Contribution of different foods according to the Nova classification to dietary fiber intake in adolescents

Meira, Rafaela de Campos Felippe; Capitani, Caroline Dario; Barros, Antonio de Azevedo; Barros, Marilisa Berti de Azevedo; Assumpção, Daniela de

doi:10.1590/1413-81232021268.09592020

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ARTICLE • Ciênc. saúde coletiva 26 (08) • Aug 2021 • https://doi.org/10.1590/1413-81232021268.09592020 copy

Contribution of different foods according to the Nova classification to dietary fiber intake in adolescents

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The aims of the present study were to evaluate dietary fiber intake and associated factors in adolescents, identify food sources of the nutrient, and determine associations between indicators of dietary patterns (energy/macronutrients/micronutrients) and dietary fiber intake. A population-based cross-sectional study was conducted involving 24-hour recall data. The NOVA classification was used to determine the contribution of foods to dietary fiber intake. Reference values from the World Health Organization (≥12.5 g) and the US Institute of Medicine (14 g) per 1,000 kcal were used to assess intake. The mean intake of dietary fiber/1,000 kcal/day was 6.4 g (1.5 g of soluble fiber and 4.9 g of insoluble fiber) among the 891 adolescents. Fiber intake was low, especially among those who ate fruits, vegetables, and beans less, those who consumed soft drinks and processed meats more, and those who did not eat breakfast every day. Unprocessed/minimally processed foods provided 68.8%, 53.7%, and 72.1% of total, soluble, and insoluble fiber, respectively, whereas ultra-processed products provided 24.8%, 37.9%, and 21.0% respectively. Fiber intake was inversely associated with energy intake, fat, free sugar, and animal protein in the diet. The insufficient fiber intake underscores the need for actions that promote healthy nutrition on the individual and family levels.

Key words:
Dietary Fiber; Adolescents; Health Surveys

Variables		n (%)	Total fiber	SD	Soluble	SD	Insoluble	SD
Variables		n (%)	g/1000 kcal	SD	g/1000 kcal	SD	g/1000 kcal	SD
Sex
	Male	463 (52.1)	6.2^a	±2.4	1.4^a	±0.9	4.8	±2.1
	Female	428 (47.9)	6.6^b	±3.9	1.6^b	±1.4	5.0	±3.1
	Total	891	6.4	±2.7	1.5	±0.9	4.9	±2.4
Age group (in years)
	10 to 14	422 (47.4)	6.4	±2.5	1.5	±0.8	4.8	±2.0
	15 to 19	469 (52.6)	6.5	±3.5	1.5	±1.1	4.8	±2.8
Race/skin color
	White	487 (55.5)	6.4	±2.9	1.6	±1.1	4.8	±2.4
	Non-white	400 (44.5)	6.4	±3.4	1.5	±1.4	4.9	±2.6
Schooling of head of family (in years)
	0 to 4	177 (19.6)	6.2	±2.5	1.4^a	±1.1	4.8	±2.0
	5 to 8	292 (33.6)	6.5	±4.1	1.6^a.b	±1.5	5.0	±3.0
	9 to 11	257 (28.9)	6.1	±3.5	1.5^a.b	±1.6	4.7	±2.7
	12 or more	150 (17.8)	6.7	±4.9	1.8^b	±1.6	4.9	±3.8
Family income per capita (minimum wage)*
	<0.5	234 (26.1)	6.4	±2.6	1.4^a	±1.1	5.0	±2.4
	≥0.5 to <1.0	302 (33.0)	6.5	±4.2	1.5^a.b	±1.4	5.0	±3.6
	≥1.0 to <1.5	190 (21.3)	6.1	±3.3	1.5^a.b	±1.4	4.6	±2.7
	≥1.5	165 (19.6)	6.6	±4.6	1.7^b	±1.5	4.9	±3.7

