Enhancing Elderly Nutrition: A Qualitative Evaluation of Menus in a Social Solidarity Institution in the North of Portugal.

This work addresses the importance of food and nutrition in promoting the health of the elderly population, with a specific focus on the qualitative evaluation of menus provided by a social solidarity institution in Portugal. The aim of this study is to conduct a qualitative evaluation of menus furnished by a social solidarity institution situated in the northern region of Portugal in order to prevent and/or treat malnutrition in the elderly. The methodology involves the evaluation of four weekly menus, totaling 28 complete daily menus for the elderly, using the "Avaliação Qualitativa de Ementas Destinadas a Idosos" (AQEDI) tool. This assessment tool comprises six domains: general items, soup, protein suppliers, carbohydrate suppliers, vegetable suppliers, and dessert, each consisting of various parameters. The findings reveal that all menus were classified as "acceptable," with percentages ranging from 60.73% to 68.84%, and suggest that there exists room for improvement. This study emphasizes the necessity for coordinated efforts within the institution to enhance menu planning, taking into account both nutritional guidelines and sensory aspects of food. Effective coordination within the institution is crucial for maintaining positive aspects and rectifying inadequacies in menu planning.

Improving school lunch menus with multi-objective optimisation: nutrition, cost, consumption and environmental impacts.

OBJECTIVE: To support school foods programmes by evaluating the relationship between nutritional quality, cost, student consumption and the environmental impacts of menus. DESIGN: Using linear programming and data from previously served menu items, the relationships between the nutritional quality, cost, student consumption and the environmental impacts of lunch menus were investigated. Optimised lunch menus with the maximum potential student consumption and nutritional quality and lowest costs and environmental impacts were developed and compared with previously served menus (baseline). SETTING: Boston Public Schools (BPS), Boston Massachusetts, USA. PARTICIPANTS: Menu items served on the 2018-2019 BPS lunch menu (n 142). RESULTS: Using single-objective models, trade-offs were observed between most interests, but the use of multi-objective models minimised these trade-offs. Compared with the current weekly menus offered, multi-objective models increased potential caloric intake by up to 27 % and Healthy Eating Index scores by up to 19 % and reduced costs and environmental impacts by up to 13 % and 71 %, respectively. Improvements were made by reducing the frequency of beef and cheese entrées and increasing the frequency of fish and legume entrées on weekly menus. CONCLUSIONS: This work can be extrapolated to monthly menus to provide further direction for school districts, and the methods can be employed with different recipes and constraints. Future research should test the implementation of optimised menus in schools and consider the broader implications of implementation.

Avaliação qualitativa das preparações servidas em um restaurante popular e os impactos do cenário pandêmico da covid-19 / Qualitative assessment of preparations served in a popular restaurant and the impacts of the COVID-19 pandemic scenario / Evaluación cualitativa de las preparaciones servidas en un restaurante popular y los impactos del escenario de pandemia COVID-19

Introdução:A chegadadapandemia da COVID-19 afetou diretamente o planejamento alimentar de instituições municipais, estaduais e de demais âmbitos, dentre eles as refeiçõesofertadas peloprograma restaurante popular, importante na garantia da segurança alimentarda população mais vulnerável.Objetivo:Avaliar de forma qualitativa as preparações do cardápio do almoço do Restaurante Popular do município de Santa Cruz-Rio Grande do Nortee os impactos do cenário pandêmico da COVID-19.Metodologia:Para tanto, avaliou-se os cardápios referentes aos meses de março, abril, maio, agosto e setembro de 2021, pelo método avaliação qualitativa das preparações do cardápio. Além disso, por meio da adaptação dométodosupracitado, designou-se as preparações de acordo com as recomendações do tipo de processamento segundo o Guia Alimentar para população Brasileira. Resultados:Identificou-se uma baixa oferta de frutas e folhosos, alta de carnes gordurosas e doce, regular de preparações ricas em enxofre e as cores iguais, todavia, quanto à fritura e ao conjunto de fritura + doce apresentou-se em apenas umdiada semana (n=109). Além disso, nos dois últimos meses de análisehouve aumento na oferta de folhosos, diminuição da monotonia, alimentos ricos em enxofre e doces, e ainda, as preparações com alimentos in natura ou minimamente processados + processados fizeram-se presentestodos os dias. Conclusões:Com a utilizaçãodométodo estudadofoipossível identificar ajustesno cardápiopara o período analisado, a fim de ofertar qualidade para os comensais.Ressalta-se que foi observadoque com a adaptação e redução dos casos da COVID-19, houve aumento na oferta de in natura e minimamente processados. Espera-se que melhorias e ajustes sejam realizadosnos cardápios, visto a necessidadede ser mais enfático em seu princípiode garantir a segurança alimentar (AU).

