How many meals and snacks do Brazilians eat a day? Findings from the 2017-2018 Brazilian National Dietary Survey / Quantas refeições e lanches os brasileiros fazem por dia? Resultados do Inquérito Nacional de Alimentação de 2017-2018 / ¿Cuántas comidas y meriendas tienen los brasileños por día? Resultados de la Encuesta Nacional de Alimentación 2017-2018

The habit of eating specific meals has been addressed in several studies, but the evaluation of meal patterns has received less attention. This study aimed to describe the meal patterns of the Brazilian population. A complex sampling design was used to select the 46,164 ≥ 10-year-old individuals examined in the Brazilian National Dietary Survey. Food consumption was assessed by two non-consecutive 24-hour recalls applied throughout a one-week period. The exploratory data analysis approach was used to determine the meal patterns, i.e., how individuals combined the main meals (breakfast, lunch, dinner) and snacks (morning, afternoon, evening/night) throughout the day. The most common meal patterns were three main meals + one snack, reported by 25.1% of the individuals, and three main meals + two snacks (24.6%). Other meal patterns identified were: three main meals + three snacks (18.5%); three main meals and no snacks (10.9%); one or two main meals + two snacks (7.4%); one or two main meals + one snack (6.9%); one or two main meals + three snacks (4.2%); and one or two main meals and no snacks (2.3%). Meal patterns varied according to gender and age group, and on typical versus atypical food consumption days. We found that eight patterns characterized the daily meal consumption in Brazil. Furthermore, around 80% of the population had three main meals every day and about 13% did not report having any snacks. The characterization of meal habits is important for tailoring and targeting health promotion actions.

Os hábitos de consumo de refeições específicas têm sido abordados em diversos estudos, no entanto, a avaliação dos padrões refeições tem recebido menos atenção. O objetivo deste estudo foi descrever os padrões de refeições da população brasileira. Um desenho amostral complexo foi utilizado para selecionar os 46.164 indivíduos de ≥ 10 anos examinados no Inquérito Nacional de Alimentação de 2017-2018. O consumo alimentar foi avaliado por meio de dois recordatórios de 24 horas não consecutivos, aplicados durante um período de uma semana. A análise exploratória de dados foi utilizada para determinar os padrões de refeições, ou seja, como os indivíduos combinam as principais refeições (café da manhã, almoço, jantar) e lanches (manhã, tarde, noite) ao longo do dia. Os padrões de refeições mais frequentes foram três refeições principais + um lanche, conforme relatado por 25,1% dos indivíduos, e três refeições principais + dois lanches (24,6%). Outros padrões de refeições identificados foram: três refeições principais + três lanches (18,5%); três refeições principais e nenhum lanche (10,9%); uma ou duas refeições principais + dois lanches (7,4%); uma ou duas refeições principais + um lanche (6,9%); uma ou duas refeições principais + três lanches (4,2%); e uma ou duas refeições principais e nenhum lanche (2,3%). Os padrões de refeições variaram de acordo com o sexo e a faixa etária, e nos dias típicos em comparação com os atípicos de consumo alimentar. Verificou-se que oito padrões caracterizaram o consumo diário de refeições no Brasil. Além disso, cerca de 80% da população realizava três refeições principais diárias e cerca de 13% reportaram não lanchar. A caracterização dos padrões de refeições é importante para adequar e direcionar ações de promoção da saúde.

Los hábitos alimenticios específicos se han abordado en varios estudios, sin embargo, poco se sabe sobre la evaluación de los patrones de alimentación. El objetivo de este estudio fue describir el patrón de alimentación de la población brasileña. Se utilizó un diseño de muestra complejo para seleccionar a 46.164 individuos de ≥ 10 años quienes participaron en la Encuesta Nacional de Alimentación 2017-2018. El consumo alimentario se evaluó mediante dos registros de 24 horas no consecutivos, aplicados durante una semana. Para determinar el patrón de alimentación, se aplicó el análisis exploratorio, es decir, cómo las personas combinan las comidas principales (desayuno, almuerzo, cena) y las meriendas (mañana, tarde, noche) a lo largo del día. Los patrones de alimentación más frecuentes fueron tres comidas principales + una merienda según informan el 25,1% de los individuos, y tres comidas principales + dos meriendas (24,6%). Otros patrones identificados destacaron tres comidas principales + tres meriendas (18,5%); tres comidas principales sin merienda (10,9%); una o dos comidas principales + dos meriendas (7,4%); una o dos comidas principales + una merienda (6,9%); una o dos comidas principales + tres meriendas (4,2%); y una o dos comidas principales sin merienda (2,3%). Los patrones de alimentación tuvieron una variación según el sexo y el grupo de edad, y en días típicos en comparación con los atípicos de consumo de alimentos. Se encontró que ocho patrones caracterizan el consumo diario de comidas en Brasil. Por lo tanto, aproximadamente el 80% de la población tienen tres comidas principales al día y aproximadamente el 13% informan que no tienen merienda. Es importante caracterizar los patrones de alimentación para adaptar y orientar las acciones de promoción de la salud.

