Exploring perceptions about Mindfulness and Mindful Eating Programs for low-income women with overweight in primary health care.

Background: Obesity and overweight are public health problems of multifactorial etiology, aggravated by the challenge that is maintaining weight loss. Used in the context of general health, mindfulness-based interventions (MBIs) have also showed positive effects when targeting changes to overweight-related eating behaviors. Methods: This study consists of a pragmatic randomized controlled trial conducted with 284 women from primary health care units. Data were collected from the last session with 16 focus groups, considering each intervention group (mindfulness or mindful eating) Aim: This article aims to present the perceptions of low-income overweight women who participated in Mindfulness and Mindful Eating intervention groups in primary health care according to each type of intervention. Results: Seven themes were identified: course challenges; valorization of the teacher's attitudes; mindfulness understanding; self-awareness development; change of expectations; development of a different food-weight relationship; and discover of a wide range of benefits. Conclusion: Mindfulness and Mindful eating interventions affect not only an individual's relationship with body and food, but also life and human relations. The results indicate the feasibility of the intervention, which addresses a large number of patients who lack treatment options for overweight or emotional and psychological issues associated with this condition. MBIs such as mindful eating are applicable in primary health care facilities, targeting overweight women and supporting treatment by addressing a repressed demand in the system. Similar to mind-body therapies, these interventions allow for comprehensive care.ClinicalTrials.gov, (NCT02893150) on 30 March 2017.

Comparative effectiveness of mindfulness and mindful eating programmes among low-income overweight women in primary health care: A randomised controlled pragmatic study with psychological, biochemical, and anthropometric outcomes.

Obesity is a chronic and multifactorial disease, with growing rates in the last 50 years worldwide, reaching pandemic levels. It is a major public health problem and is difficult to treat. Different approaches have been used to improve this scenario, including mindfulness-based interventions to enhance dietary behaviour and nutritional status. We compared the effectiveness of a 10-week mindful eating programme with that of a 10-week mindfulness programme and of a no-treatment control group. The sample was composed of adult, low-income women with a body mass index (BMI) ≥ 25 to < 40 receiving primary health care in São Paulo, Brazil. The participants (n = 284) were randomised into 3 groups: the control, mindfulness, and mindful eating. We took anthropometric and body composition measurements, applied psychometric measures, and performed biochemical tests at pre-intervention, post-intervention, and after 3 months. We estimated the regression coefficients among the analysis of adherent participants (per protocol: PP) and among those of all participants randomised to treatment (intention-to-treat: ITT) in addition to multiple imputation (MI). Both groups showed improvement in eating behaviour and reduction of binge eating both in the post-intervention and follow-up periods, but without significant changes in weight or most of the biological tests. Those in the mindful eating programme performed slightly better than those in the mindfulness and control groups in terms of improving eating behaviour and reducing binge eating among low-income overweight women.

Mindful eating for overweight and obese women in Brazil: An exploratory mixed-methods pilot study.

Background: Worldwide, approximately 95% of obese people who follow diets for weight loss fail to maintain their weight loss in the long term. To fill this gap, mindfulness-based interventions, with a focus on mindful eating, are promising therapies to address this challenging public health issue. Aim: To verify the effects of the Mindfulness-Based Eating Awareness Training (MB-EAT) protocol by exploring quantitative and qualitative data collected from Brazilian women. Methods: A single-group, mixed-methods trial was conducted at a public university with adult women (n = 34). Four MB-EAT groups were offered weekly for 2.5-h sessions over 12 weeks. Pre- and post-intervention assessments included body mass index (BMI) and self-report measures of anxiety, depression, mindfulness, self-compassion, and eating behaviour. Qualitative information was collected using focus groups in the last session of each group, including both participants and MB-EAT instructors. The qualitative data were examined using thematic analyses and empirical categories. Results: Twenty participants (58.8%) completed both pre- and post-intervention assessments, with adequate attendance (≥4 sessions). There was a significant average decrease in weight of 1.9 ± 0.6 kg from pre- to post-intervention. All participants who had scored at the risk level for eating disorders on the EAT-26 decreased their score below this risk level. Qualitative analysis identified that participants were able to engage a more compassionate perspective on themselves, as well as greater self-awareness and self-acceptance. Conclusion: The MB-EAT showed preliminary efficacy in promoting weight loss and improvements in mindfulness and eating behaviour. This intervention promoted effects beyond those expected, extending to other life contexts.

Study protocol of a multicenter randomized controlled trial of mindfulness training to reduce burnout and promote quality of life in police officers: the POLICE study.

