High ultra-processed food (UPF) consumption is associated with weight gain, obesity, metabolic syndrome, cardiovascular disease, all-cause mortality, and type 2 diabetes. "Food agency" refers to an individual's food preparation attitudes and capabilities within a given social and physical food environment. Although there is an association between the ability to prepare certain dishes and higher cooking frequency with lower UPF intake, it is still unclear if cooking and food agency influences UPF consumption due to the lack of research in this area. To date, studies of food agency have not included detailed dietary analyses. This cross-sectional study included 40 adults (73% female, aged 39±15 years, body mass index [BMI] 25.8±4.9 kg/m2) and aimed to determine the relationship between food agency and UPF intake. Food agency scores were calculated using the validated Cooking and Food Provisioning Action Scale (CAFPAS). Cooking behaviors and frequency were also collected. Dietary intake was assessed using three 24-hour dietary recalls with each item categorized by degree of processing using the NOVA classification system. Analyses included one-way ANOVAs between CAFPAS score quartiles [Q] and Pearson correlations between CAFPAS, cooking behaviors, and dietary intake. UPF intake was calculated in percent total calories and percent total grams to account for artificial sweeteners and other low calorie products that may be classified as UPFs. Low food agency was associated with a 14% higher UPF intake (% total calories) compared to high food agency (P=0.03). There were no differences between CAFPAS quartiles and UPF intake in % total grams. When age was divided into three categories, UPF intake was significantly lower in older adults (60+ years) compared to adults aged 19-39 years and 40-59 years by 26.4% and 29.1% respectively (P=0.02). When analyzed using bivariate analysis, lunch (r=-0.482, P=0.002) and dinner (r=-0.385, P=0.014) cooking frequency, frequency of cooking a meal from scratch or fresh ingredients (r=-0.320, P=0.044), and CAFPAS self-efficacy (r= -0.369; P= .019) were negatively correlated with UPF intake (% total kcal). These findings provide support for the possibility of reducing UPF intake through cooking interventions aimed at improving components of food agency such as problem solving, skills to create a meal from what is available, and cooking confidence. Future studies should include a larger, heterogeneous population to provide more insight into dietary differences between levels of food agency and expand the diversity of research in this area. / Master of Science / High ultra-processed food (UPF) consumption is linked to weight gain, obesity, metabolic syndrome, cardiovascular disease, all-cause mortality, and type 2 diabetes. "Food agency" refers to an individual's food preparation attitudes and capabilities within a given social and physical food environment. Although there is a link between the ability to prepare certain dishes and higher cooking frequency with lower UPF intake, it is still unclear if cooking and food agency influences UPF consumption due to the lack of research in this area. To date, studies of food agency have not included detailed dietary analyses. This study aimed to determine the relationship between food agency and UPF intake. Food agency scores were calculated using the validated Cooking and Food Provisioning Action Scale (CAFPAS). Cooking frequency and behaviors were also collected. Dietary intake was assessed using three 24-hour dietary recalls with each item categorized by degree of processing using the NOVA classification system. Participants with low food agency had higher UPF intake in percent total calories compared to those with high food agency. There were no differences between food agency and UPF intake in percent total grams. Adults aged 60 and over consumed less UPF compared to adults below the age of 60. Participants with higher food agency were more likely to make a meal from scratch or fresh ingredients. As frequency of cooking a meal from scratch or fresh ingredients, cooking dinner or lunch increased, and CAFPAS self-efficacy scores increased percent total calories from UPFs decreased. These findings provide support for the possibility of reducing UPF intake through cooking interventions aimed at improving components of food agency such as problem solving, skills to create a meal from what is available, and cooking confidence. Future studies should include a larger, heterogeneous population to provide more insight into dietary differences between levels of food agency and expand the diversity of research in this area.

