Impact of a Cooking Intervention on the Cooking Skills of Adult Individuals with Type 2 Diabetes Mellitus: A Pilot Study.

OBJECTIVE: To investigate the impact of the Nutrition and Culinary in the Kitchen (NCK) Program on the cooking skills of Brazilian individuals with type 2 diabetes mellitus (T2DM). METHODS: A randomized controlled intervention study was performed, with intervention and control groups. The intervention group participated in weekly sessions of the NCK Program for six weeks (including two in-person practical cooking and three online cooking workshops). The cooking recipes were adapted by replacing high glycemic index ingredients with low and medium glycemic index alternatives. Of note, the recipes did not contain added sugars or sweeteners, were based on the use of fresh or minimally processed foods, herbs, and spices, and were sensorially tested by individuals with T2DM before use in the intervention. The study outcomes were participant score changes on the seven scales. A validated online instrument was administered to the control and intervention groups at baseline (T1) and post-intervention (T2). Parametric and non-parametric tests were used to assess the differences between the T1 and T2 parameters. RESULTS: Of the 60 individuals enrolled, 44 answered the questionnaire at both times. The findings revealed a 45.37% ± 93.57% increase in Knowledge of Cooking Terms in the intervention group, whereas the control group showed a 3.82% ± 16.17% reduction (p = 0.008). There was an increase in all the other cooking skills and healthy eating scales from T1 to T2 in the intervention group, but the differences were not significant. CONCLUSIONS: The development of cooking skills can contribute to increasing culinary knowledge and the availability of time to cook at home. The results contribute to the planning of health actions aimed at individuals with DM2 through culinary interventions and public food and nutrition policies.

Adiposity and physical activity are among the main determinants of serum vitamin D concentrations in older adults: the EpiFloripa Aging Cohort Study.

The identification of factors associated with 25-hydroxycholecalciferol (25(OH)D) concentration can help suggest more specific interventions for older adults. In this cross-sectional study of older adults from southern Brazil, we hypothesized that some sociodemographic, behavioral, and health factors positively or negatively influence the 25(OH)D concentration in this population. This analysis was performed using data from the second wave of the EpiFloripa Aging Cohort Study (2013-2015). Serum 25(OH)D levels were classified according to the guidelines of the Endocrine Society. Multinomial logistic regression was performed to evaluate the relative risks of sociodemographic, behavioral, and health factors in each 25(OH)D category. A total of 574 older adults (aged 63-93 years) participated in this study. The prevalence of insufficiency (21-29 ng/mL) was 43.7% and that of deficiency (≤20 ng/mL) was 23.5%. In the adjusted analysis, female sex, higher levels of low-density lipoprotein cholesterol (LDL-C ≥160 mg/dL), obesity by adiposity (body fat percentage [%fat], male ≥31%; female ≥43%), and body mass index (BMI, >30 kg/m2) presented higher relative risks for insufficiency than for sufficiency. For those with deficiency, the associated factors were female sex, disability in 4 or more activities of daily living (ADLs), LDL-C ≥100 mg/dL, and obesity by %fat and BMI. A protective factor against insufficiency and deficiency was active leisure-time physical activity (PA, ≥150 min/week). Our results demonstrated that being female and having modifiable factors, such as high levels of LDL-C, obesity, and disability on ADLs, were negatively associated with hypovitaminosis D. On the other hand, leisure-time PA was positively associated with adequate serum vitamin D concentration.

Ketogenic diet, epilepsy and cognition: what do we know so far? A systematic review.

