Avoidant restrictive eating disorder and panic attacks in an adult man: A case report / Trastorno evitativo restrictivo de la ingesta alimentaria y ataques de pánico en un hombre adulto: Reporte de caso

Abstract Avoidant or Restrictive Food Intake Disorder (ARFID) is an eating disorder (ED) not common in adults. In this article we present a clinical case of ARFID in a 37-year-old male patient treated in an ED center in Medellin, Colombia; displaying anxious symptoms that began a year earlier and concomitant weight loss, following a traumatic event causing an overall impairment with that patient. Several medical evaluations/examinations looking for organic causes, were excluded. Interventions were implemented by a psychiatry, a psychotherapist using cognitive-behavior therapy (CBT), and a nutritionist, all in face-to-face modality, which were carried out weekly for the first three months, then biweekly and subsequently quarterly. each lasting approximately 40-60 minutes. After the set of pharmacological interventions and psychotherapy, a great improvement in the functionality of the patient was observed. Improvement was found with respect to eating in public, food variation and panic attacks. In the absence of guidelines, it is important to use standardized and replicable treatments in this population.

Resumen El trastorno evitativo restrictivo de la ingesta (TERIA) es un trastorno alimentario (TCA) raro en adultos. Se presenta el caso de un hombre de 37 años con TERIA y trastorno de pánico atendido en un centro para TCA en Medellín, Colombia, quien presentó un año de síntomas ansiosos y pérdida de peso después de evento traumático, generando disfuncionalidad. Fue evaluada y excluida organicidad. Se realizaron intervenciones por parte de psiquiatría, psicoterapia con enfoque cognitivo conductual y nutrición, todas en modalidad presencial, las cuales se realizaron semanalmente los primeros tres meses, luego quincenalmente y posteriormente trimestralmente. Cada una con una duración de 40-60 minutos aproximadamente por sesión. Posterior al conjunto de intervenciones farmacológicas y psicoterapia, se observó una gran mejoría la funcionalidad del paciente, se encontró mejoría con respecto a comer en público, variación en los alimentos y ataques de panico. Ante la ausencia de guías de manejo de TERIA en adultos es relevante realizar tratamientos estandarizados que puedan ser replicados.

Impacto de la pandemia por COVID-19 en la conducta alimentaria de niñas, niños y adolescentes con trastorno del espectro autista / Impact of the COVID-19 pandemic on the eating behaviors of children and adolescents with autism spectrum disorder

Introducción. Los niños con trastorno del espectro autista (TEA) presentan dificultades de adaptación a situaciones estresantes, como la pandemia por COVID-19. Objetivo. Evaluar el impacto del primer año de pandemia en las dificultades alimentarias de niños con TEA. Población y métodos. Se invitó a participar a cuidadores de niños con TEA no sindromático (edad: 2-18 años) de una unidad de neurodesarrollo. Los participantes respondieron en línea un cuestionario y la escala de evaluación de problemas de conducta alimentaria (BPFAS por su sigla en inglés) antes y durante el primer año de pandemia. Se calculó un puntaje de prioridad (producto entre promedio de frecuencia y problema) para cada ítem del BPFAS. Resultados. El 56,6 % (86/152) de los cuidadores contestó la encuesta (madre 74,4 %), mediana de edad 6,3 años (p25-p75: 4,7-8,2); el 80,2 % de los niños eran de sexo masculino; el 58,1 % mantuvo terapia durante la pandemia y el 61,6 % presentaba problemas de comportamiento previo a esta. Durante el primer año de pandemia, los niños presentaron mayor intensidad en dificultades conductuales (34,9 %) y de alimentación (61,6 %); sin embargo, el 31,4 % refirió mejoría en la alimentación. No existieron diferencias significativas entre puntajes BPFAS antes y durante la pandemia. Los ítems con mayor puntaje de prioridad fueron "se levanta de la mesa durante la hora de comer", "no probar alimentos nuevos", "no come verduras", "no come frutas". Conclusiones. Hubo alta frecuencia de dificultades en las conductas alimentarias durante el primer año de pandemia. No se presentaron diferencias en las características de estas conductas antes y durante la pandemia.

Introduction. Children with autism spectrum disorder (ASD) have difficulties adapting to stressful situations, such as the COVID-19 pandemic. Objective. To assess the impact of the first year of the pandemic on feeding difficulties in children with ASD. Population and methods. The caregivers of children and adolescents with non-syndromic ASD (age: 2­18 years) from a neurodevelopment unit were invited to participate. Participants completed a questionnaire and the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) online before and during the first year of the pandemic. A priority score (product between the average frequency and the problem) for each BPFAS item was estimated. Results. Among the caregivers, 56.6% (86/152) completed the survey (mother: 74.4%); children's median age was 6.3 years (p25­p75: 4.7­8.2); 80.2% of children were males; 58.1% continued with their therapy during the pandemic; and 61.6% had behavioral problems before the pandemic. During the first year of the pandemic, children had greater behavioral problems (34.9%) and feeding difficulties (61.6%); however, 31.4% of caregivers referred improvements in feeding. There were no significant differences in the BPFAS scores before and during the pandemic. The following items obtained the highest priority scores: gets up from table during meal, does not try new food, does not eat vegetables, does not eat fruits. Conclusions. A high frequency of feeding difficulties was noted during the first year of the pandemic. No differences were observed in feeding characteristics before and during the pandemic.

Un programa informático en la web para la evaluación dietética en Costa Rica / A web-based software for dietary assessment in Costa Rica

Introducción. La medición del consumo de alimentos es un importante indicador del estado nutricional de las personas; sin embargo, el proceso no es fácil y puede tener un nivel de error inaceptable. La incorporación de nuevas tecnologías pueden facilitar el proceso y minimizar el error. Objetivo. Desarrollar un programa informático en la web para nutricionistas que permita el ingreso de datos de consumo de alimentos con un recordatorio de 24 horas o de los 7 días anteriores, el análisis de la ingesta de energía y nutrientes y su comparación con las ingestas recomendadas; con el fin de minimizar el error en la recopilación y análisis de los datos. Materiales y métodos. Primero, se determinaron las características importantes que debe tener el programa, el cual fue elaborado posteriormente con los lenguajes de programación de Python y Javascript y con un patrón de diseño modelo-vista-controlador. Simultáneamente se crearon tres bases de datos, uno con el valor nutritivo de los alimentos, otro con datos de tamaños de porción de los mismos y otro con las recomendaciones nutricionales. Una vez elaborado, el programa fue sometido a una serie de pruebas para evaluar tanto su facilidad de uso como la exactitud de los cálculos. Resultados. Se describen las 9 etapas del programa y se justifica su diseño con evidencias de la literatura científica. Conclusiones. Se desarrolló el programa en la web, 'Dietnóstico', que permite la recolección y análisis de datos de consumo de alimentos. Una vez validado, el programa estará disponible para nutricionistas a usar en la atención nutricional y la investigación(AU)

