Nutritional Status, Lifestyle and Lipid Profile in Vegetarians

Abstract Background: Vegetarian diets have been linked to reduced risk of chronic noncommunicable diseases, since they positively modulate biochemical parameters, particularly those related with glycemic control and lipemia, and considered as potential strategy for weight control. Objective: To compare the nutritional status, lifestyle and lipid profile of adult vegetarians with omnivores in a sample of individuals in the city of São Paulo. Methods: This was a cross-sectional study. Anthropometric, biochemical and lifestyle variables were compared between vegetarians and omnivores. A significance level of 5% was considered for all analyses. Results: Vegetarians were more likely to practice physical activity (64.3% vs 42.5%, p = 0.056) and consuming dietary supplements (48.1% vs 20.5%, p = 0.012). There was no statistically significant difference for the variables: age, sex, triglycerides, total cholesterol and low-density lipoprotein between the two groups. Vegetarians had significantly lower weight [60.8 kg (56.7 - 69.4) vs 71.1 kg (58.0 - 75.4), p = 0.038], BMI [22.4 kg/m2 (20.9 - 23.8) vs 24.6 kg/m2 (21.7 - 26.1), p = 0.001], and waist circumference [(81.8 ± 8.2 vs 87.8 ± 10.9 cm, p = 0.003)], and higher high-density lipoprotein (54.88 ± 14.44 vs 47.30 ± 12.27 mg /dL p = 0.008) than omnivores. Conclusion: Compared with omnivores, vegetarians had a better nutritional status, with lower BMI and waist circumference, significantly higher levels of plasma lipoprotein high-density, and healthier lifestyle.

Brazilian Children's Dietary Intake in Relation to Brazil's New Nutrition Guidelines: a Systematic Review.

PURPOSE OF REVIEW: This systematic review reports the latest scientific evidence, from cross-sectional and cohort studies, describing the dietary intake of children and adolescents from Brazil. The goal of the review was to describe intakes according to Brazil's new food classification system (NOVA) which classifies foods according to the degree of processing, i.e., unprocessed/minimally processed, processed culinary ingredients, processed food, and ultra-processed food. Due to a paucity of data using the NOVA classification system, studies with other intake descriptors were included. RECENT FINDINGS: Results using the NOVA system showed a somewhat high intake of (ultra-)processed items, than of minimally processed items. Studies using other methods of dietary assessment showed not only high intake of sources rich in fat, sugar, and sodium, most of them processed items (e.g., savory snacks and sweets) but also intake of fruit, vegetables, and whole grains. Overall, the literature was marred by inconsistencies and variation in study definitions and methods making it hard to make firm conclusions regarding the dietary intake of Brazilian children. The development of tools to evaluate the complexities of dietary intake is much needed. Such a tool needs to be accepted and adopted by numerous study groups, to describe dietary status among Brazilian children and devise the most effective, and to evaluate the success of nutrition education programs.

"Healthy Habits, Healthy Girls-Brazil": an obesity prevention program with added focus on eating disorders.

PURPOSE: To evaluate the immediate post-intervention and 6-month post-intervention effects of a Brazilian school-based randomized controlled trial for girls targeting shared risk factors for obesity and disordered eating. METHODS: Total of 253 girls, mean of 15.6 (0.05) years from 1st to 3rd grades of high school participated in this 6-month school-based cluster randomized controlled trial. "Healthy Habits, Healthy Girls-Brazil (H3G-Brazil)", originally developed in Australia, emphasized 10 key nutrition and physical activity (PA) messages delivered over 6 months. Disordered eating prevention procedures, i.e., prevention of weight-teasing, body satisfaction, and unhealthy weight control behavior, were added to the intervention. Body dissatisfaction, unhealthy weight control behaviors and social cognitive-related diet, and physical activity variables were assessed at baseline, immediate post-intervention, and 6-month post-intervention. Intervention effects were determined by one-way analysis of covariance or logistic regression, after checking for the clustering effects of school. The control group did not receive intervention prior to follow-up assessment. A conservative significance level was set at p < 0.01. RESULTS: Beneficial effects were detected for PA social support (F = 6.005, p = 0.01), and healthy eating strategies (F = 6.08, p = 0.01) immediate post-intervention; and healthy eating social support (F = 14.731, p = 0.00) and healthy eating strategies (F = 5.812, p = 0.01) at 6-month post-intervention. Intervention group was more likely to report unhealthy weight control behaviors (OR = 1.92, 95% CI 1.15-3.21, p = 0.01) at 6-month post-intervention. No other significant immediate or 6-month post effects were detected. CONCLUSION: H3G-Brazil demonstrated positive 6-month effects on some social cognitive variables but an adverse effect on unhealthy weight control behaviors. Thus, this study was not able to achieve synergy by combining obesity and disordered eating prevention procedures in an intervention among low-income girls in Brazil. TRIAL REGISTRATION: Level I: cluster randomized controlled trial.

