Food and nutritional education in rural quilombola communities in Rio Grande do Sul, Brazil: methodological aspects / Educação alimentar e nutricional em comunidades quilombolas rurais do Rio Grande do Sul, Brasil: aspectos metodológicos

Background: The construction of programs to promote healthy eating should be guided by the culture and living conditions of people. Objective: To describe the methodology for a community intervention in food and nutritional education (FNE) carried out in rural quilombola communities (QC) in Rio Grande do Sul. Methods: Two communities were included. The FNE actions consisted of six workshops with a focus on the concepts of food culture, adequate and healthy food, and health promotion, focusing on food rather than nutrients. The actions were planned from the production of strategies that could be replicated by the participants to the other residents. Results: The workshops were attended by people of various ages and the participation of women was more expressive. Each workshop had specific objectives and different dynamics employed. Conclusion: This approach sought to emphasize the experiences, culture, and opinions of the people residing in the QC included in the study. It is hoped that this FNE community intervention can guide and subsidize the planning and execution of similar initiatives in other QCs in Rio Grande do Sul or even the country.

Introdução: A construção de programas de promoção da alimentação saudável deve ser pautada sobre a cultura e as condições de vida das pessoas. Objetivo: Descrever a metodologia para uma intervenção comunitária de educação alimentar e nutricional (EAN) realizada em comunidades quilombolas (CQ) rurais do Rio Grande do Sul. Métodos: Foram incluídas duas comunidades. As ações de EAN consistiram na realização de seis oficinas com abordagem pautada nos conceitos de cultura alimentar, alimentação adequada e saudável e promoção da saúde, com foco em alimentos e comida ao invés de nutrientes. As ações foram planejadas a partir da produção de estratégias que pudessem ser replicadas pelos participantes aos outros moradores. Resultados: Participaram das oficinas pessoas de várias idades e a participação das mulheres foi mais expressiva. Cada oficina teve objetivos específicos e diferentes dinâmicas empregadas. Conclusão: Essa abordagem buscou enfatizar as experiências, a cultura e as opiniões das pessoas que residem nas CQ incluídas no estudo. Espera-se que essa intervenção comunitária de EAN possa nortear e subsidiar o planejamento e execução de iniciativas similares em outras CQ do estado ou até mesmo do país.

[Self-reported prevalence of hypertension and associated factors in quilombola communities in the State of Rio Grande do Sul, Brazil]. / Prevalência autorreferida de hipertensão e fatores associados em comunidades quilombolas do Rio Grande do Sul, Brasil.

The study sought to identify the prevalence of arterial hypertension (AH) and possible associated factors in adults residing in quilombola communities in the State of Rio Grande do Sul (RS). A transversal population-based study, carried out in 2011, included 589 adult households in quilombola communities in the State of RS, by sampling proportional to the size. The outcome was obtained by the question: "Has a doctor ever told you that you have hypertension?" Poisson regression with robust variance and hierarchical input variables were used. Finally, the population attributable fractions per component (PAFC) were calculated for modifiable factors associated to AH. The self-reported prevalence of AH was 38.3% (CI95% 31.4%-45.1%). Adjusted analysis revealed an association of the outcome with age group, education, excessive alcohol consumption, waist circumference and the presence of diabetes. PAFC analysis revealed that if the individuals had greater schooling, the prevalence of AH would be reduced. Given the high prevalence of AH and the extreme social vulnerability of this population, public policies that guarantee their access to fundamental rights (health, income and schooling) could have a significant impact in reducing this outcome.

Este estudo teve como objetivo identificar a prevalência e fatores associados à hipertensão arterial (HA) em adultos quilombolas do Rio Grande do Sul (RS). Trata-se de um estudo transversal de base populacional, realizado em 2011, com 589 adultos responsáveis por domicílios e amostragem proporcional ao tamanho. O desfecho foi obtido com a pergunta: "Algum médico já lhe disse que você tem hipertensão?". Foi empregada regressão de Poisson, com variância robusta e entrada hierarquizada das variáveis. Por fim, foram calculadas as frações atribuíveis populacionais por componente (FAPC) para fatores modificáveis associados à HA. A prevalência autorreferida de HA foi de 38,3% (IC95% 31,4%-45,1%). A análise ajustada revelou associação do desfecho com faixa etária, escolaridade, consumo excessivo de álcool, circunferência da cintura acima do adequado e presença de diabetes. A análise dos FAPC revelou que, se os indivíduos tivessem maior escolaridade, a prevalência de HA seria reduzida. Diante da elevada prevalência de HA e da extrema vulnerabilidade social dessa população, políticas públicas que garantam seu acesso a direitos fundamentais (saúde, renda e escolaridade) poderiam ter impacto importante na diminuição desse desfecho.

