Análise das preparações de um serviço de alimentação hospitalar segundo o Escore para Avaliação Qualitativa de Preparação / Analysis of the preparations of a hospital food service according to the Score for Qualitative Assessment of Preparation

Introdução: A oferta de ambientes alimentares saudáveis e sustentáveis deve contar com a avaliação de cardápios que estejam adequados para além da dimensão nutricional, devendo contemplar, entre outros fatores, o grau de processamento dos alimentos conforme recomendações do Guia Alimentar para a População Brasileira. Objetivo: Analisar as preparações de um serviço de alimentação hospitalar segundo o Escore para Avaliação Qualitativa de Preparação. Métodos: O estudo foi do tipo quantitativo, observacional, transversal e analítico, desenvolvido em um serviço de nutrição hospitalar no município de Fortaleza - CE no período de janeiro a junho de 2023. A amostra foi composta por todas as preparações do cardápio de almoço e jantar dos colaboradores, pacientes e acompanhantes. Para análise, foi utilizado o Escore de Avaliação Qualitativa das Preparações, que avalia o grau de processamento industrial do ingrediente, além de outras recomendações. Resultados: Os resultados mostraram que 80% das 315 preparações foram classificadas como de "alta qualidade". As sobremesas e saladas apresentaram maior percentual de preparações classificadas como de "alta qualidade", 97% e 95,7% respectivamente (p <0,001). Uma preparação (1,2%) foi classificada como de "muito baixa qualidade". A qualidade das refeições dos pacientes foi superior à dos colaboradores e acompanhantes (p < 0,05) confirmando a hipótese do trabalho. Conclusões: A qualidade das preparações analisadas apresentou resultados satisfatórios e em concordância com as recomendações do Guia Alimentar para a População Brasileira.

Introduction: The provision of healthy and sustainable food environments should include the assessment of adequate menus beyond the nutritional dimension, and, among other factors, the food processing levels recommended by the Food Guide for the Brazilian Population. Objective: To analyze the preparations of a hospital food service under the Qualitative Preparation Assessment Score. Methods: This quantitative, observational, cross-sectional, and analytical study was conducted in a hospital nutrition service in Fortaleza, Ceará, Brazil, from January to June 2023. The sample consisted of all the lunch and dinner menu preparations for employees, patients, and companions. Besides other recommendations, we adopted the Qualitative Preparation Assessment Score for analysis to evaluate the ingredient industrial processing level. Results: The results showed that 80% of the 315 preparations were classified as "high quality". Desserts and salads had the highest percentage of preparations classified as "high quality", 97% and 95.7%, respectively (p<0.001). One preparation (1.2%) was classified as "very low quality". The quality of patients' meals was higher than that of employees and companions (p<0.05), confirming the study's hypothesis. Conclusions: The quality of the preparations analyzed was satisfactory and aligned with the recommendations of the Food Guide for the Brazilian Population.

Ferramentas para promoção e avaliação da alimentação adequada e saudável desenvolvidas no Brasil: uma revisão de escopo / Tools developed in Brazil for the promotion and assessment of adequate and healthy eating habits: A scoping review

Resumo O objetivo deste estudo foi identificar e discutir as ferramentas de promoção e avaliação da alimentação adequada e saudável baseadas no Guia Alimentar para a População Brasileira. A revisão de escopo foi conduzida de acordo com o JBI Manual for Evidence Synthesis, utilizando para relatório de revisão de escopo o guia Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews, com busca nas bases de dados PubMed/MEDLINE, EMBASE, SciELO e LILACS. Dezesseis estudos sobre ferramentas baseadas no guia alimentar para indivíduos de todas as faixas etárias, foram incluídos: dois descritivos, dois de protocolo de estudo clínico randomizado, onze metodológicos e um psicométrico, direcionados à população (n=12) ou à profissionais de saúde (n=4). Seis estudos abordaram ferramentas para promoção da alimentação adequada e saudável e dez desenvolveram ferramentas para avaliação de práticas alimentares ou de conhecimento e atividades de profissionais da saúde. Esta revisão auxiliará os profissionais de saúde na escolha dos instrumentos para o processo de implementação e, ou, divulgação das recomendações do guia alimentar, contribuindo para a promoção da alimentação adequada e saudável.

Abstract The objective of this study was to identify and discuss the tools for the promotion and evaluation of adequate and healthy eating based on the Food Guide for the Brazilian Population. The scoping review was conducted according to the JBI Manual for Evidence Synthesis via the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist and by searching PubMed/MEDLINE, EMBASE, SciELO and LILACS. Sixteen studies on relevant tools, based on the food guide for individuals of all age groups, were thus included: two descriptive studies, two randomized clinical trial protocols, eleven methodological analyses, and one psychometric paper, aimed at either a focal population (n=12) or health professionals (n=4). Six studies addressed tools for promoting adequate and healthy eating, and ten developed tools for evaluating dietary practices or the knowledge and activities of health professionals. This review can therefore assist health professionals in choosing instruments for the implementation and/or dissemination of food guide recommendations, contributing to the promotion of adequate and healthy eating habits.

Conhecimento, autoeficácia e práticas profissionais relacionadas ao Guia Alimentar para a população brasileira na atenção primária à saúde / Knowledge, self-efficacy and professional practices related to the Dietary Guidelines for the Brazilian population in primary health care

Resumo Introdução fatores individuais parecem estar relacionados à utilização de novas recomendações e mudanças de prática profissional para ações de promoção à saúde. Objetivo avaliar a relação entre conhecimento, autoeficácia (AE) e utilização das recomendações do Guia Alimentar Brasileiro (GAB) nas práticas de equipes de Núcleos de Apoio à Saúde da Família (NASF-AB). Método recorte transversal de pós-intervenção de um ensaio comunitário controlado envolvendo 26 profissionais de saúde. Conhecimento e AE em utilizar as recomendações do GAB foram coletados por escalas validadas autoaplicáveis. A utilização do GAB na prática profissional foi mensurada mediante observação da rotina de trabalho dos NASF-AB e preenchimento de escala validada sobre as recomendações do GAB. Todos os escores variaram de 0 a 100. Resultados as pontuações médias nos escores de conhecimento, AE e utilização do GAB foram de 83,07 (DP = 18,29), 63,36 (DP = 19,07) e 4,33 (DP = 8,03), respectivamente. Houve correlação positiva e moderada entre AE e escore de utilização do GAB (r = 0,45; p = 0,03). Conhecimento sobre o GAB obteve fraca correlação com o escore de utilização (r = 0,34; p = 0,11). Diferença significativa foi obtida entre as médias do escore de utilização do GAB no grupo de elevada AE (5,13; p = 0,004; DP =1,55), em relação ao de baixa AE (3,40; p = 0,059; DP = 1,69), independentemente da categoria profissional. Conclusão neste estudo, a AE demonstrou estar moderadamente correlacionada com a adoção de novas práticas profissionais.