Introduction. Assessment of food consumption is an important indicator of a person's nutritional status; however, it is not a simple process and can involve an unacceptable level of error. The application of new technologies in this process can lead to improvements and the minimization of error. Objective. To develop a computer program in the web, for nutritionists that allows the input of food consumption data using a 24- hour recall or a recall of food consumption during the 7 previous days, the analysis of energy and nutrient intake and its comparison with recommended intakes with the aim of minimizing the error involved in the collection and analysis of food consumption data. Materials and methods. The first stage was to define important characteristics to include in the programme which was developed using the programming languages of Python and Javascript and using a model-view-controller design pattern. At the same time, three databases were created: one with the nutritional value of foods, another with portion sizes of the foods and a third with the nutritional recommendations. Once created, several trials were conducted on the programme to test the operations from a user point of view, and the accuracy of the calculations. Results. The 9 stages of the software are described and its design is justified with evidence from the scientific literature. Conclusions. The program 'Dietnóstico' for use in the web, allows the collection and analysis of food consumption data. Once validated, it will be available for nutritionists involved in nutrition counselling and research(AU)

Relationship between family functioning and food consumption during a health and social crisis: A COVID-19 study in Chile

The COVID-19 pandemic and government measures have challenged family functioning (FF) and eating behaviors. In non-pandemic scenarios, FF has shown a protective role in diet quality. This study aimed to explore the role of FF in family members' food consumption during the first wave of the COVID-19 pandemic in Chile. We conducted a cross-sectional, non-probabilistic study. Chilean adults (n= 821) answered an online survey based on the Family Adaptability and Cohesion Evaluation Scales (FACES) IV and a scale of food intake perceptions (non-processed and processed food). The survey also included an open space for comments (n= 147). Most participants had a medium or high FF category. Participants with higher FF had a lower risk of decreasing the consumption of non-processed foods (RR= 0.58 for fruits and RR= 0.45 for legumes) and lower risk of increasing processed foods (RR= 0.37 for sugar-sweetened beverages, RR= 0.46 for snacks, and RR= 0.64 for chocolates) when compared to lower FF participants and controlling for per-capita income. Participants commented on changes in FF: some had more conflicts and others were happy to be together during the pandemic. Most participants indicated that they maintained or increased non-processed and processed food consumption compared to the pre-pandemic period. They perceived having the opportunity of eating healthier during the pandemic. However, the stress they suffered produced them to eat unhealthily. Therefore, FF had a protective role in diet quality during the pandemic. Policymakers should consider FF when promoting healthy diets, especially in health crises.

La pandemia por COVID-19 y las medidas gubernamentales han desafiado el funcionamiento familiar (FF) y los hábitos alimentarios. En escenarios no pandémicos, el FF ha demostrado un papel protector en la calidad de la dieta. Este estudio tuvo como objetivo explorar el papel del FF en el consumo de alimentos de los miembros de la familia durante la primera ola de la pandemia de COVID-19 en Chile. Realizamos un estudio transversal, no probabilístico. Adultos chilenos (n= 821) respondieron una encuesta online basada en la Escala de Evaluación de Cohesión y Adaptabilidad Familiar (FACES) IV y una escala de percepción de consumo de alimentos (alimentos no procesados y procesados). La encuesta también incluyó un espacio abierto para comentarios (n= 147). La mayoría de los participantes tenían una categoría de FF medio o FF alto. Los participantes con mayor FF tenían un menor riesgo de disminuir el consumo de alimentos no procesados (RR= 0,58 para frutas y RR= 0,45 para legumbres) y menor riesgo de aumentar los alimentos procesados (RR= 0,37 para bebidas azucaradas, RR= 0,46 para snacks, y RR= 0,64 para chocolates) en comparación con los participantes de FF más bajos y controlando por ingreso per cápita. Los participantes comentaron cambios en sus FF y teniendo más conflictos, aunque algunos estaban felices de estar juntos durante la pandemia. La mayoría de los participantes indicaron que mantuvieron o aumentaron los alimentos procesados y no procesados en comparación con el período pre-pandemia. Ellos percibieron tener la oportunidad de comer más sano. Sin embargo, el estrés que sufrían les producía comer menos saludable. La FF tuvo un papel protector en la calidad de la dieta durante la pandemia. Quienes formulen políticas públicas deben considerar la AF cuando promuevan dietas saludables, especialmente en crisis de salud.

Calidad de los Carbohidratos en la dieta de la población urbana costarricense / Carbohydrate Quality in the diet of the Costa Rican urban population

Introducción. La calidad de los carbohidratos consumidos juega un papel importante en la prevención de las enfermedades crónicas no transmisibles (ECNT). Objetivo. Analizar el índice de calidad de los carbohidratos (ICC) en la población urbana costarricense y su relación con las variables sociodemográficas, antropométricas y la calidad y la diversidad de la dieta. Materiales y métodos. Los datos provienen del Estudio Latinoamericano de Nutrición y Salud, en una muestra representativa de 798 personas entre 15 y 65 años que residen en zonas urbanas de Costa Rica (2014- 2015). En una visita domiciliaria se administró un cuestionario para recolectar los datos sociodemográficos y se pesó y midió a los participantes. El consumo dietético se obtuvo mediante dos recordatorios de 24 horas en días no consecutivos. El ICC se calculó mediante el consumo de fibra, el índice glicémico, la relación carbohidratos sólidos/líquidos y la relación granos enteros/granos totales. Se comparó el ICC según el sexo, el grupo de edad, el nivel socioeconómico, el estado nutricional, la circunferencia de cintura y la calidad y diversidad de la dieta de los participantes. Resultados. El ICC se asoció positivamente con un mayor consumo de energía, carbohidratos totales, proteínas, grasas, colesterol, frutas, vegetales y leguminosas (p<0,001). Un mayor ICC se asoció positivamente con un mayor porcentaje de adecuación de micronutrientes y mayor índice de diversidad y calidad de la dieta (p<0,001), así como con un menor índice de masa corporal y una menor circunferencia de cintura al ajustar por sexo y edad (p<0,005). Conclusiones. El presente estudio demostró que un mayor ICC se asocia significativamente con mejores indicadores dietéticos e índice de masa corporal, por lo que resulta fundamental establecer en Costa Rica pautas dietéticas que permitan aumentar la calidad de los carbohidratos de la dieta con el fin de contribuir en la prevención de las ECNT(AU)