Introduktion. Ultraprocessad mat innebär industriellt producerad mat som ofta har ett lågt näringsvärde men hög energitäthet, t.ex. läsk, godis, sötsaker, chips och färdigmat. Produktion, tillgänglighet och marknadsföring av processad mat och dryck ökar, vilket många forskare tror driver den fetmaepidemi som ses i världen. Tidigare forskning har visat ett samband mellan ultraprocessad mat och både övervikt och fetma, metabola sjukdomar, cancer, depression och ångest. Syfte. Syftet var att utvärdera sambandet mellan ultraprocessad mat, övervikt och fetma, samt hur övrig kosthållning ser ut vid en högre konsumtion av ultraprocessad mat. Metod. Arbetet är en litteraturstudie baserad på åtta artiklar från databaserna OneSearch och PubMed. Resultat. Resultatet visade att det verkar finnas ett samband mellan ultraprocessad mat, övervikt och fetma. En högre konsumtion av ultraprocessad mat resulterar även i ett ökat totalt energiintag, lägre intag av protein, fibrer och kalium samt ett högre intag av totalt fett, mättat fett, fleromättat fett, transfett, kolesterol, totalt socker och natrium. Konsumtionen av ultraprocessad mat är högst bland vita/infödda, yngre, rökare, fysiskt inaktiva och lägre utbildade människor. Diskussion. Huvudsaklig orsak till resultatet tros vara att en kost rik på ultraprocessad mat är rik på fett och socker, vilket resulterar i ett ökat totalt energiintag och leder till viktuppgång. / Introduction. Ultra-processed food includes industrially produced food that often has a poor nutrition value but is high in energy density, e.g. soft drinks, candy, sweets, chips and pre-cooked food. Production, availability and marketing of processed foods and drinks has increased, which several researchers believe is the main reason for the obesity epidemic in the world. Previous research has shown an association between ultra-processed food and both overweight and obesity, metabolic diseases, cancer, depression and anxiety. Objective. The objective was to evaluate the association between ultra-processed food, overweight and obesity, and how the remaining diet is composed at an increased consumption of ultra-processed food. Method. The assignment is a literature review based on articles from the databases OneSearch and PubMed. Results. The results indicate an association between ultra-processed food, overweight and obesity. An increased consumption of ultra-processed food also results in an increased total energy intake, a decreased intake of protein, fibre and potassium and an increased intake of total fat, saturated fat, polyunsaturated fat, trans fat, cholesterol, total sugar and sodium. The consumption of ultra-processed food is higher among white/native, younger people, smokers, physically inactive and those with a lower degree of education. Discussion. The main reason of the result is believed to depend on the fact that a diet rich in ultra-processed food also is a diet rich in fat and sugar, which results in an increased total energy intake that results in weight gain.

Background: Bangladesh is home to 36 million adolescents with the majority living in rural areas. Adolescence presents an additional window of opportunity to correct nutritional deficits among rural Bangladeshi adolescents. A high-quality, diverse diet is pivotal in this regard. Ultra-processed food (UPF) consumption is an emergent threat to public health. This study aimed to explore dietary diversity (DD) and UPF consumption in terms of gender and socio-economic stratification among rural adolescents in Matlab, Bangladesh. Methods: Adopting cross-sectional design 1441 adolescents were surveyed. Dietary diversity score and ultra-processed food consumption score (UFCS) were constructed through 24-hour recalls. Means and consumption proportions were compared across gender and socio-economic strata. Binary and ordinal logistic regression models were fitted to isolate socio-demographic variables associated with inadequate DD and higher UFCS respectively. Results: 43% of the adolescents had inadequate DD. Pro-boy gap in DD was evident, so was heavy reliance on rice and scant consumption of nutrient-rich foods. UPF consumption was low. Belonging to the richest and to food secure households were associated with lower odds of inadequate DD. Girls were more likely to have inadequate DD but less likely to have higher UFCS. Gender modified the effect of socio-economic status on UPF consumption. Conclusions: The diet of adolescents in Matlab lacked diversity, putting them at significant risk of nutritional deficiencies. Improving their DD requires pragmatic policies and tailored programs to tackle affordability and food insecurity issues, address social norms and intra-household dynamics that favor boys, and sensitize the adolescents to importance of consuming diverse diet. / 15-year Follow-up of MINIMat Trial

No description available.

