Dietary and Nutritional Profiles among Brazilian Adolescents.

(1) Background: The present study analyzed the prevalence of dietary and nutritional profiles among Brazilian adolescents and their associations with social determinants of health. (2) Methods: A population-based survey was administered to 16,409 adolescents assessed by the 2015 National School Health Survey. A multivariate model of dietary and nutritional profiles was estimated from correspondence analysis. (3) Results: The dietary and nutritional profiles more prevalent among Brazilian adolescents were "lower nutritional risk dietary pattern and eutrophic" (42.6%), "lower nutritional risk dietary pattern and overweight" (6.8%), and "higher nutritional risk dietary pattern and overweight" (6.0%). Healthier profiles were associated with less urbanized territories, health-promoting behaviors, and families with worse material circumstances. The less healthy profiles were associated with more urbanized environments, health risk behaviors, and families with better material circumstances. (4) Brazilian adolescents have different dietary and nutritional profiles that are characterized by sociopolitical and economic contexts, family material and school circumstances, and the behavioral and psychosocial health factors of the individuals. All of this points to the social determination of these health problems among adolescents in Brazil.

Social Determinants of Obesity and Stunting among Brazilian Adolescents: A Multilevel Analysis.

(1) Background: The purpose of this study was to identify the prevalence of obesity and stunting among Brazilian adolescents and its associations with social determinants of health (individual, family, and school), grounded on the necessity of investigating the determinants of nutritional problems within this population. (2) Methods: A population-based survey was administered to 16,556 adolescents assessed by the 2015 National School Health Survey. Multivariate models of obesity and stunting were estimated from Multilevel Poisson Regressions. (3) Results: The prevalence of obesity among Brazilian adolescents (10.0%; 95% CI: 9.4-10.6) was associated directly with indifference or dissatisfaction with body image, with eating breakfast four or fewer days a week, living with up to four people in the household, studying in private schools, and being from the South region, and was inversely associated with being female, 15 years old or older, with having the highest nutritional risk eating pattern, dining at fast-food restaurants, and eating while watching television or studying. The prevalence of stunting (2.3%; 95% CI: 2.0-2.8) was directly associated with the age of 15 years or older, and inversely associated with the lower number of residents living in the household, maternal education-decreasing gradient from literate to college level education, studying in urban schools, and being from the South and Central-West regions. (4) Conclusions: Obesity in adolescence presented behavioral determinants. Stunting and obesity have structural social determinants related, respectively, to worse and better socioeconomic position among Brazilian adolescents.

Influence of federal feeding programs on the anthropometric indicators of nutritional status of adolescents / Influência de programas federais de alimentação sobre os indicadores antropométricos do estado nutricional de adolescentes

ABSTRACT Objective To assess the influence of federal feeding programs on the anthropometric indicators of nutritional status of adolescents from Federal Institutes. Methods Temporal analysis of the anthropometric data of students from the capital of Rio Grande do Norte, Brazil (n=250), on admission in 2017 (baseline) and after one year, in 2018 (follow-up). Participation in student assistance programs, sociodemographic, anthropometric, dietary, and physical activity aspects were evaluated. The Split Plot ANOVA test was used to analyze height-for-age and body mass index-for-age as continuous variables (mean of z-score; variation in the mean of z-score between baseline and follow-up). Prevalence Ratio was used to analyze categorical variables: improvement in height-for-age (increase in z-score value between baseline and follow-up); improvement in body mass index-for-age (change in z-score towards zero between baseline and follow-up). Results There was a reduction in the height-for-age z-score (-0.173 to -0.350; p<0.001; eta=0.195), but this decline was smaller in the participants of both programs (from -0.249 to -0.357) compared to those not assisted by both simultaneously (from -0.149 to -0.345) (p=0.041). The improvement in height-for-age was positively associated with longer daily time spent at school and participation in the food program under the National Student Assistance Program. The improvement in body mass index-for-age was negatively associated with sex and positively with the number of people in the household. Conclusion The concomitant participation in the National School Feeding Program and in the National Student Assistance Program had a positive influence on the linear growth of students in situations of socioeconomic vulnerability.

RESUMO Objetivo Avaliar a influência de programas federais de alimentação sobre os índices antropométricos do estado nutricional de adolescentes matriculados em institutos federais. Métodos Análise temporal dos dados antropométricos de estudantes da capital do Rio Grande do Norte, Brasil (n=250) na admissão, em 2017 (baseline), e após um ano, em 2018 (follow-up). Foram avaliados a participação nos programas de assistência estudantil, aspectos sociodemográficos, antropométricos, práticas alimentares e de atividade física. O teste Split Plot ANOVA foi utilizado para analisar estatura-para-idade e índice de massa corporal-para-idade como variáveis contínuas (média de escore-z; variação da média de escore-z entre baseline e follow-up). A Razão de Prevalência foi utilizada para analisar as variáveis categóricas: melhora na estatura-para-idade (aumento no valor de escore-z entre baseline e follow-up) e melhora no índice de massa corporal-para-idade (mudança no escore-z em direção ao zero entre baseline e follow-up). Resultados Houve redução no escore-z de estatura-para-idade (de -0,173 para -0,350; p<0,001; eta=0,195), porém esse declínio foi menor nos participantes de ambos os programas (de -0,240 para -0,357) comparados àqueles que não foram assistidos simultaneamente por eles (de -0,149 para -0,345) (p=0,041). A melhora na estatura-para-idade associou-se positivamente a um maior tempo diário na escola e à participação no programa de alimentação do Programa Nacional de Assistência Estudantil. A melhora no índice de massa corporal-para-idade associou-se negativamente ao sexo e positivamente ao número de pessoas no domicílio. Conclusão A participação concomitante no Programa Nacional de Alimentação Escolar e no Programa Nacional de Assistência Estudantil teve uma influência positiva no crescimento linear dos escolares em situação de vulnerabilidade socioeconômica.

