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

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

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

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

Main results and public health implications of the National School Health Survey (ENSE), Colombia 2017

Introduction: The school population represents a fundamental group for health promotion actions, given that the foundations of healthy behaviors in adult life are established in children and adolescents, who can be greatly influenced by the school. Objective: To describe the health-related behavioral factors of schoolchildren between 13 and 17 years of age in secondary and middle school in Colombia. Methods: A national cross-sectional study was conducted (i.e., School Health Survey -ENSE-) that recorded information on dietary practices, physical activity, alcohol and drug consumption, injuries and bullying, and oral, visual and hearing health. Sampling was probabilistic, cluster and multistage. Results: Schoolchildren have low consumption of fruits, vegetables (13.1%) and dairy (76.5 %), high consumption of ultra-processed foods (82.4 %), sugary drinks (74.0 %) and fast foods (14.8 %), frequent addition of salt at the table (43.3 %), low compliance with physical activity recommendations (15.0 %) and high sedentary lifestyle (46.3 %), frequent consumption of alcohol (44.7 %) and psychoactive substances (14.7 %), in addition to prevalent situations of bullying (15.4 %), rejection (8.2 %) and verbal aggression (42.7 %). Conclusions: The ENSE shows critical inequalities by gender, ethnicity and social class, throughout the country. The indicators observed in schoolchildren are precursors of various chronic and degenerative diseases and mental illness, which requires the urgent attention of the different social actors in the country.

Introducción: La población escolar es un grupo fundamental para las intervenciones de promoción de la salud, ya que en los niños y adolescentes se sientan las bases de un comportamiento saludable en la vida adulta, que puede ser muy influenciado por la escuela. Objetivo: Describir los factores comportamentales relacionados con la salud de los escolares de 13 a 17 años de edad que cursan educación básica secundaria y media en Colombia. Métodos: Se realizó una encuesta nacional transversal (Encuesta de Salud en Escolares -ENSE-) con los lineamientos de Global School-based Student Health Survey para recolectar información sobre prácticas alimentarias, actividad física, consumo de alcohol y drogas, lesiones e intimidación, y salud bucal, visual y auditiva. El muestreo fue probabilístico, por conglomerados y polietápico. Resultados: Se incluyeron 79.640 escolares de 298 municipios. Los escolares presentaron bajo consumo de frutas, verduras (13.1%) y productos lácteos (76.5 %), alto consumo de alimentos ultraprocesados (82.4 %), bebidas azucaradas (74.0 %) y comidas rápidas (14.8 %); alto uso de sal añadida en la mesa (43.3 %), actividad física inferior a la recomendada (15.0 %) y sedentarismo (46.3 %). Fue frecuente el consumo de alcohol (44.7 %) y sustancias psicoactivas (14.7 %) y reportaron situaciones de intimidación (15.4 %), rechazo (8.2 %) y agresiones verbales (42.7 %). Conclusiones: La ENSE muestra desigualdades por género, etnia y clase social en todo el país. Los hallazgos observados en los escolares son factores de riesgo de enfermedades crónico-degenerativas y mentales, y requieren la atención urgente de los actores sociales del país.

Correlation of meal timing and interval with glycemic control in patients with Type 2 diabetes

Background: Eating is very essential for life. The timing of food can set all the organs and tissues in the body which relates to food digestion, absorption, and metabolism. Much research performed on many animals proves that food intake is very important which will integrate the peripheral clocks. Consequently, traditional eating habits with a good meal, timing, and interval should be ideal, and not skipping breakfast is very much important in maintaining glucose homeostasis. To make people aware of the meal timing, healthy portion of food components that have to be consumed and the time interval between food, and the importance of morning meals, this study helps to give the same. Aims and Objectives: The study of meal timing and the interval between the meals in Type 2 diabetes mellitus patients. Materials and Methods: Five hundred known cases of Type 2 diabetes patients were enrolled in the study. Reports necessary for glycemic status are collected. Diet history obtained from the patients. Results: Individuals who had their meals at an earlier time and the less time gap between their meals had good control of Diabetes when compared to the persons who had late meals and the increased time gap between the meals. Conclusion: Early or correct meal timings and fewer time intervals between meals will help in the control of Type 2 diabetes. Unhealthy timings of taking the food can lead to a severance in normal homeostasis which can result in unhealthy events. This study helps to be aware of the morbidity associated with their lifestyle habits. Further, it also helps in changing their lifestyle to a healthy eating habit which will help in reducing glycemic index and comorbidities.

Nutrition Improvement of Pediatric Cancer Patients through Hospital Meals and Nutrition education in Cambodia / 国際保健医療

Introduction  NPO Japan Heart opened a children’s medical center in Cambodia in 2018 to treat pediatric cancer. In many public hospitals in Cambodia, patients’ meals must be prepared by their families with little knowledge about hygiene and nutrition, so patients may not always receive sufficient nutrition for their treatment. We considered a hygienic and nutritious diet essential for effective pediatric cancer treatment.  Therefore, the “Japan Heart Children’s Medical Center Meal Project” was launched. The objectives of this study were as follows; (1) to describe that patients receive hygienic and nutritious meals during their hospitalization and after discharge, (2) to measure the effects of providing hospital meals and nutrition education by Cambodian staff who are not qualified dietitians, and to clarify the changes in the nutritional status of pediatric cancer patients as a result of these activities.Methods  The target group was pediatric cancer patients and their families.  Japanese dietitians and chefs conducted study sessions, created menu standards based on the Minimum Dietary Diversity (MDD) , and trained local staff to provide meals and nutrition education.   To provide hospital meals, local staff conducted hygiene management, prepared menus based on standards, and measured eating rates. They also provided nutrition education to the patients and their families, and connected survey before and after education. Nutrition assessment was conducted based on WHO Growth Chart BMI for age by measuring height and weight.Results  The MDD achievement rate for the menu increased from 72% to 100% (after intervention 1week-2 week (January, 2020)), and the eating rate increased from 45.9% to a maximum of 80.5% (April, 2020-January, 2022). Surveys before and after nutrition education showed that 89.1% of patient families improved their knowledge and awareness. Height and weight were assessed by BMI, and the percentage of patients with ≤−2SD decreased from 28.1% at admission to 15.9% at discharge.  Conclusions  In Cambodia where there is no dietitian system, it is important to do activities with contents that is feasible for local staff who have never studied nutrition.  In order to further support treatment from the nutritional aspect, it is desirable to develop nutritional human resources in Cambodia.

