It is time: free meals at schools for all.

The link between school feeding programmes (SFP) and the promotion of healthy eating and health is being explored in studies performed in different countries. The coronavirus disease-19 pandemic has revealed flaws and weaknesses in contemporary food systems, with many school-age children experiencing food insecurity and hunger. There is intense debate among policymakers regarding whether government SFP should be universal or targeted. Countries such as Brazil and India, which have two of the most comprehensive universal free-of-charge programmes, have shown the benefits of SFP, including improved nutritional status, support for more sustainable food systems, attendance and academic performance. Evidence shows and supports actions advocating that it is time to offer healthy and free school meals for all students.

Evaluation of food purchasing in the Brazilian School Feeding Programme: feasibility of the requirements and recommendations.

OBJECTIVE: To analyse the purchase of food for school feeding, according to the extent and purpose of industrial processing and variety, exploring the feasibility of achieving the requirements and recommendations of the Brazilian School Feeding Programme, and the variety of unprocessed or minimally processed foods according to the purchase of ultra-processed foods. DESIGN: Secondary data from 2016 from the Accountability Management System of the National Fund for Educational Development, concerning the food items purchased, were used to explore the feasibility of the requirements and recommendations. The foods were grouped according to the NOVA classification system. Variety was assessed by counting different types of unprocessed or minimally processed foods. SETTING: Brazil. PARTICIPANTS: 3698 Brazilian municipalities. RESULTS: Energy share from unprocessed or minimally processed foods was 44·1 % while that of ultra-processed foods was 29·9 %. The average of unprocessed or minimally processed food types purchased annually was 33·8 items. Of the municipalities, 35·8 % were within the limit established for the expenditure of funds for the purchase of processed and ultra-processed foods, while 8·7 % followed the recommendation for variety. The proportion of ultra-processed foods did not influence the variety of food items purchased. CONCLUSIONS: The results showed the feasibility of achieving the requirements and recommendations and underscored the importance of continued efforts to promote the inclusion of unprocessed or minimally processed foods in the school feeding programme while addressing the challenges associated with expenditure limits of processed and ultra-processed foods and enhancing variety, which is strategic to promote adequate and healthy meals.

Risk assessment of azo dyes as food additives: Revision and discussion of data gaps toward their improvement.

The food industry uses dyes mainly to overcome color loss during the processing and storage of products, with the azo dyes currently being the most employed. Studies on the safety of using these dyes in foods started in the 1950s and have indicated the potential for concern. This review discusses the risk assessment of food intake containing artificial azo dyes. There are case reports and, subsequently, double-blind placebo-controlled trials in some individuals who may experience adverse effects from the intake of azo dyes, but it is unclear whether these adverse effects are restricted to specific populations or more generalized. In view of this, different toxicological endpoints are evaluated to verify toxic effects in in vitro and in vivo models and to establish the no observed adverse effect level. Exposure estimation studies have shown that human exposure to azo dyes via oral intake is mainly below the acceptable daily intake established by advisory bodies. However, most countries do not have studies that estimate the oral intake of azo dyes. In this case, local food diversity and racial-ethnic specificities are not considered when stating the exposure estimate is below the acceptable daily intake for the human population and thus may not represent actual intake. Concerning the scenario established above, this review discusses the most critical gaps to be overcome to contribute to the direction of future studies and the development of more effective public policies concerning the safety of the intake of artificial azo dyes.

Adiposity and binge eating are related to liking and wanting for food in Brazil: A cultural adaptation of the Leeds food preference questionnaire.