FOOD AND NUTRITIONAL PROFILES OF BRAZILIAN ADOLESCENTS / PERFIS ALIMENTARES E NUTRICIONAIS DE ADOLESCENTES BRASILEIROS

The objective of this study was to analyze the prevalence of dietary and nutritional profiles of Brazilian adolescents and their associations with sociodemographic, behavioral and sustainability factors. Data from 16,556 adolescents evaluated by the 2015 National Adolescent Health Survey were used. The information was generated from Descriptive and Correspondence Analysis of the main variables - food and nutritional profiles (combination of dietary pattern categories with nutritional status categories) - and secondary. The most prevalent profile was identified as the type of dietary pattern (BP) with the lowest nutritional risk (NB) with normal weight, grouping 42.6% (95%CI: 41.3-43.7) of the adolescents, followed by the PA profiles of higher NB with normal weight (28.1%; 95%CI: 27.1-29.0), BP of lower NB with excess weight (17.5%; 95%CI: 16.7-18.3), BP of higher NB with excess weight (9.2%; 95%CI: 8.6-9.8), BP of lower NB with thinness (1.5%; 95%CI: 1.3-1.8) and BP of greater NB with thinness (1.1%; 95%CI: 0.9-1.4). These food and nutritional profiles coexist with different ways of life among Brazilian adolescents marked by sociodemographic, behavioral and sustainability aspects. The identification of these profiles and how they are distributed in the population allows for a better diagnosis of the realities of adolescents and the planning of more targeted and resolute feeding actions.

O objetivo desse trabalho foi analisar as prevalências dos perfis alimentares e nutricionais de adolescentes brasileiros e suas associações com fatores sociodemográficos, comportamentais e de sustentabilidade. Foram utilizados dados de 16.556 adolescentes avaliados pela Pesquisa Nacional de Saúde do Escolar 2015. As informações foram geradas a partir de Análise descritiva e de Correspondência das variáveis principais ­ perfis alimentares e nutricionais (combinação de categorias do padrão alimentar com categorias do estado nutricional) - e secundárias. Identificou-se como perfil mais prevalente o tipo padrão alimentar (PA) de menor risco nutricional (RN) com eutrofia agrupando 42,6% (IC95%: 41,3-43,7) dos adolescentes, esse foi seguido pelos perfis PA de maior RN com eutrofia (28,1%; IC95%: 27,1-29,0), PA de menor RN com excesso de peso (17,5%; IC95%:16,7-18,3), PA de maior RN com excesso de peso (9,2%; IC95%:8,6-9,8), PA de menor RN com magreza (1,5%; IC95%:1,3-1,8) e PA de maior RN com magreza (1,1%; IC95%: 0,9-1,4). Esses perfis alimentares e nutricionais coexistem com formas de vida diferentes entre os adolescentes brasileiros marcadas por aspectos sociodemográficos, comportamentais e de sustentabilidade. A identificação desses perfis e como se distribuem na população permite um melhor diagnósticos das realidades dos adolescentes e ao planejamento de ações de alimentação mais direcionadas e resolutivas.

Avaliação das boas práticas na produção de alimentos em escolas públicas do município de Currais Novos, RN / Evaluation of good practices in food production of public schools in Currais Novos, RN

Este trabalho teve como objetivo avaliar os aspectos higiênico-sanitários de Unidades de Alimentação e Nutrição Escolares (UANE) de duas escolas públicas do município de Currais Novos (RN) quanto à adoção das Boas Práticas na Alimentação Escolar. Os dados foram coletados por meio de lista de verificação própria para UANE, durante as visitas realizadas nas unidades de uma escola estadual e uma municipal. As unidades avaliadas se encontravam em risco sanitário regular, com pontuações de 74% e 54% para a escola estadual e municipal, respectivamente. As principais inadequações encontradas foram relacionadas às edificações e instalações; aos manipuladores; à higienização dos hortifrutis e ao controle de pragas e vetores urbanos. Pode-se concluir que a produção de refeições nas UANEs das escolas avaliadas não atende a requisitos importantes previstos pelas Boas Práticas na Alimentação Escolar.(AU)

This work intends to evaluate the hygiene-health aspects of Food and Nutrition Units (SFNU) of two public schools in the city of Currais Novos (RN) regarding the adoption of best practices in school food and nutrition. Data were collected through SFNU checklist, during visits to the units of a state and a municipal school. The health risk of units evaluated was regular, with scores of 74% and 54% for the state and municipal schools, respectively. The main inadequacies found were related to structure and facilities; food handlers; the hygiene of fruit and vegetables; and pest control and urban vectors. It could be concluded that the production of meals in SFNU of schools evaluated does not comply with important requirements established by the Good Practices in School Food and Nutrition.(AU)