Nutritional interventions in prison settings: a scoping review.

BACKGROUND: Mounting evidence has shown that incarceration can affect the health and well-being of individuals and increase the risk of noncommunicable diseases (NCDs). Diet quality is known to be one of the main determinants of risk of NCDs, and dietary changes are the first approach used in primary care to reduce the incidence of NCDs. OBJECTIVE: This scoping review aimed to summarize the evidence for (1) the diet quality of inmates, and (2) the effect of nutritional intervention in prison systems. In addition, we aimed to describe limitations in the current literature and to suggest potential future research areas. METHOD: A systematic search was performed in 2 databases (PubMed and Web of Science) using predefined search terms and covering the period May 2023 to June 2023. Additionally, reference lists from the retrieved studies were hand-searched to identify any additional relevant publications. The identified literature was screened based on defined search strategies, criteria, and research questions defined using the PICo (population or problem, interest, and context) framework. The review was conducted referring to the PRISMA-ScR and the PICo framework. RESULTS: A total of 19 studies out of 63 initially identified records were included in this review (11 cross-sectional evaluations and 9 intervention-based studies). In almost all studies, assessment of the diet quality of menus showed the menus to be nutritionally adequate, except for having a higher-than-recommended intake of total energy, saturated fatty acids, sodium, cholesterol, and sugar. In addition, some studies reported a lower-than-recommended intake of fiber, magnesium, potassium, vitamins D, E, and A, and omega-3 fatty acids. Nutritional interventions were mainly planned in the form of workshops, seminars, and written material to deliver information on healthy dietary choices. Although no significant changes in inmates' dietary choices were observed in any of the studies, a high participation rate was detected. CONCLUSION: Inmates might require additional prevention intervention to reduce their susceptibility to cardiometabolic diseases by virtue of their isolation from community facilities. Interventions should be tailored to the characteristics of prison settings and inmates to increase adherence to nutritional recommendations.

A three-component Breakfast Quality Score (BQS) to evaluate the nutrient density of breakfast meals.

Background: Nutrient profiling methods can be applied to individual foods or to composite meals. This article introduces a new method to assess the nutrient density of breakfast meals. Objective: This study aimed to develop a new breakfast quality score (BQS), based on the nutrient standards previously published by the International Breakfast Research Initiative (IBRI) consortium. Methods: BQS was composed of three sub-scores derived from the weighted arithmetic mean of corresponding nutrient adequacy: an eLIMf sub-score (energy, saturated fat, free sugars, and sodium), a PF (protein and fiber) sub-score, and a VMn1 - 14 micronutrient sub-score, where n varied from 0 to 14. The effects of assigning different weights to the eLIMf, PF, and VMn were explored in four alternative models. The micronutrients were calcium, iron, potassium, magnesium, zinc, vitamin A, thiamin, riboflavin, niacin, vitamin B5, vitamin B6, vitamin B12, vitamin C, and vitamin D. Micronutrient permutations were used to develop alternate VMn1 - 14 sub-scores. The breakfast database used in this study came from all breakfasts declared as consumed by adults (>18 years old) in the French dietary survey INCA3. All models were tested with respect to the Nutrient Rich Food Index (NRF9.3). BQS sensitivity was tested using three prototype French breakfasts, for which improvements were made. Results: The correlations of the models with NRF9.3 improved when the VMn>3 sub-score (n > 3) was included alongside the PF and eLIMf sub-scores. The model with (PF+VMn) and eLIMf each accounting for 50% of the total score showed the highest correlations with NRF9.3 and was the preferred final score (i.e., BQS). BQS was sensitive to the changing quality of three prototype breakfasts defined as tartine, sandwich, and cereal. Conclusion: The proposed BQS was shown to valuably rank the nutritional density of breakfast meals against a set of nutrient recommendations. It includes nutrients to limit along with protein, fiber, and a variable number of micronutrients to encourage. The flexible VMn sub-score allows for the evaluation of breakfast quality even when nutrient composition data are limited.

Dietary recommendations to customize canteen menus according to the nutritional and sensory needs of individuals with autism spectrum disorder.

Individuals with autism spectrum disorders (ASD) are often characterized by food-selectivity, food-neophobia and a marked preference for mild flavor, semi-liquid foods with pale colors. Therefore, they adopt a monotonous dietary pattern, and they prefer ultra-processed food, leading to a high risk of developing malnutrition. In Italy, where 75,072 individuals are diagnosed with ASD, center-based services play a crucial role in their daily management. Despite the centrality of nutrition in maintaining a good state of health, even more for vulnerable subjects, no validated protocol at collective catering level has been developed yet. The manuscript presents customized dietary recommendations aimed at managing the meals for individuals with ASD at collective catering service, derived from a non-systematic literature review exploring food behaviors and nutritional needs in individuals with ASD. Simple practical tips for mealtimes, such as eating together, proper seating, lighting, smell control, presenting food in a simple manner and using the same type of tableware at each meal, to meet the needs of individuals with ASD, were described. The proposal could represent a starting point in developing official guidelines aimed at ASD individuals, in collective catering service.Level of Evidence: Level V.

