Instruments and indicators for assessing organisational food environments: a scoping review protocol.

INTRODUCTION: Many studies have explored the food environment to characterise it and understand its role in food practices. Assessment of the organisational food environment can contribute to the development of more effective interventions to promote adequate and healthy eating. However, few instruments and indicators have been developed and validated for assessing this type of setting. The systematisation of those can be useful to support the planning of future assessments and the development of wide-ranging instruments. This study aims to conduct a scoping review to systematise evidence on instruments and indicators for assessing organisational food environments. METHODS AND ANALYSIS: This scoping review was planned according to the methodological framework for scoping reviews proposed by Arksey and O'Malley and subsequently enhanced by Levac et al. For the report of the review, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews (PRISMA-ScR) checklist and guidelines will be used. The search will be conducted using PubMed, Embase, Web of Science, PsycINFO, Scopus and Google Scholar databases. The studies to be included were required to have been published in peer-reviewed journals since January 2005. No geographical, population or language restrictions will be applied given the desired breadth of the review. Two researchers will select the articles and extract the data independently. The conceptual model proposed by Castro and Canella will guide the data extraction and analysis. The results will be presented with narrative synthesis for the extracted data accompanying the tabulated and charted results. ETHICS AND DISSEMINATION: This study is based on the analysis of published scientific literature and did not involve patients, medical research, or any type of personal information; therefore, no ethical approval was obtained for this study. The results of this scoping review will be submitted for publication in an international peer-reviewed journal, preferably open access.

It is time: free meals at schools for all.

The link between school feeding programmes (SFP) and the promotion of healthy eating and health is being explored in studies performed in different countries. The coronavirus disease-19 pandemic has revealed flaws and weaknesses in contemporary food systems, with many school-age children experiencing food insecurity and hunger. There is intense debate among policymakers regarding whether government SFP should be universal or targeted. Countries such as Brazil and India, which have two of the most comprehensive universal free-of-charge programmes, have shown the benefits of SFP, including improved nutritional status, support for more sustainable food systems, attendance and academic performance. Evidence shows and supports actions advocating that it is time to offer healthy and free school meals for all students.

Evaluation of food purchasing in the Brazilian School Feeding Programme: feasibility of the requirements and recommendations.

OBJECTIVE: To analyse the purchase of food for school feeding, according to the extent and purpose of industrial processing and variety, exploring the feasibility of achieving the requirements and recommendations of the Brazilian School Feeding Programme, and the variety of unprocessed or minimally processed foods according to the purchase of ultra-processed foods. DESIGN: Secondary data from 2016 from the Accountability Management System of the National Fund for Educational Development, concerning the food items purchased, were used to explore the feasibility of the requirements and recommendations. The foods were grouped according to the NOVA classification system. Variety was assessed by counting different types of unprocessed or minimally processed foods. SETTING: Brazil. PARTICIPANTS: 3698 Brazilian municipalities. RESULTS: Energy share from unprocessed or minimally processed foods was 44·1 % while that of ultra-processed foods was 29·9 %. The average of unprocessed or minimally processed food types purchased annually was 33·8 items. Of the municipalities, 35·8 % were within the limit established for the expenditure of funds for the purchase of processed and ultra-processed foods, while 8·7 % followed the recommendation for variety. The proportion of ultra-processed foods did not influence the variety of food items purchased. CONCLUSIONS: The results showed the feasibility of achieving the requirements and recommendations and underscored the importance of continued efforts to promote the inclusion of unprocessed or minimally processed foods in the school feeding programme while addressing the challenges associated with expenditure limits of processed and ultra-processed foods and enhancing variety, which is strategic to promote adequate and healthy meals.

Association between Consumption of Ultra-Processed Foods and Sociodemographic Characteristics in Brazilian Adolescents.

BACKGROUND: The consumption of ultra-processed foods is associated with several negative health outcomes. Studies on adolescents have shown that this population has a high consumption of these foods, especially in high-income countries. However, there are no studies on the types of ultra-processed foods consumed. The present study evaluated secondary data from a representative sample of the National School Health Survey, the consumption of ultra-processed foods by 159,245 Brazilian adolescents. METHODS: Data were collected via a self-administered questionnaire using a mobile device. A Poisson regression model was used to assess the prevalence of ultra-processed food consumption and its correlation with sociodemographic characteristics. RESULTS: The consumption of ultra-processed foods was significant among Brazilian adolescents, and almost half of the participants reported consumption the day before. We observed that sociodemographic characteristics such as school type, race/skin color, region, municipality type, age, living with mother, living with father, and maternal education level were associated with greater or lesser consumption of ultra-processed foods. Adolescents who study in private schools, are female, white, and live in non-capital cities consume more ultra-processed foods. CONCLUSIONS: Access to in natura and minimally processed foods must be on the agenda of governments and encouraged by food and nutrition education to guarantee the right to adequate and healthy food.

Risk assessment of azo dyes as food additives: Revision and discussion of data gaps toward their improvement.

The food industry uses dyes mainly to overcome color loss during the processing and storage of products, with the azo dyes currently being the most employed. Studies on the safety of using these dyes in foods started in the 1950s and have indicated the potential for concern. This review discusses the risk assessment of food intake containing artificial azo dyes. There are case reports and, subsequently, double-blind placebo-controlled trials in some individuals who may experience adverse effects from the intake of azo dyes, but it is unclear whether these adverse effects are restricted to specific populations or more generalized. In view of this, different toxicological endpoints are evaluated to verify toxic effects in in vitro and in vivo models and to establish the no observed adverse effect level. Exposure estimation studies have shown that human exposure to azo dyes via oral intake is mainly below the acceptable daily intake established by advisory bodies. However, most countries do not have studies that estimate the oral intake of azo dyes. In this case, local food diversity and racial-ethnic specificities are not considered when stating the exposure estimate is below the acceptable daily intake for the human population and thus may not represent actual intake. Concerning the scenario established above, this review discusses the most critical gaps to be overcome to contribute to the direction of future studies and the development of more effective public policies concerning the safety of the intake of artificial azo dyes.

