Abstract The supply of protein-enriched foods (AAPs) in the Chilean market has been increasing and is expected to continue growing. However, the specific types and characteristics of the products available in Chile remain unclear. Therefore, the objective of this study was to characterize the AAPs available in supermarkets within the Metropolitan Region. Methods: A descriptive study was conducted with a systematic search in 9 supermarkets. Products with added protein and foods modified to enhance their protein content were included. Nutritional composition, ingredients, types of added proteins, price, and availability were analyzed. Results: A total of 176 AAPs were categorized into dairy products (35.2%), farinaceous products (11.4%), snacks (31.3%), non-dairy beverages (6.8%), sugary products (4.5%), and meat/vegetable substitutes (10.8%), with the most frequent products being cereal bars (n=55) and yogurt (n=40). Snacks had the highest protein content, with a median of 33.3 g per 100 g of product. The most common proteins added were dairy proteins, soy protein, and whey protein, found in 44.9%, 37.5%, and 27.8% of the products, respectively. Conclusions: A significant presence of dairy proteins in AAPs was noted. AAPs could be a beneficial option for increasing protein intake in groups that need it. However, clinical trials are necessary to assess the impact of their consumption on different target populations.

Resumen La oferta de alimentos con adición de proteínas (AAPs) en el mercado chileno ha ido en aumento y se proyecta que continuará creciendo. Sin embargo, se desconoce con detalle el tipo y las características de los productos comercializados en Chile. Por ello, el objetivo de este estudio fue caracterizar los AAPs disponibles en supermercados de la Región Metropolitana. Métodos: Estudio descriptivo en el que se realizó una búsqueda sistemática en 9 supermercados. Se incluyeron productos con adición de proteínas y alimentos modificados para aumentar su contenido proteico. Se analizó su composición nutricional, ingredientes, proteínas añadidas, precio y disponibilidad. Resultados: Se examinaron 176 AAPs de las categorías de lácteos (35,2%), farináceos (11,4%), snacks (31,3%), bebidas no lácteas (6,8%), productos azucarados (4,5%) y cárnicos/sucedáneos de origen vegetal (10,8%), siendo los productos más frecuentes las barras de cereal (n=55) y el yogurt (n=40). Los snacks presentaron el mayor aporte de proteínas, con una mediana de 33,3 g por 100 g de producto. Las proteínas más utilizadas fueron de origen lácteo, proteína de soya y proteána de suero de leche, encontradas en un 44,9%, 37,5% y 27,8% de los productos, respectivamente. Conclusiones: Se observó una amplia adición de proteínas de origen lácteo en los AAPs. Estos productos podrían ser una opción favorable para aumentar la ingesta proteica en grupos que lo requieran, pero es necesario realizar ensayos clinicos para evaluar su impacto en distintos grupos de interés.

Resumo: Objetivo: conhecer a relação entre o perfil de consumo alimentar (frequência e tipo) com a prevalência, extensão e distribuição das lesões de cárie em crianças de 18-35 meses da cidade de Montevidéu, Uruguai. Métodos: foi realizado um estudo transversal em 50 crianças, de ambos os sexos. Os pais responderam a um questionário sobre dados sociodemográficos, hábitos alimentares e higiene bucal. Dois examinadores calibrados registraram lesões de cárie em cada superfície dentária de acordo com os critérios ICDAS-epi, índice de placa visível e índice de PUFA. Foi realizada análise descritiva das variáveis. A análise da dieta considerou o tipo de alimento, o tempo de incorporação e a frequência por meio de porcentagens. Resultados: as crianças examinadas tinham idade média de 26,6 ± 5,9 meses. A prevalência de cárie foi de 34%, com extensão de 2,3 e 4,3 para ceo-d e ceo-s respectivamente. Em sua maioria, lesões graves não tratadas foram observadas localizadas no setor anterossuperior e póstero-inferior. O índice PUFA foi de 8%. 30% consumiam leite materno, 54% leite com açúcar, 100% consumiram bebidas e alimentos açucarados antes dos 11 meses e diariamente. Crianças que consumiram bebidas açucaradas (não lácteos) em mamadeira apresentaram maior extensão e gravidade das lesões de cárie (ceo-d = 3,5 e ceo-s = 7,8). Conclusões: o conhecimento dos padrões de alimentação na primeira infância precisa ser aprofundado. A população estudada mostrou a incorporação precoce do açúcar na dieta, alertando para a presença de um fator de risco comum para diversas doenças não transmissíveis (cárie, diabetes, obesidade, doenças cardiovasculares).

Summary: Objective: to learn the relation between the food consumption profile (frequency and type) and the prevalence, extension and distribution of cavity lesions in children of 18-35 months of age from the city of Montevideo, Uruguay. Material y Methods: a cross-sectional study was carried out in 50 children, of both sexes. Parents answered a questionnaire regarding sociodemographic data, eating habits and oral hygiene. Two examiners recorded caries lesions on each tooth surface according to ICDAS-epi criteria, visible plaque index and PUFA index. Descriptive analysis of the variables were performed. The diet analysis considered food type, incorporation time and frequency through percentages. Results: children examined had an average age of 26.6 ± 5.9 months of age. The cavity prevalence was 34%, with an extension of 2.3 and 4.3 for ceo-d and ceo-s respectively. For the most part, severe untreated injuries were observed located in the anterior superior and posterior-inferior sector. The PUFA index was 8%. 30% consumed breast milk, 54% milk with sugar, 100% consumed beverages and sugary foods, mostly before 11 months and daily. Children who consumed sugary drinks (non-milk) in a bottle presented greater extent and severity of cavity lesions (ceo-d modificated= 3.5 and ceo-s modificated = 7.8). Conclusions: we need to deepen our knowledge of feeding patterns in early childhood. The population studied showed the early incorporation of sugar into the diet, warning about the presence of a common risk factor for various non-communicable diseases (cavities, diabetes, obesity, cardiovascular diseases).

