Fat globule diameter in infant formulas.

OBJECTIVES: The lipid fraction, fatty acid profile, and diameter of fat globules of infant formulas show great differences from human milk. These characteristics influence fat digestion and, consequently, the development and health of infants. The aim of this study was to evaluate the diameter of fat globules in infant formulas and compare them with those in human milk. METHODS: The diameter of fat globules of 10 infant formulas and human milk samples was determined using scanning electron microscopy. RESULTS: The starter infant formula was the only one that showed a mean diameter value (3.52 ± 2.17 µm) similar to that obtained for human milk (3.44 ± 1.68 µm). The starter infant formula showed the highest values of volume-surface D3,2 (6.13 µm) and volume-weighted D4,3, (7.05 µm) mean diameters among the infant formulas analyzed, and close to those obtained for the human milk sample (5.16 and 5.98 µm, respectively). The infant formulas whey protein partially hydrolyzed, soy protein isolate-based, whey protein extensively hydrolyzed, and thickened with pregelatinized starch had the lowest mean diameters of fat globules 0.64 ± 0.22, 0.70 ± 0.19, 1.06 ± 0.34, and 1.22 ± 0.48 µm, respectively. CONCLUSION: The analysis of principal components showed that none of the analyzed infant formulas had similarity with the diameter of fat globules and the fatty acid profile of human milk.

How Do Brazilian Consumers Understand Food Groups in the Food-based Dietary Guidelines?

In the Food-based Dietary Guidelines (FBDGs), food classification is based on food groups and nutrient sources. Much research has already investigated multiple aspects of consumer understanding of the information described in these documents. However, no study has evaluated consumer understanding of all food items contained in the groups described in the FBDGs. This study aimed to assess Brazilian consumers' understanding of food classification according to food groups in the concepts of the FBDGs. Therefore, an instrument, Consumer Understanding of Food Groups (UFG), was constructed and validated to assess consumer understanding of food groups. The instrument comprised 44 items approved by experts (agreement > 80%). A total of 894 Brazilians from all regions participated in this study. The results suggest that 48.9% of the participants believe it is easier to classify food according to food groups. The classification of food groups is based on the origin of the food (animal and vegetable). Although consumers easily recognize foods according to their origin, we still identify asymmetries regarding including food items from the animal kingdom and species from the plant kingdom. This exploratory study highlights important information that can contribute to improving the FBDGs. It is essential to consider consumers' understanding and guide them regarding choices from a technical point of view.

Is There a Convergence between the Food Classification Adopted by Food-Based Dietary Guidelines and Food Science and Technology?

The World Health Organization (WHO) proposed the dietary guidelines presented as the Food-based Dietary Guidelines (FBDG). The FBDG classify foods according to their origin, nature, nutrient source, food group, and processing level. Food science and technology (FST) ranks food according to its origin, perishability, nutrient source, processing, food group, and formulation. This paper aimed to compare the convergence points for food classification according to the FBDG and FST. This study was carried out in two phases. The first step was identifying the Food-Based Dietary Guidelines (FBDG). For each of the FBDG, food items were grouped as fruits, vegetables, cereals, sugars, fat and oils, legumes, foods from animals, dairy products, and others. The second step aimed to identify and describe the different food classification systems. The search was performed on PubMed®, Science Direct, and Web of Science and websites of international organizations such as the Food and Agriculture Organization of the United Nations (FAO), the World Health Organization (WHO), and the Codex Alimentarius. Our results show that the points of convergence between the classifications were the classification in terms of origin (animal and vegetable), nutrient sources, and food groups. However, inconsistencies were observed for the distribution of food items in each group in the 98 surveyed FBDG. As for nature, there was a convergence for in natura, minimally processed, and processed foods. However, the criteria adopted for minimally processed and processed foods described in the FBDG differ from those considered by the FST. FST also does not recognize the classification of foods concerning the level of processing.

