Food intake patterns and high blood pressure levels among Brazilians: a cross-sectional study, 2013

Aguiar, Italo Wesley Oliveira; Almondes, Kaluce Gonçalves de Sousa

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Epidemiologia e Serviços de Saúde

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ORIGINAL ARTICLE • Epidemiol. Serv. Saúde 30 (3) • 2021 • https://doi.org/10.1590/S1679-49742021000300008 copy

Food intake patterns and high blood pressure levels among Brazilians: a cross-sectional study, 2013^* * Article derived from the Lato Sensu Postgraduate Specialization Final Paper entitled ‘Pattern of food intake markers, sedentary lifestyle and other factors associated with arterial hypertension among Brazilians’, defended by Italo Wesley Oliveira Aguiar at the Lato Sensu Postgraduate Nutrition and Physical Exercise Course/Universidade Estadual do Ceará in 2020.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To analyze association between patterns of food intake markers and high blood pressure levels among Brazilians.

Methods:

This was a cross-sectional study using National Health Survey data. Its outcome was high blood pressure levels, measured during interviews between August and November 2013. Food intake marker patterns were identified. These were the exposure variables. Prevalence ratios (PR) and 95% confidence intervals (95%CI) were calculated using multivariate Poisson regression.

Results:

High blood pressure prevalence was 16.0% (95%CI - 15.3;16.7) in the sample of 37,216 participants. It was higher in those with a diet that included meat and alcoholic beverages (PR=1.21 - 95%CI 1.08;1.35). The pattern with greater presence of greens and vegetables did not show statistically significant association with high blood pressure levels (PR=0.94 - 95%CI 0.84;1.06).

Conclusion:

The pattern marked by meat and alcoholic beverages was associated with high blood pressure levels.

Keywords:
Nutritional Epidemiology; Noncommunicable Diseases; Cardiovascular Diseases; Feeding Behavior; Health Surveys; Cross-Sectional Studies

Food intake marker	Pattern 1	Pattern 2
Beans	0.16	0.05
Raw vegetables	0.74	-0.04
Cooked vegetables	0.72	-0.03
Meat without fat	0.04	-0.88
Meat with fat	-0.03	0.83
Chicken without skin	0.10	-0.08
Chicken with skin	0.02	0.20
Fish	0.05	0.13
Fruit juice	0.51	-0.01
Fruit	0.66	-0.09
Ordinary/unspecified soda	-0.25	0.15
Diet/light/zero soda	0.11	-0.18
Skimmed milk	0.23	-0.07
Whole/whole and skimmed milk	0.13	-0.11
Sweetmeats	0.19	0.01
Hamburgers, fried snacks or pizzas	0.08	-0.05
Alcoholic beverage	-0.01	0.27
Proportion of variance explained (%)	12%	10%

Variable	n^a	%^b	95%CI^c
High blood pressure levels
No	31,281	84.0	83.3;84.7
Yes	5,935	16.0	15.3;16.7
Eating pattern 1
Quartile 1	9,318	23.8	23.0;24.6
Quartile 2	9,290	25.1	24.3;25.9
Quartile 3	9,305	25.6	24.7;26.4
Quartile 4	9,303	25.5	24.7;26.4
Eating pattern 2
Quartile 1	10,682	29.1	28.2;30.0
Quartile 2	10,412	26.7	25.8;27.6
Quartile 3	7,648	19.5	18.8;20.3
Quartile 4	8,474	24.7	23.9;25.6
Brazilian macro-region
Southeast	8,440	41.8	40.8;42.7
Northeast	11,291	27.9	27.1;28.6
South	4,452	14.5	13.9;15.1
North	8,406	8.3	8.0;8.6
Midwest	4,627	7.5	7.3;7.8
Sex
Female	19,519	52.9	51.9; 53.8
Male	17,697	47.1	46.2; 48.0
Race/skin color
White	14,489	46.0	45.0;47.0
Black	3,430	9.2	8.7;9.8
Yellow	325	0.9	0.8;1.1
Brown	18,710	43.4	42.4;44.4
Indigenous	262	0.4	0.3;0.5
Age group (years)
20-29	10,167	31.0	30.2;31.9
30-39	11,008	28.6	27.7;29.5
40-49	7,567	20.7	19.9;21.3
50-59	4,562	13.7	13.0;14.4
60-69	2,320	3.6	3.4;3.9
≥70	1,592	2.4	2.2;2.7
Schooling
Incomplete high school education or lower	26,741	75.2	74.3;76.1
Complete high school education or above	10,475	24.7	23.8;25.7
*Monthly per capita* household income**
Up to 1 minimum wage	28,558	82.5	81.7;83.2
More than 1 minimum wage	8,658	17.5	16.8;18.2
Practices physical exercise
No	25,775	68.2	67.2;69.1
Yes	11,441	31.8	30.9;32.8
Tobacco smoking
No	31,427	84.6	84.0;85.3
Yes	5,789	15.4	14.7;16.0
Nutritional status^d
Underweight/normal weight	17,638	48.6	47.6;49.6
Overweight	13,219	35.6	34.8;36.5
Obesity	5,786	15.7	15.1;16.4
Waist circumference^e
Low risk	16,128	44.9	43.9;45.9
Increased risk	20,571	55.1	54.0;56.1

