Eating contexts and their associations with socio-demographic factors in Brazilian adolescents (EVA-JF Study).

OBJECTIVE: To describe the eating contexts and estimate their associations with socio-demographic factors in a sample of Brazilian adolescents. DESIGN: Cross-sectional study. We used an exploratory questionnaire about eating contexts (encompassing regularity of meals, places where they occur and if they take place with attention and in company), which was submitted to cluster analysis. Subsequently, three clusters were identified: cluster 1, 'appropriate eating contexts at breakfast, lunch and dinner'; cluster 2, 'inappropriate eating context at breakfast' and cluster 3, 'inappropriate eating context at dinner'. Multinomial logistic regression models were performed, without and with adjustments, using cluster 1 as reference. SETTING: Twenty-nine public schools of Juiz de Fora, MG, Southeast Brazil. PARTICIPANTS: Adolescents, 14-19-year-olds (n 835). RESULTS: We observed relevant prevalence of adolescents omitting breakfast (52·9 %) and dinner (39·3 %), and who had the habit of eating sitting/lying on the couch/bed or standing/walking, and in front of screens. Breakfast usually occurred unaccompanied (70·8 %); around half (47·5 %) and little over a third (36·1 %) of the sample also would usually have lunch and dinner unaccompanied, respectively. Furthermore, through multivariate analysis, we found associations of eating contexts clusters with female sex (more likely in clusters 2 and 3), age range 14-15-year-olds (less likely in cluster 2) and higher mother's schooling (more likely in cluster 3). CONCLUSIONS: We verified an alarming prevalence of adolescents with eating contexts unaligned with healthy eating recommendations. Additionally, inappropriate eating contexts at breakfast and/or at dinner were associated with socio-demographic factors (sex, age range and mother's schooling).

Eating contexts at breakfast, lunch, and dinner: Associations with ultra-processed foods consumption and overweight in Brazilian adolescents (EVA-JF Study).

This cross-sectional study estimated associations of eating contexts (including regularity of meals, places where they occur, and if they take place with attention and in company) with food consumption by degree of industrial processing and overweight indicators in a sample of Brazilian adolescents (14-19 years old) enrolled in 29 public schools in Juiz de Fora, MG (n = 805). We used an exploratory questionnaire, which was submitted to cluster analysis. Three clusters were identified: cluster 1 (n = 572), "appropriate eating contexts at breakfast, lunch, and dinner"; cluster 2 (n = 139), "inappropriate eating context at breakfast"; and cluster 3 (n = 94) "inappropriate eating context at dinner". The evaluation of food consumption involved two 24-h dietary recalls, whose items were analyzed according to the NOVA classification system. Linear regression models were performed, using cluster 1 as reference. Clusters 2 and 3 were associated with an increase in the energy fraction from ultra-processed foods [respectively, ß = 2.55% (IC 95%: 0.50; 5.05) and ß = 4.18% (IC 95%: 1.21; 7.14)]; and cluster 2 was associated with a reduction in the energy fraction from unprocessed or minimally processed foods and processed culinary ingredients [ß = -3.61% (IC 95%: -6.40; -0.82)]. Additionally, clusters 2 and 3 were associated with an increase of body mass index for age [respectively, ß = 0.23 z-score (IC 95%: 0.01; 0.46) and ß = 0.27 z-score (IC 95%: 0.02; 0.54)]; and cluster 2 was associated with an increase of body fat [ß = 1.21% (IC 95%: 0.23; 2.64)]. In conclusion, inappropriate eating contexts at breakfast and dinner were associated with higher ultra-processed food intake, higher body mass index and higher body fat percentage.

Food environment, social deprivation and obesity among students from Brazilian public schools.

OBJECTIVE: To investigate the relationship between social deprivation and the food environment. Furthermore, to evaluate if the food environment is associated with the prevalence of obesity among students in Brazilian public schools. DESIGN: Cross-sectional. For the classification of obesity, weight and height were measured, and the cut-off point of BMI-for-age Z-score >+2 was adopted. Social deprivation level was determined from the Health Vulnerability Index (HVI). To assess the food environment, the density of food establishments in urban residential areas was calculated. Associations between the food environment and the presence of obesity were estimated by binary logistic regression through a generalized estimating equations model. SETTING: Juiz de Fora, Minas Gerais, Brazil. SUBJECTS: Children and adolescents (n 661) aged 7-14 years. RESULTS: The lowest social deprivation level showed a higher density of all types of establishments that sold predominantly unhealthy foods. An inverse association was found between the density of supermarkets and hypermarkets and the presence of obesity (OR=0·58; 95 % CI 0·36, 0·93). For the other categories of food retailers, no significant differences were found. CONCLUSIONS: The findings reinforce the need for public policies that promote equality in the food environments of the city. Also, further investigations into the influence of the presence of supermarkets on the nutritional status of children and adolescents are required.

Is neighbourhood social deprivation in a Brazilian city associated with the availability, variety, quality and price of food in supermarkets?