Setting references for daily intake of micronutrients: A study on magnesium.

OBJECTIVES: The Institute of Medicine stratifies the references for daily nutrient intake into age and sex groups, considering that the basal metabolic rate varies according to these aspects, and in most cases, it extrapolates the values calculated for adults to children, because their body weights are different. In this context, this study aimed to evaluate the recommendation for magnesium in children according to energy expenditure. METHODS: This was an observational study using the database of the Social Changes, Asthma and Allergy in Latin America (SCAALA) cohort, which randomly collected information from 1445 children ages 4 to 11 y. Of these, 480 (33%) were part of the present study (children between 7 and 11 y old with eutrophic body mass index and adequate growth). Information on food intake was obtained from the child's parents or legal guardians through a 24-h recall. The population was characterized using static analyses such as the Student t test, Pearson correlation coefficient, and linear regression. RESULTS: The mean age of the sample was 8.5 ± 0.96 y, and 54% were males. The mean magnesium intake was 149 ± 70 mg, with a high correlation observed between energy expenditure and magnesium intake (boys: R, 0.716; P <0.001; girls: R, 0.641; P < 0.001). CONCLUSIONS: The metabolic rate can be considered a reference variable for recommending the daily intake of the studied nutrient, aiming to avoid deficiencies and food poisoning because of poor intake.

Nutritional Recommendations for Type 2 Diabetes: An International Review of 15 Guidelines.

OBJECTIVES: Recommendations from clinical practice guidelines (CPGs) for individuals with type 2 diabetes mellitus (T2DM) may be inconsistent, and little is known about their quality. Our aim in this study was to systematically review the consistency of globally available CPGs containing nutritional recommendations for T2DM and to assess the quality of their methodology and reporting. METHODS: PubMed, China Biology Medicine and 4 main guideline websites were searched. Four researchers independently assessed quality of the methodology and reporting using the Appraisal of Guidelines for Research and Evaluation, second edition (AGREE II) instrument and the Reporting Items for Practice Guidelines in HealThcare (RIGHT) checklist. RESULTS: Fifteen CPGs include 65 nutritional recommendations with 6 sections: 1) body weight and energy balance; 2) dietary eating patterns; 3) macronutrients; 4) micronutrients and supplements; 5) alcohol; and 6) specific, functional foods. Current nutritional recommendations for individuals with T2DM on specific elements and amounts are not completely consistent in different CPGs and fail to assign the specific supporting evidence and strength of recommendations. To use nutritional recommendations to guide and manage individuals with T2DM, it is important to address the current challenges by establishing a solid evidence base and indicating the strength of recommendations. Overall, 8 CPGs classified as recommended for clinical practice used AGREE II. Fifteen CPGs adhere to <60% of RIGHT checklist items. CONCLUSIONS: High-quality evidence is needed to potentially close knowledge gaps and strengthen the recommendation. The AGREE II instrument, along with the RIGHT checklist, should be endorsed and used by CPG developers to ensure higher quality and adequate use of their products.

Sostenibilidad alimentaria: claves para el consumidor, ventajas e inconvenientes / Food sustainability: keys for the consumer, advantages and disadvantages

Para atender las necesidades alimentarias y nutricionales de una población creciente y garantizar los recursos naturales y productivos, lossistemas alimentarios deben experimentar cambios adoptando dietas más sostenibles. Diferentes organismos e instituciones recomiendanpatrones de dieta variada y equilibrada, con predominio de alimentos de origen vegetal y menor presencia de alimentos de origen animal, paramejorar el estado de salud y bienestar y reducir el impacto medioambiental. Este tipo de dietas presentan beneficios en la salud, sobre todosi están bien planificadas y los alimentos se combinan adecuadamente. Sin embargo, en algunas etapas de la vida (escolares, adolescentes,ancianos) y en situaciones fisiológicas especiales (embarazadas, deportistas) se debe prestar atención a los requerimientos nutricionales, quepodrían verse comprometidos en caso de no llevar a cabo una correcta planificación dietética, lo que podría derivar en problemas para la salud.Por ello, para facilitar la transición de los consumidores a una dieta sostenible, se deben promover estrategias bien diseñadas que incluyanprogramas de educación nutricional con instrucciones específicas acerca de las elecciones y combinaciones de alimentos más adecuadas paraaumentar el valor nutricional de la dieta. Además, en situaciones fisiológicas específicas en las que alcanzar los requerimientos nutricionalespudiera estar comprometido, podría considerarse el consumo de alimentos enriquecidos y/o la administración de suplementos. (AU)

