Importance, performance frequency, and predicted future importance of dietitians' jobs by practicing dietitians in Korea: a survey study.

PURPOSE: This study aimed to explore the perceptions held by practicing dietitians of the importance of their tasks performed in current work environments, the frequency at which those tasks are performed, and predictions about the importance of those tasks in future work environments. METHODS: This was a cross-sectional survey study. An online survey was administered to 350 practicing dietitians. They were asked to assess the importance, performance frequency, and predicted changes in the importance of 27 tasks using a 5-point scale. Descriptive statistics were calculated, and the means of the variables were compared across categorized work environments using analysis of variance. RESULTS: The importance scores of all surveyed tasks were higher than 3.0, except for the marketing management task. Self-development, nutrition education/counseling, menu planning, food safety management, and documentation/data management were all rated higher than 4.0. The highest performance frequency score was related to documentation/data management. The importance scores of all duties, except for professional development, differed significantly by workplace. As for predictions about the future importance of the tasks surveyed, dietitians responded that the importance of all 27 tasks would either remain at current levels or increase in the future. CONCLUSION: Twenty-seven tasks were confirmed to represent dietitians' job functions in various workplaces. These tasks can be used to improve the test specifications of the Korean Dietitian Licensing Examination and the curriculum of dietetic education programs.

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.

Food provision in Australian aged care homes does not meet protein needs of residents: A call for reform.

AIM: Malnutrition is common in older adults in aged care homes, partly due to inadequate protein intake. Menu planning guidelines are available however, adherence to guidelines is unknown. This study aimed to determine; (i) what are the average serving sizes of menu items provided and do they meet recommended portion sizes? (ii) does consumption from a 'typical' menu provide sufficient protein? and (iii) can substituting a 'typical' menu with high-protein options enable residents to achieve protein adequacy? METHODS: This study involved 572 residents (73% female; aged 86.4 ± 7.3 years) from 60 aged-care homes in Australia involved in a 2-year cluster-randomised trial. During the trial, food intake was recorded quarterly using visual estimation of plate-waste and 42 061 foods analysed. As part of a secondary analysis of these data, portion sizes of foods were compared to guidelines by calculating the mean (95% confidence interval). Items were deemed inadequate if the upper 95% confidence interval remained below recommended portion sizes. RESULTS: On average 47% of breakfast and 80% of lunch/dinner items were below recommended portion sizes. Relative protein intakes, from a typical menu (most consumed foods), was 0.9 g and 0.8 g/kg body weight/day for females and males; both below recommendations. Substituting regular items with higher protein equivalents increased protein intake to 1.3 g and 1.2 g/kg body weight/day, for females and males, respectively. CONCLUSION: Aged care homes in Australia are not meeting menu planning guidelines resulting in insufficient protein being provided. Reform to menu guidelines including provision of high-protein foods, will ensure protein adequacy in older adults in aged-care homes.

Iron Bioavailability Should be Considered when Modeling Omnivorous, Vegetarian, and Vegan Diets.

BACKGROUND: To lower environmental impact of human food consumption, replacement of animal proteins with plant-based proteins is encouraged. However, the lower iron bioavailability of plant-based foods is rarely considered when designing healthy and sustainable diets by using diet modeling. The estimated absorbable iron content of vegetarian and vegan menu plans might therefore be too optimistic. OBJECTIVE: The main aim of this study was to investigate and compare the impact of various methods to estimate absorbable iron intake on the nutritional adequacy of omnivorous, vegetarian, and vegan menu plans designed for women of reproductive age. METHODS: A diet model was developed to design menu plans consisting of a selection of meals that best complied with nutritional requirements. Meals used for modeling were created based on food intake data from the National Health and Nutrition Examination Survey (NHANES). For each meal, absorbable iron concentrations were estimated by using 2 constant absorption factors (18% and 10%) and 2 diet-dependent absorption equations (Conway and Hallberg). For each absorption method and diet type, we used the diet model to design the optimal menu plan. Retrospectively, menu plans were evaluated by estimating the absorbable iron content by using the other absorption methods. RESULTS: Retrospective diet-dependent absorbable iron estimates were consistently lower than estimates based on constant absorption factors. Using diet-dependent estimates increased absorbable iron by optimizing enhancer and inhibitor concentrations. CONCLUSION: Iron bioavailability should be considered when modeling diets.

Avaliação qualitativa das preparações servidas em um restaurante popular e os impactos do cenário pandêmico da covid-19 / Qualitative assessment of preparations served in a popular restaurant and the impacts of the COVID-19 pandemic scenario / Evaluación cualitativa de las preparaciones servidas en un restaurante popular y los impactos del escenario de pandemia COVID-19

