Fatores maternos relacionados à alta frequência de consumo de sacarose por crianças acompanhadas por um programa de atenção odontológica materno-infantil nos dois primeiros anos de vida / Maternal factors related to the high frequency of sucrose intake by children followed-up by a maternal and child dental care program in the first two years of life

Objetivo: avaliar se os hábitos alimentares maternos relatados durante a gestação influenciam a ingestão de sacarose das crianças nos primeiros dois anos de vida. Sujeitos e método: participaram da pesquisa 204 díades mãe-filho acompanhadas por um programa de atenção odontológica materno-infantil em uma cidade no sul do Brasil. As variáveis independentes foram obtidas por meio dos prontuários odontológicos disponibilizados pelo programa. Os hábitos alimentares maternos foram coletados durante a gestação e a ingestão diária de sacarose pelas crianças foi baseada em um questionário alimentar de frequência, dicotomizado em < 4 vezes/ dia e ≥ 4 vezes/dia. A análise multivariada foi realizada com modelos de regressão de Poisson, com variância robusta para estimar a razão de prevalência e os intervalos de confiança de 95%. Resultados: a prevalência do consumo de sacarose nos primeiros dois anos de vida, com uma elevada ingestão de sacarose (≥ 4 vezes/dia), foi detectada em 90,69% das crianças. Após o ajuste, o desfecho (alta ingestão de sacarose) foi 10% maior para as crianças cujas mães relataram beber bebida açucarada para satisfazer sua sede durante a gestação [RP = 1,10 (IC95%: 1,02-1,18)]. Conclusões: a maioria das crianças apresentou alta ingestão de sacarose em idade precoce. A triagem de mulheres grávidas para consumo de bebidas açucaradas pode ser uma maneira possível de reconhecer crianças em risco futuro de alta ingestão de sacarose na primeira infância. (AU)

Objective: to assess whether maternal eating habits reported during pregnancy influence their children's sucrose intake in the first two years of life. Subjects and method: a total of 204 mother-child dyads followed-up by a maternal and child oral care program in southern Brazil participated in the study. The independent variables were obtained from dental records provided by the program. The maternal eating habits were collected during pregnancy and the daily sucrose intake of the children was based on a frequency food questionnaire dichotomized in <4 times/day and ≥4 times/day. The multivariate analysis was performed using Poisson regression models with robust variance to estimate the prevalence ratio and the 95% confidence intervals. Results: the prevalence of sucrose intake in the first two years of life was high. A high sucrose intake (≥4 times/ day) was detected in 90.69% of the children. After adjustment, the outcome (high sucrose intake) was 10% higher for children whose mothers reported drinking sugar-sweetened beverages to satisfy their thirst during pregnancy [PR = 1.10 (95%CI: 1.02-1.18)]. Conclusion: most of the children presented a high sucrose intake at an early age. Screening pregnant women for sugar- -sweetened beverage intake may be a potential way to recognize the children at risk for future high sucrose intake in early childhood. (AU)

Family influence on the consumption of sugary drinks by children under two years old / Influência familiar no consumo de bebidas açucaradas em crianças menores de dois anos

ABSTRACT OBJECTIVE To evaluate the influence of family habits and household characteristics on the consumption of sugary drinks by Brazilian children under two years old. METHODS This was a cross-sectional study that used secondary data generated by the National Health Survey (PNS) in 2013. We studied 4,839 pairs of children under two years old and adults living in the same house. We estimated the prevalence of the indicator of sugary drinks consumption for the total sample of children and according to family and household variables. We applied multiple logistic regression analysis to evaluate the influence of family habits and household characteristics on the consumption of sugary drinks by the children. RESULTS The consumption of sugary drinks was identified in 32% of the studied children (95%CI 30.6-33.3) and was independently associated with the following family and household characteristics: regular consumption of sugary drinks by the adult living in the house (OR = 1.78; 95%CI 1.51-2.10), watching TV for more than three hours per day (OR = 1.22; 95%CI 1.03-1.45), older age (OR = 3.10; 95%CI 1.54-6.26), greater education level (OR = 0.70; 95%CI 0.53-0.91), house located in the Northeast region (OR = 0.65; 95%CI 1.54-6.26), and number of family members (OR = 1.05; 95%CI 1.00-1.09). CONCLUSIONS Our findings indicate the high prevalence of sugary drinks consumption by Brazilian children under two years old and show that sociodemographic characteristics and family habits affect this feeding practice not recommended in childhood.

