Reducing the Use and the Consumption of Sugar by School Lunch Cooks in Public Schools: a Cluster Randomized Trial

Although Brazil is the largest producer and one of the world's largest consumers of sugar, research on sugar consumption is still a weak point among health indicators and there are no population studies to investigate the sugar intake in Brazilian population. Available data have shown reduction in the consumption of refined sugar (-37% between 1996 and 2003) but significant increase in consumption of soft drinks (400%), which constitute the main vehicle for consumption of added sugar. Moreover, studies have shown the adverse effects of excessive consumption of added sugar in dental caries and health, as excess energy intake hence in weight gain. Although several factors are associated with weight gain in adolescents, adults and elders, and several strategies have been released by both Brazil and International Agencies, as the Global Strategy, increased weight gain, particularly in adolescents, has been observed in several countries with large increase in Brazil, justifying specific projects to evaluate which messages, strategies and proposals for intervention would be effective.