To meet the food and nutritional needs of a growing population and, at the same time, guarantee natural and productive resources, food systemsmust undergo changes in production models and consumption patterns, adopting more sustainable diets. The recommendations of differentorganizations and institutions are aimed at adopting a varied and balanced dietary pattern, with a greater predominance of plant-based food anda lower presence of animal food, to improve the state of health and well-being, while reducing the environmental impact. These types of diets haveimportant health benefits, especially if diets are well planned and foods are properly combined. However, in some stages of life (schoolchildren,adolescents, elders) and in some special physiological situations (pregnancy, athletes), special attention should be paid to the increase of certainnutritional requirements that could compromise the health status if a correct dietary planning is not carried out. Therefore, well-designed strategies should be put in place to facilitate the transition to a sustainable diet, including nutrition education programs for consumers with specificinstructions on the most appropriate food choices to increase the nutritional value of the diet. In addition, in specific physiological situations,where meeting nutritional requirements may be compromised, the consumption of fortified foods and/or supplementation could be considered. (AU)

Energy and Macronutrients Intake in Indoor Sport Team Athletes: Systematic Review.

Indoor team sports are characterized by matches that are shorter in duration and with frequent substitution (high-intensity intermittent). The main goal of teams is to best cover athletes' physiological demands, while meeting their dietary intake needs is critical. The aim of this study is to conduct a systematic review of the dietary intake of indoor team sports athletes and to analyze whether they comply with nutritional recommendations. A search of PubMed-MEDLINE, Web of Science, and Scopus databases from 2008 to July 2022 was conducted and 2727 documents were identified. The studies focused on adult professional or semi-professional volleyball, basketball, handball, or futsal athletes. Two independent researchers screened and extracted the data, with 20 documents included after they met the inclusion criteria. Most of the athletes, both men and women, did not meet the official recommendations based on under-consumption (energy and carbohydrates) or over-consumption (fats). In relation to protein, 28.6% of studies met the recommendations, with 50% of those who did not meet it being due to under-consumption. Although there are references on athletes' dietary intakes, there are no references considering sexes or types of sport. More adapted recommendations are needed in order to more precisely evaluate athletes' intake to know if they meet their real nutritional requirements.

Actualización científica de Nutri-Score: mejoras para corregir algunas de sus limitaciones y garantizar una mayor coherencia con las recomendaciones nutricionales / Scientific update of Nutri-Score: improvements to correct some of its limitations and to ensure greater consistency with Nutritional recommendations

El objetivo de este artículo es resumir de manera objetiva el informe del Comité Científico Europeo que acaba de actualizar el algoritmo en el que se basa el logotipo nutricional Nutri-Score. Se revisa la metodología utilizada, las prioridades establecidas y sus justificaciones, y los diferentes escenarios probados, las modificaciones propuestas y su impacto en los diferentes grupos de alimentos afectados.El Comité Científico consideró que el algoritmo actual funciona en general bien, pero ha introducido algunas mejoras. Las modificaciones recomendadas por el Comité permiten corregir algunas limitaciones identificadas: clasificación de los aceites, pescados grasos, productos integrales, frutos secos y quesos, así como la penalización superior de los alimentos muy azucarados o muy salados, productos lácteos azucarados, platos preparados y carnes rojas, entre otros, manteniendo al mismo tiempo la coherencia global del sistema y la clasificación general de los productos entre ellos. Con la actualización del algoritmo de Nutri-Score se observa globalmente una mejor alineación entre las clasificaciones obtenidas por Nutri-Score y las recomendaciones dietéticas en vigor en los diferentes países europeos que lo han adoptado. (AU)

The aim of this article is to objectively summarize the report of the European Scientific Committee in charge of updating the algorithm underlying the front-of-pack Nutritional label Nutri-Score. It described the methodology used and the priorities established, the scientific rational and the different scenarios tested, the proposed modifications and their impact on the different food groups concerned.The Scientific Committee considered that its current algorithm works globally well, but has introduced some improvements. Modifications recommended allow to correct some of its identified limits: classification of oils, fatty fish, whole grain products, nuts, cheeses, higher penalization of very sugary or very salty foods, sweet dairy products, composite products, red meat... while maintaining the overall consistency of the system and the classification of the products. The update of the Nutri-Score algorithm permits a better alignment between the Nutri-Score classifications and Nutritional recommendations disseminated in the different European countries that have adopted it. (AU)

How Do Male Football Players Meet Dietary Recommendations? A Systematic Literature Review.