BACKGROUND: Police officers experience a high degree of chronic stress. Policing ranks among the highest professions in terms of disease and accident rates. Mental health is particularly impacted, evidenced by elevated rates of burnout, anxiety and depression, and poorer quality of life than the general public. Mindfulness training has been shown to reduce stress, anxiety, burnout and promote quality of life in a variety of settings, although its efficacy in this context has yet to be systematically evaluated. Therefore, this trial will investigate the efficacy of a mindfulness-based intervention versus a waitlist control in improving quality of life and reducing negative mental health symptoms in police officers. METHODS: This multicenter randomized controlled trial has three assessment points: baseline, post-intervention, and six-month follow-up. Active police officers (n = 160) will be randomized to Mindfulness-Based Health Promotion (MBHP) or waitlist control group at two Brazilian major cities: Porto Alegre and São Paulo. The primary outcomes are burnout symptoms and quality of life. Consistent with the MBHP conceptual model, assessed secondary outcomes include perceived stress, anxiety and depression symptoms, and the potential mechanisms of resilience, mindfulness, decentering, self-compassion, spirituality, and religiosity. DISCUSSION: Findings from this study will inform and guide future research, practice, and policy regarding police offer health and quality of life in Brazil and globally. TRIAL REGISTRATION: ClinicalTrials.gov NCT03114605 . Retrospectively registered on March 21, 2017.

Experiential Avoidance in Primary Care Providers: Psychometric Properties of the Brazilian "Acceptance and Action Questionnaire" (AAQ-II) and Its Criterion Validity on Mood Disorder-Related Psychological Distress.

BACKGROUND: A sizeable proportion of Brazilian Primary Care (PC) providers suffer from common mental disorders, such as anxiety and depression. In an effort to cope with job-related distress, PC workers are likely to implement maladaptive strategies such as experiential avoidance (EA). The Acceptance and Action Questionnaire (AAQ-II) is a widely used instrument that evaluates EA but has shown questionable internal consistency in specific populations. This study assesses the psychometric properties of the AAQ-II among Brazilian PC providers, evaluates its convergence and divergence with self-criticism and mindfulness skills, and explores its criterion validity on anxiety and depressive symptoms. METHODS: A cross-sectional design was conducted in Brazilian PC services, and the sample included 407 PC workers. The measures evaluated EA, self-criticism, mindfulness, depression, and anxiety. RESULTS: The one-factor model of the AAQ-II replicated the original version structure. The AAQ-II presented good internal consistency among Brazilian PC providers. A multiple regression model demonstrated higher relationships with self-criticism than mindfulness skills. The criterion validity of the AAQ-II on anxiety and depression was stronger in the context of more severe symptoms. CONCLUSIONS: The AAQ-II is an appropriate questionnaire to measure the lack of psychological flexibility among Brazilian PC workers in the sense of EA.

Nutritional intervention programme among a Japanese-Brazilian community: procedures and results according to gender.

OBJECTIVE: To describe the results of a nutritional intervention programme among Japanese-Brazilians according to gender. DESIGN: A non-controlled experimental study. SETTING: The research included three points of clinical, nutritional and physical activity evaluation: at baseline (in 2005), after the first year and at the end of the second year (in 2007). The paired Student t test and multiple linear regression analysis were used to evaluate changes in the subjects' profile (clinical, nutritional and physical activity variables). SUBJECTS: Japanese-Brazilians (n 575) of both genders, aged over 30 years. RESULTS: We verified statistically significant reductions in body weight (0.9 kg), waist circumference (2.9 cm), blood pressure, fasting blood glucose (>3 mg/dl) and total cholesterol (>20 mg/dl) and its fractions, in both genders. We also found reductions in intake of energy (among men), protein (among women) and fat (both genders) and increases in intake of total fibre (among women) and carbohydrate (among men). CONCLUSIONS: The intervention programme indicated meaningful benefits for the intervention subjects, with changes in their habits that led to a 'healthier' lifestyle positively impacting their nutritional and metabolic profile.

Frenetic, under-Challenged, and Worn-out Burnout Subtypes among Brazilian Primary Care Personnel: Validation of the Brazilian "Burnout Clinical Subtype Questionnaire" (BCSQ-36/BCSQ-12).

Primary healthcare personnel show high levels of burnout. A new model of burnout has been developed to distinguish three subtypes: frenetic, under-challenged, and worn-out, which are characterized as overwhelmed, under-stimulated, and disengaged at work, respectively. The aim of this study was to assess the psychometric properties of the long/short Brazilian versions of the "Burnout Clinical Subtypes Questionnaire" (BCSQ-36/BCSQ-12) among Brazilian primary healthcare staff and its possible associations with other psychological health-related outcomes. An online cross-sectional study conducted among 407 Brazilian primary healthcare personnel was developed. Participants answered a Brazil-specific survey including the BCSQ-36/BCSQ-12, "Maslach Burnout Inventory-General Survey", "Utrecht Work Engagement Scale", "Hospital Anxiety/Depression Scale", "Positive-Negative Affect Schedule", and a Visual Analogue Scale of guilt at work. The bifactor was the model with the best fit to the data using the BCSQ-36, which allowed a general factor for each subtype. The three-correlated factors model fit better to the BCSQ-12. Internal consistence was appropriate, and the convergence between the long-short versions was high. The pattern of relationships between the burnout subtypes and the psychological outcomes suggested a progressive deterioration from the frenetic to the under-challenged and worn-out. In sum, the Brazilian BCSQ-36/BCSQ-12 showed appropriate psychometrics to be used in primary healthcare personnel.

