Brazilian Household Budget Survey Research Articles

Food Acquisition Locations and Food Groups Acquired According to Levels of Food Insecurity in Brazil.

Food insecurity (FI) is a persistent issue in Brazil, with significant disparities existing across the country's macroregions. This study investigated the food acquisition locations and types of foods purchased at different levels of FI, utilizing data from 57,920 households in the 2017-2018 Brazilian Household Budget Survey. Food acquisition locations were grouped into supermarkets, small markets, street fairs/fruit and vegetable stores/public markets, and others. Foods were categorized into 12 groups: rice, beans, vegetables, fruits, red meats, fish, poultry, eggs, milk and dairy products, bread, cookies, and sugary drinks. Supermarkets are the primary source of food in Brazil. However, in the North and Northeast regions, small markets are more frequently used across all levels of FI. Nationally, most food groups are predominantly purchased at supermarkets. Nevertheless, households experiencing moderate or severe FI rely more on small markets for essential items such as rice, beans, and proteins, as well as ultraprocessed foods. These findings highlight the need for public policies that improve food access for vulnerable populations and address regional inequalities. Enhancing access and ensuring food security across different regions is essential to promoting equitable and healthy diets throughout the country.

Estimated reduction in obesity prevalence and costs of a 20% and 30% ad valorem excise tax to sugar-sweetened beverages in Brazil: A modeling study.

The consumption of sugar-sweetened beverages (SSBs) is associated with obesity, metabolic diseases, and incremental healthcare costs. Given their health consequences, the World Health Organization (WHO) recommended that countries implement taxes on SSB. Over the last 10 years, obesity prevalence has almost doubled in Brazil, yet, in 2016, the Brazilian government cut the existing federal SSB taxes to their current 4%. Since 2022, a bill to impose a 20% tax on SSB has been under discussion in the Brazilian Senate. To simulate the potential impact of increasing taxes on SSB in Brazil, we aimed to estimate the price-elasticity of SSB and the potential impact of a new 20% or 30% excise SSB tax on consumption, obesity prevalence, and cost savings. Using household purchases data from the Brazilian Household Budget Survey (POF) from 2017/2018, we estimated constant elasticity regressions. We used a log-log specification by income level for all beverage categories: (1) sugar-sweetened beverages; (2) alcoholic beverages; (3) unsweetened beverages; and (4) low-calorie or artificially sweetened beverages. We estimated the adult nationwide baseline intake for each beverage category using 24-h dietary recall data collected in 2017/2018. Taking group one as the taxed beverages, we applied the price and cross-price elasticities to the baseline intake data, we obtained changes in caloric intake. The caloric reduction was introduced into an individual dynamic model to estimate changes in weight and obesity prevalence. No benefits on cost savings were modeled during the first 3 years of intervention to account for the time lag in obesity cases to reduce costs. We multiplied the reduction in obesity cases during 7 years by the obesity costs per capita to predict the costs savings attributable to the sweetened beverage tax. SSB price elasticities were higher among the lowest tertile of income (-1.24) than in the highest income tertile (-1.13), and cross-price elasticities suggest SSB were weakly substituted by milk, water, and 100% fruit juices. We estimated a caloric change of -17.3 kcal/day/person under a 20% excise tax and -25.9 kcal/day/person under a 30% tax. Ten years after implementation, a 20% tax is expected to reduce obesity prevalence by 6.7%; 9.1% for a 30% tax. These reductions translate into a -2.8 million and -3.8 million obesity cases for a 20% and 30% tax, respectively, and a reduction of $US 13.3 billion and $US 17.9 billion in obesity costs over 10 years for a 20% and 30% tax, respectively. Study limitations include using a quantile distribution method to adjust self-reported baseline weight and height, which could be insufficient to correct for reporting bias; also, weight, height, and physical activity were assumed to be steady over time. Adding a 20% to 30% excise tax on top of Brazil's current federal tax could help to reduce the consumption of ultra-processed beverages, empty calories, and body weight while avoiding large health-related costs. Given the recent cuts to SSB taxes in Brazil, a program to revise and implement excise taxes could prove beneficial for the Brazilian population.

