Avaliação do estado nutricional em relação à presença de cárie dentária em crianças de 4 a 6 anos do município de Cajamar - São Paulo / Evaluation of the nutritional status in relation to the presence of dental caries in children aged 4 to 6 years in the city of Cajamar - São Paulo

Este artigo tem como objetivo avaliar o estado nutricional em relação à presença de cáries dentárias em crianças de 4 a 6 anos de idade, do município de Cajamar, São Paulo. Trata-se de estudo transversal com crianças entre 4 a 6 anos (n=1642), acompanhadas pelo Programa Saúde na Escola (PSE) do Município de Cajamar, São Paulo. A classificação do estado nutricional foi baseada no Índice de Massa Corporal (IMC) e a avaliação das condições bucais, por meio do índice ceo-d e critério para Risco de Cárie. A análise do estado nutricional, faixa etária e sexo conforme o número de cáries, foi feita por meio dos testes Mann-Whitney U e Kruskal-Wallis (p<0,05). Observou-se maior prevalência de meninos entre 4 a 6 anos. Em todas as faixas etárias a prevalência de excesso de peso foi de aproximadamente 30% e eutrofia em torno de 70%. 65% (n=1068) das crianças não apresentavam risco de cárie (A) e 28,8% (n=475), alto risco (D, E e F). Das 1162 crianças sem cáries, 0,2% eram magras (n=2), 67,2% (n=781) eutróficas e 32,7% (n=380) possuíam excesso de peso. A frequência de 1 a 5 cáries maior entre meninas e de 6 ou mais cáries, entre meninos. Segundo estado nutricional, o número médio do número de cáries foi de 2,17 para magreza, 0,93 para eutrofia e 0,65 para excesso de peso (p<0,010). Conclui-se que houve diferença entre número cáries e estado nutricional, na qual crianças com déficit nutricional apresentavam maior número de cáries dentárias comparadas às eutróficas ou com excesso de peso, sugerindo-se a inclusão do estado nutricional na avaliação odontológica.

This article aims at evaluating the nutritional status in relation to the presence of dental caries in children aged 4 to 6 years in the city of Cajamar, in the state of São Paulo. It is a cross-sectional study with children aged 4 to 6 years (n=1642) accompanied by the School Health Program of the City of Cajamar, São Paulo. The nutritional status classification was based on the Body Mass Index (BMI) and the evaluation of oral conditions, through the ceo-d index, and criteria for risk for caries. The analysis of the nutritional status, age, and sex according to the number of caries was made through the Mann-Whitney U and Kruskal-Wallis tests (p<0.05). A higher prevalence was observed among boys aged 4 to 6 years. In all age groups, there was a prevalence of 30% of overweight children, and eutrophy of approximately 70%. A total of 65% (n=1068) of the children presented no risk of caries (A), whereas 28.8% (n=475) showed high risk (D, E, and F). Among the 1162 children with no caries, 0.2% were thin (n=2); 67.2% (n=781) eutrophic; and 32.7% (n=380) were overweight. Girls presented a higher frequency of 1 to 5 caries while boys presented frequency of having 6 or more caries. According to the nutritional status, the average number of caries was 2.17 for thin individuals; 0.93 for eutrophic individuals; and 0.65 for overweight individuals (p<0.010). It could be concluded that there was a difference between the number of caries and the nutritional status, in which children with nutritional deficit presented a higher number of dental caries when compared to eutrophic or overweight ones, suggesting the inclusion of the nutritional status in the dental evaluation.

Estratégias para o aumento do consumo de frutas, legumes e verduras / Strategies for increasing fruit and vegetable consumption

