Objetivo: Investigar o consumo alimentar de açúcares de adição em adolescentes residentes no município de São Paulo, assim como os fatores que influenciam tal consumo. Métodos: Obteve-se uma amostra probabilística de 793 adolescentes por conglomerados. Aplicou-se um recordatório alimentar de 24 horas e um segundo recordatório em uma subamostra. O consumo alimentar habitual de energia, nutrientes e alimentos foi estimado pelos métodos propostos pela Iowa State University (ISU) e pelo National Cancer Institute (NCI). Resultados: Em média, os açúcares de adição contribuíram com 12,28% da energia consumida pelos adolescentes (sem diferença entre os sexos), sendo o refrigerante o alimento que mais contribuiu para esta ingestão. A escolaridade do chefe da família e a consumo de outros macronutrientes (proteínas, gorduras e carboidratos exceto açúcares de adição) exerceram efeito independente sobre o consumo de açúcares de adição. O aumento do consumo de calorias provenientes dos açúcares de adição determinou aumento da ingestão de gorduras e redução da ingestão de carboidratos exceto açúcares de adição e proteínas. Maior porção mediana do consumo de leite, carnes, frutas, suco industrializado, refrigerante e achocolatado em pó foi identificada entre os adolescentes com consumo excessivo de açúcares. Conclusões: A contribuição percentual dos açúcares de adição à energia consumida pelos adolescentes do município de São Paulo está acima das recomendações atuais e o consumo excessivo de açúcares exerceu efeito na ingestão e na adequação do consumo de macro e micronutrientes e no consumo de alimentos de maior densidade nutritiva. Essas evidências corroboram as recomendações nacionais e internacionais para redução do consumo de açúcares e apontam a necessidade de ações educativas sobre alimentação saudável direcionadas aos adolescentes. / Objective: To measure added sugar intake and assess the effect of this intake on the diet of adolescents living in the city of São Paulo. Methods: The study sample comprised 793 male and female adolescents selected from a population-based cross-sectional study based on a household survey conducted between March and December 2003. Food intake was assessed through 24-hour food recalls and then an adjustment approach was applied using repeat data. Food intake of energy, nutrients and foods was measured by the methods developed at Iowa State University (ISU) and National Cancer Institute (NCI). Results: Added sugars contributed on average to 12.28% of energy consumed in adolescents (no difference between males and females). Their main source was soft drinks. Family head schooling and other macronutrients intake had an independent effect on added sugar intake. Increased intake of calories from added sugars resulted in increased fat intake and decreased consumption of carbohydrates except sugars and protein. Higher median percent intake of milk, meat, fruit, processed juice, soft drink and chocolate milk was seen among adolescents with excess sugar intake. Conclusions: The percent contribution from added sugars to energy consumed among adolescents in the city of São Paulo is higher than current recommendations. Excess sugar intake had a negative effect on macronutrient and micronutrient intake and adequacy on the consumption of foods of high nutrient density. These findings corroborate Brazilian and international recommendations for reduction of sugar intake and points to the need of education actions targeting adolescents to promote healthy eating.

