Food intake and prevalence of obesity in Brazil: an ecological analysis

OBJECTIVE: To investigate the correlation between the consumption of refined carbohydrates and fats and the prevalence of obesity in the state capitals of Brazil. DESIGN: An ecological evaluation of obesity and dietary risk factors was carried out in twenty-six state capitals of Brazil. SETTING: Analysis was based on the age-standardized prevalence of obesity (BMI >or= 30.0 kg/m2) among adults aged 20-59 years. Both intake and obesity prevalence were obtained from the last National Family Household Budget Survey (HBS). The survey was conducted from July 2002 to June 2003, based on a probabilistic national sample of 48 470 households. In each household, during seven consecutive days, all monetary and non-monetary expenses for food and beverages for family consumption were transformed into energy. The relative contribution of foods and food groups was expressed as the proportion (%) of total energy. Fruits and vegetables were also measured by the quantity bought in grams. RESULTS: Prevalence of obesity varied from 5.1 % to 13.6 % among women and from 5.2 % to 17.6 % among men. For women, there were statistically significant correlations between obesity and intake of sugar and soft drinks (rS = 0.60; P = 0.001), ready-to-eat meals (rS = 0.39; P = 0.05) and potatoes (rS = 0.40; P = 0.04). For men there were no such associations. CONCLUSIONS: Increasing intake of refined carbohydrates, mainly soft drinks, may play a role in the prevalence of obesity among women in Brazil. Effecting changes in family purchase patterns may be a strategy to reduce obesity.