The Leeds Food Preference Questionnaire (LFPQ) measures separable psychological components of food reward (Liking and Wanting). In this study a cultural adaptation of the LFPQ for a Brazilian population (LFPQ-BR) was examined by comparing liking and wanting scores in fasted and fed states and their association with adiposity and disturbed eating. A culturally adapted food picture database was validated by an online questionnaire completed by 162 individuals. Cluster analysis verified if the foods were accurately perceived in terms of sweetness, fat and calorie content. Subsequently, 48 male (N = 21) and female (N = 27) adults with mean Body Mass Index 26.6 (0.9) kg/m2, and mean age 32.8 (1.4) years, were evaluated by the LFPQ-BR before and after a fixed test meal. The Binge Eating Scale was used to measure binge eating symptoms. There was a decrease in explicit liking, implicit wanting, and explicit wanting scores for food in general in the fed condition. The implicit and explicit wanting and explicit liking scores for high-and-low fat savoury food decreased and for high-and-low fat sweet foods increased to a greater extent after the savoury test meal. Body Mass Index was found to predict implicit wanting for high fat relative to low fat foods. Binge eating symptoms predicted high fat sweet explicit liking and explicit wanting in the fed condition. Finally, high fat sweet preference was found to be sex-related as females had greater implicit wanting for high fat sweet foods in fasted and fed states. The results presented here indicate that the LFPQ-BR is a useful instrument for the evaluation of liking and wanting for food in Brazil.

Leptin as a cardiovascular risk marker in metabolically healthy obese: Hyperleptinemia in metabolically healthy obese.

Adipokines contribute to the inflammatory process which can lead to obesity-associated cardiometabolic complications. Metabolically healthy obese individuals seem to be protected or more resistant to develop these complications and it is intriguing why some individuals develop comorbidities and others do not. Thus, we questioned whether the differences between metabolically healthy and unhealthy obese relied on the alterations in metabolic profile, characterized by serum leptin and adiponectin. A total of 142 obese adults were divided into 2 groups - metabolically healthy obese (MHO) or unhealthy obese (MUO) - and they were evaluated for anthropometric measures, body composition, blood pressure, dietary intakes and plasma levels of leptin and adiponectin. Leptin/adiponectin ratio (L/A) was calculated. Age, BMI and blood pressure were higher in the MUO. No differences in anthropometric measurements, body composition, dietary intake and dietary quality were observed between groups. Leptin were significantly higher in the MUO (53.07 ± 34.56 versus 36.27 ± 24.02 ng/ml in the MHO, r < 0.04). The logistic regression analysis demonstrated that leptin was an important factor associated with not being healthy, independent of age, body weight and BMI. There were no differences between groups for adiponectin and L/A. Leptin correlated positively with body weight (r = 0.25, r < 0.05), BMI (r = 0.38, r < 0.05) and BF (r = 0.74, r < 0.05), and negatively with FFM (r = -0.74, r < 0.05). Our findings suggest that leptin is an important cardiovascular disease marker to obese population and can contribute to evaluate metabolic risks in these individuals.

Impact of an education intervention using email for the prevention of weight gain among adult workers.

OBJECTIVE: To evaluate the impact of a worksite intervention to prevent weight gain among adult workers. DESIGN: A controlled community trial was performed by dividing the workers into two groups: intervention group (IG) and control group (CG). The theoretical framework applied was Intervention Mapping Protocol and the intervention was implemented through interactive software for weight self-monitoring. To evaluate the impact of the intervention, the differences in weight, BMI and waist circumference between the IG and CG were assessed before and 6 months after the intervention by regression models. Additionally, the sustainability of the intervention was evaluated at 12 months after the intervention. Settings São Paulo, Brazil. SUBJECTS: Four companies; 281 workers for the analysis of effectiveness and 427 for the analysis of sustainability. RESULTS: The intervention resulted in significant reductions in weight, BMI and waist circumference in the IG compared with the CG. The impact of the intervention on IG individuals' body weight was -0·73 kg, while the weight of CG individuals increased. IG individuals with adequate initial weights did not show significant variations, while those who were overweight demonstrated a significant reduction in body weight. The intervention resulted in a reduction of 0·26 kg/m2 in BMI and 0·99 cm in waist circumference, and the sustainability analysis after 12 months showed a continued reduction in body weight (-0·72 kg). CONCLUSIONS: The behavioural intervention was effective, resulting in weight maintenance among participants with adequate initial weight and in significant reductions among those who were overweight. More research on longer-term weight maintenance is needed.

[Mobile health and excess weight: a systematic review]. / Mobile health e excesso de peso: uma revisão sistemática.

