Quilombola communities in the Brazilian Amazon experience social vulnerability, food insecurity, and structural barriers that influence dietary practices and health conditions. Recent changes in land use, market integration, and the gradual weakening of traditional farming systems have contributed to modifications in food consumption patterns and accelerated nutritional transition processes.

To analyze dietary patterns and their association with chronic diseases among Quilombola communities in the municipality of Santarém, Pará, Brazil.

A cross-sectional analytical study with a quantitative approach was conducted. Data were collected through a structured and previously validated household survey addressing sociodemographic characteristics, self-reported diseases, and food consumption. Dietary patterns were identified through Principal Component Analysis (PCA). Descriptive statistics, chi-square tests, and multivariable logistic regression models were performed, adopting a significance level of p < 0.05.

The sample was predominantly female (60.2%), and 40.2% of participants had incomplete elementary education. Food consumption patterns revealed the coexistence of traditional foods with substantial consumption of ultra-processed products, indicating an ongoing nutritional transition. PCA identified three dietary patterns: Mixed Dietary Pattern, Traditional Amazonian Pattern, and Transitional Pattern. Among participants with valid morbidity information (n = 423), hypertension (20.6%) and diabetes mellitus (11.3%) were the most frequently reported chronic conditions. In multivariable analyses, age was independently associated with hypertension and diabetes. No statistically significant associations were observed between dietary patterns and chronic diseases after adjustment for potential confounding variables.

Quilombola communities are experiencing a nutritional transition characterized by the coexistence of traditional dietary practices and increasing exposure to ultra-processed foods. Although dietary patterns were not independently associated with chronic diseases after adjustment, the findings highlight the relevance of age and broader social and territorial determinants in shaping health conditions. Strengthening culturally appropriate food, nutrition, and primary healthcare policies remains essential to promote health equity and improve quality of life in Quilombola populations.