Division of Responsibility in Child Feeding and Eating Competence: A Cross-Sectional Study in a Sample of Caregivers of Brazilian Children with Celiac Disease.

The objective of this cross-sectional study was to assess eating competence (EC) and the adherence to the division of responsibility in child feeding (sDOR) of Brazilian caregivers of children with celiac disease (CD). It also examined the association between EC and sDOR, children's adherence to a gluten-free diet, and sociodemographic data. This study administered a survey set that included sociodemographic data, health-related data, eating habits, and the instruments ecSI2.0TMBR and sDOR.2-6yTM BR, validated for a Brazilian population. The sample comprised 50 caregivers of children with CD (between 24 and 72 months of age). The participants following a gluten-free diet (GFD) presented higher scores for all EC domains and the total EC. The total EC scores were higher for the participants over 40 y/o, frequently having meals as a family, with their children consuming more than three servings of fruit and at least one serving of vegetables daily and complying with a GFD. Different from the EC, the sDOR.2-6yTM scores did not differ between the participants complying with a GFD. The sDOR.2-6yTM mealtime structure domain scores were significantly associated with the EC eating attitude, food acceptance, contextual skills, and total. These findings support the need for greater attention to exploring the division of responsibility in feeding and EC in pediatric celiac disease, potentially enhancing intervention strategies for patients and their families.

Health-related quality of life among celiacs in Portugal: a comparison between general and specific questionnaires.

Objective: This study aimed to compare the 36-Item Short Form Survey Instrument version 2 (SF-36-v2) (generic) and Celiac Disease Questionnaire (CDQ) (specific) questionnaires used to evaluate the quality of life (QoL) in celiac Portuguese adult individuals. Methods: This cross-sectional study used non-probabilistic sampling based on Portuguese celiac patients who accessed the online survey in 2022. The online data collection used a self-reported instrument composed of three parts: (i) socioeconomic, health, and gluten-free diet (GFD) adherence questions; (ii) SF-36 v2 - Portuguese version (generic questionnaire) and (iii) Celiac Disease Questionnaire (CDQ) (specific questionnaire). Results: A total of 234 individuals who accessed the survey completed the questionnaire. Seven of the eight SF-36 domains positively correlated to the specific questionnaire CDQ. The "General Health" domain (domain 4) showed a negative correlation with the CDQ. Differences in content between the two instruments might be able to explain this finding since the CDQ explores issues regarding the specificities of celiac disease (CD) and the lifelong GFD burden. About half of the sample from this study displayed poor diet adherence, it is possible that the SF-36 could not reflect the impact of CD treatment - the complete elimination of gluten from the diet - on patients' health. Therefore, this issue should be carefully evaluated in future research. Conclusion: Specific validated questionnaires for CD individuals, such as the CDQ, contemplate social, economic, and clinical variables that permeate the patient's life context. Therefore, these instruments may be more suitable for evaluating QoL in this public. However, using a general questionnaire such as the SF-36 would be indicated for comparing QOL between celiac patients and the general population or even between CD and other disease individuals. In this case, we recommend assessing GFD compliance for control parallelly.

Eating competence in caregivers of celiac children: A cross-sectional study performed in Brazil.

OBJECTIVES: Eating competence is an intraindividual approach to eating, behaviors, and attitudes related to eating, with repercussions on the individual and family. In pediatric celiac disease, the family is involved in the gluten-free diet management, the only treatment available. A gluten-free diet might affect eating competence because gluten-free diet compliance requires knowledge about food, meal planning, and attention to food choices. The objective is to access eating competence in caregivers of children with celiac disease and the association between caregivers' eating competence, children's adherence to a gluten-free diet, and sociodemographic data of participants. METHODS: This cross-sectional study used a snowball spread method by applying a questionnaire, including sociodemographic data, data related to health, eating habits, and the Satter Eating Competence Inventory version validated for the Brazilian population. The sample consisted of 220 Brazilian parents or caregivers of celiac disease children. The scores of the Satter Eating Competence Inventory version validated for the Brazilian population were described in terms of means, SDs, medians, and interquartile range. Student's t test and analysis of variance followed by Tukey's post hoc tests were applied, and the association with the variables of interest was analyzed using Pearson χ2 tests. The tests were conducted considering bilateral hypotheses and a 5% significance level. RESULTS: Participants' sex, schooling level, and income did not affect their eating competence. Competent eaters were mostly those with normal weight, following a gluten-free diet, with children complying with a gluten-free diet, and who have meals with family and prepare them at home. Different from vegetable consumption, participants' eating competence did not differ considering the frequency of children's fruit consumption. CONCLUSIONS: The caregivers of children with celiac disease have greater eating competence scores than general Brazilian adults, and caregivers of children with celiac disease who comply with the gluten-free diet have higher eating competence scores.