The aim of this review was to determine whether male football players meet dietary recommendations according to a UEFA expert group statement and to identify priority areas for dietetic intervention, including training periodization and field position. A database search of PubMed, Web of Science, EBSCO and Scopus was performed. To be included within the final review, articles were required to provide a dietary intake assessment of professional and semi-professional football players. A total of 17 studies met the full eligibility criteria. Several studies showed insufficient energy and carbohydrate intake compared to the recommendations. A majority of athletes consume adequate protein and fat intakes compared to the recommendations. In addition, several studies showed the insufficient intake of vitamins and minerals. This systematic review showed that football players do not meet the nutritional recommendations according to the UEFA expert group statement. Future research should be focused on how to apply nutritional recommendations specific for athletes in accordance with training periodization and positions on the field.

The 2018 Revision of Italian Dietary Guidelines: Development Process, Novelties, Main Recommendations, and Policy Implications.

The fourth edition of the Italian Dietary Guidelines (IDGs) for Healthy Eating was published in 2019. The objective of this paper is to describe the developmental process of IDGs, the main recommendations, the differences with previous revisions, and the concordance and differences with international guidance on a healthy diet. A National Commission oversaw IDG development. A Scientific Dossier (SD), including analysis on nutrition, health, and risk factors status in Italy, was the reference for IDGs preparation. The IDGs are based on the principles of the Mediterranean Diet and are mainly aimed to prevent obesity and nutrition-related non-communicable diseases. The IDGs included 13 directives that were divided into four conceptual blocks: i) how to balance weight; ii) foods to be promoted; iii) foods to be limited; and iv) how to ensure a varied and sustainable diet. Each directive has a box summarizing the key recommendation, myths lists, and false beliefs to be dispelled. The topics of sustainability and the correct approach to food supplementation and weight-loss diet were introduced in the present edition of IDGs. This paper contributes to the debate on the complexity of derivation of Dietary Guidelines and their adaptation to the national context.

Differences in Cost-Effectiveness of Adherence to Nutritional Recommendations: Why, Where, and What?

Cost-effectiveness analysis of diets may comprise an important tool to promote food security; however, studies show divergent evidence regarding the relationship between diet quality and cost in diverse populations. Thus, this study assesses differences in cost-effectiveness ratios regarding adherence to nutritional recommendations using data representative of the population level in Sao Paulo municipality, Brazil. Information from adolescents and adult individuals (n = 1742) was used to estimate diet quality and cost in 2015. Differences in cost-effectiveness ratios were investigated through application of two diet quality indexes and exploration of individuals' personal and contextual characteristics. Results indicated that higher diet cost was associated with higher adherence to nutritional recommendations at the national level and inversely associated with adherence to international recommendations. Purchasing foods in street markets was linked to healthier diets at lower costs, and protein consumption was associated with higher diet cost regardless of diet quality; however, diet quality was linked to type of protein consumed by individuals. Differences in cost-effectiveness ratios were attributable to methodological choices in measuring dietary quality (why); individuals' personal and contextual characteristics, in particular, access to retail equipment (where); and certain food choices (what). Therefore, cost-effectiveness analyses should be tailored to policy goals and local environments to ensure proper assessment of nutrition programs and to foster improvements in nutritional diet quality at lower cost.

Avaliação do consumo de frutas em pacientes com diabetes mellitus tipo 2 / Fruit consumption in patients with type 2 diabetes mellitus

Introdução: O impacto do consumo de frutas sobre a saúde de pacientes com diabetes mellitus tipo 2 (DM2) requer investigações. O objetivo deste estudo foi avaliar o consumo de frutas em pacientes com DM2 e identificar a sua associação com parâmetros de controle glicêmico.Métodos: Foram incluídos 197 pacientes ambulatoriais com DM2, submetidos à avaliação clínica, sociodemográfica, antropométrica, laboratorial e de consumo alimentar. A ingestão alimentar total e o consumo de frutas foram avaliados por questionário quantitativo de frequência alimentar. Os pacientes com menor e maior consumo de frutas (de acordo com a mediana) foram comparados.Resultados: A média do consumo de frutas foi de 593,66 ± 330,74 g/dia. Entre os menores e maiores consumidores de frutas, os valores de glicemia (169,42 ± 70,83 vs. 158,62 ± 64,56 mg/dL; p = 0,273) e hemoglobina glicada (8,39 ± 1,68 vs. 8,68 ± 2,38%; p = 0,319) não foram diferentes, assim como as demais variáveis. Os pacientes com maior consumo de frutas apresentaram maior ingestão de energia (p < 0,001), carboidratos (p < 0,001) e fibras (p = 0,006) e uma menor ingestão de proteínas (p = 0,015), lipídeos totais (p = 0,040) e seus tipos. O grupo que mais consumiu frutas apresentou uma maior ingestão de vitamina C (p < 0,001) e potássio (p < 0,001) e um menor consumo de sódio (p = 0,001). Foi observado ainda uma correlação negativa entre o consumo de frutas e o índice glicêmico da dieta (p = 0,05).Conclusão: Não houve diferença na glicemia em jejum e no valor de hemoglobina glicada entre os pacientes com DM2 com maior e menor consumo de frutas.

