Eficacia de la intervención nutricional del programa PANI luego de seis meses de tratamiento en el Hospital Regional de Concepción

RESUMEN Introducción: Los programas alimentarios han demostrado ser herramientas eficaces para disminuir la prevalencia de desnutrición infantil. Objetivos: Evaluar la eficacia de la intervención nutricional del Programa Alimentario Nutricional Integral PANI en los cambios de los indicadores antropométricos y bioquímicos en niños < 5 años en riesgo de desnutrición y desnutridos que acudieron al Hospital Regional de Concepción, al ingreso al programa versus a los seis meses de intervención. Materiales y métodos: Diseño prospectivo con componente analítico. Muestreo: 134 niños y niñas <5 años, beneficiarios del PANI en Concepción durante el año 2014. Puntos de corte para desnutrición y anemia según criterios OMS. Se utilizaron medidas paramétricas y no paramétricas, χ2, τ student. Significancia p< 0,05. Resultados: 134 niños fueron evaluados. Edad: x 22,4 meses. El 59,7 % fue lactante. Madres con < 6 años de estudio 17,9%, el 80,6% con ≤ de 3 hijos. Acceso a agua segura, 44,8% y saneamiento básico 40,3%. Lactancia materna exclusiva al 5to mes 7,5 %. La prevalencia de desnutrición disminuyó al 6to.mes del 14,9 % vs 4,4 % (p<0,01). La prevalencia de niños con riesgo de desnutrir disminuyó del 73,1 % al 27,6 % al 6to mes. Anemia al ingreso, 63%. Parasitosis intestinal al ingreso 24,6%. Deserción del PANI 31,3%. Conclusiones: La prevalencia de la desnutrición y de la anemia disminuyó al 6to. mes de tratamiento en los niños beneficiarios del PANI en Concepción.

ABSTRACT Introduction: Food programs have proven to be effective tools to reduce the prevalence of child malnutrition. Objectives: To evaluate the effectiveness of the nutritional intervention of the Comprehensive Nutritional Food Program (PANI) in the changes of anthropometric and biochemical indicators in children <5 years at risk of malnutrition and malnourishment who presented to the Regional Hospital of Concepción, upon admission to the program versus after six months of intervention. Materials and Methods: This was a prospective study with an analytical component. Sample size: 134 boys and girls <5 years old, PANI participants in Concepción during 2014. Cut-off points for malnutrition and anemia were according to WHO criteria. Parametric and non-parametric measures were used, χ2, τ student test was applied. Significance p <0.05. Results: 134 children were evaluated. Average Age: 22.4 months. 59.7% were breast-fed. Mothers with <6 years of schooling, 17.9%, 80.6% with ≤ 3 children. Access to safe water, 44.8% and access to basic sanitation 40.3%. Exclusive breastfeeding at the 5th month of age was 7.5%. The prevalence of malnutrition decreased after the 6th month of intervention from 14.9% vs 4.4% (p <0.01). The prevalence of children at risk of malnutrition decreased from 73.1% to 27.6% at the 6th month. Anemia on admission, 63%. Intestinal parasitosis on admission 24.6%. PANI desertion rate was 31.3%. Conclusions: The prevalence of malnutrition and anemia decreased after the 6th month of treatment in children participating in PANI in Concepción.

Changes In Emotional Distress And Cognitive Performance Following Aerobic Exercise And Low Fat Milk Consumption In Sedentary Female Adolescents

@#Introduction: Regular aerobic exercise and low-fat milk consumption can improve certain cognitive functions and reducing emotional distress. However, the impacts of combining these modalities are less explored. Thus, the present study examined the effects of combining aerobic exercise and low-fat milk intake among sedentary female students. Methods: Using a nonrandomized pretest – posttest with a control group research design, 85 sedentary females aged 16 years old were assigned into either milk (n = 21), exercise (n = 22), combined low fat milk and exercise (n = 23), or control (n = 19) groups. One serving of low-fat milk was provided to the students during each school day, and a 1-hour supervised step aerobics exercise was conducted twice per week for 3 months. Emotional distress and sustained attention were measured at baseline, 6th and 12th weeks after the intervention. A mixed factorial ANOVA was used to analyse the data. Results: The results revealed significantly less emotional distress in the combined (p < 0.01) and exercise groups (p < 0.05) compared with the control group after 12 weeks. Additionally, significant reductions were observed in the total time taken and errors of omission for both digits 6 and 9 of the Digit Vigilance Test in the combined group (p < 0.05, p < 0.001) compared with the control group. Conclusions: The results showed that low fat milk alone did not provide any additional benefits related to distress regulation, but the combination of exercise and low-fat milk contributed to improving sustained attention.