Consumption of ultra-processed foods and low dietary diversity are associated with sedentary and unhealthy eating behaviors: A nationwide study with Brazilian Schoolchildren.

BACKGROUND: Consumption of ultra-processed foods and low dietary diversity are risk factors for chronic diseases. AIM: To evaluate the association between food consumption and sedentary and unhealthy eating behaviors of Brazilian schoolchildren between 6 and 11 years old. METHODS: Cross-sectional study. A prevalence sample was calculated considering the number of children enrolled in elementary school. This sample was distributed proportionally to Brazil's macro-regions and the type of school (public or private). The questionnaire was developed in Google Forms and disseminated through the snowball technique. The questionnaire was filled in by the children's parents, with information about the child's identification and health. Afterward, the child completed a questionnaire by her/himself. We used the previously validated Illustrated Questionnaire on Food Consumption for Brazilian Schoolchildren and the Illustrated Questionnaire on Eating and Sedentary Behaviors. Food consumption was analyzed using the NOVA score and the dietary diversity score. Poisson's regression with robust variance was performed (p<0.05). RESULTS: The study included 2,021 dyads. Of these, 27.6% of children reported eating five or more ultra-processed foods and 39.0% four or fewer natural or staple foods the previous day. Using screens, proxy of sedentary behavior (Prevalence Ratio-PR = 1.8, Confidence Interval-CI95%1.2-2.8) and eating at irregular hours (PR = 1.6, CI95%1.2-2.2) were risk factors for high consumption of ultra-processed foods and low dietary diversity in schoolchildren. In addition, eating the three main meals on the previous day (PR = 0.6, CI95%0.4-0.8) was identified as protective factors against the consumption of ultra-processed foods and in favor of dietary diversity among schoolchildren. CONCLUSION: Sedentary and unhealthy eating behaviors were associated with the consumption of ultra-processed foods and low dietary diversity in Brazilian schoolchildren.

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.

Eating Attitudes of Patients with Celiac Disease in Brazil: A Nationwide Assessment with the EAT-26 Instrument.

Celiac disease (CD) is an immune-mediated enteropathy triggered by the ingestion of gluten in genetically predisposed individuals. In this sense, a gluten-free diet is the only safe treatment available. Due to the restrictions resulting from this eating pattern, this treatment may impair the relationship of the people with CD with food, increasing the risk of a disordered eating attitude, which is associated with eating disorders. The EAT-26 is a validated instrument already applied worldwide in different populations, and higher scores are suggestive of eating attitudes prone to evolve into eating disorders. Studies carried out in other countries have already shown that people with CD are prone to developing eating disorders; however, no study has been carried out with this theme in the population with CD in Brazil. We carried out a nationwide cross-sectional study in three steps: (i) study design and instrument; (ii) recruitment of participants and ethics; (iii) statistical analysis. A total of 385 participants were included in our sample, 96.36% of them being women. The internal consistency of the applied self-administered Brazilian version of the EAT-26 online questionnaire presented a satisfactory Cronbach's alpha of 0.812, and in total, 36.1% of the respondents were classified with a disordered eating attitude. No differences were found among the scores of participants when divided by categories regarding gender, average monthly income, age, and educational level. However, scores classified as a disordered eating attitude were found in respondents with a body mass index classified as overweight and obese. Our study highlights that disordered eating attitudes are present in overweight and obese women with celiac disease; thus, public health politics are needed to prevent and treat these attitudes.