Introduction:The arrival of the COVID-19 pandemic affected directly the food planning of municipal, state and other institutions, including the meals offered by the popular restaurant program, which is important in guaranteeing the food security of the vulnerablepopulation. Objective: To qualitatively evaluate the preparations of the lunch menu at Restaurante Popular in the municipality of Santa Cruz-Rio Grande do Norteand the impacts of the COVID-19 pandemic scenario.Methodology:To this, the menus for the months of March, April, May, August and September 2021 were evaluated by the methodqualitative evaluation of menu preparations. Furthermore, through the adaptation of the methodaformentioned, preparations were designated according to the recommendations for type of processing following the Food Guide for the Brazilian population.Results:A low supply of fruits and leafy vegetables was identified, high supply of fatty and sweet meats, regular supply of preparations rich in sulfur and the same colors. However, regarding the frying and the frying + sweet combination, it was presented in just one daythe week(n=109).Moreover, in the last two months of analysis there was an increase in the supply of hardwoods, decrease in monotony,foods rich in sulfur and sweets, and even, preparations in natura or minimally processed + processed foods were presentsevery day. Conclusions:With the use of the method studied it waspossible to adjust the menufor the analyzed periodto offer qualityto diners. It should the increase in the supply of in natura and minimally processed foods stands out with the adaptation and progression of the reduction of COVID-19cases.It is expected that improvements and adjustments will be madethe menus,given the need to be more emphatic in its principleof ensuring food safety (AU).

ntroducción: La llegada de la pandemia del COVID-19 afectó directamente la planificación alimentaria de las instituciones municipales, estatales y otras, incluyendo las comidas que ofrece el programa de restaurantes populares, importante para garantizar la seguridad alimentaria de la población más vulnerable. Objetivo:Evaluar cualitativamente las preparaciones del menú del almuerzo en el Restaurante Popular del municipio de Santa Cruz-Rio Grande do Nortey los impactos del escenario de pandemia del COVID-19.Metodología:Para ello, se evaluaron los menús de los meses de marzo, abril, mayo, agosto y septiembre de 2021 por el método evaluación cualitativa de la elaboración de menús. Además, al adaptar el métodocitado, las preparaciones fueron designadas de acuerdo con las recomendaciones del tipo de procesamiento según la Guía de Alimentos para la población brasileña.Resultados: Se identificó una baja oferta de frutas y hortalizas de hoja, alta oferta de carnes grasas y dulces, regular oferta de preparaciones ricasen azufre y los mismos colores,aún,en cuanto a la fritura y la combinación fritura + dulce, se presentó en un solo díade lasemana(n=109). Además, en los últimos dos meses de análisishubo un aumento en la oferta de maderas duras, una disminución de la monotonía, alimentos ricos en azufre y dulces, y aun, las preparaciones con alimentos in natura o mínimamente procesados + procesados presentes todos los días. Conclusiones: Con el uso del método estudió fueposible identificar ajustes en el menúpara el período analizado, con el fin de ofrecer calidad a los comensales. Cabe señalar que se observó que con la adaptación y reducción delcasosCOVID-19, hubo un aumento en la oferta de productos in natura y mínimamente procesados. Se espera que se realicenmejoras y ajustesa los menús, dada las necesidades más enfáticasen su principiode garantizar la seguridad alimentaria (AU).

Stance4Health Nutritional APP: A Path to Personalized Smart Nutrition.

Access to good nutritional health is one of the principal objectives of current society. Several e-services offer dietary advice. However, multifactorial and more individualized nutritional recommendations should be developed to recommend healthy menus according to the specific user's needs. In this article, we present and validate a personalized nutrition system based on an application (APP) for smart devices with the capacity to offer an adaptable menu to the user. The APP was developed following a structured recommendation generation scheme, where the characteristics of the menus of 20 users were evaluated. Specific menus were generated for each user based on their preferences and nutritional requirements. These menus were evaluated by comparing their nutritional content versus the nutrient composition retrieved from dietary records. The generated menus showed great similarity to those obtained from the user dietary records. Furthermore, the generated menus showed less variability in micronutrient amounts and higher concentrations than the menus from the user records. The macronutrient deviations were also corrected in the generated menus, offering a better adaptation to the users. The presented system is a good tool for the generation of menus that are adapted to the user characteristics and a starting point to nutritional interventions.

Food prescription pilots: feasibility, acceptability and affordability of improving diet through menu planning and grocery delivery.

