Prevalence of ultra-processed food, alcohol and tobacco consumption and chronic non-communicable diseases in Rio Branco, capital city of the state of Acre, Brazil, 2019: comparative analysis of two epidemiological surveys

Lima, Yara de Moura Magalhães; Martins, Fernanda Andrade; Ramalho, Alanderson Alves

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Epidemiologia e Serviços de Saúde

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Research Note • Epidemiol. Serv. Saúde 31 (1) • 2022 • https://doi.org/10.1590/S1679-49742022000100023 copy

Prevalence of ultra-processed food, alcohol and tobacco consumption and chronic non-communicable diseases in Rio Branco, capital city of the state of Acre, Brazil, 2019: comparative analysis of two epidemiological surveys

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To describe, in a comparative manner, the prevalence of chronic non-communicable diseases and ultra-processed food, alcohol and tobacco consumption, estimated by the Chronic Disease Risk and Protective Factors Surveillance Telephone Survey (Vigitel) and National Health Survey (PNS), in Rio Branco, capital city of the state of Acre, Brazil.

Methods

This was a cross-sectional study on sociodemographic, health and lifestyle data from surveys conducted in 2019. Prevalence and 95% confidence intervals (95%CI) were described, and percentage difference was calculated.

Results

Of the 3,037 individuals assessed, similar prevalence, with difference between Vigitel (60.3%; 95%CI 56.2;64.3) and PNS (70.8%; 95%CI 67.4;73.9) regarding people of Brown race/skin color was found. In the stratification by sex, it could be seen percentage difference between the surveys, regarding obesity (male= 6.5%; female= 0.4%), smoking (male= 4.0%; female= -1.5%) and alcohol abuse (male= 6.9%; female= -2.5%), although with overlapping 95%CI.

Conclusion

The estimates assessed in both surveys were similar.

Keywords:
Population Surveys; Cross-sectional Studies; Epidemiological Monitoring; Chronic Disease; Prevalence