Introdução:A chegadadapandemia da COVID-19 afetou diretamente o planejamento alimentar de instituições municipais, estaduais e de demais âmbitos, dentre eles as refeiçõesofertadas peloprograma restaurante popular, importante na garantia da segurança alimentarda população mais vulnerável.Objetivo:Avaliar de forma qualitativa as preparações do cardápio do almoço do Restaurante Popular do município de Santa Cruz-Rio Grande do Nortee os impactos do cenário pandêmico da COVID-19.Metodologia:Para tanto, avaliou-se os cardápios referentes aos meses de março, abril, maio, agosto e setembro de 2021, pelo método avaliação qualitativa das preparações do cardápio. Além disso, por meio da adaptação dométodosupracitado, designou-se as preparações de acordo com as recomendações do tipo de processamento segundo o Guia Alimentar para população Brasileira. Resultados:Identificou-se uma baixa oferta de frutas e folhosos, alta de carnes gordurosas e doce, regular de preparações ricas em enxofre e as cores iguais, todavia, quanto à fritura e ao conjunto de fritura + doce apresentou-se em apenas umdiada semana (n=109). Além disso, nos dois últimos meses de análisehouve aumento na oferta de folhosos, diminuição da monotonia, alimentos ricos em enxofre e doces, e ainda, as preparações com alimentos in natura ou minimamente processados + processados fizeram-se presentestodos os dias. Conclusões:Com a utilizaçãodométodo estudadofoipossível identificar ajustesno cardápiopara o período analisado, a fim de ofertar qualidade para os comensais.Ressalta-se que foi observadoque com a adaptação e redução dos casos da COVID-19, houve aumento na oferta de in natura e minimamente processados. Espera-se que melhorias e ajustes sejam realizadosnos cardápios, visto a necessidadede ser mais enfático em seu princípiode garantir a segurança alimentar (AU).

Introduction:The arrival of the COVID-19 pandemic affected directly the food planning of municipal, state and other institutions, including the meals offered by the popular restaurant program, which is important in guaranteeing the food security of the vulnerablepopulation. Objective: To qualitatively evaluate the preparations of the lunch menu at Restaurante Popular in the municipality of Santa Cruz-Rio Grande do Norteand the impacts of the COVID-19 pandemic scenario.Methodology:To this, the menus for the months of March, April, May, August and September 2021 were evaluated by the methodqualitative evaluation of menu preparations. Furthermore, through the adaptation of the methodaformentioned, preparations were designated according to the recommendations for type of processing following the Food Guide for the Brazilian population.Results:A low supply of fruits and leafy vegetables was identified, high supply of fatty and sweet meats, regular supply of preparations rich in sulfur and the same colors. However, regarding the frying and the frying + sweet combination, it was presented in just one daythe week(n=109).Moreover, in the last two months of analysis there was an increase in the supply of hardwoods, decrease in monotony,foods rich in sulfur and sweets, and even, preparations in natura or minimally processed + processed foods were presentsevery day. Conclusions:With the use of the method studied it waspossible to adjust the menufor the analyzed periodto offer qualityto diners. It should the increase in the supply of in natura and minimally processed foods stands out with the adaptation and progression of the reduction of COVID-19cases.It is expected that improvements and adjustments will be madethe menus,given the need to be more emphatic in its principleof ensuring food safety (AU).

ntroducción: La llegada de la pandemia del COVID-19 afectó directamente la planificación alimentaria de las instituciones municipales, estatales y otras, incluyendo las comidas que ofrece el programa de restaurantes populares, importante para garantizar la seguridad alimentaria de la población más vulnerable. Objetivo:Evaluar cualitativamente las preparaciones del menú del almuerzo en el Restaurante Popular del municipio de Santa Cruz-Rio Grande do Nortey los impactos del escenario de pandemia del COVID-19.Metodología:Para ello, se evaluaron los menús de los meses de marzo, abril, mayo, agosto y septiembre de 2021 por el método evaluación cualitativa de la elaboración de menús. Además, al adaptar el métodocitado, las preparaciones fueron designadas de acuerdo con las recomendaciones del tipo de procesamiento según la Guía de Alimentos para la población brasileña.Resultados: Se identificó una baja oferta de frutas y hortalizas de hoja, alta oferta de carnes grasas y dulces, regular oferta de preparaciones ricasen azufre y los mismos colores,aún,en cuanto a la fritura y la combinación fritura + dulce, se presentó en un solo díade lasemana(n=109). Además, en los últimos dos meses de análisishubo un aumento en la oferta de maderas duras, una disminución de la monotonía, alimentos ricos en azufre y dulces, y aun, las preparaciones con alimentos in natura o mínimamente procesados + procesados presentes todos los días. Conclusiones: Con el uso del método estudió fueposible identificar ajustes en el menúpara el período analizado, con el fin de ofrecer calidad a los comensales. Cabe señalar que se observó que con la adaptación y reducción delcasosCOVID-19, hubo un aumento en la oferta de productos in natura y mínimamente procesados. Se espera que se realicenmejoras y ajustesa los menús, dada las necesidades más enfáticasen su principiode garantizar la seguridad alimentaria (AU).

Food prescription pilots: feasibility, acceptability and affordability of improving diet through menu planning and grocery delivery.

BACKGROUND: Lack of adherence is a primary reason people fail to maintain a healthy diet or lose weight. Multiple environmental factors, including aggressive marketing and convenience of nutrient-poor food, undermine people's best intentions. The aim was to assess the feasibility, acceptability and impact of food prescriptions in which participants' exposure to commercial food outlets is reduced, because the groceries are delivered with weekly menu plans and recipes. METHODS: This is a series of pre-post pilot proof-of-concept studies. We recruited 37 members of Kaiser Permanente interested in improving their diet or losing weight. Weekly meal plans meeting more than 90% of recommended dietary allowances were designed to be low cost, in line with Supplemental Nutrition Assistance Program (SNAP) allowances. Five separate pilots targeted different populations. Participants were required to provide 24-h dietary recalls (ASA24) before and during the interventions. Weight management pilot participants had height, weight and blood pressure measured before and after 4-week pilots and followed sustainability guidelines, limiting meat and dairy. RESULTS: Across pilots, the healthy eating index improved (+21.1 points; 95% CI [confidence interval] 15.9, 26.3). For the weight management pilots, most participants lost weight (average 10.3 lbs for men, 5.7 lbs for women; 95% CI -10.2, -5.4). The majority of participants liked the programme and considered it the easiest weight loss programme they ever tried. CONCLUSIONS: These pilots suggest that meal planning and grocery delivery can be affordable and acceptable and could ultimately have a major impact on diet-related chronic diseases. Longer-term studies are needed to confirm how long compliance will endure.

