Desigualdade social e consumo de alimentos ultraprocessados entre adolescentes brasileiros: uma análise dos dados da Pesquisa Nacional de Saúde do Escolar (PeNSE 2019)

Abstract

Introduction: Food consumption is influenced by socioeconomic conditions, with low consumption of natural foods and high intake of ultra-processed foods being common among low-income groups. Adolescence, a phase sensitive to social inequalities, involves biological, psychological and social changes that interact with the environment. In these contexts, adolescents are more exposed to obesogenic environments, where ultra-processed foods are widely available and promoted. Objective: To analyze social inequality and the high consumption of ultra-processed foods among Brazilian adolescents. Methods: This is a crosssectional study, whose data are from the National School Health Survey (PeNSE), conducted by the Brazilian Institute of Geography and Statistics (IBGE) in 2019, with a sample of 154,072 adolescents, aged 13 to 17, regularly enrolled in public and private schools. In this study, the wealth index estimated through principal component analysis was used as an indicator of social inequality. The intersection between social inequality, analyzed by the wealth index, and the following sociodemographic variables was performed: sex, skin color, type of school administration, and household area. For the outcome - high consumption of ultra-processed foods - <high consumption= was considered to be the daily intake equal to or greater than 5 types of ultra-processed foods, among the 13 groups of ultra- processed foods. The difference and ratio were used as simple measures and their confidence intervals estimated by linear regression and Poisson regression. As complex measures, the Inequality Slope Index (SII) and Concentration Index (CIX) were used. Results: It was observed that high consumption of ultra-processed foods is more prevalent and more unequal in low-income adolescents (47.2%; 95%CI: 46.1; 48.3); (D: -8.6; 95%CI: -10.4; -6.8); (R: 0.81; 95%CI: 0.78; 0.85); (SII: -9.2; 95%CI: -11.4; -6.9); (CIX: -3.2; 95%CI: -4.0; -2.4) in all subgroups 3 boys, racial minorities (black, brown,), public school students and residents in both areas. However, high consumption of ultra-processed foods was also observed among the wealthiest groups of adolescents (49.5%; 95%CI: 46.0; 52.9); (D: 6.5; 95%CI: 3.0; 10.0); (R:1.15; 95%CI: 1.07; 1.23); (SII: 7.7; 95%CI: 4.6; 10.7); (CIX: 2.28; 95%CI: 1.2; 3.4), when observing the private school environment. Conclusion: Adolescents with lower income consume more ultra-processed foods in the following intersections: sex, skin color, students in public schools and area of residence.