Dietary patterns and cardiovascular risk factors in adolescents

Author(s)

Adélia da Costa Pereira de Arruda Neta

• Document type: Doctoral Thesis
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Faculdade de Saúde Pública (FSP/CIR)
• Defense date: 2019-11-05

Examining board members

Dirce Maria Lobo Marchioni; Elizabeth Fujimori; Patricia de Fragas Hinnig; Betzabeth Slater Villar

• Advisor: Dirce Maria Lobo Marchioni

Abstract

Introdução: eating habits are mostly formed during adolescence, and this phase is considered a risk for the development of cardiovascular risk factors, such as overweight and dyslipidemia, which may have immediate and long-term implications for the health of adolescents. Objetivo: identify dietary patterns and prospectively assess their impact on nutritional status and lipid profile in adolescents. Métodos: this thesis was composed of three articles, one cross-sectional and two longitudinal, all using data from the Longitudinal Study on Sedentary Behavior, Physical Activity, Eating Habits and Adolescent Health - LONCAAFS Study. We analyzed 1431 adolescents in 2014, 1178 adolescents in 2015, 959 in 2016 and, finally, 773 adolescents in 2017, belonging to the public school system of João Pessoa, city of Northeast Brazil. To obtain food consumption data, the 24-hour recall was applied, duplicated in 30% of the sample, every year. Dietary patterns were identified by exploratory factor analysis by principal components. Nutritional status was obtained and classified according to the World Health Organization recommendation through BMI for gender and age. The concentrations of total cholesterol (TC), high density lipoprotein (HDL) and triglycerides (TG) were determined by turbidimetry method and low density lipoprotein (LDL) was determined by Friedwald\'s equation, and were later classified according to the Brazilian Dyslipidemia and Atherosclerosis Guideline. Socioeconomic data, on sedentary behavior and physical activity were collected. Associations between dietary patterns and nutritional status, lipid profile and variables of interest were made by generalized estimation equations (GEE). Resultados: the longitudinal analysis of the present study identified three distinct dietary patterns that were maintained throughout the study: the \"Traditional\" pattern, consisting mainly of typical foods of the traditional Brazilian diet, such as rice and beans, but also typical foods of the Northeastern culture, as cassava and couscous; a \"Sandwuiches\" pattern characterized for the consumption of breads, butters and margarines, cheeses, processed meats and coffees; and a \"Western\" pattern characterized for the consumption of high energy density and nutrient poor foods. Male adolescents showed a greater reduction in BMI z-score throughout the study. The prevalence of dyslipidemia was high, regardless of age. Females were positively associated with elevated TC and LDL levels and males with low HDL levels. The \"Western\" dietary pattern was positively associated with BMI z-score, regardless of gender and level of physical activity over time and adolescents with greater adherence to \"Sandwuiches\" and \"Western\" dietary patterns were more likely to have changes in serum total cholesterol levels. Conclusão: these results indicate that a dietary pattern that is rich in energy density, high fat and sugars, and low fiber contributes to a nutritional status and lipid profile that signals risk for the development of cardiovascular disease in these adolescents. In addition, the results of this thesis suggest the need for multidisciplinary public health actions that stimulate changes in eating habits and lifestyle, thus preventing the development of cardiovascular disease in adulthood. (AU)

• FAPESP's process: 16/16551-4 - Dietary patterns and cardiovascular risk factors in adolescents
• Grantee: Adélia da Costa Pereira de Arruda Neta
• Support Opportunities: Scholarships in Brazil - Doctorate