Sustained impact of the "Healthy Habits, Healthy Girls - Brazil" school-based randomized controlled trial for adolescents living in low-income communities.

Pediatric obesity is a major public health concern in low- and middle-income countries, such as Brazil. There is an urgent need for preventive programs for adolescents and, the assessment of their sustained impact. This paper reports the longer-term (6-month post intervention) effects of the "H3G-Brazil" obesity prevention program on weight status and weight-related behaviors. A cluster randomized controlled trial starting with 10 public schools in the city of São Paulo, Brazil involved 253 adolescent girls [mean (se) age = 15.6 (0.87) years]. Body mass index (BMI), waist circumference (WC), dietary intake, physical activity (PA) and sedentary behaviors (SB) were assessed at baseline, immediate post-intervention and 6-month post-intervention (follow-up). ANCOVA was performed using intention to treat principles. There was no effect on BMI, the primary outcome. Although, meaningful increases occurred in waist circumference for both groups, the intervention group presented a lower increase (F = 3.31, p = 0.04). This effect size, however, was lower than the criterion for small (d = 0.102). Unfortunately, significant results favored the control group for time spent on TV/weekdays (F = 5.13, p = 0.01), TV/weekends (F = 5.46, p = 0.01) and sedentary behaviors/weekdays (F = 5.32, p = 0.04). No other significant results were found. This obesity prevention intervention among Brazilian adolescent girls did not have the desire effect on BMI. The significantly lower increase in waist circumference in the intervention groups is inconsistent with the adverse changes detected in sedentary time.

Weight-teasing: does body dissatisfaction mediate weight-control behaviors of Brazilian adolescent girls from low-income communities?

The objective was to examine the mediation hypothesis of body dissatisfaction and analyze their association with weight-teasing and body satisfaction. A total of 253 girls who attended 10 schools from São Paulo, Brazil, participated in this study. Data collection was carried out through a validated and self-reported questionnaire. Study variables were weight-teasing (independent), body satisfaction (mediation), and weight control behavior (outcome). Effect mediation analyses showed a significance level of 5% (p < 0.05). Prevalence of family and peers weight-teasing were 38.5% and 40.6%, respectively. Body dissatisfaction was associated with unhealthy weight control behaviors when controlled by family and peer weight-teasing. Data indicate that family and peers teasing are important aspects that interfere in body satisfaction and weight control behaviors.

Weight-teasing: does body dissatisfaction mediate weight-control behaviors of Brazilian adolescent girls from low-income communities? / Provocações em relação ao peso corporal: a insatisfação com o próprio corpo afeta o comportamento de controle de peso de adolescentes brasileiras de comunidades de baixa renda? / Burlas y acoso por el peso: ¿la insatisfacción corporal afecta al comportamiento para el control del peso en adolescentes brasileñas dentro de comunidades con baja renta?

The objective was to examine the mediation hypothesis of body dissatisfaction and analyze their association with weight-teasing and body satisfaction. A total of 253 girls who attended 10 schools from São Paulo, Brazil, participated in this study. Data collection was carried out through a validated and self-reported questionnaire. Study variables were weight-teasing (independent), body satisfaction (mediation), and weight control behavior (outcome). Effect mediation analyses showed a significance level of 5% (p < 0.05). Prevalence of family and peers weight-teasing were 38.5% and 40.6%, respectively. Body dissatisfaction was associated with unhealthy weight control behaviors when controlled by family and peer weight-teasing. Data indicate that family and peers teasing are important aspects that interfere in body satisfaction and weight control behaviors.

O estudo teve como objetivo examinar a hipótese da mediação pela insatisfação com o próprio corpo e analisar as associações com a provocação por terceiros e com a satisfação com o corpo. A amostra incluiu um total de 253 adolescentes do sexo feminino matriculadas em dez escolas na cidade de São Paulo, Brasil. Os dados foram coletados com um questionário validado e auto-preenchido. As variáveis de estudo foram as provocações feitas por outros em relação ao peso da adolescente (independente), a satisfação com o corpo (de mediação) e o comportamento de controle do peso (desfecho). As análises de mediação mostraram um efeito estatisticamente significativo (p < 0,05). As taxas de prevalência de provocações relacionadas ao peso, feitas por familiares e colegas, foram 38,5% e 40,6%, respectivamente. Depois de ajustar para a provocação por familiares e colegas, a insatisfação com o próprio corpo esteve associada a comportamentos prejudiciais de controle de peso. Os dados indicam que as provocações por familiares e colegas são aspectos importantes que interferem na satisfação com o corpo e com os comportamentos de controle de peso.