Evaluation of Community Restaurants Linked to Government Food and Nutrition Safety Programs: A Scope Review.

Community restaurants linked to government food and nutritional security programs are establishments created to offer meals to the population in socially vulnerable situations. The objective was to identify the methods, approaches, criteria, and indicators used to evaluate restaurants linked to government food and nutrition security programs. A scoping review based on the Joanna Briggs Institute's methodology and the international guide's recommendations of preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews was conducted. Medline databases via PubMed, Lilacs, Scopus, Cochrane, Web of Science, and ScienceDirect were used. Primary observational studies, systematic reviews and meta-analyses, ethnographies, documentary studies, and case studies were included, with a quantitative, qualitative, and/or mixed approach. A total of 2498 studies were identified. After taking out 180 duplicated articles, another 2202 articles were excluded by the title. Among the 71 studies selected for complete reading, 10 did not correlate with the research objective, and 12 were included after analyzing the references, totaling 73 included studies. In this review, evaluative approaches were mapped and systematized on the menu, food consumption, food health, food security and/or insecurity, nutritional education, and human right to adequate food; users' profile and health, implantation, history, perceptions, senses, and meanings; handlers/workers; hygienic-sanitary quality; evaluation and monitoring; physical-functional planning, and rest-intake. The presented data provide elements that can be adapted in future evaluations and describe the panorama of academic production in this area.

Long-Term Lifestyle Habits and Quality of Life after Roux-in-Y Gastric Bypass in Brazilian Public versus Private Healthcare Systems: Beyond Weight Loss.

Lifestyle and health-related quality of life (HRQoL) are good markers of surgical obesity treatment. This study aimed to investigate the lifestyle and HRQoL of patients at least five years after Roux-en-Y gastric bypass in public (SUS) and private (PVT) Brazilian healthcare systems. In this cross-sectional study, weight loss (WL), % of excess WL (%EWL), diet quality, physical activity, alcohol consumption, and HRQoL were evaluated. Analysis of covariance, binary and multinomial logistic regression, adjusted for confounders, were performed. The SUS group had more vulnerable socioeconomic statuses than the PVT group. Total %WL and % EWL were 24.64 ± 0.99% and 60.46 ± 2.41%, respectively, without difference between groups. In the Pain/Discomfort and Anxiety/Depression domains of HRQoL, more than 50% reported moderate problems without differences between groups. Processed food ingestion was higher in the PVT (132.10 ± 60.15 g/1000 kcal) than in the SUS (103.43 ± 41.72 g/1000 kcal), however, without statistical significance (p = 0.093). The PVT group showed lower physical activity (OR: 0.23; 95%CI: 0.87-0.63; p = 0.004) and a higher risk of alcohol-related problems (OR: 3.23; 95%CI; 1.03-10.10; p = 0.044) compared to SUS group. Participants generally achieved satisfactory WL, regardless of healthcare systems. However, PVT participants had unfavorable lifestyle characteristics, highlighting the need for studies investigating environmental issues post-bariatric surgery.

Division of Responsibility in Child Feeding and Eating Competence among Brazilian Caregivers.

