Changes in food behavior during the first lockdown of COVID-19 pandemic: A multi-country study about changes in eating habits, motivations, and food-related behaviors.

The COVID-19 pandemic resulted in severe, unprecedented changes affecting the world population. Restrictions in mobility, social distancing measures, and the persistent social alarm, during the first period of pandemic, resulted in dramatic lifestyle changes and affected physical and psychological wellbeing on a global scale. An international research team was constituted to develop a study involving different countries about eating motivations, dietary habits and behaviors related with food intake, acquisition, and preparation. This study presents results of an online survey, carried out during the first lockdown, in 2020, assessing food-related behavior and how people perceived them to change, comparatively to the period preceding the COVID-19 outbreak. A total of 3332 responses, collected from 16 countries, were considered for analysis [72.8% in Europe, 12.8% in Africa, 2.2% in North America (USA) and 12.2% in South America]. Results suggest that the main motivations perceived to drive food intake were familiarity and liking. Two clusters were identified, based on food intake frequency, which were classified as "healthier" and "unhealthier". The former was constituted by individuals with higher scholarity level, to whom intake was more motivated by health, natural concerns, and weight control, and less by liking, pleasure or affect regulation. The second cluster was constituted by individuals with a higher proportion of male and intake more influenced by affect-related motivations. During this period, a generalized lower concern with the convenience attributes of foods was noted (namely, choice of processed products and fast-food meals), alongside an increase in time and efforts dedicated to home cooking. Understanding the main changes and their underlying motivations in a time of unprecedented crisis is of major importance, as it provides the scientific support that allows one to anticipate the implications for the future of the global food and nutrition system and, consequently, to take the appropriate action.

School lunch nutritional adequacy: what is served, consumed and wasted.

OBJECTIVE: To determine nutritional adequacy of school lunch and to assess the impact of food waste on nutrient intake of primary schoolchildren. DESIGN: The weighing method was used for evaluating initial servings and plate waste for lunch. Energy and nutritional contents of meals served, consumed and wasted were estimated using the software Food Processor Plus. The mean nutritional value of food served and consumed was compared with dietary guidelines. SETTING: Portuguese public primary schools in the city of Porto. PARTICIPANTS: All 525 fourth-grade children, aged from 9 to 10 years old, attending to twenty-one public primary schools. RESULTS: Overall, school lunches served did not meet the dietary guidelines for energy and nutrients, as only 12·5 % of the evaluated meals were adequate for energy, 33·5 % for proteins, 11·9 % for carbohydrates and 57·1 % for lipids. The majority of meals served were below the age-specific lower limit, namely for energy (83·7 %) and carbohydrates (86·8 %). The only exception, also unbalanced, was observed for proteins, as 42·4 % of lunches served exceeded the recommended upper limit. Furthermore, lunches served and consumed by children did not meet the dietary guidelines for fibre and for the micronutrients evaluated. Children wasted 26 % of the energy content provided in lunches, corresponding to 91·5 kcal, 25 % of proteins and 29 % of carbohydrates supplied. CONCLUSIONS: The lunches served and consumed by children at school canteens failed to meet nutritional standards. These results are not only a consequence of inadequate food portions served but also a result of the high plate waste values observed.

Strategies to reduce plate waste in primary schools - experimental evaluation.