Introduction: The impact of fruit consumption on the health of patients with type 2 diabetes mellitus (T2DM) warrants investigation. The aim of this study was to evaluate fruit consumption in patients with T2DM and to identify its association with glycemic control parameters.Methods: We included 197 outpatients with T2DM who underwent clinical, sociodemographic, anthropometric, laboratory, and food consumption assessments. A food frequency questionnaire was used to assess total food intake and fruit consumption. Patients with lower and higher fruit consumption (according to the median) were compared.Results: Average fruit consumption was 593.66 ± 330.74 g/day. Blood glucose (169.42 ± 70.83 vs. 158.62 ± 64.56 mg/dL; p = 0.273) and glycated hemoglobin (8.39 ± 1.68% vs. 8.68 ± 2.38%; p = 0.319) levels did not differ between the lower and higher fruit consumption groups, nor did the other variables. Patients with higher fruit consumption had a higher intake of energy (p < 0.001), carbohydrates (p < 0.001), and fibers (p = 0.006) but a lower intake of proteins (p = 0.015) and total and different types of lipids (p = 0.040). The higher consumption group had higher vitamin C (p < 0.001) and potassium (p < 0.001) intake and lower sodium intake (p = 0.001). We identified a negative correlation between fruit consumption and the diet's glycemic index (p = 0.05).Conclusion: Fasting blood glucose and glycated hemoglobin levels did not differ between the higher and lower fruit consumption groups.

How Does the Dietary Intake of Female Field-Based Team Sport Athletes Compare to Dietary Recommendations for Health and Performance? A Systematic Literature Review.

Field-based team sports present large energetic demands given their intermittent high-intensity nature. Current evidence suggests that the dietary intake of female athletes may be insufficient to meet such demands, resulting in negative consequences for athletic performance and health. The primary aim of this review was to therefore assess the adequacy of dietary intake of female field-based team sport athletes when compared to dietary recommendations. A systematic search of databases, including PubMed, Web of Science, SPORTDiscus, and OpenGrey, was performed from the earliest record available until July 2020, obtaining an initial total of 2588 articles. To be included within the final review, articles were required to provide a quantitative assessment of baseline dietary intake specific to the target population. A total of 20 studies (n = 462) met the full eligibility criteria. A majority reported that the dietary intake of female field-based team sport athletes was insufficient in overall energy (2064 ± 309 kcal·day-1), carbohydrate (4.3 ± 1.2 g·kg·day-1), and iron intake (13.6 ± 6.2 mg·day-1) when compared to recommendations. Future research is required to establish why female team sport athletes consistently demonstrate deficient dietary practices, and to explore the potential negative consequences of this.

Case Study: Free Lunch Meals Provision during the Remote Learning Conditions.

School meals for grade 1 to 4 pupils in Latvia are financed by the government, but with the onset of the COVID-19 pandemic in March 2020, and following the remote learning process, there were problems related to the delivery of these meals for pupils. The current situation in Latvia has been exacerbated again due to the spread of the pandemic; there is a great necessity to find well-thought-out solutions to ensure school lunches outside the school. The aim of this study was to develop recommendation-based one-week food packs for grade 1 to 4 pupils, providing the necessary amount of nutrients and energy. Four food packs were designed to provide five-day lunch meals for pupils, preparing a warm lunch at home. Protein, fat, saturated fatty acids, carbohydrates, sugar, dietary fiber, sodium, salt and calcium content of meals were analyzed according to standard methods. During the project, the most appropriate solution for food packs was explored. The four designed food packs will provide support to municipalities, because the composition of food packs complies with the nutrition and energy value regulation and does not exceed the planned budget. Parents will receive the developed recipe book in addition to a one-week food pack.

Selenium and Dogs: A Systematic Review.