El objetivo fue examinar la mediación en la hipótesis de la insatisfacción corporal y analiza su asociación con las burlas y acoso por el peso y la satisfacción corporal. Un total de 253 niñas que iban a diez escuelas de São Paulo, Brasil, participaron en este estudio. La obtención de datos se llevó a cabo mediante un cuestionario validado y autoinformado. Las variables de estudio fueron acoso por peso (independiente), satisfacción corporal (mediación), y control de peso comportamiento (resultado). El efecto de los análisis de mediación mostró un nivel de significancia del 5% (p < 0.05). La prevalencia de la familia y las burlas/acoso por el peso entre compañeras fueron de un 38,5% y un 40,6%, respectivamente. La insatisfacción corporal se asoció con comportamientos poco saludables de control de peso, cuando estuvo controlada por la familia y las burlas y acoso por el peso entre colegas. Los datos indican que la familia y las burlas/acoso entre compañeras son aspectos importantes que interfieren en la satisfacción corporal y comportamientos sobre el control de peso.

Home food availability, parents'/caregivers' support, and family meals influence on dietary servings of low-income urban adolescent girls from Brazil

BACKGROUND: There is a striking lack of evidence about parents'/caregivers' influence on their children's dietary intake across Brazil and other middle- and low-income countries. Therefore, the purpose of this study was to identify the associations between adolescents' dietary intake and home environment, family meals and parental support. METHODS: Cross-sectional study with 14­18 years old adolescent girls was conducted in 10 public schools in the city of São Paulo. Girls' dietary intake, home food environment, parental support, and family meals' frequency were self-reported by 253 adolescents. Brazilian Food Pyramid recommendation was used as reference for the dietary intake. Linear regressions were used to verify the associations between home environmental, parental support, and family meal frequency with dietary intake. RESULTS: Girls parents' support for healthy eating was positively associated with the fruits group (mean (95%CI) 0.75 (0.66 to 0.84) ß = 0.26,p= 0.003), and the vegetables group (3.40 (3.08 to 3.72, ß = 0.25,p= 0.006)and negatively associated with the meat and eggs group (2.09 (1.93 to 2.25), ß =−0.14,p= 0.041). Home environment was associated with fruits group (0.73 (0.63 to 0.82), ß = 0.35,p= 0.001). The associations between sharing family meals and food groups were not statistically significant. However, girls demonstrated a positive association with dietary intake and sharing family meals. CONCLUSION: Parental support and home food environment were associated with dietary intake of the adolescent girls. Future studies - mainly from low- and middle-income countries - are needed to provide additional evidence on these associations and the effects of youth home environment

Attitudes toward health and taste of food among women with bulimia nervosa and women of a non-clinical sample.

Taste preferences and health concerns play important roles in determining eating attitudes, thus influencing food choices. Disordered eating attitudes are common among women, and can lead to the development and maintenance of eating disorders (ED). Attitudes toward health and taste of food among ED patients and its comparison with non-clinical women are not well known, and this knowledge could improve eating interventions. In this study, we compared taste preferences and health concerns in 27 women with diagnosis of bulimia nervosa (BN) and 216 women of a non-clinical sample. All participants completed the Health and Taste Attitude Scale (HTAS). Using analysis of covariance we compared the HTAS scores of the BN patients with those of the college students. Risk behaviors for ED (assessed by the Eating Attitudes Test) were identified in 54 (25%) of the non-clinical sample, all of whom were therefore excluded in comparison of BN patients. Non-clinical sample, compared to patients, scored higher on the HTAS Taste domain (p < 0.001) and its pleasure subscale (p < 0.001), whereas patients scored higher on the HTAS Health domain (p < 0.05) and its light product interest subscale (p < 0.05). Based on our data, eating attitudes of women of non-clinical sample are related to taste and pleasure, whereas women with BN are concerned with adopting a diet regarded as healthy, thus increasing their interest in "light" products. Therefore, the taste and health concerns must be considered in nutrition interventions for women in general, and prevention and treatment of ED as determinants of food choice.

