Exclusive breastfeeding duration within a cohort of indigenous Terena living in the urban area of Campo Grande, Central-West Region, Brazil.

In Brazil, current information about breastfeeding indicators among indigenous living in the urban areas is lacking. This article describes the duration of exclusive breastfeeding and its associations with mother and child characteristics in a cohort of Terena infants. The study enrolled infants born between June 2017 to July 2018 (n = 42) and living in villages of the urban area of Campo Grande, Mato Grosso do Sul State, Brazil. Information was collected in four time-points. Variables on maternal sociodemographics and on maternal and child health characteristics were collected, respectively, during the antenatal and the first-month interviews. Variables on breastfeeding practices and bottle use were collected during the first-, six- and 12-month interviews. Associations were examined using Wilcoxon, Kruskal-Wallis, Pearson's chi-square, and Fisher's exact tests. The prevalence of exclusive breastfeeding duration to the ages of three and six months were, respectively, 50% and 11.9%. Compared to infants never introduced to bottles during the first three months of life, those bottle-fed had lower median duration of exclusive breastfeeding (15 versus 150 days) and lower prevalence of exclusive breastfeeding duration to the age of three months (22.7% versus 80%). Most Terena infants fell short of meeting the international recommended duration of exclusive breastfeeding until six months of age and suggested the negative impact of bottle use in the duration of exclusive breastfeeding.

Exclusive breastfeeding duration within a cohort of indigenous Terena living in the urban area of Campo Grande, Central-West Region, Brazil / Duração do aleitamento materno exclusivo em uma coorte de indígenas Terena residentes na zona urbana de Campo Grande, Região Centro-oeste do Brasil / Duración de la lactancia materna exclusiva en una cohorte de indígenas Terena que viven en el área urbana de Campo Grande, región Centro-oeste de Brasil

Abstract In Brazil, current information about breastfeeding indicators among indigenous living in the urban areas is lacking. This article describes the duration of exclusive breastfeeding and its associations with mother and child characteristics in a cohort of Terena infants. The study enrolled infants born between June 2017 to July 2018 (n = 42) and living in villages of the urban area of Campo Grande, Mato Grosso do Sul State, Brazil. Information was collected in four time-points. Variables on maternal sociodemographics and on maternal and child health characteristics were collected, respectively, during the antenatal and the first-month interviews. Variables on breastfeeding practices and bottle use were collected during the first-, six- and 12-month interviews. Associations were examined using Wilcoxon, Kruskal-Wallis, Pearson's chi-square, and Fisher's exact tests. The prevalence of exclusive breastfeeding duration to the ages of three and six months were, respectively, 50% and 11.9%. Compared to infants never introduced to bottles during the first three months of life, those bottle-fed had lower median duration of exclusive breastfeeding (15 versus 150 days) and lower prevalence of exclusive breastfeeding duration to the age of three months (22.7% versus 80%). Most Terena infants fell short of meeting the international recommended duration of exclusive breastfeeding until six months of age and suggested the negative impact of bottle use in the duration of exclusive breastfeeding.

Resumo No Brasil, não há informações atuais sobre indicadores de aleitamento materno entre indígenas residentes em áreas urbanas. O objetivo deste estudo foi descrever a duração do aleitamento materno exclusivo e suas associações com características maternas e infantis em uma coorte de lactentes Terena. O estudo incluiu crianças nascidas de junho de 2017 a julho de 2018 (n = 42) e residentes em povoados da zona urbana de Campo Grande, Mato Grosso do Sul, Brasil. As informações foram coletadas em quatro momentos. Variáveis sociodemográficas maternas e características de saúde materno-infantil foram coletadas durante o pré-natal e o primeiro mês de entrevistas, respectivamente. As variáveis sobre práticas de amamentação e uso de mamadeira foram coletadas durante as entrevistas realizadas no primeiro mês, seis meses e 12 meses. As associações foram examinadas pelos testes de Wilcoxon, Kruskal-Wallis, qui-quadrado de Pearson e exato de Fisher. As prevalências de duração do aleitamento materno exclusivo até os três e seis meses de idade foram, respectivamente, de 50% e 11,9%. Em relação aos bebês que nunca foram introduzidos à mamadeira durante os três primeiros meses de vida, aqueles que usaram mamadeira tiveram menor duração média de amamentação exclusiva (15 versus 150 dias) e menor prevalência de duração de amamentação exclusiva até os três meses de idade (22,7% versus 80%). A maioria dos lactentes Terena não atingiu a duração recomendada internacionalmente para o aleitamento materno exclusivo até os seis meses, sugerindo um impacto negativo do uso da mamadeira na duração do aleitamento materno exclusivo.

Resumen En Brasil no existe información actual sobre los indicadores de lactancia materna entre los indígenas que viven en áreas urbanas. El objetivo de este estudio fue describir la duración de la lactancia materna exclusiva y sus asociaciones con las características maternas e infantiles en una cohorte de lactantes Terena. Este estudio incluyó a niños nacidos entre junio de 2017 y julio de 2018 (n = 42) y que vivían en aldeas del área urbana de Campo Grande, Mato Grosso do Sul, Brasil. La información se recopiló en cuatro momentos. Las variables sociodemográficas maternas y las características de salud materno-infantil durante la atención prenatal y el primer mes de entrevistas, respectivamente, se recogieron para este estudio. Las variables sobre prácticas de lactancia materna y alimentación con biberón fueron recolectadas de las entrevistas realizadas en el primer mes, seis meses y 12 meses. Las asociaciones pasaron por las pruebas de Wilcoxon, de Kruskal-Wallis, el chi-cuadrado de Pearson y la prueba exacta de Fisher. La prevalencia de duración de la lactancia materna exclusiva fue del 50% hasta los tres meses de edad y del 11,9% hasta los seis meses. En comparación con los bebés que no utilizaron biberón durante los primeros tres meses de vida, los que usaron biberón tuvieron una duración promedio más corta de lactancia materna exclusiva (15 versus 150 días) y una menor prevalencia de lactancia materna exclusiva hasta los tres meses de edad (22,7% versus 80%). La mayoría de los bebés Terena no alcanzaron la duración recomendada internacionalmente para la lactancia materna exclusiva hasta los seis meses, lo que sugiere un impacto negativo de la alimentación con biberón en la duración de la lactancia materna exclusiva.