Atuação do MESA São Paulo durante a pandemia do Coronavírus / MESA São Paulo's performance during the Coronavirus pandemic

Introdução: O Mesa Brasil é um programa social desenvolvido pelo Serviço Social do Comércio que busca reduzir o desperdício de alimentos e auxiliar no enfrentamento da fome. Objetivo: O estudo teve como objetivo compreender a sua atuação frente à pandemia de COVID-19, um período de crise humanitária, sanitária, ambiental e socioeconômica mundial. Métodos: Trata-se de um estudo transversal qualitativo que envolveu a realização de entrevistas semi-estruturadas com as Coordenadoras estadual, municipal (metrópole, litoral e interior) e do Centro de Captação e Armazenagem Mesa Brasil de São Paulo. A análise de todo o conteúdo foi do tipo temática. Resultados: Dentre as principais alterações e adaptações, estão a redução das doações, para a qual houve flexibilidade no cadastro das instituições, atendimento às famílias, desenvolvimento de campanha e cestas básicas com produtos de higiene e limpeza; aumento de doações de ultraprocessados, para o qual houve a respectiva adesão a alguns produtos não usuais. Conclusão: O programa demonstrou enorme capacidade em desenvolver medidas criativas para o novo cenário a um tempo relativamente curto, muitas das quais podem servir de inspiração para outras iniciativas. Apresentou-se ainda mais imprescindível para esse cenário de emergência, especialmente no que tange a alimentação da população vulnerabilizada dentro de um país com políticas públicas ausentes para tal. (AU)

Introduction: Mesa Brazil is a social program developed by the Social Service of Commerce that seeks to reduce food waste and help fight hunger. Objective: The objective of the study was to understand its performance in a period of humanitarian, sanitary, environmental and world socioeconomic crisis. Methods: This is a qualitative cross-sectional study that carried out semi-structured interviews with the state and municipal coordinators (metropolis, coast and countryside) and the Mesa Brazil Collection and Storage Center in São Paulo. The analysis of all the material was of a thematic type. Results: Among the main changes and adaptations are the reduction of donations, for which there was flexibility in the registration of institutions, assistance to families, development of campaigns and basic baskets with hygiene and cleaning products; increase in donations of ultra-processed products, for which there was the respective adherence to certain unusual products. Conclusion: The program has shown enormous capacity to develop creative measures for the new scenario in a relatively short time, many of which can serve as inspiration for other initiatives. It was even more essential for this emergency scenario, especially with regard to feeding the vulnerable population within a country with absent public policies for this. (AU)

Update of the acquisition parameters of the Brazilian National School Feeding Program based on the Dietary Guidelines for the Brazilian Population. / Atualização dos parâmetros de aquisição do Programa Nacional de Alimentação Escolar com base no Guia Alimentar para a População Brasileira.

The Dietary Guidelines for the Brazilian Population is acknowledged as a powerful inducer of public food and nutrition policies. In this perspective, this article presents the methodological path and evidence that supported the elaboration of the new parameters of food acquisition of the Brazilian National School Feeding Program (PNAE). This elaboration involved the analyses of: (1) participation of federal resources used to purchase food, grouped according to the NOVA classification, used in Dietary Guidelines for the Brazilian Population, by the set of Brazilian municipalities and according to the classification of the execution (positive or negative); (2) monthly reference menus that were prepared following Dietary Guidelines for the Brazilian Population recommendations; (3) analysis of food acquisition by the sampling of 525 municipalities, involving the relative participation of food groups (according to NOVA) in total expenditures and energy and nutritional quality of purchased foods; and (4) analysis of ultra-processed foods that should not be offered in the school environment. We proposed the adoption of the following parameters for the participation of food groups in relation to the total federal resources used in the purchase of food: ≥ 75% of resources for fresh or minimally processed foods; < 20% for processed or ultra-processed foods and < 5% for processed culinary ingredients, as well as the expansion of the list of foods whose acquisition with federal resources from PNAE is prohibited. This process supported the elaboration of Resolution CD/FNDE n. 6 of May 8, 2020, which provides for the attendance of school feeding to primary education students within the PNAE.

O Guia Alimentar para a População Brasileira é reconhecido como um potente indutor de políticas públicas de alimentação e nutrição. Nessa perspectiva, este artigo apresenta o percurso metodológico e as evidências que subsidiaram a elaboração dos novos parâmetros de aquisição de alimentos do Programa Nacional de Alimentação Escolar (PNAE). Tal elaboração envolveu as análises de: (1) participação dos recursos federais utilizados para compra de alimentos, agrupados segundo a classificação NOVA, empregada no Guia Alimentar para a População Brasileira, pelo conjunto de municípios brasileiros e segundo classificação da execução (positiva ou negativa); (2) cardápios mensais de referência que foram elaborados seguindo recomendações do Guia Alimentar para a População Brasileira; (3) aquisição de alimentos por amostra de 525 municípios, envolvendo a participação relativa dos grupos de alimentos (segundo a NOVA) no total de gastos e de energia e a qualidade nutricional dos alimentos adquiridos; e (4) alimentos ultraprocessados que não devem ser ofertados no ambiente escolar. Foi proposta a adoção dos seguintes parâmetros para participação dos grupos de alimentos em relação ao total de recursos federais empregados na compra de alimentos: ≥ 75% de recursos para alimentos in natura ou minimamente processados; < 20% para alimentos processados ou ultraprocessados e < 5% para ingredientes culinários processados e a ampliação da lista de alimentos cuja aquisição com recursos federais do PNAE é proibida. Esse processo subsidiou a elaboração da Resolução CD/FNDE nº 6, de 8 de maio de 2020, que dispõe sobre o atendimento da alimentação escolar aos alunos da educação básica no âmbito do PNAE.