Adherencia a la ingesta de los productos del Programa de Alimentación Complementaria del Adulto Mayor (PACAM) desde la subjetividad de los adultos mayores de la comuna de Hualpén, Chile / Understanding older adults' adherence to the consumption of products provided by the Supplementary Food Program for Older Adults (PACAM ) by exploring the point of view of users from the municipality of Hualpén, Chile

INTRODUCCIÓN. El Programa de Alimentación Complementaria del Adulto Mayor (PACAM) es un programa chileno destinado a prevenir y recuperar el daño nutricional en los adultos mayores. La escasa adherencia de los últimos años motiva este estudio. OBJETIVO. Comprender cuáles son los motivos de la baja adherencia de las personas mayores a la ingesta de los productos del PACAM (bebida láctea y crema en polvo fortificada llamada 'Años Dorados'), con el fin de proponer alternativas de mejora del programa desde los propios intereses y valoraciones de los usuarios adultos mayores. MÉTODO. Es un estudio cualitativo de carácter fenomenológico y hermenéutico enfocado en la interpretación del significado de las experiencias individuales subjetivas. El estudio realizado el primer semestre del 2017, conllevó 20 entrevistas semiestructuradas realizadas a los adultos de ambos sexos beneficiarios del PACAM de la comuna de Hualpén, Chile. RESULTADOS Y CONCLUSIÓN. Olor, sabor, consistencia, formas de preparación y cantidad de los formatos son algunos de los elementos organolépticos definidos por las personas mayores, mientras los elementos externos incluyen calidad de vida, red social, influencia de otros usuarios, relación con los profesionales en los servicios de salud, cotidianidad y hábitos.

INTRODUCTION. The Supplementary Food Program for Older Adults (known by the acronym PACAM) is a Chilean program aimed at preventing and/or supporting elderly individuals' recovery from malnutrition. Poor adherence to PACAM in recent years motivates this study. OBJECTIVES. To understand the reasons for the low adherence of older adults to the consumption of PACAM products (milk drink and a fortified powdered soup known as "Golden Years Cream"), in order to propose alternatives for improving the program based on the interests and preferences of elderly users. METHODS. A qualitative study, with a phenomenological and hermeneutical approach, was conducted, focused on interpreting the meaning of the users' subjective experiences. The study, which was carried out during the first semester of 2017, consisted of 20 semi-structured interviews conducted with older adults of both sexes, who were beneficiaries of PACAM in the Chilean municipality of Hualpén. RESULTS AND CONCLUSIONS: Food odor, taste, consistency, preparation, and quantity were some of the organoleptic properties identified by the subjects, while the external factors included quality of life, social networks, the influence of other users, relationships with professionals in the health centers, daily life, and habits.

Evolución nutricional de niños y niñas menores de 5 años usuarios de un Programa Alimentario Nutricional Integral en Paraguay