Development of a Tool for Determining the Equivalence of Nutritional Supplements to Diabetic Food Exchanges.

Malnutrition is a prevalent issue in hospitals, nursing homes and the community setting. Nutritional products can be used by dietitians to supplement people's diet by adding energy, macronutrients and other constituents. The aim of the present work was (i) to create a database of nutritional products with information on their energy and macronutrient content, (ii) to estimate the food exchanges of each product and assist in diet plan development for malnourished persons and (iii) to provide a tool for calculation of food exchanges of newly developed products not included in the database. We searched the web for nutritional supplements, and an electronic database with 461 products was generated with data regarding the contained energy and macronutrients of each entry. The following companies were included: Abbott Nutrition, Nestle Nutrition, Nutricia North America, Nutricia Global, Nutricia Europe & Middle East, Axcan Pharma Inc., Kate Farms, Global Health, High Protein, NutriMedical BV, Hormel Health Labs, Hormel Health Labs/Diamond Crystal Brands, Lyons Magnus, Mead Johnson, Medical Nutrition USA Inc., Medtrition, Nutritional Designs Inc., Nutrisens, Humana (Germany), and Vitaflo USA. The created database facilitates product comparisons and categorization into several groups according to energy and protein content. In addition, a tool was created to determine food exchanges for each supplement per serving and/or food exchanges for newly developed products by simply inserting their macronutrient content. The developed tool can facilitate dietitians in comparing products and incorporating them into diet plans, if needed. Such tools may thus serve clinical practice, may be used in dietary or other smart applications and can familiarize dietitians with the digital epoch.

Exploring the Use of a Web-Based Menu Planning Tool in Childcare Services: Qualitative Cross-sectional Survey Study.

BACKGROUND: Early childhood is a critical period for supporting the development of healthy eating habits, which may affect lifelong health. Childcare services are important settings for promoting early childhood nutrition; however, food provision in childcare frequently does not align with dietary guidelines. Web-based menu planning tools are well suited to support healthy food provision in childcare, although little is known about their use. Research is needed to understand how web-based menu planning tools are used in the childcare setting and how they can effectively support healthy menu planning and food provision for children in childcare. OBJECTIVE: We aimed to explore the use of a web-based menu planning tool called FoodChecker, which is available to childcare services in Victoria, Australia. We also aimed to gain insights and perspectives from childcare staff involved in menu planning about their use of the tool to plan healthy menus and guide healthy food provision for children. METHODS: We conducted a qualitative descriptive study using a cross-sectional web-based survey completed by the staff involved in menu planning in childcare services. Thematic analysis was performed using NVivo software. Emergent themes were mapped against constructs of the Technology Acceptance Model regarding perceived usefulness, perceived ease of use, and external variables influencing perceptions and use. RESULTS: The participants included 30 cooks and 34 directors from 53 childcare services. Participants perceived the web-based menu planning tool as useful for supporting child nutrition and health, improving organizational processes, and aiding the menu planner role. Perceptions regarding ease of use were mixed. External variables influencing perceptions and use included awareness of the tool, perceived need, time, resources, organizational support, and the food budget. Participants made recommendations to improve the tool, particularly the need to integrate functionality to make it easier and faster to use or to include more links to resources to support healthy menu planning. CONCLUSIONS: The web-based menu planning tool was perceived as useful for cooks and directors in childcare services. Areas for improvement were identified; for example, the need for integrated digital features to make the tool easier and faster to use. As the first qualitative study to explore childcare staff experiences with a web-based menu planning tool, these findings inform future research and development of such tools to aid scalable and sustainable support for healthier food provision in the childcare sector.

Evaluation of quality of the children's menu in mall's restaurants / Avaliação da qualidade do menu infantil em restaurantes de shopping centers

Abstract Objective: To evaluate the quality of children's menus in restaurants located in shopping malls. Methods: To select the sample, restaurants from 30% of shopping malls in each region of the city of São Paulo were included and, after considering only one restaurant per chain, the total was limited to 151 restaurants, 30.2% of which (n=35) presented a children's menu. Data were collected through a form on Google Forms. Results: Of the restaurants with children's menu, 60% (n=21) were conventional restaurants and 40% (n=14) takeaway/fast-food. The large number of chains present in most visited malls showed a democratization of the way of eating, with popular and accessible menus, regardless of social status. Most of the analyzed foods were cooked (41.5%). Most preparations did not use grease in their preparation and there was a notable lack of fruit and vegetables (FV) (4%). Sweet desserts were offered in 11.4% of the places and 20% included gifts with meals. Conclusions: The scarce offer of children's menus, few options and low FV offer indicate the need for a new look at the development of children's menus and a greater integration between the possibilities of restaurants and the expectations of parents and children, in the challenge of integrating the relationship between the supply of new foods that promote healthier habits and their consumption.

