Orthorexia nervosa behavior in a sample of Brazilian dietitians assessed by the Portuguese version of ORTO-15.

BACKGROUND: Orthorexia nervosa (ON) is described as an obsessive pathological behavior characterized by a strong preoccupation with healthy eating and the avoidance of foods or ingredients considered unhealthy by the subject. Although it is still not officially recognized as an eating disorder, previous studies have discussed its frequency in some groups and a fifteen-question test (ORTO-15) was developed elsewhere to assess ON behavior. OBJECTIVE: The present study aimed to evaluate ON behavior in a sample of Brazilian dietitians after testing the psychometric properties of the Portuguese version of ORTO-15. METHODS: A total of 392 dietitians answered an online version of the test. The answers were analyzed regarding ON tendency, according with the scoring grid proposed by its authors. Exploratory factor analysis was performed and internal consistency was assessed. RESULTS: It was found that three questions of the test presented loadings lower than 0.5. The 12 remaining question formed 3 factors with internal consistency of -0.51, 0.63 and 0.47. The answers of the participants to these questions revealed a tendency to orthorexic behavior, mainly regarding aspects such as: making food choices conditioned by worry about health status, evaluating food rather from nutritional quality than from its taste, believing that consuming healthy food may improve appearance, discrediting the influence of mood on eating behavior and banning food choices considered by them as eating transgressions. CONCLUSION: There is no evidence of the validity and reliability of the ORTO-15 with the initial psychometric evaluation performed. Further analyses are needed. Nevertheless, it was possible to observe a high frequency of orthorexic behavior among the studied Brazilian dietitians. However, additional studies are needed to completely understand dietitians behavior toward ON.

Interactive Brazilian program to prevent eating disorders behaviors: a pilot study.

During a four month scholarly leave in United States of America, researchers designed a culturally appropriate prevention program for eating disorders (ED) for Brazilian adolescent girls. The program "Se Liga na Nutrição" was modeled on other effective programs identified in a research literature review and was carried out over eleven interactive sessions. It was positively received by the adolescents who suggested that it be part of school curricula. The girls reported that it helped them to develop critical thinking skills with regards to sociocultural norms about body image, food and eating practices.

Differences in diet composition of Brazilian adolescent girls with positive or negative score in the Eating Attitudes Test.

Dieting, a behavioral phenomenon which is becoming more frequent among adolescents, is certainly involved in the pathogenesis of eating disorders, especially anorexia nervosa (AN), and may result in an unbalanced nutrition. Our study aimed at identifying girls with symptoms of AN and describing their diets. We assessed girls with symptoms by using the Eating Attitudes Test and considered girls with a score > or = 20 as having symptoms of AN. To evaluate their diets, a "modified" 24-hour recall was applied on three alternate days. Twenty-one percent of the 279 girls studied showed symptoms of AN. Analysis of the food intake showed that calories, calcium and iron were below the recommendations of the Standing Committee on the Specific Evaluation of Dietary Reference Intakes (DRI Committee) and the National Research Council, while protein and carbohydrate were within the recommended range and fat was above the percentage of recommended total energy intake. Compared to girls without symptoms, they had a significantly smaller intake of calories and iron, and a higher intake of protein. Findings shown in this paper point out the need for intervention in adolescents because their dieting behavior can predispose to an eating disorder.

Nutritional aspects of eating episodes followed by vomiting in Brazilian patients with bulimia nervosa.