This cross-sectional study aimed to assess Brazilian child caregivers' eating competence (EC) and their adherence to the division of responsibility (sDOR) in child feeding. The research had national coverage in all Brazilian regions. The sample comprised 549 caregivers of Brazilian children (24 up to 72 months) recruited by social media (snowball method). Data on sDOR and EC were collected using the sDOR.2-6yTM Portuguese-Brazil (sDOR.2-6y-BR) and ecSI2.0TMBR, both instruments validated to the Brazilian population. The scores of the sDOR.2-6y-BR were described in terms of means, standard deviations (SD), medians, and interquartile range. Student's t-test and analysis of variance (ANOVA) followed by Tukey's post hoc tests were used to compare the scores of sDOR.2-6y-BR and ecSI2.0TMBR with interest variables. The association between the sDOR.2-6y-BR and ecSI2.0TMBR scores was verified by Pearson's correlation coefficient. Most of the participants were female (n = 88.7%), 37.8 ± 5.1 y/o, had a high schooling level (70.31%), and high monthly income (more than 15 minimum wages-MW) (31.69%). The children for whom the participants were responsible were mostly girls (53.19%), with an average age of 3.6 ± 1.3 y/o. The instrument presented good responsiveness (floor and ceiling effects = 0%). Cronbach's Alpha = 0.268. There was no statistical difference in sDOR.2-6y-BR scores between caregiver's gender, age, level of education, number of people living in the household, or by gender or age of the child. Caregivers who reported (n = 100) that their children had some medical diagnosis (e.g., food allergy, autism, or Down syndrome) had lower sDOR adherence scores than caregivers who indicated their children had no medical diagnosis (p = 0.031). There was no statistical difference in ecSI2.0TMBR scores between the categories of caregiver's gender, age, occupancy, and child's gender and age. Caregivers with income higher than 10 MW, living in houses with more than 3 people, and with graduate schooling showed higher EC scores. Caregivers considered competent eaters by ecSI2.0TMBR scores differed only for educational level, which was more frequent among graduate participants. The total EC score was positively associated with total and mealtime structure (D1), how food is available to the child (D3), and the parent gives respect to the child's autonomy in eating (D4) sDOR.2-6yTM domains. There was a negative association with the what is available to the child (D2) sDOR.2-6yTM domain. In general, the sDOR.2-6y-BR had a positive association with the ecSI2.0TMBR in all domains and total, with a low but significant correlation. This study enables the investigation of the division of responsibility in feeding and EC of a sample of caregivers of children in Brazil. This is the first study to apply the translated and validated version of the sDOR.2-6y-BR and showed good results, where competent eaters' caregivers adhere more to the principles of sDOR.

Quality of Life Perception among Portuguese Celiac Patients: A Cross-Sectional Study Using the Celiac Disease Questionnaire (CDQ).

The aim of this study is to assess Portuguese celiac patients' quality of life (QoL) perception. A cross-sectional study was performed with a non-probability convenience sample of Portuguese celiac patients using an online self-administered celiac disease quality of life questionnaire (CDQ), previously validated for the Portuguese population. The final sample comprised 234 celiac patients, which included the following: primarily women (69.2%); aged between 18 and 49 years old (56.4%); with a partner (60.6%); with a high educational level (58.9%-graduated or post-graduated); following a gluten-free diet (GFD) (55.1%); and not using antidepressants (93.1%). The Portuguese CDQ presented good reliability and responsiveness in this sample of Portuguese celiac patients. In general, the CDQ in Portugal was affected by age at diagnosis (p = 0.017), educational level (p = 0.005), and compliance with GFD (p = 0.034). The emotion domain was affected only by using antidepressants (p = 0.036). The social domain was affected by gender (females had lower rates, p = 0.016), age at diagnosis (p = 0.009), educational level (p = 0.000), and compliance with a GFD (p = 0.002). The worries domain did not differ according to socioeconomic data. The symptoms domain was affected by compliance with GFD (p = 0.000), age at diagnosis (p = 0.000), and educational level (p = 0.014). Data on celiac QoL is essential to support the formulation and implementation of strategies to minimize the issues suffered by celiac patients, lowering their physical, emotional, and social burden. Additionally, data on Portuguese celiac disease patients using the CDQ will allow future comparative research among celiac populations from different countries.

Translation of the Satter's Division of Responsibility in Feeding Questionnaire into Brazilian Portuguese: A Cross-Sectional Study.

