce Maria Lobo Marchioni

Abstract

Introduction: Cardiovascular diseases have been the main cause of death in Brazil. Obesity is a major contributor to cardiovascular diseases and it has been increasing in Brazil. The dietary energy density (DED) could be a possible aid tool to weight gain prevents and for assessing the overall quality of the diet, with independent calculation criteria of eating habits and calculation procedures simpler than diet quality indicators. Objective: To analyze the association between DED and cardiovascular risk, and to investigate the relationship between DED and the diet quality index of adults and elderly in the city of São Paulo. Methods: It was used data from participants in the cross-sectional population-based survey entitled Inquérito de Saúde de São Paulo - ISA - Capital 2008/2009: 357 subjects (20-74 years), for analysis between DED and cardiovascular risk , and 941 subjects (20 years or more), for analysis between DED and the diet quality index . The replicated 24-hour recall was used to assess dietary intake. The usual intake of foods, nutrients and DED was calculated by the Multiple Source Method. Caloric and noncaloric beverages were excluded from the calculation of DED (foods only method); the diet quality was analyzed by Brazilian Health Eating Index Revised (BHEI-R), and cardiovascular risk, by predictive equations from the Framingham cardiovascular score risk. As análises foram realizadas utilizando o módulo survey do Stata, versão 11. The relationship between the DED and IQD-R and components was verified by generalized linear models, by gaussian model and the relationship between DED and cardiovascular risk by gamma model, both with log link function. The analyzes were performed using the survey module in Stata, version 11. Results: DED mean exceeded the maximum recommended value of 1.25kcal/g, by World Cancer Research Fund, in all age groups. The DED showed a significant relationship with cardiovascular risk score in 45-59 years-old adults and elderly, independent of serum triglycerides, energy from beverages, category of per capita household income and change of eating habits. The average intake of total fiber decreased with the DED increases, whereas intakes of total fat and trans increased in all category of ages. The BHEI-R score and the scores of most of its components were significantly lower in the highest DED tertile compared with the 9 first. Conclusion: The DED has significant and positive relationship with the Framingham score in 45-74 years-old subjects and the nutrients related to the increase of cardiovascular risk. A significant relationship with BHEI-R, and most of its components, enables the use of DED as an aid instrument in the assessment of diet quality. It is clear the need of actions to improve the quality of the diet in the studied population, in order to reduce the DED, and this could help to decrease the cardiovascular diseases deaths and obesity prevalence. (AU)

• FAPESP's process: 11/14786-0 - Dietary energy density and cardiovascular risk FACTORS- population-based study in the City of São Paulo: ISA-CAPITAL study
• Grantee: Aline Mendes Peralta
• Support Opportunities: Scholarships in Brazil - Master