OBJECTIVE: To verify differences in the availability, variety, quality and price of unprocessed and ultra-processed foods in supermarkets and similar establishments in neighbourhoods with different social deprivation levels at Juiz de Fora, Minas Gerais, Brazil. DESIGN: Cross-sectional study. SETTING: The Obesogenic Environment Study in São Paulo's Food Store Observation Tool (ESAO-S) was applied in thirty-three supermarket chains, wholesale and retail supermarkets. RESULTS: Fruits, vegetables and ultra-processed foods were available in almost all establishments, without differences according to Health Vulnerability Index (HVI; which varies from 0 to 1 point and the higher the worse; P > 0·05). Most establishments were concentrated in low vulnerability areas and offered healthy foods with greater variety and quality, despite higher prices. The Healthy Food Store Index (HFSI; which varies from 0 to 16 points and the higher the best) was calculated from the ESAO-S and the mean score was 8·91 (sd 1·51). The presence and variety of unprocessed foods count as positive points, as do the absence of ultra-processed products. When HFSI was stratified by HVI, low HVI neighbourhoods presented higher HFSI scores, compared with medium, high and very high HVI neighbourhoods (P = 0·001). CONCLUSIONS: Supermarkets and similar establishments are less dense in areas of greater social deprivation and have lower prices of healthy foods, but the variety and quality of those foods are worse, compared with areas of low vulnerability. We found worse HFSI for supermarkets located in areas with greater vulnerability. Those findings can guide specific public policies improving the urban food environment.

Frequency of breakfast consumption and its associations with food consumption by degree of industrial processing and with indicators of overweight in Brazilian adolescents (EVA-JF Study).

OBJECTIVE: The aim of this study was to investigate the frequency of breakfast consumption and estimate its associations with the consumption of food at different degrees of industrial processing and with overweight indicators in Brazilian adolescents. METHODS: This cross-sectional study involved a probabilistic sample of 14- to 19-y-old adolescents enrolled in 29 public schools in the municipality of Juiz de Fora, MG, Southeast Brazil (n = 805). The frequency of breakfast consumption was evaluated via a questionnaire (classified into "do not consume", "sometimes consume", and "regularly consume"). The evaluation of food consumption involved two 24-h dietary recalls, the items of which were analyzed according to the NOVA classification system. Overweight indicators (waist circumference, body mass index for age (BMI-for-age), and body fat percentage) were evaluated according to a standard protocol. Linear regression models were performed, first without and then with adjustments for sociodemographic characteristics. RESULTS: We found that 20% of adolescents skipped breakfast, and ∼46% of the caloric intake came from ultra-processed foods. Breakfast omission was associated with a mean increase of 3.02% (95% confidence interval [CI], 0.52-5.53) in energy intake from ultra-processed foods, in addition to a mean increase of 0.28 z-score (95% CI, 0.05- 0.52) of BMI-for-age and of 1.64% (95% CI, 0.21-3.08) in body fat. CONCLUSIONS: We verified that the omission of breakfast was associated with higher consumption of ultra-processed foods, as well as a higher BMI-for-age and higher percentage of body fat, reinforcing the importance of actions to encourage the consumption of this meal and the adoption of healthy eating practices in adolescents.

Involvement of Brazilian adolescents in home cooking: An exploratory analysis (EVA-JF Study).

OBJECTIVE: The aim of this study was to investigate the involvement of Brazilian adolescents in home cooking, estimating its associations with sex and socioeconomic status. METHODS: This cross-sectional study involved a probabilistic sample of 14- to 19-y-olds enrolled in 29 public schools in the municipality of Juiz de Fora, MG, Southeast Brazil (n = 835). To assess involvement in home cooking, a 12-question questionnaire was used. The content was based on the Brazilian Food Guide, which encourages the acquisition, development, and sharing of culinary skills. Pearson's χ test and Poisson regression models were carried out, without and with adjustments. RESULTS: Most of the adolescents did not usually participate in meal planning (61%), and in the choice/purchase of food and culinary ingredients (67%). Boys were less likely to know how to cook "from scratch", positively self-evaluate their culinary skills, enjoy cooking, wish to learn more about cooking and meal preparation, and to participate frequently in the planning and preparation of meals. Belonging to a lower socioeconomic status represented a greater probability of preparing meals alone for the family. CONCLUSIONS: We verified an alarming prevalence of adolescents with behaviors unaligned with Brazilian Food Guide recommendations; that is, most of them, especially boys, were not involved in home cooking. Adolescence may present a window of opportunity for the development of culinary skills, resulting in long-term benefits for the population's diet quality. Furthermore, to change a historical pattern that overloads women's daily lives, it is necessary to encourage, from an early age, the presence of boys in the kitchen.

Effectiveness of fortification of drinking water with iron and vitamin C in the reduction of anemia and improvement of nutritional status in children attending day-care centers in Belo Horizonte, Brazil.

BACKGROUND: Because of the high prevalence of iron-deficiency anemia in Brazil, individual control measures tend to be ineffective, and fortification of foods with iron is considered the most effective method to fight anemia. OBJECTIVE: To evaluate the effectiveness of fortification of drinking water with iron and vitamin C in the reduction of anemia in children in day-care centers in Belo Horizonte, Brazil. METHODS: This before-and-after study evaluated 318 children aged 6 to 74 months. Identification data and data on socioeconomic variables were collected; anthropometric and biochemical measurements were performed before and after 5 months of fortification of water with 5 mg of elemental iron and 50 mg of ascorbic acid per liter. The fortified water was used for drinking and cooking at the day-care center. Wilcoxon's nonparametric test was used to evaluate the differences in continuous variables, and McNemar's test was used to compare the prevalence rates of anemia. RESULTS: The prevalence of anemia decreased significantly from 29.3% before fortification to 7.9% at the end of the study, with a significant increase in hemoglobin levels. Reductions in the prevalence rates of stunting and underweight were observed. CONCLUSIONS: Fortification of water with iron and vitamin C significantly reduced the prevalence of anemia and improved nutritional status among children attending day-care centers.

