ABSTRACT:

Introduction:

The study of dietary antioxidants has gained prominence owing to the elucidation of the deleterious effects of oxidative stress to the human body. Objective: To evaluate the Brazilian population’s intake of antioxidant nutrients and their association with the nutritional status.

Methods:

A cross-sectional study was carried out including secondary data on food consumption of 33,459 individuals from both sexes, aged 10 years or older, from all Brazilian regions based on microdata of the “2008-2009 Household Budget Survey, Brazilian Dairy Survey.” The content of vitamins E, A, and C; zinc; manganese; copper; and selenium from 188 food items, divided into 12 groups, according to the habitual consumption form was analyzed. The means of antioxidant nutrient intake according to the nutritional status were compared using Bonferroni’s t-test.

Results:

Higher percentages of insufficient intake of vitamins than antioxidant minerals were seen. A significant difference in the intake of vitamin E as to the nutritional status was noticed, wherein the intake in overweight individuals was lower than in those with proper weight. Participants with low weight presented lower intake of almost all antioxidant minerals, except for copper, in which the intake of participants with low weight was equal to those with normal weight.

Conclusion:

High percentages of insufficient intake of antioxidant nutrients were observed in the studied population, especially vitamins. It was also found that the intake of antioxidant nutrients varied based on nutritional status, gender, and life stage.

Keywords:
Vitamins; Minerals; Antioxidants; Food consumption; Nutritional status; Diet

INTRODUCTION

Certain nutrients and food components have been prominent in their antioxidant activity, with the ability to transform and diminish action of oxidation of free radicals, preventing their harmful effects on the body¹1. Panziera FB, Dorneles MM, Durgante PC, Silva VL. Avaliação da ingestão de minerais antioxidantes em idosos. Rev Bras Geriatr Gerontol 2011; 14(1): 49-58.. The imbalance in the production of free radicals and in their removal by the antioxidant defenses, defined as oxidative stress, can cause cellular damage by attacking membranes, nucleic acids, proteins, and polysaccharides, leading to functional alterations and the development of several diseases²2. Valko M, Leibfritz D, Moncol J, Cronin MT, Mazur M, Telser J. Free radicals and antioxidants in normal physiological functions and human disease. Int J Biochem Cell Biol 2007; 39(1): 44-84..

Although the body possesses effective endogenous antioxidant defenses to fight excess free radicals, such as enzymes superoxide dismutase, peroxidase, catalase, and glutathione peroxidase³3. Moon JK, Shibamoto T. Antioxidant assays for plant and food components. Agric Food Chem 2009; 57(5): 1655-66., they are believed to be not infallible. Therefore, there is a constant formation of free radicals⁴4. Cerqueira FM, Medeiros MH, Augusto O. Antioxidantes dietéticos: controvérsias e perspectivas. Quím Nova 2007; 30(2): 441-9.. Thus, antioxidants obtained through a diet are indispensable for proper defense against oxidation, and therefore play an important role in maintaining health. Among the diet’s nutrients with antioxidant action, there are vitamins E, A, and C and minerals zinc, manganese, copper, and selenium⁵5. Zimmermann AM, Kirsten VR. Alimentos com função antioxidante em doenças crônicas: uma abordagem clínica. Disc Scientia 2008; 9(1): 51-68.^,11. Panziera FB, Dorneles MM, Durgante PC, Silva VL. Avaliação da ingestão de minerais antioxidantes em idosos. Rev Bras Geriatr Gerontol 2011; 14(1): 49-58..

The demographic, epidemiological, and, especially, nutritional transitions that have developed in Brazil since the 20th century, characterized by the reduction in the prevalence of malnutrition and the increase of obesity, have resulted in a profile of health risk in the population⁶6. Oliveira AC, Valentim IB, Goulart MO, Silva CA, Bechara EJ, Trevisan MT. Fontes vegetais naturais de antioxidantes. Quím Nova 2009; 32(3): 689-702.. The increasing prevalence of obesity causes clinical complications, such as hypertension, diabetes, cardiovascular diseases, and osteoarthritis, leading to an increase in various comorbidities, decreasing quality of life and leading to the premature death of several people⁵5. Zimmermann AM, Kirsten VR. Alimentos com função antioxidante em doenças crônicas: uma abordagem clínica. Disc Scientia 2008; 9(1): 51-68..