Prevalência autorreferida de hipertensão e fatores associados em comunidades quilombolas do Rio Grande do Sul, Brasil / Self-reported prevalence of hypertension and associated factors in quilombola communities in the State of Rio Grande do Sul, Brazil

Resumo Este estudo teve como objetivo identificar a prevalência e fatores associados à hipertensão arterial (HA) em adultos quilombolas do Rio Grande do Sul (RS). Trata-se de um estudo transversal de base populacional, realizado em 2011, com 589 adultos responsáveis por domicílios e amostragem proporcional ao tamanho. O desfecho foi obtido com a pergunta: "Algum médico já lhe disse que você tem hipertensão?". Foi empregada regressão de Poisson, com variância robusta e entrada hierarquizada das variáveis. Por fim, foram calculadas as frações atribuíveis populacionais por componente (FAPC) para fatores modificáveis associados à HA. A prevalência autorreferida de HA foi de 38,3% (IC95% 31,4%-45,1%). A análise ajustada revelou associação do desfecho com faixa etária, escolaridade, consumo excessivo de álcool, circunferência da cintura acima do adequado e presença de diabetes. A análise dos FAPC revelou que, se os indivíduos tivessem maior escolaridade, a prevalência de HA seria reduzida. Diante da elevada prevalência de HA e da extrema vulnerabilidade social dessa população, políticas públicas que garantam seu acesso a direitos fundamentais (saúde, renda e escolaridade) poderiam ter impacto importante na diminuição desse desfecho.

Abstract The study sought to identify the prevalence of arterial hypertension (AH) and possible associated factors in adults residing in quilombola communities in the State of Rio Grande do Sul (RS). A transversal population-based study, carried out in 2011, included 589 adult households in quilombola communities in the State of RS, by sampling proportional to the size. The outcome was obtained by the question: "Has a doctor ever told you that you have hypertension?" Poisson regression with robust variance and hierarchical input variables were used. Finally, the population attributable fractions per component (PAFC) were calculated for modifiable factors associated to AH. The self-reported prevalence of AH was 38.3% (CI95% 31.4%-45.1%). Adjusted analysis revealed an association of the outcome with age group, education, excessive alcohol consumption, waist circumference and the presence of diabetes. PAFC analysis revealed that if the individuals had greater schooling, the prevalence of AH would be reduced. Given the high prevalence of AH and the extreme social vulnerability of this population, public policies that guarantee their access to fundamental rights (health, income and schooling) could have a significant impact in reducing this outcome.

Prevalence and factors associated with exposure to sunlight and sunscreen among physical education teachers in Pelotas, southern Brazil

Abstract: Background: Decreasing the time of exposure to the sun and increasing sunscreen use are important actions to prevent skin cancer. Objective: This study aimed to verify the prevalence of exposure to the sun and the use of sunscreen, as well as associated factors among physical education teachers of the basic education network from city of Pelotas, southern Brazil. Methods: A census type study was conducted with physical education teachers of the basic education network from Pelotas. This study assessed the time of exposure to the sun in the workplace for at least 20 min, between 10am and 4pm, and the use of sunscreen during the workday. Results: 188 teachers answered the questionnaire. The prevalence of exposure to the sun between 10:00am and 4:00pm was 89.2% (95% CI of 83.8% -93.3%), while sunscreen use was 63.3% (95% CI of 56.0% -70.2%). However, when the sample was stratified by sex, women reported a higher rate of sunscreen use (78.5% -95% CI of 72.2-84.3) than men (38.9% -95% CI of 31.8-46.2) (p<0.001). Teachers with longer work weeks were at greater risk of exposure to the sun. In addition, women, with normal weight and who worked less hours, were more likely to use sunscreen. Study limitations: Cross-sectional study and lack of information on the proper use and frequency of use of sunscreen. Conclusion: Physical education teachers were highly exposed to solar radiation, and less than two-thirds used sunscreen during the workday. Interventions with this professional group are necessary to reduce the risk of skin cancer.

Oral health self-perception in quilombola communities in Rio Grande do Sul: a cross-sectional exploratory study. / Autopercepção de saúde bucal em comunidades quilombolas no Rio Grande do Sul: um estudo transversal exploratório.

OBJECTIVE:: There's a shortage of evidence on the oral health of quilombolas. This study aims to describe oral health self-perception, as well as to verify its associated factors in quilombola communities in the state of Rio Grande do Sul. METHODS:: The data for this cross-sectional health survey were collected by application of a questionnaire. Since this study was part of a survey on nutritional security, the probabilistic cluster sample was estimated for the outcome of nutritional insecurity, comprising 583 individuals across quilombola communities in Rio Grande do Sul. The association between the outcome of negative oral health self-perception and sociodemographic, general health, and oral health variables was measured by prevalence ratios obtained through Poisson regressions with robust variance and 95% confidence intervals. RESULTS:: Negative self-rated oral health was reported by 313 (53.1%) of the individuals. Satisfaction with chewing ability and satisfaction with oral appearance were associated with a higher prevalence of negative perception of oral health, while there was no association between the outcome and number of teeth. Use of alcohol had a borderline association with the outcome. CONCLUSION:: Satisfaction with appearance and chewing ability are factors associated with oral-health self-perception of the quilombolas in Rio Grande do Sul.

