Socioeconomic inequalities in the consumption of minimally processed and ultra-processed foods in Brazilian adolescents.

In this study, we evaluated socioeconomic inequalities in the consumption of in natura/minimally processed and ultra-processed foods among adolescents. We used data from the Brazilian National Survey of School Health (PeNSE), 2015. According to the self-reported consumption of beans, vegetables and fruits, a score of in natura/minimally processed foods was generated (0-21 points). Sodas, sweets, instant noodles, and ultra-processed meat were used for the score of ultra-processed foods (0-21 points). Equality indicators were gender, maternal education, and socioeconomic level. Absolute difference, ratios, concentration index and slope index of inequality were calculated. Adolescents (n=101,689, 51% girls, 14.2 years) reported a mean score of 9.97 and 11.46 for ultra-processed foods and in natura/minimally processed foods, respectively. Absolute and relative differences between adolescents with the highest and lowest socioeconomic level, there were differences of 2.64 points and 33% for consumption of in natura/minimally processed foods; and 1.48 points and 15% for ultra-processed foods. Adolescents from higher socioeconomic level ate more in natura/minimally processed foods and ultra-processed foods.

Socioeconomic inequalities in the consumption of minimally processed and ultra-processed foods in Brazilian adolescents / Desigualdades socioeconômicas no consumo de alimentos minimamente processados e ultraprocessados em adolescentes no Brasil

Abstract In this study, we evaluated socioeconomic inequalities in the consumption of in natura/minimally processed and ultra-processed foods among adolescents. We used data from the Brazilian National Survey of School Health (PeNSE), 2015. According to the self-reported consumption of beans, vegetables and fruits, a score of in natura/minimally processed foods was generated (0-21 points). Sodas, sweets, instant noodles, and ultra-processed meat were used for the score of ultra-processed foods (0-21 points). Equality indicators were gender, maternal education, and socioeconomic level. Absolute difference, ratios, concentration index and slope index of inequality were calculated. Adolescents (n=101,689, 51% girls, 14.2 years) reported a mean score of 9.97 and 11.46 for ultra-processed foods and in natura/minimally processed foods, respectively. Absolute and relative differences between adolescents with the highest and lowest socioeconomic level, there were differences of 2.64 points and 33% for consumption of in natura/minimally processed foods; and 1.48 points and 15% for ultra-processed foods. Adolescents from higher socioeconomic level ate more in natura/minimally processed foods and ultra-processed foods.

Resumo Nesse estudo, avaliamos as desigualdades socioeconômicas no consumo de alimentos in natura/minimamente processados e ultraprocessados entre adolescentes. Foram utilizados dados da Pesquisa Nacional de Saúde do Escolar (PeNSE), 2015. De acordo com o consumo autorrelatado de feijão, hortaliças e frutas, foi gerado um escore de alimentos in natura/minimamente processados (0-21 pontos). Refrigerantes, doces, macarrão instantâneo e carnes ultraprocessadas prontos para o consumo foram utilizados para a pontuação dos alimentos ultraprocessados (0-21 pontos). Os indicadores de equidade foram gênero, educação materna e nível socioeconômico. Foram calculados a diferença absoluta, razões, índice de concentração e índice de inclinação de desigualdade. Os adolescentes (n=101.689, 51% meninas, 14,2 anos) relataram escore médio de 9,97 e 11,46 para alimentos ultraprocessados e in natura/minimamente processados, respectivamente. As diferenças absolutas entre os adolescentes de alto e baixo nível socioeconômico foram mais altos e mais baixos, houve diferenças de 2,64 pontos e 33% para o consumo de alimentos in natura/minimamente processados; e 1,48 pontos e 15% para alimentos ultraprocessados. Adolescentes de níveis socioeconômicos mais elevados comeram mais alimentos in natura/minimamente processados e alimentos ultraprocessados comparado aos seus pares.