Background: With an estimated number of 1.2 billion in the world, adolescents represent a major transformative force in global health. Optimum adolescent nutrition is increasingly important for scaling up population health gains in low- and middle-income countries (LMICs) of South Asia. Nevertheless, little is known about the gender and socio-economic stratification of diets consumed by rural adolescents in these countries. The aim of this project was to understand the gender and socio-economic stratification of their diet with a dual, descriptive-analytic focus on dietary diversity (DD) and consumption of ultra-processed and deep-fried foods. Methods: This thesis builds upon cross-sectional analyses of data collected during 15-year follow-up of the MINIMat (Maternal and Infant Nutrition Interventions in Matlab) trial, from September 2017 to June 2019. Data on dietary and socio-demographic variables were collected through household survey; using a pre-tested, structured questionnaire. A single, 24-hour recall was employed to assess consumption of staples and non-staples arranged in 10 groups, ultra-processed foods (UPF) in four groups, and of one group of deep-fried foods. Data were analyzed using logistic regression models. The analytic sample comprised 2463 adolescents. Results: The prevalence of inadequate DD was 42.3% (40.3-44.2). Consumption of dark green leafy vegetables, vitamin A-rich fruits and vegetables, and animal-source foods–except fish–appeared low. The proportions of adolescents consuming meat, egg and dairy were higher among those from the richest households than those from the poorest households, and among boys than girls. Belonging to the poorest households (adjusted odds ratio (aOR): 1.59; 95% confidence interval (CI): 1.27-2.00) and the food insecure households (aOR: 1.34; 95% CI: 1.13-1.59), and attaining secondary education (aOR: 1.38; 95% CI: 1.11-1.71) were positively associated with inadequate DD. Adolescents having mothers with secondary education or above had lower odds of inadequate DD (aOR: 0.76; 95% CI: 0.60-0.96). Gender was not an independent predictor of inadequate DD.Approximately 83% (81.5-84.4) adolescents reportedly consumed at least one ultra-processed or deep-fried food in the 24 hours preceding the survey. Packaged confectioneries were the most consumed and sugar-sweetened beverages (SSB) the least consumed UPF group. Boys had greater odds of consumption than girls for all UPF groups and deep-fried foods. The association was strongest for SSB (aOR: 2.57; 95% CI: 1.97, 3.37), followed by deep-fried foods (aOR 1.96; 95% CI: 1.66, 2.32). Belonging to the richest households was associated with consumption of ready-to-eat foods (aOR 1.55; 95% CI: 1.12-2.16) and of SSB (aOR: 1.44; 95% CI: 1.02-2.03). Adolescents with higher educational attainment had lower odds of consuming SSB (aOR 0.73; 95% CI: 0.54-0.98). Conclusion: The studies presented compelling evidence of limited DD concurrent with emergent consumption of ultra-processed and deep-fried foods in a rural cohort of adolescents. Inadequate DD was more likely among those from the poorest and the food insecure households. For ultra-processed and deep-fried foods, gender association persisted across the food groups with boys having a greater likelihood of consumption than girls. Wealth status influenced consumption of “instant” foods and SSB only. This suboptimal dietary pattern may place the adolescents at heightened risk of different forms of malnutrition.

