L’objectif principal de la thèse était d’étudier les effets de l’alimentation et de l’obésité sur l’asthme et son évolution, en prenant en compte des facteurs de médiations spécifiques.La première partie de la thèse visait à étudier le rôle de l’alimentation dans l'asthme, en prenant en compte l’indice de masse corporelle (IMC) comme un médiateur potentiel, et en évaluant l’effet modificateur du tabac dans ces associations. Ce travail a d’abord porté sur le rôle de la consommation de charcuterie, récemment classée cancérogène. Parmi 971 adultes de l’étude des facteurs génétiques et environnementaux de l’asthme (EGEA), nous avons montré qu’une consommation élevée de charcuterie (au moins 4 fois par semaine) était associée de façon directe à l’aggravation des symptômes de l’asthme, et que seulement 14% de l’association entre la consommation de charcuterie et l’asthme était expliqué par l’IMC (effet indirect). Ce travail a ensuite porté sur le rôle de la qualité globale de l’alimentation, évaluée par le score alimentaire Alternate Healthy Eating Index 2010. Parmi 969 participants d’EGEA, nous avons montré qu’une alimentation de qualité était associée de façon directe à une amélioration des symptômes de l’asthme chez les non-fumeurs. L’effet indirect lié à l’IMC n’était pas significatif. La deuxième partie de la thèse visait à mieux comprendre l'association entre l'obésité et l'activité de l’asthme, en prenant en compte la leptine, une adipokine pro-inflammatoire, comme un médiateur potentiel. Parmi 331 adultes d’EGEA avec un asthme actif à l’inclusion, les analyses ont montré que différentes mesures élevées de la composition corporelle étaient associées à une activité persistante de l’asthme, avec un effet indirect très fort de la leptine dans ces associations. / The general aim of the thesis was to study the role of diet and obesity in asthma, while accounting for potential mediators in these analyses.The first part of the thesis aimed to investigate the role of dietary factors in asthma at a “macro-level”, considering body mass index (BMI) as a potential mediator, and to evaluate effect modification by smoking. We first focused on processed meat intake, a recent carcinogen. Among 971 participants from the Epidemiological study on the Genetics and Environment of Asthma, bronchial hyperresponsiveness and atopy (EGEA), analysis showed that high processed meat intake (at least 4 servings/week) was associated with worsening asthma symptoms over time, through a direct effect and to a lesser extent an effect mediated by BMI. We then focused on the overall diet quality assessed by the Alternate Healthy Eating Index 2010. Among 969 participants from the EGEA study, the analyses showed that a greater adherence to a better diet quality was associated with improved asthma symptoms over time in never smokers only and was not mediated through BMI. The second part of the thesis aimed to better understand the association between obesity and asthma at a “micro-level”, considering leptin, an inflammatory biological marker related to obesity, as a mediator. Including 331 participants from the EGEA study with current asthma at baseline, analysis showed that high body adiposity estimated by different measures was associated with persistent asthma activity, likely mediated by leptin.

No description available.

Overweight and obesity are risk factors for various chronic diseases. Sleep has been associated with overweight and obesity. One potential mechanism by which sleep may lead to overweight and obesity is through positive energy balance (i.e. energy intake exceeding expenditure). There are few studies examining the impact of sleep timing (onset and wake time) on diet and exercise. In a cross sectional study, we examined associations between sleep timing and diet quality, and in separate models, between sleep timing and meeting the 2008 Physical Activity Guidelines for Americans among the participants of the UMass Vitamin D Status Study. A total of 140 young women (aged 18 to 30 years) were grouped into four sleep timing categories based on the median of participants’ sleep onset and wake time (Early sleep-Early wake, Early sleep-Late wake, Late sleep-Early wake, Late sleep-Late wake). Multivariable linear regression and multivariable logistic regression were used to model the associations between the sleep timing categories and diet quality, and sleep timing and meeting the National Physical Activity Guidelines, respectively. Participants in the Early sleep-Early wake group had the highest diet quality scores and were more likely to meet the National Physical Activity Guidelines compared to the other sleep timing categories. To our knowledge, this was the first study in the U.S. examining sleep timing and diet quality and physical activity among young women. In conclusion, the old adage early to bed, early to rise appears to be related to higher diet quality and meeting physical activity guidelines.

