Temporal trend of food consumption markers, breakfast consumption and association with overweight/obesity in schoolchildren aged 7 to 10 years between 2007 and 2019.

Obesity has a multifactorial origin. Among the behavioural risk factors, excessive consumption of unhealthy foods, skipping breakfast and reduced physical activity stand out. The main objective of this article was to identify trends in dietary habits and their association with overweight/obesity over a 12-year period in schoolchildren aged 7 to 10 years in Florianópolis, southern Brazil. A cross-sectional panel analysis study, using anthropometric, sociodemographic, physical activity and food consumption data of schoolchildren aged 7 to 10 years, collected in three waves of the Study of Prevalence of Obesity in Children and Adolescents (EPOCA), carried out during the years 2007, 2012/2013 and 2018/2019, was performed. To analyse the trend in dietary variables over the years, the 95% CIs were compared with the non-overlap of intervals indicating statistical significance. Multiple logistic regression analysis was performed to test the association of weight status with dietary markers. The prevalence of overweight/obesity was 34.4%, 37.2% and 34.2% in 2007, 2012/2013 and 2018/2019, respectively, and there were no statistically significant differences among waves. There was a progressive and significant reduction in the consumption of soft drinks and sweets and in eating breakfast by schoolchildren, from 2007 to 2019. Breakfast consumption was inversely associated with the chance of overweight/obesity (OR 0.74, 95% CI 0.59-0.93), and female students were less likely to have overweight/obesity when compared to boys (OR 0.70, 95% CI 0.61-0.81). The reduction in the consumption of soft drinks and sweets over the years might be caused by efforts in public policies that intended to reduce the consumption of unhealthy foods among schoolchildren. The progressive and significant reduction in having breakfast should be better elucidated in future studies, to minimise the potential impact of this practice on schoolchildren's bodyweight.

Trends in the prevalence of obesity, overweight, and thinness among schoolchildren aged 7-14 years from southern Brazil (2002-2019).

OBJECTIVE: To analyze the obesity, overweight, and thinness trends among Brazilian schoolchildren by sex, age group, and type of school according to World Health Organization (WHO) and International Obesity Task Force (IOTF) criteria. METHODS: We conducted four surveys between 2002 and 2018/19 involving schoolchildren aged 7-14 years from a state capital in southern Brazil. Weight status was classified using both WHO and IOTF criteria. RESULTS: In the total sample, obesity prevalence based on the IOTF and the WHO criteria were 72% and 44% higher in 2018/19 compared with 2002, respectively. Over the whole period, the obesity prevalence increased among children (WHO: 10.1% vs. 14.1%; IOTF: 5.0% vs. 8.3%), and those from public schools (WHO: 10.5% vs. 16.4%; IOTF: 5.6% vs. 10.1%). There was no significant reduction in thinness prevalence over the analyzed period. CONCLUSION: Obesity prevalence remains on an upward trend in a state capital in southern Brazil, especially among children from public schools. A higher prevalence of overweight and obesity was observed using the WHO criteria compared with IOTF criteria.

Twenty years of the Postgraduate Program in Nutrition at the Federal University of Santa Catarina: analysis of dissertations and theses / Vinte anos do Programa de Pós-Graduação em Nutrição da Universidade Federal de Santa Catarina: análise das dissertações e teses

ABSTRACT Objective To perform a descriptive analysis of the methodological characteristics of the dissertations and theses produced by the Postgraduate Program in Nutrition of the Federal University of Santa Catarina. Methods Bibliometric analysis of postgraduate dissertations and theses. The search for graduates was conducted until December 31, 2022, through queries to the Graduate Monitoring System and University Institutional Repository. Results A total of 323 dissertations and theses presented over the 20 years of the postgraduate program were reviewed. The majority was produced by nutritionists (89.0%, n=244). There was a predominance of the Dietary and Biochemical Study line related to nutritional status (47.0%, n=152), followed by the lines of Nutrition in Meal Production and Eating Behavior (27.9%, n=90) and Nutritional Diagnosis and Intervention in Collectivities (25.1%, n=81). The majority of studies were quantitative (79.0%, n=255) and observational (75.0%, n=244), investigating the adult and elderly population (41.0%, n=133), particularly the local population (78.0%, n=252). Among 30 central themes, the most researched were obesity (12.0%, n=38), methods and evaluation of food consumption (10.0%, n=34), functional foods and bioactive compounds (10.0%, n=33), food system, sustainability and food and nutritional security (8.0%, n=25) and nutritional therapy (7.0%, n=23). In the last five years, research has begun on new themes, such as Nutrition in neuroscience and sports, and meta-research in Nutrition. Conclusion The postgraduate program contributed to predominantly train nutritionists, developing studies on topics of interest to the science of Nutrition on a global scale. There is a greater local, regional and national vocation in the development of quantitative observational studies, especially with the adult and elderly population.

