Pre-pregnancy dietary pattern is associated with newborn size: results from ProcriAr study.

Babies born small-for-gestational age (SGA) have an increased risk of mortality, morbidity and adverse functional consequences. Studies suggest that pre-pregnancy maternal diet may influence newborns' size. This study aimed to determine whether maternal pre-pregnancy dietary patterns (DP) are associated with delivering SGA newborns in the ProcriAr Cohort Study, Sao Paulo-Brazil. Pre-pregnancy DP of 299 women were investigated using factor analysis with principal component's estimation, based on intake reported on a validated 110-item FFQ. Newborns were classified as SGA if their weight and/or length, adjusted by gestational age and sex, were below the 10th percentile of the INTERGROWTH-21st standards. Multivariate Poisson regression modelling with robust error variance was performed to examine associations between the different DP (in quintiles) and SGA. In a model adjusted by maternal sociodemographic and health behaviours, women who scored in the highest quintile of the DP 'Snacks, sandwiches, sweets and soft drinks' (in relation to the women who scored in the lowest quintile) were significantly more likely to deliver SGA babies (relative risk 1·92; 95 % CI 1·08, 3·39). This study verified that women's pre-pregnancy dietary behaviour characterised by an energy-dense nutrient-poor food intake was a risk factor for delivering SGA newborns. Investments in education and improved access to healthful food and nutritional information before pregnancy should be prioritised due to their potential positive impact on child health. However, further studies are warranted to identify specific metabolic pathways that may be underlying these associations.

[Weight gain rate in early childhood and overweight in children 5-11 years old in Salvador, Bahia State, Brazil]. / Velocidade de ganho de peso nos primeiros anos de vida e excesso de peso entre 5-11 anos de idade, Salvador, Bahia, Brasil.

Overweight children are more prone to become overweight or obese adults. The most effective prevention is intervention in early childhood. We analyzed the association between early weight gain and overweight/obesity in 1,056 children under 11 years of age. Data were collected on lifestyle, sanitation, socioeconomic status, birth weight, and breastfeeding. Weight gain from birth until different age brackets (< 12, > 12 to 18, > 18 to 24, and > 24 to 60 months) was considered a continuous variable in z-scores. Overweight was defined as body mass index (BMI) > +1 z-score, based on 2006 and 2007 World Health Organization (WHO) guidelines. Poisson regression and linear regression were used in the multivariate statistical analysis. Weight gain rate was associated with BMI, and overweight or obesity in the 5-11-year age bracket increased twofold for each unit increase in the weight gain standard deviation between 24 and 60 months of age (RR = 2.08; 95%CI: 1.87-2.32). For all early childhood age brackets, there was an association between rapid weight gain and subsequent overweight or obesity.

Velocidade de ganho de peso nos primeiros anos de vida e excesso de peso entre 5-11 anos de idade, Salvador, Bahia, Brasil / Weight gain rate in early childhood and overweight in children 5-11 years old in Salvador, Bahia State, Brazil

Crianças com sobrepeso estão mais propensas a se tornarem adultos com sobrepeso ou obesos, sendo a prevenção mais eficaz a intervenção em fases precoces da vida. Analisou-se a associação entre ganho de peso nos primeiros anos de vida e sobrepeso/obesidade em 1.056 crianças menores de 11 anos de idade. Foram coletadas informações relacionadas ao estilo de vida, saneamento, condições socioeconômicas, peso ao nascer e aleitamento materno. O ganho de peso do nascimento até diferentes intervalos (até 12 meses, > 12 a 18, > 18 a 24, e > 24 a 60 meses) foi considerado de forma contínua em escores-z. Foi considerado excesso de peso o índice de massa corporal (IMC) maior ou igual a +1 escore-z, usando referências da Organização Mundial da Saúde (OMS) de 2006 e 2007. Adotou-se a regressão linear e Poisson multivariada. A velocidade do ganho ponderal mostrou-se associada ao IMC, observando-se duas vezes mais sobrepeso/obesidade a cada incremento de uma unidade no desvio-padrão da velocidade do ganho ponderal para o intervalo de 24 e 60 meses (RR = 2,08; IC95 por cento: 1,87-2,32). Encontrou-se associação entre o rápido ganho de peso em todos os intervalos de idade e a ocorrência de sobrepeso/obesidade anos mais tarde.

