Challenges for obesity prevention: Study of the consumers' food environment around public schools in a small municipality / Desafios para a prevenção da obesidade: estudo do ambiente alimentar do consumidor no entorno de escolas públicas de um município de pequeno porte

ABSTRACT Objective Evaluate the consumer's food environment in food retailers around public schools in the municipality of Governador Celso Ramos, state of Santa Catarina, in southern Brazil. Methods A survey was carried out in the surroundings of three public schools, from March to May 2022. Food retailers located in a pre-established 800m buffer zone were identified. A location system device recorded latitude and longitude. An audit of the establishments was performed using a specific validated instrument for auditing the consumer food environment (AUDITNOVA). These establishments were grouped into: Group 1 - predominantly selling fresh foods, Group 2 - mixed establishments, and Group 3 - predominantly selling ultra-processed foods. These establishments were assessed using a Consumer Food Environment Healthiness Score evaluation system. The data were analyzed using the statistical software Stata version 16.0. Results The study audited 21 establishments, 47.6% of which were small neighborhood food markets, 23.8% bakeries, 14.3% butchers/fishmongers, 9.5% grocery stores and 4.8% supermarkets. It was found that privately-owned vegetable markets had a higher availability of fresh and minimally processed food categories, while the lowest scores for this category were found in bakeries. Regarding ultra-processed foods, the most commonly found items were sugary beverages and candies, chocolates, and filled cookies. Conclusion More audit studies ought to be carried out in the surroundings of schools to broaden the understanding of the relationship between access, availability, prices and food advertisement in order to support the construction of strategies aimed at preventing obesity in the population.

RESUMO Objetivo Avaliar o ambiente alimentar do consumidor em estabelecimentos de comercialização de alimentos no entorno de escolas públicas no município de Governador Celso Ramos, estado de Santa Catarina, no Sul do Brasil. Métodos Foi realizada, entre março e maio de 2022, no entorno de três escolas públicas, auditoria nos comércios varejistas localizados em uma zona pré-estabelecida de 800m. Um equipamento com sistema de localização realizou o registro da latitude e longitude. Esta auditoria foi realizada utilizando um instrumento validado próprio para auditoria do ambiente alimentar do consumidor (AUDITNOVA). Estes foram agrupados em Grupo 1 - com venda predominante de alimentos in natura; Grupo 2 - estabelecimentos mistos; Grupo 3 - com venda predominante de alimentos ultraprocessados. Os estabelecimentos foram avaliados por um sistema de avaliação de saudabilidade do ambiente alimentar do consumidor. Os dados foram analisados no programa estatístico Stata versão 16.0. Resultados O estudo auditou 21 estabelecimentos, sendo 47,6% mercados de bairro, 23,8% padarias, 14,3% açougues/peixarias, 9,5% sacolões/hortifrutis privados e 4,8% supermercados. Foi identificado que sacolões/hortifrutis privados apresentaram maior oferta de alimentos da categoria in natura e minimamente processados, enquanto os menores scores desta categoria de alimentos foram encontrados em padarias. Em relação aos alimentos ultraprocessados, os alimentos mais presentes foram bebidas açucaradas e balas, chocolates e biscoito recheado. Conclusão Sugere-se a realização de mais estudos de auditoria em comércios varejistas no entorno de escolas para ampliar a compreensão da relação entre o acesso, disponibilidade, preços e propagandas dos alimentos de modo a subsidiar a construção de estratégias que visem a prevenção da obesidade na população.