Construction and validation of a scale to measure consumers knowledge of food processing and acceptance of processed food.

Negative impressions related to food processing can compromise consumer acceptance. Thus, the aim of this study was to validate a tool to assess consumer knowledge and acceptance of food processing. Semantic evaluation was performed with a lay public (n=13). Experts with experience in the area (n=9) participated in the content validation and semantic evaluation, using the Delphi Technique. Overall, there was strong agreement between the judges (Gwet's AC2 = 0.96 [clarity] and 0.81 [relevance]), with Fleiss Kappa equivalent to 0.78, indicating almost perfect agreement. After these phases, the instrument that totaled 37 items approved (W > 0.8) was applied for validation among Brazilian consumers (n = 200). An exploratory factor analysis offered a six-factor solution. The Kaiser-Meyer-Olkin (KMO) index found was 0.90. The Bartlett Sphericity Test was statistically significant (p<0.001). The final instrument contained 34 items. The calculated Cronbach's Alpha was 0.92, indicating an excellent reliability. The developed Consumers Knowledge of Food Processing and Acceptance of Processed Food (CKAFPAPF) was consistently validated and has proven to be a tool that can help identify information asymmetries, allowing the development of strategies that help consumers to have the correct information to make their food choices more consciously.

Understanding the main factors that influence consumer quality perception and attitude towards meat and processed meat products.

Meat and meat products consumer behaviour is becoming less predictable. The objective of this review was to determine the attributes associated with the consumer's perception of quality and identify factors influencing the perception and consequent attitude. In conclusion, the findings showed that factors impacting nutritional quality, chemical and biological hazards, animal welfare, beliefs, and fraud could affect consumers' perception of how safe meat products are. Consumers positively perceive sensory attributes and recognize meat's nutritional value, still concerned with fat. Animal welfare and environmental impact have become significant drivers of consumer perception. The presence of chemical additives is a severe concern. Information received by consumers through media strongly influences perception and behaviour. The negative stigmatization of meat and meat products and beliefs often not scientifically-based shapes consumer perception. Their sensory impact and price frame the acceptance of animal production or processing modifications.

How Do Consumers Understand Food Processing? A Study on the Brazilian Population.

Food guides are official documents that guide consumers' food choices. They inform the qualitative classification of food groups and messages on how to adopt a healthy diet. The classifications and nomenclatures adopted in these documents vary according to cultural, nutritional, and scientific criteria. This study aimed to evaluate the understanding of Brazilian consumers regarding food classification according to the Food Guide for the Brazilian Population (FGBP) concepts. An instrument was constructed to assess consumer understanding. It was named "Understanding of the Level of Processing of Food" (ULPF) and validated according to the concepts of constructs presented by psychometrics such as the Delphi methodology. The instrument was composed of 36 items approved by experts (concordance > 80% and with good internal consistency). A total of 2333 Brazilians from all regions participated in the study. The results suggest that food classification according to the level of processing was difficult for participants to understand. About 85% of them did not understand or did not know the definitions and classification of food and preparations according to food and science technology (FST) and the FGBP. More than 50% of the participants believed that it was easier to classify food according to food groups.

Eating Competence among a Select Sample of Brazilian Adults: Translation and Reproducibility Analyses of the Satter Eating Competence Inventory.

