Eating Competence and Aspects Related to a Gluten-Free Diet in Brazilian Adults with Gluten-Related Disorders.

This cross-sectional study aims to assess eating competence (EC­an intra-individual approach to food, behaviors, and attitudes related to food) and aspects related to a gluten-free diet (GFD) in Brazilian adults with gluten-related disorders (GRDs). The research was conducted using an online survey with a self-reported instrument consisting of 40 items, organized into three parts: (I) Socioeconomic and demographic data; (II) the Brazilian version of the Eating Competence Satter Inventory (ec-SI2.0™BR); and (III) questions about adherence and difficulties in following the gluten-free diet. EC was measured by the ecSI2.0™BR instrument, with scores ≥32 were considered competent eaters. The instrument was applied nationwide through the GoogleForms® platform from 14 February 2022 to 30 March 2022. The publicity for the recruitment was supported by Brazilian celiac local and national associations (Acelbras and Fenacelbra), pages of food services or personal pages of tips and posts about gluten-related disorders, and specialized stores that offer gluten-free foods. The recruitment occurred through social networks (emails, Facebook groups, WhatsApp, and Instagram). A total of 1030 Brazilians with GRDs answered the questionnaire. Most participants were female, aged 40 years or older, with an income >R$3000, and a high education level. The main difficulty regarding adherence to GFD was the high cost of gluten-free foods. Individuals younger than 40 years old had lower EC scores, with no differences between men and women. Increasing socioeconomic status, schooling, and culinary practices increased the total score. Participants who "never/almost never" felt socially judged because their diet had higher scores for total EC. Competent eaters GRD individuals (EC ≥ 32) were mostly individuals aged ≥40 y/o; with income > R$3000; following a GFD; satisfied with purchased gluten-free products; consuming gluten-free products prepared at home, mainly by themselves; who do not feel judged because of the GRD and who feel that they can live a normal life with GRD. Our study showed that individuals who strictly adhere to the GFD have higher scores on eating competence than those who sometimes follow the treatment.

Brazilian Food Handlers' Years of Work in the Foodservice and Excess Weight: A Nationwide Cross-Sectional Study.

This study aimed to evaluate the association between the years of work of food handlers in the foodservice and excess weight among Brazilian low-income food handlers. A total of 559 food handlers from all Brazilian regions were characterized using a questionnaire. Weight and height were measured to estimate the Body Mass Index and classify the individuals. The association between food handlers' years of work in the foodservice, anthropometric status, and other variables (gender, age group, educational level, participation in a government program and per capita income at home and energetic consumption) were performed using Pearson's chi-square test (p < 0.05). Multinomial logistic regression analyses were performed (p < 0.05) as well as sensitivity tests using the outcome continuously and transformed, excluding underweight individuals, in a multivariate linear regression model. Most of the sample was female (63.1%), aged between 21 and 40 years old (63.5%), and 53.3% had studied up to complete elementary school. Almost 41% of the food handlers had less than half the minimum wage per capita income. Of the evaluated individuals, 59.9% presented excess weight. There was an association with family per capita income (Odds Ratio - OR: 1.73; Confidence interval - CI95%: 1.09-2.75); handlers whose per capita income was ≤0.5 minimum wage had a 73% higher chance of obesity than those with higher income. Working in foodservive ≥3 years increased the chance of being overweight by 96% compared to those who work for <3 years (OR: 1.96; CI95%: 1.11-3.49). No significant association was found between the years of work of food handlers in the foodservice and obesity. Since work-related factors may contribute to the high prevalence of excess weight, including working in a food handling environment, the government and employers should consider workplace interventions. These would guide the food handlers in avoiding high rates of excess weight and their consequences on public health. Excess weight is an important driver of costs in the workplace associated with absenteeism, job change, and diseases. More studies are necessary to clarify the relationship between the factors related to work and the anthropometric status of food handlers since excess weight is multifactorial.

Occupational Risks in Hospitals, Quality of Life, and Quality of Work Life: A Systematic Review.