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.

The purpose of this research was to develop, validate, and test an instrument to evaluate motivations to eat in low-income women during the early postpartum period. The instrument was also used in a sample of young college women to further validate the measure and explore determinants of eating in this population. In study 1, the Eating Stimulus Index was validated in 179 low-income women in early postpartum. Validity and reliability were determined via principal components analysis, internal consistency reliability, and test-retest reliability using a subgroup of 31 low-income new mothers. The factor analysis produced an eight factor structure with reliability coefficients ranging from 0.54-0.89. Convenience eating (r=-0.25, P<0.01), emotional eating (r=-0.17, P<0.05), and dietary restraint (r=-0.21, P<0.01) were significantly related to weight status. In study 2, the relationship between eating motivations and diet quality, determined via the Dietary Guidelines Adherence Index, was established in 115 low-income women in early postpartum. High diet quality was related to fruit and vegetable availability (r=0.25, P<0.01), convenience eating resistance (r=-0.36, P<0.001), and vegetable taste preference (r=0.23, P<0.05). Motivations to eat differed between overweight and obese women with the primary motivation being convenience eating and taste, respectively. In study 3, determinants of weight loss were examined in 58 low-income women in early postpartum participating in an 8-week weight loss intervention. Participants were evaluated at pre- and post-study for all measures. Factors related to weight loss included increases in dietary restraint, weight management skills, and weight loss self-efficacy and decreases in fruit juice servings, total energy, and discretionary energy intakes. After hierarchical regression analysis, improvement in weight loss self-efficacy was the most significant determinant (β=0.263, P<0.05) followed by decreases in discretionary energy intake (β=-0.241, P<0.05). In study 4, determinants of diet quality were assessed in a sample of 88 young college women using the Eating Stimulus Index. Low diet quality was associated with poor fruit and vegetable availability, convenience eating resistance, vegetable taste preference, and weight management self-efficacy, while high diet quality was related to increased frequency of meals prepared at home and decreased frequency of meals consumed at fast food restaurants. / text

Résumé Objectifs : Le syndrome métabolique (MetS) est un ensemble de composantes (obésité, résistance à l'insuline, intolérance au glucose, dyslipidémie, hypertension) qui sont associées à une augmentation du risque de diabète de type 2 et de maladies cardiovasculaires. Aux États-Unis, la fréquence du MetS atteint des proportions épidémiques avec une prévalence de 25% de la population. Les études nutritionnelles traditionnelles se sont concentrées sur l’effet d’un nutriment alors que les études plus récentes ont déterminé l’effet global de la qualité alimentaire sur les facteurs de risque. Cependant, peu d'études ont examiné la relation entre la qualité alimentaire et le MetS. Objectif: Déterminer l'association entre la qualité alimentaire et le MetS et ses composantes. Méthodes: La présence du MetS a été déterminée chez 88 femmes post-ménopausées en surpoids ou obèses, selon la définition du National Cholesterol Education Program Adult treatment Panel III alors que la qualité alimentaire a été évaluée selon le Healthy Eating Index (HEI). La sensibilité à l’insuline, la composition corporelle et le métabolisme énergétique ont été mesurés. Résultats: Le HEI corrélait négativement avec la plupart des mesures de masse grasse et du poids mais pas avec la sensibilité à l'insuline, l’hypertension et la plupart des marqueurs lipidiques. Cependant, l’HEI corrélait positivement avec LDL-C/ApoB et négativement avec le métabolisme énergétique. Conclusion: Les résultats démontrent que l’HEI est associé avec les mesures de gras corporel et la grosseur des LDL. Mots clés: Obésité, qualité alimentaire, métabolisme lipidique, syndrome métabolique. / Abstract Background: The metabolic syndrome (MetS) is a constellation of different metabolic components including central obesity, insulin resistance, abnormal glucose homeostasis, dyslipidemia and high blood pressure which identify individuals at high risk of type 2 diabetes and cardiovascular events. In the US, the prevalence of MetS has reached epidemic proportion and up to 25% of the population is affected. Traditional nutritional studies have focused on a single nutrient. Recently, measures of overall diet quality have been proposed as an alternative to assess diet-related diseases. However, few studies have addressed the relationship between diet quality and the MetS. Objective: To investigate the association of diet quality with the MetS and its components. Methods: The presence of the MetS was determined in 88 postmenopausal overweight or obese women using the National Cholesterol Education Program Adult treatment Panel III definition while diet quality was assessed with the Healthy Eating Index (HEI). We also measured insulin sensitivity, body composition and energy metabolism. Results: The HEI correlated negatively with most measures of body fat and body weight but not with insulin sensitivity, blood pressure and most markers of lipid metabolism. However, HEI correlated positively with LDL-C/ApoB and negatively with energy metabolism. Conclusion: Our results demonstrated that HEI is associated with fat distribution and LDL size. Key words: Obesity, diet quality, lipid metabolism, metabolic syndrome.