Introdução Evidências sugerem impacto das características do ambiente nas taxas de obesidade, por mediadores em nível comunitário, como acesso a comércios, disponibilidade e custo de alimentos. Porém, há insuficiente compreensão sobre a interação do meio nas práticas alimentares. Objetivos Ampliar a compreensão a respeito das relações entre o ambiente e as práticas alimentares em diferentes contextos socioeconômicos e de acesso à alimentação em que vivem indivíduos no município de São Paulo. Métodos Estudo de abordagem qualitativa baseado em dados de auditoria de ambiente alimentar, inquérito e entrevistas individuais. A amostragem propositiva abrangeu diversos estratos do ambiente socioeconômico e alimentar no município de São Paulo e incluiu 48 indivíduos adultos de ambos os sexos. O roteiro de entrevistas semiestruturadas foi elaborado a partir de duas perguntas norteadoras: Como é a percepção dos indivíduos sobre os estabelecimentos de comercialização de alimentos no bairro em que vivem e a sua influência nas práticas alimentares? e Como é a rotina de aquisição, preparo e consumo dos alimentos no bairro em que vivem e como isso se relaciona ao consumo de frutas e hortaliças e de alimentos ultraprocessados?. Para a categorização dos discursos aplicou-se análise de conteúdo proposta por Bardin. A trajetória interpretativa foi conduzida sob o referencial teórico das representações sociais. A análise de clusters hierárquica foi utilizada para o agrupamento dos indivíduos, retendo-se dois grupos: cluster 1 e cluster 2, diferenciados pelo nível socioeconômico e pela disponibilidade de alimentos saudáveis nos locais avaliados. Resultados As representações sociais sobre os ambientes alimentares estudados corresponderam às características aferidas em auditoria, revelando desigualdades entre os locais estudados. No cluster 1, caracterizado pelo maior nível socioeconômico e pelo melhor acesso à alimentação saudável, prevaleceu a percepção favorável sobre a disponibilidade de feiras, sacolões e supermercados, destacando oportunidades para a aquisição de alimentos com qualidade, variedade e preços acessíveis, dentre os quais as frutas e hortaliças. Os indivíduos do cluster 2 viviam em locais de menor nível socioeconômico e de menor acesso à alimentação saudável e representaram a falta de acesso à estabelecimentos de comércio de alimentos e a indisponibilidade de frutas e hortaliças. Nos dois clusters verificou-se a representação social: refrigerantes, salgadinhos, biscoitos recheados e fast-food se encontra em todo lugar, sobre a disponibilidade de alimentos ultraprocessados. A preocupação com a saúde foi a principal motivação para o consumo de frutas e hortaliças entre os dois clusters, e o gosto, a falta de hábito e o custo foram identificados como barreiras. Sobre o consumo de alimentos ultraprocessados, no cluster 1 ocorreu maior percepção sobre as barreiras, como a preocupação com a saúde. Já no cluster 2, se destacaram as motivações para este consumo, como o gosto e a presença de crianças. Conclusão A forma como conhecem e compreendem as características do ambiente alimentar está refletida em algumas ações dos sujeitos sobre as suas práticas de aquisição e consumo de alimentos. / Background Evidences suggest an impact of environmental characteristics on obesity and non-communicable diseases rates, by mediators at the community level such as access to markets, cost and availability of food. However, there is insufficient comprehension about the interaction of the environment in food pratices. Objective Enhancing knowledge about the relations between the environment and eating habits in different socioeconomic and food access contexts, whereupon São Paulos individuals live. Methods This is a qualitative study based on food environment audit data, inquiry and individual interviews. The purposeful sampling comprised different strata of the socioeconomic and food environments in São Paulo and included 48 adults of both genders.The script for semi-structured interviews was drawn from two guiding questions: How is the perception of the individuals on the food establishments in the neighborhood they live in, and their influence on eating habits? and How is the acquisition routine, preparation and consumption of foods in their neighborhood, and how does it relate to the consumption of fruits and vegetables, and ultra-processed food?. For categorizing the speeches Bardins content analisys was applied. The interpretative trajectory was conducted under the theoretical framework of social representations. The hierarchical clusters analisys was used for grouping individuals, retaining two groups: cluster 1 and cluster 2, differentiated by the socioeconomic level and by the availability of healthy foods at the locations assessed. Results The social representations about the food environments investigated corresponded to the characteristics measured in audit, revealing disparities between the locations assessed. In cluster 1,characterized by higher socioeconomic level and better access to healthy food, prevailed favorable perception about the availability of fairs, grocery stores and supermarkets, standing out opportunities to food acquisition with quality, variety and affordable prices, among which are fruits and vegetables.Individuals from cluster 2 lived in places of lower socioeconomic level and less access to healthy food, and they accounted for the lack of access to food establishments and the unavailability of fruits and vegetables.In both clusters there was the social representation: soft drinks, snacks, cookies and fast food are everywhere, about the availability of ultra-processed food. The concern about healthcare was the main motivation for fruits and vegetables consumption among both clusters, and the taste, the lack of habit and costs were identified as barriers. Regarding to ultra-processed food consumption, in cluster 1 there was a greater awareness about the barriers, like the concern for healthcare. On the other hand, in cluster 2, the motivations for this consumption were highlighted, such as the taste and the presence of children. ConclusionThe way individuals know and understand the environmental characteristics is reflected in some of their actions about the purchasing practices and food consumption.