PREVALENCE AND FACTORS ASSOCIATED WITH ANEMIA IN CHILDREN ENROLLED IN DAYCARE CENTERS: A HIERARCHICAL ANALYSIS. / PREVALÊNCIA E FATORES ASSOCIADOS À ANEMIA EM CRIANÇAS DE CRECHES: UMA ANÁLISE HIERARQUIZADA.

OBJECTIVE: To determine the prevalence and factors associated with anemia in children younger than five years old enrolled in public daycare centers in a city in southwestern Bahia, in the northeast of Brazil. METHODS: This was a cross-sectional study that included a sample of 677 children enrolled in public daycare centers in Vitória da Conquista, Bahia, Brazil. A portable hemoglobinometer was used to measure hemoglobin. The concentration of <11 g/dL was considered the cutoff point for a diagnosis of anemia. A questionnaire was applied to parents/guardians in order to collect socioeconomic data, maternal characteristics and information on the child's health and nutrition. Height and weight were measured to assess the child's nutritional status. Poisson regression with robust variance and hierarchical selection of variables was used to identify factors associated with anemia. RESULTS: The prevalence of anemia was 10.2% and was more frequent in children whose homes had no sanitary facilities (PR 3.36; 95%CI 1.40-8.03); in those who did not exclusively breastfeed (PR 1.80; 95%CI 1.12-2.91); in children aged less than 36 months (PR 1.85; 95%CI 1.19-2.89) and those who had low height for age (PR 2.06; 95%CI 1.10-3.85). CONCLUSIONS: The prevalence of anemia is considered to be a mild public health problem in the children, who are enrolled in daycare centers. Children with inadequate sanitary conditions, and that were not exclusively breastfed, as well as younger children and children with a nutritional deficit, were more likely to present the condition.

OBJETIVO: Determinar a prevalência e os fatores associados à anemia em crianças menores de cinco anos assistidas em creches públicas de um município no sudoeste da Bahia. MÉTODOS: Estudo transversal com uma amostra de 677 crianças matriculadas nas creches públicas de Vitória da Conquista, Bahia. Para determinação da hemoglobina por meio de punção digital, utilizou-se hemoglobinômetro portátil, considerando-se valores de hemoglobina <11 g/dL como ponto de corte para o diagnóstico da anemia. Aplicou-se questionário aos pais ou responsáveis para coleta de informações socioeconômicas, características maternas e de saúde e nutrição da criança. Medidas antropométricas de peso e estatura foram utilizadas para avaliação do estado nutricional da criança. Análise de regressão de Poisson com variância robusta e seleção hierárquica das variáveis foi usada para verificar fatores associados com anemia. RESULTADOS: A prevalência de anemia foi de 10,2% e houve mais prevalência nas crianças cujas moradias não apresentavam instalação sanitária (RP 3,36; IC95% 1,40-8,03); naquelas que não receberam aleitamento materno exclusivo (RP 1,80; IC95% 1,12-2,91); nas crianças com idade inferior a 36 meses (RP 1,85; IC95% 1,19-2,89) e com baixa estatura para a idade (RP 2,06; IC95% 1,10-3,85). CONCLUSÕES: A prevalência de anemia pode ser considerada um problema de Saúde Pública menor em crianças de creches populares nesse município. Crianças com condições sanitárias inadequadas, que não receberam leite materno exclusivo, bem como as em idades mais precoces e com déficit nutricional foram mais suscetíveis.

Factors associated with non-frequent breakfast consumption in adolescents (EVA-JF Study) / Fatores associados ao consumo não frequente de café da manhã em adolescentes (Estudo EVA-JF)

ABSTRACT Objective To estimate the association of infrequent breakfast consumption with socioeconomic, behavioral, and individual factors in a sample of Brazilian adolescents from public schools. Methods Cross-sectional study with adolescents aged from 14 to 19 from public schools in Juiz de Fora, state of Minas Gerais. The frequency of consumption of breakfast, snacks, soft drinks, industrialized drinks, the usual food consumption, body mass index, body fat percentage, and waist circumference were evaluated. Other socioeconomic, behavioral, and individual data were obtained through questionnaires. Logistic regression analysis and hierarchical selection of variables were used to verify the associated factors. Results The sample consisted of 805 adolescents; 53.4% reported infrequent breakfast consumption. Through hierarchical logistic regression analysis, it was evidenced that the house occupancy status (OR: 0.618; 95%CI: 0.4410.865; p=0.005) was the distal factor associated with infrequent breakfast consumption; the intermediate factors were the consumption of industrialized beverages (OR: 0.658; 95%CI: 0.486-0.890; p=0.007) and percentage of energy from processed foods (OR: 0.935; 95%CI: 0.907-0.964; p<0.001); and the proximal factors were the male gender (OR: 0.696; 95%CI: 0.520-0.932; p=0.0015) and being nonwhite (OR: 1.529; 95%CI: 1.131-2.069; p=0.006). Conclusion Male adolescents who lived in owned houses, with occasional consumption of industrialized beverages and a higher percentage of energy derived from processed foods, had lower chances of infrequent breakfast consumption, while non-white adolescents had higher chances.