Mindfulness as a complementary intervention in the treatment of overweight and obesity in primary health care: study protocol for a randomised controlled trial.

BACKGROUND: Mindfulness has been applied in the United States and Europe to improve physical and psychological health; however, little is known about its feasibility and efficacy in a Brazilian population. Mindfulness may also be relevant in tackling obesity and eating disorders by decreasing binge eating episodes-partly responsible for weight regain for a large number of people-and increasing awareness of emotional and other triggers for overeating. The aim of the present study protocol is to evaluate and compare the feasibility and efficacy of two mindfulness-based interventions (MBIs) addressing overweight and obesity in primary care patients: a general programme called Mindfulness-Based Health Promotion and a targeted mindful eating protocol called Mindfulness-Based Eating Awareness Training. METHODS/DESIGN: A randomised controlled trial will be conducted to compare treatment as usual separately in primary care with both programmes (health promotion and mindful eating) added to treatment as usual. Two hundred forty adult women with overweight and obesity will be enrolled. The primary outcome will be an assessment of improvement in eating behaviour. Secondary outcomes will be (1) biochemical control; (2) anthropometric parameters, body composition, dietary intake and basal metabolism; and (3) levels of mindfulness, stress, depression, self-compassion and anxiety. At the end of each intervention, a focus group will be held to assess the programme's impact on the participants' lives, diet and health. A feasibility study on access to benefits from and importance of MBIs at primary care facilities will be conducted among primary care health care professionals and participants. Monthly maintenance sessions lasting at least 1 hour will be offered, according to each protocol, during the 3-month follow-up periods. DISCUSSION: This clinical trial will result in more effective mindfulness-based interventions as a complementary treatment in primary care for people with overweight and obesity. If the findings of this study confirm the effectiveness of mindfulness programmes in this population, it will be possible to improve quality of life and health while optimising public resources and reaching a greater number of people. In addition, on the basis of the evaluation of the feasibility of implementing this intervention in primary care facilities, we expect to be able to suggest the intervention for incorporation into public policy. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02893150 . Registered retrospectively on 30 March 2017.

Effects of Mindfulness on Diabetes Mellitus: Rationale and Overview.

Diabetes mellitus (DM) is an emerging global healthcare problem and its prevalence is increasing at an alarming rate. Despite improvements in both medical and pharmacological therapies, a complex medical condition may demand a diversified approach, such as: drug therapy, healthy diet and exercises, diabetes education programs, adherence to medical treatment and active participation of the patients in their lifestyle changes, such as stress management. The concept of mindfulness is here defined as the awareness that unfolds from the intention to attentively observe the current experience in a non-judgmental and non-evaluative way. This state of awareness can be enhanced through the use of mindfulness-based interventions (MBIs), which have been associated to many physical and psychological health indicators. The aim of this overview is to offer the rationale and potential benefits of mindfulness in the control of DM and its complications. METHODS: a narrative review of the current and updated literature available on online database and which came up using the terms "mindfulness" and "diabetes mellitus". Mindfulness-based Interventions (MBIs) can be seen as preventive and complementary interventions in DM, particularly for the relief of symptoms related to depression and anxiety in diabetic patients and also in the management of other factors, including mindful eating, physical exercises and treatment adherence. Although many studies only present research protocols, mindfulness seems to have beneficial effects on all aspects of diabetes, including incidence, control and complications. Furthermore, longer term and more carefully controlled trials are necessary in order to draw consistent conclusions on the beneficial role of MBIs on DM.

Perceived stress among Primary Health Care Professionals in Brazil. / Estresse percebido em profissionais da Estratégia Saúde da Família.

OBJECTIVE:: To evaluate the perceived stress (PS) of professionals in Primary Health Care and its association with the characteristics of the teams in the Family Health Program (FHP). The association between PS and self-referred morbidity was also investigated. METHODS:: This is a cross-sectional study conducted with 450 employees from 60 teams in 12 Basic Health Units (BHUs) in a region of São Paulo. The differences in the total score in the Perceived Stress Scale were evaluated through multiple linear regression models. RESULTS:: Higher levels of PS were observed in those who had been working for one year or more in the same team, in the categories of doctors, nurses and community health workers, females, non-religious, and in BHU professionals in incomplete teams (absence of a physician). Lower perceived stress was found in widowers. It was observed that individuals with higher levels of PS have higher chances of reporting chronic health problems. CONCLUSION:: It can be concluded that the perception of stress in this population is associated with individual, professional factors, and the composition of teams in healthcare units.

