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.

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.

Brazilian health professionals' perception about the Baby-Led Weaning (BLW) method for complementary feeding: an exploratory study.

OBJECTIVE: To describe Brazilian health professionals' perception about the Baby-Led Weaning (BLW) method use for complementary feeding. METHODS: Cross-sectional, descriptive study including 458 health professionals graduated in Nursing, Speech Therapy, Medicine, Nutrition or Dentistry and working in Pediatrics, being directly or indirectly involved with pediatric nutrition. We used a convenience non-probability sampling. The questionnaire applied to participants addressed demographic characteristics, academic degree, workplace, knowledge about clinical practice and perceptions about the possible advantages of the BLW method. RESULTS: Participants had a mean age of 34.5±8.5 years, 64.6% of them working in Southeast Brazil and 65.3% being nutritionists. Most participants reported being acquainted with the BLW method (82.0%). Regarding clinical practice, 38.3% mentioned having recommended the BLW some times, 37.5% often and 20.5% always. Most participants fully agreed that the BLW method could have advantages for babies, for example, having them more likely to share family meals, facilitating adaptation to food flavors and consistencies, enhancing chewing and favoring the development of motor skills. On the other hand, important disagreements were also expressed regarding the BLW convenience and the possibility to create less concerns or anxiety in parents. CONCLUSIONS: The BLW method reported as advantageous, but disagreements were also raised, probably because scientific evidences on the suject are scarse. Further investigation is needed so we can better understand the risks and benefits and health care professionals can feel effectively assisted to offer support and advice to parents and caretakers.

Dificuldades financeiras, aspectos alimentares e de saúde em estudantes universitários, durante a pandemia de Covid-19 / Financial difficulties, dietary and health aspects in university students during the Covid-19 pandemic

Introdução: As dificuldades financeiras advindas da pandemia, em virtude de mudanças econômicas do país, além de refletirem no estado de segurança alimentar e nutricional e no estado de saúde dos indivíduos, acarretaram o aumento da evasão dos cursos superiores. Objetivo: Verificar a associação entre as dificuldades financeiras, durante a pandemia de Covid-19, com os aspectos alimentares e de saúde dos graduandos da Universidade Federal de Juiz de Fora (UFJF). Método: Estudo transversal com graduandos da UFJF. Os dados foram coletados entre setembro de 2020 e março de 2021, através de questionário on-line. Utilizou-se Teste Qui-quadrado (p<0,05) para avaliar os fatores associados às dificuldades financeiras durante a pandemia. Verificou-se a razão de chances (Odds Ratio - OR) das associações encontradas. Resultados: Avaliaram-se 584 graduandos, dentre os quais se constatou que 31,7% passaram por dificuldades financeiras durante a pandemia. Notou-se que a presença de dificuldades financeiras no período pandêmico se associou positivamente à presença de Insegurança Alimentar e Nutricional (INSAN), à autopercepção negativa de saúde, à má qualidade do sono e às alterações de depressão, ansiedade e estresse. Além disso, os indivíduos caracterizados com dificuldades financeiras tinham maiores chances de apresentarem INSAN, percepção negativa de saúde, má qualidade do sono, bem como alterações nos níveis de depressão, ansiedade e estresse, quando comparados à sua contraparte. Conclusão: Conclui-se que as dificuldades financeiras durante o período pandêmico são associadas à presença de INSAN e aspectos de saúde alterados. Assim, ressalta-se a necessidade de criação de estratégias que visem à assistência financeira e psicológica dos graduandos.

Introduction: The financial difficulties caused by the pandemic due to economic changes in the country, in addition to affecting food and nutrition security and the state of health of individuals, resulted in greater evasion from higher education courses. Objective: To check the association between financial difficulties during the COVID-19 pandemic with the dietary and health aspects of undergraduate students from Universidade Federal de Juiz de Fora (Federal University of Juiz de Fora ­ UFJF). Methods: Transversal study with UFJF undergraduate students. The data were collected between September 2020 and March 2021, via an online survey. The chi-square test (p<0.05) was used to evaluate the factors associated with financial difficulties during the pandemic. We also checked the odds ratio (OR) for the associations found. Results: We assessed 584 undergraduate students, 31.7% of which were found to have gone through financial difficulties during the pandemic. We observed that the presence of financial difficulties in that period was positively associated with Food and Nutrition Insecurity (INSAN, Portuguese acronym), negative self-perception of health, bad sleep quality, and changes in depression, anxiety, and stress levels. Moreover, individuals characterized as having financial difficulties had a higher chance of having INSAN, negative perception of health, bad sleep quality, as well as changes in the levels of depression, anxiety, and stress, when compared to their counterparts. Conclusion: We concluded that financial difficulties during the pandemic period are associated with INSAN and affected health aspects. Therefore, we highlight that there is a need for the development of strategies which aim to provide financial and psychological assistance to undergraduate students.

