Coverage and educational actions related to the national vitamin A supplementation program: a study in children from the state of Alagoas / Cobertura e ações educativas no âmbito do programa nacional de suplementação de vitamina A: estudo em crianças do estado de Alagoas

Abstract Objectives: To estimate the coverage of the National Vitamin A Supplementation Program (Programa Nacional de Suplementação de Vitamina A) in children from Alagoas, to identify factors associated with this coverage, and to analyze the adequacy of nutrition education actions. Methods: Household survey involving a representative probabilistic sample of children aged 6 to 59 months from Alagoas and their mothers (n = 509). Coverage was defined by the percentage of children with supplementation records in the last semester. The association between the independent variables (socioeconomic, demographic, and health) and the National Vitamin A Supplementation Program coverage was analyzed based on the prevalence ratio and its 95% CI. The mothers' knowledge of questions related to vitamin A was considered as an indicator of the adequacy of nutrition education actions. Results: Program coverage was 91.9% in children aged 6-11.9 months and 38.6% in children aged 12-59 months. In the adjusted analysis, the factors that were associated with greater coverage were: age between 6-11.9 months (PR = 2.50, 95% CI: 2.10-2.96), living in rural areas (PR = 1.45, 95% CI: 1.20-1.76) and living in a house with ≤ 4 rooms (PR = 1.33, 95% CI: 1.09-1.63). Only 26.1% of the mothers were able to mention some food source of vitamin A and only 19.2% were aware of the consequences of vitamin deficiency for health. Conclusions: The National Vitamin A Supplementation Program coverage is below the targets set by the Ministry of Health (except for children < 12 months). The factors associated with greater coverage indicate an adequate focus of the program. The nutrition education activities have not demonstrated satisfactory results. This information should guide actions to improve the program.

Resumo Objetivos Estimar a cobertura do Programa Nacional de Suplementação de Vitamina A em crianças de Alagoas, identificar fatores associados a essa cobertura e analisar a adequação das ações de educação nutricional. Métodos Inquérito domiciliar que envolveu amostra probabilística representativa das crianças de 6 a 59 meses de Alagoas e suas mães (n = 509). A cobertura foi definida pelo percentual de crianças com registro de suplementação no último semestre. A associação entre as variáveis independentes (socioeconômicas, demográficas e de saúde) e a cobertura do Programa Nacional de Suplementação de Vitamina A foi analisada com base na razão de prevalência e seu IC95%. O conhecimento das mães sobre questões relacionadas à vitamina A foi assumido como indicador da adequação das ações de educação nutricional. Resultados A cobertura do programa foi de 91,9% entre crianças de 6-11,9 meses e de 38,6% entre as de 12-59 meses. Na análise ajustada, os fatores que se associaram à maior cobertura foram ter idade entre 6-11,9 meses (RP = 2,50; IC95%: 2,10-2,96), residir em zona rural (RP = 1,45; IC95%: 1,20-1,76) e morar em domicílio com ≤ 4 cômodos (RP = 1,33; IC95%: 1,09-1,63). Somente 26,1% das mães souberam citar algum alimento fonte de vitamina A e apenas 19,2% conheciam as consequências da deficiência dessa vitamina para a saúde. Conclusões A cobertura do Programa Nacional de Suplementação de Vitamina A encontra-se aquém das metas estabelecidas pelo Ministério da Saúde (exceto para crianças < 12 meses). Os fatores associados à maior cobertura evidenciam adequada focalização do programa. As atividades de educação nutricional não ocorrem de forma satisfatória. Essas informações devem nortear ações de aperfeiçoamento do programa.

Protective Effect of Breastfeeding against Overweight Can Be Detected as Early as the Second Year of Life: A Study of Children from One of the Most Socially-deprived Areas of Brazil.

Millions of children live in Brazil’s semi-arid region, one of the most socially-deprived areas of the country, where undernutrition co-exists with obesity as a consequence of the nutrition transition. There is evidence that childhood obesity predisposes adult obesity and, thus, that obesity should be prevented as early as possible. Some studies have shown that breastfeeding is a protective factor against overweight and obesity while other studies have not found this association. There have been few studies on this association in developing countries and of children below two years of age. The present study aimed to investigate whether children exposed to exclusive breastfeeding for ≥6 months showed a lower prevalence of overweight in the second year of life, based on a probability sample of 2,209 children (aged 12 to 24 months). The dependent variable was overweight, defined as weight-for-length z-scores of >2, based on the WHO 2006 standard while the independent variable was exclusive breastfeeding (≥6 months). The prevalence ratio (PR) and its 95% CI were estimated using Poisson regression with robust adjustment of variance. After adjusting for potential confounding factors (socioeconomic, demographic and health-related variables), children on exclusive breastfeeding for ≥6 months showed a lower prevalence of overweight (5.7% vs 9.1%, PR 0.62, 95% CI 0.45-0.89). It was found that exclusive breastfeeding for six months or more is a protective factor against overweight in children in the second year of life living in the Brazilian semi-arid region.

Short stature and food habits as determining factors for the low productivity of sugarcane labourers in the State of Alagoas, north-eastern Brazil

Undernutrition, especially in the prenatal period and/or until 5 years of age, can cause stunting. Adults with short stature resultant from this process show a series of functional deficits. amongst which is a reduced capacity to do physical work. The aim of this investigationwas to evaluare the dietary pattern, nutritional status and stature of sugarcane cutters, and to determine possible associations with worker productivity. Sixty-two male sugarcane cutters (18-50 y) were selected randomly from a population of 600 workers from a plantation in Alagoas (Brazil), and classified as underweight, normal weight or overweight according to BMI (BMI =21.5, 21.5 to = 25 and >25 kg/m², respectively). Body fat composition (percent) was estimated by electrical biompedance and dietary intake by the direct weighing of food consumed. Whilist the average productivity was 8.13 ton/day,m labourers with normal BMI values were more productive (9.12 ton/day) and ingested significantly (p<0.05) greater amounts of energy (16506.4 kJ/dia) than their underweight (7.48 ± 1.5; 12380.7 ± 4184.1) or overweight (9.12 ± 1.5; 16506.4 ± 6360.0) counterparts, respectively. There were associations (p<0.05) between productivity, stature, energy intake and age. The tallest individuals (= 170 cm) had higher productivity and tended to have a higher energy intake, whilst those with the shortest stature (= 160 cm), had a significantly lower productivity, however ingested a similar quantity of energy, nd tented to have a large accumulation of body fat. Multiple regression analysis indetified stature as the parameter most associated with productivity, independent of age and body fat percentage. Productivity of the tallest individuals. The results emphasise the importance of good nutritional status throughghout life for full development of working productivity

The use of protein hydrolysate improves the protein intestinal absorption in undernourished mice infected with Schistosoma mansoni

Patients residing in endemic areas for schistosomiasis in Brazil are usually undernourished and when they develop the hepatosplenic clinical form of the disease should usually receive hospital care, many of them being in need of nutritional rehabilitation before specific treatment can be undertaken. In the mouse model, investigations carried out in our laboratory detected a reduced aminoacid uptake in undernourished animals which is aggravated by a superimposed infection with Schistosoma mansoni. However, in well-nourished infected mice no dysfunction occurs. In this study, we tried to improve the absorptive intestinal performance of undernourished mice infected with S. mansoni by feeding them with hydrolysed casein instead of whole casein. The values obtained for the coefficient of protein intestinal absorption (cpia) among well-nourished mice were above 90 percent (either hydrolysed or whole protein). In undernourished infected mice, however, the cpia improved significantly after feeding them with hydrolysed casein, animals reaching values close to those obtained in well-nourished infected mice