RCAAP Repository

ABSTRACT Objective Investigate the clustering of four unhealthy food habits (low intake of fruits, low intake of vegetables, high intake of candy, and high intake of fried snacks), and to identify the association between the number of these clustered habits and sociodemographic variables. Methods This was a cross-sectional representative study of industrial workers from 24 Federative Units in Brazil conducted between 2006 and 2008. The low weekly intake of fruits and vegetables (<5 days/week) and high weekly intake of candy and fried snacks (≥5 days/weeks) were evaluated using a validated questionnaire. Simultaneity was analyzed with stratification by sex, calculating the Observed (O) and Expected (E) prevalence and the O/E ratio for each of the 16 possible food intake combinations. Results Among the 47,477 workers studied, in both men and women, the simultaneous presence of high weekly intake of candy and fried snacks(O/E=3.58; 95%CI=3.12–4.10 and O/E=2.17; 95%CI=1.76–2.62) and of the four unhealthy food habits (O/E=2.32; 95%CI=2.01–2.66 and O/E=4.02; 95%CI=3.44–4.65) exceeded the expected percentages if these foods were consumed separately. When compared to subjects without or with only one unhealthy food habit, the combination of the four negative dietary behaviors was more frequent among women, workers with a lower education level, and those living without a partner. Conclusion Unhealthy food habits tend to cluster together in both sexes, suggesting a strong interaction, particularly for the four unhealthy food habits together, especially among women, less educated workers and without a partner.

ABSTRACT Objective We evaluated factors associated with protein consumption by the elderly. Methods We performed a cross-sectional study in a sample of 295 elderly consumers of health facilities in São Caetano do Sul, São Paulo, Brazil. Protein consumption data (g and g/kg) were obtained through 24-hour dietary recalls, which was reapplied in a 30% sub-sample to estimate habitual consumption, with an interval of two weeks. The association between protein consumption and sociodemographic, economic, health, and dietary variables was tested using multiple linear regression. Results There was a positive association between protein consumption (g and g/kg) and better Brazilian Healthy Eating Index-Revised, between protein consumption (g) and male sex, and a negative association between protein consumption (g/kg) and greater calf circumference. Higher average protein consumption (g or g/kg) was observed among married elderly, individuals with higher income and schooling, who were economically active, eutrophic, without dyslipidemia and symptoms of dysphagia, who consumed three main meals and an intermediate snack. Conclusion The results showed that protein consumption was associated with diet quality, sex, and calf circumference. The identification of elderly groups prone to protein inadequacy may direct individual and collective interventions to prevent muscle mass reduction and its implications, such as sarcopenia and other adverse outcomes.

ABSTRACT Objective To evaluate the protein quality and iron bioavailability of a fortifying mixture based on pork liver. Methods Determinations of protein efficiency ratio, net protein utilization, true digestibility and hemoglobin regeneration efficiency by depletion and repletion were performed. In the depletion phase, the animals (male Wistar rats) received an iron-free AIN–93G diet and in the repletion phase they received the following diets: standard AIN–93G diet, fortifying mixture and standard diet containing heptahydrated ferrous sulfate for comparison. Results For standard AIN–93G diet and fortifying mixture the results were 3.75 and 4.04 for protein efficiency ratio and 3.53 and 3.63 for net protein retention, showing that the presence of pork liver in the diet promoted an increase in protein efficiency ratio and net protein retention (not statistically significant). True digestibility results obtained with the fortifying mixture (97.16%) were higher than those obtained with the standard AIN–93G diet (casein), but without significant difference. The hemoglobin regeneration efficiency values obtained for standard AIN–93G diet, fortifying mixture and standard diet containing heptahydrated ferrous sulfate were 50.69, 31.96 and 29.96%, respectively, showing a statistically significant difference between the control (standard AIN–93G diet) and test (fortifying mixture and standard diet containing heptahydrated ferrous sulfate) samples, but not between the test samples. Conclusion The fortifying mixture showed a high protein efficiency ratio value of 4.04 and a high relative biological value (108%) and it can be added to soups, creams and meats in day-care centers for the prevention of iron-deficiency in children of school age.