OBJECTIVE: To determine and compare the effect of two interventions in reducing the plate waste of school lunches. DESIGN: A between-group analysis was conducted among children from three primary schools: (i) a group receiving intervention A, designed for children and focusing on nutrition education and food waste; (ii) a group receiving intervention B, intended for teachers and focusing on the causes and consequences of food waste; and (iii) a control group with no intervention. For each child, physical weighing of individual meals and leftovers was performed on three non-consecutive weeks at baseline (T0), 1 week (T1, short term) and 3 months (T2, medium term) following the intervention. Plate waste was recorded for a total of 1742 lunches during 14 d over eight different menus. SETTING: Portuguese public primary schools in the city of Porto. SUBJECTS: All fourth-grade children (n 212) attending the three preselected schools. RESULTS: After intervention A focusing on nutrition education designed for children, a decrease in soup waste was observed compared with the control group. The effect was greater at T1 (-11·9 (se 2·8) %; P<0·001) than at T2 (-5·8 (se 4·4) %; P=0·103). The plate waste of identical main dishes decreased strongly at T1 (-33·9 (se 4·8) %; P<0·001). However, this effect was not found at T2 (-13·7 (se 3·2) %; P<0·001). After intervention B involving teachers, plate waste decreased at T2 (-5·5 (se 1·9) % for soup; -5·4 (se 2·4) % for identical main dishes). CONCLUSIONS: Nutrition education designed for children was more effective in the short than the medium term. Thus, this kind of intervention was not effective in reducing food waste in the medium term. In contrast, an intervention focusing on teachers revealed better results in the medium term than in the short term.

System of planning and evaluation of school meals.

OBJECTIVE: To develop a software to plan and evaluate school meals according to the main national and international standards for foods and nutrition. DESIGN: Development of software. SETTING: Public schools, Portugal. SUBJECTS: School meals for students. RESULTS: The System of Planning and Evaluation of School Meals (SPARE) is a software that allows the planning of school meals in an effective and organized way, according to the main national and international standards for food and nutrition. The regular use of this tool enables the evaluation, monitoring and verification towards continuous improvement of the quality of school meals. CONCLUSIONS: The SPARE software aims to promote healthy eating by focusing on the planning and production of safe and adequate meals in the school environment. This software can be adapted to different age groups and to different contexts, attending to specific nutritional and food standards.

Adherence to the Mediterranean Food Pattern and Carbon Footprint of Food Intake by Employees of a University Setting in Portugal.

BACKGROUND: The Mediterranean diet is characterized by the predominance of the consumption of fruit, vegetables, cereals, nuts, and pulses; consumption of olive oil as the main source of fat; regular but moderate consumption of win; moderate consumption of fish, dairy products, eggs, and white meats; and low consumption of red meat as well as sugar and sugary products. In addition to the reported health benefits, the Mediterranean diet has also been widely recognized as a sustainable food pattern. The objective of this study was to understand the relationship between the degree of adherence to the Mediterranean diet of employees of the University of Porto and the relationship with the carbon footprint of their food consumption. METHODS: An observational, analytical study was carried out, through the analysis of food consumption data collected in the form of a survey in the previous 24 h inserted in the eAT24 software, as well as the analysis of sociodemographic, lifestyle, and health data collected in the questionnaire. The carbon footprint was calculated from the previous 24 h surveys using data available on a website, obtained in carbon dioxide equivalent per kilogram of food. Sociodemographic, eating habit, and lifestyle questions were selected to understand the relationship between these and adherence to the Mediterranean diet and the carbon footprint of food consumption. RESULTS: In total, 13.2% of the participants had a Mediterranean diet score equal to or greater than six, and the sample had an average food intake carbon footprint of 8146 ± 3081 CO2eq/Kg of food. A weak, statistically significant positive correlation (r = 0.142, p = 0.006) was observed between Mediterranean diet adherence and the carbon footprint of food intake. CONCLUSIONS: Most of the participants had a low adherence to the Mediterranean diet, as well as a high carbon footprint of food intake when compared to other countries. People with higher scores for Mediterranean diet adherence have, on average, a higher carbon footprint from food consumption intake.

Consumer Perception and Acceptability of Lupin-Derived Products: A Systematic Review.

The addition of lupin into other foods can enhance their nutritional value and may be an acceptable approach to introducing lupin into the food supply, particularly as an ingredient. Lupin could be used in many food products (bakery products, pasta, beverages, meat products and dairy products) to improve their protein content and possible nutraceutical effects. The main aim of this study is to summarise the recent formulation trends with lupin as an ingredient of new food products based on consumer perception and acceptability. The present systematic literature review was conducted through the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The eligibility criteria for the articles to be considered were: (a) the manufacturing of a food product with lupin as a formulation ingredient; (b) the food product developed was tested by a sensorial panel. A total of 33 studies filled the inclusion criteria and were incorporated into the qualitative synthesis. The sensory analysis of each product was notoriously different based on the jury evaluators and measurement scales used but revealed high acceptability rates for possible future consumers. The high protein and fibre contents of lupin were the most cited reason associated with the importance of nutrient-rich food products for consumers. More research on foods with high nutrition profiles and well-established sustainability parameters is crucial to promote healthier food environments.

