RCAAP Repository

ABSTRACT Objective To carry out an analysis of postgraduate education in Nutrition in Brazil in the period 2009-2018, including distance learning. Methods The article presents a historical-documentary analysis of the trajectory of Nutrition courses from 2009 to 2018. The bibliographic survey was carried out in the electronic databases of the Scientific Electronic Library Online, the National Library of Medicine, Google Academic databases, and through data collection in government websites and other institutions. Results In December 2018, there were 709 face-to-face and 1,094 distance learning Undergraduate Courses in Nutrition in the country. In the period, there was a 181.5% increase in the number of face-to-face courses, being 195.1% in the private sector, responsible for 89.1% of the total courses in the country. The highest concentration identified was in the Southeast Region did not change substantively in the period. Conclusion With 1,803 undergraduate courses in Nutrition in Brazil, of which the majority is composed of distance learning courses, the current scenario may be the most dramatic in the history of nutrition education in Brazil. Care must be taken to ensure that it is consistent, marked by opportunities for learning in society, in which the student can develop an investigative, critical, innovative spirit, having their professional identities clear in a multidisciplinary work team. The expansion of the offer of undergraduate courses in Nutrition did not correct regional asymmetries.

ABSTRACT This essay aims to present some considerations on the development of research and teaching skills, intellectual production, and current situation of stricto sensu postgraduate programs in Food and Nutrition, particularly of professional and academic master’s and doctoral programs currently classified in the evaluation category Nutrition by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior. The elements of evaluation procedures are discussed, as are the scores given to the programs in the most recent Coordenação de Aperfeiçoamento de Pessoal de Nível Superior report. There was a marked increase in the participation of Food and Nutrition postgraduate programs in the national context. Many challenges still need to be overcome, such as the offer of Nutrition postgraduate programs in the Northeast region and outside the capital cities of the country. Evaluation criteria and procedures need to be better developed to consider the main characteristic of the scientific field of Food and Nutrition, its multiplicity of disciplines.

ABSTRACT Objective To evaluate the association between sugar-sweetened beverages consumption and dietary quality in adolescents, adults, and older adults living in São Paulo, Brazil. Methods Data were drawn from a cross-sectional population-based study conducted in 2008 in a representative urban city sample involving 1494 consumers of sugar-sweetened beverages. Dietary intake was evaluated through two 24-Hour Dietary Recalls, and the usual sugar-sweetened beverages consumption was estimated using the Multiple Source Method. Dietary quality was evaluated using the Brazilian Healthy Eating Index – Revised. The association between total score of the revised index and components with sugar-sweetened beverages consumption tertiles was assessed using multiple linear regression models for each age group, considering the sample design. Results Regardless of age group, the increase of sugar-sweetened beverages consumption was associated with a decrease in the total Healthy Eating Index – Revised score and in the components “total fruit”; “whole fruit”; “meat, eggs and legumes”, and the “solid fat, alcohol and added sugar”. Conclusion The results of our study suggest that higher sugar-sweetened beverages consumption was associated with poorer dietary quality. Planning public health policies aimed at decreasing sugar-sweetened beverages consumption is essential to increase dietary quality and reduce the incidence of noncommunicable diseases.

ABSTRACT Objective In the biome of the Brazilian Cerrado, there are a lot of fruit tree species that stand out for their sensory quality and for presenting potentialities in the market of pulp and almond. Among these species, the pequi deserves attention because it has an almond rich in proteins and that is little explored. The aim of this study was to evaluate the biological quality of defatted pequi seed flour supplemented with lysine. Methods Two designs were done in this study; in the first, the animals were divided into four diet groups: control, protein-free, defatted pequi seed flour and defatted pequi seed flour supplemented with lysine. The protein-free diet was exempt of proteins and the other diets had a protein content of 10% and differed in protein source (casein: control diet or defatted pequi seed flour: test diets). The experiment lasted for 14 days. In the second design, 36 animals were used and followed-up for 28 days. The division of the experimental groups was kept, except for the protein-free diet group, which was excluded. By the end of the test, the animals were anaesthetised and euthanized. Results The results showed that the protein efficiency ratio of the control group was significantly higher than the other groups. For the other indices, the groups that received defatted pequi seed flour did not differ statistically among themselves. Conclusion These findings have shown an effect of supplementation on the protein efficiency ratio when comparing the test diets, however, when compared to the control group, no improvement was found.

