Effect of School-Based Food and Nutrition Education Interventions on the Food Consumption of Adolescents: A Systematic Review and Meta-Analysis.

The school is a favorable environment for the development of interventions to prevent obesity. The objective of this systematic review is to evaluate the effects of school-based food and nutrition education interventions on adolescent food consumption. The literature search was conducted on databases: MEDLINE/PubMed, Embase, Scopus, ERIC, Science Direct, Web of Science, Cochrane, LILACS, and ADOLEC. The following research strategies were focused on: population (adolescents), intervention (food and nutrition education), outcome (food consumption), and study design (clinical trial). The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement guidelines were followed and all stages of this review were performed by two researchers and, when necessary, a third researcher resolved discrepancies. Included studies are randomized clinical trials (RCT). A total of 24 articles were included for review and 11 articles in meta-analysis. In the evaluation of the general effects, there was a significant effect (mean difference (MD) for fruit consumption (MD = 0.09, CI 0.05, 0.14) in serving/day; and for vegetables (MD = 0.59, IC 0.15, 1.03) at times/week. In the consumption of FV (fruits and vegetables), there was no significant effect (standardized mean difference (SMD) of interventions in their consumption (SMD = 0.00, 95% C1 -0.11, 0.11). The evidence available in this review and meta-analysis concludes that food and nutrition education interventions in schools presented favorable results in the food consumption of adolescents. Registered on the PROSPERO database (CRD42019116520).

Desafios do profissional de educação física nos Núcleos Ampliados de Saúde da Família e Atenção Básica: uma revisão sistemática da literatura brasileira / Challenges of the physical education professional in the Extended Centers for Family Health and Primary Care: a systematic review of Brazilian literature

Resumo Introdução A inserção dos profissionais de educação física na atenção básica tem relevância devido aos trabalhos relacionados à promoção da saúde, porém alguns desafios são apresentados na literatura como barreiras para a atuação profissional. Objetivo Revisar na literatura os desafios encontrados por profissionais de educação física que atuam nos Núcleos Ampliados de Saúde da Família e Atenção Básica (NASF-AB). Método Uma busca utilizando os termos "educação física" e "Núcleo de Apoio à Saúde da Família" foi realizada na base de dados LILACS e no portal SciELO. Os critérios de inclusão foram: ser artigo original, estar publicado no idioma português, ter sido publicado a partir do ano de 2008 e ter avaliado a atuação de profissionais de educação física no NASF-AB. Resultados Dos 45 estudos encontrados na busca inicial, seis atenderam os critérios de inclusão. Além desses, outros dois artigos foram identificados nas referências, resultando em oito artigos incluídos na revisão. Entre os vários desafios relatados, os mais frequentes encontrados nos estudos foram a falta de infraestrutura física e material, a distância entre a formação acadêmica e a área de saúde coletiva e a instabilidade profissional. Conclusão Embora alguns desafios relatados não dependam apenas do profissional de educação física para serem resolvidos, os achados dessa revisão fornecem importantes informações para que futuros profissionais que desejam atuar no NASF-AB possam se preparar de forma mais objetiva e consigam realizar um trabalho com eficiência e qualidade.

Abstract Background The inclusion of physical education professionals in primary care is relevant due to work related to health promotion, but some challenges are presented in the literature as barriers to professional performance. Objective This study aimed to review in the literature the challenges faced by physical education professionals who work in the extended centers for family health and primary care (NASF-AB). Method A search using the terms "physical education" and "family health support centers" was performed in the LILACS and SciELO databases. The inclusion criteria were: be an original article, be published in the Portuguese language, be published from 2008 onwards, and have assessed the role of physical education professionals in the NASF-AB. Results From 45 studies identified in the initial search, six met the inclusion criteria. In addition to these, two other articles were identified in the references, resulting in eight articles included in the review. Among the several challenges reported, the most frequent ones in the different studies were the lack of physical and material infrastructure, the distance between academic formation and the collective health area, and also professional instability. Conclusion Although some of the challenges reported do not depend solely on the physical education professional to be solved, the findings of this review already provide important information for future professionals who wish to work in NASF-AB to prepare themselves more objectively and perform an efficient and quality work.

The Control and Prevention of COVID-19 Transmission in Children: A Protocol for Systematic Review and Meta-analysis.

