What Is Considered Healthy Eating? An Exploratory Study among College Students of Nutrition and Food Science.

In modern industrialized societies, the focus on healthy eating has increased significantly across multiple sectors, including the media, public policy, expert opinion, and public awareness. The aim of this research was to explore the perceptions of healthy eating and the barriers to adopting a healthy diet among undergraduate students in Human Nutrition and Dietetics (HND) and Food Science and Technology (FST) degrees in Spain. An exploratory and descriptive cross-sectional study was conducted using a qualitative and quantitative methodology and convenience sampling. Two focus groups and a questionnaire were utilized (300 participants from all academic years completed the survey). Differences in definitions of healthy eating and perceived barriers were found between genders and students at different stages of training (p < 0.05). In their understanding of healthy eating, the students placed importance on balance, variety, moderation, and individual factors. Although students considered it easy to follow a healthy diet, family's eating habits, time availability, and emotional states were found to be the main barriers to the implementation of healthy practices. The obtained data supports the need to critically address perceptions of healthy eating throughout the training of nutrition and food science professionals. The insights obtained on the perceived barriers highlight the importance of considering both individual and environmental factors.

Trends in the prevalence of obesity, overweight, and thinness among schoolchildren aged 7-14 years from southern Brazil (2002-2019).

OBJECTIVE: To analyze the obesity, overweight, and thinness trends among Brazilian schoolchildren by sex, age group, and type of school according to World Health Organization (WHO) and International Obesity Task Force (IOTF) criteria. METHODS: We conducted four surveys between 2002 and 2018/19 involving schoolchildren aged 7-14 years from a state capital in southern Brazil. Weight status was classified using both WHO and IOTF criteria. RESULTS: In the total sample, obesity prevalence based on the IOTF and the WHO criteria were 72% and 44% higher in 2018/19 compared with 2002, respectively. Over the whole period, the obesity prevalence increased among children (WHO: 10.1% vs. 14.1%; IOTF: 5.0% vs. 8.3%), and those from public schools (WHO: 10.5% vs. 16.4%; IOTF: 5.6% vs. 10.1%). There was no significant reduction in thinness prevalence over the analyzed period. CONCLUSION: Obesity prevalence remains on an upward trend in a state capital in southern Brazil, especially among children from public schools. A higher prevalence of overweight and obesity was observed using the WHO criteria compared with IOTF criteria.

Brazilian National Food and Nutritional Security System: what are the similarities in the decentralization process?

This study aimed to analyze the multiple characteristics of the decentralization of the Brazilian National Food and Nutritional Security System (SISAN) in a period before the institutional dismantling. Data from the 26 Brazilian states were collected in two public information systems, referring to the years 2017/2018. An exploratory and descriptive study was performed using a hierarchical cluster analysis, based on an analysis model with multiple characteristics of the system decentralization. The results indicated the formation of three clusters, showing the similarity among states with greater intersectoral and participatory character, better relationship with municipalities, and allocation of resources. On the other hand, states with less intersectoral and participatory character, linked to the low allocation of resources, execution of food security actions, and municipal support were clustered. These clusters composed mainly of North and Northeastern states, with a lower Gross Domestic Product, average Human Development Index, and a higher occurrence of food insecurity, expressed characteristics that may be related to greater obstacles in the system decentralization process. This information can help in the decision-making about the SISAN in a more equitable manner, supporting the actors involved in its maintenance and defense, at a time when the country presents an austere political and economic situation, marked by the progressive worsening of food insecurity.

Perceptions of Food among College Students in the Field of Food Science: A Food Sustainability Approach.

The complex concept of food sustainability has become crucial in all spheres of life. Dietitians, food scientists, and technologists are in a unique position to promote sustainability in food systems. However, the perceptions of food sustainability among food science professionals and college students are under-researched, particularly in Spain. The aim of this study was therefore to analyze perceptions related to food and to food sustainability in a sample of Human Nutrition and Dietetics (HND) and Food Science and Technology (FST) students in Barcelona (Spain). An exploratory and descriptive cross-sectional study was carried out using qualitative and quantitative methodology and convenience sampling. Two focus groups and an online questionnaire were conducted (300 participants completed the survey, 151 from HND and 149 from FST). Although the students expressed concern about food sustainability, their dietary choices were primarily associated with or influenced by taste/pleasure and health/nutrition. The issue of sustainability seemed more internalized by women than men, whereas the generalized conception of a sustainable diet was essentially based on environmental aspects, with socioeconomic dimensions largely overlooked. The concept of sustainability should be promoted among food science students in all its multidimensionality, and actions need to be implemented that bring sustainability closer to students' social practices, which should be incorporated into all university education and that is taught by professors duly trained in the subject.

Participatory construction of the food security agenda in Brazil: Interests and priorities from re-democratization to institutional dismantling

This study analyzed the trajectory of interests and priorities related to food security expressed in the reports of the five National Food and Nutritional Security Conferences (Conferências Nacionais de Segurança Alimentar e Nutricional - CNSAN) held in Brazil between 1994 and 2015. The documentary research was systematized through content analysis with a quantitative and qualitative focus. Food security dimensions were identified in the 1,181 action proposals assessed through an analysis model consisting of 3 cross-sectional categories, 8 thematic categories, and 10 subcategories. The temporal content analysis revealed: continuous reduction in demands for "universal access to adequate food", especially in the subcategory "employment and income"; constant predominance of the category "structuring sustainable food production and supply systems" with a progressive increase in the subcategory "incentive to agroecology-based production"; and increased demands for "prioritization of traditional peoples and communities". The timeline suggests different contributions of the Conferences to the evolution of the debate on food security in Brazil. However, the insertion of social actors in the process of formulating the Brazilian National Food and Nutritional Security Policy did not guarantee the incorporation of the problems into the public agenda, which should be re-established and deepened in the decision-making processes. The findings attest to the importance of social participation for the theoretical and political qualification of food security in Brazil.

