Calcium and fat metabolic balance, and gastrointestinal tolerance in term infants fed milk-based formulas with and without palm olein and palm kernel oils: a randomized blinded crossover study.

BACKGROUND: Effects of palm olein (POL) on calcium and fat metabolic balance and gastrointestinal (GI) tolerance have been clinically evaluated but its use in combination with palm kernel oil (PKO), and canola oil has not been similarly assessed in infants. METHODS: Calcium and fat balance and GI tolerance were evaluated in 33 healthy term infants (age = 68-159 d) in a randomized, double-blinded, 14 d crossover trial at a day care center in Salvador, Brazil; followed by a 4d hospital ward metabolic balance study in 17 of the male subjects. The study compared two commercially available milk-based powdered formulas in Brazil; one containing POL (44% of total fat), PKO (21.7%) and canola oil (18.5%) as predominant fats (PALM), and the other containing none (NoPALM). Occasional human milk (HM) supplementation was allowed at home. RESULTS: Formula and HM intakes, and growth were not different (p > 0.05). Calcium absorption (%) for infants fed NoPALM (58.8 ± 16.7%; means ± SD) was higher (p = 0.023) than those fed PALM (42.1 ± 19.2%), but was not significant (p = 0.104) when calcium intake was used as a covariate. Calcium intake was higher (p < 0.001) in NoPALM versus PALM fed infants. However, calcium retention (%) was higher in infants fed NoPALM compared to PALM with (p = 0.024) or without (p = 0.015) calcium intake as a covariate. Fat absorption (%) for NoPALM was greater than PALM fed infants (NoPALM = 96.9 ± 1.2 > PALM = 95.1 ± 1.5; p = 0.020 in Study Period I). Mean rank stool consistency was softer in infants fed NoPALM versus PALM (p < 0.001; metabolic period). Adverse events, spit-up/vomit, fussiness and gassiness were not different (p > 0.05). Formula acceptability was high and comparable for both formula feedings, regardless of HM supplementation. CONCLUSIONS: Term infants fed PALM based formula (containing palm olein, palm kernel and canola oils) demonstrated lower calcium retention and fat absorption, and less softer stool consistency versus infants fed NoPALM based formula. Study suggested formula fat differences may affect GI function in infants.

Programa nacional de alimentação escolar: há segurança na produção de alimentos em escolas de Salvador (Bahia)? / National school food program: are the foods produced in the schools of Salvador (Bahia), Brazil, safe?

Objetivo Avaliar a segurança da produção de alimentos em escolas atendidas pelo Programa Nacional de Alimentação Escolar, em Salvador (BA). Métodos Realizou-se um estudo transversal, com aplicação de formulários elaborados com base na Resolução de Diretoria Colegiada nº 216/04 da Agência Nacional de Vigilância Sanitária/Ministério da Saúde, em amostra estratificada formada por 235 escolas atendidas pelo Programa Nacional de Alimentação Escolar, contemplando a rede estadual e municipal de ensino da cidade de Salvador. No formulário, os itens avaliados apresentavam pontuação diferenciada em função do grau de risco associado à segurança dos alimentos. De acordo com a pontuação obtida, as escolas foram classificadas em cinco grupos em relação à condição higiênico-sanitária: crítico; insatis-fatório; regular; bom e excelente. Resultados Na avaliação global de adequação, 57,0 por cento (134) das unidades apresentaram condições insatisfatórias, 42,6 por cento (100) regulares e 0,4 por cento (1) boa. Os itens que mais contribuíram para o baixo desempenho estão relacionados aos seguintes blocos: edificação, instalações, equipamentos, móveis e utensílios; higienização; abastecimento de água; manipuladores de alimentos; preparo dos alimentos e exposição do alimento preparado para consumo. Em condição intermediária de atendimento ficaram os blocos controle integrado de vetores e pragas urbanas, manejo de resíduos e matérias-primas, ingredientes e embalagens. Conclusão Verificou-se elevado nível de não conformidade quanto ao atendimento dos requisitos sanitários vigentes, o que evidencia falhas na segurança da produção da alimentação escolar. Os resultados indicam a necessidade de adoção de medidas corretivas com vistas a reduzir riscos à saúde das crianças assistidas e aumentar a eficiência do Programa Nacional de Alimentação Escolar, no município de Salvador (BA).

Objective The objective of this study was to assess if the foods prepared in the schools of Salvador, Bahia, that participate in the National School Food Program are safe. Methods A cross-sectional study was done through the administration of forms based on the Resolução de DiretoriaColegiada nº 216/04 of the National Sanitary Surveillance Agency/Ministry of Health to a stratified sample consisting of 235 schools serviced by National School Food Program, which included the state and municipal schools of Salvador. The items assessed by the form were scored according to their risk in terms of food safety. Based on their scores, the schools were then classified into five groups according to their level of hygiene and sanitation: critical, unsatisfactory, satisfactory, good and excellent. Results In the global adequacy assessment, 57 percent (134) of the schools presented unsatisfactory hygiene and sanitation levels, 42.6 percent (100) presented satisfactory levels and 0.4 percent (1) presented good levels. The items that contributed most for the poor performance of many schools were grouped in the following categories: building, facilities, equipment, furniture and appliances, hygiene, piped water supply, food handlers, food preparation and exposed ready-to-eat foods. The groups that had some influence on poor performance were associated with the control of urban vectors and pests, management of wastes and raw materials, ingredients and packages. Conclusion A high level of non-conformity with the current sanitation requirements was verified, evidencing that the preparation of school foods was not entirely safe. The results indicate that corrective measures are necessary to reduce health risks and increase the efficiency of National School Food Program in the city of Salvador.