Introdução: Comer fora de casa tem sido relacionado com o aumento no consumo de alimentos caracterizados pelo alto grau de processamento, tal como refrigerantes, doces e fast food. Embora indiquem uma associação entre alimentação fora do domicilio e o consumo de alimentos ultraprocessados, estudos realizados até o momento não consideraram o grau e extensão de processamento industrial dos alimentos na avaliação da dieta fora de casa. Objetivo: Avaliar o consumo de alimentos fora de casa e verificar sua associação com características socioeconômicas e indicadores nutricionais. Métodos: Trata-se de um estudo transversal utilizando o Módulo de Consumo Pessoal da Pesquisa de Orçamentos Familiares realizada pelo Instituto Brasileiro de Geografia e Estatística entre maio de 2008 e maio de 2009. Os alimentos foram agrupados de acordo com a extensão e propósito do processamento industrial. O hábito de comer fora de casa foi avaliado por meio de dois indicadores: o percentual de calorias consumidas fora e a frequência de dias em que cada indivíduo relatou realizar refeições fora de domicílio, ambos descritos segundo características sociodemográficas. Foi estimado o percentual de participação dos grupos e subgrupos alimentares no total de calorias e segundo local de consumo. Adicionalmente, o percentual de participação de alimentos ultraprocessados dentro e fora de casa foi descrito segundo características sociodemográficas. Modelo multinível foi aplicado para avaliar a associação entre comer fora de casa e a participação de alimentos ultraprocessados na dieta. Análise fatorial foi conduzida para identificar padrões de alimentação fora de casa e modelos de regressão linear foram utilizados para explorar associação entre os padrões encontrados e indicadores nutricionais. Resultados: Observa-se uma maior contribuição de alimentos ultraprocessados fora de casa, destacando a participação de itens alimentares como refrigerantes e refeições prontas. Quando comparado com o consumo exclusivamente dentro do domicílio, realizar refeições fora de casa aumenta em 51% o consumo de alimentos ultraprocessados. A análise de componentes principais, no entanto, monstra que existem padrões de alimentação fora de casa que podem ter ou não um impacto negativo na dieta. Foram encontrados três padrões de alimentação na população que explicam conjuntamente 13,6% da variância. O primeiro padrão, denominado refeição tradicional, inclui em sua composição arroz, feijão, legumes e verduras, raízes e tubérculos, macarrão e outras massas, carne bovina, aves e ovos. O segundo padrão, nomeado lanche, é composto por manteiga, leite, café e chás, pão francês, queijos processados e margarina. O terceiro padrão, denominado alimentos de conveniência por ser composto exclusivamente por alimentos ultraprocessados, inclui doces, refeições prontas (tais como fast food, salgados, pizza, entre outras) e refrigerantes. De maneira geral, observou-se uma associação direta entre o padrão de refeições tradicionais e nutrientes saudáveis na dieta, enquanto o padrão lanches e alimentos de conveniência foram associados diretamente com nutrientes não saudáveis. Conclusão: Os resultados apresentados indicam que no Brasil, comer fora de casa está associado ao aumento na participação de alimentos ultraprocessados na dieta. Existem, porém, padrões de alimentação fora de casa. Quando baseada em lanches e alimentos de conveniência, comer fora de casa acarreta em um impacto negativo na dieta. É, no entanto, possível manter uma alimentação saudável fora de casa quando se adere a padrões tradicionais da culinária brasileira / Introduction: Eating out has been related to the increase on the consumption of food characterized by high degree of processing, such as soft drinks, sweets and fast food. Although they indicate an association between eating out and ultra-processed food consumption, studies do not consider the extent and purpose of food processing to evaluate eating out diet. Objective: Evaluate eating out food and verify its association with socioeconomic characteristics and nutritional indicators. Method: Cross-sectional study using the Individual Food Intake Survey, carried out with 34,003 individuals aged 10 or more, between May 2008 and May 2009. All food items were classified according to the extent and purpose of food processing. The habit of eating out was evaluated through two indicators: the percentage of calories eating out and the frequency of days in which each individual reported eating out, both indicators are described according to the sociodemographic characteristics. The percentage of food calories per group and subgroups was estimated according to the place of consumption. In addition, the ultra-processed food percentage eaten at home and out was described according to sociodemographic characteristics. Multilevel model was applied to evaluate an