Validation of a web-based questionnaire to assess the dietary intake of Brazilian children aged 7-10 years.

BACKGROUND: The Food Intake and Physical Activity of School Children (CAAFE) comprises an online questionnaire to self-report diet and physical activity of Brazilian schoolchildren. BACKGROUND: The present study aimed to assess the validity (matches, omissions and intrusions) and moderating factors of the CAAFE. METHODS: Direct observation was made of foods consumed (five public schools) and child self-reporting on the CAAFE. Additional data included school grade, gender, body mass index, completion of food diary, socioeconomic status and access to computer. Data were analysed using regression. RESULTS: In total, 602 children participated in the study [mean (SD) age 9.5 (1.24) years; 53.6% boys]. On average, there were 43% matches, 29% intrusions and 28% omissions. Matches doubled in third grade compared to the second grade (P = 0.004); matches almost tripled for afternoon snack compared to morning snack (P < 0.001); and matches were 69% higher for children with access to a computer at home (P < 0.01). Intrusions decreased by almost one-half in fifth compared to fourth grades (P = 0.004). Omissions declined significantly in the third and fourth grades but increased in the fifth grade. Omissions were 47% lower for children in the highest income and lower among children who completed the food diary. No differences were found for gender or body mass index. CONCLUSIONS: Children older than 8 years old, who owned a computer and completed a food diary, performed better in the CAAFE. A high incidence of disagreement was found in relation to the schools and the type of meal. Overall matches (43%), intrusions (29%) and omissions (28%) indicate that further studies are required to improve the validity of the CAAFE.

Qualitative analysis of the contributions of nutritionists to the development of an online instrument for monitoring the food intake of schoolchildren.

BACKGROUND: The Consumo Alimentar e Atividade Fisica de Escolares (CAAFE) questionnaire is an online research tool that has been developed to enable the self-report of physical activity and diet by Brazilian schoolchildren aged 7-10 years. Formative research was conducted with nutritionists during the development of the web-based questionnaire. The suggestions and insights obtained were used to design a tool to monitor schoolchildren's food consumption based on the concept of healthy and unhealthy food indicators. The present study aimed to report the focus group discussions conducted with nutritionists concerning the CAAFE questionnaire. METHODS: Focus group discussions were conducted using a semi-structured questionnaire, and these were then analysed thematically. RESULTS: Twenty-four nutritionists participated (four focus groups; average per group: six people); the majority (n = 22) had experience with 7-10-year-old children. Four themes emerged: (i) healthy and unhealthy food indicators; (ii) suggestions for the online instrument; (iii) potential applications; and (iv) challenges for its construction. CONCLUSIONS: Comments made by nutritionists enabled the construction of an instrument that is able to answer questions related to food consumption in schools and at home.

Antioxidant biomarkers and food intake in elderly women.

OBJECTIVE: To investigate the relationship between antioxidant biomarkers and food intake in elderly women. DESIGN: Cross-sectional study. SETTING: Recreation Center for the Elderly in the city of Itajaí, Santa Catarina, Brazil. PARTICIPANTS: 73 elderly women with an average age of 71 years, 93% caucasian, average body weight 68.7 ± 13.1 kg and average BMI 28.5 ± 2.3 kg/m². MEASUREMENTS: Nutritional status was assessed based on the Body Mass Index (BMI). Data on food intake were obtained by applying the 24h diet recall method in three non-consecutive days, including Sunday. The assessment of antioxidant biomarkers was performed based on tests for total plasma thiols and phenolic compounds. The linear regression analysis was used to assess the effect of the consumption of food groups on antioxidant biomarkers. RESULTS: A positive association was found between thiols and intake of carotenoid-rich vegetables (p=0.03), oils, fats and oilseeds (p=0.03); a negative association was observed between total concentrations of phenolic compounds and intake of cereals (p=0.04). CONCLUSION: The intake of foods from the carotenoid-rich vegetables, oils, fats and oilseeds food groups increased the levels of plasma thiols, and the intake of foods from the group of cereals decreased the plasma concentration of phenols. Studies should be conducted to investigate the association between the intake of antioxidant-rich foods and the plasma antioxidant profile, as a way to protect against the aging process.

Test-retest reliability and external validity of the previous day food questionnaire for 7-10-year-old school children.