Autopercepção de saúde bucal em comunidades quilombolas no Rio Grande do Sul: um estudo transversal exploratório / Oral health self-perception in quilombola communities in Rio Grande do Sul: a cross-sectional exploratory study

RESUMO: Objetivo: Há escassez de literatura sobre a saúde bucal dos quilombolas. O presente estudo procurou descrever a autopercepção de saúde bucal, bem como verificar fatores a ela associados em comunidades quilombolas no Estado do Rio Grande do Sul. Métodos: Os dados para este estudo transversal foram coletados por meio da aplicação de um questionário. Posto que o estudo fez parte de um levantamento sobre segurança alimentar, a amostra probabilística por conglomerado foi estimada para o desfecho de insegurança alimentar, consistindo de 583 indivíduos de comunidades quilombolas no Rio Grande do Sul. A associação entre o desfecho de autopercepção de saúde bucal negativa e variáveis sociodemográficas, de saúde geral e bucal foi aferida por intermédio de razões de prevalência obtidas por meio de regressão de Poisson com variância robusta, com intervalo de confiança de 95% (IC95%). Resultados: Autopercepção negativa de saúde bucal foi reportada por 313 (53,1%) indivíduos. Satisfação com mastigação e com aparência bucal esteve relacionada com maior prevalência de percepção negativa de saúde bucal, não havendo associação entre o número de dentes e o desfecho. Uso de álcool teve uma associação fraca com o desfecho. Conclusão: Satisfação com aparência e mastigação é fator associado com autopercepção de saúde bucal dos quilombolas no Rio Grande do Sul.

ABSTRACT: Objective: There’s a shortage of evidence on the oral health of quilombolas. This study aims to describe oral health self-perception, as well as to verify its associated factors in quilombola communities in the state of Rio Grande do Sul. Methods: The data for this cross-sectional health survey were collected by application of a questionnaire. Since this study was part of a survey on nutritional security, the probabilistic cluster sample was estimated for the outcome of nutritional insecurity, comprising 583 individuals across quilombola communities in Rio Grande do Sul. The association between the outcome of negative oral health self-perception and sociodemographic, general health, and oral health variables was measured by prevalence ratios obtained through Poisson regressions with robust variance and 95% confidence intervals. Results: Negative self-rated oral health was reported by 313 (53.1%) of the individuals. Satisfaction with chewing ability and satisfaction with oral appearance were associated with a higher prevalence of negative perception of oral health, while there was no association between the outcome and number of teeth. Use of alcohol had a borderline association with the outcome. Conclusion: Satisfaction with appearance and chewing ability are factors associated with oral-health self-perception of the quilombolas in Rio Grande do Sul.

Prevalence and factors associated with exposure to sunlight and sunscreen among physical education teachers in Pelotas, southern Brazil.

BACKGROUND: Decreasing the time of exposure to the sun and increasing sunscreen use are important actions to prevent skin cancer. OBJECTIVE: This study aimed to verify the prevalence of exposure to the sun and the use of sunscreen, as well as associated factors among physical education teachers of the basic education network from city of Pelotas, southern Brazil. METHODS: A census type study was conducted with physical education teachers of the basic education network from Pelotas. This study assessed the time of exposure to the sun in the workplace for at least 20 min, between 10am and 4pm, and the use of sunscreen during the workday. RESULTS: 188 teachers answered the questionnaire. The prevalence of exposure to the sun between 10:00am and 4:00pm was 89.2% (95% CI of 83.8% -93.3%), while sunscreen use was 63.3% (95% CI of 56.0% -70.2%). However, when the sample was stratified by sex, women reported a higher rate of sunscreen use (78.5% -95% CI of 72.2-84.3) than men (38.9% -95% CI of 31.8-46.2) (p<0.001). Teachers with longer work weeks were at greater risk of exposure to the sun. In addition, women, with normal weight and who worked less hours, were more likely to use sunscreen. STUDY LIMITATIONS: Cross-sectional study and lack of information on the proper use and frequency of use of sunscreen. CONCLUSION: Physical education teachers were highly exposed to solar radiation, and less than two-thirds used sunscreen during the workday. Interventions with this professional group are necessary to reduce the risk of skin cancer.

Gender differences in the prevalence of household food insecurity: a systematic review and meta-analysis.

