Division of Responsibility in Child Feeding and Eating Competence among Brazilian Caregivers.

This cross-sectional study aimed to assess Brazilian child caregivers' eating competence (EC) and their adherence to the division of responsibility (sDOR) in child feeding. The research had national coverage in all Brazilian regions. The sample comprised 549 caregivers of Brazilian children (24 up to 72 months) recruited by social media (snowball method). Data on sDOR and EC were collected using the sDOR.2-6yTM Portuguese-Brazil (sDOR.2-6y-BR) and ecSI2.0TMBR, both instruments validated to the Brazilian population. The scores of the sDOR.2-6y-BR were described in terms of means, standard deviations (SD), medians, and interquartile range. Student's t-test and analysis of variance (ANOVA) followed by Tukey's post hoc tests were used to compare the scores of sDOR.2-6y-BR and ecSI2.0TMBR with interest variables. The association between the sDOR.2-6y-BR and ecSI2.0TMBR scores was verified by Pearson's correlation coefficient. Most of the participants were female (n = 88.7%), 37.8 ± 5.1 y/o, had a high schooling level (70.31%), and high monthly income (more than 15 minimum wages-MW) (31.69%). The children for whom the participants were responsible were mostly girls (53.19%), with an average age of 3.6 ± 1.3 y/o. The instrument presented good responsiveness (floor and ceiling effects = 0%). Cronbach's Alpha = 0.268. There was no statistical difference in sDOR.2-6y-BR scores between caregiver's gender, age, level of education, number of people living in the household, or by gender or age of the child. Caregivers who reported (n = 100) that their children had some medical diagnosis (e.g., food allergy, autism, or Down syndrome) had lower sDOR adherence scores than caregivers who indicated their children had no medical diagnosis (p = 0.031). There was no statistical difference in ecSI2.0TMBR scores between the categories of caregiver's gender, age, occupancy, and child's gender and age. Caregivers with income higher than 10 MW, living in houses with more than 3 people, and with graduate schooling showed higher EC scores. Caregivers considered competent eaters by ecSI2.0TMBR scores differed only for educational level, which was more frequent among graduate participants. The total EC score was positively associated with total and mealtime structure (D1), how food is available to the child (D3), and the parent gives respect to the child's autonomy in eating (D4) sDOR.2-6yTM domains. There was a negative association with the what is available to the child (D2) sDOR.2-6yTM domain. In general, the sDOR.2-6y-BR had a positive association with the ecSI2.0TMBR in all domains and total, with a low but significant correlation. This study enables the investigation of the division of responsibility in feeding and EC of a sample of caregivers of children in Brazil. This is the first study to apply the translated and validated version of the sDOR.2-6y-BR and showed good results, where competent eaters' caregivers adhere more to the principles of sDOR.

Translation of the Satter's Division of Responsibility in Feeding Questionnaire into Brazilian Portuguese: A Cross-Sectional Study.

This cross-sectional study aimed to translate and perform a psychometric analysis (evaluation of reproducibility and internal consistency) of the sDOR.2-6y™ into Brazilian Portuguese. The translation and back-translation followed the protocol required by the NEEDs Center, and the approved version was called "sDOR.2-6y™-Português-Brasil". The approved version was submitted to a test-retest round to verify its reproducibility through the Intraclass Correlation Coefficient (ICC). A pilot study was performed to assess the internal consistency of the instrument. The reproducibility analysis (n = 23) showed a total ICC of 0.945. With the data from the pilot study (n = 384), the internal consistency evaluation was analyzed through Cronbach's alpha coefficient, and the instrument obtained an overall Cronbach's alpha of 0.301. The translation of the sDOR.2-6y™ into Brazilian Portuguese is the first and only tool available for the Brazilian population to exclusively assess the division of responsibility in feeding, which is essential to the academic community, health professionals, and research on child feeding. Therefore, this instrument in Brazilian Portuguese will allow future research on the division of responsibility in feeding among those responsible for children in Brazil.

Eating Competence among Brazilian Adults: A Comparison between before and during the COVID-19 Pandemic.

The coronavirus pandemic started a worldwide emergency, and tight preventive actions were necessary to protect the population, changing individuals' daily habits. Dwelling and working at home can change dietary habits, affect food choice and access, as well as the practice of physical activity. In this regard, this study's goal was to compare eating competence (EC) among Brazilian adults before and during the coronavirus pandemic, using the Brazilian version of the eating competence Satter inventory (ecSI2.0™BR) with the "retrospective post-then-pre" design. This cross-sectional study was performed from 30 April to 31 May 2021 among a convenience sample of the Brazilian adult population using an online platform (Google® Forms). In the studied sample (n = 302 in which 76.82% were females), EC total score lowered during the pandemic (31.69 ± 8.26 vs. 29.99 ± 9.72; p < 0.005), and the decrease was worst after the beginning of the pandemic among those who reported weight gain, decreased the consumption of fruit and vegetables, and increased the consumption of sugary beverages. The contextual skill component seems relevant in this scenario, where our life and routines were changed entirely, demonstrating that the ability to manage the food context is essential, especially when sanitary and economic situations represent a new challenge.