Sodium intake according to NOVA food classification in Brazil: trends from 2002 to 2018 / Ingestão de sódio segundo a classificação NOVA no Brasil: tendências de 2002 a 2018 / Ingesta de sodio según la clasificación NOVA en Brasil: tendencias del 2002 al 2018

Abstract: Excessive sodium intake is a major global public health issue and the identification of dietary sources and temporal trends in its consumption are a key to effective sodium reduction policies. This study aims to update estimates of sodium intake and its dietary sources in Brazil according to the NOVA food classification system. Records of 7-day food purchases of households from the Brazilian Household Budgets Survey of 2002-2003, 2008-2009, and 2017-2018 were converted into nutrients using food composition tables and the mean availability was estimated per 2,000kcal/day. Mean daily sodium available for consumption in Brazilian households has increased from 3.9 to 4.7g per 2,000kcal, from 2002-2003 to 2017-2018, over twice the recommended levels of sodium intake. From 2002-2003 to 2017-2018, the processed culinary ingredients, including table salt, represented the largest dietary source of sodium, although their participation in dietary sodium was reduced by 17% (66.6% to 55%), while the percentage of dietary sodium from processed foods increased by 20.3% and from ultra-processed foods increased by 47.6% (11.3% to 13.6% and 17% to 25.1%, respectively). In conclusion, the total household sodium availability remains high and has increased over time in Brazil, yet the participation of different dietary sources of sodium have gradually changed.

Resumo: A ingestão excessiva de sódio é um dos principais problemas de saúde pública em todo o mundo e a identificação de fontes alimentares e tendências temporais no seu consumo são fundamentais para a elaboração de políticas eficazes de redução de sódio. Este estudo tem como objetivo atualizar as estimativas de ingestão de sódio e suas fontes alimentares no Brasil de acordo com o sistema de classificação NOVA. Os registros de compras de alimentos no período de 7 dias de famílias das Pesquisas de Orçamentos Familiares de 2002-2003, 2008-2009 e 2017-2018 foram convertidos em nutrientes utilizando tabelas de composição de alimentos. A disponibilidade média foi estimada em 2.000kcal/dia. A média diária de sódio disponível para consumo nos domicílios brasileiros aumentou de 3,9 para 4,7g por 2.000kcal, de 2002-2003 a 2017-2018, mais do que o dobro dos níveis recomendados de ingestão desse nutriente. De 2002-2003 a 2017-2018, os ingredientes culinários processados, incluindo o sal de cozinha, representaram a maior fonte de sódio, embora a sua participação no sódio dietético tenha sido reduzida em 17% (de 66,6% para 55%), enquanto a porcentagem de sódio dietético dos alimentos processados aumentou 20,3% e dos alimentos ultraprocessados aumentou 47,6% (11,3% para 13,6% e 17% para 25,1%, respectivamente). Concluindo, a disponibilidade total de sódio nos domicílios permanece alta e tem aumentado ao longo do tempo no Brasil, mas a participação de diferentes fontes dietéticas de sódio mudou gradualmente.

Resumen: La ingesta excesiva de sodio es uno de los principales problemas de salud pública en todo el mundo, y la identificación de las fuentes alimentarias y tendencias temporales en su consumo son esenciales para desarrollar políticas efectivas de reducción de sodio. Este estudio tiene como objetivo actualizar las estimaciones de la ingesta de sodio y sus fuentes alimentarias en Brasil según el sistema de clasificación NOVA. Los registros de compras de alimentos en el período de 7 días de familias de las Encuestas de Presupuestos Familiares de Brasil de 2002-2003, 2008-2009 y 2017-2018 se convirtieron en nutrientes utilizando tablas de composición de alimentos. La disponibilidad media se estimó en 2.000kcal/día. El promedio diario de sodio disponible para el consumo en los hogares brasileños aumentó de 3,9 a 4,7g por 2.000kcal, entre 2002-2003 y 2017-2018, más del doble de los niveles de ingesta recomendados de este nutriente. Entre 2002-2003 y 2017-2018, los ingredientes culinarios procesados, incluida la sal de mesa, representaron la mayor fuente de sodio, aunque su participación en el sodio dietético se redujo en un 17% (del 66,6% al 55%), mientras que el porcentaje de sodio dietético de los alimentos procesados aumentó un 20,3% y de los alimentos ultraprocesados aumentó un 47,6% (11,3% a 13,6% y 17% a 25,1%, respectivamente). En conclusión, la disponibilidad total de sodio en los hogares sigue siendo alta y ha aumentado a lo largo del tiempo en Brasil, pero la proporción de diferentes fuentes dietéticas de sodio ha cambiado gradualmente.

Review of the diet of Icterus pustulatus (Passeriformes: Icteridae) and a new prey, Oiketicus sp. (Lepidoptera: Psychidae) from Mexico

We report a case of predation on the basket worm Oiketicus sp. (Lepidoptera, Psychidae) by the Streak-backed Oriole (Icterus pustulatus) in the Municipality of Santa Cruz Xoxocotlán, Oaxaca, Mexico. The bird was photographed, and we describe the prey based on its basket, cephalic capsule, and fragments of thoracic segments. We describe the foraging strategy and provide a list of previously recorded food resources in the diet of I. pustulatus. This is the first documentation of a basket worm being consumed by I. pustulatus, which may be considered omnivorous.

Reportamos un caso de depredación sobre el gusano canasta Oiketicus sp. (Lepidoptera, Psychidae) por la calandria dorso rayado (Icterus pustulatus) en el Municipio de Santa Cruz Xoxocotlán, Oaxaca, México. El ave fue fotografiada y describimos la presa a partir de su canasta, cápsula cefálica y fragmentos de segmentos torácicos. Describimos la estrategia de forrajeo y presentamos una lista de recursos alimentarios previamente registrados en la dieta de I. pustulatus. Esta es la primera documentación de alimentación de un gusano canasta por parte de I. pustulatus, el cual puede ser considerada omnivora.

