Camilla de Chermont P. Estima

Psychometric evaluation of the Disordered Eating Attitude Scale (DEAS). English version

UNLABELLED Eating attitudes are defined as beliefs, thoughts, feelings, behaviors and relationship with food. They could influence peoples food choices and their health status. OBJECTIVE This study aimed to adapt from Portuguese to English the Disordered Eating Attitude Scale (DEAS) and evaluate its validity and reliability. The original scale in Portuguese was translated and adapted into English and was applied to female university students of University of Minnesota-USA (n=224). Internal consistency was determined (Cronbachs Alpha). Convergent validity was assessed by correlations between Eating Attitude Test-26 (EAT-26) and Restrain Scale (RS). Reliability was evaluated applying twice the scale to a sub-sample (n=30). The scale was back translated into Portuguese and compared with the original version and discrepancies were not found. The internal consistency was .76. The DEAS total score was significantly associated with EAT-26 (r=0.65) and RS (r=0.69) scores. The correlation between test-retest was r=0.9. The English version of DEAS showed appropriate internal consistency, convergent validity and test-retest reliability and will be useful to assess eating attitudes in different population groups in English spoken countries.

Validity and reproducibility of a food frequency questionnaire to assess food group intake in adolescents

The objective of this study was to assess the validity and reproducibility of a food frequency questionnaire to assess intake of the food groups included in the food guide pyramid for adolescents (FFQ-FP). The final version of the FFQ-FP consisted of 50 food items. The study was carried out with a sample of 109 adolescents over a period of four months. A 24hr recall (24hr) was conducted four times and the FFQ-FP was conducted twice. Validity was determined by comparing the second FFQ-FP and the mean of the four 24hrs, while reproducibility was verified by comparing the results of the two FFQ-FPs. Statistical analysis was carried out using medians, standard deviations, Pearson and intraclass correlations and Kappa statistics to assess concordance. Best results were achieved for the rice (including bread, grains and starches), meats and sugars groups. Weakest correlation was observed for the variable vitamin C. The validity and reproducibility of the FFQ-FP was satisfactory for most variables.El objetivo fue evaluar la validez y reproducibilidad de un cuestionario de frecuencia de alimentos sobre la base de grupos de alimentos en la piramide alimenticia para adolescentes (FFQ-AP). Despues de identificar los alimentos que se incluyen en el FFQ-AP, la version final estuvo compuesta por 50 items. El estudio se realizo con 109 adolescentes durante un periodo de cuatro meses. Se realizaron cuatro recordatorios de 24 horas dieteticos (R24h) y dos FFQ-AP. La validez se evaluo mediante la comparacion del segundo cuestionario de frecuencia (FFQ-AP) y el promedio de los R24h, mientras que la reproducibilidad se evaluo mediante la comparacion de los dos FFQ-AP. Los analisis estadisticos se realizaron con medias, desviaciones estandar y correlaciones de Pearson y correlacion intraclase. Los grupos de alimentos con variables evaluadas fueron: arroz, pan, pasta, patatas y yuca, carne y azucar y dulces. Los peores resultados se observaron con respecto a la vitamina C. El FFQ-AP mostro una validez aceptable y de reproduccion satisfactoria para la mayoria de las variables.

Consumo de bebidas e refrigerantes por adolescentes de uma escola pública

Objective: To evaluate the consumption of beverage and soft drinks by adolescents of a public school in Sao Paulo, Brazil. Methods: 71 adolescents (aged between 14 to 17 years old) from both genders, attending a technical school in the metropolitan area of Sao Paulo, answered the following questions: the kind of beverage taken during meals, the places where soft drinks were consumed and the main reason related to this intake. Results: The most frequent consumed beverage was the industrialized fruit juice (38.1%), followed by regular soft drinks (28.6%) and natural fruit juices (22.2%). The main place where soft drinks were consumed was home (38.2%), followed by school (22.1%). The main reason associated with soft drink intake was the flavor (75.4%). Conclusions: Sweet beverage intake was frequent among adolescents, specially soft drinks. These beverages are avail- able and consumed at home and at school, and they were considered tasteful. Nutritional education programs should discuss how to prioritize the intake of other beverages and how to control the sale of these products at schools, aiming to stimulate the intake of more healthy beverages by adolescents.