Several factors are believed to be related to the development of comorbidities in obese individuals, including mechanisms that cause the excess of oxidative lesions in the human organism. Among these, it is highlighted that lipid peroxidation is a chain reaction of the fatty acids from cell membranes, capable of generating free radicals that cause damage to cells and which is increased in obesity. In addition, the decrease of cytoprotective enzymes with obesity has also been related to cellular damage and, consequently, to the development of chronic non-transmissible diseases, such as cancer, atherosclerosis, hypertension, among others⁷7. França BK. Peroxidação lipídica e obesidade: métodos para aferição do estresse oxidativo em obesos. GE J Port Gastrenterol 2013; 20(5): 199-206..

However, it is noteworthy that, recently, evidence has emerged showing that not only insufficient or excessive food consumption, but the quality of the diet, is related to the definition of health status⁸8. Tardido AP, Falcão MC. O impacto da modernização na transição nutricional e obesidade. Rev Bras Nutr Clín 2006; 21(2): 117-24., as well as nutritional status⁹9. Pontieri FM, Castro LP, Resende VA. Relação entre o estado nutricional e o consumo de frutas, verduras e legumes de pacientes atendidos em uma clínica escola de nutrição. Ensaios Ciênc Ciênc Biol Agrárias Saúde 2011; 15(4): 117-30.. Therefore, considering that dietary antioxidants are essential for the maintenance of health and taking into account the increase in the prevalence of overweight in the population, the relation of oxidative stress with chronic non-communicable diseases, the emergence of the concept of hidden hunger, as well as the importance of dietary antioxidants and the scarcity of data on their intake make studies on the ingestion of antioxidants and their relation with the nutritional status of the Brazilian population relevant. In this sense, this study aimed at evaluating the intake of antioxidant nutrients by the Brazilian population and its relationship with nutritional status.

METHODS

RESEARCH CHARACTERIZATION AND POPULATION

This is a cross-sectional study with secondary data collection, based on microdata from the National Food Inquiry (INA), which was a module of the Family Budget Research (POF) 2008-2009, developed by the Brazilian Institute of Geography and Statistics (IBGE). It is worth mentioning that the data contain detailed information on one day of food consumption from 33,459 individuals aged 10 years or more, of both sexes and all regions of Brazil.

FOOD CONSUMPTION

Data on the food consumption of the individuals interviewed by POF were collected on two consecutive days of feeding data registration. However, owing to the quality of the information obtained, the POF considered the first day of registration to estimate the average food consumption of the individuals.

Among the 1,121 food items described by the research participants, which are described in Annex 1 of POF 2008 - 2009¹⁰10. Instituto Brasileiro de Geografia e Estatística (IBGE). Pesquisa de Orçamentos Familiares 2008-2009: análise do consumo alimentar pessoal no Brasil. Rio de Janeiro: IBGE; 2011., the contents of 188 of these food items were evaluated, corresponding to 16.8%.

The criteria for the evaluation of only 188 food items were to have more than one nominal designation for several foods; lack of information on the antioxidant nutrient content of light, diet, and organic foods.

When categories in the POF classification (2008 - 2009) were described as “[specific ingredient]-based preparations,” only the main food was considered, as in “rice-based preparations,” using only rice. For categories called “other,” only foods with a higher prevalence of consumption were taken into account.

The selection and characterization of foods were performed based on the preparation method by which foods are usually consumed. Therefore, the food groups were studied as follows:

INTAKE OF ANTIOXIDANT NUTRIENTS

Quantification of the levels of antioxidant vitamins (E, A, and C) and minerals (zinc, manganese, copper, and selenium) of the selected foods was carried out using national and international food composition tables¹¹11. Núcleo de Estudos e Pesquisas em Alimentação, Universidade Estadual de Campinas (NEPA-UNICAMP). Tabela brasileira de composição de alimentos: TACO. 4 ed. Campinas: NEPA-UNICAMP; 2011.^,1212. Philippi ST. Tabela de composição de alimentos: suporte para decisão nutricional. 3 ed. Barueri: Manole; 2012.^,1313. Instituto Brasileiro de Geografia e Estatística (IBGE). Pesquisa de Orçamentos Familiares 2008-2009: tabelas de composição nutricional dos alimentos consumidos no Brasil. Rio de Janeiro: IBGE; 2011.^,1414. United States Department of Agriculture, Agricultural Research Service. USDA Nutrient Database for Standard Reference, Release 26 [Internet]. Nutrient Data Laboratory Home Page; 2013. Disponível em: http://ndb.nal.usda.gov/ndb/search/list (Acessado em 8 de janeiro de 2014).
http://ndb.nal.usda.gov/ndb/search/list... .