Resumen: Objetivo: conocer la relación entre el perfil de consumo de alimentos (frecuencia y tipo) con la prevalencia, extensión y distribución de las lesiones de caries en niños de 18-35 meses de la ciudad de Montevideo, Uruguay. Material y método: se realizó un estudio transversal con una muestra no probabilística de 50 niños, de ambos sexos. Los padres respondieron a un cuestionario sobre datos sociodemográficos, hábitos alimenticios e higiene bucal. Dos examinadoras calibradas registraron las lesiones de caries de acuerdo al criterio ICDAS-epi, índice de placa visible e índice PUFA. Se realizaron análisis descriptivos para caries dental y dieta (tipo de alimento, incorporación y frecuencia). Resultados: los niños examinados presentaban una edad promedio de 26,6±5,9 meses. La prevalencia de caries fue de 34%, con una extensión de 2,3 y 4,3 para ceo-d y ceo-s, respectivamente. Mayoritariamente se observaron lesiones severas, no tratadas, en el sector anterosuperior y posteroinferior. El índice PUFA fue de 8%. El 30% consumía leche materna, 54% leche con azúcar y el 100% consumía diariamente bebidas azucaradas no lácteas y alimentos azucarados antes de los 11 meses de vida. Los niños que consumían bebidas azucaradas (no lácteas) en biberón presentaron mayor extensión y severidad de las lesiones de caries (ceo-d modificado = 3,5 y ceo-s modificado = 7,8). Conclusiones: el conocimiento de los patrones de alimentación en la primera infancia necesitan ser profundizados. La población estudiada mostró la temprana incorporación de azúcar a la dieta, alertando sobre la presencia de un factor de riesgo común a diversas enfermedades no transmisibles (caries, diabetes, obesidad, enfermedades cardiovasculares).

ABSTRACT Objective Evaluate the consumer’s food environment in food retailers around public schools in the municipality of Governador Celso Ramos, state of Santa Catarina, in southern Brazil. Methods A survey was carried out in the surroundings of three public schools, from March to May 2022. Food retailers located in a pre-established 800m buffer zone were identified. A location system device recorded latitude and longitude. An audit of the establishments was performed using a specific validated instrument for auditing the consumer food environment (AUDITNOVA). These establishments were grouped into: Group 1 - predominantly selling fresh foods, Group 2 - mixed establishments, and Group 3 - predominantly selling ultra-processed foods. These establishments were assessed using a Consumer Food Environment Healthiness Score evaluation system. The data were analyzed using the statistical software Stata version 16.0. Results The study audited 21 establishments, 47.6% of which were small neighborhood food markets, 23.8% bakeries, 14.3% butchers/fishmongers, 9.5% grocery stores and 4.8% supermarkets. It was found that privately-owned vegetable markets had a higher availability of fresh and minimally processed food categories, while the lowest scores for this category were found in bakeries. Regarding ultra-processed foods, the most commonly found items were sugary beverages and candies, chocolates, and filled cookies. Conclusion More audit studies ought to be carried out in the surroundings of schools to broaden the understanding of the relationship between access, availability, prices and food advertisement in order to support the construction of strategies aimed at preventing obesity in the population.

RESUMO Objetivo Avaliar o ambiente alimentar do consumidor em estabelecimentos de comercialização de alimentos no entorno de escolas públicas no município de Governador Celso Ramos, estado de Santa Catarina, no Sul do Brasil. Métodos Foi realizada, entre março e maio de 2022, no entorno de três escolas públicas, auditoria nos comércios varejistas localizados em uma zona pré-estabelecida de 800m. Um equipamento com sistema de localização realizou o registro da latitude e longitude. Esta auditoria foi realizada utilizando um instrumento validado próprio para auditoria do ambiente alimentar do consumidor (AUDITNOVA). Estes foram agrupados em Grupo 1 - com venda predominante de alimentos in natura; Grupo 2 - estabelecimentos mistos; Grupo 3 - com venda predominante de alimentos ultraprocessados. Os estabelecimentos foram avaliados por um sistema de avaliação de saudabilidade do ambiente alimentar do consumidor. Os dados foram analisados no programa estatístico Stata versão 16.0. Resultados O estudo auditou 21 estabelecimentos, sendo 47,6% mercados de bairro, 23,8% padarias, 14,3% açougues/peixarias, 9,5% sacolões/hortifrutis privados e 4,8% supermercados. Foi identificado que sacolões/hortifrutis privados apresentaram maior oferta de alimentos da categoria in natura e minimamente processados, enquanto os menores scores desta categoria de alimentos foram encontrados em padarias. Em relação aos alimentos ultraprocessados, os alimentos mais presentes foram bebidas açucaradas e balas, chocolates e biscoito recheado. Conclusão Sugere-se a realização de mais estudos de auditoria em comércios varejistas no entorno de escolas para ampliar a compreensão da relação entre o acesso, disponibilidade, preços e propagandas dos alimentos de modo a subsidiar a construção de estratégias que visem a prevenção da obesidade na população.