Relationship between food environment, social isolation and diet quality in Brazil / Relación entre el entorno alimentario, el aislamiento social y calidad de la dieta en Brasil. Introducción

Introduction. The COVID-19 pandemic has impacted diet quality in differentways. In this context, community, organizational and consumer nutrition environments can influence the eating pattern. Objective. The purpose of this study was to identify how quarantine during the COVID-19 pandemic changed the diet in Brazil. Materials and methods. A natural experiment organized into experimental (social-isolated group - SIG) and control groups (non-isolated group - CG) was conducted with data collection from an online survey at the beginning of the pandemic (T0) and in the less restrictive period of 2020 (T1). Pre-post improvements in diet quality (IDQ) were determined for the SIG and CG. Intro-intergroup changes were tested using the Mann­Whitney and Wilcoxon signed rank tests. The intervention effect was estimated using crude and adjusted difference- indifference in multilevel regression analysis accounting for repeated measures. Results. A sample of 565 Brazilian adults answered the questionnaire at T0 and T1. IDQ was favored twice or more by attitudes such as buying food directly from farmers/street markets, reducing requests for food delivery, and increasing time spent on eating activities and the frequency of cooking. The isolated group had no IDQ at T1, whereas the no isolated group, who worsened diet quality (6.1%) at T0, improved it at T1 (4.8%). Conclusions. The restrictive quarantine forced the non-isolated population to have an experience comparable to a food desert, negatively affecting their diet(AU)

COVID-19 ha impactado la calidad de la dieta de diferentes maneras. Los entornos comunitarios, organizacionales y nutricionales de los consumidores pueden influir en los patrones dietéticos. Objetivo. el objetivo de este estudio fue identificar cómo la cuarentena durante la pandemia de COVID-19 cambió la dieta en Brasil. Materiales y métodos. Se realizó un experimento natural organizado en grupos experimental (grupo socialmente aislado - SIG) y control (grupo no aislado - GC) con datos recolectados en una encuesta en línea al inicio de la pandemia (T0) y en el momento menos restrictivo de 2020 (T1). Se determinaron mejoras pre-post en la calidad de la dieta (IDQ) para SIG y GC. Los cambios intra-intergrupo se probaron utilizando las pruebas de rangos con signos de Mann-Whitney y Wilcoxon. El efecto de la intervención se estimó utilizando diferencias crudas y ajustadas en el análisis de regresión multinivel, teniendo en cuenta medidas repetidas. Resultados. Una muestra de 565 adultos brasileños respondió el cuestionario en T0 y T1. IDQ se vio favorecido dos o más veces por actitudes como comprar alimentos directamente de los agricultores/mercados callejeros, reducir los pedidos de entrega de alimentos y aumentar el tiempo dedicado a las actividades alimentarias y la frecuencia de cocinar. El grupo aislado no mostró IDQ en T1, mientras que el grupo no aislado, que tenía peor calidad de la dieta (6,1%) en T0, mejoró en T1 (4,8%). Conclusiones. La cuarentena restrictiva obligó a la población no aislada a tener una experiencia comparable a un desierto alimentario, afectando negativamente su dieta(AU)

Snack consumption of children and adolescents in China and its correlation with overweight and obesity / 中国学校卫生

Objective@#To understand the current situation of snack consumption among children and adolescents in China and its relationship with overweight and obesity, so as to provide a basis for formulating strategies of preventing and controlling overweight and obesity in children and adolescents in China.@*Methods@#A total of 1 882 children and adolescents aged 6-17 years old, choosed from 15 provinces, autonomous regions and municipalities according to China Health and Nutrition Survey in 2018, were selected. Snack consumption was investigated by the 24 hour dietary retrospective method for three consecutive days. The pattern of snack consumption was explored by cluster analysis, and the relationship between snack consumption and overweight and obesity was analyzed by Logistic regression.@*Results@#The snack consumption rate was 60.6%, and the percentage of daily energy intake from snacks was 2.4%. Snack consumption characteristics could be divided into four modes. Mode 1 was characterized by daily intake of medium amount of fruit, Mode 2 was characterized by daily intake of small amount of fruit and baked goods, Mode 3 was characterized by daily intake of small amount of fruit, and Mode 4 was characterized by daily intake of medium amount of milk and small amount of fruit. After adjusting the relevant covariates such as energy intake, compared with those who did not eat snacks, the OR (95% CI ) values of the risk of overweight and obesity in different snack consumption patterns were 1.56(0.93- 2.58 ), 0.81( 0.51- 1.24), 1.24(0.94-1.63) and 1.00(0.60-1.63), respectively; the OR (95% CI ) values of percentage of daily energy intake from snacks from low to high quartiles were 1.17(0.81-1.68), 1.32(0.92-1.89), 1.12(0.77-1.61) and 1.00(0.69-1.45), respectively. There was no statistically significant difference( P >0.05).@*Conclusion@#The proportion of Chinese children and adolescents consuming snacks is relatively high, mainly including fruit and its products, milk and its products and baked goods. No association between snack consumption and overweight and obesity has been found.