Esta síntese rápida de evidências foi comissionada e subsidiada pelo Ministério da Saúde, no âmbito do projeto GEREB-010-FIO-20 e faz parte da Coleção "Rapid response for health promotion". O problema: O consumo adequado de frutas, legumes e verduras (FLV) é indicado para prevenção e controle das doenças crônicas não transmissíveis (DCNT), responsáveis pelas principais causas de morbidade e mortalidade no Brasil. Contudo, apesar da existência de uma política de saúde persiste a dificuldade de se alcançar esse objetivo. Esta síntese rápida de evidências teve como propósito identificar estratégias que contribuem para aumentar o consumo de FLV. Opções para enfrentar o problema: A busca nas bases de dados resultou em 1.854 referências, sendo selecionadas 73 revisões sistemáticas (RS) para compor esta síntese narrativa. Na avaliação da qualidade metodológica (AMSTAR-2), uma revisão foi classificada como de confiança alta, três de confiança moderada, quatro de confiança baixa e 65 de confiança criticamente baixa. Sete opções para abordar o problema foram sintetizadas, agrupando-se as estratégias conforme sua similaridade quanto ao público e/ou local de oferta. Opção 1. Promoção do consumo de FLV em ambiente escolar: Os efeitos de intervenções com foco em estudantes ou na comunidade escolar foram avaliados em 34 RS. As estratégias, de modo geral, foram realizadas em escolas, algumas vezes com a participação dos pais, e incluíram: educação nutricional e mudanças nas políticas nutricionais e alimentares das instituições; aconselhamento e intervenções comportamentais; atividades envolvendo prática culinária e manejo de hortas; e divulgação eletrônica de hábitos alimentares saudáveis, dieta e saúde. A maioria das revisões concluiu que as intervenções foram efetivas, embora sejam apontadas incertezas quanto aos resultados de algumas delas. Opção 2. Oferta de subsídios financeiros em programas governamentais O uso de subsídios financeiros (descontos, vouchers, cupons, distribuição de alimentos) foi avaliado em 6 RS. As intervenções, que estavam relacionadas a programas governamentais, foram realizadas em pontos de venda, na comunidade ou em locais de trabalho. Os resultados foram favoráveis às intervenções, no entanto, mostraram-se pouco consistentes com relação às crianças beneficiárias do WIC (Special Supplementary Nutrition Program for Women, Infants and Children), programa amplamente implementado nos Estados Unidos. Opção 3. Incentivo à abertura de pontos de venda de alimentos saudáveis: Intervenções em pontos de venda foram analisadas por 6 RS. A maioria das estratégias se referia a abertura de mercados, supermercados, mercados itinerantes ou feiras em regiões que não possuíam esses tipos de comércios para a promoção do acesso a alimentos saudáveis. Também foram analisados os efeitos de estratégias de marketing utilizadas nos pontos de venda para promover o consumo de FLV. Embora os resultados, de maneira geral, tenham se mostrado favoráveis a essas intervenções, relatou-se também redução do consumo de FLV com a abertura de supermercados, e resultado indiferente com relação à publicidade. Opção 4. Uso de intervenções de telessaúde/eHealth para incentivar o consumo de FLV Dez RS avaliaram os efeitos de intervenções de telessaúde/eHealth, relacionadas a aplicativo de celular, computador e mensagens de texto (SMS), aconselhamento ou educação Estratégias para o aumento do consumo de frutas, legumes e verduras (FLV) nutricional, subsídios financeiros e jogos. O uso dessas tecnologias apresentou resultados positivos, no entanto, um estudo mostrou que o efeito não se manteve a longo prazo. Opção 5. Promoção do consumo de FLV na comunidade: Intervenções na comunidade foram analisadas em 12 RS, em geral envolvendo multicomponentes, incluindo educação nutricional, política nutricional, hortas, intervenções comportamentais, aconselhamento e atividades de culinária. Os resultados da maioria dos estudos foram favoráveis ao uso dessas intervenções, mas mostraram incertezas principalmente com relação à efetividade da educação nutricional. Opção 6. Promoção do consumo de FLV em locais de trabalho Cinco RS apresentaram os efeitos de intervenções nos locais de trabalho, como educação nutricional, política nutricional, distribuição de alimentos, divulgação, aconselhamento, culinária, descontos e hortas. As análises mostraram resultados positivos das intervenções, porém em uma revisão não se demonstrou efetividade de intervenções ambientais e de educação. Opção 7. Promoção do consumo de FLV por meio de serviços de saúde: Intervenções no contexto de serviços de saúde foram analisadas em 7 RS, envolvendo educação nutricional, aconselhamento, dietas específicas, e telessaúde. Embora as revisões tenham apresentado resultados favoráveis às intervenções, incertezas foram levantadas com relação à efetividade de consultas com profissionais, educação nutricional e intervenções envolvendo pares (pessoas com características e/ou em situações similares ao público-alvo, geralmente formadas para atuar como líderes). Considerações finais: Esta síntese rápida de evidências identificou uma ampla gama de estudos que mostraram a efetividade de intervenções de diferentes naturezas, realizadas em locais variados, para aumentar o consumo de FLV. Os estudos também levantaram algumas incertezas, apresentando às vezes resultados contraditórios, sendo necessário olhar para os detalhes das intervenções e os contextos de aplicação. Não são feitas aqui considerações sobre implementação e implicações relativas à equidade quanto a cada uma das opções, etapas consideradas importantes para a tomada de decisão

This rapid synthesis of evidence was commissioned and subsidized by the Ministry of Health, within the scope of the GEREB-010-FIO-20 project and is part of the "Rapid response for health promotion" Collection. The problem: Adequate consumption of fruits and vegetables (FV) is indicated for the prevention and control of chronic non-communicable diseases (NCDs), responsible for the main causes of morbidity and mortality in Brazil. However, despite the existence of a health policy, the difficulty of achieving this objective persists. This rapid synthesis of evidence aimed to identify strategies that contribute to increasing FV consumption. Options to face the problem: The search in the databases resulted in 1,854 references, with 73 systematic reviews (SR) being selected to compose this narrative synthesis. In the methodological quality assessment (AMSTAR-2), one review was rated high confidence, three moderately confident, four low confidence, and 65 critically low confidence. Seven options to address the problem were synthesized, grouping the strategies according to their similarity in terms of the public and/or place of supply. Option 1. Promotion of FV consumption in the school environment: The effects of interventions focused on students or the school community were evaluated in 34 RS. The strategies, in general, were carried out in schools, sometimes with the participation of parents, and included: nutritional education and changes in the institutions' nutritional and food policies; behavioral counseling and interventions; activities involving cooking and garden management; and electronic dissemination of healthy eating habits, diet and health. Most reviews concluded that the interventions were effective, although uncertainties regarding the results of some of them are pointed out. Option 2. Provision of financial subsidies in government programs The use of financial subsidies (discounts, vouchers, coupons, food distribution) was evaluated in 6 SR. The interventions, which were related to government programs, were carried out at points of sale, in the community or in the workplace. The results were favorable to the interventions, however, they were not consistent in relation to the children benefiting from the WIC (Special Supplementary Nutrition Program for Women, Infants and Children), a program widely implemented in the United States. Option 3. Incentive to open healthy food points of sale: Interventions at points of sale were analyzed by 6 SRs. Most of the strategies referred to the opening of markets, supermarkets, itinerant markets or fairs in regions that did not have these types of shops to promote access to healthy foods. The effects of marketing strategies used at points of sale to promote FLV consumption were also analyzed. Although the results, in general, have been favorable to these interventions, a reduction in FLV consumption was also reported with the opening of supermarkets, and an indifferent result in relation to advertising. Option 4. Use of telehealth/eHealth interventions to encourage FV consumption Ten RS evaluated the effects of telehealth/eHealth interventions, related to mobile app, computer and text messaging (SMS), counseling or education Strategies for scaling up consumption of nutritional fruits and vegetables, financial subsidies and games. The use of these technologies showed positive results, however, one study showed that the effect was not maintained in the long term. Option 5. Promotion of fruit and vegetable consumption in the community: Community interventions were analyzed in 12 SRs, generally involving multi-components, including nutrition education, nutrition policy, vegetable gardens, behavioral interventions, counseling and cooking activities. The results of most studies were favorable to the use of these interventions, but showed uncertainties mainly regarding the effectiveness of nutritional education. Option 6. Promotion of fruit and vegetable consumption in the workplace Five SRs presented the effects of interventions in the workplace, such as nutrition education, nutrition policy, food distribution, dissemination, counseling, cooking, discounts and vegetable gardens. The analyzes showed positive results of the interventions, however, in a review, the effectiveness of environmental and educational interventions was not demonstrated. Option 7. Promotion of fruit and vegetable consumption through health services: Interventions in the context of health services were analyzed in 7 SR, involving nutrition education, counseling, specific diets, and telehealth. Although the reviews showed favorable results for the interventions, uncertainties were raised regarding the effectiveness of consultations with professionals, nutritional education and interventions involving peers (people with characteristics and/or in similar situations).

