ADOLESCENT GLUTEN INTAKE: POPULATION-BASED STUDY IN A BRAZILIAN CITY

This is a population-based cross-sectional study with a two-stage cluster sampling, conducted in Campinas, São Paulo, in 2008-2009. Foods containing gluten were identified using a 24-hour Recall. We calculated the prevalence and adjusted prevalence ratios with multiple Poisson regression.

Results:

The study had a sample of 924 adolescents aged 10 to 19 years. Among the foods assessed, 26.9% (confidence interval of 95% - 95%CI 25.3-28.6) contained gluten. We found a higher prevalence of gluten intake in younger individuals (10 to 14 years), as well as in subgroups of adolescents who had a higher number of household appliances, attended school, consumed fewer beans and vegetables during the week (<4 times), and whose head of the family had better education level (≥12 years of schooling). The main food sources of gluten in their diet were: bread, cakes, and cereals (30.2%), chocolate milk (14%), chicken nuggets (12.3%), and cookies (11%).

Conclusions:

The results of the study show the epidemiological profile associated with gluten intake in adolescents and could support actions aimed at promoting healthy eating habits and preventing gluten-related diseases.

Keywords:
Adolescent; Glutens; Food consumption; Health surveys

	n	% (95%CI)	p-value*	PR (95%CI)
Gender
Male	466	26.7 (25.1-28.4)	0.582	1
Female	458	27.2 (25.2-29.4)	0.582	1.02 (0.95-1.09)
Total	924	26.9 (25.3-28.6)
Age group (years)
10 to 14	508	27.8 (26.0-29.7)	0.050	1
15 to 19	416	25.9 (24.0-27.9)	0.050	0.93 (0.86-1.00)
Ethnicity (self-reported)
White	593	27.8 (26.3-29.3)	0.032	1
Non-white	328	25.4 (23.1-27.8)	0.032	0.91 (0.84-0.99)
Place of birth
Campinas	701	27.8 (26.1-29.5)	0.010	1
Another city in the state of São Paulo	104	25.5 (22.8-28.4)		0.92 (0.81-1.04)
Another state	119	23.6 (21.1-26.2)		0.85 (0.76-0.94)
Number of people in the household
1 to 2	66	28.6 (25.2-32.3)	0.116	1
3 to 4	443	27.7 (25.9-29.5)		0.97 (0.86-1.08)
5 or +	415	25.8 (23.8-27.9)		0.90 (0.78-1.04)
Schooling of the head of the family (years)
0 to 7	387	24.2 (22.3-26.2)	<0.001	1
8 to 11	313	26.9 (25.0-28.8)		1.11 (1.02-1.21)
12 or +	213	30.9 (28.6-33.3)		1.27 (1.14-1.42)
Per capita household income (according to minimum wage**)
< 1	585	25.6 (24.0-27.4)	0.001	1
≥1 and ≤ 3	264	28.4 (26.1-30.8)		1.11 (1.01-1.20)
> 3	75	31.1 (28.5-33.9)		1.21 (1.09-1.35)
Number of household appliances
0 to 7	190	22.8 (20.2-25.7)	<0.001	1
8 to 15	468	26.5 (24.9-28.3)		1.16 (1.04-1.29)
16 or +	265	30.2 (28.4-32.1)		1.32 (1.17-1.49)
Attends school
No	144	24.2 (21.6-27.0)	<0.001	1
Yes, public school	617	26.3 (24.5-28.2)		1.09 (0.98-1.20)
Yes, private school	162	31.2 (28.8-33.7)		1.29 (1.13-1.46)

	n	% (95%CI)	p-value*	PR (95%CI)
Fruits (times a week)
≥4	439	27.1 (25.4-28.9)	0.778	1
<4	485	26.8 (24.4-29.2)	0.778	0.98 (0.89-1.09)
Raw vegetables (times a week)
≥4	517	25.6 (23.8-27.4)	0.004	1
<4	407	28.9 (26.7-31.1)	0.004	1.13 (1.04-1.22)
Cooked vegetables (times a week)
≥4	345	25.2 (23.5-27.0)	0.004	1
<4	579	28.1 (26.1-30.1)	0.004	1.11 (1.03-1.19)
Milk (times a week)
≥4	650	26.9 (25.1-28.7)	0.792	1
<4	274	27.2 (24.8-29.7)	0.792	1.01 (0.92-1.10)
Beans (times a week)
≥4	767	25.9 (24.4-27.5)	<0.001	1
<4	157	32.8 (30.0-35.7)	<0.001	1.27 (1.16-1.38)
Soft drink (times a week)
≥4	359	27.5 (25.6-29.4)	0.343	1.03 (0.96-1.10)
<4	565	26.6 (24.8-28.5)	0.343	1
Smoking
Never smoked	882	26.9 (25.4-28.6)	0.894	1
Ex-smoker/smoker	42	27.2 (22.6-32.4)	0.894	1.01 (0.86-1.19)
Alcohol consumption
Does not drink	773	26.7 (25.1-28.5)	0.306	1
Drinks	146	28.1 (25.4-31.0)	0.306	1.05 (0.95-1.16)
Physical activity in leisure time
Active	197	25.7 (23.0-28.5)	0.232	1
Inactive or insufficiently active	727	27.3 (25.7-29.0)	0.232	1.06 (0.97-1.18)
Time spent watching TV (hours/day)
<3	370	27.3 (25.5-29.2)	0.481	1
≥3	540	26.6 (24.7-28.6)	0.481	0.97 (0.90-1.05)
Computer use (hours/day)
0	442	24.9 (22.8-27.1)	<0.001	1
1 to 3	369	28.3 (26.5-30.1)		1.13 (1.04-1.23)
4 or +	107	30.4 (28.2-32.7)		1.22 (1.09-1.36)

	First stage PR_adjusted* (95%CI)	Second stage PR_adjusted** (95%CI)
Age group (years)
10 to 14	1	1
15 to 19	0.92 (0.85-0.98)	0.92 (0.86-0.98)
Schooling of the head of the family (years)
0 to 7	1	1
8 to 11	1.08 (0.99-1.18)	1.08 (0.99-1.17)
12 or +	1.15 (1.03-1.28)	1.15 (1.03-1.28)
Attends school
No	1	1
Yes, public school	1.11 (1.00-1.22)	1.10 (1.00-1.21)
Yes, private school	1.18 (1.05-1.34)	1.16 (1.02-1.31)
Number of household appliances
0 to 7	1	1
8 to 15	1.12 (1.01-1.23)	1.11 (1.01-1.22)
16 or +	1.21 (1.08-1.34)	1.20 (1.07-1.32)
Leafy vegetables (times a week)
≥4		1
<4		1.10 (1.03-1.16)
Beans (times a week)
≥4		1
<4		1.16 (1.07-1.26)

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[1] *Corresponding author. E-mail: danideassumpcao@gmail.com (D. Assumpção).