Co-occurrence trend of school bullying and depression and its correlation with dietary patterns among middle school students from Inner Mongolia Autonomous Region in 2021 / 中国学校卫生

Objective@#To investigate the correlation between school bullying and depressive symptoms comorbidity and dietary patterns among middle school students in Inner Mongolia Autonomous Region from 2021, so as to provide reference for the prevention of school bullying and depressive symptoms.@*Methods@#In September 2021, stratified random cluster sampling was used to select 87 414 middle school students in 12 leagues in Inner Mongolia Autonomous Region. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess depression, and the bullying was determined according to the items related to bullying in the program of Chinese National Surveillance on Students Common Diseases and Risk Factors.@*Results@#In 2021, the detection rate of depressive symptoms among middle school students in Inner Mongolia Autonomous Region was 15.24%, school bullying was 3.02%, and the co-occurrence of school bullying and depression was 1.64%. Binary Logistic regression analysis showed that junior high school students ( OR =1.52) and girls ( OR =1.10) were more likely to suffer from comorbidity of school bullying and depression ( P < 0.05). Eating fried food less than one and more than once a day, smoking and drinking were positively correlated with school bullying and depression comorbidity ( OR =2.15,2.11,2.14,1.70, P <0.05).@*Conclusion@#The combination of bullying and depression among middle school students in Inner Mongolia Autonomous Region is affected by various dietary methods. In terms of diet, reducing the intake of fried food, no smoking, no drinking can effectively reduce the incidence of co-occurrence school bullying and depression.

A study on oral health status and behaviors of Chinese college students / 中国学校卫生

Abstract@#Oral diseases are the most important public health problems that have not received due attention, especially among college students. Based on the analysis of literatures on oral health status and behaviors of college students, the paper systematically summarizes the relevant research situation, points out the existing problems. Suggestions and countermeasures, such as attaching importance to the investigation and research on oral health of college students, improving the quality and level of scientific research on oral health of college students, exploring more effective comprehensive intervention measures for oral diseases and oral health education, should be implemented as projects are put forward, so as to provide basis for improving the oral health status of Chinese college students and promoting relevant research level.

Association of dietary behavior with nonalcoholic fatty liver disease / 临床肝胆病杂志

The prevalence rate of nonalcoholic fatty liver disease (NAFLD) is increasing year by year, which poses a heavy burden on global public health. The pathogenesis of NAFLD is closely associated with the factors including obesity, insulin resistance, and diet, among which diet is the core and cornerstone of the prevention and treatment of NAFLD. In view of the fact that previous studies focused on the association of different dietary components, structures, and plans with NAFLD and seldom explored the impact of overall dietary behavior on NAFLD, this article reviews the effect of dietary behavior on NAFLD, in order to provide a reference for the prevention and treatment of NAFLD and the guidance on rational dietary behaviors and habits for patients.

Association between eating at night and skipping breakfast with anxiety symptoms among freshman in colleges in Yunnan Province / 中国学校卫生

Objective@#To study the association between eating at night and skipping breakfast with college students anxiety symptoms, and to provide reference basis for preventing and alleviating college students anxiety symptoms.@*Methods@#A cross sectional survey was conducted among 9 960 freshman from three universities in Kunming and Dali, Yunnan Province. The dietary frequency questionnaire was used to evaluate the dietary behavior of college students. The Depression Anxiety Stress Scale-21 (DASS-21) was used to evaluate the anxiety symptoms of college students. The association of late night snack and breakfast skipping with the association of anxiety symptoms in college students used generalized linear model and Logistic regression model.@*Results@#The proportion of college students who reported eating at night and breakfast skipping in the last month was 72.5%(7 217/9 960) and 61.6%(6 131/9 960) respectively. The detection rate of anxiety symptoms in college students was 28.9%(2 875/9 960). There was a statistical significance between eating at night with anxiety symptoms( OR =1.40-2.54), and breakfast skipping with anxiety symptoms( OR =1.23-1.60)( P <0.05). The interaction between eating late at night and breakfast skipping was positively correlated with college students anxiety symptoms (multiplicative interaction, β=0.06, 95%CI=0.02- 0.10 , P<0.01; additive interaction, OR=2.00, 95%CI=1.59-2.51, P <0.01).@*Conclusion@#The study suggests that the college students who eat at night and frequently skipped breakfast are more likely to have anxiety symptoms. It suggested to promote the formation of healthy eating habits of college students, so as to reduce the occurrence of anxiety sympotoms.

Correlation between physical fitness and frequency of breakfast consumption of middle school students / 中国学校卫生

Objective@#To investigate the breakfast consumption of middle school students and to analyze its relationship with physical fitness, so as to provide reference for improving physical fitness of middle school students.@*Methods@#A total of 2 732 middle school students from Shangrao City were selected in September 2021 by random cluster stratified sampling. The breakfast consumption behaviors of middle school students were investigated by questionnaire, and the general information, family information and other lifestyle behaviors were collected. The physical fitness test includes grip strength, standing long jump, 1 minute sit up, sit forward bend, 50 m run and 20 m shuttle run test (20 m SRT) to evaluate the strength, flexibility, speed and endurance of middle school students. χ 2 tests were used to compare the correlation between different demographic characteristics, breakfast behavior and physical fitness,and Logistic regression analysis was used to infer the correlation strength between breakfast behavior and physical fitness.@*Results@#The detection rate of physical fitness failure among middle school students was 21.5%. There were statistically significant differences between breakfast frequency and grip strength and 20 m SRT( χ 2=8.27, 13.90, P < 0.05 ). Logistic regression analysis results showed that 20 m SRT was positively correlated with breakfast frequency (sometimes eat breakfast, OR =1.51, skip or occasionally eat breakfast OR =2.08, P <0.05).@*Conclusion@#The low frequency of breakfast consumption of middle school students is associated with low performance on 20 m SRT. Schools and families should pay attention to the breakfast consumption of middle school students to ensure adequate daily nutrition intake.