Padrão de refeições realizadas por adolescentes que frequentam escolas técnicas de São Paulo

OBJETIVO: Evaluar y caracterizar el consumo de comidas realizadas por adolescentes. METODOS: Estudio transversal con 71 adolescentes de la secundaria de escuelas tecnicas de Sao Paulo (Brasil), prove-nientes de un estudio transversal. Se utilizo un cuestionario que evalua actitudes alimentares de adolescentes. Las variables estudiadas fueron: frecuencia, local, con quien realiza las co-midas y la sustitucion de comidas por meriendas. Los datos fueron analizados descriptivamente y se utilizo la prueba del Chi-Cuadrado para comparaciones de las variables segun ge-nero, considerando un nivel de significancia de 5%. RESULTADOS: Del total, 58% eran del genero femenino. La mayoria relato realizar las principales comidas en casa (88% desayuno, 91% almuerzo, 96% cena). Respecto a la frecuencia del consumo, 49% desayunaban, 65% almorzaban y 51% cenaban todos los dias. Los adolescentes consumian tanto el desayuno (48%) como el almuerzo (39%) solos, mientras que la cena (77%) era realizada con los padres, siendo verificada, para esta ultima, diferencia entre generos (p=0,022). Se observo que un 29% sustituia el almuerzo por meriendas, con diferencia entre generos (p=0,057) y, de estos, el 17,4% lo hacia de 1 a 2 veces por semana. En la cena, un porcentaje mas grande de adolescentes la sustituia por merienda (62%), siendo para 42% de ellos la frecuencia de sustitucion de 1 a 2 veces por semana. CONCLUSIONES: A pesar de que los adolescentes realizan las comidas en casa, estas no eran realizadas diariamente y tampoco acompanadas por los padres.Objective: To evaluate and characterize the meal consumption of adolescents. Methods: This cross-sectional study enrolled 71 high school students from technical schools of Sao Paulo (SP), Brazil. A questionnaire to assess food attitudes of adolescents was applied to the students. The variables studied were: frequency, location, with whom they had meals and the replacement of lunch and/or dinner for snacks. Data were analyzed descriptively. The chi-square test was used to compare variables by gender, being significant p<0.05. Results: Among 71 adolescents, 58% were female. The majority reported eating the main meals at home (88% breakfast, 91% lunch, 96% dinner). Regarding the frequency of meal consumption, 49% have breakfast, 65% lunch, and 51% have dinner every day. Adolescents not only eat breakfast (48%) but also lunch (39%) alone, while the dinner Endereco para correspondencia: Erica Lie Araki Avenida Dr. Arnaldo, 715, 2o andar – Cerqueira Cesar CEP 01246-904 – Sao Paulo/SP E-mail: ericalie@usp.br Fonte financiadora: Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (Fapesp), processo n.o 2009/07224-6 Conflito de interesse: nada a declarar Recebido em: 9/3/2010 Aprovado em: 20/9/2010

Substituição de refeições por lanches em adolescentes

Objective: To verify the prevalence of replacement of lunch and dinner with snacks among adolescents and its as- sociation with gender and nutritional status, and to evaluate the food that replaces such meals. Methods: A cross-sectional study that enrolled 106 high- school students in the city of Sao Paulo, Brazil. The adolescents answered questions about how often they replaced lunch and dinner with snacks, and which foods replaced those meals. Their weight and height were measured in order to calculate the body mass index, and the nutritional classification was based on the World Health Organization criteria. Data were analyzed descriptively, with a significance level of 5%. Results: One third of the adolescents replaced lunch and half of them replaced dinner with snacks. It was observed that girls replaced meals more than boys. The prevalence of meal replacement by snacks was higher among obese adoles- cents, being 40% for lunch and 70% for dinner. Sandwiches, baked or fried salty pastries, pizzas and hamburgers were the snacks that mostly replaced the meals. Conclusions: The replacement of meals, mainly dinner, with snacks was prevalent in the studied population. Most foods consumed in replacement of lunch and dinner had high energy density and low nutritional value.OBJECTIVE: To verify the prevalence of replacement of lunch and dinner with snacks among adolescents and its association with gender and nutritional status, and to evaluate the food that replaces such meals. METHODS: A cross-sectional study that enrolled 106 high-school students in the city of Sao Paulo, Brazil. The adolescents answered questions about how often they replaced lunch and dinner with snacks, and which foods replaced those meals. Their weight and height were measured in order to calculate the body mass index, and the nutritional classification was based on the World Health Organization criteria. Data were analyzed descriptively, with a significance level of 5%. RESULTS: One third of the adolescents replaced lunch and half of them replaced dinner with snacks. It was observed that girls replaced meals more than boys. The prevalence of meal replacement by snacks was higher among obese adolescents, being 40% for lunch and 70% for dinner. Sandwiches, baked or fried salty pastries, pizzas and hamburgers were the snacks that mostly replaced the meals. CONCLUSIONS: The replacement of meals, mainly dinner, with snacks was prevalent in the studied population. Most foods consumed in replacement of lunch and dinner had high energy density and low nutritional value.