Variables	Questions
Variables	Vigitel/2019^a	PNS/2019^b	Comparison
Sociodemographic
Sex	Sex:1 ( ) Male / 2 ( ) Female	Sex:1 ( ) Male/ 2 ( ) Female	Similar questions
Age	How old are you? (you must be ≥18 years old and <150) ____ years old.	Age (calculated based on date of birth).	Similar questions
Age	The variable was re-coded according to age in years.	The variable was re-coded according to age in years.	Similar questions
Race/skin color	What is your race/skin color?	Race or skin color?	Similar questions
	1 ( ) White 2 ( ) Black	1 ( ) White 2 ( ) Black
	3 ( ) Asian 4 ( ) Brown	3 ( ) Asian 4 ( ) Brown
	5 ( ) Indigenous	5 ( ) Indigenous
Interviewee’s schooling	Schooling based on the following questions:	What is your major?	.
	Up to which grade or level did you study?	What grade level/ semester are you in?	Vigitel database includes an educational indicator, with the following categories, in years of study: 0 to 8; 9 to 11; 12 and over. For the construction of this indicator in the PNS, the aforementioned questions were used. and based on them, a variable 'years of study' was created. Thus, it was possible to categorize it for schooling, consistent with Vigitel.
	1 ( ) Primary School	What was the highest level of education/course you attended?
	2 ( ) Middle School Entrance Examination	How long did this course last?
	3 ( ) Middle School	What was the last grade level/semester you completed, and was approved, in this course?
	4 ( ) Elementary Education or Supplementary Elementary Education
	5 ( ) Standard High School or Technical High School or Scientific High School or Supplementary High School Education
	6 ( ) Higher Education
	7 ( ) Postgraduate Education (Specialization, Master’s Degree, Doctoral Degree)
	8 ( ) Never studied
	What was the highest school grade you finished?
	1^st ( ) 2^nd ( ) 3^rd ( ) 4^th ( )
	5^th ( ) 6^th ( ) 7^th ( ) 8^th or above
	Are you currently taking a course/attending school or taking someone to do a course/attend school?
	1 ( ) Yes / 2 ( ) No
Health
Diabetes mellitus	Has a doctor ever told you that you have diabetes?	Has any doctor ever given you a diagnosis of diabetes mellitus?		Similar questions
Diabetes mellitus	1 ( ) Yes / 2 ( ) No	1 ( ) Yes / 2 ( ) No		Similar questions
Arterial hypertension	Has a doctor ever told you that you have hypertension?	Has any doctor ever given you a diagnosis of Arterial hypertension?	Similar questions
Arterial hypertension	1 ( ) Yes / 2 ( ) No	1 ( ) Yes / 2 ( ) No	Similar questions
Overweight and obesity	Do you know how much you weight (even if it is an approximate value )? (only ≥30 kg and <300 kg) ____ kg are accepted	Height, first measurement: ____ cm; height, second measurement: ____ cm;	Vigitel database includes an overweight indicator, being considered as BMI >25kg/m² and obesity >30kg/m². For the construction of this indicator in the PNS, the variables 'final weight, in kg' and 'final height, in cm' were used, based on the questions presented, and based on them the 'BMI' and the overweight indicator were calculated, being considered as BMI >25kg/m² and obesity >30kg/m².
Overweight and obesity	Do you know your height? (only ≥1.20 m and <2.20 m) ____ m ____ cm are accepted	Weight, first measurement: ____ kg; weight, second measurement: ____ kg;
Lifestyle
Smoking	Do you currently smoke?	Do you currently smoke any tobacco products?	Similar questions
	1 ( ) Yes, every day	1 ( ) Yes, every day
	2 ( ) Yes, but not every day	2 ( ) Yes, but not every day
	3 ( ) No	3 ( ) Do not smoke currently
Alcohol abuse	For women: in the last 30 days, did you consume four or more doses of alcoholic drinks on a single occasion? (four doses of alcoholic drinks are equivalent to four cans of beer, four glasses of wine or four doses of cachaça, whisky or any other distilled alcoholic liquor) (only for women)	In the last 30 days, did you consume five or more doses of alcoholic drinks on a single occasion? (one dose of alcoholic drink is equivalent to one can of beer, one glass of wine or one dose of cachaça, whisky or any other distilled alcoholic liquor)	The PNS considers five or more doses for both sexes.
	1 ( ) Yes / 2 ( ) No	1 ( ) Yes / 2 ( ) No
	For men: in the last 30 days, did you consume five or more doses of alcoholic drinks on a single occasion? (five doses of alcoholic drinks are equivalent to five cans of beer, five glasses of wine or five doses of cachaça, whisky or any other distilled liquor)
	1 ( ) Yes / 2 ( ) No
Ultra-processed food consumption	Now I am going to list some industrialized foods and I would like you to tell me if you have any of them yesterday (when you woke up until you went to bed)	Now let's talk about your eating habits. I am going to ask you a few questions about industrialized foods you consumed yesterday.	Based on the questions presented, an indicator of 'consumption of five or more ultra-processed foods on the previous day' was constructed.
	a. Soft drink	Yesterday, did you drink or eat:
	1 ( ) Yes / 2 ( ) No	a. Soft drink
	b. Caton or canned juice	1 ( ) Yes / 2 ( ) No
	1 ( ) Yes / 2 ( ) No	b. Carton or canned juice or powdered juice?
	c. Powdered juice	1 ( ) Yes / 2 ( ) No
	1 ( ) Yes / 2 ( ) No	c. Chocolate milk or flavored yogurt?
	d. Chocolate milk	1 ( ) Yes / 2 ( ) No
	1 ( ) Yes / 2 ( ) No	d. Packet snacks or savory biscuits/crackers?
	e. Flavored yogurt	1 ( ) Yes / 2 ( ) No
	1 ( ) Yes / 2 ( ) No	e. Sweet or filled biscuits/crackers or packet cupcake?
	f. Packet snacks (or chips) or savory biscuit/crackers	1 ( ) Yes / 2 ( ) No
	1 ( ) Yes / 2 ( ) No	f. Ice cream, chocolate, gelatin, flan or other industrialized dessert?
	g. Sweet/wafer biscuits, filled biscuits or packet cupcakes	1 ( ) Yes / 2 ( ) No
	1 ( ) Yes / 2 ( ) No	g. Sausage, mortadella or ham?
	h. Chocolate, ice cream, gelatin, flan or other industrialized dessert	1 ( ) Yes / 2 ( ) No
	1 ( ) Yes / 2 ( ) No	h. Sliced bread, hot dog or hamburger buns?
	i. Sausage, mortadella or ham	1 ( ) Yes / 2 ( ) No
	1 ( ) Yes / 2 ( ) No	i. Margarine, mayonnaise, ketchup or other industrialized sauces?
	j. Sliced bread, hot dog or hamburger buns	1 ( ) Yes / 2 ( ) No
	1 ( ) Yes / 2 ( ) No	j. Instant noodles, packet soup, frozen lasagna or another frozen prepared food meals (takeout)?
	k. Mayonnaise, ketchup or mustard	1 ( ) Yes / 2 ( ) No
	1 ( ) Yes / 2 ( ) No
	l. Margarine
	1 ( ) Yes / 2 ( ) No
	m. Instant noodles, packet soup, frozen lasagna or another frozen prepared food meals (takeout)
	1 ( ) Yes / 2 ( ) No
Soft drink consumption	How many days a week do you usually drink soda or artificial juice?	How many days a week do you usually drink soda? ____ Days; 0. Never or less than once a week.	Vigitel took into account the consumption of soft drinks and artificial juice. The PNS took into account only the consumption of soft drinks. In both databases, an indicator was created taking into consideration how to control the consumption by five or more days a week.
	1 ( ) 1 a 2 days a week
	2 ( ) 3 a 4 days a week
	3 ( ) 5 a 6 days a week
	4 ( ) Every day (including Saturday and Sunday)
	5 ( ) Almost never
	6 ( ) Never

