Trends in the Nutrition Profile of Menu Items at Large Burger Chain Restaurants.

INTRODUCTION: Fast food restaurants, including top burger chains, have reduced calorie content of some menu items in recent years. However, the extent to which the nutrition profile of restaurant menus is changing over time is unknown. METHODS: Data from 2,472 food items on the menus of 14 top-earning burger fast food chain restaurants in the U.S., available from 2012 to 2016, were obtained from the MenuStat project and analyzed in 2019. Nutrition Profile Index scores were estimated and used to categorize foods as healthy (≥64 of 100). Generalized linear models examined mean scores and the proportion of healthy menu items among items offered in all years (2012-2016) and items offered in 2012 only compared with items newly introduced in subsequent years. RESULTS: Overall, <20% of menu items were classified as healthy with no change from 2012 to 2016 (p=0.91). Mean Nutrition Profile Index score was relatively constant across the study period among all food items (≈50 points, p=0.58) and children's menu items (≈56 points, p=0.73). The only notable change in Nutrition Profile Index score or in proportion of healthy items was in the direction of menu items becoming less healthy. CONCLUSIONS: At large chain burger restaurants, most items were unhealthy, and the overall nutrition profile of menus remained unchanged from 2012 to 2016. Future research should examine the nutrition profile of restaurant menus in a larger, more diverse sample of restaurants over a longer timeframe and examine whether results are robust when other measures of nutritional quality are used.

Calorie and nutrient trends in large U.S. chain restaurants, 2012-2018.

INTRODUCTION: Large chain restaurants reduced calories in their newly-introduced menu items from 2012 to 2015. The objective of this study was to provide updated calorie trends through 2018 and examine trends in the macronutrient composition of menu items across this time period. METHODS AND FINDINGS: Data were obtained from the MenuStat project and include 66 of the 100 largest revenue generating U.S. chain restaurants (N = 28,238 items) that had data available in all years from 2012 to 2018. Generalized linear models were used to examine per-item calorie and nutrient changes (saturated fat, trans fat, unsaturated fat, sugar, non-sugar carbohydrates, protein, sodium) among (1) items on the menu in all years (common items) and (2) newly introduced items (2013-2018). Overall, there were no significant changes in calories or nutrients among common items from 2012 to 2018. Among all newly introduced items, calories (-120 kcals, -25%, p = 0.01; p-for-trend = 0.02), saturated fat (-3.4g, -41%, p<0.01, p-for-trend = 0.06), unsaturated fat (-4.5g, -37%, p = 0.02; p-for-trend = 0.04), non-sugar carbohydrates (-10.3g, -40%, p = 0.02, p-for-trend = 0.69), and protein (-4.3g, -25%, p = 0.04, p-for-trend = 0.02) declined. CONCLUSION: Newly introduced menu items in large chain restaurants have continued to decline in calories through 2018, which may help to reduce calorie intake. Other changes in macronutrient content were sporadic and not clearly toward improved dietary quality.

The use of finger foods in care settings: an integrative review.

BACKGROUND: Reduced food intake is prevalent in people in residential and hospital care settings. Little is known about the use of finger foods (i.e. foods eaten without cutlery) with respect to increasing feeding independence and food intake. The Social Care Institute for Excellence (Malnutrition Task Force: State of the Nation, 2017) recommends the use of finger foods to enable mealtime independence and to prevent loss of dignity and embarrassment when eating in front of others. The aim of this review is to identify and evaluate the existing literature regarding the use and effectiveness of finger foods among adults in health and social care settings. METHODS: An integrative review methodology was used. A systematic search of electronic databases for published empirical research was undertaken in October 2018. Following screening of titles and abstracts, the full texts of publications, which investigated outcomes associated with the provision of finger foods in adult care settings, were retrieved and assessed for inclusion. Two independent investigators conducted data extraction and quality assessment using Critical Appraisal Skills Programme checklists. Thematic analysis was used to summarise the findings. RESULTS: Six studies met the inclusion criteria. Four themes were identified: Finger food menu implementation; Importance of a team approach; Effect on nutrition; and Influence on wellbeing. Study designs were poorly reported, with small sample sizes. CONCLUSIONS: There is some evidence that the provision of finger foods may positively affect patient outcomes in long-term care settings. There is a paucity of research evaluating the use of a finger food menu in acute care settings, including economic evaluation. Future high quality trials are required.

Evaluación del estado nutricional y comportamientos de salud en escolares de San Miguel de Tucumán, Argentina / Evaluation of nutritional status and health behaviors in schoolchildren from San Miguel de Tucumán, Argentina

INTRODUCCIÓN: La infancia y adolescencia son etapas cruciales de la vida en los cuales comienzan a formarse y adquirirse los hábitos que se van a sostener en el desarrollo hacia la adultez. OBJETIVOS: Determinar el estado nutricional y comportamientos de salud de los alumnos en escuelas y jardines municipales de San Miguel de Tucumán. MÉTODOS: Se realizó un estudio descriptivo, de corte transversal. La muestra estuvo conformada por escolares de 3 a 18 años de edad de ambos sexos (1239). Las variables estudiadas fueron edad, sexo, hábitos alimentarios, sedentarismo, peso, talla e índice de masa corporal. Se pesaron y midieron a los alumnos y los datos fueron tomados a partir de una encuesta estructurada. En el nivel inicial y primario se realizó una entrevista personal, los niños menores de 6 años fueron encuestados junto a sus padres o cuidadores, quienes colaboraron en las respuestas. En el nivel secundario el cuestionario fue autoadministrado. Se solicitó autorización a los alumnos más grandes y en el caso de menores de edad se pidió consentimiento informado a los padres. RESULTADOS: La prevalencia de sobrepeso y obesidad fue del 25,6 % y el 22,2 % respectivamente. Durante el último mes el 85,6 % de los estudiantes consumió 1 o más veces al día bebidas azucaradas, el 19,8% consumió verduras en almuerzo y cena, el 57,9% incluyó menos de dos frutas al día. El 73% consumió menos de 3 porciones al día de lácteos y el 14% incluyó 8 vasos diarios de agua. CONCLUSIONES: Se observó sedentarismo, exceso de peso y hábitos alimentarios inadecuados en relación a las recomendaciones de las nuevas "Guías Alimentarias para la población Argentina", lo que puede llevar a la aparición de Enfermedades Crónicas no Transmisibles de manera más acelerada