abstract: Background: Higher intake of carbohydrates in the evening and later eating times has been associated with higher total energy intake (TEI)1-3 and higher risk of being overweight or obese.1,4 Though existing evidence indicates a link between added sugars intake and increased body mass index (BMI), the effect of daily patterns of added sugars intake on TEI and BMI is unknown. Research on added sugars has relied on self-report dietary assessments with limited days of dietary data, resulting in unreliable estimates. The purpose of this thesis was to describe patterns of added sugars consumption, and to investigate the relationship between dietary sugars, eating patterns, TEI, and BMI using 15-days of dietary data from a feeding study. Methods: 40 participants age 18 to 70 years completed a 15-d highly controlled feeding study which imitated their normal diet, while recording meal times. Meals and snacks were coded based on participant identified, time-of-day, and meal content specific criteria. All consumed foods and beverages were carefully weighed and entered into the Nutrition Data System for Research (NDSR) for analysis. Pearson correlation, independent t-test, one-way repeated measures analysis of variance (ANOVA) with post hoc tests, and multiple linear regressions were used to investigate the association between patterns of added sugars and energy intake, as well as eating frequency (EF), with TEI and BMI. Results: 15-d median added sugars intake was 9.7% of total calories. The highest contribution to added sugars intake (% of g/d) came from snacks (44%) in women and from afternoon (39%) consumption in men. The highest contribution to TEI came from dinner (30%) and afternoon (34%) consumption in women, and from lunch (31%) or dinner (30%) and afternoon (35%) consumption in men. Total eating occasion (EO) frequency had a negative association with TEI (r = -0.31) and no association with % energy from added sugars. In multivariate regression models, besides sex, % energy from beverages only (Adjusted R2 = 0.41) and % added sugars from dinner (Adjusted R2 = 0.39) were significant predictors of TEI, while none of the variables were associated with BMI. Conclusion: Changing one’s pattern of eating, (EF and % energy from beverages only and % added sugars from dinner), may reduce TEI, potentially reducing BMI. / Dissertation/Thesis / Masters Thesis Nutrition 2019

The micronutrient intake of the average South African is not optimal. National fortification of staple foods does not solve all micronutrient deficiencies. Furthermore, urbanisation causes a shift in food intake, increasing the availability of cheaper and more energy dense food and drinks that are often lacking in micronutrients. It is unclear whether the current literature provides sufficient evidence of nutrient dilution by the moderate consumption of alcohol and/or added sugar. The aim of the present study was to evaluate the dietary intakes of a population in nutrition transition and determine the effect of intake of alcohol and added sugars on intakes of micronutrients and food groups to provide information for the development of preventive strategies in public health. A number of countries, including South Africa, suggest limited alcohol and sugar intakes in the Food Based Dietary Guidelines but do not quantify this recommendation. Data from the "Transition and Health during Urbanisation in South Africa" survey (THUSA) were analysed for dietary intakes (as determined by a validated quantified food frequency questionnaire), age and body mass index (BMI). The THUSA study was conducted during 1996 and 1998 in the North West Province and included 1854 "apparently healthy". Respondents aged 15 years and older from 37 randomly selected sites from rural and urban areas. Alcohol intake (absolute intake and percentage of energy) was the highest for men living in middle class urban areas. With increased urbanisation, the type of beer shifted from sorghum based to commercial beer. Sixty-one percent of men and 25% of women reported that they consumed alcohol at the time of the survey. Eighteen percent of men and 11.7% of women consumed more than 30g and 15g alcohol per day, respectively (intakes which are regarded as moderate). Men and women consuming the most alcohol had significantly higher mean intakes of most macro and micronutrients. However, the intake of vitamin Bi2, B6, folate, vitamin E and vitamin C did not meet the recommended dietary intake (RDA) across all levels of alcohol intake. Although the total energy intake increased with increased alcohol intake, there was no significant difference between the mean BMI of men or women with different levels of intake. One third of the population consumed more than a 100g of added sugar daily. Intake of sugar was the highest in the farm dwellers but the intake of sweets, cakes, cookies and cold drinks was the highest in the urban areas. As sugar intake increased so did energy, carbohydrates and most micronutrients. However, the intake of vitamin B12, folate, vitamin C and calcium did not meet the RDA across all levels of sugar intake. BMI did not differ between respondents with the highest and lowest sugar intake and no association was found between BMI and sugar intake. The THUSA study was conducted before fortification of staple food became law in October 2003. Maize meal and wheat flour are nowadays fortified with certain vitamins and minerals which may alleviate some micronutrient deficiencies. For future research it is imperative to establish the reasons for low intake of certain micronutrients rather than to look at a single food item in the diets of the South African adult population. Proper education on the intake of cheaper food sources of micronutrients needs to be highlighted at all levels of the health sector. / Thesis (M.Sc. (Dietetics)--North-West University, Potchefstroom Campus, 2009.