Pattern of meals eaten by adolescents from technical schools of São Paulo, SP, Brazil

OBJETIVO: Evaluar y caracterizar el consumo de comidas realizadas por adolescentes. METODOS: Estudio transversal con 71 adolescentes de la secundaria de escuelas tecnicas de Sao Paulo (Brasil), prove-nientes de un estudio transversal. Se utilizo un cuestionario que evalua actitudes alimentares de adolescentes. Las variables estudiadas fueron: frecuencia, local, con quien realiza las co-midas y la sustitucion de comidas por meriendas. Los datos fueron analizados descriptivamente y se utilizo la prueba del Chi-Cuadrado para comparaciones de las variables segun ge-nero, considerando un nivel de significancia de 5%. RESULTADOS: Del total, 58% eran del genero femenino. La mayoria relato realizar las principales comidas en casa (88% desayuno, 91% almuerzo, 96% cena). Respecto a la frecuencia del consumo, 49% desayunaban, 65% almorzaban y 51% cenaban todos los dias. Los adolescentes consumian tanto el desayuno (48%) como el almuerzo (39%) solos, mientras que la cena (77%) era realizada con los padres, siendo verificada, para esta ultima, diferencia entre generos (p=0,022). Se observo que un 29% sustituia el almuerzo por meriendas, con diferencia entre generos (p=0,057) y, de estos, el 17,4% lo hacia de 1 a 2 veces por semana. En la cena, un porcentaje mas grande de adolescentes la sustituia por merienda (62%), siendo para 42% de ellos la frecuencia de sustitucion de 1 a 2 veces por semana. CONCLUSIONES: A pesar de que los adolescentes realizan las comidas en casa, estas no eran realizadas diariamente y tampoco acompanadas por los padres.Objective: To evaluate and characterize the meal consumption of adolescents. Methods: This cross-sectional study enrolled 71 high school students from technical schools of Sao Paulo (SP), Brazil. A questionnaire to assess food attitudes of adolescents was applied to the students. The variables studied were: frequency, location, with whom they had meals and the replacement of lunch and/or dinner for snacks. Data were analyzed descriptively. The chi-square test was used to compare variables by gender, being significant p<0.05. Results: Among 71 adolescents, 58% were female. The majority reported eating the main meals at home (88% breakfast, 91% lunch, 96% dinner). Regarding the frequency of meal consumption, 49% have breakfast, 65% lunch, and 51% have dinner every day. Adolescents not only eat breakfast (48%) but also lunch (39%) alone, while the dinner Endereco para correspondencia: Erica Lie Araki Avenida Dr. Arnaldo, 715, 2o andar – Cerqueira Cesar CEP 01246-904 – Sao Paulo/SP E-mail: ericalie@usp.br Fonte financiadora: Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (Fapesp), processo n.o 2009/07224-6 Conflito de interesse: nada a declarar Recebido em: 9/3/2010 Aprovado em: 20/9/2010

A cross-cultural comparison of eating behaviors and home food environmental factors in adolescents from São Paulo (Brazil) and Saint Paul-Minneapolis (US).

OBJECTIVE Describe cross-cultural differences in nutrition-related factors among adolescents from São Paulo, Brazil and St Paul-Minneapolis, US. DESIGN Two large-population-based studies with cross-cultural comparisons. SETTING Twelve São Paulo and 10 St Paul-Minneapolis high schools in 2009-2010. PARTICIPANTS A total of 1,148 adolescents from São Paulo and 1,632 adolescents from St Paul-Minneapolis. MAIN OUTCOME MEASURE(S) Meal consumption, family meals, fast-food consumption, and home food availability. ANALYSIS Binomial regressions, weighted for age distributions and adjusted for gender, were used to compare identical measures from each sample. RESULTS Generally, São Paulo adolescents reported healthier nutritional outcomes than St Paul-Minneapolis adolescents. São Paulo adolescents were 7 times less likely to report high fast-food consumption than St Paul-Minneapolis adolescents (P < .001). Whereas most measures of the home environment indicated healthier home environments in São Paulo, more São Paulo adolescents reported that sugar-sweetened beverages were usually available at home than did St Paul-Minneapolis adolescents (P < .001). CONCLUSIONS AND IMPLICATIONS São Paulo youth tended to have healthier eating behaviors and home food environment factors than St Paul-Minneapolis youth. Brazilian eating patterns tend to be healthier and support a connection with food and culture. Interventions are needed to encourage youth and their families to maintain these patterns.