Differences in the cost and environmental impact between the current diet in Brazil and healthy and sustainable diets: a modeling study

BackgroundWhile healthy and sustainable diets benefit human and planetary health, their monetary cost has a direct impact on consumer food choices. This study aimed to identify the cost and environmental impact of the current Brazilian diet (CBD) and compare it with healthy and sustainable diets.MethodsData from the Brazilian Household Budget Survey 2017/18 and the Footprints of Foods and Culinary Preparations Consumed in Brazil database were used for a modeling study comparing the cost of healthy and sustainable diets (based on the Brazilian Dietary Guidelines (BDG) diet and the EAT-Lancet diet) versus the CBD. The DIETCOST program generated multiple food baskets for each scenario (Montecarlo simulations). Nutritional quality, cost, and environmental impact measures (carbon footprint (CF) and water footprint (WF)) were estimated for all diets and compared by ANOVA. Simple linear regressions used standardized environmental impacts measures to estimate differentials in costs and environmental impacts among diets scenarios.ResultsWe observed significant differences in costs/1000 kcal. The BDG diet was cheaper (BRL$4.9 (95%IC:4.8;4.9) ≈ USD$1.5) than the CBD (BRL$5.6 (95%IC:5.6;5.7) ≈ USD$1.8) and the EAT-Lancet diet (BRL$6.1 (95%IC:6.0;6.1) ≈ USD$1.9). Ultra-processed foods (UPF) and red meat contributed the most to the CBD cost/1000 kcal, while fruits and vegetables made the lowest contribution to CBD. Red meat, sugary drinks, and UPF were the main contributors to the environmental impacts of the CBD. The environmental impact/1000 kcal of the CBD was nearly double (CF:3.1 kg(95%IC: 3.0;3.1); WF:2,705 L 95%IC:2,671;2,739)) the cost of the BDG diet (CF:1.4 kg (95%IC:1.4;1.4); WF:1,542 L (95%IC:1,524;1,561)) and EAT-Lancet diet (CF:1.1 kg (95%IC:1.0;1.1); WF:1,448 L (95%IC:1,428;1,469)). A one standard deviation increase in standardized CF corresponded to an increase of BRL$0.48 in the cost of the CBD, similar to standardized WF (BRL$0.56). A similar relationship between the environmental impact and the cost of the BDG (CF: BRL$0.20; WF: BRL$0.33) and EAT-Lancet (CF: BRL$0.04; WF: BRL$0.18) was found, but with a less pronounced effect.ConclusionsThe BDG diet was cost-effective, while the EAT-Lancet diet was slightly pricier than the CBD. The CBD presented almost double the CF and WF compared to the BDG and EAT-Lancet diets. The lower cost in each diet was associated with lower environmental impact, particularly for the BDG and EAT-Lancet diets. Multisectoral public policies must be applied to guide individuals and societies towards healthier and more sustainable eating patterns.

Food price trends during the COVID-19 pandemic in Brazil.

The present study aims to analyze the trends in food price in Brazil with emphasis on the period of the Covid-19 pandemic (from March 2020 to March 2022). Data from the Brazilian Household Budget Survey and the National System of Consumer Price Indexes were used as input to create a novel data set containing monthly prices (R$/Kg) for the foods and beverages most consumed in the country between January 2018 and March 2022. All food items were divided according to the Nova food classification system. We estimated the mean price of each food group for each year of study and the entire period. The monthly price of each group was plotted to analyze changes from January 2018 to March 2022. Fractional polynomial models were used to synthesize price changes up to 2025. Results of the present study showed that in Brazil unprocessed or minimally processed foods and processed culinary ingredients were more affordable than processed and ultra-processed foods. However, trend analyses suggested the reversal of the pricing pattern. The anticipated changes in the prices of minimally processed food relative to ultra-processed food, initially forecasted for Brazil, seem to reflect the impact of the Covid-19 pandemic on the global economy. These results are concerning as the increase in the price of healthy foods aggravates food and nutrition insecurity in Brazil. Additionally, this trend encourages the replacement of traditional meals for the consumption of unhealthy foods, increasing a health risk to the population.

Association between ultra-processed food and snacking behavior in Brazil.