Introducción: La desnutrición es un desafío pendiente que influye nocivamente en el desarrollo de los niños/as y de una nación. Objetivo: Evaluar la evolución del estado nutricional de niños/as <5 años ingresados a un programa alimentario durante el año 2012. Materiales y Métodos: Estudio longitudinal (cohorte), descriptivo, analítico de beneficiarios del Programa Alimentario Nutricional Integral (PANI) en el 2012.Variables sociodemográficas fueron consideradas, el diagnóstico nutricional según criterios OMS según puntaje zPeso/Edad (zP/E), Índice de Masa Corporal/Edad (zIMC/E), Talla/Edad (zT/E). Resultados: Fueron procesados datos de 4946 niños/as <5años. Edad media 17,5m (0,03-59 m), 50,3% varones; 51,4% del área rural. Al ingreso, tuvieron media zP/E-1,71±0,7DE, zIMC/Edad -1,31±1,12DE y zT/E -1,34±1,30 DE. El zP/E en controles sucesivos aumentó a -0,36 DE en el 12vo. control, el zIMC/E a 0,26DE,zT/E a -0,91 de manera significativa (ANOVA p<0,0001). 22,6% presentaban Desnutrición Global-DG y 77,4% de riesgo de desnutrir al ingreso, estas prevalencias fueron de 3,4% y 21% respectivamente con 75,6% de niños/as sin desnutrición al último control ((2,p<0,0001). 21,9% tuvieron desnutrición por IMC, y 38,5%% de riesgo de desnutrir, estas prevalencias fueron de 3,1% y 10,7% al 12vo. control. Del 26% de Desnutrición Crónica-DC, se pasó a 16% al final de la intervención. Conclusiones: La desnutrición infantil disminuye significativamente con el apoyo de un programa alimentario.

Introduction: Malnutrition is a pending challenge which has a harmful influence on children's development of and for a nation. Objective: To evaluate the evolution of nutritional status of children <5 years admitted to an Integrated Nutritional Food Program (PANI) during the year 2012. Materials and Methods: Longitudinal (cohort), descriptive and analytical study of beneficiaries of the Integrated Nutritional Food Program (PANI) in 2012. Sociodemographic variables were considered, nutritional diagnosis was according to WHO criteria with zscore Weigth/Age (z(W/A), Body Mass Indesx/Age (zBMI/A) and Heigth/Age (zH/A). Results: Data were processed from 4946 children <5 years old. Mean age 17.5m (0.03-59 m), 50.3% males; 51.4% of the rural area. At entry, they had mean zW/A -1.71 ± 0.7DE, zBMI/A -1.31 ± 1.12 DE and zH/A -1.34 ± 1.30DE. The zW/A in successive controls increased to -0.36DE in the 12th control, zBMI/A at 0.26DE, zH/A at -0.91 significantly (ANOVA p <0.0001). 22.6% presented Global Malnutrition-DG and 77.4% risk of malnutrition at admission, these prevalences were 3.4% and 21%, respectively, with 75.6% of children without malnutrition at the last control ((2, p<0.0001). 21.9% had malnutrition due to BMI, and 38.5% had a risk of malnutrition, these prevalences were 3.1% and 10.7% at the 12th control. Of the 26% of Chronic Malnutrition-DC, it was changed to 16% at the end of the intervention. Conclusions: Child undernutrition decreases significantly with the support of a food program.

Eficacia de la formación sobre los conocimientos, actitudes y prácticas de manipulación de alimentos en madres procesadoras de una escuela del estado Nueva Esparta, Venezuela / Effectiveness of training on the knowledge, attitudes and practices in food handling in mothers cookers from a school in Nueva Esparta state, Venezuela

En Venezuela la Corporación Nacional para la Alimentación Escolar, S.A. proporciona comidas en planteles oficiales (Programa PAE). Para evaluar la eficacia de la formación en conocimientos, actitudes y prácticas de manipulación de alimentos se realizó un estudio sobre higiene alimentaria con trece madres procesadoras de una escuela del Estado Nueva Esparta, para aumentar sus conocimientos, estimular actitudes para prevenir enfermedades y aplicar prácticas higiénicas en su trabajo. Se recolectaron datos aplicando cuestionarios pre-intervención y post-intervención (después de transcurridos 9 meses). Comprendían cuatro secciones: Información demográfica; conocimientos (prueba de selección múltiple), actitudes y prácticas (escalas de Likert con 3 y 5 categorías respectivamente). En el intermedio del estudio se dictaron cursos de manipulación de alimentos, supervisaron tareas rutinarias, realizaron conversatorios sobre fallas detectadas, desarrollaron tormentas de ideas para subsanarlas y entrenamientos en tareas de limpieza y desinfección. Los resultados se compararon a través de t-student y Mann Whitney (Wilcoson), con un nivel de significancia de (p < 0,05). En conocimientos (pre-intervención) solo una participante superó 7/10 puntos, siendo 3,7 el promedio grupal. En post-intervención 7 de ellas superaron los 7 puntos, con un promedio grupal de 6,2 puntos. En actitudes, respuestas positivas ascendieron desde 49,5% inicialmente hasta 64,8% (post-intervención). En prácticas de manipulación, inicialmente 28,6% de las respuestas afirmaron que frecuentemente o siempre ejecutaban lo descrito en proposiciones, incrementándose hasta 72,5% al finalizar el entrenamiento. Los resultados determinaron diferencias significativas (p < 0,05) entre puntuaciones de ambas etapas y se comprobó el impacto positivo de formar a madres procesadoras en higiene alimentaria.