OBJECTIVE: The present review aimed to identify and synthesize literature on household food insecurity with respect to whether the respondent was male or female. DESIGN: A systematic review of prevalence studies followed by a meta-analysis was conducted between 28 August 2014 and 19 October 2014 in seven electronic databases. The search was updated in April 2016. The included studies used experience-based measures to assess household food insecurity. Dichotomous measures of food insecurity were used. Pooled odds ratios of household food insecurity prevalence in women v. men were obtained through random-effect modelling. Quality assessment, publication bias diagnostics and subgroup analysis were also performed. SETTING: Population-based studies (i.e. non-clinical populations). SUBJECTS: Participants aged 18 years or over. RESULTS: Out of the 5145 articles initially identified, forty-two studies with a total population of 233 153 were included. In general, results showed that the odds for household food insecurity was 40 % higher in studies where women were the respondent (95 % CI 1·27, 1·54; P<0·001). Besides, subgroup analysis revealed that female-headed households were 75% (95 % CI 49-96%) more likely to be food insecure than male-headed households. CONCLUSIONS: Our results confirm the existence of gender differences in reporting household food insecurity. Furthermore, they indicate that households headed by women constitute a segment of the population that is particularly vulnerable to food insecurity.

The teaching of the association between physical inactivity and noncommunicable diseases in physical education classes / Ensino da associação entre inatividade física e doenças e agravos não-transmissíveis nas aulas de Educação Física

The study was conducted with physical education teachers from elementary and high schools in the urban area of Pelotas, southern Brazil, and identified the prevalence of those who taught the association of physical inactivity (PI) with non-communicable diseases (NCDs) during their classes. In addition, the moment when the content was discussed in the class and the length of time used for that purpose were investigated. We used a standardized questionnaire containing questions about the relationship between PI and NCDs, as well as information on demographic and socioeconomic aspects, career time, weekly labor hours and physical activity level. Overall, 188 teachers answered the census. Despite the high percentage of teachers who reported teaching at least one association between PI and NCDs (82.8%), obesity being the disease most frequently mentioned (84.7%), only 17.3% taught the association with cancer, 33% with osteoporosis and 11% of the teachers reported teaching the associations with all NCDs. As for obesity, the youngest age group (19-30 years) was the one that taught this association least frequently (p <0.001), with a reduction as their workload increased (p <0.03). A similar trend was observed regarding teaching the associations in the main part of the class (p <0.02) and the time devoted to teaching them in the main part of the class (p <0.006). Despite the high proportion of teachers who approached the associations between PI and NCDs during physical education classes, only the most disseminated associations by the media were taught by most teachers and by teachers with lower workloads. Health-related training activities should be offered to teachers, so that classes can include other contents beyond sports.

O estudo identificou a prevalência, entre os docentes de Educação Física do ensino básico da zona urbana de Pelotas/RS, aqueles que relacionavam a inatividade física (IF) com doenças e agravos não transmissíveis (DANTs) durante as aulas; além disto, foi verificado o momento da aula utilizado e o tempo destinado ao conteúdo. Utilizou-se um questionário padronizado contendo questões sobre a relação entre IF e DANTs, informações sobre aspectos demográficos, socioeconômicos, tempo de carreira, horas de trabalho semanais e nível de atividade física. Responderam ao censo 188 docentes. Apesar do elevado percentual de professores que relataram ensinar pelo menos uma associação entre IF e DANTs (82,8%), sendo a obesidade (84,7%) a doença mais relacionada, somente 17,3% ensinavam a relação com câncer, 33% abordavam a associação com osteoporose e 11% dos docentes relataram ensinar as associações com todas as DANTs. Em relação a obesidade, a faixa etária mais jovem (19-30 anos) era a que menos ensina sobre a associação (p<0,001) e houve tendência de reduzir o ensino desta associação à medida que aumentava a carga horária do docente (p<0,03). Tendência similar ocorreu com o ensino das associações na parte principal da aula (p<0,02) e com o tempo destinado ao ensino na parte principal (p<0,006). Concluiu-se que apenas as associações mais difundidas na mídia foram ensinadas pela maioria dos docentes e por docentes com menor carga horária. Ações de capacitação devem ser oferecidas aos professores para questões relacionadas à saúde, de modo que as aulas possam ser ministradas para além do esporte.

FFQ for the adult population of the capital of Ecuador (FFQ-Quito): development, reliability and validity.

OBJECTIVE: To assess the reliability and validity of a semi-quantitative FFQ designed to evaluate the usual nutrient intake of adults in Quito, Ecuador. DESIGN: Dietary data using 24 h recalls (24hR) were used to design a list of commonly consumed foods. The relative validity of a 111-item FFQ was evaluated by comparing nutrient intakes against three non-consecutive 24hR. All nutrients were energy-adjusted. Reliability was assessed using two FFQ (FFQ1 and FFQ2) and assessed by the intra-class correlation coefficient. The comparisons between the FFQ and the 24hR were assessed by the de-attenuated Pearson correlation coefficient, weighted kappa and by Bland-Altman plots. SETTING: Quito, Ecuador. SUBJECTS: Overall, 345 adults were enrolled in the present study. Two hundred and fifty participated in FFQ development and ninety-five participated in the FFQ validity and reliability. RESULTS: The FFQ produced higher energy and nutrient intakes. Reliability correlation coefficients after adjusting for energy ranged from 0·62 to 0·88 for protein and Ca, respectively. For the validity study, energy-adjusted and de-attenuated correlation coefficients between the questionnaire and the 24hR ranged from 0·21 for fat to 0·65 for Ca. Only 4 % of the participants were grossly misclassified and 46 % had weighted kappa higher than 0·42. The Bland-Altman plot showed a constant bias with a tendency to increase according to the intake level. CONCLUSIONS: The FFQ showed reasonably good relative validity and reliable measurements, especially for nutrients considered protective and risk markers of non-communicable disease, and can be used to assess usual nutrient intake in this population.