For each food, the data of at least two references were used to facilitate the calculation of the average content, with one information being preferentially obtained from the Brazilian Food Composition Table¹¹11. Núcleo de Estudos e Pesquisas em Alimentação, Universidade Estadual de Campinas (NEPA-UNICAMP). Tabela brasileira de composição de alimentos: TACO. 4 ed. Campinas: NEPA-UNICAMP; 2011., since it is a Brazilian table with important use in academic and scientific circles, as well as for presenting the composition of the foods grown in the country, according to climatic and soil conditions.

The contents of the antioxidants obtained per 100 g of food were converted according to the average portion consumed per capita. The total daily per capita intake of each antioxidant nutrient was calculated by the sum of the content of each food, with the total daily per capita intake being quantified according to each classification of nutritional status.

NUTRITIONAL STATUS

The evaluation of the nutritional status of the individuals was carried out by calculating the body mass index (BMI), defined as the relationship between body weight and height squared, and the weight and height data of each individual were already in the database provided by POF. For adolescents, the BMI/age indicator was used, which was assessed using the reference standard and the WHO classification criteria¹⁵15. World Health Organization (WHO). Growth reference data for 5-19 years. WHO reference; 2007.. For adults and the elderly, the classification criteria of WHO (1998)¹⁶16. World Health Organization Obesity (WHO). Preventing and managing the global epidemic: report of a WHO Consultation. Geneva: WHO; 1998. and Lipschitz¹⁷17. Lipschitz DA. Screening for nutritional status in the elderly. 1994; 21(1)., respectively, were used.

STATISTICAL ANALYSIS

The intake of antioxidant nutrients from individuals evaluated according to the life stage, sex, and nutritional status was compared with the recommendations of the Dietary Reference Intakes (DRIs)¹⁸18. Institute of Medicine. Dietary reference intakes for vitamin C, vitamin E, selenium, and carotenoids. Washington, DC: National Academy Press; 2000.^,1919. Institute of Medicine. Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. Washington, DC: National Academy Press; 2002., established for each age group and sex. For adolescents, considering that there are different nutritional recommendations for this age group, the average between the recommendations defined by DRIs for adolescents aged 9 - 13 years and for adolescents aged 14 - 18 years old was calculated.

The percentage of individuals with insufficient and excessive intake was calculated. A value lower than that recommended by DRIs was found to be below the estimated average requirements (EAR) or adequate intake (AI), whereas values between EAR or AI and tolerable upper intake levels (UL) were adequate, and those above the recommended values were higher than UL.

The data were organized and analyzed using Microsoft Excel 2010 and the statistical software Sisvar^®, being expressed as mean and standard deviation of the antioxidant nutrients content, according to each nutritional status. The Kolmogorov-Smirnov data normality test was applied, and the comparisons between the data were performed by the Bonferroni t-test, with 5% significance.

RESULTS

The evaluated population consisted of 33,459 individuals, mostly adults (64.7%), with normal weight (54.7%), followed by those overweight (40.1%). The mean total intake of antioxidant nutrients and the characteristics of the analyzed population can be observed in Table 1.

The estimate of the average daily intake of antioxidant vitamins according to the nutritional status of the Brazilian population showed that there was a significant difference only in vitamin E intake (p < 0.05). Ingestion in overweight individuals was lower than those with normal weight (Table 2).

Comparison of vitamin E intake with DRI recommendations indicated an average daily intake lower than that recommended for all stages of life, sexes, and nutritional status ratings. Approximately 83.0% of the individuals had inadequate intake of this vitamin. The highest percentages of inadequacy were observed in overweight individuals, except for elderly women with low weight, who presented lower intakes than those with normal weight (p < 0.05), according to Table 3. No individual had vitamin E intake above the recommended amount (data not shown).

The mean intake of vitamin A by the total population did not differ statistically according to nutritional status (Table 2). However, adult women with adequate weight and overweight had lower intake than those with low weight, differently from the elderly with low weight, who presented lower intake than those overweight (p < 0.05), according to Table 3.

