RCAAP Repository

Objetivo: Este trabalho tem como objetivo discutir a disciplina Desenvolvimento da Comunidade no currículo do curso de Nutrição de uma universidade pública, visando contribuir com o debate sobre a formação social do nutricionista.Métodos: Trata-se de pesquisa documental, com base no material da disciplina e nos trabalhos produzidos pelos alunos ao longo de 30 anos de docência, além de reflexão sobre as experiências vividas.Resultados: Apesar da recorrente afirmação da relevância do tratamento social em saúde e nutrição, ainda é insatisfatória a introdução dos componentes que poderiam construir esse processo. Desde sempre, o trabalho prático manifestou-se sedutor e revelador da realidade social e econômica para os estudantes, enquanto a compreensão teórica dos processos e relações sociais resulta problemática e recebe a justificativa de que, para os alunos da área de saúde, a linguagem das Ciências Sociais seria estranha e difícil.Conclusão:A experiência docente na disciplina Desenvolvimento da Comunidade confirma a importância da abordagem teórica e prática da saúde, alimentação e nutrição pelas Ciências Sociais, significando um esforço pedagógico e pessoal a mais do professor e de alunos. Mesmo que a disciplina deixe de existir na formação do nutricionista com o título original, que faz parte do repertório semântico de um tempo passado, os conteúdos e as experiências permanecem sendo relevantes e podem ser incorporadas em outras disciplinas.

Trata-se de relato de experiência de estágio interdisciplinar em Nutrição Social e em Psicologia da Universidade Federal de São Paulo campusBaixada Santista, com foco na integralidade da atenção. O trabalho ocorreu entre 2010 e 2012, na Atenção Básica de Saúde do Sistema Único de Saúde no território Centro/Morro do município de Santos, São Paulo. Utilizaram-se registros de campo contendo memórias de supervisões e de reuniões entre professores e equipe de saúde. Construíram-se narrativas e projetos terapêuticos singulares. Em supervisão conjunta de professores de Nutrição e Psicologia, debateram-se situações destacadas pelos estudantes e planos de trabalho construídos para cada ciclo de formação. Isto fundamentou práticas interdisciplinares, reflexões e ações consoantes ao Sistema Único de Saúde, realizadas pelos estagiários. Os resultados corroboram a importância do trabalho interdisciplinar para a promoção da integralidade, constituindo formas de escuta e atenção diferenciadas aos usuários, em estreita relação com os serviços.

Objective: To analyze dissertations and theses produced by graduate programs in nutrition in Brazil from 2003 to 2012. We sought to identify: a) The number of studies produced per year b) the scientific approach (quantitative, qualitative, or mixed), and c) the area of knowledge in the scientific field of nutrition. Methods: This is a descriptive study. We investigated seven graduate programs linked to the area of nutrition of the Coordination for the Improvement of Higher Education Personnel, which had the web pages listing the studies. The analysis procedures included reading the titles, identifying the advisor's lines of research, reading the summaries, and reading the methods section. Results: In the study period 758 dissertations and 204 theses were defended, signifying an increase of 229.0% for the all programs. The hegemony of the quantitative approach shows the influence of the philosophical trends linked to positivism and the biological sciences, attracting interest from 92.5% of researchers. The qualitative and mixed approaches contributed only to 7.3% of the studies, expressing the influence of the social sciences and humanities and of the philosophical trends' dialectics and phenomenology about a small group of researchers. Conclusion: The distribution of dissertations and theses in the six areas of knowledge reaffirms the complexity, breadth, epistemological, and methodological heterogeneity; and the configuration of the field of knowledge production in food and nutrition, requiring the construction of collective political projects, seeking the interdisciplinarity of the different areas that structure the field.