Ultra-processed food may play a role in facilitating snacking behavior because of their convenience and low satiety potential. This study aimed to describe the association between consumption of ultra-processed foods and frequency of snacking. We analyzed data from 46,164 participants (≥ 10years old) in the 2017-2018 Brazilian Household Budget Survey. Dietary data were collected by 24-h dietary recalls over one or two days for each participant. We estimated energy intake, ultra-processed food consumption, and level of snacking. We measured the association between ultra-processed food consumption and level of snacking using multinomial logistic regression, stratified by age group(adolescents, 10-19years old; adults, 20-64years old; elders, 65 or older). We found a statistically significant tendency of increased daily energy intake and consumption of snacks and that ultra-processed food consumption was positively associated with the level of snacking for all age groups. For adolescents, adults, and elders in the highest quintile of ultra-processed food consumption as a share of their entire diet, the relative risk ratio (95% CI) of having more than two snacks per day compared to no snacks was 14.21 (9.09-22.21), 4.44 (3.54-5.57), and 4.21 (2.67-6.64), respectively, when compared to the lowest quintile. Higher consumption of ultra-processed food was associated with snacking behavior, and the strength of this association was stronger among adolescents. Efforts to mitigate ultra-processed food attributes that facilitate snacking should be incorporated into strategies to promote healthier food choices, especially among adolescents.

Food insecurity in Brazil by household arrangements and characteristics between 2004 and 2022.

Although food insecurity presents a decreasing trend worldwide, some regions recently observed an increase in hunger levels. Such was the case in Brazil between 2014 and 2018, during and after the great Brazilian recession, and between 2020 and 2021, during the COVID-19 pandemic. This paper describes the evolution of food insecurity in Brazil between 2004 and 2022 using Brazilian National Household Sample Survey (PNAD), Brazilian Household Budget Survey (POF) and Continuous PNAD. Households were classified in 20 types of arrangements, and the most vulnerable living arrangements between 2004 and 2018 were identified by multinomial logistic models. Overall, households headed by women (single blacks, whites or in couples) with or without children were the most prone to food insecurity. As for the evolution of food insecurity in Brazil between 2018 and 2022, logistic models were applied to estimate moderate and severe food insecurity levels among the 20 household types. Additionally, effects of the emergency aid and idiosyncrasies of the COVID-19 pandemic were estimated.

Inequalities in food acquisition according to the social profiles of the head of households in Brazil.

Brazil is characterized by strong social inequalities and differences in access to quality food and sufficient quantities of it, which represent a violation of the human right to adequate food. The aim was to assess food expenditures according to the social profiles of the head of the households. Data from the cross-sectional Brazilian Household Budget Survey (2017/2018) were used with a nationally representative sample of household survey participants (n=52,917). Poisson regression was used to estimate prevalence ratios (PR) to assess the association of different social profiles with the acquisition of food. The profile characterized by woman self-classified as white, with a higher education, which characteristics were positively and significantly associated with more acquisition of fruits (PR=1.22; CI95% 1.09-1.36) and vegetables and greens (PR=1.24; CI95% 1.09-1.41). Black women with low education levels showed a negative association with the consumption of soda (PR=0.53; CI95% 0.45-0.62), and prepared food (PR=0.52; CI95% 0.37-0.74). The results reveal great inequalities in the purchase of food between the social profiles of the heads of the family.

Inequalities in access to consumption of leisure goods and services in Brazil

ABSTRACT The access to leisure is unevenly distributed in the societies. Despite the status of leisure as an individual right according to the Universal Declaration of Human Rights, as well as to the World Leisure Organization Charter for Leisure, many people still have limited or no access to leisure. These discrepancies are even more noticeable in highly unequal countries and regions such as Latin America. In particular, Brazil is one of the most unequal countries in the world, where the wealthiest 1% earn 28% of the national income. This article investigates how social and economic disparities lead to inequalities in the access to consumption of leisure goods and services. Data from a recent and representative Brazilian household budget survey are analysed. Different types of leisure were examined according to Dumazedier’s categories. The results revealed that the expenditure on leisure items in Brazil is associated to region, race, gender, family size and composition, education, and income. These findings highlight the need for policies to promote equal leisure opportunities as a means to development and justice.

Undernutrition and obesity trends in Brazilian adults from 1975 to 2019 and its associated factors.

