Prevalencia y factores relacionados con desnutrición en la primera infancia. Colombia año 2018 a 2020

La desnutrición como enfermedad de origen social es la expresión última de la situación de inseguridad alimentaria y nutricional de una población, al afectar principalmente a los niños. El objetivo fue analizar la prevalencia y factores relacionados con la desnutrición en la primera infancia en Colombia durante los años 2018 a 2020, mediante un estudio cuantitativo descriptivo de tipo ecológico - exploratorio, con recolección de datos retrospectivos a partir de reportes obtenidos del Sistema Integrado de Información de la Protección Social. El total de casos corresponde a 43.823 reportes, la prevalencia para los tres años fue de 1,13% principalmente en los departamentos de Guajira (n: 3.488; 3,17%) y Boyacá (n: 1.277; 1,39%), mayor número de casos presentados en el sexo masculino (n: 23.804; 54,3%), en edad entre 0 y 1 año (n: 17.099; 39,0%), pertenecientes al régimen subsidiado (n: 28.814; 65,75%) y ubicados en la cabecera municipal (n: 28.114; 64,15%). Con relación a la pertenencia étnica la mayor frecuencia se evidencia en "otras etnias" (n: 33.050; 75,42%), seguido de la etnia indígena (n: 8.348; 19,05%) y el estrato socioeconómico más representativo es el "bajo-bajo" (n: 17.620; 40,21%). Además, existe relación entre el sexo masculino y la desnutrición, comportándose como un factor de riesgo, y el vivir en centro poblado disminuye la probabilidad de presentar desnutrición. Se evidenció una frecuencia significativa de características asociadas a los determinantes sociales en salud y variables específicas relacionadas con la desnutrición.

Malnutrition as a disease of social origin is the ultimate expression of the situation of food and nutritional insecurity of a population, mainly affecting children. The objective was to analyze the prevalence and factors related to malnutrition in early childhood in Colombia during the years 2018 to 2020, through a descriptive quantitative study of an ecological-exploratory type, with retrospective data collection from reports obtained from the Integrated System of Social Protection Information. The total number of cases corresponds to 43,823 reports, the prevalence for the three years was 1.13%, mainly in the departments of Guajira (n: 3,488; 3.17%) and Boyacá (n: 1,277; 1.39%). greater number of cases presented in males (n: 23,804; 54.3%), aged between 0 and 1 year (n: 17,099; 39.0%), belonging to the subsidized regime (n: 28,814; 65.75%) and located in the municipal seat (n: 28,114; 64.15%). In relation to ethnicity, the highest frequency is evidenced in "other ethnic groups" (n: 33,050; 75.42%), followed by the indigenous ethnic group (n: 8,348; 19.05%), and the most representative socioeconomic stratum is the "low-low" (n: 17,620; 40.21%). In addition, there is a relationship between the male sex and malnutrition, behaving as a risk factor, and living in a populated center decreases the probability of presenting malnutrition. A significant frequency of characteristics associated with the social determinants of health and specific variables related to malnutrition was evidenced.

Socio-economic Status, Food Security Status and its Coping Strategies among ‘The Lost Food Project’ (TLFP) Recipients in Klang Valley during COVID-19 Pandemic

@#Introduction: The Lost Food Project (TLFP) is a non-profit organization who continuously working on their strategic plan in combating the food insecurity problem by distributing food surplus to low income households within Klang Valley. This cross-sectional study aims to determine the socioeconomic status, food security status and its coping strategies among TLFP recipients in Klang Valley during COVID-19 pandemic. Methods: This study was conducted from April to June 2021. There were 88 respondents recruited through convenience sampling. A set of questionnaires regarding food assistance, nutrition knowledge, food security and its coping strategies was prepared, and the respondents were interviewed either by phone, face-to-face or self-administered questionnaire. Results: The prevalence of food insecurity among households in this study was 59.1%. Most of them have moderate (37.5%) to good (27.5%) nutrition knowledge. The coping strategy that most of the respondents applied was ‘using less expensive food’ (58.3%) with at least once per week within the past one month. Food insecure households tend to adopt more coping strategies compared to those food secure households (p<0.001). Moreover, households who rent their house (p<0.01), low household income (p<0.05) and high monthly food and drinks expenditure (p<0.01) were associated with the food insecurity among TLFP recipients. Conclusion: The study concluded that lower household income, higher food and drinks expenditure and those who rent the house have negative impacts on household’s food security status. Thus, the situation forced them to apply more food-related coping strategies in their daily life. Further research should be conducted on the effectiveness of TLFP in helping them to improve Malaysian’s food security status.

Food and nutrition security in the Philippines during the COVID-19 pandemic / Journal of Rural Medicine

Objective: The COVID-19 pandemic placed the Philippines’ food and nutrition issues front and center. In this paper, we discuss the response of its government in addressing food and nutrition security at the beginning of the COVID-19 pandemic and describe its implications on nutritional status. We also cite initiatives that address food accessibility and availability in the communities. Lastly, we explore the importance of nutrition security dimension in food security.Methods: We analyze food and nutrition security issues in the Philippines during the COVID-19 pandemic through online reports and news articles.Results: The distribution of food and financial assistance in the country was extensive, albeit insufficient, considering the prolonged lockdown restrictions. Constantly changing community quarantine guidelines have affected the movement of food supply, delivery of health services, and household economic security. Nutrition programs, such as vitamin A supplementation, feeding for children, and micronutrient supplementation for pregnant women, had lower coverage rates, and by the latter half of 2020, the country had reached its highest recorded hunger rate. Cases of both undernutrition and overnutrition are predicted to rise because of dietary imbalances and a variety of factors. Conversely, community members and some local government units took it upon themselves to improve the food situation in their areas. The provision of food packs containing fresh fruits and vegetables was lauded, as it exemplified a conscious effort to deal with nutrition security.Conclusion: Efforts to address food security have always focused on increasing accessibility, availability, and affordability, often neglecting the nutritional components of foods. Strategies that incorporate nutrition security into food security are much needed in the country, especially during emergencies like the COVID-19 pandemic.

Calidad en el servicio de alimentación de Casas de la niñez indígena, México: Estudio de caso

RESUMEN El Instituto Nacional de los Pueblos Indígenas es el organismo mexicano encargado de brindar alimentación, además de hospedaje a niñas y niños que provienen de localidades indígenas que no cuentan con acceso educativo en sus lugares de origen, a través de albergues denominados "Casas de la niñez indígena". En 2019 se llevó a cabo el presente estudio, cuyo objetivo fue analizar la calidad del servicio de alimentación otorgado en un albergue del Estado de México, entidad cercana a la Ciudad de México. La calidad se estudió desde una perspectiva multidimensional, por lo que se examinaron tres elementos: la estructura, los procesos y los resultados. Para verificar el cumplimiento de la estructura y los procesos se aplicaron dos listas de cotejo y se establecieron porcentajes de cumplimiento, en el caso de la dimensión resultados se evaluó la aceptabilidad del servicio, a través de la aplicación de 42 cuestionarios a usuarios de 8 a 19 años de edad, cada respuesta del cuestionario obtuvo un puntaje promedio categorizado en rechazo o aceptación del servicio. La estructura del servicio mostró un cumplimiento alto de la calidad (85,7% de cumplimiento), los procesos obtuvieron un cumplimiento medio de la calidad (64,4% de cumplimiento) y la dimensión resultados demostró baja aceptabilidad del servicio respecto a la cantidad de comida servida. Ante el bajo cumplimiento de la calidad en algunos procesos se recomendó la implementación de herramientas e indicadores de calidad para identificar problemáticas y garantizar la inocuidad, además de la calidad del servicio.

