Comensalidade, câncer e sobrevivência: uma metassíntese qualitativa sobre experiências alimentares de pacientes após o diagnóstico de câncer / Commensality, cancer and survival: A qualitative meta-synthesis of patients' food experiences after cancer diagnosis

Resumo Objetivo Compreender as experiências e as práticas alimentares a partir do diagnóstico de câncer. Método: Trata-se de uma pesquisa bibliográfica, do tipo metassíntese qualitativa. Utilizou-se a diretriz ENTREQ como protocolo, tendo como pergunta norteadora: "Quais são as experiências e as práticas alimentares de indivíduos após o diagnóstico de câncer?". A busca foi realizada nas bases de dados Lilacs, Pubmed, Embase e Food Science and Techonology, a partir da combinação de palavras-chave relacionadas à alimentação e nutrição, ao adoecimento por câncer e à pesquisa qualitativa, publicados entre 2015 e 2020, em português, inglês e espanhol. Método Foram encontrados 414 artigos e excluídos 396, após leitura dos títulos e resumos. Além dos 18 artigos potenciais, foram incluídos cinco artigos de outras fontes, totalizando 23. Foram identificadas três categorias empíricas: ruptura da trajetória alimentar e estratégias de adaptação; reconstrução da identidade; e vicissitudes da comensalidade. Conclusões As perdas relacionadas à alimentação impactam na existencialidade do ser, na expressão da identidade e nas relações sociais, podendo levar ao isolamento e a desritualização da alimentação. As mudanças físicas podem levar a distúrbios de imagem corporal e sofrimento psíquico. Em decorrência dos sintomas de impacto nutricional, a família é o suporte emocional para reorganização da alimentação.

Abstract Objective To understand the experiences and eating practices from the diagnosis of cancer. Method This is a bibliographic research, of the qualitative meta-synthesis type, using the ENTREQ guideline as a protocol, with the guiding question: "What are the experiences and eating practices of individuals after being diagnosed with cancer?". The search was carried out in the Lilacs, Pubmed, Embase and Food Science and Techonology databases based on the combination of keywords related to food and nutrition, illness from cancer and qualitative research, published between 2015 and 2020, in Portuguese, English and Spanish. Results 414 articles were found and 396 were excluded after reading the titles and abstracts. In addition to the 18 potential articles, 5 articles from other sources were included, totaling 23. Three empirical categories were identified: disruption of the food trajectory and adaptation strategies; reconstruction of identity; and vicissitudes of commensality. Conclusions Losses related to food impact the existentiality of being, the expression of identity and social relationships, which can lead to the isolation and de-ritualization of food. Physical changes can lead to body image disorders and psychological distress. Due to the symptoms of nutritional impact, the family is the emotional support for the reorganization of food.

Eating regularly and carefully, in appropriate environments and in company: An analysis between social representations and official stances on these recommendations of the Dietary Guidelines for the Brazilian Population

ABSTRACT The second edition of the Dietary Guidelines for the Brazilian Population (DGBP) advises "eating regularly and carefully", "eating in appropriate environments," and "eating in company". Individuals may interpret these guidelines differently. We analyzed social representations of these recommendations to ascertain how such representations relate to the official DGBP advice. This cross-sectional, exploratory study was conducted with a selected sample of teachers, administrative technicians, and students (N= 24) from the Federal University of Grande Dourados, Brazil. We carried out an exploratory content analysis of the responses to semi-structured interviews on the topic. We identified seven themes that encompassed the social representations of "eating regularly and carefully": 1) paying attention to what you eat; 2) having several meals; 3) eating slowly; 4) having time to eat; 5) eating without distractions; 6) eating adequate amounts; and 7) ensuring a nutritional balance. Four themes emerged from the analysis of the social representations of "eating in appropriate environments": 1) a pleasant environment; 2) at the table; 3) without interferences; and 4) a clean environment. The following themes encompassed the social representations of "eating in company": 1) eating in company is good; 2) I prefer to eat alone; and 3) eating in company is inconsequential. Although participant representations align with DGBP recommendations in the three orientations, in general, they extend beyond them. Professionals and government organizations in Brazil or abroad could take into consideration these results in order to optimize this tool's potential for research and policy in nutrition and public health.