Resumo Objetivo: Avaliar a qualidade dos menus infantis de restaurantes localizados em shopping centers. Métodos: Para a seleção da amostra foram incluídos os restaurantes de 30% dos shopping centers de cada região da cidade de São Paulo e, após considerar-se somente um restaurante por rede, o total ficou limitado a 151 restaurantes, dos quais 30,2% (n=35) apresentaram cardápio infantil. Os dados foram coletados por meio de um formulário no Google Forms. Resultados: Dos restaurantes com menu infantil, 60% (n=21) eram convencionais e 40% (n=14) eram de takeaway/fast-food. O grande número de redes presente na maioria dos shopping centers visitados mostrou a democratização da forma de comer, com cardápios populares e acessíveis, independentemente de classe social. A maior parte dos alimentos analisados era cozida (41,5%). A maioria das preparações não utilizava gordura em seu preparo e foi notável a falta da oferta de frutas, legumes e verduras (FLV) (4%). Sobremesas doces eram oferecidas em 11,4% dos locais e 20% incluíam brindes com as refeições. Conclusões: A escassa oferta de menus infantis, as poucas opções e a baixa oferta de FLV indicam a necessidade de um novo olhar no desenvolvimento de cardápios infantis e de um maior entrosamento entre as possibilidades dos restaurantes e as expectativas de pais e crianças, no desafio de integrar a relação entre a oferta de novos alimentos, que promovam hábitos mais saudáveis, e o seu consumo.

Evaluation of school lunch recipes based on digital platform / 中国学校卫生

Objective@#To understand levels of various foods and nutrients in school lunch based on digital platform and to provide reference for food preparation and serving.@*Methods@#A total of 13 018 school lunch recipes in Binhai New Area of 96 schools in Tianjin from November 2020 to April 2021 were collected by using digital management platform for food safety and nutritional health.Food types including cereals and tubers, vegetables, fruits, livestock and poultry meat, fish and shrimp, eggs, milk and dairy products, legumes and their products/nuts and others energy, and nutrients including protein, fat, carbohydrate, calcium, iron, zinc, selenium, vitamin A, vitamin B 1, vitamin B 2, vitamin C and dietary fiber were evaluated.@*Results@#The qualified rate of all kinds of food for students lunch from high to low were 96.8% (116.4 g) of livestock and poultry meat, 92.3% (179.5 g) of cereal and potato, 65.0% (170.6 g) of vegetables, 47.7% (21.4 g) of soybeans and their products/nuts, 33.4% (18.0 g) of eggs, 14.4% (8.5 g) of fish and shrimp, 14.1% (19.6 g) of fruits, 0.3% (35.4 g) of milk and dairy products. There were significant differences in the qualified rate of various food intake among different grades( P <0.05). The qualified rate of students lunch energy was 76.9%(932.6 kcal). The qualified rates of various nutrients from high to low were iron 96.9%(9.7 mg), zinc 96.8%(5.9 mg), protein 96.4%(43.8 g), carbohydrate 87.6%(130.8 g) and selenium 82.9%(23.5 μg), vitamin C 78.5%(48.8 mg), vitamin B 1 75.9%(0.5 mg), fat 74.3%(28.5 g), vitamin A 74.1%(327.1 μ g) vitamin B 2 49.9%(0.5 mg), dietary fiber 19.5%(5.9 g) and calcium 13.4%(246.1 mg). There were significant differences in the qualified rates of energy and nutrients among different grades( P <0.05).@*Conclusion@#The digital platform basically meets school lunch requirments on food types and nutrients, but still with problems regarding insufficient fish and shrimp, fruits, milk and dairy products, vitamin B 2, dietary fiber and calcium. It is suggested to optimize school lunch recipes or increase corresponding nutrients content in other meals.

Avaliação Qualitativa de Cardápios Hospitalares / Qualitative Evaluation of Hospital Menus

Modelo: Estudo caracteriza-se como transversal, qualitativo. Objetivo: Avaliar qualitativamente as preparações de cardápios oferecidos em hospitais no município de Uberaba - MG. Metodologia: A análise foi realizada pelo método "Avaliação Qualitativa de Preparações do Cardápio" dos almoços oferecidos em cinco Unidades de Alimentação e Nutrição hospitalares públicas ou particulares durante três semanas alternadas entre os meses de fevereiro a junho de 2018. Avaliou-se as ofertas de frutas, folhosos, repetições de cores, presença de alimentos sulfurados, doces, frituras, carnes gordurosas e frituras + doces na mesma refeição. Resultados: Os itens foram classificados como "ótimo" a baixa oferta de frituras (6,7%), carnes gordurosas (8,0%) e nenhuma oferta de doce + frituras no mesmo dia (0%), "bom" para oferta de folhosos (75%) e doces (22,7%), "regular" para repetição de cores (42.7%), "ruim" quanto aos alimentos sulfurados (56%) e "péssimos" quanto a oferta de frutas (9,3%). Conclusão: Os cardápios possuíam aspectos positivos como ausência de doce + fritura, baixa utilização de frituras e carnes gordurosas, boa oferta de folhosos e doces; os aspectos preocupantes relacionaram-se com a repetição de cores e negativos com a presença de alimentos sulfurados e ausência de frutas. (AU)