Variables		n (%)	Total fiber	SD	Soluble	SD	Insoluble	SD
Variables		n (%)	g/1.000 kcal	SD	g/1.000 kcal	SD	g/1.000 kcal	SD
Consumption of fruit
	≥5 times per week	330 (38.0)	7.1^a	±3.2	1.7^a	±1.1	5.4^a	±2.5
	<5 times per week	561 (62.0)	6.0^b	±4.7	1.4^b	±1.6	4.5^b	±3.5
Consumption of raw vegetables
	≥5 times per week	246 (28.3)	7.1^a	±3.1	1.7^a	±1.1	5.4^a	±2.6
	<5 times per week	645 (71.7)	6.1^b	±5.3	1.5^b	±2.0	4.7^b	±4.3
Consumption of cooked vegetables
	≥5 times per week	99 (11.2)	7.4^a	±4.1	1.8^a	±1.6	5.5^a	±3.0
	<5 times per week	792 (88.8)	6.2^b	±11.8	1.4^b	±4.5	4.7^b	±8.4
Consumption of milk
	≥5 times per week	469 (52.9)	6.5	±2.6	1.5	±1.1	4.9	±2.2
	<5 times per week	422 (47.1)	6.3	±3.3	1.5	±1.4	4.7	±2.5
Consumption of beans
	≥5 times per week	641 (71.7)	6.6^a	±2.3	1.5^a	±1.0	5.1^a	±2.3
	<5 times per week	250 (28.3)	6.0^b	±3.6	1.7^b	±1.4	4.2^b	±2.7
Consumption of soft drinks
	≤2 times per week	441 (49.4)	6.7^a	±2.7	1.6^a	±1.0	5.1^a	±2.3
	>2 times per week	450 (50.6)	6.0^b	±3.4	1.4^b	±1.3	4.6^b	±2.7
Consumption of processed meats
	≤2 times per week	495 (55.4)	6.6^a	±3.1	1.6	±1.1	5.0^a	±2.4
	>2 times per week	396 (44.6)	6.2^b	±3.6	1.5	±1.4	4.7^b	±2.8
Breakfast (frequency)
	7 times per week	569 (63.8)	6.7^a	±2.6	1.6^a	±0.9	5.0^a	±2.1
	<7 times per week	322 (36.2)	5.9^b	±3.4	1.4^b	±1.1	4.5^b	±2.7
Checking of food labels
	No	613 (68.7)	6.2^a	±2.5	1.5^a	±1.0	4.7^a	±2.2
	Yes/sometimes	278 (31.3)	6.8^b	±3.7	1.7^b	±1.3	5.1^b	±2.8
Self-rated diet quality
	Very good/good	509 (57.3)	6.5^a	±2.7	1.5	±1.1	5.0^a	±2.3
	Fair	311 (34.6)	6.4^a.b	±2.6	1.5	±1.0	4.9^a.b	±2.1
	Poor/very poor	71 (8.1)	5.6^b	±3.2	1.6	±1.5	4.0^b	±2.1
Body mass index (kg/m²)
	Underweight/ideal	543 (66.5)	6.4	±2.7	1.6	±0.9	4.8	±2.1
	Overweight/obesity	275 (33.5)	6.5	±2.8	1.6	±1.2	4.9	±2.3