The micronutrient intake of the average South African is not optimal. National fortification of staple foods does not solve all micronutrient deficiencies. Furthermore, urbanisation causes a shift in food intake, increasing the availability of cheaper and more energy dense food and drinks that are often lacking in micronutrients. It is unclear whether the current literature provides sufficient evidence of nutrient dilution by the moderate consumption of alcohol and/or added sugar. The aim of the present study was to evaluate the dietary intakes of a population in nutrition transition and determine the effect of intake of alcohol and added sugars on intakes of micronutrients and food groups to provide information for the development of preventive strategies in public health. A number of countries, including South Africa, suggest limited alcohol and sugar intakes in the Food Based Dietary Guidelines but do not quantify this recommendation. Data from the "Transition and Health during Urbanisation in South Africa" survey (THUSA) were analysed for dietary intakes (as determined by a validated quantified food frequency questionnaire), age and body mass index (BMI). The THUSA study was conducted during 1996 and 1998 in the North West Province and included 1854 "apparently healthy". Respondents aged 15 years and older from 37 randomly selected sites from rural and urban areas. Alcohol intake (absolute intake and percentage of energy) was the highest for men living in middle class urban areas. With increased urbanisation, the type of beer shifted from sorghum based to commercial beer. Sixty-one percent of men and 25% of women reported that they consumed alcohol at the time of the survey. Eighteen percent of men and 11.7% of women consumed more than 30g and 15g alcohol per day, respectively (intakes which are regarded as moderate). Men and women consuming the most alcohol had significantly higher mean intakes of most macro and micronutrients. However, the intake of vitamin Bi2, B6, folate, vitamin E and vitamin C did not meet the recommended dietary intake (RDA) across all levels of alcohol intake. Although the total energy intake increased with increased alcohol intake, there was no significant difference between the mean BMI of men or women with different levels of intake. One third of the population consumed more than a 100g of added sugar daily. Intake of sugar was the highest in the farm dwellers but the intake of sweets, cakes, cookies and cold drinks was the highest in the urban areas. As sugar intake increased so did energy, carbohydrates and most micronutrients. However, the intake of vitamin B12, folate, vitamin C and calcium did not meet the RDA across all levels of sugar intake. BMI did not differ between respondents with the highest and lowest sugar intake and no association was found between BMI and sugar intake. The THUSA study was conducted before fortification of staple food became law in October 2003. Maize meal and wheat flour are nowadays fortified with certain vitamins and minerals which may alleviate some micronutrient deficiencies. For future research it is imperative to establish the reasons for low intake of certain micronutrients rather than to look at a single food item in the diets of the South African adult population. Proper education on the intake of cheaper food sources of micronutrients needs to be highlighted at all levels of the health sector. / Thesis (M.Sc. (Dietetics)--North-West University, Potchefstroom Campus, 2009.

abstract: Although many studies have looked into the relationship between depression and eating behaviors, most have not looked into the interaction between depressive mood, weight status, and eating behaviors; specifically the consumption of added sugars. This longitudinal study examined the relationship between depressive mood and added sugar consumption among college freshmen, and how weight status play a role in this relationship. A web-based survey assessing depressive mood score and added-sugar foods consumption, and height and weight measurements were obtained. A total of 511 participants (aged 18.5±0.4 years; 70.5% females) were recruited at Arizona State University from August 2015 through January 2016. The main outcomes measured were the relationship between depressive mood score and added sugar consumption (tsp/d) within each participants and between mean weight status groups (underweight & “healthy” weight, overweight, and obese). In the study, the mean added sugar consumption was 19.1±11.87 tsp/d. There were no significant association between depressive mood and