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.

Tradução e adaptação transcultural do Questionário de Escolhas Alimentares para Adolescentes Brasileiros (FCQ-A-BR) / Translation and cross-cultural adaptation of the Food Choice Questionnaire for Brazilian Adolescents (FCQ-A-BR)

Resumo Introdução Instrumentos que busquem conhecer os motivos que propiciam as escolhas alimentares em adolescentes são inexistentes no Brasil até o momento. O Food Choice Questionnaire (FCQ) para adolescentes é um questionário de fácil aplicação e que pode ser utilizado não somente em pesquisas, mas também nos serviços de atenção à saúde. Objetivo Descrever as etapas iniciais - validade de face e de conteúdo - do processo de tradução e adaptação transcultural do FCQ para adolescentes da versão em espanhol para o português do Brasil. Método Trata-se de um estudo metodológico de tradução e adaptação transcultural, em conformidade com as normas internacionais para tradução de instrumentos para validação. Foram seguidas quatro etapas: tradução, retradução, avaliação por comitê de especialistas e dois pré-testes, que foram realizados com adolescentes com idades entre 14 e 19 anos. Resultados Os itens e o título do instrumento foram traduzidos para o português. Alguns itens necessitaram de ajustes para melhor compreensão do público-alvo. O tempo médio de aplicação foi de sete minutos. Um item foi eliminado do questionário e modificou-se a escala de resposta para melhor adequação do instrumento. Conclusão O processo inicial de tradução e adaptação transcultural do Questionário de Escolhas Alimentares para Adolescentes Brasileiros (FCQ-A-BR) atestou as validades de face e conteúdo. No entanto, faz-se necessária a complementação das análises psicométricas, para utilização do instrumento, caso elas se mostrem satisfatórias.

Abstract Background Instruments that seek to find out the reasons that lead to food choices among adolescents are not yet available in Brazil so far. The Food Choice Questionnaire (FCQ) for adolescents is a simple questionnaire that can be used not only in research, but also in healthcare. Objective To describe the initial steps - face and content validity - of the process of translation and cross-cultural adaptation of the FCQ for adolescents from the Spanish version into Brazilian Portuguese. Method This is a methodological study of translation and cross-cultural adaptation, in accordance with international standards for translation of instruments for validation. Four steps were followed: translation, back-translation, evaluation by an expert committee and two pre-tests, which were carried out with adolescents aged between 14 and 19 years. Results The items and the instrument title were translated to Portuguese. Some items needed adjustments to better understand the target audience. The average application time was seven minutes. One item was eliminated from the questionnaire and the response scale was modified to better suit the instrument. Conclusion The initial process of translation and cross-cultural adaptation of the Food Choice Questionnaire for Brazilian Adolescents (FCQ-A-BR) attested to the face and content validity. However, it is necessary to complement the psychometric analyses, to use the instrument, if they are satisfactory.

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.

Brazilian health professionals' perception about the Baby-Led Weaning (BLW) method for complementary feeding: an exploratory study / Percepções de profissionais de saúde brasileiros acerca da prática do método Baby-Led Weaning (BLW) para alimentação complementar: um estudo exploratório