Dietary patterns and hypertension: a population-based study with women from Southern Brazil.

This study investigated the association between dietary pattern and hypertension using the rank reduced regression (RRR). It was a cross-sectional population-based study with a representative sample of 1,026 women living in the city of São Leopoldo, Rio Grande do Sul State, Brazil. In order to identify dietary patterns, dietary variables from a dietary frequency questionnaire were used as predictors and sodium, potassium and saturated fat consumption were selected as response variables. The RRR identified three dietary patterns: Factor 1, Factor 2 and Factor 3. The association between hypertension and factors 1, 2 and 3, after adjustment for socio-demographic, behavioral and obesity variables, was not significant. After stratification by age, the association between hypertension and factor 2 was present in 40-60 year-old women (tertile 2 compared to 3 RP = 0.62, 95%CI: 0.43-0.91; p = 0,05). The new statistical method (RRR), proved to be a useful tool for identifying dietary patterns. In this study, healthier dietary pattern was directly associated with hypertension in women between 40 and 60 years of age.

[Utilization and coverage of a Food and Nutritional Surveillance System in Rio Grande do Sul state, Brazil]. / Utilização e cobertura do Sistema de Vigilância Alimentar e Nutricional no Estado do Rio Grande do Sul, Brasil.

This article seeks to describe the utilization and coverage percentage of the Nutritional and Food Surveillance System (SISVAN-Web) in the Regional Health Offices of Rio Grande do Sul in 2010 and to assess its correlation with socio-economic, demographic and health system organization variables at the time. It is an ecological study that used secondary data from the SISVAN-Web, the Department of Primary Health Care, the IT Department of the Unified Health System and the Brazilian Institute of Geography and Statistics. The evaluation of utilization and coverage data was restricted to nutritional status. The percentage of utilization of SISVAN-Web refers to the number of cities that fed the system. Total coverage was defined as the percentage of individuals in all stages of the life cycle monitored by SISVAN-Web. It was found that 324 cities fed the application, corresponding to a utilization percentage of 65.3%. Greater system coverage was observed in all Regional Health Coordination (RHC) Units for ages 0 to 5 years and 5-10 years. There was a significant association between the percentage of utilization of SISVAN-Web and Family Health Strategy coverage in each RHC Unit. The results of this study indicated low percentages of utilization and coverage of SISVAN-Web in Rio Grande do Sul.

[Factors associated with the consumption of high-fat foods among adults in a Southern Brazilian city]. / Fatores associados ao consumo de dietas ricas em gordura em adultos de uma cidade no sul do Brasil.

The scope of this study was to describe the frequency of consumption of high-fat foods among adults aged 20 to 69 years and to identify associated factors. A population-based cross-sectional study was conducted with 972 adults in Pelotas, Southern Brazil. The consumption of high-fat foods in the previous twelve months was evaluated using the Block questionnaire comprising fifteen food items scored according to the frequency of consumption of high-fat foods. Approximately one in every three adults (32.7%) reported the regular consumption of high-fat diets. Among individuals of both sexes, the regular consumption of fat was associated with younger ages and the regular intake of non-diet soft drinks, and only for men, to the A/B economic levels. The conclusion reached is that the consumption of high-fat food among adults is above current Ministry of Health recommendations. Interventions aimed at stimulating healthy diets are urgently needed.

[Frequency of adherence to the "10 Steps to Healthy Eating" among school-aged adolescents]. / Frequência de adesão aos "10 Passos para uma Alimentação Saudável" em escolares adolescentes.

The scope of this study was to evaluate the frequency of adherence to "10 Steps to Healthy Eating" of the Ministry of Health in adolescents from high schools in Pelotas in the state of Rio Grande do Sul, Brazil. A school-based cross-sectional study was conducted, including 1233 adolescents (13-19 years of age). The frequency of each step was evaluated through a questionnaire on food frequency and other issues included in the "10 Steps." The average number of steps achieved was 1.8. It is noteworthy that none of the subjects achieved entirely all the recommended steps. The highest frequency of compliance was found in step 4, referring to the consumption of the rice and beans. Lower frequencies of adherence were found for step 7, related to consumption of soft drinks, processed juices, sweets and snacks, and also step 3 on the consumption of fruit/vegetables/greens. Adherence to the "10 steps to Healthy Eating" by adolescents was very low. Considering the importance of healthy eating in adolescence, greater investment in public policies in the area of food and nutrition is strongly recommended.