OBJECTIVE: To evaluate the impact of using mobile health (mHealth) technologies- the practice of medicine or public health through mobile devices, such as mobile phones-on the prevention of weight gain or treatment of overweight or obesity. METHODS: A systematic literature review was conducted using the PubMed database and the Preferred Reporting Items for Systematic Reviews and Meta - Analyses (PRISMA) guidelines. Intervention studies evaluating the impact of mHealth technologies were selected on the following anthropometric measures: weight, body mass index, or waist circumference in adults. RESULTS: Out of 98 articles retrieved, 14 met the inclusion criteria and were selected for analysis. Of these, only two evaluated the prevention of weight gain instead of the treatment of overweight or obesity. mHealth technologies had a positive effect on anthropometric outcomes in 13 articles. Only one article reported no effects on the group that used these technologies. Eight articles reported impact on BMI, and seven on waist circumference. Mobile phones were the most common mHealth device, used mainly for text messages. CONCLUSIONS: mHealth technologies have the potential to be used as tools for the prevention and treatment of overweight and obesity, particularly with mobile phones and texting, which are already used daily by most of the population.

Instruments and indicators for assessing organisational food environments: a scoping review protocol.

INTRODUCTION: Many studies have explored the food environment to characterise it and understand its role in food practices. Assessment of the organisational food environment can contribute to the development of more effective interventions to promote adequate and healthy eating. However, few instruments and indicators have been developed and validated for assessing this type of setting. The systematisation of those can be useful to support the planning of future assessments and the development of wide-ranging instruments. This study aims to conduct a scoping review to systematise evidence on instruments and indicators for assessing organisational food environments. METHODS AND ANALYSIS: This scoping review was planned according to the methodological framework for scoping reviews proposed by Arksey and O'Malley and subsequently enhanced by Levac et al. For the report of the review, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews (PRISMA-ScR) checklist and guidelines will be used. The search will be conducted using PubMed, Embase, Web of Science, PsycINFO, Scopus and Google Scholar databases. The studies to be included were required to have been published in peer-reviewed journals since January 2005. No geographical, population or language restrictions will be applied given the desired breadth of the review. Two researchers will select the articles and extract the data independently. The conceptual model proposed by Castro and Canella will guide the data extraction and analysis. The results will be presented with narrative synthesis for the extracted data accompanying the tabulated and charted results. ETHICS AND DISSEMINATION: This study is based on the analysis of published scientific literature and did not involve patients, medical research, or any type of personal information; therefore, no ethical approval was obtained for this study. The results of this scoping review will be submitted for publication in an international peer-reviewed journal, preferably open access.

Nutrition classification schemes for plant-based meat analogues: Drivers to assess nutritional quality and identity profile.

Changes in dietary patterns promoted by the emergence of alternative food systems are becoming increasingly common. The decrease in the consumption of animal-derived products promoted exponential growth in plant-based product demand and, consequently, the availability of several meat analogues for this consumer market. Plant-based meat analogues (PBMAs) were developed to mimic the physical and sensory characteristics of meats and their derivatives. Therefore, the composition of these products has been studied in some countries as an attempt to evaluate their nutritional quality in comparison with that of traditional meat products. The main aim of this study was to employ different Nutrition Classification Schemes (NCSs) to assess the nutritional quality of plant-based meat and to discuss the application of one or more NCSs in defining the identity and quality profile of these foods. Five NCSs were used: three nutrient-based (Nutri-Score; Nutrient Profiling Model (NPM) from Brazil; NPM from PAHO); one food-based (NOVA classification); and one hybrid (Plant-Based Nutrient Profile Model). The nutritional composition and ingredients were collected from labels of 349 PBMAs; 117 were classified as burgers, and 182 products employed soy as the main protein ingredient. The use of different NCSs is strategic for PBMAs' nutritional quality evaluation, and the Nutri-Score was able to show the effectiveness of differentiating products as having poor nutritional quality. In this way, the employment of NPM from Brazil is recommended as a driver for PBMAs choices, especially due to the excellent agreement between the Nutri-Score and NPM from Brazil for burgers.

Association between Consumption of Ultra-Processed Foods and Sociodemographic Characteristics in Brazilian Adolescents.