A participação das famílias nas ações de alimentação em escolas para a promoção da alimentação adequada e saudável / Family participation in school feeding programs to promote adequate and healthy eating

Introdução: Os instrumentos e estratégias de Educação Alimentar e Nutricional de escolas públicas brasileiras devem apoiar pessoas, famílias e comunidades a adotarem práticas alimentares que favoreçam o desenvolvimento da autonomia e do exercício da cidadania. Objetivo: Compreender como escolas e famílias, a partir de suas ações conjuntas, podem favorecer a promoção da alimentação adequada e saudável. Métodos: Pesquisa de natureza qualitativa, na modalidade de estudo de caso, realizada em duas escolas públicas de ensino fundamental, que incluíram no Projeto Político-Pedagógico ações de alimentação e a participação das famílias. Utilizaram-se observação participante, diário de campo, entrevistas semiestruturadas e grupos focais com os membros da comunidade, analisados por triangulação de métodos qualitativos. Para as entrevistas e grupos focais, foram feitas transcrição, categorização e análise temática de conteúdo. Resultados: As categorias temáticas "Interação entre os atores sociais" e "Participação das famílias no espaço escolar" mostraram as possibilidades de ações conjuntas no papel coletivo de educadores. A organização da comunidade em grupos de responsabilidade conferiu sentido à participação social, rompeu com o suposto desinteresse pelas ações de alimentação e viabilizou a atuação nos processos decisórios da escola. Como desafios, têm-se a desconfiança recíproca e a dificuldade de promover reflexão coletiva para solucionar conflitos e disputas. Conclusões: O estabelecimento de parcerias bem-sucedidas entre escola e família coloca crianças e adolescentes no centro do debate, alusiva à função coletiva de todos como educadores, explorando características individuais e coletivas para as ações promotoras da alimentação adequada e saudável.

Introduction: Food and Nutrition Education resources and strategies in Brazilian public schools should support people, families, and communities to adopt eating practices that benefit the development of autonomy and the exercise of citizenship. Objective: To understand how schools and families, through their joint actions, can promote adequate and healthy eating. Methods: This is qualitative research carried out in two public elementary schools, which have included foodprograms and family participation in their Political-Pedagogical Project. Participant observation, field journals, semi-structured interviews, and focus groups with community members were used and analyzed using a triangulation of qualitative methods. For the interviews and focus groups, transcription, categorization, and thematic content, analysis were carried out. Results: The thematic categories "Interaction between social actors" and "Participation of families in the school space" showed the possibilities of joint actions in the collective role of educators. The organization of the community into responsibility groups gave meaning to social participation, broke down the supposed lack of interest in food actions and made it possible for them to take part in the school's decision-making processes. The challenges are mutual distrust and the difficulty of promoting collective reflection to resolve conflicts and disputes. Conclusions: Establishing successful school-family partnerships puts children and adolescents at the center of the debate, alluding to everyone's collective role as educators, exploiting individual and collective characteristics for actions to promote adequate and healthy eating.

Sociobiodiversidade na Alimentação Escolar: os desafios e as potencialidades de um campo em construção no município de Mostardas-RS / Sociobiodiversity in School Meals: the challenges and potentialities of a field in construction in the municipality of Mostardas-RS

Resumo Este trabalho busca apreender os desafios que perpassam o processo, em curso, de inserção de alimentos da sociobiodiversidade na alimentação escolar, no município de Mostardas, no Rio Grande do Sul, bem como analisar os possíveis resultados desse movimento in loco. A respeito do percurso metodológico, em decorrência do contexto pandêmico de covid-19, foram realizadas entrevistas por telefone e/ou pelo aplicativo WhatsApp© com atores que tivessem, de algum modo, envolvimento no processo de inclusão de alimentos da sociobiodiversidade no Programa Nacional de Alimentação Escolar, como nutricionistas, comunidade escolar, entidades locais, agricultores(as) familiares e pesquisadores(as). Assim, recorreu-se à abordagem qualitativa, tanto para a geração do material empírico quanto para a análise dos dados. Acerca dos resultados, foram identificados desafios relacionados ao plano da produção, do consumo e do abastecimento. E, ainda, no âmbito das políticas públicas, foram constatados entraves relacionados ao acesso a determinados programas federais, burocracia dos processos e falta de iniciativas por parte do poder público local. Com relação aos possíveis desdobramentos do movimento em questão, os participantes manifestaram repercussões sobre a saúde, a qualidade da alimentação, o meio ambiente e a economia local, o que impactaria positivamente sobre a Soberania e a Segurança Alimentar e Nutricional.

Abstract This work seeks to understand the challenges that permeate the ongoing process of inserting sociobiodiversity foods into school meals, in the municipality of Mostardas, Rio Grande do Sul, and to analyze the possible results of this movement in loco. Regarding the methodological course, due to the covid-19 pandemic context, interviews were carried out by phone call and/or by the WhatsApp© application with actors who were somehow involved with the process of inclusion of sociobiodiversity foods in the National School Feeding Program, such as nutritionists, the school community, local entities, family farmers, and researchers. Thus, a qualitative approach was used, both for the generation of empirical material and for data analysis. Regarding the results, challenges related to the production, consumption, and supply plan were identified. And yet, in the scope of public policies, obstacles related to access to certain federal programs, bureaucracy of processes, and lack of initiatives on the part of the local government were found. Regarding the possible developments of the movement in question, the participants expressed repercussions on health, food quality, the environment, and the local economy, which would positively impact Food and Nutrition Sovereignty and Security.

Adequacy of school menus and national school food program requirements: a systematic review / Adequação dos cardápios escolares e exigências do programa nacional de alimentação escolar: uma revisão sistemática

Abstract Objectives: this review aimed to evaluate the adequacy of school menus regarding the nutritional requirements of the Programa Nacional de Alimentação Escolar (PNAE) in Brazilian public schools regarding the presence of macronutrients and micronutrients and allocation of resources to purchase products from family farming. Methods: a systematic literature review was carried out using the SciELO, Bireme and Lilacs databases to select the articles. The inclusion criteria were articles that presented data on the adequacy of energy, macronutrients, micronutrients, and purchases of products from family farming during the PNAE regiment, as well as quantitative, cross-sectional, and descriptive studies carried out in the Brazilian territory. Review, editorials, letters, case studies, duplicates and those that did not assess the requirements of the PNAE were excluded. Results: at the end, 12 studies were included that showed overestimation and underestimation of nutritional adequacy in the school environment. In relation to purchases of inputs from family farming, it was observed that most of the Brazilian municipalities evaluated fulfilled the requirements for the allocation of resources. Conclusion: school menus need more supervision so that they meet the adjustments proposed by the PNAE. In addition, it is essential to promote a healthy diet that contains all the nutrients necessary to provide nutritional support for child growth and development.