Abstract Background Individual factors appear related to the adoption of new recommendations and changes to professional practice for health promotion initiatives. Objective to evaluate the relationship between knowledge, self-efficacy (SE) and adoption of the Brazilian Dietary Guideline (BDG) recommendations in the practices of Family Health Support Center (NASF-AB) teams. Method a post-intervention cross-sectional sample from a controlled community trial involving 26 health professionals. Knowledge and SE in adopting the BDG recommendations were determined using a validated self- applicable scale. BDG adoption in professional practice was measured by observing the NASF-AB work routine and the scoring on the validated scale investigating GAB recommendation uptake. Scores ranged from 0 to 100 points. Results Average scores for knowledge, SE and BDG use were 83.07 (SD = 18.29), 63.36 (SD = 19.07) and 4.33 (SD = 8.03), respectively. There was a positive moderate correlation between SE and BDG utilization scores (r = 0.45; p = 0.03). Knowledge about BDG presented a weak correlation with the utilization score (r = 0.34; p = 0.11). Significant difference was observed between the averages of the BDG utilization score in the high SE group (5.13; p = 0.004; SD = 1.55), in relation to the low SE group (3.40; p = 0.059; SD = 1.69), regardless of professional category. Conclusion in this study, SE was moderately correlated with the adoption of new professional practices.

Diseño y validación técnica del ícono del Plato Nutricional para la alimentación diaria de los guatemaltecos / Design and validation of a Healthy Plate´s model for Guatemalans daily food

Por varias décadas en el país, se han utilizado las Guías Alimentarias para Guatemala, en diferentes programas de salud, educación o seguridad alimentaria nutricional con el fin de orientar una alimentación saludable a la población logrando incidir con cierto éxito y eficacia; sin embargo, existen algunas limitaciones de comprensión y aplicación. En el contexto y objetivos de este recurso educativo, se consideró elaborar un modelo del Plato Nutricional para la población guatemalteca como una herramienta que permita orientar el consumo de una alimentación balanceada en las diferentes comidas del día e impactar en cambios de comportamiento positivos en la alimentación de las poblaciones más vulnerables del país. Se revisó literatura sobre el diseño de materiales, normativas de educación y situación de los problemas alimentarionutricionales de la población guatemalteca, se diseñó el modelo y un panel de 12 expertos valoró los criterios de aceptación, comprensión e inducción a la acción. Sobre el ícono o gráfico del plato nutricional, se calificaron aspectos de percepción sobre la alimentación balanceada y la proporcionalidad de los grupos de alimentos a comer en forma diaria en los distintos tiempos de comida. Entre los principales resultados están que el modelo del Plato Nutricional promueve una alimentación saludable, los 12 expertos (100.0% de los participantes en la validación técnica) refirieron que la metodología es de utilidad, y 10 (83.3%) indicaron que todos los materiales cumplieron con los criterios de atracción, comprensión, congruencia, aceptación e inducción a la acción. El modelo del plato considerado como un gráfico simple pero óptimo para orientar la alimentación adecuada para los guatemaltecos, es una herramienta educativa complementaria a las Guías Alimentarias para Guatemala

For several decades, the Dietary Guidelines for Guatemala have been used in different health, education, or nutritional food security programs in order to guide the population to a healthy diet, managing to influence with certain success and effectiveness. However, there are some understanding and application limitations. In the context and objectives of this educational resource, the development of a model of the Nutritional Plate was considered for the Guatemalan population, as a tool that allows guiding the consumption of a balanced diet in the different meals of the day, and promoting positive changes in eating behavior in the most vulnerable populations of the country. Literature on the design of materials, educational regulations, and the situation of food-nutritional problems of the Guatemalan population were reviewed, the model was designed, and a panel of 12 experts assessed the criteria for acceptance, understanding, and induction to action. Regarding the Healthy Plate´s model, aspects such as perception of a balanced diet and the proportionality of the food groups of the different daily meals, were rated. Among the main results are that the Nutritional Plate model promotes healthy eating, the 12 experts (100.0% of the participants in the technical validation) reported that the methodology is useful, and 10 (83.3%) indicated that all the materials complied with the criteria of attraction, understanding, congruence, acceptance, and induction to action. The healthy plate model, considered a simple but optimal graphic to guide the adequate diet for Guatemalans, is an educational tool complementary to the Dietary Guidelines for Guatemala.

Diseño y validación técnica del ícono del Plato Nutricional para la alimentación diaria de los guatemaltecos / Design and validation of a Healthy Plate´s model for Guatemalans daily food

Por varias décadas en el país, se han utilizado las Guías Alimentarias para Guatemala, en diferentes programas de salud, educación o seguridad alimentaria nutricional con el fin de orientar una alimentación saludable a la población logrando incidir con cierto éxito y eficacia; sin embargo, existen algunas limitaciones de comprensión y aplicación. En el contexto y objetivos de este recurso educativo, se consideró elaborar un modelo del Plato Nutricional para la población guatemalteca como una herramienta que permita orientar el consumo de una alimentación balanceada en las diferentes comidas del día e impactar en cambios de comportamiento positivos en la alimentación de las poblaciones más vulnerables del país. Se revisó literatura sobre el diseño de materiales, normativas de educación y situación de los problemas alimentario-nutricionales de la población guatemalteca, se diseñó el modelo y un panel de 12 expertos valoró los criterios de aceptación, comprensión e inducción a la acción. Sobre el ícono o gráfico del plato nutricional, se calificaron aspectos de percepción sobre la alimentación balanceada y la proporcionalidad de los grupos de alimentos a comer en forma diaria en los distintos tiempos de comida. Entre los principales resultados están que el modelo del Plato Nutricional promueve una alimentación saludable, los 12 expertos (100.0% de los participantes en la validación técnica) refirieron que la metodología es de utilidad, y 10 (83.3%) indicaron que todos los materiales cumplieron con los criterios de atracción, comprensión, congruencia, aceptación e inducción a la acción. El modelo del plato considerado como un gráfico simple pero óptimo para orientar la alimentación adecuada para los guatemaltecos, es una herramienta educativa complementaria a las Guías Alimentarias para Guatemala.