Nutritional status has evolved in a dual trend worldwide: underweight has become a minor or local issue while overweight or obesity has risen to play a major role in the global burden of disease. In 2014, Brazil was ranked as the third country with the highest absolute number of obese men. Our aim was to estimate trends of underweight and obesity among Brazilian adults using a comprehensive set of surveys from 1974 to 2019. The data used in the study originate from subjects aged ≥ 18 in six Brazilian national surveys, presented in chronological order: Brazilian National Survey on Household Expenses (ENDEF 1974-1975); Brazilian National Survey on Health and Nutrition (PNSN 1989); Brazilian Household Budget Survey (POF 2002-2003, 2008-2009); and Brazilian National Health Survey (PNS 2013 and 2019). All six surveys were designed to sample household complexes that were representative of the Brazilian population. Body mass index was calculated (kg/m2). The nutritional status of individuals was classified following the standards. We have modeled obesity trend according to income and education strata. The trajectories of underweight and obesity over time in Brazil draw the classical "X" of nutrition transition. From 1975 to 2019 underweight has decreased from 9.1% to 2.5% among men and 12.2% to 3.4% among women. On the other hand, obesity trajectories have scaled up from 3% to 22% among men and from 9% to 30% among women. The increase in obesity rate is directly and negatively proportional to income quintiles. Sociodemographic (income and education) improvement is associated with an increase in obesity. All public policies intending to stop the obesity spread in Brazil have been ineffective or too small to be effective.

Factors that influence children`s anthropometric indices: a focus on female single-parent families

In the last decades several alterations have occurred in the dynamics of the organization of families, including changes in size, structure, and composition. Among new family arrangements, the increase in female single-parent families stands out. This structure tends to be in a situation of greater social vulnerability in relation to other arrangements. With this in mind, the scope of this study sought to analyze the relationship between the female single-parent family arrangement and anthropometric measurements of under five-year-old offspring, with data from the 2008-2009 Brazilian household budget survey (POF/IBGE). Two equations for the analysis of anthropometric measurements, with the z-score of "height-for-age" and the z-score of "weight-for-height" as dependent variables, were estimated. The results revealed that, taking other important variables into consideration, such as income, education and domestic characteristics pertaining to the "female single-parent" arrangement, had a positive effect on anthropometric measurements when compared with the "couple with children" arrangement, indicating that in households in which the mother does not have a spouse in residence, children had better long-term health indicators than in households in which the spouse was present.

How to Estimate Food Prices and Diet Costs in Population-Based Studies?

Health and nutrition surveys usually comprise detailed information on health characteristics and food consumption of certain population groups; however, the lack of data collection on the food prices may pose challenges for the estimation of the diet costs for the comprehensive analysis of food demand. The Household Budget Survey (HBS) represents an opportunity to obtain the data on the food prices for the nutrition surveys in the diverse countries worldwide. Although the HBS and the health and nutrition surveys may correspond to different periods, the application of the appropriate Consumer Price Index (CPI) allows to address the changes in the relative prices to perform the linkage between the data of food consumption with information on the food prices. Therefore, the aim of this study was to present the methods for the extraction and linkage of the food prices data from the Brazilian HBS (2002–2003 and 2008–2009) by using the pairing features related to the household characteristics to match the Health Survey of São Paulo [Inquérito de Saúde de São Paulo (ISA-Capital)] conducted in 2003, 2008, and 2015. Data referring to the household characteristics and food prices acquired by the household members living in São Paulo municipality were selected from the HBS datasets for integration with the ISA-Capital dataset. Specific deflators referring to the food items surveyed in São Paulo were obtained from the datasets of the Brazilian Broad Consumer Price Index (BCPI). Therefore, the pairing criteria referring to time, location, and household characteristics were adopted to allow linking foods consumed by the individuals in the ISA-Capital with the prices from the foods acquired by household members interviewed in the HBS. Matching data on the key pairing criteria (location/year/household income per capita/number of residents/family profile) resulted in the linkage of 94.4% (2003), 92.6% (2008), and 81.2% of the cases (2015). Following the data linkage, it was possible to estimate diet costs per gram and per calorie including application of cooking and conversion factors. Data were presented in the International Monetary Unit under the purchasing power parity (PPP) to allow the comparison at the international level. The mean diet costs identified in the population of São Paulo municipality were $8.45 (dp = 0.38) per capita per day in 2003, $8.72 (dp = 0.24) per capita per day in 2008, and $9.62 (dp = 0.23) per capita per day in 2015. Thus, it was possible to estimate the diet costs based on the prices of food items through pairing linkage of information from the household surveys, such as the Brazilian HBS, with the health and nutrition surveys lacking information on the expenditures or prices such as the ISA-Capital. Similar procedures may be used in the diverse countries with availability of the datasets of the household expenditures and health and nutrition surveys, allowing the researchers worldwide to associate the diet quality with food demand.