Resumo Objetivo: avaliar a adequação dos cardápios escolares quanto às exigências nutricionais do Programa Nacional de Alimentação Escolar (PNAE) em escolas públicas brasileiras considerando quanto a adequação de macronutrientes e micronutrientes e destinação de recursos para compras de produtos advindos da agricultura familiar. Métodos: foi realizada uma revisão sistemática da literatura utilizando as bases de dados SciELO, Bireme e Lilacs para seleção dos artigos. Os critérios de inclusão foram: Artigos que apresentaram dados sobre a adequação de energia, macronutrientes, micronutrientes e compras de produtos oriundos da agricultura familiar durante o regimento do PNAE, assim como estudos quantitativos, transversais e descritivos realizados no território brasileiro. Foram excluídos artigos de revisão, editoriais, cartas ao editor, estudos de caso, artigos em duplicatas e que não avaliaram as exigências do PNAE. Resultados: ao final, foram incluídos12 estudos que apontaram superestimação e subestimação nas adequações nutricionais no ambiente escolar. Em relação às compras de insumo provenientes da agricultura familiar, observou-se que a maioria dos municípios brasileiros avaliados cumpriam as exigências de destinação dos recursos. Conclusões: os cardápios escolares necessitam de maior fiscalização para que atendam as adequações propostas pelo PNAE. Além disso, é primordial promover uma alimentação saudável que contenha todos os nutrientes necessários para fornecer um aporte nutricional para o crescimento e desenvolvimento infantil.

Repercussões das Conferências Nacionais de Segurança Alimentar e Nutricional nas propostas legislativas para o Programa Nacional de Alimentação Escolar / Repercussions of the National Food and Nutrition Security Conferences on legislative proposals for the National School Feeding Program

Introdução: As Conferências Nacionais de Segurança Alimentar e Nutricional (CNSAN) foram realizadas no Brasil no período de 1994 a 2015. Por seu caráter intersetorial e multidimensional, as CNSAN debateram um amplo conjunto de temas e recomendações de políticas e programas, dentre eles, o Programa Nacional de Alimentação Escolar (PNAE). Objetivo: Analisar as repercussões das recomendações das CNSAN direcionadas ao PNAE no processo legislativo. Métodos: Trata-se de estudo documental, realizado em duas fases: a primeira consistiu na identificação de recomendações para políticas públicas de SAN contempladas nos relatórios das cinco CNSAN direcionadas ao PNAE; a segunda, na busca de projetos legislativos que tivessem pertinência temática com as demandas das CNSAN no período de 24 meses após cada evento. Resultados: Identificou-se, nas CNSAN, um total de 24 recomendações para atualização do PNAE e 24 projetos legislativos que tratam integral ou parcialmente dos temas e se distribuem de forma desigual entre as CNSAN. Foram encontrados projetos legislativos para 41,7% das recomendações das CNSAN para o PNAE, indicando que há convergência entre a agenda das CNSAN e do Legislativo brasileiro; as recomendações de universalização do programa e de reajuste dos valores repassados pela União para estados e municípios sobressaíram quanto ao número de projetos no Legislativo, indicando foco na garantia do direito à alimentação escolar; duas leis foram aprovadas para o período estudado. Conclusão: Tais resultados podem estar relacionados à abertura do congresso para as recomendações das CNSAN, devido ao modelo de governança adotado no período analisado.

Introduction: The National Food and Nutrition Security Conferences (from Portuguese: Conferências Nacionais de Segurança Alimentar e Nutricional (CNSAN), were held in Brazil from 1994 to 2015. Due to its intersectoral and multidimensional nature, the CNSAN debated a wide range of themes, policy and program recommendations, among it, the National School Feeding Program (from Portuguese: Programa Nacional de Alimentação Escolar (PNAE)). Objective: To analyze the repercussions of CNSAN recommendations directed to PNAE in the legislative process. Methods: This is a documentary study, carried out in two phases: the first consisted of identifying recommendations for public policies included in the reports of the five CNSAN directed to the PNAE; the second, in the search for legislative projects that had thematic relevance with the demands of CNSAN in the 24-month period after each event. Results: A total of 24 recommendations for updating the PNAE and 24 legislative projects were identified in the CNSAN, which fully or partially address the topics and are unevenly distributed among it. Legislative projects were found for 41.7% of the CNSAN recommendations for the PNAE, indicating that there is convergence between the CNSAN agenda and the Brazilian Legislature; the recommendations for universalizing the program and readjusting the amounts transferred by the Union to states and municipalities stood out in terms of the number of projects in the Legislature, indicating a focus on guaranteeing the right to school meals; two laws were approved for the period studied. Conclusion: The results may be related to the opening of the congress to the CNSAN recommendations, due to the governance model adopted in the period analyzed.

Relaciones directas e indirectas entre apoyo familiar, comidas familiares, satisfacción familiar y vital en trabajadores / Direct and indirect relations between family support, family meals, family and life satisfaction in workers

Resumen Introducción: Para las personas con trabajo remunerado, la familia es una fuente importante de recursos psicológicos que contribuyen a su bienestar. Se hipotetiza que el apoyo familiar es un factor protector de la satisfacción vital de la persona, de modo directo y a través de otras variables como las comidas familiares y la satisfacción con la vida familiar. En ese sentido, el objetivo de este estudio fue examinar el papel mediador en serie de la atmósfera de las comidas familiares y la satisfacción con la vida familiar en la relación entre el apoyo familiar y la satisfacción con la vida, en mujeres y hombres con trabajos remunerados. Método: Se aplicó la Escala de Satisfacción con la Vida, Escala Multidimensional de Apoyo Social Percibido, Escala Atmósfera de las Comidas Familiares y Escala de Satisfacción con la Vida Familiar, a una muestra de 236 mujeres y 236 hombres con trabajo remunerado en Temuco, Chile. El análisis estadístico consideró un modelo de mediación en serie con un Intervalo de Confianza del 95%. Resultados: El apoyo familiar y la satisfacción con la vida correlacionaron de forma directa y estadísticamente significativa. Además, se obtuvo un efecto indirecto significativo de la atmósfera de las comidas familiares y la satisfacción con la vida familiar, en la relación entre el apoyo familiar y la satisfacción con la vida. La atmósfera de las comidas familiares y la satisfacción con la vida familiar son mediadores en serie en la relación entre el apoyo familiar y la satisfacción con la vida, en este grupo de trabajadores. Conclusiones: Los resultados sugieren que variables asociadas a la familia y a aspectos sociales de la alimentación influyen positivamente en la satisfacción vital de los trabajadores.

