Revisión bibliográfica: alimentación vegetariana en la infancia y adolescencia / Vegetarian diet in childhood and adolescence

RESUMEN Introducción: la popularidad de las dietas vegetarianas y veganas está aumentando en países occidentales y son adoptadas por niños, niñas y adolescentes (NNyA). Las principales asociaciones de nutrición y dietética del mundo avalan este tipo de práctica alimentaria en estos grupos etáreos si son supervisados y acompañados por profesionales idóneos. Objetivo: tomar posicionamiento como Asociación Argentina de Dietistas y Nutricionistas Dietistas acerca de la implementación de dietas vegetarianas en edad pediátrica y adolescencia, considerando recomendaciones basadas en evidencias científicas. Materiales y método: revisión y actualización bibliográfica, no sistemática con búsquedas en Google Scholar, PudMed y Medline entre diciembre 2018 y marzo 2019. Resultados: la valoración nutricional, evaluando ingesta alimentaria utilizando recordatorio de 24 horas y frecuencia de consumo, orientará sobre cuáles son las potenciales deficiencias nutricionales que puede presentar para adecuar la dieta y/o suplementación de nutrientes específicos. La alimentación vegetariana tiene una densidad energética más baja que la no vegetariana, pero se logran alcanzar las recomendaciones. Las necesidades proteicas se satisfacen fácilmente cuando la dieta incluye variedad de alimentos y las calorías son adecuadas. Algunos autores sugieren aumentar un 10 a 15% la recomendación proteica. Además, considerar el aporte de ácidos grasos omega 3 (EPA y DHA) para lograr el equilibrio óptimo entre los ácidos grasos poliinsaturados omega3/omega6. Los requerimientos nutricionales de calcio no varían con respecto a los omnívoros. Es imprescindible suplementar vitamina B12 oral a todos los NNyA vegetarianos, incluso en ovolactovegetarianos o en NNyA que consuman habitualmente alimentos fortificados. La suplementación adecuada es la mejor forma de garantizar unos niveles óptimos de esta vitamina. Se recomienda evaluar el estado de la vitamina D suplementando según edad. Conclusiones: La Asociación Argentina de Dietistas y Nutricionistas Dietistas (AADYND) plantea que la alimentación vegetariana y/o vegana planificada, supervisada y suplementada por un profesional de la nutrición idóneo, son saludables en la niñez y adolescencia. Los profesionales de la alimentación y nutrición pueden desempeñar un papel clave en la educación y acompañamiento de las personas vegetarianas acerca de fuentes específicas de nutrientes, preparación de alimentos, y modificaciones dietéticas necesarias para satisfacer sus necesidades(AU)

ABSTRACT Introduction: the popularity of vegetarian and vegan diets is increasing in western countries and are adopted by children and adolescents (Ch&A). The main nutrition and dietetic associations in the world approve this type of dietary practice in these age groups if they are supervised and accompanied by qualified professionals. Objective: take a position as the Argentine Association of Dietitians and Dietitian Nutritionists about the implementation of vegetarian diets in pediatric and adolescent age, considering recommendations based on scientific evidence. Materials and Method: review and bibliographic update, non-systematic, with searches on Google Scholar, PudMed and Medline between December 2018 and March 2019. Results: The nutritional assessment, evaluating food intake using a 24-hour reminder and frequency of consumption, will provide guidance on what are the potential nutritional deficiencies that may come up, adapt the diet and/or supplementation of specific nutrients. The vegetarian diet has a lower energy density than the non-vegetarian diet but manages to meet the recommendations. Protein needs are easily met when the diet includes a variety of foods and calories are adequate. Some authors suggest increasing the protein recommendation by 10 to 15%. Considering the contribution of omega 3 fatty acids (EPA and DHA) to achieve the optimal balance between omega3/omega6 polyunsaturated fatty acids. The nutritional requirements of calcium do not vary with respect to omnivores. It is essential to supplement oral vitamin B12 to all vegetarian Ch&A, even in ovolactovegetarians or in Ch&A that habitually consume fortified foods. Proper supplementation is the best way to ensure optimal levels of this vitamin. It is recommended to evaluate the status of vitamin D by supplementing according to age. Conclusions: Argentine Association of Dietitians and Dietitian Nutritionists states that vegetarian and/or vegan food, planned, supervised and supplemented by a suitable nutrition professional, are healthy in childhood and adolescence. Food and nutrition professionals can play a key role in educating and mentoring vegetarians about specific sources of nutrients, food preparation, and dietary modifications necessary to meet their needs(AU)

Acompanhamento fonoaudiológico nas dificuldades alimentares no câncer infanto-juvenil: uma série de casos / Speech therapy follow-up for eating difficulties with juvenile child cancer: a series of cases / Seguimiento fonoaudiológico en las dificultades de alimentación en el cáncer infantojuvenil: una serie de casos

