Adequacy of school menus and national school food program requirements: a systematic review / Adequação dos cardápios escolares e exigências do programa nacional de alimentação escolar: uma revisão sistemática

Abstract Objectives: this review aimed to evaluate the adequacy of school menus regarding the nutritional requirements of the Programa Nacional de Alimentação Escolar (PNAE) in Brazilian public schools regarding the presence of macronutrients and micronutrients and allocation of resources to purchase products from family farming. Methods: a systematic literature review was carried out using the SciELO, Bireme and Lilacs databases to select the articles. The inclusion criteria were articles that presented data on the adequacy of energy, macronutrients, micronutrients, and purchases of products from family farming during the PNAE regiment, as well as quantitative, cross-sectional, and descriptive studies carried out in the Brazilian territory. Review, editorials, letters, case studies, duplicates and those that did not assess the requirements of the PNAE were excluded. Results: at the end, 12 studies were included that showed overestimation and underestimation of nutritional adequacy in the school environment. In relation to purchases of inputs from family farming, it was observed that most of the Brazilian municipalities evaluated fulfilled the requirements for the allocation of resources. Conclusion: school menus need more supervision so that they meet the adjustments proposed by the PNAE. In addition, it is essential to promote a healthy diet that contains all the nutrients necessary to provide nutritional support for child growth and development.

Resumo Objetivo: avaliar a adequação dos cardápios escolares quanto às exigências nutricionais do Programa Nacional de Alimentação Escolar (PNAE) em escolas públicas brasileiras considerando quanto a adequação de macronutrientes e micronutrientes e destinação de recursos para compras de produtos advindos da agricultura familiar. Métodos: foi realizada uma revisão sistemática da literatura utilizando as bases de dados SciELO, Bireme e Lilacs para seleção dos artigos. Os critérios de inclusão foram: Artigos que apresentaram dados sobre a adequação de energia, macronutrientes, micronutrientes e compras de produtos oriundos da agricultura familiar durante o regimento do PNAE, assim como estudos quantitativos, transversais e descritivos realizados no território brasileiro. Foram excluídos artigos de revisão, editoriais, cartas ao editor, estudos de caso, artigos em duplicatas e que não avaliaram as exigências do PNAE. Resultados: ao final, foram incluídos12 estudos que apontaram superestimação e subestimação nas adequações nutricionais no ambiente escolar. Em relação às compras de insumo provenientes da agricultura familiar, observou-se que a maioria dos municípios brasileiros avaliados cumpriam as exigências de destinação dos recursos. Conclusões: os cardápios escolares necessitam de maior fiscalização para que atendam as adequações propostas pelo PNAE. Além disso, é primordial promover uma alimentação saudável que contenha todos os nutrientes necessários para fornecer um aporte nutricional para o crescimento e desenvolvimento infantil.

Revisión sistemática de programas de intervención para promover hábitos saludables de actividad física y nutrición en escolares españoles / Systematic review of intervention programmes to promote healthy physical activity and nutrition habits in Spanish school children

Introducción. La obesidad infantil es uno de los problemas de salud pública más graves del siglo XXI, originado porque los niños crecen en un entorno en el que no se fomenta la práctica deportiva. Esto es debido al cambio en el tipo de alimentación y al aumento del sedentarismo. Objetivo. Describir y analizar los principales programas de intervención, basados en la promoción de hábitos saludables (Nutrición y Actividad Física) en la población infantil y las principales estrategias utilizadas para su implantación en los centros educativos españoles. Materiales y métodos. Se ha realizado un estudio transversal descriptivo mediante el empleo de una revisión sistemática de la literatura realizada en el mes de octubre de 2022. La población de estudio fue el alumnado de entre 6 y 12 años escolarizados en centros de Educación Primaria de España. Resultados. Se ha identificado que las intervenciones educativas sobre nutrición y/o actividad física realizadas en los centros educativos, resultan positivas en la mejora de los hábitos de alimentación y la práctica físico-deportiva entre los escolares. Discusión. Además, combinando las temáticas de nutrición y actividad física, se fomenta la consecución de hábitos saludables, con el objetivo de prevenir la obesidad y el sedentarismo. A su vez, fomentando la participación de las familias en los programas de intervención se obtiene un resultado positivo en la efectividad de las intervenciones. Conclusiones. La mayor parte de los programas de intervención analizados demuestran su eficacia a la hora de modificar los hábitos alimentarios, además, se produce un aumento del nivel de actividad física, evitando el sedentarismo entre los escolares, y, por ende, disminuir el riesgo de obesidad(AU)

Introduction: Childhood obesity is one of the most serious public health problems of the 21st century, because children are growing up in an environment where sport is not encouraged. This is due to changes in dietary patterns and an increase in sedentary lifestyles. Objective. Describe and analyze the main intervention programs, based on the promotion of healthy habits (Nutrition and Physical Activity) in the child population and the main strategies used for their implementation in Spanish schools. Material and methods. A descriptive cross-sectional study based on a systematic review of the literature carried out in October 2022. The study population was pupils aged between 6 and 12 years old attending primary schools in Spain. Results. It has been identified that educational interventions on nutrition and/or physical activity carried out in schools are positive in improving eating habits and physical activity among schoolchildren. Discussion. In addition, by combining the topics of nutrition and physical activity, healthy habits are encouraged, with the aim of preventing obesity and sedentary lifestyles. In turn, by encouraging the participation of families in the intervention programmes, a positive result is obtained in the effectiveness of the interventions. Conclusions. Most of the intervention programmes analysed demonstrate their effectiveness in modifying eating habits, as well as increasing the level of physical activity, avoiding sedentary lifestyles among schoolchildren and, therefore, reducing the risk of obesity(AU)

Talla baja y sobrepeso en menores de 5 años que habitan la Sierra Tarahumara, México / Stunting and overweight in children under 5y who inhabit the Sierra Tarahumara in northern Mexico

La doble carga de la desnutrición y el exceso de peso (o mala nutrición) es uno de los indicadores que mejor ilustra las inequidades en salud que existen en zonas indígenas de México. Por otro lado, existe escasa evidencia del estado de nutrición en población Tarahumara. Objetivo: Estimar indicadores del estado de nutrición y su asociación con factores sociodemográficos en población indígena Tarahumara menor de 5 años. Métodos: Estudio transversal en 21 localidades indígenas de la Sierra Tarahumara en Chihuahua, México, que analizó información sociodemográfica, de salud y antropométrica en población infantil de 6 a 59 meses de edad (n=323). Se estimaron índices antropométricos y su asociación con variables de interés mediante regresión logística múltiple. Un valor de p ≤0,05 fue considerado como estadísticamente significativo. Todos los análisis se realizaron en el paquete estadístico Stata v14.2. Resultados: Se encontraron altas prevalencias de talla baja (44,4%), emaciación (5,3%), bajo peso (11,9%) y sobrepeso (15,2%). El sexo masculino se asoció significativamente con talla baja (Razón de Momios (RM)=2,5; 1,45-4,34), mientras que, ninguna escolaridad de la madre (RM=0,39; 0,15-0,99) y ser beneficiario de un programa local de nutrición por más de 2 años se asoció con sobrepeso (RM=2,97; 1,26 -6,97). Conclusión: Se encontraron indicadores de mala nutrición en la muestra estudiada; éstos hallazgos podrían sugerir la existencia de inequidad y rezago en salud y nutrición de población infantil indígena Tarahumara. Se requieren más estudios que puedan orientar programas y acciones de salud y nutrición para atender a esta población de forma prioritaria(AU)