INTRODUCTION: Childhood and adolescence are crucial stages of life in which the habits that will be sustained in the development towards adulthood begin to form and acquire. OBJECTIVES: To determine the nutritional status and health behaviors of students in schools and municipal gardens of San Miguel de Tucumán. METHODS: A descriptive, cross-sectional study was carried out. The sample was made up of schoolchildren from 3 to 18 years of age of both sexes (1239). The variables studied were age, sex, eating habits, sedentary lifestyle, weight, height, and body mass index. The students were weighed and measured and the data was taken from a structured survey. At the initial and primary level, a personal interview was carried out. Children under 6 years of age were surveyed together with their parents or caregivers, who collaborated in the responses. At the secondary level, the questionnaire was selfadministered. Authorization was requested from older students and in the case of minors, informed consent was requested from parents. RESULTS: The prevalence of overweight and obesity was 25.6% and 22.2% respectively. During the last month 85.6% of the students consumed sugary drinks 1 or more times a day, 19.8% consumed vegetables at lunch and dinner, 57.9% included less than two fruits a day. 73% consumed less than 3 servings a day of dairy and 14% included 8 glasses of water daily. CONCLUSIONS: Sedentary lifestyle, excess weight and inadequate eating habits were observed in relation to the recommendations of the new "Dietary Guidelines for the Argentine population", which can lead to the appearance of Chronic Non-Communicable Diseases more rapidly. This information is useful for knowing the current situation of municipal schools and executing health promotion policies in the school environment

Análisis de la alimentación en un centro penitenciario español y grado de percepción en una muestra de reclusos / Analysis of the diet in a Spanish prison and the level of perception in a sample of prisoners

Introducción: se analiza la oferta alimentaria del Centro Penitenciario Quatre Camins (Barcelona), en el que se modificaron los menús en el primer trimestre del año 2017, con el fin de adaptarlos a una oferta alimentaria más saludable. Objetivos: se describen los nuevos menús, según las patologías crónicas y metabólicas más prevalentes en la población reclusa, y se comprueba si se corresponden a una alimentación saludable. También se analiza la oferta de alimentos de los economatos y la percepción de los reclusos en relación a la alimentación en prisión. Materiales y métodos: se realiza un estudio con metodología mixta: a) descriptivo de la nueva oferta alimentaria del servicio de cocina; y b) análisis de los menús según el Índice de la Alimentación Saludable Español (IASE); así como una descripción de las patologías más prevalentes en el centro penitenciario. Para conocer la percepción de los internos, se diseñó un cuestionario de autocumplimentación ad hoc, que constaba de cuatro preguntas cerradas tipo Likert y cuatro preguntas abiertas sobre la percepción de la alimentación en la prisión. Los internos que respondieron al cuestionario lo hicieron de forma voluntaria, anónima y mediante consentimiento informado. Resultados: se utilizó una muestra de 22 reclusos. La puntuación media de los menús, obtenida mediante el IASE, fue de 60,5 puntos. La valoración de los internos en cuanto a calidad, cantidad y percepción de la dieta como saludable no llegó al aprobado. Discusión: la accesibilidad al agua potable y a la comida se ajusta a los requerimientos de salubridad, calidad y cantidad que queda regulada por el actual Reglamento Penitenciario. Los resultados obtenidos sugieren que la oferta alimentaria en la prisión "necesita cambios", según la clasificación del IASE

Introducción: an analysis is carried out of the diet provided at the Quatre Camins prison (Barcelona), where meals were modified in the first quarter of 2017 to provide a healthier diet. Objectives: the new meals are described in relation to the most prevalent chronic and metabolic pathologies in the prison population and it is checked if they correspond to a healthy diet. The food offered at the prison shops and the perception of prisoners regarding prison food are also analysed. Materials and methods: a mixed methodology study was carried out: a) a descriptive analysis of the new food offered by the kitchen service; and b) an analysis of the meals using the Spanish Healthy Eating Index (IASE) as a reference; as well as a description of the most prevalent pathologies in the prison. To determine the prisoners' perceptions, an ad hoc self-completed questionnaire was designed that consisted of four closed Likert questions and four open questions about the perception of prison food. The prisoners who responded to the questionnaire did so voluntarily, anonymously and under informed consent. Results: a sample of 22 prisoners was used. The score according to the IASE is 60.5 points. The assessments of the sample of 22 prisoners regarding quality, quantity and perception of diet as healthy does not reach pass. Discussion: access to safe water and food meets the requirements for healthiness, quality and quantity regulated by the current Prison Regulation. The results obtained suggest that the diet in the prison "needs changes" according to the IASE

Estudio comparativo de la valoración nutricional de menús de comedores mediante análisis bromatológico y tablas de composición de alimentos / Comparative study of the nutritional assessment of dining room menus through bromatological analysis and food composition tables