Objetivo: Este estudo teve como objetivo relatar o acompanhamento fonoaudiológico nas dificuldades alimentares no câncer infanto-juvenil. Métodos: O estudo de série de casos retrospectivo e descritivo-qualitativo teve amostra composta por 3 indivíduos com idade variando entre 8 e 14 anos, em acompanhamento com a equipe do Serviço de Oncologia Pediátrica do Hospital da Criança Santo Antônio - Irmandade Santa Casa de Misericórdia de Porto Alegre, com solicitação de avaliação fonoaudiológica para investigação de deglutição/alimentação. A coleta foi realizada por meio de dados extraídos de prontuário eletrônico da instituição, onde constavam as evoluções dos casos dos pacientes internados e atendidos em ambulatório, de março de 2018 a agosto de 2019. Resultados: Nos 3 casos relatados, os pacientes apresentaram deglutição normal, com indicação de via alternativa para alimentação pelo prejuízo na ingestão oral de alimentos durante e/ou após o tratamento oncológico. As queixas alimentares devido aos efeitos colaterais do tratamento foram inapetência, alteração de paladar, náusea e vômitos. Os casos foram acompanhados durante a internação e em ambulatório de fonoaudiologia. Dois dos pacientes permaneceram com a via alternativa por tempo prolongado e um deles reestabeleceu a alimentação por via oral exclusiva. Conclusão: O fonoaudiólogo inserido na equipe multidisciplinar de cuidados ao paciente com câncer infanto-juvenil é um dos responsáveis pelo acompanhamento das dificuldades alimentares provocadas pela doença e tratamentos, com olhar além da disfagia orofaríngea. A sua atuação deve envolver estratégias que promovam a nutrição adequada, seja por via alternativa ou via oral, visando segurança e conforto, com respeito à autonomia do paciente.

Objective: This study was aimed to report speech therapy follow-up for eating difficulties with childhood cancer. Methods: The retrospective and descriptive-qualitative case series study was sampled composed of patients aged between 8 and 14 years, under follow-up with the Pediatric Oncology Service of the Hospital da Criança Santo Antônio - Irmandade Santa Casa de Misericórdia de Porto Alegre, with a request for speech therapy evaluation for swallowing/feeding research. The collection was performed through data extracted from the institution's electronic medical records, with the evolution of the cases of patients hospitalized and attended in an outpatient clinic, from March 2018 to August 2019. Results: In the 3 reported cases, the patients presented normal swallowing, with indication of feeding tubes by impairment in oral food intake during and/or after cancer treatment. The dietary complaints due to the side effects of treatment were inapetence, taste change, nausea and vomiting. The cases were followed during hospitalization and in the speech therapy outpatient clinic. Two of the patients remained on a feeding tube for a long time and one of them reestablished exclusive oral feeding. Conclusion: The speech therapist inserted in the multidisciplinary team of care for patients with childhood cancer is one of those responsible for follow-up of eating difficulties caused by the disease and treatments, with a look beyond oropharyngeal dysphagia. Its performance should involve strategies that promote adequate nutrition, either alternatively or orally, aiming at safety and comfort, with respect to the patient's autonomy.

Objetivo: Este estudio tenía como objetivo de relatar el seguimiento fonoaudiológico en las dificultades de alimentación en el cáncer infantil. Métodos: El estudio retrospectivo y descriptivo-cualitativo de la serie de casos estaba compuesto por 3 individuos de entre 8 y 14 años, bajo seguimiento con el equipo de Servicio de Oncología Pediátrica del Hospital da Criança Santo Antônio - Irmandade Santa Casa de Misericórdia de Porto Alegre, con solicitud de evaluación fonoaudiológica para la investigación de la deglutición/alimentación. La recopilación se realizó a través de datos extraídos de la historia clínica digitalizada institucional con la evolución de los casos de pacientes hospitalizados y atendidos en un servicio de consulta externa, de marzo de 2018 a agosto de 2019. Resultados: En los 3 casos reportados, los pacientes presentaron deglución normal, con indicación de vía alterna de alimentación por presentar dificultad en la ingesta oral de alimentos durante y/o después del tratamiento oncológico. Las quejas alimenticias asociadas a los efectos secundarios del tratamiento fueron la pérdida del apetito, alteración en el sentido del gusto, náuseas y vómito. Los casos fueron acompañados por el fonoaudiólogo durante la hospitalización y el servicio de consulta externa. Dos de los pacientes permanecieron con via alterna de alimentación durante un tiempo prolongado y uno de ellos restableció la alimentación por vía oral por completo. Conclusión: El fonoaudiólogo como parte del equipo multidisciplinario de atención en pacientes con cáncer infantil, es uno de los responsables del seguimiento de las dificultades de alimentación causadas por la enfermedad y los tratamientos, con una mirada más allá de la disfagia orofaríngea. Su actuación debe incluir estrategias que promuevan una nutrición adecuada, ya sea por vía alterna o vía oral, con el objetivo de garantizar la seguridad y comodidad del paciente y respetando su autonomía.

Impacto de la Dieta Vegetariana en la Salud Mental de Adolescentes / Impact of the Vegetarian Diet on the Mental Health of Adolescents

El vegetarianismo en adolescentes está aumentando, sin embargo, la evidencia sobre las consecuencias físicas y psíquicas de este patrón dietario es aún escasa. El objetivo de esta revisión es sistematizar la información científica disponible acerca del vegetarianismo adolescente, para guiar a los jóvenes en la búsqueda de un patrón de dieta saludable. Se realiza una revisión en Pubmed. Se encuentran 9 trabajos en relación a consecuencias físicas y déficit nutricionales, y 6 sobre asociaciones con salud mental. Los resultados se sintetizan según la siguiente clasificación: (1) Consecuencias en la salud física y nutricional; (2) Consecuencias en la salud mental y relación con trastornos de la conducta alimentaria. Sobre el primero, se observa que adolescentes vegetarianos tendrían mayor ingesta de frutas y verduras, y menor riesgo de sobrepeso y obesidad. Una dieta vegetariana restrictiva conlleva déficits nutricionales, que son prevenibles. En cuanto a la salud mental, se evidencia mayor riesgo de conductas de control de peso poco saludables, y, además, tener un trastorno de conducta alimentaria aumenta la probabilidad de haber sido o ser vegetariano. A modo de conclusión, ante un adolescente vegetariano es fundamental explorar las motivaciones a tener este patrón dietético, de modo de pesquisar e intervenir en posibles trastornos alimentarios subyacentes. En cambio, a un adolescente con convicción, se le debe proporcionar orientación para convertirse en un vegetariano saludable. Palabras claves: Adolescentes; dietas vegetarianas; impacto nutricional y de salud y consecuencias en salud mental.