Objetivo: Avaliar o perfil lipídico e fatores associados à dislipidemia em crianças. Métodos: Estudo transversal que avaliou crianças de 4 a 7 anos acompanhadas nos primeiros meses de vida por um Programa de Extensão da Universidade Federal de Viçosa, Minas Gerais. Foram consideradas as dosagens de colesterol total, lipoproteína de alta densidade, lipoproteína de baixa densidade e triglicerídeos. Foram estudadas variáveis possivelmente associadas ao perfil lipídico, sendo elas variáveis maternas, sociodemográficas e aquelas associadas à criança. Foram realizadas análises bivariada e multivariadas, sendo as últimas por meio de regressão logística múltipla. Resultados: A amostra foi constituída por 185 crianças, de ambos os sexos. Observou-se que 46,5% (n=86) apresentaram valores aumentados de colesterol total, 9,2% (n=17) de lipoproteína de baixa densidade e 4,9% (n=9) de triglicerídeos. Com relação à lipoproteína de alta densidade, 35,1% (n=65) apresentaram valores abaixo do desejável. Demonstrou associação independente com o perfil lipídico das crianças a renda per capita, escolaridade materna e idade materna (associando-se à lipoproteína de baixa densidade) e o excesso de peso, que se associou a maiores prevalências de alterações em triglicerídeos. Conclusão: Foram observadas altas prevalências de dislipidemias. Condições sociodemográficas e estado nutricional demonstraram influenciar, também em crianças, a ocorrência de dislipidemias, as quais são citadas como fatores de risco para as doenças cardiovasculares. Revela-se a importância de se estudar esses fatores desde a infância, realizando-se estudos com outras faixas etárias que verifiquem a prevalência e fatores associados, de forma a promover o cuidado com a saúde desse grupo populacional.

Objective: To characterize the school cafeterias in the Federal District of Brazil with respect to the promotion of healthy eating in schools. Methods: This is a descriptive, analytical, cross-sectional study, with a representative sample of schools with cafeterias in the Federal District, Brazil (n=202). The data were collected from April to November 2010 by means of on-site interviews and a structured questionnaire. The Pearson's chi-squared and Student's t tests were used. Results: A higher prevalence of outsourcing, and few employees and dieticians were observed. The prevailing foods were baked sausage, cheese, or chicken rolls or pastries. It was also found that 42.2% of the schools influence the menu of the cafeterias, and 58.6% of the representatives believe in the possibility of influencing the students' eating habits. However, 68.0% of the respondents do not believe in the economic feasibility of completely healthful school cafeterias. Approximately 30.0% of the respondents carry out activities to promote healthy eating. Conclusion: Most of the school cafeterias in the Federal District do not encourage healthful eating. The high prevalence of outsourced services with little interference from the school community gives high autonomy to the cafeteria's owner, whose priority is the pursuit of profit at the expense of the students' nutritional education. Improving the nutritional quality of school foods should be a continuous interactive effort of the food suppliers, principals, students, parents, and government authorities.

Objective: The aims of this article are to estimate the prevalence and to identify the sociodemographic factors and food consumption associated with central obesity in schoolchildren 6-10 years old of the State of Santa Catarina, Brazil. Methods: It consists in a cross-sectional population-based study involving 4,963 schoolchildren enrolled in the public and private sectors. The dependent variable is central obesity investigated by measuring waist circumference and classified according to percentiles/gender/age. Bivariate and multivariate analyzes were also performed. Results: The prevalence of central obesity was 4,9% (CI95%=4,3;5,5), being more prevalent in boys with statistical significance (p=0,003). The other variables investigated (age the schoolchildren, type of school, maternal education, protective and risk food consumption, number of daily meals) were not associated with outcome. Among the schoolchildren who had central obesity (n=243), 99.3% of the boys and 99.0% of the girls also showed overweight/obesity. Conclusion: The prevalence of central obesity was lower than that reported in national and international studies. In this scenario, the gender (male) variable was strongly associated with the outcome. The identified prevalence is a major concern in nutrition and medical science as the central obesity may remain in adulthood and show strong association with cardiovascular risk. It is noteworthy that there is a need for obesity prevention campaigns that encourage children and their parents to adopt a healthier life style. Finally, other studies should be conducted in order to examine potential factors linked to central obesity.