Health behavioral theories used to explain dietary behaviors in adolescents: a systematic review

Background: Health behavior theories are useful to interpret adolescents'dietary behaviors. Evidences show that theories are influenced by social and psychological determinants. So, the purpose of this study is to systematically review studies that tested social cognitive theories (non-integrated) that predict adolescents 'dietary behaviors. METHODS: A structured electronic search of all publication years (through April 2016) was conducted to identify studies in MEDLINE, SciELO, PsycINFO, Scopus, and LILACS with full text. Included publications were cross-sectional and longitudinal (non-intervention) studies involving adolescents (10 to 18 years) that examined the associations between constructs of social-cognitive theories and dietary behaviors. Related strings in titles, abstracts, and indexing fields were searched. RESULTS: Theories used to explain dietary intake were the planned behavior and the social cognitive. It wasobserved evidences of positive associations between the social cognitive constructs and the fruits, the vegetables, the milk groups, and the whole-wheat foods (e.g., bread rich in fiber) and negative associations with sugar- sweetened beverages, soft drinks, snacks high in fat, sugar, and/or sodium, and sweet treats. Theories explained greater proportion of variance for intention to dietary intake. The variance for intention ranged from 3% for pizzas, candy bars, candies, and sugar-sweetened beverages to 68% for whole-wheat food (i.e., bread rich in fiber). CONCLUSION:Longitudinal designs are necessary to comprehend the theories and evaluate the behavioral changes. Finally, the use of food groups should be employed in the studies to help the comparisons and present higher reproducibility. Studies always based on objective, systematic, and rigorous evidences

Preventing obesity among Brazilian adolescent girls: Six-month outcomes of the Healthy Habits, Healthy Girls-Brazil school-based randomized controlled trial.

BACKGROUND: School-based trials to prevent and reduce prevalence of pediatric obesity in low-income countries are necessary. In Brazil, addressing adolescent obesity is a public health priority. OBJECTIVE: To evaluate the impact of a group randomized controlled trial involving a 6-month multicomponent school-based obesity prevention program targeting adolescent girls. METHODS: The Healthy Habits, Healthy Girls-Brazil program recruited participants (n=253; 16.05±0.05 years) from ten eligible public technical schools in São Paulo, Brazil. The program was adapted from an Australian intervention study, which is based on the Social Cognitive Theory. The primary outcome measure was body mass index (BMI), and secondary outcomes included BMI z score, waist circumference, and various sedentary and dietary health-related behaviours. RESULTS: Although changes in BMI were not statistically significant, differences favored the intervention group (adjusted mean difference, -0.26kg/m(2),se SE=0.018, p=0.076). Statistically significant intervention effects were found for waist circumference (-2.28cm; p=, p=0.01), computer screen time on the weekends (0.63h/day, p; p=0.02), total sedentary activities on the weekends (-0.92h/day, p<0.01), and vegetable intake (1.16servings/day, p=0.01). CONCLUSION: These findings provide some evidence for the benefit of a school-based intervention to prevent unhealthy weight gain in adolescent girls living in low-income communities.

The "Healthy Habits, Healthy Girls" randomized controlled trial for girls: study design, protocol, and baseline results.

The purpose of this article is to describe the study design, protocol, and baseline results of the "Healthy Habits, Healthy Girls" program. The intervention is being evaluated through a randomized controlled trial in 10 public schools in the city of São Paulo, Brazil. Data on the following variables were collected and assessed at baseline and will be reevaluated at 7 and 12 months: body mass index, waist circumference, dietary intake, nutrition, physical activity, social cognitive mediators, physical activity level, sedentary behaviors, self-rated physical status, and overall self-esteem. According to the baseline results, 32.4% and 23.4% of girls were overweight in the intervention and control groups, respectively, and in both groups a higher percentage failed to meet daily recommendations for moderate and vigorous physical activity and maximum screen time (TV, computer, mobile devices). There were no significant differences between the groups for most of the variables, except age (p = 0.000) and waist circumference (p = 0.014). The study showed a gap in the Brazilian literature on protocols for randomized controlled trials to prevent obesity among youth. The current study may thus be an important initial contribution to the field.

The “Healthy Habits, Healthy Girls” randomized controlled trial for girls: study design, protocol, and baseline results / Ensaio randomizado controlado para meninas “Hábitos Saudáveis, Meninas Saudáveis”: delineamento, protocolo de estudo e resultados do baseline / Ensayo randomizado controlado para niñas “Hábitos Saludables, Niñas Saludables”: delineación, protocolo de estudio y resultados iniciales

The purpose of this article is to describe the study design, protocol, and baseline results of the “Healthy Habits, Healthy Girls” program. The intervention is being evaluated through a randomized controlled trial in 10 public schools in the city of São Paulo, Brazil. Data on the following variables were collected and assessed at baseline and will be reevaluated at 7 and 12 months: body mass index, waist circumference, dietary intake, nutrition, physical activity, social cognitive mediators, physical activity level, sedentary behaviors, self-rated physical status, and overall self-esteem. According to the baseline results, 32.4% and 23.4% of girls were overweight in the intervention and control groups, respectively, and in both groups a higher percentage failed to meet daily recommendations for moderate and vigorous physical activity and maximum screen time (TV, computer, mobile devices). There were no significant differences between the groups for most of the variables, except age (p = 0.000) and waist circumference (p = 0.014). The study showed a gap in the Brazilian literature on protocols for randomized controlled trials to prevent obesity among youth. The current study may thus be an important initial contribution to the field.