This study aimed to translate and validate the Satter Eating Competence Inventory (ecSI2.0TM) from English to Brazilian Portuguese. The process included three steps: (i) translation and back-translation of the original ecSI2.0TM to Brazilian Portuguese; (ii) evaluation of its reproducibility; (iii) a pilot study to validate the Brazilian version of the Satter Eating Competence Inventory (ecSI2.0TMBR) for a selected sample of the Brazilian adult population (internal consistency and factor validity). The reproducibility (test-retest reliability) was verified using the intraclass correlation coefficient (ICC) obtained by the responses of 32 Brazilian adults. All domains of the ecSI2.0TMBR and the total score showed ICC > 0.8. Considering the entire questionnaire, none of the domains presented significant divergences among the participants' responses (p < 0.001). In the pilot study with 662 individuals, 74.9% (n= 496) were female, mean age was 40.33 ± 12.55, and they presented a higher level of schooling and income. Analyses revealed Cronbach's alpha coefficients of 0.869 for the ecSI2.0TMBR total scale, 0.793 for Eating Attitudes, 0.527 for Internal Regulation, 0.728 for Food Acceptance, and 0.822 for Contextual Skills. In general, the ecSI2.0™BR presented good acceptability, showing total floor and ceiling effects of ≤0.6%. Factor validity was examined by confirmatory factor analysis. The four domains presented a good fit in the confirmatory factor analysis: RMSEA = 0.0123 (95% CI: 0-0.0266); CFI = 0.998; χ2 = 75.9; df = 69; p = 0.266. The ecSI2.0TMBR is the first tool designed to measure eating competence (EC) in the Brazilian population, showing good reproducibility and internal consistency. We expect the ecSI2.0TMBR will support innovative research to investigate the association of EC and health outcomes, as well as new strategies based on emerging behavioral theories to enhance nutritional education policy.

Correction: Brazilian vegetarians diet quality markers and comparison with the general population: A nationwide cross-sectional study.

[This corrects the article DOI: 10.1371/journal.pone.0232954.].

Brazilian vegetarians diet quality markers and comparison with the general population: A nationwide cross-sectional study.

BACKGROUND: Vegetarianism is an increasingly common practice worldwide. Despite good evidence from other countries regarding vegetarians' diet quality, data from the Brazilian population is still scarce. OBJECTIVE: To characterize the vegetarian Brazilian population and evaluate their diet quality compared to the general Brazilian population. METHODS: We performed a nationwide cross-sectional study using an online self-administered questionnaire, previously validated for the Brazilian population, to evaluate diet quality markers of vegetarians. The invitation to participate in the survey was spread nationwide, aimed at vegetarian communities. Individuals who considered themselves vegetarians and were at least 18 years old were eligible to participate. The results on regular intake and intake adequacy were compared among vegetarians and between genders using the Pearson's chi-square test. The body mass index (BMI) were analyzed by the Analysis of Variance (ANOVA) followed by Tukey post-hoc test. The Kolmogorov-Smirnov test verified normality. All analyses considered bilateral hypotheses and a significance level of 5% (p <0.05). RESULTS: Brazilian vegetarians presented better diet quality markers, such as higher regular weekly intake and adequate daily intake of fruits and vegetables, and lower regular intake of soft drinks when compared to the general Brazilian population. Vegetarians also presented a proportionally higher consumption of natural foods and lower consumption of processed foods. Among vegetarians, a higher proportion of vegans showed positive results regarding diet markers analysis, when compared to vegetarians, pesco-vegetarians, and semi-vegetarians. CONCLUSIONS: Vegetarians showed better results of diet adequacy when compared to the general population in Brazil, and vegans fared better when compared with other vegetarians. Despite the good results found, a large proportion of the participants still did not achieve the fruits and vegetables daily intake, according to the World Health Organization recommendations.

Nutrition support team activities can improve enteral nutrition administration in intensive care units.

OBJECTIVES: The aim of this study was to evaluate the effect of the nutritional support team (NST) activities on the quality of enteral nutrition administration in intensive care units. METHODS: An observational, analytical, and cross-sectional study was performed in nine hospitals in the Brazilian Federal District through the administration of two questionnaires. One questionnaire focused on the activities of the NST and the other on the quality of enteral nutrition administration in intensive care units. RESULTS: There was a strong correlation between the scores of the two questionnaires, which was confirmed by a linear regression model (R2 = 0.623; P = 0.007). The results suggest that high scores in the NST activities questionnaire predict a better performance in enteral nutrition administration. The sections of the NST activity questionnaire that most strongly affected enteral nutrition administration were the protocols (r = 0.895; P < 0.01), quality control (r = 0.779; P < 0.05), and continuing education (r = 0.753; P < 0.05). CONCLUSIONS: The NST has the potential to positively influence enteral nutrition management in intensive care units and investments could be directed to the areas of continuing education, protocols, and quality control to maximize the effect of NST in intensive care units.