added sugar consumption within or between freshman students over time. But overall, there was a slightly positive relationship between depressive mood and added sugar consumption across four time points. No significant interaction was found between BMI, depressive mood, and added sugar consumption within each student, but significant differences in the relationship of depressive mood and added sugar between mean weight status groups (p=0.025). Each individual’s BMI in the previous time points was significantly negatively associated with added sugar consumption in the current time points (beta = -0.70; p=0.010). The results from this study indicates that depressive mood may not affect added sugar intake in this sample. BMI did not have an impact on the relationship within each student, but have an impact between mean weight status groups, so further studies are needed to continue look at how BMI influences the relationship between depressive mood and added sugar consumption. / Dissertation/Thesis / Masters Thesis Nutrition 2017

Objetivo: Investigar o consumo alimentar de açúcares de adição em adolescentes residentes no município de São Paulo, assim como os fatores que influenciam tal consumo. Métodos: Obteve-se uma amostra probabilística de 793 adolescentes por conglomerados. Aplicou-se um recordatório alimentar de 24 horas e um segundo recordatório em uma subamostra. O consumo alimentar habitual de energia, nutrientes e alimentos foi estimado pelos métodos propostos pela Iowa State University (ISU) e pelo National Cancer Institute (NCI). Resultados: Em média, os açúcares de adição contribuíram com 12,28% da energia consumida pelos adolescentes (sem diferença entre os sexos), sendo o refrigerante o alimento que mais contribuiu para esta ingestão. A escolaridade do chefe da família e a consumo de outros macronutrientes (proteínas, gorduras e carboidratos exceto açúcares de adição) exerceram efeito independente sobre o consumo de açúcares de adição. O aumento do consumo de calorias provenientes dos açúcares de adição determinou aumento da ingestão de gorduras e redução da ingestão de carboidratos exceto açúcares de adição e proteínas. Maior porção mediana do consumo de leite, carnes, frutas, suco industrializado, refrigerante e achocolatado em pó foi identificada entre os adolescentes com consumo excessivo de açúcares. Conclusões: A contribuição percentual dos açúcares de adição à energia consumida pelos adolescentes do município de São Paulo está acima das recomendações atuais e o consumo excessivo de açúcares exerceu efeito na ingestão e na adequação do consumo de macro e micronutrientes e no consumo de alimentos de maior densidade nutritiva. Essas evidências corroboram as recomendações nacionais e internacionais para redução do consumo de açúcares e apontam a necessidade de ações educativas sobre alimentação saudável direcionadas aos adolescentes. / Objective: To measure added sugar intake and assess the effect of this intake on the diet of adolescents living in the city of São Paulo. Methods: The study sample comprised 793 male and female adolescents selected from a population-based cross-sectional study based on a household survey conducted between March and December 2003. Food intake was assessed through 24-hour food recalls and then an adjustment approach was applied using repeat data. Food intake of energy, nutrients and foods was measured by the methods developed at Iowa State University (ISU) and National Cancer Institute (NCI). Results: Added sugars contributed on average to 12.28% of energy consumed in adolescents (no difference between males and females). Their main source was soft drinks. Family head schooling and other macronutrients intake had an independent effect on added sugar intake. Increased intake of calories from added sugars resulted in increased fat intake and decreased consumption of carbohydrates except sugars and protein. Higher median percent intake of milk, meat, fruit, processed juice, soft drink and chocolate milk was seen among adolescents with excess sugar intake. Conclusions: The percent contribution from added sugars to energy consumed among adolescents in the city of São Paulo is higher than current recommendations. Excess sugar intake had a negative effect on macronutrient and micronutrient intake and adequacy on the consumption of foods of high nutrient density. These findings corroborate Brazilian and international recommendations for reduction of sugar intake and points to the need of education actions targeting adolescents to promote healthy eating.

No description available.