O objetivo deste artigo é descrever o delineamento, protocolo de estudo e resultados do baseline do programa “Hábitos Saudáveis, Meninas Saudáveis”. A intervenção será avaliada por meio de um ensaio randomizado controlado em 10 escolas públicas de São Paulo, Brasil. As variáveis foram mensuradas no baseline e serão avaliadas após 7 e 12 meses do baseline: índice de massa corporal, circunferência da cintura, dieta, mediadores sociais cognitivos da nutrição e atividade física, nível de atividade física, comportamentos sedentários, autopercepção física e autoestima global. Resultados do baseline demonstraram que 32,4% do grupo intervenção e 23,4% do controle estavam acima do peso, e para ambos uma grande porcentagem não atingiu as recomendações diárias de atividade física moderada/vigorosa, e tempo de tela. Para a maioria das variáveis, com exceção de idade (p = 0,000) e circunferência da cintura (p = 0,014), não houve diferença significante entre os grupos. Há uma lacuna na literatura brasileira sobre ensaios randomizados controlados para prevenir obesidade em adolescentes. Este trabalho pode apresentar uma importante contribuição para a área.

El propósito de este trabajo es describir el diseño del estudio, protocolo y resultados iniciales del programa “Hábitos Saludables, Niñas Saludables”. La intervención se evaluó a través de un ensayo controlado aleatorio en 10 escuelas de São Paulo, Brasil. Las variables se recogieron y evaluaron al inicio del estudio y serán evaluadas tras 7 y 12 meses en base a: índice de masa corporal; circunferencia de cintura; dieta; factores mediadores cognitivos-sociales de nutrición y actividad física; actividad física; sedentarismo; auto-percepción y autoestima. Los resultados iniciales demostraron que el 32,4% y el 23,4% del grupo intervención y control tenían sobrepeso, y para ambos grupos un mayor porcentaje no cumplían con las recomendaciones diarias de actividad física y tiempo dedicado a actividades de ocio. La mayoría de las variables, con excepción edad (p = 0,000) y circunferencia de cintura (p = 0,014), no presentaron diferencias entre grupos. Existe un cierto vacío en la literatura brasileña sobre protocolos de ensayos controlados aleatorios para prevenir la obesidad en jóvenes. Este tipo de trabajos podrían ser una contribución para este campo.

[Cross-cultural adaptation and validation of the Health and Taste Attitude Scale (HTAS) in Portuguese]. / Adaptação transcultural e validação para o português da Escala de Atitudes em Relação ao Sabor da Health and Taste Attitude Scale (HTAS).

The scope of this study was to show the cross-cultural adaptation and validation of the Health and Taste Attitude Scale in Portuguese. The methodology included translation of the scale; evaluation of conceptual, operational and item-based equivalence by 14 experts and 51 female undergraduates; semantic equivalence and measurement assessment by 12 bilingual women by the paired t-test, the Pearson correlation coefficient and the coefficient intraclass correlation; internal consistency and test-retest reliability by Cronbach's alpha and intraclass correlation coefficient, respectively, after application on 216 female undergraduates; assessment of discriminant and concurrent validity via the t-test and Spearman's correlation coefficient, respectively, in addition to Confirmatory Factor and Exploratory Factor Analysis. The scale was considered adequate and easily understood by the experts and university students and presented good internal consistency and reliability (µ 0.86, ICC 0.84). The results show that the scale is valid and can be used in studies with women to better understand attitudes related to taste.

Adaptação transcultural e validação para o português da Escala de Atitudes em Relação ao Sabor da Health and Taste Attitude Scale (HTAS) / Cross-cultural adaptation and validation of the Health and Taste Attitude Scale (HTAS) in Portuguese

O objetivo do estudo foi apresentar a adaptação transcultural e validação da Escala de Atitudes em Relação ao Sabor da Health and Taste Attitude Scale para o Português. A metodologia contou com a tradução da escala; avaliação da equivalência conceitual, operacional e de item, por 14 experts e 51 universitárias; avaliação da equivalência semântica e mensuração, por 12 mulheres bilíngues por meio do teste t pareado, do coeficiente de correlação de Pearson e do coeficiente de correlação intraclasse; avaliação da consistência interna e confiabilidade teste-reteste por meio do Alpha de Cronbach e do Coeficiente de Correlação Intraclasse, respectivamente, após aplicação em 216 universitárias; avaliação da validade discriminante e concorrente, por meio do teste T e do Coeficiente de Correlação de Spearman, respectivamente; além de Análise Fatorial Confirmatória e Analise Fatorial Exploratória. A escala foi considerada adequada e de fácil compreensão pelos experts e universitárias e apresentou boa consistência interna e confiabilidade (µ 0,86; CCI 0,84). Os resultados apontam que a escala é válida e pode ser utilizada em estudos com mulheres, para entender melhor as atitudes em relação ao sabor.