The double burden of malnutrition and excess weight (or poor nutrition) is one of the indicators that best illustrates the health inequities that exist in indigenous areas of Mexico. On the other hand, there is scarce evidence of the nutritional status of the Tarahumara population. Objective: To estimate indicators of the nutritional status and its association with sociodemographic factors in the Tarahumara indigenous population under 5 years of age. Methods: A cross-sectional study in 21 indigenous localities of the Sierra Tarahumara in Chihuahua, Mexico, which analyzed sociodemographic, health and anthropometric information in children from 6 to 59 months of age (n=323). Anthropometric indices and their association with variables of interest was estimated by multiple logistic regression. A value of p ≤0.05 was considered statistically significant. All analyzes were performed using the Stata v14.2 statistical package. Results: It were founded high prevalences of short stature (44.4%), emaciation (5.3%), underweight (11.9%) and overweight (15.2%). Male sex was significantly associated with short stature (Odds Ratio (OR) = 2.5; 1.45-4.34), while no education of the mother (OR = 0.39; 0.15-0.99) and being a beneficiary of a local nutrition program for more than 2 years it was associated with being overweight (OR = 2.97; 1.26-6.97). Conclusion: Indicators of malnutrition and overweight were founded in the sample studied; these findings suggest inequity and delays in health and nutrition of the indigenous Tarahumara child population. More research is required that can guide health and nutrition programs and actions to serve this indigenous population as a priority(AU)

Avaliação do estado nutricional em relação à presença de cárie dentária em crianças de 4 a 6 anos do município de Cajamar - São Paulo / Evaluation of the nutritional status in relation to the presence of dental caries in children aged 4 to 6 years in the city of Cajamar - São Paulo

Este artigo tem como objetivo avaliar o estado nutricional em relação à presença de cáries dentárias em crianças de 4 a 6 anos de idade, do município de Cajamar, São Paulo. Trata-se de estudo transversal com crianças entre 4 a 6 anos (n=1642), acompanhadas pelo Programa Saúde na Escola (PSE) do Município de Cajamar, São Paulo. A classificação do estado nutricional foi baseada no Índice de Massa Corporal (IMC) e a avaliação das condições bucais, por meio do índice ceo-d e critério para Risco de Cárie. A análise do estado nutricional, faixa etária e sexo conforme o número de cáries, foi feita por meio dos testes Mann-Whitney U e Kruskal-Wallis (p<0,05). Observou-se maior prevalência de meninos entre 4 a 6 anos. Em todas as faixas etárias a prevalência de excesso de peso foi de aproximadamente 30% e eutrofia em torno de 70%. 65% (n=1068) das crianças não apresentavam risco de cárie (A) e 28,8% (n=475), alto risco (D, E e F). Das 1162 crianças sem cáries, 0,2% eram magras (n=2), 67,2% (n=781) eutróficas e 32,7% (n=380) possuíam excesso de peso. A frequência de 1 a 5 cáries maior entre meninas e de 6 ou mais cáries, entre meninos. Segundo estado nutricional, o número médio do número de cáries foi de 2,17 para magreza, 0,93 para eutrofia e 0,65 para excesso de peso (p<0,010). Conclui-se que houve diferença entre número cáries e estado nutricional, na qual crianças com déficit nutricional apresentavam maior número de cáries dentárias comparadas às eutróficas ou com excesso de peso, sugerindo-se a inclusão do estado nutricional na avaliação odontológica.

This article aims at evaluating the nutritional status in relation to the presence of dental caries in children aged 4 to 6 years in the city of Cajamar, in the state of São Paulo. It is a cross-sectional study with children aged 4 to 6 years (n=1642) accompanied by the School Health Program of the City of Cajamar, São Paulo. The nutritional status classification was based on the Body Mass Index (BMI) and the evaluation of oral conditions, through the ceo-d index, and criteria for risk for caries. The analysis of the nutritional status, age, and sex according to the number of caries was made through the Mann-Whitney U and Kruskal-Wallis tests (p<0.05). A higher prevalence was observed among boys aged 4 to 6 years. In all age groups, there was a prevalence of 30% of overweight children, and eutrophy of approximately 70%. A total of 65% (n=1068) of the children presented no risk of caries (A), whereas 28.8% (n=475) showed high risk (D, E, and F). Among the 1162 children with no caries, 0.2% were thin (n=2); 67.2% (n=781) eutrophic; and 32.7% (n=380) were overweight. Girls presented a higher frequency of 1 to 5 caries while boys presented frequency of having 6 or more caries. According to the nutritional status, the average number of caries was 2.17 for thin individuals; 0.93 for eutrophic individuals; and 0.65 for overweight individuals (p<0.010). It could be concluded that there was a difference between the number of caries and the nutritional status, in which children with nutritional deficit presented a higher number of dental caries when compared to eutrophic or overweight ones, suggesting the inclusion of the nutritional status in the dental evaluation.

Curso de contenido propio Alimentación Saludable: su implementación en la carrera de Medicina en Cuba / Course on Healthy Food: its implementation in the Medicine degree in Cuba

RESUMEN Fundamento: el Plan de Estudio D para la carrera de Medicina incluyó un curso de contenido propio o curso propio sobre nutrición, cuyo programa original fue sustituido por una versión confeccionada por docentes de la Universidad de Ciencias Médicas de Villa Clara. Objetivo: valorar los resultados del curso propio Alimentación Saludable elaborado por docentes de la Universidad de Ciencias Médicas de Villa Clara, e implementado desde 2018-2019 en la carrera de Medicina en Cuba. Métodos: se realizó una investigación descriptiva en la Universidad de Ciencias Médicas de Villa Clara, curso 2019-2020. Se utilizaron métodos teóricos para la fundamentación de la investigación y recogida de información, y empíricos: análisis documental, cuestionario a docentes y la técnica de grupo focal. Resultados: los criterios de profesores y estudiantes de la carrera en Villa Clara y de algunos docentes de 20 facultades de Medicina en Cuba fueron favorables en cuanto al diseño del curso, su pertinencia y posibilidades de su implementación; consideraron sus contenidos en correspondencia con el perfil declarado en el modelo del profesional; la mayoría de los docentes logró motivar a los estudiantes y los resultados de promoción fueron satisfactorios; aunque se advierten aspectos a mejorar, entre los que se destaca que docentes de diez facultades consideraron que se requiere preparación previa para lograr un proceso enseñanza aprendizaje con mayor calidad. Conclusiones: el curso Alimentación Saludable es un proyecto válido en el empeño de elevar la calidad de la enseñanza de la nutrición en la carrera de Medicina.