Estimativa do risco de doenças cardiovasculares entre adultos indígenas da etnia krenak, minas gerais, brasil / Estimación de riesgo de enfermedades cardiovasculares entre adultos indígenas de la etnia krenak, minas gerais, brasil / Risk estimation of cardiovascular diseases among indigenous adults of the krenak ethnicity, minas gerais, brazil

RESUMO Objetivo: estimar o risco de doenças cardiovasculares em indígenas Krenak por meio do Escore de Risco Cardiovascular de Framingham. Metodologia: estudo epidemiológico transversal realizado com indígenas de 30 a 74 anos, em Terra Indígena localizada na região leste de Minas Gerais, Brasil. Os dados coletados foram: peso e altura para cálculo do IMC, aferição da pressão arterial e glicemia capilar casual, sexo, idade e tabagismo. O risco cardiovascular estimado em 10 anos foi calculado a partir do algoritmo de Escore de Framingham. Além disso, foram calculados o risco cardiovascular normal, o risco cardiovascular ótimo e a idade cardiovascular. A amostra foi caracterizada com a apresentação das frequências absolutas e relativas das variáveis que compõem o escore de risco cardiovascular de Framingham, estratificada pelo sexo. Resultados: observou-se que o risco cardiovascular em 10 anos entre os indígenas Krenak foi superior ao risco normal, bem como a idade cardiovascular foi maior que a idade cronológica, apesar da maioria da amostra ter apresentado um baixo risco cardiovascular em 10 anos, sem diferença estatística entre os sexos. Conclusão: apesar da predominância de baixo risco cardiovascular em 10 anos entre os indígenas Krenak, o resultado da idade cardiovascular superior à idade cronológica pode ocasionar morbimortalidade por doenças cardiovasculares ao longo do tempo nessa população.

RESUMEN Objetivo: estimar el riesgo de las enfermedades cardiovasculares a los indígenas Krenak por medio de la Puntuación de Riesgo Cardiovascular de Framingham. Metodología: estudio epidemiológico transversal realizado con indígenas de 30 a 74 años, en Tierra Indígena localizada en la región este de Minas Gerais, Brasil. Los datos recolectados fueron: peso y altura para calcular el IMC, medición de la presión arterial y glucemia capilar casual, sexo, edad y tabaquismo. El riesgo cardiovascular estimado en 10 años fue calculado a partir del algoritmo de Puntuación de Framingham. Además, se han calculado el riesgo cardiovascular normal, el riesgo cardiovascular óptimo y la edad cardiovascular. La muestra fue caracterizada con la presentación de las frecuencias absolutas y relativas de las variables que componen la puntuación de riesgo cardiovascular de Framingham, estratificada por sexo. Resultados: se observó que el riesgo cardiovascular en 10 años entre los indígenas Krenak fue superior al riesgo normal, así como la edad cardiovascular fue mayor que la edad cronológica, aunque la mayoría de la muestra presentó un bajo riesgo cardiovascular en 10 años, sin diferencia estadística entre los sexos. Conclusión: a pesar de la predominancia de bajo riesgo cardiovascular en 10 años entre los indígenas Krenak, el resultado de la edad cardiovascular superior a la edad cronológica puede ocasionar morbimortalidad por enfermedades cardiovasculares a lo largo del tiempo en esa población.

ABSTRACT Objective: to estimate the risk of cardiovascular diseases in indigenous Krenak through the Framingham Cardiovascular Risk Score. Methodology: cross-sectional epidemiological study conducted with indigenous people aged 30 to 74 years, in Indigenous Land located in the eastern region of Minas Gerais, Brazil. The data collected were: weight and height to calculate BMI, measurement of blood pressure and casual capillary blood glucose, sex, age and smoking. The cardiovascular risk estimated at 10 years was calculated from the Framingham Score algorithm. In addition, normal cardiovascular risk, optimal cardiovascular risk and cardiovascular age were calculated. The sample was characterized with the presentation of absolute and relative frequencies of the variables that make up the cardiovascular risk score of Framingham, stratified by sex. Results: it was observed that cardiovascular risk at 10 years among the Krenak indigenous was higher than normal risk, as well as cardiovascular age was higher than chronological age, although most of the sample had a low cardiovascular risk at 10 years, no statistical difference between the sexes. Conclusion: despite the predominance of low cardiovascular risk in 10 years among the Krenak indigenous, the result of cardiovascular age above chronological age can cause morbidity and mortality from cardiovascular diseases over time in this population.

The relationship between diet and sleep in 2-y-old children: Results from Growing Up in New Zealand.

OBJECTIVES: This study aimed to examine the relationship between dietary practices and sleep in young children. METHODS: In this study, 2-y-old children (n = 6327) and their mothers were enrolled at birth and during pregnancy, respectively. The study obtained maternal demographic, health, and lifestyle data during late pregnancy. Parents reported the 2-y-old child's dietary practices on a food frequency questionnaire, as well as sleep duration and night-waking frequency. Measures of dietary intake quantified servings per day for each food group (grouped as low/moderate/high intake). Sleep measures were as inadequate sleep when <11 h sleep in a 24-h period and increased night waking when waking ≥2 times per night. Multivariable logistic regression analyses examined associations between toddler diet and sleep, which were described using adjusted odds ratios (ORs) and 95% confidence intervals. RESULTS: In this study, 2-y-old children (n = 6288) slept for a mean of 12.3 hours (standard deviation: ±1.5 hours) over a 24-h period, with 734 children (12%) getting <11 h of sleep in 24 h. Increased night waking occurred in 1063 children (17%). Compared with low intake, high soft drink/snack/fast food intake was associated with inadequate sleep (OR: 1.37) and increased night waking (OR: 1.34). High milk/cheese/yoghurt intake (OR: 1.55) was associated with increased odds of night waking, but moderate (OR: 0.81) or high (OR: 0.78) vegetable intake was associated with decreased odds of night waking. Exposure to screens (OR: 1.28) and heavy maternal cigarette smoking (OR: 2.20) were also associated with inadequate sleep and increased night waking, respectively. CONCLUSIONS: At age 2 y, higher consumption of soft drinks/snacks/fast foods is associated with shorter, more disrupted sleep. Conversely, higher vegetable consumption is associated with less disrupted sleep. Dietary modifications may improve toddlers' sleep.

Who We Seek and What We Eat? Sources of Food Choice Inspirations and Their Associations with Adult Dietary Patterns before and during the COVID-19 Lockdown in New Zealand.

Research shows the shaping of food choices often occurs at home, with the family widely recognised as significant in food decisions. However, in this digital age, our eating habits and decision-making processes are also determined by smartphone apps, celebrity chefs, and social media. The 'COVID Kai Survey' online questionnaire assessed cooking and shopping behaviours among New Zealanders during the 2020 COVID-19 'lockdown' using a cross-sectional study design. This paper examines how sources of food choice inspirations (cooking-related advice and the reasons for recipe selection) are related to dietary patterns before and during the lockdown. Of the 2977 participants, those influenced by nutrition and health experts (50.9% before; 53.9% during the lockdown) scored higher for the healthy dietary pattern. Participants influenced by family and friends (35% before; 29% during the lockdown) had significantly higher scores for the healthy and the meat dietary patterns, whereas participants influenced by celebrity cooks (3.8% before; 5.2% during the lockdown) had significantly higher scores in the meat dietary pattern. There was no evidence that associations differed before and during the lockdown. The lockdown was related to modified food choice inspiration sources, notably an increase in 'comforting' recipes as a reason for recipe selection (75.8%), associated with higher scoring in the unhealthy dietary pattern during the lockdown. The lockdown in New Zealand saw an average decrease in nutritional quality of diets in the 'COVID Kai Survey', which could be partly explained by changes in food choice inspiration sources.

