This paper describes the design, sampling methods, and data collection procedures, with particular focus on dietary data, used for the 2015 Health Survey of São Paulo (Inquérito de Saúde de São Paulo, 2015 ISA-Capital) with Focus in Nutrition Study (2015 ISA-Nutrition). The ISA is a household cross-sectional, population-based survey that uses complex, stratified, multistage sampling to create a representative sample of residents from urban São Paulo, Brazil. The 2015 ISA-Nutrition comprised a sub-sample of the 2015 ISA-Capital and intended to include 300 adolescents (aged 12 to 19 years), 300 adults (aged 20 to 59 years), and 300 older adults (aged ≥60 years). From February 2015 to February 2016, 1737 individuals answered the first 24-h dietary recall (24HR), and 901 individuals consented to have their blood sample collected, to undergo anthropometric and blood pressure assessment, and to answer the second 24HR. The 2015 ISA-Nutrition aims to evaluate lifestyle-related modifiable factors in São Paulo’s residents, as well as their association with biochemical and genetic markers, and environmental aspects related to cardiometabolic risk factors. This paper concludes that 2015 ISA-Nutrition may provide valuable insights into the cardiometabolic risk factors in a big city in an upper middle-income country and contribute to the formulation of health and nutritional policies.

Introduction: The intake of sugar-sweetened beverages (SSB) varies according to the characteristics of the population. Objective: To investigate the SSB intake and demographic, socioeconomic and lifestyle factors associated with its consumption in adolescents, adults, and older adults in São Paulo. Methods: Data were drawn from the Health Survey of São Paulo, a cross-sectional population-based study including 1,662 individuals aged 12 years or more. SSB were classified into six groups: sugar-sweetened sodas, sweetened coffee and tea, sweetened milk and dairy products, sweetened fruit juice, sweetened fruit drink, and total SSB. The association of each group with demographic, socioeconomic and lifestyle variables was assessed using linear regression models. Results: The mean SSB intake was 668.4 mL in adolescents, 502.6 mL in adults, and 358.2 mL in elderly adults. Sodas and sweetened coffee and tea represented had the greatest contribution to energy intake. SSB consumption was lower among female sex and higher among overweight adolescents, among sufficiently active adults, and among lower household per capita income older adults. Consumption of SSB was high, particularly among adolescents. Public policies are required in order to decrease the consumption of these beverages. Conclusion: Age group, sex, household per capita income, and body mass index status were associated with SSB intake.

Food environment and income act as determinants of diet, and consequently, of the consumption of fruits and vegetables. The objective of this study is to investigate the association between fruit and vegetable consumption, income, and street market density in adolescents living in São Paulo, Brazil. Data from 521 adolescents (12 to 19 years) participating in the 2015 Health Survey of São Paulo were used. Buffers (500, 1000, and 1500 m) were drawn around the households and the street markets were counted in each zone. Multilevel logistic regression models were used to evaluate the association between fruit and vegetable consumption, income, and street market density. The main results showed that the presence of a street market in the zone closest to the households (500 m) was associated with higher consumption of fruits and vegetables (OR: 1.73; CI 95% 1.01–3.00). Higher family income was associated with a higher consumption of fruits and vegetables for models of 500 m buffer (OR: 2.56; CI 95% 1.47–4.45), 1000 m (OR: 2.30; CI 95% 1.33–3.96), and 1500 m (OR: 2.32; CI 95% 1.35–4.00). These results support the implementation of public policies that jointly consider income and the availability of street markets or healthy food environments.

Dietary patterns derived by data-driven techniques are still scarce in the food security context and may be a useful tool to inform policymakers to promote adequate and healthy diets for vulnerable populations. We investigated the association between food security status and dietary patterns among 28,127 Brazilian adults using data from the 2017–2018 Household Budget Survey. Food security status was measured by the Brazilian Food Insecurity Scale. Food items reported in two 24 h dietary recalls were combined into food groups. Dietary patterns were derived from exploratory factor analysis, and participants were grouped according to their factor scores by K-means cluster analysis. Multiple logistic regression models were fitted to investigate the association between food security status and clusters of adherence to dietary patterns. Four dietary patterns were derived: ‘Brazilian breakfast style’ (cluster 3), ‘Brazilian Traditional staple foods’ (cluster 2), ‘Beverages, ready-to-eat and convenience foods’ (cluster 4), and ‘Fruits, vegetables, and whole grains’ (cluster 1). After adjustments, food insecurity was inversely associated with adherence to the ‘Fruits vegetables, and whole grains’ pattern (OR = 0.75, 95% CI: 0.63–0.89). Findings suggest food insecurity negatively impact the adoption of a nutrient-dense dietary pattern and highlight the critical role of policy actions in a scenario of increasing food insecurity.