Programa vida ativa melhorando a saúde: alcance e efetividade em idosas com excesso de peso / Active life improving health program: reach and effectiveness in overweight elderly

O objetivo deste estudo foi verificar o alcance e a efetividade do Programa Vida Ativa Melhorando a Saúde (VAMOS) sobre o nível de atividade física, comportamento alimentar e em variáveis antropo-métricas em idosas com excesso de peso participantes do projeto de extensão "Atividade Física para a Terceira Idade". Participaram da pesquisa 34 idosas com excesso de peso divididas em dois grupos: Grupo Intervenção (GI; n=17) com média de idade de 69,2±5,8 anos e Grupo Controle (GC; n=17) com 69,9±6,0 anos. O GI participou de 12 encontros semanais, durante três meses, do VAMOS ­ programa de mudança de comportamento que objetiva motivar as pessoas a adotarem um estilo de vida ativo e saudável. Ambos os grupos praticaram ginástica duas vezes por semana e realizaram avaliações no início e ao final do Programa. Foram realizadas avaliações sociodemográficas, antropométricas, de nível de atividade física e do comportamento alimentar. Os resultados demonstraram que o programa VAMOS teve uma taxa de alcance de 27,5% e manteve a circunferência do quadril (CQ). Quanto à alimentação, foi identificado aumento no preparo de carnes na forma não fritura e diminuição no preparo de frituras em ambos os grupos (p=0,012). Conclui-se que o Programa VAMOS foi efetivo em não aumentar a CQ de idosas com excesso de peso.(AU)

This study has as aim to verify the reach and effectiveness of the Active Life Improving Health Program on the physical activity level, eating behavior and anthropometric variables in overweight elderly women participating in the extension project "Physical Activity for Third Age". Thirty-four overweight elderly women participated in the research, divided into two groups: Intervention Group (IG; n = 17), with a mean age of 69.2 ± 5.8 years; and Control Group (CG; n = 17), with 69.9 ± 6.0 years. IG participated in 12 weekly meetings, during three months of VAMOS, which is a behavior change program that aims to motivate people to adopt an active and healthy lifestyle. Both groups practiced gymnastics twice a week and performed evaluations at the beginning and the end of the program. Sociodemo- graphic, anthropometric, physical activity level and eating behavio assessments were collected. The results showed that the VAMOS program had a reach rate of 27.5% and maintained the hip circumference (HC). Regarding food, it was identified an increase in meat preparation in the non-fried form and a decrease in the preparation as fried in both groups (p = 0.012). It is concluded that the VAMOS Program was effective in not increasing the HC of elderly women with overweight.(AU)

Physical activity and sedentary behavior as multimorbidity discriminators among elderly Brazilians: a cross-sectional study

ABSTRACT BACKGROUND: Associations between behaviors and individual chronic diseases have been demonstrated. However, the relationship between time spent on sedentary behavior and multimorbidity remains less clear. OBJECTIVE: To identify the predictive power of various intensities of physical activity versus sedentary behavior, as discriminatory factors for cardiometabolic multimorbidity (cardiovascular diseases and diabetes) in the elderly. DESIGN AND SETTING: Cross-sectional study in different residential census tracts and residential households in Florianópolis (SC). METHODS: The participants were 425 elderly people (65% women) from the EpiFloripa Aging study in 2014. Sociodemographic variables and self-reported incidence of cardiovascular diseases and diabetes were obtained via a questionnaire. Light physical activity (LPA), moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) were measured using accelerometers. The analyses were stratified according to sex and included a diagnosis for interpretation. Behaviors were taken into consideration if their predictive power in terms of area under the receiver operating characteristic (ROC) curve was greater than 0.50. The time cutoff point was defined from sensitivity and specificity. RESULTS: For older adult men with diabetes, the predictive value of MVPA for absence of multi-morbidity was an area of 0.75 (95% confidence interval, CI: 0.538-0.962), and a cutoff of 17 minutes per day. Older adult women with diabetes had an area of 0.71 (95% CI: 0.524-0.866) and a cutoff of 10 minutes per day. LPA and SB did not present predictive values. CONCLUSION: The time spent on MVPA is a predictor of absence of multimorbidity in elderly people with diabetes, for both sexes.

Physical activity and sedentary behavior as multimorbidity discriminators among elderly Brazilians: a cross-sectional study.

