[Household appliances and food insecurity: gender, referred skin color and socioeconomic differences]. / Bens de consumo e insegurança alimentar: diferenças de gênero, cor de pele autorreferida e condição socioeconômica.

OBJECTIVE: Data from the National Household Survey 2004 was analyzed to compare differences in prevalence among moderate or severe food insecurity. Also, it was compared food security or mild food insecurity households in relation to the assets and other socioeconomic and demographic conditions of the household. METHOD: Private permanent households, with per capita monthly income of up to one minimum wage and with the Brazilian Food Insecurity Scale answered by a household resident were studied (n=51,357). Association of variables with the dependent variable (food security) was verified using χ² test, with 5% significance level. Crude prevalence ratio, respective 95% confidence interval and adjusted analyses were carried out using Poisson multiple regression Stata 8.0. It considers the weights of the complex sampling design of the survey. RESULTS: The per capita monthly household income was the variable with strongest association to food security. Both in urban and rural areas, there were higher risk of moderate or severe food insecurity prevalence ratio when the head of the household was a female, black color, presence of six or more members in the household, metropolitan area and with absence of some specific assets (stove, water filter, refrigerator, freezer, washing machine and cellular phone). In a model that, among assets, included just the refrigerator, it was observed the highest prevalence ratio for household income of up to » of a minimum wage and after this, the absence of refrigerator among households headed by white and black males and white or black female. Although female and black headed households have greater food restriction, internal differences among these groups were higher for households headed by white males and lower for those headed by black females. CONCLUSION: At national level and households with monthly income of up to one minimum age, poor socioeconomic conditions are associated to household food insecurity. This situation is worse among those headed by women and black people. Among poor people, the absence of assets identifies the most vulnerable population to food insecurity and may be used as complementary indicator, mainly in local studies with poor technical resources for data collection and more sophisticated analyzes.

Bens de consumo e insegurança alimentar: diferenças de gênero, cor de pele autorreferida e condição socioeconômica / Household appliances and food insecurity: gender, referred skin color and socioeconomic differences

OBJETIVO: Com base nos dados da Pesquisa Nacional por Amostra de Domicílios (PNAD, 2004), foram comparadas as diferenças na prevalência de insegurança moderada/grave em relação à segurança alimentar, e insegurança leve quanto à posse de bens de consumo e outras condições socioeconômicas e demográficas. MÉTODOS: Foram estudados os domicílios particulares permanentes, com rendimento domiciliar per capita de até um salário mínimo, utilizando-se a Escala Brasileira de Insegurança Alimentar respondida por morador do domicílio (n=51.357). A associação entre as variáveis e a variável dependente (segurança alimentar) foi verificada pelo teste do Χ2 com nível de significância de 5 por cento. Foram calculadas razões de prevalência brutas e intervalos de confiança de 95 por cento e a análise ajustada foi conduzida por meio de regressão múltipla de Poisson, utilizando Stata 8.0, que incorpora as ponderações do desenho amostral com delineamento complexo. RESULTADOS: A renda domiciliar mensal per capita foi a variável com maior força de associação com a segurança alimentar. Tanto em áreas urbanas quanto rurais, foram encontradas elevadas razões de prevalência para insegurança alimentar moderada ou grave nos domicílios chefiados por mulheres, de cor negra, presença no domicílio de seis ou mais moradores, localização metropolitana e com ausência de alguns bens específicos (fogão, filtro, geladeira, freezer, máquina de lavar roupa e telefone celular). Em modelo que incluiu, entre os bens, apenas a posse de geladeira, a maior razão de prevalência ocorreu na renda de até » de salário mínimo, seguindo-se a ausência de posse de geladeira, tanto nos domicílios chefiados por homens brancos, como por negros e mulheres brancas ou negras. Embora os domicílios chefiados por mulheres e por negros apresentem maior insegurança alimentar, as diferenças intragrupais foram maiores em domicílios chefiados por homens brancos e menores nos de mulheres negras. CONCLUSÃO: Em nível nacional e em domicílios com renda de até um salário mínimo, condições socioeconômicas mais precárias estão associadas à insegurança alimentar, sendo a situação agravada naqueles chefiados por mulheres e onde residem pessoas de cor autorreferida como negra. A ausência de bens identifica, entre os pobres, a população mais vulnerável à insegurança alimentar e pode se constituir em indicador complementar, sobretudo em estudos locais, onde há escassez de recursos técnicos para coleta de dados e análises mais sofisticadas.