ABSTRACT Objective To evaluate iron bioavailability of roots and cooked seeds of Lupinus rotundiflorus for human consumption using a low-iron-diet rat model. Methods A hemoglobin depletion–repletion test was performed using rats. A standard diet containing 8mg kg-1 of iron was used. Three experimental diets were prepared based on the standard diet: 2.3g of root flour added to D1, 21.5g cooked seed flour added to D2, and 0.03g of ferrous sulfate added to D3 (control diet), adjusting iron concentration of the diets to 24mg kg-1. Hemoglobin regeneration efficiency was used to measure iron bioavailability. Results Hemoglobin regeneration efficiency showed values of 13.80+2.49%, 13.70+1.60% and 18.38+1.56 in D1, D2 and D3 respectively, and biological relative values of 72.8, 75.08, and 100.00% (.<0.05). Conclusion Roots and cooked seeds of Lupinus rotundiflorus showed potential iron bioavailability, despite being a vegetal source, which could also encourage the study of other species of lupin as a source of iron.

ABSTRACT Objective To describe the profile and performance of nutritionists in Primary Health Care. Methods A cross-sectional study was carried out, and all nutritionists in two municipalities of Paraíba, Brazil, were interviewed. Information was collected through structured interviews on demographic characteristics, professional qualification, development of food and nutrition activities, knowledge and use of essential bibliography for the work in Primary Care. Results In one municipality there were 28 teams of the Family Health Strategy and in the other, nineteen teams. In all, nineteen nutritionists were interviewed, fourteen of whom were working in the health teams and five were working exclusively in the Family Health Support Centers. All but one were women and the majority were between 20 and 39 years; the majority (n=10) had no graduate training. Nutritionists from the basic health teams developed more public health nutrition actions, such as defining nutritional care protocols and vitamin A and iron supplementation than those from the Family Health Support Centers (11 versus 1; and 13 versus 1, respectively). About half were satisfied with work in general, and dissatisfaction was related to deficiencies in the availability and quality of anthropometric equipment, physical structure and material. Conclusion Nutritionists work in food and nutrition actions in collective health, emphasizing the importance of qualification and practices that better combine the programmatic agenda of this area with Primary Care.

ABSTRACT This narrative literature review aimed to analyze the results of studies on the food intake of university students. A literature search was conducted in July 2014 and updated in July 2016 in the Scopus, MedLine/PubMed, and SciELO databases, using descriptors related to university students and food intake in English and Portuguese. Overall, 37 studies that analyzed university students’ food intake were included in this review, eight of which were conducted in Brazil. The results demonstrated that most university students have unhealthy eating behaviors, such as high intake of fast foods, snacks, sweets, soft drinks, and alcoholic beverages, and low intake of fruits, vegetables, fish, whole grains, and legumes. Undergraduate students of health sciences, such as nursing, nutrition, and medicine, did not have healthier diets. University students’ food intake was characterized as unhealthy, regardless of undergraduate program or sex, especially among students who left the parents’ home and became responsible for their own food. Therefore, there is a need of developing public policies that promote healthy eating habits among students, such as interventions to change their eating habits and increase their access to healthy foods at the university environment.

ABSTRACT Objective To identify the main dietary patterns in type 2 diabetes patients and study their association with glycemic indexes. Methods This is a cross-sectional study carried out in a diabetes treatment reference institution located in the city of Fortaleza (CE). Two R24h were applied, as well as 12h fast blood glucose tests and anthropometric assessments in 188 diabetic patients. The principal components factor analysis method was applied together with a Varimax orthogonal rotation method to identify dietary patterns. The Poisson Regression and the Spearman coefficient were used to test the association with glycemic indexes. Results A hundred eighty eight diabetic patients were evaluated, of which 51.1% patients had decompensated glucose values. Five main dietary patterns were identified: traditional Brazilian, energy-dense, infusion and wholegrain cereal, sandwich and dairy, and healthy diets, which explained 37.2% of the total variance in intake. A negative correlation with glucose was found for the traditional Brazilian diet (p=0.018; r=-0.173). Conclusion Out of the five identified dietary patterns consumed by the type 2 diabetes patients studied, a higher adherence to the traditional Brazilian dietary patterns resulted in lower blood glucose levels.