Percepção dos residentes de favelas brasileiras sobre o ambiente alimentar: um estudo qualitativo / Perception of the food environment by Brazilian slum residents: a qualitative study / Percepción de los residentes de favelas brasileñas sobre el entorno alimentario: un estudio cualitativo

Resumo A disponibilidade de venda de alimentos no território pode influenciar no consumo alimentar da população. Entretanto, é importante compreender como as pessoas percebem o seu ambiente alimentar para se entender como essa disponibilidade afeta seu consumo em contextos distintos. O objetivo foi avaliar a percepção dos moradores de favelas brasileiras sobre o ambiente alimentar em suas vizinhanças. Estudo qualitativo, em que foram realizados grupos focais online guiados por um roteiro para reunir discursos coletivos sobre o acesso aos alimentos em favelas brasileiras. O convite ocorreu por meio das redes sociais e do contato com líderes comunitários e organizações não governamentais que atuam em favelas, por meio da técnica de amostragem "bola de neve". Para a análise, foi utilizada a abordagem grounded theory (teoria fundamentada) e, como técnica, foi empregada a análise de redes temáticas. O acesso aos alimentos por moradores de favelas é permeado pela falta de recursos e elementos fundamentais para uma alimentação adequada e saudável, como: a falta de informação sobre alimentação; a renda insuficiente; e a baixa disponibilidade de estabelecimentos que comercializam alimentos saudáveis a preços acessíveis. São necessários programas e políticas públicas que incentivem a ampliação de equipamentos de segurança alimentar e nutricional, como hortas e feiras, e que aumentem a oferta de alimentos saudáveis com valores baixos nas favelas. Também são necessárias ações que abordem a complexidade das barreiras enfrentadas por moradores de favelas para ter acesso aos alimentos saudáveis.

Abstract Food availability in the territory can influence food consumption by the population. However, it is important to understand how people perceive their food environment to see how food availability affects consumption in different contexts. This study aimed to assess the perception of the food environment by Brazilian slum residents in their neighborhoods. This is a qualitative study, with online focus groups guided by a script in order to gather collective discourses about access to food in Brazilian slums. The invitation to participate in this study was made through social media, and community leaders and nongovernmental organizations with actions in slums were contacted using the snowball sampling technique. Grounded theory analysis was applied with the technique of thematic networks. Access to food for slum residents involves lack of resources and essential elements for an adequate and healthy diet, such as lack of information about food, low income, and low availability of stores that sell healthy food at affordable prices. Public programs and policies are required to encourage the expansion of food and nutritional security resources, such as vegetable gardens and markets, to increase the supply and sell healthy food at affordable prices in slums. Actions are also required to address the complexity of obstacles faced by slum residents in the access to healthy foods.

Resumen La disponibilidad de venta de alimentos en el territorio puede influir en el consumo alimentario de la población. Sin embargo, es importante comprender la manera en que las personas perciben su entorno alimentario para comprender cómo esta disponibilidad afecta su consumo en diferentes contextos. El objetivo fue evaluar la percepción de los residentes de favelas brasileñas sobre el entorno alimentario en sus vecindarios. Estudio cualitativo, en el que se formaron grupos focales en línea orientados por un guion con el objetivo de reunir discursos colectivos sobre el acceso a los alimentos en favelas brasileñas. La invitación se dio por medio de las redes sociales y mediante el contacto con líderes comunitarios y organizaciones no gubernamentales que trabajan en favelas, utilizando la técnica de muestreo "bola de nieve". Para el análisis, se utilizó el enfoque de la grounded theory (teoría fundamentada) y, como técnica, se empleó el análisis de redes temáticas. El acceso a los alimentos de los habitantes de las favelas está permeado por la falta de recursos y elementos fundamentales para una alimentación adecuada y sana, tales como: la falta de información sobre la alimentación, los bajos ingresos y la poca disponibilidad de establecimientos que vendan alimentos sanos a precios asequibles. Se necesitan programas y políticas públicas para fomentar la ampliación de equipos de seguridad alimentaria y nutricional, como huertas y mercadillos, que aumenten la oferta y vendan alimentos sanos a precios asequibles en las favelas. También se necesitan acciones para abordar la complejidad de las barreras que enfrentan los residentes de las favelas para acceder a alimentos sanos.