WebPalestra: diretrizes nutricionais em Geriatria

O envelhecimento humano leva a uma serie de alterações que quando acompanhadas de doença interferem no estado nutricional desta população. A abordagem nutricional é estratégia central na prevenção e tratamento de muitas condições crônicas da velhice e problemas geriátricos sendo fundamental sua abordagem correta.

El NutriScore recala en España / No disponible

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Intervenciones de Fomento al Bienestar Nutricional en América Latina y el Caribe: oportunidades para fortalecer las políticas y programas de alimentación y nutrición / Intervention that fostering nutritional well-being in Latin America and the Caribbean: opportunities to strengthen food and nutrition public policies

Fundamentos: América Latina y el Caribe (ALC) se encuentran actualmente en una transición epidemiológica, el sobrepeso y la obesidad se han incrementado rápidamente. El objetivo fue analizar experiencias nacionales para fomento del bienestar nutricional en ALC. Métodos: estudio descriptivo de fuentes secundarias y a través de entrevistas a profundidad para identificar intervenciones de fomento del bienestar nutricional que tengan potencial de escalabilidad. La información se obtuvo de fuentes primarias y secundarias en los 33 países participantes, de febrero a abril de 2016. Resultados: 204 intervenciones identificadas en tres subregiones, Mesoamérica, Sudamérica y Caribe. Las intervenciones buscan prevenir o reducir la malnutrición causadas por deficiencias o promover estilos de vida saludables entre grupos vulnerables. Pocas intervenciones encontradas para mejorar la cultura alimentaria, se incluyen como parte de programas que también abordan otros temas. Conclusión: Existe un potencial significativo para fortalecimiento de políticas públicas que fomenten el bienestar nutricional en ALC. La implementación de un marco de políticas públicas de nutrición regional podría complementar el compromiso continuo de la Década de las Naciones Unidas para la Nutrición con la lucha contra la doble carga de la malnutrición en ALC

Background: The Latin America and the Caribbean (LAC) region is currently in an epidemiological transition, overweight and obesity have increased rapidly. The objective was to analyze national experiences that fostering nutritional well-being in LAC. Methods: This isa descriptive study including in-depth interview to identify interventions to foster nutritional well-being with potential of scalability. Information was obtained from primary and secondary sources in the 33 LAC countries, from February to April 2016. Results: 204 interventions were identified in the three sub regions, Mesoamerica, South America and the Caribbean. Most interventions seek to prevent or reduce malnutrition caused by deficiencies or promote healthy lifestyles among vulnerable groups. The few interventions found to improve food culture are included as part of programs that also address other issues. Conclusion: There is a significant potential for the strengthening of nutrition public policies to promote comprehensive interventions that foster nutritional well-being in LAC that currently faces the double burden of malnutrition and the NCD epidemic. The implementation of a regional nutrition policy framework could complement the continued commitment of the United Nations Decade of Action on Nutrition to the fight against the double burden of malnutrition in LAC

La Declaración de Cracovia: la última apuesta europea para vencer el déficit de yodo / The Krakow Declaration: The last chance for Europe to eradicate iodine deficiency

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El plátano: indicador de hambre y escasez de alimentos en familias beneficiarias de programas alimentarios en Vigía del Fuerte, Colombia / Plantain: indicator of hunger and food shortage in families benefiting from food programs in Vigia del Fuerte, Colombia

RESUMEN Objetivo Interpretar la percepción de hambre y escasez de alimentos en familias beneficiarias de Programas alimentarios MANA (Mejoramiento Alimentario y Nutricional de Antioquia) en Vigía del Fuerte. Método La investigación se orientó desde el enfoque cualitativo, usando la Etnografía Focalizada como método, para la recolección de la información se utilizaron entrevistas individuales y grupos de discusión. Resultados Las comunidades de la cuenca del río Murrí están protegidas del hambre física por la disponibilidad permanente del plátano; el hambre está asociada a la ausencia de carne o "liga" y al hecho de comer "plátano vacío"; así mismo se refieren al hambre como la sensación de desasosiego, debido al dolor de cabeza y de estómago que experimentan de manera permanente e intensa. Conclusiones A pesar de que las comunidades vigieñas disponen durante todo el tiempo de plátano, protegiéndolas del hambre física; estas no lo aprecian así, como alimento que calma su hambre y los libera, de cierta manera, de la escasez, porque su presencia como único alimento disponible, les recuerda, precisamente, que tienen carencia y hambre.(AU)

ABSTRACT Objective To analyze the perception of hunger and food shortage in families benefiting from MANA (Food and Nutritional Improvement) food programs in Vigía del Fuerte, Colombia. Methods Qualitative research, using focused ethnography as a method for collecting information. Individual interviews and discussion groups were used. Results Even though the communities that live by the Murrí River basin are protected from physical hunger due to the constant availability of plantain or musa, hunger is associated with the absence of meat or liga and the fact that they feel forced to eat empty musa. They also refer to hunger as the feeling of uneasiness caused by headache and stomachache. Conclusions Despite the fact that the communities of Vigía del Fuerte have access to plantain throughout the year, thus protecting them from physical hunger, they do not consider it as food that could calm their hunger and free them from scarcity. This happens because its presence as the only food available reminds them, precisely, that they lack certain conditions and feel hunger.(AU)

Nutrición parenteral en neonatos: individualización de la prescripción / Parenteral nutrition in neonates: Individualization of the prescription