RESUMO Objetivo Realizar análise descritiva das características metodológicas das dissertações e teses produzidas pelo Programa de Pós-Graduação em Nutrição da Universidade Federal de Santa Catarina. Métodos Realizou-se análise bibliométrica das dissertações e teses produzidas pelo programa de pós-graduação. A busca dos egressos ocorreu até o dia 31 de dezembro de 2022, a partir de consultas ao Sistema de Acompanhamento de Egressos e ao Repositório Institucional da universidade. Resultados Foram analisadas 323 dissertações e teses defendidas nos 20 anos do programa de pós-graduação, desenvolvidas majoritariamente por nutricionistas (89,0%, n=244). Houve predominância da linha de Estudo Dietético e Bioquímico relacionado ao estado nutricional (47,0%, n=152), seguida pelas linhas de Nutrição em Produção de Refeições e Comportamento Alimentar (27,9%, n=90) e de Diagnóstico e Intervenção Nutricional em Coletividades (25,1%, n=81). A maioria dos estudos foi do tipo quantitativo (79,0%, n=255) e observacional (75,0%, n=244), investigando a população de adultos e idosos (41,0%, n=133), sobretudo a população local (78,0%, n=252). Das 30 temáticas centrais, as mais investigadas foram obesidade (12,0%, n=38), métodos e avaliação do consumo alimentar (10,0%, n=34), alimentos funcionais e compostos bioativos (10,0%, n=33), sistema alimentar, sustentabilidade e segurança alimentar e nutricional (8,0%, n=25) e terapia nutricional (7,0%, n=23). Nos últimos cinco anos, iniciaram-se pesquisas com novas temáticas, tais como Nutrição em neurociência e no esporte, e metapesquisa em Nutrição. Conclusão O programa de pós-graduação apresentou contribuição à formação predominante de nutricionistas, desenvolvendo estudos em temáticas de interesse da ciência da Nutrição em âmbito global. Destaca-se maior vocação local, regional e nacional no desenvolvimento de estudos quantitativos observacionais, sobretudo com população adulta e idosa.

Findings of evaluative research on the Brazilian Food and Nutritional Security System: a scoping review from 2006 to 2022 / Resultados de pesquisas avaliativas sobre o Sistema Nacional de Segurança Alimentar e Nutricional: uma revisão de escopo de 2006 a 2022

ABSTRACT Objective This study analyzes the results of evaluative research on the Brazilian Food and Nutritional Security System. Method Was conducted a scoping review by collecting information from four bibliographic databases: Scientific Electronic Library Online (SciELO), Latin American and Caribbean Literature in Health Sciences (LILACS), National Library of Medicine (MEDLINE/PubMed), and Web of Science. Three researchers systematically selected the studies and extracted data. The researchers categorized the studies included according to an evaluative approach to the topics of financing, social participation, decentralization and government management, and monitoring and evaluation. Results Were found 1,987 references, 17 of which were selected for analysis. It is presented the evaluation of the System and of its public policy as a developing field permeated by different types of research and methods and which needs to be better qualified in relation to its theoretical and methodological approaches. The results and recommendations of the studies analyzed point out important elements to guide decision-making in relation to the System and its public policy. Conclusion In view of the recent weakening of the governance structure of this public policy at a national level, this study contributes to the debate on food and nutritional security and its reintegration into the Brazilian governmental agenda.

RESUMO Objetivo Este estudo analisou os resultados de pesquisas avaliativas sobre o Sistema Nacional de Segurança Alimentar e Nutricional no Brasil. Método Foi realizado uma revisão a partir da coleta de informações em quatro bancos de dados bibliográficos: Scientific Electronic Library Online (SciELO), Latin American and Caribbean Literature in Health Sciences (LILACS), National Library of Medicine (MEDLINE/PubMed), e Web of Science. Três pesquisadores selecionaram sistematicamente os estudos e extraíram os dados. Os pesquisadores categorizaram os estudos incluídos de acordo com uma abordagem avaliativa sobre os temas de financiamento, participação social e controle, descentralização e gestão governamental, e monitoramento e avaliação. Resultado Foram encontradas 1.987 referências, das quais 17 foram selecionadas para análise. Apresenta-se a avaliação do Sistema e de sua política pública como um campo em desenvolvimento permeado por diferentes tipos de pesquisa e métodos, e que precisa ser mais bem qualificado em relação às suas abordagens teóricas e metodológicas. Os resultados e recomendações dos estudos analisados apontam elementos importantes para orientar a tomada de decisão em relação ao Sistema e sua política pública. Conclusão Diante da recente fragilização da estrutura de governança dessa política pública em nível nacional, este estudo contribui para o debate sobre segurança alimentar e nutricional e sua reinserção na agenda governamental brasileira.

Neighborhood Availability and Use of Food, Physical Activity, and Social Services Facilities in Relation to Overweight and Obesity in Children and Adolescents.

OBJECTIVE: To evaluate the association of a combined measure of availability and use of facilities from the food environment and overweight (including obesity) among schoolchildren, while taking into account the physical activity and social-assistance environments. METHODS: Cross-sectional study with a probabilistic sample of schoolchildren aged 7 to 14 years living in a southern Brazilian city (n = 2026). Multilevel analyses were performed with overweight as outcome and the food environment as main exposure. Models were adjusted for the physical activity and social-assistance environments, as well as individual and other residential neighborhood characteristics. RESULTS: Greater availability of restaurants around the home was associated with higher odds of overweight (odds ratio [OR] = 1.40; 95% CI = 1.06-1.85). Stronger associations were found for schoolchildren reporting to use restaurants (OR = 1.48; 95% CI = 1.15-1.90). This association remained significant after adjusting for the presence of other food retailers. Schoolchildren who had social-assistance facilities around their homes, but reported not to use them, showed consistently higher odds of being overweight (OR = 1.34; 95% CI = 1.01-1.78) as compared to schoolchildren who had these facilities near home and used them. The physical activity environment was not associated with the outcome. CONCLUSIONS: Availability and use of the food and social-assistance environments were significantly associated with overweight (including obesity) among the schoolchildren. Future research should consider the use of environmental facilities in combination to their geographical availability. Our results highlight the need for policies that limit the access to obesogenic food outlets by children and adolescents.