This cross-sectional study aimed to translate and perform a psychometric analysis (evaluation of reproducibility and internal consistency) of the sDOR.2-6y™ into Brazilian Portuguese. The translation and back-translation followed the protocol required by the NEEDs Center, and the approved version was called "sDOR.2-6y™-Português-Brasil". The approved version was submitted to a test-retest round to verify its reproducibility through the Intraclass Correlation Coefficient (ICC). A pilot study was performed to assess the internal consistency of the instrument. The reproducibility analysis (n = 23) showed a total ICC of 0.945. With the data from the pilot study (n = 384), the internal consistency evaluation was analyzed through Cronbach's alpha coefficient, and the instrument obtained an overall Cronbach's alpha of 0.301. The translation of the sDOR.2-6y™ into Brazilian Portuguese is the first and only tool available for the Brazilian population to exclusively assess the division of responsibility in feeding, which is essential to the academic community, health professionals, and research on child feeding. Therefore, this instrument in Brazilian Portuguese will allow future research on the division of responsibility in feeding among those responsible for children in Brazil.

Nutrition Literacy Level in Bank Employees: The Case of a Large Brazilian Company.

Nutrition Literacy (NL) positively impacts diet quality and has the potential to promote health and prevent nutrition-related chronic diseases. Brazil is one of the countries with the highest rates of nutrition-related chronic diseases. Nevertheless, in Brazil, few studies have explored the NL levels of its population. To provide remote access to the Nutrition Literacy Assessment Instrument for Brazilians (NLit-Br) and assess Brazilian bank employees, we conducted a study to estimate the validity of the NLit-Br online and to investigate whether bank employees have an adequate NL level. In the first step, we randomly assigned 21 employees from three financial institution branches to two groups to complete NLit-Br paper and online versions. After an interval period, both groups completed the NLit-Br with an opposite delivery method (paper vs. online). We compared the validity of the digital and paper versions of the NLit-Br by the Intraclass Correlation Coefficient (ICC), and the reliability by Kuder-Richardson formula 20. Second, we evaluated 1174 bank employees using the NLit-Br online version. We found an excellent absolute agreement (ICC ≥ 0.75) between the paper and online versions. The questionnaire had good internal consistency (KR-20 = 0.64). The sample was characterized as mostly male (61.0%), married/cohabitant (73.8%), and white (69.8%), with high household income (85.2%), and graduated or postgraduate (97.4%). The mean age of the population was 42.1 (SD = 7.6) years. Subjects predominantly had possibly inadequate NL (62.3%). The online NLit-Br total score was significantly associated with gender, age, and household income (p < 0.05). Women and individuals with higher incomes had a higher degree of NL. Subjects over 50 years old had a lower degree of NL. There was no significant association between the NLit-Br score and the participants' education. The NLit-Br online is a valid instrument to assess NL remotely. The population studied showed a high prevalence of inadequacy of the NL. Therefore, there is a need for targeted actions to improve the NL of bank employees.

Eating Competence among Brazilian College Students.

Eating competence (EC) is a biopsychosocial concept related to a healthier eating pattern. Studies have shown that weight gain and body shape and weight dissatisfaction are typical among college students, contributing to low self-esteem, risky eating behaviors, and a propensity to develop eating disorders. As eating habits are determinant factors for food choices that can be modified by eating behavior, this study aimed to evaluate EC in college students from Brazil, using the Brazilian version of the EC Satter Inventory (ecSI2.0™BR), and EC's association with health data. This cross-sectional study was conducted using an online survey spread using the snowball method. The self-report instrument was divided into three parts (socioeconomic and demographic data; health data; and ecSI2.0™BR). Recruitment took place through social networks, and 593 students from public and private universities from all five regions of Brazil participated in the survey. The EC average was 29.46 ± 8.67, and 46.2% of the sample were considered competent eaters. Total EC did not differ among gender and Brazilian region. Younger participants (up to 20 y/o) presented higher scores for total EC, contextual skills and food acceptance. The total EC and contextual skills of health sciences students did not differ from those of students in other areas, except for agricultural sciences in which students had lower total EC. Obese individuals and the participants who perceived themselves to be overweight had low scores for EC. This study confirmed the hypothesis that college students have low EC, causing worse health outcomes related to BMI, perceived body weight, and occurrence of hypertension and dyslipidemia.

Reproducibility and Validity of a Self-Administered Food Safety Assessment Tool on Children and Adolescent's Risk Perception, Knowledge, and Practices.