Becoming a vegetarian is an increasing trend among adolescents; however, evidence on the physical and mental health consequences of assuming this dietary pattern is still scarce. This review seeks to review the available scientific knowledge about adolescent vegetarianism in order to guide young people in their search for a healthier diet. A Pubmed review was performed, obtaining 9 studies with relation to physical consequences and nutritional deficits, and 6 on associations with mental health. The results are summarized according to the following classification: (1) Consequences in physical and nutritional health; (2) Consequences in mental health and links to eating disorders. The first findings point to vegetarian teenagers having a higher intake of fruits and vegetables, and a lower risk of overweight and obesity. Nonetheless, a restrictive vegetarian diet leads to nutritional deficits, which are preventable. In terms of mental health issues, we observed a greater risk of unhealthy weight control behaviour; moreover, having an eating disorder increases the likelihood of being (or having been) vegetarian. We suggest that for physicians evaluating a vegetarian adolescent, it is fundamental to explore the motivations behind this dietary pattern in order to diagnose and intervene in possible underlying eating disorders. However, a vegetarian teenager with strong personal beliefs should be provided with guidance and support to develop a healthier diet. Keywords: adolescents, vegetarian diet, physical and nutritional impact, mental health consequences

Mejora del conocimiento y conducta alimentaria de los adolescentes con una intervención educativa basada en orientación alimentaria / Improvement of knowledge and feeding behavior of adolescents with an educational intervention based on food orientation

Métodos: estudio cuasiexperimental, con 32 adolescentes entre 15 y 17 años. Se aplicó un cuestionario estructurado pretest y postest de un programa educativo de orientación alimentaria con base en la NOM-043-SSA2-2012. Los datos se analizaron con estadística descriptiva y t de Student no paramétrica para observar la diferencia (p ≤ 0.05). Resultados: el 56.2% de los adolescentes de ambos sexos se encuentran en Normopeso. El sobrepeso fue mayor en hombres (44.5%) que en mujeres (35.7%). Hubo incremento en el consumo de agua pura (20%) y disminución del consumo de refresco o agua de sabor (8%). También aumentó el consumo de frutas y verduras (18%), cereales y tubérculos (16%), y alimentos de origen animal (9%). La diferencia pretest y postest fue significativa (p ≤ 0.05). Conclusión: la intervención educativa basada en orientación alimentaria tiene un efecto positivo sobre el conocimiento reforzando la conducta alimentaria de los adolescentes.

Introduction: Adolescents are susceptible to unhealthy eating behaviors that trigger health problems such as obesity, malnutrition or eating disorders. Objective: To evaluate the effect of an educational intervention based on food orientation to improve knowledge and eating behavior of high school students. Methods: Quasi-Experimental study, with 32 adolescents between 15 and 17 years old. A structured pre-test and post-test questionnaire was applied to an educational food orientation program based on NOM-043-SSA2-2012. The data were analyzed with descriptive statistics and nonparametric Student t to observe the difference (p ≤ 0.05). Results: 56.2% of adolescents of both sexes are in Normopeso. Overweight was higher in men (44.5%) than in women (35.7%). There was an increase in the consumption of pure water (20%) and a decrease in the consumption of soft drink or water of flavor (8%). The consumption of fruits and vegetables (18%), cereals and tubers (16%) and foods of animal origin (9%) also increased. The pretest and posttest difference was significant (p ≤ 0.05). Conclusions: The educational intervention based on food orientation has a positive effect on knowledge by reinforcing the adolescents' eating behavior.

Effects of iron supplementation and nutrition education on haemoglobin, ferritin and oxidative stress in iron-deficient female adolescents in Palestine: randomized control trial

Background: Iron deficiency and iron-deficiency anaemia are associated with oxidative stress, but their role is largely unclear. Information is scarce on the effects of iron supplementation on biomarkers of oxidative stress in humans.

Aims: This study evaluated the effectiveness of iron supplementation and nutrition education on improving the levels of haemoglobin and ferritin, and decreasing oxidative stress among iron-deficient female adolescents in Gaza, Palestine.

Methods: A total 131 iron-deficient female adolescents were recruited and allocated randomly into 3 different groups. The iron supplementation group [A] received 200 mg of ferrous fumarate weekly during the 3-month intervention, the iron supplementation with nutrition education group [B] received iron supplements with nutrition education sessions, and the control group [C] did not receive any intervention. The levels of haemoglobin, ferritin and malonyl dialdehyde were measured at baseline, after 3 months [at which point the intervention was stopped], and then 3 months later. Trial registration number: ACTRN12618000960257.

Results: Haemoglobin levels increased significantly after supplementation in both groups A and B. At the follow-up stage [3 months after stopping the intervention], iron and haemoglobin levels in group B continued to increase and malonyl dialdehyde decreased. In Group A, haemoglobin, ferritin and malonyl dialdehyde levels decreased after 3 months of stopping the intervention. No changes were seen in Group C.