ABSTRACT: Abstract: The consumption of sugar-sweetened beverages and unhealthy foods is a public health problem that has become a regulatory issue for the public policies aimed at reducing the impact of Non Communicable Diseases (NCDs) in Latin America. Objective: to identify the Public Policies in Colombia, Argentina and Chile for the regulation of the consumption of sugar and junk food. Materials and methods. Exploratory analysis through a literature and policy documents review. Results: In 2021, Colombia approved the Law 2120 called “Junk Food Law” promoting public access to information for a healthy food environment to prevent NCDs. It includes food labeling for overweight and obesity prevention and establishes a specific labeling regulation for processed and ultra-processed food and sweet drink products. Chile was pioneer in the development of warning stamps on food packages and since 2014 also taxes sweet non-alcoholic beverages. In 2021, Argentina approved a law to add labels on food packages to alert consumers about excess of sugars, fats and sodium. Conclusions: The three investigated countries have labeling policies for processed food, and Chile puts taxes on sugary drinks. It is important to study the impact of these policies on NCD prevalence, severity and on dental caries.

RESUMEN: Introducción: El consumo de bebidas azucaradas y alimentos no saludables es un problema de Salud Pública y de las Políticas Públicas que buscan reducir el impacto de las Enfermedades No Trasmisibles (ENT) en América Latina. Objetivo: identificar las Políticas Públicas generadas en Colombia, Argentina y Chile para la regulación del consumo de azúcar y comida chatarra. Materiales y Métodos: Análisis exploratorio a través de una revisión de literatura y revisión de documentos normativos. Resultados: Colombia en el año 2021 sancionó la Ley 2120 denominada “Ley de Comida Chatarra”, que promueve el acceso a información necesaria para fomentar entornos alimentarios saludables y prevenir las ENT, que incluye nuevas normas para el etiquetado de alimentos y describir sus características al consumidor y así limitar el consumo de alimentos procesados y ultraprocesados. Chile fue pionero en el desarrollo de los sellos de advertencia y desde el año 2014, aplica un impuesto adicional a las bebidas no alcohólicas. Argentina en 2021, sancionó la ley que obliga a la industria de alimentos a disponer de etiquetas en los envases que alerten al consumidor sobre los excesos de azúcares, grasas y sodio Conclusiones: Los tres países investigados cuentan con políticas de etiquetado de alimentos procesados, y en Chile existen impuestos a las bebidas azucaradas. Es importante estudiar el impacto de dichas políticas en la prevalencia y severidad de las ENT y de la caries.

Resumen Introducción: La población escolar es un grupo fundamental para las intervenciones de promoción de la salud, ya que en los niños y adolescentes se sientan las bases de un comportamiento saludable en la vida adulta, que puede ser muy influenciado por la escuela. Objetivo: Describir los factores comportamentales relacionados con la salud de los escolares de 13 a 17 años de edad que cursan educación básica secundaria y media en Colombia. Métodos: Se realizó una encuesta nacional transversal (Encuesta de Salud en Escolares -ENSE-) con los lineamientos de Global School-based Student Health Survey para recolectar información sobre prácticas alimentarias, actividad física, consumo de alcohol y drogas, lesiones e intimidación, y salud bucal, visual y auditiva. El muestreo fue probabilístico, por conglomerados y polietápico. Resultados: Se incluyeron 79.640 escolares de 298 municipios. Los escolares presentaron bajo consumo de frutas, verduras (13.1%) y productos lácteos (76.5 %), alto consumo de alimentos ultraprocesados (82.4 %), bebidas azucaradas (74.0 %) y comidas rápidas (14.8 %); alto uso de sal añadida en la mesa (43.3 %), actividad física inferior a la recomendada (15.0 %) y sedentarismo (46.3 %). Fue frecuente el consumo de alcohol (44.7 %) y sustancias psicoactivas (14.7 %) y reportaron situaciones de intimidación (15.4 %), rechazo (8.2 %) y agresiones verbales (42.7 %). Conclusiones: La ENSE muestra desigualdades por género, etnia y clase social en todo el país. Los hallazgos observados en los escolares son factores de riesgo de enfermedades crónico-degenerativas y mentales, y requieren la atención urgente de los actores sociales del país.

Abstract Introduction: The school population represents a fundamental group for health promotion actions, given that the foundations of healthy behaviors in adult life are established in children and adolescents, who can be greatly influenced by the school. Objective: To describe the health-related behavioral factors of schoolchildren between 13 and 17 years of age in secondary and middle school in Colombia. Methods: A national cross-sectional study was conducted (i.e., School Health Survey -ENSE-) that recorded information on dietary practices, physical activity, alcohol and drug consumption, injuries and bullying, and oral, visual and hearing health. Sampling was probabilistic, cluster and multistage. Results: Schoolchildren have low consumption of fruits, vegetables (13.1%) and dairy (76.5 %), high consumption of ultra-processed foods (82.4 %), sugary drinks (74.0 %) and fast foods (14.8 %), frequent addition of salt at the table (43.3 %), low compliance with physical activity recommendations (15.0 %) and high sedentary lifestyle (46.3 %), frequent consumption of alcohol (44.7 %) and psychoactive substances (14.7 %), in addition to prevalent situations of bullying (15.4 %), rejection (8.2 %) and verbal aggression (42.7 %). Conclusions: The ENSE shows critical inequalities by gender, ethnicity and social class, throughout the country. The indicators observed in schoolchildren are precursors of various chronic and degenerative diseases and mental illness, which requires the urgent attention of the different social actors in the country.