The aim of this study was to assess the reliability and external validity of the Previous Day Food Questionnaire (PDFQ) designed to obtain a report of the foods eaten on the previous day by schoolchildren. Participants were 7-10-year-old school children of the first four grades of a public school in Southern Brazil (N=227). Test-retest reliability was evaluated by kappa coefficient for two administrations of the PDFQ on the same day to the same children. External validity of the PDFQ was evaluated via sensitivity, specificity, and positive and negative predictive values (PPV and NPV, respectively) using trained observers of the food eaten on the previous day as gold standard. The association between responses from observed food intake with those from reported food intake on PDFQ was evaluated by multivariate logistic regression, controlled for school grade, gender, time of the eating, and the variation between first and second PDFQ applications. For the reliability study, the analyses stratified by school eating occasions (3 a day) indicated that agreement level was moderate or better for all food categories. PDFQ's sensitivity ranged from 57.1% (vegetables) to 93.3% (rice), whereas its specificity ranged from 77.8% (bread/pasta) to 98% (meats). Both, PPV and NPV were reasonably high. PDFQ was highly associated with observed food intake, with effect magnitude several times larger than any other factor analyzed for all foods. PDFQ also showed good test-retest reliability, suggesting that it may generate reliable and valid data for assessing food intake at the group (school) level.

Motivational effects of 12-week moderately restrictive diets with or without special attention to the Glycaemic Index of foods.

Low glycaemic index (GI) diets may facilitate weight loss via behavioural and/or endocrine mechanisms. This study investigated whether the outcomes of the Weight Watchers POINTS Weight-Loss System could be improved by encouraging dieters to select low GI, high-carbohydrate foods. Ninety-six women (age 20-72 years; BMI 25-40 kg/m2) were recruited as they started the Weight Watchers POINTS programme for 12 weeks. Weekly classes were randomized so that seven (forty-five women) followed the regular programme while seven others (fifty-one women) followed a revised programme encouraging the selection of low GI foods. Anthropometric and biochemical parameters were measured before and after the 12-week diets. Participants rated hunger and desire to eat using visual analogue scales on 1 d per week, several times per d. Attrition was the same in both groups (32 v. 30 %), as well as many benefits (5 % weight loss, decreases in insulinaemia and blood lipids, waist and hip circumferences, blood pressure). Hunger and desire to eat were rated consistently lower in the low GI group over the 12-week diet. Group differences in subjective sensations were especially large in the afternoon. The 12-week weight management yielded many significant anthropometric and biochemical benefits that were not improved by encouraging dieters to select low GI foods. The subjective benefits (lower hunger and desire to eat) of the low GI diet may be a worthwhile contribution to the motivation of dieters that might affect adherence to the diet over the long term.

Central adiposity in Brazilian schoolchildren aged 7-10 years.

Waist circumference (WC) is a measure of central adiposity related to elevated risk factor levels in children and adolescents. The aim of the present study was to describe WC percentiles in 7- to 10-year-old Brazilian children and to compare frequencies of obesity and overweight as defined by BMI and frequencies of excess and at risk of abdominal adiposity as defined by WC to the corresponding age and sex data from British references. A representative sample of 2919 schoolchildren of the city of Florianopolis (southern Brazil) was examined. Smoothed WC percentiles were derived using the least mean square method. Frequencies of overweight and obesity and of excess and at risk of abdominal adiposity were assessed using the 91st and 98th centiles of the British references as cut-off points. WC increased with age in both boys and girls, with higher values for boys at every age and percentile level. Nutritional status categories of children assessed by the 91st and 98th British BMI and WC centiles showed moderate agreement (weighted kappa = 0.58). Overweight was more frequent in Brazilian than British children: 15.1 % of girls and 20.1 % of boys were above the 91st percentile of the 1990 BMI for age British references. About one-quarter (22.0 % of girls and 26.9 % of boys) exceeded the 91st percentile of WC British references. The present data could be used to compare WC in children in other populations and may serve as a baseline for future studies of temporal trends in WC in Brazil.

Obesity, overweight and thinness in schoolchildren of the city of Florianópolis, Southern Brazil.