BACKGROUND: The clinical aspects of bulimia nervosa (BN) are similar in countries with different sociocultural backgrounds, but less is known about dietary composition in patients from developing countries. Little is also known about the role that nutritional aspects may play in behaviours aimed at counteracting the effects of binge eating. OBJECTIVES: To describe the daily energy intake and eating behaviour of BN patients in Brazil and compare the dietary patterns of the patients who terminated eating episodes by vomiting and those patients who did not. METHODS: Thirty patients from an eating disorders programme in a university-affiliated hospital completed a 14-day dietetic diary; the data were analysed using nutritional software. RESULTS: Mean age and BMI of the patients were respectively 27.2 +/- 9.6 years and 25.5 +/- 6.7 Kg/m2. The patients in the vomiting subgroup ate more irregularly and consumed a more variable number of meals per day than those in the non-vomiting subgroup. The daily energy intake of the patients as a whole was 2,202 kcal, with a macronutrient composition of 53% carbohydrates, 31% fats and 17% proteins. The mean energy intake of the eating episodes followed by vomiting was 1,331 kcal with a macronutrient profile of 51% carbohydrates, 36% fat and 14% protein. Intake and eating patterns were characterised by between- and within- individual variability, and so no significant differences were found in the subgroup comparisons. Foods with a high energy density were preferred during the eating episodes followed by vomiting. CONCLUSIONS: The results indicate that patients who vomit have a more irregular and variable eating pattern than those who do not vomit, but their daily nutrient content is comparable.

Validation of a semi-quantitative adolescent food frequency questionnaire applied at a public school in São Paulo, Brazil.

OBJECTIVE: To develop a food frequency questionnaire for adolescents (AFFQ) and demonstrate its relative validity. DESIGN: The final version of the AFFQ was composed of 76 food items previously identified according to their contribution in nutrients and overall importance within the eating habits of this population group. The validation study, which was undertaken during a 6 month period (June to November 1999), was administered to a sample of 79 who answered at least three 24 h dietary recalls (R24 h) applied at intervals of 45 days and one AFFQ at the end of the study. Applying the paired t-test and calculating Pearson correlation coefficients on nutrient data, differences in the mean of nutrients were obtained. Correlation coefficients between the mean energy-adjusted nutrients computed by the two methods were calculated, and correction was made for within-person variability. Agreement was evaluated by distribution of the adolescents according to quartiles of consumption. LOCUS: A public school within the metropolitan region of São Paulo city. RESULTS: A high variability in the dietary intake of adolescents was observed, with high rates of variability for cholesterol, retinal and vitamin C. The Pearson correlation coefficients, after being adjusted and corrected for variability, ranged from 0.10 to 0.72 among females and from 0.16 and 0.91 among males. The mean correlation coefficient for the entire group was 0.52. CONCLUSIONS: These results indicate that the AFFQ provides a potentially reliable scale for categorizing individuals by level of past intake of most nutrients, excluding retinol and iron.

Lipid profile of nutrition students and its association with cardiovascular disease risk factors.

OBJECTIVE: To describe the lipid profile and to verify its relationship with cardiovascular disease risk factors in students at a public university in São Paulo. METHODS: After obtaining clinical, anthropomorphic, and lipid profile data from 118 students, variables of the lipid profile were related to other risk factors. RESULTS: The mean age of the students was 20.3 years (SD = 1.5). The risk of cardiovascular disease was characterized by a positive family history of ischemic heart disease in 38.9%; sedentariness in 35.6%; limiting and increased total and LDL-C cholesterol levels in 17.7% and 10.2%, respectively; decreased HDL-C levels in 11.1%; increased triglyceride levels in 11.1%; body mass index > 25 in 8.5%, and smoking in 6.7% of the subjects. Students' diet was found to be inadequate regarding protein, total fat, saturated fat, sodium, and fiber contents. A statistically significant association between cholesterol and contraceptive use, between HDL-C and contraceptive use, age and percent body fat, and triglycerides and percent lean weight was observed. CONCLUSION: A high prevalence of some risk factors of cardiovascular disease as well as the association between these factors with altered lipid profiles was observed in the young population studied.

[Child health and nutrition in a Teréna indigenous community, Mato Grosso do Sul, Brazil]. / Nutrição e saúde infantil em uma comunidade indígena Teréna, Mato Grosso do Sul, Brasil.