Mindfulness, promoção da saúde e semiótica: bases para modelos comunicacionais em saúde online / Mindfulness, health promotion, and semiotics: Bases for communication models in online health / Mindfulness, promoción de la salud e semiótica: bases para modelos de comunicación en salud em línea

OBJETIVO: identificar como o texto verbo-visual do curso produz sentidos e como isso pode auxiliar na construção do design de outros cursos. MÉTODO: foi feita a análise semiótica de duas práticas e de um print de tela do curso denominado Programa de Autocuidado Baseado em Mindfulness, na modalidade Educação à Distância, desenvolvido pelo Centro Brasileiro de Mindfulness e Promoção da Saúde ("Mente Aberta"), do Departamento de Medicina Preventiva da Universidade Federal de São Paulo. Foram avaliados os elementos estéticos que contribuiriam para a construção de um ambiente de prática eufórico (ligado à saúde) e estabelecidas relações entre o plano de conteúdo e o plano de expressão das práticas, responsáveis pela construção de um sistema semissimbólico. RESULTADOS: confirmou-se a valorização de uma estética da simplicidade de cores e formas que converge para uma afirmação dos valores calma e bem-estar compatíveis com as práticas de mindfulness. CONCLUSÃO: a partir dessa análise, busca-se refletir sobre as bases para o desenvolvimento de modelos comunicacionais relacionados à promoção da saúde em ambiente digital.

OBJECTIVE: to analyze an online course on health promotion based on mindfulness (mindfulness) through the theory of discursive semiotics in one of its most recent developments, the visual or plastic aspect. The objective is to identify how the verbal-visual text of the course produces meanings and how it can help in the design of other courses. METHOD: a semiotic analysis of two practices and a screen print of the course called Mindfulness-Based Self-Care Program, in distance learning, developed by the Brazilian Center for Mindfulness and Health Promotion ("Open Mind"), of the Department of Preventive Medicine at the Federal University of São Paulo. RESULTS: the aesthetic elements that contributed to the construction of an euphoric practice environment (linked to health) were evaluated and relationships were established between the content plan and the practice expression plan, responsible for the construction of a semi-symbolic system. CONCLUSION: it was confirmed the appreciation of an aesthetics of simplicity of colors and shapes that was converged to an affirmation of the values ​​of calm and well-being compatible with the practices of mindfulness. From this analysis, we seek to reflect on the bases for the development of communicational models related to health promotion in a digital environment.

OBJETIVO: analizar un curso en línea sobre promoción de la salud basado en la atención plena (mindfulness) a través de la teoría de la semiótica discursiva en uno de sus desarrollos más recientes, el aspecto visual o plástico. El objetivo es identificar cómo el texto verbal-visual del curso produce significados y cómo puede ayudar en el diseño de otros cursos. MÉTODO: se llevó a cabo un análisis semiótico de dos prácticas y una impresión de pantalla del curso llamado Programa de autocuidado basado en la atención plena, en educación a distancia, desarrollado por el Centro Brasileño de Mindfulness y Promoción de la Salud ("Mente Abierta"), del Departamento de Medicina Preventivade de la Universidad Federal de São Paulo. RESULTADOS: se evaluaron los elementos estéticos que contribuyeron a la construcción de un entorno de práctica eufórica (vinculado a la salud) y se establecieron relaciones entre el plan de contenido y el plan de expresión de práctica, responsables de la construcción de relaciones semi-simbólicas. CONCLUSIÓN: se confirmó la valoración de una estética de simplicidad de colores y formas, que convergió en una afirmación de los valores de calma y bienestar compatibles con las prácticas de mindfulness. A partir de este análisis, buscamos reflexionar sobre las bases para el desarrollo de modelos comunicacionales relacionados con la promoción de la salud en un entorno digital.

[Reproducibility and validity of a food frequency questionnaire]. / Reprodutibilidade e validade do questionário de freqüência de consumo de alimentos.

OBJECTIVE: Methods to evaluate food consumption still need improvement. A study was conducted to verify the reproducibility and validity of a food frequency questionnaire (FFQ) among overweight adults. METHODS: The study was carried out in a private university in São Paulo, Brazil. The study sample consisted of 146 individuals of both sex with body mass index =25 kg/m2 and age between 18 and 60 years old. For reproducibility the FFQ was applied by trained interviewers at two different instances with a mean interval time of 47 days. For validity, data collected from the FFQ were compared with those obtained from the average of 3 different daily records of a 24-hour dietary recall (mean interval time: 15 days). Validity and reproducibility of data on calories and macronutrients consumption was assessed using pondered kappa statistics and intraclass correlation coefficient. RESULTS: A higher variability in the reporting of regular food consumption was seen among obese than overweight individuals. Concerning reproducibility, kappa statistical values varied from 0.23 (carbohydrates and fats) to 0.40 (calories), and intraclass correlation coefficients ranged from 0.28 (protein) to 0.54 (total calories). For FFQ validity, the highest kappa value was 0.25 (calories), and the intraclass correlation coefficient was 0.21 (protein). CONCLUSIONS: Food consumption reports of overweight individuals tend to be underestimated. Despite its limitations, FFQ could be used in epidemiological studies to assess the regular food consumption of overweight individuals.