Conclusions: A nutrition programme should be adopted and integrated into comprehensive intervention programmes to target iron-deficiency anaemia among female adolescents in Palestine

Implementation of a peer-mediated health education model in the United Arab Emirates: addressing risky behaviours among expatriate adolescents

Tobacco use among young people is increasing in the United Arab Emirates, and the country is ranked 15th in the world for prevalence of type II diabetes. Expatriates comprise a majority of the population, making them an important subset to study. We aimed to test whether an educational intervention would be effective in this cultural setting. We designed 2 peer-to-peer health workshops: tobacco use and nutrition/physical activity. One workshop was randomly assigned to 18 classrooms in private schools in Abu Dhabi. Surveys were administered before and after the workshops to assess intervention effectiveness. The tobacco workshop significantly improved responses [P < 0.05]. The nutrition and physical activity workshop resulted in decreased satisfaction with personal activity levels. This study provides evidence to support the national adoption of a peer-to-peer health education model as an intervention for tobacco use but not for nutrition and physical activity choices

Nutritional knowledge and habits of adolescents aged 9 to 13 years in Sharjah, United Arab Emirates: a crosssectional study

Good nutritional knowledge and behaviour among adolescents is important to avoid health problems that can continue into adulthood. This cross-sectional study aimed to provide baseline data on nutritional knowledge and eating habits of adolescents in Sharjah. Data were collected from 300 adolescents aged 9-13 years attending 4 private schools using a validated self-administered questionnaire. Most students [86%] had poor nutritional knowledge, especially in key areas: nutritional terms, what constitutes healthy snacks and foods, daily nutritional requirements and components of food [e.g. fibre, fat, sugar]. Only 34% of the students had healthy eating behaviour: 33% had eaten none or 1 vegetable only in the previous week, 25% had eaten unhealthy snacks 3 or more times, 19% had eaten frequently or daily at fast food outlets, and 36% had skipped breakfast frequently or daily. Culturally-specific, school-based educational interventions are warranted to build sound nutritional knowledge among adolescents and motivate the diet and behaviour changes needed to promote health throughout the lifespan

Social portrayal of nourishment and repercussions in nutritional habits of pregnant adolescents / Representações sociais da alimentação e suas repercussões no comportamento alimentar de gestantes adolescentes

The aim of this study was to analyze the impact of social repercussions in nutritional habits of pregnant adolescents conducted by a Primary Health Care Unit in the county of Sobral, Ceará. Using a qualitative approach, exploratory and descriptive, the data was collected through semi-structured interviews at the homes of 15 pregnant adolescents in 2014. Using the material obtained from the thematic perspective, the core issues were analyzed: the nutritional habits during pregnancy; myths/taboos, and intrinsic changes of pregnancy. Changes were observed in nutritional habits related to regularity in meal times and the consumption of fruits and vegetables. During the speeches there was the valorization about proper nourishment, however, the consumption of high-calorie foods coexists. Regarding the myths/taboos, they indicated the existence of 'strong' and 'weak' foods and the need to 'eat for two'. It can be determined that the intrinsic change can interfere with nutrition. It was evident that their beliefs permeated during pregnancy, bringing repercussions in eating behavior, and that health professionals should understand the context experienced by pregnant adolescents, in order to provide adequate care.

O objetivo desse trabalho foi analisar as repercussões das representações sociais no comportamento alimentar de gestantes adolescentes acompanhadas por uma Unidade Básica de Saúde no município de Sobral-Ceará. Com abordagem qualitativa, do tipo exploratório descritivo, a coleta de dados ocorreu por meio de entrevista semiestruturada no domicílio de 15 gestantes adolescentes, em 2014. Analisou-se o material obtido com a técnica de análise temática, construindo-se os temas centrais: as práticas alimentares na gestação; mitos/tabus e alterações intrínsecas da gestação. Foram verificadas alterações nas práticas alimentares relacionadas à regularidade nos horários das refeições e o consumo de frutas e verduras. Houve nos discursos a valorização da boa alimentação, no entanto, o consumo de alimentos calóricos coexiste. Com relação aos mitos/tabus, destacaram-se a existência de alimentos fortes e fracos e a necessidade de comer por dois. Pode-se identificar que as alterações intrínsecas interferiram na alimentação. Ficou evidente que as crenças permeadas na gestação trazem repercussões no comportamento alimentar, e que os profissionais de saúde devem compreender o contexto vivenciado pelas gestantes adolescentes, a fim de prestar um adequado atendimento.

Nutrition in Chinese-Korean Children and Adolescents / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To study the nutrition habits among Chinese-Korean children and adolescents in Yanbian Autonomous Prefecture, Jilin, China.</p><p><b>METHODS</b>Data were obtained from the Chinese National Survey on Students' Constitution and Health in 1995, 2000, 2005, and 2010 for Chinese-Korean children and adolescents aged 7-18 years. The number of the subjects included was 4789, 4704, 5875, and 5315, respectively.</p><p><b>RESULTS</b>The rate of the occurrence of stunting showed a declining trend from 1995 to 2010 (for boys: urban, 6.3%; rural, 12.7% in 1995 and 3.5% for both in 2010. For girls: urban, 7.8%; rural, 13.4% in 1995 and 4.2% and 5.5%, respectively, in 2010). Although the ratio of wasting did not show significant differences between the urban and rural children and adolescents in 1995, 2000, 2005, and 2010 respectively, the ratio of occurrence of overweight or obesity increased (for boys: urban, 7.3% and 1.3% in 1995, 17.6% and 12.9% in 2010; rural, 7.0% and 1.3% in 1995, 14.6% and 12.8% in 2010, respectively. For girls: urban, 8.1% and 1.0% in 1995, 17.3% and 8.6% in 2010; rural 5.7% and 0.7% in 1995, 16.4% and 7.4% in 2010, respectively).</p><p><b>CONCLUSION</b>The ratio of malnutrition in children and adolescents in Chinese-Korean areas declined from 1995 to 2010, and the distinction in malnutrition between the urban and rural areas was negligible in 2010. Further, the ratio of overweight and obesity increased over this period.</p>