The scope of this study was to show the cross-cultural adaptation and validation of the Health and Taste Attitude Scale in Portuguese. The methodology included translation of the scale; evaluation of conceptual, operational and item-based equivalence by 14 experts and 51 female undergraduates; semantic equivalence and measurement assessment by 12 bilingual women by the paired t-test, the Pearson correlation coefficient and the coefficient intraclass correlation; internal consistency and test-retest reliability by Cronbach's alpha and intraclass correlation coefficient, respectively, after application on 216 female undergraduates; assessment of discriminant and concurrent validity via the t-test and Spearman's correlation coefficient, respectively, in addition to Confirmatory Factor and Exploratory Factor Analysis. The scale was considered adequate and easily understood by the experts and university students and presented good internal consistency and reliability (µ 0.86, ICC 0.84). The results show that the scale is valid and can be used in studies with women to better understand attitudes related to taste.

Cultural adaptation and psychometric properties of social cognitive scales related to adolescent dietary behaviors / Adaptação cultural e propriedades psicométricas das escalas sociais cognitivas relacionadas ao comportamento dietético de adolescentes

Establishing valid and reliable methods for assessing social cognitive measures of dietary behaviors support the design and delivery of more effective interventions. The aims of this study were to culturally adapt social cognitive measures related to adolescent dietary behaviors and evaluate the reliability and factorial validity of these measures in Brazilian adolescents. The instrument was culturally adapted from an Australian questionnaire based on the Banduras' Social Cognitive Theory, and it included the following constructs: self-efficacy, intentions, situation, social support, behavioral strategies, and outcome expectations and expectancies. The questionnaire was administered in a two-week test-retest with 173 adolescents (M=15.3±1.53 years old). A confirmatory factor analysis was employed to examine model-fit for each scale using multiple indices including: chi-square, comparative-fit, goodness-of-fit, and root mean square error of approximation. Reliability properties were also examined. The reliability and factorial validity are appropriate, suggesting for each scale values between adequate to exact; internal consistency from acceptable to excellent (α=0.66 to 0.94); and rank order repeatability from adequate to strong (ICC=0.65–0.93). The Brazilian version showed appropriate internal consistency, factorial validity and test-retest reliability, and will be useful to assess social cognitive dietary behaviors among Brazilian adolescents.

O estabelecimento de métodos validados e confiáveis para avaliar os aspectos sociais cognitivos do comportamento dietético suportam o delineamento e o desenvolvimento de intervenções mais efetivas. Os objetivos deste estudo foram adaptar um instrumento que avalia os aspectos sociais cognitivos do comportamento dietético, bem como a sua confiabilidade e validade fatorial confirmatória em adolescentes brasileiros. O instrumento foi culturalmente adaptado de um questionário australiano baseado na Teoria Cognitiva Social de Bandura, que incluiu os seguintes construtos: autoeficácia, intenções, situação, apoio social, estratégias comportamentais, expectativas e preditores de expectativas. O questionário foi administrado com duas semanas de teste-reteste em 173 adolescentes (M=15,3±1,53 anos). A análise confirmatória fatorial foi empregada para examinar o modelo de ajuste para cada escala utilizando múltiplos índices que incluíam: qui-quadrado, comparative-fit (CFI), goodness-of-fit (GFI) e o root mean square error of aproximation (RMSEA) As propriedades de confiabilidade também foram avaliadas. A validade fatorial e confiabilidade estão adequadas, sugerindo para cada escala valores entre adequado a exato; consistência interna de aceitável à excelente (α=0,66 a 0,94) e repetitividade da ordem de classificação de adequada à forte (ICC=0,65 a 0,93). A versão brasileira apresentou consistência interna, validade fatorial e confiabilidade do teste-reteste aceitáveis, e poderá ser útil para avaliar os aspectos sociais cognitivos dos comportamentos dietéticos dos adolescentes brasileiros.