The intent of this review is to summarize the knowledge about selenium and its function in a dog's body. For this purpose, systematic literature search was conducted. For mammals, including dogs, a balanced diet and sufficient intake of selenium are important for correct function of metabolism. As for selenium poisoning, there are no naturally occurring cases known. Nowadays, we do not encounter clinical signs of its deficiency either, but it can be subclinical. For now, the most reliable method of assessing selenium status of a dog is measuring serum or plasma levels. Levels in full blood can be measured too, but there are no reference values. The use of glutathione peroxidase as an indirect assay is questionable in canines. Commercial dog food manufactures follow recommendations for minimal and maximal selenium levels and so dogs fed commercial diets should have balanced intake of selenium. For dogs fed home-made diets, complex data are missing. However, subclinical deficiency seems to affect, for example, male fertility or recovery from parasitical diseases. Very interesting is the role of selenium in prevention and treatment of cancer.

Conhecimento de recomendações nutricionais por outros profissionais da Estratégia Saúde da Família / Knowledge on nutritional recommendations by doctors and nurses of the Family Health Strategy / Conocimiento de recomendaciones nutricionales de otros profesionales de la Estrategia Salud de la Familia

Objetivo: Analisar o conhecimento de médicos e enfermeiros da Estratégia Saúde da Família sobre as orientações nutricionais para diabetes mellitus tipo 2 (DM2) e hipertensão arterial sistêmica (HAS). Métodos: Estudo transversal e descritivo realizado com 67 médicos e enfermeiros de 11 Unidades de Atenção Primária à Saúde da Regional II do município de Fortaleza, Ceará, entre dezembro de 2019 e janeiro de 2020. Foram incluídos profissionais contratados, concursados ou participantes de programas de educação em serviço, aplicando-se um questionário fechado do tipo Likert, elaborado pelos pesquisadores, contendo 29 questões relacionadas às recomendações nutricionais das sociedades de referência em DM2 e HAS, e do Guia Alimentar para a População Brasileira. A análise dos dados ocorreu de forma descritiva, utilizando frequências absolutas e relativas e teste qui-quadrado. Resultados: A concordância com as diretrizes nutricionais das sociedades de referência de DM2 e HAS pelos profissionais foi de 17,9% (n=12) para a proporção de carboidratos na dieta do paciente diabético; 22,4% (n=15) para o consumo de café e controle da pressão arterial; 34,3% (n=23) para o consumo de açúcar pelo diabético e 37,3% (n=25) para o consumo de leite e controle da pressão arterial. Em relação às orientações do guia alimentar, a totalidade (n=67) dos entrevistados concordou que os alimentos ultraprocessados devem ser evitados, e que deve haver regularidade e atenção no consumo das refeições. Conclusão: Os profissionais apresentaram conhecimento insuficiente a respeito das recomendações nutricionais estabelecidas pelas principais sociedades nacionais e internacionais de DM2 e HAS.

Objective: To analyze the knowledge of doctors and nurses from the Family Health Strategy on nutritional guidelines for type 2 diabetes mellitus (DM2) and systemic arterial hypertension (SAH). Methods: Cross-sectional and descriptive study was carried out with 67 physicians and nurses from 11 Primary Health Care Units in Regional II in the city of Fortaleza, Ceará, between December 2019 and January 2020. service, applying a closed Likert-type questionnaire, prepared by the researchers, containing 29 questions related to the nutritional recommendations of reference societies in DM2 and SAH, and the Food Guide for the Brazilian Population. Data analysis was descriptive, using absolute and relative frequencies and the chi-square test. Results: The agreement of the nutritional guidelines of the reference societies of DM2 and SAH by the professionals was 17.9% (n=12) for the proportion of carbohydrates in the diabetic patient's diet; 22.4% (n=15) for coffee consumption and blood pressure control; 34.3% (n=23) for the consumption of sugar by the diabetic and 37.3% (n=25) for the consumption of milk and blood pressure control. Regarding the guidelines of the Food Guide, all (n=67) of the interviewees agreed that ultra-processed foods should be avoided and that there should be regularity and attention in the consumption of meals. Conclusion: The professionals showed a lack of knowledge about the nutritional recommendations established by the main national and international societies of DM2 and SAH.

Objetivo: Analizar el conocimiento de médicos y enfermeros de la Estrategia Salud de la Familia sobre las orientaciones nutricionales de la Diabetes Mellitus del tipo 2 (DM2) y la Hipertensión Arterial Sistémica (HAS). Métodos: Estudio transversal y descriptivo realizado con 67 médicos y enfermeros de 11 Unidades de Atención Primaria de Salud de la Regional II del municipio de Fortaleza, Ceará, Brasil, entre diciembre de 2019 y enero de 2020. Se ha incluido los profesionales contratados, los concursantes o los participantes de programas de educación en servicio aplicándose un cuestionario cerrado del tipo Likert elaborado por los investigadores con 29 preguntas relacionadas con las recomendaciones nutricionales de las sociedades de referencia en DM2 y HAS, y del Guía Alimentario para la Población Brasileña. El análisis de los datos se dio de modo descriptivo utilizándose las frecuencias absolutas y relativas y la prueba de chi-cuadrado. Resultados: La concordancia con las directrices nutricionales de las sociedades de referencia de DM2 y HAS por los profesionales ha sido del 17,9% (n=12) para la proporción de carbohidratos de la dieta del paciente diabético; el 22,4% (n=15) para el consumo de café y el control de la presión arterial; el 34,3% (n=23) para el consumo de azúcar por el diabético y el 37,3% (n=25) para el consumo de la leche y el control de la presión arterial. Respecto las orientaciones de la guía alimentaria, la totalidad (n=67) de los entrevistados estuvo de acuerdo de que se debe evitar a los alimentos ultra procesados y tener regularidad y atención con el consumo de las comidas. Conclusión: Los profesionales presentaron conocimiento insuficiente respecto las recomendaciones nutricionales establecidas por las principales sociedades nacionales e internacionales de DM2 y HAS.