Resumo Objetivou-se avaliar o impacto do consumo de sucos antes dos 6 meses de idade no Índice de Massa Corporal para Idade (IMC/I) e no consumo alimentar em pré-escolares. Estudo longitudinal com amostra composta por mães e seus filhos (n=103) entre 6 meses e 3 a 6 anos. Peso e estatura foram aferidos e convertidos para o escore z de IMC/I. Para avaliar o consumo alimentar, foi utilizado o Questionário de Frequência Alimentar Infantil. Testes de Qui-Quadrado e t de Student foram utilizados para comparação entre os grupos. Não houve diferença nos parâmetros antropométricos entre pré-escolares que receberam ou não suco antes dos seis meses. Aquelas que tiveram introdução de suco mais precoce (≤150 dias de vida) apresentaram consumo mais frequente (≥1x/dia) de suco artificial (63,8% versus 35,7%; p=0,028) e biscoito recheado (21,3% versus 14,3%; p=0,001) na idade pré-escolar. Crianças que receberam suco do tipo artificial antes dos 6 meses tiveram maior prevalência de consumo de refrigerante entre 1 e 4x/semana (69,2% versus 27,4%; p=0,014) e menor prevalência de consumo de achocolatado pelo menos 1x/dia (38,5% versus 69,4%; p=0,027). Sendo assim, crianças com introdução precoce de suco apresentaram maior consumo de alimentos doces e bebidas açucaradas em fase pré-escolar.

Abstract The aim of this study was to evaluate the impact of fruit juice consumption before 6 months of age on Body Mass Index-for-age (BMI-for-age) and food consumption in preschoolers. We conducted a longitudinal study with mothers and their children (n=103) at 6 months and 3-6 years. Weight and height were measured and converted into BMI-for-age z-scores. Food consumption was analyzed using the Food Frequency Questionnaire for Children. Groups were compared using the chi-squared and Student’s t-tests. No differences in anthropometric measurements were found at preschool age between children who had been given fruit juice before 6 months and those who had not. Consumption of artificial juice (≥once/day) and sandwich cookies at preschool age was higher in children with early introduction of fruit juice (≤150 days of life) (63.8% versus 35.7%; p=0.028 and 21.3% versus 14.3%; p=0.001, respectively). The prevalence of the consumption of soda (1 to 4 times/week) and chocolate milk (at least once/day) was higher in children who had been given artificial juice before 6 months (69.2% versus 27.4%; p=0.014 and 38.5% versus 69.4%; p=0.027, respectively). It can be concluded that the consumption of sweet foods and sugary beverages was higher in children with early introduction of fruit juice.

Resumo Objetivou-se avaliar o impacto do consumo de sucos antes dos 6 meses de idade no Índice de Massa Corporal para Idade (IMC/I) e no consumo alimentar em pré-escolares. Estudo longitudinal com amostra composta por mães e seus filhos (n=103) entre 6 meses e 3 a 6 anos. Peso e estatura foram aferidos e convertidos para o escore z de IMC/I. Para avaliar o consumo alimentar, foi utilizado o Questionário de Frequência Alimentar Infantil. Testes de Qui-Quadrado e t de Student foram utilizados para comparação entre os grupos. Não houve diferença nos parâmetros antropométricos entre pré-escolares que receberam ou não suco antes dos seis meses. Aquelas que tiveram introdução de suco mais precoce (≤150 dias de vida) apresentaram consumo mais frequente (≥1x/dia) de suco artificial (63,8% versus 35,7%; p=0,028) e biscoito recheado (21,3% versus 14,3%; p=0,001) na idade pré-escolar. Crianças que receberam suco do tipo artificial antes dos 6 meses tiveram maior prevalência de consumo de refrigerante entre 1 e 4x/semana (69,2% versus 27,4%; p=0,014) e menor prevalência de consumo de achocolatado pelo menos 1x/dia (38,5% versus 69,4%; p=0,027). Sendo assim, crianças com introdução precoce de suco apresentaram maior consumo de alimentos doces e bebidas açucaradas em fase pré-escolar.

Abstract The aim of this study was to evaluate the impact of fruit juice consumption before 6 months of age on Body Mass Index-for-age (BMI-for-age) and food consumption in preschoolers. We conducted a longitudinal study with mothers and their children (n=103) at 6 months and 3-6 years. Weight and height were measured and converted into BMI-for-age z-scores. Food consumption was analyzed using the Food Frequency Questionnaire for Children. Groups were compared using the chi-squared and Student’s t-tests. No differences in anthropometric measurements were found at preschool age between children who had been given fruit juice before 6 months and those who had not. Consumption of artificial juice (≥once/day) and sandwich cookies at preschool age was higher in children with early introduction of fruit juice (≤150 days of life) (63.8% versus 35.7%; p=0.028 and 21.3% versus 14.3%; p=0.001, respectively). The prevalence of the consumption of soda (1 to 4 times/week) and chocolate milk (at least once/day) was higher in children who had been given artificial juice before 6 months (69.2% versus 27.4%; p=0.014 and 38.5% versus 69.4%; p=0.027, respectively). It can be concluded that the consumption of sweet foods and sugary beverages was higher in children with early introduction of fruit juice.