Food safety knowledge and climate in the university canteens of three European countries.

The association of food safety knowledge and climate with gender, education level, length of employment, food safety training, and professional role was measured using a 15-item food safety climate survey and a 20-item food safety questionnaire on a sample of 263 employees from 19 small and medium-sized university canteens in Croatia, Hungary, and Portugal. The relationship between knowledge and climate and the demographic determinants of both variables were examined. Food safety knowledge was inadequate (45.5% of correct responses), while perceptions of food safety, as measured by the food safety climate survey, were positive (2.69 out of a maximum of 3.00). The perception of resources in canteens was the least favorable across all countries. Leaders did not exhibit better food safety knowledge or perceptions. Food safety climate and knowledge were significantly positively correlated and influenced by training. Perceptions of food safety compared to employee knowledge levels indicated that some employees were overly optimistic about food safety risks. Therefore, food safety knowledge and food safety climate should be assessed in parallel, and both could be improved through ongoing training of employees, especially leaders.

Sustainability Dimensions of the Mediterranean Diet: A Systematic Review of the Indicators Used and Its Results.

The concern about sustainability is growing and the Mediterranean diet has been extensively identified as a promising model, with benefits for human and environmental health. This systematic review aims to identify and describe the indicators that have been used to evaluate the sustainability of the Mediterranean diet and the results from their application. A methodology using PRISMA guidelines was followed, and searches were performed in Web of Science, PubMed, Scopus, and GreenFile. A total of 32 studies assessing the sustainability of the Mediterranean diet were identified. Twenty-five of these studies quantified the environmental impact, 7 studies evaluated the nutritional quality, and 12 studies assessed the daily cost of this dietary pattern. A total of 33 distinct indicators were identified, of which 10 were used to assess the environmental dimension (mainly, carbon, water, and ecological footprint), 8 were used to assess the nutritional dimension (mainly Health score and Nutrient Rich Food Index), 1 was used to assess the economic dimension (dietary cost), and 8 used combined indicators. The remaining 6 indicators for the assessment of sociocultural dimension were only identified in 1 study but were not measured. The Mediterranean diet had a lower environmental impact than Western diets and showed a carbon footprint between 0.9 and 6.88 kg CO2/d per capita, a water footprint between 600 and 5280 m3/d per capita, and an ecological footprint between 2.8 and 53.42 m2/d per capita. With regard to the nutritional dimension, the Mediterranean diet had a high nutritional quality and obtained 122 points on the Health score and ranged between 12.95 and 90.6 points on the Nutrient Rich Food Index. The cost of the Mediterranean diet is similar to other diets and varied between 3.33 and 14.42€/d per capita. These findings show that no uniformity in assessing the MDiet's sustainability exists.

Food Consumption Determinants and Barriers for Healthy Eating at the Workplace-A University Setting.

BACKGROUND: A wide variety of social, cultural and economic factors may influence dietary patterns. This work aims to identify the main determinants of food consumption and barriers for healthy eating at the workplace, in a university setting. METHODS: A cross-sectional observational study was conducted with 533 participants. Data were obtained through the application of a self-administered questionnaire that included socio-demographic information, food consumption determinants and the main perceived barriers for healthy eating at the workplace. RESULTS: The respondents identified "price" (22.5%), "meal quality" (20.7%), and "location/distance" (16.5%). For women, the determinant "availability of healthy food options" was more important than for men (p < 0.001). The food consumption determinants at the workplace most referred to by respondents were related to the nutritional value. Smell, taste, appearance and texture, and good value for money, were also considered important for choosing food at the workplace. Respondents referred to work commitments and lack of time as the main barriers for healthy eating at the workplace. CONCLUSIONS: Identification of determinants involved in food consumption, and the barriers for healthy eating, may contribute to a better definition of health promotion initiatives at the workplace aiming to improve nutritional intake.