Abstract Introduction: For workers, family is an important source of psychological resources that contribute to the individual's well-being. It is hypothesized that family support is a protective factor of the person's life satisfaction, directly and through other variables such as family meals and satisfaction with family life. In this regard, the aim of this study was to examine the serial mediating role of the atmosphere of family meals and satisfaction with family life in the relationship between family support and satisfaction with life, in women and men with paid jobs. Method: The Satisfaction with Life Scale, the Multidimensional Scale of Perceived Social Support (family subscale), a measure of Atmosphere Scale of Family Meals and the Satisfaction with Family Life Scale were administered to a sample of 236 women and 236 men with paid jobs in Temuco, Chile. The statistical analysis considered a serial mediation model with a 95% Confidence Interval. Results: Family support and satisfaction with life significantly correlated with one another. In addition, a significant indirect effect of the atmosphere of family meals and satisfaction with family life was obtained in the relationship between family support and life satisfaction. The atmosphere of family meals and satisfaction with family life are serial mediators in the relationship between family support and life satisfaction in this group of workers. Conclusions: Results suggest that variables related to the family domain and to social aspects of food consumption have a positive impact in workers' life satisfaction.

Designing of Ready to Eat Convenient Mid - Day Meal for Children (5-10 yrs) and Adolescents (11-19 yrs) of Sri Lanka Based on Nutritional Perspective

The most prevalent malnutrition issues in Sri Lanka are the protein-energy malnutrition (PEM), vitamin A deficiency, and iron deficiency. Childhood and adolescence are the crucial stages of life which mostly susceptible to malnutrition since their major physiological and psychological changes take place. Although a balanced, nutritious diet is essential to them, present socio-economical and higher academic expectations have created a complex environment that often pushes them towards junk foods and unhealthy snacks. The objective of the present study was to develop ready-to-reconstitute convenient mid-day meals in three categories of chicken, fish, and soya, which match to the Sri Lankan local culinary style, with acceptable sensory properties to upgrade the nutritional status of school children (5-10 yrs) and adolescents (11-19 yrs). Those mid-day meals were designed according to the Food-Based Dietary Guidelines (FBDG) of Sri Lanka. The selected ingredients were processed; rice to instant rice, vegetables to dehydrated vegetables, and protein source of chicken, fish, and soya to pre-cooked sterilized curry pouches. The convenient mid-day meal packages were prepared using three portions of instant rice containing 10% of green gram flakes, dehydrated vegetables, and retorted curry mix respectively. Labeling was performed according to the type of curry mix inserted into the package as Chicken, Fish, or Soy mid-day meals. Physicochemical and sensorial properties of meals were evaluated. The caloric value of mid-day meals ranged 575 - 640.82 kcal. The protein content of meals ranged from 25.88 g to 32.68g and there was no significant difference (p<0.05) between protein contents in chicken and fish meals. The fat contents and dietary fiber contents significantly (p<0.05) differed and the highest contents of fat (3.15 g) and dietary fiber (4.40 g) were observed in chicken meal and soy meal respectively. The mineral contents of tested meals significantly differed (p<0.05) and the significant highest Ca, Fe, K, Fe, and P were observed in soya mid–day meals. The highest mean rank scores for all sensory attributes in terms of odor, appearance, texture, taste, and overall acceptability were observed in the chicken mid-day meal. Ready-to-reconstitute mid-day meals in three categories of chicken, fish, and soya, which could match to the Sri Lankan local culinary style, were developed with acceptable sensory properties.

Safe, Nourishing, Accessible Community Kitchen (S.N.A.C.K.): A community kitchen manual for public health emergencies

@#<p style="text-align: justify;"><strong>Objective:</strong> The project aims to develop a community kitchen manual for public health emergencies.</p><p style="text-align: justify;"><strong>Participants:</strong> The officers and members of the Samahan ng Nagkakaisang Kababaihan ng BASECO served as community respondents for this project. These eight women were in charge of the community kitchen operations, particularly the feeding program during the COVID-19 pandemic.</p><p style="text-align: justify;"><strong>Implementation:</strong> The whole project comes in three phases. The design stage was executed in phase one of this project. The phase one also focused on the development of manual content based on available literatures and considered the interviews conducted with respondents.</p><p style="text-align: justify;"><strong>Discussion:</strong> The manual contains guidelines on food safety and meal preparations. Based on the interview, the proponents identified specific contents that must be included in the guidelines, as compared with the need to improve current operations of the group's community kitchen. Looking at the activities of the community, the proponents indicated the food flow guidelines to ensure a safe, nourishing and accessible community kitchen (S.N.A.C.K).</p><p style="text-align: justify;"><strong>Conclusion:</strong> The designed community kitchen manual may be of use to lay groups putting up community kitchens, since there is no existing manual in the Philippines. However, phases two and three must be conducted to validate its usefulness and accuracy in the field.</p>

Progress of clinical nutrition support management and corresponding data analysis in a tertiary (A) children's hospital in Shanghai in the past ten years / 中华临床营养杂志

Objective:To analyze the paradigm and changes of enteral nutrition support for hospitalized children in Shanghai Children's Medical Center affiliated to School of Medicine of Shanghai, Jiao Tong University in last ten years, so as to provide guidance for nutritionists and dietitians on the application and management of enteral nutrition.Method:Relevant data were collected and analyzed from 2011 to 2020 in the Clinical Nutrition Department of Shanghai Children's Medical Center, including the implementation status of parenteral and enteral nutrition as well as the types and distribution of different enteral nutrition formulas and diet.Results:The Clinical Nutrition Department of our hospital provided seventy-five types of diet for hospitalized children. The utilization of ordinary diets and specialized diets has been stable at about 76,000 cases per year. In the past decade, twenty-one ordinary formulas and special formulas were provided every year by the Clinical Nutrition Department in our hospital and the utilization has been stable at 46,000 cases per year. The total consumption of ordinary formulas and the proportion of ordinary formulas users showed a descending trend. The proportion of specialized formulas users among discharged patients remained at 10%, with an upward trend in the proportion of high-calorie formulas and extensively-hydrolyzed formulas.Conclusions:The enteral nutrition formulas and inpatient diets are important components of nutritional treatment. The evolution of its clinical application to some extent reflects the changes of disease spectrum and the development of clinical disciplines. In short, the dietitians play a significant role in the nutrition support team.

