Análise de recomendações para o controle do consumo do açúcar como medidas de intervenção em doenças crônicas não transmissíveis

Abstract

The research aimed to analyze the national and international recommendations, of global scope, and the Brazilian government regulations, for the control of sugar as an intervention measures in non-communicable diseases, to investigate a congruence between recommendations, scientific knowledge and consumption. The present research involved two phases, the first being a mapping of the literature aimed at evaluating the evidence on the frequency of consumption of sugary foods by schoolchildren in Brazil, and the second phase, a documentary approach to dietary recommendations and current legislation regarding sugars. To assess the consumption of sugary foods, a scoping review was carried out based on the methodological precepts of the Joana Briggs Institute (JBI). The second phase was a documentary, exploratory research with a qualitative approach. Therefore, it involved secondary data in the form of documents, both national and international, published between the years 1961 and 2023. The search was conducted online on open-access portals. A thematic content analysis was carried out to analyze the recommendations. As for the current Brazilian legislation, a documentary review was conducted. Regarding the research findings about the consumption of sugary foods, 24 studies were analyzed. Most of the studies included were quantitative epidemiological. Soft drinks were the most investigated among studies. A high frequency of consumption of sugary foods was also observed in this population group. Regarding dietary recommendations, 18 global and 15 nationals were analyzed. As for the typology focused on sugary foods, "free sugars" and the nutritional term "sugars" were the most frequent in the World Health Organization (WHO) documents and Brazilian documents, respectively. The documents, by presenting messages restrictive to sugars, also demonstrated narratives aimed at healthy eating. The WHO documents that presented quantitative limits, mostly using the official limit of a reduction to less than 10% of total energy intake, as well as a 5% reduction. The noncommunicable diseases (NCDs) group has been frequently recognized in international and national documents. Tooth decay has been recognized and associated with high consumption of sugars. On the other hand, periodontal disease was not mentioned in any of the documents analyzed. Narratives related to the approach to common risk factors were also present, with the approach focused on behaviors being more frequent in the WHO documents, while the Brazilian documents focused on social and structural aspects. The research, by identifying federal legislation, identified the existence of timid efforts to fulfill a government agenda aimed at low sugar intake. It is concluded that the documents analyzed were emphatic about the need to control sugars, and a review of these is necessary, focusing on the recommendation of control of specific sugary foods, with recognition of oral diseases and structural aspects related to food. In addition, despite initiatives for a government agenda focused on healthy eating, such as school meals and nutritional labeling, more specific goals would favor its control, since the consumption of sugary foods remains significant.