Well-Being at Work: A Cross-Sectional Study on the Portuguese Nutritionists.

This exploratory, nationwide cross-sectional study was performed to investigate the well-being of Portuguese nutritionists, in addition to outlining their professional and demographic profile. Descriptive analyses were carried out to determine the measures relating to centralising tendency and dispersion of the sample. We compared means and proportions through t-tests and Analysis of Variance (ANOVA). The sample size was 206 individuals, respecting a minimum of eight respondents per item to validate the instrument. We recruited Nutritionists from Portugal nationwide using the list of electronic mail provided by the Order of Nutritionists. We sent an electronic mail to all the Nutritionists registered in this Order. We also used messaging applications and social networks (Instagram, Facebook) to reach Nutritionists who were not accessing electronic mail. Most respondents are women (92.5%), young (mean age = 31.4 ± 8.07 years; 54.2% of participants aging under 30 years), single, and with no children. More than half are Catholic (73.8%) and have less than ten years of nutritionist undergraduate completion (55.4%). The only variable that influences well-being at work is the economic variable Household Monthly Income. Those who earn less than €500.00 per month perceive themselves at a lesser state of work well-being than those who earn from €2501.00 to €5000.00 per month.

KIMEHS-Proposal of an Index for Qualitative Evaluation of Children's Menus-A Pilot Study.

Considering the importance of the food environments for health promotion, and the lack of simple, easy to use, low-cost measures of the quality of meals, the authors developed a qualitative menu index (KIMEHS-Kids' Menu Healthy Score), tailored to children's menu evaluation. Development of the tool was based on the Mediterranean food pattern. It includes 18 components, divided into seven main groups that reflect key aspects of menu quality, including protein source, side dishes, vegetables, dessert and beverages, and also allergens and nutritional information. The index was analysed for content and construct validity, as well as inter-rater reliability, and was applied to a sample of menus from restaurants in shopping centres in the Lisbon region. Possible index point ranges from -17 to 17, with a higher score indicating greater compliance with the recommendations. A value of 5.5 is obtained if all KIMEHS items are available, considering healthy and non-healthy options. The inter-rater reliability was assessed and values above 0.80 were obtained for Alpha Cronbach, as well as agreement % rate >75%. Agreement percentage is above 75% for all the components. Evaluated restaurants scored from -14 to 7, with an average KIMEHS of -6.15. Only four restaurants scored positive values, ranging from 0.25 to 7. KIMEHS was considered to be an adequate index to evaluate children's menus, from the menu information displayed on restaurant websites and/or on restaurant displays or table menus. It is a simple, low-cost tool that may be used as a reference for health professionals as an objective measure to evaluate the food environment. Stakeholders could also be involved in their own assessment to help educate consumers about healthy food choices, strengthening the efforts to promote an adequate food pattern and health, contributing to the fight against obesity.

Factors influencing food waste during lunch of fourth-grade school children.

This study aims to explore the factors that influence plate waste at lunches served in primary schools. Data was collected for all fourth-grade children attending 21 primary schools from the city of Porto (Portugal) (n = 463). Plate waste was evaluated by the weighing method and factors influencing plate waste were collected by observation of menu and canteen characteristics and through the application of a questionnaire to children aiming to evaluate factors related to preferences and dietary patterns. Logistic regression was performed to identify predictors of plate waste. It was observed that fish menus and composed dishes showed a higher tendency for increased plate waste. However, this effect was not observed when adjusted for other variables. Soups without pulses and blended soups were less likely to be discarded by children. The presence of the teacher during meals and the possibility for children to leave the canteen whenever they wish, protected both the main dish and the soup from being wasted. A higher number of children in the canteen was associated with increased soup waste. As expected, children more pleased with the sensory characteristics of the main dish and soup were less likely to waste food. Children who consumed high-saturated fat content mid-morning snacks were more likely to waste soup. The main factors associated with plate waste were related to the presence of teachers during the mealtime, school meal policies and the meals' sensory characteristics. Additionally, soup waste was determined by its composition, mid-morning snacks and the number of children in the canteen.