Práticas de comensalidade em estudantes universitários / Commensality practices among university students

O Guia Alimentar para a População Brasileira aborda orientações para uma alimentação adequada e saudável, incluindo recomendações sobre o ato de comer e a comensalidade. Ao ingressar na vida universitária, os estudantes tendem a modificar sua rotina, o que contribui para a realização de refeições rápidas, sem horários regulares e inadequadas do ponto de vista nutricional. O objetivo do presente estudo foi investigar práticas de comensalidade e fatores associados em ingressantes de uma universidade pública do Rio Grande do Sul. Trata-se de um estudo transversal realizado em 2019. O desfecho constituiu-se da orientação do Guia sobre comer em companhia e participação nas atividades que envolvem a alimentação. As variáveis de exposição investigadas foram sexo, idade, composição de moradia, trabalho remunerado, classe econômica e turno na universidade. Dos 207 participantes, 83,9% e 62,4% informaram que costumam realizar almoço e jantar em companhia, respectivamente. A maior parte dos estudantes participa "às vezes" do planejamento (49,8%) e da preparação de refeições (50,5%), e "sempre" participam da compra de alimentos (51,2%) e limpeza de utensílios e ambiente (62,8%). Além disso, a maioria dos estudantes de 30 anos ou mais informou que costuma realizar o café da manhã em companhia (p=0,010), enquanto estudantes que moram com familiares são os que mais realizam as três refeições acompanhados (p<0,05). Houve maior frequência de mulheres que participam do planejamento (p=0,012) e da preparação de refeições (p=0,002). Conclui-se que, de maneira geral, os estudantes praticam a comensalidade, com maior ocorrência entre aqueles que residem com familiares.

The Food Guide for the Brazilian Population addresses guidelines for an adequate and healthy diet, including recommendations on the act of eating and commensality. When entering university life, students tend to change their routine, which contributes to having quick, irregularly scheduled, and nutritionally inadequate meals. The aim of the present study was to investigate commensality practices and associated factors in newcomers to a public university in Rio Grande do Sul. This is a cross-sectional study carried out in 2019. The outcome consisted of the Guide's direction on eating in with others and participation in activities involving food. The exposure variables investigated were sex, age, housing composition, paid work, economic class, and university study period. Of the 207 participants, 83.9% and 62.4% reported that they usually have lunch and dinner together, respectively. Most students participate "sometimes" in planning (49.8%) and preparing meals (50.5%), and "always" participate in buying food (51.2%) and cleaning utensils and environment (62.8%). In addition, most students aged 30 years or older reported that they usually have breakfast together (p=0.010), while students who live with family members are the ones who most eat the three meals together (p<0.05). There was a higher frequency of women participating in planning (p=0.012) and meal preparation (p=0.002). It is concluded that, in general, students practice commensality, with a higher occurrence among those who live with family members.

Efetividade de intervenção multicomponente na adesão e aceitabilidade à alimentação escolar: ensaio randomizado de base escolar de múltiplos braços em Sumidouro - RJ / Effectiveness of a multicomponent intervention on adherence and acceptability to school meals: a multi-arm, school-based randomized trial in Sumidouro - RJ

O Programa Nacional de Alimentação Escolar possui papel fundamental na promoção da alimentação saudável de milhões de escolares em todo o Brasil. Entretanto, pesquisas nacionais apontam baixa adesão e aceitabilidade à alimentação escolar na rede pública de ensino. Intervenções baseadas em arquitetura de escolhas e padronização de técnicas gastronômicas têm sido implementadas com o intuito de melhorar este cenário e estimular o desenvolvimento de hábitos alimentares saudáveis. Assim, o objetivo do presente estudo foi avaliar a efetividade de intervenção multicomponente na adesão e aceitabilidade à alimentação escolar. Um ensaio randomizado foi conduzido com alunos do 4o ao 9o ano de 3 escolas públicas da rede municipal de ensino da cidade de Sumidouro, Rio de Janeiro, em 2019. As escolas participantes foram alocadas aleatoriamente em três grupos: uma escola no grupo controle (sem intervenção), uma escola no grupo intervenção 1 (modificações ambientais e inclusão de sistema de autosserviço) e uma escola no grupo intervenção 2 (modificações ambientais, inclusão de sistema de autosserviço e adição de novas preparações no cardápio). A escola do grupo intervenção 1 recebeu intervenções ambientais baseadas nos princípios da arquitetura de escolhas, que consistiram em: elaboração de cartazes e displays com mensagens e imagens motivacionais para promoção de hábitos alimentares saudáveis e incentivo ao consumo da alimentação escolar; implementação de toalhas com imagens coloridas de alimentos in natura nas mesas do refeitório; alocação das frutas servidas na alimentação escolar em posição de destaque, em uma barraca de frutas; posicionamento de um banner com o cardápio das preparações diárias na entrada do refeitório; e aplicação de pegadas no chão que, de forma lúdica, direcionavam os escolares ao refeitório. Além disso, foi implementado o sistema de autosserviço, com a incorporação de um balcão térmico de distribuição de alimentos no refeitório. A escola do grupo intervenção 2 recebeu as mesmas intervenções da escola do grupo intervenção 1, com a adição da padronização de técnicas gastronômicas para alterações nas preparações culinárias que fizeram parte dos cardápios no ano letivo de 2019, além da elaboração de novas preparações a partir da identificação das percepções acerca dos motivos da não adesão à alimentação escolar relatadas em grupos focais realizados com merendeiras e escolares. A adesão à alimentação escolar (≥3 vezes na semana) foi avaliada por meio de questão inserida em questionário aplicado em três momentos (linha de base, 1o seguimento [após 5 meses de intervenção] e 2o seguimento [após 8 meses de intervenção]). Foram realizadas análises longitudinais por meio da aplicação de modelos lineares generalizados que levam em conta as medidas repetidas e os dados ausentes de desfecho dos participantes. Também foram realizadas análises do tipo piecewise, permitindo a identificação dos parâmetros no intervalo 1 (linha de base-1o seguimento) e no intervalo 2 (1o seguimento-2o seguimento). Foi observado aumento da adesão à alimentação escolar na escola intervenção 1 vs. escola controle (RR=1,20; p-valor=0,0166) e maior aumento na escola intervenção 2 vs. escola controle (RR=1,27; p-valor=0,0041). Foi possível observar também aumento da adesão na escola intervenção 1 vs. escola controle no intervalo 1 e intervalo 2 (RR=1,18; p-valor=0,0146 e RR=1,14; p-valor=0,0424, respectivamente), e maior aumento da adesão na escola intervenção 2 vs. escola controle no intervalo 1 (RR=1,22; p-valor=0,0095) e no intervalo 2 (RR=1,20; p-valor=0,0070). Não houve diferença estatisticamente significativa na variação da adesão entre as escolas intervenção 2 e 1. A aceitabilidade à alimentação escolar foi avaliada por meio da aplicação de teste de aceitabilidade referente ao cardápio servido nas escolas antes das intervenções e, aos demais cardápios, após o início das intervenções, através do uso da escala hedônica facial e verbal. Para as análises longitudinais, foram empregados modelos lineares generalizados, que levam em conta as medidas repetidas e os dados ausentes de desfecho dos participantes. Observou-se aumento significativo no índice de aceitabilidade nos grupos de preparações à base de carne bovina e doces entre os participantes da escola intervenção 1 (RR=1,36; p-valor=0,0008 e RR=3,99; p-valor=<,0001, respectivamente) e da escola intervenção 2 (RR=1,34; p-valor=0,0029 e RR=2,22; p-valor=<,0001, respectivamente), quando comparados aos da escola controle ao longo do tempo. O incremento na aceitabilidade das frutas foi maior entre os participantes da escola intervenção 2, quando comparados aos da escola intervenção 1 (RR=1,60; p-valor=0,0052). Redução da aceitabilidade de preparações à base de feijão foi observada entre escola intervenção 2 e as escolas intervenção 1 e controle (RR=0,60; p-valor=0,0003 e RR=0,57; p-valor=0,0013, respectivamente). Os resultados alcançados sugerem que intervenções multicomponentes baseadas em modificações ambientais de baixo custo e complexidade, e em modificações nos aspectos sensoriais das refeições oferecidas na alimentação escolar através da inserção de técnicas gastronômicas, podem ser efetivas para promover o aumento da adesão e aceitabilidade à alimentação escolar e, consequentemente, auxiliar na elaboração de políticas públicas voltadas à promoção da alimentação saudável.