OBJECTIVE: Data from the National Household Survey 2004 was analyzed to compare differences in prevalence among moderate or severe food insecurity. Also, it was compared food security or mild food insecurity households in relation to the assets and other socioeconomic and demographic conditions of the household. METHOD: Private permanent households, with per capita monthly income of up to one minimum wage and with the Brazilian Food Insecurity Scale answered by a household resident were studied (n=51,357). Association of variables with the dependent variable (food security) was verified using Χ2 test, with 5 percent significance level. Crude prevalence ratio, respective 95 percent confidence interval and adjusted analyses were carried out using Poisson multiple regression Stata 8.0. It considers the weights of the complex sampling design of the survey. RESULTS: The per capita monthly household income was the variable with strongest association to food security. Both in urban and rural areas, there were higher risk of moderate or severe food insecurity prevalence ratio when the head of the household was a female, black color, presence of six or more members in the household, metropolitan area and with absence of some specific assets (stove, water filter, refrigerator, freezer, washing machine and cellular phone). In a model that, among assets, included just the refrigerator, it was observed the highest prevalence ratio for household income of up to » of a minimum wage and after this, the absence of refrigerator among households headed by white and black males and white or black female. Although female and black headed households have greater food restriction, internal differences among these groups were higher for households headed by white males and lower for those headed by black females. CONCLUSION: At national level and households with monthly income of up to one minimum age, poor socioeconomic conditions are associated to household food insecurity. This situation is worse among those headed by women and black people. Among poor people, the absence of assets identifies the most vulnerable population to food insecurity and may be used as complementary indicator, mainly in local studies with poor technical resources for data collection and more sophisticated analyzes.

[Food insecurity as an indicator of inequity: analysis of a population survey]. / Insegurança alimentar como indicador de iniqüidade: análise de inquérito populacional.

This study aimed to analyze the association between food insecurity and certain socioeconomic and demographic variables that measure social inequality: income, schooling, race, family structure, household characteristics, and sewage conditions. A sample of 456 families in Campinas, São Paulo State, was interviewed using the Brazilian Food Insecurity Scale (EBIA). Family food insecurity was associated with: more children < 18 years; precarious housing; overcrowding; lack of sewage system; low income (< 2 times the minimum wage); head-of-household with no schooling; no university graduate in the family; and race (black). Directly measuring food insecurity is important for monitoring inequality, and can be used either with other socioeconomic and demographic indicators or alone to identify social vulnerability in population groups.

Insegurança alimentar como indicador de iniqüidade: análise de inquérito populacional / Food insecurity as an indicator of inequity: analysis of a population survey

O objetivo deste trabalho foi investigar a associação da insegurança alimentar com algumas variáveis indicativas de desigualdades sociais, como renda, escolaridade, raça/cor, composição familiar, características da moradia e condições de saneamento. Para medida de segurança alimentar, aplicou-se o instrumento EBIA (Escala Brasileira de Insegurança Alimentar) a uma amostra de 456 famílias residentes em área urbana do Município de Campinas. Verificou-se que a insegurança alimentar concentrou-se em famílias com maior número de membros menores de 18 anos, vivendo em construções precárias e com alta aglomeração de moradores, sem rede de esgoto, de baixa renda (menos de dois salários mínimos), cujo responsável não freqüentou a escola, sem membros com nível universitário e nas quais os informantes referiram ter cor da pele preta. Considera-se que a medida direta de segurança alimentar por meio da EBIA seja um importante indicador para monitoramento da iniqüidade, podendo complementar um conjunto de indicadores sociais ou, mesmo de forma isolada, identificar grupos com vulnerabilidade social.

This study aimed to analyze the association between food insecurity and certain socioeconomic and demographic variables that measure social inequality: income, schooling, race, family structure, household characteristics, and sewage conditions. A sample of 456 families in Campinas, São Paulo State, was interviewed using the Brazilian Food Insecurity Scale (EBIA). Family food insecurity was associated with: more children < 18 years; precarious housing; overcrowding; lack of sewage system; low income (< 2 times the minimum wage); head-of-household with no schooling; no university graduate in the family; and race (black). Directly measuring food insecurity is important for monitoring inequality, and can be used either with other socioeconomic and demographic indicators or alone to identify social vulnerability in population groups.