Wellbeing at Work before and during the SARS-COV-2 Pandemic: A Brazilian Nationwide Study among Dietitians.

This study aimed to evaluate the perceptions of dietitians' wellbeing at work before and during the SARS-COV-2 pandemic in Brazil. This cross-sectional study was performed using a previously validated instrument to investigate the wellbeing of dietitians at work in Brazil. The questionnaire on the wellbeing of dietitians was composed of 25 items (with a 5-point scale), characteristics, and questions about the SARS-COV-2 period. The application was carried out with GoogleForms® tool from 26 May to 7 June 2020. The weblink to access the research was sent via email, messaging apps, and social networks. Volunteers were recruited nationwide with the help of the Brazilian Dietitians Councils, support groups, as well as media outreach to reach as many dietitians as possible. Volunteers received, along with the research link, the invitation to participate, as well as the consent form. A representative sample of 1359 dietitians from all the Brazilian regions answered the questionnaire-mostly female (92.5%), Catholic (52.9%), from 25 to 39 years old (58.4%), with a partner (63.8%), and with no children (58%). Most of the participants continue working during the pandemic period (83.8%), but they did not have SARS-COV-2 (96%), nor did their family members (80.7%). The wellbeing at work before SARS-COV-2 was 3.88 ± 0.71, statistically different (p < 0.05) from during the pandemic, with the wellbeing of 3.71 ± 0.78. Wellbeing at work was higher before the pandemic for all the analyzed variables. Analyzing variables separately before and during the pandemic, dietitians with partners, children and a Ph.D. presented higher scores for wellbeing at work. Professionals receiving more than five times the minimum wage have higher scores. During the pandemic, better wellbeing was observed for dietitians working remotely.

Quality of children's menus in malls in Brazil / Qualidade dos menus infantis em shoppings centers do Brasil

Abstract Objectives: characterize the availability and assess the nutritional quality of children's menus ofered in regular and fast food restaurants in Brazilian malls. Methods: this is an observational and cross-sectional study. Data were collected on the websites of each restaurant and in food sales applications, with a questionnaire consisting of two sections: characterization of the restaurant and characterization of the children's menu. Data collection took place in ten capitals in the fve regions of Brazil. Results: 116 children's menus were evaluated. The study identifed a higher number of regular (n=70, 60%) than fast-food (n=46,40%) restaurants. The cooking methods most used in the main dishes were grilled (n=236, 64%) and boiled (n=74, 20%), and in the side dishes were boiled (n=204, 53%) and fried (n=109, 28%). Only 40% (n=46) of the menus contained vegetables. Less than 10% (n=seven) ofered fruit as dessert, 31% (n = 36) had drinks included in the children's menu and 22% (n=25) ofered gifts associated with the menu. Only 32 (28%) restaurants had the combination of beans and rice. Conclusion: most of the options ofered to children were of low nutritional quality, with low ofer of vegetables, fruits and the traditional beans and rice. The beverages included in the menus, most of them sugary, can contribute to a high-energy intake. There is a need to provide healthy options and encourage these choices.