Methodological aspects and characteristics of participants in the study on the prevalence of obesity in children and adolescents in Florianópolis, Southern Brazil, 2018-2019: EPOCA study.

PURPOSE: To describe the methodological aspects and characteristics of the participants of the EPOCA survey. METHODS: The study was conducted with schoolchildren aged between seven to 14 years old from 30 schools in Florianópolis, Southern Brazil. Body mass, height, girths, and skinfold thicknesses were measured. Food consumption and physical activity from the previous day were self-reported using the validated Web-CAAFE questionnaire. Adolescents completed a specific questionnaire about physical activity, meal consumption, and weight control behaviors. Parents/guardians responded to a sociodemographic and habits questionnaire. RESULTS: A total of 1671 schoolchildren participated in the study (response rate: 27.2%). About 63% of schoolchildren were enrolled in public schools. Most studied in the morning shift (54.2%), were female (53.1%) and aged between seven and 10 years (58.1%). The prevalence of overweight was 33.7% and obesity was 11.3%. CONCLUSIONS: The data obtained will allow us to assess the trend in the prevalence of overweight and obesity and associated factors when compared to other surveys performed. Descriptions of the logistics and protocols can help in the development and improvement of similar studies. It is hoped that the results of EPOCA 2018/2019 may help in the design of obesity prevention policies and programs for this population.

Presença de desertos alimentares em um distrito sanitário de uma capital brasileira: um estudo descritivo e exploratório sobre a distribuição espacial de estabelecimentos comerciais de alimentos / Food deserts in a health district of a Brazilian capital: a descriptive and exploratory study on the spatial distribution of commercial food establishments

Introdução: O ambiente alimentar que a comunidade está inserida pode influenciar, positiva ou negativamente no acesso à alimentação de qualidade e consequentemente na sua saúde. Objetivo: Identificar a presença de desertos alimentares em um distrito sanitário de uma capital brasileira. Métodos: Estudo descritivo, transversal e exploratório, utilizando dados secundários de diferentes fontes institucionais para mapear a distribuição espacial de estabelecimentos de comercialização de alimentos: restaurantes, padarias, supermercados, minimercados/mercearias, hortifrutigranjeiros, vendedores ambulantes e lanchonetes/fastfood. Os estabelecimentos foram agrupados nas categorias in natura, ultraprocessados e mistos, de acordo com a predominância do tipo de alimentos comercializados. Para a análise, a densidade de estabelecimentos in natura juntamente com os mistos por mil habitantes (usuários cadastrados nos centros de saúde) foram calculadas.  Resultados: Foram investigados 111 estabelecimentos, sendo 20% que comercializavam alimentos in natura (saudáveis), 27% alimentos ultraprocessados (não saudáveis) e 53% considerados mistos. Conclusões: Foram observadas áreas que podem ser consideradas desertos alimentares, locais onde há pouca (ou ausência) de oferta de alimentos in natura, e por consequência dificultando o acesso a alimentos saudáveis.

Introduction: The communities' food environment can positively or negatively influence access to quality food and consequently, people's health. Objective: Identify the presence of food deserts in a health district of a Brazilian capital. Methods: Descriptive, cross-sectional and exploratory study, using secondary data from different institutional sources to map the spatial distribution of food establishments such as restaurants, bakeries, supermarkets, minimarkets/grocery stores, fruit and vegetable stores, street vendors and cafeterias/fast food. The establishments were grouped into fresh, ultra-processed and mixed food categories, according to the predominance of the type of food offered. For the purpose of analysis, the density of fresh food establishments together with mixed food establishments per thousand inhabitants (as registered in the health centers) was calculated.  Results: A total of 111 establishments were investigated, 20% selling fresh foods (healthy), 27% ultra-processed foods (unhealthy) and 53% considered mixed food sellers. Conclusions: Areas that can be considered food deserts were found, i.e. places where there is little (or absence) of fresh food supply, and consequently making access to healthy foods difficult.

Popular Restaurants as strategies to fight hunger and to promote Food and Nutrition Security: an integrative review of scientific publications in the period 2011-2021 / Restaurantes Populares como estratégias de combate à fome e de promoção da Segurança Alimentar e Nutricional: uma revisão integrativa de publicações científicas no período de 2011-2021

ABSTRACT Objective Evaluate the contribution of Popular Restaurants in promoting Food and Nutrition Security and fighting hunger. Methods This is an integrative review with searches performed in Scopus, Virtual Health Library, Directory of Open Access Journals, Scientific Electronic Library Online, Web of Science, PubMed and Google Scholar databases. The capture of studies was limited to the period from 2011 to 2021. The articles were categorized according to the focus of the evaluation carried out, conceptualization and thematic analysis procedures, and aggregated into five categories of analysis: 1) users' profile; 2) food handlers; 3) leftovers, food loss and waste; 4) physical-functional structure; and 5) promotion of the human right to adequate food. Results 35 articles were included. There was a predominance of a quantitative approach and, among the focus of the studies, the most recurrent was related to the "users' profile" (54%), followed by the categories: "food handlers" (14%), "Leftovers, food loss and waste" (14%), "promotion of the Human Right to Adequate Food" (12%), and "physical-functional structure (6%). 88.5% of the studies discuss the equipment in a sectored way, evaluating specific items of the equipment and/or the population served. Only four studies discussed Popular Restaurants as promoters of the Human Right to Adequate Food. Conclusion There was a scarcity of the analyzed literature, attesting to the existing gap in the role of Popular Restaurants in the promotion of Food and Nutrition Security. It is recommended to carry out evaluative studies that can contribute to the qualification and expansion of Popular Restaurants as instruments to promote the Human Right to Adequate Food and fight hunger.

