Name: Monica Cattafesta
Type: PhD thesis
Publication date: 23/07/2021
Advisor:

Namesort descending Role
Luciane Bresciani Salaroli Advisor *

Examining board:

Namesort descending Role
Edson Theodoro dos Santos Neto Internal Examiner *
Eliana Zandonade Internal Alternate *
Elizabete Regina Araújo de Oliveira Internal Examiner *
Fabíola Lacerda Pires Soares External Examiner *
Luciane Bresciani Salaroli Advisor *
Renata Moraes Bielemann Teixeira External Examiner *
Valdete Regina Guandalini External Alternate *

Summary: Despite the importance of eating habits for the health-disease process, there are gaps in the analysis of the food consumption of rural workers and populations, as well as in the monitoring of the nutritional status of these groups. Thus, the objective was to analyze the food consumption of rural workers and its association with sociodemographic, labor, lifestyle and obesity factors in the city of Santa Maria de Jetibá, Espírito Santo, Brazil. This is a cross-sectional epidemiological study with 740 farmers (51.5%, n = 381 men; 48.5%, n = 359 women), in which dietary data were obtained from multiple 24-hour dietary recalls. Dietary patterns were determined a posteriori through Principal Component Analysis with Varimax orthogonal rotation, and foods were classified according to the degree and purpose of their processing. Still, obesity was evaluated by the Body Mass Index and abdominal obesity by the Waist Circumference, both classified according to the World Health Organization. Three dietary patterns were identified as the main findings of this investigation, the first pattern being “local traditional”, which was associated with sociodemographic and labor variables. The permanence of a “traditional Brazilian” pattern and the occurrence of an “industrialized” pattern were also observed. Regarding food processing, the greatest caloric contribution of these workers` diets came from the minimally processed food group (64.7%), followed by ultra-processed foods (17.7%), processed culinary ingredients (12.4%) and processed foods (5.2%). Individuals in the fourth quartile of caloric contribution of minimally processed foods had lower energy intake (&#946; -0.16, P < 0.001) and higher intake of all 15 micronutrients analyzed. Conversely, the greater caloric contribution of ultra-processed foods was associated with a higher caloric content of the diet (&#946; 0.17, P < 0.001) and lower consumption of all 23 nutrients analyzed. Furthermore, the overall prevalence of obesity in this population was 19.7% (95%CI 16.8–22.6%) and that of abdominal obesity was 31.5% (95%CI 28.2–34.8 %), being higher in women (P < 0.001). Men from a higher socioeconomic class had a prevalence of obesity 2.3 times higher (95%CI 1.08–4.90). For women, the older the age group, the greater the general and central obesity. In addition, lower adherence to traditional dietary patterns (approximately PR 1.6 for general obesity and PR 1.3 for abdominal obesity) and a greater number of places to buy food were associated with higher obesity rates. Finally, female farmers with a higher workload had a 20% lower prevalence of obesity (PR 0.80; 95%CI 0.65–0.97). The findings indicate that the rural population studied maintains the consumption of traditional food patterns, but also adheres to the consumption of industrialized foods, especially the younger, higher socioeconomic class and those with more urbanized rural habits. Furthermore, the greatest
caloric contribution of foods, according to their degree and purpose of processing, came from minimally processed foods, followed by ultra-processed foods. Besides, greater adherence to traditional dietary patterns was associated with lower obesity in rural workers. Finally, the data show that obesity should also be a part of health care for remote and rural populations, as this population has a high prevalence of general obesity and abdominal obesity.

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