La Guía Alimentaria para la Población Brasileña está reconocida como un potente inductor de políticas públicas de alimentación y nutrición. Desde esta perspectiva, este artículo presenta la trayectoria metodológica y evidencias que apoyaron la elaboración de los nuevos parámetros de adquisición de alimentos del Programa Nacional de Alimentación Escolar (PNAE). Tal elaboración implicó los análisis de: (1) participación de los recursos federales utilizados para la compra de alimentos, agrupados según la clasificación NOVA, empleada en el Guía Alimentaria para la Población Brasileña, por el conjunto de municipios brasileños, y según la clasificación de la ejecución (positiva o negativa); (2) menús mensuales de referencia que fueron elaborados siguiendo recomendaciones del Guía Alimentaria para la Población Brasileña; (3) adquisición de alimentos mediante una muestra de 525 municipios, implicando la participación relativa de los grupos de alimentos (según NOVA) en el total de gastos y de energía, así como la calidad nutricional de los alimentos adquiridos; y (4) alimentos ultraprocesados que no deben ser ofrecidos en el entorno escolar. Se propuso la adopción de los siguientes parámetros para la participación de los grupos de alimentos, en relación con el total de recursos federales empleados en la compra de alimentos: ≥ 75% de recursos para alimentos in natura o mínimamente procesados; < 20% para alimentos procesados o ultraprocesados, y < 5% para ingredientes culinarios procesados, así como la ampliación de la lista de alimentos, cuya adquisición con recursos federales del PNAE está prohibida. Este proceso apoyó la elaboración de la Resolución CD/FNDE nº 6, del 8 de mayo de 2020, que organiza la atención de la alimentación escolar a alumnos de educación básica en el ámbito del PNAE.

Characteristics of Brazilian school food and physical activity environments: PeNSE 2015.

OBJECTIVE: To characterize the food and physical activity environments in Brazilian public and private schools, and develop indicators to evaluate them. METHODS: This is a cross-sectional study conducted with data from a questionnaire on school characteristics of the 2015 National Adolescent School-based Health Survey, answered by principals or coordinators, referring to 3040 public and private schools throughout the country. The variables related to food and physical activity environments were described in isolation, and an indicator was developed for each environment, with scores ranging from 0 to 100. The frequency and mean score of each variable were described according to the administrative sphere (public or private). RESULTS: The public sector showed a predominance of school meals offer (97.8%), whereas the private sector, of canteens (89.8%). Both had a similar frequency of alternative food outlets in the surroundings. Private schools provided all markers of healthy and unhealthy eating in canteens more frequently. Public schools scored higher in "Food and beverage availability" (64.9) than private schools (55.8). The characteristics of physical activity environments showed that sports courts and sports or games equipment were common in public (69.2% and 90.7%, respectively) and private schools (94.1% and 99.8%, respectively), though at a significantly higher frequency in the second group. Private schools scored higher in "Structures and materials availability" than public schools (63.3 and 41.6, respectively). CONCLUSIONS: Public schools provide a more favorable food environment, whereas private schools, a physical activity environment.

The contribution of school meals to food security among households with children and adolescents in Brazil.

OBJECTIVES: This study aimed to analyze the relationship between food insecurity and school meal consumption, adjusted for sociodemographic variables. METHODS: This cross-sectional study investigated households with children and adolescents living in Brazilian municipalities. A semistructured survey was administered to parents/guardians at a parent-teacher meeting to assess their socioeconomic conditions and access to food, using the Brazilian Food Insecurity Scale to classify households as having food security or mild, moderate, or severe food insecurity. Parents and students were asked about the frequency of their consumption of school meals offered by the Brazilian School Food Program, which is one of the largest public policies in Brazil and offers free meals to all students in all public schools. Multinomial regression was performed to assess the relationship between food security and frequency of school meal consumption. RESULTS: A total of 1705 students participated in the study, most of whom displayed some degree of food insecurity (56.5%) per the Brazilian Food Insecurity Scale. Regular consumption of school meals (>3 times/wk) was reported by 78.5% of students. Regarding the frequency of school meal consumption adjusted by sociodemographic variables, students from households with food insecurity (moderate or severe) were more likely to regularly consume school meals. The prevalence of households with moderate or severe food insecurity was twice as high as for those who lived in households with food security after adjusting for sociodemographic variables (odds ratio: 2.35; 95% confidence interval 1.53-3.61). CONCLUSIONS: The Brazilian School Food Program has contributed greatly to food security. Although the guarantee of universality is essential for the program to reach all school children who are experiencing food insecurity, the program should also aim for greater equity.

School feeding in Federal Institutes: characterization and analysis of food acquisitions from family farming / Alimentação escolar nos Institutos Federais: caracterização e análise das aquisições de alimentos da agricultura familiar

ABSTRACT Objective The Federal Institutes of Education, Science, and Technology provide Basic Education and, thus, must execute the National School Feeding Program. The study aimed to characterize school feeding in these institutes, focusing on the purchase of food from family farming. Methods Cross-sectional study with Brazilian Federal Institutes that offer Basic Education courses. The characteristics of purchases from family farming in 2019 were analyzed, as well as the type of management of the school food service, the presence of a nutritionist in the unit acting as technical manager, and the presence of a canteen. Pearson's chi-square test was used to analyze the association between the variables, adopting a statistical significance level of 5%. Results A total of 171 campuses, distributed in the five Brazilian regions, participated in the study. Among the participants in the survey, 35.1% did not offer any type of food to their students. The percentage of Federal Institutes that carried out acquisitions from family farming was 48%. The presence of a nutritionist was verified in 33.9% of the campuses and associated with food purchases from family farming. The type of food service management was shown to be related to the diversity of the purchases and the main categories of purchased foods. Conclusion The results demonstrate the importance of monitoring the school feeding policy at the federal level, being possible to characterize the school feeding in the Federal Institutes, also showing that more than half of the sample did not make purchases from family farming.