BACKGROUND: The consumption of ultra-processed foods is associated with several negative health outcomes. Studies on adolescents have shown that this population has a high consumption of these foods, especially in high-income countries. However, there are no studies on the types of ultra-processed foods consumed. The present study evaluated secondary data from a representative sample of the National School Health Survey, the consumption of ultra-processed foods by 159,245 Brazilian adolescents. METHODS: Data were collected via a self-administered questionnaire using a mobile device. A Poisson regression model was used to assess the prevalence of ultra-processed food consumption and its correlation with sociodemographic characteristics. RESULTS: The consumption of ultra-processed foods was significant among Brazilian adolescents, and almost half of the participants reported consumption the day before. We observed that sociodemographic characteristics such as school type, race/skin color, region, municipality type, age, living with mother, living with father, and maternal education level were associated with greater or lesser consumption of ultra-processed foods. Adolescents who study in private schools, are female, white, and live in non-capital cities consume more ultra-processed foods. CONCLUSIONS: Access to in natura and minimally processed foods must be on the agenda of governments and encouraged by food and nutrition education to guarantee the right to adequate and healthy food.

Characteristics of Brazilian school food and physical activity environments: PeNSE 2015.

OBJECTIVE: To characterize the food and physical activity environments in Brazilian public and private schools, and develop indicators to evaluate them. METHODS: This is a cross-sectional study conducted with data from a questionnaire on school characteristics of the 2015 National Adolescent School-based Health Survey, answered by principals or coordinators, referring to 3040 public and private schools throughout the country. The variables related to food and physical activity environments were described in isolation, and an indicator was developed for each environment, with scores ranging from 0 to 100. The frequency and mean score of each variable were described according to the administrative sphere (public or private). RESULTS: The public sector showed a predominance of school meals offer (97.8%), whereas the private sector, of canteens (89.8%). Both had a similar frequency of alternative food outlets in the surroundings. Private schools provided all markers of healthy and unhealthy eating in canteens more frequently. Public schools scored higher in "Food and beverage availability" (64.9) than private schools (55.8). The characteristics of physical activity environments showed that sports courts and sports or games equipment were common in public (69.2% and 90.7%, respectively) and private schools (94.1% and 99.8%, respectively), though at a significantly higher frequency in the second group. Private schools scored higher in "Structures and materials availability" than public schools (63.3 and 41.6, respectively). CONCLUSIONS: Public schools provide a more favorable food environment, whereas private schools, a physical activity environment.

Update of the acquisition parameters of the Brazilian National School Feeding Program based on the Dietary Guidelines for the Brazilian Population. / Atualização dos parâmetros de aquisição do Programa Nacional de Alimentação Escolar com base no Guia Alimentar para a População Brasileira.

The Dietary Guidelines for the Brazilian Population is acknowledged as a powerful inducer of public food and nutrition policies. In this perspective, this article presents the methodological path and evidence that supported the elaboration of the new parameters of food acquisition of the Brazilian National School Feeding Program (PNAE). This elaboration involved the analyses of: (1) participation of federal resources used to purchase food, grouped according to the NOVA classification, used in Dietary Guidelines for the Brazilian Population, by the set of Brazilian municipalities and according to the classification of the execution (positive or negative); (2) monthly reference menus that were prepared following Dietary Guidelines for the Brazilian Population recommendations; (3) analysis of food acquisition by the sampling of 525 municipalities, involving the relative participation of food groups (according to NOVA) in total expenditures and energy and nutritional quality of purchased foods; and (4) analysis of ultra-processed foods that should not be offered in the school environment. We proposed the adoption of the following parameters for the participation of food groups in relation to the total federal resources used in the purchase of food: ≥ 75% of resources for fresh or minimally processed foods; < 20% for processed or ultra-processed foods and < 5% for processed culinary ingredients, as well as the expansion of the list of foods whose acquisition with federal resources from PNAE is prohibited. This process supported the elaboration of Resolution CD/FNDE n. 6 of May 8, 2020, which provides for the attendance of school feeding to primary education students within the PNAE.