RESUMEN La segunda edición de la Guía Alimentaria para la Población Brasileña (DGBP) aconseja "comer con regularidad y atención", "comer en ambientes adecuados" y "comer en compañía". Las personas pueden interpretar estas pautas de manera diferente. Analizamos las representaciones sociales de estas recomendaciones para determinar cómo se relacionan con la postura oficial de la DGBP. Este estudio transversal y exploratorio se realizó con una muestra seleccionada de profesores, técnicos administrativos y estudiantes (N= 24) de la Universidad Federal de Grande Dourados, Brasil. Realizamos un análisis exploratorio de contenido de las respuestas a entrevistas semiestructuradas sobre el tema. Identificamos siete temas que abarcan las representaciones sociales de "comer con regularidad y atención": 1) prestar atención a lo que come; 2) tener varias comidas; 3) comer despacio; 4) tener tiempo para comer; 5) comer sin distracciones; 6) comer cantidades adecuadas; y 7) asegurar un equilibrio nutricional. Cuatro temas surgieron del análisis de las representaciones sociales de "comer en ambientes adecuados": 1) ambiente agradable; 2) en la mesa; 3) sin interferencias; y 4) medio ambiente limpio. Los siguientes temas engloban las representaciones sociales de "comer en compañía": 1) comer en compañía es bueno; 2) prefiero comer solo; y 3) comer en compañía es intrascendente. Aunque las representaciones de los participantes se alinean con las recomendaciones de la DGBP en las tres orientaciones, en general, se extienden más allá de ellas. Investigadores y organizaciones gubernamentales en Brasil y en el extranjero podrían tener en cuenta estos resultados para optimizar el potencial de esta herramienta para la investigación y las políticas en nutrición y salud pública.

Guias alimentares para a população brasileira: uma análise a partir das dimensões culturais e sociais da alimentação / Dietary guidelines for Brazilian population: an analysis from the cultural and social dimensions of food

Resumo Este artigo analisa as dimensões sociais e culturais da alimentação abordadas nas diretrizes alimentares da segunda edição do Guia Alimentar para a População Brasileira (GAPB), contrapondo-o com a sua primeira edição. Trata-se de um estudo qualitativo. Empregamos a análise de discurso Pecheutiana. O universo de estudo são a primeira e a segunda edição do GAPB. A análise dos dados utilizou três etapas: identificação de textos similares e diferentes dos materiais; elucidação das dimensões sociais e culturais da alimentação nos materiais; e análise sistemática com contraposição dos discursos emergentes em ambos os GAPBs. Enfatizamos que na segunda edição os referenciais teóricos - estudos epidemiológicos, clínicos, sociológicos, antropológicos e saberes populares - e a utilização da classificação de alimentos NOVA favoreceram o desenvolvimento de diretrizes alimentares mais holísticas que abordam os padrões de alimentação e refeição, as práticas culinárias, o ato de comer e a comensalidade. Conclui-se que a segunda edição do GAPB possibilita aos profissionais de saúde e à população uma compreensão do alimento enquanto parte concreta da vida dos indivíduos e coletividade, extrapolando sua dimensão fisiológica e biológica.

Abstract This article analyzes the social and cultural dimensions of food addressed in the dietary guidelines of the second edition of the Dietary Guideline for the Brazilian Population (DGBP) in contrast to its first edition. This is a qualitative study. We employ the Pecheutian discourse analysis. The study universe is the first and second edition of DGBP. Data analysis used three steps: identification of similar and different texts of these materials; elucidation of the social and cultural dimensions of food in these materials; and systematic analysis with contrasting emerging discourses in both DGBPs. We emphasize that in the second edition the theoretical references—epidemiological, clinical, sociological, anthropological studies, and popular knowledge—and the use of the NOVA food classification favored the development of more holistic dietary guidelines that address food and eating patterns, culinary practices, the act of eating and the commensality. It is concluded that the second editions of DGPB allows health professionals and the population an understanding of food as something concrete in the life of individuals and collectivity, extrapolating its physiological and biological dimension.