ABSTRACT Objective To assess the eating behavior, food practices, nutritional and metabolic profiles of patients with schizophrenia undergoing treatment. Methods Cross-sectional exploratory descriptive qualitative study used a semi-structured questionnaire on the eating behavior, food practices, and perception of changes after the initiation of drug therapy and a quantitative method using anthropometric and body composition measurements, metabolic parameters, and 5-day dietary records to analyze nutrient ingestion of patients with schizophrenia in an outpatient clinic at a tertiary hospital (n=33). The qualitative data were analyzed and coded by three researchers and quantitative data were analyzed using descriptive exploratory statistics. Results The results of this study showed that schizophrenic patients presented high prevalence of excess weight (71.0%), metabolic syndrome (42.0%), dyslipidemia (62.0%), changes in appetite (76.0%), and increase in energy intake (74.2%), associated with important irregularities in eating behavior and food practices (such as irregularity of meals, emotional intake, high carbohydrate and fat intake, and low energy expenditure) and lifestyle (changes in social and work routines). Conclusion This eating profile may interact synergistically with psychotropic drugs to contribute to weight gain and metabolic changes in schizophrenia. Nutrition education may prevent and monitor the risk of metabolic and nutrition problems, irrespective of the medications used.

ABSTRACT Objective The goal of this study were to investigate the effects of continuous exercise with/or without the ingestion the Camu-camu pulp in a rat model of obesity. Methods Neonate male Wistar rats, receiving monosodium glutamate, subcutaneously were separated into foour groups: sedentary group S (no treatment), exercise group E (continuous swimming training), Camu-camu group C (25mL of pulp of Camu-camu/day) and exercise and Camu-camu group EC (25mL of pulp of Camu-camu/day, continuous swimming). After 12 weeks, the animals were received euthanasia. Results The exercise program was conducted for five days for 12 weeks and the effects of supplementation with or without Camu-camu in obese rats were analyzed, showing that the relative levels of the variables cholesterol, triglycerides, glucose, High Density Lipoprotein and Low Density Lipoprotein and in all groups there was a significant reduction (.<0.001), except for the control group. Body weight and feed intake, epididymal and visceral fat deposits were not significantly different between the means of groups C and E, but these groups showed a significant difference when compared to the EC group (.<0.001). Conclusion The results demonstrate the effectiveness of continuous exercise and diet supplemented with Camu-camu fruit pulp to control obesity.

ABSTRACT Objective To describe meal consumption habits and assess their associations with anthropometric indicators. Methods A cross-sectional study was performed on 1,749 elementary and high school students from public and private schools in the city of Rio de Janeiro, Brazil (mean age=15.3 years), who were selected for the baseline of the Longitudinal Study for Nutritional Assessment of Adolescents. Meal habits and meals consumed in the company of parents were assessed using a self-administered questionnaire. The consumption of the main meals was categorized as regular (daily) or irregular (≤6 times a week). The meal consumption profile was considered either satisfactory (breakfast, lunch, and dinner consumed on a daily basis) or unsatisfactory. Body Mass Index, waist-to-height ratio, and body fat percentage were calculated. The association between meal consumption habits and anthropometric indicators was estimated using multivariate logistic regression models, adjusted for age and sex and stratified according to the type of school. Results Regular lunch consumption was more frequent among private schools students, who also had higher frequency of eating dinner irregularly. Among students from private schools, the unsatisfactory meal consumption profile and irregular meal habits were associated with being overweight, having a high waist-to-height ratio, and increased body fat percentage. Among students from public schools, it was observed association between being overweight with irregular breakfast habits. Conclusion In adolescents, the association between meal habits and weight status may be modulated by socioeconomic condition.