It was also verified that the average daily intake of vitamin A was inferior to that recommended in all stages of life, sexes, and nutritional status ratings. The percentage of individuals who did not reach the recommendations was high and ranged from 83.0 to 95.0% (Table 3), and the adults and the elderly with low weight presented the highest percentage of inadequacy. Only 1.4% of participants had an intake higher than recommended (data not shown).

Regarding the mean intake of vitamin C, the elderly with low weight had the lowest intake of this vitamin in relation to the other nutritional status classifications (p < 0.05), as well as the higher percentage of inadequacy in comparison to those recommended by DRIs (82.0%), followed by adults with 81.5% (Table 3).

Insufficient intake of vitamin C was observed in approximately 72.0% of the individuals evaluated. Among adolescents of both sexes, with adequate weight, and adult women, those overweight women presented the highest percentage of inadequacy. Vitamin C intake above the recommended value was observed in 0.4% of participants (data not shown).

In relation to the antioxidant minerals, the estimate of the average daily intake of the total population showed that the individuals with low weight had inferior intake of all the minerals in comparison with the other classifications of the nutritional state (p < 0.05), according to Table 2. For copper alone, the intake of low-weight individuals did not differ from those with normal weight.

The percentages of insufficient intake found for the intake of antioxidant minerals were lower than those found for antioxidant vitamins. Approximately 35.0, 51.0, 24.0, and 19.0% of individuals had insufficient intake of zinc, manganese, copper, and selenium, respectively.

The mean daily intake of antioxidant minerals at all stages of life, sexes, and nutritional status was within the recommended range, except for manganese in adults and the elderly with low weight.

Concerning zinc, the highest percentages of insufficient intake were observed in low-weight individuals, except for adolescents and adult and elderly women in whom no significant difference was observed between the nutritional status ratings (p < 0.05), as shown in Table 4.

Regarding manganese, among adolescents of both sexes, the highest percentages of inadequacy were found in overweight individuals. However, in adult males and elderly of both sexes, the highest percentages of inadequacy were observed in individuals with low weight, and, for adult women, in those of adequate weight.

With regard to copper, the highest percentages of insufficient intake were found among the elderly of both sexes and among adults with low weight. For adolescents and adults, the highest percentages of inadequacy were observed in individuals with normal weight and overweight.

For selenium, the highest percentages of insufficient intake were found in individuals with low weight, especially in the elderly.

Intake of antioxidant minerals above the recommended value was observed in 0.2, 0.4, 1.4, and 1.9% of the individuals for manganese, copper, zinc, and selenium, respectively (data not shown).

DISCUSSION

This study addresses a subject that has not yet been explored in the country, since it is one of the first to evaluate the nutritional status of antioxidant nutrients. Nevertheless, these estimates still have limitations, such as cross-sectional data, the use of a single food record and the adjustment according to the amount of energy consumed. Therefore, prospective studies of food consumption assessment in Brazilians are necessary to verify their relationship with the ingestion of antioxidant nutrients.

In previous studies, such as Fernandes et al.²⁰20. Fernandes M, Paes C, Nogueira C, Souza G, Aquino L, Borges F, et al. Perfil de consumo de nutrientes antioxidantes em pacientes com síndrome metabólica. Rev Ciênc Med 2007; 16(4-6): 209-19. and Rodrigues et al.²¹21. Rodrigues GP, Abreu CL, Vasconcelos VM, Oliveira LM, Castro TC, Constantino EV, et al. Correlação entre antioxidantes dietéticos e síndrome metabólica em idosos. In: Anais do 11º Congresso Nacional da Sociedade Brasileira de Alimentação e Nutrição (SBAN); 2011 jun 20-23; Fortaleza (BR) - Ceará - Hotel Praia Centro. São Paulo: NUTRIRE; 2011. 172p., in adults and elderly people with metabolic syndrome, respectively, high percentages of inadequate intake of antioxidant vitamins by Brazilians were also observed. In the first study mentioned, the inadequacy of the intake of vitamins E and A was 100.0%, whereas that of vitamin C was 93.0%. In the second, inadequacy in vitamin E intake was 72.0%; of vitamin A, 92.0% and vitamin C, 88.0%, similar to the results found in this study.

