Intersection of gender and race/skin color and food consumption of adolescents: analysis of Brazil’s National Student Health Survey (PENSE) 2019

BACKGROUND: Food consumption of adolescents is characterized by a highly prevalent intake of ultra-processed food and a low intake of fresh or minimally processed foods. Factors such as income, gender, race/skin color, and their intersection can influence this consumption. The objective of this study was to analyze the relationship between food consumption and intersections of race/skin color and gender among Brazilian adolescents. METHODS: Data from Brazil's National Student Health Survey of 2019 was used. A total of 10 analytical categories (exposure) were designed, based on the intersection of binary gender (man and woman) and race/skin color (white, Asian, black, brown - pardo in Brazilian Portuguese, and Indigenous) to represent social identities. As outcomes, assessments were made of regular intake (5 or more times a week) of three subgroups of fresh or minimally processed food (beans, fruits, and vegetables) and two subgroups of ultra-processed foods (sweet treats and soft drinks). Crude and adjusted (for age group, goods and services score, region and type of school) Poisson regression models were used to estimate prevalence ratios (PR). RESULTS: Based on data from 155,415 Brazilian school-aged adolescents, it has been identified that regular intake of fruit and vegetables was higher among white men. Compared to white men (reference category), in three of the five food subgroups analyzed (beans, vegetables, and sweets), black (PR 0.94, 0.79, and 1.48, respectively), brown (PR 0.91, 0.89, and 1.42, respectively) and Indigenous (PR 0.85, 0.82, and 1.38, respectively) women showed a statistically significant disadvantage. Black men reported lower PR of regular intake of vegetables and higher of sweet treats (PR 0.87 and 1.15) while brown, Asian, and Indigenous men presented higher PR of regular intake of beans in comparison to the reference category. CONCLUSION: Food consumption of adolescents differed among the analytical categories that represent social identities. Black and Indigenous women showed greater vulnerability compared to white men, who have a privileged social identity because of racial and gender inequalities. This study takes a novel approach by employing inter-categorical analysis of social identities with a view to presenting them as social experiences.