Resumo Objetivos: caracterizar a disponibilidade e a qualidade nutricional dos menus infantis nos restaurantes e estabelecimentos de fast-foods em Shoppings Centers no Brasil. Métodos: trata-se de um estudo observacional e transversal. Os dados foram coletados nos websites de cada estabelecimento e em aplicativos de vendas de alimentos, com questionário composto por duas seções: Caracterização do estabelecimento e caracterização do menu infantil. A coleta dos dados ocorreu em dez capitais distribuídas nas cinco regiões do Brasil. Resultados: foram avaliados 116 menus infantis. Maior número de estabelecimentos foi classifcado como restaurante do que fast-food. Os métodos de cocção mais utilizados nos pratos principais foram grelhados (n=236, 64%) e cozidos (n=74, 20%), e nos acompanhamentos foram cozidos (n=204, 53%) e fritos (n=109, 28%). Apenas 40% (n=46) dos menus continham hortaliças. Menos de 10% (n=sete) ofertavam fruta como sobremesa; 31% (n=36) constavam bebida inclusa no menu infantil; 22% (n=25) ofereciam brindes associados ao menu. Apenas 32 (28%) estabelecimentos apresentavam a combinação feijão e arroz. Conclusão: a maioria das opções ofertadas às crianças era de baixa qualidade nutricional, com pouca oferta de hortaliças, frutas e do tradicional feijão e arroz. As bebidas incluídas nos menus, a maioria açucaradas, podem contribuir para uma elevada ingestão energética. Constata-se a necessidade de disponibilizar opções saudáveis e incentivar essas escolhas. Objetivos fastfoods fast foods Brasil Métodos tratase trata se transversal alimentos seções infantil Resultados 11 fastfood. fastfood food. food fast-food n=236, n236 n 236 (n=236 64% 64 n=74, n74 74 (n=74 20%, 20 20% , 20%) n=204, n204 204 (n=204 53% 53 n=109, n109 109 (n=109 28%. 28 28% . 28%) 40 n=46 n46 46 (n=46 hortaliças 10 n=sete nsete sete (n=sete sobremesa 31 n=36 n36 36 (n=36 22 n=25 n25 25 (n=25 3 (28% arroz Conclusão açucaradas energética Constatase Constata escolhas 1 n=236 n23 23 (n=23 6 n=74 n7 7 (n=7 2 n=204 n20 (n=20 5 n=109 n10 (n=10 4 n=4 n4 (n=4 n=3 n3 (n=3 n=2 n2 (n=2 (28 n=23 n=7 (n= n=20 n=10 n1 (n=1 n= (2 (n n=1 (

Abstract Objectives: characterize the availability and assess the nutritional quality of children’s menus ofered in regular and fast food restaurants in Brazilian malls. Methods: this is an observational and cross-sectional study. Data were collected on the websites of each restaurant and in food sales applications, with a questionnaire consisting of two sections: characterization of the restaurant and characterization of the children’s menu. Data collection took place in ten capitals in the fve regions of Brazil. Results: 116 children’s menus were evaluated. The study identifed a higher number of regular (n=70, 60%) than fast-food (n=46,40%) restaurants. The cooking methods most used in the main dishes were grilled (n=236, 64%) and boiled (n=74, 20%), and in the side dishes were boiled (n=204, 53%) and fried (n=109, 28%). Only 40% (n=46) of the menus contained vegetables. Less than 10% (n=seven) ofered fruit as dessert, 31% (n = 36) had drinks included in the children’s menu and 22% (n=25) ofered gifts associated with the menu. Only 32 (28%) restaurants had the combination of beans and rice. Conclusion: most of the options ofered to children were of low nutritional quality, with low ofer of vegetables, fruits and the traditional beans and rice. The beverages included in the menus, most of them sugary, can contribute to a high-energy intake. There is a need to provide healthy options and encourage these choices. Objectives childrens s malls Methods crosssectional cross sectional applications sections Brazil Results 11 evaluated n=70, n70 n 70 (n=70 60% 60 fastfood n=46,40% n4640 46 40 (n=46,40% n=236, n236 236 (n=236 64% 64 n=74, n74 74 (n=74 20%, 20 20% , 20%) n=204, n204 204 (n=204 53% 53 n=109, n109 109 (n=109 28%. 28 28% . 28%) n=46 n46 (n=46 vegetables 10 n=seven nseven seven (n=seven dessert 31 36 22 n=25 n25 25 (n=25 3 (28% rice Conclusion sugary highenergy high energy intake choices 1 n=70 n7 7 (n=7 6 n=46,40 n464 4 (n=46,40 n=236 n23 23 (n=23 n=74 2 n=204 n20 (n=20 5 n=109 n10 (n=10 n=4 n4 (n=4 n=2 n2 (n=2 (28 n=7 (n= n=46,4 (n=46,4 n=23 n=20 n=10 n1 (n=1 n= (2 n=46, (n=46, n=1 (

Abstract The aim of this multicenter study was to explore the early-life sugar consumption and dietary practices in Latin America as well as to investigate the association between breastfeeding duration and the age at which foods and beverages with added sugars are introduced. A cross-sectional study was conducted with 805 1- to 3-year-old children from 10 Latin American countries, as a complementary study to the Research Observatory for Dental Caries of the Latin American Region (OICAL). A Food Frequency Questionnaire previously tested in different countries was applied to children’s mothers and data on breastfeeding and age at introduction of sugary foods and beverages was collected. Statistical analysis included the Kruskal-Wallis test and Poisson regression with robust variance, with the calculation of crude and adjusted mean ratios (MR) and 95% of confidence intervals (CI). The average age at introduction of sugary foods and beverages was 10.1 months (95%CI 9.7–10.4) and 9.6 (95%CI 9.2–9.9) months, respectively, with a significant variation between countries (p < 0.001). The average daily frequency of sugary foods-beverages was 3.3 times per day (95%CI 3.1–3.5) and varied significantly between countries (p = 0.004). Breastfeeding duration of over six months was associated with an increase in the age of introduction of sweet drinks (16%; MR 1.16; 95%CI 1.05–1.28) and foods (21%; MR 1.21; 95%CI 1.10–1.33). In conclusion, most children from vulnerable settings in Latin America start consuming sugary products in the first year of life and a high frequency of consumption was reported through early childhood. Additionally, breastfeeding contributes to a delay in the introduction of sugary products.