School lunch leftovers of primary and middle school students and its influencing factors in Ningbo / 中国学校卫生

Objective@#To analyze the situation and associated factors of school lunch leftovers of primary and middle school students in Ningbo, so as to provide a basis for formulating policies to improve the quality of nutritious meals and reduce the leftover meal rates.@*Methods@#During March to May of 2022, 20 primary and middle schools were selected from 10 districts in Ningbo, and 4 443 students were selected from grade 4 to 6 of primary school and grade 1 to 3 of middle school. A questionnaire was conducted among them for the students general situation and remaining meal situation.@*Results@#The total leftover rate was 62.4%, 7.9% of the students left rice every day, and 18.3% of the students left vegetables every day. The frequency of primary school students leftover food was lower than that of junior high school students ( χ 2=-2.18, P <0.05). Most of the students (68.3%) had only a little leftover food, half of the students (49.4%) had less than half leftovers, and the proportion of primary school students with large leftover food and leftovers was smaller than that of junior high school students ( χ 2=-2.05, -2.36, P <0.05). The main reason for students leftover food was "too much to eat" (accounting for 30.6%), and there was a statistical difference between primary school students and junior high school students in the composition of leftover food and leftovers ( χ 2=16.94, 14.28, P <0.05). The leftover rate of vegetables was the highest (54.5%) and the leftover rate of milk was the lowest (2.5%). Multivariate Logistic regression model showed that nutrition and food related courses during recent year, being aware the Chinese residents dietary guidelines, statisfaction with canteen food (general, more satisfied, very satisfied), reckoning school canteen food better than home food (almost, better than home) were less possibility to have leftover meals ( OR=0.79, 0.73, 0.57, 0.41, 0.26, 0.69, 0.82, P <0.05). Students chosed the meal after the teacher served the meal, the teacher divided meals and students who ate more frequently (4-6 times/week, 1 time/d, 2 times/d, ≥3 times/d) were more likely to have leftover meals ( OR=1.64, 2.23, 1.27, 1.21, 1.52, 1.44 , P < 0.05).@*Conclusion@#More than half of the students have leftovers. It should optimize the configuration of nutrition lunch, strengthen the education of nutrition knowledge and reduce the leftovers rate.

Aquisição de alimentos em domicílios brasileiros com e sem crianças / Food pourchase in brazilian households with and without child

-A construção dos hábitos alimentares infantis pode ser influenciada pela disponibilidade dos alimentos presentes nos domicílios. Não se sabe o quanto os pais modificam seu padrão de compra de alimentos para mais saudáveis quando há crianças em casa. Esta informação é importante para avaliar a percepção dos pais sobre a influência do ambiente domiciliar na formação de hábitos alimentares saudáveis em seus filhos. A renda familiar é uma variável que pode ter efeito na modificação dos hábitos alimentares dos pais, uma vez que reflete os recursos financeiros disponíveis para compra de alimentos. Investigar a aquisição de alimentos no Brasil em dois períodos com dez anos de diferença possibilita avaliar o efeito macroeconômico do engajamento dos pais na alimentação de seus filhos, uma vez que o país experimentou momentos econômicos distintos na última década. A fim de comparar a aquisição de alimentos saudáveis e não saudáveis em domicílios com e sem crianças no Brasil este estudo utilizou os dados da Pesquisa de Orçamentos Familiares (POF) conduzidos pelo IBGE, no Brasil, em seus inquéritos de 2008-2009 e 2017-2018. Os domicílios foram classificados em: i) presença ou não de crianças de um a cinco anos de idade e ii) maiores de cinco anos até dez anos de idade. Foram considerados todos os domicílios que compunham as amostras: 55.970 (POF 2007-2008) e 69.660 (POF 2017-2018), sem distinção por macrorregião ou zona urbana e rural, assim representando todo o território brasileiro. Os grupos de alimentos utilizados foram constituídos a partir das adaptações de agregados estipulados pela POF nas duas edições do inquérito. Foram estimadas as médias per capita em quilogramas da aquisição (Kg) de frutas, vegetais, refrigerantes e biscoitos num período de 7 dias consecutivos (uma semana). As diferenças das médias per capita da aquisição (Kg) dos alimentos entre domicílios com e sem criança foram estimadas por modelos de regressão de duas partes, combinando um modelo de regressão logística e um modelo linear generalizado de distribuição gama para valores positivos de aquisição, em função da distribuição assimétrica e inflada de zeros para compra de alguns itens alimentares. As análises foram estratificadas por quartos de renda domiciliar per capita, com ajustes pelo sexo e idade do morador de referência do domicílio, número de bebês, adolescentes, adultos e idosos vivendo no domicílio, e gasto mensal com alimentação. A comparação entre as médias de aquisição de alimentos entre os domicílios com e sem crianças foi dada pela intersecção dos intervalos de confiança de 95% e levou-se em consideração o peso amostral e o desenho complexo das POF. A média de aquisição de frutas em 2008-2009 foi maior nos domicílios com crianças das duas faixas etárias nos domicílios mais pobres. Em 2017-2018, a média de aquisição de frutas foi maior entre os domicílios com crianças de cinco a dez anos de idade pertencentes aos estratos socioeconômicos mais ricos. A compra de vegetais diferiu para menos em domicílios com crianças de 5-10 anos nos dois períodos. Houve uma maior média de aquisição per capita de biscoitos nos domicílios com crianças de todas as classes de rendimentos, em ambos os períodos avaliados.