ABSTRACT Background: Study Plan D for the Medicine degree included a course on nutrition; the original program was replaced by a version prepared by teachers from Villa Clara University of Medical Sciences. Objective: to assess the results of the Healthy food course prepared by teachers from Villa Clara University of Medical Sciences, and implemented from 2018 to 2019 in the Medicine degree in Cuba. Methods: a descriptive research was carried out at Villa Clara University of Medical Sciences, 2019-2020 academic year. Theoretical methods were used to base the research and information gathering, and empirical ones: documentary analysis, questionnaire for teachers and the focal group technique. Results: the criteria of professors and students of the degree in Villa Clara and some teachers of 20 medical schools in Cuba were favorable regarding the design of the course, its relevance and possibilities of its implementation; they considered its contents in correspondence with the profile declared in the professional model; most of the teachers managed to motivate the students and the course grade results were satisfactory; although there are aspects to be improved, among which it stands out that teachers from ten faculties considered that prior preparation is required to achieve a higher quality teaching-learning process. Conclusions: the Healthy food course is a valid project in the effort to raise the quality of nutrition teaching in Medicine.

¿Qué pasa con la formación de nutricionistas en Chile? / What happening with nutritionist training in Chile?

RESUMEN El propósito de este artículo es analizar la evolución de las carreras y programas de Nutrición y Dietética en Chile. Se verifica un incremento sostenido de la oferta formativa, particularmente en los últimos veinte años, asociado a procesos de mercantilización de la Educación Superior. El aseguramiento de la calidad ha operado a través de la acreditación voluntaria y sus resultados son congruentes con el contexto nacional. La creciente importancia de la alimentación y nutrición en la salud pública del país exige formular cambios en la formación en Nutrición y Dietética, para lo cual se plantean diversas recomendaciones para lograr mayores niveles de pertinencia y el mejoramiento continuo de la calidad.

ABSTRACT The purpose of this article is to analyze the evolution of Nutrition and Dietetics degree programs and majors in Chile. This research demonstrated a sustained increase in the number of training programs, particularly during the last twenty years, due to the process of commodification of higher education. Quality assurance has been implemented by voluntary accreditation, which has shown results consistent with the national context. The growing importance given to food and nutrition in the national public health scenario requires changes in Nutrition and Dietetics academic programs. To this end, different recommendations are made in order to achieve improved relevance standards and continuous quality improvement.

Bases para el desarrollo de políticas y programas para garantizar el bienestar en los primeros mil días de vida / Bases for the development of Policies and Programs to guarantee well-being in the first thousand days of life

Los primeros mil días de vida, desde la concepción hasta el final de los primeros dos años de vida, constituye un período crucial para establecer el desarrollo de la enfermedad o de la salud en la vida futura de los individuos. La exposición a ambientes adversos determinará las alteraciones temporales en el ADN que perduran en el tiempo que dicha exposición exista. Las políticas y programas destinados a garantizar el bienestar durante esta ventana crítica del crecimiento son cruciales para que la población goce de las mejores condiciones posibles que permitan la expresión de su máximo potencial, al cual están programados para desarrollar. Palabras clave: condiciones ambientales, programas y políticas(AU)

The first thousand days of life, from the conception until the end of the first two years of life, constitutes a key period in which the development of disease or health establishes in the future lives of individuals. Exposure to adverse environments will determine the temporary impairments in DNA that last as long as the exposure exists. Policies and programs aimed at guaranteeing well-being during this critical window of growth are crucial for the population to enjoy the best possible conditions that allow the expression of their maximum potential, to which they are programmed to develop(AU)

Motivos de deserción de niños beneficiarios del Programa Alimentario Nutricional Integral en Asunción / Reasons for children dropouts of the Comprehensive Nutritional Food Program in Asunción

Introducción: El Instituto Nacional de Alimentación y Nutrición (INAN) implementa el Programa Alimentario Nutricional Integral (PANI), el cual consiste en un conjunto de actividades de carácter preventivo y de recuperación nutricional. El PANI ha tenido resultados positivos en los años de implementación, pero una problemática constante ha sido el abandono injustificado del Programa. Objetivo: describir los motivos que influyen en la deserción de niños beneficiarios del Programa Alimentario Nutricional Integral, ingresados en el año 2016, en los servicios de salud pública de la ciudad de Asunción. Metodología: Estudio observacional descriptivo de corte transversal, muestreo no probabilístico por conveniencia. Se incluyeron a niños beneficiarios del PANI en Asunción, ingresados en el año 2016. Se utilizaron datos asentados en las tarjetas índice de los beneficiarios en deserción e informes mensuales de deserción del PANI. Se calculó el porcentaje de deserción de beneficiarios en Asunción y se evaluaron los principales factores que influyeron en el abandono del Programa. El análisis de datos se realizó con el paquete estadístico Stata 12. Resultados: 36,9% de los beneficiarios ingresados al PANI en Asunción desertaron el Programa. El principal motivo de deserción fue "No le gusta la leche" (25,2%). Conclusión: La palatabilidad del complemento nutricional es un factor preponderante para la adherencia al PANI. Palabras claves: Asistencia alimentaria, desarrollo infantil, deserción escolar.