Abstract Objective: To describe Brazilian health professionals' perception about the Baby-Led Weaning (BLW) method use for complementary feeding. Methods: Cross-sectional, descriptive study including 458 health professionals graduated in Nursing, Speech Therapy, Medicine, Nutrition or Dentistry and working in Pediatrics, being directly or indirectly involved with pediatric nutrition. We used a convenience non-probability sampling. The questionnaire applied to participants addressed demographic characteristics, academic degree, workplace, knowledge about clinical practice and perceptions about the possible advantages of the BLW method. Results: Participants had a mean age of 34.5±8.5 years, 64.6% of them working in Southeast Brazil and 65.3% being nutritionists. Most participants reported being acquainted with the BLW method (82.0%). Regarding clinical practice, 38.3% mentioned having recommended the BLW some times, 37.5% often and 20.5% always. Most participants fully agreed that the BLW method could have advantages for babies, for example, having them more likely to share family meals, facilitating adaptation to food flavors and consistencies, enhancing chewing and favoring the development of motor skills. On the other hand, important disagreements were also expressed regarding the BLW convenience and the possibility to create less concerns or anxiety in parents. Conclusions: The BLW method reported as advantageous, but disagreements were also raised, probably because scientific evidences on the suject are scarse. Further investigation is needed so we can better understand the risks and benefits and health care professionals can feel effectively assisted to offer support and advice to parents and caretakers.

Resumo Objetivo: Descrever as percepções de profissionais de saúde brasileiros acerca do método baby-led weaning (BLW) para alimentação complementar. Métodos: Estudo de corte transversal conduzido com 458 profissionais de saúde graduados em Enfermagem, Fonoaudiologia, Medicina, Nutrição ou Odontologia e que atuavam em pediatria, estando direta ou indiretamente envolvidos com nutrição infantil. A amostragem foi não probabilística, de conveniência. O questionário englobou características demográficas, titulação e local de trabalho dos participantes, além do conhecimento, da prática clínica e das percepções sobre possíveis vantagens do BLW. Resultados: Os profissionais de saúde tinham idade média de 34,5±8,5 anos, 64,6% atuavam no sudeste do Brasil e 65,3% eram nutricionistas. A maioria relatou conhecer o BLW (82,1%). Quanto à prática clínica, 38,3% mencionaram que costumavam recomendar o BLW às vezes, 37,5%, frequentemente, e 20,5%, sempre. Grande parte declarou que concordava totalmente que o método poderia trazer vantagens, tornando os bebês mais propensos a compartilharem refeições em família, facilitando a adaptação aos sabores e às consistências dos alimentos, potencializando a mastigação e favorecendo o desenvolvimento de habilidades motoras, porém manifestaram-se discordâncias importantes em relação à comodidade/conveniência e ao argumento de gerar menos preocupação ou ansiedade para os pais/cuidadores. Conclusões: Em geral, o BLW foi relatado como vantajoso, mas foram evidenciadas discordâncias, que são um provável reflexo da escassez de evidências científicas factuais sobre essa temática. São necessários mais estudos, para a melhor compressão de seus riscos e benefícios. Só assim os profissionais de saúde se sentirão efetivamente respaldados para fornecer suporte ou aconselhamento aos pais/cuidadores.

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.

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.

Fatores associados à insatisfação corporal de crianças e adolescentes de escola pública em município da Zona da Mata mineira / Factors associated with body dissatisfaction among children and teenagers enrolled in a public school in a city in the Zona da Mata Mineira area

Objetivos: determinar os fatores associados à insatisfação corporal entre estudantes de uma escola pública de um município da Zona da Mata mineira. Métodos: foi realizado um estudo transversal, descritivo, analítico e exploratório. A amostra foi constituída por escolares entre oito e doze anos. Utilizou-se uma escala de figuras de silhuetas para avaliar a insatisfação corporal. Os dados foram analisados através do Statistical Software for Professional (STATA), versão 12.0. A medida de associação utilizada foi a Razão de Prevalência (RP), determinada através da regressão de Poisson com estimador de variância robusta. Foi considerado um nível de significância de 5% para definição do modelo final. Resultados: observou-se frequência de insatisfação corporal de 86,5% e sua associação significativa com a porcentagem de gordura corporal, duração da atividade física, escolaridade materna e trabalho materno. Conclusões: a infância e a adolescência são períodos em que se adquirem hábitos que poderão ser levados por toda a vida, além de representarem um público propenso a atitudes inadequadas. Assim, destaca-se a importância em se realizar pesquisas com esses indivíduos, especialmente relativas à imagem corporal, já que a insatisfação com o corpo traz pensamentos e sensações negativas, influenciando a saúde emocional, a qualidade de vida e o convívio social.