Objective: This study investigated the chronic (oral) and acute (hypothalamic infusion) effects of L-arginine supplementation on feed intake, body composition, and behavioral changes in rats. Methods: Twenty rats were divided into two groups treated orally for 60 days; one group received L-arginine (1 g/kg body weight) and one group received saline (1 mL/NaCl 0.9%). Daily consumption of water and food were evaluated, and weight monitored. After the oral treatment, the rats underwent stereotactic biopsy and a group was injected with 2 µL of L-arginine (0.5 mM) and another received an injection of saline (0.9% NaCl), in the hypothalamic route, through micro infusion. Immediately after micro infusion, the animal behavior was evaluated through tests in the open field. Food and water consumption were evaluated at 12 and 24 hours after the micro infusion. Daily water consumption and weight gain evolution were evaluated. At the end of treatments, rats were euthanized and blood was collected for glucose, glycerol, and cholesterol evaluation, and histological analysis of vital organs. Results: Oral supplementation with L-arginine increased water intake (11%, p<0.05) and promoted weight gain (3%, p<0.05). However, hypothalamic infusion promoted a significant increase in chow intake (30%, p<0.05) after 24 hours of L-arginine administration. Conclusion: Chronic oral treatment with L-arginine was not effective on appetite modulation; however, an effect was observed when L-arginine was administered directly into the hypothalamus, suggesting a central regulation on appetite through nNOS sensitization. Chronic use of L-arginine did not cause substantial changes in anthropometric, biochemical, behavioral, or histological variables.

Objetivo: O objetivo deste trabalho foi avaliar o efeito do consumo crônico do óleo de semente de uva, obtido do mercado brasileiro, nos marcadores bioquímicos e inflamatórios de ratos saudáveis. Métodos: Ratos Wistar, recém-desmamados e saudáveis, receberam por 65 dias óleo de semente de uva e soja em duas concentrações (3 e 6 mL/kg de peso corporal). Os parâmetros avaliados foram a ingestão alimentar, peso corporal e dos tecidos hepático, cerebral e adiposo retroperitonial; neste último, foi ainda realizado o perfil de ácidos graxos. A análise dos parâmetros bioquímicos, peroxidação lipídica e perfil inflamatório através da quantificação das citocinas TNF-α, IL-10 e IL-6 foi realizada no soro. Resultados: O óleo de semente de uva, independentemente da dose administrada, promoveu maior acúmulo de gordura no tecido hepático e aumento nos níveis de peroxidação lipídica do soro. Verificou-se que, quando consumido na maior dose, houve maior incorporação do ácido graxo linoleico no tecido adiposo retroperitonial. Modificações nos parâmetros bioquímicos e inflamatórios séricos não foram observadas. Conclusão: O consumo de óleo de semente de uva não provocou alterações metabólicas significantes em nenhuma das doses administradas ainda que se tenha observado uma elevação nos níveis de peroxidação lipídica sérica.

Objective: This study aimed to analyze the prevalence of perceived food insecurity in households of employees of Popular Restaurants, as well as associate this perception with socioeconomic, labor and health variables. Methods: This is a cross-sectional study of 273 workers from seven restaurants located in the city of Rio de Janeiro, Brazil. We applied a questionnaire with different scales and anthropometric measurements were taken. Assessment of food insecurity was performed using the Brazilian Food Insecurity Scale, classifying individuals in food security and food insecurity. The analyses were performed by calculating the gross and adjusted odds ratio. The logistic regression was performed considering three groups of variables: socio-economic, employment and health. Results: The estimated prevalence of food insecurity was 53.7%. The variables: education (OR=2.39; 95%CI=1.38-4.16), time working in kitchens <29 months (OR=2.72; 95%CI=1.44-5.16) and opinion on the satisfaction with food composition and regularity (OR=2.01; 95%CI=1.12-3.57) were significantly associated with food insecurity. Conclusion: Although the study population find themselves inserted into a social facility to promote food security, food insecurity results are worrying. Additionally, factors like lower education and less time working in restaurants increased the chance to realize their households in food insecurity.

This paper discusses theoretical and methodological challenges in the production of knowledge located in the interface between the Social Sciences and the Sciences of Food and Nutrition, mediated by Health Sciences. We recognize that the discussion on the intersections between these scientific fields arises from the need to expand the understanding of the phenomena surrounding the field of Food and Nutrition from other theoretical frameworks beyond the biomedical paradigm. The discussion will guide a reflection on the following issues: a) how to establish Brazilian academic-scientific output at the interface between the Nutritional Sciences and Social Sciences, mediated by Health Sciences; b) considering that there is a 'field' of the socio-anthropology of food developed historically within the Social Sciences and Humanities, which distinguishes the production of knowledge in the field of health; c) the main theoretical and methodological challenges of academic-scientific output today. We also discuss challenges related to the practical consequences of this output, considering the interventionist legacy in the field of health. Lastly, we highlight that such reflections also face another important challenge, namely the urgent need to reinvent ways of thinking and doing science which, articulated with demands inherent to a new field shaped by the search for production of knowledge and practices, is more important to issues raised by health care.