Introducción: El análisis de la composición nutricional de los alimentos mediante análisis bromatológico es una ardua tarea; por ello, gracias a la recopilación de los datos obtenidos de estos análisis en diferentes países se han elaborado las tablas de composición de alimentos (TCA). Estas suponen la base de los programas informáticos nutricionales, con los que se consigue agilizar el cálculo de la composición en nutrientes de la dieta. Objetivo: comprobar sí hay diferencias significativas entre los resultados obtenidos para el cálculo de proteínas, glúcidos, lípidos, fibra dietética y hierro mediante análisis bromatológico, y el obtenido mediante el cálculo por programas informáticos. Métodos: para el análisis bromatológico se han utilizado las técnicas recomendadas por la AOAC y para los valores obtenidos mediante cálculo se han utilizado los programas informáticos nutricionales de distintas épocas: Programa utilizado por la Subdirección general de protección del comercio de la Comunidad de Madrid, Dietowin, Dietsource y Dial. Se han estudiado veintitrés platos diferentes: doce primeros y once segundos, correspondientes al menú de siete comedores colectivos de una empresa de la Comunidad Valenciana, en un estudio transversal y longitudinal durante un periodo de dos años. Resultados: se ha comprobado que los valores promedio determinados por análisis directo y los obtenidos por cálculo, muestran diferencias significativas tras aplicar el estadístico de la t de Student. En el caso de los valores obtenidos para los distintos programas informáticos no se encuentran diferencias significativas. Conclusión: Los programas informáticos que se han utilizado presentan un 65% e incluso superior, de diferencias significativas en los valores calculados para los distintos nutrientes, con respecto a los valores obtenidos mediante análisis bromatológico. Una de entre las posibles causas que se podrían considerar por la que se dan estas diferencias sería: porque en TCA la mayoría de los valores de los nutrientes son obtenidos a partir de alimentos en crudo; mientras que en el análisis directo se han analizado platos completos en los cuales los alimentos se han sometido a técnicas culinarias o de procesado. En cuanto a la segunda hipótesis planteada, decir que no hay diferencias entre los valores obtenidos por los diferentes programas informáticos utilizados, ya que los valores para todas las TCA están valorados en crudo

Introduction: The analysis of the nutritional composition of foods by bromato- logic analysis is an arduous task; for this reason, thanks to the collection of the data obtained from these analyses in different countries, the food composition tables have been developed. These are the basis of nutritional software, which gets speed up the calculation of the composition of nutrients in the diet. Objective: check if there are significant differences between the results obtained for the calculation of proteins, carbohydrates, lipids, dietary fiber and iron through bromatological analysis, and the one obtained by the calculation with computer programs. Methods: for the bromatological analysis have been used the techniques recommended by the AOAC and for the values obtained by calculation, the nutritional computer programs of different periods have been used: Program used by the General Subdirectorate for Commercial Protection of the Community of Madrid, Dietowin, Dietsource and Dial. 23 different dishes were studied: twelve starters and eleven main dishes, corresponding to the menu of seven collective dining rooms of a company from the Valencian Community, in a transversal and longitudinal study over a period of two years. Results: it has been verified that the average values determined by direct analysis and those obtained by calculation, show significant differences after applying the t of Student. In the case of the values obtained for the different computer programs, no significant differences were found. Conclusion: The computer programs that have been used present about 65% and even higher significant differences in the values calculated for the different nutrients, with respect to the values obtained by bromatolo- gical analysis. One of the possible causes that could explain these differences would be: because in TCA most of the values of the nutrients are obtained from raw foods; While in the direct analysis, complete dishes have been analyzed in which the food has been subjected to culinary or processing techniques. Regarding the second hypothesis, it could be said that there are no differences between the values obtained by the different computer programs used, since the values for all TCAs are valued in crude

XVIII Congreso SEINAP. Comedores escolares / XVIII Congress of SEINAP. School cafeterias

No disponible

Nutrition-related practices in kindergartens in the context of changes to legal regulations on foodstuffs used in canteen menus for children

Background: In order to improve the quality of nutrition in care and educational institutions, in year 2015 a restrictive law regulation was introduced. The following year this regulation was withdrawn, and a new legal policy has been introduced. However, data on the impact of these legislations on nutrition in kindergartens are lacking. Objective: The aim of the study was to evaluate the compliance with mandatory nutrition recommendations in preschools. Material and methods: The study included 706 institutions. Data were collected during the periods when two consecutive Regulation of the Minister of Health were in force (I - 01.09.2015 - 31.08. 2016 and II - 01.09.2016 to 30.05.2017). Data were obtained by face-to-face interviews with staff with a validated questionnaire. Parameters characterizing the quality of nutrition were analyzed with focus on compliance with legal regulations. 706 decade's menus and 7060 daily inventory reports were analyzed to verify information on vegetables and fruit supply, frequency of frying and type of fat used, sweetening and salting practices. Statistical significances were determined in Statistica 13.1 with t-Student and Chi2 tests (p< 0.05).The study included 706 institutions. Data were collected during the periods when two consecutive Regulation of the Minister of Health were in force (I - 01.09.2015 - 31.08. 2016 and II - 01.09.2016 to 30.05.2017). Data were obtained by face-to-face interviews with staff with a validated questionnaire. Parameters characterizing the quality of nutrition were analyzed with focus on compliance with legal regulations. 706 decade's menus and 7060 daily inventory reports were analyzed to verify information on vegetables and fruit supply, frequency of frying and type of fat used, sweetening and salting practices. Statistical significances were determined in Statistica 13.1 with t-Student and Chi2 tests (p< 0.05). Results: The preschools have implemented regulations concerning the supply of fresh fruit and vegetables (~93%), the amount of fried dish per week (~75%), and the use of suitable frying fat (~95%). About half of institutions managed to serve vegetables and/or fruits in every meal. Compliance with the regulations on sweetening and salting was unsatisfactory: about » of institutions used banned sugar, and 46% regular salt. Conclusions: Legislations influenced nutrition practices in preschools, but additional support is needed to bring all institutions into compliance with the current policies. The current law regulations are general, and allow a great flexibility in planning menus, which might has an adverse effect on menus quality. Therefore, nutrition education and more detailed mandatory nutrition standards for kindergartens are crucial.

Higher-Calorie Menu Items Eliminated in Large Chain Restaurants.