Brazilian Foodborne Disease National Survey: Evaluating the Landscape after 11 Years of Implementation to Advance Research, Policy, and Practice in Public Health.

The poor control of public and private agencies regarding the quality of foods offered to populations has a significant impact on the occurrence of foodborne diseases. Precise information about foodborne diseases (FBD) can adequately inform policy-makers and help to allocate appropriate resources for the control of food safety. This study aimed to evaluate the Brazilian foodborne disease landscape after 11 years of implementation of the Epidemiological Surveillance System of Foodborne Diseases. The study analyzed secondary data from the National System of Injuries and Notifications (SINAN-NET), available from the Health Department. We evaluated the characteristics of FBD, such as the food involved, the location of ingestion, the total time to the outcome investigation, the microorganism involved and deaths. We also calculated the global incidence, mortality and lethality rates of the country. There were 7630 FBD outbreaks in the National Epidemiological Surveillance System of Foodborne Diseases (VE-DTA). Of the registered reports, a total of 134,046 individuals were sick with FBD; 19,394 were hospitalized, and there were 127 registered deaths. We found a coefficient of incidence of FBD of 67.57 per 100,000 inhabitants; a mortality coefficient of 0.06 per 100,000 inhabitants and lethality of 0.09% over the 11 years investigated. Data are probably underreported since the VE-DTA system lacks completeness, and because FBD symptoms are mostly mild, a large part of the population does not seek care from health services.

Epidemiological Surveillance System on Foodborne Diseases in Brazil after 10-Years of Its Implementation: Completeness Evaluation.

This study aimed to evaluate the data quality of the Brazilian Epidemiological Surveillance System on Foodborne Diseases (VE-DTA) through the evaluation of the completeness of the record after 10-years of its implementation. The study evaluated the measurement of completeness by quantifying ignored, incomplete or blank responses of the data items filled. The evaluation used the percentage of completion of these items regarding the total number of notifications registered in the system. We organized the results according to the general Category of completeness of the database, by year of notification and region of occurrence. We also evaluated the overall completeness percentages of the database and the completeness levels according to the degree of recommendation of completion of each variable (mandatory, essential, and complementary) by the VE-DTA manual. The system presented 7037 outbreaks of foodborne diseases. According to the completeness classification, the database presented general classification as Category 1 since it has 82.1% (n = 5.777) of variables with the level of completion up to 75.1%. We observed that 8.6% of the database was classified as category 2; 9.2% as category 3 and 0.1% as category 4. The improvement on database quality regarding completeness can positively impact on public health and public policies, reducing the number of FBDs deaths.

Construction and validation of a psychometric scale to measure awareness on consumption of irradiated foods.

Although food irradiation has been used to ensure food safety, most consumers are unaware of the basic concepts of irradiation, misinterpreting information and demonstrating a negative attitude toward food items treated with ionizing radiation. This research is aimed at developing a tool to assess the awareness on the consumption of irradiated food. The sample was composed by employees from different social classes and school levels of Brazilian universities, who reflect the end-users of the irradiated foods, representative of the views of lay consumers. The total number of respondents was 614. In order to assess the Awareness Scale on Consumption of Irradiated Foods (ASCIF), an instrument has been developed and submitted to semantic tests and judge's validation. The instrument, that included 32 items, contemplated four construct factors: concepts (6 items), awareness (10 items), labeling (7 items) and safety of Irradiated foods (9 items). The data were collected by electronic means, through the site . By using exploratory factorial analysis (EFA) 4 factors have been found. They summarize the 31 items included. These factors account for 64.32% of the variance of the items and the internal consistency of the factors has been deemed good. An Exploratory Structural Equation Modeling (ESEM) was conducted to evaluate the factor structure of the instrument. The proposed instrument has been found to meet consistency criteria as an efficient tool for indicating assessing potential challenges and opportunities for the irradiated food markets.