Este estudio analizó la trayectoria de los intereses y prioridades relacionados con la seguridad alimentaria expresados en los informes de las cinco Conferencias Nacionales de Seguridad Alimentaria y Nutricional (Conferências Nacionais de Segurança Alimentar e Nutricional - CNSAN) realizadas en Brasil entre 1994 y 2015. La investigación fue sistematizada a través del análisis de contenido con un enfoque cuantitativo y cualitativo. Las dimensiones de la seguridad alimentaria se identificaron en las 1.181 propuestas de acción evaluadas a través de un modelo de análisis que consta de 3 categorías transversales, 8 categorías temáticas y 10 subcategorías. El análisis de contenido temporal reveló: continua reducción de las demandas de "acceso universal a una alimentación adecuada", especialmente en la subcategoría "empleo e ingresos"; predominio de la categoría "estructuración de sistemas sostenibles de producción y abastecimiento de alimentos" con un aumento progresivo de la subcategoría "incentivo a la producción basada en la agroecología"; y mayores demandas de "priorización de los pueblos y comunidades tradicionales". La línea de tiempo sugiere diferentes contribuciones de las Conferencias a la evolución del debate sobre la seguridad alimentaria en Brasil. Sin embargo, la inserción de los actores sociales en el proceso de formulación de la Política Nacional de Seguridad Alimentaria y Nutricional de Brasil no garantizó la incorporación de los problemas en la agenda pública, que debe ser reconquistada y profundizada en los procesos de toma de decisiones. Los hallazgos atestiguan la importancia de la participación social para la calificación teórica y política de la seguridad alimentaria en Brasil.

Methodological aspects and characteristics of participants in the study on the prevalence of obesity in children and adolescents in Florianópolis, Southern Brazil, 2018-2019: EPOCA study.

PURPOSE: To describe the methodological aspects and characteristics of the participants of the EPOCA survey. METHODS: The study was conducted with schoolchildren aged between seven to 14 years old from 30 schools in Florianópolis, Southern Brazil. Body mass, height, girths, and skinfold thicknesses were measured. Food consumption and physical activity from the previous day were self-reported using the validated Web-CAAFE questionnaire. Adolescents completed a specific questionnaire about physical activity, meal consumption, and weight control behaviors. Parents/guardians responded to a sociodemographic and habits questionnaire. RESULTS: A total of 1671 schoolchildren participated in the study (response rate: 27.2%). About 63% of schoolchildren were enrolled in public schools. Most studied in the morning shift (54.2%), were female (53.1%) and aged between seven and 10 years (58.1%). The prevalence of overweight was 33.7% and obesity was 11.3%. CONCLUSIONS: The data obtained will allow us to assess the trend in the prevalence of overweight and obesity and associated factors when compared to other surveys performed. Descriptions of the logistics and protocols can help in the development and improvement of similar studies. It is hoped that the results of EPOCA 2018/2019 may help in the design of obesity prevention policies and programs for this population.

Analysis of the implementation of Food and Nutrition Education actions in public schools in a capital city in southern Brazil / Análise da implementação de ações de Educação Alimentar e Nutricional em escolas públicas municipais de uma capital da região do Sul do Brasil

ABSTRACT Objective To analyze the insertion of Food and Nutrition Education actions in Early Childhood and Elementary Education units of the municipal public school system of Florianópolis, Santa Catarina, Brazil, in 2019. Methods This analytical study applied an online questionnaire directed to the 125 Early Childhood and Elementary Education schools in Florianópolis. Results Ninety-four schools (75.2%) participated in the study, among which 94.7% developed Nutritional Food Education actions in 2019. It was made evident that the insertion of Nutritional Food Education in the Pedagogical Political Project (p<0.001) and the planning of such actions (p<0.001) in schools has a significant association with their implementation. The participation of the professionals in training in food and nutrition showed no association with the implementation of the Nutritional Food Education actions. The actions developed most frequently were the pedagogical activities in the school curriculum (95.5%), the school garden (71.9%), and the hands-on cooking classes (46.1%). Conclusion The study identified a positive panorama in the capital of Santa Catarina, with actions included transversally in the school curriculum with a multiprofessional focus standing out. However, the need for studies that monitor and evaluate the actions is emphasized.

RESUMO Objetivo Analisar a inserção de ações de Educação Alimentar e Nutricional em unidades de Educação Infantil e Ensino Fundamental da rede pública municipal de Florianópolis, no ano de 2019. Métodos Ratos Wistar machos foram divididos em dois grupos experimentais de acordo com a dieta da mãe durante a gestação e lactação: grupo controle (NP: 17% caseína n=6) e grupo desnutrido (LP: 8% caseína n=6). Aos 60 dias de vida, os ratos foram sacrificados para coleta do hipotálamo para posterior análise bioquímica. Resultados Participaram do estudo 94 das 125 escolas de Educação Infantil e Ensino Fundamental de Florianópolis (75,2%). Dessas, 94,7% desenvolveram ações de Educação Alimentar Nutricional no ano de 2019. Evidenciou-se que a inserção da Educação Alimentar Nutricional no Projeto Político Pedagógico (p<0,001) e o planejamento dessas ações (p<0,001) nas escolas têm associação significativa com a sua realização. A participação dos profissionais em formação sobre alimentação e nutrição não mostrou associação com a realização das ações de Educação Alimentar Nutricional. As ações desenvolvidas com mais frequência foram a inclusão de atividades pedagógicas no currículo escolar (95,5%), a horta pedagógica (71,9%) e as oficinas culinárias (46,1%). Conclusão O estudo identificou um panorama positivo na capital catarinense, com destaque para ações incluídas transversalmente no currículo escolar, com enfoque multiprofissional. Ressalta-se, no entanto, a necessidade de desenvolvimento de estudos de monitoramento e avaliação das ações.

Brazilian National Food and Nutritional Security System: what are the similarities in the decentralization process? / Sistema Nacional de Segurança Alimentar e Nutricional: quais são as semelhanças no processo de descentralização? / Sistema Nacional de Seguridad Alimentaria y Nutricional: ¿cuáles son las similitudes en el proceso de descentralización?