Viabilidade no atendimento às normas do Programa Nacional de Alimentação Escolar e sua relação com custo dos cardápios / Feasibility in meeting nutrient amounts of the National School Feeding Program and its relationship with the menu cost

Resumo O estudo avaliou a viabilidade da adequação de cardápios em relação às exigências nutricionais estabelecidas pelo Programa Nacional de Alimentação Escolar (PNAE) e a relação entre o custo do cardápio. Cada cardápio semanal contou de uma combinação de alimentos dentro de cada grupo. Para cada combinação de alimentos foi elaborado um modelo de otimização de dados para obter as quantidades de cada alimento de forma a atender às exigências do PNAE ao menor custo possível (cardápios com 20% e 30% da ingestão dietética de referência para energia, macronutrientes, cálcio, ferro, magnésio, zinco, vitaminas A e C, além de restrições para sódio, gorduras saturada e trans, e açúcar de adição). Não foi obtida nenhuma solução que acomodasse todas as exigências do PNAE. Os componentes limitantes foram cálcio, sódio e carboidratos; para os demais os cardápios foram adequados. O custo foi diretamente correlacionado com a frequência de carne e frutas, e inversamente com os conteúdos de sódio e carboidratos, e com as frequências de arroz e feijão. A probabilidade de adequação de carboidratos foi próxima de zero quando a frequência de carne foi acima de 1 vez por semana. Concluindo, é pouco provável a obtenção de cardápios que atendam à todas as exigências do PNAE.

Abstract We evaluated the feasibility of the menu adequacy regarding the nutritional constraints established by the National School Feeding Program (PNAE) and its relation to the cost. Each menu accounted for a given food combination within each food group. A diet optimization model comprising each set of foods was designed to obtain food quantities in order to meet the exigences of the PNAE at the lowest cost (menus with 20% and 30% of dietary reference intake for energy, macronutrients, calcium, iron, magnesium, zinc, vitamins A and C, also restrictions for sodium, saturated and trans fats, and added sugar). There was no feasible solution that accommodated all nutrient targets. Limiting components were calcium, sodium, and carbohydrates; but the menus were adequate for the other nutrients. There was a positive correlation between the menu cost and the frequency of meat and fruits, and a negative correlation with the contents of sodium and carbohydrates, and with the frequencies of rice and beans. The probability of obtaining carbohydrate adequacy was close to zero when the meat frequency was higher than one serving per week. In conclusion, it is unlikely to obtain menus that meet all the requirements of the PNAE.

O uso terapêutico dos alimentos em meados do século XIX / The therapeutic use of food in the mid-19th century

Introdução: No decorrer do século XIX surgiram as primeiras informações a respeito das substâncias químicas contidas nos alimentos. A partir dessas descobertas, a higiene alimentar como meio terapêutico estabeleceu critérios para a prescrição de azote (nitrogênio) e carbone (carbono), bem como recomendações alimentares nos diferentes ciclos de vida e estados de convalescença. Objetivos: Este trabalhou buscou analisar como e para que fins eram prescritos alguns alimentos cuja composição química era caracterizada pela presença do azote (nitrogênio) e carbone (carbono). Método: Foram utilizados como fonte de pesquisa os cadernos de visitas (prontuários) de embarcações encontrados no Arquivo Histórico da Marinha Portuguesa, os tratados médicos do período e publicações referentes à história da ciência e nutrição. Resultados e discussão: Nos cadernos de visitas consultados (anos 1859 e1863), as refeições à base de alimentos de origem animal (ricos em azote), como os caldos de carne e de galinha, foram as mais prescritas aos doentes, pois se pautavam nos princípios da dieta fibrinosa, que promovia a reparação tecidual e crescimento da matéria orgânica. Considerações finais: Ao longo dos dois últimos séculos, muitas teorias a respeito da função dos alimentos se modificaram, mas parte significativa de seus pressupostos foram constituídos no decorrer do século XIX.