Objectives: to determine the factors associated with body dissatisfaction among students of a public school in a city in the Zona da Mata Mineira area. Methods: a cross-sectional, descriptive, analytical and exploratory study was performed. The sample consisted of students between eight and twelve years, and a body shape figures scale was used to assess body dissatisfaction. The data was analyzed using the Statistical Software for Professional (STATA) version 12.0. The measure of association used was the prevalence ratio (PR), determined by the Poisson regression with robust variance estimator. A significance level of 5% for the definition of the final model was considered. Results: it was observed a frequency of body dissatisfaction of 86.5% and it's significant association with body fat percentage, duration of physical activity, maternal literacy and maternal employment. Conclusions: childhood and adolescence are periods in which people acquire habits that may be carried forever, and they represent a grouo of people prone to inadequate attitudes. Thus, it is important to conduct research with these individuals, especially relating to body image, as body dissatisfaction brings negative thoughts and feelings, influencing emotional health, quality of life and social interaction.

Insatisfação corporal em adolescentes e fatores associados / Body dissatisfaction in adolescents and associated factors

O objetivo do estudo foi avaliar a insatisfação corporal entre os adolescentes, assim como os fatores associados. Avaliou-se 345 adolescentes de 10 a 14 anos. Foram aferidas as variáveis: peso, altura, circunferência da cintura, circunferência braquial, percentual de gordura, glicemia de jejum, triglicerídeos, colesterol total, maturação sexual e pressão arterial. A imagem corporal foi avaliada por meio da escala de imagem corporal. Foram realizados os testes t de Student ou Kruskal Wallis, calculou-se a Razão de Prevalência e os fatores associados à insatisfação corporal foram verificados por regressão de Poisson, para avaliar a adequação do modelo final, utilizou-se o teste de Qui-quadrado. Observou-se que 32,6% dos adolescentes apresentavam excesso de peso, desses, 13,1% foram classificados como obesos, segundo o IMC por idade. Apenas o percentual de gordura corporal foi estatisticamente diferente entre os sexos. A prevalência de insatisfação foi elevada (sexo feminino: 81,02% e masculino: 75,62%) e apresentou associação, em ambos os sexos, com o IMC, percentualde gordura corporal e circunferência da cintura. Nas meninas, também foi obtida associação com a glicemia. Já nos meninos, com a circunferência braquial e circunferência muscular braquial. Após ajuste do modelo a insatisfação manteve-se associada no sexo feminino com as variáveis: circunferência da cintura e glicemia. Nos meninos, com a gordura corporal e IMC. Concluiu-se que apesar da maioria apresentar o peso adequado, muitos adolescentes estavam insatisfeitos com seus corpos. Os achados também apontam que essa insatisfação atinge ambos os sexos e idades.

The aim of this study was to evaluate the body dissatisfaction among adolescents and associated factors. A total of 345 adolescents aged 10 to 14 years were evaluated. The variables were: weight, height, waist circumference, brachial circumference, fat percentage, fasting glycemia, triglycerides, total cholesterol, sexual maturation and blood pressure. Body image was assessed using the body image scale. The t Student or Kruskal Wallis tests were performed, prevalence ratio was calculated and the factors associated with body dissatisfaction were verified by Poisson regression, to evaluate the suitability of the final model, the chi-square test. It wasobserved that 32.6% of adolescents were overweight, of these, 13.1% were classified as obese, according to age-based BMI. Only the percentage of body fat was statistically different between the sexes. The prevalence of dissatisfaction was high (female: 81.02% and male: 75.62%) and had an association, in both sexes, with BMI, percentage of body fat and waist circumference. In girls, an association with glycemia was also obtained. Already in boys, with brachial circumference and brachial muscle circumference. After adjustment of the model, the dissatisfaction remained associated in the female gender with the variables: waist circumference and glycemia. In boys, with body fat and BMI. It was concluded that although most present adequate weight, many adolescents were dissatisfied with their bodies. The findings also indicate that this dissatisfaction reaches both sexes and ages.