BACKGROUND: The pandemic following the rapid spread of the new SARS-CoV-2 virus has hit all continents and caused thousands of deaths worldwide. Evidence has been published on epidemiological and clinical characteristics of population groups considered at risk; however, information for the other population groups, especially for the child population, is needed. In this context, this protocol describes a systematic review that will aim to identify the evidence on control and prevention of COVID-19 transmission among children and adolescents, as well as to describe the epidemiological profile and clinical and immunological characteristics of COVID-19 in this population. METHODS: This protocol will be developed in accordance with PRISMA-P. The searches will be conducted in PubMed, Web of Science, ScienceDirect, EMBASE, and Scopus, seeking clinical trials. Observational studies and case reports with Children and adolescents (≤19 years) infected with SARS-CoV-2 will be included whether they report information on the control of prevention and COVID-19 transmission. Two independent researchers will perform the selection of articles, removal of duplication, and screening by Rayyan QCRI application. Cochrane's RoB 2.0, ROBINS-I, and CASP tools will be used to assess the risk of bias. Meta-analysis, subgroup analyses, and/or descriptive analyses will be carried out based on the data conditions included. RESULTS: A high-quality synthesis of the available evidences on the epidemiological profile, the clinical and immunological characteristics involved in children, and adolescents diagnosed with COVID-19, as well as the participation of this population in the transmission dynamics of SARS-CoV-2 will be provided. CONCLUSION: This systematic review has an important relevance in the current context because it has a great potential to help the development of new control and prevention strategies in the pediatric population. RECORD OF SYSTEMATIC REVIEW: CRD42020179263.

The Effects of Exercise on BDNF Levels in Adolescents: A Systematic Review with Meta-Analysis.

The aim of this study was to analyze the evidence available in the literature about the effects of exercise on brain-derived neurotrophic factor levels in adolescents. The literature searches were conducted in PubMed, Embase, Scopus, ScienceDirect, Web of Science, SportDiscus, the Cochrane Central Register of Controlled Trials (CENTRAL) and CINAHL. Randomized controlled trials and non-randomized controlled trials performed with adolescents (10-19 years) who underwent different exercise programs and who evaluated BDNF levels before and after the intervention were included. We included six studies, four RCTs and two non-RCTs in the systematic review with a total of 407 adolescents. In two randomized trials and one non-RCT, the intervention groups showed significant improvements in BDNF levels compared with the control group. The results presented in the meta-analysis indicate that despite the positive effect in favor of the intervention, there were no significant differences (standardized mean difference 0.28 ng/mL, 95% confidence interval -0.28 to 0.85; p = 0.32, I² = 0%). The results presented in our review indicate that aerobic exercise programs practiced in moderate- or high-intensity are promising strategies to increase BDNF levels in adolescents. However, further studies are required to support this finding.

Escolhas para uma vida saudável: intervenção nutricional em adolescentes escolares / Choices for a healthy life: nutritional intervention in school adolescents

O aumento na prevalência da obesidade precoce, sobretudo nas primeiras décadas do século XXI, se converteu em importante problema de saúde pública com proporções mundiais, especialmente, em função de que a obesidade entre as crianças e adolescentes tende a persistir na idade adulta e estar fortemente associada ao desenvolvimento de doenças crônicas e aumento no risco de óbito. Ações tornam-se relevantes e necessárias para conter essa progressão e, nesse sentido, o ambiente escolar mostra-se adequado para intervenções educacionais para a prevenção e combate a obesidade. O Programa AME "Atitude, Movimento e Escolhas para uma vida saudável" foi elaborado no Programa de Pós Graduação em Saúde Coletiva da Universidade Federal do Rio Grande do Norte e trata-se de uma intervenção multicomponente, baseada na escola, com a abordagem na educação em saúde voltada para alimentação adequada e saudável e estímulo ao estilo de vida ativo (redução do comportamento sedentário e prática de atividade física). O objetivo da tese de doutorado é desenvolver estratégias de Educação Alimentar e Nutricional (EAN) em um programa de intervenção multicomponente baseada na escola para promoção de alimentação adequada e saudável e estilo de vida ativo entre adolescentes. Trata-se de uma pesquisa de desenvolvimento em que foi utilizada a literatura científica atual e disponível com o intuito de elaborar estratégias do eixo de EAN do Programa AME. O método está organizado em duas seções, a primeira descreveu o método dos estudos de revisões sistemáticas (RS) que contribuíram com o embasamento técnico-científico para o desenvolvimento do protocolo; e a segunda seção descreveu o protocolo do ensaio clínico randomizado (ECR). Na primeira seção, duas RS foram desenvolvidas seguindo as recomendações dos Itens para Relatório Preferenciais para Revisões Sistemáticas e Meta-análises (PRISMA) e foram registradas no International prospective register of systematic reviews (PROSPERO - CRD42019116520 e CRD42019100914). Para contextualizar onde está inserido o eixo EAN do Programa AME, a segunda seção apresenta os métodos do ECR. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa (CEP-HUOL UFRN) e registrada no Registro Brasileiro de Ensaios Clínicos (RBR-86xv46). A tese de doutorado está organizada no formato coletânea de artigos. A primeira RS investiga a efetividade de intervenções de EAN baseado na escola e seus efeitos sobre o consumo alimentar de adolescentes e nela foram incluídos 24 ECR. Em 16 estudos a intervenção conseguiu melhorar o consumo de pelo menos um alimento ou grupo de alimentos recomendados como alimentos saudáveis. Os resultados indicam que as intervenções baseadas na escola estão gerando mudanças favoráveis no consumo alimentar de adolescentes. A segunda RS investiga as evidências científicas quanto à associação entre o consumo de carne vermelha e doenças cardiovasculares, incluindo o efeito dose-resposta e nela foram incluídos 22 estudos prospectivos de coorte. Os resultados indicam uma possível associação entre o consumo de carne vermelha, especialmente carne processada, e a incidência e mortalidade por doença cardíaca coronária, derrame e/ou insuficiência cardíaca. A tendência de dose resposta linear indica que, quanto maior o consumo de carne vermelha, maior o risco de incidência e mortalidade por doenças cardiovasculares. Assim, baseada nos resultados encontrados nas RS, no contexto do ECR e aliadas às recomendações de documentos oficiais da Organização Mundial da Saúde, Ministério da Saúde do Brasil e instituições internacionais, foi realizada a construção da fundamentação teórica da proposta de intervenção do eixo de EAN do Programa AME. O estudo apresenta a justificativa para o desenvolvimento do eixo; as teorias orientadoras do programa AME; objetivos e metas; e características do eixo EAN do programa AME. Desenvolver estratégias de EAN em um programa de intervenção multicomponente baseada na escola para promoção de estilo de vida ativo e alimentação adequada e saudável entre adolescentes poderá propiciar aos adolescentes a construção de pensamentos críticos e reflexivos, que poderão transformar sua vida, a de sua família, comunidade e até mesmo de seu território (AU).