This paper describes the health and nutritional situation of South American Indian children from a Teréna community, characterizing their nutritional status, food consumption, and socioeconomic and environmental conditions. The sample included 100 children, ranging from 0 to 59 months of age and living in Aldeia Córrego do Meio, Mato Grosso do Sul. Prevailing nutritional deficits were: 8.0% for the weight-for-age index, 16.0% for height-for-age, and 5.0% for weight-for-height. The growth deficit rate was higher than that of the Brazilian population as a whole, probably reflecting the precarious socioeconomic, environmental, and health conditions in this Teréna community. Analysis of the average nutrient sufficiency in the infant diet showed that nutritional recommendations for the different groups were not complied with. New studies, characterized as transdisciplinary and longitudinal, are necessary to better understand this process.

[Health and nutritional status of infants in a population of the Center-Western region of Brazil]. / Saúde e estado nutricional infantil de uma população da região Centro-Oeste do Brasil.

OBJECTIVE: To evaluate the nutritional status of infants who reside in the city of Campo Grande, State of Mato Grosso do Sul, Brazil. METHODS: The method used was that of a cross sectional household study by means of an anthropometric social survey, sampling 652 children from 0 to 59 months of age. RESULTS: A low prevalence of nutritional deficit, excepting that of height-for-age, starting in the first year of life, was found. The nutritional status proved to be influenced by the socioeconomic conditions, especially concerning per capita family income. Nearly all children started breast-feeding but were weaned during the first month. Exclusive breast-feeding is of short duration and soon replaced by infant formula. The survey of mother-child assistance demonstrated an excellent coverage of prenatal care, but inadequacy in the follow-up of the child's health at all income levels. CONCLUSIONS: The need to carry out changes in the approach to preventive actions and in the monitoring of the nutritional situation of the children, concerning the problems identified in this study in order to allow for the development of differential actions in the nutritional field has been identified.

Ascaris-Trichuris association and malnutrition in Brazilian children.

This work was designed to evaluate the role of intestinal parasites on nutritional status in three rural areas of Brazil. A total of 520 children aged 1-12 years were studied through a questionnaire concerning housing, socio-economic conditions and a 24-h food intake recall. Measurements of weight and height were also performed, and three stool samples were collected on consecutive days for parasitological analysis. Scores of the standard deviation (z-scores) for the weight-for-height and height-for-age were used to characterise the growth profile. A high prevalence of intestinal parasites was detected, with Giardia lamblia (44%), Endolimax nana (43%), Ascaris lumbricoides (41%) and Trichuris trichiura (40%) being the most prevalent. Eleven per cent of the children were classified as showing stunting. Inadequate daily caloric intake was observed in 78% of the population and the proportion of those with inadequate protein intake was 34%. Logistic regression analysis was employed for the multivariate study. Stunting was significantly associated with estimators of low economic income, inadequate protein intake and polyparasitism, especially the association between Ascaris lumbricoides and Trichuris trichiura.

PIP: This study was designed to assess the association between stunting and helminthic infections by studying children aged 1-12 years living in a rural area near Sao Paolo, Brazil. A total of 520 children were studied through a questionnaire concerning housing, socioeconomic conditions and a 24-hour food intake recall. Measurement of weight and height were also performed, and three stool samples were collected on consecutive days for parasitological analysis. The study has demonstrated a positive association between intestinal parasites and stunting in children. Intestinal parasites were present in 79% and stunting in 11.5% of children from the sample. 56.7% of the children with stunting were between 5 and 12 years of age, which justified the unusual inclusion of children above 5 years of age. The most prevalent intestinal parasites detected were Giardia lamblia (44%), Endolimax nana (43%), Ascaris lumbricoides (41%), and Trichuris trichiura (40%). In the study, no children reported diarrhea and/or fever. Nevertheless, the mechanism of parasitic infections includes anorexia, type of food intake, intestinal villus damage, competition for nutrients, facilitation of bacterial colonization, increase in energy requirements, decrease in hepatic protein synthesis, protein-losing enteropathy, and blood loss. Inadequate daily caloric intake was observed in 78% of the population, and the proportion of those with inadequate protein intake was 34%. Stunting was significantly associated with estimators of low economic income, inadequate protein intake and polyparasitism.