Estresse percebido em profissionais da Estratégia Saúde da Família / Perceived stress among Primary Health Care Professionals in Brazil

RESUMO: Objetivo: Avaliar o estresse percebido (EP) de profissionais da Estratégia de Saúde da Família (ESF) e a associação com características das equipes. Também foi investigada a ocorrência de associação entre EP e morbidade autorreferida. Métodos: Trata-se de estudo transversal com 450 trabalhadores de 60 equipes em 12 Unidades Básicas de Saúde (UBS), em uma região de São Paulo. As diferenças entre o escore total da Escala de Estresse Percebido e suas associações com as características individuais e das equipes foram avaliadas por meio de modelos múltiplos de regressão linear. Resultados: Observaram-se níveis mais elevados de EP naqueles com tempo de trabalho igual ou superior a um ano na mesma equipe, nas categorias de médicos, enfermeiros e agentes comunitários de saúde, gênero feminino, em não praticantes de credos religiosos, e em profissionais de UBS com equipes incompletas (ausência do médico). Menor estresse percebido foi encontrado em viúvos. Observou-se que indivíduos com níveis mais elevados de EP têm mais chance de relatar problemas crônicos de saúde. Conclusão: Conclui-se que a percepção de estresse na população estudada está associada a fatores individuais, profissionais, e à composição das equipes nas unidades básicas de saúde.

ABSTRACT: Objective: To evaluate the perceived stress (PS) of professionals in Primary Health Care and its association with the characteristics of the teams in the Family Health Program (FHP). The association between PS and self-referred morbidity was also investigated. Methods: This is a cross-sectional study conducted with 450 employees from 60 teams in 12 Basic Health Units (BHUs) in a region of São Paulo. The differences in the total score in the Perceived Stress Scale were evaluated through multiple linear regression models. Results: Higher levels of PS were observed in those who had been working for one year or more in the same team, in the categories of doctors, nurses and community health workers, females, non-religious, and in BHU professionals in incomplete teams (absence of a physician). Lower perceived stress was found in widowers. It was observed that individuals with higher levels of PS have higher chances of reporting chronic health problems. Conclusion: It can be concluded that the perception of stress in this population is associated with individual, professional factors, and the composition of teams in healthcare units.

[Impact of a lifestyle intervention program on metabolic, anthropometrical and dietary profile of Japanese-Brazilians with and without metabolic syndrome]. / Impacto de um programa de intervenção sobre o estilo de vida nos perfis metabólico, antropométrico e dietético em nipo-brasileiros com e sem síndrome metabólica.

OBJECTIVE: We evaluated the changes in biochemical and nutritional profiles of Japanese-Brazilians with and without metabolic syndrome after two years of participation in the intervention program. MATERIALS AND METHODS: It was a non-controlled experimental study. The biochemical and clinical assessments were conducted at baseline (2005), after a year (2006) and after two years (2007) of intervention. On the present study, data of 360 individuals, who participated on the three assessments were considered. RESULTS: Both groups presented improvements on the anthropometric and metabolic profile, after two years of intervention. It was observed reduction in the intake of total fat, saturated fat, and dietary cholesterol, and increased intake of fiber among men without metabolic syndrome. It was observed reduction in the intake of total fat (p = 0,003) and monounsaturated fatty acid (p = 0,002). CONCLUSION: The results showed a positive impact of the lifestyle intervention program in metabolic and nutritional profile of Japanese-Brazilians with and without metabolic syndrome.

Ambulatório de mindfulness e promoção da saúde: relato de experiência / Outpatient clinic of mindfulness and health promotion: experience report

O objetivo deste trabalho foi descrever a experiência e o perfil dos usuários do ambulatório de mindfulness e promoção da saúde de uma universidade pública. O perfil dos participantes foi obtido a partir da aplicação de diferentes escalas psicométricas (BDI, SUBI, MAAS e EUROQOL 5 D), bem como informações sociodemográficas e de saúde. A descrição da experiência do ambulatório foi realizada a partir da técnica SWOT. Nesta amostra, o perfil encontrado foi predominantemente feminino, com plano de saúde e assistência médica regular. Apesar dos problemas relatados, a percepção subjetiva de qualidade de vida ficou acima da média. Pertencer a uma universidade pública, contar com equipe multiprofissional e facilitadores de distintas formações em mindfulness, além de local de fácil acesso, são pontos fortes deste ambulatório, bem como a alta prevalência de ansiedade e depressão, que podem oportunizar a expansão desta atividade.(AU)