This study aimed to analyze the multiple characteristics of the decentralization of the Brazilian National Food and Nutritional Security System (SISAN) in a period before the institutional dismantling. Data from the 26 Brazilian states were collected in two public information systems, referring to the years 2017/2018. An exploratory and descriptive study was performed using a hierarchical cluster analysis, based on an analysis model with multiple characteristics of the system decentralization. The results indicated the formation of three clusters, showing the similarity among states with greater intersectoral and participatory character, better relationship with municipalities, and allocation of resources. On the other hand, states with less intersectoral and participatory character, linked to the low allocation of resources, execution of food security actions, and municipal support were clustered. These clusters composed mainly of North and Northeastern states, with a lower Gross Domestic Product, average Human Development Index, and a higher occurrence of food insecurity, expressed characteristics that may be related to greater obstacles in the system decentralization process. This information can help in the decision-making about the SISAN in a more equitable manner, supporting the actors involved in its maintenance and defense, at a time when the country presents an austere political and economic situation, marked by the progressive worsening of food insecurity.

Este estudo teve como objetivo analisar as múltiplas características da descentralização do Sistema Nacional de Segurança Alimentar e Nutricional (SISAN) em um período anterior ao desmonte institucional. Dados dos 26 estados brasileiros foram coletados em dois sistemas públicos de informação, referentes aos anos de 2017/2018. Um estudo exploratório e descritivo foi realizado por meio de uma análise de cluster hierárquica baseada em um modelo de análise com múltiplas características de um sistema descentralizado. Os resultados indicaram a formação de três clusters, mostrando a semelhança entre os estados com maior caráter intersetorial e participativo, assim como melhor relação com municípios e alocação de recursos. De forma oposta, os estados com menor caráter intersetorial e participativo foram agrupados, ligados à baixa alocação de recursos, execução de ações de segurança alimentar e de apoio municipal fracos. Os clusters compostos principalmente por estados do Norte e Nordeste, com menor Produto Interno Bruto, Índice de Desenvolvimento Humano médio e maior ocorrência de insegurança alimentar, expressaram características que podem estar relacionadas a maiores obstáculos na descentralização. Essas informações podem auxiliar na tomada de decisão do SISAN de forma mais equitativa, servindo de apoio aos atores envolvidos em sua manutenção e defesa, em um momento em que o país apresenta uma situação política e econômica de austeridade, marcada pela piora progressiva da situação de insegurança alimentar.

Este estudio tuvo como objetivo analizar las múltiples características de la descentralización del Sistema Nacional de Seguridad Alimentaria y Nutricional (SISAN) en el periodo anterior al desmantelamiento institucional. Los datos de los 26 estados brasileños se recolectaron de dos sistemas de información pública referentes al periodo 2017/2018. Se realizó un estudio exploratorio y descriptivo mediante análisis de clúster jerárquico basado en un modelo de análisis con múltiples características de un sistema descentralizado. Los resultados indicaron la formación de tres clústeres, mostrando la similitud entre los estados de mayor intersectorialidad y participación, así como una mejor relación con los municipios y asignación de recursos. Por otro lado, se agruparon los estados de menor carácter intersectorial y participativo, vinculados a la baja asignación de recursos, ejecución de acciones de seguridad alimentaria y débil apoyo municipal. Los clústeres compuestos principalmente por los estados del Norte y Nordeste de Brasil, con menor Producto Interno Bruto, Índice de Desarrollo Humano medio y mayor ocurrencia de inseguridad alimentaria tuvieron características expresadas que pueden estar relacionadas con mayores obstáculos en la descentralización. Estos datos pueden ayudar al SISAN en la toma de decisiones de manera más equitativa y servir de apoyo a los actores involucrados en su mantenimiento y defensa, en momentos en que el país se enfrenta a una situación política y económica de austeridad, marcada por el progresivo empeoramiento de la inseguridad alimentaria.

Association between lower serum vitamin D (25-hydroxy-cholecalciferol) concentrations and cognitive impairment in older adults: data from a populational-based cohort study in a middle-income country.

OBJECTIVE: To investigate the association between serum vitamin D (25-hydroxy-cholecalciferol) (25(OH)D) concentrations and cognitive impairment in older adults living in Southern Brazil. DESIGN: Cross-sectional analysis using data from the second follow-up wave of the populational-based EpiFloripa Aging Cohort Study was collected in 2013-2014. SETTING: Cognitive impairment was evaluated using the Mini-Mental State Examination (MMSE). Blood samples were collected to measure serum vitamin D concentrations using a chemiluminescent microparticle immunoassay. Vitamin D concentrations were distributed in quartiles (Q1: 4·0-20·7 ng/ml; Q2: 20·8-26·6 ng/ml; Q3: 26·7-32·0 ng/ml and Q4: 32·1-60·1 ng/ml), and its association with cognitive impairment was tested by crude and adjusted logistic regression (sociodemographic, behavioural and health aspects) using Q4 as a reference group. PARTICIPANTS: 200 men and 371 women aged 60 years or older participated in this study. RESULTS: The prevalence of probable cognitive impairment was 21·7 %. Those without cognitive impairment had a higher mean of vitamin D serum concentrations (26·8 v. 24·6, P = 0·014). In the crude analysis, only individuals in Q2 of vitamin D presented an increased risk for probable cognitive impairment compared with Q4 (highest quartile) (OR 2·65, 95 % CI 1·46, 4·81), remaining significant in the adjusted analysis (OR 6·04, 95 % CI 2·78, 13·13). While Q1 (lowest quartile) was not associated in the crude analysis, but when adjusted, an increased risk of cognitive impairment was observed. CONCLUSION: The lowest quartile of vitamin D was directly associated with probable cognitive impairment in older adults in Southern Brazil. More studies are needed to investigate whether maintaining adequate serum levels may represent a significant factor in preventing age-related neurological disorders as well as to verify the need for new cutoff points for this age group.