ABSTRACT The National Institute of Indigenous People is a Mexican institution in charge of providing food and lodging for indigenous children living in rural areas. These services were provided in shelters known as "Casas de la niñez indígena". In 2019, we carried out this research with the objective of analyzing the quality of the food service provided in a shelter near Mexico City. Quality was analyzed from a multidimensional perspective, we studied three elements: structure, processes and results. The structure and processes were evaluated through checklists and compliance percentages. Results focused on evaluating the acceptability of the service through the application of 42 questionnaires to users from 8 to 19 years of age. Answers were analyzed through an average score categorized in rejection or acceptance of the service. Structure demonstrated high-quality compliance (85.7%), medium quality compliance (64.4%) for processes and the results dimension showed little acceptance to the amount of food served. The implementation of quality tools and indicators were recommended to identify problems in the processes and to guarantee food safety and quality of service.

Prácticas alimentarias de familias afrodescendientes con niños en primera infancia en el oriente de Cali / Food practices of afro-descendant families with kids in early childhood living in eastern Cali / Práticas alimentares de famílias afrodescendentes com crianças em primeira infância no oriente de Cali

Resumen Objetivo: describir las prácticas alimentarias de 50 familias afrodescendientes con niños y/o niñas de primera infancia que asisten a un Centro de Desarrollo Infantil (CDI) en el Oriente de Cali. Materiales y métodos: Estudio cuantitativo, descriptivo y de corte transversal. Se aplicó un cuestionario a 50 cuidadores de niños o niñas que asistieron al CDI Potrero Grande del oriente de Cali. El cuestionario fue estructurado con preguntas de múltiple elección con base en tres ejes de la seguridad alimentaria: acceso, consumo e inocuidad; adicionalmente un cuestionario de frecuencia de consumo de alimentos. Resultados: 70 % se autorreconoció como afrodescendiente, 63 % procedía principalmente de la costa del sur occidente colombiano, con nivel educativo básico. El 87,5 % se dedicaba exclusivamente al hogar. En el 85 % de los hogares la madre es la encargada de preparar los alimentos, el aporte de proteína animal del 70 % de los hogares, proviene principalmente del huevo cuyo consumo fue diario, el 94 % de las madres expresaron que sus familias nunca consumieron brócoli, coliflor, alverja verde, espinacas, ullucos, repollo y el 95 % de las personas refirieron que se lavan las manos antes de preparar los alimentos. Conclusiones: la dieta no es variada y se basa en alimentos fuentes de carbohidratos principalmente el arroz, papa y los plátanos verdes y maduros, que se consumen cocidos y fritos, al igual que los alimentos fuentes de proteína. El análisis de la ingesta sugiere que no se consumen alimentos característicos del lugar de procedencia como los pescados y/o mariscos.

Abstract Objective: To describe the eating practices of 50 Afro-descendant families with early childhood kids who attend a Child Development Center -CDC- in eastern Cali. Materials and methods: Quantitative, descriptive, and crosssectional study. A questionnaire was applied to 50 caregivers of children who attended the CDI Potrero Grande in eastern Cali. The questionnaire was structured with multiple choice questions based on three axes of food security: access, consumption and safety. Additionally, a food consumption frequency questionnaire was applied. Results: Seventy percent of the participants self-recognized as Afro-descendant, 63% came mainly from the southwestern coast of Colombia with a basic educational level, and 87.5% were dedicated exclusively to the home. The mother was in charge of preparing the food in 85% of the homes. Animal protein contribution of 70% of the homes comes mainly from eggs with daily consumption. A total of 94% of the mothers expressed that their families never consumed broccoli, cauliflower, green peas, spinach, manioc or cabbage and 95% of the people reported that they washed their hands before preparing food. Conclusions: The diet is not varied and is based on carbohydrate source food mainly rice, potatoes and green and ripe bananas which are consumed boiled and fried, as well as protein sources. The analysis of the intake suggests that characteristic foods of the place of origin such as fish and/ or shellfish are not consumed.

Resumo Objetivo: descrever as práticas alimentares de 50 famílias afrodescendentes com meninos e/ou meninas de primeira infância que vão a um Centro de Desenvolvimento Infantil (CDI) no Oriente de Cali. Materiais e métodos: estudo quantitativo, descritivo e de corte transversal. Se fez um questionário a 50 cuidadores de meninos ou meninas que foram ao CDI Potrero Grande do oriente de Cali. O questionário foi estruturado com preguntas de múltiplo eleição com base em três eixos da segurança alimentar: aceso, consumo e inocuidade; adicionalmente um questionário de frequência de consumo de alimentos. Resultados: 70 % se auto reconheceu como afrodescendente, 63 % procedia principalmente do litoral do sudoeste colombiano, com nível educativo básico. O 87,5 % se dedicava exclusivamente ao lar. No 85 % dos lares a mãe é a encarregada de preparar os alimentos, a proteína animal do 70 % dos lares, provem principalmente do ovo cujo consumo foi diário, o 94 % das mães disseram que suas famílias nunca comeram brócolis, couve-flor, ervilhas, espinafre, ullucos, repolho e o 95 % das pessoas disseram que se lavam as mãos antes de preparar os alimentos. Conclusões: a dieta não é variada e baseada em alimentos fontes de carboidratos principalmente o arroz, batata e os plâtanos verdes e maduros, que se consumem cozidos e fritos, ao igual que os alimentos fontes de proteína. A análise da ingesta sugere que não se consumem alimentos característicos do lugar de procedência como os pescados e/ou mariscos.

Situação de insegurança alimentar em domicílios de Pernambuco, Região Nordeste do Brasil: contribuições para discussão da violação do direito à alimentação / Food insecurity in households in Pernambuco, Northeast region of Brazil: contributions to the discussion on the violation of the right to adequate food

Resumo O objetivo deste estudo foi investigar os fatores associados à insegurança alimentar em domicílios do Estado de Pernambuco, localizado na região Nordeste do Brasil. Trata-se de um estudo transversal realizado em 1.008 domicílios particulares. Para a investigação, utilizou-se a Escala Brasileira de Insegurança Alimentar (EBIA) e foram analisadas associações com variáveis socioeconômicas, demográficas e práticas relacionadas à alimentação. Calculou-se razão de prevalência e ajuste por meio da regressão de Poisson, sendo estatisticamente significantes aquelas associações cujo p≤0,05. Encontrou-se prevalência de 68,4% de insegurança alimentar. Apresentaram associação com insegurança: escolaridade do chefe da família; renda per capita; participação no programa Bolsa Família; número de moradores; regime de ocupação do domicílio; classe social; práticas; e opiniões acerca da alimentação da família. O maior risco de insegurança foi encontrado naqueles com pior condição econômica, em beneficiários do Bolsa Família e naqueles que indicavam a falta de produtos ultraprocessados para melhorar a alimentação da família. Observou-se insegurança alimentar atrelada às condições de vulnerabilidade social e àqueles que não consideravam ter uma boa alimentação. Grande parte dos sujeitos referiram utilizar os recursos do Bolsa Família para aquisição de alimentos, o que reforça a importância dessa estratégia na promoção do acesso à alimentação.