For several decades, the Dietary Guidelines for Guatemala have been used in different health, education, or nutritional food security programs in order to guide the population to a healthy diet, managing to influence with certain success and effectiveness. However, there are some understanding and application limitations. In the context and objectives of this educational resource, the development of a model of the Nutritional Plate was considered for the Guatemalan population, as a tool that allows guiding the consumption of a balanced diet in the different meals of the day, and promoting positive changes in eating behavior in the most vulnerable populations of the country. Literature on the design of materials, educational regulations, and the situation of food-nutritional problems of the Guatemalan population were reviewed, the model was designed, and a panel of 12 experts assessed the criteria for acceptance, understanding, and induction to action. Regarding the Healthy Plate´s model, aspects such as perception of a balanced diet and the proportionality of the food groups of the different daily meals, were rated. Among the main results are that the Nutritional Plate model promotes healthy eating, the 12 experts (100.0% of the participants in the technical validation) reported that the methodology is useful, and 10 (83.3%) indicated that all the materials complied with the criteria of attraction, understanding, congruence, acceptance, and induction to action. The healthy plate model, considered a simple but optimal graphic to guide the adequate diet for Guatemalans, is an educational tool complementary to the Dietary Guidelines for Guatemala.

Práticas de comensalidade em estudantes universitários / Commensality practices among university students

O Guia Alimentar para a População Brasileira aborda orientações para uma alimentação adequada e saudável, incluindo recomendações sobre o ato de comer e a comensalidade. Ao ingressar na vida universitária, os estudantes tendem a modificar sua rotina, o que contribui para a realização de refeições rápidas, sem horários regulares e inadequadas do ponto de vista nutricional. O objetivo do presente estudo foi investigar práticas de comensalidade e fatores associados em ingressantes de uma universidade pública do Rio Grande do Sul. Trata-se de um estudo transversal realizado em 2019. O desfecho constituiu-se da orientação do Guia sobre comer em companhia e participação nas atividades que envolvem a alimentação. As variáveis de exposição investigadas foram sexo, idade, composição de moradia, trabalho remunerado, classe econômica e turno na universidade. Dos 207 participantes, 83,9% e 62,4% informaram que costumam realizar almoço e jantar em companhia, respectivamente. A maior parte dos estudantes participa "às vezes" do planejamento (49,8%) e da preparação de refeições (50,5%), e "sempre" participam da compra de alimentos (51,2%) e limpeza de utensílios e ambiente (62,8%). Além disso, a maioria dos estudantes de 30 anos ou mais informou que costuma realizar o café da manhã em companhia (p=0,010), enquanto estudantes que moram com familiares são os que mais realizam as três refeições acompanhados (p<0,05). Houve maior frequência de mulheres que participam do planejamento (p=0,012) e da preparação de refeições (p=0,002). Conclui-se que, de maneira geral, os estudantes praticam a comensalidade, com maior ocorrência entre aqueles que residem com familiares.

The Food Guide for the Brazilian Population addresses guidelines for an adequate and healthy diet, including recommendations on the act of eating and commensality. When entering university life, students tend to change their routine, which contributes to having quick, irregularly scheduled, and nutritionally inadequate meals. The aim of the present study was to investigate commensality practices and associated factors in newcomers to a public university in Rio Grande do Sul. This is a cross-sectional study carried out in 2019. The outcome consisted of the Guide's direction on eating in with others and participation in activities involving food. The exposure variables investigated were sex, age, housing composition, paid work, economic class, and university study period. Of the 207 participants, 83.9% and 62.4% reported that they usually have lunch and dinner together, respectively. Most students participate "sometimes" in planning (49.8%) and preparing meals (50.5%), and "always" participate in buying food (51.2%) and cleaning utensils and environment (62.8%). In addition, most students aged 30 years or older reported that they usually have breakfast together (p=0.010), while students who live with family members are the ones who most eat the three meals together (p<0.05). There was a higher frequency of women participating in planning (p=0.012) and meal preparation (p=0.002). It is concluded that, in general, students practice commensality, with a higher occurrence among those who live with family members.

Falta de habilidades culinárias é obstáculo para adolescentes terem uma alimentação saudável? / Is the lack of culinary skills an obstacle for teenagers to eat healthy?