The present study aimed to verify the instrument's reliability and validity for assessing children and adolescents' risk perception, knowledge, and food safety practices in the school context. Moreover, it aimed to test the hypothesis that both application methods (paper and pencil (PAPI) and online) are valid. The instrument comprised three questionnaires and followed a strict protocol to combine online and PAPI models, resulting in five application forms. The sample consisted of 439 Brazilian students from 10 to 14 years old (y/o). The results related to reliability and validity indicated that the knowledge questionnaire presented adequate stability and discriminant validity coefficients. The self-reported practices questionnaire obtained acceptable coefficients of stability and internal consistency. Regarding risk perception data, it was observed that students attribute a low probability of Foodborne Diseases (FBD) outbreaks occurrence and low severity of possible symptoms. In addition, students demonstrated insufficient knowledge and inadequate practices on issues related to failures associated with the time and temperature of preparation, storage, and exposure of food, contamination of food, and consumption of unsafe food. In this context, the reproducibility and validity indices need to be interpreted and discussed correctly, and young people in food safety actions are a priority in facing FBD.

Substance use disorders and social functioning from an occupational perspective: a pre and post-study / Transtornos pelo uso de substâncias e funcionamento social sob uma perspectiva ocupacional: um pré e pós estudo

Abstract Introduction Improvements in the social functioning (SF) of people experiencing substance use disorders (SUD) can occur even without use discontinuation. Occupational Therapy (OT) performs multifaceted work on it. Objective This study analyzes the SF of people experiencing SUD before and after treatment and the contributions of OT. Method A pre and post-study before and after starting treatment for SUD in a Psychosocial Care Centre - Alcohol and other Drugs (CAPS-AD) in Brasilia, Brazil - was conducted with 35 clients based on an SF questionnaire. A measure of the participant's SF improvement was defined as the difference between the SF before treatment (SFpre) with the SF after treatment (SFafter). The association between SF and sociodemographic variables/drug/previous treatment was verified by linear regression; all analyses considered a significance level <5%. Results Most of the 35 participants were male (83%), 30-49 years old (77%), attended elementary school (57%), unemployed (57%), single (46%), Black (40%), had been treated previously (60%) and had present alcohol use disorder (46%). Overall, people undergoing treatment significantly improved their SF. Multivariate analysis showed that Whites improved their SF more (mean of 18.8± 10.4) than Pardos/Blacks (10.8± 8.7; 14.1± 6.4), and the improvement in SF was lower for participants who were taking treatment for the first time (10.3± 5.7) compared with those who had previous treatment (17.2± 9.4). Conclusion Treatment in CAPS-AD improved the SF of people experiencing SUD, and the OT professional is a key agent in improving SF due to its performance and approach to clients in vulnerable contexts.

Resumo Introdução Melhorias no funcionamento social (FS) de pessoas com transtornos pelo uso de substâncias (TUS) podem ocorrer mesmo sem descontinuar o uso. A terapia ocupacional realiza um trabalho multifacetado sobre isso. Objetivo Este estudo analisa o funcionamento social das pessoas com transtornos pelo uso de substâncias antes e depois do tratamento e contribuições da terapia ocupacional. Método Um pré e pós-estudo - antes e depois do tratamento para TUS em um Centro de Atenção Psicossocial álcool/drogas (CAPS-AD) em Brasília, Brasil - foi realizado com 35 clientes com um questionário sobre FS. A melhora do FS foi definida como a diferença entre o valor do FS antes (FSpre) e depois do tratamento (FSafter). A associação entre o FS e as variáveis sociodemográficas/drogas/tratamento anterior foi verificada por regressão linear; foi considerado um nível de significância <5%. Resultados A maioria era homens (83%), 30-49 anos de idade (77%), com ensino fundamental (57%), desempregados (57%), solteiros (46%), negros (40%), com tratamento anterior (60%), e apresentavam TU de álcool (46%). Em geral, as pessoas submetidas a tratamento melhoraram significativamente seu FS. A análise multivariada mostrou que os brancos melhoraram mais seu FS (média de 18.8± 10.4) que os Pardos/Negros (10.8± 8.7; 14.1± 6.4), e foi menor entre os que estavam fazendo tratamento pela primeira vez (10.3± 5.7) em comparação com os que o fizeram anteriormente (17.2± 9.4). Conclusão O tratamento no CAPS-AD melhorou o FS das pessoas com TUS, o profissional terapeuta ocupacional é um agente chave para melhorar o FS devido a sua atuação e abordagem em contextos vulneráveis.