Variables	Vigitel^a		PNS^b		Difference in percentage points
	n=1,812		n=1,225
	%	95%CI^c	%	95%CI^c
Sex
Male	47.6	43.5;51.7	46.7	42.3;51.1
Female	52.4	48.3;56.5	53.3	48.9;57.7	-0.9^d
Age (in years)
18-24	17.9	15.3;20.9	18.1	14.8;21.8	-0.2^d
25-39	38.1	33.9;42.6	31.3	28.4;34.4	6.8^d
40-59	31.6	28.2;35.2	35.0	31.8;38.4	-3.4^d
≥60	12.4	10.9;14.0	15.6	13.2;18.2	-3.2^d
Race/skin color
White	25.9	22.5;29.6	20.5	17.8;23.6	5.4^d
Black	6.7	4.5;9.8	7.6	6.0;9.5	-0.9^d
Asian	0.3	0.2;0.8	0.3	0.1;0.9	0.0^d
Brown	60.3	56.2;64.3	70.8	67.4;73.9	-10.5
Indigenous	0.8	0.4;1.6	0.8	0.4;1.6	0.0^d
Schooling (in years of study)
0-8	31.0	26.8;35.6	28.5	23.9;33.6	2.5^d
9-11	38.2	34.5;42.0	38.8	33.3;43.0	0.6^d
≥12	30.8	27.7;34.1	33.4	29.6;37.5	-2.6^d
Diabetes mellitus
No	95.1	93.6;96.1	93.9	92.4;95.1
Yes	4.9	3.9;6.3	6.1	4.9;7.6	-1.2^d
Arterial hypertension
No	81.5	78.8;83.9	79.5	76.6;82.1
Yes	18.5	16.1;21.2	20.5	17.9;23.4	-2.0^d
Overweight
No	43.4	39.4;47.5	41.8	38.4;45.3
Yes	56.6	52.5;60.6	58.2	54.7;61.6	-1.6^d
Obesity
No	76.7	73.0;80.0	79.9	76.6;82.8
Yes	23.3	20.0;27.0	20.1	17.2;23.4	3.2^d
Smoking
No	88.1	84.0;91.2	89.3	86.6;91.5
Yes	11.9	8.8;16.0	10.7	8.5;13.4	1.2^d
Alcohol abuse
No	82.3	78.3;85.8	84.4	81.7;86.8
Yes	17.7	14.2;21.7	15.6	13.2;18.2	2.1^d
Consumption of five or more groups of ultra-processed foods on the day before the interview
No	85.3	82.4;87.8	84.4	81.7;86.8
Yes	14.7	12.2;17.6	15.6	13.2;18.2	2.1^d