Submitted by Rosivalda Pereira (mrs.pereira@ufma.br) on 2017-05-10T19:02:24Z No. of bitstreams: 1 ElizabethCosta.pdf: 1115019 bytes, checksum: 7bb115996a69101584c50ccc1ee319ae (MD5) / Made available in DSpace on 2017-05-10T19:02:24Z (GMT). No. of bitstreams: 1 ElizabethCosta.pdf: 1115019 bytes, checksum: 7bb115996a69101584c50ccc1ee319ae (MD5) Previous issue date: 2016-02-29 / Fundação de Amparo à Pesquisa e ao Desenvolvimento Científico e Tecnológico do Maranhão (FAPEMA) / Introduction: Several risk factors are associated with the ECC, including the S. mutans, identified as responsible for the onset of the disease; maternal saliva, the main source of primary infection to the child, socioeconomic factors, dietary habits and oral hygiene shared in the family environment. Thus, this thesis is divided into two chapters: Chapter I aimed at analyzing the contamination of S. mutans in the mother mediated by the contamination of S. mutans in the child together with the ECC. Chapter II aimed at analyzing the association between the consumption of added sugar by the mother and the frequency of the child's added sugar consumption. Methods: The sample consisted of 697 preschool children between 24 and 71 months old and their mothers. The mothers answered a questionnaire on their general and oral health as well as the child and a food frequency questionnaire (FFQ) to assess the diet of the binomial and the consumption of added sugar by the mother and the child. Mothers and children were subjected to an oral clinical examination to measure the caries index (DMF/ceo), IPV, ISG, anthropometric analysis of the mother's waist circumference and microbiological examination of saliva in 400 mothers / children pairs. A theoretical model based on causal diagrams (DAGs) that allows control of confounding factors in the most appropriate manner and at the same time avoids unnecessary adjustments to mothers / children mediators has been prepared. For Article 1, two models have been suggested, adjusted and analyzed: a total effect model and a mediated effect model of the association between maternal contamination S. mutans and ECC. The Paramed test was used to quantify the proportion of maternal S. mutans contamination effects mediated by contamination by S. mutans in the child in the ECC. To Article 2, two models have been suggested to study the association between the consumption of added sugar by the mother and child: an Effect 1 model and an Effect 2 model. The multinomial regression analysis was used to test the models, based on the DAGs. The marginal structural model was estimated by weighting by the inverse of the probability of consumption exposure in order to assess the association between consumption of added sugar by the mother and child. We estimated the prevalence ratio (PR) and confidence intervals (95% CI), in a 5% significance level. Results: In the total effect model, the presence of high colonization of S. mutans in the mother, the largest measurement of the waist circumference of the mother were associated with the ECC; Maternal IPV; child's age ≥ 4 years old and higher frequency of sugar consumption by the child. In the mediated effect model, the high maternal colonization remained linked to the ECC. Paramed test showed the proportion of mediated effect in 33% of maternal contamination of S. mutans by contamination in the child of S. mutans in the ECC. In effect model 1, the second and third tertile of the mother added sugar consumption was associated with the second tertile of added sugar consumption by the child; likewise the second and third tertile of consumption by the mother were also associated with the third tertile of the child's added sugar consumption. In effect model 2, all these variables of maternal consumption were also associated with the greatest child's consumption tertiles; yet maternal CW ≥88cm was also associated with the highest tertile of sugar consumption by the child. In marginal structural model, the consumption of added sugar by the mother was associated with added sugar consumption by the child. Conclusions: The contamination of S. mutans in the child only partially measured the association of the mother's S. mutans contamination in ECC. Other factors must be considered in the mother/child