Resumo Objetivos: caracterizar a disponibilidade e a qualidade nutricional dos menus infantis nos restaurantes e estabelecimentos de fast-foods em Shoppings Centers no Brasil. Métodos: trata-se de um estudo observacional e transversal. Os dados foram coletados nos websites de cada estabelecimento e em aplicativos de vendas de alimentos, com questionário composto por duas seções: Caracterização do estabelecimento e caracterização do menu infantil. A coleta dos dados ocorreu em dez capitais distribuídas nas cinco regiões do Brasil. Resultados: foram avaliados 116 menus infantis. Maior número de estabelecimentos foi classifcado como restaurante do que fast-food. Os métodos de cocção mais utilizados nos pratos principais foram grelhados (n=236, 64%) e cozidos (n=74, 20%), e nos acompanhamentos foram cozidos (n=204, 53%) e fritos (n=109, 28%). Apenas 40% (n=46) dos menus continham hortaliças. Menos de 10% (n=sete) ofertavam fruta como sobremesa; 31% (n=36) constavam bebida inclusa no menu infantil; 22% (n=25) ofereciam brindes associados ao menu. Apenas 32 (28%) estabelecimentos apresentavam a combinação feijão e arroz. Conclusão: a maioria das opções ofertadas às crianças era de baixa qualidade nutricional, com pouca oferta de hortaliças, frutas e do tradicional feijão e arroz. As bebidas incluídas nos menus, a maioria açucaradas, podem contribuir para uma elevada ingestão energética. Constata-se a necessidade de disponibilizar opções saudáveis e incentivar essas escolhas.

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

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

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

UNDERNUTRITION, SERUM VITAMIN B12, FOLIC ACID AND DEPRESSIVE SYMPTOMS IN OLDER ADULTS.

BACKGROUND: the question on whether undernutrition remains linked to depressive symptoms, considering the effect of deficiencies of vitamin B12 and folate, is of practical relevance because they are potentially preventable and treatable. This study aims to evaluate whether undernutrition is linked to depressive symptoms, considering the effect of vitamin B12 and folate plasma levels. METHOD: a cross-sectional study was conducted in a sample of 84 older adults living in care homes. Data about nutritional status using Mini-Nutritional Assessment, serum folic acid and Vitamin B12 levels, cognitive ability, functional dependency, symptoms and /or depressive behaviour was obtained. Depression symptoms were measured using the 20-item version of the Center for Epidemiologic Studies Depression scale. RESULTS: fifty three older adults were at depression risk (63.1%). Of those, 34% were at undernutrition risk. Although a high frequency of older adults with low plasma levels of vitamin B12 (42.9%) and lower levels of folic acid (5.9%) was found, no significant differences concerning the existence of depressive symptoms were found. In the multivariable analysis, an increase in depression risk was observed amongst participants nutritionally at risk OR = 3.47 (1.05-11.46), whereas having low levels of folic acid and Vitamins B12 were not associated with depression risk. CONCLUSION: amongst undernourished older adults, an increase in risk of depression was observed independently of folic acid and vitamin B12 status. These results highlight the need to implement preventive strategies, particularly directed at older adults living in care home.

Antecedentes: la cuestión del posible vínculo entre la desnutrición y los síntomas depresivos, considerando el efecto de las deficiencias de vitamina B12 y de folato, es de importancia práctica porque estas son potencialmente prevenibles y tratables. Este estudio tiene como objetivo evaluar si la desnutrición está relacionada con los síntomas depresivos, teniendo en cuenta el efecto de los niveles plasmáticos de vitamina B12 y de folato. Método: un estudio transversal se llevó a cabo en una muestra de 84 adultos mayores que viven en hogares de cuidado. Se obtuvieron datos sobre el estado nutricional utilizando Mini-Nutritional Assessment, los niveles séricos de ácido fólico y vitamina B12, la capacidad cognitiva, la dependencia funcional, y/o los síntomas de comportamiento depresivo. Los síntomas de depresión se midieron utilizando la versión de 20 ítems de la Escala de Depresión del Centro de Estudios Epidemiológicos. Resultados: cincuenta y tres adultos mayores estaban en riesgo de depresión (63,1%). De ellos, el 34% estaban en riesgo de desnutrición. Aunque se encontró una alta frecuencia de adultos mayores con bajos niveles plasmáticos de vitamina B12 (42,9%) y niveles más bajos de ácido fólico (5,9%), no se encontraron diferencias significativas en relación con la existencia de síntomas depresivos. En el análisis multivariable se observó un aumento en el riesgo de depresión entre los participantes con riesgo nutricional OR = 3,47 (1,05 a 11,46), mientras tener bajos niveles de ácido fólico y vitamina B12 no se asociaron con el riesgo de depresión. Conclusión: entre los adultos mayores desnutridos se observó un aumento en el riesgo de depresión, independientemente del ácido fólico y del estado de la vitamina B12. Estos resultados ponen de manifiesto la necesidad de implementar estrategias preventivas, especialmente dirigidas a los adultos mayores que viven en hogares de cuidado.