The aim of this study was to describe the experience and the profile of users of an outpatient clinic of Mindfulness and health promotion from a public University in Brazil. The profile of the participants was obtained from the application of different psychometric scales (BDI, SUBI, MAAS and EUROQOL 5 D), as well as socio­demographic and health information. The description of the experience of the clinic was held from the SWOT technique. In this sample, the profile found was predominantly female, with health insurance and medical care. Despite the problems reported, the subjective perception of quality of life was above average. Belong to a public University, rely on multidisciplinary team and facilitators of different configurations in mindfulness, plus easily accessible location are strengths of this clinic, as well as the high prevalence of anxiety and depression, which can enhance the expansion of this activity.(AU)

Avaliação das condições higienicossanitárias no preparo de refeições por caminhoneiros

O presente projeto de pesquisa teve como objetivo avaliar as condições higienicossanitárias, no preparo de refeições por caminhoneiros e o seu conhecimento sobre higiene dos alimentos. Este estudo, de delineamento transversal, foi realizado com cinqüenta caminhoneiros que passaram pelo Sistema Ecovias, na região de São Bernardo do Campo, no período de março à junho de 2012. A coleta de dados foi realizada a partir de um questionário sócio demográfico e de conhecimento higienicossanitário e checklist baseado na Resolução RDC-216 de 15 de setembro de 2004 e Portaria CVS 6 de 10 de março de 1999. De acordo com os resultados encontrados, utilizando a análise estatística de qui-quadrado e análise de variância, a maioria dos caminhoneiros encontrava-se em sobrepeso e obesidade (84%). Neste grupo encontravam-se aqueles que ficavam fora de casa viajando por mais tempo, dormiam menos horas por dia e eram mais jovens. A avaliação da concepção higienicossanitária dos entrevistados encontrou-se não satisfatória, com 28% de não conformidade, em relação à higienização de utensílios e equipamentos, e ao armazenamento de alimentos perecíveis no veículo. Dentre os itens avaliados pelo checklist do caminhão, o armazenamento de alimentos refrigerados, uso de utensílios no preparo de refeições, e ausência de pragas urbanas apresentaram não conformidades. A partir dos resultados foi elaborada para os caminhoneiros uma cartilha orientativa sobre preparação de refeições e alimentação como devolutiva. Estes achados revelam a necessidade de intervenção nutricional e educativa neste grupo a fim de melhorar o perfil nutricional e os conhecimentos e práticas de manipulação.

This research project aimed to evaluate the higienicossanitárias conditions, to prepare meals for truck drivers and their knowledge of food hygiene. This study, of a cross-sectional structure, was conducted with fifty truck drivers who underwent the Ecovias system in the region of São Bernardo do Campo, from March to June 2012. Data collection was conducted with a socio-demographic questionnaire and hygienic-sanitary knowledge and CheckList based on the RDC-216 Resolution, of September 15th, 2004 and CVS 6 Portary, of March 10th, 1999. According to the results found, using statistical analysis of Chi-square and analysis of variance, most truck drivers were overweight and obese (84%). ln this group there were those who were traveling away from home for longer, slept fewer hours per day and were younger. The evaluation of the interviewed's concenption on hygienic and sanitary knowledge was not satisfactory, with 28% of non-compliance in relation to the cleaning of utensils and equipment, and storage of perishable food in the vehicle. Among the items evaluated by the truck's CheckList, refrigerated food storage, use of utensils to prepare meals, and lack of urban pests showed noncompliance. From the results, a prime guidance was designed for truck drivers on preparing meals and eating as a return. These findings reveal the need for nutritional intervention and educational in this group in order to improve the nutritional profile, knowledge and food handling practices.

[Dietary intake and macrovascular disease in a Japanese-Brazilian population: a cross-sectional study]. / Consumo alimentar e doença macrovascular em nipo-brasileiros: um estudo transversal.

OBJECTIVE: To describe the food intake of Japanese-Brazilians with and without macrovascular disease (MVD). METHODS: MVD was defined, for 1,165 Japanese-Brazilians, by scores attributed to the health historical, electrocardiogram and ankle-brachial index values. The usual dietary intake was determined using a food frequency questionnaire. RESULTS: The MVD prevalence was of 3.2%, being similar among genders. Statistically higher frequencies of individuals with MVD were observed among those of first generation, with age > 60 years, tobacco user, with hypertension, hypertriglyceridemia and diabetes. Subjects with MVD were older, with smaller hip circumference, and higher systolic blood pressure levels, triglycerides and glycemia concentration; they informed higher consumption of iron source food and smaller of grains fibers. Statistically significant difference was found to saturated fat (crude analysis: second tercile versus first tercile). CONCLUSIONS: Programs of nutritional education should be stimulated in this group with high prevalence of non-communicable chronic diseases.