binomial, such as diet, oral hygiene practices and history of caries in the family environment. Sugar consumption by the mother and the highest maternal metabolic risk seem to explain the child's added sugar consumption in early childhood. / Introdução: Diversos fatores de risco estão associados à CPI, dentre eles os S.mutans, apontados como responsável pelo início da doença; a saliva materna, como principal fonte de infecção primária para o filho, os fatores socioeconômicos, os hábitos de dieta e de higiene bucal compartilhados no ambiente familiar. Assim sendo, esta tese foi dividida em dois capítulos: O capítulo I teve como objetivo, analisar a contaminação de S.mutans na mãe mediado pela contaminação de S.mutans no filho em associação com a CPI. O capítulo II teve como objetivo analisar a associação entre o consumo de açúcar de adição pela mãe e a frequência do consumo de açúcar de adição pelo filho. Métodos: A amostra foi composta por 697 pré-escolares de 24 a 71 meses de idade e suas mães. As mães responderam a um questionário sobre saúde geral e bucal da mãe e do filho e questionário de frequência alimentar (QFA), para avaliar a dieta do binômio e o consumo de açúcar de adição pela mãe e consumo de açúcar de adição pelo filho. Mães e filhos foram submetidos a um exame clínico bucal para aferição do índice de cárie (CPOD/ceo), IPV, ISG, análise antropométrica da circunferência da cintura da mãe e exame microbiológico da saliva em 400 pares mães/filhos. Foi elaborado um modelo teórico baseado em diagramas causais (DAGs) que permite o controle de fatores de confusão da forma mais adequada e ao mesmo tempo evita ajustes desnecessários para mediadores mães/filhos. Para o Artigo 1, dois modelos foram sugeridos, ajustados e analisados: um modelo de efeito total e outro modelo de efeito mediado da associação entre contaminação de S. mutans materna e CPI. O teste paramed foi usado para quantificação da proporção do efeito da contaminação de S. mutans materna mediada pela contaminação por S. mutans no filho na CPI. Para o artigo 2, foram sugeridos dois modelos para o estudo da associação entre o consumo de açúcar de adição pela mãe e o consumo de açúcar de adição pelo filho: um modelo de Efeito 1 e um modelo de Efeito 2. A análise de regressão multinomial foi usada para testar os modelos, baseados nos DAGs. Modelo estrutural marginal foi estimado pela ponderação pelo inverso da probabilidade do consumo da exposição, para avaliar a associação entre consumo de açúcar de adição pela mãe e consumo de açúcar de adição pelo filho. Estimou-se o razão de prevalência (RP) e os respectivos intervalos de confiança (IC 95%), a um nível de significância de 5%. Resultados: No modelo de efeito total, foram associadas à CPI, a presença de alta colonização de S. mutans na mãe, as maiores medidas da circunferência da cintura materna; IPV materno; idade da criança ≥ 4 anos e maior frequência de consumo de açúcar pelo filho. No modelo de efeito mediado, a alta colonização materna permaneceu associada à CPI. O teste paramed mostrou a proporção do efeito mediado de 33% da contaminação materna de S. mutans pela contaminação no filho de S. mutans na CPI. No modelo de efeito 1, o segundo e terceiro tercil do consumo de açúcar de adição pela mãe foram associados o segundo tercil do consumo de açúcar de adição pela filho; da mesma forma o segundo e terceiro tercil de consumo pela mãe foram também associados ao terceiro tercil do consumo de açúcar de adição pelo filho. No modelo de efeito 2, todas essas variáveis de consumo maternas também foram associadas aos maiores tercis de consumo do filho; ainda a CC materna ≥88cm também foi associada ao maior tercil de consumo de açúcar pelo filho. No modelo estrutural marginal, o consumo de açúcar de adição pela mãe foi associado ao consumo de açúcar de adição pelo filho. Conclusões: A contaminação de S. mutans no filho media apenas parcialmente a associação da contaminação de S. mutans da mãe na CPI. Outros fatores devem ser considerados no binômio mãe-filho, como hábitos alimentares, práticas de higiene bucal e a história da cárie no ambiente familiar. O consumo de açúcar pela mãe e o maior risco metabólico materno parecem explicar o consumo de açúcar de adição pelo filho na primeira infância.