Consumo de bebidas azucaradas en adolescentes escolarizados de la provincia de salta. Centro nacional de investigaciones nutricionales, 2014 / Sweetened beverages consumption in school adolescents in the province of salta. National centre of nutritional investigations, 2014

El consumo elevado de bebidas azucaradas se ha relacionado con mayor prevalencia de obesidad y hábitos de vida no saludables. Sus calorías, vacías de nutrientes, son elegidas por muchos consumidores, entre ellos adolescentes, constituyendo la mayor fuente de azúcares añadidos en sus dietas. La ingesta calórica resultante del consumo de estas bebidas es un factor que podría contribuir al aumento de peso entre los jóvenes. Objetivos: evaluar la prevalencia y asociación de factores nutricionales, socio-demográficos y hábitos de vida con consumo frecuente de bebidas azucaradas en adolescentes escolarizados de Salta (2008-2009). Metodología: estudio transversal. Muestreo probabilístico de escuelas de nivel medio. Valoración antropométrica, cuestionario de frecuencia de consumo de alimentos y hábitos de vida a adolescentes del último curso (16-20 años). Análisis estadístico: distribución de frecuencias, chi2. Regresión logística multivariada (OR, p< 0,05). SPSS19, EPI-INFO.Resultados: se evaluaron 659 adolescentes; 73,7% consumía bebidas azucaradas en forma frecuente (>3 veces/semana), 42,8% no realizaba actividad física. La prevalencia de sobrepeso/obesidad fue de 13,8 y 3,9 %. El consumo de bebidas azucaradas se asoció a familias de bajos ingresos (OR 1.63), al consumo frecuente de golosinas (OR 2.26) y la falta de actividad física (OR 2.24). No se asoció con el estado nutricional. Conclusiones: se observa consumo elevado de bebidas azucaradas, asociado a hábitos de vida no saludables y familias de bajos ingresos. Es imperativo aplicar estrategias de salud pública, como la educación sobre la ingesta de bebidas y su reemplazo por líquidos más saludables.

The high consumption of sweetened beverages has beenlinked to increased prevalence of obesity and unhealthy living habits. Their calories, nutrient de cient, are chosen by many consumers, including adolescents, constituting the largest source of added sugars in their diets. The resulting caloric intake from consumption of these drinks is a factor that may contribute to weight gain among young adults.Objective: to evaluate the prevalence and association of nutritional, socio- demographic and lifestyle factors with frequent consumption of sugar-sweetened beverages among adolescent students of the last course (2008-2009). Methods: cross-sectional study. Probability sampling of high schools. Anthropometric evaluation, frequency questionnaire and food consumption habits of last year teenagers (16-20 years). Statistical analysis: frequency distribution, chi2. Multivariate logistic regression (OR, p < 0,05).SPSS 19. EPIINFO. Results: 659 adolescents were evaluated, 73,7% consumed sugary drinks frequently (> 3times/week), 42,8% did not perform physical activity. The prevalence of overweight / obesity was 13,8% and 3,9%. Consumption of sweetened beverages was associated with low-income families (OR 1.63), frequent consumption of sweets (OR 2.26) and lack of physical activity (OR 2.24). It was not associated with the nutritional status. Conclusion: High consumption of sugar-sweetened beveragesis associated with unhealthy life habits and low-income families. It is imperative to implement public health strategies, such as education about beverage intake and replacing them with healthier liquids.

Fatores Associados à Vitalidade no Nascimento em Neonatos de Mães Adolescentes Precoces / Associated with Vitality Birth in Early Adolescent Mothers of Newborns / Factores Asociados con la Vitalidad Nacimiento en Primeros Madres Adolescentes de los Recién Nacidos

Conforme dados emitidos pelo Ministério da Saúde, o Brasil encontra-se entre os dez países com o maior número de parto prematuro e este número tem ligação direta com a gravidez precoce na adolescência. Do total de partos realizados pelo SUS no ano de 2007 (2.795.207), 1% eram em mulheres de 10 a 14 anos. Poucos são os estudos que abordam a gravidez na fase precoce da adolescência e suas complicações para com os recém-nascidos. No entanto, embora diversas ações de saúde venham sendo desenvolvidas para reduzir os números de gestações precoces, tais direcionamentos apontam para uma população jovem numa faixa etária entre os 14 e os 19 anos. Neste contexto, existe uma lacuna frente às adolescentes que veem engravidando entre os 10 e 14 anos, aumentando assim os riscos, tanto para a saúde materna quanto para a neonatal. Este estudo tem como objetivo verificar a associação entre os fatores relacionados à vitalidade no nascimento dos recém-nascidos de mães adolescentes precoces. Trata-se de um estudo epidemiológico, de corte transversal, desenvolvido a partir de dados secundários obtidos do Sistema de Informações de Nascidos Vivos (SINASC) no ano de 2012. Os sujeitos deste estudo foram os recém-nascidos de mães na fase precoce da adolescência (idade entre 10 e 14 anos), nascidos no período de janeiro a dezembro de 2012 no estado da Bahia. Após processamento dos dados foi realizada uma análise bivariada, calculando a razão de prevalência (RP) e os seus respectivos intervalos de confiança de 95% (IC95%). Utilizou-se a regressão logística para realizar a análise multivariada. Optou-se pelo método de regressão stepwise backward. O resultado da análise multivariada para medir a associação das covariáveis com desfecho foi estimado pela Odds Ratio (OR). O estudo identificou que 156 (11,6%) dos recém-nascidos apresentaram o escore de Apgar inferior a sete no primeiro minuto de vida, enquanto que 1.188 (88,4%) se mostraram com Apgar superior ou igual a sete. 1252 (93,2%) das adolescentes em estudo foram declaradas negras. 3,5% dos partos ocorreram em adolescentes com idades extremas (10-12 anos), 74,1% das mães não possuíam companheiros. Ser primigesta (OR=2,03; IC:0,26-0,97) manteve associação com o Apgar. A gravidez ser com feto único (OR=7,16; IC: 1,82-28,25) aumentou as chances de ter um Apgar satisfatório ao nascimento, sendo considerado fator de proteção. Em sentido oposto, ter realizado, durante a gestação, três consultas pré-natais ou menos (OR=0,41; IC: 0,22-0,77) reduziu as chances de apresentar um escore de Apgar ao quinto minuto satisfatório, sendo considerado fator de risco. A gravidez na adolescência precoce traz importantes consequências para a vitalidade no nascimento em recém-nascidos. A alimentação das bases de dados do Sistema de informação em Saúde é algo crucial e que deve ser mais bem trabalhado entre os profissionais da área. Os dados da pesquisa também poderão servir para subsidiar a criação de novas políticas de saúde voltadas para o processo assistencial no que tange ao cuidado materno-infantil.(AU)