Food environment near schools in the largest Brazilian metropolis: analyses and contributions based on census data / Ambiente alimentar próximo às escolas na maior metrópole brasileira: análises e contribuições com base em dados censitários / Entorno alimentario cerca de las escuelas en la mayor metrópoli brasileña: análisis y contribuciones a partir de datos censales

Abstract: We aimed to investigate and compare the distribution of establishments that sell food near municipal, state, and private schools in the municipality of São Paulo, Brazil. This cross-sectional, exploratory, and census study was conducted in 3,121 schools. Circular buffers were traced around schools and concentrations or dispersions of food stores (in absolute numbers and densities) were analyzed. A p-trend was calculated to analyze how food stores density behaved as the buffer radius distance increased. Stratified regression models were built to analyze the characteristics of the food environment. Snack bars and street vendors are the most common types of establishments surrounding schools. Some categories of food stores are concentrated (such as candy stores around municipal and private schools, mini markets around municipal schools, and snack bars around private schools), whereas others (such as super and hypermarkets and fruit and vegetable stores) are dispersed around public schools. The food environment around schools shows differences regarding the instance that administers them and private schools have more food stores around them. Poor-quality food environment around schools exposes students to risk factors regarding excessive unhealthy food consumption.

Resumo: Este estudo transversal, exploratório e censitário realizado em 3.121 escolas buscou investigar e comparar a distribuição de estabelecimentos de venda de alimentos no entorno de escolas municipais, estaduais e particulares da cidade de São Paulo, Brasil. Foram traçados buffers circulares ao redor das escolas e analisadas as concentrações ou dispersões de estoques de alimentos (em números absolutos e densidades). Foi calculado o valor de p de tendencia para analisar o comportamento das densidades dos estabelecimentos com o aumento da distância do raio do buffer. As características do ambiente alimentar foram analisadas por modelos de regressão estratificada. Lanchonetes e vendedores ambulantes são os tipos de estabelecimentos mais presentes nos entornos das escolas. Algumas categorias de lojas de alimentos estão concentradas (como lojas de doces em torno de escolas municipais e particulares, minimercados em torno de escolas municipais e lanchonetes em torno de escolas particulares), e outras (como super e hipermercados e hortifrútis) estão dispersas em torno de escolas públicas. O ambiente alimentar ao redor das escolas difere de acordo com a instância que as administra, e as particulares têm mais lojas de alimentos nos arredores. O ambiente alimentar de baixa qualidade ao redor das escolas expõe os alunos a fatores de risco para o consumo excessivo de alimentos não saudáveis.

Resumen: Este estudio transversal, exploratorio y censal realizado en 3.121 escuelas, buscó investigar y comparar la distribución de los establecimientos de venta de alimentos en el entorno de escuelas municipales, estatales y privadas de la ciudad de São Paulo, Brasil. Se trazaron buffers circulares alrededor de las escuelas y se analizaron las concentraciones o dispersiones de las existencias de alimentos (en números absolutos y densidades). Se calculó el valor de p de la tendencia para analizar el comportamiento de las densidades de los establecimientos al aumentar la distancia al radio del buffer. Las características del entorno alimentario se analizaron por medio de modelos de regresión estratificada. Las cafeterías y los vendedores ambulantes son los tipos de establecimientos más presentes en el entorno de las escuelas. Algunas categorías de tiendas de alimentos están concentradas (como tiendas de dulces alrededor de las escuelas municipales y privadas, minimercados alrededor de escuelas municipales y cafeterías alrededor de escuelas privadas), y otras (como super e hipermercados y tiendas de frutas y hortalizas) están dispersas alrededor de las escuelas públicas. El entorno alimentario alrededor de las escuelas difiere según la instancia que las administra, y hay más tiendas de alimentos en las inmediaciones de las escuelas privadas. El entorno alimentario de baja calidad alrededor de las escuelas expone a los estudiantes a factores de riesgo para el consumo excesivo de alimentos poco saludables.

