Development and application of the Meal and Snack Assessment (MESA) quality scale for children and adolescents using item response theory.

BACKGROUND: Meals differ in terms of food items and nutritional quality. The aim of the present study was to propose a scale to measure the meals quality of schoolchildren according to food processing degree, perform a preliminary evaluation of the scale's validity and reliability and apply the scale to a representative sample of schoolchildren in a city in southern Brazil. METHODS: A methodological study based on the generalized graded unfolding model (GGUM) of item response theory (IRT) with analysis of secondary data was carried out in 6,399 schoolchildren of 6-15y-old attending 2nd to 5th grades of public elementary schools in Florianópolis, Brazil, in 2013-2015 who answered the validated Food Intake and Physical Activities of Schoolchildren (WebCAAFE) questionnaire. Meal quality was the latent trait. The steps for the development of the scale included: latent trait definition; item generation; dimensionality analysis; estimation of item parameters; scale levels definition; assessment of validity and reliability; and assessment of the meal quality of a subsample of schoolchildren aged 7 to 12 years (n = 6,372). RESULTS: Eleven out of eighteen items had adequate parameters, without differential item functioning for sex or age. Meal quality was categorized into three levels: healthy, mixed, and unhealthy. Higher scores indicate a greater prevalence of ultra-processed foods in daily meals. Most schoolchildren had mixed (40.6%) and unhealthy (41%) meal patterns. CONCLUSIONS: IRT analysis allowed the development of the scale, which measures the quality of meals and snacks based on the degree of food processing. At all snack times, there was a higher frequency of ultra-processed foods consumption, therefore foods consumed as snacks are a potential focus for nutritional interventions.

Validity of WebCAAFE questionnaire for assessment of schoolchildren's dietary compliance with Brazilian Food Guidelines.

OBJECTIVE: To estimate reporting bias of WebCAAFE, a web-based questionnaire for the assessment of food intake (recall of frequency of intake of thirty-two food items the day before) and physical activity in schoolchildren. DESIGN: Cross-sectional study. Self-reported food intake on WebCAAFE was compared with direct observation of school meals in five public schools. Additional data included school grade, sex, BMI, socio-economic status and access to Internet at home. Poisson regression was used to calculate the reporting bias (WebCAAFE v. direct observation) and the sample size necessary to detect a statistically significant difference between WebCAAFE reports and at least 75 % compliance with the recommendations for a healthy diet. SETTING: Intentional sample of five elementary public schools in Florianopolis, Brazil. SUBJECTS: Schoolchildren (n 629) from 2nd to 5th grades. RESULTS: Moderate bias magnitude was found for most food groups of interest. Frequency of consumption was not related to the bias. Sample sizes necessary to detect the compliance with dietary recommendations varied between four and seventy-four individuals for the different groups investigated. CONCLUSIONS: After adjusting for moderate bias, WebCAAFE may be used as a food questionnaire for evaluation of schoolchildren's food compliance on a group level, even with a relatively small sample size.

Avaliação do estado nutricional de idosos institucionalizados / Nutritional status assessment of institutionalized elderly

OBJETIVO: Identificar o estado nutricional, segundo o índice de massa corporal, e fornecer informações sobre medidas antropométricas de idosos institucionalizados no município de Florianópolis (SC). MÉTODOS: Estudo transversal, no qual a população em estudo foi composta por 232 idosos, com idade a partir de 60 anos, residentes em instituições geriátricas do município de Florianópolis (SC). A avaliação antropométrica foi realizada obtendo-se o valor do índice de massa corporal, da prega cutânea triciptal e da circunferência da panturrilha. O diagnóstico do estado nutricional foi realizado utilizando-se os pontos de corte preconizados pela Organização Pan-Americana de Saúde para índice de massa corporal. Os dados são apresentados sob a forma de média e desvio-padrão. Foi realizado o teste t de Student para verificar a diferença entre os valores médios das variáveis entre os sexos. RESULTADOS: A amostra constituiu-se de 167 idosos de ambos os sexos. Encontrou-se uma prevalência de 45,5 por cento de baixo peso, 33,5 por cento de peso normal, 7,8 por cento de pré-obesidade e 13,2 por cento de obesidade. Para todas as variáveis antropométricas, o valor médio das mulheres foi superior ao dos homens. CONCLUSÃO: Os resultados encontrados indicaram a prevalência de 66,5 por cento da amostra com estado nutricional inadequado, evidenciando a necessidade de medidas de promoção ou reabilitação da saúde dos idosos. Os dados mostram que há diferenças entre os sexos com relação ao estado nutricional e às variáveis índice de massa corporal e prega cutânea triciptal, além de contribuírem para a ampliação do referencial antropométrico de idosos institucionalizados.

OBJECTIVE: The objective of this study was to identify the nutritional status, according to body mass index, and provide information regarding anthropometric measurements of institutionalized seniors in the city of Florianópolis (SC), Brazil. METHODS: This is a cross-sectional study. The research population consisted of 232 senior citizens, aged 60 or more, living in geriatric institutions in Florianópolis (SC), Brazil. Anthropometric assessment included determining the body mass index, tricipital skinfold, and calf circumference. Diagnosis of the nutritional status was performed using the cut-off points determined by the Pan-American Health Organization for body mass index. The data are presented as means and standard deviation. The Student's " t" test was used to detect differences in mean values of the variables between both genders. RESULTS: The sample consisted of 167 senior citizens of both genders. A prevalence of 45.5 percent of low weight, 33.5 percent of normal weight, 7.8 percent of overweight and 13.2 percent of obesity was observed. The mean values for women were higher than those for men for all anthropometric variables. CONCLUSION: The data obtained showed that 66.5 percent of the sample presented inadequate nutritional status, clearly evidencing the need to take some measures that promote or recover the health of senior citizens. In addition, the data obtained show that there are differences between both genders regarding the nutritional status and the variables body mass index and tricipital skinfold and contribute to increase the anthropometric references of institutionalized senior citizens.

Adiposidade corpórea e sua relaçäo com o gasto energético e a composiçäo da dieta de escolares do sexo feminino / Percent body fat and its relationship with energy expenditure and diet in adolescent girls

Este estudo objetivou analisar escolares do sexo feminino, de 13 a 16 anos, quanto ao percentual de gordura corporal e relacioná-lo com o gasto energético e a composiçäo da dieta. Participaram da amostra 59 escolares, selecionadas de forma näo probabilística acidental. O percentual de gordura foi estimado pela equaçäo apresentada por Lohman (1986). Para a estimativa da Ingestäo Calórica Total (IC), da Ingestäo Calórica por quilograma de massa corporal (IC/Kg) e de macronutrientes, utilizou-se um registro alimentar (3 dias) e o software NUT. O Gasto Energético Total (GET) e por quilograma de massa corporal (GE/Kg) foram estimados pelo registro de atividades físicas de BOUCHARD (1983). O teste "t" de student foi utilizado para verificar diferenças entre o GET e a IC e entre os subgrupos de maior e menor percentagem de gordura. Para verificar associaçöes entre as variáveis utilizou-se a Correlaçäo Linear de Pearson (r). O percentual de gordura correlacionou-se de forma positiva e significativa com o percentual de lipídios e negativamente com o percentual de carboidratos, com a IC/Kg e com o GE/Kg. O subgrupo de maiores percentuais de gordura revelou um maior consumo de lipídios, um menor consumo de carboidratos, IC/Kg e GE/Kg. Os resultados sugerem que um baixo gasto energético e a composiçäo da dieta, especialmente um maior consumo de lipídios, parecem exercer um importante papel no acúmulo de adiposidade corpórea.(au)