association between eating out and the participation of ultra-processed food on diet. Factor analysis was used to identify the eaten out food consumption patterns and linear regression models were used to explore the association between patterns and the nutrient content of the diet. Results: It is possible to observe a higher contribution of ultra-processed food out home, emphasizing the participation of food items such as soft drinks and ready-to-eat meals. When compared to consumption exclusively at home, eating meals out increases the consumption of ultra-processed foods by 51%. Principal component analysis, however, demonstrates that there are eating out patterns, whether or not may have a negative impact on the diet. We identified three food patterns. The first pattern, called traditional meal, was positive for rice, beans, vegetables and greens, roots and tubers, pasta, beef, poultry and eggs. The second pattern, called snack, was positive for butter, milk, coffee and tea, processed bread, processed cheese and margarine. The third pattern, called convenience food because it consists exclusively of ultra-processed food, was positive for sweet, ready to eat meals and soft drinks. In general, there was a positive association between traditional meal pattern and healthy dietary markers, while snacks and the convenience pattern were positively associated to unhealthy dietary markers. Conclusion: In Brazil, eating out is directly associated to ultra-processed food consumption. There is, however, eating out patterns. When based on snacks and convenience food, eating out has a negative impact in diet. It is, however, possible to maintain a healthy diet out when adhering to traditional Brazilian patterns

Introdução: Comer fora de casa tem sido relacionado com o aumento no consumo de alimentos caracterizados pelo alto grau de processamento, tal como refrigerantes, doces e fast food. Embora indiquem uma associação entre alimentação fora do domicilio e o consumo de alimentos ultraprocessados, estudos realizados até o momento não consideraram o grau e extensão de processamento industrial dos alimentos na avaliação da dieta fora de casa. Objetivo: Avaliar o consumo de alimentos fora de casa e verificar sua associação com características socioeconômicas e indicadores nutricionais. Métodos: Trata-se de um estudo transversal utilizando o Módulo de Consumo Pessoal da Pesquisa de Orçamentos Familiares realizada pelo Instituto Brasileiro de Geografia e Estatística entre maio de 2008 e maio de 2009. Os alimentos foram agrupados de acordo com a extensão e propósito do processamento industrial. O hábito de comer fora de casa foi avaliado por meio de dois indicadores: o percentual de calorias consumidas fora e a frequência de dias em que cada indivíduo relatou realizar refeições fora de domicílio, ambos descritos segundo características sociodemográficas. Foi estimado o percentual de participação dos grupos e subgrupos alimentares no total de calorias e segundo local de consumo. Adicionalmente, o percentual de participação de alimentos ultraprocessados dentro e fora de casa foi descrito segundo características sociodemográficas. Modelo multinível foi aplicado para avaliar a associação entre comer fora de casa e a participação de alimentos ultraprocessados na dieta. Análise fatorial foi conduzida para identificar padrões de alimentação fora de casa e modelos de regressão linear foram utilizados para explorar associação entre os padrões encontrados e indicadores nutricionais. Resultados: Observa-se uma maior contribuição de alimentos ultraprocessados fora de casa, destacando a participação de itens alimentares como refrigerantes e refeições prontas. Quando comparado com o consumo exclusivamente dentro do domicílio, realizar refeições fora de casa aumenta em 51% o consumo de alimentos ultraprocessados. A análise de componentes principais, no entanto, monstra que existem padrões de alimentação fora de casa que podem ter ou não um impacto negativo na dieta. Foram encontrados três padrões de alimentação na população que explicam conjuntamente 13,6% da variância. O primeiro padrão, denominado refeição tradicional, inclui em sua composição arroz, feijão, legumes e verduras, raízes e tubérculos, macarrão e outras massas, carne bovina, aves e ovos. O segundo padrão, nomeado lanche, é composto por manteiga, leite, café e chás, pão francês, queijos processados e margarina. O terceiro padrão, denominado alimentos de conveniência por ser composto exclusivamente por alimentos ultraprocessados, inclui doces, refeições prontas (tais como fast food, salgados, pizza, entre outras) e refrigerantes. De maneira geral, observou-se uma associação direta entre o padrão de refeições tradicionais e nutrientes saudáveis na dieta, enquanto o padrão lanches e alimentos de conveniência foram associados diretamente com nutrientes não saudáveis. Conclusão: Os resultados apresentados indicam que no Brasil, comer fora de casa está associado ao aumento na participação de alimentos ultraprocessados na dieta. Existem, porém, padrões de alimentação fora de casa. Quando baseada em lanches e alimentos de conveniência, comer fora de casa acarreta em um impacto negativo na dieta. É, no entanto, possível manter uma alimentação saudável fora de casa quando se adere a padrões tradicionais da culinária brasileira / Introduction: Eating out has been related to the increase on the consumption of food characterized by high degree of processing, such as soft drinks, sweets and fast food. Although they indicate an association between eating out and ultra-processed food consumption, studies do not consider the extent and purpose of food processing to evaluate eating out diet. Objective: Evaluate eating out food and verify its association with socioeconomic characteristics and nutritional indicators. Method: Cross-sectional study using the Individual Food Intake Survey, carried out with 34,003 individuals aged 10 or more, between May 2008 and May 2009. All food items were classified according to the extent and purpose of food processing. The habit of eating out was evaluated through two indicators: the percentage of calories eating out and the frequency of days in which each individual reported eating out, both indicators are described according to the sociodemographic characteristics. The percentage of food calories per group and subgroups was estimated according to the place of consumption. In addition, the ultra-processed food percentage eaten at home and out was described according to sociodemographic characteristics. Multilevel model was applied to evaluate an association between eating out and the participation of ultra-processed food on diet. Factor analysis was used to identify the eaten out food consumption patterns and linear regression models were used to explore the association between patterns and the nutrient content of the diet. Results: It is possible to observe a higher contribution of ultra-processed food out home, emphasizing the participation of food items such as soft drinks and ready-to-eat meals. When compared to consumption exclusively at home, eating meals out increases the consumption of ultra-processed foods by 51%. Principal component analysis, however, demonstrates that there are eating out patterns, whether or not may have a negative impact on the diet. We identified three food patterns. The first pattern, called traditional meal, was positive for rice, beans, vegetables and greens, roots and tubers, pasta, beef, poultry and eggs. The second pattern, called snack, was positive for butter, milk, coffee and tea, processed bread, processed cheese and margarine. The third pattern, called convenience food because it consists exclusively of ultra-processed food, was positive for sweet, ready to eat meals and soft drinks. In general, there was a positive association between traditional meal pattern and healthy dietary markers, while snacks and the convenience pattern were positively associated to unhealthy dietary markers. Conclusion: In Brazil, eating out is directly associated to ultra-processed food consumption. There is, however, eating out patterns. When based on snacks and convenience food, eating out has a negative impact in diet. It is, however, possible to maintain a healthy diet out when adhering to traditional Brazilian patterns

Introdução Evidências sugerem impacto das características do ambiente nas taxas de obesidade, por mediadores em nível comunitário, como acesso a comércios, disponibilidade e custo de alimentos. Porém, há insuficiente compreensão sobre a interação do meio nas práticas alimentares. Objetivos Ampliar a compreensão a respeito das relações entre o ambiente e as práticas alimentares em diferentes contextos socioeconômicos e de acesso à alimentação em que vivem indivíduos no município de São Paulo. Métodos Estudo de abordagem qualitativa baseado em dados de auditoria de ambiente alimentar, inquérito e entrevistas individuais. A amostragem propositiva abrangeu diversos estratos do ambiente socioeconômico e alimentar no município de São Paulo e incluiu 48 indivíduos adultos de ambos os sexos. O roteiro de entrevistas semiestruturadas foi elaborado a partir de duas perguntas norteadoras: Como é a percepção dos indivíduos sobre os estabelecimentos de comercialização de alimentos no bairro em que vivem e a sua influência nas práticas alimentares? e Como é a rotina de aquisição, preparo e consumo dos alimentos no bairro em que vivem e como isso se relaciona ao consumo de frutas e hortaliças e de alimentos ultraprocessados?. Para a categorização dos discursos aplicou-se análise de conteúdo proposta por Bardin. A trajetória interpretativa foi conduzida sob o referencial teórico das representações sociais. A análise de