Normative decentralization of the food and nutrition security agenda: descriptive study of legislation published in Brazilian capitals / Descentralização normativa da agenda de segurança alimentar e nutricional: estudo descritivo das legislações publicadas nas capitais brasileiras

ABSTRACT Objective This study aimed to identify and characterize the legislation published in Brazilian capitals regarding food and nutritional security. Methods This is a descriptive, exploratory, and documentary research, with a survey on public and free access websites to legislation published until July 2021 in the 26 Brazilian state capitals. Document characterization information was extracted, systematized, and systematically analyzed. Results Of the 1,390 legislations found, 307 were included in the analysis, 31% from the South region of Brazil and 23% from the Southeast region. The legislation mainly referred to the Structuring of the Brazilian System of Food and Nutritional Security (76.5%) and the Promotion of Universal Access to Adequate Food (17.3%). The categories less present were Evaluation and Monitoring of the Brazilian System of Food and Nutritional Security and Food and Nutritional Security (1.9%), Food and Nutrition Actions Aimed at Quilombolas and Traditional Communities (1.3%) and Universal Access to Water (0.7%), with 17 capitals (65.4%) having no localized legislation for these three themes. Conclusion The results point to the need for qualification of transparency mechanisms in public management and good governance, and demonstrate an incipient process of implementing the government food and nutrition security agenda in Brazilian capitals, with low incidence on different government sectors and other public policies

RESUMO Objetivo O estudo teve o objetivo de identificar e caracterizar as legislações relacionadas à segurança alimentar e nutricional publicadas nas capitais brasileiras. Métodos Trata-se de uma pesquisa descritiva, exploratória e documental, com levantamento em sites públicos e de acesso livre de legislações publicadas até julho de 2021 nas 26 capitais dos estados brasileiros. Informações de caracterização dos documentos foram extraídas, sistematizadas e analisadas de forma sistemática. Resultados Das 1.390 legislações localizadas, 307 foram incluídas na análise, sendo 31% da região Sul e 23% da região Sudeste. As legislações referiam-se principalmente à Estruturação do Sistema Naiconal de Segurança Alimentar e Nutricional (76,5%) e à Promoção do Acesso Universal à Alimentação Adequada (17,3%). As categorias menos presentes nas legislações foram Avaliação e Monitoramento do Sistema Nacional de Segurança Alimentar e Nutricional e de Segurança Alimentar e Nutricional (1,9%), Ações de Alimentação e Nutrição Voltadas para Quilombolas e Comunidades Tradicionais (1,3%) e Acesso Universal à Água (0,7%), sendo que 17 capitais (65,4%) não tiveram legislações localizadas para o conjunto destes três temas. Conclusão Os resultados apontam para a necessidade de qualificação dos mecanismos de transparência na gestão pública e de boa governança, e demonstram um processo incipiente de implementação da agenda governamental de segurança alimentar e nutricional nas capitais brasileiras, com baixa incidência sobre os diferentes setores de governo e demais políticas públicas.

Factors associated with the academic performance of Nutrition students at a public university in southern Brazil / Fatores associados ao desempenho acadêmico de estudantes de Nutrição de uma universidade pública do sul do Brasil

ABSTRACT Objective To assess the association of socioeconomic factors, characteristics of the academic trajectory, and curriculum of students of a Nutrition course in the academic performance in the Exame Nacional de Desempenho dos Estudantes. Methods A study of cross-sectional panels with secondary data (Exame Nacional de Desempenho dos Estudantes 2004, 2007, 2010, 2013, 2016, and 2019) of 174 graduating students was carried out. Academic performance was classified into two groups, one with a score below the median and another above the median. The differences in median scores according to the variables were tested using the Mann-Whitney, Kruskal-Wallis, or non-parametric trend analysis. Logistic regression analysis was used to assess the association of the score variable with the other variables. The analyses were carried out using the Stata version 13.0 program, using a value of p<0.05 for the statistical decision. Results It was observed that the profile of graduating students was composed mainly of female individuals (92.5%), self-declared white (90.8%), and mostly coming from private schools (65.8%). Those who had some type of income obtained a higher score in Exame Nacional de Desempenho dos Estudantes compared to those who did not have an income (61.8 vs. 57.4, respectively, p=0.010), and the curricular change seems to be the main variable in the chances of obtaining a score above the median of the course (OR: 1.92, p=0.046). Conclusion Financial status and curriculum change were associated with the academic performance of the assessed students. These results can be used as a reference for investigations in other institutions, public or private, of different courses and, thus, assist in planning more effective educational policies.

RESUMO Objetivo Avaliar a associação dos fatores socioeconômicos, características da trajetória acadêmica e currículo de estudantes de um curso de Nutrição com o desempenho acadêmico deles no Exame Nacional de Desempenho de Estudantes. Métodos Realizou-se o estudo de painéis transversais com dados secundários (Exame Nacional de Desempenho de Estudantes 2004, 2007, 2010, 2013, 2016 e 2019) de 174 estudantes concluintes. O desempenho acadêmico foi classificado em dois grupos, um com nota abaixo da mediana e outro acima da mediana. As diferenças de mediana de notas segundo as variáveis foram testadas por meio dos testes de Mann Whitney, Kruskal Wallis ou análise não paramétrica de tendência. A análise de regressão logística foi utilizada para avaliar a associação da variável nota com as demais. Utilizou-se o programa Stata versão 13.0 com valor de p<0,05 para a decisão estatística. Resultados Observou-se que o grupo de estudantes concluintes era composto majoritariamente por indivíduos do sexo feminino (92,5%), autodeclarados brancos (90,8%) e, em sua maioria, oriundos de escolas privadas (65,8%). Os que dispunham de algum tipo de renda obtiveram nota maior no Exame Nacional de Desempenho de Estudantes em relação àqueles que não possuíam renda (nota 61,8 vs 57,4, respectivamente; p=0,010), e a mudança curricular parece ser a principal variável nas chances de se obter uma nota acima da mediana do curso (OR: 1,92, p=0,046). Conclusão A situação financeira e a mudança curricular foram associadas ao desempenho acadêmico dos estudantes avaliados. Esses resultados podem ser usados como referência para investigações em outras instituições, públicas ou privadas, com estudantes de diferentes cursos, e, assim, auxiliar no planejamento de políticas educacionais mais efetivas.

Meal and snack patterns of 7-13-year-old schoolchildren in southern Brazil.