RESUMO Objetivo Estimar as associações do consumo não frequente de café da manhã com fatores socioeconômicos, comportamentais e individuais em uma amostra de adolescentes de escolas públicas. Métodos Estudo transversal realizado com adolescentes de 14 a 19 anos matriculados em escolas públicas de Juiz de Fora (MG). Foram avaliadas a frequência de consumo de café da manhã, lanches, refrigerantes e bebidas industrializadas, consumo alimentar usual, IMC, percentual de gordura corporal e perímetro da cintura. Demais dados socioeconômicos, comportamentais e individuais foram obtidos através de questionários. A análise de regressão logística e seleção hierárquica das variáveis foram usadas para verificar fatores associados. Resultados A amostra foi composta por 805 adolescentes e 53,4% deles relataram consumo não frequente de café da manhã. Através da análise de regressão logística hierarquizada, evidenciou-se que a ocupação em domicílio próprio (OR: 0,618; IC95%: 0,441-0,865; p=0,005) foi o fator distal associado ao consumo não frequente de café da manhã, além dos fatores intermediários "consumo não frequente de bebidas industrializadas" (OR: 0,658; IC95%: 0,486-0,890; p=0,007) e "percentual de energia proveniente de alimentos processados" (OR: 0,935; IC95%: 0,907-0,964; p<0,001) e dos fatores proximais "sexo masculino" (OR: 0,696; IC95%: 0,520-0,932; p=0,0015) e "cor da pele não branca" (OR: 1,529; IC95%: 1,131-2,069; p=0,006). Conclusão Adolescentes que residiam em domicílios próprios, com consumo não frequente de bebidas industrializadas, com maior percentual de energia proveniente de alimentos processados e do sexo masculino apresentaram menores chances de consumo não frequente de café da manhã, enquanto, adolescentes com cor da pele não branca apresentaram maiores chances.

Consumption of differently processed food by public school adolescents / Consumo alimentar de adolescentes de escolas públicas segundo grau de processamento industrial dos alimentos

ABSTRACT Objective To characterize food consumption, considering the degree of industrial food processing by public schools' adolescents. Methods Cross-sectional study involving adolescents aged 14 to 19 years, of both genders, attending public schools in Juiz de Fora, MG. Food consumption was assessed using two 24-hour dietary recalls. Foods were classified into three groups according to the degree of industrial processing: (1) unprocessed foods or minimally processed foods, culinary ingredients and preparations based on these foods; (2) processed foods; (3) ultra-processed foods. In addition, weight and height information was collected, with subsequent calculation of body mass index/age to assess the individuals' nutritional status according to the gender. Pearson's chi-square, Mann-Whitney and Kruskal-Wallis tests were performed, adopting a value of p<0.05. Results The sample consisted of 804 adolescents, with a predominance of females (57.5%). In the sample, 29.9% and 26.1%, of girls and boys, respectively, were overweight. There was a difference in the daily consumption of ready-made sweet-tasting foods, being higher in females (26.2%) when compared to males (18.1%), whereas the consumption of soft drinks (one to four times a week) was 47.2% and 55.6% in girls and boys, respectively (p<0.05). Higher consumption of ultra-processed foods was observed in females (p=0.02) and processed foods in males (p=0.008). Conclusion There was a high contribution of ultra-processed foods in the diet of adolescents in public schools; a high prevalence of overweight was observed in both genders.

RESUMO Objetivo Caracterizar o consumo alimentar através do grau de processamento industrial dos alimentos consumidos por adolescentes matriculados em escolas públicas. Métodos Estudo transversal com adolescentes de 14 a 19 anos de ambos os sexos matriculados em escolas públicas de Juiz de Fora, MG. O consumo alimentar foi avaliado através de dois recordatórios de 24h. Os alimentos foram classificados em três grupos de acordo com o grau de processamento industrial: (1) alimentos in natura ou minimamente processados, ingredientes culinários e preparações a base desses alimentos; (2) alimentos processados; (3) alimentos ultraprocessados. Ademais, foram coletadas informações de peso e altura dos estudantes, com posterior cálculo de índice de massa corporal/idade para avaliação do estado nutricional conforme o sexo. Foram realizados os testes Qui-quadrado de Pearson, Mann-Whitney e Kruskal-Wallis, adotando o valor de p<0,05. Resultados A amostra foi composta por 804 adolescentes, com predomínio do sexo feminino (57,5%). Entre os adolescentes, 29,9% das meninas e 26,1% dos meninos apresentaram excesso de peso. Observou-se diferença no consumo diário de alimentos prontos de sabor doce, sendo maior no sexo feminino (26,2%) quando comparado ao masculino (18,1%), ao passo que o consumo de refrigerantes de uma a quatro vezes na semana foi de 47,2% e 55,6% nas meninas e meninos, respectivamente (p<0,05). Maior consumo de alimentos ultraprocessados foi observado no sexo feminino (p=0,02) e de alimentos processados no sexo masculino (p=0,008). Conclusão Verificou-se elevada contribuição proveniente do grupo dos alimentos ultraprocessados na dieta dos adolescentes de escolas públicas, com altas prevalências de excesso de peso em ambos os sexos.

[Prevalence and factors associated to anemia and iron deficiency in 18-to 24-month old infants]. / Prevalência e fatores associados â anemia e deficiência de ferro em crianças de 18 a 24 meses.

A transversal study was carried out with 101 18-to 24-month old infants, attended at public health services in Viçosa, MG, Brazil, The objective of this study was to verify the prevalence and factors associated to anemia and iron deficiency among infants. Data were obtained by interviews of the infants' parents or guardians at their households. Hemoglobin and ferritin analyses were peformed using an automatic counter and the immunometric dosage method, respectively. Feces samples were analyzed by the Hoffman, Faust and Ritchie methods. Anemia was characterized by hemoglobin concentration and iron deficiency by ferritin. For dietary practice, the 24-hour recall was used. Linear regression and logistics analyses were conducted to evaluate the variables associated to hemoglobin and iron deficiency, respectively. Anemia, iron deficiency and intestinal parasite prevalences were 30.1; 38.4, and 21%, respectively. The number of household members, age infants were introduced to juices/or fruit, mother's level of instruction, and total breastfeeding period were associated to the levels of hemoglobin plasma. The associated variables for iron deficiency were milk consumption near meals and number of household members.