Variable		Crude model		Model 1^a		Model 2^b		Model 3^c
Variable		PR^d (95%CI^e)	p-value^f	PR^d (95%CI^e)	p-value^f	PR^d (95%CI^e)	p-value^f	PR^d (95%CI^e)	p-value^f
Pattern 1
	Quartile 1	1.00	0.417	1.00	0.446	1.00	0.815	1.00	0.510
	Quartile 2	0.92 (0.82;1.03)		0.92 (0.82;1.02)		0.92 (0.83;1.03)		0.91 (0.82;1.02)
	Quartile 3	0.92 (0.82;1.03)		0.90 (0.81;1.01)		0.92 (0.82;1.03)		0.91 (0.81;1.02)
	Quartile 4	0.95 (0.84;1.07)		0.93 (0.83;1.05)		0.96 (0.85;1.08)		0.94 (0.84;1.06)
Pattern 2
	Quartile 1	1.00	<0.001	1.00	<0.001	1.00	<0.001	1.00	<0.001
	Quartile 2	1.01 (0.90;1.13)		1.02 (0.91;1.14)		1.02 (0.91;1.14)		1.03 (0.92;1.15)
	Quartile 3	1.16 (1.03;1.31)		1.09 (0.96;1.23)		1.09 (0.97;1.23)		1.10 (0.97;1.24)
	Quartile 4	1.42 (1.27;1.60)		1.23 (1.10;1.38)		1.23 (1.09;1.37)		1.21 (1.08;1.35)
Brazilian macro-region
	Southeast	1.00	<0.001	1.00	<0.001	1.00	<0.001	1.00	<0.001
	Northeast	0.93 (0.84;1.02)		0.91 (0.82;1.01)		0.91 (0.82;1.01)		0.91 (0.82;1.01)
	South	0.98 (0.85;1.12)		1.03 (0.90;1.17)		1.03 (0.90;1.17)		1.01 (0.89;1.15)
	North	0.60 (0.53;0.69)		0.63 (0.54;0.72)		0.63 (0.55;0.72)		0.63 (0.55;0.73)
	Midwest	0.83 (0.74;0.93)		0.85 (0.76;0.96)		0.85 (0.76;0.96)		0.85 (0.76;0.96)
Race/skin color
	White	1.00	0.469	1.00	0.799	1.00	0.842	1.00	0.499
	Black	1.38 (1.20;1.58)		1.38 (1.21;1.58)		1.38 (1.21;1.57)		1.4 (1.22;1.60)
	Yellow	0.83 (0.51;1.33)		0.96 (0.63;1.48)		0.97 (0.63;1.49)		1.06 (0.69;1.63)
	Brown	0.99 (0.91;1.09)		1.10 (1.00;1.20)		1.09 (1.00;1.20)		1.11 (1.01;1.22)
	Indigenous	0.79 (0.47;1.31)		0.93 (0.57;1.53)		0.93 (0.57;1.52)		0.97 (0.60;1.57)
Age group (years)
	20-29	1.00	<0.001	1.00	<0.001	1.00	<0.001	1.00	<0.001
	30-39	1.69 (1.46;1.94)		1.66 (1.44;1.91)		1.63 (1.41;1.89)		1.49 (1.29;1.72)
	40-49	2.65 (2.31;3.03)		2.59 (2.26;2.96)		2.53 (2.20; 2.90)		2.21 (1.92;2.53)
	50-59	3.85 (3.35;4.43)		3.59 (3.12;4.14)		3.49 (3.02;4.03)		3.03 (2.61;3.52)
	60-69	4.4 (3.77;5.14)		4.30 (3.68;5.02)		4.16 (3.55;4.86)		3.65 (3.12;4.26)
	≥70	6.02 (5.15;7.04)		5.77 (4.91;6.77)		5.58 (4.74;6.58)		5.15 (4.35;6.09)
Sex
	Female	1.00	<0.001	1.00	<0.001	1.00	<0.001	1.00	<0.001
	Male	1.68 (1.54;1.82)		1.60 (1.47;1.74)		1.61 (1.48;1.75)		1.67 (1.53;1.81)
Schooling
	Complete high school education or above	1.00	<0.001	1.00	<0.001	1.00	<0.001	1.00	<0.001
	Incomplete high school education or lower	1.78 (1.59;1.99)		1.33 (1.18;1.50)		1.31 (1.16;1.48)		1.29 (1.15;1.46)
*Monthly per capita* household income**
	Up to 1 minimum wage	1.00	0.147	1.00	0.165	1.00	0.257	1.00	0.044
	More than 1 minimum wage	1.07 (0.98;1.18)		0.92 (0.83;1.02)		0.93 (0.84;1.03)		0.89 (0.81;0.99)
Practices physical exercise
	No	1.00	<0.001	-		1.00	0.019	1.00	0.028
	Yes	0.72 (0.65;0.80)		-		0.9 (0.81;1.00)		0.9 (0.82;1.00)
Tobacco smoking
	No	1.00	<0.001	-		1.00	0.207	1.00	0.004
	Yes	1.34 (1.21;1.49)		-		1.03 (0.93;1.14)		1.13 (1.02;1.25)
Nutritional status
	Underweight/normal weight	1.00	<0.001	-				1.00	<0.001
	Overweight	1.59 (1.44;1.74)		-		-		1.19 (1.06;1.33)
	Obesity	1.91 (1.71;2.12)		-		-		1.45 (1.28;1.65)
Waist circumference
	Low risk	1.00	<0.001	-		-		1.00	<0.001
	Increased risk	2.05 (1.86;2.25)		-		-		1.44 (1.27;1.62)

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 61 3315-3464, Fax: +55 61 3315-3464 - Brasília - DF - Brazil
E-mail: ress.svs@gmail.com

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[1] Correspondence: Italo Wesley Oliveira Aguiar - Universidade Federal do Ceará, Programa de Pós-Graduação em Saúde Pública, Bloco Didático, 5º andar, Rua Professor Costa Mendes, No. 1608, Rodolfo Teófilo, Fortaleza, CE, Brazil. CEP: 60430-140. E-mail: aguiar.iwo@gmail.com