The increase in the prevalence of early obesity, especially in the first decades of the 21st century, has become an important public health problem of worldwide proportions. This is due to the fact that obesity among children and adolescents tends to persist in adulthood and is strongly associated with the development of chronic diseases and increased risk of death. Actions become relevant and necessary to contain this progression, in this sense, the school environment is suitable for educational interventions to prevent and combat obesity. The AME Program "Attitude, Movement and Choices for a Healthy Life" was developed in the Postgraduate Program in the Collective Health at the Federal University of Rio Grande do Norte and is a multicomponent, including school-based food and nutrition education, reduction of sedentary behavior, and the practice of physical activity. The objective of the doctoral thesis is to develop strategies in Food and Nutrition Education (FNE) in a schoolbased multicomponent intervention program to promote adequate and healthy food and active lifestyle among adolescents. This is a developmental research in which the current scientific literature was used and available in order to develop strategies for FNE axis of the AME Program. The method is organized in two sections, the first described the method of studies of systematic reviews (SR) that contributed with the technical-scientific basis for the development of the protocol; and the second section described the protocol of the randomized clinical trial (RCT). In the first section, two SRs were developed following the recommendations of the Preferred Report Items for Systematic Reviews and Meta-analyzes (PRISMA) and were registered in the International prospective register of systematic reviews (PROSPERO - CRD42019116520 and CRD42019100914). To contextualize where the FNE axis of the AME Program is inserted, the second section presents the methods of the RCT. The research was approved by the Research Ethics Committee (CEP-HUOL UFRN) and registered in the Brazilian Registry of Clinical Trials (RBR-86xv46). The doctoral thesis is organized in the collection of articles. The first SR investigates the effectiveness of schoolbased FNE interventions and their effects on adolescent food consumption and 24 RCTs were included. In 16 studies, the intervention managed to improve the consumption of at least one food or group of foods recommended as healthy foods. The results indicate that school-based interventions are generating favorable changes in adolescent food consumption. The second SR investigates the scientific evidence regarding the association between red meat consumption and cardiovascular diseases, including the dose-response effect and 22 prospective cohort studies were included. The results indicate a possible association between the consumption of red meat, especially processed meat, and the incidence and mortality from coronary heart disease, stroke and / or heart failure. The trend of linear dose response indicates that the greater the consumption of red meat, the greater the risk of incidence and mortality from cardiovascular diseases. Thus, based on the results found in the SR, in the context of the RCT and combined with the recommendations of official documents of the World Health Organization, Ministry of Health of Brazil and international institutions, the theoretical foundation of the intervention proposal for the FNE axis of the AME Program was carried out. The study presents the rationale for the development of the axis; the guiding theories of the AME program; goals and objectives; and characteristics of the FNE axis of the AME program. Developing FNE strategies in a school-based multicomponent intervention program to promote an active lifestyle and adequate and healthy nutrition among adolescents may provide adolescents with the construction of critical and reflective thoughts that can transform their lives, that of their families, community and even their territory (AU).