OBJECTIVE: The aim of the current study was to identify and describe the meal and snack patterns (breakfast, mid-morning snack, lunch, mid-afternoon snack, dinner and evening snack) of public schoolchildren. DESIGN: Cross-sectional study. Information on the previous day's food intake was obtained through the Web-CAAFE (Food Intake and Physical Activity of Schoolchildren), an interactive questionnaire, which divides daily food consumption into three meals (breakfast, lunch and dinner) and three snacks (mid-morning, mid-afternoon and evening). Each meal contains thirty-one food items and the schoolchildren clicked on the food items consumed in each meal. Factor analysis was used to identify meal and snack patterns. The descriptions of the dietary patterns (DP) were based on food items with factor loads ≥ 0·30 that were considered representative of each DP. SETTING: Schoolchildren, Florianopolis, Brazil. PARTICIPANTS: Children (n 1074) aged 7-13 years. RESULTS: Lunch was the most consumed meal (96·0 %), followed by dinner (86·4 %), breakfast (85·3 %) and mid-afternoon snack (81·7 %). Four DP were identified for breakfast, mid-morning snack, lunch, dinner and evening snack, and three for mid-afternoon snack. Breakfast, lunch and dinner patterns included traditional Brazilian foods. DP consisting of fast foods and sugary beverages were also observed, mainly for the evening snack. CONCLUSIONS: The results of the current study provide important information regarding the meal and snack patterns of schoolchildren to guide the development of nutrition interventions in public health.

Factors associated with the consumption of fruits and vegetables by schoolchildren: a comparative analysis between 2007 and 2012 / Fatores associados ao consumo de frutas e de vegetais por escolares: uma análise comparativa entre 2007 e 2012

ABSTRACT Objective Perform comparative analysis of adequate consumption of fruits and vegetables and their associated factors in schoolchildren. Methods Probabilistic samples representative of students of both sexes, 7 to 14 years old, from public and private schools in Florianópolis, SC were investigated in cross-sectional studies in 2007 (n=2,836) and 2012 (n=2,506). The exposure variables were: sex, age, family income per capita, mother's education and school system. The outcome variable (fruit and vegetable consumption) was collected using the third validated version of the previous day's food questionnaire. Using the Chi-Square test, exposure variables with a p-value <0.20 were eligible for analysis using crude and adjusted multiple logistic regression models. Exposure variables with p<0.05 were considered to be associated with the consumption of fruits and vegetables. Results There were no significant differences in the adequate consumption between 2007 and 2012. While in 2007 the per capita family income was the only exposure variable associated, in 2012 only a mother with complete higher education was a protective factor for the adequate consumption of fruits and vegetables Conclusion Despite governmental strategies to stimulate the consumption of fruits and vegetables in Brazil, their results are still not perceptible, requiring more time for an evaluation of effectiveness

RESUMO Objetivo Realizar análise comparativa do consumo adequado de frutas e de vegetais e seus fatores associados em escolares. Métodos Em estudos transversais de 2007 (n=2.836) e de 2012 (n=2.506), foram investigadas amostras probabilísticas representativas de escolares de ambos os sexos, com idade entre 7 e 14 anos, pertencentes a escolas públicas e privadas de Florianópolis, SC. As variáveis de exposição foram: sexo, idade, renda familiar per capita, escolaridade da mãe e sistema escolar. A variável de desfecho (consumo de frutas e de vegetais) foi coletada por meio da terceira versão validada do questionário alimentar do dia anterior. A partir do teste de chi-quadrado, as variáveis de exposição com valor de p<0,20 foram elegíveis para análise por meio de modelos bruto e ajustado de regressão logística múltipla. Enquanto isso, as que apresentaram valor de p<0,05 foram consideradas associadasao consumo de frutas e de vegetais. Resultados Não houve diferenças significativas no consumo adequado entre 2007 e 2012. Enquanto em 2007 a renda familiar per capita era a única variável de exposição associada, em 2012 apenas a escolaridade da mãe, com ensino superior completo, foi fator protetor para o consumo adequado de frutas e de vegetais. Conclusão Apesar das estratégias governamentais para estimular o consumo de frutas e de vegetais no Brasil, seus resultados ainda não são perceptíveis, exigindo mais tempo para uma avaliação de eficácia.

Government-subsidized restaurants in Brazil: an evaluation within the framework of food and nutrition security / Restaurantes populares brasileiros: avaliação no âmbito da segurança alimentar e nutricional

ABSTRACT Objective The objective was to evaluate government-subsidized restaurants in southern Brazil according to current regulations and the National Food and Nutrition Security Policy. Methods An evaluation matrix was developed on the basis of a literature review, logic model, immersion in a government-subsidized restaurant, and workshops with experts in the field. The Government-Subsidized Restaurant Evaluation Matrix contemplates two dimensions: Political/Organizational, composed of the subdimensions Administration, Structure, and Target Groups; and Technical/Operational, composed of the subdimensions Meal Quality, Food and Nutrition Education, and Extended Social Support. Subdimensions comprised 24 indicators. Data were gathered through an online survey of the 35 government-subsidized restaurants operating in southern Brazil. Results Of the 35 government-subsidized restaurants in southern Brazil, 86% (n=30) participated in the study. Meal Quality and Administration received the highest score in 73% and 60% of government-subsidized restaurants, respectively, whereas Food and Nutrition Education and Extended Social Support received the lowest score in 47% and 40%, respectively. Conclusion Advances are needed in the understanding of government-subsidized restaurants as public facilities for ensuring food and nutrition security and the human right to adequate food.

RESUMO Objetivo O objetivo do estudo foi avaliar os restaurantes populares da região Sul do Brasil utilizando como parâmetros as diretrizes e normativas em vigor e a Política Nacional de Segurança Alimentar e Nutricional. Métodos Avaliação do tipo normativa. Para isso, foi utilizada a Matriz Avaliativa elaborada por meio das seguintes etapas: revisão sistematizada; elaboração do Modelo Teórico-Lógico; processo de imersão em um restaurante popular e oficinas de consenso com especialistas na temática. A matriz avaliativa contempla duas dimensões: Político-Organizacional, organizada nas subdimensões Administração, Estrutura e Público Frequentador; e Técnico-Operacional, organizada nas subdimensões Alimentação Adequada, Educação Alimentar e Nutricional e Assistência Ampliada ao Público Frequentador. Foram elencados 24 indicadores, coletados por meio de questionário online respondido pelos gestores dos restaurantes. Resultados Dos 35 restaurantes existentes na região Sul, 86% (30) participaram da pesquisa. As subdimensões mais bem avaliadas foram Alimentação Adequada e Administração, com 70% e 63% dos restaurantes avaliados como "bom", respectivamente. As subdimensões com piores avaliações foram Educação Alimentar e Nutricional e Assistência Ampliada ao Usuário, com 47% e 40% dos restaurantes classificados como "ruim", respectivamente. Conclusão Destaca-se a boa avaliação dos itens referentes à administração, estrutura e ao processo de produção de refeições, em detrimento aos aspectos relacionados à garantia dos direitos dos usuários.