Prevalência estimada e fatores associados à hipertensão arterial em indígenas adultos Krenak do Estado de Minas Gerais, Brasil / Estimated prevalence of hypertension and associated factors in Krenak indigenous adults in the state of Minas Gerais, Brazil / Prevalencia estimada y factores asociados a la hipertensión arterial en indígenas adultos Krenak del Estado de Minas Gerais, Brasil

Estudo transversal realizado em 2016, cujo objetivo foi descrever a prevalência estimada e os fatores associados à hipertensão arterial sistêmica entre adultos e idosos Krenak, em Terra Indígena localizada na beira do rio Doce, na região leste de Minas Gerais, Brasil. Foram aferidos peso, estatura, perímetro da cintura, pressão arterial sistólica, pressão arterial diastólica e glicemia capilar. Informações sociodemográficas e de estilo de vida foram obtidas via aplicação de questionário face a face. Modelos de regressão de Poisson foram construídos para estimar a associação independente entre as variáveis de interesse e a hipertensão arterial sistêmica. A prevalência da hipertensão arterial sistêmica foi de 31,2% (IC95%: 24,4-37,9) entre os indígenas Krenak. Houve associação independente no modelo final para o aumento da idade, obesidade abdominal e hiperglicemia. Destaca-se a necessidade de ações eficazes de prevenção, de diagnóstico e acompanhamento frente aos fatores modificáveis da hipertensão arterial sistêmica, uma vez que foi observada elevada prevalência dessa condição na comunidade indígena Krenak.

This cross-sectional study in 2016 aimed to describe the estimated prevalence of systemic arterial hypertension and associated factors in Krenak adults and elderly in an indigenous community located along the Rio Doce in eastern Minas Gerais state, Brazil. We measured weight, height, waist circumference, systolic blood pressure, diastolic blood pressure, and capillary blood glucose. Sociodemographic and lifestyle information was obtained from a face-to-face questionnaire. Poisson regression models were constructed to estimate independent associations between the target variables and hypertension. Prevalence of hypertension was 31.2% (95%CI: 24.4-37.9) in Krenak indigenous. The final model showed an independent association with increasing age, abdominal obesity, and hyperglycemia. The results highlight the need for effective measures in prevention, diagnosis, and follow-up of modifiable risk factors for hypertension, since high prevalence of this condition was observed in the Krenak indigenous community.

Estudio transversal realizado en 2016, cuyo objetivo fue describir la prevalencia estimada y los factores asociados a la hipertensión arterial sistémica entre adultos y ancianos Krenak, en Terra Indígena localizada en la ribera del río Doce, en la región este de Minas Gerais, Brasil. Se midieron peso, estatura, perímetro de la cintura, presión arterial sistólica, presión arterial diastólica y glucemia capilar. Informaciones sociodemográficas y de estilo de vida se obtuvieron vía la aplicación de un cuestionario cara-a-cara. Modelos de regresión de Poisson se construyeron para estimar la asociación independiente entre las variables de interés y la hipertensión arterial sistémica. La prevalencia de la hipertensión arterial sistémica fue de 31,2% (IC95%: 24,4-37,9) entre los indígenas Krenak. Hubo asociación independiente en el modelo final para el aumento de edad, obesidad abdominal e hiperglicemia. Se destaca la necesidad de acciones eficaces de prevención, de diagnóstico y acompañamiento frente a los factores modificables de la hipertensión arterial sistémica, ya que se observó una elevada prevalencia de esa condición en la comunidad indígena Krenak.

[Estimated prevalence of hypertension and associated factors in Krenak indigenous adults in the state of Minas Gerais, Brazil]. / Prevalência estimada e fatores associados à hipertensão arterial em indígenas adultos Krenak do Estado de Minas Gerais, Brasil.

This cross-sectional study in 2016 aimed to describe the estimated prevalence of systemic arterial hypertension and associated factors in Krenak adults and elderly in an indigenous community located along the Rio Doce in eastern Minas Gerais state, Brazil. We measured weight, height, waist circumference, systolic blood pressure, diastolic blood pressure, and capillary blood glucose. Sociodemographic and lifestyle information was obtained from a face-to-face questionnaire. Poisson regression models were constructed to estimate independent associations between the target variables and hypertension. Prevalence of hypertension was 31.2% (95%CI: 24.4-37.9) in Krenak indigenous. The final model showed an independent association with increasing age, abdominal obesity, and hyperglycemia. The results highlight the need for effective measures in prevention, diagnosis, and follow-up of modifiable risk factors for hypertension, since high prevalence of this condition was observed in the Krenak indigenous community.

Estudo transversal realizado em 2016, cujo objetivo foi descrever a prevalência estimada e os fatores associados à hipertensão arterial sistêmica entre adultos e idosos Krenak, em Terra Indígena localizada na beira do rio Doce, na região leste de Minas Gerais, Brasil. Foram aferidos peso, estatura, perímetro da cintura, pressão arterial sistólica, pressão arterial diastólica e glicemia capilar. Informações sociodemográficas e de estilo de vida foram obtidas via aplicação de questionário face a face. Modelos de regressão de Poisson foram construídos para estimar a associação independente entre as variáveis de interesse e a hipertensão arterial sistêmica. A prevalência da hipertensão arterial sistêmica foi de 31,2% (IC95%: 24,4-37,9) entre os indígenas Krenak. Houve associação independente no modelo final para o aumento da idade, obesidade abdominal e hiperglicemia. Destaca-se a necessidade de ações eficazes de prevenção, de diagnóstico e acompanhamento frente aos fatores modificáveis da hipertensão arterial sistêmica, uma vez que foi observada elevada prevalência dessa condição na comunidade indígena Krenak.

Estudio transversal realizado en 2016, cuyo objetivo fue describir la prevalencia estimada y los factores asociados a la hipertensión arterial sistémica entre adultos y ancianos Krenak, en Terra Indígena localizada en la ribera del río Doce, en la región este de Minas Gerais, Brasil. Se midieron peso, estatura, perímetro de la cintura, presión arterial sistólica, presión arterial diastólica y glucemia capilar. Informaciones sociodemográficas y de estilo de vida se obtuvieron vía la aplicación de un cuestionario cara-a-cara. Modelos de regresión de Poisson se construyeron para estimar la asociación independiente entre las variables de interés y la hipertensión arterial sistémica. La prevalencia de la hipertensión arterial sistémica fue de 31,2% (IC95%: 24,4-37,9) entre los indígenas Krenak. Hubo asociación independiente en el modelo final para el aumento de edad, obesidad abdominal e hiperglicemia. Se destaca la necesidad de acciones eficaces de prevención, de diagnóstico y acompañamiento frente a los factores modificables de la hipertensión arterial sistémica, ya que se observó una elevada prevalencia de esa condición en la comunidad indígena Krenak.

[Nutritional status and environmental and health conditions of Pataxó indigenous children, Minas Gerais State, Brazil]. / Estado nutricional e condições ambientais e de saúde de crianças Pataxó, Minas Gerais, Brasil.