Overweight children are more prone to become overweight or obese adults. The most effective prevention is intervention in early childhood. We analyzed the association between early weight gain and overweight/obesity in 1,056 children under 11 years of age. Data were collected on lifestyle, sanitation, socioeconomic status, birth weight, and breastfeeding. Weight gain from birth until different age brackets (< 12, > 12 to 18, > 18 to 24, and > 24 to 60 months) was considered a continuous variable in z-scores. Overweight was defined as body mass index (BMI) > +1 z-score, based on 2006 and 2007 World Health Organization (WHO) guidelines. Poisson regression and linear regression were used in the multivariate statistical analysis. Weight gain rate was associated with BMI, and overweight or obesity in the 5-11-year age bracket increased twofold for each unit increase in the weight gain standard deviation between 24 and 60 months of age (RR = 2.08; 95 percentCI: 1.87-2.32). For all early childhood age brackets, there was an association between rapid weight gain and subsequent overweight or obesity.

Early interruption of exclusive breastfeeding and associated factors, state of São Paulo, Brazil.

Many reports about breastfeeding prevalence and factors associated with weaning have been published in the scientific literature. However, the influence of newborn feeding practices on the duration of exclusive breastfeeding has received less attention. This study provides information about the introduction of liquids, other than the mother's milk, to infants in the first 6 months and factors associated with this practice.

Feeding habits of children aged 6 to 12 months and associated maternal factors.

OBJECTIVE: To identify the feeding practices of children aged 6 to 12 months of age and associated maternal factors. METHODS: This was a cross-sectional study analyzing data from the 2004 Breastfeeding and the Municipalities Project, which was implemented in 136 municipalities in the state of São Paulo, Brazil, with 24,448 children. The foods these children ate were profiled according to the number of children who had been given breastmilk and/or other foods during the previous 24 hours, and based on this data the probability of consumption of each food at each age was estimated by means of probit analysis. RESULTS: It was observed that 50% of the sample were being given breastmilk, 77% other types of milk, 63% porridge, 87% fruit, 78% soups, 64% the family meal, 58% meals including beans and 36% soup or meals containing meat. The probability of a 6-month-old child being given soup is elevated (78%), while for the family meal it is low (39%), and the probability of being fed breastmilk is 59%, lower than for other milks (70%) and than for porridge (63%). Associations were observed between milk-based meals and primiparous mothers, mothers employed outside the home and mothers who had spent longer in education. Similar findings were observed for soups, added to maternal age of more than 20 years. The family meal was associated with mothers under 20 years old, mothers who were not employed outside the home, mothers with fewer years' education and multiparous mothers. CONCLUSIONS: Excessive consumption was observed of liquid and semi-solid foods, suggesting that appropriate guidance on complementary feeding is needed, taking into account age, primiparity, education and employed mothers.

Feeding habits of children aged 6 to 12 months and associated maternal factors

OBJETIVOS: Identificar as práticas alimentares de crianças de 6 a 12 meses de idade e sua associação com fatores maternos. MÉTODOS: Trata-se de um estudo de delineamento transversal, no qual foram analisados os dados do Projeto Amamentação e Municípios de 2004, conduzido em 136 municípios do estado de São Paulo com 24.448 crianças. O padrão de consumo de alimentos foi avaliado segundo a freqüência de crianças que receberam leite materno e outros alimentos nas últimas 24 horas, e a probabilidade de consumo dos alimentos, nas faixas de idade, foi estimada por meio da análise de probitos. RESULTADOS: O consumo de alimentos revelou que 50 por cento receberam leite materno, 77 por cento outros tipos de leite, 63 por cento mingau, 87 por cento frutas, 78 por cento sopas, 64 por cento comida de panela, 58 por cento comida com feijão e 36 por cento sopa ou comida com carne. A probabilidade de a criança, aos 6 meses de idade, consumir sopas é elevada (78 por cento), comida de panela é baixa (39 por cento), e a probabilidade dela receber leite materno é de 59 por cento, inferior aos outros leites (70 por cento) e mingau (63 por cento). Encontrou-se associação entre consumo de refeições lácteas e mães primíparas, que trabalhavam fora e com maior escolaridade. Semelhantes achados foram observados para consumo de sopas, acrescido à idade da mãe superior a 20 anos. O consumo de comida de panela associou-se a mães com menos de 20 anos, que não trabalhavam fora, com menor escolaridade e multíparas. CONCLUSÃO: Verificou-se consumo excessivo de alimentos líquidos e semi-sólidos e a necessidade do aconselhamento adequado em alimentação complementar, considerando idade, primiparidade, escolaridade e trabalho materno.

