Food-based dietary guidelines for children and adolescents.

Objective: This study aimed at reviewing food-based dietary guidelines (FBDGs) with content targeted at children and adolescents to present their main characteristics, thus enabling comparisons among countries. Design: We conducted a search of the FBDGs available on the Food and Agriculture Organization (FAO) website, followed by a scoping review with a gray literature search to find FBDGs for children or adolescents non-listed on the FAO's website. Data extraction included the year of publication, language, and guidelines for the target group. Results: From FAO website searches, 109 documents were found, and 17 of them could not be translated. The Scoping review search conducted in 5,190 articles, and none led to new guidelines, nor from the gray literature. Regarding the 92 FBDGs explored, 41 were specific for infants under 24 months old, children, and/or adolescents, and 51 were for the general population with information for the studied group. Twelve percent of the general FBDG and 35% of the specific ones have food icons. All of the guidelines were published after 2001. Latin America and the Caribbean were the regions that presented more specific FBDGs and the majority of countries with guidelines for fruits and vegetables. The information about fat (15 countries) and sugar (26 countries) consumption reduction is frequent. Reduction of sodium intake appears to be in the majority of guidelines after 2015. Food hygiene guidelines are recurrent in Latin American documents. NOVA classification was adopted in five countries and 21 countries approach recommendations for mealtimes. Both exclusive and continued breastfeeding guidance and healthy complementary feeding orientation are present in over 50% of the specific FBDG for infants and children under 24 months old. Conclusion: Food-based dietary guidelines are diverse due to both the nutritional and political aspects of each region. Latin America stands out for its orientations for the studied group. Further studies should measure the possible impacts and comprehension of FBDGs.

Stages of change and self-efficacy are related to consumption of food markers among Brazilian adolescents and young adults.

Objective: This study aimed at analyzing the association between stages of change, consumption of food markers, and self-efficacy in the adoption of healthy eating practices, adjusted by nutritional knowledge, among Brazilian adolescents and young adults. Methods: A cross-sectional analysis was conducted with 347 individuals from schools in the Federal District, Brazil. They completed a self-administered questionnaire covering: consumption of food markers, stage of change, self-efficacy in the adoption of healthy eating practices, and nutritional knowledge. Adjusted logistic regression was conducted. Results: Participants in pre-contemplation (OR = 0.22), contemplation (OR = 0.19), decision (OR = 0.13) and action (OR = 0.40) stages have less chance to have healthy eating than those in maintenance, including fruits and vegetables [pre-contemplation (OR = 0.23), contemplation (OR = 0.19), and decision (OR = 0.09)]. Adolescents and young adults in pre-contemplation (OR = 0.29) and contemplation (OR = 0.37) had lower chances of having low consumption of sugar-sweetened beverages compared to those in maintenance (p < 0.05). Adolescents and young adults in pre-contemplation (OR = 0.38) and contemplation (OR = 0.36) were less likely to have high self-efficacy scores than those in maintenance (p < 0.05). Higher score of self-efficacy was associated with a lower chance of having a high consumption of sugar-sweetened beverages (OR = 1.02; p = 0.032). Conclusion: Regardless of nutritional knowledge, individuals in the earlier stages of change are less likely to have an adequate consumption of healthy foods markers, including fruits and vegetables, and low sugar-sweetened beverages consumption. They are also less likely to have high self-efficacy scores than those in maintenance. Nutritional interventions to focus on enhancing self-efficacy among adolescents and young adults in earlier stages of change to improve dietary habits.

Percepções, barreiras e facilitadores da implementação da lei das cantinas escolares por adolescentes do Distrito Federal / Perceptions, barriers, and facilitators of the implementation of the school cafeteria law for adolescents in the Federal District

Este estudo objetivou caracterizar a percepção de estudantes sobre a implementação da Lei 5.146/2013, que visa à promoção da alimentação saudável nas escolas do Distrito Federal, identificando as barreiras e os facilitadores existentes para adotá-la e as perspectivas para a implementação de ações de Educação Alimentar e Nutricional (EAN) no ambiente escolar. Participaram 52 adolescentes do 9º ano de três escolas, públicas e privadas, distribuídos em seis grupos focais. Seguiu-se roteiro semiestruturado com perguntas, validadas pela técnica de Delphi, para conhecer o que era vendido e consumido nas cantinas, segundo os adolescentes, se eles conheciam a lei, e avaliar barreiras e facilitadores para colocar a legislação em funcionamento no ambiente escolar. Por fim, apresentou-se uma situação fictícia aos estudantes em que estes conduziriam ações de EAN para implementar a lei. Os debates foram gravados, transcritos, e agrupadas as falas semelhantes pela análise de conteúdo de Bardin. Os adolescentes consideraram positiva a lei das cantinas, mas pontuaram que estas ainda não haviam se adequado à legislação. Identificaram como barreiras o preço dos alimentos saudáveis e a baixa divulgação da lei e, como facilitadores, a escola e a família. Para EAN, sugeriram meios de divulgação inovadores, como as redes sociais e a utilização de figuras e cores para chamar à atenção do leitor. Apesar de bem recebida pelos adolescentes, a simples promulgação de uma lei não é suficiente para alterar práticas alimentares já adotadas no ambiente escolar se não for associada a estratégia de divulgação e conscientização de toda a comunidade escolar.