Introduction: Plusieurs indices de qualité alimentaire globale ont été élaborés en misant sur la consommation de certains nutriments ou aliments, ou des groupes d’aliments. Les indices de la qualité alimentaire globale sont en mesure d’évaluer de manière intégrée les aspects recherchés d’une bonne alimentation. C’est dans ce cadre que le Canadian Healthy Eating Index (C-HEI) a été développé pour évaluer le degré auquel les apports alimentaires des individus rencontrent les consignes du guide alimentaire canadien et les Recommandations nutritionnelles canadiennes. Objectif: Evaluer les liens entre l’indice de la qualité alimentaire globale C-HEI calculé à partir de la moyenne de trois rappels alimentaires de 24 heures et des paramètres nutritionnels, anthropométriques et des indicateurs de santé au recrutement (T1) dans l’étude longitudinale québécoise sur la nutrition et le vieillissement réussi (NuAge). Méthodologie: Des analyses bivariées (coefficients de corrélation, tableaux croisés et la statistique khi deux) ont été réalisées afin de déterminer les associations entre le score total C-HEI et certaines variables nutritionnelles, anthropométriques et le nombre de maladies chroniques. Résultats et discussion: Les participants ont rencontré ou dépassé la plupart de leurs apports nutritionnels de référence. Le C-HEI n’a pas été fortement corrélé aux nutriments individuels (rs= 0,14-0,52, p<0,01). Le C-HEI total était significativement associé aux recommandations canadiennes pour l’apport en fibres (rs= 0,51), le % d’énergie provenant des lipides (rs=-0,60) et des acides gras saturés (rs= -0,59), p<0,01. De plus, la suffisance en protéines et en énergie est augmentée lorsqu’on passait du Q1 (plus faible) à Q4 (plus élevé) du C-HEI (p<0,05). De même, les proportions des sujets ayant des mesures anthropométriques associées aux risques accrus pour la santé sont diminuées en passant du Q1 au Q4 (p<0,05), témoignant ainsi des liens entre une alimentation de bonne qualité et la protection des risques de santé associés à l’embonpoint et à l’obésité. Conclusion : Les résultats de cette recherche ont fourni des preuves additionnelles sur le lien entre le score C-HEI et certains paramètres nutritionnels et anthropométriques d’intérêt, et ce, provenant des données alimentaires quantitatives colligées au sein d’une population âgée vivant dans la communauté. / Introduction: Several diet quality indicators have been developed based on nutrient intakes, foods or food groupings, or a combination of nutrient and foods. Measures of overall diet quality consider numerous aspects of dietary intake. It is within this framework that the Canadian Healthy Eating Index (C-HEI) was adapted to Canadian dietary and nutritional guidance using Canada’s Food Guide and Nutrition recommendations for Canadians. Objectives: To determine the links between the C-HEI using the mean of three 24-hour diet recalls, and certain health outcomes at entry into the study (T1). The analyses were carried out using data collected from participants in the Quebec Longitudinal Study on Nutrition and Successful Aging (NuAge). Methodology: Bivariate analyses (Spearman correlation, cross-tabulation and chi-square) were carried out to assess relationships between nutritional and anthropometric variables, the number of chronic disease and the C-HEI. Results and Discussion: Participants met or exceeded most Dietary Reference Intakes (DRI). The C-HEI did not show consistent relationships with individual nutrients (rs= 0.14-0.52, p<0.01). However, selected sub-scores of the C-HEI reflect attainment of Canada’s Food Guide recommendations, showing a strong association with dietary fiber intakes (rs= 0.51) and nutrition recommendations addressing percent energy as fat (rs=-0.60) and as saturated fat (rs= -0.59), p<0.01. Energy and protein adequacy increased from Q1 to Q 4 of C-HEI (p<0.05). In addition, proportions of subjects with anthropometric measures associated with a health risk decreased from quartiles Q1 to Q4 (p<0.05), attesting to links between good diet quality and lower health risks associated with overweight and obesity. Conclusion: The C-HEI discriminates overall diet quality based on dietary data collected from 24HR, providing further evidence on the links between the C-HEI and selected nutritional and anthropometric parameters as applied to quantitative dietary data obtained from community-dwelling older adults.