Variables		Model 1 - Total dietary fiber*
Variables		Estimate	p-value
Intercepto		7.9
	Sex (female)/(male)	0.36	0.064
	Fruit (<5 days/week)/(≥5)	-0.78	<0.001
	Raw vegetables (<5 days/week)/(≥5)	-0.60	0.001
	Beans (<5 days/week)/(≥5)	-0.55	0.007
	Soft drinks (>2 days/week)/(≤2)	-0.32	0.037
	Processed meats (>2 days/week)/(≤2)	-0.40	0.014
	Breakfast (<7 days/week)/(7)	-0.60	0.001
Variables		Model 2 - Soluble dietary fiber**
Variables		Estimate	p-value
Intercept		1.7
	Sex (female)/(male)	0.14	0.035
	Fruit (<5 days/week)/(≥5)	0.26	0.036
	Raw vegetables (<5 days/week)/(≥5)	-0.14	0.024
	Beans (<5 days/week)/(≥5)	-0.17	0.010
	Soft drinks (>2 days/week)/(≤2)	0.27	0.002
	Processed meats (>2 days/week)/(≤2)	-0.16	0.013
	Breakfast (<7 days/week)/(7)	-0.23	<0.001
Variables		Model 3 - Insoluble dietary fiber***
Variables		Estimate	p-value
Intercept		6.1
	Sex (female)/(male)	0.22	0.143
	Fruit (<5 days/week)/(≥5)	-0.66	<0.001
	Raw vegetables (<5 days/week)/(≥5)	-0.47	0.004
	Beans (<5 days/week)/(≥5)	-0.82	<0.001
	Soft drinks (>2 days/week)/(≤2)	-0.36	0.008
	Processed meats (>2 days/week)/(≤2)	-0.44	0.004

Food groups		Density (g/1000 kcal/day)			Contribution (%)
Food groups		TDF	SDF	IDF	TDF	SDF	IDF
In natura/minimally processed		4.2	0.8	3.4	68.0	53.7	72.1
	Beans	1.7	0.1	1.6	28.2	4.7	35.1
	Grains	0.7	0.2	0.5	10.8	15.5	9.5
	Fruit	0.6	0.2	0.4	9.1	15.1	7.4
	Roots and tubers	0.4	0.2	0.2	7.1	13.6	5.2
	Rice	0.4	0.0	0.4	6.3	0.2	8.1
	Vegetables	0.4	0.1	0.3	5.9	4.6	6.3
Processed		0.4	0.1	0.3	7.2	8.4	6.9
	French roll	0.4	0.1	0.3	6.5	7.6	6.2
Ultra-processed		1.5	0.5	1.0	24.8	37.9	21.0
	Cookies/crackers	0.3	0.1	0.2	5.2	8.8	4.2
	Sandwich bread	0.3	0.1	0.2	4.5	8.1	3.5
	Chocolate milk	0.2	0.0	0.2	3.5	3.3	3.6
	Processed sauces	0.2	0.1	0.1	2.9	3.7	2.8
	Sweets	0.2	0.1	0.1	2.8	4.2	2.3
	Salty snacks	0.1	0.0	0.1	2.2	2.5	2.1
	Instant pasta	0.1	0.0	0.1	1.4	1.8	1.3

Variables		Total mean	Density of dietary fiber (g/1000 kcal) in quartiles				p-value*
Variables		Total mean	1	2	3	4
Energy (kcal/day)		2034.0	2164.8	2142.2	1978.8	1849.5	<0.001
% of energy from:
	Carbohydrates	50.6	46.5	49.6	51.8	54.8	<0.001
	Total protein	15.8	16.6	15.7	15.5	15.4	0.083
	Plant protein	5.4	4.0	5.2	5.9	6.6	<0.001
	Animal protein	10.4	12.6	10.6	9.6	8.8	<0.001
	Total fat	33.6	36.6	34.6	32.7	30.4	<0.001
	Saturated fat	10.8	12.4	11.4	10.3	9.2	<0.001
	Trans fat	1.2	1.4	1.2	1.2	1.1	0.064
	Free sugar	11.8	15.0	12.3	10.2	9.4	<0.001
Cholesterol (mg)		239.2	311.2	244.8	212.4	187.7	<0.001
Sodium (g)		3.5	3.5	3.7	3.4	3.3	0.072
Potassium (mg)		1968.8	1724.0	1953.5	1996.5	2203.1	<0.001

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[1] Collaborations

RCF Meira participated in the proposal of the article, literature review, and writing of the manuscript. CD Capitani, AA Barros Filho, and MBA Barros performed a critical review of the intellectual content and statistical analyses. D Assumpção guided the proposal of the article, performed the data analysis, and contributed to the writing of the manuscript. All authors approved the final version of the manuscript.