RESUMO Objetivo Avaliar a contribuição dos Restaurantes Populares na promoção da Segurança Alimentar e Nutricional e combate à fome. Métodos Trata-se de revisão integrativa com buscas nas bases de dados Scopus, Biblioteca Virtual em Saúde, Directory of Open Access Journals, Scientific Electronic Library Online, Web of Science, PubMed e Google Acadêmico. A captura de estudos limitou-se ao período entre 2011 e 2021. Os artigos foram categorizados segundo o enfoque da avaliação realizada, conceituação e procedimentos de análise temática e agregados em cinco categorias de análise: 1) perfil dos usuários; 2) manipuladores de alimentos; 3) resíduos, perdas e desperdício; 4) estrutura físico-funcional; e 5) promoção do direito humano à alimentação adequada. Resultados Foram incluídos 35 artigos. Observou-se predominância de abordagem quantitativa e, dentre os focos dos estudos, o mais recorrente foi relacionado ao "perfil dos usuários" (54%), seguido pelas categorias: "manipuladores de alimentos" (14%), "resíduos, perdas e desperdício" (14%), "promoção do Direito Humano à Alimentação Adequada" (12%), e "estrutura físico-funcional (6%). 88,5% dos estudos discute o equipamento de forma setorizada, avaliando itens pontuais do mesmo e/ou da população atendida. Apenas quatro estudos discutiram os Restaurantes Populares como promotores do Direito Humano à Alimentação Adequada. Conclusão Verificou-se escassez da literatura analisada, atestando a lacuna existente sobre o papel dos Restaurantes Populares na promoção da Segurança Alimentar e Nutricional. Recomenda-se a realização de estudos avaliativos que possam contribuir com a qualificação e a ampliação dos Restaurantes Populares como instrumentos de promoção do Direito Humano à Alimentação Adequada e combate à fome.

I Plano Municipal de Segurança Alimentar e Nutricional de Duque de Caxias (2017-2020): uma avaliação com base no ciclo das políticas públicas / I Duque de Caxias, Brazil, Municipal Plan for Food and Nutrition Security (2017-2020): an assessment based on the public policy cycle

Introdução: O I Plano Municipal de Segurança Alimentar e Nutricional (PLAMSAN) é uma ferramenta de planejamento, gestão e implementação da Política de Segurança Alimentar e Nutricional. Em Duque de Caxias, RJ, o I PLAMSAN foi sancionado em 2016. Objetivo: Realizar avaliação do I PLAMSAN-DC (2017-2020), utilizando como procedimentos metodológicos uma aproximação do "Ciclo de Políticas Públicas". Métodos: Estudo de avaliação usando elementos da ferramenta "ciclo de políticas públicas" com base nos seguintes procedimentos metodológicos: 1) Análise documental; 2) Revisão de literatura; 3) Avaliação do cumprimento das metas com base nas respostas advindas das Secretarias que compõem a Câmara Intersetorial de Segurança Alimentar e Nutricional. Resultados: Verificou-se que, dentre as 42 metas do Plano, 14,7% foram cumpridas, 34,1% foram parcialmente cumpridas, e 51,2% não foram cumpridas. Conclusões: Observou-se que ainda não há acentuado papel por parte do nível municipal para a concretude de inúmeras ações que necessitam de recursos financeiros. Além disso, verifica-se a necessidade de superação de entraves, sobretudo em relação ao alcance da intersetorialidade e fortalecimento das estruturas componentes do sistema de segurança alimentar e nutricional.

Introduction: The I Plano Municipal de Segurança Alimentar e Nutricional (PLAMSAN, I Municipal Plan for Food and Nutrition Security) is a planning, managing and implementing tool of the Food and Nutrition Security Policy. In Duque de Caxias, RJ, the I PLAMSAN was sanctioned in 2016. Objective: To carry out an evaluation of the I PLAMSAN-DC (2017-2020), using as methodological procedures an approximation of the "Public Policies Cycle". Methods: Evaluation study using elements of the "Public Policies Cycle" tool based on the following methodological procedures: 1) Document analysis; 2) Literature review; 3) Assessment of achievement of goals based on responses from the secretariats that make up the Intersectoral Chamber for Food and Nutrition Security. Results: Among the 42 goals of the Plan, 14.7% were met, 34.1% were partially met, and 51.2% were not met. Conclusions: The municipality still does not play an important role in the implementation of a number of food and nutrition initiatives that require financial resources. In addition, there is a need to overcome barriers, especially in terms of achieving intersectoriality and of strengthening the structures that make up the food and nutrition security system.

Age at menarche and its association with overweight including obesity and socio-economic conditions of Brazilian schoolgirls: A time-trend analysis.