This study aimed at characterizing the students' perception of Law 5.146/2013's implementation, whose objective is to promote healthy eating in schools in the Federal District, and to identify the barriers and facilitators that exist in adopting it, as well as the perspectives for the implementation of actions of Food and Nutrition Education (FNE) in the school environment. Fifty-two 9th grade teenagers from three public and private schools participated, distributed in six focus groups. A semi-structured script was followed with questions, validated by the Delphi technique, to find out what was being sold and consumed in the cafeterias according to the adolescents, whether they knew the law, and to assess barriers and facilitators to put the legislation into operation in the school environment. Finally, a fictitious situation was presented to the students in which they would conduct FNE actions to implement the law. The debates were recorded, transcribed, and similar speeches were grouped by Bardin's content analysis. The adolescents considered the cafeteria law to be positive but pointed out that they had not yet adapted to the legislation. They identified the price of healthy foods and the poor disclosure of the law as barriers, and the school and family were facilitators. Concerning FNE, they suggested innovative means of dissemination, such as social networks and the use of figures and colors to draw the reader's attention. Despite being well received by adolescents, the mere passing of a law is not enough to change dietary practices already adopted in the school environment, if it is not associated with a strategy of dissemination and awareness of the entire school community.

Memorization of messages, satisfaction, and feasibility of a nutritional intervention using a mobile text messaging app among adolescents / Memorização de mensagens, satisfação e usabilidade de intervenção nutricional via aplicativo de envio de mensagens entre adolescentes

ABSTRACT Objective This study aimed to evaluate the memorization of messages that promote healthy eating, as well as satisfaction and feasibility of a nutritional intervention using a mobile text messaging app aimed at adolescents from public schools in the Federal District, Brazil. Methods The messages sent addressed aspects of healthy eating based on the Dietary Guidelines for the Brazilian Population. A self-reported questionnaire was applied with 94 students to assess the memorization of the messages received during the nutritional intervention, the level of satisfaction with the intervention, whether the messages were read and shared, the frequency of reading, and what was learned from the intervention. The association of memorization with satisfaction and with the frequency of reading the messages was also investigated. Results About 48% of participants reported remembering at least one message; 77.7% showed high ranges of satisfaction; 54.3% always read the messages; 66.0% did not share messages with other people. Most of the students reported positive learning or good impressions about the intervention. An association was found between memorization and satisfaction with the intervention (p=0.002), as well as between reading and memorization (p=0.005). Conclusion Although the memorization of the healthy eating messages sent in the nutritional intervention was less than expected, a great satisfaction and high frequency of reading the messages were reported by adolescents. Future studies should investigate the permanence of the results of long-term nutrition intervention, the main influencers of memorization, and how to improve it.

RESUMO Objetivo Este estudo teve como objetivo avaliar a memorização de mensagens de promoção de alimentação adequada e saudável, a satisfação e a usabilidade de uma intervenção nutricional via aplicativo direcionada para adolescentes de escolas públicas do Distrito Federal. Métodos As mensagens enviadas abordavam aspectos sobre alimentação adequada e saudável com base no Guia Alimentar para a População Brasileira. Foi aplicado um questionário de autopreenchimento a 94 estudantes para avaliar a memorização das mensagens recebidas durante a intervenção nutricional, o nível de satisfação com a intervenção, se as mensagens eram lidas e compartilhadas, a frequência de leitura e quais foram os aprendizados decorrentes da intervenção. Investigou-se ainda a associação entre a memorização, a satisfação e a frequência de leitura das mensagens. Resultados Cerca de 48% dos participantes referiram lembrar de pelo menos uma mensagem da intervenção; 77,7% se mostraram satisfeitos com o estudo; 54,3% sempre liam as mensagens que recebiam e 66% não compartilhava as mensagens com outras pessoas. A maioria relatou aprendizados ou impressões positivas sobre a intervenção. Foi encontrada uma associação entre a memorização das mensagens e a satisfação com o estudo (p=0,002), bem como entre a leitura e a memorização das mensagens (p=0,005). Conclusão Apesar de a memorização das mensagens enviadas na intervenção nutricional ter sido aquém do esperado, foi referida grande satisfação e alta frequência de leitura pelos adolescentes. Futuros estudos devem investigar a permanência dos resultados de intervenções nutricionais a longo prazo, os principais influenciadores da memorização e como melhorá-la.