Um incentivo à comida de verdade: relato de experiência em Educação Alimentar e Nutricional com escolares / An incentive to real food: report of experience in Food and Nutrition Education with school children

O presente trabalho objetivou relatar um projeto de educação alimentar e nutricional desenvolvido com escolares em uma escola municipal da cidade de Juiz de Fora ­ MG, no período de maio a junho de 2018. Foram realizadas quatro intervenções através de atividades de até 60 minutos cada, com intervalo de uma semana. As ações contaram com: questionário (pré-intervenção); exposição verbal com incentivo ao diálogo; recursos lúdicos; e oficina culinária. Foi realizada antropometria, seguindo recomendações do Ministério da Saúde, e para classificação de estado nutricional, utilizou-se o programa WHO AntroPlus®. Participaram da intervenção 91 alunos, sendo 56% do sexo masculino e com mediana de idade de 8 anos (6-10). Os resultados reforçaram a necessidade de ações de educação alimentar e nutricional. Quanto às atividades, houve boa aceitação, bem como compreensão, avaliada pelos comentários que traduziam, em suas palavras e contexto, o que lhes era ensinado. Notou-se que sequenciar o conteúdo, fazer uso de analogias e de abordagens lúdicas e participativas foram escolhas que facilitaram o processo.

The present work aimed to report a food and nutritional education project developed with school children at a municipal school in the city of Juiz de Fora, MG, from May to June 2018. Four interventions were carried out through activities of up to 60 minutes each, with an interval of one week. The actions included: questionnaire (pre-intervention); oral presentation with encouragement of dialogue; recreational resources; and cooking workshop. Anthropometry was performed, following the recommendations of the Ministry of Health, and for the classification of nutritional status, the WHO program AntroPlus® was used. 91 students participated in the intervention, 56% of them male and with median age of 8 years (6-10). The results reinforced the need for food and nutrition education actions. As for the activities, there was good acceptance, as well as understanding, evaluated by the comments that translated, in their words and context, what they were taught. It was noted that sequencing content, making use of analogies and playful and participatory approaches, were choices that facilitated the process.

[Association between fat mass index and fat-free mass index values and cardiovascular risk in adolescents]. / Associação entre índice de massa de gordura e índice de massa livre de gordura e risco cardiovascular em adolescentes.

OBJECTIVE: To describe the association between fat mass index and fat-free mass index values and factors associated with cardiovascular risk in adolescents in the city of Juiz de Fora, Minas Gerais. METHODS: Cross-sectional study with 403 adolescents aged 10-14 years, from public and private schools. Anthropometric, clinical, biochemical measurements were obtained, as well as self-reported time spent performing physical exercises, sedentary activities and sexual maturation stage. RESULTS: Regarding the nutritional status; 66.5% of the adolescents had normal weight; 19.9% were overweight and 10.2% were obese. For both genders, the fat mass index was higher in adolescents that had high serum triglycerides, body mass index and waist circumference. CONCLUSIONS: Adolescents that had anthropometric, clinical and biochemical characteristics considered to be of risk for the development of cardiovascular disease had higher values of fat mass index. Different methodologies for the assessment of body composition make health promotion and disease prevention more effective.

Fatores associados ao tempo e à frequência do aleitamento materno / Factors associated with time and frequency of breast-feeding

Objetivos: Avaliar os fatores que determinam o tipo e o tempo de aleitamento materno, bem como delinear sobre a situação social e nutricional de mulheres atendidas na rede de atenção primária à saúde no município de Juiz de Fora (MG). Métodos: Realizaram-se quatro avaliações: a primeira no terceiro trimestre da gestação, e as outras, nos 1o, 3o e 6o meses pós-parto. Inicialmente, aplicou-se um questionário sobre amamentação e um Recordatório 24 horas, também aplicado no 6o mês pós-parto. Posteriormente, questionou-se sobre a frequência, tipo de aleitamento e dificuldades no manejo. Resultados: As variáveis que influenciaram significativamente no aleitamento materno exclusivo nos 1°, 3° e 6° meses foram: maior consumo mediano de Vitamina C e B9, maior desempenho no teste sobre amamentação, idade da mãe entre 20 e 35 anos, consumo adequado de carboidratos e suplementação de complexo vitamínico. Os fatores protetores do aleitamento materno exclusivo ou predominante foram: apresentar alguma dificuldade para amamentar e dieta inadequada em relação aos lipídios. Já os fatores de risco foram: fumo na gestação, não saber responder sobre o correto manejo da lactação e renda familiar menor que um salário mínimo. Conclusões: Variáveis maternas, dietéticas, socioeconômicas e conhecimentos sobre o manejo da lactação influenciaram no tempo e tipo do aleitamento materno.

Objectives: To evaluate the factors determining the type and maternal breastfeeding time and report on the social and nutritional status of women at the local network of primary health care in the city of Juiz de Fora (MG). Methods: There were four evaluations: the first in the third trimester of pregnancy and the others in the first, third, and sixth months following delivery. At first, we applied a questionnaire about breastfeeding and 24-hour dietary recall, also applied in the sixth month postpartum. Subsequently, they were asked about the frequency, type of feeding, and difficulties in management. Results: The variables that significantly influenced the exclusive breastfeeding in the first, third, and sixth months were higher mean intake of vitamins C and B9, higher scores in the test on breastfeeding, mother aged between 20 and 35 years old, adequate intake of carbohydrates and supplementation of vitamin complex. Protective factors in exclusive or predominant breastfeeding were having some difficulty in breastfeeding and inadequate diet in relation to lipids. However, the risk factors were smoking during pregnancy, being unable to correctly answer about lactation management, and family income lower than one minimum wage. Conclusions: Maternal variables, diet, socioeconomic, and knowledge about lactation management influenced the time and type of breastfeeding.