O desenvolvimento de habilidades culinárias tem sido apontado como importante fator associado à melhor qualidade da alimentação e a diminuição da transmissão dessas habilidades entre gerações tem favorecido o maior consumo de produtos ultraprocessados. No entanto, ainda há escassez de estudos que avaliem as habilidades culinárias da população brasileira, e se ressalta que, até o momento, não foram encontrados estudos no Brasil que tenham avaliado tais habilidades em adolescentes. O objetivo deste estudo foi avaliar a associação entre habilidades culinárias autopercebidas e qualidade do consumo alimentar de adolescentes. Trata-se de um estudo transversal com adolescentes da rede pública de ensino de Itaqui/RS. Foram investigadas variáveis demográficas e socioeconômicas, habilidades culinárias autopercebidas e frequência semanal de 22 itens alimentares, a qual deu origem ao índice de qualidade do consumo alimentar. As médias (DP) do índice de qualidade do consumo alimentar, de acordo com as habilidades culinárias autopercebidas, foram calculadas para toda a amostra e estratificadas por sexo, utilizando-se teste ANOVA ou Mann-Whitney. Calcularam-se IC95% e o nível de significância considerado foi de 5%. Observaram-se maiores médias (DP) do índice de qualidade do consumo alimentar entre adolescentes do sexo feminino que relataram saber "escolher os alimentos" [59,99 (9,43)] (p=0,027), "temperar" [60,53 (9,58)] (p=0,0109), e "combinar ingredientes ou preparações" [61,14 (9,64)] (p=0,0051). Já no sexo masculino, maior média (DP) do índice de qualidade do consumo alimentar foi observada entre adolescentes que referiram saber "lavar, descascar, cortar ou medir ingredientes" [(62,16 (10,69)] (p=0,0012). Ainda, observou-se associação positiva do índice de qualidade do consumo alimentar com número de habilidades culinárias autopercebidas no sexo feminino (p de tendência=0,003). Este estudo evidenciou que maior número de habilidades culinárias autopercebidas pode estar associado a melhor qualidade no consumo alimentar de adolescentes.

The development of culinary skills has been identified as an important factor associated with better food quality, and the reduction in the transmission of these skills between generations has favored a greater consumption of ultra-processed products. However, there is still a lack of studies that assess the culinary skills of the Brazilian population, and it is noteworthy that, so far, no studies have been found in Brazil that have evaluated such skills in adolescents. The aim of this study was to evaluate the association between self-perceived culinary skills and the quality of food consumption in adolescents. This is a cross-sectional study with adolescents from public schools in Itaqui, RS. Demographic and socioeconomic variables, self-perceived cooking skills, and weekly frequency of 22 food items were investigated, which gave rise to the food consumption quality index. Means (SD) of the food consumption quality index, according to self-perceived cooking skills, were calculated for the entire sample and stratified by sex, using ANOVA or Mann- Whitney test. The 95%CI was calculated, and the significance level considered was 5%. Higher means (SD) of the food consumption quality index were observed among female adolescents who reported knowing how to "choose foods" [59.99 (9.43)] (p=0.027), "seasoning" [60, 53 (9.58)] (p=0.0109), and "combining ingredients or preparations" [61.14 (9.64)] (p=0.0051). Among males, the highest mean (SD) of the food consumption quality index was observed among adolescents who reported knowing how to "wash, peel, cut or measure ingredients" [(62.16 (10.69)] (p=0.0012). Furthermore, there was a positive association between the index of food consumption quality and the number of self-perceived culinary skills in females (p trend =0.003). This study showed that a greater number of self-perceived culiunary skills may be associated with better quality in adolescent food consumption.

Dietary guidelines training may improve health promotion practice: Results of a controlled trial in Brazil.

BACKGROUND: The double burden of malnutrition points to an urgent need to develop strategies to promote healthy diets. Health professionals are key elements for health promotion and must be prepared to deal with these issues in health services. AIM: This study aimed to evaluate the impact of an educational intervention based on Brazilian Dietary Guidelines in the practice of multidisciplinary teams working in primary health care. METHODS: A controlled trial comprising pre- and post-tests was conducted with four multidisciplinary healthcare teams. The intervention group received 16 hours of training on the Brazilian Dietary Guidelines. The professionals' practices were evaluated by direct observation, before and after the intervention, for two months at each timepoint. Data on dietary counselling were collected using a previously validated scale. The Kruskal-Wallis test was used for intragroup comparison at T0 versus T1, and the intergroup effects of the intervention were estimated by generalized linear regression analysis with a 95% confidence interval. RESULTS: The regression with the interaction term between the intervention group and time showed a positive effect of the educational intervention on professionals' practices in the intervention group in the crude and adjusted models (coefficient = 1.36 and p = 0.020). Brazilian Dietary Guidelines application significantly increased in non-nutritionist professionals' practices (p = 0.007) and in activities not related to nutrition (p = 0.028) in the intervention group over time (T1-T0). No significant differences were found in the control group. CONCLUSION: The intervention proved to be effective in promoting changes in health professionals' practices, demonstrating the strength of the strategy for dissemination of nutrition guidelines in primary health care.

Estimación del consumo de alimentos en menores de dos años de la provincia Las Tunas / Estimate of food consumption in children under two years old in Las Tunas province

Introducción: La introducción de la alimentación complementaria es un importante momento en el crecimiento de un niño. Las guías alimentarias constituyen la traducción de los objetivos nutricionales en consejos prácticos y cobran un valor fundamental en las primeras etapas de la vida. Objetivos: Estimar el consumo de alimentos en menores de dos años de edad de la provincia Las Tunas. Métodos: Se realizó un estudio transversal, con muestreo aleatorio bietápico, en niños con edades entre 6 y 23 meses. El tamaño muestral fue de 495 niños. Se aplicó una encuesta de consumo de alimentos por recordatorio de 24 horas y se estimó la adecuación de las porciones de alimentos ingeridas según las recomendaciones de las guías alimentarias del menor de 2 años. Se calculó el índice de diversidad alimentaria. Resultados: La lactancia materna continuada al año de edad fue de un 34,5 por ciento en el grupo menor de un año y de un 10,6 por ciento en el grupo de 1 a 2 años. Se observó un bajo cumplimiento de consumo de las porciones de vegetales, frutas, grasas y huevo recomendadas en las guías alimentarias. El 84,5 por ciento de los menores de un año y el 42,1 por ciento de los de 1 a 2 años excedían el consumo diario recomendado de energía. Conclusiones: No se cumplen las porciones de alimentos recomendadas en las guías alimentarias para el logro de una alimentación saludable en menores de dos años. El alto porcentaje de niños con ingestas excesivas de energía constituye un factor predisponente a la obesidad desde las etapas tempranas de la vida(AU)