Lipid profile of different infant formulas for infants.

Situations including premature infants, or those in which there is a rejection to breastfeeding, require the use infant formulas for total or partial replacement of human milk. The objective of this study was to determine the lipid content and to identify the lipid profile of infant formulas. Samples were collected from ten different infant formulas, used as a substitute for breast milk at the Maternal and Child Hospital of Brasilia. The human milk sample consisted of a pool of samples from 10 mature milk donors at the milk bank of the University Hospital of Brasilia. The lipid content and lipid profile of the different infant formulas and human milk were analyzed. The experiment was conducted in a randomized block design, with eleven treatments and three replicates, in triplicate. The data obtained in this study indicated significant differences between infant formulas and human milk, and among the infant formulas analyzed in relation to the percentage of total lipids and the fatty acid profile, except for the fractions of linoleic acid and linolenic acid. Regarding the percentage of polyunsaturated fatty acids in relation to the total unsaturated fatty acids, only the Soy Protein Isolate-based Infant Formula (SPIIF) and Whey Protein Extensively Hydrolyzed Infant Formula (WPEHIF) resembled human milk. It was concluded that despite the observed differences, the use of infant formulas is a viable strategy for the development of infants subjected or not to specific physiological conditions.

Microbiological quality of enteral feeding and infant formula produced in dietary units, according to the triad of Donabedian / Calidad microbiológica de dietas enterales y fórmulas infantiles producidas en unidades dietéticas, de acuerdo con la tríada de Donabedian

Introduction and aims: Microbial contamination of enteral feeding and infant formulas can result in a risk of worsening of the clinical condition of the patients, who are already weakened and susceptible to pathogens. The objective was to evaluate aspects of the management of quality hygienic - sanitary of enteral feeding and infant formulas in hospitals, focusing on the structure, process and outcome. Methods: An observational, descriptive, prospective, with quantitative and qualitative variables study was done. The survey was conducted for 12 months and 227 samples of enteral feeding and 176 of infant formula were collected in Nutrition and Dietetic Services of Health Secretary / Federal District. In evaluating the operating conditions, the Tool 2 was applied to: Enteral Nutrition Preparation. Data were analyzed from the unified Donabedian’s triad for evaluation of health services. Results: The results obtained with the Tool 2 demonstrated that the Storage Block complies with legal requirements. Moreover, Dressing Block is a risk factor for the contamination. From the 403 samples, 56% corresponded to samples of Enteral Nutrition and 44% to samples of Infant Formulas. The data indicate that from 227 samples of Enteral Nutrition, 6.2% were in disagreement with the legislation, while from 176 samples of Infant Formulas, 4.6% were also in disagreement with the legislation. Conclusion: The ineffective implementation of the sanitary and hygienic requirements during the preparation results in a microbiologically unsafe product to patients in debilitated health state, and the count of mesophilic microorganisms can be a good indicator of microbiological safety (AU)