Derecho a la alimentación en la Constitución chilena: elementos jurídicos, sociales y nutricionales para una propuesta / Right to food in the Chilean constitution: legal, social and nutritional elements for a proposal

BACKGROUND: The Human Right to Food is not incorporated in the Chilean Constitution. Aim: To identify the legal, social, and nutritional elements for its incorporation into the new Constitution, and to draft a text proposal for the constituent discussion. MATERIAL AND METHODS: Descriptive and qualitative study on the perceptions of experts and key actors of the food chain in Chile. The sample was for convenience and included civil society, academia, international organizations, parliamentarians, food traders and producers, and national and local authorities (n = 26). The research team, previously trained and standardized, applied semi-structured online surveys, which were recorded and transcribed. Through an inductive approach, a thematic analysis was carried out using the Atlas.ti 9.0 software. RESULTS: Eighty-one percent of the interviewees were in favor of the Constitutional incorporation of the Right to Food. According to interviews, a constitutional text was proposed considering the characteristics of adequate, healthy, safe, and nutritious foods. Also, the food items must be available, physically and economically accessible, and culturally relevant. A guaranteed citizen participation, food sovereignty, food security, and environmental sustainability must be considered. Conclusions: The high prevalence of malnutrition due to excess, poor diet, and food insecurity during the COVID-19 pandemic, and a current Constitution that does not explicitly guarantee physical and economic access to food, establish a factual and normative background that justifies the incorporation of this right in a new Constitution.

Desarrollo de una bebida mixta tipo néctar con cápsulas de Aloe vera (L.) Burm. f. y vitamina C / Development of a nectar-type mixed drink with Aloe vera (L.) Burm. f. and vitamin C capsules

RESUMEN El mercado de productos naturales, a nivel alimenticio, medicinal e industrial, se ha incrementado notablemente, promoviendo la innovación e investigación y el uso de materias primas vegetales y animales. La presente investigación tuvo como objetivo diseñar un néctar, con una combinación de matrices de frutas y de vegetales, como uva, espinaca, mora, agraz, yacón, enriquecida con cápsulas de Aloe vera y vitamina C. Se plantearon tres formulaciones, variando la cantidad de ingredientes en la mezcla; se seleccionó el tratamiento más aceptable, mediante evaluación sensorial en panel no entrenado. Todos los néctares tuvieron una buena aceptación organoléptica; no obstante, el 50% de los panelistas mostraron preferencias por el tratamiento 1, que contenía 13% de uva, 4% de espinaca, 3% de agraz y mora, 2% de yacón; el porcentaje restante correspondió a la cantidad de agua y azúcar empleada en la formulación. Al tratamiento con mayor aceptación (T1), se le analizaron los atributos físico químicos, mostrando un pH de 2,96, 12,11°Brix, color, olor y apariencia normales y estables; asimismo, se evaluó la presencia de bacterias mesófilas, hongos y levaduras, E. coli y Salmonella. Con el fin de enriquecer el producto, se elaboraron cápsulas de A. vera y vitamina C, para ser incorporadas en el néctar. Este tipo de producto promueve el consumo de frutas y de vegetales en alimentos procesados de uso frecuente, como los néctares.

ABSTRACT The market of natural products at a nutritional, medicinal and industrial level, has increased remarkably, promoting innovation and research and the use of vegetable and animal raw materials. The objective of this research was to design a nectar, with a combination of fruit and vegetable matrices such as grape, spinach, blackberry, blueberry, yacon, enriched with Aloe vera capsules and vitamin C. Three formulations were proposed varying the number of ingredients in the mixture; the most acceptable treatment was selected through sensory evaluation in an untrained panel. All the nectars had a good organoleptic acceptance, however, 50% of the panelists showed preferences for the treatment 1, it contained 13% of grape, 4% of spinach, 3% of blueberry and blackberry, 2% of yacon, the remaining percentage corresponded to the amount of water and sugar used in the formulation. To the treatment with greater acceptance (T1) the physical-chemical attributes were analyzed, showing a pH of 2.96; 12.11°Brix, color, smell and appearance normal and stable, likewise the presence of mesophilic bacteria, fungi and yeasts, E. coli and Salmonella was evaluated. In order to enrich the product, capsules of A. vera and vitamin C were prepared to be incorporated into the nectar. This type of product promotes the consumption of fruits and vegetables in processed foods of frequent use such as nectars.