Prevalence and factors associated with excessive weight gain in pregnancy in health units in the southwest of Bahia.

OBJECTIVE: To determine the prevalence of excessive gestational weekly weight gain and to identify its association with demographic, socioeconomic, obstetric, anthropometric, and behavioral characteristics. METHODS: This cross-sectional study included 328 pregnant women attending all health units in the urban area of Vitória da Conquista, Bahia. The data were collected from May 2010 to June 2011. The weekly weight gain was evaluated according to the current recommendations of the Institute of Medicine. The association among the studied factors and the excessive weekly weight gain was observed in pregnant women in the second and third trimesters, using the Poisson regression with robust variance. RESULTS: The prevalence rate of excessive weekly weight gain in pregnant women in the second and third trimesters was found to be 42.5%. The determinants of excessive weekly weight gain were family income < 1 minimum wage (PR: 2.65; 95%CI 1.18 - 4.83) and pregestational weight status overweight/obesity (PR: 1.33; 95%CI 1.01 - 1.75). CONCLUSION: The results emphasize the importance of monitoring the weight gain during pregnancy. The evaluation of the weekly weight gain enables early interventions with the goal of preventing the excessive total weight gain and its consequences for both the mother and the child.

Evaluation of the predictive capacity of vertical segmental tetrapolar bioimpedance for excess weight detection in adolescents.

OBJECTIVE: To analyze the predictive capacity of the vertical segmental tetrapolar bioimpedance apparatus in the detection of excess weight in adolescents, using tetrapolar bioelectrical impedance as a reference. METHODS: This was a cross-sectional study conducted with 411 students aged between 10 and 14 years, of both genders, enrolled in public and private schools, selected by a simple and stratified random sampling process according to the gender, age, and proportion in each institution. The sample was evaluated by the anthropometric method and underwent a body composition analysis using vertical bipolar, horizontal tetrapolar, and vertical segmental tetrapolar assessment. The ROC curve was constructed based on calculations of sensitivity and specificity for each point of the different possible measurements of body fat. The statistical analysis used Student's t-test, Pearson's correlation coefficient, and McNemar's chi-squared test. Subsequently, the variables were interpreted using SPSS software, version 17.0. RESULTS: Of the total sample, 53.7% were girls and 46.3%, boys. Of the total, 20% and 12.5% had overweight and obesity, respectively. The body segment measurement charts showed high values of sensitivity and specificity and high areas under the ROC curve, ranging from 0.83 to 0.95 for girls and 0.92 to 0.98 for boys, suggesting a slightly higher performance for the male gender. Body fat percentage was the most efficient criterion to detect overweight, while the trunk segmental fat was the least accurate indicator. CONCLUSION: The apparatus demonstrated good performance to predict excess weight.

Associação de estado nutricional e maturação sexual com insatisfação com a imagem corporal / Assossiation of nutritional status and sexual maturation with dissatisfaction with body image

Objetivo: Avaliar a associação do estado nutricional e maturação sexual com a insatisfação corporal em adolescentes. Métodos: Trata-se de estudo transversal, realizado com adolescentes de 10 a 14 anos de escolas públicas. Avaliaram-se peso, altura, IMC para idade, perímetro da cintura, percentual de gordura corporal, maturação sexual (escala de Tanner) e insatisfação corporal, por meio da pontuação na Escala de Evaluación de Insatisfación Corporal para Adolescentes (EEICA). Para as análises estatísticas, utilizou-se o programa SPSS versão 17.0 e realizaram-se os testes de Kolmogorov-Smirnov, Qui-quadrado de Pearson, t de Student ou Anova, considerando-se nível de significância de 5%. Resultados: A amostra foi composta por 345 adolescentes, sendo 53,6% do sexo feminino. A maioria (63,6 % meninas e 66,7% dos meninos) são eutróficos. A pontuação média da EEICA no sexo feminino (11,46 ± 5,90) foi superior ao masculino (9,29 ± 4,71) (p<0,001). Em ambos os sexos, o IMC para idade, percentual de gordura corporal e razão cintura/estatura associaram-se a uma maior pontuação na EEICA (p<0,001). No sexo feminino, as pós-puberes foram mais insatisfeitas que as púberes. Conclusão: Observou-se maior pontuação no sexo feminino, assim como associação entre insatisfação corporal e o estado nutricional em ambos os sexos e com a maturação sexual no sexo feminino. Tais achados reforçam a importância da abordagem do tema e suas possíveis consequências, estimulando a reflexão sobre os padrões de beleza. (AU)