ABSTRACT Objective To evaluate feeding styles of adolescent mothers and complementary feeding practices of their infants. Methods A cross-sectional study comparing a group of dyads of 50 adolescent mothers (ages 15 to 19) with 62 adult mothers (ages 24 to 44) and their infants (9 to 24 months) was performed. All mothers and infants were assisted by three basic health family units in the city of Recife, Brazil. Data were collected through a structured interview on socioeconomic conditions, maternal styles of feeding the child, and evaluation of infant feeding practices. The food styles were classified as responsive, authoritative, and passive, according to the adapted form of Carvalhaes, Perosa and Silveira of 2009. The frequency of food intake was calculated for six food groups (1. Bread and cereals; 2. Fruits and vegetables; 3. Meat, eggs, and beans; 4. Milk and dairy products; 5. Sugars, sweets, and fats; 6. Industrialized food). Children’s anthropometry and body mass index by age were classified into Z-score according to the World Health Organization Standard Curves, 2006. Results Adolescent mothers began complementary feeding more frequently before the seventh month (.=0,02), presented less responsive (.=0.04) and more authoritarian feeding styles (.=0.01), and their children received more foods with sugars, oils, and fats (.=0.02), and less meat, eggs, and beans (.=0.06) than the children of adult mothers. Conclusion Adolescent mothers adopt less responsive eating styles and offer more inadequate complementary feeding for their infants.

ABSTRACT Objective The high prevalence of obesity and its association with chronic diseases is a major public health problem. This study aimed to evaluate a group-based Food and Nutrition Education Program for the treatment of excess weight in Brazilian women attending the Family Health Strategy. Methods This quasi-experimental intervention study was conducted among 172 women, including 87 women in the intervention group who participated in a nutritional education program that addressed topics in the area of nutrition. The Intervention and Control groups underwent an anthropometric evaluation at the beginning of the study and at the 6th month. Results At the end of the intervention, the intervention group showed a significant reduction in weight and Body Mass Index, while the control group showed an increase in these variables. Women who completed the intervention (n=71) showed a mean difference of -5.15 kg and a reduction of 2.04 points in the Body Mass Index. Still 50.7% of the participants in the intervention group achieved a weight loss greater than or equal to 5.0%, and 40.8% of them maintained this reduced weight for up to seven months after the end of the intervention. Conclusion This study emphasizes the importance of group-based food and nutritional education interventions to promote and maintain weight loss, and thus, prevent and treat chronic diseases.

ABSTRACT Objective This study aimed to understand the role of health professionals in educational groups that have food and nutrition as their theme. Methods Qualitative research was conducted in the city of São Paulo, with professionals from the Family Health Strategy. Interviews were conducted to understand the professionals’ perceptions of the roles played in groups. These were analyzed using the Discourse of the Collective Subject technique. The groups’ observations on the performance of the professionals in their mediations were analyzed, based on the following items: meeting organization, communication, support, participation, confirmation of messages, and encouragement to ask questions. Results Twenty-two professionals from different backgrounds were interviewed, and 23 groups of different configurations were observed. The speeches showed that the professionals recognize themselves as organizers, mediators, and evaluators of the groups. Under the topic of organization, teamwork was highlighted. In mediation, there was an assumption of different types of performance that are inserted in conceptions of banking education and dialogical education. In the theme of evaluation, conflict and contradiction arose, pointing out the complexity of approaching a group theme when professionals seek a more horizontal posture with users. Observation of the groups revealed a duality between discourse and professional practice, which is surrounded by contradictions inserted into academic formation and the work process of the teams. Conclusion It was possible to understand the complexity of the practice of professionals when approaching the theme in groups, evidencing the need for spaces of care and for permanent education, especially when regarding professionals who use problematic and active approaches.