Dietary patterns and hypertension: a population-based study with women from Southern Brazil / Padrões alimentares e hipertensão arterial: um estudo de base populacional com mulheres do Sul do Brasil / Patrón alimentario e hipertensión: un estudio basado en la población de mujeres del sur de Brasil

This study investigated the association between dietary pattern and hypertension using the rank reduced regression (RRR). It was a cross-sectional population-based study with a representative sample of 1,026 women living in the city of São Leopoldo, Rio Grande do Sul State, Brazil. In order to identify dietary patterns, dietary variables from a dietary frequency questionnaire were used as predictors and sodium, potassium and saturated fat consumption were selected as response variables. The RRR identified three dietary patterns: Factor 1, Factor 2 and Factor 3. The association between hypertension and factors 1, 2 and 3, after adjustment for socio-demographic, behavioral and obesity variables, was not significant. After stratification by age, the association between hypertension and factor 2 was present in 40-60 year-old women (tertile 2 compared to 3 RP = 0.62, 95%CI: 0.43-0.91; p = 0,05). The new statistical method (RRR), proved to be a useful tool for identifying dietary patterns. In this study, healthier dietary pattern was directly associated with hypertension in women between 40 and 60 years of age.

O estudo investigou a associação entre os padrões alimentares, obtidos usando-se a regressão de posto reduzido (RRR), e hipertensão arterial. Foi um estudo transversal de base populacional com 1.026 mulheres residentes na cidade de São Leopoldo, Rio Grande do Sul, Brasil. Para a identificação dos padrões alimentares foram utilizadas como preditores as variáveis alimentares de um questionário de frequência alimentar e como variáveis respostas o consumo de sódio, potássio e gordura. Foram identificados três padrões alimentares: o Fator 1, o Fator 2, e o Fator 3. Em uma análise ajustada para fatores sociodemográficos, comportamentais e obesidade não houve associação entre a hipertensão e os padrões alimentares. Em uma análise estratificada para idade, houve associação entre hipertensão e o Fator 2 nas mulheres com 40 anos ou mais (tercil 2 comparado ao 3 RP = 0.62; IC95%: 0.43-0.91; p = 0,050). O método estatístico (RRR), mostrou-se uma ferramenta útil para a identificação de padrões alimentares. Neste estudo, o padrão alimentar saudável esteve diretamente associado à hipertensão nas mulheres entre 40 e 60 anos.

El estudio investigó la asociación entre los hábitos alimentarios, obtenidos por la regresión con rango reducido (RRR) y la hipertensión. Fue un corte transversal de 1.026 mujeres, basado en la población que vive en São Leopoldo, Río Grande do Sul, Brasil. Para identificar los hábitos alimentarios se utilizó como predictor de variables de la dieta un cuestionario de frecuencia alimentaria y las variables de respuesta fueron: consumo de potasio, sodio y grasa. Se identificaron tres patrones alimenticios: Factor 1; Factor 2 y Factor 3. En un análisis ajustado sociodemográfico, de conducta y obesidad no hay asociación entre la hipertensión y los hábitos alimentarios. En un análisis estratificado por edad, se observó una asociación entre la hipertensión y el Factor 2 en las mujeres de 40 años o más (tercil 2, en comparación con el 3 RP = 0,62, IC95%: 0,43-0,91; p = 0,05). El método estadístico (RRR) fue una herramienta útil para la identificación de los patrones dietéticos. En este estudio, el patrón de dieta saludable está directamente asociado con la hipertensión en las mujeres entre 40 y 60 años.

Fatores associados ao consumo de dietas ricas em gordura em adultos de uma cidade no sul do Brasil / Factors associated with the consumption of high-fat foods among adults in a Southern Brazilian city

O objetivo deste estudo foi descrever a frequência de consumo de dieta rica em gordura por adultos de 20 a 69 anos de Pelotas, RS, e analisar fatores associados. Foi realizado um estudo transversal de base populacional, incluindo 972 adultos. A frequência do consumo de gordura alimentar no ano anterior à pesquisa foi avaliada pelo questionário de Block, composto por quinze itens alimentares, pontuados de acordo com a frequência de consumo de alimentos com elevados teores de gordura. Cerca de 1/3 da população adulta (32,7%) consumia regularmente dieta rica em gordura. Para ambos os sexos, o consumo regular de gordura mostrou-se associado a idades mais jovens e consumo regular de refrigerantes e, somente para homens, aos níveis econômicos A/B. A frequência do consumo regular de alimentos ricos em gordura na população adulta residente no município de Pelotas encontra-se além das recomendações atuais do Ministério da Saúde. Políticas públicas que estimulem uma alimentação saudável são urgentemente necessárias.