BACKGROUND: Lack of adherence is a primary reason people fail to maintain a healthy diet or lose weight. Multiple environmental factors, including aggressive marketing and convenience of nutrient-poor food, undermine people's best intentions. The aim was to assess the feasibility, acceptability and impact of food prescriptions in which participants' exposure to commercial food outlets is reduced, because the groceries are delivered with weekly menu plans and recipes. METHODS: This is a series of pre-post pilot proof-of-concept studies. We recruited 37 members of Kaiser Permanente interested in improving their diet or losing weight. Weekly meal plans meeting more than 90% of recommended dietary allowances were designed to be low cost, in line with Supplemental Nutrition Assistance Program (SNAP) allowances. Five separate pilots targeted different populations. Participants were required to provide 24-h dietary recalls (ASA24) before and during the interventions. Weight management pilot participants had height, weight and blood pressure measured before and after 4-week pilots and followed sustainability guidelines, limiting meat and dairy. RESULTS: Across pilots, the healthy eating index improved (+21.1 points; 95% CI [confidence interval] 15.9, 26.3). For the weight management pilots, most participants lost weight (average 10.3 lbs for men, 5.7 lbs for women; 95% CI -10.2, -5.4). The majority of participants liked the programme and considered it the easiest weight loss programme they ever tried. CONCLUSIONS: These pilots suggest that meal planning and grocery delivery can be affordable and acceptable and could ultimately have a major impact on diet-related chronic diseases. Longer-term studies are needed to confirm how long compliance will endure.

Recetario nutritivo para niñas y niños de 6 a 23 meses / Nutritious recipes for girls and boys from 6 to 23 months

La presente publicación trata sobre recetas nutritivas para niños menores de 1 año, en cada cartilla está la receta y la preparación, además cuenta con una pequeña tabla sobre el aporte nutricional de cada receta. Cabe indicar que dichas recetas fueron elaboradas tomando en cuenta un diagnóstico previo recogido en hogares y en mercados locales, a fin de conocer la disponibilidad, el acceso, así como los atributos positivos y negativos que las madres asignan a los alimentos que incorporan en la alimentación infantil. Cada una de las recetas ha pasado por un proceso de validación a nivel de hogares donde las madres han elaborado sus preparaciones según los alimentos disponibles localmente y con gran valor nutricional, bajo la asesoría de profesionales nutricionistas, proponiendo mejorar o crear nuevas recetas

Campanha Um dia sem carne na alimentação escolar de Barueri e seus impactos / "Um dia sem carne na alimentação escolar" campaign in Barueri and its impacts

Introdução. Sabe-se que nos últimos anos o consumo de carne vermelha pelo brasileiro vem aumentando gradativamente e que o seu consumo excessivo está relacionado a impactos negativos na saúde humana e no meio ambiente. O incentivo a dietas sustentáveis, com menor consumo de carne, em ambientes institucionais como escolas, refeitórios e hospitais pode contribuir positivamente em diversos aspectos. Nesse contexto, o ambiente escolar é um cenário oportuno para estabelecimento das bases de uma alimentação adequada e saudável, pois os alunos estão em processo de crescimento físico e de formação de seus conceitos, conhecimentos e hábitos alimentares. Objetivo. Sendo assim, o presente estudo consiste na avaliação do impacto nutricional, econômico e ambiental de uma possível implantação de um cardápio mensal para campanha Um Dia Sem Carne na Alimentação Escolar da cidade de Barueri-SP, de maneira comparativa com um cardápio utilizado. Metodologia. O cardápio proposto para a campanha foi baseado em cardápios executados pela Prefeitura de Barueri-SP, mas com troca da preparação proteica de origem animal por uma preparação proteica de origem vegetal, em quatro dos vinte dias que compõem o mês. As preparações têm leguminosas como ingrediente principal e foram escolhidas com base em preparações utilizadas em projetos semelhantes. O novo cardápio proposto foi comparado com o tradicional, com o intuito de identificar e avaliar os possíveis impactos ambientais (emissão de gases de efeito estufa, uso de água, uso de terra, eutrofização), econômicos (preço) e nutricional de forma qualitativa e quantitativa, por meio do IQ COSAN e composição nutricional (energia, macronutrientes, vitamina A, vitamina C, ferro e cálcio). Resultados. Verificou-se que os quatro dias de cardápio modificado gerou menor impacto ambiental per capita relacionado aos valores de uso da terra, emissão de gases de efeito estufa e eutrofização, além de ofertar maiores quantidades de fibras e menores quantidades de colesterol. Observou-se também que a inserção de quatro dias sem carne no cardápio mensal, produziu um menor impacto ambiental absoluto, sem interferir na oferta nutricional e nos gastos públicos. Conclusão. Cardápios sem alimentos de origem animal em um dia na semana não comprometem as necessidades nutricionais dos estudantes, gerando menor impacto ambiental e sem interferir nos gastos públicos. Assim, a implementação de cardápios escolares sem carne uma vez na semana pode ser saudável e sustentável.