Alimentos saludables y no saludables en la opinión de adolescentes de las escuelas públicas y privadas en la capital del nordeste brasileño / Opinions on healthy and unhealthy foods among adolescentes from public and private schools in a Northeastern Brazilian capital city

RESUMEN Objetivo. Analizar la opinión de los adolescentes sobre alimentos saludables y no saludables. Estudio transversal con adolescentes de escuelas públicas y privadas. Métodos. La muestra se estratificó en tres etapas: escuela, clase y alumno, resultando en 1507 adolescentes estudiados. Los adolescentes respondieron sobre alimentos saludables y no saludables. Resultados: 995 adolescentes respondieron al cuestionario de forma completa. Los adolescentes concordaron con los beneficios de las frutas para la salud. Hubo discordancia entre las respuestas de los estudiantes de escuelas públicas y privadas sobre los maleficios de los saladitos ultraprocesados y las papas fritas para la salud; estudiantes de la red privada de enseñanza, así como del sexo femenino concordaron que las gaseosas ayudan a engordar y provocan obesidad, mientras que los de la red pública discreparon; adolescentes de escuelas privadas, de sexo femenino y grupo de edad de 15 a 17 años discreparon que carnes rojas y grasas protegen contra enfermedades del corazón. Conclusión: Los adolescentes de las escuelas de la red privada de enseñanza parecen presentar una mejor percepción acerca de los refrescos y carnes y sus maleficios a la salud, como aquellos que presentaron la mayor edad y del sexo femenino.

ABSTRACT Objective: To analyze adolescents' opinion on healthy and unhealthy foods. We conducted a cross-sectional study involving adolescents from public and private schools. Methods: The sample was stratified in three stages: school, class and student, resulting in 1507 surveyed adolescents. The adolescents answered questions on healthy and unhealthy foods. Results: A total of 995 adolescents answered the questionnaire and were considered for analysis. By and large, adolescents agreed on the benefits of fruits for health. There was disagreement between responses of public versus private school students with regard to the health risks of processed salty snacks and French fries; private school students, as well as females, agreed that soft drinks contribute to weight gain and obesity, while those belonging to the public schools disagreed; adolescents from private schools, female and adolescents aged 15 to 17 years disagreed that red and fatty meats protect against heart diseases. Conclusion: Adolescents from private versus public schools, females compared to males, and who were older demonstrated a better understanding of the negative health effects of soft drinks and meat consumption

Una mirada actualizada de los beneficios fisiológicos derivados del consumo de legumbres / Revisiting the physiological benefits of legume consumption

RESUMEN Las legumbres han sido históricamente consideradas una apetecible fuente de proteínas y fibra. En estos tiempos caracterizados por una tendencia epidemiológica al sobrepeso y a la obesidad, corregir hábitos poco saludables es prioritario. La incorporación de legumbres al menú cotidiano como sustituto de carnes podría significar, a mediano y largo plazo, aminorar la prevalencia de enfermedades crónicas no-transmisibles. Este trabajo ofrece una mirada actualizada de algunos constituyentes claves presentes en las semillas de legumbres frecuentemente consumidas por la población chilena: porotos (Phaseolus vulgaris L.), lentejas (Lens culinaris L.); garbanzos (Cicer arietinum L.) y arvejas (Pisum sativum L.). Con una perspectiva realista, se expone el efecto del remojo y la cocción, ambos procesos simples utilizados frecuentemente en su preparación. Además, se ha considerado la digestión y fermentación como procesos claves en la liberación de compuestos bioactivos y su interacción con la microbiota residente en la porción distal del tracto gastrointestinal. Finalmente, estudios epidemiológicos en conjunto con datos experimentales permiten obtener una idea de los mecanismos que subyacen al impacto nutricional que tiene el consumo habitual de legumbres.