To describe the nutritional status and the environmental and health conditions of the Pataxó children from five villages of Minas Gerais State, Brazil. Among the under 10 years old, weight and height/length were classified according to the growth references of World Health Organization. Questionnaires evaluating environmental conditions of the households and health conditions of under 5 years old were based in the First National Survey of Indigenous People's Health and Nutrition. Among the 70 children evaluated (93.3%), 34 were under 5 years old. Nutritional deficits were not observed and overweight was registered for 11.4% of the children. Most of the children (74.3%) lived in households with electric energy, 95% in households with toilets and 52.9% in households that threw waste in septic tanks. Six or more antenatal appointments were reported by 82.4% of the mothers of the under five years old and 91.2% started the antenatal appointments within the first trimester of pregnancy. Among the causes of hospitalizations in the previous 12 months (23.5%), only one was due to diarrhea and none to respiratory infection. Universal coverage was observed for the majority of the vaccines. The absence of nutritional deficits among the Pataxó children may be associated to better housing and sanitation conditions and coverage of basic childhood health actions when compared to the conditions reported by the First National Survey of Indigenous People's Health and Nutrition and related studies with other specific indigenous peoples. The current study aims to back discussions and measures to improve the nutritional status of indigenous children in Brazil.

Descrever o estado nutricional e as condições ambientais e de saúde das crianças Pataxó de cinco aldeias de Minas Gerais, Brasil. O estado nutricional foi classificado com base no peso e estatura/comprimento, tendo como referência o padrão de crescimento da Organização Mundial da Saúde. Questionários baseados no I Inquérito Nacional de Saúde e Nutrição dos Povos Indígenas foram utilizados para a avaliação das condições ambientais dos domicílios e de saúde dos menores de cinco anos. Dos 70 menores de dez anos avaliados (93,3%), 34 tinham menos de cinco anos. Não se observaram déficits nutricionais e sobrepeso foi registrado para 11,4% das crianças. A maioria das crianças (74,3%) vivia em domicílios com energia elétrica, 95% em domicílios com latrina/sanitário e 52,9% lançavam dejetos em fossa séptica. A realização de seis ou mais consultas de pré-natal foi reportada por 82,4% das mães dos menores de cinco anos, e 91,2% iniciaram o pré-natal no primeiro trimestre de gestação. Dentre as causas de internações hospitalares nos últimos 12 meses (23,5%), somente uma foi devido à diarreia e nenhuma por causa de infecções respiratórias. Foram verificadas coberturas universais para a maioria das vacinas avaliadas. A inexistência de déficits nutricionais entre as crianças Pataxó pode estar associada às melhores condições de habitação, saneamento e cobertura das ações básicas de saúde infantil quando comparadas às condições verificadas no I Inquérito Nacional de Saúde e Nutrição dos Povos Indígenas e de estudos pontuais. Este trabalho pretende subsidiar discussões e ações que visem a melhorias do estado nutricional infantil dos indígenas no Brasil.

El objetivo de este trabajo fue describir el estado nutricional, así como las condiciones ambientales y de salud de niños Pataxó, procedentes de cinco aldeas de Minas Gerais, Brasil. El estado nutricional se clasificó en base al peso y estatura/longitud, teniendo como referencia el patrón de crecimiento de la Organización Mundial de la Salud. Se utilizaron cuestionarios basados en la I Encuesta Nacional de Salud y Nutrición de los Pueblos Indígenas para la evaluación de las condiciones ambientales de los domicilios y de salud de los menores de cinco años. De los 70 menores de 10 años evaluados (93,3%), 34 tenían menos de cinco años. No se observaron déficits nutricionales y se registro sobrepeso en 11,4% de los niños. La mayoría de los niños (74,3%) vivía en domicilios con energía eléctrica, 95% en domicilios con letrina/retrete y un 52,9% efectuaba deposiciones en fosa séptica. La realización de seis o más consultas de carácter prenatal fueron informadas por parte de un 82,4% de las madres de los menores de cinco años, y un 91,2% comenzaron las consultas prenatales durante el primer trimestre de gestación. Entre las causas de internamientos hospitalarios en los últimos 12 meses (23,5%), solamente una se debió a diarrea y ninguna a causa de infecciones respiratorias. Se verificaron coberturas universales para la mayoría de las vacunas evaluadas. La inexistencia de déficits nutricionales entre los niños Pataxó puede estar asociada a las mejores condiciones de vivienda, saneamiento y cobertura de las acciones básicas respecto a salud infantil, cuando se comparan con las condiciones verificadas en la I Encuesta Nacional de Salud y Nutrición de los Pueblos Indígenas y de otros estudios puntuales. Este trabajo pretende servir de apoyo para futuras discusiones y acciones que tengan por objetivo las mejoras en el estado nutricional infantil de los indígenas en Brasil.

Agreement between Future Parents on Infant Feeding Intentions and Its Association with Breastfeeding Duration: Results from the Growing Up in New Zealand Cohort Study.

Maternal intentions are believed to have the strongest influence on infant feeding. However, what has rarely been studied, are the associations of maternal and partner intentions, and the influence these factors have on infant feeding. Our objective was to describe breastfeeding intentions of pregnant women and their partners, agreement about these intentions, and whether this agreement is associated with breastfeeding initiation and duration. This study was completed within the Growing Up in New Zealand study. Agreement between mothers and partners on intended initial infant feeding method was fair (κ = 0.21, 95% confidence interval (CI) 0.17⁻0.25) as was intended breastfeeding duration (κ = 0.25, 95% CI 0.22⁻0.28). Infants whose parents agreed antenatally on breastfeeding only were more likely to have been breastfed for >6 months, after adjustment for maternal (odds ratio (OR) = 6.3, 95% CI 3.9⁻10.2) and partner demographics (OR = 5.7, 95% CI 3.6⁻9.2). Likewise, infants whose parents agreed antenatally to breastfeed for >6 months were more likely to have been breastfed for >6 months, after adjustment for maternal (OR = 4.9, 95% CI 3.9⁻6.2) and partner demographics (OR = 5.0, 95% CI 4.0⁻6.3). Interventions that promote breastfeeding to both mothers and partners which enable parents to reach agreement about intended feeding methods have the potential to increase both breastfeeding initiation and duration.

Dietary patterns are influenced by socio-demographic conditions of women in childbearing age: a cohort study of pregnant women.