Introduction. It is known that in recent years the consumption of red meat by Brazilians has been gradually increasing and that excessive consumption is related to negative impacts on human health and the environment. Encouraging sustainable diets, with less meat consumption, in institutional places such as schools, dining halls and hospitals can contribute positively in several ways. In this context, the school environment is an opportune scenario for establishing the foundations of an adequate and healthy diet, because students are in the process of physical growth and formation of their concepts, knowledge and eating habits. Objective. Therefore, the present study consists in evaluating the nutritional, economic and environmental impact of a possible implementation of a monthly menu for the "Um Dia Sem Carne na Alimentação Escolar" campaign in the city of Barueri-SP, brig-in a comparative way with a menu already used. Methodology. The menu proposed for the campaign was based on menus already implemented by the public administration of Barueri-SP, but with a substitution of the animal protein preparation for a plant-based protein preparation, on four of the twenty days that make up the month. The preparations have legumes as the main ingredient and were chosen based on preparations already used in similar projects. The new proposed menu was compared with the traditional one, in order to identify and evaluate the possible environmental impacts (emission of greenhouse gasses, water use, land use, eutrophication), economic (price) and nutritional impacts in a qualitative and quantitative ways, through IQ COSAN and nutritional composition (energy, macronutrients, vitamin A, vitamin C, iron and calcium). Results. It was found that the four days of the modified menu generated a lower per capita environmental impact related to land use, greenhouse gas emissions, and eutrophication, in addition to offering higher amounts of fiber and lower amounts of cholesterol. It was also observed that the inclusion of four meatless days in the monthly menu resulted in a lower absolute environmental impact without interfering with nutritional supply and public expenditure. Conclusion. Menus without animal-derived foods for one day a week do not compromise the nutritional needs of students, resulting in a lower environmental impact and without interfering with public expenditure. Therefore, the implementation of meatless school menus once a week can be both healthy and sustainable.

Caregiver Nutritional Health Outcomes of the Simple Suppers Study: Results from a 10 Week, Two-Group Quasi-Experimental Family Meals Intervention.

Individuals from racial minority backgrounds, especially those in low income situations, are at increased risk for obesity. Family meals positively impact child nutritional health; however, there is limited evidence examining the impact on caregivers, particularly racial minority and income-restricted individuals. The objective of this intervention study was to determine the effect of Simple Suppers, a 10 week family meals program, on caregiver diet and nutrition outcomes. Intervention versus waitlist control participants were compared from baseline (T0) to post-intervention (T1). In addition, intervention participants were assessed at a 10 week follow-up time point (T2). This study was a two-group quasi-experimental intervention trial. Lessons (10 total) were delivered on a weekly basis for 90 min. Data were collected from intervention and waitlist control participants at T0 and T1, and intervention participants at T2. After baseline (T0) data collection, families enrolled in the immediate upcoming session of Simple Suppers (intervention group) or waited for 10 weeks (waitlist control group) to begin the program. Participants were caregivers of children ages 4-10 years. This study was conducted in a faith-based community center for underserved families in Columbus, Ohio. Primary outcomes were: diet quality assessed by Healthy Eating Index (HEI) total and component scores, and total energy intake (kcal/day); body mass index (BMI) (kg/m2), waist circumference (cm), systolic and diastolic blood pressure (BP) (mmHG); and self-efficacy for having healthy meals and menu planning (both scalar). The impact of the intervention (T0:T1) was assessed using generalized mixed-effects linear regression models. Maintenance of change in study outcomes among intervention participants (T1:T2) was examined with paired t-tests. 109 caregivers enrolled in this study. The retention rate at T1 was 90% (i.e., 98 participants). 56 of 68 intervention participants completed T2, resulting in a retention rate of 82%. Almost all (99%) were female, 61% were Black, and 50% were between 31 and 40 years old. In total, 40% had low income and 37% had low or very low food security. At T1, intervention vs. waitlist controls had a lower daily energy intake (p = 0.04), but an HEI-2010 component score for fatty acids (adequacy) that was lower indicating a lower dietary intake of fatty acids (p = 0.02), and a component score for empty calories (moderation) that was significantly lower indicating a higher intake of empty calorie foods (p = 0.03). At T1, intervention vs. waitlist controls also had a lower BMI (p < 0.001) and systolic BP (p = 0.04), and higher self-efficacy (p = 0.03). There were no group differences in other outcomes. At T2, intervention participants maintained the changes in daily energy intake, BMI, systolic BP, and self-efficacy that improved during the intervention period. There was no change (improvement) in the component score for fatty acids; however, the component score for empty calories significantly improved (p = 0.02). Engagement in the Simple Suppers program led to improvements in caregivers' daily caloric intake, weight status, systolic blood pressure, and self-efficacy for family meals. Future research should further explore the dietary and nutritional health benefits of family meals among caregivers at the highest risk for obesity.

Changes in Calorie Content of Menu Items at Large Chain Restaurants After Implementation of Calorie Labels.