Master of Science / Department of Human Nutrition / Mary Meck Higgins / Because of the ever-changing nature of the economy and the food environment, research as recent as 2010 may not be relevant to today’s discussion on food insecurity, food deserts, obesity rates, and nutritional quality in the U.S. population’s diet. Today, people of low socioeconomic status in the U.S. are at risk for overweight, obesity, and chronic illnesses such as type 2 diabetes, hypertension, and certain cancers. In this report, I investigate published research about low-income populations in the U.S. relative to the food environment and describe implications for healthcare professionals implementing interventions with these populations, discussed in the following categories: Dietary Intake Quality and Socioeconomic Status; Food Insecurity; Barriers to Quality Food Access in the U.S. Food Environment; Communities Alleviating Food Insecurity; Food-Related Perceptions, Attitudes, and Behaviors; Homelessness and Food-Related Behaviors; Why Do People Buy What They Buy?; Nutrition Assistance Programs and Policies; Current U.S. Food Costs; and Comparing the Nutritional Value Versus Price of Foods. Although the literature on the subject of low-income diet quality is thorough, much of it needs to be updated with current data on food prices, food environments, and U.S. diet quality. For this purpose, I compiled the most recent data from the National Bureau of Labor & Statistics on food prices to discuss the elevated food prices of healthful foods as opposed to less healthful foods. I also created a one-month menu based on the U.S. Department of Agriculture’s Thrifty Food Plan budget allowance in order to follow a healthful diet in this harsh economic climate utilizing the Dietary Guidelines for Americans 2010 and the Affordable Nutrients Index.

Introdução: O excesso de peso (EP, inclui sobrepeso e obesidade) configura um grande problema de saúde pública no país. A compreensão do estado nutricional ao longo do tempo e de fatores associados, como a dieta, além de suas possíveis consequências, como fatores de risco cardiometabólico, é essencial para o desenvolvimento de ações em saúde. Objetivo: Avaliar a prevalência de sobrepeso e obesidade na população da cidade de São Paulo, assim como modificações na dieta da população entre os anos de 2003 e 2015 e sua associação com fatores de risco cardiometabólico. Métodos: Foram utilizados dados do estudo transversal de base populacional ISA - Capital dos anos de 2003, 2008 e 2015, referentes à amostra probabilística de residentes do município de São Paulo com 12 anos ou mais, de ambos os sexos, totalizando 8.682 indivíduos. Dados socioeconômicos, antropométricos, de estilo de vida e recordatório alimentar de 24 horas foram coletadas em visitas domiciliares e inquérito telefônico. Os indivíduos foram classificados segundo IMC em duas categorias: com e sem EP. Os fatores de risco cardiometabólico avaliados foram: circunferência de cintura aumentada, pressão arterial sistólica ou diastólica elevada, dislipidemia, glicemia de jejum ou hemoglobina glicada elevadas e resistência à insulina. Foram avaliados a frequência de consumo e o tamanho das porções de 30 grupos de alimentos e a qualidade da dieta, utilizando o Índice de Qualidade da Dieta Revisado para a população brasileira (IQD-R) e o Alternate Healthy Eating Index-2010 (AHEI) americano. Variáveis categóricas foram descritas e comparadas por teste qui-quadrado de Pearson e intervalo de confiança de 95%. Foram utilizados modelos de regressão logística e logística ordinal para avaliar a associação das variáveis investigadas com EP e com fatores de risco cardiometabólico. Resultados: No período avaliado, a prevalência de obesidade na população dobrou: de 10% (8,0; 12,5) em 2003 para 19,2% (17,8; 20,6) em 2015, sendo o maior aumento entre adolescentes e adultos do sexo feminino. Adultos, pessoas com maior renda e ex-fumantes apresentaram maior chance de ter EP, o qual aumentou 31% entre 2003 e 2008 e 126% entre 2003 e 2015, quando metade da população passou a ter EP. Se esse padrão se mantiver, espera-se