Dietary patterns and body adiposity in children in Brazil: a cross-sectional study.

OBJECTIVES: Many factors are associated with the increase in total and central body adiposity in children, especially eating habits. This has led to an increasing number of studies analysing food patterns, which consider the synergistic effect of food and nutrient intake on the nutritional status. The objective of this study was to identify the dietary patterns of children aged 4-7 years and associate these with different indicators of total and central body adiposity. STUDY DESIGN: Cross-sectional study METHODS: The study consisted of 403 children from a retrospective cohort in Minas Geraes, Brazil. Four indicators of body adiposity were evaluated: body mass index (BMI), waist-to-height ratio (WHtR) and percentages of total and central body fat (assessed by dual-energy X-ray absorptiometry). The dietary habits of the children were evaluated by identifying the dietary patterns using principal component analysis. The adjustment predictor variables were related to the socio-economic characteristics, lifestyle and duration of exclusive breastfeeding. Food patterns were identified by factor analysis. Linear regression was used to estimate the regression coefficient and the confidence interval, considering statistical significance of α = 5%. RESULTS: Five dietary patterns were identified, which explained 42.3% of the data variance: 'Traditional', 'Unhealthy', 'Milk and chocolate', 'Snack' and 'Healthy'. The multiple linear regression model showed that a greater adherence to the 'Traditional' and 'Unhealthy' patterns was related to higher BMI, WHtR, and total and central body adiposity. CONCLUSION: Children with a higher intake of food from the 'Traditional' and 'Unhealthy' patterns showed an increase in total and central body adiposity.

A Web-based distance education course in nutrition in public health: case study.

BACKGROUND: Strict work timetables, personal and professional duties or an inability to be absent from home or work can all represent major constraints for those wishing to improve their professional skills. Within this context, the World Wide Web can allow people to conveniently follow distance courses from their homes. OBJECTIVE: To present an experience in the use of the Web in the continuing education of healthcare professionals in Brazil. METHODS: A Web-based distance education course in nutrition in public health was developed. The methodology was an adaptation of both problem-based and task-based learning. At the end of the course an evaluation questionnaire which covered the course s contents, the educational methodology and resources, the duration and schedule, and the use of the Web as a tool for distance education was given to the students. RESULTS: There were 83 on line registrations from 13 states, 73 of the applicants were female, 62 had a degree in nutrition and 18 were physicians. From these; eleven students from ten states were chosen: nine female nutritionists, two female physicians, and one male physician. Seven students completed the course, took and passed the final exam. Of the other four students, two failed to follow the schedule, one had health problems, and one did not obtain the minimal score for sitting the final exam. The students had a mean age of 35, and a mean of ten years in practice. They all stated that they were unable to attend a regular course, even though they felt that they needed to improve their professional skills. Most of them studied seven days a week for between two and four hours a day. The students also felt that their professional skills had improved and each reported having made changes in their practice as a result of their participation. The students approved of the course s contents, methodology and resources, however they were divided about its duration. The Web as a tool in distance education was approved by the students. If it was not for the Web they could not have taken part in a continuing education program. All students said they would attend another virtual course, if available. Even though most of them did not have difficulty adapting to the virtual environment, they did feel that an adaptation period would be of value. CONCLUSIONS: A Web-based course may be more effective than other distance education methodologies because it is more interactive and dynamic. On-line material can be constantly reviewed and updated, and the students can have the opportunity to submit commentaries or questions directly to the teaching staff. A Web-based course also allows the students to go beyond the course content as they learn how to search and take advantage of the huge resources of information available on the Internet.