O objetivo deste texto é apresentar uma ferramenta teórico-instrumental, a décalage, que possibilita uma visão compreensiva sobre os agentes do campo da saúde. A Alimentação e Nutrição e a Educação Física são tomadas como campos científicos de formação, de práticas profissionais e de produção de conhecimentos e saberes que correspondem a dois fortes pilares na reprodução de um específico discurso eivado de normas biomédicas intensamente disseminadas na sociedade. Contudo, nem os profissionais dessas áreas, nem os estudantes dos correspondentes cursos de graduação seguem fielmente aquilo que pregam, como a alimentação saudável e a prática regular de exercícios físicos. Configura-se, assim, um espaço entre "o que se fala" e "o que se faz" em relação às práticas alimentares e corporais, frequentemente identificado como "erro a ser corrigido" na visão biomédica da vida. Distintamente, considera-se aqui a necessidade de um instrumento metodológico que auxilie na compreensão de dois aspectos da subjetividade: a ação e o discurso sobre a ação, que se complementam nas relações sociais. O ser humano convive com a décalage em suas relações sociais, com criatividade na reconstrução de significados, considerando incompatibilidades ou incongruências, sustentando uma dinâmica social na percepção de sua condição de ser humano, criando aquilo que é possível e sonhando com o que seria impossível. Sonhando o impossível, ele constrói o que é possível. Um mundo sempre novo. Talvez um mundo menos doente, se a décalage for considerada.

A conceptual discussion on the discourses of the social actors in the field of Food and Nutrition is proposed, presenting the existing conflicts, discursive strategies and struggles for academic legitimacy. The line of argumentation follows the biopower concept developed by Michel Foucault, who presents medicine as a knowledge-power focused at the same time on the body and the population, the human body and the biological processes, producing disciplinary results and widespread regulatory effects on society. Based on this concept it is argued that the discourses produced in the field put hegemonic and counter-hegemonic interests in confrontation, political disputes disguised by "abstract" epistemological discussions, strategies to lure consumers, life standardization and medicalization. Such discourses translate instances of power in dispute, economic interests, structural conflicts, political impasses. New elements are presented for the production of knowledge for professionals of Nutrition and for the perception of the feeding act beyond the nutritional, biological, biomedical and epistemological parameters, which in essence are clearly political once they convey tensions between the conceptual structures that also operate in the interior of the field. It is assumed that there is no such health or nutrition as abstract, neutral fields, detached from reality; such dimensions are part of the material, concrete life and carry symbolic, cultural and subjective values. Considering only the nutritional aspects of nutrition is to impoverish and weaken it, and the discussion that seems to be "merely conceptual" brings to light important issues that the professionals in the field of Food and Nutrition should address.

OBJECTIVE: To identify the prevalence of iron-deficiency anemia in children aged less than 60 months and the conditioning factors in Minas Gerais, Brazil. METHODS: This cross-sectional study conducted from February 2007 to July 2008 in Minas Gerais included a random sample of 725 male and female children aged less than 60 months. A household survey was administered to the children's parents or guardians to collect socioeconomic, demographic, food security, and the child's anthropometric data. The hemoglobin level was determined by a portable hemoglobinometer. Anemia was considered present when hemoglobin levels were below 11.0 g/dL. Statistical analyses estimated the prevalence of anemia and its association with socioeconomic, demographic, and food security-related variables. The model was adjusted by multivariate logistic regression. The significance level was set at 5% (p<0.05). RESULTS: The prevalence of anemia was 37.4%. The greatest prevalence occurred in the age group 6 to 24 months (43.0%). The associated variables were being female (PR=1.43; p<0.026); age (PR=1.53; p<0.024); and not frequenting a daycare center (PR=2.41; p<0.001). In the multivariate regression model, the variables being female and not frequenting a daycare center remained in the model. CONCLUSION: The present population-based study found that in Minas Gerais, one-third (37.5%) of the children aged less than 60 months have iron-deficiency anemia. The results show that not frequenting a daycare center and being female are risk factors for anemia.