Introducción y objetivo: La contaminación microbioló- gica de dietas enterales y fórmulas infantiles puede conducir a una situación de riesgo de agravación del cuadro clínico de pacientes, ya debilitados y susceptibles a los agentes patógenos. El objetivo fue evaluar aspectos de la gestión de calidad de condiciones sanitarias de dietas enterales y fórmulas infantiles en los hospitales, centrándose en estructura, proceso y resultado. Métodos: Fue hecho un estudio observacional, descriptivo, prospectivo, con variables cuantitativas y cualitativas. La encuesta fue por 12 meses y se recogieron 227 muestras de dietas enterales y 176 de fórmulas infantiles en los Servicios de Nutrición y Dietética de la Secretaría de Estado de Salud del Distrito Federal. Los datos fueron analizados a partir de la Tríada de Donabedian para la evaluación de los servicios de salud por medio de un cuestionario. Resultados: Los resultados obtenidos muestran que en Bloque Almacenamiento cumple con los requisitos legales. Por otro lado, el Bloque Vestuario es un factor de riesgo de contaminación. De las 403 muestras, 56% eran muestras de Nutrición Enteral y 44%, muestras de Fórmulas Infantiles. Los datos indican que de 227 muestras de Nutrición Enteral, un 6,2% estaban en desacuerdo con la ley, mientras que de las 176 muestras de las Fórmulas Infantiles, 4,6% también estaban en desacuerdo con la legislación. Conclusión: La falta de aplicación efectiva de requisitos higiénicos sanitarios durante la preparación resulta en producto microbiológicamente inseguro para pacientes debilitados, y el recuento de mesófilos totales puede ser un buen indicador de la seguridad microbiológica (AU)

Are fat acids of human milk impacted by pasteurization and freezing? / ¿Son los ácidos grasos de la leche humana afectados por la pasteurización y la congelación?

The Human Milk Bank undergo human milk to pasteurization, followed by storage in a freezer at -18° C for up to six months to thus keep available the stocks of this product in maternal and infant hospitals. The objective of this study was to evaluate the effects of processing on the lipid fraction of human milk. A sample of human milk was obtained from a donor and was subdivided into ten sub-samples that was subjected to the following treatments: LC = raw milk; T0 = milk after pasteurization; T30 = milk after pasteurization and freezing for 30 days; T60 = milk after pasteurization and freeze for 60 days, and so on every 30 days until T240 = milk after pasteurization and freezing for 240 days, with 3 repetitions for each treatment. Lipids were extracted, methylated and fatty acid profiles determined by gas chromatography. The fatty acids were characterized by nuclear magnetic resonance and functional groups were identified by infrared spectroscopy. There were variations in the concentration of fatty acids. For unsaturated fatty acids there was increasing trend in their concentrations. The IR and NMR analyze characterized and identified functional groups presents in fatty acids (AU)

Los Bancos de Leche Humana someten la leche la pasteurización, seguido del almacenamiento en un congelador a -18 grados por até seis meses, para así disponerlo a los Hospitales Materno Infantiles. El objetivo de este estudio fue evaluar los efectos del procesamiento de la fracción lipídica de la leche humana. Para esto, una muestra obtenida de una donante y sometida a diez diferentes tratamientos: LC = leche cruda; TO = leche después de la pasteurización; T30 = leche después de la pasteurización y congelación por 30 días; T60 = leche después de la pasteurización y congelación por 60 días y así sucesivamente a cada 30 días hasta T240 = leche después de la pasteurización y congelación por 240 días, con tres repeticiones a cada tratamiento. Los lípidos fueron extraídos y los ácidos grasos metilados fueron determinados por cromatografía gaseosa. Los ácidos grasos fueron caracterizados por resonancia magnética nuclear y los grupos funcionales identificados por espectroscopia infrarroja. Hubo variaciones en las concentraciones de ácidos grasos. Para los ácidos grasos insaturados hubo un aumento en sus concentraciones. Sin embargo, los grupos funcionales se caracterizaron por espectroscopia infrarroja y resonancia magnética nuclear, RMN (AU)

Development of a tool for quality control audits in hospital enteral nutrition / Desarrollo de una herramienta de auditorías de control de calidad en nutrición enteral hospitalaria

