Alimentação de estudantes: associação com fatores individuais, familiares, comportamentais e indicadores socioeconômicos.

Abstract

Adolescent food consumption has multiple individual and contextual determinants, whose monitoring in surveillance systems can support public policies that are more effective. Therefore, this thesis aimed to investigate the food consumption of students and its relation with individual, family, behavioral, and macroeconomic indicators. For this, it presents three articles: 1) "Consumption of sugar-rich food products among Brazilian students: National School Health Survey (PeNSE 2012)"; 2) "Coexistence of risk behaviors for being overweight among Brazilian adolescents"; and 3) "Markers of healthy and unhealthy food consumption and macroeconomic indicators: Analysis of students from 74 countries". The first two articles present a cross-sectional design and used from a representative sample of Brazilian students from public and private schools in urban and rural areas, evaluated in the National School Health Survey (PeNSE 2012). In article 1, the objective was to analyze the consumption of sugary foods (sweets and soft drinks) among Brazilian students and to identify the associated factors. The second article evaluated the magnitude and the aspects associated with the coexistence of risk behaviors for being overweight (sedentary behavior, regular consumption of sugary and fried foods, and irregular fruits and vegetables). Article 3 has an ecological design and was based on representative samples of Brazilian students (Sample 2 - PeNSE 2015) and from 73 other countries evaluated in the Global School-Based Student Health Survey (GSHS). The objective of this study was to compare the prevalence of daily consumption of healthy (fruits and vegetables) and unhealthy (soft drinks) food markers among students from these 74 countries, according to macroeconomic indicators. The regular consumption of sugary foods (sweets or soft drinks) was verified among 36.1% of Brazilian adolescents, and was higher among girls, 14-15 years old students, with higher maternal education, who did not live with both parents, who did not eat meals with their parents, who ate in front of the television (TV) and with greater daily time watching TV. More than 90.0% of Brazilian students had at least one risk behavior (sedentary behavior, regular consumption of sugary and fried foods, and irregular fruits and vegetables) and 6.1% all four. Being female, presenting a higher level of maternal education, attending private schools, not regularly having breakfast and meals with parents, having the habit of eating in front of the TV and not practicing leisure physical activity weekly were related to the greater number of risk behaviors. Among the 74 countries evaluated, there was a high percentage of daily consumption of soft drinks (54.1%), with a positive association with the Human Development Index (HDI) and Gross National Income per capita (GNIpc), especially in countries with worse levels of human development and income. The prevalence of daily fruit consumption reached 67.9%, with higher values as there was an increase in RNBpc, particularly in the group of lower income countries. The daily consumption of vegetables resulted in prevalence above 70%, but without any association with the macroeconomic indicators. The prevalence of 13 food consumption considered unhealthy, sedentary behavior and the coexistence of risk behaviors among Brazilian students were worrisome, and were associated with family, behavioral and sociodemographic aspects. According to these results, the macroeconomic indicators of the 74 countries evaluated were especially related to the consumption of soft drinks and fruit among the poorest countries. These results require intersectoral and integral actions that encompass the complexity of the food consumption of adolescents, as well as highlighting the importance of maintaining health surveillance systems active.