Dietary diversity score as an indicator of nutritional adequacy of diets among 16-19 year-old adolescents

OBJECTIVES: This study was conducted to determine the dietary diversity score and its relation to nutritional adequacy among 16-19 year-old adolescents. METHODS: Secondary data analyses were undertaken with a representative sample of 16-19 year-old adolescents (n=521) in a university campus in Manila in 2008. Dietary diversity scores (DDS) were calculated. Nutrient adequacy ratio (NAR) is the ratio of subject's nutrient intake to the 2002 Recommended Energy and Nutrient Intakes (RENI) for Filipinos. The mean adequacy ratio (MAR) was calculated as the sum of NARs for all evaluated nutrients divided by the number of nutrients evaluated, expressed as a ratio (range from 0-1). MAR was used as a measure of adequacy of overall diet. Pearson correlation coefficients between DDS and MAR were calculated and also evaluated for sensitivity and specificity, with MAR taken as the ideal standard of adequate intake. RESULTS: The adolescents had a mean DDS of 3.94 (1.21) and a mean MAR of 0.67 (0.18). There was a strong correlation between MAR and DDS (r=0.543; P CONCLUSION: DDS can be used as a simple and quick indicator of the nutritional adequacy of the diets among these group of adolescents. Further investigation of this tool is needed for other population groups i.e., adults and elderly.

Por que os adolecentes comem o que comem: determinantes do consumo alimentar / Why adolescents eat what they eat: determinants of food choice

Introdução: Muitos são os estudos que avaliam o consumo alimentar na adolescência entretanto não se sabe quais fatores motivam esses jovens a se alimentarem de forma inadequada. Objetivo: Avaliar, de forma quantitativa e qualitativa, os fatores determinantes do consumo alimentar de adolescentes de escolas técnicas em São Paulo. Métodos: O presente estudo é parte de uma pesquisa matriz, que avaliou 1167 jovens de ambos os gêneros. Os fatores determinantes do consumo alimentar foram avaliados em duas etapas. Na primeira etapa quantitativa foram utilizados dois instrumentos que foram desenvolvidos para a pesquisa matriz, o primeiro um questionário de avaliar atitudes alimentares de adolescentes e o segundo avaliou o consumo alimentar através de um questionário de frequência alimentar baseado na pirâmide dos alimentos. O primeiro instrumento apresenta uma questão onde 15 fatores determinantes do consumo alimentar são apresentados e cada adolescente deveria escolher os 3 mais importantes. O peso e a estatura de todos os indivíduos foi mensurado e posteriormente o Índice de Massa Corporal foi calculado afim de classificar os adolescentes quanto à adequação de seu estado nutricional segundo os critérios da Organização Mundial da Saúde. A avaliação qualitativa foi realizada com uma subamostra do projeto matriz (n=45) e contou com a realização de grupos focais. Os 15 fatores determinantes do consumo foram agrupados em 3 grupos a partir da realização da análise de cluster e esses grupos foram comparados com relação ao gênero, estado nutricional, consumo de alimentos e dos grupos alimentares baseados na pirâmide dos alimentos para adolescentes. Resultados: Os 3 fatores determinantes mais referidos pelos adolescentes na etapa quantitativa foram, em ordem de preferência, o sabor, o fato do adolescente gostar do alimento e tentar ter uma alimentação mais saudável, enquanto que a etapa qualitativa mostrou que os fatores de falta de tempo, conveniência e praticidade foram os...

Introduction: Many studies evaluate food consumption in adolescence however little is known about the factors that influence adolescent's food choices. Objective: To evaluate, in a quantitative and qualitative way, the factors that influence adolescent's food choice from technical schools from São Paulo. Methods: This study is part of a research which evaluated 1167 adolescents from both gender. Factors that influence adolescent's food choice were evaluated in two steps, the first one evaluated in a quantitative way used two surveys that were developed to the research. The questionnaire evaluated adolescent's eating attitudes and included a question which included 15 factors which the adolescents should select the 3 more important, and the second survey assessed food consumption through a food frequency questionnaire that was based on the food pyramid. Body weight and height were measured and the Body Mass Index calculated in order to classify their weight status according to the World Health Organization criteria. The second part of this study, the qualitative analyses, used a smaller sample from the main study (n=45) and focus groups were performed. The 15 factors were divided into groups using the cluster analyses method and compared between genders, weight status and food consumption. Results: Taste and liking the food and trying to have a healthier eating were the 3 most referred factors in the quantitative analyses, while in the qualitative research lack of time and convenience were the most reported factors that influence the adolescent's food choices. Adolescents who prefer factors related to the food characteristics, such as taste, eat significantly more high fat and sugar foods. Conclusion: In this group the taste of food was the most important factor and can explain the eating inadequacies seen in this population.