ABSTRACT Legumes have historically been considered a good source of proteins and fiber. Currently, there is an undeniable epidemiologic trend towards overweight and obesity; therefore, it is a priority to correct unhealthy habits. The incorporation of legumes to the daily menu, perhaps as a replacement for meat, could lead, in the short- or longterm, to a slowing in the prevalence of non-communicable chronic diseases. This work offers an updated perspective to some key constituents present in the legumes frequently consumed in the Chilean diet: beans (Phaseolus vulgaris L.), lentils (Lens culinaris L.), chickpeas (Cicer arietinum L.) and green peas (Pisum sativum L.). The effects of soaking and cooking, both simple processes widely used during its home preparation, along with digestion and fermentation, are crucial in the release of bioactive compounds at the distal portion of gastrointestinal tract, which determines its interaction with resident microbiota. In conclusion, epidemiological studies together with experimental data offer an integral view of subjacent mechanisms of nutritional impact by regular consumption of legumes.

Access to Healthy Foods and Indications of Food Insecurity among Private University Students in a Colombo Suburb, Sri Lanka

The limited availability of nutritionally adequate and safe foods or inadequate accessibility to acquire foods can result in food insecurity. This study was conducted to investigate access and attitudes among private university students in a Colombo suburb, Sri Lanka to acquire healthy foods. Methods: A self-administered pre-validated questionnaire was used to interview a total of 103 undergraduate students who were conveniently recruited from private universities. Indications of food insecurity were assessed in terms of dietary habits. Relationships between demographic characteristics and dietary habits were determined. Access to healthy foods was based on availability of healthy foods such as herbal porridge, boiled grains and fruit salads at their university premises, and the students’ willingness to buy them. Results: The majority of the subjects were females (60.2%) and 66.7% of the subjects resided outside their family homes. Frequency of consuming at least one serving per week of grain, milk, fruits & vegetables showed no significant relationship with gender. Location of residence was significantly related to consumption of grains (P=<0.000). The results revealed that 73.1% of the subjects had no access to healthy foods in their respective university premises, while more than half (61.3%) were not satisfied with the foods they consumed. Conclusion: This study revealed a lack of access to healthy foods in private higher educational premises in the Colombo suburb, indicating the risk of food insecurity among university students.

Proceso de formulación y validación de las guías alimentarias para la población chilena / Development and validation process of food-based dietary guidelines for the chilean population

The Food Based Dietary Guidelines (FBDG) are educational tools that help people to select appropriate foods for good nutrition and health. Most countries have FBDG's, but its dissemination and implementation have shown weaknesses. This paper presents the development process and validation of the 2012 FBDG for the Chilean population. The latest scientific evidence was reviewed and new messages were validated with METAPLAN, a qualitative-quantitative method for problem analysis applied to information gathered with 48 focus groups from Arica, Santiago and Chillán-Concepción. The messages promote consumption of healthy foods, focusing on critical nutrients (sugar, saturated fats, sodium) and energy intake reduction. Final version of the messages considered comments and suggestions from participants and from two expert panels. Its implementation should include promotion strategies that involve the Ministry of Health, Education, Agriculture, universities, industry and mass media, in order to achieve changes in feeding behavior in the most vulnerable segments of the Chilean population.

Las Guías Alimentarias Basadas en Alimentos (GABA), son instrumentos educativos que ayudan a la población a seleccionar alimentos apropiados para una buena nutrición y salud. La mayoría de los países tienen GABA, pero su difusión e implementación presentan grandes debilidades. Se presenta el proceso para la formulación y validación de las GABA 2012 para la población chilena. Se revisó la evidencia científica reciente y se validaron los mensajes con el Metaplán, método para el análisis de problemas, con 48 grupos focales en Arica, Santiago y Chillán-Concepción. Los mensajes promueven el consumo de alimentos saludables, un menor consumo de energía y de nutrientes críticos. En los mensajes definitivos se incorporó los comentarios y sugerencias de los participantes y de 2 paneles de expertos. Su implementación debería incorporar estrategias de promoción de los Ministerios de Salud, Educación, Agricultura, universidades, la industria y los medios masivos, para lograr cambios en el comportamiento alimentario de los segmentos más vulnerables de la población chilena.