Introducción: El parto prematuro suprime radicalmente la energía fácilmente asimilable que proporciona el transporte placentario, planteando una emergencia médica nutricional, ya que el aparato digestivo del recién nacido pretérmino es incapaz de manejar y absorber la energía que requiere la vida extrauterina y el crecimiento posnatal. Por sus características de inmadurez y la morbilidad propia del recién nacido pretérmino y/o pequeño para su edad gestacional, es necesario individualizar la composición de la nutrición parenteral, adaptándola a las necesidades y a la tolerancia de cada neonato. Objetivo: El objetivo de nuestro trabajo es diseñar un programa que permita el cálculo de la nutrición parenteral del recién nacido de forma individualizada. Métodos: Se revisan las recomendaciones actuales de macro/micronutrientes, y con las variables edad gestacional, peso, días de vida y parámetros analíticos se establecen unas ecuaciones matemáticas. Resultados: Se obtiene una serie de funciones continuas que relacionan los requerimientos basados en la evidencia científica ac-tual con la edad, el peso y el día de la nutrición, simplificando la prescripción individualizada y la elaboración de la nutrición parenteral. Conclusiones: Este método de cálculo permite disminuir los errores en la estimación de la nutrición parenteral en recién nacidos pretérmino, ya que, al simplificar las operaciones, el riesgo de error disminuye, lo que permite realizar el cálculo de una nutrición parenteral individualizada de forma sencilla, rápida y segura (AU)

Introduction: Preterm birth suppresses radically easily assimilable energy that provides placental transport, posing a nutritional medical emergency, because the digestive tract of preterm infant is unable to manage and absorb the energy required by extrauterine life and postnatal growth. Because of the characteristics of immaturity and own morbidity of newborn preterm and/or small for gestational age, it’s necessary to individualize the composition of parenteral nutrition, adapting it to the needs and tolerance of each newborn. Objective: The aim of our work is to design a program that allows the calculations of parenteral nutrition of the newborn individually. Methods: Current recommendations of macro and micronutrients are reviewed, and with the variables gestational age, weight, days of life and laboratory parameters, some mathematical equations are established. Results: We obtain a series of continuous functions relating requirements based on current scientific evidence with age, weight and nutrition day, simplifying the individualized prescription and the development of parenteral nutrition. Conclusions: This calculation method allow us to reduce errors in the calculation of parenteral nutrition in preterm infants, because simplifying operations the risk of error decreases, allowing the calculation of an individual parenteral nutrition easily, quickly and safely (AU)

Utilidad del cuestionario «Edmonton Obesity Staging System» para el desarrollo de la nutrición médica de precisión / Usefulness of the «Edmonton Obesity Staging System» to develop precise medical nutrition

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Evolución del estado nutricional en niños menores de 5 años beneficiarios de un programa alimentario, al ingreso, a los 3 y 6 meses de tratamiento que acuden al Hospital distrital de la ciudad de Coronel Bogado / Evolution of nutritional status in children under 5 years of age who are beneficiaries of a food program, on admission, at 3 and 6 months of treatment, who come to the District Hospital of the city of Coronel Bogado

Introducción: la desnutrición es un problema de salud pública a nivel nacional. Objetivo: Evaluar la evolución nutricional de los niños menores de 5 años beneficiarios de un programa alimentario, al ingreso, a los 3 y 6 meses de tratamiento que acuden al Hospital Distrital de la Ciudad de Coronel Bogado. Metodología: estudio de cohorte retrospectivo, observacional, descriptivo con componente analítico de casos consecutivos, evaluados durante setiembre de 2016 a marzo de 2017. Resultados: fueron evaluados 40 pacientes. El 52,50% (n=21) corresponde al sexo masculino y 47,50% (n=19) al femenino. La edad promedio fue de 13.606 ± 14.52 meses. El 37.50% (n=15) provino de una zona rural y el 62.50% (n=21) de zona urbana. Se encontró desnutrición al ingreso 15%, a los 3 meses 10% y a los 6 meses no se detectaron casos de desnutrición. Riesgo de desnutrición al ingreso 85%, a los 3 meses 45% y finalmente a los 6 meses 16%. Por último, 45% presentaron peso adecuado a los 3 meses y 84% a los 6 meses. El aumento total de peso promedio durante los meses de tratamiento fue :2,81 ±1,16 kg. El 85 % tiene un ingreso menor al sueldo mínimo, 58% accedió solo a la educación primaria, 53% no tiene acceso a agua potable, 38% no cuenta con baño moderno, 27% no cumplió los 6 meses de lactancia materna exclusiva, 27% presento bajo peso al nacer. No se observó relación significativa de los factores en relación al estado nutricional a los 3 meses. Conclusiones: Se observó una tendencia hacia la mejoría del estado nutricional a través de un Programa alimentario que brinda apoyo nutricional

Evolución del Estado Nutricional de Niños/as del 1ro. a 6to. grado de las Escuelas de Asentamientos del Distrito de Edelira beneficiados con la Alimentación Escolar, periodo 2016 / Evolution of the Nutritional State of Children from 1st to 6th Grade of the Edelira District Basic Schools of Settlements benefited from School Feeding, Period 2016