O Guia Alimentar para a População Brasileira é reconhecido como um potente indutor de políticas públicas de alimentação e nutrição. Nessa perspectiva, este artigo apresenta o percurso metodológico e as evidências que subsidiaram a elaboração dos novos parâmetros de aquisição de alimentos do Programa Nacional de Alimentação Escolar (PNAE). Tal elaboração envolveu as análises de: (1) participação dos recursos federais utilizados para compra de alimentos, agrupados segundo a classificação NOVA, empregada no Guia Alimentar para a População Brasileira, pelo conjunto de municípios brasileiros e segundo classificação da execução (positiva ou negativa); (2) cardápios mensais de referência que foram elaborados seguindo recomendações do Guia Alimentar para a População Brasileira; (3) aquisição de alimentos por amostra de 525 municípios, envolvendo a participação relativa dos grupos de alimentos (segundo a NOVA) no total de gastos e de energia e a qualidade nutricional dos alimentos adquiridos; e (4) alimentos ultraprocessados que não devem ser ofertados no ambiente escolar. Foi proposta a adoção dos seguintes parâmetros para participação dos grupos de alimentos em relação ao total de recursos federais empregados na compra de alimentos: ≥ 75% de recursos para alimentos in natura ou minimamente processados; < 20% para alimentos processados ou ultraprocessados e < 5% para ingredientes culinários processados e a ampliação da lista de alimentos cuja aquisição com recursos federais do PNAE é proibida. Esse processo subsidiou a elaboração da Resolução CD/FNDE nº 6, de 8 de maio de 2020, que dispõe sobre o atendimento da alimentação escolar aos alunos da educação básica no âmbito do PNAE.

La Guía Alimentaria para la Población Brasileña está reconocida como un potente inductor de políticas públicas de alimentación y nutrición. Desde esta perspectiva, este artículo presenta la trayectoria metodológica y evidencias que apoyaron la elaboración de los nuevos parámetros de adquisición de alimentos del Programa Nacional de Alimentación Escolar (PNAE). Tal elaboración implicó los análisis de: (1) participación de los recursos federales utilizados para la compra de alimentos, agrupados según la clasificación NOVA, empleada en el Guía Alimentaria para la Población Brasileña, por el conjunto de municipios brasileños, y según la clasificación de la ejecución (positiva o negativa); (2) menús mensuales de referencia que fueron elaborados siguiendo recomendaciones del Guía Alimentaria para la Población Brasileña; (3) adquisición de alimentos mediante una muestra de 525 municipios, implicando la participación relativa de los grupos de alimentos (según NOVA) en el total de gastos y de energía, así como la calidad nutricional de los alimentos adquiridos; y (4) alimentos ultraprocesados que no deben ser ofrecidos en el entorno escolar. Se propuso la adopción de los siguientes parámetros para la participación de los grupos de alimentos, en relación con el total de recursos federales empleados en la compra de alimentos: ≥ 75% de recursos para alimentos in natura o mínimamente procesados; < 20% para alimentos procesados o ultraprocesados, y < 5% para ingredientes culinarios procesados, así como la ampliación de la lista de alimentos, cuya adquisición con recursos federales del PNAE está prohibida. Este proceso apoyó la elaboración de la Resolución CD/FNDE nº 6, del 8 de mayo de 2020, que organiza la atención de la alimentación escolar a alumnos de educación básica en el ámbito del PNAE.

The contribution of school meals to food security among households with children and adolescents in Brazil.

OBJECTIVES: This study aimed to analyze the relationship between food insecurity and school meal consumption, adjusted for sociodemographic variables. METHODS: This cross-sectional study investigated households with children and adolescents living in Brazilian municipalities. A semistructured survey was administered to parents/guardians at a parent-teacher meeting to assess their socioeconomic conditions and access to food, using the Brazilian Food Insecurity Scale to classify households as having food security or mild, moderate, or severe food insecurity. Parents and students were asked about the frequency of their consumption of school meals offered by the Brazilian School Food Program, which is one of the largest public policies in Brazil and offers free meals to all students in all public schools. Multinomial regression was performed to assess the relationship between food security and frequency of school meal consumption. RESULTS: A total of 1705 students participated in the study, most of whom displayed some degree of food insecurity (56.5%) per the Brazilian Food Insecurity Scale. Regular consumption of school meals (>3 times/wk) was reported by 78.5% of students. Regarding the frequency of school meal consumption adjusted by sociodemographic variables, students from households with food insecurity (moderate or severe) were more likely to regularly consume school meals. The prevalence of households with moderate or severe food insecurity was twice as high as for those who lived in households with food security after adjusting for sociodemographic variables (odds ratio: 2.35; 95% confidence interval 1.53-3.61). CONCLUSIONS: The Brazilian School Food Program has contributed greatly to food security. Although the guarantee of universality is essential for the program to reach all school children who are experiencing food insecurity, the program should also aim for greater equity.