Importance: Calorie labeling on menus is required in US chain food establishments with 20 or more locations. This policy may encourage retailers to offer lower-calorie items, which could lead to a public health benefit by reducing customers' calorie intake from prepared foods. However, potential reformulation of restaurant menu items has not been examined since nationwide enforcement of this policy in 2018. Objective: To examine the calorie content of menu items at large chain restaurants before and after implementation of federally mandated menu calorie labels. Design, Setting, and Participants: This pre-post cohort study used restaurant menu data from MenuStat, a database of nutrition information for menu items offered in the largest chain restaurants in the US, collected annually from 2012 to 2019. The study comprised 35 354 menu items sold at 59 large chain restaurants in the US. Statistical analysis was conducted from February 4 to October 8, 2021. Intervention: Nationwide implementation of menu calorie labeling. Main Outcomes and Measures: Changes in menu items' calorie content after restaurant chains implemented calorie labels were estimated, adjusting for prelabeling trends. All menu items, continuously available items, items newly introduced to menus, and items removed from menus were examined separately. Results: Among the 59 restaurant chains included in the study, after labeling, there were no changes in mean calorie content for all menu items (change = -2.0 calories; 95% CI, -8.5 to 4.4 calories) or continuously available items (change = -2.3 calories; 95% CI, -11.5 to 6.3 calories). Items that were newly introduced after labeling, however, had a lower mean calorie content than items introduced before labeling (change = -112.9 calories; 95% CI, -208.6 to -25.2 calories), although there was heterogeneity by restaurant type. Items removed from menus after labeling had similar calorie content as items removed before labeling (change = 0.5 calories; 95% CI, -79.4 to 84.0 calories). Conclusions and Relevance: In this cohort study of large chain restaurants, implementing calorie labels on menus was associated with the introduction of lower-calorie items but no changes in continuously available or removed items.

Avaliação Qualitativa de Cardápios Hospitalares / Qualitative Evaluation of Hospital Menus

Modelo: Estudo caracteriza-se como transversal, qualitativo. Objetivo: Avaliar qualitativamente as preparações de cardápios oferecidos em hospitais no município de Uberaba - MG. Metodologia: A análise foi realizada pelo método "Avaliação Qualitativa de Preparações do Cardápio" dos almoços oferecidos em cinco Unidades de Alimentação e Nutrição hospitalares públicas ou particulares durante três semanas alternadas entre os meses de fevereiro a junho de 2018. Avaliou-se as ofertas de frutas, folhosos, repetições de cores, presença de alimentos sulfurados, doces, frituras, carnes gordurosas e frituras + doces na mesma refeição. Resultados: Os itens foram classificados como "ótimo" a baixa oferta de frituras (6,7%), carnes gordurosas (8,0%) e nenhuma oferta de doce + frituras no mesmo dia (0%), "bom" para oferta de folhosos (75%) e doces (22,7%), "regular" para repetição de cores (42.7%), "ruim" quanto aos alimentos sulfurados (56%) e "péssimos" quanto a oferta de frutas (9,3%). Conclusão: Os cardápios possuíam aspectos positivos como ausência de doce + fritura, baixa utilização de frituras e carnes gordurosas, boa oferta de folhosos e doces; os aspectos preocupantes relacionaram-se com a repetição de cores e negativos com a presença de alimentos sulfurados e ausência de frutas. (AU)

Study design: Cross-sectional, qualitative study. Objectives: To qualitatively evaluate the menu preparations offered at hospitals from the city of Uberaba - MG Methods: The analysis was conducted using the method "Qualitative evaluation of menu preparations" to evaluate lunch menus offered at 5 Food and Nutrition Units from public or private Hospitals for 3 weeks alternated between February and June 2018. The offer of fruits, leafy vegetables, sweets, fried food, fatty meats and fried food + sweets in the same meal were evaluated, as well as the color repetitions and the presence of sulphurated food. Results: Items rated as "Excellent" showed low offer of fried food (6.7%), fatty meats (8.0%) and no offer of sweet + fried food on the same day (0%); "Good" showed the offer of leafy vegetables (75%) and sweets (22.7%); "Regular" indicated color repetition (42.7%); "Bad" indicated sulphurated food (56%) and "Very bad" stood for fruit offer (9.3%). Conclusion: The menus had positive aspects such as the absence of sweet + fried food, low presence of fried food and fatty meats, good offer of leafy vegetables and sweets. The worrying aspects were associated with color repetition and the negative aspects were related to the presence of sulphurated food and absence of fruits. (AU)

Fitoestrógenos no climatério: proposição de um cardápio rico em fitoestrógenos para mulheres climatéricas / Phytoestrogens in climacteric: proposition of a menu rich in phytoestrogens for climacteric women