BACKGROUND: Women's health during their reproductive years and whilst pregnant has implications for their children's health, both in utero and during childhood. Associations of women's pre-pregnancy dietary patterns (DP) with maternal socio-demographic characteristics and nutrient intake were investigated in ProcriAr cohort study in São Paulo/Brazil, 2012. METHODS: The DPs of 454 women were investigated by principal component factor analysis, using dietary information from a validated 110-item food frequency questionnaire. Multiple linear regression models identified independent associations between DPs and maternal socio-demographic characteristics and Spearman's correlation determined associations between DPs and nutrients intake. RESULTS: Participants' mean age was 26.1 years (standard deviation = 6.3), 10.3% had more than 8 years of formal education, 30% were migrants from outside of the Southeast of Brazil, 48% were employed, 13% were smokers, and 51% were overweight/obese. Four DPs were derived: 'Lentils, whole grains and soups,' 'Snacks, sandwiches, sweets and soft drinks,' 'Seasoned vegetables and lean meats,' and 'Sweetened juices, bread and butter, rice and beans'. The 'Lentils, whole grains and soups' score was positively related to maternal age, being non-smoker and born in the South, North or Midwest of Brazil. The 'Snacks, sandwiches, sweets and soft drinks' score was positively related to higher maternal education, and negatively related to age, lack of formal work and being born in the Northeast region. The 'Seasoned vegetables and lean meats' score was positively related to higher maternal education. The 'Sweetened juices, bread and butter, rice and beans' score was positively related to unemployment and to no family history of hypertension, and negatively related to maternal overweight and obesity. Dietary intake of fruits and vegetables, foods that require preparation, nutrients from one-carbon metabolism, protein, iron, calcium and vitamin D were correlated with the 'Seasoned vegetables and lean meats'. Dietary intake of sugar-sweetened and alcoholic beverages, industrialized and takeaway foods, and foods rich in sugar, energy, fat, and synthetic folate were correlated with the 'Snacks, sandwiches, sweets and soft drinks'. CONCLUSIONS: Findings from this study add perspectives to be considered in the implementation of health interventions, which could improve women's nutritional status and provide an adequate environment for the developing fetus.

Estado nutricional e condições ambientais e de saúde de crianças Pataxó, Minas Gerais, Brasil / Nutritional status and environmental and health conditions of Pataxó indigenous children, Minas Gerais State, Brazil / Estado nutricional y condiciones ambientales y de salud de niños Pataxó, Minas Gerais, Brasil

Resumo: Descrever o estado nutricional e as condições ambientais e de saúde das crianças Pataxó de cinco aldeias de Minas Gerais, Brasil. O estado nutricional foi classificado com base no peso e estatura/comprimento, tendo como referência o padrão de crescimento da Organização Mundial da Saúde. Questionários baseados no I Inquérito Nacional de Saúde e Nutrição dos Povos Indígenas foram utilizados para a avaliação das condições ambientais dos domicílios e de saúde dos menores de cinco anos. Dos 70 menores de dez anos avaliados (93,3%), 34 tinham menos de cinco anos. Não se observaram déficits nutricionais e sobrepeso foi registrado para 11,4% das crianças. A maioria das crianças (74,3%) vivia em domicílios com energia elétrica, 95% em domicílios com latrina/sanitário e 52,9% lançavam dejetos em fossa séptica. A realização de seis ou mais consultas de pré-natal foi reportada por 82,4% das mães dos menores de cinco anos, e 91,2% iniciaram o pré-natal no primeiro trimestre de gestação. Dentre as causas de internações hospitalares nos últimos 12 meses (23,5%), somente uma foi devido à diarreia e nenhuma por causa de infecções respiratórias. Foram verificadas coberturas universais para a maioria das vacinas avaliadas. A inexistência de déficits nutricionais entre as crianças Pataxó pode estar associada às melhores condições de habitação, saneamento e cobertura das ações básicas de saúde infantil quando comparadas às condições verificadas no I Inquérito Nacional de Saúde e Nutrição dos Povos Indígenas e de estudos pontuais. Este trabalho pretende subsidiar discussões e ações que visem a melhorias do estado nutricional infantil dos indígenas no Brasil.

Abstract: To describe the nutritional status and the environmental and health conditions of the Pataxó children from five villages of Minas Gerais State, Brazil. Among the under 10 years old, weight and height/length were classified according to the growth references of World Health Organization. Questionnaires evaluating environmental conditions of the households and health conditions of under 5 years old were based in the First National Survey of Indigenous People's Health and Nutrition. Among the 70 children evaluated (93.3%), 34 were under 5 years old. Nutritional deficits were not observed and overweight was registered for 11.4% of the children. Most of the children (74.3%) lived in households with electric energy, 95% in households with toilets and 52.9% in households that threw waste in septic tanks. Six or more antenatal appointments were reported by 82.4% of the mothers of the under five years old and 91.2% started the antenatal appointments within the first trimester of pregnancy. Among the causes of hospitalizations in the previous 12 months (23.5%), only one was due to diarrhea and none to respiratory infection. Universal coverage was observed for the majority of the vaccines. The absence of nutritional deficits among the Pataxó children may be associated to better housing and sanitation conditions and coverage of basic childhood health actions when compared to the conditions reported by the First National Survey of Indigenous People's Health and Nutrition and related studies with other specific indigenous peoples. The current study aims to back discussions and measures to improve the nutritional status of indigenous children in Brazil.

Resumen: El objetivo de este trabajo fue describir el estado nutricional, así como las condiciones ambientales y de salud de niños Pataxó, procedentes de cinco aldeas de Minas Gerais, Brasil. El estado nutricional se clasificó en base al peso y estatura/longitud, teniendo como referencia el patrón de crecimiento de la Organización Mundial de la Salud. Se utilizaron cuestionarios basados en la I Encuesta Nacional de Salud y Nutrición de los Pueblos Indígenas para la evaluación de las condiciones ambientales de los domicilios y de salud de los menores de cinco años. De los 70 menores de 10 años evaluados (93,3%), 34 tenían menos de cinco años. No se observaron déficits nutricionales y se registro sobrepeso en 11,4% de los niños. La mayoría de los niños (74,3%) vivía en domicilios con energía eléctrica, 95% en domicilios con letrina/retrete y un 52,9% efectuaba deposiciones en fosa séptica. La realización de seis o más consultas de carácter prenatal fueron informadas por parte de un 82,4% de las madres de los menores de cinco años, y un 91,2% comenzaron las consultas prenatales durante el primer trimestre de gestación. Entre las causas de internamientos hospitalarios en los últimos 12 meses (23,5%), solamente una se debió a diarrea y ninguna a causa de infecciones respiratorias. Se verificaron coberturas universales para la mayoría de las vacunas evaluadas. La inexistencia de déficits nutricionales entre los niños Pataxó puede estar asociada a las mejores condiciones de vivienda, saneamiento y cobertura de las acciones básicas respecto a salud infantil, cuando se comparan con las condiciones verificadas en la I Encuesta Nacional de Salud y Nutrición de los Pueblos Indígenas y de otros estudios puntuales. Este trabajo pretende servir de apoyo para futuras discusiones y acciones que tengan por objetivo las mejoras en el estado nutricional infantil de los indígenas en Brasil.