Determination of plate waste in primary school lunches by weighing and visual estimation methods: a validation study.

The aim of this study was to validate the visual estimation method for aggregated plate waste of main dish at Portuguese primary school canteens. For this purpose plate waste at school lunch was measured for 505 individual servings, using weighing individual servings and plate waste and visual estimation method by a 6-point scale, as developed by Comstock et al. (1981). A high variability of initial serving weights was found with serving sizes ranging from 88.9 to 283.3g and with a coefficient of variation ranging from 5.5% to 24.7%. Mean plate waste was 27.5% according to the weighing method. There was a significant bias in the conversion of the visual waste estimations to actual waste, being overestimated by an average of 8.0 g (ranging from -12.9 g to 41.4 g). According to Bland and Altman plot, the mean difference between methods was of 8.0 g and the amplitude interval was 102.6g. The study showed that the visual estimation method is not as accurate as the weighing method in assessing nonselective aggregated plate waste at primary school canteens. Our findings are thus very important on considering plate waste assessment, since the wide variation on initial servings introduces a relevant bias when considering standard portions or a random sample of initial servings. Although, greater convenience, time-saving and the possibility to monitor plate waste of large groups, make the visual estimation method an important method to assess plate waste at school canteens, these results highlighted the need of portions standardization and control of initial servings to allow for its use.

Salt reduction in vegetable soup does not affect saltiness intensity and liking in the elderly and children.

STUDY BACKGROUND: Reduction of added salt levels in soups is recommended. We evaluated the impact of a 30% reduction of usual added salt in vegetable soups on elderly and children's saltiness and liking evaluation. METHODS: Subjects were elderly and recruited from two public nursing homes (29 older adults, 79.7±8.9 years), and preschool children recruited from a public preschool (49 children, 4.5±1.3 years). This study took place in institutional lunchrooms. Through randomization and crossover, the subjects participated in two sensory evaluation sessions, on consecutive days, to assess perceived saltiness intensity (elderly sample) and liking (elderly and children samples) of a vegetable soup with baseline salt content and with a 30% salt reduction. Elderly rated perceived liking through a 10 cm visual analogue scale ['like extremely' (1) to 'dislike extremely' (10)] and children through a five-point facial scale ['dislike very much' (1) to 'like very much' (5)]. RESULTS: After 30% added salt reduction in vegetable soup, there were no significant differences in saltiness noted by the elderly (p=0.150), and in perceived liking by children (p=0.160) and elderly (p=0.860). CONCLUSIONS: A 30% salt reduction in vegetable soup may be achieved without compromising perceived saltiness and liking in children and the elderly.

Conhecimentos de manipuladores de alimentos sobre segurança dos alimentos e alergias / Knowledge of food handlers about food safety and allergies