The National School Feeding Program plays a key role in promoting healthy eating for millions of schoolchildren throughout Brazil. However, national surveys indicate low adherence and acceptability to school meals in the public school system. Interventions based on choices architecture and standardization of gastronomic techniques have been implemented aiming to improve this scenario and encourage the development of healthy eating habits. Thus, the objective of this study was to evaluate the effectiveness of a multicomponent intervention in adherence and acceptability to school meals. A randomized trial was conducted with students from 4th to 9th grade from 3 public schools of Sumidouro, a city located in Rio de Janeiro, in 2019. The participating schools were randomly allocated into three groups: one school in the control group (no intervention), another school in the intervention group 1 (environmental modifications and addition of a self-service system) and other one in the intervention group 2 (environmental modifications, addition of a self-service system and inclusion of new dishes in the menu). The school from the intervention group 1 received environmental interventions based on the principles of choices architecture, which consisted of: creation of posters and displays with motivational messages and images to promote healthy eating habits and encourage the consumption of school meals; implementation of tablecloth with colorful images of fresh food on the cafeteria tables; allocation of fruits in a prominent position, in a fruit stand; placement of a banner with the daily menu at the cafeteria's entrance; and application of footprints on the floor that, in a playful way, directed students to the cafeteria. Moreover, a self-service system was implemented through the addition of a thermal food distribution counter in the cafeteria. The school from intervention group 2 received the same interventions as the school from intervention group 1, plus the standardization of gastronomic techniques for changes in the dishes that were part of the menus in 2019, and also the creation of new ones, based on the perceptions about the reasons for non-adherence to school meals reported in focus groups carried out with lunch ladies and schoolchildren. Adherence to school meals (≥3 times a week) was assessed through a question inserted in a questionnaire applied at three different moments (baseline, 1st follow-up [after 5 months of intervention] and 2nd follow-up [after 8 months of intervention]). Longitudinal analyzes were performed through the application of generalized linear models that take into account repeated measures and missing participant outcome data. Piecewise analyzes were also performed, allowing the identification of parameters in interval 1 (baseline - 1st follow-up) and in interval 2 (1st follow-up - 2nd follow-up). An increase in adherence to school meals was observed in the intervention school 1 vs. control school (RR=1.20; p-value=0.0166) and greater increase in intervention school 2 vs. control school (RR=1.27; p-value=0.0041). It was also observed an increase in adherence in the intervention school 1 vs. control school in interval 1 and interval 2 (RR=1.18; p-value=0.0146 and RR=1.14; p-value=0.0424, respectively), and greater increase in adherence in intervention school 2 vs. control school in interval 1 (RR=1.22; p-value=0.0095) and in interval 2 (RR=1.20; p-value=0.0070). There was no statistically significant difference in the variation of adherence between intervention 2 and 1 schools. The acceptability of school meals was evaluated by applying an acceptability test referring to the menu served in schools before the interventions and, to the other menus, after the beginning of the interventions, through the use of facial and verbal hedonic scale. For the longitudinal analyses, generalized linear models were used, taking into account repeated measures and missing outcome data from the participants. There was a significant increase in the acceptability index in the groups of preparations based on meat and sweets among participants in the intervention school 1 (RR=1.36; p-value=0.0008 and RR=3.99; p- value=<.0001, respectively) and intervention school 2 (RR=1.34; p-value=0.0029 and RR=2.22; p-value=<.0001, respectively), when compared to the control school over time. The increase in fruit acceptability was greater among participants in the intervention school 2, when compared to those in the intervention school 1 (RR=1.60; p-value=0.0052). Reduction in the acceptability of bean-based preparations was observed between intervention 2 school and intervention 1 and control schools (RR=0.60; p-value=0.0003 and RR=0.57; p-value=0.0013, respectively). The results suggest that multicomponent interventions based on low cost and complexity environmental modifications, and also on changes in the sensory aspects of meals offered at school through the use of gastronomic techniques, can be effective in increasing adherence and acceptability to school meals, assisting in the creation of public policies aimed at promoting healthy eating.

Household income, frequency of purchasing outside meals, eating behaviour and body mass index status among undergraduate students during first phase of COVID-19 lockdown

@#Introduction: COVID-19 lockdown has changed the eating behaviours of people, which could affect their body mass index (BMI). These changes affected meal purchasing habits of university students, depending on their household income. Thus, the current study aimed to investigate the association between eating behaviour, household income, frequency of purchasing outside meals with BMI among undergraduate students. Methods: This was a retrospective cross-sectional study conducted among 112 undergraduate students. Subjects recalled information during the first phase of COVID-19 lockdown, which was from March 2020 till July 2020. Questionnaire consisted of socio-demography, anthropometry, frequency of purchasing outside meals, and eating behaviour using the Malay version Dutch Eating Behaviour Questionnaire (DEBQ). Results: About 64.3% of subjects reported purchasing outside meals 1-2 times per week. Higher restrained eating behaviour score was correlated with purchasing outside meals about 3-4 times and >4 times a week. Normal weight students had significantly higher restrained eating behaviour score [3.0(1.1)] than those in the obese group [2.9(1.1)]. Household income had no association with frequency of purchasing outside meals. Conclusion: Eating behaviour affected BMI and the frequency of purchasing outside meals during COVID-19 lockdown. COVID-19 lockdown has resulted in tremendous changes in the eating behaviour and physical activity pattern of university students. Future studies should focus on increasing the nutrition knowledge of university students, especially on the aspect of eating out.