Submitted by Rosivalda Pereira (mrs.pereira@ufma.br) on 2017-08-31T20:27:06Z No. of bitstreams: 1 ElizabethLimaCosta.pdf: 1115114 bytes, checksum: d6818412fe12c8ac2583651c4f42aed3 (MD5) / Made available in DSpace on 2017-08-31T20:27:06Z (GMT). No. of bitstreams: 1 ElizabethLimaCosta.pdf: 1115114 bytes, checksum: d6818412fe12c8ac2583651c4f42aed3 (MD5) Previous issue date: 2016-02-04 / FAPEMA / Introduction: Several risk factors are associated with the ECC, including the S. mutans, identified as responsible for the onset of the disease; maternal saliva, the main source of primary infection to the child, socioeconomic factors, dietary habits and oral hygiene shared in the family environment. Thus, this thesis is divided into two chapters: Chapter I aimed at analyzing the contamination of S. mutans in the mother mediated by the contamination of S. mutans in the child together with the ECC. Chapter II aimed at analyzing the association between the consumption of added sugar by the mother and the frequency of the child's added sugar consumption. Methods: The sample consisted of 697 preschool children between 24 and 71 months old and their mothers. The mothers answered a questionnaire on their general and oral health as well as the child and a food frequency questionnaire (FFQ) to assess the diet of the binomial and the consumption of added sugar by the mother and the child. Mothers and children were subjected to an oral clinical examination to measure the caries index (DMF/ceo), IPV, ISG, anthropometric analysis of the mother's waist circumference and microbiological examination of saliva in 400 mothers / children pairs. A theoretical model based on causal diagrams (DAGs) that allows control of confounding factors in the most appropriate manner and at the same time avoids unnecessary adjustments to mothers / children mediators has been prepared. For Article 1, two models have been suggested, adjusted and analyzed: a total effect model and a mediated effect model of the association between maternal contamination S. mutans and ECC. The Paramed test was used to quantify the proportion of maternal S. mutans contamination effects mediated by contamination by S. mutans in the child in the ECC. To Article 2, two models have been suggested to study the association between the consumption of added sugar by the mother and child: an Effect 1 model and an Effect 2 model. The multinomial regression analysis was used to test the models, based on th e DAGs. The marginal structural model was estimated by weighting by the inverse of the probability of consumption exposure in order to assess the association between consumption of added sugar by the mother and child. We estimated the prevalence ratio (PR) and confidence intervals (95% CI), in a 5% significance level. Results: In the total effect model, the presence of high colonization of S. mutans in the mother, the largest measurement of the waist circumference of the mother were associated with the ECC; Maternal IPV; child's age ≥ 4 years old and higher frequency of sugar consumption by the child. In the mediated effect model, the high maternal colonization remained linked to the ECC. Paramed test showed the proportion of mediated effect in 33% of maternal contamination of S. mutans by contamination in the child of S. mutans in the ECC. In effect model 1, the second and third tertile of the mother added sugar consumption was associated with the second tertile of added sugar consumption by the child; likewise the second and third tertile of consumption by the mother were also associated with the third tertile of the child's added sugar consumption. In effect model 2, all these variables of maternal consumption were also associated with the greatest child's consumption tertiles; yet maternal CW ≥88cm was also associated with the highest tertile of sugar consumption by the child. In marginal structural model, the consumption of added sugar by the mother was associated with added sugar consumption by the child. Conclusions: The contamination of S. mutans in the child only partially measured the association of the mother's S. mutans contamination in ECC. Other factors must be considered in the mother/child binomial, such as diet, oral hygiene practices and history of caries in the family environment. Sugar consumption by the mother and the highest maternal metabolic risk seem to explain the child's added sugar consumption in early childhood. / Introdução: Diversos fatores de risco estão associados à CPI, dentre eles os S.mutans, apontados como responsável pelo início da doença; a saliva materna, como principal fonte de infecção primária para o filho, os fatores socioeconômicos, os hábitos de dieta e de higiene bucal compartilhados no ambiente familiar. Assim sendo, esta tese foi dividida em dois capítulos: O capítulo I teve como objetivo, analisar a contaminação de S.mutans na mãe mediado