The construction of children's eating habits can be influenced by the availability of food at the home. It's not known how much parents change their pattern of food purchase when there are children at household. That information is important in order to assess parents' perception of the home environment influence in the construction of healthy eating habits at their children. It's possible that family income have an effect on parents' eating habits, once reflects the financial resources available to food purchase. Investigating the food purchase in Brazil in two periods with ten years of diference leads to assess the macroeconomic effect of parental engagement in children's eating habits, since the country has experienced different moments in the last decade. In order to compare the food disponibility in households with and without children, this study utilized data from the Household Budget Surveys (POF) conducted by the Brazilian Institute of Geography and Statistics (IBGE), in Brazil, surveys 2008-2009 and 2017- 2018. The households were categorized into: i) presence or not of children aged between one and five years old and ii) children aged five and ten years old. The sample considered was 55,970 (POF 2007-2008) and 69,660 (POF 2017-2018). The food groups used were constituted from the recommendations of aggregates previously stipulated by the POF in the two editions of the survey. The means per capita were calculated in kilograms of purchase (Kg) of fruits, vegetables, soft drinks and cookies, over a period of 7 consecutive days (one week). Diferences in of food means per capita purchase (Kg) between households with and without children were estimated by using two-part regression models, that combines a logistic regression model and a generalized linear model with gamma distribution for positive values ​​of purchase, in function of the asymmetric and zero-inflated distribution for purchase of some food items. The analyzes were stratified by income quartiles per capita. With adjustments for sex and age of the household's main resident, number of babies, adolescents, adults and elderlys living in the household, and monthly expenditure on food purchase. The comparison between the means of food purchase between households with and without children was given by the intersection of the 95% confidence intervals, considering the weight sample. The means per capita purchase (Kg) of fruit in 2008-2009 was higher in households with children of both age groups in the poorest households. In 2017-2018, the average purchase of fruit was higher among households with children between five and ten years of age belonging to the elevates socioeconomic stratas. The purchase of vegetables were less in households with children aged 5-10 years in both periods. There was a higher purchase of cookies in households with children of all income classes, in both periods.

Independent food purchasing behavior and associated factors among primary and secondary school students in Haidian District, Beijing / 中国学校卫生

Objective@#To examine independent food purchasing behavior and influence factors among primary and secondary school students, and to provide evidence for formulating and implementing corresponding intervention measures.@*Methods@#Using a two stage stratified random cluster sampling principle, 976 primary and secondary school students in Haidian District of Beijing were selected to participate in a questionnaire survey from March to May 2021, and students independent food purchases and associated factors were considered.@*Results@#The proportion of middle school students who often purchased food independently (22.79%) was higher than that of primary school students(16.77%)( χ 2=5.58， P <0.05). The proportion of middle school students and primary school students who sometimes purchased food independently was 66.32% and 60.33%, respectively( χ 2=3.78， P >0.05). The proportion of middle school students who never purchased food independently (10.88%) was lower than that of primary school students(22.90%)( χ 2=25.10， P <0.05). The proportion of middle school students and primary school students who often purchased food with their parents was 30.80% and 32.52%, respectively( χ 2=0.33， P >0.05). The factors that primary and secondary school students often considered when purchasing food included personal factors (e.g., physical and psychological factors), family factors, social factors, and the food itself. The top five factors that middle school students often considered when purchasing food were taste, hygiene, production date, student s mood, and advertisement. The top five factors that primary school students often considered when purchasing food were hygiene, taste, production date, advertising, and quality. The proportion of students with consideration of nutritional value, calorie level and collocation type, as well as other nutritional factors, when purchasing food was low, no significant differences were observed between primary and middle school students( χ 2=3.25，2.93，3.06， P >0.05).@*Conclusion@#Independent food purchasing behavior is prevalent among primary and secondary school students. Nutritional awareness among middle and primary school students is low. Effective and comprehensive nutrition interventions should be actively carried out for primary and secondary school students, while considering multiple dimensions such as schools, families and society, so as to encourage students to adopt a healthy diet.

Trend of diet related behaviors among secondary school students in Shanghai, 2008-2019 / 中国学校卫生

Objective@#To understand the prevalence and trend of diet related behaviors among secondary school students in Shanghai, and to provide a scientific basis for developing appropriate health education strategies.@*Methods@#Anonymous questionnaire surveys were conducted among 71 291 students selected by multi stage stratified cluster sampling method from junior high schools,senior high schools and vocational schools in Shanghai in the year of 2008,2012,2015,2017,2019. The questionnaire adopted was "Shanghai adolescent health related behavior questionnaire". Test for trend test were applied for the analysis of the prevalence of their dietary behaviors.@*Results@#The proportion of middle school students nutritional status within the normal range in each survey year were 73.40 %, 72.60%, 68.06%, 68.73%, 67.53%, respectively, while the rate of overweight and obesity increased from 13.17% in 2008 to 23.73% in 2019. The proportion of "eating fried food" decreased significantly by year, from 12.05 % to 4.23% (male, APC=-7.94%, t =-4.33, female, APC= -9.29%, t=-7.71, P <0.05) respectively. And the proportion of "eating dessert" also decreased significantly by year, from 31.66% to 11.14% (male, APC=-8.41%, t =-6.37, female, APC=-8.67%, t=-6.96, P <0.05). In the five surveys, the percentages of healthy diet related behaviors of secondary school students were 12.81%-21.82%, no significant upward trend was observed in the whole( P >0.05). The proportion of diet-related behaviors of nutrition unbalance and easily leading to obesity decreased significantly from 35.47% to 17.00%(APC=-6.71%, t= -5.00 , P <0.05). The proportion of diet related behavior of nutrition unbalance and not easily leading to obesity increased significantly from 39.15% to 60.16%(APC=3.46%, t=6.18, P <0.05).@*Conclusion@#Overweight and obesity among secondary school students in Shanghai are increasing during the past decade, and the proportion of healthy dietary behaviors is low. The knowledge of rational diet should be publicized among these students in order to develop healthy dietary behaviors.