Objective: To evaluate the association of nutritional status and sexual maturation with body dissatisfaction in adolescents. Methods: This is a crosssectional study carried out with adolescentes aged 10 to 14 from public schools. Weight, height, BMI for age, waist circumference, percentage of body fat,sexual maturation (Tanner's scale) and body dissatisfaction were assessed using the Scale for Assessment of Body Dissatisfaction for Adolescents (EEICA). For the statistical analysis, the SPSS version 17.0 program was used and the Kolmogorov-Smirnov, Pearson's Chi-square, Student's T or Anova tests were used, considering a significance level of 5%. Results: The sample consisted of 345 adolescents, 53.6% female. The majority (63.6% girls and 66.7% boys) are eutrophic. The mean EEICA sco ,302r for females (11.46 ± 5.90) was higher than for males (9.29 ± 4.71) (p <0.001). In both sexes, the BMI for age, percentage of body fat and waist-toheight ratio were associated with a higher score in the EEICA (p <0.001). In the female, the post-puberals were more dissatisfied than the pubescent ones. Conclusion: It was observed a higher score in the female, as well as an association between body dissatisfaction and nutritional status in both sexes and sexual maturation in females. Such findings reinforce the importance of approaching the theme and its possible consequences, stimulating reflection on beauty standards. (AU)

Perfil nutricional e percepção da imagem corporal em adolescentes de escolas públicas e privadas de município mineiro / Nutritional profile and perception of body image in adolescents of public and private schools in the city of minas gerais

Introdução: A caracterização do perfil nutricional da população de adolescentes, assim como o diagnóstico de sobrepeso e obesidade, é de suma importância para auxiliar a elaboração de medidas de controle e reversão do quadro, possibilitando melhora na qualidade de vida e a prevenção das doenças crônicas não transmissíveis (DCNTs). Objetivo: Traçar o perfil nutricional e fatores associados (gênero, tipo de escola, idade e percepção da imagem corporal) em adolescentes de município de Minas Gerais. Material eMétodos: Estudo transversal, desenvolvido com estudantes de ambos os gêneros do ensino fundamental 2, com idade entre dez a dezesseis anos, matriculados em escolas públicas e privadas. Foram coletados dados antropométricos de 576 indivíduos, incluindo peso, altura e circunferência da cintura, padronizados de acordo com as orientações do Ministério da Saúde. Também foram coletados dados referentes ao hábito alimentar e a percepção da imagem corporal dos indivíduos, através de questionários semi-estruturados e auto preenchidos. Resultados: Dos adolescentes estudados, 58,7% pertenciam à rede pública de ensino, 64,9% do gênero feminino e a mediana de idade foi de 13 anos. Em relação ao estado nutricional, 1,5% da amostra encontrava-se com a estatura inadequada para a idade, 30,93% apresentavam excesso de gordura abdominal e 34,4% excesso de peso. Em relação a imagem corporal, observou-se que os indivíduos obesos e com sobrepeso apresentaram maior insatisfação com sua imagem corporal, quando comparados ao grupo dos indivíduos eutróficos. Em relação aos hábitos alimentares, 37,1% dos adolescentes relataram nunca realizar o café da manhã, mas em relação as outras refeições (almoço e janta) a maioria relatou consumir sempre. Em relação aos alimentos ultraprocessados, 41,2% dos adolescentes relataram consumir guloseimas diariamente e 33,2%, refrigerantes ou suco em pó. Conclusão: São necessárias medidas que promovam a alimentação saudável, visando a prevenção da obesidade, sobrepeso e das doenças crônicas não transmissíveis em adolescentes.

Introduction: The characterization of the nutritional profile of the adolescent population, as well as the diagnosis of overweight and obesity, is of paramount importance to help the elaboration of measures of control and reversion of the picture, allowing improvement in the quality of life and the prevention of chronic diseases noncommunicable diseases (NCDs). Objective: To describe the nutritional profile and associated factors (gender, school type, age and perception of body image) in adolescents from Minas Gerais. Material and Methods: A cross-sectional study, developed with students from both genders of elementary school 2, aged between ten and sixteen, enrolled in public and private schools. Anthropometric data were collected from 576 individuals, including weight, height and waist circumference, standardized according to the guidelines of the Ministry of Health. Data were also collected regarding dietary habits and body image perception of the individuals through semi- structured and self-filled. Results: Of the adolescents studied, 58.7% belonged to the public school system, 64.9% were female, and the median age was 13 years. Regarding nutritional status, 1.5% of the sample was inadequate for height, 30.93% had abdominal fat excess and 34.4% were overweight. Regarding body image, it was observed that obese and overweight individuals showed greater dissatisfaction with their body image, when compared to the group of eutrophic individuals. Regarding eating habits, 37.1% of adolescents reported never having breakfast, but in relation to other meals (lunch and dinner) the majority reported consuming always. In relation to ultraprocessed foods, 41.2% of adolescents reported consuming daily goodies and 33.2%, soft drinks or juice powder. Conclusion: Measures to promote healthy eating are needed to prevent obesity, overweight and chronic noncommunicable diseases in adolescents.

Contribuição de atividades de pesquisa e extensão na formação profissional: a experiência do mercado escola / Contribution of activities of research and extension: the mercado escola experience

Introdução: O conhecimento científico é fundamental para impulsionar o desenvolvimento da sociedade e melhorar as condições de vida da humanidade. Objetivo: O presente estudo teve como objetivo analisar a contribuição de um projeto de pesquisa e extensão para a formação acadêmica dos integrantes do projeto. Material e Métodos: Estudo transversal com 55 alunos do curso de Nutrição da Universidade Federal de Juiz de Fora (UFJF), que participaram do projeto de pesquisa e extensão intitulado "Mercado Escola: ações de educação alimentar e nutricional". Foi entregue questionário auto aplicado e anônimo composto por 04 questões e os alunos respondiam com uma das seguintes opções: discordo totalmente, discordo parcialmente, indiferente, concordo parcialmente e concordo totalmente. As variáveis foram submetidas ao teste de normalidade de Kolmogorov-Smirnov e posteriormente aos testes não paramétricos de Kruskal-Wallis ou Mann-whitney, com nível de significância de p<0.05. Resultados: A maioria dos alunos (92,72%) concordam que o projeto é uma forma de contribuição da Universidade para sua formação acadêmica. Em relação ao saber trabalhar em equipe e a ter mais segurança para lidar com o público, a maioria, (76,36% e 81,81% respectivamente) dos alunos relatou conseguir melhorar essas habilidades, concordando totalmente com a afirmativa. Grande parte dos alunos (98,18%) concordam que a participação no projeto de pesquisa e extensão foi algo importante ou muito importante para o curso de nutrição, sendo essa uma forma de contribuição da Universidade para a formação acadêmica dos alunos. Conclusão: A participação no projeto de pesquisa e extensão foi de grande importância para a formação acadêmica dos alunos, permitindo que eles conseguissem correlacionar os conhecimentos teóricos com a prática vivenciada durante a realização do projeto.