Impact of an intervention on the availability and consumption of fruits and vegetables in the workplace.

OBJECTIVE: To evaluate the impact of an educational and environmental intervention on the availability and consumption of fruits and vegetables in workplace cafeterias. DESIGN: This was a randomized intervention study involving a sample of companies that were divided into intervention and control groups. The intervention, which focused on change in the work environment, was based on an ecological model for health promotion. It involved several different aspects including menu planning, food presentation and motivational strategies to encourage the consumption of fruits and vegetables. The impact of the intervention was measured by changes (between baseline and follow-up) in the availability of fruits and vegetables that were eaten per consumer in meals and the consumption of fruits and vegetables in the workplace by workers. We also evaluated the availability of energy, macronutrients and fibre. SETTINGS: Companies of São Paulo, Brazil. SUBJECTS: Twenty-nine companies and 2510 workers. RESULTS: After the intervention we found an average increase in the availability of fruits and vegetables of 49 g in the intervention group, an increase of approximately 15 %, whereas the results for the control group remained practically equal to baseline levels. During the follow-up period, the intervention group also showed reduced total fat and an increase in fibre in the meals offered. The results showed a slight but still positive increase in the workers' consumption of fruits and vegetables (about 11 g) in the meals offered by the companies. CONCLUSIONS: Interventions focused on the work environment can be effective in promoting the consumption of healthy foods.

Use Database to Evaluate the Prevalence of Hunger Among Adolescents in Brazil.

Food insecurity and malnutrition have become serious problems in many countries. In recent years, Brazil has experienced an increase in the prevalence of food insecurity and hunger. However, there is limited information on the status of these issues, and food security assessments are only performed as household measures. Therefore, the use of available databases is essential to expand information and support decision-making in the fight against food insecurity. This study aimed to evaluate the relationship between reports of hunger among adolescents and their sociodemographic characteristics. We used data from the 2015 National School Health Survey. The main variable of interest was obtained from responses to the following question: "Over the past 30 days, how often have you gone hungry because you did not have enough food at home?". The responses were separately gathered from those who reported going hungry and those who did not. Socioeconomic characteristics were evaluated simultaneously. For statistical analysis, a Pearson chi-square test and multiple analyses were performed using Poisson regression models. A total of 101,888 adolescents were evaluated. The variable used to measure hunger was associated with maternal education, internet access, and fruit intake. The results showed a positive association between adolescents who reported going hungry and women, black and indigenous adolescent students living in households with more than five people, adolescents not living with their father, and adolescents planning to work or not knowing what they will do after completing the ninth grade. The results demonstrate that it is possible to use secondary data with a single question to assess, monitor, and provide insights into how food security impacts the sociodemographic groups differently.

Temporal variation in food consumption of Brazilian adolescents (2009-2015).

BACKGROUND: Worldwide population has been increasingly exposed to ultra-processed foods, which are associated with obesity. Adolescence is a transition period of life and WHO recommends the surveillance of risk factors to the adolescents' health, such as diet, because experiences in this phase can result in health risks. OBJECTIVE: To assess the trends in food consumption of adolescents from Brazilian capitals according to sociodemographic variables, based on data from the National Survey of School Health (PeNSE). METHODS: Data from in 2009, 2012 and 2015 of a total of 173,310 9th graders enrolled in public and private schools in Brazilian capitals and in the Federal District were assessed. Food consumption was assessed from regular consumption (five or more times a week) of healthy eating markers (beans; vegetables; fruit) and unhealthy eating markers (sweets; soft drinks; fried salty snacks). For sociodemographic variables, we considered macro regions; age; race/ skin color; gender; school administrative status. We assessed these markers trends for the population and, additionally, the analyses were stratified by gender, race/ skin color, and school administrative status. Statistical significance of the temporal trends was assessed by linear regression model. RESULTS: Over six years, three types of change in Brazilian adolescents' diet were observed: decreasing regular consumption of beans, sweets and soft drinks, increasing regular consumption of vegetables, and stable consumption of fruit and fried salty snacks. CONCLUSION: Brazilian adolescents' diet composition has changed in a short period, and therefore it is necessary to monitor it to propose actions aimed at this public.