The scope of this study was to describe the frequency of consumption of high-fat foods among adults aged 20 to 69 years and to identify associated factors. A population-based cross-sectional study was conducted with 972 adults in Pelotas, Southern Brazil. The consumption of high-fat foods in the previous twelve months was evaluated using the Block questionnaire comprising fifteen food items scored according to the frequency of consumption of high-fat foods. Approximately one in every three adults (32.7%) reported the regular consumption of high-fat diets. Among individuals of both sexes, the regular consumption of fat was associated with younger ages and the regular intake of non-diet soft drinks, and only for men, to the A/B economic levels. The conclusion reached is that the consumption of high-fat food among adults is above current Ministry of Health recommendations. Interventions aimed at stimulating healthy diets are urgently needed.

Utilização e cobertura do Sistema de Vigilância Alimentar e Nutricional no Estado do Rio Grande do Sul, Brasil / Utilization and coverage of a Food and Nutritional Surveillance System in Rio Grande do Sul state, Brazil

O objetivo deste artigo é descrever o percentual de utilização e a cobertura do Sistema de Vigilância Alimentar e Nutricional - Web (SISVAN-Web) nas Coordenadorias Regionais de Saúde do Rio Grande do Sul em 2010 e verificar sua correlação com variáveis socioeconômicas, demográficas e de organização do sistema de saúde. Estudo ecológico que utilizou dados secundários do SISVAN-Web, Departamento de Atenção Básica do Ministério da Saúde, Departamento de Informática do Sistema Único de Saúde e Instituto Brasileiro de Geografia e Estatística. A avaliação de utilização e cobertura restringiu-se aos dados de estado nutricional. Percentual de utilização refere-se ao número de municípios que alimentaram o sistema. Cobertura total foi definida como o percentual de indivíduos acompanhados pelo SISVAN-Web. Verificou-se que 324 municípios do RS alimentaram o aplicativo, correspondendo a um percentual de utilização de 65,3%. Observou-se em todas as CRS uma maior cobertura do sistema nas idades de 0 a 5 anos e 5 a 10 anos. Verificou-se relação significativa entre o percentual de utilização do SISVAN-Web e a cobertura da Estratégia de Saúde da Família (ESF) em cada CRS. Os resultados deste estudo indicaram baixos percentuais de utilização e cobertura do SISVAN-Web no Rio Grande do Sul em 2010.

This article seeks to describe the utilization and coverage percentage of the Nutritional and Food Surveillance System (SISVAN-Web) in the Regional Health Offices of Rio Grande do Sul in 2010 and to assess its correlation with socio-economic, demographic and health system organization variables at the time. It is an ecological study that used secondary data from the SISVAN-Web, the Department of Primary Health Care, the IT Department of the Unified Health System and the Brazilian Institute of Geography and Statistics. The evaluation of utilization and coverage data was restricted to nutritional status. The percentage of utilization of SISVAN-Web refers to the number of cities that fed the system. Total coverage was defined as the percentage of individuals in all stages of the life cycle monitored by SISVAN-Web. It was found that 324 cities fed the application, corresponding to a utilization percentage of 65.3%. Greater system coverage was observed in all Regional Health Coordination (RHC) Units for ages 0 to 5 years and 5-10 years. There was a significant association between the percentage of utilization of SISVAN-Web and Family Health Strategy coverage in each RHC Unit. The results of this study indicated low percentages of utilization and coverage of SISVAN-Web in Rio Grande do Sul.

Frequência de adesão aos "10 Passos para uma Alimentação Saudável" em escolares adolescentes / Frequency of adherence to the "10 Steps to Healthy Eating" among school-aged adolescents

O objetivo deste estudo foi avaliar a frequência de adesão aos "10 Passos para uma Alimentação Saudável" do Ministério da Saúde, em adolescentes de escolas de Ensino médio de Pelotas (RS). Foi realizado um estudo transversal de base escolar incluindo 1233 adolescentes de 13 a 19 anos. A frequência de cada passo foi coletada através de um questionário de frequência de consumo de alguns alimentos e outros aspectos contidos nos "10 Passos". A média de passos alcançados foi de 1,8. Ressalta-se que nenhum adolescente aderiu a todos os passos recomendados A maior frequência de adesão foi encontrada no passo 4, referente ao consumo de arroz e feijão; e menores frequência de adesão nos passos 7, referentes ao consumo de refrigerantes, sucos industrializados, doces e guloseimas, e passo 3, relativo ao consumo de Frutas/legumes/hortaliças. A adesão aos "10 passos para uma alimentação saudável" pelos adolescentes foi muito baixa. Considerando a importância de uma alimentação saudável na adolescência, recomenda-se maior investimento em políticas públicas na área de alimentação e nutrição.

The scope of this study was to evaluate the frequency of adherence to "10 Steps to Healthy Eating" of the Ministry of Health in adolescents from high schools in Pelotas in the state of Rio Grande do Sul, Brazil. A school-based cross-sectional study was conducted, including 1233 adolescents (13-19 years of age). The frequency of each step was evaluated through a questionnaire on food frequency and other issues included in the "10 Steps." The average number of steps achieved was 1.8. It is noteworthy that none of the subjects achieved entirely all the recommended steps. The highest frequency of compliance was found in step 4, referring to the consumption of the rice and beans. Lower frequencies of adherence were found for step 7, related to consumption of soft drinks, processed juices, sweets and snacks, and also step 3 on the consumption of fruit/vegetables/greens. Adherence to the "10 steps to Healthy Eating" by adolescents was very low. Considering the importance of healthy eating in adolescence, greater investment in public policies in the area of food and nutrition is strongly recommended.