Introduction. The carbohydrate quality index (CQI) plays an important role in the prevention of chronic non-communicable diseases (NCD) and adequate macro and micronutrient intake. Objective. To analyze the carbohydrate quality index (CCI) in the Costa Rican urban population and its relationship with sociodemographic and anthropometric variables and the quality and diversity of the diet. Materials and methods. Data come from the Latin American Nutrition and Health Study (ELANS), in a representative sample of 798 people between 15 and 65 years of age who reside in urban areas of Costa Rica (2014-2015). During a home visit, a questionnaire was administered to collect sociodemographic data, and participants were measured and weighed. Dietary intake was obtained through two 24-hour recalls in non- consecutive days. The CQI was calculated using fiber intake, glycemic index, liquid/solid carbohydrate ratio, and whole grain/total grains. CCI was then compared according to sex, age-group, socioeconomic level, nutritional status and diet quality and diet diversity. Results. The CQI was positively associated with energy intake, total carbohydrates, proteins, fats, cholesterol, fruits, vegetables, and legumes (p<0,001). Also, CQI was associated with a higher percentage of micronutrient adequacy and diet quality and diversity (p<0,001), as well as with a lower body mass index and lower waist circumference when adjusting for sex and age (p<0,005). Conclusions. The present study showed that higher CQI is associated with better dietary and body mass index, which shows that it is essential to establish dietary guidelines for public health in Costa Rica that allows increasing the quality of carbohydrates in the diet to contribute to the prevention of chronic NCD(AU)

Sostenibilidad alimentaria y prevalencia de consumo de preparaciones tradicionales y típicas en hogares del centro-sur de Chile / Food sustainability and prevalence of consumption of traditional and typical preparations in households in central-southern Chile

Introducción. Las preparaciones tradicionales típicas incluyen ingredientes mínimamente procesados, provenientes de la agricultura local, raíces y tradiciones de un territorio. A nivel mundial la población ha cambiado sus patrones dietéticos, incorporando alimentos ultraprocesados impactando la salud poblacional y planetaria. Objetivo. Identificar la sostenibilidad y la prevalencia de consumo de preparaciones tradicionales típicas chilenas en hogares de una región de la zona centro-sur de Chile. Materiales y Métodos. Diseño transversal descriptivo, con una muestra de 104 hogares mediante muestreo no probabilístico por conveniencia. Se identificó la sostenibilidad de 34 preparaciones tradicionales típicas chilenas, aplicando el sistema NOVA de clasificación de los alimentos según grado y tipo de procesamiento. Las preparaciones se clasificaron en sostenibles (>60% de ingredientes del grupo 1), medianamente sostenibles (50-60%) y no sostenibles (<50%). El estudio contó con la aprobación del Comité de Bioética de la Universidad del Bío-Bío. El análisis de datos consideró frecuencias, porcentajes e IC95% en STATA 17.0. Resultados. El 64% de las preparaciones fueron clasificadas como sostenibles, el 23% medianamente sostenibles y un 13% como no sostenibles. Las preparaciones sostenibles son las más consumidas por los hogares, especialmente aquellas que incluyen legumbres. Las preparaciones no sostenibles consumidas en los hogares se basan en harina refinada, manteca vegetal hidrogenado y/o aceites. Conclusiones. La sostenibilidad de las preparaciones tradicionales típicas chilenas depende de sus ingredientes. Las preparaciones sostenibles son las más consumidas por los hogares de esta región, y se basan en alimentos naturales o poco procesados(AU)

Introduction. Typical traditional preparations include minimally processed ingredients from local agriculture, roots and traditions of a territory. Globally, the population has changed its dietary patterns, incorporating ultra-processed foods, impacting population and planetary health. Objective. To identify the sustainability and prevalence of consumption of typical Chilean traditional preparations in households in central-southern Chile. Materials and Methods. Descriptive cross-sectional design, with a sample of 104 households using non-probabilistic convenience sampling. The sustainability of 34 typical Chilean traditional preparations was identif ied, applying the NOVA food classif ication system according to degree and type of processing. The preparations were classif ied as sustainable (>60% of group 1 ingredients), moderately sustainable (50- 60%) and non-sustainable (<50%). The Bioethics Committee of the Universidad del Bío-Bío approved the study. Data analysis considered f requencies, percentages and 95%CI in STATA 17.0. Results. 64% of the preparations were classif ied as sustainable, 23% moderately sustainable, and 13% non-sustainable. Sustainable preparations are the most consumed by households, especially those that include pulses. Unsustainable preparations households consume are based on ref ined flour, hydrogenated vegetable shortening and/or oils. Conclusions. The sustainability of typical Chilean traditional preparations depends on their ingredients. Sustainable preparations are the most consumed by households in this region and are based on natural or minimally processed foods(AU)

Evaluación de ingesta dietética en un grupo de mujeres lactantes en dos poblaciones de Antioquia, Colombia, 2021-2022 / Dietary intake assessment in a group of breastfeeding women in two populations of Antioquia, Colombia, 2021-2022

Objetivos: Describir la prevalencia del riesgo de deficiencia o exceso en la ingesta de nutrientes y el patrón de consumo de alimentos de acuerdo con las recomendaciones establecidas por el Ministerio de Salud y Protección Social y el Instituto Colombiano de Bienestar Familiar. Materiales y métodos: Se realizó un estudio transversal descriptivo en mujeres sanas que fueron atendidas en dos hospitales del oriente antioqueño, con seguridad alimentaria y nutricional (SAN) según la Escala Latinoamericana y Caribeña de Seguridad Alimentaria (ELCSA), en el primer trimestre de lactancia, evaluadas entre los años 2021 y 2022. La fuente de información fue la historia clínica. Se midieron las características sociodemográficas, clínicas, antropométricas y la ingesta dietética y de micronutrientes. Se empleó estadística descriptiva. Se presenta la prevalencia de déficit o exceso de ingesta calórica y el índice de relación de consumo (IRC). Se utilizaron los software EVINDI v5, PC-SIDE v1.0, Stata 16.1 y Jasp 0.16.4. Resultados: Se incluyeron 30 mujeres lactantes. La prevalencia de riesgo de deficiencia en la ingesta usual de energía fue 43 % y exceso 16 %; el riesgo de deficiencia proteica fue 98 %. El consumo superior al valor de referencia para grasa saturada fue 86 % y carbohidratos simples 72 %. El patrón de consumo se caracterizó por superar las recomendaciones para azúcares (IRC = 1,29), leche y derivados (IRC = 1,09), cereales, raíces, plátanos y tubérculos (IRC = 1,04). No cumplieron las recomendaciones en la ingesta de grasas (IRC = 0,70), carnes, huevos, leguminosas, frutos secos y semillas (IRC = 0,49), frutas y verduras (IRC = 0,41). Conclusiones: El patrón alimentario identificado dista de las guías nacionales, lo que limita el consumo de macro y micronutrientes, y contribuye al círculo intergeneracional de la malnutrición. Es fundamental realizar nuevas investigaciones en el país para identificar otros patrones de consumo e impulsar acciones de política al respecto.