Breakfast consumption behaviors of senior primary school students from agricultrual and pastoral areas of Qinghai Province / 中国学校卫生

Objective@#To examine breakfast consumption among primary school students in grades 4 and 5 in Qinghai Province, China, and to provide evidence for nutrition education and intervention strategies.@*Methods@#We used a multistage stratified cluster random sampling method to select the participants. A total of 969 students were selected from 10 primary schools in four counties and districts of three cities, namely Haidong City, Hainan Prefecture and Haixi Prefecture in Qinghai Province. A self rated questionnaire was administered to investigate breakfast consumption.@*Results@#The proportion of students who consumed breakfast 5 to 7 times per week, 3 or 4 times per week, and 1 or 2 times per week were 82.0%, 9.7%, and 6.7%, respectively, while 1.5% never ate breakfast. In descending order, the breakfast food types consumed were cereals and tubers; milk, legumes and nuts; vegetables and fruits; fish and poultry; and meat and eggs (84.1%, 69.8%, 66.8%, and 37.7%, respectively). The proportion of vegetables and fruits in the breakfast of grade 5 students was higher than that of grade 4 students( χ 2=4.81, P = 0.03 ), the proportion of fish, poultry,meat and eggs in county urban areas was higher than that of students in rural( χ 2=6.94, P =0.03), while the proportion of vegetables and fruits in urban areas was lower than that of students in suburban areas( χ 2=53.33, P <0.01). The proportion of breakfast food containing fish,poultry,meat and eggs of boarding students was higher than that of non boarding students( χ 2=41.26, P <0.01), while the proportion of breakfast food containing vegetables and fruits, milk & legumens & nuts was lower than that of non-boarding students( χ 2=21.11, 4.41, P <0.01). A total of 44.8% of students had a poor quality breakfast, and only 16.3% had a good quality breakfast. Moreover, 47.5% of breakfasts were prepared by mothers, followed by the school canteen which prepared 29.9%. Except for students in different grades, there were statistically significant differences in the distribution of breakfast preparers in other groups( P <0.05).@*Conclusion@#In Qinghai Province,breakfast skipping is observed in some senior primary school students, and the quality of breakfast is poor. Diet and nutrition education should be provided for students, parents, and school canteen staff to improve the frequency and nutritional quality of children s breakfasts.

Status of snack behavior of senior primary school students in agricultural and pastoral areas of Qinghai Province / 中国学校卫生

Objective@#To understand the current situation regarding snack food consumption among grade 4 and grade 5 primary school students in agricultural and pastoral areas of Qinghai Province, China, and to provide a scientific basis for nutrition education and intervention strategies.@*Methods@#Multistage stratified cluster random sampling was employed. The research included 969 fourth and fifth grade students were selected from 10 primary schools in four counties and districts of three cities in Haidong City, Hainan Prefecture and Haixi Prefecture in Qinghai Province. The self report questionnaire method was used to investigate the current status regarding snack food consumption in this population.@*Results@#The proportion of students who consumed snack food at home, school and elsewhere were 98.2%, 88.5% and 75.4%, respectively. Male students reported a lower rate of snack consumption at school than female students ( χ 2=9.66). The fifth grade students reported a higher rate of snack consumption at home and other places than the fourth grade students ( χ 2=10.31, 6.77). The reported rate of snack consumption of students in the rural was higher than that in the county( χ 2=6.03,100.53, 24.77). The reported rate of snack consumption of boarding students at home was lower than that of non-boarding students ( χ 2=7.22), while the reported rate of snack consumption at school was higher than that of non-boarding students ( χ 2=9.04）（ P <0.01). The most popular snacks consumed at home included fruits and vegetables, cereals and nuts (76.9%, 67.2%, 63.7%), while the most popular snacks consumed at school were fruits and vegetables, cereals and candies (45.1%, 36.9%, 24.4%). The most popular snacks consumed in other settings included ice cream, candies and beverages(54.7%, 51.6%, 42.9%). The top three reasons for snacking were that snacks were regarded as delicious, healthy/nutritious and clean (76.9%, 65.5% and 59.0%, respectively).@*Conclusion@#Snacking is popular among students, although many snacks are unhealthy. Therefore, there is a need to improve food environments and nutrition education, so as to help students to choose healthy beverages and adopt healthy eating behaviors.