OBJECTIVE: To investigate the relationship between food habits and risk factors for cardiovascular disease in schoolchildren of the city Ouro Preto, Minas Gerais. METHODS: A cross-sectional study was conducted in a population-based sample of 738 schoolchildren aged 6-14 years. A semi-structured questionnaire was used for collecting demographic, socioeconomic, biochemical, clinical, and anthropometric data. Food intake was determined by a food-frequency questionnaire. Food habits were evaluated according to the adapted Recommended Food Score. Multiple linear regression models were constructed to assess how food consumption was associated with cardiovascular risk factors. RESULTS: The schoolchildren presented a dietary pattern characterized by low consumption of healthy foods. Association of cardiovascular risk factors showed that the consumption of foods according to the adapted Recommended Food Score was negatively and significantly associated with tetrapolar percentage of body fat (p=0.030) and systolic blood pressure (p=0.049) in children aged 6-9 years. CONCLUSION: Children's dietary patterns proved to be an important determinant of some of the cardiovascular risk factors studied. Thus, food intake assessment is a primary tool for the prevention and early intervention on cardiovascular risk factors during childhood.

OBJECTIVE: To analyze the situation of breastfeeding and complementary feeding in the city of Registro, São Paulo. METHODS: This cross-sectional study collected sociodemographic and feeding information of infants aged less than one year who participated in the 2011 multiple vaccine campaign. Breastfeeding and complementary feeding were analyzed by indicators proposed by the World Health Organization. The association between outcomes (exclusive breastfeeding and introduction to complementary feeding) and the explanatory variables (maternal and child characteristics) was investigated by the Poisson model with a robust error variance. RESULTS: We analyzed 713 children. The prevalence of exclusive breastfeeding was 50.0%. Children who were breastfed exclusively on the first day at home (PR=2.40; 95%CI=1.42-4.06) and not given pacifiers (PR=1.95; 95%CI=1.153.30) were more likely to be exclusively breastfed. The complementary feeding indicators showed that 62.1% of the children aged 6 to 8.9 months consumed fruit plus savory mashes. None of the explanatory variables was significantly associated with this outcome. CONCLUSION: The study identified inappropriate infant feeding practices. Such studies can contribute to the proposal of policies, which is particularly important in an unfavorable social development context characterized by the study city.

OBJETÍVO: El artículo analiza los marcos interpretativos de 82 niños/as (10-12 años) y de 10 madres/1 padre, sobre obesidad y sobrepeso, en dos colegios de Valencia (España). MÉTODOS: Se trata del estudio piloto de un proyecto de investigación cualitativa. Con los niños se usaron cuestionarios de respuesta abierta y elaboración de obras de teatro y cuentos, mientras que con los padres se realizaron grupos de discusión. Se tuvieron en cuenta aspectos como: diferencias de género, atributos negativos y formas de discriminación. En el caso de los padres, se propuso la cuestión de las causas y posibles soluciones del problema en relación a las existentes. RESULTADOS: Entre los niños/as emergieron términos negativos asociados al sobrepeso, presentando una mayor focalización corporal en el abdomen los niños y una notable importancia de la estética las niñas, unida a una percepción más amplia de los efectos del sobrepeso en la sociabilidad. Entre los padres, la preocupación tuvo una preponderancia en los efectos psicológicos del sobrepeso en sus hijos por encima de las consecuencias para la salud (solo en casos graves de obesidad). CONCLUSIÓN: La percepción de los padres sobre las posibles soluciones mostró la clara influencia de los discursos nutricionales, resultado de campañas de concienciación, así como el escaso conocimiento de otras posibles formas de intervención con mayor énfasis social o participativo.

OBJECTIVE: High blood pressure is a major rick factor for cardiovascular disease, and it is closely associated with salt intake. Schools are considered ideal environments to promote health and proper eating habits. Therefore the objective of this study was to evaluate the amount of salt in meals served in school canteens and consumers' perceptions about salt. METHODS: Meals, including all the components (bread, soup, and main dish) were retrieved from school canteens. Salt was quantified by a portable salt meter. For food perception we constructed a questionnaire that was administered to high school students. RESULTS: A total of 798 food samples were analysed. Bread had the highest salt content with a mean of 1.35 g/100 g (SD=0.12). Salt in soups ranged from 0.72 g/100 g to 0.80 g/100 g (p=0.05) and, in main courses, from 0.71 g/100 to 0.97 g/100g (p=0.05). The salt content of school meals is high with a mean value of 2.83 to 3.82 g of salt per meal. Moreover, a high percentage of students consider meals neither salty nor bland, which shows they are used to the intensity/amount of salt consumed. CONCLUSION: The salt content of school meals is high, ranging from 2 to 5 times more than the Recommended Dietary Allowances for children, clearly exceeding the needs for this population, which may pose a health risk. Healthy choices are only possible in environments where such choices are possible. Therefore, salt reduction strategies aimed at the food industry and catering services should be implemented, with children and young people targeted as a major priority.