Background and aims: Malnutrition is very prevalent in hospitals, causing physical capacity deterioration, increasing complications and raising mortality. This scenario overloads public health costs enormously. Enteral nutrition (EN) is the first option to fight against malnutrition. Nutrition support teams (NST) work combating such conditions, promoting humanization, but also analyzing the cost benefit of EN therapy. Brazil is one of the first Latin American countries to develop EN laws. Quality control it is in the core of this legal instrument, playing an essential role in NST`s task of providing care. Nowadays, tools to access quality control represent a gapin the area. The aim of this study was to develop a quality control tool, according to Brazilian law for EN Therapy regarding multidisciplinary approach, good practices, standard operating procedures, protocol implementation, proper registration and electronic health record. Methods: A content validation method was utilized in this four stages development process: bibliographic research, expert opinion (subjective), semantic evaluation and expert opinion (objective). In the latter stage ten specialists, expressed their opinion, evaluating the tools by four different attributes: utility, simplicity, objective and low cost on a 5-point Likert scale (1-5).Results: We elaborate three independent tools that together, represent the whole evaluation process, named: NST Activities, EN Preparation and EN Administration. Content Validation Index to the four different attributes ranged from 0,9 to 1.Conclusion: This tool had positive approval from experts and is of great value guiding hospital audits, or even serving as checklist to implement a plan on ENtherapy (AU)

Introducción: La desnutrición es muy frecuente en hospitales provocando degradación de capacidad física, complicaciones y elevando la mortalidad. Este escenario sobrecarga enormemente los costos de salud pública. Nutrición enteral (NE) es la primera opción para luchar contra la desnutrición. Equipos de soporte nutricional(ESN) trabajan combatiendo tales condiciones, humanizando el tratamiento sino también analizando su costo beneficio. Brasil fue uno de los primeros países latinoamericanos en desarrollar legislación específica para NE. El control de calidad es el centro de este instrumento legal, ejerciendo rol esencial para proporcionar atención nutricional de calidad. Actualmente, herramientas de acceso al control de calidad representan un vacío en este nicho. Objetivo: Desarrollar una herramienta de control de calidad para NE, conforme la legislación brasileña, con respecto a ESN, buenas prácticas, implementación de protocolos y registros electrónicos. Métodos: Se utilizó una validación de contenido desarrollada en cuatro etapas: investigación bibliográfica, opinión de expertos (subjetiva), evaluación semántica y opinión de expertos (objetivo). En la última etapa diez especialistas, evaluaran los instrumentos utilizando cuatro atributos diferentes: utilidad, simplicidad, objetividad y bajo costo en una escala Likert de 5 puntos (1-5).Resultados: Elaboramos tres herramientas independientes que juntas, representan todo proceso de la NE: Actividades de ESN, Preparación de NE y Administración de NE. Indicies de validación de contenido calculados para los 4 atributos variaran entre 0,9 y 1,0.Conclusión: Estas herramientas tienen aprobación positiva de los expertos y son de gran valor en auditorias hospitalarias, además de servir como una lista de verificación para implementar un plan de terapia nutricional (AU)

Coeliac disease. Following the diet and eating habits of participating individuals in the Federal District, Brazil.

The western diet includes several food items based on wheat. Adherence and obedience to a gluten-free diet requires self-determination on the part of the person with Coeliac disease, as well as their family members. The objective of this research is to identify the main difficulties noted by people with Coeliac disease in their eating habits, the frequency of consumption and their satisfaction with gluten-free products. We employed an adapted already validated questionnaire, with open, closed, and multiple choice questions. Of the 105 participants with Coeliac disease, 90.38% of them followed, where possible, a gluten-free diet; 67.12% consumed food with gluten inadvertently or because of a lack of alternatives and/or information in food found in public places. Seventy percent affirmed that their diet provided all the energy and nutrients they need; 77.67% of the Coeliac participants prepared their meals by themselves or this task was assumed by their caregivers; 77.14% read the manufacturers labels on products, and, 74.49% expressed dissatisfaction regarding the price and availability of gluten-free products. The data show an association only between the energy and nutrients needed for good health and gluten-free dietary tracking (p=0.0315). That is, people with Coeliac disease who avoided gluten consumed more calories and were more likely to have adequate nutrients in their diet.

