Processo saúde-doença e classificação nova dos alimentos: estudo Brazuca Natal

Abstract

Introduction: The health-disease process (HDP) is described by epidemiology as the understanding of all variables involved in both health and disease. Furthermore, studying the HDP in contemporary times implies understanding non-communicable chronic diseases (NCDs), such as cognitive decline and dementias. The HDP focusing on these NCDs aims to investigate how factors can be protective against illness and promoters of health, as well as risk predictors, with lifestyle being the primary research focus in this area due to its highly modifiable and preventable variables. Thus, in this dissertation, we aim to investigate the association between the HDP, specifically of the brain, and food consumption according to the Nova Classification of Foods, which is still considered an important scientific gap. Objective: To analyze food consumption based on the Nova Classification of foods in adults and elderly individuals, as well as the health-disease process, specifically of the brain, through the lens of cognitive decline and dementias. Method: This study is developed from different methodologies: 1) An original cross-sectional and population-based study on food consumption using the Nova Classification [unprocessed or minimally processed foods (NMPF), culinary ingredients (CI), processed foods (PF), and ultraprocessed foods (UPF)] of the Brazuca Natal Study population, as well as the association of this consumption with socioeconomic, demographic, lifestyle, and anthropometric nutritional status variables; 2) A systematic review protocol, according to the 2020 guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA), to analyze whether there is an association between the type of food processing according to Nova and cognitive decline and dementias in adults and elderly individuals; 3) A systematic review of the relationship between food processing types according to Nova and cognitive decline and dementia in adults and elderly individuals, based on searches in the Web of Science, Scopus, PubMed, EMBASE, and LILACS databases in February 2024. Results: In the original article, we found that energy consumption was 1936 kcal, primarily from NMPF (55.70%) and UPF (19.20%). In the model adjusted for socioeconomic, demographic, lifestyle, and anthropometric nutritional status variables, we observed that being an adult (OR: 0.54; 95% CI: 0.32-0.89) and illiterate (OR: 0.29; 95% CI: 0.10-0.90) reduces the chances of consuming a percentage above the national average of NMPF. For PF, having one to nine years of schooling (OR: 0.37; 95% CI: 0.17-0.82) or being illiterate (OR: 0.15; 95% CI: 0.04-0.47) reduces the chances of consuming a percentage below the national average. Conversely, living in the Western (OR: 2.52; 95% CI: 1.12-5.65) and Eastern (OR: 3.61; 95% CI: 1.38-9.49) zones, having a per capita income up to half a minimum wage (OR: 1.86; 95% CI: 1.09-3.17), and alcohol consumption (OR: 1.82; 95% CI: 1.09-3.04) increase these chances. Regarding UPF, we observed that being male (OR: 0.44; 95% CI: 0.26- 0.73) and adult (OR: 0.25; 95% CI: 0.15-0.43) reduces the chances of consuming a percentage below the national average. The systematic review protocol presents an initial bibliographic survey showing that the type of food processing impacts the risk and development of cognitive decline and dementias. In the systematic review, four studies were included. Three evaluated cognitive decline/performance as an outcome, and one evaluated dementias. Only one study did not observe an association between UPF consumption and brain health. One study analyzed the association between NMPF and dementia from all causes. Conclusion: In Article 1, we demonstrated that the daily energy contribution is predominantly from unprocessed or minimally processed foods, followed by a significant portion from ultraprocessed and processed foods. We also found that factors ranging from individual characteristics to collective conditions and lifestyle were crucial in analyzing food consumption in the studied population. In Articles 2 and 3, we concluded that food processing impacts brain health in both adults and elderly individuals, and that this association is influenced by socioeconomic and lifestyle factors.