This study aims to describe the time trend of age at menarche in Brazilian schoolgirls evaluated in 2007, 2012/2013 and 2018/2019, and to assess its association with having overweight, including obesity and socio-economic conditions. Three cross-sectional studies were carried out in 2007, 2012/2013 and 2018/2019 in schoolchildren enrolled between the second and ninth years of elementary school and comprising 838, 688 and 326 schoolgirls, respectively. Body mass index Z scores were calculated and categorised as either without overweight or with overweight (including obesity). The type of school (a proxy of socio-economic condition) was categorised as either public or private. Menarche data were collected using the status quo and recall methods. The mean age at menarche was estimated by survival analysis. Differences in age at menarche according to the year of survey, weight status and type of school were verified by the Log-Rank test and Cox's univariate and multiple regression. There was an increase in the prevalence of overweight in girls throughout the surveys, with 21.4% in 2007, 27.2% in 2012 and 28.5% in 2018 (p = 0.007) having overweight. There was a decrease in the mean age at menarche between 2007 and 2018/2019 (12.3 vs. 11.9 years, respectively). The mean age at menarche in girls with overweight was lower in the three time periods when compared to girls without overweight (11.9, 11.8 and 11.5 vs. 12.4, 12.4 and 12.1, respectively). Girls with overweight were more likely to have had earlier age at menarche than girls without overweight (Hazard Ratio 1.57; 95% CI 1.36; 1.80). There were no differences in the age at menarche according to the type of school. The increase in the prevalence of girls with overweight (including obesity) may be associated with the age at menarche. Girls with overweight had a higher risk of earlier age at menarche than girls without overweight.

Distúrbio mineral e ósseo: prevalência subestimada nos estágios iniciais da doença renal crônica / Mineral and bone disorder: underestimated prevalence in the early stages of chronic kidney disease / Trastorno mineral y óseo: prevalencia subestimada en las primeras fases de la enfermedad renal crónica

Introdução: o objetivo foi avaliar a prevalência do distúrbio mineral e ósseo em pacientes com doença renal crônica e a associação entre Taxa de Filtração Glomerular estimada (TFGe) e os indicadores do distúrbio mineral e ósseo (DMO) (cálcio, fósforo e PTH) em pacientes renais crônicos não dialíticos. Materiais e Métodos: estudo seccional da linha de base de uma coorte de dois anos, com adultos e idosos renais crônicos em tratamento conservador. Para identificação do DMO utilizamos os seguintes valores séricos: PTH (> 150 pg/mL) e/ou hipocalcemia (Ca < 8,8mg/dl) e/ou hiperfosfatemia (P > 4,6 mg/dl). Na análise estatística utilizou-se: regressão de Poisson; T de Student, Mann Whitney e correlações de Pearson e Spearman. Nível de significância foi de 5%. Resultados: prevalência de DMO de 54,6% (n=41) (IC 95%: 43,45 - 65,43). A maior prevalência de DMO foi em pessoas do sexo feminino, alfabetizadas, idosas, não etilistas, não tabagistas, sedentárias e de cor de pele branca, porém, sem diferença estatística entre os grupos com e sem DMO. As correlações entre P e PTH com TFGe foram significativas, inversas, de força moderada (p= <0,005 e p = 0,003; coeficientes de correlação = - 0,312 e - 0,379 respectivamente). Discussão:os achados desse estudo mostraram que existe uma lacuna no acompanhamento do DMO-DRC pela atenção primária e a prática clínica deve ser revista. Conclusão:identificou-se prevalência robusta de DMO nos estágios precoces da DRC, além de correlações significativas entre o aumento dos níveis de fósforo e PTH e piora das funções renais.

Introduction: mineral and bone disorder (BMD) is a serious complication of chronic kidney disease (CKD) that increases risks for death from cardiovascular causes and impairs quality of life of affected patients. Objetive: to evaluate the prevalence of BMD in patients with CKD and the association between estimated Glomerular Filtration Rate (eGFR) and BMD indicators (calcium, phosphorus and PTH) in non-dialysis patients. Materials and Methods:sectional study of a two-year cohort of chronic renal adults and elderly patients on conservative treatment. BMD was identified by serum values of: PTH (> 150 pg/mL) and/or hypocalcemia (Ca < 8.8mg/dl) and/or hyperphosphatemia (P > 4.6 mg/dl). The statistical analysis used: Poisson regression; Student's T, Mann Whitney and Pearson and Spearman correlations with 5% significance level. Results:BMD prevalence was 54.6% (n=41) (95% CI: 43.45 - 65.43), more frequent in women, literate, elderly, non-drinkers, non-smokers, sedentary and white skin color. Correlations between P and PTH with GFRe were significant, inverse, moderate strength (p= <0.005 and p = 0.003; correlation coefficients = - 0.312 and - 0.379 respectively). Discussion: the findings of this study highlighted gaps in the monitoring of BMD-DRC by primary care, requiring a review of clinical practices. Conclusion: robust prevalence of BMD in the early stages of CKD was identified, in addition to correlations between increased phosphorus and PTH levels and worsening kidney function.