El Programa de Alimentación Escolar del Paraguay trabaja para combatir el hambre, la desnutrición infantil e incentivar a la permanencia de los niños/as en las escuelas. Objetivo: Describir la evolución del estado nutricional de niños/as del 1ro a 6to grado de las escuelas básicas de asentamientos del Distrito de Edelira beneficiados con la alimentación escolar, periodo 2016. Métodos: Estudio observacional descriptivo, longitudinal. Se utilizó el Manual Básico de Evaluación Nutricional Antropométrica del INAN-2015 para diagnosticar el estado nutricional por IMC/Edad y Talla/Edad. Resultados: Se analizó la planilla de valoración nutricional de 47 niños/as, el 66% (n= 31) de la población estudiada corresponde al sexo femenino y el 34% (n=16) al sexo masculino. La mediana encontrada fue de 8,45 ± 1,69 años. Antes de la alimentación escolar, el estado nutricional según el IMC/E resultaron peso adecuado (A) 60 % (n= 28), (RD) del 19 % (n=9), sobre peso ( S) 13% (n=6), (DM) 2% (n=1), obesidad (O) 6% (n=3).Talla para la edad ( T/E); fue sin talla baja en un 89% (n= 42), (RTB) 9 % (n=4), (TB) 2% (n=1). Después de iniciado la alimentación escolar, el estado nutricional según el IMC/E resultaron peso adecuado (A) 74 % (n= 35), (RD) 15 % (n=7), sobre peso (S) 9 % (n= 4), (DM) 0% (n=0), y obesidad (O) 2% (n=1). Sin talla baja se mantuvo en 89% (n=42), (RTB) 9% y (TB) 2% (n=1). Conclusiones: 4 meses iniciado el programa de alimentación escolar, los hallazgos indican una evolución favorable en cuanto al IMC/E en un 14%, un descenso del (RD) 4%, sobre peso (S) 4%, obesidad (O) 4% , no se evidenció (DM). En cuanto a la T/E no se evidenció cambio importante por el crecimiento lento, propio de la edad

The School Feeding Program of Paraguay works to combat hunger, child malnutrition and encourage children to stay in school. Objective: To describe the evolution of the nutritional status of children from the 1st to the 6th grade of the basic schools of settlements of the District of Edelira beneficiaries with school education, 2016 period. Methods: Descriptive, longitudinal observational study. The Basic Manual of Nutritional Anthropometric Evaluation of the INAN-2015 was used to diagnose the nutritional status by BMI / Age and Size / Age. Results: The nutritional assessment form of 47 children was analyzed, 66% (n = 31) of the studied population corresponds to the female sex and 34% (n = 16) to the male sex. The median found was 8.45 ± 1.69 years. Before school feeding, nutritional status according to BMI / E resulted in adequate weight (A): 60% (n = 28), (RD) of 19% (n = 9), overweight (S) 13% ( n = 6), (DM) 2% (n= 1), obesity (O) 6% (n= 3) .Talk for age (T / E); it was without a low stature in 89% (n = 42), (RTB) 9% (n = 4), (TB) 2% (n = 1). After starting school feeding, the nutritional status according to BMI / E resulted in adequate weight (A): 74% (n = 35), (RD) 15% (n = 7), overweight (S) 9% (n = 4), (DM) 0% (n = 0), and obesity (O) 2% (n = 1). No short stature remained at 89% (n = 42), (RTB) 9% and (TB) 2% (n = 1). Conclusions: 4 months into the school feeding program, the findings indicate a favorable evolution in terms of BMI / E in 14%, a decrease in (RD) 4%, overweight (S) 4%, obesity (O) 4 %, was not evidenced (DM). Regarding T / E, there was no significant change due to the slow growth, typical of age

Nutrición adecuada aplicada a los docentes. Una revisión / Adequate nutrition applied to teachers. A review

Fundamentos: En la actualidad los docentes tienen estilos de vida sedentarios producto de su propio trabajo y esto les provoca, en muchos casos, enfermedades asociadas. Esta revisión pretende actualizar los conocimientos existentes sobre la nutrición adecuada de los docentes a nivel internacional. Métodos: se realizó una revisión documental y bibliográfica de artículos científicos publicados hasta abril de 2016. Para ello se consultaron las bases de datos Scopus y Scielo. Se usaron las siguientes palabras claves: nutrición, docentes, salud; en idioma español e inglés. Se seleccionaron aquellos estudios de donde se reflejaban programas, intervenciones y revisiones sobre la nutrición adecuada y saludable en docentes o futuros docentes de cualquier tipo de enseñanza, a nivel internacional. Resultados: se encontraron diez estudios de aplicación en diferentes niveles de experimentación, donde se demostraban los beneficios de distintos programas de nutrición saludable en poblaciones de docentes y futuros docentes. Conclusiones: la aplicación correcta de programas de nutrición aplicados a los docentes y futuros docentes resulta beneficioso de forma general

Background: Nowadays, teachers have sedentary lifestyles as a result of their own work and this causes them, in many cases, associated diseases. This review intends to update existing knowledge on the adequate nutrition of teachers at the international level. Methods: a documentary and bibliographical review of scientific articles published until April 2016 was carried out. For this, the Scopus and Scielo databases were consulted. The following keywords were used: nutrition, teachers, health; In Spanish and English. Those studies which reflected programs, interventions and reviews on adequate and healthy nutrition in teachers or future teachers of any type of education, at the international level, were selected. Results: ten application studies were found at different levels of experimentation, showing the benefits of healthy nutrition programs in teachers and future teachers. Conclusions: the correct application of nutrition programs applied to teachers and future teachers is generally beneficial

Programa de comedores escolares de la Comunidad de Madrid (2001-2015): diseño, protocolo, metodología y actualización / School Meals Programme of the Community of Madrid (2001-2015): design, protocol, methodology and update

Introducción: a finales del siglo XX, no se conocía con precisión si la comida del comedor escolar contribuía adecuadamente a la dieta de la población infantil. Además, este servicio complementario no se contemplaba en el proyecto educativo del centro pese a considerarse fundamental en todas sus dimensiones. Objetivo: describir el origen y desarrollo del programa de comedores escolares de la Comunidad de Madrid (CM) en 15 años desde su implantación. Métodos: se elaboró una normativa a cumplir por las empresas de restauración, y que contemplaba aspectos nutricionales y de composición y variedad de los menús, que se utilizó en los concursos para acceder a la prestación del servicio de comedor escolar, publicados en los años 2001, 2002, 2005, 2009 y 2013. Además se realizaron visitas acreditadas a los centros sin previo aviso para verificar el cumplimiento de la documentación aportada durante el concurso. Resultados: los criterios más actuales sobre programación y elaboración de menús escolares se recogen en el Pliego de Prescripciones Técnicas del año 2013 (C-504/001-2013). Un 92% de las empresas de restauración superaron los cinco concursos habidos en los 15 años de funcionamiento. Hasta el año 2014, se han realizado 755 visitas, revisándose un total de 574 centros. Conclusiones: el programa de comedores escolares de la CM, desde su implementación pionera en España, ha contribuido a la mejora del servicio complementario de comedor. En estos años se han ido incluyendo nuevos requisitos dietéticos y nutricionales que han logrado menús cada vez más ajustados a las recomendaciones de la población escolar (AU)