Government-Subsidized Restaurants as promoters of the realization of the Human Right to Adequate Food: Proposal of an evaluation model / Restaurantes Populares enquanto promotores da realização do Direito Humano à Alimentação Adequada: proposição de um modelo avaliativo

ABSTRACT Objective This article presents an evaluation model for Government-Subsidized Restaurants within the framework of the National Food and Nutrition Security Policy. Methods This is an evaluation study. The Evaluation Matrix was elaborated from five stages: systematized revision for elaboration of the theoretical-logical model; immersion process; construction of the preliminary theoretical-logical model; consensus workshops, through the traditional committee technique; elaboration of the evaluation matrix proposal; and external consensus with specialists in the subject and in the implementation and management of Government-Subsidized Restaurants. Results The proposed matrix contemplates two dimensions: Political-Organizational, with the subdimensions: Management, Structure and Target Public; and Technical-Operational, with the sub-dimensions: Adequate Food, Food and Nutrition Education, and Extended Public Assistance. Twenty-four indicators and 29 measures were listed. Conclusion The findings point to the need for advances in evaluation methodologies that contemplate Food and Nutrition Security as the guiding principle of the actions performed by Government-Subsidized Restaurants. Thus, the evaluation matrix presented aims to contribute to the improvement of the GSR as a multifunctional tool, promoter of Food and Nutrition Security and the realization of the Human Right to Adequate Food within the National Food and Nutrition Security Policy.

RESUMO Objetivo Apresentar um modelo de avaliação para os Restaurantes Populares no âmbito da Política Nacional de Segurança Alimentar e Nutricional. Métodos Trata-se de um estudo de avaliabilidade. A Matriz Avaliativa foi elaborada a partir de cinco etapas: revisão sistematizada para elaboração do modelo teórico-lógico; processo de imersão; construção do modelo teórico--lógico preliminar; oficinas de consenso, por meio da técnica de comitê tradicional; elaboração da proposta da matriz avaliativa; e consenso externo com especialistas na temática e na implantação e gestão de Restaurantes Populares. Resultados A Matriz proposta contempla duas dimensões: Político-Organizacional, com as subdimensões: Administração, Estrutura e Público Frequentador; e Técnico-Operacional, com as subdimensões: Alimentação Adequada, Educação Alimentar e Nutricional e Assistência Ampliada ao Público Frequentador. Foram definidos 24 indica-dores e 29 medidas. Conclusão A literatura científica investigada apontou a necessidade de avanços em metodologias avaliativas que contemplem a Segurança Alimentar e Nutricional enquanto norteadora das ações executadas pelos Restaurantes. Assim, a Matriz Avaliativa apresentada visa contribuir para a melhoria dos Restaurantes Populares como ferramenta multifuncional promotora da Segurança Alimentar e Nutricional e da realização do Direito Humano à Alimentação Adequada dentro da Política Nacional de Segurança Alimentar e Nutricional.

State Plan for Food and Nutrition Security: Potentialities and limitations / Plano Estadual de Segurança Alimentar e Nutricional: potencialidades e limites

ABSTRACT Objective To identify potentialities and limitations for the execution of a State Plan for Food and Nutrition Security. Methods This is a qualitative research, using as a case the State Plan of Food and Nutrition Security of the state of Santa Catarina. The data were collected from an interview with eight key informants nominated by the executive secretaries of the Food and Nutrition Security Council and the Inter-Sectoral Food and the state Nutrition Security Board. The analysis took place through the Collective Subject Discourse method. Results The main potentialities were the quality of the plan and the structuring of the National System of Food and Nutrition Security in the state. The main limitations were related to the financial resources, to political interests and to the structure of the Management Chamber. Conclusion It is hoped that this study may support strategies that strengthen potentialities and minimize the limitations identified in the case studied, as well as in similar state contexts, contributing to the qualification of the Plans and consequent execution of the Food and Nutrition Security Policy.

RESUMO Objetivo Este estudo teve como objetivo identificar potencialidades e limites para a execução de um Plano Estadual de Segurança Alimentar e Nutricional. Métodos Trata-se de uma pesquisa qualitativa, utilizando como caso o Plano Estadual de Segurança Alimentar e Nutricional de Santa Catarina. Os dados foram coletados a partir de entrevista com oito informantes-chave indicados pelas secretarias executivas do Conselho de Segurança Alimentar e Nutricional e da Câmara de Gestão Intersetorial de Segurança Alimentar e Nutricional do estado. A análise ocorreu por meio do método do Discurso de Sujeito Coletivo. Resultados As principais potencialidades apontadas foram a qualidade do Plano e a estruturação do Sistema Nacional de Segurança Alimentar e Nutricional no estado. Já as principais limitações estavam relacionadas aos recursos financeiros, interesse político e estrutura da Câmara de Gestão. Conclusão Espera-se que este estudo possa subsidiar estratégias tanto no caso estudado quanto em contextos estaduais similares, que fortaleçam as potencialidades e minimizem as limitações identificadas, contribuindo para a qualificação dos Planos e a consequente execução da Política de Segurança Alimentar e Nutricional.

[Compliance with guidelines by state plans for food and nutritional security in Brazil]. / Adequação normativa dos planos estaduais de segurança alimentar e nutricional no Brasil.