Resumen: Antecedentes y Objetivos: Las bebidas de Annona muricata se utilizan ampliamente en la medicina tradicional para tratar diferentes padecimientos; sin embargo, han sido poco caracterizadas fitoquímicamente y se consumen como bebidas azucaradas, y pueden contribuir a enfermedades no trasmisibles, entre ellas la obesidad. El objetivo de este trabajo fue obtener y caracterizar una bebida sensorialmente aceptable a partir de un extracto de hojas y pulpa de A. muricata. Métodos: Se utilizó un diseño de mezcla para formular nueve bebidas, combinando diferentes proporciones del extracto acuoso de hojas y pulpa de A. muricata. Estas bebidas se sometieron a una evaluación fisicoquímica y sensorial. A partir de estos resultados, se seleccionó una bebida para caracterizarla por espectrofotometría y compararla con una bebida infusionada y otra comercial. Además, se analizó la composición fitoquímica de la bebida seleccionada mediante cromatografía de ultra alta resolución acoplada a espectrometría de masas y cromatografía líquida de alta resolución acoplada a un detector de matriz de fotodiodos. Resultados clave: La bebida seleccionada se formuló con 25% de pulpa, 50% de extracto de hojas y 25% de agua; además, presentó un valor de 7.63 °Brix, un pH 3.42 y una acidez de 0.40%. Esta bebida fue hasta tres veces superior en compuestos bioactivos respecto a las bebidas infusionada y comercial. Se cuantificaron catorce compuestos fenólicos y dos acetogeninas, mientras que se identificaron provisionalmente dos alcaloides (coclaurina y reticulina) y quince acetogeninas. Conclusiones: La combinación de extracto de hojas y pulpa de A. muricata es una alternativa vital para obtener una bebida sensorialmente aceptable que contiene compuestos bioactivos con potencial acción medicinal, ya que los compuestos fenólicos, alcaloides y acetogeninas presentes en la bebida podrían tener actividades biológicas eficientes en la prevención de enfermedades crónicas degenerativas.

Abstract: Background and Aims: Annona muricata beverages are widely used in traditional medicine to treat different ailments; however, they have been little characterized phytochemically and are consumed as sugary beverages, and may contribute to non-communicable diseases, including obesity. The objective of this work was to obtain and characterize a sensorially acceptable beverage from an extract of A. muricata leaves and pulp. Methods: A mixture design was used to formulate nine beverages by combining different ratios of the aqueous extract of A. muricata leaves and pulp. These beverages were subjected to physicochemical and sensory evaluation. Based on these results, one beverage was selected to be characterized by spectrophotometry and compared with an infused and commercial beverage. In addition, the selected beverage was further analyzed for its phytochemical composition by ultra-high-performance chromatography coupled to mass spectrometry and high-performance liquid chromatography coupled to a photodiode array detector. Key results: The selected beverage was formulated with 25% pulp, 50% leaf extract, and 25% water; it also displayed a 7.63 °Brix, pH 3.42, and 0.40% acidity. This beverage was up to three times higher in bioactive compounds than infused and commercial beverages. Fourteen phenolic compounds and two acetogenins were quantified, while two alkaloids (coclaurine and reticuline) and fifteen acetogenins were tentatively identified. Conclusions: The combination of A. muricata leaf extract and pulp is a vital alternative to obtain a sensorially acceptable beverage that contains bioactive compounds with a potential medicinal action since the phenolic compounds, alkaloids, and acetogenins present in the beverage could have efficient biological activities in the prevention of chronic degenerative diseases.

Resumen El alto contenido de azúcar añadido en gran parte de las bebidas comerciales ha representado una problemática para la salud a nivel mundial desde hace muchos años, debido al alto consumo de este tipo de bebidas por parte de la población promedio, y donde el contexto costarricense no presenta un panorama distinto. La investigación reflejada en este artículo, se propuso realizar un escrutinio de las principales bebidas con contenido de azúcar añadido que se adquieren en el comercio de la zona occidental de Costa Rica, así como la indagación sobre los hábitos de consumo de este tipo de bebidas en la población estudiantil del Recinto de Grecia en la Universidad de Costa Rica (UCR). Se desarrollaron visitas presenciales y virtuales a comercios de la zona de influencia del Recinto, con miras a lograr el inventariado de bebidas disponibles y la clasificación según su contenido de azúcares reportado en las etiquetas nutricionales, además de la elaboración y aplicación de una encuesta a estudiantes de las distintas carreras que se imparten en el Recinto de Grecia - UCR. Como resultados, destacan un inventariado exhaustivo de más de 191 bebidas distintas entre marcas y presentaciones con contenido de azúcar añadido, incluyendo gaseosas, hidratantes, jugos (no gaseosos) y energéticas. Asimismo, 147 estudiantes encuestados de los cuales la mayoría no consumen cantidades excesivas del tipo de bebidas en estudio, pero se obtienen elementos importantes que demandan atención especial en torno a la salud. En conclusión, en muchas de las bebidas contempladas en el estudio, el contenido de azúcares reportados en la etiqueta ya sobrepasa el consumo diario máximo recomendado de sacarosa, si se ingiere una bebida completa de un volumen de uso personal (600 ml o inferior); y existe un porcentaje pequeño, pero no despreciable, que requiere atención en los encuestados, por la alta ingesta de bebidas azucaradas y el deshabito con respecto a la práctica de ejercicio físico.