Percepção de risco como estratégia de convívio comensal com jovens órfãos pelo HIV/AIDS em São Paulo, SP, Brasil / Percepción de riesgo como estrategia de convivencia comensal con jóvenes huérfanos por VIH/SIDA en São Paulo, SP, Brasil / Commensal meetings strategies regarding youth orphaned by HIV/AIDS in São Paulo, SP, Brazil

No contexto do HIV/AIDS, estratégias comensais são acordadas pelas famílias para reduzir riscos. Com o objetivo de identificar percepções de risco nos convívios comensais desenvolveu-se estudo qualitativo com jovens órfãos pela AIDS. Os dados foram obtidos durante entrevista com questões sobre o cotidiano. Utilizou-se a proposta de Wright Mills do artesanato intelectual, na qual os sujeitos são considerados atores históricos e sociais. As estratégias mediante a percepção de risco ao HIV/AIDS foram consideradas acordos pactuados pela família para assegurar a interação social. Foi possível observar que as estratégias incluem a restrição do toque e do contato corporal; separação de utensílios e inutilização da comida tocada por soropositivos. A percepção de risco pode ser decorrente da inconstância dos achados científicos e de crenças que reforçam o processo de estigma e discriminação.(AU)

En el contexto del VIH/SIDA, las familias acuerdan estrategias comensales para reducir riesgos. Con el objetivo de identificar percepciones de riesgo en las convivencias comensales se desarrolló un estudio cualitativo con jóvenes huérfanos debido al SIDA. Los datos se obtuvieron durante entrevista con preguntas sobre el cotidiano. Se utilizó la propuesta de Wright Mills de la artesanía intelectual, en la cual los sujetos se consideran actores históricos y sociales. Las estrategias mediante la percepción de riesgo del VIH/SIDA se consideraron acuerdos pactados por la familia para asegurar la interacción social. Fue posible observar que las estrategias incluyen la restricción del toque y del contacto corporal, separación de utensilios e inutilización de la comida tocada por personas que son seropositivas. La percepción del riesgo puede ser consecuencia de la inconstancia de los hallazgos científicos y de creencias que refuerzan el proceso de estigmatización y discriminación.(AU)

Within the HIV/AIDS context, commensal strategies are agreed upon by the families aiming to reduce risks. With the objective of identifying risk perceptions in the commensal meetings, we developed a study with youth orphaned by AIDS. Interviews produced data through questions regarding daily life. The Wright Mills' proposal about intellectual craftsmanship was used for analysis. In this approachsubjects are considered historical and social actors. The strategies used from risk perception of HIV/AIDS were assumed as agreements by the families to ensure social interaction. It was observed that strategies include restrictions for touching and body contact; separation of dishes and disposal of food touched by the HIVpositive. The risk perception found may be due to variability of scientific findings and beliefs, thus reinforcing the process of stigma and discrimination.(AU)

Perceptions and practices of commensality and solo-eating among Korean and Japanese university students: A cross-cultural analysis