RESUMO OBJETIVO Avaliar a influência de hábitos familiares e características do domicílio sobre o consumo de bebidas açucaradas em crianças brasileiras menores de dois anos. MÉTODOS Estudo transversal que utilizou dados secundários gerados pela Pesquisa Nacional de Saúde (PNS), em 2013. Foram estudados 4.839 pares de crianças menores de dois anos e adultos residentes no mesmo domicílio. Foram estimadas as prevalências do indicador consumo de bebidas açucaradas para a amostra total de crianças e segundo categorias de variáveis familiares e do domicílio. Aplicou-se análise de regressão logística múltipla para avaliar a influência de hábitos familiares e características do domicílio sobre o consumo de bebidas açucaradas pelas crianças. RESULTADOS O consumo de bebidas açucaradas foi identificado em 32% das crianças estudadas (IC95% 30,6–33,3) e esteve independentemente associado com as seguintes caraterísticas familiares e domiciliares: consumo regular de bebidas açucaradas pelo adulto residente no domicílio (OR = 1,78; IC95% 1,51–2,10), hábito de assistir TV por mais de 3 horas diárias (OR = 1,22; IC95% 1,03–1,45), maior idade (OR = 3,10; IC95% 1,54–6,26), maior escolaridade (OR = 0,70; IC95% 0,53–0,91), domicílio localizado na região Nordeste (OR = 0,65; IC95% 1,54–6,26) e número de componentes da família (OR = 1,05; IC95% 1,00–1,09). CONCLUSÕES Os achados apontam a alta prevalência de consumo de bebidas açucaradas em crianças brasileiras menores de dois anos e que características sociodemográficas e hábitos familiares influenciam essa prática alimentar não recomendada na infância.

Cambios en el consumo aparente de lácteos, bebidas azucaradas y jugos procesados en el Gran Santiago. Chile. 1987-2007: Changes in the consumption of dairy products, sugary drinks and processed juices in the Chilean population

Background: Nowadays, Chilean population tends to replace or eat a lower amount of food with health protective properties and a higher proportion of unhealthy foodstuff. Aim: To describe and compare the intake of dairy products, sugary drinks and processed juices among Chileans. Material and Methods: An analysis of data compiled from the Survey on Household Budget and Expenses carried out by the Chilean National Institute of Statistics (INE), using a representative sample of households. The sample was surveyed between 1987 and 2007. The analysis was performed for all households surveyed and for households belonging to the second (highest incomes) and fifth quintile (lowest incomes). The Chilean Food Guide and the international recommendations of the Institute of Medicine of the United States and the American Heart Association (in the case of sugars) were used as reference. Results: Even though the intake of dairy products increased during the period of the survey, it was lower than the intake of sugary drinks and juices, which increased. Also, calcium recommendations were not covered. On the other hand, the intake of added sugars increased to figures over current recommendations. Conclusions: The intake of dairy products and calcium is below the recommended amounts established by international organisms, and added sugars intake is greater than the advisable levels recommended by international organisms.

Estimates of self-reported dietary behavior related to oral health among adolescents according to the type of food

Objective: To compare estimates of food behavior related to oral health obtained through a self-report measure and 24 hour dietary recalls (R24h). Method: We applied three R24h and one self-report measure in 87 adolescents. The estimates for eleven food items were compared at individual and group levels. Results: No significant differences in mean values were found for ice cream, vegetables and biscuits without filling. For the remaining items, the values reported by the adolescents were higher than the values estimated by R24h. The percentage of adolescents who reported intake frequency of 1 or more times/ day was higher than the value obtained through R24h for all food items except soft drinks. The highest values of crude agreement between the instruments, individually, were found in the biscuits without filling (75.9%) and ice cream (72.4%). Conclusion: The results suggest that adolescents tend to report a degree of exposure to the food items larger than what they actually experience in their daily lives. .

Reducao do uso de acucar em escolas publicas: ensaio randomizado por conglomerados / Reduccion del uso de azucar en escuelas publicas: ensayo aleatorio por conglomerados / Reducing the use of sugar in public schools: a randomized cluster trial

OBJETIVO Analisar a eficácia de ações de educação nutricional com merendeiras na redução da adição de açúcar na alimentação escolar e no próprio consumo. MÉTODOS Ensaio randomizado por conglomerado, controlado, conduzido em 20 escolas municipais na cidade metropolitana de Niterói, RJ, de março a dezembro de 2007. Programa de educação nutricional foi implementado nas escolas de intervenção, junto a merendeiras, usando mensagens, atividades e material educativo que encorajassem a redução da adição de açúcar na alimentação escolar e no consumo. A redução da disponibilidade de açúcar pelas escolas foi analisada por planilhas com dados da utilização dos itens do estoque. O consumo individual das merendeiras foi avaliado pelo uso de questionário de frequência de consumo alimentar. As medidas antropométricas foram realizadas de acordo com técnicas padronizadas e a variação na mudança do peso foi medida ao longo do estudo. RESULTADOS A redução da disponibilidade de açúcar ocorreu mais acentuadamente nas escolas de intervenção quando comparadas às escolas controle (-6,0 kg versus 3,4 kg), sem diferença estatisticamente significante (p = 0,21), embora o poder do estudo tenha sido baixo. Houve redução do consumo de doces e bebidas açucaradas nos dois grupos, mas o consumo de açúcar não apresentou diferenças estatisticamente significativas entre eles. Houve redução do peso e do consumo de energia total nos dois grupos, mas sem diferença estatisticamente significante entre eles e sem modificação dos percentuais de adequação dos macronutrientes em relação ao consumo de energia. CONCLUSÕES Não foi possível ...