Introdução: A terapia de reposição hormonal é uma das principais formas de tratamento utilizadas no combate dos déficits hormonais durante o climatério. Entretanto, muitas mulheres buscam alternativas terapêuticas mais seguras e/ou naturais, como por exemplo, os fitoestrógenos. Objetivo: Elaborar um cardápio alimentar baseado em alimentos fontes de fitoestrógenos. Material e métodos: Trata-se de um estudo qualitativo e quantitativo descritivo, realizado nos meses de junho a setembro de 2019 no Núcleo de estudos em Alimentação e Nutrição da Universidade CEUMA. Foi elaborado um cardápio baseado na alimentação padrão da população brasileira (2000 kcal) segundo a Pesquisa de Orçamentos Familiares e Vigitel Brasil. Foram feitas adaptações nessa alimentação conforme a Pirâmide Alimentar Brasileira, incluindo alimentos fonte de fitoestrógenos. A adequação calórica de macronutrientes e compostos bioativos seguiram as recomendações da OMS, DRI's e IOM. Os dados foram analisados através do software NutriLife® e do programa Excel®, onde estavam contidas a Tabela de Composição dos Alimentos e a Tabela de Medidas Caseiras. Resultados: As principais fontes de fitoestrógenos são leguminosas e grãos (até três porções/dia). A fonte primordial de isoflavonas é a soja (295,55 mg/100g); de lignanas é a linhaça (370 mg/100g) e de coumestanos é a ervilha (8,11 mg/100g). A quantidade de fitoestrógenos totais atingida no cardápio foi de 42,2 a 55,2 mg/dia, com valores oscilantes para isoflavonas, lignanas e coumestanos durante a semana. Conclusão: O cardápio rico em fitoestrógenos configura uma alternativa adaptável e natural na remissão de determinados sintomas climatéricos, onde a baixa ocorrência de efeitos adversos facilita sua adesão.(AU)

Introduction: Hormone replacement therapy is one of the main forms of treatment used to combat hormonal deficits during the climac- teric. However, many women seek safer and/or natural therapeutic alternatives, such as phytoestrogens. Objective: To elaborate a food menu based on foods that are sources of phytoestrogens. Material and Methods: This is a qualitative and quantitative descriptive study, conducted in the months of June to September 2019 in the Center for Food and Nutrition Studies at CEUMA University. A menu was elaborated based on the standard feeding of the Brazilian population (2000 kcal) according to Family Budget Survey and Vigitel Brazil. Adaptations were made to this menu according to the Brazilian Food Pyramid, including foods source of phytoestrogens. The caloric adequacy of macronutrients and bioactive compounds followed the recommendations of the WHO, DRI's and IOM. The data were analyzed using NutriLife® software and Excel® program, which contained the Food Composition Table and the Homemade Measures Table. Results: The main sources of phytoestrogens are legumes and grains (up to three servings/day). The primary source of isoflavones is soy (295,55 mg/100g); of lignans is flaxseed (370 mg/100g) and of coumestans is pea (8,11 mg/100g). The total amount of phytoestrogens reached in the menu was 42,2 to 55,2 mg/day, with oscillating values for isoflavones, lignans and coumestans during the week. Conclusion: The menu is rich in phytoestrogens and constitutes an adaptable and natural alternative in the remission of certain climacteric symptoms, in which the low occurrence of adverse effects facilitates their adhesion.(AU)

A Cluster Randomized Controlled Trial Evaluating the Impact of Tailored Feedback on the Purchase of Healthier Foods from Primary School Online Canteens.

Few online food ordering systems provide tailored dietary feedback to consumers, despite suggested benefits. The study aim was to determine the effect of providing tailored feedback on the healthiness of students' lunch orders from a school canteen online ordering system. A cluster randomized controlled trial with ten government primary schools in New South Wales, Australia was conducted. Consenting schools that used an online canteen provider ('Flexischools') were randomized to either: a graph and prompt showing the proportion of 'everyday' foods selected or a standard online ordering system. Students with an online lunch order during baseline data collection were included (n = 2200 students; n = 7604 orders). Primary outcomes were the proportion of foods classified as 'everyday' or 'caution'. Secondary outcomes included: mean energy, saturated fat, sugar, and sodium content. There was no difference over time between groups on the proportion of 'everyday' (OR 0.99; p = 0.88) or 'caution' items purchased (OR 1.17; p = 0.45). There was a significant difference between groups for average energy content (mean difference 51 kJ; p-0.02), with both groups decreasing. There was no difference in the saturated fat, sugar, or sodium content. Tailored feedback did not impact the proportion of 'everyday' or 'caution' foods or the nutritional quality of online canteen orders. Future research should explore whether additional strategies and specific feedback formats can promote healthy purchasing decisions.

Pre-Emptive and Non-Pre-Emptive Goal Programming Problems for Optimal Menu Planning in Diet Management of Indian Diabetes Mellitus Patients.

Diet management or caloric restriction for diabetes mellitus patients is essential in order to reduce the disease's burden. Mathematical programming problems can help in this regard; they have a central role in optimal diet management and in the nutritional balance of food recipes. The present study employed linear optimization models such as linear, pre-emptive, and non-pre-emptive goal programming problems (LPP, PGP and NPGP) to minimize the deviations of over and under achievements of specific nutrients for optimal selection of food menus with various energy (calories) levels. Sixty-two food recipes are considered, all selected because of being commonly available for the Indian population and developed dietary intake for meal planning through optimization models. The results suggest that a variety of Indian food recipes with low glycemic values can be chosen to assist the varying glucose levels (>200 mg/dL) of Indian diabetes patients.