Breakfast patterns and weight status among adolescents: a study on the Brazilian National Dietary Survey 2008-2009.

Examining the composition of breakfast concerning weight status is essential for evaluating adolescent health and understanding this gap. This study aimed to identify breakfast patterns and investigate the relationship with weight status among Brazilian adolescents. We used a subsample of 7425 adolescents aged 10-19 years from the 2008-2009 Brazilian Household Budget Survey. Breakfast eaters were those with intake of at least 50 kcal (209·2 kJ) between 05.00 and 10.00 hours. Breakfast dietary patterns were derived by principal component factor analysis with varimax rotation. We performed logistic regression analyses between breakfast patterns and weight status, considering the complexity of the survey sample design. Three breakfast patterns were identified explaining 44·8 % of data variability: (1) the Cereal, protein, fruit beverages and Northern/Northeastern pattern, characterised by high consumption of cookies, meats, dairy products, preparations with maize, eggs, fruit juices/fruit drinks/soya-based drinks, tubers/roots/potatoes and cereals, and negative adherence to cold cut meat and savoury snacks/crackers; (2) the Protein-based pattern, characterised by positive loadings for cold cut meat, milk and cheese, and negative for cookies, fruit juices/fruit drinks/soya-based drinks, tubers/roots/potatoes and cereals; and (3) the Mixed pattern, with positive loadings for cakes, coffee/tea, bread, fruit juices/fruit drinks/soya-based drinks, chocolate/desserts and savoury snacks/crackers. No association was found between skipping and weight status. Overweight adolescents had lower adherence to the Cereal, protein, fruit beverages and Northern/Northeastern pattern (OR = 0·67; 95 % CI 0·47, 0·96). This is the first study to address dietary patterns at the meal level with adolescent population-based data, which requires further investigation.

Assessment of dietary intake of bioactive food compounds according to income level in the Brazilian population.

There is an inverse association between bioactive compounds intake and disease risk. The knowledge of its consumption according to socio-economic strata is important, which allows identification of potential intervention targets. Thus, we aimed to investigate bioactive compounds intake according to income level in Brazilian population. Data were obtained from the Brazilian Household Budget Survey, a cross-sectional survey which included data on individual food intake of 34,003 subjects aged 10 years and over collected using two 24-h dietary records. Polyphenol and carotenoid content of foods was identified using published databases. Total polyphenol and carotenoid intake were determined according to per capita income, as well as main food sources. Total polyphenols and flavonoids intake increased with income level, and subjects with lower income showed higher phenolic acids intake than individuals in highest income (p = 0.0001). Total carotenoids and classes intake (with exception to β-cryptoxanthin and zeaxanthin) were higher among subjects in highest income quartile, compared to the lowest quartile (p = 0.0001). Coffee was major source to total polyphenols and phenolic acids intake, and orange juice was main flavonoid provider in individuals from all income levels. In the upper income quartile, total carotenoid was supplied mainly by tomato and kale, and fruits had important contribution to carotenoid intake in the lowest income quartile. There is important influence of income level on diet quality regarding intake of foods with bioactive compounds, and individuals with lower income may experience lower quality diets due to less availability of foods with bioactive compounds.