OBJETIVO Analizar la eficacia de acciones de educación nutricional con las manipuladoras de alimentos en la reducción de la adición de azúcar en la alimentación escolar y en el propio consumo. MÉTODOS Ensayo aleatorio por conglomerado, controlado, conducido en 20 escuelas municipales en la ciudad metropolitana de Niterói, RJ, de marzo a diciembre de 2007. El programa de educación nutricional fue implementado en las escuelas de intervención, manipuladoras de alimentos, usando mensajes, actividades y material educativo de forma de incentivar la reducción en la adición de azúcar a los alimentos y en el consumo. La reducción de la disponibilidad de azúcar en las escuelas fue analizada por planillas con datos de la utilización de los ítems de almacenamiento. El consumo individual de las manipuladoras de alimentos fue evaluado a través de cuestionario de frecuencia de consumo alimentario. Las medidas antropométricas fueron realizadas de acuerdo con técnicas estandarizadas y la variación en el cambio de peso fue medida a lo largo del estudio. RESULTADOS La reducción de la disponibilidad de azúcar ocurrió de forma más acentuada en las escuelas de intervención al compararse con las escuelas control (-6,0 kg versus 3,4 kg), sin diferencia estadísticamente significativa (p= 0,21), a pesar de que el poder del estudio haya sido bajo. Hubo reducción en el consumo de dulces y bebidas azucaradas en los dos grupos, aunque el consumo de azúcar no presentó diferencias estadísticamente significativas entre ellos. Hubo reducción en el peso y en el consumo de energía total en los dos grupos, pero sin diferencia estadísticamente significativa entre ellos, y sin modificación en los porcentajes de adecuación de los macronutrientes con relación al consumo de energía. CONCLUSIONES ...

OBJECTIVE To test the efficacy of nutritional guidelines for school lunch cooks aiming to reduce added sugar in school meals and their own sugar intake. METHODS A controlled randomized cluster trial was carried out in twenty public schools in the municipality of Niteroi in Rio de Janeiro, Southeastern Brazil, from March to December 2007. A nutrition educational program was implemented in the schools in question through messages, activities and printed educational materials encouraging reduced levels of added sugar in school meals and in the school lunch cooks’ own intake. The reduced availability of added sugar in schools was evaluated using spreadsheets including data on the monthly use of food item supplies. The cooks’ individual food intake was evaluated by a Food Frequency Questionnaire. Anthropometric measurements were taken according to standardized techniques and variation in weight was measured throughout the duration of the study. RESULTS There was a more marked reduction in the intervention schools compared to the control schools (-6.0 kg versus 0.34 kg), but no statistically significant difference (p = 0.21), although the study power was low. Both groups of school lunch cooks showed a reduction in the consumption of sweets and sweetened beverages, but the difference in sugar intake was not statistically significant. Weight loss and a reduction in total energy consumption occurred in both groups, but the difference between them was not statistically significant, and there was no alteration in the percentages of adequacy of macronutrients in relation to energy consumption. CONCLUSIONS The strategy of reducing the use and consumption of sugar by school lunch cooks from public schools could not be proved to be effective. .

Cariogenic and erosive potential of industrialized fruit juices available in Brazil

Aim: This in vitro study evaluated the cariogenic and erosive potential of different industrialized fruit juices available in the Brazilian market. Methods: Twenty-five samples of fruit juices were analyzed physically and chemically by means of the following parameters: pH, titratable acidity(TA) and total soluble solid content (TSSC), reducing sugars (e.g.: glucose), non-reducing sugars (e.g.: sucrose) and total sugars. The analyses were made in triplicate. Data were collected by a single examiner and were recorded in study-specific charts. Data were statistically analyzed by A NOVA and Tukey’s post-test (p<0.05). Results: All fruit juices showed pH below the critical value of 5.5, with significant differences among the samples (p<0.0001). Mango juice (Jandaia®)presented the lowest TSSC (10.25 oBrix), while orange juice (Del Valle®) presented the highest TSSC (12.75 oBrix), with no significant differences among the samples. The lowest and the highest TA values were recorded for cashew juice (Jandaia®) (0.13%) and passion fruit (Del Valle®)(0.52%), respectively (p<0.0001). For reducing sugars (glucose), the highest value was recorded for purple fruit juice (Skinka®) (10.85 g/100mL) and the lowest was recorded for strawberry juice(Kapo®) (1.84 g/100mL). Regarding non-reducing sugars (sucrose), the values ranged from0.45 g/100mL (passion fruit/Del Valle®) to 9.07 g/100mL (orange/Del Valle®). Purple fruit juice(Skinka®) presented the highest total sugars content (12.09 g/100mL), while guava juice (Jandaia®)presented the lowest content (7.25 g/100mL). There were significant differences among the samples for reducing, non-reducing and total sugars (p<0.0001). Conclusions: The industrialized fruit juices evaluated in this study presented low pH and high total sugar content, differing in their erosive and cariogenic potential, respectively.