A descriptive and documental study was performed from August to October 2016 to analyze compliance by state plans for food and nutritional security (PlanSAN) with the guidelines set by the Brazilian National Policy for Food and Nutritional Security (PNSAN). The state plans were accessed via the websites of the Inter-Ministerial Chamber for Food and Nutritional Security (CAISAN) or the state governments, plus complementary data collection at the state level. All the states of Brazil joined the National System for Food and Nutritional Security (SISAN), while fewer than half (13 states, 48%) had drafted their plans. Of these, 5 (38%) of the PlanSAN had schedules that coincided with the same state's pluriannual plan, 5 (38%) of the PlanSAN specified the budget requirements for meeting the proposed targets, 7 (54%) specified mechanisms for monitoring the plan, and only 2 (15%) defined methodologies for monitoring food and nutritional security. The recent existence of (and adherence to) the CAISAN appear to be related to the lack of state plans in half the states. Although most of the states that did have plans met some of the guidelines laid out by the PNSAN, these mechanisms become weak and impractical when they lack earmarked budget funds to meet their targets. Since the PNSAN is structurally inter-sectorial, the development of plans requires collective work by various government departments. Importantly, the items analyzed here are all guidelines, which implies the need for mechanisms to monitor their actual implementation.

Com o intuito de analisar a adequação dos Planos Estaduais de Segurança Alimentar e Nutricional (PlanSAN) às normas estabelecidas pela Política Nacional de Segurança Alimentar e Nutricional (PNSAN), foi realizada pesquisa descritiva e documental, com coleta de dados entre agosto a outubro de 2016. O acesso aos planos foi realizado na página de Internet da Câmara Interministerial de Segurança Alimentar e Nutricional (CAISAN) ou dos governos estaduais, com coleta de informações complementares no âmbito dos estados. Todos os estados brasileiros aderiram ao Sistema de Segurança Alimentar e Nutricional (SISAN), entretanto menos da metade (13 estados, 48%) elaborou seus planos, destacando-se alguns aspectos: 5 (38%) dos PlanSAN tinham vigência correspondente ao plano plurianual do estado; 5 (38%) dos PlanSAN descreviam os requisitos orçamentários para execução das metas propostas; e 7 (54%) descreviam mecanismos de monitoramento do plano e apenas 2 (15%) definiam metodologia para monitoramento de segurança alimentar e nutricional. O menor tempo de existência da CAISAN e de adesão parecem estar relacionados com a inexistência de PlanSAN. Ainda que a maioria dos estados com planos atendam algumas normativas estabelecidas pela PNSAN, esses instrumentos tornam-se frágeis e pouco exequíveis quando não possuem vinculação orçamentária para suas metas. Pelo fato de a PNSAN ser estruturalmente intersetorial, a construção dos planos depende de um trabalho coletivo das diversas secretarias de governo. Reforça-se que os itens analisados foram todos normativos, o que implica necessidade do estabelecimento de mecanismos que garantam a sua adequada execução.

Con el propósito de analizar la adecuación de los planes estatales de seguridad alimentaria y nutricional (PlanSAN), a las normas establecidas por la Política Nacional de Seguridad Alimentaria y Nutricional (PNSAN), se realizó una investigación descriptiva y documental, con una recogida de datos entre agosto a octubre de 2016. El acceso a los planes se realizó en el sitio web de la Cámara Interministerial de Seguridad Alimentaria y Nutricional (CAISAN) de los gobiernos estatales, con una recogida de información complementaria en el ámbito de los estados. Todos los estados brasileños se adhirieron al Sistema de Seguridad Alimentaria y Nutricional (SISAN), mientras que menos de la mitad (13 estados, un 48%) elaboró sus planes, destacándose algunos aspectos: 5 (38%) de los PlanSAN tenían una vigencia correspondiente al plan plurianual del estado; 5 (38%) de los PlanSAN describían los requisitos presupuestarios para la ejecución de las metas propuestas; y 7 (54%) describían mecanismos de monitoreo del plan y solamente 2 (15%) definían la metodología para el monitoreo de la seguridad alimentaria y nutricional. El menor tiempo de existencia de la CAISAN y de adhesión parecen estar relacionados con la inexistencia de PlanSAN. A pesar de que la mayoría de los estados con planes atiendan algunas normativas establecidas por la PNSAN, esos instrumentos se convierten en frágiles y poco viables, cuando no poseen una vinculación presupuestaria para sus metas. Debido al hecho de que el PNSAN sea estructuralmente intersectorial, la construcción de los planes depende de un trabajo colectivo de las diversas secretarías de gobierno. Se refuerza que los ítems analizados fueron todos normativos, lo que implica necesidad del estabelecimiento de mecanismos que garanticen su adecuada ejecución.

Adequação normativa dos planos estaduais de segurança alimentar e nutricional no Brasil / Compliance with guidelines by state plans for food and nutritional security in Brazil / Adecuación normativa de los planes estatales de seguridad alimentaria y nutricional en Brasil

Resumo: Com o intuito de analisar a adequação dos Planos Estaduais de Segurança Alimentar e Nutricional (PlanSAN) às normas estabelecidas pela Política Nacional de Segurança Alimentar e Nutricional (PNSAN), foi realizada pesquisa descritiva e documental, com coleta de dados entre agosto a outubro de 2016. O acesso aos planos foi realizado na página de Internet da Câmara Interministerial de Segurança Alimentar e Nutricional (CAISAN) ou dos governos estaduais, com coleta de informações complementares no âmbito dos estados. Todos os estados brasileiros aderiram ao Sistema de Segurança Alimentar e Nutricional (SISAN), entretanto menos da metade (13 estados, 48%) elaborou seus planos, destacando-se alguns aspectos: 5 (38%) dos PlanSAN tinham vigência correspondente ao plano plurianual do estado; 5 (38%) dos PlanSAN descreviam os requisitos orçamentários para execução das metas propostas; e 7 (54%) descreviam mecanismos de monitoramento do plano e apenas 2 (15%) definiam metodologia para monitoramento de segurança alimentar e nutricional. O menor tempo de existência da CAISAN e de adesão parecem estar relacionados com a inexistência de PlanSAN. Ainda que a maioria dos estados com planos atendam algumas normativas estabelecidas pela PNSAN, esses instrumentos tornam-se frágeis e pouco exequíveis quando não possuem vinculação orçamentária para suas metas. Pelo fato de a PNSAN ser estruturalmente intersetorial, a construção dos planos depende de um trabalho coletivo das diversas secretarias de governo. Reforça-se que os itens analisados foram todos normativos, o que implica necessidade do estabelecimento de mecanismos que garantam a sua adequada execução.