Objectives: To describe the prevalence of the risk of under or overnutrition and the food intake pattern vis á vis the recommendations of the Ministry of Health and Social Protection and the Colombian Family Welfare Institute. Material and methods: Descriptive cross-sectional study carried out in healthy women receiving care in two hospitals of eastern Antioquia, with food and nutrition security in accordance with the Latin American and Caribbean Food Security Scale (ELCSA), in the first trimester of breastfeeding, assessed between 2021 and 2022. The clinical record was used as the source of information. The sociodemographic, clinical, anthropometric characteristics, as well as dietary and micronutrient intake, were measured. Descriptive statistics were used. The prevalence of deficient or excessive energy intake and the food consumption score (FCS) are presented. The EVINDI v5, PC-SIDE v1.0, Stata 16.1 and Jasp 0.16.4 software packages were used. Results: Overall, 30 breastfeeding women were included. The prevalence of the risk of deficient energy intake was 43 %, while the risk of excessive intake was 16 % and the risk of protein deficiency was 98 %. Intake exceeding the reference value for saturated fats was 86 %, and 72 % for simple carbohydrates. The consumption pattern was characterized by exceeding the recommendations for sugars (FCS = 1.29), milk and dairy products (FCS = 1.09), grains, roots, plantains and tubers (FCS = 1.04). Recommendations for the intake of fats (FCS = 0.70), meats, eggs, legumes, nuts, seeds (FCS = 0.49), fruits and vegetables (FCS = 0.41) were not met. Conclusions: The food intake pattern identified is far from meeting the national guidelines, limiting macro and micronutrient intake and contributing to the intergenerational malnutrition cycle. Additional research in the country is essential in order to identify other intake patterns and drive political action.

Estado de las Políticas de regulación para el consumo de azúcar y para la comida chatarra en 3 países de América Latina

Introducción: El consumo de bebidas azucaradas y alimentos no saludables es un problema de Salud Pública y de las Políticas Públicas que buscan reducir el impacto de las Enfermedades No Trasmisibles (ENT) en América Latina. Objetivo: identificar las Políticas Públicas generadas en Colombia, Argentina y Chile para la regulación del consumo de azúcar y comida chatarra. Materiales y Métodos: Análisis exploratorio a través de una revisión de literatura y revisión de documentos normativos. Resultados: Colombia en el año 2021 sancionó la Ley 2120 denominada "Ley de Comida Chatarra", que promueve el acceso a información necesaria para fomentar entornos alimentarios saludables y prevenir las ENT, que incluye nuevas normas para el etiquetado de alimentos y describir sus características al consumidor y así limitar el consumo de alimentos procesados y ultraprocesados. Chile fue pionero en el desarrollo de los sellos de advertencia y desde el año 2014, aplica un impuesto adicional a las bebidas no alcohólicas. Argentina en 2021, sancionó la ley que obliga a la industria de alimentos a disponer de etiquetas en los envases que alerten al consumidor sobre los excesos de azúcares, grasas y sodio Conclusiones: Los tres países investigados cuentan con políticas de etiquetado de alimentos procesados, y en Chile existen impuestos a las bebidas azucaradas. Es importante estudiar el impacto de dichas políticas en la prevalencia y severidad de las ENT y de la caries.

Abstract: The consumption of sugar-sweetened beverages and unhealthy foods is a public health problem that has become a regulatory issue for the public policies aimed at reducing the impact of Non Communicable Diseases (NCDs) in Latin America. Objective: to identify the Public Policies in Colombia, Argentina and Chile for the regulation of the consumption of sugar and junk food. Materials and methods. Exploratory analysis through a literature and policy documents review. Results: In 2021, Colombia approved the Law 2120 called "Junk Food Law" promoting public access to information for a healthy food environment to prevent NCDs. It includes food labeling for overweight and obesity prevention and establishes a specific labeling regulation for processed and ultra-processed food and sweet drink products. Chile was pioneer in the development of warning stamps on food packages and since 2014 also taxes sweet non-alcoholic beverages. In 2021, Argentina approved a law to add labels on food packages to alert consumers about excess of sugars, fats and sodium. Conclusions: The three investigated countries have labeling policies for processed food, and Chile puts taxes on sugary drinks. It is important to study the impact of these policies on NCD prevalence, severity and on dental caries.

The Need for Food Fortification With Zinc in India: Is There Evidence for This?

There has been recent advocacy for food fortification with zinc in India. However, there are three important conditions that should be established before fortifying food with any micronutrient, which requires that there should be i) Established high prevalence of biochemical or sub-clinical deficiency (?20%), ii) Low dietary intakes that increase the risk of deficiency, and iii) Evidence of efficacy of supplementation from clinical trials. For zinc, all three conditions are not satisfied. The prevalence of low serum zinc concentrations in Indian children is well below 20% (~6%), signifying that zinc deficiency is not a public health problem. There is no risk of dietary zinc inadequacy in Indian populations where intake has been measured. Finally, there is no robust evidence that zinc-fortified foods improve functional outcomes, even if the serum zinc concentration is increased. Thus, contemporary evidence does not justify the need for food fortification with zinc in India.

La sed ¿un mecanismo suficiente para lograr euhidratación?: una revisión narrativa / Is thirst sufficient as a mechanism for achieving euhydration? a narrative review

Capitán, C. y Aragón, L.F. (2023). La sed ¿un mecanismo suficiente para lograr euhidratación?: una revisión narrativa. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 21(1), 1-16. El papel de la percepción de sed para mantener el balance hídrico ha sido ampliamente estudiado, tanto durante el ejercicio como después de este. Sin embargo, la forma de evaluarla y la eficacia de los instrumentos existentes son aún áreas que necesitan más investigación. El objetivo de esta revisión fue integrar, de forma general, la información disponible en la literatura sobre el funcionamiento del mecanismo de la sed como respuesta a la deshidratación durante y después del ejercicio. Se explican los mecanismos fisiológicos y las respuestas de estos durante y posterior al ejercicio; además, se describen los instrumentos disponibles en la literatura científica, sus debilidades y fortalezas, y se plantea una serie de preguntas que aún no tienen respuesta en el área. En esta revisión se presenta el aspecto teórico de los mecanismos de la sed, además, se discuten los estudios científicos que respaldan o refutan el comportamiento de estos mecanismos en el ejercicio. Finalmente, se hace un resumen de las principales conclusiones extraídas de la literatura científica sobre la sed como un mecanismo suficiente para prevenir la deshidratación tanto durante como después del ejercicio.

Capitán, C. y Aragón, L.F. (2023). Is thirst sufficient as a mechanism for achieving euhydration? a narrative review. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 21(1), 1-16. The role of thirst perception for keeping hydric balance, both during and after exercise, has been extensively studied. However, the way to assess it and the effectiveness of the existing instruments are areas that still require further research. The objective of this review is to integrate, in a general way, the information available in the literature on the functioning of the thirst mechanism as a response to dehydration during and after exercise. The physiological mechanisms and their responses during and after exercise are explained. In addition, a description of the instruments available in scientific literature is included, together with their weaknesses and strengths, and a series of as yet unanswered questions in this area are raised. This review presents the theoretical aspect of thirst mechanisms, and discusses the scientific studies that support or refute the behavior of these mechanisms in exercise. Finally, a summary is made of the major conclusions drawn from the scientific literature on thirst as a sufficient mechanism to prevent dehydration both during and after exercise.