Introduction: At the end of the 20th century there was no precise knowledgment of whether the food delivered at schools supported the children´s diets. Furthermore, this additional service was not included in the educational plan of the school, even though it had an impact in the pupils´ education in several ways. Objective: To describe the origins and development of School Meals Programme of the Community of Madrid after 15 years of functioning. Methods: A law gathering all the nutritional aspects, composition and variety of the menus was implemented and had to be followed by all the catering companies. Such law was used in different terms (2001, 2002, 2005, 2009 and 2013) to choose who could access to the school meals service. Visits to the schools without previous warning took place to verify that they were complying with the standards. Results: The most recent nutritional standards about the planning and elaboration of the school menus are gathered at the 2013 «Pliego de Prescripciones Técnicas» (C-504/001-2013). As an average, 92% of the participating catering companies approved in the fi ve terms. Until year 2014, 755 visits to these schools took place, revising a total of 574 of them. Conclusions: The School Meals Programme of the Community of Madrid, since the pioneer implementation in Spain, has markedly contributed to the improvement of this key service in the schools. Over these years new dietary requirements have been progressively introduced to produce more suitable menus to fit the scholar population recommendations (AU)

Ações de alimentação e nutrição na estratégia saúde da família: estrutura e processo de trabalho / Food and nutrition actions in the family health strategy: structure and work process / Acciones de alimentación y nutrición en la estrategia salud de la familia: estructura y proceso de trabajo

Objetivo: caracterizar as ações de alimentação e nutrição no âmbito da estratégia saúde da família, analisando a estrutura e o processo de trabalho. Método: estudo transversal desenvolvido em 2010, em 20(29,85%) das unidades básicas de saúde da família do município de Campina Grande. As informações foram obtidas nas unidades de saúde, mediante questionário individual, aplicado aos enfermeiros, e outro respondido pela equipe de saúde. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da UEPB (355013300009). Resultados: na ausência do nutricionista, os médicos e enfermeiros são os profissionais que desenvolvem as principais atividades de alimentação e nutrição. Esses profissionais, além de não contarem com estrutura adequada, como materiais educativos, enfrentam problemas relacionados à demanda, adesão e situação socioeconômica da população, destacando-se a importância de capacitação profissional. Conclusão: o desenvolvimento das ações de alimentação e nutrição na atenção básica precisa de nutricionista que trabalhe com o apoio de uma equipe multidisciplinar.

Objective:to characterize food and nutrition actions in the context of the family health strategy, and analyze the structure and work process. Method: this cross-sectional study was conducted in 2010 at 20 (29.85%) of the family health primary care units of Campina Grande. Data was collected by questionnaires answered individually by nurses and collectively by the healthcare team. The project was approved by the UEPB research ethics committee (No. 0355013300009). Results: in the absence of nutritionists, doctors and nurses conduct the main food and nutrition activities. These professionals, in addition to lacking proper structure, such as educational materials, face problems related to user population demand, adherence and socioeconomic status, and professional training is particularly important. Conclusion: food and nutrition actions in primary health care require the inclusion of nutritionists working with the support of a multidisciplinary team.

Objetivo: caracterizar las acciones de alimentación y nutrición en el ámbito de la estrategia salud de la familia, analizando la estructura y el proceso de trabajo. Método: estudio transversal desarrollado en 2010 en 20 (29,85% de las unidades básicas de salud de la familia del municipio de Campina Grande. Las informaciones fueron obtenidas en las unidades de salud mediante aplicación de un cuestionario individual, aplicado a los enfermeros, y otro respondido por los miembros de las unidades. El proyecto fue aprobado por el Comité de Ética en Investigaciones de la UEPB (355013300009). Resultados: en la ausencia de nutricionista, los médicos y enfermeros son los profesionales que desarrollan las principales actividades de alimentación y nutrición. Esos profesionales, además de no contar con estructura adecuada, como materiales educativos, enfrentan problemas relacionados a la demanda, adhesión y situación socioeconómica de la población, destacando-se la importancia de capacitación profesional. Conclusión: el desarrollo de las acciones de alimentación y nutrición en la atención primaria necesita de nutricionista que trabaje con el apoyo de una equipe multidisciplinar.

Adherencia al consumo de los suplementos alimenticios del programa PROSPERA en la reducción de la prevalencia de anemia en niños menores de tres años en el estado de San Luis Potosí, México / Adherence to the consumption of food supplements of PROSPERA program, in the decrease of the prevalence of anemia in children under three years old in the state of San Luis Potosí, México

Introducción: la anemia es un factor de riesgo en la población infantil con consecuencias graves para su crecimiento y desarrollo. Los programas de ayuda alimentaria pueden contribuir a su prevención y control. Objetivo: estudiar la adherencia al consumo de suplementos y su relación con la prevalencia de anemia en niños menores de 3 años de edad en San Luis Potosí, México beneficiarios del programa PROSPERA. Métodos: se realizó un análisis comparativo en niños de 12 a 36 meses que consumen diferentes suplementos alimenticios: 414 pertenecientes al grupo de intervención y 334 al de comparación. Se midió la hemoglobina (Hb) por Hemocue clasifi cando como anémicos a quienes tuvieron valores < 110 g/l. Se aplicaron pruebas de t de Student y X2 . Se estimaron efectos de intervención mediante el método de diferencias en diferencias y un puntaje de adherencia al consumo de suplementos. Resultados: al final del estudio la prevalencia de anemia disminuyó 11,2 pp en el grupo de intervención y 8,7 pp en el de comparación; la interacción del puntaje de adherencia por suplemento y etapa de observación mostró que la adherencia al consumo de Bebida láctea + Vitaniño reduce el riesgo de presentar anemia (p = 0,14). El consumo de Nutrisano + Vitaniño se asoció con menor riesgo (0,2), ambos con respecto al consumo de Nutrisano. Conclusiones: el programa PROSPERA tuvo efectos importantes en la disminución de las prevalencias de anemia. Se recomienda llevar a cabo acciones para mejorar la adherencia al consumo de suplementos alimenticios, a fin de mejorar la efectividad de los programas (AU)