Study design: Cross-sectional, qualitative study. Objectives: To qualitatively evaluate the menu preparations offered at hospitals from the city of Uberaba - MG Methods: The analysis was conducted using the method "Qualitative evaluation of menu preparations" to evaluate lunch menus offered at 5 Food and Nutrition Units from public or private Hospitals for 3 weeks alternated between February and June 2018. The offer of fruits, leafy vegetables, sweets, fried food, fatty meats and fried food + sweets in the same meal were evaluated, as well as the color repetitions and the presence of sulphurated food. Results: Items rated as "Excellent" showed low offer of fried food (6.7%), fatty meats (8.0%) and no offer of sweet + fried food on the same day (0%); "Good" showed the offer of leafy vegetables (75%) and sweets (22.7%); "Regular" indicated color repetition (42.7%); "Bad" indicated sulphurated food (56%) and "Very bad" stood for fruit offer (9.3%). Conclusion: The menus had positive aspects such as the absence of sweet + fried food, low presence of fried food and fatty meats, good offer of leafy vegetables and sweets. The worrying aspects were associated with color repetition and the negative aspects were related to the presence of sulphurated food and absence of fruits. (AU)

Fitoestrógenos no climatério: proposição de um cardápio rico em fitoestrógenos para mulheres climatéricas / Phytoestrogens in climacteric: proposition of a menu rich in phytoestrogens for climacteric women

Introdução: A terapia de reposição hormonal é uma das principais formas de tratamento utilizadas no combate dos déficits hormonais durante o climatério. Entretanto, muitas mulheres buscam alternativas terapêuticas mais seguras e/ou naturais, como por exemplo, os fitoestrógenos. Objetivo: Elaborar um cardápio alimentar baseado em alimentos fontes de fitoestrógenos. Material e métodos: Trata-se de um estudo qualitativo e quantitativo descritivo, realizado nos meses de junho a setembro de 2019 no Núcleo de estudos em Alimentação e Nutrição da Universidade CEUMA. Foi elaborado um cardápio baseado na alimentação padrão da população brasileira (2000 kcal) segundo a Pesquisa de Orçamentos Familiares e Vigitel Brasil. Foram feitas adaptações nessa alimentação conforme a Pirâmide Alimentar Brasileira, incluindo alimentos fonte de fitoestrógenos. A adequação calórica de macronutrientes e compostos bioativos seguiram as recomendações da OMS, DRI's e IOM. Os dados foram analisados através do software NutriLife® e do programa Excel®, onde estavam contidas a Tabela de Composição dos Alimentos e a Tabela de Medidas Caseiras. Resultados: As principais fontes de fitoestrógenos são leguminosas e grãos (até três porções/dia). A fonte primordial de isoflavonas é a soja (295,55 mg/100g); de lignanas é a linhaça (370 mg/100g) e de coumestanos é a ervilha (8,11 mg/100g). A quantidade de fitoestrógenos totais atingida no cardápio foi de 42,2 a 55,2 mg/dia, com valores oscilantes para isoflavonas, lignanas e coumestanos durante a semana. Conclusão: O cardápio rico em fitoestrógenos configura uma alternativa adaptável e natural na remissão de determinados sintomas climatéricos, onde a baixa ocorrência de efeitos adversos facilita sua adesão.(AU)

Introduction: Hormone replacement therapy is one of the main forms of treatment used to combat hormonal deficits during the climac- teric. However, many women seek safer and/or natural therapeutic alternatives, such as phytoestrogens. Objective: To elaborate a food menu based on foods that are sources of phytoestrogens. Material and Methods: This is a qualitative and quantitative descriptive study, conducted in the months of June to September 2019 in the Center for Food and Nutrition Studies at CEUMA University. A menu was elaborated based on the standard feeding of the Brazilian population (2000 kcal) according to Family Budget Survey and Vigitel Brazil. Adaptations were made to this menu according to the Brazilian Food Pyramid, including foods source of phytoestrogens. The caloric adequacy of macronutrients and bioactive compounds followed the recommendations of the WHO, DRI's and IOM. The data were analyzed using NutriLife® software and Excel® program, which contained the Food Composition Table and the Homemade Measures Table. Results: The main sources of phytoestrogens are legumes and grains (up to three servings/day). The primary source of isoflavones is soy (295,55 mg/100g); of lignans is flaxseed (370 mg/100g) and of coumestans is pea (8,11 mg/100g). The total amount of phytoestrogens reached in the menu was 42,2 to 55,2 mg/day, with oscillating values for isoflavones, lignans and coumestans during the week. Conclusion: The menu is rich in phytoestrogens and constitutes an adaptable and natural alternative in the remission of certain climacteric symptoms, in which the low occurrence of adverse effects facilitates their adhesion.(AU)

Análise da qualidade nutricional de cardápios escolares segundo diferentes métodos / Analysis of the nutritional quality of school menus according to different methods

O objetivo deste trabalho foi utilizar diferentes métodos para analisar a qualidade nutricional de almoços oferecidos em sete Unidades de Alimentação e Nutrição Escolares (UANEs) de um município brasileiro. A análise das porções alimentares foi realizada utilizando a Tabela Brasileira de Composição dos Alimentos e os resultados foram comparados com as recomendações do Programa Nacional de Alimentação Escolar (PNAE). Utilizou-se o Indicador de Qualidade para Cardápios da Alimentação Escolar (IQCAE) e os dados foram apresentados em escores. Utilizou-se também o método Avaliação Qualitativa das Preparações de Cardápios (AQPC) e os resultados foram classificados de muito satisfatório a muito insatisfatório. A maioria das médias nutricionais mostrou-se acima das recomendações e também se observou a ausência de alimentos vegetais in natura na maioria dos cardápios. Os resultados demonstraram a importância da análise dos cardápios escolares com vistas à definição de estratégias para sua adequação em direção às recomendações e diretrizes do PNAE.