Associated factors of malnutrition among African children under five years old, Bom Jesus, Angola / Fatores associados aos deficit nutricionais entre crianças africanas menores de cinco anos, Bom Jesus, Angola

ABSTRACT Objective: To identify the determinants of wasting and stunting in children under five years old in the commune of Bom Jesus, Angola Methods: A population-based cross-sectional study was conducted with 742 children in 2010, and nutritional deficits were defined by World Health Organization criteria. Prevalence ratios and associated factors of wasting and stunting were estimated using Poisson regression with robust variance, using a conceptual hierarchical model Results: For both deficits, there were significant differences in the prevalence ratios according to the children's neighborhood and age. Boys and those children living in households whose water supply came from the river or lake, as well those with recent expulsion of parasites and infections were more likely to present stunting. Children of fathers with higher number of children or that which the fathers were not living at home and whose mothers were 25-34 years old were less likely to have wasting Conclusion: It was identified independent variables from different levels of determination of malnutrition, standing out the basic sanitation conditions and family structure as important predictors of the nutritional deficits. The knowledge of the associated factors of malnutrition may contribute for subside public policies in planning interventions to improve the childhood nutrition status in Bom Jesus and communes with similar characteristics in Angola.

RESUMO Objetivo: Identificar os determinantes dos deficit estatural (índice altura/idade) e ponderal (índice peso/altura) entre crianças menores de cinco anos da Comuna de Bom Jesus, Angola. Métodos: O estudo, transversal de base populacional, foi conduzido entre 742 crianças no ano de 2010 e os deficit nutricionais foram definidos de acordo com os criterios da Organização Mundial da Saúde. Razões de prevalência e fatores associados aos deficit nutricionais foram estimados mediante regressão de Poisson com variância robusta, utilizando-se modelo conceitual de análise hierarquizado. Resultados: Para ambos os índices houve diferença significativa nas razões de prevalência de acordo com bairro de moradia e idade da criança. Crianças do sexo masculino e aquelas que residiam em domicílios cujo abastecimento de água era proveniente do rio ou lago, tão bem quanto aquelas que apresentaram expulsão de parasitas e infecções nos 15 dias anteriores à pesquisa, tiveram maior probabilidade de acometimento estatural. Para o deficit de peso/altura, menor probabilidade de acometimento foi observada entre crianças cujas mães tinham idade entre 25-34 ano. Conclusão: Foram identificadas variáveis independentes de diferentes níveis de determinação da desnutrição, destacando--se as condições sanitárias básicas e a estrutura familiar como importantes fatores associados aos deficit nutricionais. O conhecimento acerca dos determinantes da desnutrição pode subsidiar políticas públicas no planejamento de intervenções que visem melhorar o estado nutricional infantil em Bom Jesus e comunas com características semelhantes em Angola.

[Management, operations, and menus in Kaingáng indigenous schools participating in the National School Nutrition Program in Rio Grande do Sul State, Brazil.] / Características de gestão, funcionamento e cardápios do Programa Nacional de Alimentação Escolar em escolas Kaingáng do Rio Grande do Sul, Brasil.

Few studies have focused on the National School Nutrition Program (PNAE) in indigenous schools in Brazil. The current study describes the program's operations, management, and menus in 35 Kaingáng indigenous schools in Rio Grande do Sul State, Brazil. A cross-sectional study design was used to obtain information on the program through questionnaires submitted to the Regional Educational Offices (CRE) and to the schools. The menus suggested to the schools by the regional offices were obtained. There were no Centers for Indigenous Education in the regional offices. All the assistant principals were indigenous, 26 schools (74.6%) practiced local management of the meal program, and 34 (97.1%) reported purchasing food from local markets. Most cooks (63.9%) had temporary work contracts with the schools and 65.7% were indigenous. Low offerings of veges, milk and dairy products were observed in around 60% of the menus, and legumes and fruits low in around 80%. It points out the need for more studies about the indigenous PNAE and intends to support public policies in health, food and nutrition for the national indigenous school .

Características de gestão, funcionamento e cardápios do Programa Nacional de Alimentação Escolar em escolas Kaingáng do Rio Grande do Sul, Brasil / Management, operations, and menus in Kaingáng indigenous schools participating in the National School Nutrition Program in Rio Grande do Sul State, Brazil / Características de la gestión, la operatividad y los menús del Programa Nacional de Alimentación Escolar en escuelas Kaingáng de Río Grande do Sul, Brasil

Há poucos estudos sobre o Programa Nacional de Alimentação Escolar (PNAE) em escolas indígenas no país. O objetivo do presente artigo é descrever características de funcionamento, gestão e cardápios do PNAE de todas as 35 escolas Kaingáng do Rio Grande do Sul, Brasil. Em estudo transversal, as informações do PNAE foram recolhidas por meio de questionários aplicados a cada Coordenadoria Regional de Educação (CRE) e às escolas. Foram obtidos os cardápios sugeridos pelas CREs às escolas. Não existia o Núcleo de Educação Indígena nas CREs. Todos os vice-diretores eram indígenas, 26 escolas (74,6%) tinham gestão escolarizada e 34 escolas (97,1%) compravam alimentos de mercados próximos. A maioria das merendeiras (62,9%) tinha contrato de trabalho temporário e 65,7% eram indígenas. Observou-se baixa oferta de verduras/legumes e de leite e derivados em cerca de 60% dos cardápios, o mesmo ocorrendo com leguminosas e frutas em cerca de 80% destes. Aponta-se a necessidade de mais estudos sobre o PNAE indígena e pretende-se subsidiar políticas públicas de saúde, alimentação e nutrição para o espaço escolar indígena nacional.

Few studies have focused on the National School Nutrition Program (PNAE) in indigenous schools in Brazil. The current study describes the program’s operations, management, and menus in 35 Kaingáng indigenous schools in Rio Grande do Sul State, Brazil. A cross-sectional study design was used to obtain information on the program through questionnaires submitted to the Regional Educational Offices (CRE) and to the schools. The menus suggested to the schools by the regional offices were obtained. There were no Centers for Indigenous Education in the regional offices. All the assistant principals were indigenous, 26 schools (74.6%) practiced local management of the meal program, and 34 (97.1%) reported purchasing food from local markets. Most cooks (63.9%) had temporary work contracts with the schools and 65.7% were indigenous. Low offerings of veges, milk and dairy products were observed in around 60% of the menus, and legumes and fruits low in around 80%. It points out the need for more studies about the indigenous PNAE and intends to support public policies in health, food and nutrition for the national indigenous school .

Hay pocos estudios sobre el Programa Nacional de Alimentación Escolar (PNAE) en las escuelas indígenas del país. El objetivo es describir características de la gestión, la operatividad y los menús del PNAE de 35 escuelas Kaingáng de Río Grande do Sul, Brasil. Se trata de un estudio transversal, donde las informaciones del PNAE se obtuvieron por medio de cuestionarios aplicados a las Coordinaciones Regionales de Educación (CRE) y a las escuelas. Fueron obtenidos los menús sugeridos por las CRE a las escuelas. No existía el Centro para la Educación Indígena en las CRE. Todos los sub-directores eran indígenas, 26 (74,7%) escuelas tenían gestión escolarizada y 34 escuelas hacían la compra de alimentos en mercados próximos. La mayoría de los cocineros (62,9%) tenía un contrato de trabajo temporal y un 65,7% eran indígenas. Se observó una baja oferta de verduras y leche y derivados en alrededor de 60% de los menús y de leguminosas y frutas en alrededor de un 80%. Se indica la necesidad de más estudios sobre el PNAE indígena y se pretende subvencionar políticas públicas de salud, alimentación y nutrición para el espacio escolar indígena nacional.

