Abstract
Non-communicable diseases are increasing worldwide, and it has been known that sugar intake is associated with health implications. Studies show that sugar consumption is high among the low-income population. In Brazil, there is a Food Assistance Program to offer inexpensive and healthy meals to the low-income population, aiming to improve their health. However, no study has evaluated either the amount of sugar consumption by the Brazilian low-income population or its distribution among the consumed products. This work aimed to analyze the sugar (sucrose) consumption by the Brazilian low-income population. We carried out a cross-sectional and descriptive study to evaluate the typical customers of a popular restaurant (PR) in Brazil (a Brazilian Food Assistance Program for low-income people). In the final sample, 1232 adult PR customers were surveyed. The exclusion criteria were pregnant women, diabetics, or people following any special diet with sucrose restrictions. Individuals were selected at lunchtime while they were in line waiting to collect their meal. Invitations to participate occurred to the first person in line, then the 15th person, and this pattern was used until the sample was completed. Three-day 24 h recall was used to evaluate sugar consumption. Sociodemographic and anthropometric data were collected to allow profiling of the customers. A statistical analysis of the data with descriptive nature (frequency, mean, median, percentage, and standard deviation) was performed to characterize the sample. For all the analyses, statistical normality tests were performed (Kolmogorov–Smirnov) to verify the statistical test assumptions. The mean total energy value (TEV) over the evaluated three-day period was 1980.23 ± 726.75 kcal. A statistically significant difference was found between income groups (p < 0.01). The North and Northeast region presented the lowest mean income in Brazil, statistically different from the South (p < 0.01) and the Southeast (p < 0.01). The North region presented the lowest sugar intake from industrialized products—different from the Northeast (p = 0.007), the Southeast (p = 0.010), and the South (p = 0.043). Also, the North presented the lowest consumption for food prepared at home among other regions (p < 0.001). Total sugar (sucrose) intake did not differ according to body mass index (p = 0.321). There was no significant difference in sugar (sucrose) consumption among the three days (p = 0.078). The addition of sugar (sucrose) contributed to 36.7% of all sugar (sucrose), and sweetened beverages with 22.53%. Food prepared at home contributed 20.06% and industrialized products 22.53% of the sugar (sucrose) intake. Therefore, free sugar (sucrose) consumption is still the largest contributor to the total consumption of sugar (sucrose), followed by sweetened drinks, especially during the weekend. The average percentage of sugar (sucrose) intake is above the World Health Organization recommendation to consume less than 5% of the total energy that comes from sugars. Since this population presents a high percentage of overweight and obese, the sugar (sucrose) consumption could increase health implications, increasing the costs for public health.
Highlights
There is a consensus in public health that sugar needs to be reduced from desserts, snacks, and sugar-sweetened beverages [1]
Brazilian low incomes were evaluated in the present study, and POF represents the consumption for the Brazilian population
This study was conducted using adults participating in a social program of great importance in Brazil
Summary
There is a consensus in public health that sugar (sucrose) needs to be reduced from desserts, snacks, and sugar (sucrose)-sweetened beverages [1]. Non-communicable diseases are increasing worldwide, and the association between sugar intake and health implications is known [4,5,6]. A strong body of evidence shows that the putative main effect of sugar is that it provides additional energy [7,8]. A systematic review showed a positive association between a higher intake of sugar (sucrose) and body fat in adults, increasing the prevalence of chronic diseases [9]. In this context, the World Health Organization (WHO) [10] stated in its guidelines, in
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