Introduction: The introduction of complementary feeding is an important moment in a child's growth. Food guides are the translation of nutritional goals into practical advice and take on fundamental value in the early stages of life. Objectives: Estimate food consumption in children under two years old in Las Tunas province. Methods: A cross-sectional study, with two-stage random sampling, was conducted in children aged from 6 to 23 months. The sample size was of 495 children. A food consumption by 24-hours reminder´s survey was applied and the adequacy of food portions ingested was estimated according to the recommendations of the children under 2 years´ food guides. The food diversity index was calculated. Results: Continued breastfeeding at 1 year of age was 34.5 percent in the group under one year and 10.6 percent in the 1 to 2 years group. Low consumption compliance with the portions of vegetables, fruits, fats and eggs recommended in food guides was observed. 84.5 percent of children under one-year-old and 42.1 percent of those in 1 to 2 years old exceeded the recommended daily energy consumption. Conclusions: The food portions recommended in the food guides for healthy eating in children under two years old are not met. The high percentage of children with excessive energy intakes is a factor that predispose to obesity in early stages of life(AU)

Da Amazônia ao guia: os dilemas entre a alimentação quilombola e as recomendações do guia alimentar para a população brasileira / From the Amazon to the guidelines: the dilemmas between quilombola foods and the recommendations of the dietary guidelines for the Brazilian population

Resumo O objetivo deste trabalho é analisar se o hábito alimentar das famílias quilombolas paraenses segue as orientações do Guia Alimentar para a População Brasileira, publicado pelo Ministério da Saúde, em 2014. Foram realizadas entrevistas semiestruturadas nas comunidades de Santo Antônio (Concórdia do Pará, nordeste paraense) e São João (Salvaterra, ilha do Marajó) sob o protocolo CEP 060/07. Foram feitas análises do consumo e das preferências alimentares de acordo com o guia. Os resultados evidenciam: alto consumo de café adoçado, feijão, arroz e farinha; baixa participação de verduras, legumes e frutas na dieta dos entrevistados. Alimentos como pão, leite de vaca, macarrão, margarina e bolacha salgada são as formas comuns de diversificar os alimentos consumidos pelo grupo. Como fontes proteicas, destacam-se a carne vermelha - silvestre ou não -, o pescado, o charque, o frango e o ovo de galinha. São apresentadas algumas contradições do guia quando aplicado às comunidades. Apesar dos avanços do guia, conclui-se que o cumprimento das orientações para uma alimentação adequada e saudável nos grupos quilombolas da região amazônica enfrenta desafios. Guias alimentares são importantes para a saúde e a nutrição da população, porém precisam ser combinados com outros tipos de intervenções que respeitem a diversidade cultural do país.

Abstract The objective of this study is to analyze the food habit of quilombola families in Pará, following the guidelines of the Food Guide for the Brazilian Population published by the Brazilian Health Ministry in 2014. Semi-structured interviews were conducted in the communities of Santo Antônio (Concórdia do Pará, in the Northeast) and São João (Salvaterra, on Marajó Island) under protocol CEP 060/07. Analysis of consumption and preferences were made according to the guide. The results show a high consumption of sweetened coffee, beans, rice and flour, and a low participation of vegetables and fruits in the interviewees' diet. Foods such as bread, cow's milk, pasta, margarine, and salt crackers are common means to diversify the foods consumed by the group. As protein sources, the most notable were red meat - wild or not -, fish, beef jerky, chicken and chicken eggs. Some contradictions of the Guide are discussed in relation to such communities. Despite the advancements promoted by the guide, we conclude that following the guidelines for an adequate and healthy food habit in quilombola groups in the Amazon region presents many challenges. Food guides are important for the health and nutrition of the population; however, they need to be combined with other types of interventions that respect the country's cultural diversity.

Improving knowledge, self-efficacy and collective efficacy regarding the Brazilian dietary guidelines in primary health care professionals: a community controlled trial.

BACKGROUND: Capacity-building of health professionals regarding to nutrition is a strategy for qualifying public health work to promote healthy diets in primary health care (PHC) services. OBJECTIVE: To evaluate the effect of an intervention based on Brazilian Dietary Guidelines (BDG) on the knowledge, self-efficacy (SE) and collective efficacy (CE) of interprofessional teams working in PHC. METHODS: It refers to a pre-post intervention study involving 24 health professionals divided into a control group (CG) and intervention (IG). The IG received a 16-h educational workshop on the BDG, guided by a validated protocol. Knowledge, SE and CE for using the BDG were assessed via a self-administered scale, ranging from 0 to 16 and 0 to 36 points, respectively; the scale was previously validated, completed before and after 2 months of the intervention. The effects of the intervention were estimated by paired t-test for intragroup comparisons over time. RESULTS: The mean difference in the knowledge and SE scores of the IG pre- and post-intervention was 2.0 (CI 0.49-3.51) and 6.75 (CI 4.05-9.45) points, respectively. These results means the IG participants obtained 59 and 52.8% more points in knowledge and in SE in relation to CG, with significative difference (p = 0.007 and p <  0.00, respectively). There was no significant variation in the CE scores in both groups. CONCLUSIONS: Considering the results presented and due to the originality of the study in question, the educational workshop was effective in increasing the knowledge and SE of professionals working in PHC in using the Dietary Guidelines in their work routines. These findings can assist other research in developing nutrition interventions with interprofessional teams.

Adherence to Daily Food Guides Is Associated with Lower Risk of Metabolic Syndrome: The Nutrition and Health Survey in Taiwan.

Although nutritional health knowledge serves as the basis for the daily food guides, limited epidemiologic studies were conducted to verify whether adherence to the daily food guides reduced the prevalence of diseases. This study aims to examine whether adherence to the daily food guides relates to the lower risk of having metabolic syndrome, as well as to assess the association between levels of adherence to daily food guides and demographic characteristics. A cross-sectional study was conducted using data from the Nutrition and Health Survey in Taiwan (NAHSIT) 2014-2016. Face-to-face dietary assessments were conducted using a validated food-frequency questionnaire. Six food groups were defined according to the daily food guides in Taiwan. We constructed a daily food guide index to measure the levels of adherence to the daily food guides. Logistic regression was performed to assess the association between the levels of adherence to the daily food guides and the risk of having metabolic syndrome. A total of 2534 participants (51% of females) were included in the final analysis. After adjusting for age, sex, body mass index, education level, marital status, and family income, we found a negative correlation between the levels of adherence to daily food guides and the prevalence of metabolic syndrome. The odds ratios (ORs) for the highest versus lowest quartile of the adherence level was 0.65 (95% confidence interval (CI) = 0.48-0.88). In addition, males, younger age, lower education, divorced, separated, and widowed, and lower family income were associated with lower adherence to daily food guides. In conclusion, participants reporting better adherence to the daily food guides during the past month had a lower risk of having metabolic syndrome.