Capitán, C. y Aragón, L.F. (2023). A sede é um mecanismo suficiente para alcançar a hidratação? uma revisão narrativa. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 21(1), 1-16. O papel da percepção da sede na manutenção do equilíbrio hídrico tem sido amplamente estudado, tanto durante quanto após o exercício. Entretanto, como avaliá-la e a eficácia dos instrumentos existentes ainda são áreas que necessitam de mais pesquisas. Esta revisão visou integrar, de forma geral, as informações disponíveis na literatura sobre o funcionamento do mecanismo da sede em resposta à desidratação durante e após o exercício. Ele explica os mecanismos fisiológicos e suas respostas durante e após o exercício, descreve os instrumentos disponíveis na literatura científica, seus pontos fracos e fortes, e levanta uma série de questões que permanecem sem resposta no campo. Esta revisão apresenta o aspecto teórico dos mecanismos da sede e discute os estudos científicos que respaldam ou refutam o comportamento desses mecanismos no exercício. Finalmente, é feito um resumo das principais conclusões extraídas da literatura científica sobre a sede como mecanismo suficiente para prevenir a desidratação tanto durante quanto após o exercício.

A associação entre câncer colorretal e índice de qualidade nutricional (INQ); um estudo de caso-controle / The association between colorectal cancer and index of nutritional quality (inq); a case-control study

ABSTRACT Background: The nutritional quality of diet may influence the risk of colorectal cancer (CRC). This study compared the Index of Nutritional Quality (INQ) of various dietary components between colorectal cancer patients and healthy controls. Methods: A total of 480 participants were enrolled in the study (160 patients with colorectal cancer as a case group and 320 healthy control). An analysis was conducted on the general characteristics of the participants, their medical histories, anthropometric indicators, physical activity, alcohol consumption, reproductive history, smoking and food intake. A valid food frequency questionnaire was used to assess nutrient intake and INQ was calculated from daily nutrient intake. Results: A Significant inverse association was found between CRC and INQ for vitamins A (OR=0.01, CI: 0.01-0.01), K (OR=0.04, CI: 0.01-0.15), and B12 (OR=0.71, CI: 0.51-0.98), B5 (OR=0.43, CI: 0.00-0.01), zinc (OR=0.35, CI: 0.13-0.95), and phosphorus (OR=0.17, 0.19-0.94). The association between the INQ of vitamin B12 and zinc with colorectal cancer was disappeared after age adjustment. There was a significant negative association between CRC with the INQ of vitamins A, K, B5, phosphorus, and calcium after further adjustments for gender, BMI, menopausal status, and total energy intake. Conclusion: CRC is significantly associated with INQ for some micronutrients. INQ can be considered as an indicator to assess clinical nutritional problems.

RESUMO Contexto: A qualidade nutricional da dieta pode influenciar o risco de câncer colorretal (CCR). Este estudo comparou o Índice de Valor Nutricional (INQ) de vários componentes dietéticos entre pacientes com CCR e controles saudáveis. Métodos: Um total de 480 participantes foram inscritos no estudo (160 pacientes com CCR como um grupo de casos e 320 controles saudáveis). Uma análise foi conduzida sobre as características gerais dos participantes, seus históricos médicos, indicadores antropométricos, atividade física, consumo de álcool, histórico reprodutivo, tabagismo e ingestão de alimentos. Um questionário de frequência alimentar válido foi usado para avaliar a ingestão de nutrientes e o INQ foi calculado a partir da ingestão diária de nutrientes. Resultados: Associação significativa entre CCR e INQ para as vitaminas A (OR=0,00, IC: 0,00-0,01), K (OR=0,04, IC: 0,01-0,15), B12 (OR=0,71, IC: 0,51-0,98) houve uma associação negativa), B5 (OR=0,43, IC: 0,00-0,01), zinco (OR=0,35, IC: 0,13-0,95), fósforo (OR=0,17, IC: 0,19-0,94). A associação entre o INQ da vitamina B12, zinco e CCR desapareceu após o ajuste pela idade. Houve uma associação negativa significativa entre CCR e INQ de cálcio, e outros resultados não mudaram após ajustes adicionais para idade, gênero, Índice de Massa Corporal, estado de menopausa e ingestão total de energia. Conclusão: CCR está significativamente associado ao INQ para alguns micronutrientes. O INQ pode ser usado como um indicador para avaliar problemas nutricionais clínicos.

Consumo alimentario en mujeres embarazadas, mujeres que dan de lactar y niños de 0 a 5 años. Centros de salud ciudad de La Paz - área urbana, 2018 / Food consumption in pregnant women, breastfeeding women and children from 0 to 5 years old. La Paz city health centers - urban area, 2018

OBJETIVO: Determinar el consumo de alimentos en mujeres embarazadas, mujeres que dan de lactar y niños de 0 a 5 años, atendidos en Centros de Salud de Primer Nivel en la ciudad de La Paz en el mes de septiembre de 2018. MATERIAL Y MÉTODOS: Estudió transversal descriptivo correlacional en 126 mujeres embarazadas, 120 mujeres que dan de lactar, 105 niños de 0 a 5 meses y 117 niños de 6 a 60 meses, que asistieron a consulta en Centros de Salud. Se aplicó el método de Recordatorio de 24 Horas (R24H) para determinar el consumo de alimentos, método antropométrico para la evaluación nutricional. RESULTADOS: La ingesta promedio en mujeres embarazadas 1999 kcal y mujeres que dan de lactar 1943 Kcal, es menor a la recomendada; inadecuada en grasas, calcio y zinc; suficiente en proteínas, hidratos de carbono, vitaminas A y C; el hierro es deficiente en embarazadas. Los niveles de adecuación de la dieta en niños de 6 a 23 meses en calcio 88,3%, hierro 75%. De 24 a 60 meses en: calorías 86,3%, grasas 46,9% y zinc 50,6%. CONCLUSIONES: El consumo promedio observado en mujeres y niños es inferior a las recomendaciones nutricionales. El estado nutricional no corresponde al exceso o déficit en la ingesta. La ingesta deficiente de micronutrientes, es debida al consumo insuficiente de verduras y frutas.