ABSTRACT Objective To evaluate the job satisfaction of nutritionists who work in food service in the state of Paraná (Brazil). Methods A survey was carried out with 249 nutritionists through a semi-structured online questionnaire, which assessed their profile, professional activities, and job satisfaction. The Mann-Whitney and Kruskal-Wallis tests and the ordinal logistic regression at a 5% significance level were applied to evaluate the differences and relationship between job satisfaction and the independent variables. Results The average age of the survey participants was 31.9±6.4 years, the majority was female (95.58%), and graduated between 2000 and 2016 (90.36%). The survey revealed that 55.41% of the nutritionists were satisfied at work, 33.68% were indifferent, 6.86% were highly satisfied, and 4.04% were dissatisfied. The variables that influenced job satisfaction the most were age, years of training, income, and workdays in the week. Income explained satisfaction positively. There was statistical difference in relation to the satisfaction of participants regarding their knowledge on food service (p=0.0350), completion of postgraduate courses (p=0.0082), and interest in working in an area of nutrition other than food service (p<0.0001). Conclusion Although most professionals are satisfied, many were indifferent to job satisfaction, which may reflect a low perspective on their current job or poor experience in the food service. These results suggest the need for further actions aiming at raising nutritionists’ perceived professional importance.

ABSTRACT Objective To analyze quantitatively the diets available on blogs and websites. Methods The following 15 diets were analyzed: low-carb diet, gluten-free diet and intermittent fasting diet using the Virtual Nutri software program. The nutrients analyzed were as follows: carbohydrates, fibers, proteins, lipids, iodine, sodium, calcium, magnesium, iron, zinc, manganese, phosphorus, selenium, vitamins A, C, B6, B12, D, niacin, and folate. The nutrient values were compared with the Dietary Reference Intake recommendation for adults between the ages of 19-50 years. The macronutrient adequacy percentage was based on a 2000-kcal diet for a healthy life, as recommended by the World Health Organization. Results It was observed that most of the composition of macro and micronutrients was lower than the one established by the World Health Organization and the Dietary Reference Intake recommendation for adults between the ages of 19-50 years. Conclusion Long-term dieting can be a risk factor for several deficiency diseases and may endanger the health of individuals.

ABSTRACT Objective This study aimed at knowing and analyzing sociocultural meanings of the daily dietary practices revealed by a university community, in the context of a wellness program to their community and its surroundings. Methods The research team ran 28 workshops with the participation of 34 university units and 558 subjects in total. All workshops were recorded and transcribed verbatim. Content analysis was performed with the identification of emerging themes and categories. Results From the analysis of this material four categories emerged. There is the desire caused by the pleasure of having meals in a group of people and consuming foods rich in fat and sugar, but with its consumption shrouded by guilt. Healthy foods were considered important but related to obligation and displeasure. The community also wants to consume healthy foods daily in the academic environment, however, pointed out barriers such as an increasing pace of work and lack of time. Conclusion It was possible to identify barriers and desires related to food practices in the daily life of the university. This study demonstrated that changing the eating behavior of an academic community is a major challenge for wellness programs, even for an institution that produces and disseminates scientific knowledge.

