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

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

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

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

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.

Dietary Patterns of Children and Adolescents from High, Medium and Low Human Development Countries and Associated Socioeconomic Factors: A Systematic Review.

The purpose of this systematic review is to assess the associations among education, income and dietary pattern (DP) in children and adolescents from high, medium and low human development countries (HHDC, MHDC and LHDC, respectively). Observational studies that evaluated the association between family income or education with the DP are obtained through electronic database searches. Forty articles are selected for review. In HHDC, education is inversely associated with "unhealthy" DP and positively associated with "healthy" DP. In cross-sectional studies from HHDC, higher income is negatively associated with "unhealthy" DP. In MHDC, there is no association between the socioeconomic variables (SE) and the DPs, although, in some studies, the unhealthy diet is positively associated with SE. Only one study conducted in LHDC showed an inverse association between income/education with "unhealthy" DP and there is no association between the SE and "healthy" DP. In conclusion, children and adolescents living in HHDC with high parental education tend to have a healthier diet. In MHDC, although an unhealthy diet is found among the high-income and educated population, the associations are not clear. Additional research is needed to clarify the associations between income and education with "unhealthy" and "healthy" DPs in MHDC and LHDC.

Educational training of nutritionists in Public Health Nutrition: A systematic review / Formação do nutricionista em Saúde Pública. uma revisão sistemática

ABSTRACT The present systematic review aimed to synthesize the findings of studies in the literature on the educational training of nutritionists in Public Health. The study was conducted by searching international databases (PubMed, Science Direct, Lilacs, PsycINFO, Scopus, and Web of Science), as well as in the gray literature. The steps of systematic search followed the recommendations of the Preferred Reporing Itens for Systematic Reviews and Meta-Analysis. Eligibility criteria included studies on the Public Health training in Nutrition Undergraduate courses, whose subjects were students, educators, and professionals who practice in the field of Nutrition. A total of 633 articles were identified, of which, 66 were eligible for reading and analysis of the full text and 12 were included in the systematic review. Of these, five of these 12 articles used quantitative methods, 3 used mixed methods, and 4 used exclusively qualitative methods. There was high heterogeneity among the studies, such as different samples, subjects, and evaluation methods. The studies included were carried out from 2008 to 2017 in 28 different countries, including Brazil, Canada, Vietnam, and some European countries. In most of these articles, Public Health was one of the main areas in the formal education of nutritionists, with predominant traditional teaching approach, with a biological focus and a fragmented curricular structure. The included studies were evaluated with low risk of bias. In spite of the limitations identified in the professional training of nutritionists, there was a clear emphasis on the importance of the relationship between theory and practice, teaching-research-extension approaches, and practical activities or internships in Public Health, which can promote the development of skills and competencies that can exert an impact on their professional performance.

RESUMO A presente revisão sistemática objetivou sintetizar os achados disponíveis na literatura sobre a formação profissional do nutricionista em Saúde Pública. A pesquisa foi realizada em bases de dados internacionais (PubMed, Science Direct, Lilacs, PsycINFO, Scopus e Web of Science), bem como uma busca adicional na literatura cinzenta. As etapas da pesquisa seguiram as recomendações do Preferred Reporing Itens for Systematic Reviews and Meta--Analysis. Como critérios de elegibilidade incluiu-se os estudos sobre a formação em Saúde Pública nos cursos de Graduação em Nutrição, cujos sujeitos respondentes eram estudantes, docentes e profissionais do campo da Nutrição. Foram identificados incialmente 633 artigos, dos quais 66 foram elegíveis para leitura completa e 12 incluídos na revisão sistemática. Destes, cinco utilizaram a abordagem quantitativa, três se serviram da metodologia mista, e quatro são estudos qualitativos. A heterogeneidade dos estudos foi alta, com amostras, público-alvo e métodos de avaliação distintos. As pesquisas incluídas foram realizadas em 28 países, entre eles Brasil, Canadá, Vietnã e países da Europa, nos anos de 2008 a 2017. Na maioria dos estudos, a Saúde Pública está entre as principais áreas na formação profissional do nutricionista, num processo de ensino que se mostrou tradicional, biologicista e com estrutura curricular fragmentada. A qualidade dos estudos indicou baixo risco de vieses. Houve um destaque para a importância da articulação teoria-prática, ensino-pesquisa-extensão e atividades práticas-estágios na formação em Saúde Pública, o que favorece o desenvolvimento de competências e habilidades que podem se refletir na atuação profissional.