Pegadas ambientais do consumo alimentar, determinantes sociais em saúde e práticas alimentares de adultos e idosos: estudo Brazuca Natal

Abstract

Introduction: The consequences of environmental deterioration caused by human actions have underscored the necessity for a unified approach to One Health, which encompasses the interrelated domains of human, animal, and environmental health. Food systems exert a significant influence on the capacity of planetary boundaries. It is therefore crucial to gain an understanding of the environmental impact of food consumption and the factors that can influence it if we are to promote healthy and sustainable diets. Objective: The objective of this study is to assess the environmental footprints of food consumption among adults and older adults, and to ascertain whether there is a correlation between these footprints and social determinants of health, as well as markers of adherence to the recommendations set forth in the Dietary Guidelines for the Brazilian Population. Methodology: This study employed a variety of methodological approaches. A systematic literature review was conducted to ascertain the environmental footprints of adults and older adults in population studies globally. In crosssectional studies, the carbon (PC), water (PH), and ecological (PE) footprints of food consumption of adults and older adults from Brazuca Natal/RN study were calculated based on the 24-hour dietary recall. A multinomial logistic regression was conducted to examine the relationship between environmental footprints and social determinants of health, as indicated by social and economic variables. To assess the relationship between the environmental impact of dietary habits and adherence to dietary recommendations, as assessed by a validated questionnaire, multiple regression analysis was employed. Results: The findings of the review showed that environmental footprints can be influenced by factors related to their measurement and were more significant among men and adults. In the first cross-sectional study, it was identified that males (CF: OR = 4.45; CI = 2.61 - 7.57; WF: OR = 5.18; CI = 2.99 - 8.96; EF: OR = 4.13; CI = 2.45 - 6.98) and the adult age group (CF: OR = 2.32; CI = 1.38 - 3.91; WF: OR = 2.64; CI = 1.55 - 4.49; EF: OR = 1.77; CI = 1.06 - 2.94) were associated with larger environmental footprints (CF, WF and EF). The data obtained show that having a lower income increases the chances of an intermediate in the diet (OR = 1.93; CI = 1.08 - 3.45), while not having daily access to treated water increases the chances of having higher WF (OR = 0.46; CI = 0.22 - 0.95). In the 2nd cross-sectional study, the increase in environmental footprints of food consumption was associated with the following markers: Frequenting snack bars and fast-food restaurants (CF: PR = 1.80; CI = 1.20 - 2.68), not participating in food preparation (WF: PR = 1.74; CI = 1.39 - 2.18; EF: PR = 1.40; CI = 1.48 - 2.40), and skipping main meals (EF: PR = 1.50; CI = 1.10 - 2.04). Final considerations: The environmental impact of diets is greater for men and adults. Lower income and limited access to clean water can directly impact these footprints, thereby exerting a significant influence on the environmental impact of dietary choices. Furthermore, the consumption of fast food, a lack of involvement in food preparation, and the skipping of meals have been identified as dietary practices that contribute to an increase in these footprints. This evidence underscores the necessity for policies and actions aimed at mitigating adverse environmental impacts to be informed by the imperative of ensuring access to nutritionally sound and sustainable foodstuffs.