INTRODUCTION: Large chain restaurants have reduced calories in their new menu items. No research has examined the calorie content of items eliminated from these menus. METHODS: Data are from the MenuStat project (2012-2015), which includes 66 of the 100 largest U.S. chain restaurants (n=27,238 items), to compare: (1) mean calories for items on the menu in all years compared with those dropped after 2012 and (2) mean calories for items new in 2013 or 2014 that stayed on the menu compared with items new in 2013 or 2014 that were dropped. The data were analyzed in 2016. RESULTS: Menu items that were dropped from the menu relative to those on the menu in all years had 71 more calories (p=0.02). New items that were dropped relative to new items that stayed on the menu had 52 more calories (p=0.04). CONCLUSIONS: Items dropped from chain restaurant menus are significantly higher in calories than items that remain on the menu. Eliminating higher-calorie items from restaurant menus may have a significant and positive impact on population health by reducing calorie intake without relying on individual behavior, which is very resistant to change.

Evaluación de la variedad y calidad en los menús escolares de Asturias. Curso 2015/2016 / Evaluation of variety and quality in the school menus of Asturias. 2015/2016

Fundamentos: Desde la primera evaluación en 2011 del "Programa de Alimentación Saludable y de Producción Ecológica en los Comedores Escolares de Asturias ", se ha venido analizando la mejora de los menús en cuanto a frecuencias en la oferta de grupos de alimentos. El objetivo de este estudio fue evaluar la calidad culinaria de los menús, de forma que complemente a dicho análisis. Métodos: Estudio descriptivo transversal con una muestra por conveniencia de los 243 centros de Educación Primaria de Asturias, es decir, 195 en el curso 2015-16. Se solicitó un menú mensual a todos los centros y en caso de no recibir respuesta se realizó una búsqueda en Internet. Se definieron unos criterios mínimos a cumplir en frecuencias, variedad y recetas diferentes para cada grupo de alimentos. Se analizaron todos los días de los menús y las diferencias entre los menús cocinados in situ vs catering, así como entre centros de titularidad pública vs privada/concertada. El análisis de datos se realizó con el programa SPSS y las diferencias entre porcentajes de cumplimiento con la prueba Chi cuadrado. Resultados: Se analizaron 195 menús (80,2%), obteniéndose altos porcentajes de cumplimiento en todos los criterios (superiores al 80%), excepto en la variedad de carbohidratos (27,7%), fruta (22,1%), carne procesada (13,9%), oferta de verdura como primer plato (6,1%) y proteína animal en el primer plato (2,6%). Conclusiones: El cumplimiento general de las recomendaciones respecto a variedad y recetas diferentes en los colegios es muy adecuado, especialmente en los de titularidad pública y de cocina propia

Background: Since the first evaluation in 2011 of the "Healthy Eating and Ecological Production Program in School Meals of Asturias ", the improvement of the menus has been analyzed in terms of frequencies in the food group offer. The objective of this study was to evaluate the culinary quality of the menus, in order to complement this analysis. Methods: Transversal descriptive study with a sample for convenience of the 243 Primary Education centers of Asturias, that is, 195 in the 2015-16 academic year.. A monthly menu was requested to all the centers and in case of not receiving a response, a search was made on the Internet. Minimum criteria were defined to comply with frequencies, variety and recipes for each food group. The menus were analyzed every day and the differences between the menus cooked on site vs catering, as well as between public versus private / concerted centers. The data analysis was performed with the SPSS program and the differences between percentages of compliance with the Chi square test. Results: 195 menus were analyzed (80.2%), obtaining high percentages of compliance in all the criteria (over 80%), except in the variety of carbohydrates (27.7%), fruit (22.1%). %), processed meat (13.9%), vegetable offer as first course (6.1%) and animal protein in the first course (2.6%). Conclusions: The general compliance of the recommendations with respect to variety and different recipes in the schools is very adequate, especially in those of public ownership and with own kitchen type

Análisis del grado de satisfacción alimentaria percibido por los pacientes en un hospital de tercer nivel / Assessment of the level of alimentary satisfaction received by patients in a tertiary hospital

Introducción: la alimentación constituye el pilar fundamental del soporte nutricional de los pacientes hospitalizados. Evaluar el grado de aceptación de la dieta es imprescindible en aras de combatir la desnutrición hospitalaria. Objetivos: a) determinar el grado de satisfacción de los pacientes en relación con las dietas; y b) analizar posibles variables asociadas a un grado de satisfacción mayor (apetito y tipo de dieta). Material y métodos: estudio descriptivo de corte transversal. Se emplea una encuesta de 17 preguntas con datos sociodemográficos, datos cualitativos, así como la valoración general del paciente. Se comparó el grado de satisfacción global en función del apetito y el tipo de dieta (terapéutica vs. basal; con sal vs. sosa) (Test no paramétric o Krustal-Wallis y T-Student para muestras independientes, respectivamente). Resultados: mil cuatrocientos trece pacientes. Edad: 53,9 ± 19 años; 51,3% mujeres. Dieta terapéutica (34,9%). Solo el 39,4% tomó dieta con sal. El 66,8% refi rió ingresos previos. La alimentación del hospital para un 43% de pacientes fue «como esperaba», mientras que para un 44,1% fue «mejor de lo que esperaba». El horario de comidas era adecuado (89,1%) y el tiempo para comer, suficiente (96,4%). En cuanto a las características de la comida servida, consideraron como buenas o muy buenas la misma el porcentaje reflejado: sabor/gusto (56.3%), olor (65,5%), cocinado (69,2%), presentación (80,4%), tamaño de ración (75,9%), calidad (73%), cantidad (77,9%), variedad (67,6%), temperatura (70,4%). La valoración global de la alimentación en una escala de 1 a 10 fue de 6,8 ± 2,3. El apetito se asoció a un aumento significativo de la satisfacción global alimentaria del paciente (p < 0,01). El tipo de dieta o la presencia de sal en la misma no se asociaron a un aumento significativo de la satisfacción con la dieta de los pacientes (p = 0,99 y 0,35, respectivamente). Conclusiones: aunque el grado de satisfacción de la dieta de nuestro hospital es aceptable, es preciso introducir mejoras que aumenten su aceptación. El apetito se asocia a un aumento significativo de la satisfacción global alimentaria. La presencia de sal y el tipo de dieta (basal versus terapéutica) no se relacionan con una mejoría significativa de la valoración global de la dieta (AU)

