Dirce Maria Sigulem

Eating attitudes and body image in ethnic Japanese and Caucasian adolescent girls in the city of São Paulo, Brazil

OBJECTIVE: Despite investigations into the rapid increase in eating disorders across diverse ethnic groups, conclusions concerning ethnicity and eating disorders are contradictory. The objective of the present study was to investigate eating attitudes in ethnic Japanese and Caucasian adolescents in Brazil. The influence of body mass index (BMI), menarche and social-affective relationships on the development of eating disorders was also assessed. METHODS: Questionnaires evaluating the incidence of eating disorders and the influence of social-affective relationships were applied to 544 Japanese-Brazilian and Caucasian adolescent girls: 10 to 11-year-old Japanese-Brazilian (n = 122) and Caucasian (n = 176) pre-menarcheal adolescents, and 16 to 17-year-old Japanese-Brazilian (n = 71) and Caucasian (n = 175) post-menarcheal adolescents. RESULTS: Caucasian girls obtained higher scores on the Eating Attitudes Test (EAT-26), showed greater body image dissatisfaction, dieted more often and had more diet models introduced by their mothers and peers than the Japanese-Brazilian girls. CONCLUSION: The Caucasian adolescents overall appeared to be more sensitive to aesthetic and social pressures regarding body image than the Japanese adolescents. The high incidence of EAT-26 scores above 20 in the Caucasian pre-menarcheal group indicates that individual body image concerns are developing at an earlier age. Multiple logistic regression revealed several associations between mother-teen interactions and the development of abnormal eating attitudes.

Diagnosis of child and adolescent nutritional status

OBJECTIVE: To present a review on the methods for the assessment of child and adolescent nutritional status, emphasizing anthropometry and the various methods for the assessment of body composition; pointing out their advantages, limitations and risks. METHODS: Chapters of textbooks, theses, and articles relevant to the topic, as well as personal files and authors previous publications were selected. RESULTS: Anthropometry, which consists of the assessment of physical dimensions and global composition of the human body, has been regarded as the most frequently used isolated method for nutritional diagnosis, especially in childhood and adolescence, due to its ease of use, low cost and innocuousness. The most frequently adopted measurements aim at determining body mass, expressed by weight; linear dimensions, especially height; body composition and reserves of energy and proteins, estimated through subcutaneous fat and muscle mass. Laboratorial methods especially developed for the assessment of body composition are presented here. The justification for the use of methods that expose children and adolescents to ionizing radiation is also presented. CONCLUSIONS: On defining methods for the assessment of nutritional status, we should select those that better detect the nutritional deficiencies we want to correct, also taking into consideration their costs, level of personal skill required for their proper application, necessary time for application, acceptability by the studied population and possible health risks.

The risk approach in preschool children suffering malnutrition and intestinal parasitic infection in the city of São Paulo, Brazil

The association between parasitic infection and malnutrition in preschool children in the city of São Paulo, was studied according to degree of malnutrition, age, and income. Associations were assessed by risk analysis. Higher risks of malnutrition were found in children above 24 months of age infected with Ascaris, Trichuris or with more than three different parasites. The presence of more than three parasites per child affected nutritional status independently of income level. It is suggested that more attention should be given to intensity and chronicity of intestinal parasitic infection.

Variáveis maternas e infantis associadas à ocorrência de anemia em crianças nos serviços de atenção básica em São Paulo

OBJECTIVE: To analyze mother and child factors associated with the occurrence of anemia in children assisted at primary health care centers in Sao Paulo city, Brazil. METHODS: The study enrolled 357 children from four to 24 months assisted at three health care centers in the southern region of the city. Possible factors associated to anemia and related to mother and children characteristics were categorized. Hemoglobin was determined by digital puncture and the cut value for anemia diagnosis was 11g/dL. Student t test was used to compare the hemoglobin means of two independent groups; ANOVA for three or more independent groups, and Mann-Whitney was used to test the association of anemia and age group or speed of growing. RESULTS: The prevalence of anemia was 60%. Anemia was not associated to maternal variables. Weight gain and male gender were associated to a higher prevalence of anemia. Anemia was also associated with poor qualitative or quantitative ingestion of iron. The occurrence of anemia was not avoided by breastfeeding practice. CONCLUSIONS: The high prevalence of anemia was related to masculine gender, which had a faster speed of weight gain in children less than six months old and from 18 to 24 months old. Anemia was also related to low ingestion of iron in the diet.

[Effect of in-home boiling and refrigeration on bacterial load of pasteurized milk]

OBJECTIVES: To assess the efficacy of in-home boiling of pasteurized milk in reducing the bacterial load and the ability of the refrigeration in preserving the milk after boiling.METHODS: Thirty samples of pasteurized milk bought in São Paulo, Brazil, were submitted to in-home boiling procedure at the laboratory. Portions of samples were taken before and after boiling, and after 2, 4, 6 and 24 hours under refrigeration for microbiological analyses. Methods used were mesophilic bacteria count, and coliforms and Escherichia coli (E.coli) enumeration.RESULTS: No sample presented mesophilic bacteria count above the Brazilian standard for pasteurized milk. E.coli was not recovered from any sample. Ten samples (33%) had coliform bacteria; of these, 3 samples (10%) were above the standard. Mesophilic bacteria count after boiling was significantly lower than before boiling. After 24 hours under refrigeration, mesophilic bacteria count was significantly higher than after boiling. No significant differences were found between the intervals of 2, 4, 6 and 24 hours under refrigeration. Samples before boiling presented significantly higher coliform bacteria. No coliform bacteria were recovered at any time after boiling.CONCLUSIONS: In-home boiling of milk reduced bacterial load, while refrigeration kept bacteria under low counts.