Abstract Objective Describe the development and the reliability assessment of an index that evaluates the confidence in performing cooking skills considered relevant in Brazil. Methods The development of the Cooking Skills Index was based on the self-efficacy beliefs and its theoretical reference was the Dietary Guidelines for the Brazilian Population. It measures, from zero to 100, the degree of confidence in performing ten cooking skills considered as facilitators for the implementation of Brazilian Dietary Guidelines recommendations. Experts (face validity) evaluated the index. A pilot study (n=10) and a test-retest (n=51) was conducted by telephone interviews and computerized assistance with adults responsible for food preparation at home in São Paulo. Reliability was assessed by Cronbach’s alpha, quadratic weighted kappa and prevalence and bias adjusted kappa. Results The Cooking Skills Index was coherent with the adopted theoretical framework according to the experts. It was fast and easy to apply to the participants. It showed a good internal consistency (Cronbach’s alpha >0.70) and an acceptable to excellent reproducibility (weighted kappa=0.55, adjusted kappa=0.89). Conclusion The Cooking Skills Index has a good reliability and is therefore recommended to evaluate cooking skills confidence in Brazilian studies developed in contexts similar to those of this study.

Abstract Objective The objective was to analyze the occurrence and the associated factors with food insecurity and overweight among government-backed economy restaurant workers in one of the biggest cities in Brazil. Methods A sample comprised of 180 individuals and represented 76.0% of all economy restaurant workers in the city of Belo Horizonte. Food insecurity was identified through the Brazilian Food Security Scale, and excess weight was identified by the body mass index. Data collection included sociodemographic and occupational information, and also health and quality of life perception. Logistic regression models were applied to identify the association. Results Food insecurity and overweight prevalence levels were 24.0% and 66.7%, respectively. The odds of identifying food insecurity were 2.34 times higher among workers that perceived their quality of life to be regular/poor/very poor and 62.0% and 74.0% lower among workers from the 2nd and 3rd tertile of per capita income, respectively. Individuals ≥40 years old (Odds Ratio=2.69, Confidence Interval 95%:1.33-5.43) and food handlers (Odds Ratio=3.62, Confidence Interval 95%:1.68-7.81) had higher odds of being classified as overweight compared to reference categories. Workers with higher per capita income presented lower odds of being classified as overweight (Odds Ratio=0.40, Confidence Interval 95%:0.17-0,96). Conclusion It was evidenced an occurrence of overweight among government-backed economy restaurant workers, which was associated with age, income and job position. Food insecurity prevalence was associated with income and quality of life perception. Although the sample work in a food and nutritional security promotion program, it is necessary to recommend actions aimed at the promotion of healthy eating habits.

ABSTRACT Objective The objective was to analyze the interactions between food and identity by exploring the daily food eaten by a rural community. Under the gift theory view, the aim is to present readings concerning a rural identity that the research participants constituted through eating; this aim is premised on the assumption that analyzing the relationship between the identity of a group and eating becomes important because of the marked influence that belonging to a collective has in food. Methods An ethnographic approach was used including participant observation, field diary annotations, and interviews with 21 interlocutors. Results The activity of eating produced at least two categories that characterized rural identity: one marked by the stigma of the past, and the other by values that, above all, denote a reaction to stigma; a reaction to stigma is linked to the work that also sustains the honor of a family, the consumption of food/goods common in the city, inclusion in a larger society, and commitment to the collective. Conclusion Eating, in addition to the biological and individual, can also be apprehended as a complex and revealing sociocultural phenomenon, including ways of belonging to a group. With food a marked rural identity appears, mainly through reactions to stigmata.

ABSTRACT Objective We aimed to establish equations for dimensioning of the physical area and determining the required number of food handlers in food services of schools and to compare them with reference equations. Methods It was visited 44 municipalities located in the states of São Paulo (n=36) and Rio de Janeiro (n=8) between 2013 and 2014. The physical area for school food services was evaluated using a measuring tape. For all food services, we calculated the Maximum Attendance Capacity, which is the sum of small and large meals served during the busiest shift. A validated checklist was used to evaluate food safety practices. Linear regression models were developed to establish the proposed equations. Results In total, we evaluated 205 school units. Based on the data, the following equations were established: Equation A: area of production=15.22+(maximum attendance capacity×0.02), which estimates the minimum area needed for a school food service; and Equation B: the number of food handlers=2.17+(maximum attendance capacity×0.002), to determine the minimum number of food handlers needed. These equations were established based on school food services that presented adequate food safety practices (i.e., low health risk). Conclusion It was established new equations for calculating the size of the physical area for school food services and the required number of food handlers. These new equations can be used as a starting point in management planning of a school food service.