Changes in the calorie and nutrient content of purchased fast food meals after calorie menu labeling: A natural experiment.

BACKGROUND: Calorie menu labeling is a policy that requires food establishments to post the calories on menu offerings to encourage healthy food choice. Calorie labeling has been implemented in the United States since May 2018 per the Affordable Care Act, but to the best of our knowledge, no studies have evaluated the relationship between calorie labeling and meal purchases since nationwide implementation of this policy. Our objective was to investigate the relationship between calorie labeling and the calorie and nutrient content of purchased meals after a fast food franchise began labeling in April 2017, prior to the required nationwide implementation, and after nationwide implementation of labeling in May 2018, when all large US chain restaurants were required to label their menus. METHODS AND FINDINGS: We obtained weekly aggregated sales data from 104 restaurants that are part of a fast food franchise for 3 national chains in 3 US states: Louisiana, Mississippi, and Texas. The franchise provided all sales data from April 2015 until April 2019. The franchise labeled menus in April 2017, 1 year prior to the required nationwide implementation date of May 2018 set by the US Food and Drug Administration. We obtained nutrition information for items sold (calories, fat, carbohydrates, protein, saturated fat, sugar, dietary fiber, and sodium) from Menustat, a publicly available database with nutrition information for items offered at the top revenue-generating US restaurant chains. We used an interrupted time series to find level and trend changes in mean weekly calorie and nutrient content per transaction after franchise and nationwide labeling. The analytic sample represented 331,776,445 items purchased across 67,112,342 transactions. Franchise labeling was associated with a level change of -54 calories/transaction (95% confidence interval [CI]: -67, -42, p < 0.0001) and a subsequent 3.3 calories/transaction increase per 4-week period (95% CI: 2.5, 4.1, p < 0.0001). Nationwide implementation was associated with a level decrease of -82 calories/transaction (95% CI: -88, -76, p < 0.0001) and a subsequent -2.1 calories/transaction decrease per 4-week period (95% CI: -2.9, -1.3, p < 0.0001). At the end of the study, the model-based predicted mean calories/transaction was 4.7% lower (change = -73 calories/transaction, 95% CI: -81, -65), and nutrients/transaction ranged from 1.8% lower (saturated fat) to 7.0% lower (sugar) than what we would expect had labeling not been implemented. The main limitations were potential residual time-varying confounding and lack of individual-level transaction data. CONCLUSIONS: In this study, we observed that calorie labeling was associated with small decreases in mean calorie and nutrient content of fast food meals 2 years after franchise labeling and nearly 1 year after implementation of labeling nationwide. These changes imply that calorie labeling was associated with small improvements in purchased meal quality in US chain restaurants.

The Promotions of Sustainable Lunch Meals in School Feeding Programs: The Case of Italy.

School is considered a privileged environment for health education and school feeding represents an opportunity for promoting sustainable foods to young generations. The objective of this paper is to demonstrate that is possible to select, from existing school menus, recipes that combine healthy foods with low environmental impact. A national sample of Italian school menus was collected and a total number of 194 recipes were included on a database containing 70 first courses, 83 s courses, 39 side dishes, 1 portion of fruit, and 1 portion of bread. A mathematical model was conceived to combine nutritional adequacy and acceptability criteria while minimizing GHGs emissions. The result is a four-week menu characterized by large vegetable components that were used not only as side dishes but also as ingredients in the first and second courses. Legumes and pasta are often included, and white meat is selected instead of red meat. The findings presented in this paper demonstrated that it is possible to design environmental-friendly meals from existing school menus. The mathematical model developed in this work has the potentiality of being completely scalable, easily updatable, and widely utilizable in different settings either for design or monitoring purposes as well as for research data collection.

Avaliação do resto e ingesta de refeições em um restaurante de empresa privada / Evaluation of the rest and intake and the meals in a private company restaurant

O presente estudo objetivou avaliar o índice de resto e ingesta em um restaurante de empresa privada, que possui clientela fixa. Para a mensuração desse índice, foram utilizadas 25 numerações aleatórias nos pratos dispostos na unidade de alimentação e nutrição, os quais foram pesados inicialmente e recolhidos ao final das refeições, e colocados em fórmula padrão para o cálculo desse índice. Foram observados que de acordo com a média e desvio padrão, o índice de resto e ingesta foi maior que 10%, o que mostra desperdício de alimentos nessa unidade, o que aumenta os custos ao final da produção, visto que o tempo dispendido em cada etapa da produção é somado ao custo final, sendo importante que haja ações educativas para capacitação dos colaboradores da unidade a fim de diminuir o quantitativo de refeições rejeitadas, fazendo só a quantidade suficiente para cada.(AU)

The present study aims to evaluate the rate of reinstatement and entrance to the restaurant of a private company, which has a fixed clientele. To measure this index, 25 random numbers were used in dishes arranged in the food and nutrition unit, which were weighed and collected at the end of meals, and used in the standard method for calculating the index. It was observed that the agreement with mean and standard deviation, the rest ratio and the input was greater than 10%, which shows the waste of food in this unit, which increases the costs until the final production, given the time spent in each the production stage is added to the final cost, and it is important that there are educational actions to train the unit's employees and reduce the quantitative value of rejected meals, thus making the quantity sufficient for each meal schedule.(AU)

Examining Parent Preferences for the Use of Behavioral Economic Strategies on Children's Menus in Restaurants.