Beverage and soft drink consumption by adolescents from a public school

Objective: To evaluate the consumption of beverage and soft drinks by adolescents of a public school in Sao Paulo, Brazil. Methods: 71 adolescents (aged between 14 to 17 years old) from both genders, attending a technical school in the metropolitan area of Sao Paulo, answered the following questions: the kind of beverage taken during meals, the places where soft drinks were consumed and the main reason related to this intake. Results: The most frequent consumed beverage was the industrialized fruit juice (38.1%), followed by regular soft drinks (28.6%) and natural fruit juices (22.2%). The main place where soft drinks were consumed was home (38.2%), followed by school (22.1%). The main reason associated with soft drink intake was the flavor (75.4%). Conclusions: Sweet beverage intake was frequent among adolescents, specially soft drinks. These beverages are avail- able and consumed at home and at school, and they were considered tasteful. Nutritional education programs should discuss how to prioritize the intake of other beverages and how to control the sale of these products at schools, aiming to stimulate the intake of more healthy beverages by adolescents.

Replacement of meals with snacks among adolescents

Objective: To verify the prevalence of replacement of lunch and dinner with snacks among adolescents and its as- sociation with gender and nutritional status, and to evaluate the food that replaces such meals. Methods: A cross-sectional study that enrolled 106 high- school students in the city of Sao Paulo, Brazil. The adolescents answered questions about how often they replaced lunch and dinner with snacks, and which foods replaced those meals. Their weight and height were measured in order to calculate the body mass index, and the nutritional classification was based on the World Health Organization criteria. Data were analyzed descriptively, with a significance level of 5%. Results: One third of the adolescents replaced lunch and half of them replaced dinner with snacks. It was observed that girls replaced meals more than boys. The prevalence of meal replacement by snacks was higher among obese adoles- cents, being 40% for lunch and 70% for dinner. Sandwiches, baked or fried salty pastries, pizzas and hamburgers were the snacks that mostly replaced the meals. Conclusions: The replacement of meals, mainly dinner, with snacks was prevalent in the studied population. Most foods consumed in replacement of lunch and dinner had high energy density and low nutritional value.OBJECTIVE: To verify the prevalence of replacement of lunch and dinner with snacks among adolescents and its association with gender and nutritional status, and to evaluate the food that replaces such meals. METHODS: A cross-sectional study that enrolled 106 high-school students in the city of Sao Paulo, Brazil. The adolescents answered questions about how often they replaced lunch and dinner with snacks, and which foods replaced those meals. Their weight and height were measured in order to calculate the body mass index, and the nutritional classification was based on the World Health Organization criteria. Data were analyzed descriptively, with a significance level of 5%. RESULTS: One third of the adolescents replaced lunch and half of them replaced dinner with snacks. It was observed that girls replaced meals more than boys. The prevalence of meal replacement by snacks was higher among obese adolescents, being 40% for lunch and 70% for dinner. Sandwiches, baked or fried salty pastries, pizzas and hamburgers were the snacks that mostly replaced the meals. CONCLUSIONS: The replacement of meals, mainly dinner, with snacks was prevalent in the studied population. Most foods consumed in replacement of lunch and dinner had high energy density and low nutritional value.

Validade e reprodutibilidade de um questionário de frequência alimentar baseado nos grupos alimentares para adolescentes

The objective of this study was to assess the validity and reproducibility of a food frequency questionnaire to assess intake of the food groups included in the food guide pyramid for adolescents (FFQ-FP). The final version of the FFQ-FP consisted of 50 food items. The study was carried out with a sample of 109 adolescents over a period of four months. A 24hr recall (24hr) was conducted four times and the FFQ-FP was conducted twice. Validity was determined by comparing the second FFQ-FP and the mean of the four 24hrs, while reproducibility was verified by comparing the results of the two FFQ-FPs. Statistical analysis was carried out using medians, standard deviations, Pearson and intraclass correlations and Kappa statistics to assess concordance. Best results were achieved for the rice (including bread, grains and starches), meats and sugars groups. Weakest correlation was observed for the variable vitamin C. The validity and reproducibility of the FFQ-FP was satisfactory for most variables.El objetivo fue evaluar la validez y reproducibilidad de un cuestionario de frecuencia de alimentos sobre la base de grupos de alimentos en la piramide alimenticia para adolescentes (FFQ-AP). Despues de identificar los alimentos que se incluyen en el FFQ-AP, la version final estuvo compuesta por 50 items. El estudio se realizo con 109 adolescentes durante un periodo de cuatro meses. Se realizaron cuatro recordatorios de 24 horas dieteticos (R24h) y dos FFQ-AP. La validez se evaluo mediante la comparacion del segundo cuestionario de frecuencia (FFQ-AP) y el promedio de los R24h, mientras que la reproducibilidad se evaluo mediante la comparacion de los dos FFQ-AP. Los analisis estadisticos se realizaron con medias, desviaciones estandar y correlaciones de Pearson y correlacion intraclase. Los grupos de alimentos con variables evaluadas fueron: arroz, pan, pasta, patatas y yuca, carne y azucar y dulces. Los peores resultados se observaron con respecto a la vitamina C. El FFQ-AP mostro una validez aceptable y de reproduccion satisfactoria para la mayoria de las variables.