Consumo alimentar e síndrome metabólica em adolescentes / Dietary consumption and metabolic syndrome in adolescents

OBJETIVOS: Determinar a prevalência de síndrome metabólica em adolescentes e comparar o consumo alimentar dos indivíduos com e sem a síndrome. MÉTODOS: Foi conduzido um estudo transversal com adolescentes de 15 a 17 anos de idade, matriculados em escolas públicas e privadas do município de Juiz de Fora, Minas Gerais, Brasil. Utilizou-se o índice de massa corporal para determinar o estado nutricional, classificado de acordo com a Organização Mundial de Saúde. A medida de circunferência da cintura foi aferida segundo Petroski 2003. Para o diagnóstico da síndrome metabólica foram coletados dados de triglicerídeos, colesterol ligado à lipoproteína de alta densidade, glicemia de jejum e pressão arterial e utilizados os critérios da International Diabetes Federation. Para a avaliação dietética utilizou-se um registro alimentar de três dias não consecutivos. Na análise estatística para a associação entre os grupos, foram usados os testes qui quadrado e exato de Fisher e os testes t de Student (teste paramétrico) ou Mann Whitney (não paramétrico). RESULTADOS: Foram avaliados 302 adolescentes, sendo 51,99% do sexo masculino e 73,51% estudantes de escolas públicas A prevalência de obesidade foi de 27,48% e a de síndrome metabólica de 3,97%, sendo esta de 4,83% entre as meninas e 3,18% entre os meninos (p=0,46). A prevalência de síndrome metabólica entre os alunos de escolas públicas foi de 4,50% e entre os de escolas privadas de 2,50% (p=0,73). Na comparação entre os grupos com e sem a síndrome, não foram observadas diferenças estatísticas significativas na adequação calórica e de micronutrientes, exceto de vitamina D (p=0,01). Verificou-se que os adolescentes com síndrome metabólica consumiam menos vitamina D do que aqueles sem a síndrome. CONCLUSÕES: A prevalência de síndrome metabólica encontrada foi relevante, considerando-se sua complexidade, gravidade e a faixa etária em estudo. Detectou-se menor ingestão de vitamina D entre os adolescentes com síndrome metabólica.

AIMS: To determine the prevalence of metabolic syndrome in adolescents and to compare the dietary intake of individuals with and without the syndrome. METHODS: A cross-sectional study was conducted with adolescents aged 15 to 17 years, enrolled in public and private schools in Juiz de Fora, Minas Gerais, Brazil. Body mass index was used to determine the nutritional status, classified according to the World Health Organization. Waist circumference was measured according to Petroski (2003). Triglyceride, high-density lipoprotein cholesterol, fasting blood glucose, and blood pressure were assessed and the International Diabetes Federation criteria were used for the diagnosis of metabolic syndrome. A non-consecutive 3-day food record was used for dietary assessment. The chi-square test, Fisher's exact test, Student's parametric t test or the Mann-Whitney U test were used for associations between the groups. RESULTS: A total of 302 adolescents ­ 51.99% males and 73.51% from public schools ­ were evaluated. The prevalence of obesity was 27.48% and that of metabolic syndrome was 3.97%; 4.83% among girls and 3.18% among boys (p=0.46). The prevalence of metabolic syndrome among public school students was 4.50% compared with 2.50% (p=0.73) among those from private schools. In the comparison between the groups with and without metabolic syndrome, there were no statistically significant differences in dietary energy and micronutrient adequacy, except for vitamin D (p=0.01). Adolescents with metabolic syndrome consumed less vitamin D than those without the syndrome. CONCLUSIONS: The prevalence of metabolic syndrome was found to be relevant considering its complexity, severity, and the age group studied. Lower vitamin D intake was observed among adolescents with metabolic syndrome

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

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 was with 403 adolescents aged 10–14 years, from public and private schools. Anthropometric, clinical, and 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 who had high serum triglycerides, body mass index and waist circumference. Conclusions: Adolescents who had anthropometric, clinical and biochemical characteristics considered to be at 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.