Can Eating Food Offered by Schools Have a Positive Influence on Nutritional Status of Children? An Example from Brazil

Objective: Considering that the school environment can impact food consumption and children’s weight, our aim was to evaluate the relationship between the origin of foods consumed at school and children’s nutritional status. Methods: We used data from the nationally representative Brazilian Household Budget Survey of children under 10 years old. The relationship between consumption of foods at school and its origin (offered by the school; taken from home; bought at the canteens) and nutritional status were evaluated using linear (BMI-for-age) and logistic (excess weight and obesity) regression models stratified by type of school (private or public). Results: A total of 95.5% of children referred consumption of food at school, independent of its origin, and 28.0% had excess weight and 10.2% had obesity. In private schools, 70.7% of children ate food taken from home, whereas in public schools, 90.6% of children ate food offered by the school through a school food service program. According to adjusted analyses related to public schools, consuming food offered by the school decreased BMI-for-age and the odds of having obesity. No differences were verified among children from private schools. Conclusion: Eating food offered by public schools seems to be better for Brazilian children’s nutritional status.

The Effect of Social Behavior on Residential Water Consumption

We analyze how residential water consumption is influenced by the consumption of households belonging to the same social group (peer effect). Analyses are based on household-level data provided by the Brazilian Household Budget Survey and use an innovative strategy that estimates the spatial dependence of water consumption while simultaneously controlling for potential sources of sample selectivity and endogeneity. The estimates of our quantile regression models highlight that, conditional on household characteristics, the greater the household water consumption, the greater the peer effect. In other words, the overconsumption of residential water seems to be influenced mainly by the behavior of social peers.

Replacing ultra-processed foods with fresh foods to meet the dietary recomendations: a matter of cost?

The study aimed to analyze the economic impact of the adoption of optimized and nutritionally balanced diets to Brazilian families, considering the Brazilian dietary guidelines and the economic disparities of the population. Data from the Brazilian Household Budget Survey from 2008-2009 (550 strata; 55,970 households) were used. About 1,700 foods and beverages purchased by the Brazilians were classified into 4 groups according to NOVA system. Linear programming models estimated isoenergetic diets preserving the current diet as baseline and optimizing healthier diets gradually based on the "golden rule" of the Brazilian dietary guidelines, respecting nutritional restrictions for macronutrients and micronutrients (based on international recommendations) and food acceptance limits (10th and 90th percentiles of the per capita calorie distribution from the population). The diet cost was defined based on the sum of the average cost of each food group, both in the current and optimized diets (BRL per 2,000Kcal/person/day). The economic impact of the Brazilian dietary guidelines to Brazilian household budget was analyzed by comparison the cost of the optimized diets to the cost of the current diet, calculated for the total population and by income level. Three healthier diets were optimized. Current diet cost was BRL 3.37, differed among low- and high-income strata (BRL 2.62 and BRL 4.17, respectively). Regardless of income, diet cost decreased when approaching the guidelines. However, low-income strata compromised their household budget more than two times the high-income strata (20.2% and 7.96%, respectively). Thus, the adoption of healthier eating practices can be performed with the same or lower budget.

Estimated dietary polyphenol intake and major food sources of the Brazilian population.

Epidemiological studies have suggested an inverse association between polyphenol intake and the risk of chronic diseases. However, the lack of comprehensive data on population-level intakes, especially in Latin American countries, has limited research on this topic. We aimed to estimate total and individual polyphenol intakes and determine the major dietary contributors in a representative sample of the Brazilian population. Data were obtained from the Brazilian Household Budget Survey, a cross-sectional survey which included data on individual food intake of 34003 subjects aged 10 years and over collected using two 24-h dietary records. Polyphenol content of foods was identified using the Phenol-Explorer database and Brazilian Food Composition Database. Total and individual polyphenol intake was calculated, as well as the intake distribution by socio-demographic factors. The median and 25-75th percentiles of polyphenol intake were 364·3 and 200·9-1008 mg/d, respectively. After energy adjustment, the median and 25-75th percentiles of polyphenol intake were 204 and 111·4-542·1 mg/1000 kcal/d (4184 kJ/d), respectively. Non-alcoholic beverages and fruits were the major polyphenol suppliers, and coffee and orange juice the main individual food contributors to polyphenol intake. The individual compounds most consumed were isomers of chlorogenic acid (5-caffeoylquinic acid, 4-caffeoylquinic acid, 3-caffeoylquinic acid), naringenin and hesperetin. The present study provides, for the first time, data on dietary intake of total and individual polyphenols by the Brazilian population and illustrates the low quality of their diet. These results will facilitate the study of associations between polyphenol class intake and health outcomes, and will also be useful for future dietary intake recommendations.