que 77% da população tenha EP em 2030. Neste período, houve uma variação no tamanho das porções consumidas, com aumento em alguns grupos de alimentos (carne branca, salgados, café/chá, ovos) e redução em outros (arroz, carne vermelha, doces, massas, sanduiches, frios). Além disso, a frequência de consumo de seis grupos aumentou no período (arroz, carne branca, doces, frutas, sucos industrializados, torradas/biscoitos). Nesta população, o EP se associou positivamente com maiores porções de frios, petiscos fritos, sucos naturais e industrializados, pizza, carne vermelha, arroz, salgados, refrigerantes, sopas e açúcar. Em relação à qualidade da dieta, adolescentes com EP apresentaram pior qualidade da dieta para os componentes grãos integrais (IQD-R) e bebidas açucaradas (AHEI) em relação aos adolescentes sem EP. O IQD-R foi inversamente associado ao EP (OR=0.87; 0.80, 0.95) e ao número de fatores de risco cardiovascular (OR=0.89; 0.80, 0.98) nesta população. Conclusões: O EP aumentou substancialmente em um curto período na cidade de São Paulo, especificamente em alguns subgrupos e se associou positivamente com maior tamanho da porção de 11 grupos de alimentos na população geral e com menor qualidade da dieta entre os adolescentes. Adolescentes com menor qualidade da dieta também apresentaram maior chance de ter mais fatores de risco cardiometabólico. Esses achados podem subsidiar intervenções e políticas para redução da tendência de aumento do excesso de peso e melhora no consumo alimentar na população. / Introduction: Excess body weight (EBW, including overweight and obesity) is a major public health problem in the country. Understanding nutritional status over time and associated factors, such as diet, besides its consequences, such as cardiometabolic risk factors, is essential for the development of interventions in health. Objective: To evaluate the prevalence of overweight and obesity in the population of the city of São Paulo, as well as changes in diet between 2003 and 2015, and its association with cardiometabolic risk factors. Methods: We used data from the cross-sectional population based study ISA-Capital 2003, 2008, and 2015, with probabilistic sampling of residents of the city of São Paulo aged 12 years and more, of both sexes, totaling 8,682 individuals. Socioeconomic, anthropometric, and lifestyle data and 24-hour dietary recalls were collected in the households and by telephone. The individuals were categorized according to BMI in two categories: with and without EBW. The evaluated cardiometabolic risk factors were: central obesity, hypertension, dyslipidemia, high fasting glycaemia or glycated hemoglobin, and insulin resistance. We evaluated the frequency of intake and the portion sizes of 30 food groups, besides the diet quality, using the Revised Diet Quality Index for Brazilian population (BHEI-R) and the American Healthy Eating Index-2010 (AHEI). Categorical variables were described and compared by Pearson\'s chi-square test and 95% confidence interval. Ordinal logistic and logistic regression models were performed to evaluate the association of the investigated variables with EBW and cardiometabolic risk factors. Results: The prevalence of obesity in the population doubled in the evaluated period, from 10% (8.0; 12.5) in 2003 to 19.2% (17.8; 20.6) in 2015, with the highest increase among female adolescents and adults. Adults, those with higher income, and former smokers were more likely to have EBW, which increased 31% between 2003 and 2008, and 126% between 2003 and 2015, when half of the population had EBW. If this pattern continues, it is expected that 77% of the population will have EBW by 2030. During this period, there was a variation in the portion sizes of food groups consumed, with increase in some groups (white meat, salted snacks, coffee/tea, eggs) and decrease in others (rice, red meat, sweets, pasta, sandwiches, cold cuts). In addition, there was an increase in the frequency of consumption of six groups (rice, white meat, sweets, fruits, commercial juices, toasts/biscuits). In this population, EBW was positively