Descrever a relação entre valores de índice de massa de gordura e índice de massa livre de gordura e fatores associados a risco cardiovascular em adolescentes de Juiz de Fora (MG). Métodos: Estudo transversal feito com 403 adolescentes de 10-14 anos, de escolas públicas e privadas. Avaliaram-se medidas antropométricas, clínicas, bioquímicas, autorrelato do tempo dedicado ao exercício físico, atividades sedentárias e estágio de maturação sexual. Resultados: Quanto ao estado nutricional, 66,5% dos adolescentes estavam eutróficos, 19,9% com sobrepeso e 10,2% obesos. Para ambos os sexos, o índice de massa de gordura foi maior nos adolescentes que estavam com triglicerídeos séricos, índice de massa corporal e circunferência da cintura elevados. Conclusões: Os adolescentes que tinham características antropométricas, clínicas e bioquímicas consideradas de risco para o desenvolvimento de doenças cardiovasculares apresentaram maiores valores do índice de massa de gordura. Metodologias diferenciadas para avaliação da composição corporal tornam a promoção da saúde e a prevenção de agravos futuros mais eficazes.

Avaliação da capacidade preditiva da bioimpedância tetrapolar segmentada vertical na detecção do excesso de peso em adolescentes / Evaluation of the predictive capacity of vertical segmental tetrapolar bioimpedance for excess weight detection in adolescents

Resumo Objetivo Analisar a capacidade preditiva da bioimpedância tetrapolar segmentada vertical na detecção do excesso de peso em adolescentes com o uso da bioimpedância tetrapolar horizontal como referência. Métodos Estudo transversal feito com 411 alunos de 10 a 14 anos, de ambos os sexos, matriculados em escolas públicas e privadas, selecionados por processo amostral aleatório simples e estratificados de acordo com sexo, idade e proporção em cada instituição. Foi feita avaliação antropométrica e analisada a composição corporal por meio das bioimpedâncias bipolar vertical, tetrapolar horizontal e tetrapolar segmentada vertical. Foram construídas as curvas ROC com base nos cálculos de sensibilidade/especificidade para cada ponto das diferentes medições possíveis de gordura corporal do equipamento em questão. Posteriormente, foram executados os seguintes testes estatíticos: t de Student, correlação de Pearson e qui-quadrado de McNemar. Para a interpretação das variáveis, usou-se o software SPSS 17.0. Resultados A amostra foi composta por 53,7% meninas e 46,3% meninos. Do total, 20% e 12,5% exibiram, respectivamente, sobrepeso e obesidade. Os gráficos das medidas dos segmentos corporais refletiram-se em altos valores de sensibilidade e especificidade, além de elevadas áreas sob a curva ROC, que variaram de 0,83 a 0,95 para meninas e de 0,92 a 0,98 para meninos, o que sugere um desempenho levemente superior para o sexo masculino. O percentual de gordura total foi apontado como o critério mais eficiente do equipamento para a detecção do excesso de peso, enquanto a gordura segmentar do tronco apresentou-se como um indicador de precisão inferior. Conclusão A aparelho comportou-se satisfatoriamente na predição do excesso de peso.

Abstract 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.

Fatores relacionados ao peso ao nascer: influência de dados gestacionais / Factors related to birth weight: influence of gestational data

Introdução: o peso ao nascer é fator determinante do estado de saúde do recém-nascido. Fatores ligados à saúde e comportamento materno exercem influência nas condições de nascimento e, consequentemente, no peso ao nascer. Objetivos: determinar a relação entre as características maternas e o peso ao nascer. Pacientes e métodos: estudo longitudinal que incluiu 87 mulheres e realizado em duas etapas. Na primeira, as gestantes responderam um questionário contendo informações socioeconômicas, variáveis referentes à gestação, história obstétrica e recordatório alimentar 24 horas. A segunda etapa ocorreu no primeiro mês pós-parto e as nutrizes foram questionadas sobre as características do parto, do recém-nascido e o ganho de peso total na gestação, por meio de contato telefônico. Foi utilizada análise de regressão logística para analisara relação entre as variáveis gestacionais e o peso ao nascer. Resultados: o consumo mediano de ferro, cálcio, ácido fólico e vitamina A estavam abaixo das recomendações nutricionais, exceto vitamina C, que apresentou consumo adequado. Após ajustes da regressão logística, permaneceram associadas ao peso ao nascer as variáveis estado nutricional pré-gestacional (OR=5,457; p=0,012), início do pré-natal (OR=1,509; p=0,015) e densidade de cálcio dietético (OR=2,672; p=0,048). Conclusões: ressalta-se a importância de acompanhamento médico e nutricional adequado e de qualidade durante o pré-natal, para minimizar a ocorrência de consequências desfavoráveis na gestação e prejuízos no estado de saúde do recém-nascido.