As doenças de origem alimentar são uma causa importante de morbilidade e mortalidade e não se limitam apenas aos países em desenvolvimento. A manipulação incorreta de alimentos em unidades de alimentação é um dos principais fatores responsáveis pela transmissão de doenças de origem alimentar e envolve tradicionalmente contaminação cruzada entre alimentos crus e cozidos, confeção inadequada e armazenamento a temperaturas incorretas. Os restaurantes e unidades de alimentação representam ainda um potencial perigo para os consumidores com alergia alimentar. Diversos estudos identificaram falhas importantes nos conhecimentos dos manipuladores de alimentos sobre alergia alimentar. Neste estudo pretendeu-se avaliar os conhecimentos dos manipuladores de alimentos sobre segurança e alergia alimentar, em restaurantes e unidades de alimentação. O estudo envolveu 28 unidades de alimentação de diferentes setores de alimentação coletiva na cidade do Porto, Portugal. Em cada unidade, foram selecionados aleatoriamente 3 manipuladores de alimentos e foram realizadas entrevistas presenciais, recorrendo a um questionário estruturado e organizado em quatro secções: (i) características sociodemográficas, experiência profissional e formação em segurança alimentar; (ii) características da unidade de alimentação; (iii) conhecimentos em higiene e segurança alimentar; (iv) conhecimentos sobre alergias alimentares. A classificação global média obtida no questionário de avaliação de conhecimentos foi 74,7 ± 5,7. Fatores como o sexo, a idade, o nível de escolaridade e a existência de formação prévia não tiveram influência no nível de conhecimento dos participantes, ao contrário da experiência profissional, que teve um impacto significativo (p=0,011). Os manipuladores de estabelecimentos que disponibilizam refeições para consumidores com alergias alimentares (77,3 ± 11,5) apresentaram maior pontuação no grupo de questões sobre alergia alimentar do que aqueles que referiram não disponibilizar (69,3 ± 16,2) (p=0,028). Os manipuladores de alimentos apresentaram um nível razoável de conhecimento sobre manipulação segura de alimentos e alergia alimentar. No entanto, são necessários mais estudos para avaliar se os conhecimentos são efetivamente traduzidos em alteração positiva dos comportamentos.

Qualitative evaluation of the menu and plate waste in public day care centers in São Paulo city, Brazil / Avaliação qualitativa do cardápio e desperdício de alimentos em creches públicas do município de São Paulo

OBJECTIVE: This study assessed menu quality and plate waste in public day care centers of São Paulo (SP), Brazil. METHODS: This cross-sectional study collected data from the nurseries of seven day care centers, totaling 366 children aged 12 to 36 months. Each day care center was assessed for three days, totaling 42 days and 210 meals. Menu quality was assessed by the Qualitative Analysis of Menu Preparations method (Análise Qualitativa das Preparações do Cardápio), adapted for day care centers, which provides nutritional and sensory criteria. Food waste was determined by the Plate Waste-Ingestion Index. RESULTS: The supply of vegetables was inadequate in more than 90% of the days, and the amount of leafy vegetables and high-sulfur foods met the recommended amounts on 50% of the days. The supply of sweets and foods containing trans fatty acids was considerable. The Plate Waste-Ingestion Index for daycare centers varied from 25% to 43%, and the Plate Waste-Ingestion Index for food items varied from 11% to 47%. CONCLUSION: The preparations served and serving sizes clearly need to be reviewed, and new menu creation strategies are needed to control food waste.

OBJETIVO: Avaliar qualitativamente o cardápio e o desperdício de alimentos em creches públicas de São Paulo (SP). MÉTODOS: Este estudo é transversal e os dados foram coletados nos berçários de 7 creches, que atendiam 366 crianças entre 12 e 36 meses. Cada creche foi avaliada durante 3 dias, totalizando 42 dias e 210 refeições. A qualidade do cardápio foi avaliada segundo o método Análise Qualitativa das Preparações do Cardápio, adaptado à realidade de creches, que estabelece critérios nutricionais e sensoriais. Foi avaliado o desperdício de alimentos pelo Índice de Resto-Ingestão. RESULTADOS: Os resultados refletiram que a oferta de legumes e verduras foi insuficiente em mais de 90% dos dias e, a quantidade de folhosos e alimentos ricos em enxofre foi compatível com o recomendado em metade dos dias, sendo expressiva a oferta de doces e alimentos contendo ácidos graxos trans. O Índice de Resto - Ingestão variou de 25% a 43% nas creches e de 11% a 47% nos alimentos analisados. CONCLUSÃO: Evidencia-se a importância de revisão das preparações servidas e porcionamento dos alimentos, sendo necessária a adoção de novas estratégias na elaboração dos cardápios, visando o controle do desperdício alimentar.