The highest percentage of the insufficient intake of antioxidant vitamins in comparison to the antioxidant minerals observed in this study can be explained by the dietary sources of these nutrients. Food sources of antioxidant vitamins include, among other foods, fruits, vegetables, and oilseeds, whereas sources of antioxidant minerals include meat, cereals, coffee, and tea²²22. Whitney E, Rolfes SR. Nutrição: entendendo os nutrientes. São Paulo: Cengage Learning; 2008., which are foods of high prevalence of consumption in Brazil¹⁰10. Instituto Brasileiro de Geografia e Estatística (IBGE). Pesquisa de Orçamentos Familiares 2008-2009: análise do consumo alimentar pessoal no Brasil. Rio de Janeiro: IBGE; 2011..

Thus, considering the lower presence of fruits and vegetables in the Brazilian diet, since, according to the analyses of POF 2008 - 2009¹⁰10. Instituto Brasileiro de Geografia e Estatística (IBGE). Pesquisa de Orçamentos Familiares 2008-2009: análise do consumo alimentar pessoal no Brasil. Rio de Janeiro: IBGE; 2011., less than 10.0% of the Brazilian population reaches the recommended consumption for these foods, which is 400 g/day, it is likely that the low intake of vitamin C in the population is due to insufficient consumption of these foods.

As for vitamin E, the high percentage of insufficient intake of this vitamin can be explained by the reduced consumption of oilseeds, wheat germ, seeds, and whole grains. These foods have an important vitamin E content, but their presence in food is low, especially in relation to whole foods¹⁰10. Instituto Brasileiro de Geografia e Estatística (IBGE). Pesquisa de Orçamentos Familiares 2008-2009: análise do consumo alimentar pessoal no Brasil. Rio de Janeiro: IBGE; 2011.^,2323. Freitas AM, Philippi ST, Ribeiro SM. Listas de alimentos relacionadas ao consumo alimentar de um grupo de idosos: análises e perspectivas. Rev Bras Epidemiol 2011; 14(1): 161-77.^,2424. Pires RK. Avaliação da qualidade da dieta em participantes da linha de base do estudo longitudinal de saúde do adulto - ELSA - Brasil [dissertação]. Rio de Janeiro: Escola Nacional de Saúde Pública Sérgio Arouca; 2014..

In relation to vitamin A, it is observed that the Brazilian population frequently consumes meats, the source food of this vitamin, but poorly consumes fruits and vegetables, which are sources especially of carotenoids that are precursors to this vitamin, as well as of viscera, milks, and dairy, which may possibly explain the high percentages of inadequate intake. According to Souza et al.²⁵25. Souza AM, Pereira RA, Yokoo EM, Levy RB, Sichieri R. Alimentos mais consumidos no Brasil: Inquérito Nacional de Alimentação 2008-2009. Rev Saúde Pública 2013; 47(Suppl 1): s190-9., milk was cited by 12.9% of adolescents, 11.6% of adults, and 15.8% of the elderly surveyed by POF 2008 - 2009.

As for antioxidant minerals, the most frequently mentioned foods by the Brazilian population in POF 2008 - 2009 were rice (84.0%), coffee (79.0%), beans (72.8%), bread (63.0%), and beef (48.7%), which are food sources of these minerals²⁵25. Souza AM, Pereira RA, Yokoo EM, Levy RB, Sichieri R. Alimentos mais consumidos no Brasil: Inquérito Nacional de Alimentação 2008-2009. Rev Saúde Pública 2013; 47(Suppl 1): s190-9..