Introduction: birth weight is a determinant factor in the health of newborns. Factors related to health and maternal behaviors influence the birth conditions and, consequently, birth weight. Objectives: to determine the relationship between maternal characteristics and birth weight. Patients and methods: this was a longitudinal study performed in two stages including 87 women. In the first, pregnant women answered a questionnaire with socio-economic information, variables related to pregnancy, obstetric history, and 24 hours food recall. The second stage took place in the first postpartum month; nursing mothers were questioned through telephone contacts about their delivery characteristics, theirnewborn, and total weight gain during pregnancy. Logistic regression analysis was used to analyze the relationship between the pregnancy variables and birth weight. Results: the average consumption of iron, calcium, folic acid, and vitamin A were below the nutritionalrecommendations, except for vitamin C, which was appropriately consumed. After the logistic regression adjustments, the variables pre-pregnancy nutritional status (OR = 5.457; p = 0.012), start of prenatal care (OR = 1.509; p = 0.015), and density of dietary calcium (OR = 2.672; p = 0.048) remained associated with birth weight. Conclusions: the importance of medical and nutritional appropriate follow-up during the prenatal period is highlighted in order to minimize the occurrence of adverse effects on pregnancy and damage in the health status of newborns.

Fatores nutricionais e sociais de importância para o resultado da gestação,em mulheres em acompanhamento na rede de atenção primária de Juiz de Fora / Important nutritional and social factors to pregnancy outcomes in women followed at primary care network of Juiz de Fora

Introdução: a gestação requer elevadas necessidades nutricionais e, devido à sua alta vulnerabilidade, várias condições podem interferir na evolução normal da gestação, por isso o seu acompanhamento médico é importante. Objetivos: avaliar o estado nutricional e de saúde, analisar o consumo alimentar e investigar o perfil socioeconômicode gestantes atendidas em Unidades de Saúde de Juiz de Fora (MG). Métodos: trata-se de estudo observacional descritivo. O acompanhamento longitudinal iniciou-se no terceiro trimestre da gestação e durou até o primeiro mês pós-parto. A coleta de dados foi realizada na rede de atenção primária de saúde, em oito unidades básicasdas regiões oeste e sul de Juiz de Fora, por meio de aplicação de questionários e avaliação antropométrica. Resultados: participaram do estudo 111 mulheres; a maioria apresentava-se eutrófica antes da gestação; mais da metade iniciou o pré-natal até oterceiro mês de gestação e realizou mais que sete consultas no total. Verificou-se que 20% apresentavam anemia gestacional. A amostra foi predominantemente constituída de população de baixa renda - meio salário mínimo ou menos. A ingestão média de macronutrientes estava entre as faixas de recomendação, sendo adequada. Observou-se consumo de dietas inadequadas em relação aos micronutrientes cálcio, ferro e ácidofólico. Conclusões: as gestantes avaliadas tinham acesso aos serviços de pré-natal, porém notou-se falta de acompanhamento nutricional e de orientações em relação aos cuidados com a gestação.

Introduction: pregnancy requires elevated nutritional needs and, due to its high vulnerability, various conditions can interfere in the normal course of pregnancy; therefore, medical follow-up is important. Objectives: to evaluate the nutritional and health status, analyze food intake and investigate the socioeconomic profile of pregnant womenattending the Juiz de Fora Health Units (MG). Methods: this was a descriptive observational study. The longitudinal monitoring began in the third trimester of pregnancy and lasted until the first postpartum month. Data collection was carried out in the network of primary health care in eight basic units in the western and southern regions of Juiz deFora through questionnaires and anthropometric evaluations. Results: 111 women participated in the study; most were eutrophic before the pregnancy; more than half began the prenatal care up to the third month of pregnancy and attended to more than seven consultations in total. Gestational anemia was detected in 20% of women. The sample conwaspredominantly made up of low-income women - half the minimum wage or less. The average intake of macronutrients was within the recommended ranges, being adequate. An inadequate diet consumption ofthe calcium, iron, and folic acid micronutrients was observed. Conclusions: the evaluated pregnant women had access to prenatal services. However, a lack of nutritional monitoring and provision of guidelines forpregnancy care were observed.