Abstract This study aimed to investigate factors associated with food insecurity in households in the state of Pernambuco, in the Northeast region of Brazil. This is a cross-sectional study carried out in 1,008 private households. The investigation used the Brazilian Food Insecurity Scale (EBIA) and analyzed associations with socioeconomic and demographic variables, as well as practices related to eating. Prevalence ratio and adjustment were calculated using Poisson regression, and associations where p ≤ 0.05 were statistically significant. Food insecurity prevalence was 68.4%. Variables associated with insecurity were: education of the head of the family; per capita income; participation in the Bolsa Família Program; number of residents; occupation of the household; social class; practices and opinions about family eating habits. The greatest insecurity risk was found in those with the worst economic conditions, in beneficiaries of the Bolsa Família Program and in those who considered the lack of ultra-processed products to improve the family's diet. Food insecurity was linked to conditions of social vulnerability and to those who did not perceive that they had a good diet. Most of the subjects reported using resources of the Bolsa Família program to purchase food, which reinforces the importance of this strategy in promoting access to food.

Who really counts in Iran's National Food Assistance Program? Lessons from multi-stakeholder processes in the wicked policy area of food security / Quem importa realmente no Programa Nacional de Assistência Alimentar do Irã? Lições dos processos com múltiplos atores na área política complexa de segurança alimentar / ¿A quién se tiene en cuenta realmente en el Programa Nacional de Asistencia Alimentaria en Irán? Lecciones sobre procesos con participación múltiple en la complicada área de política de seguridad alimentaria

Abstract: Multi-stakeholder processes - as a necessary part in the development of public policies - can provide diverse perspectives to inform and to improve food security policy-making. Iran's National Food Assistance Program (NFAP) is one of the major welfare programs in Iran that reduces food insecutiry to low-income households. This study aimed to identify and to categorize actual and potential stakeholders in NFAP using the stakeholder salience model. According to Mitchell's theory, stakeholders' attributes (power, legitimacy, and urgency) were assessed based on the nature of their interactions, roles, and level of engagement. Results revealed a number of significant but marginalized stakeholders, including Iranian Ministry of Health (office of community nutrition improvement), academia, center for food and nutrition research, target group, charities, and international organizations, who have not received any targeted organizational attention and priority to their claims. The unbalanced attention provided to some stakeholder groups characterized as "definitive" and "dominant" and ignoring some important ones will jeopardize long-term viability and undermine support for the program with inevitable declines in legitimacy. Understanding the change in the stakeholders' characteristics is the main variable to determine the allocation of organizational resources in response to different and rising stakeholders' demands and possibly the projects outcomes. This will facilitate and enhance the possibility of knowledge exchange and learning, and greater trust among stakeholders during the food and nutrition policy-making process.

Resumo: Os processos com múltiplos atores (multi-stakeholder), como parte necessária do desenvolvimento de políticas públicas, podem ajudar a reunir perspectivas diversas para informar e melhorar as políticas de segurança alimentar. O Programa Nacional de Assistência Alimentar do Irã (NFAP) é um dos maiores programas de bem-estar social no Irã, e que fornece apoio a famílias de baixa renda para reduzir a insegurança alimentar. O estudo teve como objetivo identificar e categorizar os atores atuais e potenciais envolvidos no NFAP, usando o modelo de stakeholder salience). De acordo com a teoria de Mitchell, os atributos (poder, legitimidade e urgência) foram avaliados com base na natureza de suas interações, papeis e níveis de engajamento. Os resultados revelaram uma série de atores importantes, porém marginalizados, incluindo o Ministério da Saúde do Irã (Divisão de Melhoria Nutricional Comunitária), academia, centros de pesquisas em alimentação e nutrição, grupo-alvo, filantropias e organizações internacionais, que não receberam nenhuma atenção institucional dirigida ou prioritária quanto às suas demandas. O desequilíbrio da atenção prestada a alguns dos grupos interessados, caracterizados como "definitivos" e "dominantes", ignorando outros atores importantes, irá prejudicar a viabilidade no longo prazo e reduzir o apoio para o programa, com um declínio inevitável na legitimidade. A compreensão da mudança nas características dos atores é a principal variável na determinação da alocação dos recursos institucionais na resposta às diversas e crescentes demandas dos atores, e possivelmente dos resultados dos projetos. Tal compreensão facilitará e fortalecerá a troca de conhecimentos e lições, além de maior confiança mútua entre os atores durante o processo de políticas de alimentação e nutrição.

Resumen: Los procesos de participación múltiple, constituyen una parte necesaria en el desarrollo de políticas públicas, puesto que pueden ayudar a presentar diversas perspectivas, así como informar y mejorar la creación de políticas públicas en seguridad alimentaria. El Programa Nacional de Asistencia Alimentaria de Irán (NFAP) es uno de los principales programas de bienestar social en Irán, que proporciona ayuda a los hogares con bajos ingresos, a fin de reducir la inseguridad alimentaria. El objetivo del estudio fue identificar y categorizar a los actuales y potenciales participantes múltiples en el NFAP, utilizando un modelo de copartícipes relevantes. Los atributos de las partes interesadas (poder, legitimidad y urgencia), según la teoría de Mitchell, fueron evaluados basados en la naturaleza de sus interacciones, roles, y nivel de implicación. Los resultados revelaron un número de copartícipes importantes, pero marginalizados, incluyendo el Ministerio de Salud de Irán (Departamento de Mejora de la Nutrición en la Población), instituciones académicas, centros de investigación de alimentación y nutrición, así como grupos objetivo, organizaciones de beneficencia, y organizaciones internacionales, que no habían recibido ninguna atención específica institucional, ni ninguna prioridad en sus reclamaciones. La atención desequilibrada, otorgada a alguno de los grupos partícipes, caracterizada como "definitiva" y "dominante", e ignorando algunas otras importantes, pondrá en peligro a largo plazo la viabilidad y socavará el apoyo para el programa con su inevitable declive en términos de legitimidad. Entender el cambio en las características de los participantes es la variable principal para determinar la asignación de los recursos organizativos, en respuesta a las diferentes y crecientes demandas de los participantes, así como posiblemente a los resultados de los proyectos. Esto facilitará y acrecentará la posibilidad de intercambio de conocimiento y aprendizaje, así como una mayor confianza entre los partícipes durante los procesos de políticas alimentarias y nutricionales.