Major dietary patterns among female adolescent girls of Talaat Intelligent Guidance School, Tabriz, Iran

Increasingly nutritional experts express the necessity of research on dietary patterns to identify numerous modifiable risk factors of disease. This study was conducted to identify major dietary patterns among adolescent girls in Talaat intelligent guidance school, Tabriz, Iran. Among 257 adolescent girls aged 11-15 years, usual dietary intakes were assessed using a 162-item semi-quantitative food frequency questionnaire [FFQ]. Factor analysis was used to identify major dietary patterns in this Turkish population. We identified 6 major dietary patterns: [1] Western pattern high in pizza, meats and fruit juice; [2] Sweat junk foods pattern high in dried fruits, jams, honey and sugar; [3] Asian pattern high in legumes, potato and other vegetables; [4] Salty junk foods pattern high in carrot, puffs and potato chips and [6] Iranian traditional dietary pattern high in hydrogenated fats, garlic and broth. Our findings suggested that among the 6 major dietary patterns, Asian-like food was the healthiest one

Dietary diversity score as an indicator of nutritional adequacy of diets among 16-19 year-old adolescents

Objective. This study was conducted to determine the dietary diversity score and its relation to nutritional adequacy among 16-19 year-old adolescents. Methods. Secondary data analyses were undertaken with a representative sample of 16-19 year-old adolescents (n=521) in a university campus in Manila in 2008. Dietary diversity scores (DDS) were calculated. Nutrient adequacy ratio (NAR) is the ratio of subject's nutrient intake to the 2002 Recommended Energy and Nutrient Intakes (RENI) for Filipinos. The mean adequacy ratio (MAR) was calculated as the sum of NARs for all evaluated nutrients divided by the number of nutrients evaluated, expressed as a ratio (range from 0-1). MAR was used as a measure of adequacy of overall diet. Pearson correlation coefficients between DDS and MAR were calculated and also evaluated for sensitivity and specificity, with MAR taken as the ideal standard of adequate intake. Results. The adolescents had a mean DDS of 3.94 (1.21) and a mean MAR of 0.67 (0.18). There was a strong correlation between MAR and DDS (r=0.543; P < 0.0001). A DDS of 4 was shown to be the best indicators for both MAR equivalent to 0.5 and 0.7 since they provided the best sensitivity and specificity. Conclusion. DDS can be used as a simple and quick indicator of the nutritional adequacy of the diets among these group of adolescents. Further investigation of this tool is needed for other population groups i.e., adults and elderly.

Estado nutricional en adolescentes, exceso de peso corporal y factores asociados / Nutritional status in adolescents, body excess weight and associated factors

Introducción: la adolescencia es una etapa crucial, con alta prevalencia de trastornos nutricionales, que luego continúan durante la vida adulta y se asocian con complicaciones a corto y a largo plazo. Objetivos: identificar la asociación entre el exceso de peso corporal y los antecedentes patológicos familiares de interés y algunos factores perinatales, la presencia de la hipertensión arterial y su relación con la historia familiar de hipertensión, el exceso de peso corporal y el incremento de adiposidad abdominal; y por último, identificar la presencia de acantosis nigricans y su relación con iguales factores. Métodos: se desarrolló un estudio descriptivo transversal para caracterizar el estado nutricional de los adolescentes de séptimo grado que asisten a la Secundaria Básica José María Heredia, en el curso 2009-2010. La población estuvo constituida por 192 adolescentes, a los cuales, con previo consentimiento de los padres, se les realizaron las mediciones antropométricas (peso, talla, circunferencia de cintura y se calculó el índice de masa corporal), y además se midió la tensión arterial y se buscaron signos clínicos de resistencia insulínica. También se aplicó una encuesta a los padres acerca de los antecedentes patológicos familiares y algunos datos de sus hijos. Resultados: se encontró que el 20,31 por ciento de los adolescentes presentaba sobrepeso u obesidad, lo cual se relacionó de forma significativa con la presencia de hipertensión arterial y signos clínicos de resistencia insulínica. La hipertensión arterial se halló en el 9,9 por ciento de los adolescentes, sin relación con factores hereditarios. Conclusiones: la obesidad y el sobrepeso corporal constituyen un problema de salud en la población adolescente estudiada, lo cual se asocia con la presencia de hipertensión arterial y resistencia insulínica, no existió relación en su comportamiento con factores no modificables (antecedentes patológicos familiares y personales)(AU)

Introduction: the adolescence is a decisive stage with a high level of prevalence of nutritional disorders that latter remains during the adulthood and are associated with short- and long term complications. Objectives: to identify the association between excess of body weight and the interesting family pathological backgrounds and some perinatal risks, the presence of high blood pressure and its relation to the family history of high blood pressure and the increase of abdominal adiposity and finally, to identify the presence of acanthosis nigricans and its relation with the similar factors. Methods: a cross-sectional and descriptive study was conducted to characterize the nutritional status of the adolescents of the seventh grade from the José María Heredia secondary school during 2009-2020. Group included 192 adolescents who with a previous consent of parents underwent anthropometric measurements (weight, height, waist circumference and estimation of the body mass index) and also the blood pressure and search of clinical signs of insulin resistance. A survey to parents on the family pathological backgrounds and on some data of their children was applied. Results: there was that the 20,31 percent of adolescents had excess weight or obesity, which was related in a significant way to the presence of a high blood pressure and clinical signs of insulin resistance. The high blood pressure was present in the 9,9 percent of adolescents without any relation to hereditary factors. Conclusions: obesity and body excess weight are a health problem in study adolescent population, which is associated with the presence of a high blood pressure and insulin resistance; there was not relation in its behavior to non-modifiable factors (family and personal pathological backgrounds)(AU)