Cambios en el patrón de consumo de alimentos en escolares chilenos con la implementación de un kiosco saludable / Changes in food consumption pattern among Chilean school children after the implementation of a healthy kiosk

En las escuelas públicas de Chile existe un kiosco que vende una gran cantidad de alimentos altos en calorías. El objetivo de este estudio fue determinar las barreras que los niños tienen para comprar alimentos saludables y evaluar el cambio en el patrón de compra durante el año escolar al implementar un “Espacio Saludable" que incluía un kiosco (que ofertaba alimentos saludables), juegos, mesas y sillas. El personal del kiosco fue capacitado y se generaron estrategias de marketing para promocionar el consumo de alimentos. Se seleccionó una escuela control y una intervenida donde se aplicó una encuesta para determinar la compra de alimentos a niños de 9 a 12 años de edad al inicio del estudio y durante el seguimiento. El número total de escolares fue de 477 (291 de la intervención y 115 de la escuela de control). No hubo diferencias significativas en la cantidad de dinero disponible para comprar alimentos entre los niños de ambas escuelas. Las barreras identificadas para la compra de alimentos sanos fueron el aroma, sabor, baja disponibilidad y alto precio. Hubo un aumento significativo en la compra de frutas, leche, yogur, refrescos y jugos light, frutos secos, sándwiches saludables y helados sin grasa (p <0,05) de los escolares de la escuela intervenida. En la escuela control, no se observaron cambios en el consumo. El aumento en la oferta de alimentos saludables, junto a las estrategias de marketing, aumentan significativamente el consumo de estos alimentos en la población escolar.

In Chilean school there is a kiosk that sells a large number of high-calorie products. The aim of this study was to determine the barriers that children have for buying healthy food and evaluate changes in the pattern of food purchases during a school year at a school where a "Healthy Space" was created. We designed implemented and assessed changes in food purchases by developing a “Healthy Space” which included a kiosk that incorporated a range of healthy food at affordable prices. The staff in charge of the kiosk was trained and we generate communication and marketing strategies to promote the consumption of healthy food. A validated survey to determine food purchases was applied to 9-12 year-old children from both schools at baseline and follow up 8 months later. The total number of schoolchildren was 477 (291 from the intervention and 115 from the control school). There weren’t significant differences in the amount of money available to buy food between children of both schools. There was a significant increase in the purchase of fruit, milk, yoghurt, soft drinks and light juices, dried seeds, healthy sandwiches and non-fat ice cream (p <0.05) of school children from the intervention school. At the control school, no change in consumption was observed. The increase in the supply of affordable healthy food, including communication and marketing strategies, significantly increases the consumption of these products among school children.

Association of Liver Dysfunction with Self-Medication History in Korean Healthy Male Adults / 예방의학회지

BACKGROUND: Korean people could abuse healthy foods as well as medications, which might cause serious side effects. The aim of this study was elucidating liver dysfunction due to the self-medications of hepatotonics, healthy foods and herb medications by nested case-control study. METHODS: Study subjects were drawn from male members of seoul Cohort Study who were recruited by self-administered structured questionnaire survey through mailing to the healthy men between the age of 40 and 59 years through the program of biennial health check-up offered by Korea Medical Insurance Corporation(KMIC). The liver dysfunction was defined as the level of serum AST and ALT above 40 IU/L and increased in more than one hundred per-cent during the 2 year follow-up period. To estimate the odds ratio between self-medication and liver dysfunction after controlling for potential confounders, logistic regression was performed. RESULTS: During the follow-up period, 30 members were identified to fit into case criteria and 2,625 members were selected as control. In logistic regression analyses, history of healthy foods intake, age under 45 years, obesity, and habit of regular exercise were significantly associated with liver dysfunction. The following factors exhibited no statistical significance: intake of hepatotonics, of herb medicine; history of disease in family, of operation, and of radiologic examination; smoking habits and drinking amounts. CONCLUSION: The significant association between the intake of healthy foods and the liver dysfunction illustrates that chronically optional overuse of healthy foods might bring to hazards to health. As the increasing trend of the size of purchasing healthy foods in Korea, pharmacoepidemiologic studies evaluating the safety and efficacy of the widely used healthy foods should be performed in the near future.