RESUMO Objetivo Os Institutos Federais de Educação, Ciência e Tecnologia ofertam Ensino Básico, e, assim, devem executar o Programa Nacional de Alimentação Escolar. O objetivo do estudo foi caracterizar a alimentação escolar nos Institutos Federais, com enfoque na aquisição de alimentos da agricultura familiar. Métodos Estudo transversal com Institutos Federais de todo o Brasil que ofertam cursos do Ensino Básico. Foram analisadas as características das compras realizadas da agricultura familiar, o tipo de gestão do serviço de alimentação escolar, a presença de nutricionista na unidade atuando como responsável técnico e a existência de cantina. Para a análise da associação entre as variáveis, utilizou-se o teste qui-quadrado de Pearson, adotando nível de significância estatística de 5%. Resultados Participaram do estudo 171 campi, distribuídos nas cinco regiões brasileiras. Entre os participantes da pesquisa, 35,1% não ofertavam qualquer tipo de alimentação aos seus estudantes. O percentual de Institutos Federais que realizaram aquisições da agricultura familiar foi de 48%. A presença de nutricionista foi verificada em 33,9% dos campi e mostrou associação com a compra de alimentos da agricultura familiar, enquanto o tipo de gestão do serviço de alimentação mostrou relação com a diversidade da aquisição, bem como com as principais categorias de alimentos adquiridos. Conclusão Os resultados demonstram a importância do acompanhamento da política de alimentação escolar na esfera federal, sendo possível caracterizar a alimentação escolar nos Institutos Federais, além de evidenciar que mais da metade da amostra não realizou aquisições da agricultura familiar.

Use Database to Evaluate the Prevalence of Hunger Among Adolescents in Brazil.

Food insecurity and malnutrition have become serious problems in many countries. In recent years, Brazil has experienced an increase in the prevalence of food insecurity and hunger. However, there is limited information on the status of these issues, and food security assessments are only performed as household measures. Therefore, the use of available databases is essential to expand information and support decision-making in the fight against food insecurity. This study aimed to evaluate the relationship between reports of hunger among adolescents and their sociodemographic characteristics. We used data from the 2015 National School Health Survey. The main variable of interest was obtained from responses to the following question: "Over the past 30 days, how often have you gone hungry because you did not have enough food at home?". The responses were separately gathered from those who reported going hungry and those who did not. Socioeconomic characteristics were evaluated simultaneously. For statistical analysis, a Pearson chi-square test and multiple analyses were performed using Poisson regression models. A total of 101,888 adolescents were evaluated. The variable used to measure hunger was associated with maternal education, internet access, and fruit intake. The results showed a positive association between adolescents who reported going hungry and women, black and indigenous adolescent students living in households with more than five people, adolescents not living with their father, and adolescents planning to work or not knowing what they will do after completing the ninth grade. The results demonstrate that it is possible to use secondary data with a single question to assess, monitor, and provide insights into how food security impacts the sociodemographic groups differently.

Atualização dos parâmetros de aquisição do Programa Nacional de Alimentação Escolar com base no Guia Alimentar para a População Brasileira / Actualización de los parámetros de adquisición del Programa Nacional de Alimentación Escolar en base a la Guía Alimentaria para la Población Brasileña / Update of the acquisition parameters of the Brazilian National School Feeding Program based on the Dietary Guidelines for the Brazilian Population

O Guia Alimentar para a População Brasileira é reconhecido como um potente indutor de políticas públicas de alimentação e nutrição. Nessa perspectiva, este artigo apresenta o percurso metodológico e as evidências que subsidiaram a elaboração dos novos parâmetros de aquisição de alimentos do Programa Nacional de Alimentação Escolar (PNAE). Tal elaboração envolveu as análises de: (1) participação dos recursos federais utilizados para compra de alimentos, agrupados segundo a classificação NOVA, empregada no Guia Alimentar para a População Brasileira, pelo conjunto de municípios brasileiros e segundo classificação da execução (positiva ou negativa); (2) cardápios mensais de referência que foram elaborados seguindo recomendações do Guia Alimentar para a População Brasileira; (3) aquisição de alimentos por amostra de 525 municípios, envolvendo a participação relativa dos grupos de alimentos (segundo a NOVA) no total de gastos e de energia e a qualidade nutricional dos alimentos adquiridos; e (4) alimentos ultraprocessados que não devem ser ofertados no ambiente escolar. Foi proposta a adoção dos seguintes parâmetros para participação dos grupos de alimentos em relação ao total de recursos federais empregados na compra de alimentos: ≥ 75% de recursos para alimentos in natura ou minimamente processados; < 20% para alimentos processados ou ultraprocessados e < 5% para ingredientes culinários processados e a ampliação da lista de alimentos cuja aquisição com recursos federais do PNAE é proibida. Esse processo subsidiou a elaboração da Resolução CD/FNDE nº 6, de 8 de maio de 2020, que dispõe sobre o atendimento da alimentação escolar aos alunos da educação básica no âmbito do PNAE.

La Guía Alimentaria para la Población Brasileña está reconocida como un potente inductor de políticas públicas de alimentación y nutrición. Desde esta perspectiva, este artículo presenta la trayectoria metodológica y evidencias que apoyaron la elaboración de los nuevos parámetros de adquisición de alimentos del Programa Nacional de Alimentación Escolar (PNAE). Tal elaboración implicó los análisis de: (1) participación de los recursos federales utilizados para la compra de alimentos, agrupados según la clasificación NOVA, empleada en el Guía Alimentaria para la Población Brasileña, por el conjunto de municipios brasileños, y según la clasificación de la ejecución (positiva o negativa); (2) menús mensuales de referencia que fueron elaborados siguiendo recomendaciones del Guía Alimentaria para la Población Brasileña; (3) adquisición de alimentos mediante una muestra de 525 municipios, implicando la participación relativa de los grupos de alimentos (según NOVA) en el total de gastos y de energía, así como la calidad nutricional de los alimentos adquiridos; y (4) alimentos ultraprocesados que no deben ser ofrecidos en el entorno escolar. Se propuso la adopción de los siguientes parámetros para la participación de los grupos de alimentos, en relación con el total de recursos federales empleados en la compra de alimentos: ≥ 75% de recursos para alimentos in natura o mínimamente procesados; < 20% para alimentos procesados o ultraprocesados, y < 5% para ingredientes culinarios procesados, así como la ampliación de la lista de alimentos, cuya adquisición con recursos federales del PNAE está prohibida. Este proceso apoyó la elaboración de la Resolución CD/FNDE nº 6, del 8 de mayo de 2020, que organiza la atención de la alimentación escolar a alumnos de educación básica en el ámbito del PNAE.