Introduction: Food is a key element of nutritional support of hospitalized patients. To assess the level of food acceptance is essential to fight hospitalary malnutrition. Aims: a) To determine the level of satisfaction of patients to our diets; and b) to analyse variables associated with a higher level of satisfaction (appetite and type of diet). Material and methods: Cross-sectional descriptive study. A survey was used, including socio-demographic data, qualitative data as well as the overall assessment of the patient. The global level of satisfaction was compared depending on the appetite and on the type of diet (therapeutic versus basal; with salt versus unsalted) (non-parametric Krustal-Wallis test and T-students for independent samples, respectively). Results: One thousand four hundred and thirteen patients. Age: 53.9 ± 19 year old; 51.3% women. Therapeutic diet (34.9%). Only 39.4% took a salted diet. The 66.8% confirmed previous admissions. Food hospital for 43% of patients was «as expected», while for 44.1% «better than it was expected». Meal times were adequate for 89.1% and the time for eating enough in 96.4%. About the food served, the percentage of patients who considered as good or very good: taste (56.3%), smell (65.5%), cooked (69.2%), variety (67.6%), temperature (70.4%). The global assessment of food on scale 1 to 10 was 6.8 ± 2.3. The appetite was associated with a significant increase in global food patient satisfaction (p < 0.01). The type of diet or the presence of salt were not related to a relevant increase of satisfaction with the patient’s diet (p = 0.99 y 0.35, respectively). Conclusions: Although the level of satisfaction of our hospital diet is reasonable, we should introduce improvements which enhance its acceptance. Appetite is associated with a significant increase in global food satisfaction. The presence of salt or the type of diet (basal versus therapeutic) is not related to an outstanding improvement of the overall assessment of the diet (AU)

Ingesta de energía y nutrientes en niños de 2-4 años que asisten al programa «Buen Comienzo», Medellín (Colombia) / Energy and nutrients intake in children of 2-4 years at the «Buen Comienzo» program, Medellín (Colombia)

Introducción: a escala mundial y nacional se reporta una alta prevalencia de sobrepeso y obesidad en menores de 5 años. La etiología es multifactorial, pero factores ambientales como sedentarismo y el progresivo deterioro de la alimentación promueven el exceso de peso y conllevan a mayor riesgo de enfermedades crónicas no transmisibles en temprana edad. Objetivo: describir la ingesta de alimentos, energía y nutrientes en los niños de 2-4 años con obesidad y eutróficos del programa «Buen Comienzo». Método: estudio de corte con 111 niños con obesidad clasificada según IMC > 3 DE, que fueron pareados por sexo, edad y tipo de atención con un niño clasificado con estado nutricional normal. Personal entrenado realizó la valoración antropométrica con equipos y métodos estandarizados y se evaluó la ingesta dietética a través de recordatorio de 24 horas. Se aplicó la prueba t-student y U de Mann Whitney en el análisis bivariado y para determinar el patrón de consumo de alimentos y se efectuó un análisis de clases latentes (ACL). Resultados: los niños tienen un consumo de energía superior a su requerimiento, pero existe diferencia significativa según el estado nutricional; el consumo en los niños obesos es de 1.632 kcal (IQR: 1.475-1.801 kcal) y eutróficos de 1.798 kcal (IQR 1.702-1.632 kcal) (p = 0,00). Los niños con peso adecuado tienen mayor ingesta de macronutrientes y micronutrientes (p < 0,05); hay una mayor ingesta de proteínas y micronutrientes durante la semana (p < 0,05); el 30% de los niños no consumió ninguna verdura y el 60% ninguna fruta el día anterior a la encuesta y tuvieron, además, un alto consumo de azúcares y dulces. Conclusiones: los niños están sometidos a una dieta obesogénica caracterizada por un bajo consumo de frutas y verduras y una alta ingesta de energía, grasas saturadas y carbohidratos concentrados, lo que promueve una ganancia de peso no deseado (AU)

Introduction: At a global and national level, high prevalence of overweight and obesity in children under five years old has been reported. The etiology is multi-factorial, but environmental factors such as sedentary lifestyle, as well as eating habits become more important, given the progressive deterioration in the food quality that promotes the overweight in childhood and leads to increased risk of chronic, noncommunicable early. Objective: To describe the intake of food, energy and nutrients in children aged 2-4 years with obesity and healthy children, attending the «Buen Comienzo» Program in the form of institutional care setting. Method: A Cross-sectional study of 111 children with obesity, classified according to IMC > 3 SD, which had were matched by sex, age and type of care, with a child with normal nutritional status, Trained personnel performed the anthropometric assessment and standardized methods, and dietary intake was assessed using 24-hour recall. Student t-test and Mann Whitney test was used in the bivariate analysis and to determine the pattern of food intake in obese and eutrophic children, Latent Class Analysis (LCA) was performed. Results: All children have a higher intake of calories to their requirements, but there are significant differences as nutritional status, consumption in obese children is 1,632 kcal (IQR: 1,475-1,801kcal) and eutrophics of 1,798 kcal (IQR 1,702-1,632 kcal) (p = 0,00). Children with healthy weight, have a higher intake of macro and micro-nutrients (p < 0,05); there is a higher intake of protein and micronutrients during the week (p < 0,05) and 30% of children did not consume any vegetables and 60% fruit any day prior to the survey and also had a high consumption of sugars. Conclusions: The children subjected to a obesogenic diet, characterized by a low consumption of fruits and vegetables, as well as highly caloric diet with saturated fats and concentrated carbohydrates, that surpasses their daily requirements to gain weight in undesirable (AU)

Menú saludable gitano: participación y empoderamiento de la comunidad gitana en la alimentación saludable / Gypsy health menu: participation and empowerment of the gypsy community in a balanced nutritional diet