The objective of this study was to use different methods to analyze the nutritional quality of lunchs offered at seven School Nutrition and Food Units (SNFU) in a Brazilian municipality. The analysis of the food portions was performed using the Brazilian Food Composition Table and the results were compared with the recommendations of the National School Feeding Program (NSFP). The Quality Indicator for School Feeding Menus (QISFM) was used and the data were presented in scores. Qualitative Evaluation of Menu Preparations (QEMP) was also used and the results were classified from very satisfactory to very unsatisfactory. Most of the nutritional averages were above the recommendations and the absence of fresh vegetable foods was also observed in most of the menus. The results demonstrated the importance of analyzing school menus in order to define strategies for their adaptation towards the recommendations and guidelines of the NSFP.

Qualidade nutricional dos cardápios de Instituições Federais de Educação / Nutritional quality of Federal Education Institutions

Este estudo objetivou verificar se os estudantes universitários têm conhecimento sobre as formas de transmissão do HIV/AIDS e a adoção de práticas de prevenção e se há associação com a renda. A pesquisa contou com 682 estudantes, que responderam a um questionário. Foram analisadas dez questões a respeito das formas de transmissão, o número de acertos e a possível associação com a renda familiar. Na amostra, predominaram as mulheres e a renda inferior a cinco salários mínimos. Seiscentos e oito estudantes (89%) acertaram oito ou mais perguntas acerca das formas de transmissão do vírus. Aqueles com renda familiar menor que cinco salários mínimos apresentaram uma porcentagem maior de acertos em todas as questões sobre a transmissão. Concluiu-se que a maioria tem bom conhecimento em relação à transmissão, porém não utiliza preservativo em todas as relações sexuais, e há maior conhecimento entre estudantes de menor renda.

This study aimed to verify whether university students have knowledge about the ways of HIV/AIDS transmission and the adoption of prevention practices and if there is an association with income. The survey included 682 students, who answered a questionnaire. Ten questions about the ways of transmission, the number of correct answers and the possible association with family income were analyzed. In the sample, women and income below five minimum wages predominated. Six hundred and eight students (89%) answered eight or more questions about the ways in which the virus was transmitted. Those with a family income of less than five minimum wages had a higher percentage of correct answers in all questions about transmission. The majority has good knowledge regarding transmission, but does not use condoms in all sexual relations, and there is greater knowledge among students with lower income.

Qualitative evaluation of school meal menus offered in Brazilian municipalities / Avaliação qualitativa de cardápios escolares oferecidos em municípios brasileiros

Abstract This article aims to evaluate the quality of Brazilian school meal menus. Cross-sectional study that analyzed 2,500 menus of 500 Brazilian municipalities. The menus were evaluated based on the Quality Index for School Meal Menus (IQCAE - Indicador de Qualidade para Cardápios da Alimentação Escolar). The data were submitted to descriptive analysis. We found that 29,4% of menus presented high quality; 50,6%, regular quality; and 20%, low quality. Grains and tubers (86%) and Meat and eggs (67%) were the groups most found in menus, followed by Legumes (42,16%), Vegetables (40%), Fruits (35,56%), and Dairy products (18,6%); the frequency of Cured meats and sausages (8,68%) and Sweets as meals (3,64%) was lower. Among other components, 84,6% of the menus offered Sweets as dessert in none or one day a week; ultra-processed foods appear in 65,6% of menus at least once a week. In 22% of the menus, meal time was compatible with type meal served. Important food for child nutrition, such as dairy, vegetables, and fruits, are not regularly provided by school meals. Despite the advances in policy management, the presence of ultra-processed foods at least once a week is still frequent in the menus.

Resumo O objetivo deste artigo é avaliar a qualidade de cardápios escolares brasileiros. Estudo transversal analisou 2.500 cardápios, de 500 municípios brasileiros, com base no Indicador de Qualidade para Cardápios da Alimentação Escolar. Os dados foram submetidos à análise descritiva. Observou-se que 29,4% dos cardápios apresentaram alta qualidade, 50,6% qualidade regular e 20% baixa qualidade. Cereais e tubérculos (86%) e carnes e ovos (67%) foram os grupos de maior frequência nos cardápios, seguidos de leguminosas (42,16%), hortaliças (40%), frutas (35,56%) e laticínios (18,6%); a frequência da oferta de alimentos embutidos (8,68%) e doces como refeições (3,64%) foi menor. Entre os demais componentes, 84,6% dos cardápios ofertavam doces como sobremesa em nenhum ou em apenas um dia da semana; os formulados aparecem em 65,6% dos cardápios pelo menos uma vez por semana. Em 22% dos cardápios o horário estava compatível com o tipo de refeição servida. Alimentos importantes para a nutrição infantil, como laticínios, hortaliças e frutas, não são oferecidos regulamente na alimentação escolar. A despeito dos avanços observados na gestão da política, a presença de formulados pelo menos uma vez por semana ainda é frequente nos cardápios.