Introducciòn: el trastorno mineral y óseo (TMO) es una complicación grave de la enfermedad renal crónica (ERC) que aumenta el riesgo de muerte por causas cardiovasculares y deteriora la calidad de vida de los pacientes afectados. Objetivo: evaluar la prevalencia de la DMO en pacientes con RDC y la asociación entre la tasa de filtración glomerular estimada (TFGe) y los indicadores de DMO (calcio, fósforo y PTH) en pacientes no dialíticos. Materiales y Métodos: estudio seccional de una cohorte de dos años de pacientes renales crónicos adultos y ancianos en tratamiento conservador. La DMO se identificó por los valores séricos de: PTH (> 150 pg/mL) y/o hipocalcemia (Ca < 8,8mg/dl) y/o hiperfosfatemia (P > 4,6 mg/dl). El análisis estadístico utilizado: regresión de Poisson; T de Student, Mann Whitney y correlaciones de Pearson y Spearman con un nivel de significación del 5%. Resultados: la prevalencia de DMO fue del 54,6% (n=41) (IC 95%: 43,45 - 65,43), más frecuente en mujeres, alfabetizadas, de edad avanzada, no bebedoras, no fumadoras, sedentarias y de color de piel blanca. Las correlaciones entre el P y la PTH con el GFRe fueron significativas, inversas, de fuerza moderada (p= <0,005 y p = 0,003; coeficientes de correlación = - 0,312 y - 0,379 respectivamente). Discusión: los resultados de este estudio evidencian lagunas en el seguimiento de la DMO-DRC por parte de la atención primaria, lo que requiere una revisión de las prácticas clínicas. Conclusión: se identificó una fuerte prevalencia de la DMO en las primeras fases de la ERC, además de correlaciones entre el aumento de los niveles de fósforo y PTH y el empeoramiento de la función renal.

Body image and association with BMI, and purgative behaviours for weight control in adolescents aged 11-14 years.

We aimed to evaluate the association of overweight/obesity based in BMI and purgative behaviours with body image (BI). Methods: Cross-sectional study, with probabilistic sample of 976 adolescents, aged 11-14 years, from the city of Florianópolis, Brazil. Multivariate analyses were performed. Overweight (including obesity) and four variables related to purgative methods for body weight control or eating behaviour were evaluated as outcomes, while BI satisfaction was the primary independent variable in each model. Models were controlled for age, sex, type of school (public or private), intake of fruit and vegetables, number of daily meals, and physical activity scores levels. A total of 31·4 % of adolescents wanted to enlarge their silhouette and 45·6 % wanted to reduce it. Among overweight/obese adolescents, 9·6 % were satisfied with their bodies, while 89·8 % wanted to reduce it, while among the not overweight/obese adolescents, 45·4 % wanted to enlarge their silhouette (P < 0·001). Multivariate analysis showed that the odds for overweight/obesity is higher among adolescents who wanted to reduce their silhouette (OR = 11·20; 95 % CI = 5·55, 22·58). Adolescents who want to reduce their silhouette are more likely to use diuretics (OR = 3·08; CI = 1·78, 5·32) and to use laxatives (OR = 2·10; CI = 1·20, 3·68). A significant association was also found between dissatisfaction with BI and overeating (among those who want to enlarge their silhouette: OR = 1·78; CI = 1·12, 2·85 and among those who want to reduce their silhouette: OR = 1·81; CI = 1·03, 3·19). Conclusion: BI dissatisfaction was associated with overweight/obesity, as well with overeating, and the use of purgative methods.

Assessment of the median ages at sexual maturation stages of Brazilian schoolchildren according to overweight status and type of school over a 5-year period: 2007-2012/2013.

OBJECTIVES: A secular trend of earlier puberty has been observed in girls, and, although more uncertain in boys, is associated with an increasing trend in the prevalence of overweight and obesity. We aimed to compare the median ages of sexual maturation stages in schoolchildren from a city in southern Brazil over a 5-year period, according to weight status and type of school. METHODS: Two cross-sectional studies were performed in 2007 and 2012/2013, including 2215 and 1614 schoolchildren, respectively. Body mass index z-scores were calculated and categorized as either nonoverweight or overweight (including obesity). The type of school was categorized as either public or private. Sexual maturation was self-assessed according to the Tanner stages. Mann-Whitney and Kruskal-Wallis tests were performed to compare the median ages of sexual maturation stages. RESULTS: The median age decreased for almost all stages over the 5-year period in both sexes. In boys, the decrease ranged from 0.3 to 1.0 years (stages 2, 3, 4, and 5 for genitalia, and stages 2 and 4 for pubic hair), and from 0.3 to 0.7 years (stages 2, 3, and 4 for breast, and stages 3, 4, and 5 for pubic hair). In 2012, overweight students had lower median ages for most stages compared to those in 2007, especially in girls. Differences by type of school were balanced across years. CONCLUSIONS: The median age of Tanner's stages after 5 years was reduced in both sexes. In overweight girls, the reduction was more pronounced. The results by type of school were inconsistent.

The Brazilian cash transfer program (Bolsa Família): A tool for reducing inequalities and achieving social rights in Brazil.

Conditional cash transfer programs are strategies used by countries over the past two decades, and they play a key role in reducing income inequalities and expanding access to basic services such as health and education. The Brazilian Cash Transfer Program (Bolsa Família), the largest conditional cash transfer program in the world, aims to bring immediate poverty alleviation and eradicate hunger. The objective of this study was to analyse the contributions of the Brazilian Cash Transfer Program for reducing social inequalities and ensuring the right to health, food, education and social assistance in Brazil. A review of the scientific literature published between 2003 and 2020 was conducted, associated with documentary research on government websites. There was a relationship between the Brazilian Cash Transfer Program, reduction of child mortality and increase in access to Primary Health Care services; increased access to food, including in natura; higher school attendance and reduced dropout. However, no improvement in the nutritional status of the families entitled to the program was observed, nor the interruption of the intergenerational cycle of poverty was ensured. The Brazilian Cash Transfer Program continues as a potent intersectoral policy for reducing inequities, which reinforces the need to strengthen and combine complementary policies to expand its effects.