Impacto de estratégias de educação nutricional sobre variáveis antropométricas e conhecimento alimentar / Impact of nutritional education strategies on anthropometric variables and nutrition knowledge / Impacto de estrategias de educación nutricional sobre variables antropométricas y conocimiento alimentario

Avaliar o impacto de um programa de educação nutricional sobre o estadonutricional e conhecimento alimentar de pacientes com excesso de peso. Métodos: Estudo longitudinal, de natureza quantitativa, realizado entre setembro e outubro de 2012, com amostra constituída por 15 pacientes com excesso de peso (sobrepeso: Índice de Massa Corpórea (IMC)>25,0kg/m2 e <30kg/m2, e obesidade: IMC>30kg/m2), frequentadores de um grupo de educação alimentar em uma Unidade Básica de Saúde (UBS). A intervenção nutricional ocorreu em seis encontros semanais (M1: triagem geral e M2 a M7: 6 intervenções nutricionais), sendo aplicado um questionário para avaliar o conhecimento dos participantes sobre os assuntos a serem discutidos antes e após a intervenção. Antes do primeiro encontro e na última intervenção, foram aferidos peso, altura e perímetro de cintura. Realizou-se teste não paramétrico de Wilcoxon, com nível de significância de 5%, para analisar a média do número de acertos nas questões e na evolução nutricional. Resultados: Após a estratégia de educação nutricional, houve uma redução média de 1,51kg do peso inicial; o valor médio de IMC passou de 37,41lg/m² para 36,85lg/m²; o perímetro de cintura apresentou redução média de 5,6cm; além do aumento no número de acertos dos questionários. Conclusão: A estratégia de educação nutricional parece ter influenciado na boa evolução do estado nutricional dos participantes, propiciando redução de medidas antropométricas e ampliando os conhecimentos sobre alimentação saudável...

To assess the impact of a nutrition education program on the nutritional status and food knowledge of patients with overweight. Methods: A longitudinal quantitative study, performed between September and October 2012, with sample consisting of 15 patients with excessive weight (overweight: Body Mass Index or BMI between 25kg/m2 and 29,9kg/m2; and obesity: above 30kg/m2), enrolled in a group of food education in a Primary Healthcare Unit. Nutritional intervention occurred in six weekly meetings (M1: general screening; and M7 to M2: 6 nutritional interventions), being applied a questionnaire assessing the participants? knowledge on the subjects to be discussed before and after the intervention. Prior to the first meeting and in the last intervention, measures of weight, height and waist circumference were obtained. Nonparametric Wilcoxon tests were performed, with a significance level of 5%, to analyze the average number of correct answers and the nutritional outcome. Results: Following the nutritional education strategy, there was an average reduction of 1.51kg in relation to the initial weight; the average BMI increased from 37.41kg/m² to 36.85kg/m²; waist circumference showed mean reduction of 5.6cm; and the number of correct answers in the questionnaires increased. Conclusion: The nutritional education strategy seems to have influenced the good evolution of the participants? nutritional status, leading to a decrease in the anthropometric measures and increasing knowledge about healthy eating...

Evaluar el impacto de un programa de educación nutricional sobre el estado nutricional y conocimiento alimentario de pacientes con exceso de peso. Métodos: Estudio longitudinal de naturaleza cuantitativa realizado entre septiembre y octubre de 2012 con una muestra de 15 pacientes con exceso de peso (sobrepeso: Índice de Masa Corpórea (IMC)>25,0kg/m2 y <30kg/ m2, y obesidad: IMC>30kg/m2), frecuentadores de un grupo de educación alimentaria en una Unidad Básica de Salud (UBS). La intervención nutricional se dio en seis encuentros semanales (M1: selección general y M2 a M7: 6 intervenciones nutricionales), com la aplicación de un cuestionario para evaluar el conocimiento de los participantes sobre los asuntos discutidos antes y después de la intervención. El peso, la altura y el perímetro de cintura fueron medidos antes del primer encuentro y en la última intervención. Se realizó el test no paramétrico de Wilcoxon con nivel de significancia de 5% para analizar la media del número de aciertos en las cuestiones y en la evolución nutricional. Resultados: Hubo una reducción media de 1,51kg del peso inicial; el valor médio del IMC cambió de 37,41lg/m² para 36,85lg/m²; el perímetro de cintura presentó reducción media de 5,6cm; además Del aumento del número de aciertos de los cuestionarios después de la estrategia de educación nutricional. Conclusión: La estratégia de educación nutricional parece haber influenciado en la buena evolución del estado nutricional de los participantes llevando a una reducción de medidas antropométricas y ampliando los conocimientos de alimentación saludable...