The Dietary Guidelines for the Brazilian Population is acknowledged as a powerful inducer of public food and nutrition policies. In this perspective, this article presents the methodological path and evidence that supported the elaboration of the new parameters of food acquisition of the Brazilian National School Feeding Program (PNAE). This elaboration involved the analyses of: (1) participation of federal resources used to purchase food, grouped according to the NOVA classification, used in Dietary Guidelines for the Brazilian Population, by the set of Brazilian municipalities and according to the classification of the execution (positive or negative); (2) monthly reference menus that were prepared following Dietary Guidelines for the Brazilian Population recommendations; (3) analysis of food acquisition by the sampling of 525 municipalities, involving the relative participation of food groups (according to NOVA) in total expenditures and energy and nutritional quality of purchased foods; and (4) analysis of ultra-processed foods that should not be offered in the school environment. We proposed the adoption of the following parameters for the participation of food groups in relation to the total federal resources used in the purchase of food: ≥ 75% of resources for fresh or minimally processed foods; < 20% for processed or ultra-processed foods and < 5% for processed culinary ingredients, as well as the expansion of the list of foods whose acquisition with federal resources from PNAE is prohibited. This process supported the elaboration of Resolution CD/FNDE n. 6 of May 8, 2020, which provides for the attendance of school feeding to primary education students within the PNAE.

Clock hours of food and nutrition education in curricula of undergraduate nutrition programs: a two-country comparison / Horas de instrução de educação alimentar e nutricional nos currículos de cursos de graduação em nutrição: comparação entre dois países

ABSTRACT Objective To make a critical and comparative analysis of curricula of Brazilian and Portuguese higher education institutions in terms of clock hours and semester distribution of food and nutrition education in undergraduate nutrition programs, also assessing the main differences among courses classified into thematic axes and professional practice areas. Methods The curricula of fifteen Brazilian and eleven Portuguese nutrition programs were collected and classified into thematic axes and professional practice areas with the method of Document Analysis. Next, we performed statistical analysis regarding the total and proportional clock hours of instruction and their semester distribution to assess the differences between the two countries. The variables of interest were the hours of Food and Nutrition Education and their semester distribution. Results The Food and Nutrition Education axis was the second smallest one, with statistically significant differences among the axes (2.2% of curricula; p<0.001). Brazilian higher education institutions showed greater total clock hours of Food and Nutrition Education (p=0.018), Human and Social Sciences (p=0.003), Public Health (p<0.001), as well as a wider dispersion and lower relative weighted mean for the semester offering of courses (p=0.004) of Food and Nutrition Education courses. Portuguese higher education institutions showed greater total and proportional clock hours of instruction for Exact Sciences (p<0.005; p=0.001, respectively) and more proportional hours of Biologic and Health Sciences (p<0.001). Conclusion Our study found a reduced presence of the area of Food and Nutrition Education in the undergraduate training of nutritionists in both countries.

RESUMO Objetivo Realizar uma análise crítica e comparativa das horas de instrução e distribuição semestral da Educação Alimentar e Nutricional nos cursos de graduação em nutrição. Além disso, analisar as principais diferenças entre disciplinas classificadas em Eixos Temáticos e em Áreas De Atuação Profissional de currículos de cursos de nutrição das Instituições de Ensino Superior brasileiras e portuguesas. Métodos Os currículos de quinze instituições brasileiras e onze portuguesas foram coletados, e o método Análise Documental foi usado para classificar as disciplinas de cada curso em Eixos Temáticos e em Áreas de Prática Profissional. Em seguida, foi feita uma análise estatística das horas de aula totais e proporcionais e do semestre de oferta, para verificar a diferença entre os países. As horas de instrução de Educação Alimentar e Nutricional e a distribuição semestral foram as variáveis de interesse. Resultados O eixo Educação Alimentar e Nutricional foi o segundo menor, com diferença estatisticamente significativa entre eixos (2,2% dos currículos; p<0,001). As Instituições de Ensino Superior brasileiras apresentaram maior carga horária absoluta para Educação Alimentar e Nutricional (p=0,018), Ciências Humanas e Sociais (p=0,003) e Saúde Pública (p<0,001), e maior dispersão e menor média ponderada relativa de localização do curso (p=0,004) para as disciplinas de Educação Alimentar e Nutricional. As Instituições de Ensino Superior portuguesas apresentaram maior carga horária absoluta e proporcional em Ciências Exatas (p<0.005; p=0,001 respectivamente) e maior proporcional em Ciências Biológicas e da Saúde (p<0.005). Conclusão Este estudo encontrou uma presença reduzida da área de Educação Alimentar e Nutricional na formação de nutricionistas em ambos os países.

Characteristics of Brazilian school food and physical activity environments: PeNSE 2015 / Características do ambiente escolar relativas à alimentação e atividade física: PeNSE 2015

ABSTRACT OBJECTIVE To characterize the food and physical activity environments in Brazilian public and private schools, and develop indicators to evaluate them. METHODS This is a cross-sectional study conducted with data from a questionnaire on school characteristics of the 2015 National Adolescent School-based Health Survey, answered by principals or coordinators, referring to 3040 public and private schools throughout the country. The variables related to food and physical activity environments were described in isolation, and an indicator was developed for each environment, with scores ranging from 0 to 100. The frequency and mean score of each variable were described according to the administrative sphere (public or private). RESULTS The public sector showed a predominance of school meals offer (97.8%), whereas the private sector, of canteens (89.8%). Both had a similar frequency of alternative food outlets in the surroundings. Private schools provided all markers of healthy and unhealthy eating in canteens more frequently. Public schools scored higher in "Food and beverage availability" (64.9) than private schools (55.8). The characteristics of physical activity environments showed that sports courts and sports or games equipment were common in public (69.2% and 90.7%, respectively) and private schools (94.1% and 99.8%, respectively), though at a significantly higher frequency in the second group. Private schools scored higher in "Structures and materials availability" than public schools (63.3 and 41.6, respectively). CONCLUSIONS Public schools provide a more favorable food environment, whereas private schools, a physical activity environment.