Mechanism of the action of bioactive proteins of vegetables in diabetes mellitus type 2: Systematic review protocol.

BACKGROUND: Diabetes mellitus type 2 (DM2) is a chronic disease of significant prevalence causing hyperglycemia and several comorbidities. Evidences highlight the performance of non - protein bioactive compounds found in vegetables in the control of hyperglycemia. This study describes a protocol of a systematic review, which analyzes the action of proteins and bioactive peptides of plants in DM2. METHODS: The Preferred Reporting Items guide this protocol for Systematic Reviews and Meta-Analyzes Protocols (PRISMA-P) was used. The databases that will be used for searching will be PubMed, ScienceDirect, Scopus, Web of Science, EMBASE, and Virtual Health Library, Brazil (VHL). Studies that use bioactive proteins and peptides of vegetal origin in DM2 will be included in the systematic review. The studies will be identified using clinical parameters and the effect on insulin resistance. The characteristics of the studies as control groups, test substance, dosage, intervention time, and the main results will be described. Selection of studies, data extraction, and methodological quality assessment will be performed independently by two experienced reviewers. RESULTS: This protocol will be the basis for a systematic review identifying the mechanism of action of plant proteins and peptides in type 2 diabetes mellitus. CONCLUSION: Systematic reviews from this protocol will provide support for the construction of researches that analyze the effect of plant bioactive proteins and peptides on the control of hyperglycemia and how these molecules act in the control of DM2. PROSPERO REGISTRATION NUMBER: CRD42019110956.

Red meat consumption, risk of incidence of cardiovascular disease and cardiovascular mortality, and the dose-response effect: Protocol for a systematic review and meta-analysis of longitudinal cohort studies.

BACKGROUND: Red and (particularly) processed meats are high in cholesterol and saturated and solid fatty acids. Their consumption is considered one of the risk factors for metabolic disorders. Numerous studies demonstrated a possible association between red meat consumption and cardiovascular disease (CVD). In this protocol, we propose a systematic review of the literature to examine the associations of red meat consumption with CVD incidence and mortality, and explore the potential dose-response relationship. METHODS: We will search MEDLINE/PubMed, Scopus, SciELO, LILACS, ScienceDirect, Web of Science, Cochrane (CENTRAL), WHOLIS, PAHO, and Embase. We will include prospective epidemiological studies (longitudinal cohort). Risk of bias will be assessed using the Newcastle-Ottawa scale (NOS). Four independent researchers will conduct all evaluations. Disagreements will be referred to a fifth reviewer. We will summarize our findings using a narrative approach and tables to describe the characteristics of the included studies. The heterogeneity between trial results will be evaluated using a standard chi-squared test with P < .05. We will conduct the study in accordance with the guideline of the Preferred Reporting Items for Systematic Review and Meta-analyses Protocols (PRISMA-P). RESULTS: This review will evaluate the association between red meat consumption and incidence of CVD and mortality (primary outcome measures). The secondary outcome measure will include the dose-response effect. CONCLUSION: The findings of this systematic review will summarize the latest evidence of the association between red meat consumption and incidence of CVD and mortality and the dose-response effect through a systematic review and meta-analysis. REGISTRATION: PROSPERO CRD42019100914.

Training programs in communication skills to improve self-efficacy for health personnel: Protocol for a systematic review and meta-analysis.

BACKGROUND: Patient-centered care should be the focus of health services, where improvements in the communication skills of health professionals promote excellent health and quality care. Thus, this study is a protocol for a systematic review and meta-analysis to evaluate the effectiveness of training programs in communication skills to promote self-efficacy in the communication of health personnel. METHODS: This systematic review protocol is conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) statement guidelines and the Cochrane Handbook of Systematic Reviews of Interventions. The review should include studies carried out with health professionals who have undergone training in communication skills aimed at promoting their self-efficacy. Clinical trials (randomized, non-randomized), community trials, and quasi-experimental studies should be included. Therefore, the comprehensive search strategy will be conducted in the following databases: PubMed/Medline, Scopus, Web of Science, EMBASE, Science Direct, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials (CENTRAL). Two independent reviewers will conduct all study selection procedures, data extraction, and methodological evaluation, and disagreements will be referred to a third reviewer. RevMan 5.3 software will be used to gather data and perform the meta-analysis if possible. RESULTS: This systematic review will provide evidence on more effective programs for communication skills training and will consider information such as duration, educational strategies, assessment measures, and outcomes that promote health worker self-efficacy. DISCUSSION: This systematic review should provide evidence for effective communication skills training for health professionals in order to guide new strategies for quality care. DISSEMINATION AND ETHICS: The findings of this scoping review will be disseminated in print, at conferences, or via peer-reviewed journals. Ethical approval is not necessary as this paper does not involve patient data. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019129384.