Waist circumference and waist circumference to height ratios of Kaingáng indigenous adolescents from the State of Rio Grande do Sul, Brazil.

The aim of this study was to describe the distribution of waist circumference (WC) and WC to height (WCTH) values among Kaingáng indigenous adolescents in order to estimate the prevalence of high WCTH values and evaluate the correlation between WC and WCTH and body mass index (BMI)-for-age. A total of 1,803 indigenous adolescents were evaluated using a school-based cross-sectional study. WCTH values > 0.5 were considered high. Higher mean WC and WCTH values were observed for girls in all age categories. WCTH values > 0.5 were observed in 25.68% of the overall sample of adolescents. Mean WC and WCTH values were significantly higher for adolescents with BMI/age z-scores > 2 than for those with normal z-scores. The correlation coefficients of WC and WCTH for BMI/age were r = 0.68 and 0.76, respectively, for boys, and r = 0.79 and 0.80, respectively, for girls. This study highlights elevated mean WC and WCTH values and high prevalence of abdominal obesity among Kaingáng indigenous adolescents.

Waist circumference and waist circumference to height ratios of Kaingáng indigenous adolescents from the State of Rio Grande do Sul, Brazil / Circunferência da cintura e circunferência da cintura/estatura entre adolescentes indígenas Kaingáng do Rio Grande do Sul, Brasil

The aim of this study was to describe the distribution of waist circumference (WC) and WC to height (WCTH) values among Kaingáng indigenous adolescents in order to estimate the prevalence of high WCTH values and evaluate the correlation between WC and WCTH and body mass index (BMI)-for-age. A total of 1,803 indigenous adolescents were evaluated using a school-based cross-sectional study. WCTH values > 0.5 were considered high. Higher mean WC and WCTH values were observed for girls in all age categories. WCTH values > 0.5 were observed in 25.68% of the overall sample of adolescents. Mean WC and WCTH values were significantly higher for adolescents with BMI/age z-scores > 2 than for those with normal z-scores. The correlation coefficients of WC and WCTH for BMI/age were r = 0.68 and 0.76, respectively, for boys, and r = 0.79 and 0.80, respectively, for girls. This study highlights elevated mean WC and WCTH values and high prevalence of abdominal obesity among Kaingáng indigenous adolescents.

Os objetivos do estudo foram descrever a distribuição das medidas de circunferência de cintura (CC) e CC/estatura (CC/E) para adolescentes indígenas Kaingáng; estimar a prevalência de valores elevados para CC/E; e avaliar a correlação entre CC e CC/E com o IMC/idade. Um total de 1.803 adolescentes indígenas foi avaliado no estudo seccional de base escolar. Foram considerados elevados valores de CC/E superiores a 0,5. Observaram-se maiores valores médios de CC e CC/E para meninas, em todas as faixas etárias. Valores de CC/E > 0,5 foram encontrados em 25,6% dos adolescentes. Valores médios de CC e CC/E foram significativamente maiores para os adolescentes com IMC/idade > 2 z-scores, em comparação aos eutróficos. Os coeficientes de correlações entre CC e CC/E com o IMC/idade foram: meninos: r = 0,68 e 0,76, respectivamente, e meninas: r = 0,79 e 0,80, respectivamente. Destaca-se proeminência de valores médios elevados de CC e CC/E e prevalências expressivas de obesidade abdominal.

Educação alimentar e nutricional crítica: reflexões para intervenções em alimentação e nutrição na atenção primária à saúde / Educacion alimentario nutricional critica: consideraciones para intervenciones alimentario nutricionales en la atencion primaria de salud / Considerations for a critical food and nutrition intervention in primary health care

Neste artigo, foram traçados aspectos conceituais relevantes abarcados pela educação alimentar e nutricional crítica e, com base neles, apresentados direcionamentos teóricos para apoio às intervenções em alimentação e nutrição voltadas para grupos específicos da atenção primária à saúde. Desafios encontrados pelo nutricionista diante da promoção de práticas alimentares saudáveis nesse nível de atenção à saúde também foram expostos. Realizou-se revisão bibliográfica crítica mediante seleção direcionada de referências, com o propósito de apresentar conceitos que compõem o panorama atual da educação alimentar nutricional crítica, sem a pretensão de esgotamento do tema. Evidenciou-se a importância da atuação do nutricionista como educador e de forma mais abrangente em todas as etapas das intervenções alimentares e nutricionais, cujo trabalho deve ser fundamentado em teorias pedagógicas norteadoras da educação alimentar e nutricional crítica, que agregam, dentre outros, conceitos da educação em saúde, do aconselhamento dietético, da psicologia grupal, da antropologia da alimentação e da segurança alimentar e nutricional. Dentre os desafios do profissional, destaca-se a fragilidade de sua formação em capacitações pedagógicas analíticas, dinâmicas, criativas e conscientes, além da ausência de uma base teórica consolidada que respalde as ações do nutricionista no contexto.

This article aimed to delineate relevant conceptual aspects encompassed by a critical food and nutritional education. On this basis, it aims to provide a theoretical background to support food and nutrition interventions addressed to specific groups in primary health care. The study also reveals the challenges faced by the nutritionists when promoting healthy eating habits in PHC, as well as the nutritionist's role as an educator in all phases of food and nutrition interventions. Their actions should be based on pedagogical theories including health education concepts, dietary counselling, social psychology, food anthropology, and food and nutritional security. Among the challenges, the study pointed out the limitations of the professionals' training on an analytical, dynamic, creative, and critical pedagogy and the absence of a consolidated theoretical basis that would support the nutritionist's actions.

Este artículo busca trazar aspectos conceptuales de la educación alimentario nutricional crítica y, en base a dichos aspectos, presentar propuestas para realizar intervenciones en la alimentación y nutrición de grupos específicos de pacientes de atención primaria. Se exponen también los retos enfrentados por el nutricionista al promover prácticas alimentarias saludables. Se realiza una revisión bibliográfica crítica de referencias seleccionadas con miras a presentar conceptos actuales de la educación alimentario nutricional crítica, sin la pretensión de dar el tema por terminado. Se realza la importancia de la actuación del nutricionista como educador en todas las etapas de las intervenciones. Su labor debe basarse en teorías pedagógicas de la educación alimentario nutricional crítica que incluye, entre otros, conceptos de educación en salud, consejos dietéticos, de psicología grupal, de antropología de la alimentación y de seguridad alimentario nutricional. Entre los desafíos del profesional se destaca la fragilidad de su capacitación pedagógica analítica, dinámica, creativa y consciente, mas allá de la falta de una base teórica concreta que respalde las acciones del nutricionista en este contexto.