Percepção sobre a segurança alimentar e nutricional de instituições cadastradas no Banco de Alimentos de Itapecerica da Serra / Perception of food and nutritional security of institutions registered in the Food Bank of Itapecerica da Serra

Resumo Introdução O Banco de Alimentos recebe gêneros alimentícios fora dos padrões para comercialização, mas que estão próprios para o consumo humano e sem nenhuma restrição sanitária. Objetivo Verificar a percepção das instituições beneficiadas pelo Banco de Alimentos de Itapecerica da Serra sobre a segurança alimentar e nutricional. Método Estudo qualitativo realizado com 12 instituições cadastradas no Banco de Alimentos, por meio de entrevista gravada com roteiro semiestruturado. Resultados As instituições participantes atenderam cerca de 2.140 indivíduos em situação de vulnerabilidade social, sendo que sete delas distribuíam os alimentos doados, quatro utilizavam os alimentos doados no preparo de refeições e apenas uma realizava as duas atividades. A partir dos dados obtidos, foram extraídos cinco temas: segurança alimentar e nutricional; contribuição à instituição; vulnerabilidade social; falta de cadastro; e monotonia alimentar. Conclusão Os responsáveis das instituições beneficiadas pelo Banco de Alimentos apresentaram uma percepção sobre segurança alimentar e nutricional fundamentada no acesso aos alimentos pelas famílias atendidas. Isso satisfaz, parcialmente, o conceito de segurança alimentar e nutricional adotado no Brasil.

Abstract Background Food banks receive foodstuffs that are non-standard, but suitable for human consumption without any health restrictions. Objective To verify the perception of the institutions benefited by the Itapecerica da Serra Food Bank about food and nutrition security. Method Qualitative study conducted with 12 institutions registered at the Food Bank using recorded with semi-structured interviews. Results The participating institutions assisted approximately 2140 socially vulnerable people. Seven of these institutions distributed the donated food, four use the donated food in the preparation of meals, and only one performed both activities. Five themes were extracted from the data obtained: food and nutrition security, contribution to the institution, social vulnerability, lack of registration, and food monotony. Conclusion The heads of the institutions benefited by the Food Bank presented a perception of food and nutrition security based on access to food by the families assisted. This partially meets the concept of food and nutrition security adopted in Brazil.

Consensus on the standard terminology used in the nutrition care of adult patients with chronic kidney disease / Consenso sobre a terminologia padronizada do processo de cuidado em nutrição para pacientes adultos com doença renal crônica

Abstract This nutrition consensus document is the first to coordinate the efforts of three professional organizations - the Brazilian Association of Nutrition (Asbran), the Brazilian Society of Nephrology (SBN), and the Brazilian Society of Parenteral and Enteral Nutrition (Braspen/SBNPE) - to select terminology and international standardized tools used in nutrition care. Its purpose is to improve the training delivered to nutritionists working with adult patients with chronic kidney disease (CKD). Eleven questions were developed concerning patient screening, care, and nutrition outcome management. The recommendations set out in this document were developed based on international guidelines and papers published in electronic databases such as PubMed, EMBASE(tm), CINHAL, Web of Science, and Cochrane. From a list of internationally standardized terms, twenty nutritionists selected the ones they deemed relevant in clinical practice involving outpatients with CKD. The content validity index (CVI) was calculated with 80% agreement in the answers. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework was used to assess the strength of evidence and recommendations. A total of 107 terms related to Nutrition Assessment and Reassessment, 28 to Diagnosis, nine to Intervention, and 94 to Monitoring and Evaluation were selected. The list of selected terms and identified tools will be used in the development of training programs and the implementation of standardized nutrition terminology for nutritionists working with patients with chronic kidney disease in Brazil.

Resumo Este consenso representa a primeira colaboração entre três organizações profissionais com foco em nutrição: Associação Brasileira de Nutrição (Asbran), Sociedade Brasileira de Nefrologia (SBN) e Sociedade Brasileira de Nutrição Parenteral e Enteral (Braspen/SBNPE), com o objetivo de identificar a terminologia e instrumentos padronizados internacionalmente para o processo de cuidado em nutrição. O foco é facilitar a condução de treinamentos de nutricionistas que trabalham com pacientes adultos com doenças renais crônicas (DRC). Foram levantadas onze questões relacionadas à triagem, ao processo de cuidado e à gestão de resultados em nutrição. As recomendações foram baseadas em diretrizes internacionais e em bancos de dados eletrônicos, como PubMed, EMBASE(tm), CINHAL, Web of Science e Cochrane. A partir do envio de listas de termos padronizados internacionalmente, vinte nutricionistas especialistas selecionaram aqueles que consideraram muito claros e relevantes para a prática clínica com pacientes ambulatoriais com DRC. Foi calculado o Índice de Validade de Conteúdo (IVC), com 80% de concordância nas respostas. O Grading of Recommendations, Assessment, Development and Evaluation (GRADE) foi usado para atribuir força de evidência às recomendações. Foram selecionados 107 termos de Avaliação e Reavaliação, 28 de Diagnóstico, 9 de Intervenção e 94 de Monitoramento e Aferição em Nutrição. A lista de termos selecionados e identificação de instrumentos auxiliará no planejamento de treinamentos e na implementação de terminologia padronizada em nutrição no Brasil, para nutricionistas que trabalham com pacientes renais crônicos.

Profile and Knowledge of Community Health Agents (CHAS) of Cajamar City, Brazil / Perfil e Conhecimento dos Agentes Comunitários de Saúde (ACS) do Município de Cajamar, Brasil

Community Health Agents (CHAs) are important collaborators in combating illnesses related to poor eating habits. The objective of this work was to verify the knowledge of the community health workers of Cajamar city about food and the main diseases related to bad eating habits. This is a cross-sectional study, conducted from August to September 2011, in Cajamar city, São Paulo by trained interviewers. 57 HCWs were interviewed who answered two questionnaires, the first to characterize them and the second to obtain data on basic knowledge about food and the main diseases related to poor eating habits. 96.5% of the CHA were female, had an average of 34 years, 88.1% had two children, predominance of complete high school (56.1%; n=32). They had the function of CHAs as the main source of income, receiving up to three minimum wages and exercising it for at least six months (52.6%). When the subject was food, 94.5% report that they are the first to address the issue. The main difficulties were that people did not follow the guidelines (43%) and lack of knowledge (40%). There was a good performance in the issues regarding chronic diseases (76.6% of hits) and risk groups (97%). In questions about food groups and food security, there was low performance (rate of hits of 55.2% and 55.3%, respectively). The qualification of CSAs is fundamental for the improvement of the work performed, being important the use of educational strategies that provide continuous learning. (AU)