In Venezuela country the National Corporation for Scholar´s Food, S.A. (CNAE), undertakes the responsibility for providing balanced meals in official schools (PAE Program). In order to evaluate the effectiveness of training in knowledge, attitudes and practices of food handling, a study in food hygiene was conducted with thirteen cookers from a school in the State of Nueva Esparta. The objective was to increase their knowledge, encourage attitudes to prevent food borne disease and apply hygiene practices in their work. Data were collected with questionnaires both before (pre-intervention stage) and (post-intervention stage) after nine (9) months. The questionnaires consisted of four sections: demographic information, knowledge (multiple choice test, and attitudes and practices that were measured using a scale of Likert with 3/5 categories respectively. Food handling courses were given in the middle of the development of the study, supervising routine procedures in kitchen, talking about several faults detected and also it was taken place storm ideas for rectify and it was given training about cleaning and disinfection tasks. The quantitative results of questionnaires were compared through t-student and Mann Witney (Wilcoson) tests. In the all cases, the significance level was (p <0.05). The knowledge results (pre-intervention) only one cooker overcomes 7/10 points, it was 3.7 points the group media. In the post-intervention, seven cookers obtained more than seven points, and the group media it was 6.2 points. Of relation to attitudes, the positive answers increased from 49.5% (pre-intervention) to 64.8% (post-intervention). As soon as handling practice, in the beginning 28.6% responses confirm that often or ever practicing the described in the questions, reaching to 72.5% in the post intervention phase. The study found significant difference (p < 0.05) among both scores. It was higher in the post-intervention. The survey findings suggest that training to cooker´s mothers hygienic was positive impact and the continuous education is needed to assure change to correct food handling practices and attitudes.

Consumo de sódio em uma unidade de alimentação e nutrição de Belo Horizonte, MG / Sodium consumption in a food and nutrition unit of Belo Horizonte, MG

Este trabalho teve como objetivo avaliar as quantidades de sódio nas preparações e nas fichas técnicas de preparo de uma unidade de alimentação e nutrição industrial cadastrada pelo Programa de Alimentação do Trabalhador do município de Belo Horizonte, Minas Gerais. Caracterizou-se como um estudo transversal sobre a avaliação quantitativa do consumo de sódio utilizado nas preparações e nas Fichas Técnicas de Preparo de uma Unidade de Alimentação e Nutrição industrial. Dos cardápios de 20 dias analisados, apenas em um dia, a quantidade per capita de sódio ficou abaixo do valor máximo de sódio recomendado pelo Programa de Alimentação do Trabalhador, 960mg para as grandes refeições. Considerando que os usuários desta unidade de alimentação realizam suas refeições diariamente neste local, existe uma grande possibilidade dos mesmos apresentarem hipertensão arterial, ressaltando a importância do papel do nutricionista na elaboração de cardápios, visando alcançar as recomendações do Programa de Alimentação do Trabalhador e, principalmente, a promoção da saúde dos usuários desta unidade.