ABSTRACT Objective The study aimed to shed light on the use of the terms “homemade”, “traditional”, and other similar terms in the front-of-pack labels of industrialized foods. Methods Labels of all packaged foods products (n=5,506) available for sale in a Brazilian supermarket were analyzed. The analysis verified the relative and absolute frequency of terms according to the similarity of expressions and semantics by food groups according to Brazilian regulation (nº 359/2003). A chi-square test identified differences in the total food terms with terms between food groups (.<0.001). Results Of all foods analyzed, 14.1% (n=778) presented the target terms. On the analyzed labels, the age of the brand or product was found more frequently (58.1%, n=495), followed by the terms “traditional” (20.1%, n=175) and “original” (11.0%, n=94). The groups that presented the highest relative frequency were groups I (baking goods) and II (canned vegetables), both with 21.4%. Conclusion The study confirmed the commercialization of packaged foods with terms that refer to a traditional and homemade production with different connotations. The information contained in the labels should be clear and correct to ensure that the consumer can make informed choices. The findings indicate the importance of investigating consumers’ perception of the presence of these terms on labels and clarifying the composition of these foods.

ABSTRACT The present systematic review aimed to synthesize the findings of studies in the literature on the educational training of nutritionists in Public Health. The study was conducted by searching international databases (PubMed, Science Direct, Lilacs, PsycINFO, Scopus, and Web of Science), as well as in the gray literature. The steps of systematic search followed the recommendations of the Preferred Reporing Itens for Systematic Reviews and Meta-Analysis. Eligibility criteria included studies on the Public Health training in Nutrition Undergraduate courses, whose subjects were students, educators, and professionals who practice in the field of Nutrition. A total of 633 articles were identified, of which, 66 were eligible for reading and analysis of the full text and 12 were included in the systematic review. Of these, five of these 12 articles used quantitative methods, 3 used mixed methods, and 4 used exclusively qualitative methods. There was high heterogeneity among the studies, such as different samples, subjects, and evaluation methods. The studies included were carried out from 2008 to 2017 in 28 different countries, including Brazil, Canada, Vietnam, and some European countries. In most of these articles, Public Health was one of the main areas in the formal education of nutritionists, with predominant traditional teaching approach, with a biological focus and a fragmented curricular structure. The included studies were evaluated with low risk of bias. In spite of the limitations identified in the professional training of nutritionists, there was a clear emphasis on the importance of the relationship between theory and practice, teaching-research-extension approaches, and practical activities or internships in Public Health, which can promote the development of skills and competencies that can exert an impact on their professional performance.

ABSTRACT This paper aimed to conduct a literature review about the concept of cooking skills to contribute to the scientific debate about the subject. A systematic search was performed in the Scopus, PubMed/MedLine and Web of Science databases as well as the periodicals of the Federal Agency for Support and Evaluation of Graduate Education in Brazil Coordenação de Aperfeiçoamento de Pessoal de Nível Superior website, using the following Portuguese and English keywords: cooking skills, cooking and food/meal preparation. We also consulted references cited by these papers, electronic dictionaries (in Portuguese, English and French), technical documents found on public and private institutional websites, as well as books. Basic, etymological/vernacular and systematic definitions for cooking were identified, including historical global and national contexts. To conceptualize cooking skills, categories related to food and individuals were established, purposing a conceptual model. The category related to food referred to the use of unprocessed/minimal processed foods (which require procedures prior to their preparation), and/or processed/ultra-processed foods (which need a little or no preparation, such as re-heating). The category related to individuals involved dimensions such as confidence, attitudes, behavior, and individual knowledge used to prepare foods. The historical definitions of cooking allowed us to clarify the concept of cooking skills. Considering the global context of valuing and recovering cooking for the promotion of healthy eating, this review can contribute to the scientific discussion about the concept of cooking skills. The purposed conceptual model enables parameters to be established for further investigations, allowing cooking interventions to be directed toward promoting healthy eating.

ABSTRACT Objective To compare the effects of fermented kefir on the nutritional, physiological, and biochemical parameters of rats. Methods Grains of milk kefir (whole and skimmed) and water kefir (brown sugar) were used. The chemical composition analysis was performed on substrates and fermented beverages. The rats were evaluated for weight gain, body mass index, as well as their food, water, kefir, and calorie intake. We also evaluated their energy efficiency coefficient, weight of organs, in addition to their serum, and hepatic biochemistry. Results Fermentation increased the acid content index owing to degradation of lactose and brown sugar. The animals consumed more kefir, reducing the intake of chow and water. Kefir did not alter body and organ weight, while improving the lipid profile. Conclusion Water kefir with brown sugar was more effective in improving the lipid profile.