ABSTRACT Objective The aim of this study was to analyze the effects of carbohydrate ingestion prior to exercise on the number of bench press repetitions. Methods Eight male physically active (21.3±2.7 years, 176±5cm, 73.12±6.12kg), with a minimum experience of at least one year exercising regularly, visited the laboratory at three moments. During the first visit, candidates went through their anthropometric evaluation and the application of their maximum number of bench press repetitions. The experimental tests were performed during their second and third visits in a crossover and blind study. The participants performed the maximum number of repetitions with an intensity of 70% of their maximum repetition strength. One hour before the experimental trials, participants randomly ingested a solution containing either carbohydrate or a placebo. Results The ingestion of carbohydrate increases muscle resistance in relation to placebo (p=0.014; effect size=0.71). This is evidenced by the increase in the number of repetitions (12.9±2.4 and 11.3±1.9, respectively). The individual’s perception of effort is higher in the carbohydrate group than in the placebo group after exhaustion (4±0.93 and 3.1±0.64, respectively, p=0.006, effect size=0.89). Conclusion It is concluded that a previous intake of carbohydrate is useful in improving performance in resistance exercises, providing an increase in the individual’s perception of effort.

ABSTRACT Objective To analyze potential Drug-Food Interactions identified in prescriptions of patients admitted to the Cardiology Unit of a university hospital. Methods This is a descriptive, cross-sectional quantitative study carried out in the Cardiology Unit of a university hospital in the city of Rio de Janeiro, Brazil. Data collection took place in archived medical records of hospitalized patients between August and September, 2016. Results In each prescription, there were on average 7.5 drugs mentioned (Standard Deviation of 2.1). Most were tablets (93%) and antihypertensive drugs (40%). Two hundred and fifty two potential Drug-Food Interactions were identified. Acetylsalicylic acid and omeprazole were the most potentially interactive drugs. Conclusion Drug-Food Interactions occur with commonly used drugs, for example omeprazole and acetylsalicylic acid. However, health teams do not know or identify a substantial part of interactions. This factor leads to an exposure to risks related to changes in drug response and patient safety.

ABSTRACT Objective To evaluate and associate the frequency of consumption of five daily servings of fruits and vegetables with socioeconomic and demographic factors of students in the city of Santa Cruz do Sul, Brazil. Methods A cross-sectional study with a sample stratified by clusters of 1,578 students aged 7 to 17 in the city of Santa Cruz do Sul (Rio Grande do Sul state), Brazil. Volunteers were asked whether they consumed five daily servings of fruits and vegetables. This consumption was classified as irregular or regular. Data regarding gender, age, socioeconomic status, domicile area, and information on the nutritional status of students were also collected. The prevalence ratio was calculated with a significance level of p<0.05. Results The consumption of at least five servings of fruits and vegetables per day was reported by 40.6% of students. The irregular consumption of fruits and vegetables was higher among students aged 10-12 (69.7%, p<0.001), boys (60.9%, p<0.001), and urban area residents (61.8%, p<0.001). There were no significant differences between the consumption of fruits and vegetables and the students’ socioeconomic status (p=0.094), nor with their nutritional status (p=0.999). Conclusion The students presented an irregular consumption of fruits and vegetables in relation to the recommendations of five servings per day. However, age and domicile area, which were significantly associated with the consumption of fruits and vegetables, were not associated with their socioeconomic and nutritional status.