Introduction: Anemia is a risk factor in children with serious consequences for growth and development. Food aid programs can contribute to its prevention and control. Objective: To study the adherence to supplement consumption and its relation to the prevalence of anemia in children under three years old in San Luis Potosi, Mexico benefi ciaries of PROSPERA program. Methods: A comparative analysis was performed in 12 to 36 months old children consuming different food supplements: 414 belonging to the intervention group and 334 in the comparison group. Hemoglobin (Hb) was measured by Hemocue classifi ying as anemic those who have values < 110 g/L. Student t test and X2 were applied. Intervention effects were estimated by the method of difference in difference and a score of adherence to taking supplements. Results: At the end of the study the prevalence of anemia decreased 11.2 pp in the intervention group and 8.7 pp in the comparison group; interaction score adhesion supplement and stage of observation showed that adherence to the consumption of dairy drink + Vitaniño reduced the risk of anemia (p = 0.14). Nutrisano + Vitaniño intake was associated with a lower risk (0.2), both with respect to consumption Nutrisano. Conclusions: PROSPERA program had a signifi cant impact in reducing the prevalence of anemia. It is recommended to take actions to improve adherence to the consumption of dietary supplements to improve the effectiveness of programs (AU)

Diagnosis of metabolic syndrome in children as a potential indicator of technical ability in medical and nutritional care / Diagnóstico de síndrome metabólico en niños como indicador potencial de la capacidad técnica en la atención médica y nutricional

Background: currently, there is an increase in the incidence of obesity in the pediatric population, which is associated with an increase in metabolic syndrome (MetS). Thus, an early diagnosis of MetS is needed in this population to improve the prevention of cardiovascular disease and type 2 diabetes in adulthood. Objective: the aim of this study was to explore the ability of health professionals to identify the main criteria for MetS in children, which is required for establishing the conditions for early diagnosis and timely treatment. Methods: a cross-sectional study was conducted using a survey and conducted in two states of the republic (Aguascalientes and Hidalgo) and in the Federal District from January to December 2014. Results: the questionnaire was applied to 274 health professionals. Most of these professionals (61.7%) reported knowledge of the criteria for MetS diagnosis in children and adolescents. Additionally, it was observed that 63.1% of professionals did not perform the needed measurements the waist of circumference in preschool children and that 46.4% did not measure them in school children. However, 64.6% of professionals performed the measurements in adolescents. Conclusions: this study found that health professionals providing care to pediatric patients do not know the parameters and cutoff points for MetS diagnosis. They do not conduct a deliberate search for MetS risk factors, which is a major limitation for diagnosis and early treatment. Therefore, we suggest a systematic approach for maintaining the standards of health professionals and to make determining the criteria for proper diagnosis of MetS a target of clinical practice (AU)

Introducción: actualmente se ha producido un aumento en la incidencia de obesidad en la población pediátrica, y con ello un incremento del Síndrome Metabólico (SM) por lo que es necesario realizar un diagnóstico oportuno del SM en esta población, así se propiciará la prevención de la enfermedad cardiovascular y la diabetes tipo 2 en la edad adulta. Objetivo: explorar la capacidad de los profesionales de la salud para identificar los principales criterios de SM en niños, requisito para poder establecer las condiciones para el diagnóstico temprano y su tratamiento oportuno. Material y métodos: se realizó un estudio transversal de investigación a través de una encuesta para identificar el conocimiento y la capacidad técnica de los profesionales de la salud en la atención y detección de niños y adolescentes con SM. Se llevó a cabo en dos Estados de la República (Aguascalientes e Hidalgo) y en el Distrito Federal en los meses de enero a diciembre de 2014. Resultados: el cuestionario se aplicó a 274 profesionales de la salud dentro de los cuales se encontraban licenciados en nutrición, médicos generalistas, médicos pediatras, licenciados en enfermería y licenciados en enfermería con especialidad pediátrica. El 61,7% de los encuestados refirieron conocer los criterios de diagnóstico de SM en esta población, sin embargo solo el 32,8% contestó de manera correcta a estos. Por otro lado se observó que el 63,1% del total de los profesionales no miden la circunferencia de cintura en preescolares y el 46,4% en escolares; no obstante, el 64,6% sí realiza esta medición en adolescentes. Por otro lado, el 72,6% de los encuestados no mide la presión arterial en edad preescolar y el 64,6% en edad escolar; sin embargo, el 52,2% sí la mide en adolescentes. Conclusión: en el estudio observamos que los profesionales de la salud que dan atención a los pacientes pediátricos no conocen los parámetros y puntos de corte para diagnosticar el SM; no realizan una búsqueda intencionada de esos factores de riesgo y, por lo tanto, esto se considera una gran limitación para realizar el diagnóstico y tratamiento temprano. Por lo que sugerimos un acercamiento sistemático para mantener los estándares de los profesionales de la salud y establecer como objetivo de la práctica el determinar los criterios de SM para realizar el diagnóstico adecuadamente (AU)

Actividad física y sedentarismo como moduladores de la situación nutricional / Physical and sedentary activity as modulating factors of the nutritional status

La conducta sedentaria y la práctica de ejercicio físico parecen influir en el estado nutricional de la población de forma independiente. En este sentido, el comportamiento sedentario se asocia de forma inversa con los patrones de alimentación saludable y, de forma directa, con el IMC, la grasa corporal, el riesgo de enfermedades crónicas y los problemas psicológicos. Por el contrario, la práctica regular de ejercicio se asocia con una dieta más saludable y efectos beneficiosos para la salud, como la prevención o la reducción del exceso de peso y la prevención de enfermedades. No obstante, parece difícil compensar totalmente, con actividad física, las asociaciones entre la conducta sedentaria y los factores de riesgo para la salud. Para mejorar el estado nutricional y la salud de la población sería recomendable aumentar los comportamientos no sedentarios y disminuir el tiempo que se pasa frente a la pantalla. Así mismo, se recomienda realizar ejercicio físico de forma regular (AU)