Fundamentos: La promoción de hábitos de alimentación saludable entre la comunidad gitana requiere de intervenciones multisectoriales. El objetivo principal fue elaborar un menú saludable para las familias gitanas logrando la participación de la comunidad haciéndola protagonista del proyecto, además de realizar propuestas de mejora en relación a la alimentación. Métodos: Investigación cualitativa con perspectiva interaccionista y método etnográfico e interpretativo. Los datos se recogieron mediante entrevistas individuales estructuradas abiertas, realizadas a un total de 7 representantes de familias gitanas. Para finalizar se realizó la trascripción, puesta en orden y análisis de la información recabada. Resultados: Se recogió información del consumo de alimentos de 17 miembros de 7 familias gitanas, mostrando un consumo excesivo de embutido, carne grasa y azúcares, y con bajo consumo de frutas, verduras, pescado, legumbres y carnes magras. La compra se realiza en supermercados, contando las familias con espacios y menaje adecuado para cocinar, así como frigoríficos con congelador para la conservación de la comida y cocinas con horno para la elaboración de los alimentos. Conclusiones: Se propone un decálogo de propuestas de mejora en relación a la alimentación familiar, además de un menú semanal equilibrado y variado teniendo en cuenta los gustos y costumbres de la comunidad gitana. Palabras clave: gitanos, hábitos alimenticios, participación comunitaria, promoción de la salud, cultura, estilo de vida (AU)

Background: The promotion of eating habits amongst the gypsy community requires multisectorial interventions. The main objective was to develop a healthy menu for gypsy families, making the participation of the community a protagonist of the project, besides making proposals for improvement in relation to food. Methods: Qualitative research with an interactionist perspective and etnographic and interpretative method. Data were collected through individual interviews, carried out to a total of 7 representatives of the gypsy families. Finally, the transcription, ordering and analysis of the collected information were carried out. Results: Food consumption data were collected from 17 members of 7 gypsy families, showing an excessive consumption of sausage, meat and sugars, and low consumption of fruits, vegetables, fish, vegetables, beans and lean meats. The purchase was made in supermarkets, counting the families with spaces and suitable utensils for cooking, as well as fridges with freezer for food preservation, and kitchens with oven for the preparation of food. Conclusions: We propose a decalogue of proposals for improvement in relation to family nutrition as well as weekly menu, balanced and varied, taking into account the tastes and customs of the gypsy community (AU)

Menús ofertados en centros de educación infantil de Sevilla: adecuación a criterios nutricionales y a las recomendaciones dietéticas / Menus offered in early childhood education centers of Seville: adaptation to the nutritional criteria and dietary recommendations

Introducción: en la actualidad existe un déficit en la evaluación de comedores dirigidos a niños menores de 3 años, a pesar de que se han realizado numerosas intervenciones en los comedores escolares con el fin de conseguir una alimentación segura y adecuada. Objetivo: realizar una evaluación nutricional de los menús ofertados en los centros de educación infantil de Sevilla. Material and methods: se evaluó la frecuencia, variedad, rotación de alimentos, métodos culinarios e información de los menús de seis centros infantiles de Sevilla. Se valoró el aporte energético y nutricional mediante el programa Dietowin® y el método de pesada. Resultados: las frutas y verduras fueron deficitarias en la mayoría de los menús, y excesivas la carne, patatas, pasta y arroz. Se observó una escasa variedad de recetas por grupo de alimentos y no se daba una información completa del menú. Sin embargo, la variedad de procesos culinarios y la rotación de alimentos fueron adecuadas. Aunque la energía y el aporte de carbohidratos (~55%) se ajustaban a las necesidades, se observó un aporte excesivo de proteínas (~19%) y deficiente de lípidos (< 30%), sobre todo de grasas insaturadas. Respecto a los micronutrientes, solo vitamina C, E y calcio estaban por debajo de lo recomendado. Conclusiones: los centros de educación infantil están haciendo un gran esfuerzo por cumplir las recomendaciones nutricionales, pero todavía deben disminuir el aporte proteico y aumentar las grasas insaturadas de la dieta. Además, deben fomentar la oferta de frutas y verduras, ampliar la variedad de recetas, dar mayor información y disminuir el aporte de alimentos cárnicos (AU)

Introduction: Today there is a lack in the evaluation of canteens aimed at children under 3 years although there have been numerous interventions in school canteens in order to achieve a safe and adequate food. Objective: To perform a nutritional assessment of menus offered in early childhood education centres of Seville. Material and methods: The frequency, variety, rotation of food, cooking methods and information of 6-childhood centre’s menus from Seville were evaluated. Energy and nutrient intakes were assessed by Dietowin® program and weighing method. Results: Fruits and vegetables were deficient in most menus, and meat, potatoes, pasta and rice were excessive. A poor variety of recipes by food group was observed and the menu gave no comprehensive information. However, the variety of culinary processes and food rotation were adequate. Although energy and carbohydrate intake (~55%) complied with the requirements, an excessive protein intake (~19%) and low lipid intake (< 30%), especially unsaturated fats, was observed. Regarding micronutrients, only calcium, vitamin C and E were below recommended. Conclusions: The early childhood centres are making a great effort to meet the nutritional recommendations, but they still should reduce the protein intake and increase unsaturated fats in the diet. They should also encourage the offer of fruit and vegetables, expand the variety of recipes, provide more information and decrease meat food intake (AU)

Aproximación a la integración de la huella de carbono y aspectos nutricionales para un consumo sostenible de alimentos / An approach to integrate carbon footprint and nutritional aspects for sustainable food consumption