Food Neophobia in Children with Autistic Spectrum Disorder (ASD): A Nationwide Study in Brazil.

Food neophobia (FN) is common among children with autistic spectrum disorder (ASD), potentially impairing their health and diet quality. This study aimed to investigate and classify the prevalence of FN among 4-to-11-year-old Brazilian children with ASD. This descriptive cross-sectional study was performed by applying online a validated instrument to identify FN in Brazilian children with ASD through their caregivers' responses for a national prevalence of FN in this group. The final sample included 593 children with ASD, 80.1% of boys, with a mean age of 6.72 ± 2.31 years, and 83% having only ASD. Almost 75% (n = 436) of the children with ASD had high food neophobia scores. The fruit neophobia domain had the lowest prevalence of high neophobia (63.7%). No significant difference in FN (total, fruit, and vegetable domains) was found, considering gender and age. There was no statistical difference in FN (all domains) by the number of residents in the same household, income, or the caregivers' educational level. FN did not decrease in older children with ASD. FN is a more complex problem, requiring a multidisciplinary trained team to face the problem.

Vegan milk and egg alternatives commercialized in Brazil: A study of the nutritional composition and main ingredients.

Worldwide, there is an increasing demand for plant-based food due to sustainable, health, ethical, religious, philosophical, and economic reasons. In Brazil, 14% of the population declares themselves vegetarians, and a noticeable increase in the consumption of vegan products is also noted. Substitution of animal dairy and egg is challenging from both sensory and nutritional aspects. Yet, there are no data regarding the nutritional value and ingredients of Brazilian commercial dairy and egg substitutes. Therefore, this study aimed to analyze the nutritional composition and used ingredients in Brazilian commercial vegan alternatives to dairy and eggs to provide information for Brazilian consumers of these products. A cross-sectional quantitative study was carried out in three steps: (i) sample mapping. (ii) data collection, and (iii) statistical analysis. A total of 152 samples were included. No differences were found between the energy value and total fat of vegan products and their animal counterparts. Vegan products showed higher amounts of carbohydrates and dietary fiber, and only the vegan versions of beverages and cheeses showed less protein than their counterparts. Cashews, rice, coconut, and soy were the most used ingredients in dairy substitutes. Emulsions of oil, starch, and isolated protein were used in vegan egg products. Most vegan beverages presented sugar in their composition. Vegan alternatives of dairy and eggs might be suitable for substituting their animal counterparts, but given that traditional versions of cheeses and milk are sources of protein in omnivorous diets, for equivalent nutritional replacement in vegan products, it is necessary to improve the protein content of their vegan counterparts.

Factors interfering with the adoption of good hygiene practices in public school food services in Bahia, Brazil.

