Influência dos ambientes alimentares na mortalidade prematura por doenças cardiovasculares no Brasil.

Abstract

Introduction: Cardiovascular diseases (CVD) are the main causes of general and premature death in Brazil and worldwide. Harmful food environments have been identified as one of the factors associated with morbidity and mortality from CVD, as theyaffect people's health and nutrition conditions. Objective:To explore the association between harmful food environments and premature mortality from CVD in the Brazilian population in 2016. Methodology:Cross-sectional ecologicalstudy, with data from5,558 Brazilian municipalities. Data on CVD mortality were obtained from the Mortality Information System (SIM) of the Ministry of Health. The study on mapping food deserts in Brazil developed by the Interministerial Chamber for Food and Nutritional Security –CAISAN was used to assess the physical dimension of the food access. Standardized ratesof general premature mortality from CVD and from specific causes (CVA and IHD) werecalculated for the period analyzed. To characterize the food environments, the density of establishments that sell food (in natura and ultra-processed) per 10,000 inhabitants in tertiles was used. Crude and adjusted negative binomial regression models were used to study the associations of interest. Results: After the appropriate adjustments), it was found that the municipalities in which there was little supply of fresh food had a higher risk for increased mortality in women due to stroke ([RT1st tertile 1.08 (1.01-1.15)]. Onthe other hand, municipalities in which there was a greater supplyof ultra-processed foodspresented a higher risk of death [RT2nd tertile 1.17 (1.12-1.22), RT3rd tertile 1.20 (1.14- 1, 26)] by CVD; [RT2nd tertile 1.19 (1.13-1.25), RT3rdtertile 1.22 (1.15-1.30)] by strokeand [RT2nd tertile 1.19 (1.12 -1.25), RT3rd tertile 1.22 (1.13-1.29)] due to Infarction Conclusion: Our findings show an increased risk of mortality from CVD, CVA and IHD,especially in municipalities where there was greater offer of ultra-processed foods, theseare of low nutritional quality and come from unsustainable food systems. Initiatives to minimize the effects of these environments are necessary and urgent in the Brazilian context.