Os Agentes Comunitários de Saúde (ACS) são importantes colaboradores no combate de doenças relacionadas aos maus hábitos alimentares. O objetivo deste trabalho foi verificar o conhecimento dos ACS do município de Cajamar sobre alimentação e as principais doenças relacionadas aos maus hábitos alimentares. Trata-se de um estudo transversal, realizado no período de agosto a setembro de 2011, no município de Cajamar, São Paulo por entrevistadores treinados. Foram entrevistados 57 ACS que responderam a dois questionários, o primeiro com intuito de caracterizá-los e o segundo para obter dados quanto aos conhecimentos básicos sobre alimentação e as principais doenças relacionadas aos maus hábitos alimentares. 96,5% dos ACS eram do sexo feminino, possuíam em média 34 anos, 88,1% possuíam dois filhos, predominância de ensino médio completo (56,1%; n=32). Possuíam a função de ACS como principal fonte de renda, recebendo até três salários mínimos e exercendo-a há pelo menos seis meses (52,6%). Quando o assunto foi alimentação, 94,5% relatam que são os primeiros a abordar o assunto. As principais dificuldades encontradas foram que as pessoas não seguem as orientações (43%) e a falta de conhecimentos (40%). Verificou-se bom desempenho nas questões que se referiam às doenças crônicas (76,6% de acertos) e grupos de risco (97%). Já nas questões sobre grupos alimentares e segurança alimentar, houve baixo desempenho (índice de acertos de 55,2% e 55,3%, respectivamente). A capacitação dos ACS mostra-se fundamental para o aprimoramento do trabalho desempenhado, sendo importante o uso de estratégias educativas que proporcionem aprendizado contínuo. (AU)

Salud y sus determinantes socio culturales en la Venezuela actual. Retos y desafíos en salud pública / Health and its socio-cultural determinants in current Venezuela. A challenge in public health

El concepto de salud-enfermedad es un proceso dinámico que involucra la consideración de los determinantes socio culturales. Objetivo: explorar los determinantes de la salud venezolana identificando las principales tendencias, retos y desafíos que en materia de salud pública enfrenta Venezuela y, el impacto de los determinantes socioculturales en la condición de salud. Métodos: Partiendo de revisiones bibliográficas y fuentes analíticas se utilizó como referencia el marco de acción de la OMS para el fortalecimiento de los sistemas de salud utilizando como descriptores de búsqueda retos, desafíos, determinantes de salud, inequidades en salud. Resultados: Dentro de los desafíos se señalan la reducción de las iniquidades en salud, la mejoría de la calidad de la atención y de los sistemas de información y reformulación de los mecanismos de rendición de cuenta y de evaluación de políticas, premisas fundamentales para el fortalecimiento del sistema de salud, caracterizado por la inexistencia al derecho de la salud, ausencia de información epidemiológica y sanitaria, distorsión del modelo oficial salud-enfermedad, debilitamiento de la promoción de la salud y deterioro sistemático y progresivo del sector salud. Conclusiones: la investigación deja de manifiesto, la necesidad de resolver el problema de la fragmentación del financiamiento y de la prestación de servicios, tomando en consideración los elementos para una optimización de la calidad de vida en un sentido global, a fin de solventar las insuficiencias de cobertura y de acceso efectivo a los servicios públicos de salud de los hogares venezolanos(AU)

The concept of health-disease is a dynamic process that involves the consideration of socio-cultural determinants. Objective: to explore the determinants of Venezuelan health, identifying the main trends, challenges, and challenges that Venezuela faces in terms of public health, and the impact of sociocultural determinants on the health condition. Methods: Based on bibliographic reviews and analytical sources, it was used as references the WHO action framework for strengthening health systems using challenges, health determinants, health inequities as search descriptors. Results: Among the challenges are the reduction of inequities in health, the improvement of the quality of care and information systems and the reformulation of the mechanisms of accountability and evaluation of policies, fundamental premises for the strengthening of the health system, characterized by the non-existence of the right to health, absence of epidemiological and health information, distortion of the official health-disease model, weakening of health promotion and systematic and progressive deterioration of the health sector. Conclusions: the research reveals the need to solve the problem of the fragmentation of financing and the provision of services, taking into account the elements for an optimization of the quality of life in a global sense, in order to solve the insufficiencies coverage and effective access to public health services for Venezuelan households(AU)

Um olhar interdisciplinar sobre o trabalho das merendeiras terceirizadas de escolas estaduais do município de Campinas, SP / An interdisciplinary look at the work of outsourced school cooks from state schools in the city of Campinas, state of São Paulo, Brazil

Resumo Introdução: o Programa Nacional de Alimentação Escolar (PNAE) do Brasil é um dos maiores do mundo, porém há poucos estudos que tenham por objeto os responsáveis por sua execução, em especial, as merendeiras. Objetivo: compreender a organização e as características do trabalho das merendeiras, assim como suas consequências, tanto para a implementação do programa de alimentação escolar quanto para as próprias trabalhadoras. Métodos: estudo qualitativo fundamentado na análise ergonômica do trabalho (AET). Os resultados foram discutidos à luz da ergonomia da atividade e da ciência política. Pesquisa realizada em 2017 com oito merendeiras terceirizadas alocadas em três escolas da rede pública estadual em Campinas (SP). Resultados: caracterizou-se o trabalho das merendeiras, seus desafios e desdobramentos. Desvelaram-se as dificuldades da realidade enfrentada nas cozinhas escolares, os principais mecanismos de enfrentamento desenvolvidos por elas para lidar com as demandas do trabalho prescrito pelas instâncias de controle e para viabilizar o trabalho nas condições que lhes são propiciadas. Discutiu-se o papel importante, embora não suficientemente reconhecido, desempenhado por essas profissionais na implementação do PNAE. Conclusão: o duplo olhar teórico possibilitou reconhecer a presença do coping no cotidiano dessas trabalhadoras e permitiu evidenciar os problemas gerados pela terceirização e pela desvalorização do saber prático.

Abstract Introduction: the National School Feeding Program (PNAE), in Brazil, is one of the largest in the world. However, only few studies focus on those who are responsible for its execution, in particular, the school cooks. Objective: to understand the organization and the characteristics of the cooks' work and their consequences, both for the implementation of the school feeding program and for the workers themselves. Methods: qualitative study based on ergonomic work analysis (EWA). The results were discussed according to activity ergonomics and political science. This study, conducted in 2017, involved eight outsourced cooks allocated to three state schools of Campinas public network, in the state of São Paulo, Brazil. Results: the cooks' work was characterized, along with its challenges and developments. The study unveiled the reality faced in school kitchens. We identify the main coping mechanisms developed by the workers to deal with the work prescribed demands and to make it feasible according to the conditions offered to them. We discuss the important role, although not sufficiently recognized, played by these professionals in the implementation of the PNAE. Conclusion: the double theoretical view made it possible to recognize how coping is present in these workers' daily lives and made it possible to highlight the problems generated by outsourcing and the devaluation of practical knowledge.