OBJECTIVE: To assess the prevalence of obesity, overweight (including obesity) and thinness in children of the city of Florianopolis (southern Brazil). DESIGN: Cross-sectional study. SUBJECTS: Representative sample of 7-10-y-old schoolchildren of the first four grades of elementary schools (1432 girls, 1504 boys). METHODS: Measurements of weight, height and triceps skinfold thickness (TSF) were taken following standard techniques. The body mass index (BMI) was computed as weight/height2. Nutritional status was defined using two references: (1) the Must et al reference for BMI and TSF to define thinness, overweight and obesity (5th, 85th and 95th percentiles, respectively); (2) the International Obesity Task Force (IOTF) BMI cutoffs to define overweight and obesity. RESULTS: Using BMI, according to the Must et al, and IOTF references, the prevalence of obesity was 10.6 and 5.5%, respectively; overweight (including obesity) affected 26.2 and 22.1% of children, respectively. According to the Must et al reference, the prevalence of thinness was 3.2%. Using TSF rather than BMI, according to the Must et al references, fewer children were classified as obese (8.0%) or overweight (20.2%) and more children were classified as thin (4.9%). CONCLUSION: This study supports the previously reported high frequencies of childhood overweight and obesity in developing countries. The data allow comparisons with other studies carried out in Brazil and other parts of the world.

Meals, snacks and food choices in Brazilian shift workers with high energy expenditure.

OBJECTIVE: To describe the food intake of garbage collectors, who works in three shifts, in terms of meal and snack frequency, content, time distribution and the contribution of various popular foods to the total diet. METHODS: Sixty-six Brazilian garbage collectors, who work in morning, afternoon, and night shift, participated in the present study. The quantitative methods used were a combination of one 24-h recall and two 24-h records during three nonconsecutive work days. The qualitative method used was the food-based classification of eating episodes model modified in order to define meals or snacks in three categories of events: meals with three food groups of high nutrient density (three HND meals), meals with two food groups of high nutrient density (two HND meals) and snacks, composed of only one food category of high nutrient density. RESULTS: The total number of eating events per day was significantly higher for night shift workers. Over 24-h, 'two HND meals' were the most common events and contributed the most energy, in all three shifts. Night shift workers ate more at dawn and less in the morning than other shifts. In all three shifts, meat was the most important food contributing to energy intake. CONCLUSION: Different work schedules did not affect the relative frequency of meal types and snacks or their contribution to daily energy intake, but affected the daily distribution of eating events, with a redistribution of intake from day to night in night shift workers.

Use of 'light' foods and drinks in French adults: biological, anthropometric and nutritional correlates.

BACKGROUND: A population of over 12,000 mature subjects participated in a longitudinal study (8 years) of nutrition and health (the Su.Vi.Max Study). In this context, a specific cross-sectional study was carried out in a randomly selected subpopulation. AIM: To identify anthropometric, nutritional and biochemical correlates of spontaneous use of 'light' foods and drinks in a free-living population. DESIGN: Men (n = 2299) and women (n = 1979), 45-60 years, reported their food intakes over six non-consecutive days. Consumers of low-fat and low-sugar foods and drinks, and artificial sweeteners, were compared with non-consumers. RESULTS: Users of low-sugar products were heavier than non-users; female consumers of low-fat products, but not males, had higher body weight and BMI than non-consumers. Users of low-sugar products had higher triacylglycerols and glycaemia than non-users while biochemical parameters were not different in users and non-users of low-fat products. Use of low-sugar products led to increased diet density of a few micronutrients, including cholesterol. Low-fat product selection was associated with increased intake of most micronutrients, both in absolute value and in density. CONCLUSIONS: In mature adults, selection of fat-reduced products was associated with improved quality of the diet, while anthropometric and biological parameters appeared less favourable in consumers of low-sugar products vs. non-consumers. The longitudinal follow-up of the cohort in future years will help determine cause-and-effect relationships among these parameters.

Incidence of Listeria spp. and Salmonella spp. in horsemeat for human consumption.

The incidence of Salmonella spp., Listeria spp. and Listeria monocytogenes in horsemeat for human consumption was investigated. One-hundred and twenty-one samples of frozen horsemeat collected from two Brazilian abattoirs were analysed over a period of 1 year. Twenty-two samples (18.2%) were positive for Listeria spp. with nine (7.4%) containing L. monocytogenes. None of the samples harbored Salmonella spp.

[Planning of a human milk bank and information center on breast feeding]. / Planejamento de banco de leite humano e central de informações sobre aleitamento materno.

PIP: The planning of activities and the layout of the Human Milk Bank and Information Center on Breastfeeding of the Carmela Dutra Maternity Hospital of the Santa Catarina Hospital Foundation (Brazil) are presented. The implantation of this service seeks to attend to the necessities of babies under treatment in Intensive Care Units of the Maternity and other children's hospitals in this Foundation. Besides collecting, analyzing, sorting, and processing adequately the milk donated by volunteer wet nurses, educational and promotional activities related to breast feeding are carried out in the community and among health professionals. (author's modified)^ieng