Viabilidade no atendimento às normas do Programa Nacional de Alimentação Escolar e sua relação com custo dos cardápios / Feasibility in meeting nutrient amounts of the National School Feeding Program and its relationship with the menu cost

Resumo O estudo avaliou a viabilidade da adequação de cardápios em relação às exigências nutricionais estabelecidas pelo Programa Nacional de Alimentação Escolar (PNAE) e a relação entre o custo do cardápio. Cada cardápio semanal contou de uma combinação de alimentos dentro de cada grupo. Para cada combinação de alimentos foi elaborado um modelo de otimização de dados para obter as quantidades de cada alimento de forma a atender às exigências do PNAE ao menor custo possível (cardápios com 20% e 30% da ingestão dietética de referência para energia, macronutrientes, cálcio, ferro, magnésio, zinco, vitaminas A e C, além de restrições para sódio, gorduras saturada e trans, e açúcar de adição). Não foi obtida nenhuma solução que acomodasse todas as exigências do PNAE. Os componentes limitantes foram cálcio, sódio e carboidratos; para os demais os cardápios foram adequados. O custo foi diretamente correlacionado com a frequência de carne e frutas, e inversamente com os conteúdos de sódio e carboidratos, e com as frequências de arroz e feijão. A probabilidade de adequação de carboidratos foi próxima de zero quando a frequência de carne foi acima de 1 vez por semana. Concluindo, é pouco provável a obtenção de cardápios que atendam à todas as exigências do PNAE.

Abstract We evaluated the feasibility of the menu adequacy regarding the nutritional constraints established by the National School Feeding Program (PNAE) and its relation to the cost. Each menu accounted for a given food combination within each food group. A diet optimization model comprising each set of foods was designed to obtain food quantities in order to meet the exigences of the PNAE at the lowest cost (menus with 20% and 30% of dietary reference intake for energy, macronutrients, calcium, iron, magnesium, zinc, vitamins A and C, also restrictions for sodium, saturated and trans fats, and added sugar). There was no feasible solution that accommodated all nutrient targets. Limiting components were calcium, sodium, and carbohydrates; but the menus were adequate for the other nutrients. There was a positive correlation between the menu cost and the frequency of meat and fruits, and a negative correlation with the contents of sodium and carbohydrates, and with the frequencies of rice and beans. The probability of obtaining carbohydrate adequacy was close to zero when the meat frequency was higher than one serving per week. In conclusion, it is unlikely to obtain menus that meet all the requirements of the PNAE.

Factors influencing food service provision decisions in centre-based early childhood education and care services: Cooks' perspective.

ISSUE ADDRESSED: Considerable public effort has been directed at centre-based childcare as an early childhood education and care (ECEC) setting to promote healthy food-related behaviours in young children. However, in the real-world setting, best practice, evidence-based guidelines are not always well-translated into usual, day-to-day routines. This study aims to understand what factors influence the centre-based childcare cooks' food and nutrition decisions for children aged 2-5 years. METHODS: Semi-structured qualitative interviews were conducted with cooks in centre-based childcare using purposeful maximum variation sampling and data analysed thematically. RESULTS: Fourteen cooks were interviewed from 14 services across South Australia. Central to providing a healthy food environment was expert-led knowledge and training gained through the workplace over several years and the embodiment of the service's healthy food and nutrition policy, evidenced through menu planning to maintain a focus on healthy eating. Threatening these positive, routine practices and decisions were pressures to modify menus in response to increasing food allergies and changing cultural and family preferences, in the absence of ongoing relevant training and expertise at the system-level. CONCLUSIONS: Children in ECEC benefit from cooks' commitment to providing nutritious foods; however, the requirements to extend their role to respond to increasing demands without relevant system-level support and training puts the children at risk of not being exposed to health-promoting menus and possible errors in providing dietary modifications. ECEC cooks urgently need access to system-level support and training. SO WHAT?: Understanding and addressing the barriers experienced by cooks and the complexity of factors that inform their food-related decision-making will sustain the implementation of effective, healthy eating guidelines and nutrition practices in ECEC.

Avaliação da composição de cardápios de escolas públicas do município de São Paulo utilizando o índice de qualidade da Coordenação de Segurança Alimentar e Nutricional e o método de análise qualitativa das preparações do cardápio / Evaluation of the composition of public-school menu in the municipality of São Paulo using the quality index of the Food and Nutrition Security Coordination and the method of qualitative analysis of menu preparations

Introdução: Na infância, a escola tem importante impacto na formação de hábitos alimentares. A alimentação qualitativa e quantitativamente adequada é essencial para garantir o crescimento e o desenvolvimento e, nesse cenário, o Programa Nacional de Alimentação Escolar tem por objetivo realizar ações de educação alimentar e nutricional e oferecer refeições que garantam as necessidades nutricionais durante o período letivo. Objetivo: Avaliar quanti-qualitativamente a composição dos cardápios do Programa de Alimentação Escolar da rede municipal de São Paulo. Métodos: A coleta de dados foi realizada nos meses de agosto a outubro de 2019, por meio dos cardápios disponibilizados na plataforma eletrônica "Prato Aberto", publicada sob responsabilidade da Secretaria Municipal de Educação de São Paulo nos meses de agosto a outubro de 2019, para as Escolas Municipais de Ensino Fundamental. Os cardápios foram avaliados por sorteio das escolas de acordo com sua localização. Resultados: A média de pontuação total demonstra que todos os cardápios avaliados foram classificados como adequados; entretanto, ao analisar detalhadamente os resultados mensais para cada escola, foi possível notar o impacto das diferentes formas de gestão, compras de alimentos e planejamento dos cardápios. Conclusão: Os cardápios foram avaliados positivamente frente às duas ferramentas e estavam adequados quanto às recomendações do PNAE, embora houvesse pontos a serem melhorados, sobretudo quanto à alta previsão de oferta de alimentos restritos. (AU)