Las políticas y programas de alimentación y nutrición en Colombia bajo la lógica del mercado / Food and Nutrition Policies and Programs under the Colombian markets logic

Resumen El propósito de este artículo es comprender los significados de las políticas alimentarias para madres beneficiarias y, para técnicos que diseñan e implementan dichas políticas. Se utilizó el método de la teoría fundamentada. Las técnicas de recolección fueron la entrevista semi-estructurada y el grupo focal. Los participantes fueron beneficiarias de algún programa de alimentación y nutrición, con una experiencia mínima de dos años y; los técnicos con cinco años o más de desempeño en el diseño y/o implementación de las políticas. Las políticas alimentarias se conciben y se gestionan bajo una lógica de mercado, la cual requiere de una institucionalidad que le sea funcional al modelo mercantil para proveer servicios públicos, lo cual se materializa en el esquema de la subcontratación a terceros, especialmente empresas privadas, quienes implementan estas políticas con el propósito de lograr la rentabilidad financiera. El mercado se impone como el referencial de las acciones del Estado, por tanto, se configura un Estado que limita su función a la fiscalización de las acciones subcontratadas, y las políticas de alimentación se constituyen en dispositivos para la desviación de recursos públicos hacia el sector privado.

Abstract This paper aims to understand the meanings of food and nutrition policies for beneficiary mothers and for technicians designing and implementing said policies. The Grounded Theory method was employed. The data collection techniques adopted were the semi-structured interview and the focus group. The participants were beneficiaries of food and nutrition programs, with a minimum two-year experience, and technicians with five-year experience in designing or implementing these policies and programs. Food and nutrition policies are conceived and managed under a market logic, which has required an institutional framework that adopted this commercial model to provide public services, which is implemented in the scheme of outsourcing third parties, especially private companies, who implement these policies to achieve financial profitability. The market is imposed as the benchmark for the State's actions, and, therefore, the State's action is limited the oversight of outsourced actions, and food policies become devices for the diversion of public resources to the private sector.

Inseguridad alimentaria y obesidad en madres del Noroeste Argentino: estudio local en contexto global / Food insecurity and obesity among mothers in Northwest Argentina: local study in global context

RESUMEN INTRODUCCIÓN La inseguridad alimentaria (IA) es un fenómeno multidimensional, que obliga a las personas a reducir la cantidad o calidad de los productos que consumen y presenta un continuum de niveles de gravedad (de leve a severa). El objetivo fue analizar la relación entre IA y estado nutricional en madres de niños concurrentes a Centros de Atención Primaria de Salud de cuatro provincias del Noroeste de Argentina. MÉTODOS Se aplicó un cuestionario con el indicador de insuficiencia alimentaria de la USDA y NHANES III a 995 madres. El estado nutricional se evaluó mediante el indice de masa corporal (IMC) y la circunferencia de cintura. RESULTADOS La prevalencia de obesidad (IMC ≥30 kg/m2) fue mayor entre las participantes con IA severa (37,1%) y moderada (28,7%) que en aquellas con IA leve (20,3%) o con seguridad alimentaria (SA) (22,4%) (p 0,003). En modelos de regresión logística multivariada la IA severa incrementaba la probabilidad de IMC ≥30 kg/m2 (OR 1,8) y de circunferencia de cintura ≥80 cm (OR 1,8). Tener bajos niveles de ingresos y de educación, estar casada o en pareja y consumir asiduamente comidas fritas también constituían factores de riesgo significativos. DISCUSIÓN Las políticas alimentarias deben combinarse con politicas de empleo y de distribución de ingresos, de producción y acceso a alimentos saludables, junto a legislación sobre la composición y publicidad de alimentos y bebidas, y a la diseminación de información y de buenas prácticas alimentarias.

ABSTRACT INTRODUCTION Food insecurity (FI) is a multidimensional phenomenon which forces people to reduce the quantity or quality of consumed products and has a continuum of severity levels (from mild to severe). The objective of this study was to analyze the relationship between FI and nutritional status in mothers attending Primary Health Care Centers in four provinces of Argentine Northwest. METHODS A questionnaire with USDA and NHANES III FI indicator was applied to 995 mothers. Nutritional status was assessed using body mass index (BMI) and waist circumference. RESULTS The prevalence of obesity (BMI ≥30 kg/m2) was higher among women with severe (37.1%) and moderate (28.7%) FI than in women reporting low FI (20.3%) or food security (FS) (22.4%) (p 0.003). In multivariate logistic regression models, severe FI increased the likelihood of BMI ≥30 kg/m2 (OR 1.8) and of waist circumference ≥80 cm (OR 1.8). Low income and education level, being married/living with a partner, and fried food consumption also were significant risk factors for obesity. DISCUSSION Food policies should combine with employment and income distribution, production and access to healthy foods, food and beverage composition and advertising regulations, together with the dissemination of information and healthy nutrition practices.

De una crisis alimentaria anunciada a la emergencia humanitaria en Venezuela / From a food crisis to a humanitarian emergency in Venezuela

La crisis alimentaria anunciada por científicos en el año 2007 se ha convertido en una emergencia humanitaria en el 2021. Se fueron gestando una economía desequilibrada, elevados precios de alimentos, falta de servicios básicos como el agua, servicios sanitarios, trayendo como consecuencia una hiperinflación de 3713%, un salario mínimo que cubre 0,88% de la canasta alimentaria, 97% de inseguridad alimentaria, 15% de desnutrición aguda y 30% de baja talla en menores de 5 años y la movilización de 4,6 millones venezolanos. Este trabajo analiza las percepciones sobre una crisis alimentaria en Venezuela, factores asociados y estrategias para mejorarla desde la mirada de profesionales de la alimentación y nutrición en el año 2007. Se seleccionó intencionalmente 51 profesionales, de los cuales 10 sujetos respondieron una entrevista confidencial y electrónica. La categorización y análisis de las entrevistas se complementó con referencias de otros autores, para la construcción de la teoría. La mayoría de los entrevistados admitió una crisis alimentaria en el 2007, con factores asociados de índole político, económico, de servicios y hasta moral. Como recomendaciones surge: "reorientar las políticas agrícolas, pecuarias, de educación, trabajo y remuneración entre otras, relacionadas directa e indirectamente con el sector de los alimentos, para lograr abastecer los mercados y permitir que los alimentos puedan llegar a la población". Esta aproximación de la crisis alimentaria permitió comprender cómo la crisis se exacerbó hasta convertirse en una emergencia humanitaria agravada por la pandemia. Se ha perdido toda una generación de venezolanos por enfermedad, muerte, oportunidades y migraciones(AU)

The food crisis announced by scientists in 2007 has become a humanitarian emergency in 2021. An unbalanced economy, high food prices, lack of basic services such as water, sanitation, were brewing, resulting in a hyperinflation of 3713%, a minimum wage that covers 0.88% of the food basket, 97% of the population with food insecurity, 15% of acute malnutrition and 30% of stunting in children under 5 y. and the migration of 4.6 million Venezuelans. This manuscript analyzes the perceptions of a food crisis in Venezuela, associated factors and strategies to improve it from the perspective of food and nutrition professionals in 2007. Fifty-one professionals were intentionally selected, of which 10 subjects answered a confidential and electronic interview. The categorization and analysis of the interviews was complemented with references from other authors, for the construction of the theory. Most of those interviewed admitted a food crisis in 2007, with associated factors of a political, economic, essential utilities and even moral nature. As recommendations arise: "reorient agricultural, livestock, education, work and remuneration policies, among others, directly and indirectly related to the food sector, in order to supply markets and allow food to reach the population." This approach to the food crisis made it possible to understand how the crisis exacerbated into a humanitarian emergency aggravated by the pandemic. A whole generation of Venezuelans has been lost to illness, death, opportunities, and migration(AU)