RESUMO OBJETIVO Caracterizar o ambiente alimentar e o ambiente para a prática de atividade física em escolas brasileiras públicas e privadas, bem como desenvolver indicadores-síntese de avaliação desses ambientes. MÉTODOS Estudo transversal, realizado com dados oriundos de questionário sobre características da escola da Pesquisa Nacional de Saúde do Escolar 2015 respondido pelo diretor ou responsável pelas escolas, referentes a 3.040 escolas públicas e privadas de todo o território nacional. As variáveis relacionadas aos ambientes alimentar e de prática de atividades físicas foram descritas isoladamente e, adicionalmente, foi desenvolvido um indicador-síntese para cada um dos ambientes, com pontuação variando de 0 a 100. A frequência de cada variável e a pontuação média dos escores foi descrita segundo a esfera administrativa (pública ou privada). RESULTADO A oferta de alimentação escolar foi predominante na rede pública (97,8%) e a presença de cantinas na rede privada (89,8%). A presença de pontos alternativos de venda foi similar nas duas esferas. A disponibilidade de todos os marcadores de alimentação saudável e não saudável nas cantinas foi mais frequente nas escolas privadas. A pontuação do escore "Disponibilidade de alimentos e bebidas" foi maior para as escolas públicas (64,9), comparada à das privadas (55,8). A caraterização do ambiente para a prática de atividade física mostrou que a presença de quadra de esporte e de material esportivo foi frequente em escolas públicas (69,2% e 90,7%, respectivamente) e em escolas privadas (94,1% e 99,8%, respectivamente), ainda que em frequência significativamente maior no segundo grupo. A pontuação do escore "Disponibilidade de estruturas e materiais" foi maior entre escolas privadas do que entre as públicas (63,3 e 41,6, respectivamente). CONCLUSÕES O ambiente alimentar de escolas públicas foi mais favorável à promoção da alimentação saudável que o de escolas privadas, sendo que o oposto foi verificado para o ambiente para a prática de atividade física.

Temporal variation in food consumption of Brazilian adolescents (2009-2015).

BACKGROUND: Worldwide population has been increasingly exposed to ultra-processed foods, which are associated with obesity. Adolescence is a transition period of life and WHO recommends the surveillance of risk factors to the adolescents' health, such as diet, because experiences in this phase can result in health risks. OBJECTIVE: To assess the trends in food consumption of adolescents from Brazilian capitals according to sociodemographic variables, based on data from the National Survey of School Health (PeNSE). METHODS: Data from in 2009, 2012 and 2015 of a total of 173,310 9th graders enrolled in public and private schools in Brazilian capitals and in the Federal District were assessed. Food consumption was assessed from regular consumption (five or more times a week) of healthy eating markers (beans; vegetables; fruit) and unhealthy eating markers (sweets; soft drinks; fried salty snacks). For sociodemographic variables, we considered macro regions; age; race/ skin color; gender; school administrative status. We assessed these markers trends for the population and, additionally, the analyses were stratified by gender, race/ skin color, and school administrative status. Statistical significance of the temporal trends was assessed by linear regression model. RESULTS: Over six years, three types of change in Brazilian adolescents' diet were observed: decreasing regular consumption of beans, sweets and soft drinks, increasing regular consumption of vegetables, and stable consumption of fruit and fried salty snacks. CONCLUSION: Brazilian adolescents' diet composition has changed in a short period, and therefore it is necessary to monitor it to propose actions aimed at this public.

Programa Nacional de Alimentação Escolar: estratégias para enfrentar a insegurança alimentar durante e após a COVID-19 / Programa Nacional de Alimentación Escolar: estrategias para enfrentar la inseguridad alimentaria durante y después de la COVID-19 / National school feeding program: strategies to overcome food insecurities during and after the COVID-19 pandemic

Resumo Este artigo tem como objetivo analisar a contribuição do Programa Nacional de Alimentação Escolar (PNAE) para o enfrentamento da fome e da insegurança alimentar (IA), ao propor um conjunto de estratégias para que o PNAE possa garantir a alimentação dos escolares neste momento de crise. Realizamos um diagnóstico da IA e da fome no Brasil, analisamos o processo de enfraquecimento das políticas de segurança alimentar e nutricional, consideramos a evolução histórica do PNAE e sua situação atual e, com base nessas reflexões, apresentamos um conjunto de propostas, avaliando seus impactos no orçamento destinado ao PNAE. Apresentamos as seguintes estratégias para o período em que as aulas estiverem suspensas: distribuição de kits ou refeições para escolares, se possível mantendo o caráter universal da política ou beneficiando estudantes das famílias elegíveis para receber o Auxílio Emergencial; ampliar o valor repassado pelo PNAE para os municípios com Índice de Desenvolvimento Humano (IDH) baixo e muito baixo; manter e incentivar a aquisição de alimentos da agricultura familiar. Após o retorno das aulas, sugerimos as seguintes estratégias: levantamento da IA entre os estudantes, manutenção da equidade da política por meio da ampliação do valor do repasse para municípios com IDH baixo e muito baixo, além de atendimento dos escolares de famílias em IA durante as férias e o recesso escolar.