Abstract: A descriptive and documental study was performed from August to October 2016 to analyze compliance by state plans for food and nutritional security (PlanSAN) with the guidelines set by the Brazilian National Policy for Food and Nutritional Security (PNSAN). The state plans were accessed via the websites of the Inter-Ministerial Chamber for Food and Nutritional Security (CAISAN) or the state governments, plus complementary data collection at the state level. All the states of Brazil joined the National System for Food and Nutritional Security (SISAN), while fewer than half (13 states, 48%) had drafted their plans. Of these, 5 (38%) of the PlanSAN had schedules that coincided with the same state's pluriannual plan, 5 (38%) of the PlanSAN specified the budget requirements for meeting the proposed targets, 7 (54%) specified mechanisms for monitoring the plan, and only 2 (15%) defined methodologies for monitoring food and nutritional security. The recent existence of (and adherence to) the CAISAN appear to be related to the lack of state plans in half the states. Although most of the states that did have plans met some of the guidelines laid out by the PNSAN, these mechanisms become weak and impractical when they lack earmarked budget funds to meet their targets. Since the PNSAN is structurally inter-sectorial, the development of plans requires collective work by various government departments. Importantly, the items analyzed here are all guidelines, which implies the need for mechanisms to monitor their actual implementation.

Resumen: Con el propósito de analizar la adecuación de los planes estatales de seguridad alimentaria y nutricional (PlanSAN), a las normas establecidas por la Política Nacional de Seguridad Alimentaria y Nutricional (PNSAN), se realizó una investigación descriptiva y documental, con una recogida de datos entre agosto a octubre de 2016. El acceso a los planes se realizó en el sitio web de la Cámara Interministerial de Seguridad Alimentaria y Nutricional (CAISAN) de los gobiernos estatales, con una recogida de información complementaria en el ámbito de los estados. Todos los estados brasileños se adhirieron al Sistema de Seguridad Alimentaria y Nutricional (SISAN), mientras que menos de la mitad (13 estados, un 48%) elaboró sus planes, destacándose algunos aspectos: 5 (38%) de los PlanSAN tenían una vigencia correspondiente al plan plurianual del estado; 5 (38%) de los PlanSAN describían los requisitos presupuestarios para la ejecución de las metas propuestas; y 7 (54%) describían mecanismos de monitoreo del plan y solamente 2 (15%) definían la metodología para el monitoreo de la seguridad alimentaria y nutricional. El menor tiempo de existencia de la CAISAN y de adhesión parecen estar relacionados con la inexistencia de PlanSAN. A pesar de que la mayoría de los estados con planes atiendan algunas normativas establecidas por la PNSAN, esos instrumentos se convierten en frágiles y poco viables, cuando no poseen una vinculación presupuestaria para sus metas. Debido al hecho de que el PNSAN sea estructuralmente intersectorial, la construcción de los planes depende de un trabajo colectivo de las diversas secretarías de gobierno. Se refuerza que los ítems analizados fueron todos normativos, lo que implica necesidad del estabelecimiento de mecanismos que garanticen su adecuada ejecución.

Prevalência de fatores de risco cardiovascular em idosos não institucionalizados / Prevalence of cardiovascular risk factors in non-institutionalized elderly

INTRODUÇÃO: Na medida em que mais pessoas vivem até a idade avançada, aumenta a prevalência de doenças em que a idade é fator de risco, como as doenças cardiovasculares. OBJETIVO: Descrever as prevalências de fatores de risco para doenças cardiovasculares em idosos não institucionalizados, conforme sexo e grupo etário. MÉTODO: Estudo transversal com amostra de conveniência composta por idosos não institucionalizados. Foram analisadas as variáveis hipertensão arterial, hipercolesterolemia, excesso de peso e adiposidade abdominal. Utilizou-se o teste Qui-quadrado para a análise das diferenças estatísticas. RESULTADOS: As prevalências de hipertensão arterial, hipercolesterolemia, excesso de peso e adiposidade abdominal foram, respectivamente, de 82,30% para idosas e 76,81% para idosos (p>0,05), 43,64% para idosas e 25,48% para idosos (p<0,05), 47,40% para idosas e 36,12% para idosos (p<0,05) e de 76,16% para idosas e 41,06% para idosos (p<0,05). A respeito das diferenças por grupo etário, identificou-se menor prevalência, somente para o excesso de peso, à medida que a idade avança. CONCLUSÃO: As idosas podem ser consideradas como grupo mais vulnerável para fatores de risco cardiovascular, pois tiveram maior número de medidas com valores acima do recomendado, bem como maior prevalência de hipertensão arterial, hipercolesterolemia, excesso de peso e adiposidade. Com relação ao grupo etário, identificou-se menor prevalência somente para o excesso de peso, à medida que a idade avança.

INTRODUCTION: As people live longer, prevalence of diseases in which age is risk factor increase, as cardiovascular disease OBJECTIVE: To investigate the prevalence of risk factors for cardiovascular diseases in non-institutionalized elderly by different age and sex groups. METHOD: Cross-sectional study with a convenience sample of non-institutionalized elderly. The variables hypertension, hypercholesterolemia, overweight and abdominal adiposity were investigated. The chi-square test was used to analyze statistical differences. RESULTS: The prevalence of hypertension, hypercholesterolemia, overweight and abdominal fat were, respectively, 82.30% for woman and 76.81 for men (p>0.05), 43.64% for woman and 25.48% for men (p<0.05), 47.40% for woman and 36.12% for men (p<0.05) and 76.16% for woman and 41.06% for men (p<0.05). Prevalence of overweight was lowest in the age group >80 year. CONCLUSION: Older woman may be considered as the most vulnerable group for cardiovascular disease, with variables above recommended, and higher prevalence of arterial hypertension, hypercholesterolemia, overweight and abdominal adiposity. Regarding age group, we identified prevalence in overweight only, as age advances.

Prevenção de quedas: capacitação de profissionais de saúde para a semana mundial de 2011 / Fall prevention: training health professionals for the 2011 global week

Fraturas por quedas são identificadas em um número expressivo de pessoas idosas.Em 2007, a prevalência de quedas em idosos brasileiros frequentadores da Rede Básicas de Saúde, foi...