clusters hierárquica foi utilizada para o agrupamento dos indivíduos, retendo-se dois grupos: cluster 1 e cluster 2, diferenciados pelo nível socioeconômico e pela disponibilidade de alimentos saudáveis nos locais avaliados. Resultados As representações sociais sobre os ambientes alimentares estudados corresponderam às características aferidas em auditoria, revelando desigualdades entre os locais estudados. No cluster 1, caracterizado pelo maior nível socioeconômico e pelo melhor acesso à alimentação saudável, prevaleceu a percepção favorável sobre a disponibilidade de feiras, sacolões e supermercados, destacando oportunidades para a aquisição de alimentos com qualidade, variedade e preços acessíveis, dentre os quais as frutas e hortaliças. Os indivíduos do cluster 2 viviam em locais de menor nível socioeconômico e de menor acesso à alimentação saudável e representaram a falta de acesso à estabelecimentos de comércio de alimentos e a indisponibilidade de frutas e hortaliças. Nos dois clusters verificou-se a representação social: refrigerantes, salgadinhos, biscoitos recheados e fast-food se encontra em todo lugar, sobre a disponibilidade de alimentos ultraprocessados. A preocupação com a saúde foi a principal motivação para o consumo de frutas e hortaliças entre os dois clusters, e o gosto, a falta de hábito e o custo foram identificados como barreiras. Sobre o consumo de alimentos ultraprocessados, no cluster 1 ocorreu maior percepção sobre as barreiras, como a preocupação com a saúde. Já no cluster 2, se destacaram as motivações para este consumo, como o gosto e a presença de crianças. Conclusão A forma como conhecem e compreendem as características do ambiente alimentar está refletida em algumas ações dos sujeitos sobre as suas práticas de aquisição e consumo de alimentos. / Background Evidences suggest an impact of environmental characteristics on obesity and non-communicable diseases rates, by mediators at the community level such as access to markets, cost and availability of food. However, there is insufficient comprehension about the interaction of the environment in food pratices. Objective Enhancing knowledge about the relations between the environment and eating habits in different socioeconomic and food access contexts, whereupon São Paulos individuals live. Methods This is a qualitative study based on food environment audit data, inquiry and individual interviews. The purposeful sampling comprised different strata of the socioeconomic and food environments in São Paulo and included 48 adults of both genders.The script for semi-structured interviews was drawn from two guiding questions: How is the perception of the individuals on the food establishments in the neighborhood they live in, and their influence on eating habits? and How is the acquisition routine, preparation and consumption of foods in their neighborhood, and how does it relate to the consumption of fruits and vegetables, and ultra-processed food?. For categorizing the speeches Bardins content analisys was applied. The interpretative trajectory was conducted under the theoretical framework of social representations. The hierarchical clusters analisys was used for grouping individuals, retaining two groups: cluster 1 and cluster 2, differentiated by the socioeconomic level and by the availability of healthy foods at the locations assessed. Results The social representations about the food environments investigated corresponded to the characteristics measured in audit, revealing disparities between the locations assessed. In cluster 1,characterized by higher socioeconomic level and better access to healthy food, prevailed favorable perception about the availability of fairs, grocery stores and supermarkets, standing out opportunities to food acquisition with quality, variety and affordable prices, among which are fruits and vegetables.Individuals from cluster 2 lived in places of lower socioeconomic level and less access to healthy food, and they accounted for the lack of access to food establishments and the unavailability of fruits and vegetables.In both clusters there was the social representation: soft drinks, snacks, cookies and fast food are everywhere, about the availability of ultra-processed food. The concern about healthcare was the main motivation for fruits and vegetables consumption among both clusters, and the taste, the lack of habit and costs were identified as barriers. Regarding to ultra-processed food consumption, in cluster 1 there was a greater awareness about the barriers, like the concern for healthcare. On the other hand, in cluster 2, the motivations for this consumption were highlighted, such as the taste and the presence of children. ConclusionThe way individuals know and understand the environmental characteristics is reflected in some of their actions about the purchasing practices and food consumption.