Doença celíaca, hábitos e práticas alimentares e qualidade de vida / Celiac disease, eating habits and practices and life quality of life

Esta comunicação apresenta o cenário da doença celíaca e suas implicações em hábitos, práticas alimentares e qualidade de vida de indivíduos intolerantes ao glúten. Apresenta dados importantes sobre a questão que, mundialmente, é considerada problema de saúde pública. Por ser uma doença cujo tratamento é fundamentalmente dietético, a terapia durante a transição alimentar deve ser bem conduzida pelo nutricionista para melhor adesão do paciente à dieta, considerando que a inclusão de novas práticas alimentares pode significar uma ruptura com a identidade individual e cultural: a alimentação de cada cidadão não pode ser deslocada da sociedade. Nesse contexto, a melhoria da qualidade de vida passa a ser um dos resultados esperados tanto das práticas assistenciais quanto das políticas públicas para o setor nos campos da promoção da saúde e da prevenção de doenças. A vigilância sanitária contempla as ações capazes de eliminar, diminuir ou prevenir riscos à saúde e de intervir nos problemas sanitários decorrentes do meio ambiente, da produção e circulação de bens e da prestação de serviços de interesse da saúde. O conhecimento do cenário da doença celíaca no País se justifica pela necessidade de fundamentar as ações da política de alimentação e nutrição ancoradas no conceito de alimentação saudável com ênfase na dieta isenta de glúten. Os artigos pesquisados foram selecionados nas bases de dados MedLine e SciELO, considerando o período de 1995 a 2006.

This study presents information on celiac disease and its implications on the eating habits and practices, as well as on the quality of life, of gluten-intolerant patients. Papers published from 1995 to 2006 were searched in the MedLine and SciELO databases. This paper includes important data about this disease, which is considered a public health problem throughout the world. Since it is a disease whose treatment is essentially dietary, therapy during food transition must be well conducted by the dietician in order to improve the patient's adherence to the diet since the introduction of new food practices may mean a rupture with the individual's culture and identity: the diet of each citizen cannot be disconnected from the society in which he or she lives in. In this context, quality of life is included, as quality of life is expected to improve both because of the care provided and because of the public policies for the sector in the areas of health promotion and prevention of diseases. Sanitary surveillance contemplates the activities that are capable of eliminating, reducing or preventing health risks and intervene in the sanitation problems that are secondary to the environment, production and circulation of goods and provision of health-related services. Knowledge about celiac disease in the country is justified because of the need to base food and nutrition policies on the concept of healthy eating, emphasizing a gluten-free diet.

Psyllium as a substitute for gluten in bread.

Celiac disease is an antibody-mediated enteropathy that presents permanent intolerance to ingested gluten. Currently, only one kind of treatment is available: the complete dietary elimination of all sources of gluten. The aim of the present study was to evaluate the effect of replacing gluten with psyllium on sensory characteristics of bread dough and to compare the chemical, nutritional, technological, and sensory characteristics of the modified preparations. This study is experimental and was subdivided into five steps: selection and development of preparation, chemical analysis, sensory analysis, and statistical analysis. Modified samples of the bread dough achieved a 93.0% acceptance rate for individuals with celiac disease and up to 97.0% for individuals without celiac disease. The most affected characteristics were odor and texture. In terms of chemical composition of the bread dough, energy was reduced by 32.1% and the fat fraction was 42.3% before being cooked. Data obtained from sensory analysis of psyllium doughs indicate that the products had good acceptance by individuals with celiac disease as well as by individuals without celiac disease. This suggests that psyllium can replace gluten in preparations. Furthermore, in terms of chemical composition, products made with modified dough had less fat and fewer calories.