Percepción de satisfacción entre beneficiarios del programa de alimentación escolar en Bucaramanga-Colombia / Perception of satisfaction among beneficiaries of the school food program of Bucaramanga-Colombia

Resumen Introducción: El Programa de Alimentación Escolar PAE en Colombia es uno de los más antiguos orientado a la protección de la población infantil para potenciar su desarrollo y disminuir la deserción escolar; sin embargo, no hay investigación suficiente que permita evidenciar avances y logros del programa. Objetivo: Determinar la prevalencia en la percepción de satisfacción de los beneficiarios del Programa de Alimentación Escolar - PAE en Bucaramanga, Colombia y sus factores asociados. Metodología: Se realizó en 2017 un estudio cuantitativo de corte transversal analítico. La población correspondió al universo de escolares beneficiarios del PAE en la ciudad (N= 31.230) y la muestra a 401 escolares la cual se dividió en dos grupos según edad: grupo 1 (de 5 a 8 años) y grupo 2 (de 9 a 17 años). Las encuestas para evaluar los componentes sensorial, organizacional y social, fueron sometidas a prueba piloto para validación aparente o facial y ajustadas según resultados. Una vez recogidos los datos se hizo análisis descriptivo a características de interés; para corroborar diferencias estadísticamente significativas se usó la prueba de chi2 y T de Student y se realizaron análisis bivariados y multivariados entre las características de interés y la percepción de satisfacción usando regresión lineal simple y múltiple. Resultados: Los estudiantes mostraron un nivel alto de percepción de satisfacción frente a las raciones recibidas, siendo los más satisfechos los de nivel socioeconómico bajo y medio bajo (Coef B 2,43; IC 95%: 1,61-3,25) y los que recibieron ración preparada en sitio (niños de 5 a 8 años), (Coef B 8,36; IC 95%: 7,08-9,64). Se encontró que el 25% de los estudiantes de nivel socioeconómico medio-medio y medio-alto botaba los alimentos a la basura. Conclusiones: Estos hallazgos mostraron la necesidad prioritaria de ser más rigurosos en la focalización de los beneficiarios del programa, así como llevar a cabo otros ajustes planteados en el estudio, para incrementar la calidad del programa PAE de Bucaramanga.

Abstract Introduction: The PAE School Feeding Program in Colombia is one of the oldest oriented to the protection of the child population to enhance their development and decrease school dropouts; however, there is not enough research to show progress and achievements of the program. Objective: To determine the prevalence of perception of satisfaction of the beneficiaries of the School Feeding Program, in Bucaramanga, Colombia and its associated factors. Methodology: An analytical cross-sectional study was carried out in 2017 with an empirical non-experimental analytical approach. The population corresponded to the universe of PAE schoolchildren in the city (N = 31,230) and the sample to 401 students which was divided into two groups according to age: group 1 (from 5 to 8 years) and group 2 (from 9 to 17 years). The surveys to evaluate the sensory, organizational and social components were submitted to a pilot test for apparent or facial validation and adjusted according to results. Once the data was collected, a descriptive analysis was made to the characteristics of interest; To corroborate statistically significant differences, the chi2 and Student's T test were used and bivariate and multivariate analyzes were performed between the characteristics of interest and the perception of satisfaction using simple and multiple linear regression. Results: The students showed a high level of satisfaction perception compared to the rations received, being the most satisfied those low and medium low socioeconomic status (Coef B 2.43; 95%CI: 1.61-3.25) and those who received ration prepared on site (children 5 to 8 years old), (Coef B 8.36; 95%CI: 7.08-9.64). Conclusions: These findings showed the priority need to be more rigorous in the targeting of the beneficiaries of the program, as well as carry out other adjustments proposed in the study, to increase the quality of the PAE program in Bucaramanga.

Evolución de los programas de ayuda alimentaria en México a través de información de la Ensanut MC 2016 / Evolution of social food assistance programs in Mexico through Ensanut MC 2016 data

Resumen: Objetivo: Describir la cobertura y focalización de los Programas de Ayuda Alimentaria (PAA) en México. Material y métodos: Se obtuvo información de 9137 hogares de la Encuesta Nacional de Salud y Nutrición Medio Camino (Ensanut MC) 2016 sobre los PAA que reciben. Se analizó la distribución de los PAA por lugar de residencia, índice de nivel socioeconómico y pertinencia los PAA. Resultados: El 44% de los hogares recibe algún PAA, con mayor concentración en hogares indígenas (70%), de muy bajo nivel socioeconómico (70%) y en inseguridad alimentaria moderada y severa. Los PAA con mayor cobertura fueron Prospera (21%), Liconsa (9%), Programa de Desayunos Escolares (17%) y el Programa de Adultos Mayores; de éstos, el programa mejor focalizado fue Prospera. Conclusiones: Es necesario revisar los recursos de los programas y dirigirlos a la población con mayores carencias y mayor vulnerabilidad nutricional.

Abstract: Objective: To describe the coverage and targeting of Social Food Assistance Programs (SFAP) in Mexico. Materials and methods: Data were obtained from 9137 households of the Halfway National Health and Nutrition Survey 2016 (Ensanut MC 2016) who receive SFAP. The distribution of the SFAP by place of residence, index of socioeconomic status and SFAP relevance were analyzed. Results: 44% of households receive some SFAP, with a higher concentration in indigenous households (70%), a very low socioeconomic level (70%), and moderate and severe food insecurity. The SFAP with the greatest coverage were Prospera (21%), Liconsa (9%), School Breakfasts Program (17%) and the Support Program for Older Adults; of these the best-focused program was Prospera. Conclusions: It is necessary to review the resources of the programs and direct them to the population with greater deficiencies and greater nutritional vulnerability.

Evolución de la inseguridad alimentaria en los hogares mexicanos: 2012-2016 / Evolution of food insecurity in Mexican households: 2012-2016

Resumen: Objetivo: Describir tres aspectos importantes de la inseguridad alimentaria (IA) en México: la magnitud y distribución de acuerdo con características de vulnerabilidad social, su evolución entre 2012 y 2016 y el efecto de los programas sociales de ayuda alimentaria en la IA de los hogares mexicanos. Material y métodos: Se incluyó información de 40 809 y 9 019 hogares provenientes de la Ensanut 2012 y 2016, respectivamente. Se realizó un análisis de diferencias en diferencias para medir el efecto de los programas de ayuda alimentaria en la evolución de la IA. Resultados: El 69.5% de los hogares se clasificó en IA. Los más afectados por la IA fueron hogares más pobres (85.8%) y de áreas rurales (78.0%). En el periodo 2012-2016, la prevalencia de IA moderada y severa disminuyó en hogares con apoyo de programas de ayuda alimentaria. Conclusión: Los resultados presentados son una herramienta para mejorar el diseño y focalización de políticas públicas y fortalecer la gobernanza de la seguridad alimentaria en México.