Ingesta de calcio y densidad mineral ósea en adolescentes chilenos con desarrollo puberal completo

Introducción: La cantidad diaria recomendada (RDA) de calcio en adolescentes es de 1.300 mg/día. La última Encuesta Nacional de Consumo Alimentario de Chile, mostró que la mediana de ingesta total de calcio fue menos de la mitad de la RDA. Una ingesta insuficiente de calcio puede impactar negativamente la mineralización ósea. Objetivo: Determinar el efecto de la ingesta de calcio y estado nutricional sobre la densidad mineral ósea (DMO) de adolescentes con desarrollo puberal completo. Métodos: Estudio de corte transversal. Participaron n= 79 adolescentes de ambos sexos de entre 17 y 18 años elegidos al azar, aparentemente sanos, estadio Tanner 5 e IMC-1 DE). Según estado nutricional, no hubo diferencias significativas en la ingesta de nutrientes, pero sí en la DMO. En media, la DMO estandarizada (puntaje Z) fue normal para ambos sexos (>-1 DE); los adolescentes con obesidad presentaron una DMO estandarizada significativamente mayor que los adolescentes de peso normal (1,05±0,85 vs 0.33±0,86; P= 0,04). La ingesta de calcio no se relacionó con la masa ósea total ni con la DMO estandarizada. Conclusión: En adolescentes con desarrollo puberal completo no hubo relación entre la ingesta de calcio y los niveles de mineralización ósea. Sí hubo relación entre mineralización ósea y estado nutricional, siendo mayor la DMO en los individuos con obesidad.

Background: In adolescents, the recommended daily intake (RDI) of calcium is 1,300 mg. In Chile, the latest National Survey of Food Consumption showed that the median total calcium intake was less than half of the RDI. An adequate intake of calcium in adolescence negatively affects BMD. Aim: To determine the association of calcium intake and nutritional status with bone mineral density (BMD) in male and female adolescents with completed pubertal development (Tanner 5). Methods: Cross-sectional study in a random sample of 79 male and female adolescents, ages 17-18. Participants were healthy, Tanner stage 5, and BMI −1 SD. BMD was higher in obese participants compared to normal-weight adolescents (1.05±0.85 vs 0.33±0.86; P= 0.04), although no differences in nutrients and food intake. Calcium intake was unrelated to total bone mass and unstandardized BMD. Conclusions: In our sample of adolescents with complete pubertal development, there was no relationship between calcium intake and bone mineralization levels. There was a significant relationship between bone mineralization and nutritional status, with BMD being higher in adolescents with obesity.

Evaluación de ingesta dietética según el nivel socioeconómico en un grupo de personas vegetarianas en Colombia

Diferentes estudios han relacionado el nivel socioeconómico con la calidad de la dieta y la prevalencia de riesgo de deficiencia de nutrientes. En personas vegetarianas, cuando no se sigue una dieta adecuada, existe la posibilidad de tener una baja ingesta de ciertos nutrientes, principalmente de vitamina B12, vitamina D, calcio, hierro, zinc, ácidos grasos omega-3 y proteínas. Este estudio tiene como objetivo evaluar la ingesta dietética en personas vegetarianas según su nivel socioeconómico en una región de Colombia. Los participantes completaron un cuestionario en el cual se les preguntó por variables socioeconómicas, antropométricas y la frecuencia de consumo de 48 alimentos y suplementos. Posteriormente, a un subgrupo de la muestra se le realizaron dos recordatorios de 24 horas en diferentes días de la semana. Se encontró que, a menor nivel socioeconómico, hay un menor consumo de lácteos, cereales integrales, frutas y verduras. Así mismo, se observó que según el tipo de vegetarianismo hay diferencias en el consumo de cobalamina, fibra y calcio. Se concluye que, de manera similar a los omnívoros, se requiere de educación nutricional para mejorar la elección de los alimentos y lograr suplir los requerimientos nutricionales, independientemente del nivel económico.

Different studies have related socioeconomic status to diet quality and the prevalence of nutrient deficiency risk. Among vegetarians, when an adequate diet is not followed, there is a possibility of having a low intake of certain nutrients, mainly vitamin B12, vitamin D, calcium, iron, zinc, omega-3 fatty acids and proteins. This study aims to evaluate the dietary intake of vegetarians according to their socioeconomic level in a region of Colombia. Participants completed a questionnaire in which they were asked about socioeconomic and anthropometric variables and the frequency of consumption of 48 foods and supplements. Subsequently, a subgroup of the sample was given two 24-hour reminders on different days of the week. We found that the lower the socioeconomic level, the lower the consumption of dairy products, whole grains, fruits and vegetables. Likewise, it was observed that depending on the type of vegetarianism, there are differences in the consumption of cobalamin, fiber and calcium. We conclude that, similar to omnivores, nutritional education is required to improve the choice of foods and to meet nutritional requirements, regardless of economic level.

Association between abdominal obesity, screen time and sleep in adolescents

Abstract Objective: To assess the association between abdominal obesity, food intake, sleep deprivation, and screen time in adolescents. Methods: This cross-sectional study was conducted with 432 adolescents aged 14-19 years, from public and private schools. Anthropometric and body composition measures included body weight, waist circumference, body mass index for age, waist-to-hip ratio, waist-to-height ratio, and body fat percentage. Abdominal obesity was defined by age and sex specific cut-off points for waist circumference. Food intake, screen time, sexual maturation, and sleep duration were evaluated by self-administered questionnaires. Results: The prevalence of excess body weight and abdominal obesity was 16.7% and 27.5%, respectively. Students in the adult phase (post-puberty), with inadequate waist-to-height ratio, high body fat percentage, and screen time ≥ 3 h/day were, respectively, 2.5 (95% CI 1.40-4.46), 7.44 (95% CI 1.08-51.46), 2.79 (95% CI 1.04-7.50), and 1.43 (95% CI 1.24-3.89) more likely to have abdominal obesity. Low intake of unprocessed or minimally processed foods was associated with inadequate sleep duration, while high intake of ultra-processed foods was associated with high screen time. Conclusions: Abdominal obesity was associated with the adult phase, short sleep duration and high screen time. The degree of food processing was associated with screen time and sleep duration. Assessing the risk factors of abdominal obesity may be a useful strategy for preventing cardiovascular disease in adolescents.

Vitamin D deficiency in bedridden elderly people at home

SUMMARY OBJECTIVE: The aim of this study was to evaluate serum 25(OH)D concentrations in the homebound elderly people and relate them to level of dementia, nutritional risk, and route of dietary administration. METHODS: This is a cross-sectional study involving 207 bedridden elderly people assisted by the Home Care Service in the city of Santo André - SP, from June to December 2016. The following factors were evaluated: dietary intake of vitamin D, arm circumference, triceps skin fold thickness, calf circumference, nutritional risk by Mini-Nutritional Assessment, level of dementia by the adapted Clinical Dementia Rating questionnaire, and laboratory tests such as serum concentrations of 25(OH)D, ultrasensitive C-reactive protein, alkaline phosphatase, serum calcium, and parathormone. RESULTS: The mean age of the elderly people was 81.6 (9.2) years. Deficiency of 25(OH)D was observed in 76.3% of the elderly people. There was an inverse correlation between serum concentrations of 25(OH)D: parathormone (r=-0.418, p<0.001) and alkaline phosphatase (r=-0.188, p=0.006) and a direct correlation with serum calcium (r=-0.158, p=0.022). Logistic regression showed that vitamin D deficiency was directly and independently associated with oral feeding (odds ratio 7.71; 95%CI 2.91-20.40). CONCLUSION: Bedridden households showed high prevalence of vitamin D deficiency without association with nutritional risk and level of dementia. Oral diet was associated with vitamin D deficiency, possibly due to low consumption of source foods.

