Consumo de peixe e de ácidos graxos poli-insaturados e fatores associados em adolescentes brasileiros - ERICA

Abstract

Eating habits and healthy behaviors acquired in childhood and adolescence that are perpetuated in adulthood can contribute to the primary prevention of cardiovascular diseases, type 2 diabetes mellitus and obesity. Fish is recognized as an important component of a balanced diet and contains several healthy constituents, including polyunsaturated fatty acids (PUFA), essential elements for growth, cognitive and visual development, and cardiovascular health. Considering the relevance of this theme, the present study aimed to verify the consumption of fish and PUFA and associated factors in Brazilian adolescents. Two manuscripts were prepared based on data from the Study of Cardiovascular Risk in Adolescents (Portuguese acronym: ERICA) and, taking into account the sample design, routines were used for complex sampling. In total, were evaluated data of 71,533 adolescents, students from public and private schools in Brazilian cities with more than 100,000 inhabitants. Of these, 37,815 participants were included for biochemical analysis, and the PUFA intake of 37,023 adolescents were analyzed using a 24-hour food recall. The first article describes the prevalence of fish consumption and its association with cardiovascular risk factors and healthy behavior. The prevalence of fish consumption in the 7 days prior to the interview was 28.6% (95%CI 26.9-30.3). A positive association was observed between fish consumption and healthy behavior (breakfast consumption: OR= 1.16; 95%CI 1.10-1.22; meals with family members: lunch: OR= 1.07; 95%CI 1.01-1.13; dinner: OR= 1.13; 95%CI 1.04-1.23; physical activity: OR= 1.14; 95%CI 1.02-1.28) and an inverse association with hypertriglyceridemia (OR= 0.84; 95%CI 0.73-0.98), that remained significant even after adjusting for possible confounders. The purpose of the second article was to investigate the association between PUFA intake and insulin resistance. Mean total fat intake was 30.1% of energy (95%CI 29.9-30.4). Most participants met the current recommended daily values of linoleic acid (LA) and α-linolenic acid (ALA) and presented LA/ALA ratio ranging from 5:1 to 10:1 (80.9%, 95%CI 79.8-81.8). No significant association was observed between the variables of glucose homeostasis and the consumption of LA and ALA, separately. ALA intake was inversely associated with higher waist circumference (PR= 0.996; 95%CI 0.994-0.998), LA/ALA ratio ≥ 9:1 was significantly associated with higher levels of HOMA-IR (PR= 1.01; 95%CI 1.006-1.02), and ratio >10:1 showed significant association with higher levels of glycated hemoglobin (PR= 1.14; 95%CI 1.04-1.26) and HOMA-IR (PR= 1.02; 95%CI 1.01-1.03); these associations remained significant after adjustment. This study demonstrated that fish consumption proved to be an indicator of a healthy lifestyle and it is associated with lower cardiovascular risk, and the promotion of ALA intake and LA/ALA ratio < 9:1 could be considered as health strategies to contribute to the management of adolescents with insulin resistance.