Classificação de alimentos NOVA: comparação do conhecimento de estudantes ingressantes e concluintes de um curso de Nutrição / NOVA food classification: comparison of the knowledge among incoming and outgoing Nutrition students

Introdução: A segunda edição do Guia Alimentar para a População Brasileira utiliza a classificação NOVA de alimentos nas recomendações para uma alimentação saudável. Essa classificação, portanto, desempenha importante papel na formação de nutricionistas. Objetivo: Comparar o conhecimento da classificação NOVA de alimentos entre estudantes ingressantes e concluintes de Nutrição. Métodos: Estudo transversal realizado em 2016 com estudantes ingressantes e concluintes de um curso de Nutrição do Mato Grosso do Sul. Questionário contendo 30 alimentos foi aplicado com estudantes que os classificaram em: in natura ou minimamente processado, ingrediente culinário processado, processado ou ultraprocessado. O conhecimento foi avaliado por meio de escore de classificações corretas, global e por grupo alimentar. Para análise comparativa, foi utilizado teste U de Mann-Whitney (significância p≤0,05). Resultados: Participaram 69 estudantes (64% ingressantes). O escore global de classificações corretas foi significativamente maior (p=0,000) nos concluintes (mediana=17) comparado aos ingressantes (mediana=14). O escore de classificações corretas entre ingressantes e concluintes apresentou diferenças significativas para todos os grupos alimentares, excetuando ingredientes culinários (p=0,117). Entre todos estudantes, o grupo ingrediente culinário obteve o menor percentual de acertos (24,1%), e ultraprocessado, obteve o maior percentual (77,8%). Conclusão: Apesar do maior conhecimento dos concluintes em relação aos ingressantes, identificou-se um conhecimento insatisfatório sobre a classificação NOVA em ambos. É importante garantir o aprendizado de estudantes de Nutrição quanto à NOVA, uma vez que esta classificação é central na orientação nutricional da população brasileira e, portanto, passa a ser ferramenta fundamental na atuação do profissional nutricionista. (AU)

Introduction: The second edition of the Dietary Guidelines for the Brazilian population uses the NOVA food classification for healthy diet recommendations. Therefore, this classification plays an important role in the training of nutritionists. Objective: To compare the knowledge of the NOVA food classification among incoming and outgoing Nutrition students. Methods: A cross-sectional study was conducted in 2016 involving the incoming and outgoing students of an undergraduate Nutrition course in Mato Grosso do Sul. A questionnaire containing 30 food items was administered to the students, who classified them into: unprocessed or minimally processed, processed culinary ingredients, processed, and ultra-processed food. The students' knowledge was then evaluated using a score of correct classifications, overall and by food group. The Mann­Whitney U test was used for comparative analysis (significant when p≤0,05). Results: A total of 69 students participated (64% were incoming). The overall score of correct classifications was significantly higher (p=0.000) in outgoing students (median=17) than in incoming students (median=14). The score difference of correct classifications between the incoming and outgoing student groups showed significant differences for all food groups, except culinary ingredients (p=0.117). The culinary ingredient group obtained the lowest percentage of correct answers (24.1%), and the ultra-processed food group obtained the highest percentage (77.8%) among all students. Conclusion: Although outgoing students had greater knowledge than incoming students, unsatisfactory knowledge was identified on the NOVA classification in both groups. It is important to assure that the Nutrition students learn about the NOVA classification, since this classification is central to the nutritional guidance of the Brazilian population and, therefore, becomes a fundamental tool in the work of the professional nutritionist. (AU)

Eat regularly and carefully, in appropriate environments and in company": A brief analysis of this recommendation of the Brazilian Food Guide.

The second edition of the Dietary Guidelines for the Brazilian Population has gained prominence both nationally and internationally for its recommendations. "Eating regularly and carefully, in appropriate environments and, whenever possible, in company" is an example of such recommendations presented in the chapter entitled "the act of eating and the commensality". The purpose of this study was to perform a brief analysis of the following 1) the expression "the act of eating" from a sociologic and historical perspective and 2) the recommendation "eat regularly and carefully, in appropriate environments and, whenever possible, in company", separately from each other. It was performed a qualitative study that used documentary research and bibliographic research. The materials considered for the analysis were the fourth chapter of the Brazilian Food Guide, as a document, and books and scientific articles, as bibliographies. The materials were evaluated and selected considering five dimensions: (i) the context; (ii) the author (or the authors); (iii) the authenticity and reliability of the text; (iv) the nature of the text; (v) the key concepts and the internal logic of the text. Then, the document analysis was performed elaborating, for each theme, tables with: (i) names of the authors; (ii) definition or scope of the themes found in the materials, and (iii) annotations from which perspectives the themes were addressed. We present a brief analysis of the relevant aspects of the themes "the act of eating", "eating regularly and carefully", "eating in appropriate environments", and "eating in company". This article contributed to enlarging the scientific discussion on these themes, from various perspectives, and could be taken into account in the development, by other countries, of its dietary guidelines.

Análise comparativa dos guias alimentares para a população brasileira e argentina / Comparative analysis of diet guidelines for brazilians and argentines

Vários países já desenvolveram seus guias com objetivos semelhantes, porém, abrangendo suas particularidades. Objetivou-se analisar o Guia Alimentar para a População Brasileira e o Guia Alimentar para a População Argentina, identificando possíveis semelhanças e diferenças entre estes, relacionando-os quanto à estrutura e à promoção de práticas alimentares saudáveis. Trata-se do estudo descritivo que utilizou o Guia Alimentar Brasileiro e Argentino, com levantamento bibliográfico e análise documental quanto às principais diferenças e semelhanças estruturais e de desenvolvimento. Ao comparar os guias alimentares, observou-se maior conteúdo técnico no guia argentino. Enquanto o brasileiro apresenta as informações de forma mais resumida e dinâmica. Ambos chamam a atenção para a importância da promoção de práticas alimentares saudáveis em todas as fases da vida. A melhoria da qualidade e o aprimoramento dos guias alimentares são fundamentais para a qualidade de vida da população. Logo, maiores estudos que abordem o entendimento e o ponto de vista da população sobre o guia alimentar fazem-se necessários.