Cuantificación del desperdicio de alimentos en servicios de alimentación de la Universidad de Costa Rica / Quantification of Food Waste in Food Services of the Universidad de Costa Rica

Resumen Antecedentes: los alimentos desperdiciados en ventas al detalle en Latinoamérica (15 %) podrían suplir las necesidades alimenticias del 64 % de quienes sufren hambre en la región. Objetivo: determinar los desperdicios de alimentos en tres servicios de alimentación de la sede Rodrigo Facio de la Universidad de Costa Rica a partir de la guía de medición de la Red Costarricense para Disminuir la Pérdida y el Desperdicio de Alimentos. Materiales y métodos: los desperdicios en los servicios de alimentación N1 y N2 fueron medidos en 2018 y 2019 y en el N3 en 2019; se realizaron 15 mediciones siguiendo la metodología de la guía y se reportaron como porcentaje del total de producción de sólidos. Resultados: los desperdicios en la producción total fueron 15,0-16,6 % en 2018 y 6,4-11,5 % en 2019. No se encontraron diferencias entre los servicios de alimentación en la producción promedio (p=0,1467), en el desperdicio del área de almacenamiento (p=0,1293) ni en la producción de alimentos (p=0,7718). Se encontraron diferencias en el desperdicio entre los servicios de alimentación en el área de servicio: desperdicios en barra (p=0,0197), en plato/ desayuno (p=0,0075) y en plato/almuerzo (p=0,0362). Conclusiones: la cantidad de desperdicios encontrados son menores a los reportados en otros estudios.

Abstract Background: Food wasted in retail in Latinamerica (15%) could supply the nutritional needs of 64% of the hungry in the region. Objective: To determine food waste in three food services of the Rodrigo Facio campus of the Universidad de Costa Rica, using the measurement guide of the Costa Rican Network to reduce food loss and waste. Materials and Methods: Waste in food services N1 and N2 were measured in 2018 and 2019, and in the N3 in 2019. In total 15 measurements were made following the methodology of the guide and they were reported as a percentage of total solids production. Results: Waste in total production was 15.0-16.6% in 2018 and 6.4-11.5% in 2019. No differences were found between food services in average production (p=0.1467), in the waste storage area (p=0.1293), nor food production (p = 0.7718). Differences in waste were found between food services in the service area: Waste in the service bar (p=0.0197), in plate/breakfast (p=0.0075), and in plate/lunch (p=0.0362). Conclusions: The amount of waste found is lower than that reported in other studies.

Association of dietary patterns, number of daily meals and anthropometric measures in women in age of menopause

ABSTRACT Objective: To investigate the association of dietary patterns, number of daily meals and anthropometric measures among women in age of menopause. Subjects and methods: This was a transversal study with 320 women over 50 years old from Caxias do Sul, Brazil. The outcomes were body mass index (BMI) and waist circumference (WC). Multiple linear regression was performed. Results: Three dietary patterns: regional, fruits and vegetables, and common Brazilian was identified by Principal Component Analysis. After adjustment, higher adoption of the regional dietary pattern was associated with increased BMI (β = 0.56 [CI95% = 0.03-1.08], p = 0.037) and WC (β = 1.28 [CI95% = 0.17-2,55], p = 0.047). The highest number of meals per day (>=5/day) was associated with reduced BMI (β = -1.18 [CI95% = -2.30 to -0.05], p = 0.041) and WC (β = -2.77 [CI95% = -5.41 to -0.13], p = 0.039), and a mid-afternoon snack BMI (β = -2.16 [CI95% = -3.66 to -0.65], p = 0.005) and WC (β = -5.76 [CI95% = -9.29 to -2.23], p = 0,001). The regional dietary pattern was inversely associated with have five or more meals per day (β = -0.51 [CI95% = -0.84 to -0.18], p = 0.002) and have a mid-afternoon snack (β = -0.63 [CI95% = -1.07 to -0.18], p = 0.006). The fruit and vegetables dietary pattern was positively associated with have five or more meals per day (β = 0.35 [CI95% = 0.02-0.69], p = 0.034). Conclusion: The regional dietary pattern has resulted in higher BMI and WC measures and contributes to decreased meals per day, behavior associated with higher anthropometric measures.

School environment and adherence to school meals among Brazilian public-school adolescents

ABSTRACT Objective: To assess whether the school environment is associated with adherence to school meals among adolescent students in Brazilian public schools. Methods: Data from the 2015 National School Health Survey were analyzed. The provision of school meals was assessed according to student report and adherence through the frequency of weekly consumption, classified as adherence (≥3x/week), unsatisfactory adherence (≤2x/week), and non-adherence (none). The following characteristics of the school environment were considered: availability of a properly functioning kitchen and dining hall, cafeteria, and alternative outlets inside or outside schools, and sale of unhealthy food in the cafeteria and alternative outlets. Prevalence estimates were calculated considering the sample's complex design. Results: 86.5% of public schools offered school meals, to which 31.3% of students adhered, 37.9% had unsatisfactory adherence, and 30.8% did not adhere to school meals. Adherence to school meals was higher among schoolchildren in the Midwest Region, from non-capitals, and rural area, while less adherence was observed among students from schools with a cafeteria, an alternative food outlet, and a cafeteria selling soft drinks. Conclusions: Low adherence to school meals is associated with the school geography and food environment. These results can support the formulation of actions to improve the school environment and help the universality of participation in the School Nutrition and Food Policy.