Introduction: The National Institute of Food and Nutrition (INAN) implements the Comprehensive Nutritional Food Program (PANI), which consists of a set of preventive activities and nutritional recovery. PANI has had positive results in the years of implementation, but despite this, a constant problem has been the unjustified dropouts of the Program. Objective: describe the reasons for the desertion of children benefiting from the Comprehensive Nutritional Food Program, admitted in 2016, in the public health services of the city of Asunción. Methods: Retrospective descriptive cross-sectional observational study, non-probability sampling for convenience. PANI beneficiary children admitted in the year 2016 in Asuncion were included. Data recorded in the beneficiary cards in desertion and monthly dropouts reports from PANI were used. The percentage of dropouts of beneficiaries in Asuncion was calculated and the main factors affecting the dropouts of the Program were assessed. For the analysis of the data, the statistical package Stata 12 was used. Results:36.9% of the children who joined PANI in Asunción dropped out of the Program. The main reason for desertion was "He does not like the milk" (25.2%). Conclusion: The palatability of the nutritional complement is a preponderant factor for adherence to PANI. Key words: Food Assistance, child development, scholar desertion

Malnutrición en niños beneficiarios de programas comunitarios en alimentación y nutrición / Malnutrition in children beneficiaries of community food and nutrition programs

Ante la emergencia compleja en Venezuela, la seguridad alimentaria y nutricional se ha deteriorado, especialmente en aquellas personas vulnerables, incluyendo a los niños. Este artículo presenta información sobre el estado nutricional de 1851 niños beneficiarios de proyectos de atención alimentaria y nutricional en 20 centros comunitarios en cinco estados de Venezuela. Se midió peso corporal y talla o longitud y se construyeron indicadores peso/talla en menores de 5 años e Índice de Masa Corporal (IMC)/edad en mayores de 5, así como talla o longitud/edad en ambos grupos. Se estimó la proporción de desnutrición aguda (GAM), delgadez y retraso del crecimiento, sobrepeso y obesidad en los niños, tomando las referencias de la OMS. La GAM y la desnutrición crónica en menores de 5 años estuvieron dentro del nivel "pobre", 5% y 29%, respectivamente, según el estándar de la OMS. Los más afectados por la GAM fueron los menores de 2 años (8%), en los mayores de 5 años la delgadez fue mayor que la GAM (10%) y el retraso en talla fue 25%. La vulnerabilidad según peso/talla fue 16%, según IMC/edad 33%, y según talla/edad superó el 50% en todos los grupos etarios. La vulnerabilidad es mayor en los menores de 2 años y entre 11 y 15 años. Se requiere de medidas orientadas a la atención de los grupos más afectados, así como los que se encuentran en riesgo de desnutrición. Es necesario un alto compromiso político que priorice el derecho a la alimentación ante la emergencia(AU)

n the context of the complex emergency in Venezuela, food security and nutrition have been damaged, particularly in the vulnerable people, including children. This article presents information about the nutritional status of 1851 children beneficiaries of food assistance and nutritional care projects in 20 community centers in five state of Venezuela. Body weight and size were measured to construct indicators on weight/length in children under five, and body mass number (BMI)/age in children over five, and size or length/age as well in both groups. The anthropometric categories allowed to calculate the acute malnutrition (GAM), the thinness and growth retardation, the overweight, and obesity; taking into account the OMS's metrics. The GAM and chronic malnutrition in children under five were in level "poor" (5% and 29% respectively) under the OMS's standards. The most affected group by GAM was children under two (8%). In the children over the age of five, the thinness was higher than GAM (10%) and the growth retardation was 25%. The vulnerability according to weight/length was 16%, according to BMI/age was 33%, and according to stature/age, it exceeded 50% in all age groups. The vulnerability level is higher in the children under two and between the ages of 11 and 15. Measures oriented to the attention of the most affected groups is required, and also in the groups with a risk of malnutrition. A great political commitment is necessary to promote the right to food as a priority sector in front of the emergency(AU)

Impacto de un programa de promoción de la salud nutricional y ambiente alimentario escolar en escuelas primarias públicas / the impact of a nutritional health and school food environment promotion program in public elementary schools

INTRODUCCIÓN: Los programas de prevención de obesidad infantil que incluyen al ambiente escolar y se apoyan en políticas públicas que promueven ambientes saludables, presentan mayores oportunidades de éxito. El objetivo de este estudio fue evaluar el impacto de un Programa de Educación Nutricional (PREN), considerando el ambiente alimentario escolar (AAE) y del hogar. MATERIALES Y MÉTODOS: Se identificaron los factores que influyen en las conductas alimentarias y se evaluó el estado nutricional de niños de 13 escuelas primarias púbicas en la ciudad de Hermosillo, en el noroeste de México, antes y después del PREN (2014-2016). RESULTADOS: Uno de cada 4 escolares participantes presentó sobrepeso u obesidad. Más de la mitad de las escuelas no siguieron las regulaciones oficiales en la oferta de alimentos; aun así, la respuesta de los padres de familia permitió la reducción del consumo de energía total en las comidas y colaciones en casa. Después de la implementación y evaluación del PREN, el AAE fue la principal barrera para la promoción de estilos de vida saludables. DISCUSIÓN: Se concluye que para enfrentar el ambiente obesogénico actual, es necesario un mayor compromiso de autoridades a través del fomento de estrategias reguladoras del ambiente escolar que propicien elecciones alimentarias saludables y el aumento de la actividad física en el entorno escolar. (AU)

INTRODUCTION: Keys to preventing childhood obesity include implementing prevention programs in schools and the presence of policies that promote healthy environments. The objective of this study was to assess the to evaluate the impact of a nutrition education program (NEP), while considering the school food environment (SFE) and home. MATERIALS AND METHODS: We identified factors that influence eating behavior and evaluated the nutritional status of children from 13 public elementary schools in the city of Hermosillo, in northeast Mexico, before and after the NEP. RESULTS:One in every four participating students were overweight or obese. Over half of the schools do not follow official regulations about which food should be offered; even so, the parents' response permitted the reduction of the total energy consumption through the meals and snacks at home. After the implementation and evaluation of the NEP, SFE was found to be the main barrier to the promotion of healthy lifestyles. DISCUSSION: To address the current obesogenic environment, a greater commitment of authorities is needed through the promotion of regulatory strategies in school set-tings that support healthy food choices and increased physical activity. (AU)

Criteria adopted for school menu planning within the framework of the Brazilian School Feeding Program / Critérios adotados para a elaboração de cardápios no Programa Nacional de Alimentação Escolar

ABSATRCT Objective This study aimed to investigate the main criteria used by nutritionists to plan school menus within the framework of the Brazilian National School Feeding Program. Methods Nutritionists from 21 municipalities in Southern Brazil were interviewed. Municipalities had between 20,000 and 70,000 inhabitants and were located in different mesoregions. Data were collected using an open-ended questionnaire and subjected to content analysis using NVivo® software. Results Sixteen criteria were identified, grouped into four categories: (1) food habits, culture, and acceptance; (2) nutritional characteristics; (3) food availability; and (4) management and execution. Brazilian National School Feeding Program regulations were recurrently cited within all identified categories, which demonstrates the influence of the program on nutritionists' activities. Conclusion Brazilian National School Feeding Program regulatory guidelines for the development of school menus seem to influence the decision making of nutritionists. However, food purchase from family farms and calculation of meal nutritional value seem to be incipient criteria.