[Critical analysis of the revised diet quality index for the Brazilian population (DQI-R): its application in ELSA-Brasil]. / Análise crítica do índice de qualidade da dieta revisado para a população brasileira (IQD-R): aplicação no ELSA-Brasil.

The scope of this study was to conduct a critical analysis of the application of the Brazilian Healthy Eating Index - Revised (BHEI-R), to explain the ease and difficulties in its calculation, to suggest adaptations and to compare its distribution. This was done in accordance with sociodemographic variables among the 15,105 public servants participating in the Longitudinal Study of Adult Health from 2008 to 2010. Food consumption was assessed based on a Food Frequency Questionnaire and BHEI-R was estimated in four ways: original; weighted for frequency of consumption of fruits and vegetables; modified considering legumes separated from other vegetables, and adapted covering the two previous changes. The results indicated that irrespective of the adaptation performed, women, individuals over 65 years of age and individuals with lower schooling had higher mean scores indicating a better quality diet. It is believed that the proposed adaptations may be useful for future studies that apply BHEI-R.

O objetivo deste estudo foi analisar criticamente a aplicação do Índice de Qualidade da Dieta ­ Revisado (IQD-R), explicitar facilidades e dificuldades em seu cálculo, sugerir adaptações e comparar sua distribuição segundo variáveis sociodemográficas entre os 15.105 servidores públicos participantes do Estudo Longitudinal de Saúde do Adulto, no período de 2008 a 2010. O consumo alimentar foi aferido com base em Questionário de Frequência Alimentar e o IQD-R foi estimado de quatro maneiras: original; ponderado para frequência de consumo de frutas e hortaliças; modificado considerando leguminosas separado dos demais vegetais e adaptado abrangendo as duas alterações anteriores. Os resultados indicaram que independentemente da adaptação realizada, as mulheres, os indivíduos com mais de 65 anos e os indivíduos de menor escolaridade apresentaram escores médios mais altos indicando dieta de melhor qualidade. Acredita-se que as adaptações propostas podem ser úteis para estudos futuros que apliquem o IQD-R.

Positive influence of school meals on food consumption in Brazil.

OBJECTIVE: To analyze the contribution of school meals to healthy food consumption among public school students in Brazil. METHODS: The data from the National Adolescent School-Based Health Survey (PeNSE), containing 86,660 ninth-grade students, were used. The students were asked about their consumption of school meals and of food in general over the preceeding seven days and on the day before the interview. A multinomial regression was performed to assess the relationship between the students' food consumption over the previous seven days and regular consumption of school meals (≥3 days/week), which were adjusted for sociodemographic factors. Poisson regression models were used for the relationship between food consumed on the day before the interview and regular consumption of school meals. RESULTS: Nearly one in five students (22.8%) stated that they consume school meals regularly. The adjusted analyses revealed that the consumption of school meals was associated positively with moderate (3-4 days/week) and regular (≥5 days/week) consumption of beans, raw or cooked vegetables, cooked vegetables, and fruits, and with moderate consumption of raw vegetables. In addition, school meal consumption was associated negatively with moderate or regular consumption of fried salty snacks and processed meat, and with regular consumption of packaged salty snacks, crackers, sweet biscuits, and sweets. Based on food consumption on the day preceding the interview, the consumption of school meals significantly affect the consumption of raw and cooked vegetables, and fruits. CONCLUSION: School meal consumption affects positively the consumption of healthy foods among students.