Introduction: Scientific knowledge is fundamental to boost the development of society and improve the living conditions of humanity. Objective: This study aimed to analyze the contribution of a research and extension project to the academic background of the project members. Material and Methods: Cross-sectional study with 55 students from the Federal University of Juiz de Fora (UFJF) Nutrition course, who participated in the research and extension project entitled "School Market: Food and Nutrition Education Actions". A self-administered and anonymous questionnaire consisting of 4 questions was delivered and the students answered with one of the following options: totally disagree, partially disagree, indifferent, partially agree and totally agree. The variables were submitted to the Kolmogorov-Smirnov normality test and subsequently to the nonparametric Kruskal-Wallis or Mann-whitney tests, with a significance level of p<0.05. Results: Most students (92.72%) agree that the project is a form of contribution of the University to their academic formation. Regarding knowing how to work in a team and having more security in dealing with the public, the majority (76.36% and 81.81% respectively) of the students reported to be able to improve these skills, totally agreeing with the statement. Most students (98.18%) agree that participation in the research and extension project was important or very important for the nutrition course, which is a form of contribution of the university to the academic formation of students. Conclusion: Participation in the research and extension project was of great importance for students' academic education, allowing them to correlate theoretical knowledge with the practice experienced during the project.

Estado nutricional, consumo de alimentos ultraprocessados e imagem corporal de adolescentes de uma escola privada do município de Juiz de Fora ­ MG / Nutritional status, consumption of ultraprocessed foods and body image of adolescents from a private school in the city of Juiz de Fora - MG

Introdução: A adolescência é uma fase com intensas mudanças nutricionais e de elevada vulnerabilidade, o que fortalece a necessidade de investigação do referido grupo. Objetivo: Avaliar a percepção da imagem corporal e fatores associados em adolescentes de uma escola privada do município de Juiz de Fora- MG. Material e métodos: Trata-se de um estudo transversal, realizado no ano de 2016, desenvolvido com estudantes de ambos os sexos, cuja faixa etária varia de dez a quatorze anos de idade, matriculados em uma escola privada do Município de Juiz de Fora, Minas Gerais. Os dados antropométricos avaliados nos adolescentes foram peso, altura e circunferência da cintura, padronizados de acordo com as orientações do Ministério da Saúde. Também foram coletados dados referentes ao hábito alimentar e a percepção da imagem corporal dos indivíduos, através de questionários semi-estruturados e auto preenchidos. Foram coletados dados antropométricos de 50 indivíduos. As análises foram processadas no software SPSS, versão 20.0. Resultados: Encontrou-se associação entre a variável idade e insatisfação da imagem corporal, onde os adolescentes com idade inferior à 12 anos apresentaram maior descontentamento com imagem corporal. Ademais, em relação ao estado nutricional foi possível observar elevada prevalência de insatisfação corporal entre indivíduos obesos e com excesso de peso. Em relação aos hábitos alimentares, 84,6% dos adolescentes destinavam metade de suas compras à aquisição de alimentos ultraprocessados. Conclusão: O consumo de ultraprocessados entre os adolescentes foi grande, assim como foi elevada a insatisfação com a imagem corporal. Esses achados demonstram a importância da implementação de ações públicas, voltadas aos adolescentes, com intuito de promoção da alimentação saudável e prevenção da obesidade, sobrepeso e distúrbios de imagem corporal.

Introduction: Adolescence is a phase with intense nutritional changes and high vulnerability, which strengthens the need for research in this group. Objective: To evaluate the perception of body image and associated factors in adolescents from a private school in the city of Juiz de Fora- MG. Material and methods:This is a cross-sectional study carried out in 2016, developed with students of both sexes, whose age ranges from ten to fourteen years of age, enrolled in a private school in the Municipality of Juiz de Fora, Minas Gerais . The anthropometric data evaluated in the adolescents were weight, height and waist circumference, standardized according to the guidelines of the Ministry of Health. Data were also collected regarding dietary habits and the perception of body image of the individuals, through semi-structured questionnaires and auto-filled. Anthropometric data were collected from 50 individuals. The analyzes were processed in SPSS software, version 20.0. Results: We found an association between the age variable and body image dissatisfaction, where adolescents below 12 years of age presented greater dissatisfaction with body image. In addition, in relation to nutritional status, it was possible to observe a high prevalence of body dissatisfaction among obese and overweight individuals. Regarding eating habits, 84.6% of adolescents allocated half of their purchases to the purchase of ultraprocessed foods. Conclusion: The consumption of ultraprocessed among adolescents was great, as was dissatisfaction with body image. These findings demonstrate the importance of the implementation of public actions, aimed at adolescents, aiming to promote healthy eating and prevention of obesity, overweight and body image disorders.