Mycotoxins in cereals and cereal-based products: Incidence and probabilistic dietary risk assessment for the Brazilian population

A probabilistic dietary risk assessment on mycotoxins was conducted using the Monte Carlo Risk Assessment software, with consumption data from the 2008/2009 Brazilian Household Budget Survey for individuals who were at least 10 years old and occurrence data for 646 samples of rice, maize, wheat, and their products, collected in the Federal District and in the state of Rio Grande do Sul, Brazil. Processing factors were estimated and applied to concentration data. Chronic exposure was estimated for fumonisins (free and bound/hidden), deoxynivalenol (DON) (including the acetylated forms) and zearalenone (ZON) (including alfa-zearalenol) and acute exposure was estimated for DON. For the general population, the chronic exposure exceeded the safe exposure levels at the 95P for DON and at the 99P for fumonisins. Additionally, safe level exceedance occurred at the 97.5P for fumonisins and at the 95P for DON for teenagers, as well as at the 99P for fumonisins for women of child-bearing-age. No exceedances were found for chronic exposure to ZON and acute exposure to DON. Maize couscous contributed most of the total fumonisins (91%) and ZON intakes (~40%) and bread to total intake of DON (~30%). Further studies should be conducted with updated Brazilian consumption data, which should include information for individuals aged less than 10 years old.

Income and out-of-pocket health expenditure in living arrangements of families with older adults in Brazil

The main objective of this study was to characterize household sociodemographic and economic patterns of different living arrangements of families with older adults in Brazil and their relationship with income and out-of-pocket health expenditure. Data were extracted from the 2008-2009 Brazilian Household Budget Survey (POF, in Portuguese) database of the Brazilian Institute of Geography and Statistics. Families with older adults represented 28% of all families, being smaller and having higher average income when compared to families without older adults. Older adults were head of the household in 85% of the families, with income based mainly on social protection policies. The families with older adult or couple as head of the household had significantly higher average monthly income. The proportion of out-of-pocket health expenditure per income quintile per capita was higher for families with one older adult or couple as head of the household, when compared to families without older adult as head of the household and even more in families without older adults at all. These findings allow the identification of potential positive impacts on the quality of life of families with older adults in Brazil. The higher household income of families with older adults is a consequence of the expansion of inclusive social protection policies for this population in the 2000s in Brazil, especially for families with lower average income levels, representing 4/5 of this population. The economic and political crisis in the 2010s have probably reduced these families' relative advantage, and this study will compare with results of the next survey.

Assessment of trends of nutritional status, central obesity, and growth profile using anthropometric measurements in adolescent athletes from a sport-oriented public school.

The aims were to evaluate the nutritional status, central adiposity, and physical growth profile of adolescents in a sports-oriented public school (SOPS) and to describe the results considering the Brazilian and American adolescents' survey studies. This study was a dynamic cohort, performed in 2012-2013 and 2015. 1,082 adolescent athletes (11-16 years old) participated. Anthropometric data (height [H], weight, and waist circumference [WC]) were collected yearly. The nutritional status was assessed using BMI Z-score; trunk fat, using WC and WC/H ratio; and growth, using height z-score. The SOPS results were described considering data from the Brazilian Household Budget Survey (HBS-Southeast region) and the National Health and Nutrition Examination Survey (NHANES). Anthropometric data was compared using linear mixed effects regression models, considering sex, age group and time. Considering height Z-score and BMI Z-score values, none of the adolescents in the SOPS had short stature or underweight, and the obesity prevalence was approximately 1% throughout the study. HBS survey revealed 3.4% of obesity prevalence in adolescents (11-16 years old). Considering age and time, significant differences in WC for both sexes were observed. However, considering NHANES data, our participants were classified in P5-25. These results suggest that the nutritional status of adolescents in the SOPS was good, obesity prevalence was 1% and WC measurement was within P5-25 considering NHANES data. This supports the public policies encouraging involvement in sports at school, which should be one of the priorities in the health promotion agenda, reducing the development of future chronic diseases.