Insegurança alimentar intrafamiliar e perfil de consumo de alimentos / Intra-family food insecurity and profile of food consumption

OBJETIVO: Descrever e avaliar o perfil de consumo diário de alimentos entre famílias em situação de insegurança alimentar. MÉTODOS: Inquérito populacional realizado em Campinas (SP), em 2003, com 456 famílias. Realizou-se levantamento do consumo diário de 14 grupos de alimentos, mediante informação de membro qualificado da família. Para categorização da insegurança alimentar utilizou-se uma escala dividida em 3 categorias: 1) Segurança alimentar; 2) Insegurança alimentar leve; 3) Insegurança alimentar moderada ou grave. RESULTADOS: Foram detectadas diferenças significativas entre categorias de segurança alimentar e consumo alimentar. A proporção de famílias em situação de insegurança, cujo informante não consome diariamente leite e derivados, frutas, verduras/legumes, e carnes é significantemente maior do que aquelas em situação de segurança alimentar (p<0,001). Nas famílias em segurança alimentar, o consumo de pelo menos uma fruta diariamente foi 73,7 por cento e de derivados do leite 62,1 por cento. Essas proporções são 11,4 por cento e 5,5 por cento, respectivamente, em famílias que experimentam insegurança alimentar moderada ou grave. Nestas últimas, a maioria consome diariamente apenas cereais, óleo, açúcar e feijão e gasta cerca de 68,0 por cento da renda com despesas em alimentação. Existem diferenças significantes na freqüência das principais refeições diárias entre as categorias de segurança, sempre com menor freqüência entre os informantes das famílias em insegurança alimentar moderada ou grave. CONCLUSÃO: Famílias em insegurança alimentar moderada ou grave apresentaram dieta monótona, basicamente composta por alimentos energéticos. A condição de acesso ao alimento entre famílias em segurança alimentar, entretanto, não garantiu a adequação qualitativa da dieta. Esses resultados trazem a necessidade de reforçar, nas políticas de segurança alimentar, ações educativas direcionadas à promoção de alimentação saudável.

OBJECTIVE: Describe and evaluate daily food consumption among families experiencing food insecurity. METHODS: A population survey was conducted in Campinas, São Paulo, in 2003, with 456 families. One qualified member of each family was interviewed about their daily intake of 14 food groups. For the food insecurity classification, a scale divided into three categories was used: 1) Food security; 2) Mild food insecurity; 3) Moderate or Severe food insecurity. RESULTS: Significant differences were found among the categories of food insecurity with respect to food consumption. The proportion of respondents from families experiencing moderate or severe food insecurity or mild food insecurity that did not consume dairy products, fruits, vegetables, meats, on a daily basis is significantly higher than respondents from families who are food-secure (p<0.001). Among food-secure families, 73.7 percent consumed at least one fruit per day and 62.1 percent consumed dairy products every day. These percentages were 11.4 percent and 5.5 percent, respectively, in families with moderate or severe food insecurity. The majority of these families consumed only grains, oil, sugar, and dried beans on a daily basis, and they spend roughly 68 percent of their monthly income on food. There are significant differences in the frequency of the main daily meals among the food security categories, which is always less frequent among families with moderate or severe food insecurity. CONCLUSION: Families experiencing moderate or severe food insecurity have a boring diet, composed basically of energetic foods. Even among food secure families, adequate diet quality was not always present. These results show that it is necessary to strengthen nutrition education efforts in public policies that aim to improve food security and promote healthy diets.

[Food security in Teréna indigenous families, Mato Grosso do Sul, Brazil]. / Segurança alimentar em famílias indígenas Teréna, Mato Grosso do Sul, Brasil.

This study aims to describe the food security situation among Teréna families in the villages of Agua Azul, Olho D'Agua, and Oliveiras in Mato Grosso do Sul State, Brazil. The Brazilian Food Insecurity Scale was adapted to 15 questions that reflect food insecurity at different levels of intensity. A survey was conducted in the villages with 49 families that had under-five children. Information was obtained on income, family size, maternal education, and children's food intake. 75.5% of families showed some level of food insecurity (22.4% low, 32.7% moderate, and 20.4% high). A large percentage (67.3%) of the families live with fear of lack of food. One-fourth of women had experienced hunger during the month prior to the survey, and 14.3% (7) reported the same condition for children in the household. More serious food insecurity was observed in families with lower per capita income and lower maternal education, more family members, and more children per family group in which the children's diet was insufficient, especially in protein and iron.