Resumen Este artículo tiene como objetivo analizar la contribución del Programa Nacional de Alimentación Escolar (PNAE) en la lucha contra el hambre y la inseguridad alimentaria (IA) y proponer un conjunto de estrategias para que el PNAE pueda garantizar la alimentación de los estudiantes en este momento de crisis. Para tanto, realizamos un diagnóstico de la IA y el hambre en Brasil, analizamos el debilitamiento de las políticas de seguridad alimentaria y nutricional, consideramos la evolución histórica del PNAE y su situación actual. Con base en estas reflexiones, presentamos un conjunto de propuestas evaluando sus impactos en el presupuesto asignado al PNAE. Presentamos las siguientes estrategias para el período en que las clases estén suspendidas: distribución de kits de alimentos o comidas a los alumnos, manteniendo, si fuera posible, el carácter universal de la política o beneficiando a los estudiantes de familias elegibles para recibir la Ayuda de Emergencia debido a la COVID-19; aumentar el monto transferido por el PNAE a los municipios con un índice de desarrollo humano (IDH) bajo y muy bajo y; mantener e incentivar la compra de alimentos a la agricultura familiar. Después del regreso de las clases, sugerimos las siguientes estrategias: encuesta de IA entre los estudiantes; mantenimiento de la equidad de la política mediante el aumento del monto de la transferencia a municipios con IDH bajo y muy bajo; y asistencia a los estudiantes de familias en situación de IA durante las vacaciones y el receso escolar.

Abstract This article aims to analyze the contribution of the National School Feeding Program (PNAE), in the fight against hunger and food insecurity (FI) and to propose a set of strategies to guarantee that students will continue to receive food during the COVID-19 pandemic. Diagnosis of FI and hunger in Brazil was carried out, analyzing the weakening of Food and Nutritional Security Policies, considering the historical evolution of PNAE and its current situation, and from this analysis, a set of proposals were drawn up, assessing their impacts on the PNAE's budget. We present the following strategies for the period of school closures: distribution of meals for students, maintaining, if possible, the universal character of the policy or benefiting students from families eligible to receive Emergency Aid due to COVID-19; expand the amount transferred by the PNAE to municipalities with a low and very low Human Development Index (HDI) and; maintenance and incentive to purchase food from family farming. When schools re-open, we suggest the following strategies: FI survey among students; maintenance of the equity of the policy by expanding the transfer amount to municipalities with low and very low HDI, and; attendance of students from families in FI during the vacations.

University food environment: characterization and changes from 2011 to 2016 in a Brazilian public university / Ambiente alimentar universitário: caracterização e mudanças no período de 2011 a 2016 em uma universidade pública brasileira

ABSTRACT Objective To describe the food environment of a public university located in the city of Rio de Janeiro, Brazil, and to review the changes that occurred between the years 2011 and 2016. Methods Time trend study (through repeated cross-sectional studies) of the sale of food, culinary preparations and beverages in the University Campus establishments in 2011, 2012 and 2016. Variables regarding the description of the establishments and the offer, price and advertising of food, beverages and culinary preparations were assessed through a checklist. Comparisons between establishments in each year and the analysis of such comparison changes during the period were performed by assessing the difference between absolute and relative values observed in each year. Results Increased number of establishments available, good convenience and financial accessibility were observed. There was a relative disadvantage in the availability of fresh or minimally processed foods and culinary preparations; a predominance of advertising of ultra-processed foods; and lack of nutritional information of culinary preparations. The predominance of establishments selling snacks and candies increased over the years. Conclusion In the period studied, the university food environment did not favor healthy food choices.

RESUMO Objetivo Descrever o ambiente alimentar de uma universidade pública localizada na cidade do Rio de Janeiro e analisar as mudanças nele ocorridas no período de 2011 a 2016. Métodos Estudo de tendência temporal (por meio de estudos transversais repetidos) da comercialização de alimentos, preparações e bebidas nos estabelecimentos existentes dentro do campus em 2011, 2012 e 2016. Foram examinadas, por meio de checklist, variáveis referentes à descrição dos estabelecimentos e a oferta, preço e propaganda de alimentos, bebidas e preparações. A comparação entre os estabelecimentos e a análise das variações verificadas no período foi realizada com base no exame das diferenças entre valores absolutos e relativos observadas em cada ano. Resultados Foram observados aumento da disponibilidade de estabelecimentos, boa comodidade e acessibilidade financeira. Verificou-se desvantagem relativa da disponibilidade de alimentos in natura ou minimamente processados e de preparações, predominância de propaganda de alimentos ultraprocessados e ausência de informações nutricionais das preparações. A predominância de estabelecimentos que comercializavam lanches e guloseimas se acentuou no período. Conclusão No período estudado, o ambiente alimentar universitário não favoreceu escolhas alimentares saudáveis.

The National School Feeding Program as a promoter of Food and Nutrition Education actions in Brazilian schools / O Programa Nacional de Alimentação Escolar comopromotor de ações de Educação Alimentar e Nutricional nas escolas do Brasil

The National School Feeding Program - NSFP is the public health policy that guarantees the minimum supply ofhealthy food and offers space for the construction of healthy eating habits in Brazilian schools. The objective of thepresent study was to evaluate the presence of Food and Nutrition Education (FNE) actions within the framework ofthe NSFP to verify its adequacy toward the program’s legislation and to investigate which parameters are predictorsof running school gardens. This was a cross-sectional observational study using secondary data obtained from thedatabase of the Efficient School Lunch Management Award for the year 2010, with a sample of 749 municipalities inBrazil. A binary logistic regression was performed, considering the running of school gardens as a dependent variable,and the FNE indicators and the demographic variables as independent. The model containing the presence of FNE inthe school curriculum was significant (p<0.001). The presence of FNE in school curricula OR=2.406;95%CI=[1.725,3.357] was the most significant predictor of running school gardens, followed by the use of food from family farmsOR=2.049;95%CI=[1.477, 2.842] and the carrying out of culinary workshops OR=2.032;95%CI=[1.442; 2.863],considering p<0.05. The presence of FNE in the school curriculum was positively associated with growing vegetablegardens, showing that complex actions that require more resources can be stimulated from simpler measures, and theNSFP as a public health policy is an important tool to promote actions throughout the national territory