CONTEXT: Epilepsy is a chronic neurological disorder that has social, cognitive, and psychological consequences to the patient. OBJECTIVE: The effects of the ketogenic diet (KD) in children and adults with pharmacoresistant epilepsy on cognitive function were evaluated in this systematic review. DATA SOURCES: The MEDLINE, Cochrane Library, Scopus, Web of Science, and LILACS databases were searched up to February 2021. STUDY SELECTION AND DATA EXTRACTION: From the 2973 records initially identified, 24 studies were included in the systematic review. These records were screened via PICO criteria, focusing on studies that evaluated the effects of KD on cognitive function of patients with pharmacoresistant epilepsy. RESULTS: Nineteen studies described improvements in cognitive function attributed to KD; improvements were not observed in 2 studies, but neither was aggravation. Contradictory results were reported in 3 studies, depending on the method used to assess cognition. At first glance, cognitive function appears to be associated with the number of seizures, diet effectiveness, amount of carbohydrate ingested, and antiseizure medication used. However, due to the diversity of methods used to assess cognitive function, especially self-perception of cognitive improvement by the patient, it was not possible to confirm this hypothesis. CONCLUSION: It was not possible to confirm if KD itself promotes improvements in cognitive function in patients with pharmacoresistant epilepsy. Certainly, more studies are needed with better methodological quality, larger and more homogeneous samples in relation to epileptic syndrome and clinical aspects of the disease, more rigid monitoring of adherence to the diet, and use of standardized tests for neuropsychological assessment. Systematic Review Registration: PROSPERO registration no. CRD42019129236.

Government-Subsidized Restaurants as promoters of the realization of the Human Right to Adequate Food: Proposal of an evaluation model / Restaurantes Populares enquanto promotores da realização do Direito Humano à Alimentação Adequada: proposição de um modelo avaliativo

ABSTRACT Objective This article presents an evaluation model for Government-Subsidized Restaurants within the framework of the National Food and Nutrition Security Policy. Methods This is an evaluation study. The Evaluation Matrix was elaborated from five stages: systematized revision for elaboration of the theoretical-logical model; immersion process; construction of the preliminary theoretical-logical model; consensus workshops, through the traditional committee technique; elaboration of the evaluation matrix proposal; and external consensus with specialists in the subject and in the implementation and management of Government-Subsidized Restaurants. Results The proposed matrix contemplates two dimensions: Political-Organizational, with the subdimensions: Management, Structure and Target Public; and Technical-Operational, with the sub-dimensions: Adequate Food, Food and Nutrition Education, and Extended Public Assistance. Twenty-four indicators and 29 measures were listed. Conclusion The findings point to the need for advances in evaluation methodologies that contemplate Food and Nutrition Security as the guiding principle of the actions performed by Government-Subsidized Restaurants. Thus, the evaluation matrix presented aims to contribute to the improvement of the GSR as a multifunctional tool, promoter of Food and Nutrition Security and the realization of the Human Right to Adequate Food within the National Food and Nutrition Security Policy.

RESUMO Objetivo Apresentar um modelo de avaliação para os Restaurantes Populares no âmbito da Política Nacional de Segurança Alimentar e Nutricional. Métodos Trata-se de um estudo de avaliabilidade. A Matriz Avaliativa foi elaborada a partir de cinco etapas: revisão sistematizada para elaboração do modelo teórico-lógico; processo de imersão; construção do modelo teórico--lógico preliminar; oficinas de consenso, por meio da técnica de comitê tradicional; elaboração da proposta da matriz avaliativa; e consenso externo com especialistas na temática e na implantação e gestão de Restaurantes Populares. Resultados A Matriz proposta contempla duas dimensões: Político-Organizacional, com as subdimensões: Administração, Estrutura e Público Frequentador; e Técnico-Operacional, com as subdimensões: Alimentação Adequada, Educação Alimentar e Nutricional e Assistência Ampliada ao Público Frequentador. Foram definidos 24 indica-dores e 29 medidas. Conclusão A literatura científica investigada apontou a necessidade de avanços em metodologias avaliativas que contemplem a Segurança Alimentar e Nutricional enquanto norteadora das ações executadas pelos Restaurantes. Assim, a Matriz Avaliativa apresentada visa contribuir para a melhoria dos Restaurantes Populares como ferramenta multifuncional promotora da Segurança Alimentar e Nutricional e da realização do Direito Humano à Alimentação Adequada dentro da Política Nacional de Segurança Alimentar e Nutricional.