Selenium intake is not associated with the metabolic syndrome in Brazilian adolescents: an analysis of the Study of Cardiovascular Risk Factors in Adolescents.

Se reduces cellular inflammation and lipid peroxides; therefore, its association with CVD and the metabolic syndrome (MetS) has been studied. We aimed to investigate the association between Se intake and the MetS and its parameters (high waist circumference, hyperglycaemia, high blood pressure, high TAG and low HDL-cholesterol) in Brazilian adolescents between 12 and 17 years old. This research is part of the Study of Cardiovascular Risks in Adolescents (ERICA), a Brazilian nationwide school-based study with regional and national relevance. We assessed: (1) socio-demographic data (sex, age, type of school and maternal education) using a self-administered questionnaire; (2) dietary intake using a 24-h recall applied for the whole sample and a second one applied to a subsample to allow within-person variability adjustment; (3) anthropometric data (weight, height, waist circumference) and blood pressure using standardised procedures; and (4) biochemical analyses (fasting glucose, TAG and HDL-cholesterol). Logistic regression was applied, basing the analysis on a theoretical model. Median Se intake was 98·3 µg/d. Hypertension and hyperglycaemia were more prevalent among boys, while a high waist circumference was more frequent in girls, and low HDL-cholesterol levels were higher among private school students. The prevalence of the MetS was 2·6 %. No association between the MetS and its parameters and Se intake was found. This lack of association could be due to an adequate Se intake in the studied population.

Advances and setbacks in the 20 years of the Brazilian National Food and Nutrition Policy. / Avanços e desafios nos 20 anos da Política Nacional de Alimentação e Nutrição.

We sought to analyze the processes of formulation, updating and implementation of the Brazilian National Food and Nutrition Policy (PNAN), from 1999 to April 2020. This is a discussion paper, using institutional documentary sources, bibliographic search in national and international databases, as well as theses and dissertations. The theory of the cycle of public policies was adopted to systematize and present the set of information. PNAN was established in 1999 and updated ten years later, in a participatory process, based on an innovative approach centered on the paradigms of healthy food practices, the human right to food and nutritional security, aligned with the Brazilian Unified National. Regarding implementation, there are advances related to the publication of Food Guides with national guidelines; to the promotion of research in food and nutrition; to collective action to build the regulatory agenda, even if with disputes, and to the decentralization of financial resources for the execution of PNAN actions. The monitoring and evaluation focused on the food and nutritional situation; we found that there were insufficient mechanisms to feed back the policy. After 20 years, PNAN maintains the challenge of effectively fulfilling its historic commitment: the universal guarantee of the human right to adequate and healthy food.

Objetivou-se analisar aspectos dos processos de formulação, atualização e implementação da Política Nacional de Alimentação e Nutrição (PNAN), de 1999 a abril de 2020. Trata-se de artigo de debate, utilizando-se de fontes documentais institucionais, busca bibliográfica em base de dados nacionais e internacionais, teses e dissertações. Adotou-se a teoria do ciclo das políticas públicas para sistematizar e apresentar o conjunto das informações. A PNAN foi instituída em 1999 e atualizada 10 anos depois, em processo participativo, fundamentando-se em abordagem inovadora centrada nos paradigmas das práticas alimentares saudáveis, do direito humano à alimentação e da segurança alimentar e nutricional, alinhados ao Sistema Único de Saúde. Quanto à implementação, verificam-se avanços relativos à publicação dos Guias Alimentares com diretrizes nacionais; ao fomento à pesquisa em alimentação e nutrição; à ação coletiva para construção da agenda regulatória, ainda que com embates, e à descentralização de recursos financeiros para execução das ações da PNAN. O monitoramento e a avaliação focaram-se na situação alimentar e nutricional; constatou-se a insuficiência de mecanismos para retroalimentar a política. Após 20 anos, a PNAN mantém o desafio de cumprimento efetivo do seu compromisso histórico: a garantia universal do direito humano à alimentação adequada e saudável.

El objetivo fue analizar aspectos de los procesos de formulación, actualización e implementación de la Política Nacional de Alimentación y Nutrición (PNAN), de 1999 a abril de 2020. Se trata de un artículo de debate, donde se utilizaron fuentes documentales institucionales, búsqueda bibliográfica, en base de datos nacionales e internacionales, tesis y disertaciones. Se adoptó la teoría del ciclo de las políticas públicas para sistematizar y presentar el conjunto de la información. La PNAN se instituyó en 1999, y se actualizó 10 años después, en un proceso participativo, fundamentándose en un abordaje innovador, centrado en los paradigmas de las prácticas alimentarias saludables, del derecho humano a la alimentación y de la seguridad alimentaria y nutricional, alineados en el Sistema Único de Salud. Respecto a la implementación, se verifican avances relacionados con la publicación de las Guías Alimentarias con directrices nacionales; al fomento a la investigación en alimentación y nutrición; a la acción colectiva para la construcción de la agenda regulatoria, aunque con complicaciones, y a la descentralización de recursos financieros para la ejecución de las acciones de la PNAN. El monitoreo y la evaluación se centraron en la situación alimentaria y nutricional; se constató la insuficiencia de mecanismos para retroalimentar la política. Tras 20 años, la PNAN mantiene el desafío de cumplimiento efectivo de su compromiso histórico: la garantía universal del derecho humano a una alimentación adecuada y saludable.