Tendências de pesquisa em políticas públicas: uma avaliação do Programa Nacional de Alimentação Escolar - PNAE / Research trends in public policy: an assessmentof the National School Food Program (PNAE)

O objetivo do artigo é avaliar as tendências de pesquisa do Programa Nacional de Alimentação Escolar (PNAE), analisando os periódicos disponibilizados pela Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES, no período de 2008 a 2013. Pesquisa bibliográfica com a observação dos assuntos abordados mais relevantes, discutidos pelo programa neste período por uma análise qualitativa. Foram selecionados 10 artigos científicos vinculados à área, sendo que a escolha ocorreu pela leitura dos resumos e das questões de pesquisa dos artigos, bem como pela busca das seguintes palavras-chave: políticas públicas, agricultura familiar, alimentação escolar. Estudos relacionados ao PNAE e os seus impactos também foram considerados, devido à ligação com as atividades desempenhadas pelas Políticas Públicas. O artigo apresenta as temáticas mais analisadas e exploradas sobre o tema durante o período considerado. Conclui-se que as principais tendências de pesquisa, se caracterizam pelo estudo de estratégias de Segurança Alimentar e Nutricional, analisando a composição e a aceitação dos alimentos oferecidos aos estudantes, pela analise da produção, melhores condições de vida e desenvolvimento local dos produtores rurais.

The scope of the article is to evaluate the research trends of the Brazilian School Food Program (PNAE), by analyzing the papers published in journals on the Brazilian Federal Agency for Support and Evaluation of Graduate Education (CAPES) website in the period from 2008 to 2013. It involved bibliographical research by means of qualitative analysis to detect the most relevant issues addressed and discussed by the program. Ten scientific articles related to the area were selected after reading the abstracts and research topics of the articles and by a search for the following key words: public policy, family farming, school food. Studies related to the PNAE and its impacts were also considered, due to the connection with the activities carried out in Brazilian public policy. The paper presents the issues analyzed and discussed most on the subject during the period under consideration. The conclusion reached is that the main research trends are characterized by the study of strategies for food and nutrition safety, analyzing the composition and acceptance of foods offered to students by an analysis of production, better living conditions and local development of rural producers.

Evaluación de un programa de entrega de frutas con educación nutricional en escuelas públicas rurales de la Región Metropolitana, Chile / Evaluation of a fruits delivery program with nutrition education in rural public schools from the Metropolitan Region, Chile

The objective of this study was to assess the delivery of fruits with nutrition education in rural schools measuring its impact on food knowledge, food consumption and children nutritional status. A longitudinal quasi-experimental study of one year was carried out in an experimental group with delivery of fruits plus nutrition education, compared with a control group. Subjects were 784 school children (preschool to 8th grade) in 5 basic schools in María Pinto and 192 in the control group in Curacaví. Nutritional status, food knowledge, food consumption, the amount of fruit distributed and customer satisfaction were evaluated. Results showed that 85% of preschool to 2nd grade and 68.2% 3th to 8th grade children reported to consume fruit as a snack at least 3 times perweek. In children from 3th to 8th grade dairy consumption (more than 2 times per day) increased from 62% to 74%, respectively (p<0.01). Consumption of fruit more than 2 times per day increased to 34.9%, and legumes intake more than twice per week increased 37.7% to 51.7% (p<0.0001). In preschool from 57.6% to 76.2% and vegetables consumption more than 2 times per day increased from 26.8% to 2nd grade children there was a significant increase in healthy food knowledge in the period of the intervention (p<0.0001), while in children from 3th to 8th grade there was a significant improvement in consumption of fish and dairy food (p<0.0001). In the control group there were no changes either in food knowledge or in fruit consumption, and no changes in nutritional status were observed in both groups. In conclusion, the success of the program resides in the improvement of food knowledge and fruit consumption as a protective factor. To achieve an impact in nutritional status is necessary the long-term continuity of the program.