Fundamentos: El consumo de alimentos influye sobre el calentamiento global. Pero no hay que olvidar que los alimentos son una fuente de nutrientes. Para apoyar un consumo sostenible, se ha desarrollado un indicador que integra la huella de carbono (HC) y el valor nutricional de los alimentos. Métodos: Con el fin de proporcionar una ponderación objetiva, se utilizó la técnica no paramétrica 'Análisis Envolvente de Datos' (DEA) para definir la eficiencia-eco-nutricional (ENE). La ENE, definida como 'rendimiento nutricional/impacto ambiental', varía entre 0 y 1, significando 1 que el menú es eficiente. Se presentan dos modelos DEA: el primero basado en el contenido en macronutrientes, mientras que el segundo considera la ingesta diaria recomendada. Los modelos se probaron en un caso de estudio de 256 menús diarios. Resultados: Ambos modelos mostraron valores de ENE entre 0.42 y 1, lo que supone un potencial de reducción de la HC de hasta un 58%. El modelo 2 es preferible porque se basa en recomendaciones nutricionales. Conclusiones: La ENE permite agregar la HC y los aspectos nutricionales en un valor único para apoyar la toma de decisiones. Se proponen mejoras como la introducción de micronutrientes y otros impactos ambientales (AU)

Background: Food consumption has a large influence on global warming. Although we must not forget that the main role of food is nutrient provision. This study develops an indicator to integrate the carbon footprint (CFP) and nutritional values of diets to facilitate sustainable food consumption. Methods: To provide a non-subjective weighting, the nonparametric technique 'Data Envelopment Analysis' (DEA) was used to define the eco-nutritional-efficiency (ENE). The ENE, defined as the ratio 'nutritional performance/environmental impact', ranges between 0 and 1, with 1 being efficient. Two DEA models are presented: model 1 focuses on the macronutrient content, whereas model 2 takes the recommended daily intake into account. They were tested through a case study consisting of 256 daily menus. Results: The case study showed that the vegetarian lunch was in all efficient menus. Western menus performed the worst due to a high CFP from meat. Both models led to ENEs between 0.42 and 1, therefore showing a potential CFP reduction of up to 58%. Model 2 is preferred because it focuses on nutritional recommendations. Conclusions: The ENE succeeds in aggregating the CFP and nutritional aspects to create a unique value that can support decision-making. Further investigation is needed to include micronutrients and other environmental impacts (AU)

Calorie Changes in Large Chain Restaurants: Declines in New Menu Items but Room for Improvement.

INTRODUCTION: Large chain restaurants reduced the number of calories in newly introduced menu items in 2013 by about 60 calories (or 12%) relative to 2012. This paper describes trends in calories available in large U.S. chain restaurants to understand whether previously documented patterns persist. METHODS: Data (a census of items for included restaurants) were obtained from the MenuStat project. This analysis included 66 of the 100 largest U.S. restaurants that are available in all three of the data years (2012-2014; N=23,066 items). Generalized linear models were used to examine: (1) per-item calorie changes from 2012 to 2014 among items on the menu in all years; and (2) mean calories in new items in 2013 and 2014 compared with items on the menu in 2012 only. Data were analyzed in 2014. RESULTS: Overall, calories in newly introduced menu items declined by 71 (or 15%) from 2012 to 2013 (p=0.001) and by 69 (or 14%) from 2012 to 2014 (p=0.03). These declines were concentrated mainly in new main course items (85 fewer calories in 2013 and 55 fewer calories in 2014; p=0.01). Although average calories in newly introduced menu items are declining, they are higher than items common to the menu in all 3 years. No differences in mean calories among items on menus in 2012, 2013, or 2014 were found. CONCLUSIONS: The previously observed declines in newly introduced menu items among large restaurant chains have been maintained, which suggests the beginning of a trend toward reducing calories.

Satisfacción con el menú hospitalario e incorporación del queso de cabra como postre en comparación con el queso de vaca / Satisfaction with hospital menu and inclusion of goat cheese as dessert compared with cow cheese

Introducción: la valoración de los menús hospitalarios debe realizarse periódicamente para adecuarlos a las necesidades de los pacientes. El queso de cabra podría tener ventajas nutricionales, en comparación con el de vaca. Objetivos: evaluar la satisfacción de los pacientes con el menú hospitalario y con la incorporación del queso de cabra, dado como postre en el menú hospitalario vs queso de vaca. Material y métodos: se realizó una encuesta de satisfacción del menú hospitalario y del postre (queso de cabra (QC) vs queso de vaca (QV)) en pacientes con dietas basales. Resultados: se analizaron 334 encuestas. El 46,7% fueron mujeres. La edad media fue de 58,16 ± 15,15 años y la estancia media de 11,21 ± 11,53. La aceptación del menú hospitalario fue valorado como buena en un alto porcentaje de los encuestados (temperatura 91%, presentación 94%, humedad 75% y horario 84%). La satisfacción global del almuerzo (1 al 10) fue 7,31 ± 2,10 en QV vs 7,39 ± 1,75 QC (ns) y del postre 6,93 ± 2,89 vs 6,88 ± 3,52 (ns) respectivamente. Los pacientes que habitualmente no toman queso de cabra (57%) tampoco tomaron postre en el 50% de los casos, frente a los que sí toman en su domicilio (42,98%), que no ingirieron nada del postre solo en el 8% (p < 0.01). Conclusiones: la satisfacción global con el menú hospitalario es alta y la aceptación del nuevo postre (QC) es equivalente a la obtenida con el queso de vaca, por lo que podría incluirse en el código de dietas (AU)

Introduction: the evaluation of hospital menus should be performed periodically to suit the needs of patients. Goat cheese may have nutritional benefits, compared to cow cheese. Objectives: to evaluate patient satisfaction with the hospital menu and with the inclusion of goat cheese, given like dessert in hospital vs menu with cow cheese. Methods: a survey of hospital menu satisfaction and dessert (goat cheese (GC) vs cow cheese (CC)) in patients with basal diets was conducted. Results: 334 surveys were analyzed. 46.7% were women. The average age was 58.16 ± 15.15 years and the average stay of 11.21 ± 11.53. Acceptance of the hospital menu was rated as “good” in a high percentage of respondents (91% Temperature, presentation 94%, humidity 75% and 84% schedule). Overall satisfaction lunch (1 to 10) was 7.31 ± 2.10 en CC vs 7.39 ± 1.75 GC (ns) and dessert satisfaction was 6.93 ± 2.89 vs 6.88 ± 3.52 (ns) (respectively). Conclusions: the overall satisfaction with the hospital menu is high and the acceptance of new dessert (QC) is equivalent to acceptance obtained with cow cheese, which could be included in the code of diets (AU)

Calorie changes in chain restaurant menu items: implications for obesity and evaluations of menu labeling.