Atuação do MESA São Paulo durante a pandemia do Coronavírus / MESA São Paulo's performance during the Coronavirus pandemic

Introdução: O Mesa Brasil é um programa social desenvolvido pelo Serviço Social do Comércio que busca reduzir o desperdício de alimentos e auxiliar no enfrentamento da fome. Objetivo: O estudo teve como objetivo compreender a sua atuação frente à pandemia de COVID-19, um período de crise humanitária, sanitária, ambiental e socioeconômica mundial. Métodos: Trata-se de um estudo transversal qualitativo que envolveu a realização de entrevistas semi-estruturadas com as Coordenadoras estadual, municipal (metrópole, litoral e interior) e do Centro de Captação e Armazenagem Mesa Brasil de São Paulo. A análise de todo o conteúdo foi do tipo temática. Resultados: Dentre as principais alterações e adaptações, estão a redução das doações, para a qual houve flexibilidade no cadastro das instituições, atendimento às famílias, desenvolvimento de campanha e cestas básicas com produtos de higiene e limpeza; aumento de doações de ultraprocessados, para o qual houve a respectiva adesão a alguns produtos não usuais. Conclusão: O programa demonstrou enorme capacidade em desenvolver medidas criativas para o novo cenário a um tempo relativamente curto, muitas das quais podem servir de inspiração para outras iniciativas. Apresentou-se ainda mais imprescindível para esse cenário de emergência, especialmente no que tange a alimentação da população vulnerabilizada dentro de um país com políticas públicas ausentes para tal. (AU)

Introduction: Mesa Brazil is a social program developed by the Social Service of Commerce that seeks to reduce food waste and help fight hunger. Objective: The objective of the study was to understand its performance in a period of humanitarian, sanitary, environmental and world socioeconomic crisis. Methods: This is a qualitative cross-sectional study that carried out semi-structured interviews with the state and municipal coordinators (metropolis, coast and countryside) and the Mesa Brazil Collection and Storage Center in São Paulo. The analysis of all the material was of a thematic type. Results: Among the main changes and adaptations are the reduction of donations, for which there was flexibility in the registration of institutions, assistance to families, development of campaigns and basic baskets with hygiene and cleaning products; increase in donations of ultra-processed products, for which there was the respective adherence to certain unusual products. Conclusion: The program has shown enormous capacity to develop creative measures for the new scenario in a relatively short time, many of which can serve as inspiration for other initiatives. It was even more essential for this emergency scenario, especially with regard to feeding the vulnerable population within a country with absent public policies for this. (AU)

Consumption of vegetables and their relation with ultra-processed foods in Brazil.

OBJECTIVE To characterize the household purchase and the individual consumption of vegetables in Brazil and to analyze their relation with the consumption of ultra-processed foods. METHODS We have used data on the purchase of food for household consumption and individual consumption from the 2008-2009 Brazilian Household Budget Survey. The Brazilian Household Budget Survey studied the purchase of food of 55,970 households and the food consumption of 34,003 individuals aged 10 years and over. The foods of interest in this study were vegetables (excluding roots and tubers) and ultra-processed foods. We have described the amount of vegetables (grams) purchased and consumed by all Brazilians and according to the quintiles of caloric intake of ultra-processed food. To this end, we have calculated the crude and predicted values obtained by regression models adjusted for sociodemographic variables. We have analyzed the most commonly purchased types of vegetables (% in the total amount) and, in relation to individual food consumption, the variety of vegetables consumed (absolute number), the participation (%) of the types of culinary preparations based on vegetables, and the time of consumption. RESULTS The adjusted mean household purchase of vegetables was 42.9 g/per capita/day. The adjusted mean individual consumption was 46.1 g. There was an inverse relation between household purchase and individual consumption of vegetables and ultra-processed foods. Ten types of vegetables account for more than 80% of the total amount usually purchased. The variety consumed was, on average, 1.08 type/per capita/day. Approximately 60% of the vegetables were eaten raw, and the amount consumed at lunch was twice that consumed at dinner; individuals with higher consumption of ultra-processed foods tended to consume even less vegetables at dinner. CONCLUSIONS The consumption of vegetables in Brazil is insufficient, and this is worse among individuals with higher consumption of ultra-processed foods. The most frequent habit was to consume raw vegetables at lunch and with limited variety.