BACKGROUND: A majority of children's restaurant meals are nutritionally deficient; use of behavioral economics may improve healthful menu selections. Parents play a role in children's restaurant meal selection, thus understanding parent preferences for potential behavioral economic strategies is warranted. OBJECTIVE: To examine parent-derived and -stated preferences for selected attributes of children's restaurant menus, which included behavioral economic strategies (eg, optimal defaults and vice-virtue bundles). DESIGN: A descriptive, cross-sectional, within-subjects survey integrating a conjoint design was developed along with 8 children's menus. Menus were manipulated by varying levels of attributes (meal price, healthful side dishes, number of side dish items, healthful entrées, and cost for sugar-sweetened beverages [SSB]). Parents rated menus and attributes using Likert scales. PARTICIPANTS/SETTING: A national sample of US parents with children 4 to 10 years (n = 463) were recruited in August of 2019 via Amazon's Mechanical Turk. ANALYSIS: A conjoint (regression) analysis was conducted to derive parent preference for each attribute and overall menu preference. Descriptive statistics (means) described overall stated parent menu preferences and ratings. Cluster analysis segmented parents into groups with similar preferences. RESULTS: Derived preferences showed parents had the strongest preference for choice of side dishes (ß = .73) and low-priced menus (ß = .51), and weak preferences for inclusion of healthful entrées (ß = .04) and added cost for SSB (ß = .18). Parents stated preference was for a menu that included healthful entrées, was low priced, and featured choices for side dishes. Cluster analysis revealed half of parents preferred the low-cost children's menu with the other half of parents split evenly across preferences related to health, choice, and traditional menus. CONCLUSION: Parents stated preference was for a socially desirable menu featuring healthful entrée options and added cost for SSB, which was contrary to the conjoint derived menu preferences. Understanding parent preferences may help guide nutrition professionals working to build a more healthful food environment through the use of behavioral economic strategies.

Taste Ratings of Healthier Main and Side Dishes among 4-to-8-Year-Old Children in a Quick-Service Restaurant Chain.

Restaurants are regular eating environments for many families. Children's consumption of restaurant foods has been linked with poorer diet quality, prompting emerging research examining strategies to encourage healthier eating among children in restaurants. Although taste is a primary determinant of restaurant meal choices, there is a lack of research considering children's perspectives on the taste of different healthier kids' meal options. The current study sought to examine, via objective taste testing, children's liking of and preference for healthier kids' meal options at a quick-service restaurant (QSR) and to describe bundled kids' meals with evidence of both taste acceptability and consistency with nutrition guidelines. Thirty-seven 4-to-8-year-old children completed taste tests of ten healthier main and side dish options. Liking and preference were assessed using standard methods after children tasted each food. Children also reported their ideal kids' meal. Results show the majority of children liked and preferred three main (turkey sandwich, chicken strips, peanut butter/banana sandwich) and side dishes (yogurt, applesauce, broccoli), with rank order differing slightly by age group. Accepted foods were combined into 11 bundles meeting nutritional criteria. Results highlight healthier kids' meals with evidence of appeal among children in a QSR. Findings can inform future research and may increase the success of healthy eating interventions in these settings.

Foodservice Management Educators' Perspectives on Nutrition and Menu Planning in Student-Operated Restaurants.

OBJECTIVE: Explore how student-operated restaurant (SOR) managers consider and apply nutrition principles and menu planning in SORs. DESIGN: Nineteen SOR managers in the US were recruited to complete an online survey and participate in a 30-60-minute interview. Interviews were conducted via video conference and explored the menu and nutritional characteristics of the SOR at each facility. SETTING: SORs across the US. PARTICIPANTS: Managers of SORs. PHENOMENON OF INTEREST: Menu and nutrition characteristics and their use in SORs. ANALYSIS: Demographic data were analyzed using SPSS. Thematic analysis was conducted using NVivo software. RESULTS: Thematic analysis revealed nutrition in practice, nutrition philosophy, and menu planning as the 3 major themes. Nutrition in practice captured the role of nutrition in menu planning, special diets, and healthy options. Nutrition philosophy subthemes explored issues such as the purpose of the SOR experience and instructor perspective on nutrition. Menu planning subthemes addressed issues regarding the menu development process, including menu planning that was student-driven and faculty-driven. CONCLUSIONS AND APPLICATIONS: Approaches to menu planning had varying degrees of student involvement. Although nutrition was stated as a consideration in menu planning, most programs did not include formalized nutrition criteria as part of the SOR curriculum.