OBJECTIVE: To identify the feeding practices of children aged 6 to 12 months of age and associated maternal factors. METHODS: This was a cross-sectional study analyzing data from the 2004 Breastfeeding and the Municipalities Project, which was implemented in 136 municipalities in the state of São Paulo, Brazil, with 24,448 children. The foods these children ate were profiled according to the number of children who had been given breastmilk and/or other foods during the previous 24 hours, and based on this data the probability of consumption of each food at each age was estimated by means of probit analysis. RESULTS: It was observed that 50 percent of the sample were being given breastmilk, 77 percent other types of milk, 63 percent porridge, 87 percent fruit, 78 percent soups, 64 percent the family meal, 58 percent meals including beans and 36 percent soup or meals containing meat. The probability of a 6-month-old child being given soup is elevated (78 percent), while for the family meal it is low (39 percent), and the probability of being fed breastmilk is 59 percent, lower than for other milks (70 percent) and than for porridge (63 percent). Associations were observed between milk-based meals and primiparous mothers, mothers employed outside the home and mothers who had spent longer in education. Similar findings were observed for soups, added to maternal age of more than 20 years. The family meal was associated with mothers under 20 years old, mothers who were not employed outside the home, mothers with fewer years' education and multiparous mothers. CONCLUSIONS: Excessive consumption was observed of liquid and semi-solid foods, suggesting that appropriate guidance on complementary feeding is needed, taking into account age, primiparity, education and employed mothers.

Ações de Nutrição no Sistema de Saúde: o que pensam os gestores e profissionais de saúde do Município de Francisco Morato a respeito dessa prática? / Nutrition Actions in the Health System: what do managers and health professionals in the Municipality of Francisco Morato think about this practice?

A alimentação e a nutrição constituem requisitos básicos para a promoção e a proteção da saúde. A constatação dessa evidência colaborou para a aprovação, em 1999, da Política Nacional de Alimentação e Nutrição (PNAN), um conjunto de políticas que propõe ações para o setor Saúde, tornando-se um instrumento político fundamental para o planejamento e operacionalização da Segurança Alimentar e Nutricional enquanto direito humano. No entanto, gestores e profissionais da saúde precisam se apoderar deste instrumento para que conheçam suas atribuições e se sintam responsáveis em implementar esta prática no sistema de saúde.

Avaliação das Ações de Monitoramento do Estado Nutricional de Gestantes Atendidas em 2002 pelo PSF do Município de Francisco Morato / Evaluation of Monitoring Actions for the Nutritional Status of Pregnant Women Attended in 2002 by the PSF of the Municipality of Francisco Morato

O Programa de Saúde da Família (PSF) foi criado pelo Ministério da Saúde (MS) em 1994, com o propósito de reorganizar a prática de atenção básica à saúde e priorizar as ações de prevenção, promoção, diagnóstico precoce, tratamento e recuperação da saúde de forma integral e contínua. Um dos propósitos prioritários do PSF é a atenção às gestantes, por ser considerado um dos grupos mais vulneráveis na atenção básica. De acordo com Engstrom (2002), a gestação é um período no qual a mulher fica mais vulnerável, mais sensível a doenças carenciais, necessitando de um constante cuidado.