RESUMEN Objetivo: Evaluar si el ambiente escolar está asociado con la adherencia a las comidas escolares entre los estudiantes adolescentes de las escuelas públicas brasileñas. Métodos: Se analizaron datos de la Encuesta Nacional de Salud Escolar de 2015. La provisión de comidas escolares se evaluó de acuerdo con el informe del estudiante y la adherencia a través de la frecuencia de consumo semanal, clasificada como adherencia (≥3x/semana), adherencia insatisfactoria (≤2x/semana) y no adherencia (ninguna). Las características del entorno escolar consideradas fueron: la disponibilidad de una cocina y comedor, quiosco y punto alternativo de venta de alimentos dentro o en la entrada de la escuela, y la venta de alimentos no saludables en el quiosco y en los locales alternativos. Las estimaciones de la prevalencia se calcularon considerando el complejo diseño de la muestra. Resultados: 86.5% de las escuelas públicas ofrecieron comidas escolares, a las cuales se adhirió 31.3% de los estudiantes, 37.9% tuvo adherencia insatisfactoria y 30.8% no se adhirió a las comidas escolares. La adherencia a las comidas escolares fue mayor entre los escolares de la Región Centro-Oeste, de las no capitales y del área rural, mientras que se observó una menor adherencia entre los estudiantes de las escuelas con cafetería, un punto de venta de comida alternativa y una cantina que vende refrescos. Conclusiones: La baja adherencia a las comidas escolares se asocia con variables geográficas de la escuela, así como con el entorno alimentario escolar. Por tanto, estos resultados pueden apoyar la formulación de acciones que tengan como objetivo mejorar el entorno escolar y ayudar a la universalidad de la asistencia a la Política de Nutrición y Alimentación Escolar.

Adequação da frequência e tipos de refeições realizadas por idosos comunitários do sul do Brasil / Adequacy of the frequency and types of meals consumed by community-dwelling elderly folk in the south of Brazil

Resumo O objetivo do estudo foi descrever a frequência e tipos de refeições realizadas por idosos de Pelotas-RS e fatores associados à frequência adequada de refeições. Foi realizado estudo transversal com indivíduos ≥60 anos. Questionou-se sobre as refeições diárias na semana anterior à entrevista. A adequação de refeições foi definida conforme recomendação do Ministério da Saúde (pelo menos três refeições principais e dois lanches por dia). As variáveis independentes foram as características sociodemográficas, de saúde e da rotina alimentar. Razões de prevalência e intervalos de confiança de 95% foram calculados por regressão de Poisson. Dos 1.438 idosos entrevistados, cerca de 40% afirmaram realizar quatro refeições diárias. O almoço foi a refeição mais relatada, seguido do café da manhã. Apresentaram frequên cia adequada de refeições 30,6% dos homens e 38,6% das mulheres (p=0,002). Homens com edentulismo (perda dentária total) tiveram 35% maior probabilidade de adequação, enquanto essa probabilidade foi cerca de 30% menor em mulheres de cor da pele não branca, não escolarizadas e que declararam falta de dinheiro para a compra de alimentos. Um a cada três idosos atendeu a recomendação da frequência adequada de refeições e algumas características sociodemográficas foram negativamente associadas com esse hábito.

Abstract The scope of this study was to describe the frequency and types of meals consumed by the elderly in Pelotas (Brazil) and factors associated with the adequacy of meal frequency. A cross-sectional study was carried out with ≥60 years of age individuals. They were asked about daily meals during the week prior to the interview. The adequacy of meals was defined as recommended by the Ministry of Health (at least three main meals and two small snacks per day). The independent variables were sociodemographic, health and food routine characteristics. Prevalence ratios and 95% confidence intervals were calculated using Poisson regression. Of the 1,438 elderly individuals interviewed, about 40% reported consuming four meals a day. Lunch was the most reported meal, followed by breakfast. A total of 30.6% of men and 38.6% of women had adequate frequency of meals (p=0.002). Men with edentulism (total tooth loss) were 35% more likely to eat adequately, while this probability was about 30% lower among non-white women, those without schooling and those who reported a lack of money to buy food. One in each three elderly people met the recommendation of adequate frequency of meals and some sociodemographic characteristics were negatively associated with this habit.

Principais ações dos Estados e do Distrito Federal para preservar o direito à alimentação escolar durante a pandemia do novo coronavírus / Central actions of the states and the Federal District to preserve the right to school meals during the new coronavirus Pandemic

Introdução: A alimentação escolar é a principal ou a única refeição do dia para grande parte dos estudantes brasileiros. Em decorrência da Covid-19, foi decretado estado de emergência e foram interrompidas as aulas na rede pública de ensino, colocando de forma necessária cerca de 40 milhões de estudantes sem aulas presenciais. Objetivos: Verificar as principais ações dos estados e do Distrito Federal em relação à alimentação escolar durante a pandemia e se as mesmas estão condizentes a Lei Federal nº 13.987/2020. Métodos: Foi realizada revisão narrativa da literatura, utilizando-se informações sobre as principais ações realizadas pelos estados e Distrito Federal, advindas de reportagens, boletins oficiais, homepages do Ministério da Educação, decretos e/ou portarias estaduais, entre março e maio de 2020. Resultados e Discussão: As principais ações que todos os 26 estados brasileiros e o Distrito Federal realizaram durante a suspensão das aulas foram díspares: seis estados brasileiros optaram pela transferência direta de renda; nove distribuíram kits de alimentos, sendo que cinco incluíram itens de agricultura familiar; e o Distrito Federal realizou as duas modalidades supracitadas. Destaca-se que tais ações foram focalizadas nas famílias beneficiárias do Programa Bolsa Família. Ademais, em determinados estados, não foi considerada a compra de no mínimo 30% da agricultura familiar. Conclusão: Apesar de todos os estados e o Distrito Federal terem agido para preservar o direito à alimentação escolar dos estudantes da rede pública de ensino, observou-se que tais ações foram heterogêneas e não condizentes com a Lei Federal nº 13.987/2020.

Introduction: School meals are the main or only meal of the day for most Brazilian students. As a result of Covid-19, a state of emergency was decreed, and classes in the public school system were interrupted, making it necessary to place around 40 million students without in-person classes. Objectives: To verify the main actions of the states and the Federal District concerning school meals during the pandemic and whether they are aligned with Federal Law No. 13.987/2020. Methods: We carried a narrative literature review using the information on the main actions carried out by the states and the Federal District, from reports, official bulletins, Ministry of Education homepages, decrees, or state ordinances, between March and May 2020. Results and Discussion: The main actions that all 26 Brazilian states and the Federal District carried out during the suspension of classes were different: six Brazilian states opted for the direct transfer of income; nine distributed food kits, five of which included family farming items; and the Federal District carried out the two modalities mentioned above. It is noteworthy that such actions were focused on the beneficiary families of the Bolsa Família (Family Allowance) Program. Furthermore, in certain states, the purchase of at least 30% of family farming was not considered. Conclusion: Although all states and the Federal District have acted to preserve the right to school meals for students in the public school system, we observed that such actions were heterogeneous and not aligned with Federal Law No. 13.987/2020.