pela contaminação de S.mutans no filho em associação com a CPI. O capítulo II teve como objetivo analisar a associação entre o consumo de açúcar de adição pela mãe e a frequência do consumo de açúcar de adição pelo filho. Métodos: A amostra foi composta por 697 pré-escolares de 24 a 71 meses de idade e suas mães. As mães responderam a um questionário sobre saúde geral e bucal da mãe e do filho e questionário de frequência alimentar (QFA), para avaliar a dieta do binômio e o consumo de açúcar de adição pela mãe e consumo de açúcar de adição pelo filho. Mães e filhos foram submetidos a um exame clínico bucal para aferição do índice de cárie (CPOD/ceo), IPV, ISG, análise antropométrica da circunferência da cintura da mãe e exame microbiológico da saliva em 400 pares mães/filhos. Foi elaborado um modelo teórico baseado em diagramas causais (DAGs) que permite o controle de fatores de confusão da forma mais adequada e ao mesmo tempo evita ajustes desnecessários para mediadores mães/filhos. Para o Artigo 1, dois modelos foram sugeridos, ajustados e analisados: um modelo de efeito total e outro modelo de efeito mediado da associação entre contaminação de S. mutans materna e CPI. O teste paramed foi usado para quantificação da proporção do efeito da contaminação de S. mutans materna mediada pela contaminação por S. mutans no filho na CPI. Para o artigo 2, foram sugeridos dois modelos para o estudo da associação entre o consumo de açúcar de adição pela mãe e o consumo de açúcar de adição pelo filho: um modelo de Efeito 1 e um modelo de Efeito 2. A análise de regressão multinomial foi usada para testar os modelos, baseados nos DAGs. Modelo estrutural marginal foi estimado pela ponderação pelo inverso da probabilidade do consumo da exposição, para avaliar a associação entre consumo de açúcar de adição pela mãe e consumo de açúcar de adição pelo filho. Estimou-se o razão de prevalência (RP) e os respectivos intervalos de confiança (IC 95%), a um nível de significância de 5%. Resultados: No modelo de efeito total, foram associadas à CPI, a presença de alta colonização de S. mutans na mãe, as maiores medidas da circunferência da cintura materna; IPV materno; idade da criança ≥ 4 anos e maior frequência de consumo de açúcar pelo filho. No modelo de efeito mediado, a alta colonização materna permaneceu associada à CPI. O teste paramed mostrou a proporção do efeito mediado de 33% da contaminação materna de S. mutans pela contaminação no filho de S. mutans na CPI. No modelo de efeito 1, o segundo e terceiro tercil do consumo de açúcar de adição pela mãe foram associados o segundo tercil do consumo de açúcar de adição pela filho; da mesma forma o segundo e terceiro tercil de consumo pela mãe foram também associados ao terceiro tercil do consumo de açúcar de adição pelo filho. No modelo de efeito 2, todas essas variáveis de consumo maternas também foram associadas aos maiores tercis de consumo do filho; ainda a CC materna ≥88cm também foi associada ao maior tercil de consumo de açúcar pelo filho. No modelo estrutural marginal, o consumo de açúcar de adição pela mãe foi associado ao consumo de açúcar de adição pelo filho. Conclusões: A contaminação de S. mutans no filho media apenas parcialmente a associação da contaminação de S. mutans da mãe na CPI. Outros fatores devem ser considerados no binômio mãe-filho, como hábitos alimentares, práticas de higiene bucal e a história da cárie no ambiente familiar. O consumo de açúcar pela mãe e o maior risco metabólico materno parecem explicar o consumo de açúcar de adição pelo filho na primeira infância.

Consumption of sugar, sugar-containing food and drinks, related health risks and change of life style in our population are currently addressed issues with negative consequences already observed in childhood. The aim of the diploma thesis was to study the consumption of sugar and foods containing sugar in children attending kindergarten and 1st grade of elementary school. The theoretical part was focused on an overview of knowledge about sugars, both naturally occurring and added, and health risks associated with frequent consumption of foods containing added sugars. In the practical part, the consumption of these foods in terms of quantity and various forms and its influence on the development of childhood obesity and other metabolic diseases was monitored. At the same time, other aspects of children's lifestyle that could determine children's obesity were identified. The basis of the practical part was a questionnaire survey using questions determining eating habits of children. The research showed a relationship between the BMI of children above the 75th percentile and more frequent sweets consumption and less frequent active (sports) and natural physical activities. Almost 84% of children consume sugar and sweets more often than 3 times a week, with more frequent consumption in kindergarten...