Adiposidade em adolescentes e obesidade materna / Relationship between maternal obesity and adiposity in adolescents

OBJETIVO: Descrever a relação entre adiposidade na adolescência e obesidade materna. MÉTODOS: Foi realizado estudo transversal com 660 indivíduos de 8 a 18 anos, de ambos os sexos, matriculados em uma escola pública e outra privada do município de São Paulo. A coleta de dados foi realizada por meio de entrevista, medidas antropométricas e inquérito alimentar. A adiposidade na adolescência foi mensurada a partir do índice de massa corporal e, por meio de análise de regressão, verificou-se sua relação com a obesidade materna, ajustada por sexo, idade, estágio de maturação sexual, valor energético total da dieta, atividade física, sedentarismo, peso ao nascer e escolaridade materna. RESULTADOS: Dos adolescentes estudados, 64,7 por cento eram do sexo feminino. A média (desvio-padrão) de idade foi de 12,4 (1,80), variando de 8 a 17 anos. Verificou-se maior prevalência de excesso de peso e obesidade entre os indivíduos do sexo masculino, não sendo observada associação significativa entre estado nutricional e sexo. Após ajuste pelas covariáveis, detectou-se que filhos de mães obesas têm risco quatro vezes maior de ser obesos, quando comparados aos adolescentes filhos de mães não obesas. CONCLUSÃO: Conclui-se que a obesidade materna representa fator de risco importante para o desenvolvimento da obesidade na adolescência.

OBJECTIVE: This study aimed to describe the relationship between teenager's adiposity and maternal obesity. METHODS: A cross-sectional study was done with 660 teenagers aged 8 to 18 years, of both genders, students of private and public schools of São Paulo. The data were collected by interviews, anthropometric measurements and food intake records. Teenagers' adiposity was determined by body mass index and regression analyses was used to verify its relationship with maternal obesity adjusted for gender, age, stage of sexual development, energy intake, physical activity, sedentary lifestyle, birth weight and mother's education level. RESULTS: Most (64.7 percent) of the teenagers were female. The mean age was 12.4 years (SD=1.80), aged 8 to 17 years. The prevalence of obesity and overweight was higher in boys. No statistical difference was found between nutritional status and gender. After the adjustments, the data show that children of obese mothers were 4 times more likely to be at risk of obesity than children of normal weight mothers. CONCLUSION: Maternal obesity is a great risk factor for adolescent obesity.

Milk consumption and effects on dietary nutrients and growth status among Chinese children in nine provinces (autonomous region) from 1991 to 2006 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate milk consumption and effects on dietary nutrients and growth status among 7 - 17 years-old Chinese children in 9 provinces (autonomous region) from 1991 to 2006.</p><p><b>METHODS</b>Data was collected in 1991, 1993, 1997, 2000, 2004 and 2006 China Health and Nutrition Survey, and 11 691 subjects aged 7 to 17 years old were included. The subjects were divided into the following groups according to milk consumption per day, 0 (no milk drinking), 1 - 99, 100 - 199, 200 - 299 and ≥ 300 g/d. Variables from different years were compared, such as milk categories, energy, protein, calcium intake, body mass index (BMI), as well as that dietary nutrients, height and weight among different milk consumption groups.</p><p><b>RESULTS</b>From 1991 to 2006, milk drinking rate and milk consumption among Chinese children had great improvement: milk drinking rate reached to 14.1% (161/1145) in 2006, while that was 3.0% (73/2441) in 1991; milk consumption reached to (26.7 ± 85.0) g/d in 2006, which was 6.8 times of that in 1991 (3.9 ± 31.9) g/d (χ(2) = 474.5, P < 0.01). BMI increased from (17.3 ± 2.9) kg/m(2) in 1991 to (18.5 ± 6.0) kg/m(2) in 2006 (χ(2) = 123.5, P < 0.01). Meanwhile, energy intake decreased from (8653.3 ± 2789.2) kJ/d in 1991 to (8058.3 ± 2866.6) kJ/d in 2006 (χ(2) = 72.6, P < 0.01); protein intake decreased from (63.0 ± 22.8) g/d in 1991 to (57.3 ± 23.1) g/d in 2006 (χ(2) = 71.9, P < 0.01). Average height of 0 (no milk drinking), 1 - 99, 100 - 199, 200 - 299 and ≥ 300 g/d groups were (142.9 ± 16.9), (146.9 ± 18.8), (147.6 ± 16.2), (148.8 ± 16.0), (149.9 ± 15.3) cm, respectively (χ(2) = 29.4, P < 0.01); average weight were (37.1 ± 13.2), (40.3 ± 13.9), (41.3 ± 16.9), (41.7 ± 14.6), (41.4 ± 12.2) kg, respectively (χ(2) = 25.7, P < 0.01).</p><p><b>CONCLUSION</b>In the period of 1991 to 2006, milk drinking rate and milk consumption has improved greatly. Main nutrient intake, height and weight increased with milk consumption.</p>