ABSTRACT
ABSTRACT Objective: Assess adherence to school food offered by the School Food Program (Programa Nacional de Alimentação Escolar - PNAE) and the associated factors among Brazilian adolescents. Methods: Cross-sectional study with data from the Study of Cardiovascular Risks in Adolescents conducted in 2013-2014, with 58,707 adolescents aged 12 to 17 years-old who attended public schools. Logistic regression models were stratified by sex and the significance level of 5% was adopted for all analyses. Results: There was low adherence to school meals (17.2%). The chance of regular consumption of school meals was higher among male adolescents belonging to the medium (p<0.05) and the low (p<0.05) socioeconomic score categories. For females, the chance of regular consumption of food offered at school was higher among black-skinned, brown-skinned, indigenous-skinned or yellow-skinned adolescents (p<0.05), aged 16 and 17 (p<0.05), who worked (p<0.001) and belonged to the medium (p<0.05) and low (p<0.05) socioeconomic score categories. The regular purchase of food in school cafeterias reduced the chance of regular consumption of school meals for males (p<0.001) and females (p<0.001). Conclusions: Adherence to the food offered by the PNAE is far from ideal, and it is important to create public policies that encourage the consumption of school meals and improve adherence. In addition, the strengthening and drafting of regulations aimed at the sale of food in the interior and surrounding schools' areas is necessary.
RESUMEN Objetivo: Evaluar la adherencia a la comida escolar ofrecida por el Programa Nacional de Alimentación Escolar y los factores asociados entre los adolescentes brasileños. Métodos: Estudio transversal con datos del Estudio de Riesgos Cardiovasculares en Adolescentes realizado en 2013-2014, con 58.707 adolescentes de 12 a 17 años que asistieron a escuelas públicas. Los modelos de regresión logística se realizaron estratificados por sexo, y se aplicó el nivel de significancia del 5% para todos los análisis. Resultados: Hubo baja adherencia a las comidas escolares (17,2%). La posibilidad de consumo regular de comidas escolares fue mayor entre los adolescentes varones pertenecientes a las categorías de puntaje socioeconómico medio (p<0,05) y bajo (p<0,05). Para las mujeres, la probabilidad de consumo regular de alimentos ofrecidos en la escuela fue mayor entre las adolescentes de piel negra, marrón, indígena o amarilla (p<0,05), de 16 y 17 años (p<0,05), quién trabaja (p<0,001) y pertenece a las categorías de puntaje socioeconómico medio (p<0,05) y bajo (p<0,05). La compra regular de alimentos en las cafeterías escolares redujo la posibilidad de consumo regular de comidas escolares para hombres (p<0,001) y mujeres (p<0,001). Conclusiones: La adhesión a los alimentos ofrecidos por el PNAE está lejos de ser ideal, y es importante crear políticas públicas que fomenten el consumo de comidas escolares, mejoren su adherencia, además de ayudar en el fortalecimiento y la redacción de regulaciones dirigidas a la venta de alimentos en el interior y las áreas de las escuelas circundantes.
Subject(s)
Adolescent , School Feeding , Nutritional Sciences , Heart Disease Risk Factors , Schools , Adolescent , MealsABSTRACT
Abstract: Objective: To investigate the frequency distribution of daily meals and its relation to demographic, socioeconomic, behavioral, anthropometric and biochemical factors in children and adolescents. Methods: This was a cross-sectional study with a representative sample of 708 schoolchildren aged 7-14 years. Data on personal information, socioeconomic status, physical activity and number of meals were obtained through semi-structured questionnaire and consumption by 24-h recall and food record. Weight and height measurements were also performed to calculate the body mass index. Finally, blood samples were collected for analysis of total cholesterol, high- and low density lipoprotein, triglyceride, and glucose levels. Descriptive statistics, the Mann-Whitney test, and Poisson regression were used in statistical analysis. Results: Meal frequency <4 was associated in children, family income <3 Brazilian minimum wages (PR = 5.42; 95% CI: 1.29-22.77; p = 0.021) and adolescents, the number of sons in the family >2 (PR = 1.53; 95% CI: 1.11-2.11; p = 0.010). Even in the age group of 10-14 years, <4 meals was related to higher prevalence of body mass index (PR = 1.33; 95% CI: 1.02-1.74; p = 0.032) and low-density lipoprotein (PR = 1.39; 95% CI: 1.03-1.87; p = 0.030) higher after adjustments. Conclusion: Lower frequency of meals was related to lower income in children and adolescents, larger number of sons in the family, and increased values of body mass index and low-density lipoprotein.
Resumo: Objetivo: Investigar a distribuição da frequência de refeições diárias e sua relação com fatores demográficos, socioeconômicos, comportamentais, antropométricos e bioquímicos em crianças e adolescentes. Métodos: Estudo transversal feito com uma amostra representativa de 708 escolares 7 e 14 anos. Os dados sobre informações pessoais, nível socioeconômico, atividade física e número de refeições foram obtidos por meio de questionário semiestruturado e o consumo por meio de recordatório de 24 horas e registro alimentar. Medidas de peso e altura também foram feitas para cálculo do índice de massa corporal. Por fim, coletaram-se amostras de sangue para análises de colesterol total, lipoproteína de baixa e de alta densidade, triglicerídeos e glicemia. Análises descritivas, teste de Mann-Whitney e regressão de Poisson foram usados nas análises estatísticas. Resultados: Frequência de refeições < 4 se associou, em crianças, a renda familiar < 3 salários (RP = 5,42; IC 95%: 1,29-22,77; p = 0,021) e, em adolescentes, ao número de filhos na família > 2 (RP = 1,53; IC 95%: 1,11-2,11; p = 0,010). Ainda na faixa de 10 a 14 anos, < 4 refeições se relacionou a maior prevalência de índice de massa corporal (RP = 1,33; IC 95%: 1,02-1,74; p = 0,032) e lipoproteína de baixa densidade (RP = 1,39; IC 95%: 1,03-1,87; p = 0,030) elevados após ajustes. Conclusão: Menor frequência de refeições se associou a menor renda em crianças e em adolescentes a maior número de filhos na família e valores aumentados de índice de massa corporal e lipoproteína de baixa densidade.