Several countries have prepared guidelines with similar aims, albeit featuring their peculiarities. Current study analyzes the Food Guidelines for Brazilians and Argentines, identifying possible similarities and differences and relating them to structures and promotion of health food practices. Current descriptive study uses the Brazilian and Argentine Food Guide, bibliographic survey and documental analysis with regard to the main differences and similarities, structures and their development. A comparison of the food guides reveals high technical contents in the Argentine book, whilst the Brazilian guide provides dynamic and short information. The two guides focus on the promotion of healthy food practices in all life stages. Quality improvement in food guides is basic for population´s life quality. Further studies on the understanding and point of view of the population on food guides are required.

Ingesta de alimentos proteicos en adolescentes de la ciudad de Chillán, Chile / High-protein foods intake by adolescents in Chillan, Chile

RESUMEN El objetivo del estudio fue analizar la ingesta de alimentos proteicos distintos de los lácteos y sus derivados, en adolescentes que asisten a un establecimiento educacional subvencionado en la comuna de Chillán. Se realizó un estudio analítico de corte transversal, con una muestra de 154 adolescentes de edades entre 14 y 17 años. Se evaluó estado nutricional según IMC e ingesta alimentaria mediante encuesta de frecuencia de consumo cuantificado, con énfasis en la ingesta de alimentos de origen proteico distinto de los lácteos. El 90% de los encuestados, independiente del sexo, consumió semanalmente legumbres, carnes, pescados y mariscos. Las medianas de consumo de carnes, alcanzó los 275 g en hombres y 191 g en mujeres (p<0,01). Los hombres consumieron 1,5 veces más embutidos que las mujeres (148 g v/s 89 g; p=0,02). Al comparar la ingesta de los alimentos proteicos estudiados, con la Guía Alimentaria para los adolescentes, el 60% presentó un bajo cumplimiento de ingesta semanal en carnes, huevos, pescados y mariscos, por lo que es imperativo implementar estrategias tendientes a mejorar el consumo de alimentos con proteínas de alto valor biológico que les permitan un adecuado desarrollo.

ABSTRACT The objective of the present study was to analyze the intake of high-protein foods, other than dairy products and their derivatives, by adolescents attending a subsidized school in the city of Chillán, Chile. A cross-sectional analytic study was conducted with a sample of 154 adolescents between the ages of 14 and 17. Nutritional status was evaluated using body mass index (BMI) and food intake was measured using a quantified food consumption trend survey emphasizing the consumption of high-protein foods other than dairy products. Ninety percent of surveyed subjects, independently of sex, consumed legumes, meat, fish, and seafood on a weekly basis. Median weekly consumption of meat was 275 g for boys and 191 g for girls (p<0.01). Boys consumed 1.5 times more sausages than girls (148 g vs. 89 g; p=0.02). When comparing food intake of the high-protein foods under study with the Chilean Food Guide for adolescents, 60% complied poorly with weekly intake of meat, eggs, fish, and seafood. It is therefore imperative to implement strategies to improve the consumption of foods with high levels of biological protein to ensure the adequate development of adolescents.

Content validity of an educational workshop based on the Dietary Guidelines for the Brazilian Population / Validade de conteúdo de uma ofi cina educativa baseada no Guia Alimentar para a População Brasileira

ABSTRACT Objective To describe the development and validation of a workshop protocol for the implementation of the Dietary Guidelines for the Brazilian Population in primary healthcare units. Methods This descriptive study was developed in the state of São Paulo, Brazil, and it involved 20-25 professionals in the experimentation phase and 12 experts in the content validity phase. The workshop protocol was developed according to three theoretical references: Dietary Guidelines, Interprofessional Collaborative Practice and Critical Reflexive Methodology. The protocol consisted of four 4-hour modules, 16 activities in 16 hours. The activities matrix was composed of three axes: (a) organizational strategies, (b) dietary guideline comprehension and (c) dietary guideline implementation. For the validity analysis, the expert panel assessed clarity, relevance and theoretical representativeness. Content validity index was calculated, and adequate activities scored >0.80. The proportion of experts who recognized the presence of the theoretical framework in the activities was calculated. Results All 16 proposed activities obtained a score greater than the established cut-off point, both for clarity and relevance. For theoretical representativeness analysis, the dietary guidelines reached higher scores on the (b) and (c) axes of the protocol and was less recognized on the (a) axis, whose highest score was for the Critical Reflexive Methodology. Interprofessional Collaborative Practice presented a higher score on the (c) axis and a lower one on the (b) axis. Conclusion The protocol was considered appropriate for its purpose and with potential application in the different scenarios of primary health care in Brazil.

RESUMO Objetivo Descrever o desenvolvimento e validação de um protocolo de oficina de educação permanente para implementação do Guia Alimentar para a População Brasileira no âmbito da atenção primária à saúde. Métodos Este estudo descritivo foi desenvolvido no estado de São Paulo. Participaram do estudo 20-25 profissionais de saúde na fase de experimentação e 12 doze especialistas na fase de validação de conteúdo. O protocolo da oficina foi desenvolvido de acordo com três referenciais teóricos: o Guia Alimentar, a Prática Colaborativa Interprofissional e a Metodologia Crítico Reflexiva. O protocolo da oficina foi definido em 4 módulos com 16 atividades, em 16 horas. A matriz de atividades compreendeu três eixos: (a) estratégias organizacionais, (b) compreensão do Guia Alimentar e (c) implementação do Guia Alimentar. Para validação de conteúdo o painel de especialistas avaliou a clareza, relevância e representatividade teórica do protocolo. Índice de validade de conteúdo foi calculado e atividades adequadas pontuaram >0,80. A proporção de especialistas que reconheceu a presença do referencial teórico nas atividades foi calculada. Resultados Todas as 16 atividades propostas obtiveram escores maiores do que o ponto de corte estabelecido, tanto para clareza como para relevância. Na análise da representatividade teórica, o Guia Alimentar alcançou escores mais altos nos eixos (b) e (c), e foi menos reconhecido no eixo (a), cuja maior pontuação ocorreu para a Metodologia Crítico Reflexiva. A Prática Colaborativa Interprofissional apresentou maior pontuação no eixo (c) e menor no eixo (b). Conclusão O protocolo foi considerado adequado à sua finalidade e com potencial de aplicação nos diversos cenários da atenção primária à saúde no Brasil.