associated with larger portions of cold cuts, fried snacks, fruit and commercial juices, pizza, red meat, rice, salted snacks, soft drinks, soups and sugar. Regarding diet quality, adolescents with EBW had lower diet quality for the components whole grains (BHEI-R) and sugar sweetened beverages (AHEI) compared with adolescents without EBW. BHEI-R was inversely associated with EBW (OR = 0.87, 0.80, 0.95) and cardiovascular risk factors count (OR = 0.89, 0.80, 0.98) in this population. Conclusions: EBW increased substantially over a short period in the city of São Paulo, especially in some subgroups and it was positively associated with larger portion size of 11 food groups in the population, and with lower diet quality among adolescents. Also, adolescents with lower diet quality were more likely to have higher number of cardiovascular risk factors. These findings can subsidize interventions and policies to reduce the tendency of increase in EBW and to improve food intake in the population.

Introdução: Baixo nível de atividade física (AF) associado ao alto consumo energético contribuíram para transição nutricional no Brasil. Estilo de vida saudável reverte em benefícios cardiometabólicos. Considerando que estado inflamatório subclínico media os danos ao sistema cardiovascular, é possível que hábitos de vida saudáveis melhorem os fatores de risco, via atenuação da inflamação. Instrumentos padronizados para medir qualidade da dieta e AF estão disponíveis, mas não estudos locais avaliando a relação destes fatores entre si com base nestes instrumentos, ou examinando suas associações com estado inflamatório e perfil lipídico. Objetivos: Este estudo avaliou a associação entre a versão brasileira do Healthy Eating Index (B-HEI) e nível de AF e destes com marcadores inflamatórios, índice de resistência à insulina e variáveis lipídicas em indivíduos com alto risco cardiometabólico. Métodos: Nesta análise transversal foram incluídos 204 participantes (64,7 por cento mulheres; média de idade de 54,1 anos) de Estudo de Prevenção de Diabetes do CSEscola da FSP-USP, com pré-diabetes ou de síndrome metabólica sem diabetes. Foram realizados questionários e coletas de sangue. Foram utilizados três recordatórios alimentares de 24h para obtenção do B-HEI. O nível de AF foi medido pela versão longa do IPAQ, sendo determinada a AF no lazer, na locomoção, AF total e tempo de TV. Coeficiente de Spearman foi empregado para testar correlações. Para avaliar a relação entre o B-HEI e AF e dos tercis destas variáveis com marcadores inflamatórios e HOMA-IR foi usada ANOVA. Para avaliar associações independentes do B-HEI, tendo como variáveis dependentes parâmetros lipídicos, inflamatórios ou HOMA-IR, usou-se regressão linear múltipla e, para associações independentes da AF como as mesmas variáveis, usou-se regressão logística, sendo obtidos odds ratios (OR) e p de tendência. Resultados: Nos tercis do B-HEI, o nível de AF não diferiu; à medida que melhorava a qualidade da dieta houve tendência à redução do tempo de TV (21,4±11,6; 20,5±11,5; 16,8±10,4 h/sem; p=0,09). Na regressão linear, a circunferência abdominal associou-se inversamente aos escores de B-HEI, mantendo-se marginalmente significante após ajuste para idade e sexo. No mesmo modelo, proteína C reativa associou-se negativamente ao índice (p=0.02). Concentrações de adiponectina apresentaram significância marginal na análise sem ajustes (p=0.06). Estratificando-se indivíduos segundo a duração de AF na locomoção, lazer e total, indivíduos mais ativos (150 min/ sem) apresentaram menores medidas antropométricas, mas apenas para AF no lazer a tendência de redução foi significante. O perfil lipídico melhorou à medida que aumentou o nível de AF. Concentrações de interleucina-6 diminuíram com o aumento das durações de AF no lazer e total (p de tendência = 0,02 e 0,03, respectivamente), enquanto as de adiponectina tenderam a aumentar nos estratos mais ativos apenas para AF no lazer (p de tendência = 0,03). A tendência de hipercolesterolemia aumentou significantemente à medida que reduziu a duração de AF no lazer. Valores elevados