Introduction: During the 19th century, emerged the first information about the chemical substances contained in food. From these discoveries, food hygiene as a therapeutic mean established criteria for the prescription of nitrogen (nitrogen) and carbon (carbon), as well as dietary recommendations in the different life cycles and convalescent states. Objectives: This work sought to analyze how and for what purposes some foods whose chemical composition was characterized by the presence of nitrogen (nitrogen) and carbon (carbon)were prescribed . Methodology: The visiting notebooks (medical records) of vessels found in the Historical Archive of the Portuguese Navy, medical treaties of the period and publications referring to the history of science and nutrition were used as a research source. Results and discussion: In the consulted notebooks (years 1859 and 1863), meals based on animal foods (rich in nitrogen), such as meat and chicken broths, were the most prescribed to patients, as they were based on principles of the fibrinous diet, which promoted tissue repair and growth of organic matter. Final considerations: Over the past two centuries, many theories about the function of food have changed, but a significant part of their assumptions were made during the 19th century.

Análise cardiovascular e antropométrica de intervenção com apoio tecnológico em hipertensos: ensaio clínico randomizado / Cardiovascular and anthropometric analysis of intervention with technological support in hypertensives: a randomized clinical trial

O estudo comparou o efeito de intervenções com diferentes estímulos tecnológicos sobre variáveis cardiovasculares e antropométricas de hipertensos. 23 adultos hipertensos foram randomizados em três grupos: grupo intervenção padrão - sem acompanhamento; grupo ligação ­ com acompanhamento por ligação telefônica; grupo aplicativo ­ com acompanhamento por mensagem no grupo do whatsapp. As variáveis foram avaliadas Pré e Pós um período de 12 semanas. Não houve diferença significativa entre grupos com e sem acompanhamento profissional, e nas formas de acompanhamento com diferentes estímulos tecnológicos. Entretanto, houve uma redução significativa da pressão arterial sistólica (p = 0,040), frequência cardíaca (p = 0,010) e da circunferência abdominal (p = 0,039) de hipertensos do grupo intervenção padrão, assim como um efeito na mudança de comportamento. A intervenção influenciou a mudança de comportamento dos voluntários, que se tornaram mais ativos fisicamente e melhoraram hábitos alimentares, contudo não houve diferença nas respostas cardiovasculares e antropométricas entre os grupos

This study compared the effect of interventions with different technological stimuli on cardiovascular and anthropometric variables of hypertensives. 23 hypertensive adults were randomized into three groups: standard intervention group ­ with no follow-up; telephone group ­ with follow-up by phone calls; application group ­ with follow-up by WhatsApp messages. The variables were evaluated before and after a period of 12 weeks. There was no significant difference between the groups with and without professional follow-up, and the same applied to the types of follow-up with different technological stimuli. However, there was a significant reduction of systolic blood pressure (p = 0,040), heart rate (p = 0,010) and waist circumference (p = 0,039) of the hypertensives from the standard intervention group, as well as a behavior change effect. The intervention had influence on the volunteers' behavior change. They became more physically active and improved their eating habits. Yet, there was no difference in the cardiovascular and anthropometric responses among the groups.

A Review of Nutritional Requirements of Adults Aged ≥65 Years in the UK.

Appropriate dietary choices in later life may reduce the risk of chronic diseases and rate of functional decline, however, there is little well-evidenced age-specific nutritional guidance in the UK for older adults, making it challenging to provide nutritional advice. Therefore, the aim of this critical review was to propose evidence-based nutritional recommendations for older adults (aged ≥65 y). Nutrients with important physiological functions in older adults were selected for inclusion in the recommendations. For these nutrients: 1) recommendations from the UK Scientific Advisory Committee for Nutrition (SACN) reports were reviewed and guidance retained if recent and age-specific, and 2) a literature search conducted where SACN guidance was not sufficient to set or confirm recommendations for older adults, searching Web of Science up to March 2020. Data extracted from a total of 190 selected publications provided evidence to support age-specific UK recommendations for protein (1.2 g·kg-1·d-1), calcium (1000 mg·d-1), folate (400 µg·d-1), vitamin B-12 (2.4 µg·d-1), and fluid (1.6 L·d-1 women, 2.0 L·d-1 men) for those ≥65 y. UK recommendations for carbohydrates, free sugars, dietary fiber, dietary fat and fatty acids, sodium, and alcohol for the general population are likely appropriate for older adults. Insufficient evidence was identified to confirm or change recommendations for all other selected nutrients. In general, significant gaps in current nutritional research among older adults existed, which should be addressed to support delivery of tailored nutritional guidance to this age group to promote healthy aging.