How Are School Menus Evaluated in Different Countries? A Systematic Review.

School meals should focus on quality of life issues, particularly on reducing food shortages, overweight, obesity and its consequences. As an essential tool for quality assurance, creating the menu is an activity of great complexity and requires multidisciplinary knowledge. This activity covers the observation of countless aspects of quality, highlighting nutritional, sensory, cultural, hygienic, and sanitary issues, among others. This study aims to identify and analyze instruments and methods to evaluate school menus in different countries. The authors developed specific search strategies for Scopus, Web of Science, Science Direct, Pubmed, Lilacs, ProQuest Global, and Google Scholar. The included studies' methodological quality was assessed using the statistical analysis and meta-analysis review tool (MASTARI). A total of 16 cross-sectional studies met the inclusion criteria and were analyzed. Brazil and Spain were the countries that presented the highest number of studies (n = 5; 31.25% for each). The majority of the studies have a qualitative approach (n = 12, 75%), and only 25% (n = 4) of the studies present quantitative assessment methods to evaluate school menus. No school menu assessment tools were found to assess all aspects of menu planning. The results show a lack of a methodology or of instruments for evaluating the menus offered for school meals that can contribute to better dietary care offered to students.

Eating Competence Associated with Food Consumption and Health Outcomes among Brazilian Adult Population.

This study aimed to associate Eating Competence (EC) with food consumption and health outcomes in the Brazilian adult population. Researchers developed a questionnaire to associate EC with sociodemographic information, health outcomes, and food consumption. Data on body weight and height was referred to by participants in the questionnaire, and body mass index (BMI) was calculated and classified. A question to evaluate the perception of body size was included. After constructing the questionnaire items, content validation and semantic evaluation were performed following the Delphi method with a group of judges composed of 26 health professionals. The judges evaluated the sociodemographic information, health outcomes, and food consumption items associated with the eating competence instrument (previously validated in Brazilian-Portuguese). The final version of the questionnaire was composed of 33 items. Our results confirmed good reliability, responsiveness, and internal consistency. A total of 1810 Brazilians answered the questionnaire. Most of the participants were female, up to 40 years old, with a high education level and high income. Most of the participants did not report diabetes or hypertension. The EC total score did not differ among males and females. Individuals up to 40 years old presented a lower total score. The increase in educational level and income also increased EC total score. Excess weight individuals showed lower EC compared to the normal weight/underweight. Individuals who consumed fruits and/or vegetables five or more days/week presented the best scores for total EC.

Eating Competence among a Select Sample of Brazilian Adults: Translation and Reproducibility Analyses of the Satter Eating Competence Inventory.

This study aimed to translate and validate the Satter Eating Competence Inventory (ecSI2.0TM) from English to Brazilian Portuguese. The process included three steps: (i) translation and back-translation of the original ecSI2.0TM to Brazilian Portuguese; (ii) evaluation of its reproducibility; (iii) a pilot study to validate the Brazilian version of the Satter Eating Competence Inventory (ecSI2.0TMBR) for a selected sample of the Brazilian adult population (internal consistency and factor validity). The reproducibility (test-retest reliability) was verified using the intraclass correlation coefficient (ICC) obtained by the responses of 32 Brazilian adults. All domains of the ecSI2.0TMBR and the total score showed ICC > 0.8. Considering the entire questionnaire, none of the domains presented significant divergences among the participants' responses (p < 0.001). In the pilot study with 662 individuals, 74.9% (n= 496) were female, mean age was 40.33 ± 12.55, and they presented a higher level of schooling and income. Analyses revealed Cronbach's alpha coefficients of 0.869 for the ecSI2.0TMBR total scale, 0.793 for Eating Attitudes, 0.527 for Internal Regulation, 0.728 for Food Acceptance, and 0.822 for Contextual Skills. In general, the ecSI2.0™BR presented good acceptability, showing total floor and ceiling effects of ≤0.6%. Factor validity was examined by confirmatory factor analysis. The four domains presented a good fit in the confirmatory factor analysis: RMSEA = 0.0123 (95% CI: 0-0.0266); CFI = 0.998; χ2 = 75.9; df = 69; p = 0.266. The ecSI2.0TMBR is the first tool designed to measure eating competence (EC) in the Brazilian population, showing good reproducibility and internal consistency. We expect the ecSI2.0TMBR will support innovative research to investigate the association of EC and health outcomes, as well as new strategies based on emerging behavioral theories to enhance nutritional education policy.