RESUMO Objetivo Explorar os principais critérios utilizados na elaboração de cardápios escolares na perspectiva de nutricionistas que participam do Programa Nacional de Alimentação Escolar. Métodos Foram entrevistadas nutricionistas responsáveis pela alimentação escolar de 21 municípios de diferentes mesorregiões da região Sul do Brasil que possuíam entre 20 e 70 mil habitantes. Utilizando um questionário aberto, as nutricionistas foram interrogadas sobre os critérios utilizados na elaboração dos cardápios. O conteúdo dos questionários foi analisado com auxílio do software NVivo®. Resultados Dezesseis critérios foram identificados e agrupados em quatro categorias: (1) hábitos, cultura alimentar e aceitação; (2) características nutricionais; (3) disponibilidade de alimentos; (4) gestão e execução. A regulamentação do Programa foi um critério recorrente em todas as categorias, demonstrando sua influência nas atividades das nutricionistas. Conclusão Os critérios estabelecidos pela legislação do Programa Nacional de Alimentação Escolar para a elaboração de cardápios parecem influenciar a tomada de decisões das nutricionistas. O cálculo nutricional dos cardápios e a compra de alimentos produzidos pela agricultura familiar, no entanto, parecem ser critérios ainda incipientes.

Políticas públicas sobre nutrición en Uruguay y la autonomía de las personas / Public nutritional policies in Uruguay and people's autonomy

Tomado como punto de partida el concepto de autonomía desarrollado por la bioética americana y tras realizar una revisión actualizada de las políticas públicas en nutrición en Uruguay, se presenta un análisis de los problemas que han tenido estas en relación a la noción objeto de estudio. La investigación fue basada en una revisión de puntos de referencia históricos en el campo de políticas que fueron concebidas por el Estado para combatir los problemas nutricionales. Se revisaron documentos del gobierno fueron publicados al efecto, tales como: programas, planes y guías. En el análisis se discuten los valores que tradicionalmente han sido identificados como derechos básicos de autonomía y aspectos que la rodean y, en cierto modo, son determinantes a la hora de las elecciones individuales y las posibilidades reales de los individuos de elegir con libertad. La finalidad del presente trabajo es hacer un recorrido de las políticas nutricionales del Estado uruguayo desde mediados del siglo xx hasta la actualidad, enfatizando en la injerencia de estas en la construcción de la autonomía(AU)

Based on the concept of autonomy developed by American bioethics and after carrying out an updated review of the public nutritional policies in Uruguay, it is presented an analysis of the problems that these policies had in relation to this concept. The research was based in a review of the historical points of reference in the field of policies that were designed by the State to combat nutritional problems. Government documents which were published as programmes, plans and guides were reviewed. The analysis discusses the values that have traditionally been identified as basic rights of autonomy and aspects that surround it, and that in some way are determinants when individual choices and the real possibilities of individuals to choose freely appear. The purpose of this study is to show the nutritional policies of the Uruguayan State, from the mid twentieth century to the present, emphasizing their interference in the construction of autonomy(AU)

Comunicar para el desarrollo: una propuesta de divulgación radiofónica en la lucha contra el hambre y la malnutrición en Nicaragua / Communicating for development: a proposal for radio broadcasting to deal with hunger and malnutrition in Nicaragua

Nicaragua presenta altos niveles de inseguridad alimentaria y nutricional. Predomina la deficiencia proteico-energética y la carencia de nutrientes específicos y al mismo tiempo presenta la superposición epidemiológica-nutricional y la doble carga de riesgos para la salud. Faltan conocimientos para optimizar los escasos recursos para adquirir productos de mayor valor nutricional. El objetivo fue contribuir a reducir el hambre y la desnutrición y mejorar la alimentación y el estado nutricional de la población del municipio nicaragüense de Somotillo, a través de estrategias educativas difundidas por el medio radiofónico. Se ejecutó el programa "Por una mejor nutrición" en la radio (1 junio al 29 de julio, 2016) y se abordaron cuatro temas: conocimientos sobre alimentación saludable, higiene alimentaria, enfermedades asociadas a la malnutrición y alimentación del escolar y se acompañaron de tres cápsulas informativas cada uno, transmitidas 1v/s y 5v/s (8v/día), respectivamente, más una sesión 1v/s de respuesta a los oyentes (maestros y niños escolares). Además, se hizo una evaluación cualitativa (grupo de discusión con maestros y promotores de salud) y se aplicó un cuestionario de 5 preguntas pre y post intervención a 600 escolares seleccionados al azar en 20 escuelas rurales. Se encontró dominio parcial del tema de higiene pre-intervención y fallas en las acciones para prevenir las enfermedades que afectan el estado nutricional de los escolares (post intervención). El programa benefició a 2.349 estudiantes y familias. Esta experiencia puede mejorar el empoderamiento de las familias y la comunidad frente a los problemas de alimentación y prácticas higiénicas peligrosas existentes, pero requieren por parte de las comunidades garantizar la sostenibilidad y replicabilidad del mismo(AU)

Nicaragua has high levels of food and nutritional insecurity. Protein-energy deficiency and lack of specific nutrients predominate, while epidemiological-nutritional deficiencies and excess overlap and the double burden of health risks. There is a lack of knowledge in order to optimize scarce resources and to acquire products of greater nutritional value. The aim was to contribute to the reduction of hunger and malnutrition and to improve the diet and nutritional status of the population of the Nicaraguan municipality of Somotillo, through educational strategies broadcasted by radio. The program "For better nutrition" was carried out on the radio (1 June to 29 July 2016) and addressed four topics: knowledge of healthy eating, food hygiene, diseases associated with malnutrition and school feeding, and was accompanied by three information capsules, each transmitted 1/s and 5/s (8v/day), respectively, plus a 1/s response session for listeners (teachers and school children). In addition, a qualitative evaluation (discussion group with teachers and health promoters) and a questionnaire of 5 pre and post intervention questions were applied to 600 randomly selected schoolchildren in 20 rural schools. Partial mastery was found of the issue of pre-intervention hygiene and failures in actions to prevent diseases that affect the nutritional status of schoolchildren (post-intervention). The program benefited 2,349 students and families. This experience can improve the empowerment of families and the community in the face of existing food problems and dangerous hygiene practices(AU)

Intervención nutricional precoz en ancianos con neumonía adquirida en la comunidad / Precocious nutritional intervention in elder people with community-acquired pneumonia