El objetivo de la presente investigación fue evaluar la entrega de fruta, con educación nutricional en escuelas básicas rurales midiendo su impacto en conocimiento, consumo y estado nutricional de los niños. Para ello se realizó un estudio cuasi-experimental, de seguimiento longitudinal de un año de duración en niños intervenidos con educación nutricional y entrega de frutas, comparados con un grupo control. La muestra fue de 784 niños de prekinder a 8° básico de 5 escuelas de María Pinto y 192 de una escuela control en Curacaví. Se evaluó el estado nutricional, consumo de alimentos seleccionados, conocimientos sobre alimentación saludable y consumo de la fruta entregada y satisfacción de usuarios. Resultados: el 85% de los niños de prekinder a 2° básico y el 68,2% de 3° a 8° básico reportaron consumir fruta de colación 3 días a la semana. En niños de 3° a 8° básico aumentó el consumo en 2 o más porciones al día de lácteos, de 62% a 74% (p<0,01). El consumo diario de 2 o más frutas aumentó de 57,6% a 76,2% y de 2 o más porciones de verduras de 26,8% a 34,9% y las legumbres 2 o más veces por semana aumentaron de 37,7% a 51,7% (p<0,0001). Hubo un aumento significativo en el conocimiento de una alimentación saludable entre el inicio y final (p<0,0001) en niños de prekinder a 2° básico; en los de 3° a 8° básico el cambio fue significativo en pescados y lácteos (p<0,0001). El grupo control no presentó cambios en el conocimiento ni consumo (p>0,1). No hubo cambios significativos en el estado nutricional del grupo intervenido ni del control. Se concluye que el programa fue exitoso ya que se cumplió el propósito de aumentar el conocimiento y consumo de fruta como un factor protector de la salud y que para lograr impacto en el estado nutricional se requiere darle continuidad en el tiempo.

Raciones de desayuno y almuerzo entregadas a preescolares por el Programa de Alimentación Escolar (PAE): calorías aportadas y consumidas / National School Food Program: calories provided and consumed by preschool children for breakfast and lunch

Chile's School Feeding Program delivers approximately 215,000 and 1.3 million breakfast and lunch trays daily to preschool and school children attending public schools. In 2011 we carried out a study with the objective to determine Kcal provided and consumed from breakfast and lunch trays respectively, acceptance" of the preparations and assess if there was an association between K cal consumed and nutritional status. The sample included 199 5 y old children from 6 schools located in 3 low income districts of Santiago (2 per district). K cal consumed was determined by the difference in weight of each preparation from 429 and 1491 breakfast and lunch trays, respectively. Almost 50% of the children were overweight. 10.8% and 30% of the breakfast and lunch trays respectively provided less K cal than indicated, while in 50% of them, there was an excess. In 22.5% of breakfast and lunch trays added together, consumption exceeded the amount indicated. The correlation between consumption of the preparation and acceptance was good. Salads showed low acceptability. No relation was found between K cal consumed and nutritional status. This program should include a revision of the combination of food preparations and their correct portioning as a means of addressing the high prevalence of childhood obesity.

El Programa de Alimentación Escolar de Chile (PAE) entrega diariamente 215.000 raciones de desayuno y almuerzo a preescolares y 1.3 millones a escolares de escuelas públicas y subvencionadas del país. El año 2011 efectuamos un estudio cuyo objetivo fue determinar las Kcal aportadas y consumidas en el desayuno y almuerzo, determinar si las preparaciones les gustaban a los niños y verificar si habría una relación entre Kcal consumidas y estado nutricional. La muestra incluyó a 199 niños de 5 años de 6 escuelas de 3 comunas (2 por comuna) de nivel bajo de Santiago. Se determinaron las K cal consumidas por la técnica de pesaje por diferencia en 429 y 1491 bandejas de desayuno y almuerzo respectivamente. Cerca del 50% de los niños tenía sobrepeso. En 10,8% y 30% de las bandejas de desayuno y almuerzo respectivamente el aporte calórico fue inferior a lo indicado; en 50% fue superior. En 22,5 % de las bandejas de ambos servicios, el consumo fue superior a lo establecido. Hubo una buena correlación entre consumo de la preparación y si les gustó. Las ensaladas mostraron baja aceptabilidad. No hubo relación entre estado nutricional y el consumo de calorías. Frente a la alta prevalencia de obesidad, se recomienda revisar la combinación de preparaciones y el porcionamiento de éstas.