Teasing and weight-control behaviors in adolescent girls / Provocaciones y comportamientos para control de peso en adolescentes del sexo femenino / Provocacoes e comportamentos para controle de peso em adolescentes do sexo feminino

OBJECTIVE: To analyze the association between weight teasing, body satisfaction and weight control behaviors. METHODS: Cross-sectional study based on adaptation and validity research of a North American questionnaire for adolescent girls about physical activity, nutrition, body image, perceptions, and behaviors. The variables used to conduct the study were weight control behaviors, body satisfaction and presence of teasing by family members. Descriptive analyses were carried out by chi-square test, being significant p<0.05. RESULTS: A total of 159 adolescent girls, with 16.2±1.3 years old were enrolled in this study. Of the total, 60.1% reported that family members did not tease them. The teasing was associated with weight dissatisfaction (p<0.001), body shape (p=0.006), belly (p=0.001), waist (p=0.001), face (p=0.009), arms (p=0.014) and shoulders (p=0.001). As a consequence, there was association with unhealthy weight control behaviors (p<0.001), vomiting (p=0,011), diet (p=0.002) and use of laxatives (p=0.035). CONCLUSIONS: The teasing about body image by family members was associated with risk for unhealthy weight control behaviors in female adolescents. .

OBJETIVO: Analizar la asociación entre las provocaciones relativas al peso, la satisfacción corporal y los comportamientos para control de peso. MÉTODOS: Estudio transversal basado en investigación de adaptación y validación de un cuestionario estadounidense para adolescentes del sexo femenino sobre percepciones, comportamientos, actividad física, alimentación e imagen corporal. Las variables utilizadas para la realización del estudio fueron los comportamientos para control de peso corporal, el grado de satisfacción corporal y la presencia de provocaciones relativas al peso por parte de miembros familiares. Se realizaron análisis descriptivos por la prueba del chi-cuadrado, considerándose diferencias estadísticamente significantes para p<0,05. RESULTADOS: Participaron del estudio 159 adolescentes del sexo femenino, con promedio de edad de 16,2 y desviación estándar de 1,27 años. Del total, 60,1% relataron no haber sufrido provocaciones relativas al peso por miembros familiares. Las provocaciones se asociaban a la insatisfacción con el peso (p<0,001), forma del cuerpo (p=0,006), abdomen (p=0,001), cintura (p=0,001), cara (p=0,009), brazos (p=0,014) y hombros (p=0,001). Por consiguiente, hubo asociación con comportamientos no sanos para controlar el peso (p<0,001), provocar vómito (p=0,011), realizar dieta (p=0,002) y tomar laxante (p=0,035). CONCLUSIONES: Tales provocaciones se relacionan al riesgo para comportamientos no sanos para control de peso. .

OBJETIVO: Analisar a associação entre as provocações relativas ao peso, a satisfação corporal e os comportamentos para controle de peso. MÉTODOS: Estudo transversal baseado em pesquisa de adaptação e validação de um questionário norte-americano para adolescentes do sexo feminino sobre percepções, comportamentos, atividade física, alimentação e imagem corporal. As variáveis utilizadas para a realização do estudo foram os comportamentos para controle de peso corporal, o grau de satisfação corporal e a presença de provocações relativas ao peso por parte de membros da família. Realizaram-se análises descritivas pelo teste do qui-quadrado, considerando-se significante p<0,05. RESULTADOS: Participaram do estudo 159 adolescentes do sexo feminino, com idade de 16,2±1,3 anos. Do total, 60,1% relataram não ter sofrido provocações relativas ao peso por membros da família. As provocações associavam-se à insatisfação com peso (p<0,001), forma do corpo (p=0,006), abdome (p=0,001), cintura (p=0,001), rosto (p=0,009), braços (p=0,014) e ombros (p=0,001). Consequentemente, houve associação com comportamentos não saudáveis para controlar o peso (p<0,001), provocar vômito (p=0,011), realizar dieta (p=0,002) e tomar laxantes (p=0,035). CONCLUSÕES: As provocações relativas à imagem corporal por membros da família relacionam-se ao risco para comportamentos não saudáveis para controle de peso em adolescentes do sexo feminino. .

Validity and reproducibility of a food frequency questionnaire to assess food group intake in adolescents.

The objective of this study was to assess the validity and reproducibility of a food frequency questionnaire to assess intake of the food groups included in the food guide pyramid for adolescents (FFQ-FP). The final version of the FFQ-FP consisted of 50 food items. The study was carried out with a sample of 109 adolescents over a period of four months. A 24hr recall (24hr) was conducted four times and the FFQ-FP was conducted twice. Validity was determined by comparing the second FFQ-FP and the mean of the four 24hrs, while reproducibility was verified by comparing the results of the two FFQ-FPs. Statistical analysis was carried out using medians, standard deviations, Pearson and intraclass correlations and Kappa statistics to assess concordance. Best results were achieved for the rice (including bread, grains and starches), meats and sugars groups. Weakest correlation was observed for the variable vitamin C. The validity and reproducibility of the FFQ-FP was satisfactory for most variables.