RESUMEN Introducción: la nutrición tiene importancia capital en la evolución de los pacientes ingresados. La prevalencia de malnutrición oscila entre 30% y 60% de los enfermos hospitalizados. Objetivo: evaluar impacto en la mortalidad y complicaciones a corto plazo de una intervención nutricional precoz. Material y método: se realizó un estudio caso control con todos los pacientes que ingresaron en la Unidad de Cuidados intensivos emergentes con el diagnóstico de neumonía adquirida en la comunidad asociada a desnutrición en Hospital Militar Dr. Carlos J. Finlay, de noviembre de 2017 hasta mayo del 2018. Resultados: la media de la edad del estudio fue de 80,73 ± 9,01 años. El 46 % fueron mujeres. La mortalidad global estuvo en el 26 %. El 69 % de los pacientes presento alguna complicación. Existió una mayor sobrevida en el grupo de estudio (7 fallecidos y 29 vivos), que en el grupo de control donde hubo 12 fallecidos y 24 vivos x2 = 0,18. En la tabla 2 se evidencia que existe diferencia entre los grupos según las complicaciones aparecidas. Fue marcada la diferencia entre los grupos en relación a la cantidad de pacientes con diarreas. La incidencia fue mayor tanto en el subgrupo de vivos(8) como en el de fallecidos(3) del grupo control. Por otro lado la hiperglucemia fue mucho mayor en el grupo de estudio(11) y sin embargo, no hubo impacto en la mortalidad x2 = 0,03. En la tabla 3 se evidencia una fuerte evidencia que relaciona al estado nutricional deficiente con una peor evolución. Entre los fallecidos solo 1 tenía un estado nutricional catalogado como desnutrido ligero, sin embargo entre los 22 fallecidos 14 presentaron desnutrición severa. Conclusiones: el estado nutricional al ingreso impacta negativamente en la mortalidad a corto plazo y la estrategia nutricional mixta precoz no reduce ese aspecto sin embargo si reduce el número de complicaciones aunque se asoció a mayor incidencia de hiperglucemia sin impactar en la mortalidad (AU).

SUMMARY Introduction: nutrition has a capital importance in the evolution of in-patients. Malnutrition prevalence ranges from 30 % to 60 % of the admitted patients. Objective: to evaluate the impact on mortality and the short time complications of the precocious nutritional intervention. Material and Method: a case control study was carried out with all patients who entered the Emergency Intensive Care Unit with the diagnosis of community-acquired pneumonia associated to malnutrition in the Military Hospital "Dr, Carlos J. Finlay" from November 2017 to May 2018. Results: the average age was 80.73 ± 9.01 years. 46 % were female patients. Global mortality was 26 %. 69 % of patients had complications. The group of study showed a higher survival (7 deads and 29 survivors) than the control one where there were 12 deads and 24 survivors (2=0.18). Table 2 shows that there are differences between groups according to the complications found. The difference between groups was remarkable in relation to the quantity of patients with diarrhea. The incidence was higher both in the group of survivors(8) and in the group of dead peoples(3) of the control group. On the other hand, hyperglycemia was much higher in the group of study(11) but without striking on mortality (2= 0.03). Table 3 shows strong evidence relating deficient nutritional status to a worth evolution. Among the deceased patients only 1 had a nutritional status classified as slightly malnutrition, but among the 22 deceased, 14 had severe malnutrition. Conclusions: the nutritional status at admission negatively strikes on short term mortality, and mixed precocious nutritional strategy does not reduce that aspect. However it does reduce the number of complications, though it was associated to a higher incidence of hyperglycemia without striking on mortality (AU).

Algunos planteamientos teóricos frente a los programas de transferencias condicionadas y el derecho a la alimentación / Some theoretical approaches against conditioned cash transfer programs and the right to food / Alguns planteamientos teóricos frente aos programas de transferencias condicionadas e o direito à alimentação

Objetivo: Plantear un marco de referencia conceptual y teórico para el análisis de los PTCE y su papel frente al derecho a la alimentación. Materiales y métodos: Este manuscrito es una investigación de carácter teórica derivada de un estudio marco, el cual estuvo basado en el método de la teoría fundamentada y cuyo propósito fue comprender los signi cados de las políticas alimentarias para un grupo de bene ciarios. Resultados: El derecho a la alimentación tiene un contexto político y económico que corresponde a un Estado neoliberal, el cual centra su política social en la lucha contra la pobreza, aunque solo en algunas expresiones de ésta. La pobreza se concibe como dé cit de capital humano y los programas de trasferencias condicionadas constituyen la estrategia emblemática de la política social en el neoliberalismo. En este escenario los programas de transferencias condicionadas se convierten en mecanismos para la inclusión de los pobres al mercado, en donde los sujetos deben procurarse su alimentación. Los análisis derivados de la investigación marco permiten comprender que los programas de transferencias en efectivo no resuelven la situación de seguridad alimentaria de los bene ciarios. Conclusión: Los programas de transferencias condicionadas, como parte de un enfoque de asistencia social residual, no garantizan el derecho a la alimentación, sino que abocan a los pobres procurarse por sí mismos su alimentación, en condiciones de franca desventaja frente al resto de la población.

Objective: To propose a conceptual and theoretical reference framework for the analysis of the CCTP and its role in relation to the right to food. Materials and methods: This article is a theoretical research derived from a framework study, which was based on the grounded theory method and whose purpose was to understand the meaning of food policies for a group of bene ciaries. Results: The right to food has a political and economic context that corresponds to a neoliberal state, which focuses its social policy on the ght against poverty, although only in some of its expressions. Poverty is conceived as a de cit of human capital and the conditioned cash transfer programs constitute the emblematic strategy of the social policy in neoliberalism. In this scene, of conditioned cash transfer programs become mechanisms for the inclusion of the poor people in the market, where the subjects must procure their food. Analyzes derived from the framework research allow understanding that the cash transfer programs do not solve the food security situation of the bene ciaries. Conclusion: The conditioned cash transfer programs, as part of a residual social assistance approach, do not guarantee the right to food but rather head the poor people towards procuring themselves their food, under conditions of clear disadvantage compared to the rest of the population.

Objetivo: Sugerir um marco de referência conceptual e teórico para o analise dos PTCE e seu papel frente ao direito à alimentação. Materiais e métodos: Este manuscrito é uma pesquisa de caráter teórica derivada dum estudo marco, o qual esteve baseado no método da teoria fundamentada e cujo propósito foi compreender os signi cados das políticas alimentaria para um grupo de bene ciários. Resultados: O direito à alimentação tem um contexto político e econômico que corresponde a um Estado neoliberal, o qual centra sua política social na luta contra a pobreza, porém só em algumas expressões desta. A pobreza se concebe como dé cit de capital humano e os programas de transferências condicionadas constituem a estratégia emblemática da política social no neoliberalismo. Neste cenário os programas de transferências condicionadas se tornam em mecanismos para a inclusão dos pobres ao mercado, onde os sujeitos devem procurar-se sua alimentação. As análises derivados da pesquisa marco permitem compreender que os programas de transferências em efetivo não resolvem a situação de segurança alimentaria dos bene ciários. Conclusão: Os programas de transferências condicionadas, como parte dum enfoque de assistência social residual, não garantiram o direito à alimentação, se não que abocam aos pobres procurar se por si mesmos sua alimentação, em condiciones de franca desvantagem frente ao resto da povoação.