Variables	Male			Female
	Vigitel^a N=631	PNS^b N=538	Difference in percentage points	Vigitel^a N=1,181	PNS^b N=687	Difference in percentage points
	% (95%CI^c)	% (95%CI^c)	Difference in percentage points	% (95%CI^c)	% (95%CI^c)	Difference in percentage points
Diabetes mellitus
No	95.9 (93.8;97.1)	93.5 (90.3;95.6)		94.3 (92.3;95.8)	94.2 (92.3;95.7)
Yes	4.1 (2.8;6.1)	6.5 (4.4;9.7)	-2.4^d	5.7 (4.2;7.7)	5.8 (4.3;7.7)	-0.1^d
Arterial hypertension
No	85.1 (80.9;88.3)	82.6 (78.8;85.8)		78.3 (74.7;81.5)	76.8 (72.7;80.4)
Yes	14.9 (11.6;19.0)	17.4 (14.2;21.2)	-2.5^d	21.7 (18.5;25.3)	23.2(19.6;27.3)	-1.5^d
Overweight
No	42.0 (35.3;49.1)	40.5 (34.6;46.7)		44.6 (40.1;49.2)	43.0 (38.6;47.4)
Yes	58.0 (50.9;64.7)	59.5 (53.3;65.4)	-1.5^d	55.4 (50.8;59.9)	57.0 (52.6;61.4)	-1.6^d
Obesity
No	76.7 (70.6;81.9)	83.2 (79.0;86.7)		76.6 (72.1;80.7)	77.0 (72.4;81.0)
Yes	23.3 (18.1;29.4)	16.8 (13.3;21.0)	6.5^d	23.4 (19.3;27.9)	23.0 (19.0;27.6)	0.4^d
Smoking
No	82.9 (74.9;88.7)	86.9 (81.3;91.1)		92.8 (90.2;94.8)	91.3 (88.8;93.3)
Yes	17.1 (11.3;25.1)	13.1 (8.9;18.7)	4.0^d	7.2 (5.2;9.8)	8.7 (6.7;11.2)	-1.5^d
Alcohol abuse
No	71.4 (64.0;77.7)	78.3 (73.8;82.3)		92.3 (89.7;94.3)	89.8 (86.7;92.2)
Yes	28.6 (22.3;36.0)	21.7 (17.7;26.2)	6.9^d	7.7 (5.7;10.3)	10.2 (7.8;13.3)	-2.5^d
Consumption of five or more groups of ultra-processed foods on the day before the interview
No	83.3 (78.2;87.4)	83.3 (78.7;87.1)		87.2 (83.8;89.9)	90.4 (87.8;92.5)
Yes	16.7 (12.6;21.8)	16.7 (12.9;21.3)	0.0^d	12.8 (10.1;16.2)	9.6 (7.5;12.2)	3.2^d
Regular consumption of soft drink five or more days a week
No	85.8 (80.0;90.1)	84.3 (79.8;87.8)		89.6 (85.8;92.4)	93.2 (90.6;95.1)
Yes	14.2 (9.9;20.0)	15.7 (12.2;20.2)	-1.5^d	10.4 (7.6;14.2)	6.8 (4.9;9.4)	3.6^d

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 61 3315-3464, Fax: +55 61 3315-3464 - Brasília - DF - Brazil
E-mail: ress.svs@gmail.com

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[1] Correspondence Yara de Moura Magalhães Lima ymagalhaes9@gmail.com.