ABSTRACT Objective To evaluate the relationship between ultra-processed food consumption and obesity indicators in adolescents. Methods Cross-sectional study with a convenience sample of 200 10- to 18-year-old adolescents from Campinas, São Paulo (SP). Usual dietary intake was determined through a semiquantitative food frequency questionnaire. Daily intake of each food was obtained from the intake frequency. Subsequently, foods were classified as raw and minimally processed, cooking ingredients or ultra-processed foods, and their caloric contribution to the total energy value was calculated. Sociodemographic and anthropometric variables were also investigated. Overweight was defined as Z-score>+1 and obesity was defined as Z-score>+2 according to the Body Mass Index per age group. The associations were tested by chi-square test and linear trend. Results The frequency of obesity was 47.0%, and 21.5% presented increased waist circumference. The average energy intake was 4,176kcal/day, of which 50.6% was derived from ultra-processed foods. The categories with the highest caloric contributions among ultra-processed foods were industrial loaves/cakes (16.2%), sweets and candy (6.2%), pastas (6.0%) and sweetened drinks (5.1%). No association was found between ultra-processed food consumption and anthropometric indicators. Conclusion The significant contribution of ultra-processed foods to daily calories is evidence of a poor diet of this population of young people, although this has not been shown as a factor associated with excess weight. Therefore, there is an urgent need for public policies that discourage the consumption of these products and encourage the return to a traditional diet.

ABSTRACT Objective To describe and analyze the implementation aspects of the purchase of food from family farms, according to the management of the School Feeding Program and characteristics of municipalities in the state of São Paulo. Methods A cross-sectional descriptive-analytical study, including 25 municipalities from São Paulo that purchased from family farms for school feeding, where 105 schools were drawn, in 2013, to verify: knowledge of the Law No.11,947/2009, disclosure of the purchasing process, guidance on the management of food, kitchen improvements, variety of food purchased and the use ≤30% of the Program’s resources with family farming. Absolute and relative frequencies were analyzed, and Chi-square test and Fisher’s exact test were performed (p<0.05). Results The knowledge of Law No.11,947/2009 predominated in centralized management (p=0.010) and the disclosure of the purchasing process in school/mixed management (p=0.010); all municipalities of school/mixed management used ?30% of resources (p=0.015). The disclosure of the purchasing process was more frequent in municipalities with fewer students (p=0.038) and lower Gross Domestic Product (p=0.020); guidance on food management was more frequent in smaller municipalities (p=0.011), with fewer public schools (p=0.040) and lower Gross Domestic Product (p=0.003); the variety of foods was more frequent in smaller municipalities (p=0.027), with fewer students (p=0.025), smaller area (p=0.025) and medium Human Development Index (p=0.001). Conclusion The management of the School Feeding Program and municipal factors can influence the implementation of the purchase of food from family farms.

ABSTRACT Objective This study aimed to compare dietary intake estimates using two different methodological approaches: use of new portions obtained with the 24-Hour Diet Recall, which was applied in the current study population, and the application of calibration equations, which were estimated using the same 24h-recalls. Methods Calibration equations were estimated using linear regression. The medians and confidence intervals of energy and nutrient intakes were assessed using all the approaches. The U Mann Whitney test was applied to verify differences among dietary intakes obtained with the 24 Hour Recall and Food Frequency Questionnaire-based methods. The correlation between different measures was assessed with Spearman coefficient. Weighted Kappa was used to verify the capability of the Food Frequency Questionnaire -based methods to classify individuals in the same intake levels of the 24 Hour Recall. Results Nine of the eleven components that were analyzed using the Food Frequency Questionnaire with standard portions and calibrated had medians significantly different from those obtained using the 24 Hour Recall; only the measurements of vitamin E and energy were statistically equal. For the Food Frequency Questionnaire with 24 Hour Recall portions, only the medians of vitamin D and B12 did not significantly differ from the 24 Hour Recall medians. Finally, for the Food Frequency Questionnaire with 24 Hour Recall portions and calibrated, all components, except folate and iron, had medians statistically equal to those obtained using the 24 Hour Recall. Spearman correlation coefficients were higher for the Food Frequency Questionnaire with 24 Hour Recall portions calibrated for all the assessed components, and the values ranged from 0.27 (total fat) to 0.57 (iron). Higher Kappa correlation coefficients were found for the Food Frequency Questionnaire 24 Hour Recall portions calibrated. Conclusion Calibrated FFQ with portions estimated from the own target population obtained better estimates of dietary intake, with values considerably more similar to those obtained with the reference method.