This cross-sectional study aimed to identify factors that interfere with the adoption of good hygiene practices in public school food services (SFS) in Bahia, Brazil. The search was conducted in public schools in Bahia/Brazil. Data collection included (i) evaluation of the adoption of Good Practices in school food services through visual observation and registration in the checklist in Good Hygienic Practices in School Food Services; (ii) Identification of schools' foodservice physical areas and environmental comfort measures; (iii) identification of sociodemographic and occupational characteristics and assessment of attitudes and level of knowledge in food hygiene. The minimum sample of 158 schools (confidence level of 95% and an error of 5%) was stratified considering the total number of districts (areas) and the schools' number per area. The data were analyzed using the Statistical Package for Science-SPSS® in version 26.0. The categorical variables were described as frequencies and percentages, and the quantitative variables as mean and standard deviation. Chi-square, Kruskal-Wallis with Tukey's post-hoc tests were used to examine qualitative variables. Independent Student t-test and ANOVA with Tukey's post-hoc tests were used to examine quantitative variables. Categorical variables were evaluated by Pearson Chi-squared tests. The Pearson test was used to analyze the correlation between Attitude and knowledge. The classification of the sanitary status was of moderate risk in 74.8% (n = 119) of the SFS (51-75% of compliance) and 25.2% (n = 40) at high risk (26-50% compliance). The average percentage of compliance for the 159 SFS in the municipality was 50.23%, obtaining a high-risk classification (26-50% compliance). In the SFS, the absence of dry goods' storage, meat preparation area, and storage of residues in more than 98% of schools was observed. Accessing attitudes, 1.4% (n = 2) of the food handlers were classified as unsatisfactory (0 to 49% of correct answers), 8.5% (n = 12) as satisfactory with restriction (50-69% of correct answers) and 90.1% (n = 128) as satisfactory. There was no correlation between Attitude and Knowledge level (p = 0.394). Considering the knowledge level, the item with the highest and lowest number of hits were: "To avoid food contamination, I wash and disinfect my hands before preparing food" and "Contaminated food will always have some change in color, smell, or taste". There was a significant difference in the level of knowledge considering mean wage (p = 0.000), time working in school food service (p = 0.001), weekly workday (p = 0.000), and participation in food hygiene training (p = 0.000). Therefore, factors that interfered in adopting good practices in the SFS were: inadequate physical structure, absence of areas in the SFS, and absence/low number of equipment to control the production process in the cold and hot chain. Food handlers showed satisfactory attitudes and level of knowledge. However, the physical structure of the SFS compromises the adoption of good practices. It risks the safety of the food served to students at the evaluated public schools.

The Increased Alcohol and Marijuana Use Associated with the Quality of Life and Psychosocial Aspects: a Study During the Covid-19 Pandemic in a Brazilian University Community.

The primary practice adopted to reduce Covid-19 contamination is social distancing (SD). SD had significant consequences on alcohol/drug use, quality of life, and psychosocial aspects. In the university community specifically, SD produces a collective traumatic event with changes in the work routine by the suspension of presence. This study aims to identify and analyze the associations of increased alcohol and marijuana consumption on the quality of life and psychosocial aspects of the university community (students, professors, and technical and administrative staff) at a Brazilian public university during SD due to Covid-19 pandemic. This descriptive and cross-sectional study used an online questionnaire to obtain information from 2790 university community participants. Data were analyzed using IBM SPSS Statistics version 22. The analysis included descriptive associations performed using Spearman's correlation coefficient and p < 0.05 was taken as statistically significant. The participants' majority was 62% female, 95.4% students, 73% were 17-25 years old, 33.4% had income between 1 and 3 minimum wage, and 48% of the university community "totally adhered to SD." The increased alcohol consumption during SD was associated with a worsening in quality of life (p = 0.001), health satisfaction (p = 0.015), the meaning of life (p = 0.040), ability to concentrate (p = 0.001), satisfaction with yourself (p = 0.029), and frequency of negative feelings (p = 0.001); in contrast, increased alcohol use improved satisfaction with peer support (p = 0.042), as well as increased marijuana use improved satisfaction with sex life (p < 0.001). The increased alcohol use was higher in women (30.5%) than in men (26.7%) and was negatively associated with more quality of life and psychosocial aspects among women than men. Students were the segment that presented the highest frequency of associations with increased alcohol and/or marijuana use in the three domains analyzed. This study innovated by associating increased alcohol and/or marijuana use with worsening quality of life and psychosocial aspects rather than evaluating them apart. Future studies must identify whether this association between increased alcohol use, mainly, and the worsening quality of life and psychosocial aspects during the SD period is maintained or improved with the return to face-to-face activities at the university, with particular attention to women and students. Psychologists and other mental health professionals should be called upon to develop interventions to meet emerging mental health needs.

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.