Impacto de um programa de intervenção sobre o estilo de vida nos perfis metabólico, antropométrico e dietético em nipo-brasileiros com e sem síndrome metabólica / Impact of a lifestyle intervention program on metabolic, anthropometrical and dietary profile of Japanese-Brazilians with and without metabolic syndrome

OBJETIVO: Avaliar as mudanças nos perfis metabólico e nutricional de nipo-brasileiros com e sem síndrome metabólica, após dois anos de participação em programa de intervenção. MATERIAIS E MÉTODOS: Trata-se de estudo experimental não controlado. A pesquisa incluiu três momentos de avaliação clínico-laboratorial: basal (2005), após o primeiro ano de intervenção (2006) e ao final do segundo ano (2007). Na presente análise, utilizaram-se informações de 360 indivíduos examinados nos três momentos. RESULTADOS: Ambos os grupos apresentaram melhora no perfil metabólico e antropométrico, após o segundo ano de intervenção. Observaram-se diminuição na ingestão de gorduras totais, ácidos graxos saturados, colesterol e aumento de fibras totais nos homens sem síndrome metabólica. No sexo feminino sem síndrome metabólica, observou-se redução de gordura total (p = 0,003) e ácido graxo monoinsaturado (p = 0,002). CONCLUSÃO: Os resultados encontrados mostraram impacto positivo do programa de intervenção nos perfis metabólico e nutricional dos nipo-brasileiros com e sem síndrome metabólica.

OBJECTIVE: We evaluated the changes in biochemical and nutritional profiles of Japanese-Brazilians with and without metabolic syndrome after two years of participation in the intervention program. MATERIALS AND METHODS: It was a non-controlled experimental study. The biochemical and clinical assessments were conducted at baseline (2005), after a year (2006) and after two years (2007) of intervention. On the present study, data of 360 individuals, who participated on the three assessments were considered. RESULTS: Both groups presented improvements on the anthropometric and metabolic profile, after two years of intervention. It was observed reduction in the intake of total fat, saturated fat, and dietary cholesterol, and increased intake of fiber among men without metabolic syndrome. It was observed reduction in the intake of total fat (p = 0,003) and monounsaturated fatty acid (p = 0,002). CONCLUSION: The results showed a positive impact of the lifestyle intervention program in metabolic and nutritional profile of Japanese-Brazilians with and without metabolic syndrome.

Desenvolvimento e pré-teste de um questionário de frequência alimentar para graduandos / Development and pretesting of a food frequency questionnaire for undergraduate students

Objetivo Desenvolver e aplicar em um projeto-piloto um questionário de frequência alimentar quantitativo de autopreenchimento destinado a graduandos da área da saúde. Métodos Trata-se de um estudo transversal realizado em 151 universitários de ambos os sexos, usuários do ambulatório de Nutrição do Corpo Discente da Universidade Federal de São Paulo, Brasil. O questionário inicial foi composto a partir dos alimentos e preparações informados no Registro Alimentar de Três Dias. As informações em medidas caseiras foram transformadas em gramas ou mililitros com o auxílio de tabelas, e os alimentos foram ordenados segundo a porcentagem de contribuição para o valor energético total informado. Foram selecionados 198 ali-mentos responsáveis por 95 por cento do consumo energético e agrupados em 77 itens alimentares de acordo com a similaridade nutricional. O tamanho das porções alimentares foi classificado conforme o valor do percentil 50 da distribuição dos pesos correspondentes às medidas caseiras referidas. Definiu-se como porção pequena, aquela cujo valor foi igual ou inferior ao percentil 25; como média, o percentil 50 e grande, o valor igual ou superior ao percentil 75. Resultados Após o pré-teste do questionário inicial, o questionário final resultou em uma lista com 89 alimentos, agrupados em 70 itens alimentares. As instruções para o autopreenchimento foram refeitas, objetivando-se um melhor preenchimento. Conclusão Após as modificações realizadas, o questionário de frequência alimentar quantitativo encontra-se pronto para o estudo de validação e calibração.

Objective The objective of this study was to develop and pretest a self-administered, quantitative food frequency questionnaire for undergraduate students of the health sciences. Methods This is a cross-sectional study with 151 undergraduate students of both genders from the Students' Healthcare Service of the Universidade Federal de São Paulo, Brazil. The first version of the food frequency questionnaire was based on the foods and preparations listed in the 3-day food records. Tables were used to convert cooking units into grams or milliliters and the foods were ranked according to their percentage contribution to the total calorie intake. The 198 foods responsible for 95 percent of the energy intake were selected and grouped into 77 food items according to nutritional resemblance. Serving size was classified according to the 50th percentile of the weight distribution corresponding to the cooking units. Serving size was defined as small (S) when £25th percentile; average (A) when equal to the 50th percentile and large (L) when ≥75th percentile. Results The pretest of the first version of the questionnaire resulted in a final version with a list of 89 foods, grouped into 70 food groups. The instructions for filling out the questionnaire were rewritten to get better answers from the students. Conclusion After these changes, the quantitative food frequency questionnaire is ready for the validation and calibration study.