BACKGROUND: Associations between behaviors and individual chronic diseases have been demonstrated. However, the relationship between time spent on sedentary behavior and multimorbidity remains less clear. OBJECTIVE: To identify the predictive power of various intensities of physical activity versus sedentary behavior, as discriminatory factors for cardiometabolic multimorbidity (cardiovascular diseases and diabetes) in the elderly. DESIGN AND SETTING: Cross-sectional study in different residential census tracts and residential households in Florianópolis (SC). METHODS: The participants were 425 elderly people (65% women) from the EpiFloripa Aging study in 2014. Sociodemographic variables and self-reported incidence of cardiovascular diseases and diabetes were obtained via a questionnaire. Light physical activity (LPA), moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) were measured using accelerometers. The analyses were stratified according to sex and included a diagnosis for interpretation. Behaviors were taken into consideration if their predictive power in terms of area under the receiver operating characteristic (ROC) curve was greater than 0.50. The time cutoff point was defined from sensitivity and specificity. RESULTS: For older adult men with diabetes, the predictive value of MVPA for absence of multi-morbidity was an area of 0.75 (95% confidence interval, CI: 0.538-0.962), and a cutoff of 17 minutes per day. Older adult women with diabetes had an area of 0.71 (95% CI: 0.524-0.866) and a cutoff of 10 minutes per day. LPA and SB did not present predictive values. CONCLUSION: The time spent on MVPA is a predictor of absence of multimorbidity in elderly people with diabetes, for both sexes.

Planejamento em saúde sobre práticas corporais e atividade física no Programa Academia da Saúde / Health planning on body practices and physical activity in the health academy program

O objetivo foi analisar o planejamento das práticas corporais e atividades físicas (PC/AF) dos profissionais de educação física concluintes do Curso de Aperfeiçoamento em Implementação da Política Nacional de Promoção da Saúde: Programa Academia da Saúde (PAS). Das ações analisadas (n = 149), 60,5% (n = 286) eram de PC/AF. A ginástica foi mais frequente (20,1%; n = 95) e 21,4% (n = 101) das práticas tinham a alimentação associada. Mais de 60% das ações não informaram instrumentos (n = 330), cronograma (n = 345), recursos financeiros (n = 366) e alcance dos usuários (n = 394). A atuação multiprofissional foi prevista em 61,7% (n = 292) das ações. Sendo assim, o planejamento em saúde carece de informações metodológicas, avaliação e público-alvo para implementação de ações

The aim was to analyze the planning of body practices and physical activities (BP/PA) of physical education professionals concluding the Improvement Course in Implementation of the National Health Promotion Policy: Academia da Saúde Program (PAS). Of the analyzed actions (n = 149), 60.5% (n = 286) were of BP/PA. Gymnastics was more frequent (20.1%; n = 95) and 21.4% (n = 101) of the practices had associated food. More than 60% of the actions did not inform instruments (n = 330), schedule (n = 345), financial resources (n = 366) and reach of users (n = 394). Multiprofessional action was expected in 61.7% (n = 292) of the actions. Thus, health planning lacks methodological information, assessment, and target audience for implementing actions

Monitoramento do programa academia da saúde de 2015 a 2017 / Monitorización del programa Academia de Salud de 2015 a 2017 / Monitoring the Health Academy program from 2015 to 2017

O objetivo foi analisar a implementação do Programa Academia da Saúde ao longo de três anos (2015 a 2017). Os dados são do monitoramento anual da implantação do programa no Brasil, por questionários respondidos pela gestão estadual, municipal e dos polos. Foram analisados os polos por região, profissionais atuantes, ações desenvolvidas e público-alvo. Análise descritiva e análise inferencial foram realizadas para diferenças das proporções. Observou-se um aumento na taxa de resposta ao monitoramento, especialmente na região nordeste; mais de 88% dos polos mantiveram em maior proporção profissionais de educação física; houve aumento significativo da oferta de práticas corporais e atividade física (2015 vs 2016) e, redução nas ações em alimentação (2015 vs 2016), práticas integrativas complementares (2015 vs 2016) e no atendimento à idosos (2015 vs 2017). Há uma disparidade na implementação do programa nas regiões ao longo dos anos e o monitoramento poderá contribuir para estratégias em promoção de saúde