Malnutrition among children under 60 months of age in two cities of the state of Acre, Brazil: prevalence and associated factors.

OBJECTIVE: To investigate the prevalence of malnutrition and associated factors in children under the age of 60 months in two cities in the state of Acre, Brazil. METHODS: A population-based cross-sectional study was carried out with 667 children living in urban areas of the cities of Acrelândia and Assis Brasil. The prevalence of malnutrition was calculated by height for age (stunting) and weight for height (W/H) indexes, which were calculated with a cutoff point of -2 for Z scores as determined by the 2006 World Health Organization child growth standards. A structured questionnaire was used to gather information on socioeconomic conditions, access to services and child care, birth weight and morbidity. Poisson regression was used to identify the factors associated with child malnutrition. RESULTS: The prevalence of height-for-age and weight-for-height deficit was 9.9% and 4.1%, respectively. The factors associated with height-for-age deficit were low household wealth index (prevalence ratio [PR]: 1.74; 95% confidence interval [95% CI]: 0.95-3.18); having an illiterate father or stepfather (PR: 1.82; 95% CI: 1.01-3.27); having 2 or more younger siblings (PR: 2.88; 95% CI: 1.45-5.72); biological mother not living in the home (PR: 2.63; 95% CI: 1.32-5.24); and exposure to open wastewater near the home environment (PR: 2.46; 95% CI: 1.51-4.00). "Low weight at birth" was the only factor associated with weight-for-height deficit (PR: 2.91; CI95%: 1.16-7.24). CONCLUSIONS: In the cities studied, malnutrition in children under 60 months is an important public health problem, and is associated with indicators of social inequality, access to health services and biological mother not living in the home.

Desnutrição em crianças menores de 60 meses em dois municípios no Estado do Acre: prevalência e fatores associados / Malnutrition among children under 60 months of age in two cities of the state of Acre, Brazil: prevalence and associated factors

OBJETIVO: Investigar a prevalência da desnutrição e fatores associados em crianças menores de 60 meses em dois municípios do Estado do Acre. MÉTODOS: Estudo transversal de base populacional realizado com 667 crianças da área urbana dos municípios de Acrelândia e Assis Brasil. A prevalência da desnutrição foi calculada pelo padrão de crescimento da Organização Mundial da Saúde de 2006, com o ponto de corte -2 escores Z. Informações sobre condições socioeconômicas, acesso aos serviços e cuidado da criança, peso ao nascer e morbidade foram obtidas por questionário estruturado. A regressão de Poisson foi utilizada para identificar os fatores associados à desnutrição de crianças. RESULTADOS: A prevalência do déficit estatura para idade e déficit peso para estatura foi de 9,9 por cento e 4,1 por cento, respectivamente. Os fatores associados ao déficit estatura para idade foram o baixo índice de riqueza (razão de prevalência [RP]: 1,74; intervalo de confiança em 95 por cento [IC95 por cento]: 0,95 - 3,18), analfabetismo do pai ou padrasto (RP: 1,82; IC95 por cento: 1,01 - 3,27), ter 2 ou mais irmãos menores (RP: 2,88; IC95 por cento: 1,45 - 5,72), ausência da mãe biológica no domicílio (RP: 2,63; IC95 por cento: 1,32 - 5,24) e exposição ao esgoto a céu aberto no âmbito domiciliar (RP: 2,46; IC95 por cento: 1,51 - 4,00). Somente o baixo peso ao nascer mostrou-se como fator associado ao déficit peso para estatura (RP: 2,91; IC95 por cento: 1,16 - 7,24). CONCLUSÕES: Nos municípios estudados, a desnutrição em crianças menores de 60 meses apresenta-se como um importante problema de saúde pública, associado aos indicadores de iniquidades sociais, acesso aos serviços de saúde e ausência da mãe no domicílio.

OBJECTIVE: To investigate the prevalence of malnutrition and associated factors in children under the age of 60 months in two cities in the state of Acre, Brazil. METHODS: A population-based cross-sectional study was carried out with 667 children living in urban areas of the cities of Acrelândia and Assis Brasil. The prevalence of malnutrition was calculated by height for age (stunting) and weight for height (W/H) indexes, which were calculated with a cutoff point of -2 for Z scores as determined by the 2006 World Health Organization child growth standards. A structured questionnaire was used to gather information on socioeconomic conditions, access to services and child care, birth weight and morbidity. Poisson regression was used to identify the factors associated with child malnutrition. RESULTS: The prevalence of height-for-age and weight-for-height deficit was 9.9 percent and 4.1 percent, respectively. The factors associated with height-for-age deficit were low household wealth index (prevalence ratio [PR]: 1.74; 95 percent confidence interval [95 percent CI]: 0.95 - 3.18); having an illiterate father or stepfather (PR: 1.82; 95 percent CI: 1.01 - 3.27); having 2 or more younger siblings (PR: 2.88; 95 percent CI: 1.45 - 5.72); biological mother not living in the home (PR: 2.63; 95 percent CI: 1.32 - 5.24); and exposure to open wastewater near the home environment (PR: 2.46; 95 percent CI: 1.51 - 4.00). "Low weight at birth" was the only factor associated with weight-for-height deficit (PR: 2.91; CI95 percent: 1.16-7.24). CONCLUSIONS: In the cities studied, malnutrition in children under 60 months is an important public health problem, and is associated with indicators of social inequality, access to health services and biological mother not living in the home.

Bioelectrical impedance values among indigenous children and adolescents in Rio Grande do Sul, Brazil.

OBJECTIVE: To describe the nutritional status of indigenous children and adolescents in Rio Grande do Sul, Brazil, through bioelectrical values, and to compare the nutritional classifications of the anthropometric method to those of the body composition method. METHODS: A cross-sectional survey was conducted of 3 204 subjects at 35 schools in the 12 Kaingang indigenous lands of Rio Grande do Sul, Brazil. Following World Health Organization recommendations, the weight and height (H) of each subject was measured twice and the body mass index/age (BMI/A) was classified. Body composition was assessed by Bioelectrical Impedance Vector Analysis (BIVA). Resistance (R) and reactance (Xc) were estimated using a bioelectrical impedance analyzer. Divergences between these two methods were performed on RXc graph. RESULTS: Of the sample, 56.8% were adolescents and 50.6% were males. The mean values of phase angle were higher in adolescents, in males, and in individuals overweight by BMI/A. Mean values of R, Xc, R/H, and Xc/H were higher among children and among those with BMI/A < +2 z scores. Divergences in overweight classification were: male children, 94.6%; male adolescents, 77.1%; female children, 85.4%; and female adolescents, 94.8%. CONCLUSIONS: The mean values of bioelectrical measures observed among the Kaingang children and adolescent were similar to those found for different populations in other studies. For both gender and age groups, differences were observed between nutritional classifications by BMI/age and by BIVA. These results reinforce the importance of employing multiple techniques, such as anthropometry and BIVA, when conducting nutritional assessments of a population.