Validation of a food frequency questionnaire for assessing the intake of food groups and nutrients in adults / Validação de um questionário de frequência alimentar para avaliação do consumo de grupos de alimentos e nutrientes em adultos

ABSTRACT Objective: To validate a food frequency questionnaire used to assess food consumption among adults in a Brazilian cohort. Methods: Cross-sectional study conducted on 100 adults. Food intake was assessed by the food frequency questionnaire and by two 24-hour recalls. Validation was performed for nutrients (n=19) and food groups (n=21). Results: Moderate deattenuated Pearson's correlation coefficients (>0.4) were observed for the consumption of dairy products, breads and crackers, rice, pasta and tubers, leafy vegetables, other vegetables, fats, sweetened drinks, sandwiches and savory snacks, and nuts, and for the following nutrients (deattenuated and adjusted for energy intake): fiber, calcium, and vitamins A, B2, and C. Based on almost all food groups and nutrients assessed, ≥70% of the individuals were classified into the same or adjacent quartile for both methods, except for red and pork meat, snacks, nuts, phosphorus, potassium, and vitamin B3. The food groups and nutrients with fair kappa agreement (>0.2) were: dairy products, other vegetables, sweetened drinks, breakfast cereals, energy, carbohydrate, iron, and vitamin A. Conclusion: The food frequency questionnaire has proven useful for estimating the intake of some nutrients and food groups of the subjects evaluated. Only the intake of red and pork meat, snacks, nuts, vitamin B3, phosphorus and potassium were estimated with less accuracy.

RESUMO Objetivo: Validar um questionário de frequência alimentar para avaliar o consumo alimentar de adultos em uma coorte brasileira. Métodos: Estudo transversal realizado com 100 adultos. A ingestão alimentar foi avaliada pelo questionário de frequência alimentar e por dois recordatórios de 24 horas. A validação foi realizada para nutrientes (n=19) e grupos de alimentos (n=21). Resultados: Coeficientes de correlação de Pearson deatenuados moderados (>0,4) foram observados para o consumo de laticínios, pães e biscoitos, arroz, macarrão e tubérculos, vegetais folhosos, outros vegetais, gorduras, bebidas adoçadas, sanduíches e salgadinhos, e nozes, e para os seguintes nutrientes (deatenuados e ajustados para ingestão de energia): fibra, cálcio e vitaminas A, B2 e C. Com base em quase todos os grupos de alimentos e nutrientes avaliados, ≥70% dos indivíduos foram classificados no mesmo quartil ou quartil adjacente para ambos os métodos, exceto para carnes vermelhas e suínas, salgadinhos, nozes, fósforo, potássio e vitamina B3. Os grupos de alimentos e nutrientes com concordância kappa justa (>0,2) foram: laticínios, outras verduras, bebidas açucaradas, cereais matinais, energia, carboidratos, ferro e vitamina A. Conclusão: O questionário de frequência alimentar mostrou-se útil para estimar a ingestão de alguns nutrientes e grupos de alimentos dos sujeitos avaliados. Apenas o consumo de carnes vermelhas e suínas, salgadinhos, nozes, vitamina B3, fósforo e potássio foi estimado com menor precisão.

Qualidade da dieta e fatores associados em pacientes adultos e idosos atendidos em um ambulatório de nutrição na cidade de Recife, Pernambuco / Diet quality and associated factors in adult and elderly patients treated in a nutrition outpatient clinic in the city of Recife, Pernambuco

O consumo alimentar atual, caracterizado pelo aumento da ingestão de alimentos de alta densidade calórica e baixo valor nutricional pode influenciar negativamente no estado nutricional e surgimento de agravos à saúde. Este estudo teve como objetivo avaliar a qualidade da dieta e fatores associados em pacientes adultos e idosos atendidos num ambulatório de nutrição. Trata-se de um estudo transversal realizado de maio a outubro de 2021 no ambulatório de nutrição do Instituto de Medicina Integral Prof. Fernando Figueira em Recife, Pernambuco. Foram coletadas as informações do perfil sociodemográfico e econômico, estilo de vida, variáveis clínicas e estado nutricional, no momento do atendimento nutricional (primeira consulta e/ou consulta de acompanhamento). A avaliação do consumo alimentar foi realizada por meio da análise do Índice de Qualidade da Dieta Revisado (IQDR). A amostra foi composta por 102 pacientes, e foi evidenciada uma maior frequência de excesso de peso/obesidade e risco cardiovascular muito elevado. Com relação ao IQDR, 72,6% da amostra apresentam dieta saudável. O tempo de acompanhamento foi correlacionado positivamente com a qualidade da dieta (ρ 0,199; p<0,045); e quanto à glicemia de jejum, houve uma correlação negativa com o consumo de cereais totais (ρ -0,229; p<0,050), e positiva com o consumo de leite e derivados (ρ0,265; p<0,023). No que se refere às variáveis antropométricas, evidenciou-se correlações negativas com o consumo de hortifrútis e cereais integrais. O consumo alimentar é considerado complexo e necessita da avaliação dos fatores que possam interferir no mesmo. O acompanhamento nutricional, a modificação e a melhora da qualidade da alimentação, favorecem à adoção de um estilo de vida mais saudável, relacionando-se com a prevenção e/ou o controle das doenças crônicas não transmissíveis e suas complicações.

Current food consumption, characterized by increased intake of high-density foods and low nutritional value can negatively influence nutritional status and the emergence of health problems. This study aimed to evaluate the quality of the diet and associated factors in adult and elderly patients treated in a nutrition outpatient clinic. This is a cross-sectional study conducted from May to October 2021 at the Nutrition Outpatient Unit of the Fernando Figueira Institute of Integral Medicine in Recife, Pernambuco. The information of the sociodemographic and economic profile, lifestyle, clinical variables, and nutritional status was collected at the time of nutritional consultation (first consultation and/or follow-up consultation). The evaluation of food consumption was performed through the analysis of the Diet Quality Index - Revised (DQI-R). The sample consisted of 102 patients, and there was a higher frequency of overweight/obesity and very high cardiovascular risk. Regarding DQI-R, 72.6% of the sample has a healthy diet. The follow-up time was positively correlated with the quality of the diet (ρ 0.199; p <0.045); and regarding fasting blood glucose, there was a negative correlation with the consumption of total cereals (ρ -0.229; p <0.050) and a positive correlation with the consumption of milk and derivatives (ρ 0.265; p <0.023). Regarding anthropometric variables, negative correlations with the consumption of whole grains and cereals was demonstrated. Food consumption is considered complex and requires the evaluation of factors that may interfere with it. Nutritional monitoring, modifying, and improving the quality of food, favors the adoption of a healthier lifestyle, which relates to the prevention and/or control of chronic non-communicable diseases and their complications.