El plátano: indicador de hambre y escasez de alimentos en familias beneficiarias de programas alimentarios en Vigía del Fuerte, Colombia / Plantain: indicator of hunger and food shortage in families benefiting from food programs in Vigia del Fuerte, Colombia

RESUMEN Objetivo Interpretar la percepción de hambre y escasez de alimentos en familias beneficiarias de Programas alimentarios MANA (Mejoramiento Alimentario y Nutricional de Antioquia) en Vigía del Fuerte. Método La investigación se orientó desde el enfoque cualitativo, usando la Etnografía Focalizada como método, para la recolección de la información se utilizaron entrevistas individuales y grupos de discusión. Resultados Las comunidades de la cuenca del río Murrí están protegidas del hambre física por la disponibilidad permanente del plátano; el hambre está asociada a la ausencia de carne o "liga" y al hecho de comer "plátano vacío"; así mismo se refieren al hambre como la sensación de desasosiego, debido al dolor de cabeza y de estómago que experimentan de manera permanente e intensa. Conclusiones A pesar de que las comunidades vigieñas disponen durante todo el tiempo de plátano, protegiéndolas del hambre física; estas no lo aprecian así, como alimento que calma su hambre y los libera, de cierta manera, de la escasez, porque su presencia como único alimento disponible, les recuerda, precisamente, que tienen carencia y hambre.(AU)

ABSTRACT Objective To analyze the perception of hunger and food shortage in families benefiting from MANA (Food and Nutritional Improvement) food programs in Vigía del Fuerte, Colombia. Methods Qualitative research, using focused ethnography as a method for collecting information. Individual interviews and discussion groups were used. Results Even though the communities that live by the Murrí River basin are protected from physical hunger due to the constant availability of plantain or musa, hunger is associated with the absence of meat or liga and the fact that they feel forced to eat empty musa. They also refer to hunger as the feeling of uneasiness caused by headache and stomachache. Conclusions Despite the fact that the communities of Vigía del Fuerte have access to plantain throughout the year, thus protecting them from physical hunger, they do not consider it as food that could calm their hunger and free them from scarcity. This happens because its presence as the only food available reminds them, precisely, that they lack certain conditions and feel hunger.(AU)

Estudio piloto del programa internacional de balance energético para niños en una escuela de caracas / Pilot study of the international program of energy balance for children in a school in caracas

El Programa Balance Energético para Niños (EB4K, en inglés), incluye una metodología que integra múltiples componentes utilizado inicialmente para prevenir la obesidad desde la escuela, en los Estados Unidos, basado en evidencia científica. Este modelo se adaptó para un estudio piloto en una escuela de bajos recursos del Municipio Sucre del Estado Miranda de Venezuela, cuyo objetivo fue evaluar la efectividad del programa EB4K. Se planteó un estudio longitudinal, cuasi-experimental con diseño pre y post intervención, de 12 semanas de duración en el cual se aplicó el programa educativo EB4K a 133 estudiantes de 3ro a 5to grado de educación básica. Se evaluaron datos demográficos, estado nutricional antropométrico, conocimiento nutricional, frecuencia de desayuno semanal y conocimiento sobre actividad física mediante un cuestionario desarrollado con base en el original de EB4K y adaptado para tal fin. Posterior a la intervención, el estado nutricional antropométrico clasificado por Índice de Masa Corporal para la edad, presentó una tendencia a disminuir en 11,3% de los sujetos; se registró un aumento de 8,2% en el conocimiento nutricional y de 4,5% para la ingesta diaria de desayuno. No se observaron cambios en relación al conocimiento sobre actividad física. Se concluye que el programa EB4K, pudiera generar cambios positivos en los escolares, especialmente en el manejo de los conocimientos nutricionales, siendo la práctica de actividad física una de las variables cuyo tratamiento debe ser reforzado en el programa(AU)

The Energy Balance for Kids (EB4K) Program is founded on an evidence based multicomponent methodology initially implemented to prevent obesity in school environments in the USA. This model was adapted for a pilot study with the aim to evaluate the effectiveness of the EB4K revised program for Venezuela, in a low-income school at Sucre Municipality of Miranda State. This is a longitudinal, quasi-experimental study with a design before and after the lasting 12 weeks in which the EB4K educational program was applied to 133 students from 3rd to 5th grade of basic elementary school. Demographic data, anthropometric nutritional status, nutritional information, frequency of weekly breakfast and knowledge of physical activity were evaluated through a questionnaire developed based on the original EB4K and adapted for that purpose. After the 12 weeks, there was an increase of 8.2% in the nutritional knowledge and 4.5% for the daily breakfast intake, after the intervention. Regarding the knowledge about physical activity, no changes were observed, while the anthropometric nutritional status classified by Body Mass Index for age showed a tendency to decrease in 11.3% of the subjects, after 12 weeks. In conclusion, the EB4K program could generate positive changes in schoolchildren, especially in nutritional knowledge, being the practice of physical activity a message that should be reinforced in this program(AU)

Asociación entre la participación en programas de asistencia alimentaria y patrones del perfil lipídico en Perú / Association between food assistance program participation and lipid profile patterns in Peru

RESUMEN Evaluamos si la participación en programas de asistencia alimentaria (Comedores Populares y Vaso de Leche) se asocia a patrones de perfil lipídico en población peruana. Análisis secundario de los datos de la Encuesta Nacional de Indicadores Nutricionales, Bioquímicos, Socioeconómicos y Culturales Relacionados con las Enfermedades Crónicas Degenerativas. Se estudió individuos ≥20 años seleccionados de cinco estratos geográficos del Perú. En cada estrato se seleccionó conglomerados por muestreo aleatorio. Se construyeron modelos de regresión de Poisson con varianza robusta para determinar la asociación entre los programas de asistencia alimentaria y el perfil lipídico (colesterol total (CT), HDL-colesterol (HDL-c), LDL-colesterol (LDL-c) y triglicéridos (TG)) de los participantes. De 4028 participantes, solo 123 (3,1%) reportaron ser beneficiarios del programa Comedores Populares y 827 (20,5%) del Vaso de Leche. En modelo multivariable, se encontró asociación entre ser beneficiario de los Comedores Populares y LDL-c elevado (razón de prevalencia (RP)= 2,33; IC95%:1,18-4,59); mientras que ser beneficiario del Vaso de Leche incrementó la probabilidad de tener HDL-c bajo (RP= 1,08; IC95%:1,02-1,14), pero redujo la de tener hipertrigliceridemia (RP= 0,70; IC95%:0,56-0,88). Ser beneficiario del programa Comedor Popular se asoció a presentar LDL-c elevado; mientras que, ser beneficiario del Vaso de Leche aumentó la probabilidad de presentar HDL-c bajo, pero redujo la probabilidad de presentar hipertrigliceridemia.