Sedentary behavior and physical exercise seem to influence the nutritional status of the population independently. In this sense, sedentary behavior is associated inversely with healthy eating patterns and directly with BMI, body fat, risk of chronic diseases and psychological problems. By contrast, regular exercise is associated with a healthier diet and health benefits as the prevention or reduction of excess weight and disease prevention. However, it seems difficult to completely compensate, sedentary behavior and risk factors for health, with physical activity. To improve the nutritional status and health of the population would be advisable to increase non-sedentary behaviors and decrease the time spent in front of the screen. Also, it is encouraged to exercise regularly (AU)

Effectiveness of the Brazilian Conditional Cash Transfer Program - Bolsa Alimentação - on the variation of linear and ponderal increment in children from northeast of Brazil / Efectividad del Programa de transferencia de ingreso -Bolsa Alimentação (PBA)- sobre la variación del incremento del peso y de la talla de niños en el nordeste del Brasil

Background: social programs can improve the conditions required for families provide sufficient care and attention for an adequate health and nutrition. Objective: This study evaluates the effectiveness of the Brazilian’s conditional cash transfer program - Bolsa Alimentação (PBA) on children anthropometric status. Methods: a cohort of 1847 children, followed for 12 months: 1615 PBA children; 232 non-PBA. There were 316 (14.6%) missing children during the study. A quasi-experimental study adopting the before-after strategy was applied and the effectiveness approach was used to assess the impact of the program on children nutritional status. Multilevel analysis with three levels was used in the statistical analysis. The mean increment variations of height-for-age and weight-for-age were the outcome variables and the participation in the PBA was the exposition. Four participation groups were established: children not exposed to the program (internal control group); exposed to the program throughout the 12 months, exposed to the program only in the last 6 months; and exposed to the program only in the first 6 months. Repeated measures were obtained at baseline and at 12 months. Results: it was found that the exposure to the program was associated to a mean variation in weight-for-age of 0.34 Z-score (IC = 0.04; 0.63) and height-for-age of 0.38 (IC = 0.05; 0.70) for children who were regular program beneficiaries during the follow-up. The exposure to the program in other periods was not statistically associated with a mean variation in the indicators. Conclusions: Cash transfers direct to the family were associated to anthropometric deficits reduction in childhood (AU)

Objetivo: evaluar la eficacia del programa de transferencia de ingreso brasileño -Bolsa Alimentação (PBA)- sobre la variación media del incremento del peso y de la talla de niños. Métodos: cohorte de 1.847 niños seguida durante 12 meses: 1.615 eran niños PBA; 232 eran niños no PBA. Se ha registrado la pérdida de 316 (14,6%) niños durante el estudio. Se adopta el diseño casi-experimental y la estrategia antes-después con el enfoque de eficacia para evaluar el impacto del programa sobre el estado antropométrico de los niños. La regresión lineal multinivel fue usada en el análisis estadístico. La variación media del incremento del crecimiento de la talla y del peso para la edad fueron los resultados, y la participación en el programa la variable de exposición principal. Se establecieron cuatro grupos de participación en el programa: niños no expuestos al programa (control interno; expuestos al programa durante 12 meses de acompañamiento, expuestos al programa solo en los últimos 6; niños expuestos al programa solo en los primeros 6 meses. Las medidas repetidas se obtuvieron al inicio y a los 12 meses del seguimiento. Resultados: después de ajustar los efectos por los factores de confusión, la exposición al programa se asoció a una variación media de peso por edad de 0,34 Z-score (IC = 0,04; 0,63) y talla para la edad de 0,38 Z-score (IC = 0,05; 0,70) para los niños que fueron expuestos al programa durante los 12 meses. La exposición al programa en otros períodos de seguimiento no fue estadísticamente asociado con una variación media de peso o talla para la edad. Conclusiones: transferencias directas de ingresos a la familia se asociaron con la reducción de los déficits antropométricos en la infancia (AU)

Herramientas para planificar y medir el consumo en intervenciones nutricionales: fortificación de alimentos / Tools for planning and measuring consumption in nutritional interventions: food fortification

Las intervenciones nutricionales a nivel poblacional están justificadas cuando en una población existen deficiencias de nutrientes. Los métodos más confiables y preferidos son aquellos que proporcionan resultados individuales que al ser sumados pueden revelar la situación general de la población. Los métodos de evaluación de la dieta más comúnmente utilizados en programas de nutrición incluyen las Hojas de Balance de Alimentos (FBS), el Recordatorio de veinticuatro Horas (24 HR), los Cuestionarios de Frecuencia de Consumo alimentario (FFQ), la Herramienta de Evaluación Rápida de Fortificación (FRAT) y las Encuestas de Consumo y Gasto en los Hogares (HCES). Cada método de evaluación de la dieta tiene fortalezas y debilidades que varían según el contexto y la finalidad. La selección del método debe basarse en las necesidades de datos del programa, la disponibilidad de los métodos, el costo y una clara comprensión de las ventajas y desventajas involucradas (AU)

Nutritional interventions at the population level are justified when there are nutrient deficiencies in the population. The most trusted and preferred methods are those that provide individual results that can be added to reveal the overall situation of the population. The methods of dietary assessment most commonly used in nutrition programs include the Food Balance Sheets (FBS), the twenty-four Hours Recall (24 HR), Food Frequency Questionnaires (FFQ), Fortification Rapid Assessment Tool (FRAT) and Household Consumption and Expenditure Surveys (HCES). Each method of dietary assessment has strengths and weaknesses that vary according to context and purpose. The choice of method should be based on the data needs of the program, the availability of methods, cost and a clear understanding of the advantages and disadvantages involved (AU)