BACKGROUND: Supply-side reductions to the calories in chain restaurants are a possible benefit of upcoming menu labeling requirements. PURPOSE: To describe trends in calories available in large U.S. restaurants. METHODS: Data were obtained from the MenuStat project, a census of menu items in 66 of the 100 largest U.S. restaurant chains, for 2012 and 2013 (N=19,417 items). Generalized linear models were used to calculate (1) the mean change in calories from 2012 to 2013, among items on the menu in both years; and (2) the difference in mean calories, comparing newly introduced items to those on the menu in 2012 only (overall and between core versus non-core items). Data were analyzed in 2014. RESULTS: Mean calories among items on menus in both 2012 and 2013 did not change. Large restaurant chains in the U.S. have recently had overall declines in calories in newly introduced menu items (-56 calories, 12% decline). These declines were concentrated mainly in new main course items (-67 calories, 10% decline). New beverage (-26 calories, 8% decline) and children's (-46 calories, 20% decline) items also had fewer mean calories. Among chain restaurants with a specific focus (e.g., burgers), average calories in new menu items not core to the business declined more than calories in core menu items. CONCLUSIONS: Large chain restaurants significantly reduced the number of calories in newly introduced menu items. Supply-side changes to the calories in chain restaurants may have a significant impact on obesity prevention.

Alimentos funcionais em alimentação coletiva: reflexões acerca da promoção da saúde fora do domicílio / Functional foods in collective feeding: reflections on promoting health outside the home

OBJECTIVE: The present study aimed to conduct a review and reflect on the importance of functional foods and their applicability in menus of Food and Nutrition Units as a means of promoting health outside the home. Data source: To this end, we carried out a literature review of scientific works published at SciELO, Lilacs and Scholar google for the past 14 years. Conclusions: Several factors have contributed to the dietary changes that are currently occurring, in which the consumption of foods high in fat, sugar and salt has been replacing whole grains, fruit and vegetables. The population's increased purchasing power, the decrease in time to prepare meals, and the changing in household structure, with women working outside the house, has led to the practice of eating out. In this context, there is the need to combine the consumption of a balanced diet that contributes to reduce the risk of diseases and this practice, and that is where the role of functional foods stands out. Successful experiences regarding the inclusion of these foods on menus of Food and Nutrition Units were identified. However, aspects such as the bioavailability of the bioactive compound and creativity in preparations are essential. Thus it is important that the nutritionist provide access to functional foods as well as educational activities to encourage their consumption, because beneficial effects on human health depend on their usual intake

OBJETIVO: O presente trabalho teve como objetivo realizar uma revisão e reflexão sobre a importância dos alimentos funcionais e sua aplicabilidade nos cardápios de Unidades de Alimentação e Nutrição (UAN) como forma de promoção da saúde fora do domicílio. Fonte de dados: Para isso, realizou-se uma revisão de literatura das publicações dos últimos 14 anos nas bases de dados SciELO, Lilacs e Google acadêmico. Conclusões: Diversos fatores contribuíram para as modificações dos hábitos alimentares observados atualmente, nos quais o consumo de alimentos ricos em lipídios, açúcares e sal vem substituindo o de cereais integrais, frutas e hortaliças. O aumento do poder aquisitivo da população, a diminuição do tempo de preparo das refeições e a modificação dos núcleos familiares, com a saída da mulher para o mercado de trabalho, culminaram na prática da alimentação fora do domicílio. Nesse contexto surge a necessidade de aliar o consumo de uma alimentação equilibrada e que contribua para redução do risco de doenças a essa prática e é nesse sentido que se destaca o papel dos alimentos funcionais. Foram identificadas experiências bem-sucedidas em relação à inclusão desses alimentos nos cardápios das UAN. No entanto, aspectos como a biodisponibilidade do composto bioativo e a criatividade na elaboração das preparações são fundamentais. Assim, é importante que o nutricionista proporcione o acesso aos alimentos funcionais, bem como ações educativas para incentivo do seu consumo, uma vez que seus efeitos benéficos à saúde humana dependem da ingestão habitual

Combating child obesity: impact of HENRY on parenting and family lifestyle.

BACKGROUND: One-quarter of children in England are overweight/obese at school entry. We investigated the impact of a programme designed to provide parents of infants and preschool children with the skills required for a healthier family lifestyle. METHOD: A cohort of families was followed across the 8-week HENRY (Health Exercise Nutrition for the Really Young) parent course at nine locations in England. Seventy-seven parents enrolled on the course, of which 71 agreed to complete questionnaires addressing eating behaviours, dietary intake and parental self-efficacy. Pre- and post-course data was available from 60 (84.5%) parents (8-week follow-up data from 58 parents) and was analysed using repeated measures analyses. RESULTS: Significant changes were observed, with most sustained at follow-up. Parents reported increased self-efficacy and ability to encourage good behaviour (P < 0.001). Increased consumption of fruits and vegetables was reported in both children and adults, together with reduced consumption of sweets, cakes and fizzy drinks in adults (all P < 0.01). There were also positive changes in eating behaviours (e.g., frequency of family mealtimes and eating while watching television or in response to negative emotion [P < 0.01] ) and reduced screen time in adults (P < 0.001). DISCUSSION: The results build upon earlier evaluation, indicating that the HENRY intervention has a beneficial impact upon the families of infants and preschool children. Furthermore, the findings suggest that positive changes inspired by the programme can be maintained beyond its completion. Such changes may serve to protect against later obesity.