Abstract The high content of added sugar in a large part of commercial beverages has represented a global health problem for many years, due to the high consumption of this type of beverages by the average population, and where the Costa Rican context does not presents a different picture. The research reflected in this article proposed to carry out a scrutiny of the main beverages with added sugar content that are acquired in the commerce of the western zone of Costa Rica, as well as the investigation of the consumption habits of this type of beverages in the student population of the Greece Campus at the University of Costa Rica (UCR). Face-to-face and virtual visits were carried out to businesses in the area of influence of the Campus, with a view to achieving the inventory of available beverages and the classification according to their sugar content reported on nutritional labels, in addition to the preparation and application of a survey to students. of the different careers taught at the Greece Campus - UCR. As results, an exhaustive inventory of more than 191 different beverages between brands and presentations with added sugar content stands out, including soft drinks, moisturizers, juices (not carbonated) and energy. Likewise, 147 students surveyed, most of whom do not consume excessive amounts of the type of beverages under study, but important elements are obtained that demand special attention regarding health. In conclusion, for many of the beverages contemplated in the study, the sugar content reported on the label already exceeds the maximum recommended daily intake of sucrose, if a full drink of a volume for personal use (600 ml or less) is ingested; and there is a small, but not negligible, percentage that requires attention in the respondents, due to the high intake of sugary drinks and the lack of habit with respect to the practice of physical exercise.

RESUMO INTRODUÇÃO: O consumo alimentar fora de casa é um importante determinante da saúde da população no geral e dos estudantes em particular, que recorrem com frequência à restauração pública existente nas imediações dos estabelecimentos de ensino. OBJETIVOS: Caraterizar a oferta alimentar incluída nos menus para estudantes em estabelecimentos de restauração pública portugueses. METODOLOGIA: Trata-se de um estudo observacional transversal realizado em estabelecimentos de restauração pública portugueses. Recolheram-se informações sobre a composição de alimentos e bebidas que compõem os menus para estudantes. RESULTADOS: Analisaram-se 138 menus com uma média de 3,4 opções por menu (desvio-padrão = 3). Apenas 10% dos menus incluem sopa e nenhum inclui fruta. A opção vegetariana é escassa (11%) e apenas 20% dos menus oferecem pescado, contrastando com 35% de opções de carne branca e 73% de carne vermelha. Em 68% das opções são servidas batatas fritas como acompanhamento. Relativamente à bebida, 31% dos menus incluem bebidas açucaradas e 42% incluem água. Os alergénios são apresentados somente em 3,6% dos menus. CONCLUSÕES: Os menus para estudantes analisados refletem que a oferta alimentar é desadequada e pouco variada, destacando-se a falta de hortofrutícolas e opções vegetarianas e o excesso de carne vermelha e bebidas açucaradas. É relevante adotar estratégias nacionais que promovam hábitos alimentares mais saudáveis na população jovem, considerando a oferta existente na proximidade dos estabelecimentos de ensino.

ABSTRACT INTRODUCTION: Food consumption outside home is an important health determinant for population in general and for students, who resort frequently to public catering in the areas surrounding educational establishments. OBJECTIVES: To characterize the food offer included in the student menus in the Portuguese catering establishments. METHODOLOGY: This is a cross-sectional observational study was design in the Portuguese public catering establishments. It was collected information about the composition of foods and beverages that compose the Student Menu. RESULTS: 138 student menus were analyzed with an average of 3.4 options per menu (standard deviation = 3). Only 10% include soup and none of them include fruit. The vegetarian option is rare (11%) and only 20% include the fish option, contrasting with 35% that include the white meat option and 73% that include the red meat option. In 68% of the menus french fries are served, as a side dish. Regarding to drinks, 31% of the menus include sugary drinks and 42% include water. Allergen information is presented only in 3.6% of the menus. CONCLUSIONS: The Students Menus that were analyzed reflect the inadequacy of lack of variety of food supply, highlighting the lack of fruit and vegetables and vegetarian options and the excess of red meat and soft drinks. It is relevant to adopt national strategies that promote healthier eating habits in the young population, considering the existing offer in the proximity of educational establishments.

Resumen Introducción: Los edulcorantes no calóricos (ENC) se utilizan para sustituir azúcares en alimentos y bebidas. Para que este reemplazo sea beneficioso para la salud, la ingesta de cada ENC no de bería superar su ingesta diaria admisible (IDA). El objetivo principal de este estudio es determinar el consumo de aspartamo, acesulfame-K, sucralosa y sacarina en la población argentina de 15 a 65 años y evaluar este consumo en relación con la IDA. Otros objetivos son estratificar el consumo en función de distintas variables sociodemográficas y determinar las principales fuentes de ENC consumidas por la población argentina. Métodos: La muestra fue de 1266 individuos (población urbana 15-65 años), estratificada por región, edad, sexo y nivel socioeconómico. Los datos de ingesta fueron recolectados con dos recordatorios de 24 horas. Resultados: En Argentina, el consumo promedio de sacarina, aspartamo, acesulfame-K y sucralosa está muy por debajo de su respectiva IDA: 8.4%, 3.2%, 2% y 0.3% de la IDA respectivamente. Los consumos máximos reportados tampoco superan la IDA. Hay una mayor proporción de mujeres consumidoras de ENC. La proporción de consumidores de ENC aumenta con la edad. Las regiones noreste y sur presentan el menor porcentaje de consumidores de ENC. Las bebidas constituyen la principal fuente de ENC, seguidas por los edulcorantes de mesa. La contri bución de los alimentos al consumo de ENC es despreciable. Discusión: En Argentina existe un buen margen de seguridad para la reformulación de productos azucarados tendiente a disminuir el exceso de calorías y el consumo de azúcares añadidos.