ABSTRACT Objective To analyze the relationship between the maternal attitudes, beliefs and practices and the children’s food consumption and nutritional status. Methods A cross-sectional study of 563 mother-child pairs. Mothers answered an online questionnaire that collected the following information: sociodemographic data, maternal nutritional status, the child’s food consumption (evaluated through the Food Frequency Questionnaire and the School Child Diet Index), and maternal attitudes, beliefs and practices about the schoolchildren’s eating (assessed through the Child Feeding Questionnaire). Children had their anthropometric measurements evaluated for the interpretation of the nutritional status. Results Mothers who considered their children to be bigger (ORaj=6.60) and who worried more about their children’s weight (ORaj=3.47) presented greater chances of having overweight children. Mothers with a greater perception of responsibility (ORaj=0.57) and who put more pressure in their children to eat (ORaj=0.38) presented lower chances of having overweight children. The majority of children consumed high-quality food (77.4%). Mothers who more closely monitored their children’s food consumption were 2.79 times more likely to have their children eating high-quality food. Conclusion Nutritional interventions should focus on stimulating the parents’ sense of responsibility for the child’s nutrition, as well as on promoting the frequent monitoring of the child’s food intake.

ABSTRACT Objective The objective of this study was to evaluate the situation of food and nutritional (in)security in families of farmers who supply the National School Feeding Program. Methods It is a cross-sectional study with 27 families of farmers (n=91). The socioeconomic, anthropometric, biochemical, food availability and perception of food insecurity indicators of the Brazilian Food Insecurity Scale, as well as the time of supply and annual income originating from the program, were evaluated. Results Food insecurity, as measured by the scale, was present in 25.9% (n=7) of the families. Food insecurity was associated with socioeconomic factors such as per capita income, the presence of children at home and the number of residents. Food and nutritional insecurity caused by a low caloric availability (<2500kcal/day) occurred in 11.0% (n=3) of the families. Presence of dystrophies such as overweight, low weight and short stature individuals occurred in 89.0% (n=24) of the families. Conclusion The study reinforces the existence of variables associated with food insecurity. Social and nutritional factors should be monitored, worked on, and improved in order to achieve food and nutritional security.

ABSTRACT Objective To determine the effect of nutritional habits on kidney stone formation and recurrence. Methods This study was conducted on 44 healthy individuals and 44 patients diagnosed with nephrolithiasis and aging between 20 and 65 years. Participants shared their salt consumption habits, daily fluid consumption amounts and general information about themselves in a questionnaire form. In addition, food and beverage consumption frequencies of participants were recorded through a food frequency questionnaire. Results Salt consumption frequencies of patients are higher than that of healthy individuals in both genders (p<0.05). It was found out that male individuals in the patient group salt dishes without tasting more frequently (p<0.05). Daily total water consumption of both genders in patient group is lower than that of healthy individuals (p<0.05). Meat consumption of male patients (51.6±31.35g/day) was found to be higher than that of healthy group (34.1±22.58g/day) (p<0.05). Additionally, individuals in the patient group consume less stinging nettle, corn, plum, loquat, orange juice and lemonade than healthy individuals (p<0.05). Conclusion Results of the study showed that total fluid intake, salt consumption habits, and vegetable, fruit and beverage consumption may be correlated with stone formation risk and nutrition habits may affect stone recurrence.