da razão Apo B/Apo A foram inversamente associados com AF na locomoção, lazer e total. Foi observado aumento significante da OR de resistência à insulina entre categorias de AF no lazer (p de tendência = 0,04). Não foram observadas associações de qualquer domínio de AF com proteína C-reativa. Conclusões: Nossos dados não apoiam a hipótese de que boa qualidade da dieta e prática de AF estejam associadas. Reforçou-se a esperada associação de perfil cardiometabólico mais favorável com a prática de AF, mas não a da dieta de melhor qualidade medida pelo B-HEI / Background: Low physical activity (PA) level and high energy intake contributed to nutrition transition in Brazil. A healthy lifestyle reverts in cardiometabolic benefits. Considering that subclinical inflammatory status mediates damages to the cardiovascular system, healthy life habits may improve risk factors via attenuation of inflammation. Standardized tools to measure quality of diet and PA are available but not local studies assessing the relationship of these factors based on those tools, or examining their associations with inflammatory status and lipid profile. Objectives: This study evaluated the association between the Brazilian version of the Healthy Eating Index (B-HEI) and total, leisure and transportation PA level, and between those with inflammatory markers, insulin resistance index and lipids in individuals at high cardiometabolic risk. Methods: In this cross-sectional analysis, 204 participants (64.7 per cent women; mean age of 54.1 years) of the Study on Prevention of Diabetes from the FSP-USP School Health Center, with prediabetes or metabolic syndrome without diabetes were included. They were submitted to questionnaires and blood sample collections. 24-h food recalls were used to assess the B-HEI and PA was measured by the long version of the IPAQ. Spearman coefficient was employed to test correlations and ANOVA to analyze the association between the B-HEI and PA, and between the tertiles of these variables with inflammatory markers and HOMA-IR. Multiple linear regression was used to test independent associations of B-HEI, taking lipids, inflammatory markers and HOMA-IR as dependent variables. Logistic regression was used to test independent associations of PA with the same variables, and odds ratios (OR) and p for trend were obtained. Results: Across the B-HEI tertiles PA did not differ. However, as the quality of diet improves TV time decreases (21.4±11.6, 20.5±11.5, 16.8±10.4 h/week p=0.09). In linear regression analysis, abdominal circumference was inversely associated with BHEI, maintaining borderline significance after adjustment for age and sex. Creactive protein was shown to be inversely associated with the index (p=0.02). Adiponectin concentrations had borderline significance with B-HEI in crude analysis but not after adjustments (p=0.06). Stratifying according to the duration of transportation, leisure-time and total PA, the most active subset (150 min/week) showed lower anthropometric measurements, but only for leisure PA the tendency to decreasing values was significant. Lipid profile improved as PA levels increased. Interleukin-6 concentrations decreased as total and leisure PA increased (p for trend = 0.02 and 0.03, respectively), while adiponectin tended to increase in more active subsets only for PA at leisure time (p for trend = 0.03). Tendency for hypercholesterolemia increased significantly as leisure PA duration decreased. High Apo B/Apo A ratio was inversely associated with transportation, leisure and total PA. Significant increase in adjusted OR for insulin resistance from the category of highest to the lowest leisure PA was found (p for trend = 0.04) but statistical significance disappeared when adjusted for BMI. For increased C-reactive protein concentration, no significant association with any PA domain was observed. Conclusion: Our data do not support the hypothesis that good diet quality and PA practice were associated. The expected association of more favorable cardiometabolic profile with PA practice but not with better quality of diet was reinforced