Validity and reproducibility of a food frequency questionnaire to assess food group intake in adolescents / Validade e reprodutibilidade de um questionário de frequência alimentar baseado nos grupos alimentares para adolescentes / Validez y reproducibilidad de un cuestionario de frecuencia alimentaria sobre la base de grupos de alimentos para los adolescentes

The objective of this study was to assess the validity and reproducibility of a food frequency questionnaire to assess intake of the food groups included in the food guide pyramid for adolescents (FFQ-FP). The final version of the FFQ-FP consisted of 50 food items. The study was carried out with a sample of 109 adolescents over a period of four months. A 24hr recall (24hr) was conducted four times and the FFQ-FP was conducted twice. Validity was determined by comparing the second FFQ-FP and the mean of the four 24hrs, while reproducibility was verified by comparing the results of the two FFQ-FPs. Statistical analysis was carried out using medians, standard deviations, Pearson and intraclass correlations and Kappa statistics to assess concordance. Best results were achieved for the rice (including bread, grains and starches), meats and sugars groups. Weakest correlation was observed for the variable vitamin C. The validity and reproducibility of the FFQ-FP was satisfactory for most variables.

O objetivo foi verificar a validade e reprodutibilidade de um questionário de frequência alimentar baseado nos grupos alimentares da pirâmide alimentar para adolescentes (QFA-PA). Após a identificação dos alimentos a serem incluídos no QFA-PA, a versão final consistiu em 50 itens. O estudo foi realizado com 109 adolescentes durante um período de quatro meses. Foram aplicados quatro recordatórios de 24h (R24h) e dois QFA-PA. A validade foi obtida pela comparação entre o segundo QFA-PA e a média dos R24h, enquanto que a reprodutibilidade foi mensurada por meio da comparação dos dois QFA-PA. As análises estatísticas foram realizadas utilizando-se médias, desvios-padrão, correlações de Pearson, e intraclasse e concordância. As variáveis melhor avaliadas foram os grupos do arroz, pão, massa, batata e mandioca, das carnes e de açúcares e doces. Os piores resultados foram observados para a vitamina C. O QFA-PA apresentou validade satisfatória e reprodutibilidade aceitável para a maioria das variáveis.

El objetivo fue evaluar la validez y reproducibilidad de un cuestionario de frecuencia de alimentos sobre la base de grupos de alimentos en la pirámide alimenticia para adolescentes (FFQ-AP). Después de identificar los alimentos que se incluyen en el FFQ-AP, la versión final estuvo compuesta por 50 ítems. El estudio se realizó con 109 adolescentes durante un período de cuatro meses. Se realizaron cuatro recordatorios de 24 horas dietéticos (R24h) y dos FFQ-AP. La validez se evaluó mediante la comparación del segundo cuestionario de frecuencia (FFQ-AP) y el promedio de los R24h, mientras que la reproducibilidad se evaluó mediante la comparación de los dos FFQ-AP. Los análisis estadísticos se realizaron con medias, desviaciones estándar y correlaciones de Pearson y correlación intraclase. Los grupos de alimentos con variables evaluadas fueron: arroz, pan, pasta, patatas y yuca, carne y azúcar y dulces. Los peores resultados se observaron con respecto a la vitamina C. El FFQ-AP mostró una validez aceptable y de reproducción satisfactoria para la mayoría de las variables.

Risk behaviors for eating disorder in adolescents and adults with type 1 diabetes.

OBJECTIVE: To evaluate the frequency of risk behaviors for eating disorder (ED) in patients with type 1 diabetes (T1D) and their association with gender, nutritional status, variables related to T1D, and body satisfaction. METHOD: 189 individuals with T1D (12-56 years old) answered the Bulimic Investigation Test (BITE), the Eating Attitude Test (EAT), the Binge Eating Scale (BES), Stunkard's Figure Rating Scale, and questions regarding control of T1D. Association between ED risk behaviors and the selected variables was assessed with the chi-square test and Student's t-test; factors that influenced the risk of ED were identified by means of logistic regression. RESULTS: Of the patients with T1D, 58.7% were at risk of ED (45, 40, and 16% according to the EAT, BITE and BES, respectively). There were significant differences between groups with and without risk for ED related to BMI (p = 0.009), gender (p = 0.001), insulin omission (p = 0.003), use of the carbohydrate counting method (p = 0.019), and body dissatisfaction (p = 0.001). The risk of ED was nine times higher in patients who reduced or omitted insulin (p = 0.036). CONCLUSIONS: Patients with T1D demonstrated a high frequency of body dissatisfaction and ED risk behaviors; the omission or reduction of insulin was an important risk factor.