Segurança alimentar em famílias indígenas Teréna, Mato Grosso do Sul, Brasil / Food security in Teréna indigenous families, Mato Grosso do Sul, Brazil

O presente estudo buscou descrever a situação de segurança alimentar vivenciada por famílias Teréna, das aldeias Agua Azul, Olho D'Agua e Oliveiras, Mato Grosso do Sul, Brasil. Foi utilizada a Escala Brasileira de Insegurança Alimentar adaptada, com 15 questões que refletem a insegurança alimentar em diferentes níveis de intensidade. Foram investigadas 49 famílias que continham em seu núcleo crianças menores de sessenta meses e obtidas informações sobre renda, densidade familiar, escolaridade materna e consumo alimentar das crianças. A prevalência de famílias com algum grau de insegurança alimentar observada foi 75,5 por cento, 22,4 por cento das famílias com insegurança leve, 32,7 por cento moderada e 20,4 por cento grave. Grande parte das famílias (67,3 por cento) convive com o medo de ficar sem alimentos. Um quarto das mulheres entrevistadas afirmou ter passado por situações de fome no mês anterior à entrevista e 14,3 por cento (7) apontaram que o mesmo ocorreu com as crianças da casa. Situações mais graves de insegurança alimentar foram observadas em famílias com menor renda mensal per capita, menor escolaridade materna, maior densidade domiciliar, maior número de filhos por grupo familiar e cuja dieta das crianças era insuficiente, sobretudo em proteínas e ferro.

This study aims to describe the food security situation among Teréna families in the villages of Agua Azul, Olho D'Agua, and Oliveiras in Mato Grosso do Sul State, Brazil. The Brazilian Food Insecurity Scale was adapted to 15 questions that reflect food insecurity at different levels of intensity. A survey was conducted in the villages with 49 families that had under-five children. Information was obtained on income, family size, maternal education, and children's food intake. 75.5 percent of families showed some level of food insecurity (22.4 percent low, 32.7 percent moderate, and 20.4 percent high). A large percentage (67.3 percent) of the families live with fear of lack of food. One-fourth of women had experienced hunger during the month prior to the survey, and 14.3 percent (7) reported the same condition for children in the household. More serious food insecurity was observed in families with lower per capita income and lower maternal education, more family members, and more children per family group in which the children's diet was insufficient, especially in protein and iron.

A percepção de insegurança alimentar em famílias com idosos em Campinas, São Paulo, Brasil / Food insecurity perception in families with elderly in Campinas, São Paulo, Brazil

O objetivo deste estudo foi determinar a prevalência de insegurança alimentar em famílias com idosos e descrever seu perfil sócio-demográfico. Foram estudadas famílias com membros de 65 anos e mais (n = 195), selecionadas de inquérito domiciliar realizado em 2003, em Campinas, São Paulo, Brasil. A Escala Brasileira de Insegurança Alimentar, versão brasileira do módulo de insegurança alimentar do United States Department of Agriculture, foi utilizada para diagnosticar segurança/insegurança alimentar (SA/IA). Observou-se insegurança alimentar leve em 33,0 por cento das famílias, moderada em 11,8 por cento e grave em 7,2 por cento. Em menos de 5,0 por cento das famílias o idoso não tinha renda. Os idosos de famílias com insegurança alimentar apresentaram, em forma similar aos Estados Unidos, maior proporção de idosos de baixa renda (< R$ 500,00) e baixa escolaridade (até o primário incompleto). As famílias em segurança alimentar apresentaram significativa maior proporção de consumo qualitativo diário de alimentos (verduras 92,3 vs. 61,8 por cento; OR = 7,4; IC95 por cento: 2,9-19,6; carne 74,2 vs. 43,1 por cento; OR = 3,8; IC95 por cento: 1,9-7,3; frutas 77,4 vs. 49,0 por cento OR = 3,6; IC95 por cento: 1,8-6,9). Os idosos contribuem para a renda familiar, não sendo, portanto, uma carga para suas famílias.

[Food insecurity perception in families with elderly in Campinas, São Paulo, Brazil]. / A percepção de insegurança alimentar em famílias com idosos em Campinas, São Paulo, Brasil.