This study systematically reviewed the relationship between occupational risks and quality of life (QoL) and quality of work life (QWL) in hospitals. A systematic review was performed according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guide, and the protocol was submitted on the PROSPERO website (CRD 2019127865). The last search was performed in June 2021 by two independent reviewers in the main databases, a gray literature database, and a manual search (LILACS, MEDLINE/PubMed, PsycINFO, CINAHL, Scopus, Embase, Brazilian Digital Library of Theses and Dissertations, Ovid). As eligibility criteria, we included observational studies, with adult hospital workers, with no restrictions on date and language, any type of instrument to assess QoL and QWL, any definition of QoL and QWL, and studies that presented the relationship between exposure and outcome. Newcastle-Ottawa was used to assess the methodological quality and RTI-Item Bank to assess the risk of bias. Given the impossibility of performing a meta-analysis, a qualitative synthesis was used to present the results. Thus, 11 studies met the criteria and were included in the review, with 6923 individuals aged 18 to 64 years. The studies were mainly carried out with health professionals (81.81%), women (63.60%), and in Asian countries (63.63%). All studies used different instruments and ways to categorize the QoL and QWL, and occupational risks. Only one study assessed occupational noise and another the ergonomic risk. All of them presented a relationship between occupational risk and quality of work life. They pointed to the need for measures to improve the lives of these professionals in the work environment. Therefore, studies show a relationship between occupational risks (noise, ergonomics, and stress) and workers' perception of low or moderate quality of work life. However, more homogeneous studies are necessary for instruments, conceptualization, and categorization of quality of work life.

A Systematic Review on Gluten-Free Bread Formulations Using Specific Volume as a Quality Indicator.

This study aimed to perform a systematic review on gluten-free bread formulations using specific volumes as a quality indicator. In this systematic review, we identified 259 studies that met inclusion criteria. From these studies, 43 met the requirements of having gluten-free bread with a specific volume greater than or equal to 3.5 cm3/g. Other parameters such as the texture profile, color (crumb and crust), and sensory analysis examined in these studies were presented. The formulations that best compensated the lack of the gluten-network were based on the combination of rice flour, rice flour with low amylose content, maize flour, rice starch, corn starch, potato starch, starch with proteins and added with transglutaminase (TGase), and hydrocolloids like hydroxypropylmethylcellulose (HPMC). Of the 43 studies, three did not present risk of bias, and the only parameter evaluated in common in the studies was the specific volume. However, it is necessary to jointly analyze other parameters that contribute to the quality, such as texture profile, external and internal characteristics, acceptability, and useful life of the bread, especially since it is a product obtained through raw materials and unconventional ingredients.

Nutritional Quality of Breakfast Consumed by the Low-Income Population in Brazil: A Nationwide Cross-Sectional Survey.

OBJECTIVE: This study aimed to characterize the nutritional quality of breakfast consumed by the low-income Brazilian population. METHODS: A cross-sectional study was conducted with a sample of 1547 low-income individuals attending 36 Community Restaurants (CRs) in Brazil. Food consumption was analyzed by the frequency of food groups presented in the 24 h recall for three days. The nutritional consumption consisted of the analysis of the total energetic value (TEV) and the macronutrients, fibers, monounsaturated fatty acids, saturated fatty acids, trans fatty acids, calcium, and sodium. The nutrients were evaluated considering the percentage of contribution concerning the daily recommendation of consumption. RESULTS: Among the 4641 breakfasts expected to be consumed and reported, 17.2% (n = 797) of the consumers did not consume breakfast. Therefore, we analyzed the 3844 breakfasts. The analysis of food groups showed a high consumption of dairy and cereals, and low consumption of fruits, roots/tubers, and meat/eggs. The percentages of energy contribution of the macronutrients in the TEV were adequate for a balanced diet. The mean intake of monounsaturated fatty acids was low, and the contribution percentages of saturated fatty acids and trans fatty acids were within the recommendations. The mean fiber intake of the breakfast was low, agreeing with the result of low fruit consumption. Calcium intake covered 73.49% of that expected for this meal, and sodium intake was adequate in breakfast. CONCLUSION: The individuals studied consumed a nutritionally balanced breakfast. Although dairy was one of the most consumed groups, calcium consumption was low, indicating the need to consume higher portions of food sources of this nutrient.

Consumption of Fruits and Vegetables by Low-Income Brazilian Undergraduate Students: A Cross-Sectional Study.

Objective: This study aimed to evaluate the consumption of fruits and vegetables (FV) by low-income students participating in the Brazilian Student Assistance Program. Methods: For three days, we measured participants' consumption through direct observation of food intake at the University Restaurant (UR) and 24-h recall outside the restaurant. The 174 undergraduates were divided into two groups to obtain data on FV intake at the weekend (Sunday) and two days of the week. Group 1 included low-income undergraduates who received their meals for free, and Group 2 included students who paid for their meals at the UR. Results: Both groups presented a very low consumption of FV. On the weekend, Group 1 consumption was equal to Group 2, but it was higher than Group 2 on weekdays, demonstrating how important the UR is for this population. The lowest contribution of the UR to the daily consumption of FV was 59%, reaching a percentage of 87.27%. Fruit supply in the restaurant menu may have positively influenced this consumption. Conclusions: The consumption of FV varied according to the menu offered at the UR. The UR should be a space to promote healthy eating habits including more FV in its menus.