Consumption of ultra-processed foods and associated factors in children from Barbacena (MG), Brazil / Consumo de alimentos ultraprocessados e fatores associados em crianças de Barbacena (MG), Brasil

Abstract Objective: To evaluate the prevalence of ultra-processed food consumption and associated factors among children enrolled in the public school system of the city of Barbacena, Minas Gerais, Brazil. Methods: This is a cross-sectional study conducted with schoolchildren aged 7-9 years, of both sexes, enrolled in state public schools. Food intake was assessed using the Previous Day Food Questionnaire and the level of physical activity by the Previous Day Physical Activity Questionnaire. The listed foods were classified according to the extent and purpose of industrial processing, using the NOVA classification. Pearson's χ2 test, Fisher's exact test, χ2 with Yates correction, and Poisson regression were used in the statistical analysis, estimating the crude and adjusted prevalence ratio, with 95% confidence intervals. Results: The prevalence of daily ultra-processed food consumption was 69.6%. After adjusted analyses, the consumption of ultra-processed food was associated with the omission of breakfast, mid-afternoon snack, supper, low physical activity, and consumption of risk foods. On the other hand, consumption of in natura or minimally processed foods was associated with older age, the consumption of lunch, mid-afternoon snack, dinner, and protective foods. Conclusions: There is a high prevalence of ultra-processed foods consumption, associated with unhealthy dietary habits among schoolchildren. This highlights the need for nutritional counseling and educational actions, favoring healthy eating in childhood.

RESUMO Objetivo Avaliar a prevalência de consumo de alimentos ultraprocessados e fatores associados em crianças matriculadas na rede pública do município de Barbacena, Minas Gerais, Brasil. Métodos Trata-se de um estudo transversal realizado com escolares de 7 a 9 anos de ambos os sexos, matriculados na rede pública estadual de ensino. O consumo alimentar foi avaliado utilizando o Questionário Alimentar do Dia Anterior e o nível de atividade física pelo Questionário de Atividade Física do Dia Anterior. Os alimentos listados foram classificados segundo a extensão e propósito do processamento industrial, conforme proposto pela classificação NOVA. Na análise estatística foram utilizados os testes χ2 de Pearson, Exato de Fisher, χ2 com correção de Yates e regressão de Poisson, estimando-se a razão de prevalência bruta e ajustada, com intervalos de confiança de 95%. Resultados A prevalência de consumo de alimentos ultraprocessados foi de 69,6%. Após análises ajustadas, o consumo de alimentos ultraprocessados foi associado à omissão do café da manhã, lanche da tarde e ceia, baixo nível de atividade física e ao consumo de alimentos de risco. Por outro lado, o consumo de alimentos in natura ou minimamente processados foi associado à maior idade, consumo de almoço, lanche da tarde, jantar e alimentos protetivos. Conclusões Verificamos uma alta prevalência no consumo de alimentos ultraprocessados, associada a hábitos alimentares não saudáveis, em crianças escolares. Isso destaca a necessidade de ações de educação alimentar e nutricional, favorecendo o consumo alimentar saudável na infância.

Changes in the frequency of food consumption by adults/elderly according to food insecurity: evidence from a longitudinal study in the northeastern semi-arid region, Brazil, 2011-2014 / Mudanças na frequência do consumo alimentar de adultos/idosos segundo a situação de insegurança alimentar: evidências a partir de um estudo longitudinal no semiárido nordestino, Brasil, 2011-2014

ABSTRACT Objective: To prospectively analyze changes in the frequency of individual food consumption of adults/elderly people according to different food insecurity outcomes over time. Methods: Population-based longitudinal study carried out in 2011 (358 individuals) and 2014 (301 individuals) in a municipality in the northeastern semi-arid region. The frequency of food consumption of 37 foods in adults/elderly was assessed using the Food Frequency Questionnaire and food insecurity using the Brazilian Food Insecurity Scale. Differences in the proportion of frequency of consumption of each food at baseline (2011) and follow-up (2014) were calculated according to longitudinal categories of change in food insecurity. The McNemar test for paired samples was applied to estimate differences between 2011 and 2014. Results: Among the individuals studied, 38.9% and 30.6% were classified in food security and food insecurity in the two periods (2011 and 2014), respectively, and 23.2% changed from food insecurity in 2011 to food security in 2014. Increase in the frequency of food consumed in the three groups of food insecurity outcomes. Only in the food insecurity group at both times, an increase in the consumption frequency of soft drinks and industrialized juices was observed. In the three groups, when comparing 2011 and 2014, there was an increase in the consumption of local agricultural foods, such as mangoes, sweet potatoes and a decrease in the consumption of pumpkin. Conclusion: Overcoming food insecurity results in positive changes in food consumption, and seasonality is a factor that promotes and limits food consumption.

RESUMO Objetivo: Analisar prospectivamente mudanças na frequência do consumo alimentar individual de adultos/idosos segundo diferentes desfechos de insegurança alimentar no tempo. Métodos: Estudo longitudinal de base populacional realizado em 2011 (358 indivíduos) e 2014 (301 indivíduos) em um município do semiárido nordestino. Foi avaliada a frequência de consumo alimentar de 37 alimentos em adultos/idosos por Questionário de Frequência Alimentar e a insegurança alimentar pela Escala Brasileira de Insegurança Alimentar. Foram calculadas as diferenças na proporção da frequência de consumo de cada alimento no baseline (2011) e follow-up (2014) segundo categorias longitudinais de mudança na insegurança alimentar. Foi aplicado o teste de McNemar para amostras pareadas para estimar diferenças entre 2011 e 2014. Resultados: Dentre os indivíduos estudados, 38,9% e 30,6% foram classificados em segurança e insegurança alimentar nos dois tempos (2011 e 2014), respectivamente, e 23,2% mudaram da insegurança alimentar em 2011 para segurança alimentar em 2014. Houve aumento na frequência dos alimentos consumidos nos três grupos de desfechos da insegurança alimentar. Apenas no grupo insegurança alimentar nos dois tempos, observou-se aumento na frequência alimentar de refrigerantes e sucos industrializados. Nos três grupos, ao comparar 2011 e 2014, houve aumento no consumo de alimentos da vocação agrícola local, como manga, batata-doce e diminuição do consumo de jerimum/abóbora. Conclusão: A superação da insegurança alimentar resulta em mudanças positivas no consumo de alimentos, e a sazonalidade é um fator promotor e limitante do consumo de alimentos.