The aim of this study was to determine the prevalence of food insecurity (FI) in families with elderly members and to describe their socio-demographic profile. The study focused on families with members aged 65 years or more (n = 195) participating in a household survey in Campinas, São Paulo, Brazil, in 2003. The Brazilian Food Insecurity Scale, an adaptation of the USDA FI module, was used to diagnose food security/insecurity (FS/FI). Mild FI was present in 33.0% of families, moderate in 11.8%, and severe in 7.2%. The elderly had no income in < 5.0% of the families. Families with FI, as in the United States, had a greater proportion of elderly with low income and low level of education (no schooling or incomplete primary schooling). A significantly higher proportion of daily qualitative food intake was observed in FS families (vegetables 92.3 vs. 61.8%; OR = 7.4; 95%CI: 2.9-19.6; meat 74.2 vs. 43.1%; OR = 3.8; 95%CI: 1.9-7.3; fruit 77.4 vs. 49.0%; OR = 3.6; 95%CI: 1.8-6.9). The elderly contribute to family income and thus do not pose a burden to their families.

An adapted version of the U.S. Department of Agriculture Food Insecurity module is a valid tool for assessing household food insecurity in Campinas, Brazil.

Until recently, Brazil did not have a national instrument with which to assess household food insecurity (FI). The objectives of this study were as follows: 1) to describe the process of adaptation and validation of the 15-item USDA FI module, and 2) to assess its validity in the city of Campinas. The USDA scale was translated into Portuguese and subsequently tested for content and face validity through content expert and focus groups made up of community members. This was followed by a quantitative validation based on a convenience (n = 125) and a representative (n = 847) sample. Key adaptations involved replacing the term "balanced meal" with "healthy and varied diet," to construct items as questions rather than statements, and to ensure that respondents understood that information would not be used to determine program eligibility. Chronbach's alpha was 0.91 and the scale item response curves were parallel across the 4 household income strata. FI severity level was strongly associated in a dose-response manner (P < 0.001) with income strata and the probability of daily intake of fruits, vegetables, meat/fish, and dairy. These findings were replicated in the 2 independent survey samples. Results indicate that the adapted version of the USDA food insecurity module is valid for the population of Campinas. This validation methodology has now been replicated in urban and/or rural areas of 4 additional states with similar results. Thus, Brazil now has a household food insecurity instrument that can be used to set national goals, to follow progress, and to evaluate its national hunger and poverty eradication programs.

[Breastfeeding patterns and energy adequacy]. / Padrões de aleitamento materno e adequação energética.

To analyze caloric adequacy in infant feeding six months of age or under, the volume of breast milk consumed was estimated through a regression equation as proposed by Drewett. Energy adequacy was estimated according to World Health Organization guidelines for developing countries and the recommended daily allowance of the Food and Nutrition Board. A cross-sectional analysis was conducted on data from a cohort of 118 infants in a neighborhood around a health center in Campinas, São Paulo, Brazil, with home interviews by trained students. Data were gathered on social and demographic characteristics, infant feeding patterns, duration of breastfeeding, frequency of feedings, and age when breast milk substitutes were introduced. On average, weaning began early, with a 2.7-month median duration of exclusive breastfeeding. Mean breast milk volume was estimated (from frequency of feeding) as 561.0 ml, 558.9 ml and 565.5 ml for children in exclusive, predominant, and supplemented breastfeeding, respectively. Mean energy consumption was adequate for all exclusively breastfed children regardless of age and above the recommended level for infants with supplemented breastfeeding and those already weaned.

Padrões de aleitamento materno e adequação energética / Breastfeeding patterns and energy adequacy

Com o objetivo de analisar o consumo energético de crianças < de 6 meses, em diferentes padrões de aleitamento materno, foram colhidas informações na primeira observação de estudo de coorte. Mães de Campinas, São Paulo, Brasil, foram entrevistadas em seus domicílios sobre: condições sócio-demográficas, características do aleitamento materno, consumo alimentar dos lactentes. A adequação energética foi estimada pelo volume de leite materno consumido com base na equação de regressão de Drewett et al. ; os valores de referência seguiram recomendação da Organização Mundial da Saúde ² e da Food and Nutrtition Board . A população de estudo (118) caracteriza-se como de classe média baixa, em condições satisfatórias de moradia e saneamento. O desmame inicia-se precocemente, com mediana de duração do aleitamento materno exclusivo de 2,7 meses. O volume de leite materno consumido foi de 561ml, 558,9ml e de 515,2ml, em aleitamento materno exclusivo, aleitamento materno com água e/ou chá e complementado com outros alimentos, respectivamente. O consumo energético médio foi adequado para as crianças em aleitamento materno exclusivo e acima do recomendado para crianças em amamentação complementada ou desmamadas.