Abstract Introduction: Non-caloric sweeteners (NCS) are used to replace added sugars in foods and bev erages. For this replacement to be a health benefit, the intake of each NCS should not exceed its Acceptable Daily Intake (ADI). The main objective of this study is to determine the consumption of aspartame, acesulfame-K, sucralose, and saccharin in the argentine population aged 15 to 65 years and to evaluate this consumption in relation to the ADI. Other objectives are to stratify the consumption based on different sociodemographic vari ables and to determine the main sources of NCS consumed by the argentine population. Methods: The sample consisted of 1266 individuals (urban population aged 15-65), stratified by region, age, sex, and socioeconomic level. Intake data was collected with two 24-hour recalls. Results: In Argentina, the average consumption of saccharin, aspartame, acesulfame-K and sucralose is well below their respective ADI: 8.4%, 3.2%, 2% and 0.3% of the ADI, respectively. The maximum reported consumptions do not exceed the ADI either. There is a higher proportion of women who consume NCS. The proportion of NCS consumers increases with age. The Northeast and South regions have the lowest percentage of NCS consumers. Beverages constitute the main source of NCS, followed by tabletop sweeteners. The contribution of food to NCS consumption is negligible. Discussion: In Argentina there is a good safety margin for the reformulation of sugary products aimed at reduc ing the excess calories and added sugars consumed by the population.

Resumen En 2014 se promulgó en Ecuador el Reglamento de Etiquetado de Alimentos Procesados para el Consumo Humano, un instrumento legal que crea la obligación que los alimentos procesados lleven un rotulado en forma de semáforo que permita informar de un solo vistazo la calidad alimenticia de un producto. Por su parte, en 2016, en Chile se promulgó la Ley Sobre Composición Nutricional de los Alimentos y su Publicidad. Estos instrumentos pretenden mejorar la información sobre los productos que recibe el usuario y así mejorar su salud. En la presente investigación se comparó la efectividad de ambos instrumentos jurídicos mediante el cambio de comportamiento del consumidor, para lo cual se usaron los ingresos por rentas internas a bebidas azucaradas en cada país. Para Ecuador se tomaron como datos: el ingreso por impuestos a bebidas gaseosas, y el impuesto por botellas de plástico para un solo uso; encontrándose que, en Ecuador, luego de la promulgación del Reglamento de Etiquetado no existe algún cambio en el comportamiento del consumidor. En Chile se tomó como indicador el ingreso por impuestos a bebidas analcohólicas, encontrándose que, luego de la promulgación de la Ley Alimentos (2016) no se observó algún cambio en el comportamiento del consumidor.

Abstract In 2014 in Ecuador, it was promulgated a legal instrument that creates the obligation for processed foods to carry a label in the form of a traffic light that allows to know nutritional quality of a product to be reported at a single look. In Chile in 2016, it was promulgated similar legal instrument: “Ley Sobre Composición Nutricional de los Alimentos y su Publicidad” which requires that processed foods bear a label with a warning, for both legal instruments were analyzed their effectiveness through the change in consumer behavior in the consumption of sugary drinks. For Ecuador, the following data were taken: the income from taxes on soft drinks, and the tax on plastic bottles for single use; finding that, in Ecuador, that after the enactment of the Labeling Regulation there is no change in consumer behavior. In Chile, the income from taxes on non-alcoholic beverages was taken as an indicator, finding that, after the enactment of the Food Law (2016), It was no change observed in consumer behavior.

Resumen El incremento en la prevalencia de obesidad en adolescentes es alarmante, mismo que puede estar relacionado con el consumo de bebidas azucaradas. El objetivo del estudio fue determinar si el comportamiento afectivo de los padres y la edad de los hijos se relacionan con el consumo de bebidas azucaradas y alcohólicas en hombres y mujeres adolescentes mexicanos. Se realizó un estudio descriptivo, comparativo y correlacional en 296 adolescentes del nivel secundaria en una escuela pública de Xalapa, Veracruz, México. Se aplicaron la Escala de Evaluación del Comportamiento Afectivo y el Beverage Intake Questionnaire-15. Se encontraron factores predictores de magnitud moderada. En las mujeres el consumo de jugos ultra procesados se relacionó negativamente con la calidez de la madre, mientras que la hostilidad del padre se relacionó positivamente con el consumo de bebidas alcohólicas. En los hombres la hostilidad de la madre se asoció negativamente con el consumo de agua y jugo de frutas, y positivamente con el consumo de refrescos. Mientras que la hostilidad del padre se asoció positivamente con el consumo de jugos ultra-procesados y bebidas energéticas o deportivas.

Abstract The increase in the prevalence of obesity in adolescents is alarming and may be related to the consumption of sugar-sweetened beverages. The objective of the study was to determine whether parental affective behavior and age are related to consumption of sugar-sweetened beverages and alcoholic beverages in Mexican adolescent men and women. A cross-sectional and analytical study was conducted among 296 adolescents, who are students of a public secondary school located in Xalapa, Veracruz, Mexico. The Behavioral Affect Rating Scale and the Beverage Intake Questionnaire-15 were both conducted. Through multivariate analysis, predictors of moderate magnitude were found. In females, consumption of ultra-processed juices was negatively related to the mother’s warmth, while the father’s hostility was positively related to consumption of alcoholic beverages. In males, the mother’s hostility was negatively associated with water and fruit juice consumption and positively associated with soft drink consumption. While the father’s hostility was positively associated with the consumption of ultra-processed juices and energy or sports drinks.