Introduction: In childhood, school has an important impact on the formation of eating habits. Qualitatively and quantitatively adequate food is essential to ensure growth and development and, in this scenario, the National School Feeding Program aims to carry out food and nutrition education actions and offer meals that guarantee nutritional needs during the school term. Objective: To quantitatively and qualitatively evaluate the composition of the menus in the School Meals Program of the municipal network of São Paulo. Methods: Data collection was carried out from August to October 2019, using menus available on the electronic platform "Prato Aberto", published under the responsibility of the Municipal Education Department of São Paulo from August to October 2019, for Municipal Elementary Schools. The menus were evaluated by drawing lots of schools according to their location. Results: The average total score demonstrates that all evaluated menus were classified as adequate; however, when analyzing in detail the monthly results for each school, it was possible to notice the impact of different forms of management, food purchases and menu planning. Conclusion: The menus were positively evaluated against the two tools and were adequate in terms of the PNAE recommendations, although there were points to be improved, especially regarding the high forecast of restricted food supply. (AU)

Quality of kids' meals in fast-food restaurants: the nutritional content is not enough for an informed choice / Qualidade das refeições infantis em restaurantes de fast-food: a informação nutricional não é suficiente para uma escolha informada

ABSTRACT Objective Eating out in restaurants is a common family behavior, but it has been persistently associated with unbalanced nutrient intakes, contributing to create and reinforce unhealthy food habits among children. The purpose of this study was to evaluate the kids' meals from three common well-known restaurant chains in Portugal. Methods The nutritional composition (total fat, carbohydrates, protein, and sodium content) of the menus was analyzed bromatologicaly, and food portions were also examined. The assessment was carried out according to the European Food Safety Authority recommendations. Results Analyses of the menus from the two points of view revealed that the evaluations for macronutrients and food portions may return contradictory results. Protein, carbohydrates, and fats are compliant with the requirements for most of the meals. The analysis from the food portion perspective exceeds the requirements for the meat, fish, and eggs groups, as well as for fats and oils. Fruits, vegetables, and pulses are not present in the menus. Despite the balance associated with the macronutrients, the salt content exceeds the recommendations for most of the meals. Conclusions Popular fast-food chain restaurants have already adapted to comply with nutritional recommendations, whilst neglecting important recommended foods such as fruit, pulses, and vegetables. This study points not only to the need of investing in the improvement of the offerings, but also to the importance of fighting the tendency to reduce the perception of food quality to its nutritional content, leading consumers to believe that the meals offered are balanced when they are not.

RESUMO Objetivo Comer fora de casa tem se tornado um comportamento cada vez mais frequente entre as famílias, fato que tem sido persistentemente associado à ingestão desequilibrada de nutrientes e contribuído para reforçar hábitos alimentares infantis pouco saudáveis. Este estudo avaliou menus infantis de três redes de restaurantes bem conhecidas em Portugal. Métodos A composição nutricional (gordura total, carboidratos, proteína e sódio) dos cardápios foi analisada bromatologicamente, assim como as porções dos alimentos fornecidas. A avaliação foi realizada de acordo com as recomendações da Autoridade Europeia para a Segurança dos Alimentos. Resultados A análise dos cardápios, na perspetiva da composição em macronutrientes e das porções alimentares, apresentou resultados contraditórios. Os teores de proteínas, carboidratos e gorduras cumprem os requisitos na maioria das refeições. A análise das porções alimentares excede as recomendações para os grupos da carne, peixe e ovos, bem como para gorduras e óleos. No entanto, frutas, hortícolas e leguminosas não estão presentes nos menus. Apesar do equilíbrio associado aos macronutrientes, o teor de sal supera as recomendações na maioria das refeições. Conclusão As redes de fast-food mais populares já adaptaram a sua oferta às recomendações nutricionais. No entanto, verifica-se que negligenciaram algumas recomendações alimentares importantes, como incluir frutas, leguminosas e hortícolas nas refeições. Este estudo aponta para a necessidade de investir não só na melhoria da oferta, como também para a importância de combater a tendência crescente dos consumidores se focarem nos nutrientes e se esquecerem dos alimentos, o que os leva a acreditar que as refeições oferecidas são equilibradas, quando não o são.

Changing trends in school-meal catering services as part of the Nutrition Improvement Program for Rural Compulsory Education Students / 中国学校卫生

Objective@#To analyze the usage of catering software and the creation of recipes by schools, as part of the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES) 2013-2017.@*Methods@#In each county of the 699 trial counties across 22 provinces in central and western area of China under the NNIPRCES, no less than 10% of primary and junior middle schools were randomly selected according to their catering mode (i.e., school feeding, food packages, and family feeding). School questionnaires were used to collect information concerning the schools and the creation of recipes.@*Results@#From 2013 to 2017, the utilization rate of catering software was 11.7%, 8.0%, 17.8%, 16.9%, and 14.0%, respectively with significant differences(χ 2=345.09，P<0.01). The creators of school-meal recipes included schools, the Education Bureau, hospitals and colleges, the centers of disease prevention and control. Differences were observed in the proportion of recipe creators across school type, area, and catering mode, while annual trends also varied (P<0.01), as indicated by the following proportions: 74.9%, 20.0%, 3.7%, 1.3%, respectively. Food safety was identified as the main factor that needs to be considered when creating school recipes, the proportions of which were 58.0%, 78.4%, 70.6%, and 87.4% from 2014 to 2017.@*Conclusion@#From 2013 to 2017, the utilization rate and the frequency of catering software were both relatively low, and recipe creation was in need of professional guidance. It is necessary to strengthen the popularization of catering software and improve the nutritional knowledge and skills of canteen workers to ensure the quality of school meals.