O Programa Nacional de Alimentação Escolar - PNAE é a política pública de saúde que garante a oferta mínima dealimentos saudáveis e oferece espaço para a construção de hábitos alimentares saudáveis nas escolas brasileiras. Oobjetivo do presente estudo foi de avaliar a presença de ações de Educação Alimentar e Nutricional - EAN no âmbito doPNAE para verificar sua adequação à legislação do programa e investigar quais parâmetros são previsores da execuçãode hortas escolares. Estudo observacional transversal que utilizou dados secundários obtidos a partir do banco dedados do Prêmio Gestor Eficiente da Merenda Escolar, do ano 2010, com amostra de 749 municípios do Brasil. Foirealizada uma regressão logística binária, considerando como variável dependente a execução de Hortas Escolares, eos indicadores de EAN e as variáveis demográficas como independentes. O modelo contendo a presença de EAN nocurrículo escolar foi significativo (p<0,001). A presença de EAN no currículo escolar OR=2,406;IC95%=[1,725;3,357]foi o previsor mais significativo da execução de hortas escolares, seguida da utilização de alimentos da agriculturafamiliar OR=2,049;IC95%=[1,477;2,842] e a execução de oficinas culinárias OR=2,032;IC95%=[1,442; 2,863],considerando p<0,05. A presença de EAN no currículo escolar foi associado positivamente a execução de hortas,evidenciando que ações complexas e que exigem mais recursos podem ser estimuladas a partir de medidas maissimples e o PNAE como política pública de saúde mostra-se como uma importante ferramenta para promover ações de EAN em todo território nacional

Dimensioning of the physical area and required number of food handlers for school food services / Dimensionamento da área física e do número de manipuladores de alimentos de serviços de alimentação escolar

ABSTRACT Objective We aimed to establish equations for dimensioning of the physical area and determining the required number of food handlers in food services of schools and to compare them with reference equations. Methods It was visited 44 municipalities located in the states of São Paulo (n=36) and Rio de Janeiro (n=8) between 2013 and 2014. The physical area for school food services was evaluated using a measuring tape. For all food services, we calculated the Maximum Attendance Capacity, which is the sum of small and large meals served during the busiest shift. A validated checklist was used to evaluate food safety practices. Linear regression models were developed to establish the proposed equations. Results In total, we evaluated 205 school units. Based on the data, the following equations were established: Equation A: area of production=15.22+(maximum attendance capacity×0.02), which estimates the minimum area needed for a school food service; and Equation B: the number of food handlers=2.17+(maximum attendance capacity×0.002), to determine the minimum number of food handlers needed. These equations were established based on school food services that presented adequate food safety practices (i.e., low health risk). Conclusion It was established new equations for calculating the size of the physical area for school food services and the required number of food handlers. These new equations can be used as a starting point in management planning of a school food service.

RESUMO Objective Estabelecer equações para o dimensionamento da área física e do número de manipuladores em serviços de alimentação escolar comparando-as com equações de referência. Métodos Foram visitados, entre 2013 e 2014, 44 municípios localizados nos estados de São Paulo (n=36) e Rio de Janeiro (n=8). A área útil dos serviços de alimentação escolar foi avaliada por meio de uma trena. Para todas as unidades foi calculada a Capacidade Máxima de Atendimento que é a soma das pequenas e grandes refeições servidas no turno de maior movimento. Para a avaliação das boas práticas de manipulação de alimentos foi utilizada uma lista de verificação validada. As equações foram estabelecidas por meio de regressão linear com base em serviços de alimentação escolar que apresentaram boa adequação das boas práticas (i.e. baixo risco sanitário). Resultados Foram avaliados 205 serviços de alimentação escolar. Com base nos dados foi determinada a Equação A: m2 da área de produção=15,22+(Capacidade máxima de atendimento×0,02) que estima a área mínima para um serviço de alimentação escolar e a Equação B: número de manipuladores=2,17+(Capacidade máxima de atendimento×0,002) para o número mínimo de manipuladores de alimentos. Conclusão Novas equações para cálculo do dimensionamento da área física de serviços de alimentação escolar e para o número de manipuladores de alimentos necessários foram estabelecidas. Essas novas equações podem ser utilizadas como ponto de partida para o planejamento gerencial de um serviço de alimentação escolar.

Consumption of vegetables and their relation with ultra-processed foods in Brazil.

OBJECTIVE To characterize the household purchase and the individual consumption of vegetables in Brazil and to analyze their relation with the consumption of ultra-processed foods. METHODS We have used data on the purchase of food for household consumption and individual consumption from the 2008-2009 Brazilian Household Budget Survey. The Brazilian Household Budget Survey studied the purchase of food of 55,970 households and the food consumption of 34,003 individuals aged 10 years and over. The foods of interest in this study were vegetables (excluding roots and tubers) and ultra-processed foods. We have described the amount of vegetables (grams) purchased and consumed by all Brazilians and according to the quintiles of caloric intake of ultra-processed food. To this end, we have calculated the crude and predicted values obtained by regression models adjusted for sociodemographic variables. We have analyzed the most commonly purchased types of vegetables (% in the total amount) and, in relation to individual food consumption, the variety of vegetables consumed (absolute number), the participation (%) of the types of culinary preparations based on vegetables, and the time of consumption. RESULTS The adjusted mean household purchase of vegetables was 42.9 g/per capita/day. The adjusted mean individual consumption was 46.1 g. There was an inverse relation between household purchase and individual consumption of vegetables and ultra-processed foods. Ten types of vegetables account for more than 80% of the total amount usually purchased. The variety consumed was, on average, 1.08 type/per capita/day. Approximately 60% of the vegetables were eaten raw, and the amount consumed at lunch was twice that consumed at dinner; individuals with higher consumption of ultra-processed foods tended to consume even less vegetables at dinner. CONCLUSIONS The consumption of vegetables in Brazil is insufficient, and this is worse among individuals with higher consumption of ultra-processed foods. The most frequent habit was to consume raw vegetables at lunch and with limited variety.