Abstract: Objective: To describe three relevant aspects of household food insecurity (FI) in Mexico: its magnitude, its distribution by social and nutritional vulnerability characteristics; its evolution between 2012 and 2016 and the effect of food assistance programs on FI in Mexican households. Materials and methods: Data on 9 019 households were drawn from the 2016 National Health and Nutrition Survey (Ensanut 2016 for its Spanish initials) and were compared with data from the 2012 Ensanut. An analysis of differences in differences was made to measure the effect of food assistance programs on the evolution of FI. Results: As many as 69.5% of households were classified as FI. Families located in rural areas (78.0%) and residing in southern Mexico (76.3%). Households with support from a food assistance program experienced a decrease in moderate and severe FI between 2012 and 2016. Conclusion: Findings can be used to design and target public policies seeking to improve food security governance in Mexico.

An anthropometric and physical condition assessment of university students attending a food assistance program in colombia / Evaluación antropométrica y de la condición física en estudiantes universitarios, beneficiarios de un programa de asistencia alimentaria en colombia

ABSTRACT The university life implies significant changes in the food habits and physical activities. The university students usually don't fulfill neither the recommended nutritional requirements nor the physical condition advises. The objective of this study was to evaluate the nutritional state and physical condition in Colombian university students attending to a food assistance program. It was a descriptive cross-sectional study with undergraduate students from the University of Caldas, Colombia. Anthropometric measurements (e.g. height, weight, biceps, triceps, subscapular and suprailiac skinfolds, arm and waist circumferences) were taken. Besides, functional manual pressure tests and the Harvard step test were performed. The correlation between anthropometrical and functional variables was calculated. According to the Body mass index (BMI), 22.4% from 420 students had malnutrition. The weight excess was 3.6 times bigger than undernourishment (17.9 compared to 4.5%). However, when the body fat was measured the situation got worse: the 46.4% of them had fat excess. The women were the most affected. The waist circumference showed a fat distribution with abdominal predominance in 14% of the population. The forearm strength and muscle mass were decreased in almost the 50% of men and 30% of women. The physical condition was inappropriate for the 38.1% of participants with a greater alteration in the men. Contradicting the assumptions, it has found out that around 50% of the public university students and beneficiaries of a food assistance program had body fat excess and an inappropriate physical condition. Efforts to improve the physical activity and food habits must be carried out. At the same time, the impact of the malnutrition in health and academic efficiency must be reduced.

RESUMEN La etapa universitaria conlleva cambios significativos en los hábitos de alimentación y en la actividad física. Los estudiantes universitarios usualmente no cumplen los requerimientos nutricionales ni de condición física recomendados. El objetivo del presente estudio fue evaluar el estado nutricional y la condición física de estudiantes de universidad pública, pertenecientes a un programa de asistencia alimentaria. Como método investigativo se empleó un estudio descriptivo de corte transversal en estudiantes de pregrado de la Universidad de Caldas, Colombia. Se realizaron mediciones antropométricas de estatura, peso, pliegue bicipital, tricipital, subescapular y suprailiaco, circunferencia de la cintura y del brazo. Además, se realizaron pruebas funcionales de fuerza de prensión manual y test de banco de Harvard. Se calcularon las correlaciones entre variables antropométricas y funcionales. De acuerdo al índice de masa corporal, de 420 estudiantes, 22,4% presentaban malnutrición. El exceso de peso fue 3,6 veces mayor que la desnutrición (17,9 vs. 4,5%). Sin embargo, al medir la grasa corporal la situación empeoró: el 46,4% de ellos tenían exceso de grasa, siendo las mujeres las más afectadas. La circunferencia de la cintura mostró una distribución de la grasa con un predominio abdominal en el 14% de la población. La fuerza y la masa muscular del antebrazo estuvieron disminuidas en casi el 50% de los hombres y el 30% de las mujeres. La condición física fue inadecuada en el 38,1% de los estudiantes y fue mayor en los hombres. Contrario a lo que podría suponerse en estudiantes de una universidad pública y beneficiarios de un programa de asistencia alimentaria, cerca del 50% presentaron exceso de grasa corporal y una inadecuada condición física. Deben hacerse esfuerzos para mejorar los hábitos de alimentación y actividad física, reduciendo el impacto que tiene la malnutrición en el rendimiento académico y en la salud.

Restaurante popular: a política social em questão / Popular restaurants: social policies under debate

Resumo As políticas públicas sociais são reconhecidas, nesse ensaio, como imperativas, nos marcos das sociedades capitalistas, para materialização de direitos e necessidades humanas. No Brasil, e nos demais países capitalistas, as políticas sociais se instituíram como desdobramento das lutas de classe, caminho para a conquista de direitos e diminuição de desigualdades. No entanto, dependentes da liberação de recursos públicos, mostram-se fragmentadas e descontínuas. No que tange às políticas sociais, no âmbito da segurança alimentar e nutricional, o Programa de Rede de Equipamentos Públicos de Segurança Alimentar e Nutricional, com destaque para os restaurantes populares, tem como objetivo promover o acesso da população urbana à alimentação adequada, a preços acessíveis, com prioridade aos segmentos mais vulneráveis. Nascidos sob a égide da desigualdade social, originalmente na década de 1940, continuam sendo utilizados para minimizar desajustamentos políticos, sociais e econômicos. A contribuição efetiva desses restaurantes é amenizar a situação de insegurança alimentar, entretanto a irregularidade dos recursos públicos e a restrita participação e controle sociais podem comprometer a execução da política social e a materialização do direito humano à alimentação. O fechamento dos 16 restaurantes, em 2016, no Rio de Janeiro, significou abrir mão do atendimento emergencial e da necessária proteção social.

Abstract Public social policies are recognized, in this paper, as imperative, in capitalist societies, to enforce rights and fulfill human needs. In Brazil, and also in other capitalist countries, social policies were developed as a result of class struggle. However, when dependent on the release of public funds, these policies can be discontinuous. In terms of social policies, and in the context of food and nutritional security, Brazil's Network of Public Facilities for Food and Nutritional Security and, particularly, the so-called popular restaurants, are aimed at providing the urban population with access to adequate food at affordable prices, thus giving priority to the most vulnerable people. The restaurants were originally created in the 1940s, and they are still being used to minimize political, social and economic imbalances. The effective contribution of these restaurants is to mitigate the situation of food insecurity. However, the irregular availability of public funds and the limited participation and control of society can compromise the implementation of this social policy and the fulfillment of the human right to food. Therefore, the shutdown of 16 restaurants, in 2016, in Rio de Janeiro, meant to relinquish the provision of emergency care and social protection.