BACKGROUND/OBJECTIVES: Commensality, eating together with others, is a major representation of human sociality. In recent time, environments around commensality have changed significantly due to rapid social changes, and the decline of commensality is perceived as a serious concern in many modern societies. This study employs a cross-cultural analysis of university students in two East Asian countries, and examines cross-cultural variations of perceptions and actual practices of commensality and solo-eating. SUBJECTS/METHODS: The analysis was drawn from a free-list survey and a self-administrative questionnaires of university students in urban Korea and Japan. The free-listing survey was conducted with a small cohort to explore common images and meanings of commensality and solo-eating. The self-administrative questionnaire was developed based on the result of the free-list survey, and conducted with a larger cohort to examine reasons and problems of practices and associated behaviors and food intake. RESULTS: We found that Korean subjects tended to show stronger associations between solo-eating and negative emotions while the Japanese subjects expressed mixed emotions towards the practice of solo-eating. In the questionnaire, more Korean students reported they prefer commensality and tend to eat more quantities when they eat commensally. In contrast, more Japanese reported that they do not have preference on commensality and there is no notable difference in food quantities when they eat commensally and alone. Compared to the general Korean cohort finding, more proportion of overweight and obese groups of Korean subjects reported that they tend to eat more when they are alone than normal and underweight groups. This difference was not found in the overweight Japanese subjects. CONCLUSION: Our study revealed cross-cultural variations of perceptions and practices of commensality and solo-eating in a non-western setting.

Repercussões do cenário contemporâneono ato de compartilhar refeições em família / The influence of the contemporary scenario on the meal sharing amid families

O presente artigo teve por objetivo discutir as transformações que o ato de se alimentar em família sofreu nas últimas décadas. Com este propósito, discorre-se sobre as influências econô-micas e tecnológicas que provocaram variações de comportamento e dos valores na sociedade e, por consequência, na organização do grupo familiar, envolvendo, entre outros processos, a alimentação. Buscou-se fazer leituras que primeiramente auxiliassem a compreensão do ato de alimentar-se, considerando a influência de fenômenos de ordem cultural e histórica, como a industrialização, a crescente urbanização e até mesmo as guerras. A literatura tem sinalizado modificações importantes na família, especialmente em hábitos relacionados à alimentação e aos aspectos emocionais devido às mudanças na sociedade contemporânea. Muito embora esteja claro para os pesquisadores que a comensalidade exerça um papel protetivo para a saúde física e mental dos indivíduos, o que se constata é um crescente aumento da alimentação em restaurantes e lanchonetes, ou seja, fora de casa, o que, em geral, é inadequado e nocivo à saúde. Percebe-se que as famílias convivem com um excesso de informações sobre alimentação saudável e não saudável e têm rotinas desregradas em função de elevadas e crescentes demandas sociais e profissionais. Pesquisadores apontam que os encontros familiares reduziram e este fato pode repercutir nas escolhas e práticas alimentares. Programas interdisciplinares de intervenção com famílias que considerem o cenário atual ainda são escassos, mas extremamente necessários. Sugestões para investigações futuras são apresentadas e discutidas.

This paper aimed to discuss the transformations that the habit of eating with the family suffered in the last decades. For this purpose, technological and economic influences responsible for society behaviors and values variations, as well as accounting for changes in family organization involving eating are described. The readings focused on the comprehension of the eating act, taking into account the influence of cultural and historical phenomena as industrialization, growing urbanization and even wars. The literature presents significant changes in families nowadays, especially in relation to eating habits and emotional aspects, due to contemporary society changes. Therefore it is already a consensus to researchers that commensality is a protective factor to human’s physical and mental health, what one observes is an increase of the habit of eating at restaurants and snack bars, in other words, outside home, what is inadequate and risky for health. Something observed is that families receive excessive information about healthy and non healthy habits and have disorderly routines because of increasing social and professional demands. Researchers evidenced that familiar reunions are not so common nowadays and that this fact may reverberates in the eating choices and practices. Interdisciplinary programs for families that take into account the actual scenario are still rare although extremely necessary. Suggestions for future investigations are presented and discussed.

