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Dietary Quality and Associated Factors among Adults Living in the State of São Paulo, Brazil

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Abstract

This study sought to analyze dietary quality and associated factors among adults living in regions of the State of São Paulo, Brazil. It was a cross-sectional population-based study of a sample of 3,454 adults ages 20 years and over who were included in the Household Health Survey. Dietary intake was measured by means of the 24-hour recall method, and dietary quality was assessed by means of the Healthy Eating Index (HEI), adapted to local realities. Probabilistic samples were obtained via multistage cluster samples from four regions in the State of São Paulo. Linear regression analyses were performed to evaluate the relationships between the HEI and the demographic, socioeconomic, and lifestyle variables. Among the individuals assessed, 5% had a good diet, 74% a diet that needed some degree of improvement, and 21% a poor diet. The means for HEI components were lowest for vegetables, fruits, and dairy products. The highest HEI scores were obtained by individuals who were nonsmokers, practiced physical activity, were retired, lived in houses or apartments, and had adequate living conditions surrounding them. In the multiple regression analysis, the variables of numbers of consumer durable goods, schooling of the head of the family, energy intake, and age had a positive association with the HEI. However, the association was inverse for the variables of smoking and body mass index. Higher dietary quality is associated with higher income, higher schooling level, better nutritional status, and being a nonsmoker. Knowledge of these factors is important for implementing programs for preventive nutrition or intervention.

Section snippets

Design and Study Population

The data for this study came from a dietary survey in regions of the State of São Paulo. This dietary study forms part of the Health Survey of the State of São Paulo (Household Health Survey), which is a multicenter and multi-institutional project that collected health data from four geographical areas: the southwestern sector of the Greater São Paulo region (municipalities of Taboão da Serra, Embu, and Itapecerica), the Butantã district of the city of São Paulo, and the municipalities of

Results

The study included 3,454 individuals that were representative of a population of 1,213,065 inhabitants living in the four geographical areas studied. The mean age was 41.06 years (standard error=0.60) for men and 41.25 years (standard error=0.51) for women.

The majority of the study population was of white ethnic origin, and the proportions of men and women were very similar. Almost 13% of the sample studied was composed of individuals ages 60 years and over. Around 44% of the individuals were

Discussion

The purpose of this study was to measure the quality of the diet and associated factors among adults living in four geographical areas. The results suggested that the quality of the diet was in general inadequate and was related to the socioeconomic conditions, age, nutritional state, and lifestyle.

In our study, the mean HEI score was 60.4 points. In other words, 60.4% of the maximum score was achieved, thus indicating the need to improve the quality of the diet. Rafferty and colleagues (13),

R. M. Fisberg is associate professor, Department of Nutrition, Faculty of Public Health, University of São Paulo, Brazil.

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R. M. Fisberg is associate professor, Department of Nutrition, Faculty of Public Health, University of São Paulo, Brazil.

J. M. Morimoto is assistant lecturer, School of Biological and Health Sciences, Methodist University, Sao Bernardo do Campo, Brazil.

B. Slater is lecturer, Department of Nutrition, Faculty of Public Health, University of São Paulo, Brazil.

M. Berti de Azevedo Barros is lecturer, Department of Preventive Medicine, University of Campinas, Brazil.

L. Carandina and M. Goldbaum are lecturers, Department of Preventive Medicine, University of the State of São Paulo, Botucatu, Brazil.

M. do Rosário Dias de Oliveira Latorre and C. Luiz Galvão César are full professors, Department of Epidemiology, Faculty of Public Health, University of São Paulo, Brazil.

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