Consumo de alimentos ultraprocessados entre idosos brasileiros e associação com fatores sociodemográficos, de estilo de vida e presença de doenças: dados da pesquisa nacional de saúde, 2019

Abstract

The consumption of ultra-processed foods (UPF) is rapidly increasing in low- and middle-income countries like Brazil. This consumption is associated with other unfavorable health factors, such as physical inactivity, sedentary behaviors, and Non-Communicable Diseases (NCDs). These are more prevalent in the elderly population. In this context, understanding the consumption profile of UPF among the elderly is essential for developing adequate and healthy eating strategies tailored to the characteristics of this population. OBJECTIVE: To assess the consumption of UPF and its association with socioeconomic factors, lifestyle, and the presence of NCDs among Brazilian elderly. METHODS: A cross-sectional study was conducted with data from 22,728 elderly participants in the 2019 National Health Survey (PNS). The dependent variable was the UPF consumption score, calculated based on questions about the previous day’s consumption of the following items: 1. Soda 2. Boxed/canned juice 3. Chocolate drink/flavored yogurt 4. Packaged snacks/crackers 5. Sweet/biscuits/cake 6. Ice cream/chocolate/jelly/flan 7. Sausage/sausage/bologna/ham 8. Sliced bread/hot dog/hamburger 9. Margarine/mayonnaise/ketchup/others 10. Instant noodles/packaged soup/frozen lasagna/others. The score was created by summing positive responses to these items, then dichotomized into <5 UPF and ≥5 UPF. Consumption was evaluated according to sociodemographic variables (sex, age, skin color, education, marital status, and living with a partner), lifestyle variables (physical activity, TV time, screen time, tobacco and alcohol use), presence of NCDs (diabetes, hypertension, and depression), and nutritional status (underweight, normal weight, and overweight). In the bivariate analysis, statistically significant differences were assessed by the non-overlap of 95% confidence intervals (CI). Variables associated with the outcome were included in simple and adjusted logistic regression models. SPSS 22.0 was used, considering sample complexity and sampling weights. RESULTS: Overall, 7.1% consumed five or more groups of UPF on the previous day, being more frequent among whites than non whites (8.3% vs. 5.9%) and those with any level of education compared to those without education. Consumption was more frequent among residents of the South (11.5%) and Southeast (8.7%) regions, urban areas compared to rural areas (7.8% vs. 3.3%), those who watched TV for ≥3 hours per day (9.5% vs. 6.1%), and those who used tablets, computers, or cell phones for ≥3 hours per day (11.3% vs. 6.9%). Regarding NCDs, only diabetes was inversely associated with UPF consumption (5.4% vs. 7.6%). After adjustments, having any level of education, living in the South, Southeast, and Central-West regions, in urban areas, and watching TV for ≥3 hours per day were associated with consuming five or more groups of UPF. Additionally, having diabetes remained inversely associated with UPF consumption. CONCLUSION: The consumption of UPF was associated with sociodemographic and lifestyle variables. It is believed that the diagnosis of diabetes may have influenced the improvement of dietary habits in this population. This work is expected to contribute to the management of elderly care in public health.