However, it is important to emphasize that although it has been verified that most of the daily intake averages of the antioxidant minerals of the Brazilian population are in agreement with the recommendations of the DRIs, the percentages of inadequacy suggest concern with the compromising of the action of the antioxidant minerals in the antioxidant defense, as it relates to the development of various diseases such as inflammatory bowel diseases²⁶26. Najafzadeh M, Reynolds PD, Baumgartner A, Anderson D. Flavonoids inhibit the genotoxicity of hydrogen peroxide (H2O2) and of the food mutagen 2-amino-3-methylimadazo[4,5-f]-quinoline (IQ) in lymphocytes from patients with inflammatory bowel disease (IBD). Mutagenesis 2009; 24(5): 405-11., infertility²⁷27. Agarwal A, Makker K, Sharma R. Clinical relevance of oxidative stress in male factor infertility: an update. Am J Reprod Immunol 2008; 59(1): 2-11., degenerative diseases such as Alzheimer’s and Parkinson²⁸28. Hayashi M. Oxidative stress in developmental brain disorders. Neuropathology 2009; 29(1): 1-8., cancer and inflammatory diseases²⁹29. Fang J, Seki T, Maeda H. Therapeutic strategies by modulating oxygen stress in cancer and inflammation. Adv Drug Deliv Ver 2009; 61(4): 290-302., lung diseases³⁰30. Park HS, Kim SR, Lee YC. Impact of oxidative stress on lung diseases. Respirology 2009; 14(1): 27-38., diabetes³¹31. Naito Y, Uchiyama K, Yoshikawa T. Oxidative stress involvement in diabetic nephropathy and its prevention by astaxanthin. Oxidative Stress Dis 2006; 21: 235-42., and cardiovascular diseases³²32. Ulrich-Merzenich G, Zeitlher H, Vetter H, Kraft K. Synergy research: vitamins and secondary plant components in the maintenance of the redox-homeostasis and in cell signaling. Phytomedicine 2009; 16(1): 2-16..

The low intake of antioxidant nutrients among the elderly with low weight is possibly due to the smaller volume of food ingested by these individuals. This condition can be explained by the very characteristic of the aging process, since morphological, biochemical, physiological, behavioral, and biopsychosocial changes occur, which result in a progressive loss of adaptability to the environment, as well as a deterioration in the act of feeding, which leads to malnutrition and pathological processes³³33. Silva SM, Mura JD. Tratado de alimentação, nutrição e dietoterapia. 2 ed. São Paulo: Roca; 2010..

According to Moreira, Boas and Ferreira³⁴34. Moreira PL, Boas PJ, Ferreira AL. Association between oxidative stress and nutritional status in theelderly. Rev Assoc Med Bras 2014; 60(1): 75-83., there is a relationship between oxidative stress and the nutritional status of the elderly, including both malnutrition and overweight. Thus, the authors emphasize the importance of encouraging the ingestion of antioxidant foods, such as fruits and vegetables, as well as maintaining weight within the normal range.

The highest percentages of insufficient intake of antioxidant nutrients in both people with adequate weight and overweight individuals, as observed for vitamin E in the total population, for vitamins A and C and copper in adult women and for vitamin C, manganese and copper in adolescents of both sexes, can be attributed possibly to the food choices of these individuals.

According to IBGE¹⁰10. Instituto Brasileiro de Geografia e Estatística (IBGE). Pesquisa de Orçamentos Familiares 2008-2009: análise do consumo alimentar pessoal no Brasil. Rio de Janeiro: IBGE; 2011., food consumption in Brazil is mainly composed of food with a high energy and low nutrient content, which constitutes a risk for deficits in important nutrients, obesity, and many chronic non-transmissible diseases, which are characteristic of the nutritional transition. Thus, the importance of changes in Brazilian food habits, including the replacement of high-calorie and low-nutrient foods by fruits, vegetables, legumes, milk, whole grains, oilseeds, viscera, fish, all produced in Brazil.

In this context, many people with low weight can present greater intake of antioxidant vitamins and minerals in comparison to eutrophic and overweight people. This is due to the fact that although these may consume a greater amount of food, the intake of antioxidant nutrients seems to be related to the quality of the diet.

In addition, it should be noted that the mean BMI of the underweight individuals in this study was 18.31 kg/m², which is close to the lower limit for the nutritional diagnosis of eutrophy. This may indicate that, in addition to malnourished people, those who are constitutionally thinner or overly concerned about their physical appearance are included in this group.

CONCLUSIONS

High percentages of insufficient intake of antioxidant nutrients were observed in the evaluated population, especially in relation to vitamins. In addition, differences in the intake of antioxidant nutrients in the Brazilian population according to their nutritional status, life stage, and sex were found. The highest percentages of insufficient intake of antioxidant vitamins were observed in overweight individuals, especially in women, and with the exception of the elderly. Also, with respect to minerals, there was a predominance of inadequacy in people with low weight. Finally, it was possible to verify that the intake of antioxidant nutrients seems to be related to the quality of the diet of the population.

References

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