ABSTRACT Objective To evaluate the prescription of protein-calorie nutrition and its adequacy to the requirements of preterm newborns. Methods Prospective study with 30 preterm infants from a neonate intensive unit care. Anthropometric and nutritional therapy data were collected daily. Nutritional demands were defined according to the national guidelines. Protein-calorie nutritional support was considered adequate when it reached 70% of the calculated demand. The evolution of nutritional status was evaluated according to the growth curves of preterm infants. Statistical analyses were performed with the Statistical Package for Social Sciences 20.0, at a 5% significance level. Results The means of demand, prescription and infusion significantly differed from each other. The values of calories and proteins prescribed and infused were inadequate according to the calculated ones. There was no significant difference between the volume of prescribed and administered nutrition (p>0.05). At birth, 30% of the children were small, 66.7% were adequate, and 3.3% were large for gestational age. At discharge, the percentages were 33.3%; 63.3%; 3.3%, respectively. The values at birth significantly differed from those at discharge (p<0.01). Conclusion In the Unit of Neonatal Care studied, inadequate nutrient prescription and support is a factor that can compromise the nutritional status of the newborns at hospital discharge.

ABSTRACT Objective This study aims to evaluate the prevalence, temporal trends and associated factors with excess weight in mothers of children under five years of age. Methods This is a time-series study using data from two household surveys conducted in 2005 and 2015. A total of 1,436 mothers were evaluated in 2005, and 690 were evaluated in 2015. The dependent variables were excess body weight (Body Mass Index [BMI] ≥25.0kg/m2), high percentage of Body Fat (%BF ≥33%) and abdominal obesity (waist circumference >80cm). The independent variables were the socioeconomic and demographic factors. The changes that occurred between the two surveys were expressed in percentages, and the measure of association was the Prevalence Ratio, calculated by Poisson regression, in both the crude and multivariate analyses. Results There were increases of 33.2%, 59.2% and 31.0%, respectively, for the prevalence of excess weight (PR=1.33, 95% Confidence Interval [CI]:1.21-1.46), abdominal obesity (PR=1.59, 95% CI:1.43-1.77) and high %BF (PR=1.31, 95% CI:1.07-1.60). The factors independently associated with excess weight and abdominal obesity were the highest age group (>30 years), menarche ≤12 years and higher parity (>2 children). The same was observed for high %BF, except for the loss of significance in the adjusted analysis for the variable menarche ≤12 years. Conclusion The prevalence of high body adiposity is a problem of relevant importance in the studied population and has presented an upward trend in the last 10 years. Women over 30 years and with more than two children should be given priority in prevention and control.

ABSTRACT Objective Assess the correlation between classification of nutritional status of schoolchildren and the perception of their guardians. Methods A cross-sectional study with children aged 6-10 years from a public school in the South of Brazil. Weight and height of the schoolchildren were collected, and the guardians answered a questionnaire containing the range of silhouettes of Brazilian children. The perception through the scale of silhouettes was compared with the actual nutritional status. Kappa coefficient was used to check the consistency of actual and perceived perception. The prevalence ratio was calculated between perceived overweight and well-nourished children. Results A total of 236 guardians of schoolchildren were interviewed. The level of agreement between the nutritional status assessment of actual and perceived perception was weak (Kappa=0.32, p<0.001). As for the perception of nutritional status, 50.8% of the guardians scored the nutritional rating their children correctly, of which 42.0% of these children were overweight and 60.2% were well-nourished, p<0.05. The prevalence of guardians who underestimated the classification of the nutritional status was 21.6%, and underestimation of overweight children was 1.8 times greater than of well-nourished children. The overestimation of the nutritional status was 27.5%. The most prevalent nutritional status was well-nourished, followed by overweight. Conclusion The study showed that guardians do not have the correct perception of the nutritional status of the schoolchildren. Public interventions for health education must be conducted to reduce erroneous perceptions.