OBJECTIVE: To analyze the food intake of sugarcane workers' family members. METHODS: The food intake of 159 family members of sugarcane workers from Gameleira, Pernambuco, Brazilian Northeast, was investigated by directly weighing the foods on three non-consecutive days. The percent risk of inadequate macro- and micronutrient intakes was analyzed according to the Reference Dietary Intakes. The macronutrients were analyzed in relation to acceptable distribution intervals. The energy consumed from the various food groups was expressed as a ratio of the total energy intake. RESULTS: The median intake of carbohydrates and proteins remained above the Estimated Average Requirement, and all age groups presented a low risk of inadequate carbohydrate and protein intakes. The median intakes of riboflavin, niacin, thiamin, and iron remained above the Estimated Average Requirement for all age groups, but children aged 1-3 years presented a high percent risk of inadequate iron intake. All age groups presented high percent risk of inadequate zinc, calcium, vitamin A, and vitamin C intakes. Grains and derivatives had a greater participation in the total energy intake, especially in men aged 19-30 years. The group "milk and dairy products" had a greater participation in the diet of children aged 1-3 years. CONCLUSION: The low percent risk of inadequate carbohydrate and protein intakes in all age groups was opposed to the high risk of inadequate mineral and vitamin intakes, making the population vulnerable to nutritional disorders caused by excess macronutrient intake and inadequate micronutrient intake.

OBJECTIVE: Estimate the intake of phenolic compounds by the Brazilian population. METHODS: To estimate the average per capita food consumption, micro data from the National Dietary Survey and from the Household Budget Survey from 2008 to 2009 was analyzed. The phenolic content in food was estimated from the base of Phenol-Explorer. It was chosen according to compatibility and variety of food items and usual method of preparation. RESULTS: The Brazilian population consumed, on average, 460.15 mg/day of total phenolic compounds, derived mainly from beverages (48.9%), especially coffee and legumes (19.5%). Since this analysis of classes of phenolics it was possible to observe an intake of 314 mg/day of phenolic acids, 138.92 mg/day of flavonoids and 7.16 mg/ day of other kinds of phenolics. Regarding the variables studied this present study shows that those men who live in the countryside and in the northeastern region of the country had a higher consumption of phenolic compounds. Besides, consumption was higher by adults and the elderly, the medium income classes, the population with incomplete and complete primary education and those with adequate nutrition and also overweight status. CONCLUSION: The intake of phenolic compounds can be considered low, especially where consumption of fruit and vegetables is insufficient. We can conclude that coffee and black beans were the best contributors to phenolic intake.

OBJECTIVE: Describe the eating habits of hypertensive and diabetic individuals, classify their adequacy according to the Ministry of Health's Food Guide for the Brazilian Population and determine the association between adequate diet and the health problems under investigation. METHODS: Descriptive study from the baseline of a longitudinal study begun in 2011, with a sample of hypertensive and diabetic patients from a Primary Health Care facility in Southern Brazil, interviewed at home. RESULTS: A total of 2,482 people were interviewed, of which 66.5% were hypertensive, 6.5% diabetic and 27.1% suffered from hypertension and diabetes. Of those interviewed, 29.6% had inadequate eating habits, 46.9% partially inadequate and 23.4% had adequate diets. Low fiber intake was identified along with high consumption of soda, sugar, salt and saturated fat. The most adequate diet was associated with poor health status and the prevalence of inadequate diet was 30.0% higher among those who were only hypertensive. CONCLUSION: According to Ministry of Health guidelines, the eating habits of diabetic and hypertensive subjects are inadequate. The association between adequate diet and the health problems studied indicated a delayed improvement in diet, suggesting an urgent need for preventive and effective interventions to promote healthy eating.