Association between body weight misperception and dietary patterns in Brazilian adolescents: Cross-sectional study using ERICA data.

The association between body image and eating behaviors or weight control strategies has been demonstrated in the scientific literature, but there is a lack of evidence on the association between weight misperception and food consumption indicators in adolescents. This study aimed to evaluate the association between weight misperception and dietary patterns (DPs) in the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA). It was a national school-based cross-sectional study conducted among students aged 12-17 years. Data were collected in the form of anthropometric measurements, responses in self-answered questionnaires, and 24-h dietary recall. The following variables were assessed: weight underestimation and overestimation (independent variables), which were defined as the presence of a disagreement between nutritional status and self-perceived weight; dietary patterns (dependent variables), defined by a posteriori method using principal component factor analysis; and individual and demographic variables (covariates). Data analysis was performed using the Poisson regression models method, stratified by sex. A total of 52,038 adolescents with normal weights were evaluated. The weight misperception prevalence was 34.0% (95% confidence interval [CI]: 33.0, 35.0). Three DPs were identified: "Traditional Brazilian," "Processed meat sandwiches and coffee," and "Ultra-processed and sweet foods." In girls, weight underestimation was directly associated with the "Traditional Brazilian" (1.24; 95% CI: 1.08, 1.43) and "Ultra-processed and sweet foods" DPs (1.29; 95% CI: 1.09, 1.54), and overestimation was inversely associated with all the DPs. In boys, a direct association between underestimation and the "Ultra-processed and sweet foods" DP (1.29; 95% CI: 1.10, 1.51) was found. Overestimation was inversely associated with the "Traditional Brazilian" DP (0.79; 95% CI: 0.63, 0.99). The inverse association between overestimation and the "Traditional Brazilian" DP, and the direct association between underestimation and the "Ultra-processed and sweet foods" DP indicated that weight misperception was related to unhealthy eating habits in Brazilian adolescents.

Aplicações da tomografia computadorizada de feixe cônico na cirurgia de dentes inclusos / Applications of cone beam tomography in the surgery of included teeth

It is necessary to use criteria based on the scientific literature, in order to obtain correct indications for cone beam computed tomography (CBCT). Therefore, the objective of this work is to analyze, through a bibilographic review, the applications of CBCT in oral surgery, mainly addressing surgery for included / impacted teeth. A bibliographic survey was performed in the PubMed database, selecting the keywords impacted teeth AND preoperative planning AND cone beam computed tomography. Twelve studies related to the topic were analyzed, some related to the use of CBCT and conventional radiographs in surgeries of included teeth, seeking to evaluate the influence of CBCT on the diagnosis and planning of cases and on the incidence of postoperative complications such as sensorineural disorders. It has been observed that CBCT is a good indication for surgery of included / impacted teeth when one wants to obtain a precise location of the dental element within the bone structure and its relationship with the adjacent structures, resulting in a better diagnosis and planning of cases, bringing more security and predictability during procedures... (AU)

É necessária a utilização de critérios baseados na literatura científica, para se obter indicações corretas da tomografia computadorizada de feixe cônico (TCFC). Sendo assim, o objetivo deste trabalho é analisar, por meio de revisão bibilográfica, as aplicações da TCFC em cirurgia oral, abordando principalmente a cirurgia de dentes inclusos/impactados. Realizou-se um levantamento bibliográfico no banco de dados PubMed, selecionado os descritores impacted teeth AND preoperative planning AND cone beam computed tomography. Foram analisados 9 estudos relacionados ao tema, alguns relacionaram o uso da TCFC e de radiografias convencionais nas cirurgias de dentes inclusos buscando avaliar a influência da TCFC no diagnóstico e planejamento dos casos e na incidência de complicações pós operatórias como distúrbios neurossensoriais. Foi observado que a TCFC é uma boa indicação na cirurgia de dentes inclusos/impactados quando se quer obter uma localização precisa do elemento dental dentro da estrutura óssea e sua relação com as estruturas adjacentes, resultando em um melhor diagnóstico e planejamento dos casos, trazendo mais segurança e previsibilidade durante os procedimentos... (AU)

ASSOCIATION BETWEEN BREASTFEEDING AND OVERWEIGHT/OBESITY IN SCHOOLCHILDREN AGED 7-14 YEARS.

OBJECTIVE: To evaluate the prevalence of breastfeeding (BF) and the association between occurrence/duration of BF and overweight/obesity in schoolchildren aged 7-14 years. METHODS: This is a cross-sectional study, conducted in 2012-2013, on schoolchildren aged 7-14 years from Florianópolis, Santa Catarina, Southern Brazil. Weight and height were measured according to procedures of the World Health Organization. Breastfeeding and sociodemographic data were obtained from a questionnaire responded by parents/guardians. BF was categorized as a dichotomous variable (yes/no) and according to duration (months). Nutritional status was evaluated according to the Z score of the body mass index per age for sex and it was categorized into two groups: normal weight (