Analizar la implementación del Programa Academia de la Salud a lo largo de tres años (2015 a 2017). Los datos pertenecen al seguimiento anual de la implantación del Programa Academia de Salud en Brasil, por medio de cuestionarios respondidos por administraciones del estado, município y de los polos. Las variables investigadas fueron número de polos por región, profesionales actuantes, acciones desarrolladas y público objetivo atendido. Se realizó un análisis descriptivo de frecuencia absoluta y relativa como también, una análisis inferencial para las diferencias de las proporciones entre los años. Hubo un aumento en el número de polos, destacando la región nordeste; más del 88% de los pueblos mantuvieron en mayor proporción profesionales de educación física; hubo un aumento significativo de la oferta de prácticas corporales y actividad física (2015 vs 2016) y reducción en las acciones en alimentación (2015 vs 2016), prácticas integradoras complementarias (2015 vs 2016) y en la atención a los ancianos (2015 vs 2017). Se observó una disparidad en las regiones que adoptaron el programa a lo largo de los años, y el monitoreo puede contribuir a las estrategias de promoción de la salud

To analyze the implementation of the Health Academy Program over three years (2015 to 2017). The data is taken from the annual monitoring of the application of poles of the Health Academy Program in Brazil through questionnaires answered by the state, cities and poles management. The variables investigated were number of poles per region, active professionals, developed actions and target audience attendance. We performed a descriptive analysis of absolute and relative frequency and inferential analysis to the differences in proportions among the years. Monitoring response rate increased, especially in the northeast region; more than 88% of the poles maintained a higher proportion of physical education professionals; significant increase in actions of corporal practices and physical activity (2015 vs 2016) and reduction in actions on food (2015 vs 2016), complementary integrative practices (2015 vs 2016) and care for the elderly (2015 vs 2017).There has been a disparity in the regions that adopted the program over the years and the monitoring may contribute to health promotion strategy

Avaliação da efetividade do "vamos" no contexto do programa academia da saúde: um estudo qualitativo / Evaluating the effectiveness of program vamos in the context of program academy of health: a qualitative study / Evaluación de la efectividad del "vamos" en el contexto del programa academia de la salud: un estudio cualitativo

Resumo: O objetivo deste estudo foi avaliar a efetividade do Vida Ativa Melhorando a Saúde (VAMOS) a partir da percepção dos usuários do Programa Academia da Saúde (PAS) de Belo Horizonte. Foi realizado um estudo qualitativo com participantes do GI (Grupo Intervenção) de um ensaio controlado e randomizado em dois polos do PAS. O GI participou das atividades do PAS e, adicionalmente, de um programa de mudança de comportamento (VAMOS) durante 12 semanas. A efetividade foi avaliada por meio de relatos em três grupos focais realizados com 32 participantes do GI (61 anos, ± 7,07) utilizando o roteiro baseado nas dimensões do modelo RE-AIM. A partir da análise de conteúdo foram identificados benefícios em quatro categorias: atividade física, alimentação, peso corporal e qualidade de vida. Pela percepção dos participantes, concluiu-se que o VAMOS trouxe benefícios nos marcadores do programa e que a metodologia utilizada foi efetiva para atingir os resultados.

Abstract: This study evaluates the effectiveness of program VAMOS (Active Life Improving Health) based on the perception of the Health Academy Program (PAS) users in Belo Horizonte. A qualitative study was conducted with participants of a randomized clinical trial in two PAS units. The IG (Intervention Group) participated in PAS activities and a behavioral change program (VAMOS) for 12 weeks. Effectiveness was evaluated through reports on three focus groups with 32 IG participants (aged 61 ± 7.07) using the script based on the dimensions of the RE-AIM framework. Through content analysis, benefits were identified in four categories: physical activity, food intake, body weight, and quality of life. Participants' perception reflected benefits in the program markers. Therefore, the methodology used proved to be effective in achieving the VAMOS goals.

Resumen: El objetivo de este estudio fue evaluar la efectividad del "Vida Activa Mejorando la Salud" (VAMOS) desde la percepción de los usuarios del Programa Academia de la Salud (PAS) de Belo Horizonte. El estudio fue cualitativo, con participantes del GI (Grupo Intervención) en un ensayo controlado aleatorio en dos polos del PAS. El GI participó en las actividades del PAS y en un programa de cambio de comportamiento (VAMOS) durante 12 semanas. La efectividad se evaluó a través de relatos en tres grupos focales realizados con 32 participantes del GI (61 años, ± 7,07) utilizando el guión basado en el modelo RE-AIM. A partir del análisis de contenido, se identificaron beneficios en cuatro categorías: actividad física, alimentación, peso corporal y calidad de vida. A partir de la percepción de los participantes, se concluyó que el VAMOS trajo beneficios en los marcadores del programa y que la metodología utilizada fue efectiva para alcanzar los resultados.