Comensalidade e cuidado: meninas-jovens-mulheres órfãs no contexto de HIV/Aids / Commensality and care: orphan girls and young women in the context of HIV/Aids / Comensalia y cuidado: chicas-jóvenes-mujeres huérfanas en el contexto del VIH/Sida

O "monopólio da cozinha", histórica e culturalmente, é atribuído às mulheres, mães. Para cuidar da família, elas elegem alimentos, compram, cozinham e os servem. Sustentam a comensalidade. Em contextos de HIV/Aids, onde há perda da mãe, as filhas tornam-se responsáveis por esses cuidados. O que pensam as meninas do papel de cuidadoras com o qual, prematuramente, deparam-se? O que dizem seus irmãos sobre isso? Realizamos entrevistas semidirigidas com 14 jovens órfãos. Os dados foram analisados pela proposta de Mills (2009). As jovens não demonstram insatisfação por executarem novas tarefas, mas deploram o fato de impedirem o estudo e a vida além-casa. Seus irmãos entendem a lida da cozinha como coisa de mulher e, por isso, dificilmente colaboram. Essas jovens necessitam de cuidados direcionados à situação vulnerável em que vivem. As políticas de Saúde Pública poderiam pleitear macroestruturas que atuassem sobre essa demanda.

"Monopoly of the kitchen" is historically and culturally attributed to women and mothers. To care for their families, they select and buy food, and cook and serve it. They sustain commensality. In contexts of HIV/AIDS, when mothers die, the daughters become responsible for such care. What do the girls think of the caregiver's role that they prematurely have to face? What do their brothers think about this? Semi-structured interviews were conducted with 14 young orphans. The data were analyzed as proposed by Mills (2009). The young women did not show any dissatisfaction with the new tasks that they were doing, but deplored the fact that this impeded them from studying and having a life beyond the home. Their brothers viewed dealing with the kitchen as women's business and rarely collaborated. These young women need care directed towards the vulnerable situation in which they live. Public health policies could seek macrostructures that would act on this demand.

Histórica y culturalmente, el "monopolio de la cocina" se atribuye a las mujeres, a las madres. Para cuidar de la familia eligen los alimentos, los compran, los cocinan y los sirven. Mantienen la comensalia. En el contexto del VIH/SIDA, cuando la madre muere, las hijas se hacen responsables de dichos cuidados. ¿Qué piensan las niñas del papel de cuidadoras? ¿Qué dicen sus hermanos al respecto? Realizamos entrevistas semi-estructuradas con 14 jóvenes huérfanos. Los datos fueron analizados por la propuesta de Mills (2009). Las huérfanas no mostraron descontento por desarrollar nuevas tareas, pero lamentaron el hecho de que esas tareas les impiden de estudiar y vivir una vida más allá del hogar. Sus hermanos conciben la cocina como cosa de mujeres y casi nunca colaboran. Estas jóvenes necesitan de atención por su situación de vulnerabilidad. Las políticas de Salud Pública podrían reclamar macro-estructuras para cubrir esa demanda.

Comparison of Eating Behavior between Commensality and Solo-eating of University Students by BMI / 대한지역사회영양학회지

The objective of this research was to explore the influences of 'having a meal with someone' on individuals' eating pattern. Eating is not a simple matter of energy intake but also serves to anchor daily routines being cultivated by people and society. This study was conducted using a cross-sectional eating behavior survey of university students (N = 893, 380 men, 513 women) aged 20 to 24 years. Results were analyzed and presented as frequencies, means and chi2-test with SPSS 14.0. Differences in dietary habits by commensality and solo-eating were observed; Students who ate alone, spent 15 min for a meal and ate convenience food items when they didn't feel hungry. Compared to students who ate alone, those who ate together with someone spent 30 min for a meal and ate more amount of food. Eighty percent of respondents ate more various menus in commensality than solo-eating. They felt lonely when they ate alone and preferred to eat together. In conclusion, university students start to decide and select their own meals by themselves after junior and high school food services which are fixed with regard to menu and the amount. Dietary habits of Koreans rapidly changed concomitant with social changes over the past half century. Governments and health experts recognize that unbalanced meals cause lifestyle-related diseases, in particular obesity. Our research findings will contribute to more comprehensive efficient nutrition education programs in order to prevent obesity and other lifestyle-related diseases in early stages of adulthood.