Beverage behaviors of senior primary school students in agricultrual and pastoral areas of Qinghai Province / 中国学校卫生

Objective@#To study the consumption of beverages among senior primary school students in rural and pastoral areas of Qinghai Province, China, in order to provide evidence for the development of nutrition and intervention strategies.@*Methods@#A multi stage stratified cluster random sampling method was employed to select 969 primary school students in grades 4 and 5 from 10 schools in Hainan Autonomous Prefecture, Haixi Autonomous Prefecture and Haidong City. All participants completed a questionnaire survey on daily beverage consumption. The Chi square test was performed to compare differences in reported rates of beverage consumption among students in different groups.@*Results@#The proportion of students who consumed beverages at home, school and elsewhere were 96.9%, 64.5% and 84.9%, respectively. The most popular beverages consumed at home were milk and yogurt ( 63.1 %), tea water (53.0%), and tea drinks (52.4%). The most popular beverages consumed at school were tea(29.8%), milk and yogurt (27.8%) and tea drinks (18.4%), while the most popular beverages consumed in other places were tea drinks ( 42.0 %), carbonated drinks (38.1%) and milk and yogurt (35.0%). The top five reasons for choosing a given beverage were taste delicious (81.2%), nutritious (57.6%),healthy and clean(52.6%),many students like to drink(39.6%),family members often drink(37.7%).@*Conclusion@#The consumption of beverages was popular among students, and sugared beverages represented a large proportion of the beverages consumed. Therefore, there is an urgent need to improve the food environment and provide effective nutrition education for students, so as to encourage the consumption of healthy beverages and cultivate healthy eating behaviors.

Beverage behaviors of senior primary school students in agricultrual and pastoral areas of Qinghai Province / 中国学校卫生

Objective@#To study the consumption of beverages among senior primary school students in rural and pastoral areas of Qinghai Province, China, in order to provide evidence for the development of nutrition and intervention strategies.@*Methods@#A multi stage stratified cluster random sampling method was employed to select 969 primary school students in grades 4 and 5 from 10 schools in Hainan Autonomous Prefecture, Haixi Autonomous Prefecture and Haidong City. All participants completed a questionnaire survey on daily beverage consumption. The Chi square test was performed to compare differences in reported rates of beverage consumption among students in different groups.@*Results@#The proportion of students who consumed beverages at home, school and elsewhere were 96.9%, 64.5% and 84.9%, respectively. The most popular beverages consumed at home were milk and yogurt ( 63.1 %), tea water (53.0%), and tea drinks (52.4%). The most popular beverages consumed at school were tea(29.8%), milk and yogurt (27.8%) and tea drinks (18.4%), while the most popular beverages consumed in other places were tea drinks ( 42.0 %), carbonated drinks (38.1%) and milk and yogurt (35.0%). The top five reasons for choosing a given beverage were taste delicious (81.2%), nutritious (57.6%),healthy and clean(52.6%),many students like to drink(39.6%),family members often drink(37.7%).@*Conclusion@#The consumption of beverages was popular among students, and sugared beverages represented a large proportion of the beverages consumed. Therefore, there is an urgent need to improve the food environment and provide effective nutrition education for students, so as to encourage the consumption of healthy beverages and cultivate healthy eating behaviors.

Fast food consumption behaviors among senior primary school students in agricultural and pastoral areas of Qinghai Province / 中国学校卫生

Objective@#To investigate fast food consumption behaviors among 4th and 5th grade primary school students in agricultural and pastoral areas in Qinghai Province, and to provide scientific basis for nutrition education and intervention measures for school age children in agricultural and pastoral areas.@*Methods@#Using multi stage stratified cluster random sampling method, a total of 969 fourth and fifth grade students were selected from 10 primary schools in 4 counties and districts in 3 cities of Haidong City, Hainan Prefecture and Haixi Prefecture from Qinghai Province. Self administered questionnaires were used to investigate the fast food consumption behaviors of participants.@*Results@#The proportions of senior primary school students in agricultural and pastoral areas of Qinghai Province who had consumed western fast food and traditioal fast food in the past week were 45.8% and 75.6%, respectively, with statistically significant differences ( χ 2=290.24, P <0.05). The times of traditional fast food consumption in the past week among boarding students were higher than that of non boarding students( Z =6.44,5.84, P <0.05). The main reasons for senior primary school students in agricultural and pastoral areas of Qinghai Province to choose to consume western fast food were that it was delicious (84.7%), nutritious (62.6%), clean and hygienic (57.4%), and a better environment (57.0%). The top 4 reasons for chousing Chinese fast food were yummy(83.8%),nutritious(82.8%),clean and healthy(67.4%),and good environment(53.5%). Among the surveyed primary school students, 64.7% believed that diet structure of Chinese fast food was reasonable, 43.0% believed that the nutritional value of Chinese fast food was high, and 39.4% believed that the energy content of western fast food was high.@*Conclusion@#Fast food consumption is a common dietary behavior of senior primary school students in agricultural and pastoral areas of Qinghai Province. Relevant departments should strengthen the nutrition education related to fast food, promote the dissemination of health knowledge, enable students to develop a good lifestyle and reduce fast food consumption.

Focus on dietary behaviors and health among school aged children in western China / 中国学校卫生

Abstract@#Children s school aged time is the key period for the formation of dietary behaviors and the dietary behaviors is affected by economic, social, cultural, family, and personal factors. Due to economic, geographical, and food culture reasons, there exists several nutritional problems in western China, such as lack of nutrition health education and poor food environment. These problems may lead to suboptimal dietary behaviors of school aged children, including but not limited to having single breakfast food and unhealthy snacks and drinks. The unhealthy dietary behaviors may further hinder the growth of children in western China. Experiences and lessons should be drawn from various effective interventions developed in other regions in China. It is necessary to develop a local adapted comprehensive intervention program which incorporates the aspects of policies and laws, nutritious meals, school nutrition health education, and social nutrition health atmosphere.