Variação temporal no excesso de peso e obesidade em adolescentes de escola privada do Sul do Brasil / Temporal variation in overweight and obesity in adolescents from a private school of Southern Brazil

O objetivo do estudo foi avaliar a variação temporal em doze anos nas prevalências de excesso de peso e obesidade em adolescentes de uma escola privada de Pelotas-RS e a associação transversal com atividade física e tempo de televisão. Foram realizados dois inquéritos transversais com estudantes do ensino médio da escola em 2000 e 2012. Foram aferidos peso e altura dos adolescentes. Valores de escore-z de IMC para idade superiores a +1 e +2, respectivamente, classificaram o excesso de peso e obesidade. Foram considerados ativos os adolescentes que atingiram pelo menos 300 minutos/semana de atividade física em 2012. Tempo igual ou superior a duas horas assistindo televisão foi considerado alto. Em 2000 a prevalência de excesso de peso foi de 21,5%, enquanto que em 2012 aumentou para 30,7% (p=0,003). Quanto à obesidade, a prevalência quase dobrou, passando de 5,0% para 9,7% (p=0,01). Em ambos os períodos, os dois desfechos mostraram-se mais prevalentes no sexo masculino. A prevalência de excesso de peso aumentou significativamente nos meninos (p=0,002), enquanto a obesidade aumentou mais nas meninas (p=0,01). Maiores incrementos de ambos os desfechos se deram na faixa etária dos 16 anos ou mais. A prática de atividade física não foi associada com as prevalências dos desfechos em 2012. Entretanto, assistir televisão por pelo menos duas horas/dia foi associada com incremento superior a 10 pontos percentuais na prevalência de excesso de peso. Os resultados mostraram um grande aumento nas prevalências de excesso de peso e obesidade dos adolescentes desta escola.

The aim of this study was to evaluate the temporal variation in a 12-year period of the overweight and obesity prevalence in adolescents at a private school from Pelotas-RS and the cross-sectional association with physical activity and TV-viewing. Two cross-sectional studies were carried-out with high school students in 2000 and 2012. Standing height and weight were measured. Overweight and obesity were defined when the z scores of BMI for age were higher than +1 and +2, respectively. Adolescents who reached at least 300 minutes/week of physical activity were considered as active in 2012. TV-viewing ≥ 2 hours/day was considered as high. In 2000, the overweight prevalence was 21.5%, whereas in 2012 increased to 30.7% (p=0.003). Concerning the obesity, the prevalence almost doubled, changing from 5.0% to 9.7% (p=0.001). In the two periods, both overweight and obesity were more prevalent in boys. Between 2000 and 2012, the overweight prevalence increased more in boys (p=0.002), whereas the obesity increased more in girls (p=0.01). Both outcomes increased mainly in adolescents aged 16 years old or more. Physical activity was not associated with both outcomes in 2012. However, TV-viewing ≥ 2 hours/day was associated with more than 10 percentage points in the overweight prevalence. The results showed a large increase in the overweight and obesity in adolescents from this school.

[Food consumption and dietary factors involved in health and disease in Nikkeis: systematic review]. / Consumo alimentar e fatores dieteticos envolvidos no processo saude e doenca de Nikkeis: revisao sistematica.

OBJECTIVE: To analyze food consumption and dietary factors involved in the Nikkei population's health and disease processes METHODS: A systematic review of observational studies that described Nikkeis' food intake was carried out in electronic databases Lilacs, SciELO and PubMed/Medline databases, from 1997 to 2012. Initially, 137 titles and abstracts were analyzed, excluding intervention studies, those which only presented metabolite and vitamin plasma levels and those which did not meet the objective of this study. Of these, 38 studies were selected and evaluated using a method based on Downs & Black (1998), adapted for observational studies, leaving 33 studies to be analyzed. RESULTS: Few studies about Nikkei food intake were found outside of Hawaii, in the United States, and Sao Paulo (mainly in the city of Bauru) in Brazil. The total energy intake of Japanese-Brazilians had an elevated fat contribution, decreasing carbohydrate and protein intake. In the United States, the prevalence of Japanese-Americans who consumed high density energy food was elevated. The Niseis (children of immigrants) presented, on average, higher intake of Japanese food products, while the Sanseis (grandchildren of immigrants) showed more Westernized dietary habits. CONCLUSIONS: Although some Japanese food habits have been maintained, the Nikkeis' dietary intake reveals a high prevalence of typical Westernized food intake (high in processed food, fat and sodium, and poor in fiber), that may be contributing to the increasing development of chronic disease in this population.