ABSTRACT Purpose: To assess whether the participation in food assistance programs (Community Kitchens and Glass of Milk) was associated with lipid profile patterns in the Peruvian population. We conducted a secondary data analysis using data from the National Survey of Nutritional, Biochemical, Socioeconomic, and Cultural indicators related to Chronic Degenerative Diseases. The sample included individuals aged ≥20 years, selected from five geographic strata in Peru. From each stratum a random sample of clusters was chosen. Different Poisson regression models with robust variance were built to determine the association between food assistance programs and participant lipid profile (total cholesterol (TC), HDL-cholesterol (HDL-c), LDL-cholesterol and triglycerides (TC)). Data from 4028 participants was analyzed, 123 (3.1%) reported being beneficiaries of the Community Kitchens program and 827 (20.5%) were beneficiaries of the Glass of Milk program. An association between being a beneficiary of Community Kitchens and increased LDL-c (Prevalence ratio (PR)= 2.33; 95% CI: 1.18-4.59) was found. Being a beneficiary of the Glass of Milk program increased the probability of having low HDL-c levels (PR= 1.08; 95% CI: 1.02-1.14), but reduced the probability of hypertriglyceridemia (PR= 0.70; 95% CI: 0.56-0.88). Being a beneficiary of the Community Kitchen program was associated with increased LDL-c levels; while, being a beneficiary of the Glass of Milk increased the probability of low HDL-c, but reduced the probability of developing hypertriglyceridemia.

Um olhar sobre a agenda de alimentação e nutrição nos trinta anos do Sistema Único de Saúde / A look at the food and nutrition agenda over thirty years of the Unified Health System

A alimentação e a nutrição são requisitos básicos para a promoção e a proteção da saúde. A vigilância nutricional e a orientação alimentar estão inclusas no campo de atuação do Sistema Único de Saúde (SUS), conforme estabelecido na Lei Orgânica da Saúde nº 8.080 de 1990. O presente artigo apresenta e discute a agenda de alimentação e nutrição no SUS e sua interface com a Segurança Alimentar e Nutricional, seus marcos históricos, avanços e desafios. Este ensaio foi orientado por pesquisa biográfica e documental e, sobretudo, no resgate das experiências e percepções das autoras que, em diferentes momentos e contextos, foram e são sujeitos da agenda de alimentação e nutrição no Brasil. Reforçamos assim a ideia do SUS, com suas conquistas e imperfeições, como um sistema vivo e derivado do compromisso técnico-ético-político dos gestores, dos trabalhadores, da academia e da sociedade como um todo. Desta forma, buscamos contribuir com o debate sobre a trajetória brasileira de construção de um sistema público de proteção social que se comprometeu com o direito humano à saúde e à alimentação adequada.

Adequação numérica de nutricionista, perfil de cardápios, número de alunos nos serviços de alimentação escolar do sul do Rio Grande do Sul / Numerical adequacy of nutritionist, profile of menus, number of students in school feeding services in the south of Rio Grande do Sul

O objetivo desse trabalho foi caracterizar a execução dos serviços de alimentação escolar de escolas públicas de municípios da Zona Sul do Rio Grande do Sul, bem como obter informações referentes aos seus cardápios, alunos e adequação numérica de nutricionistas. Em 2015 foi realizado um estudo transversal com nutricionistas dos serviços de alimentação escolar de municípios da Associação da Zona Sul do estado filiada à Federação das Associações de Municípios do Rio Grande do Sul. Após autorização dos gestores municipais e consentimento próprio, os profissionais responderam a um questionário online sobre suas características sociodemográficas, de formação e de atuação nos serviços de alimentação escolar, além de perguntas sobre número de alunos e de refeições nas escolas. Verificou-se a inadequação do número de nutricionistas nos municípios, bem como a carga horária total dos mesmos em relação às recomendações. Todos os nutricionistas dos serviços eram do sexo feminino, mais da metade tinha mais de 40 anos (53,9%) e quase 2/3 tinham pós-graduação (61,5%). A maior parte dos profissionais relatou ter responsabilidade técnica pela alimentação escolar (84,6%) e em termos de esfera das escolas, as municipais foram mais frequentes (77,0%). Quanto ao número de refeições servidas anualmente, a maioria servia 20 mil ou mais na creche (46,2%), na pré-escola (76,9%) e no ensino fundamental (76,9%). Todas as profissionais elaboravam os cardápios das escolas conforme hábitos alimentares, sendo que, 46,1% elaboravam por modalidade de ensino e quase 70% referiram preocupação com valor calórico total, macro e micronutrientes conforme a faixa etária do escolar. Referente às preparações apenas 30% referiram uso de per capitas, de ficha técnica de preparo e de ficha técnica de produto. A inadequação do número de profissionais e a falta de padronização das preparações, encontrados no estudo, podem ser devido à sobrecarga de tarefas, as quais possivelmente despendem bastante tempo para o gerenciamento dos serviços e dos recursos do Programa Nacional de Alimentação Escolar.

The aim of this study was to characterize the execution of school feeding services of public schools in the Southern Zone of Rio Grande do Sul, as well as to obtain information regarding their menus, students and numerical adequacy of nutritionists. A cross-sectional study was carried out with nutritionists from the school feeding services of municipalities of the Southern Zone Association of the state affiliated to the Federation of Associations of Municipalities of Rio Grande do Sul. After authorization by the municipal managers and their own consent, the professionals answered an online questionnaire about their sociodemographic characteristics, training and performance in school feeding services, as well as questions about number of students and meals in schools. It was verified the inadequacy of the number of nutritionists in the municipalities, as well as the total workload of the same in relation to the recommendations. All service nutritionists were female, more than half were over 40 years old (53.9%) and almost two-thirds had postgraduate degrees (61.5%). Most professionals reported having technical responsibility for school feeding (84.6%) and in terms of schools, municipal schools were more frequent (77.0%). As for the number of meals served annually, the majority served 20 thousand or more in day care (46.2%), pre-school (76.9%) and elementary school (76.9%). School menus according to eating habits, with 46.1% elaborating by type of education and almost 70% reported concern with total caloric value, macro and micronutrients according to the age group of the school. Regarding the preparations, only 30% referred to the use of per capita, technical data sheet and product data sheet. The inadequacy of the number of professionals and the lack of standardization of the preparations found in the study may be due to the overload of tasks, which may take a long time to manage the services and resources of the National School Feeding Program