Applying a food processing-based classification system to a food guide: a qualitative analysis of the Brazilian experience.

OBJECTIVE: The present paper aimed to identify the stakeholders, as well as their arguments and recommendations, in the debate on the application of a food processing-based classification system to the new Brazilian Food Guide. DESIGN: Qualitative approach; an analysis was made of documents resulting from the consultation conducted for the development of the new Brazilian Food Guide, which uses the NOVA classification for its dietary recommendations. A thematic matrix was constructed and the resulting themes represented the main points for discussion raised during the consultation. SETTING: Brazil. SUBJECTS: Actors from academia, government and associations/unions/professional bodies/organizations related to the area of nutrition and food security; non-profit institutions linked to consumer interests and civil society organizations; organizations, associations and food unions linked to the food industry; and individuals. RESULTS: Four themes were identified: (i) conflicting paradigms; (ii) different perceptions about the role and need of individuals; (iii) we want more from the new food guide; and (iv) a sustainable guide. CONCLUSIONS: There was extensive participation from different sectors of society. The debate generated by the consultation revealed two main conflicting opinions: a view aligned with the interests of the food industry and a view of healthy eating which serves the interests of the population. The first group was against the adoption of a food processing-based classification system in a public policy such as the new Brazilian Food Guide. The second group, although mostly agreeing with the new food guide, argued that it failed to address some important issues related to the food and nutrition agenda in Brazil.

Characterization of adolescents' diet with the Dietary Guidelines for the Brazilian Population / Caracterização da dieta dos adolescentes com o Diretrizes Dietéticas para a População Brasileira

Adolescence is characterized by the transition period between childhood and adulthood. The evaluation of dietary habits at this stage provides ground for the implementation of prevention policies of chronic noncommunicable diseases. The aim of this study was to describe the eating habits of adolescent students from two technical schools in the eastern zone of the city of São Paulo and compare them with the Dietary Guidelines for the Brazilian Population. All incoming students of 2017, of both sexes, up to 19 years old and enrolled in the first year of all the Integrated Technical Courses were invited to participate. In this cross-sectional study, the total sample was 111 students. The research was conducted through an online questionnaire structured by the researcher and was developed based on the Dietary Guidelines' 10 steps for a healthy diet. We verified that among the main meals, the most neglected by adolescents was breakfast, since it was neglected in 1 out of 4 students. Most adolescents consume less than 1 liter of water per day, do not eat whole foods, and often consume rice and beans, milk and dairy products, fruits, sweets and ultra-processed products. The eating habits of this group is not yet in line with the recommendations of the Dietary Guidelines, so a food and nutritional education work aimed at disseminating the recommendations based on this instrument is important for adopting healthier eating practices.

A adolescencia é caracterizada pelo período de transição entre a infância e a fase adulta. A avaliação dos hábitos alimentares nesta fase tem sua importância evidenciada, pois serve como base para implantação de políticas para prevenção de Doenças Crônicas não Transmissíveis. O objetivo desse estudo foi caracterizar a alimentação de estudantes adolescentes de duas escolas técnicas da zona leste do município de São Paulo de acordo com o Guia Alimentar para População Brasileira. Foram convidados todos os alunos ingressantes de 2017, de ambos os sexos, com até 19 anos, matriculados no primeiro ano de todos os Cursos Técnico Integrado ao Médio. Trata-se de um estudo de transversal com uma amostra total de 111 estudantes. A pesquisa foi realizada por meio de questionário online estruturado pelo pesquisador, desenvolvido com base nos 10 passos para uma alimentação saudável do Guia Alimentar. Observando os hábitos comportamentais ligados a alimentação verificou-se que dentre as principais refeições, a mais negligenciada pelos adolescentes foi o café da manhã, pois era omitida por cerca de 1 em cada 4 dos estudantes. A maioria dos adolescentes ingere menos de 1 litro de água por dia, não ingere alimentos integrais e ingere frequentemente arroz e feijão, leite e derivados, frutas, doces e produtos ultraprocessados. A alimentação desse grupo ainda não está em consonância com as recomendações do Guia Alimentar, por isso um trabalho de educação alimentar e nutricional voltado a divulgação de recomendações baseadas nesse instrumento é importante para adoção de práticas alimentares mais saudáveis.

Nutritional Guidelines and Fermented Food Frameworks.

This review examines different nutritional guidelines, some case studies, and provides insights and discrepancies, in the regulatory framework of Food Safety Management of some of the world's economies. There are thousands of fermented foods and beverages, although the intention was not to review them but check their traditional and cultural value, and if they are still lacking to be classed as a category on different national food guides. For understanding the inconsistencies in claims of concerning fermented foods among various regulatory systems, each legal system should be considered unique. Fermented foods and beverages have long been a part of the human diet, and with further supplementation of probiotic microbes, in some cases, they offer nutritional and health attributes worthy of recommendation of regular consumption. Despite the impact of fermented foods and beverages on gastro-intestinal wellbeing and diseases, their many health benefits or recommended consumption has not been widely translated to global inclusion in world food guidelines. In general, the approach of the legal systems is broadly consistent and their structures may be presented under different formats. African traditional fermented products are briefly mentioned enhancing some recorded adverse effects. Knowing the general benefits of traditional and supplemented fermented foods, they should be a daily item on most national food guides.