Elisabetta Recine

Television Food Advertising to Children: A Global Perspective

OBJECTIVES We compared television food advertising to children in several countries. METHODS We undertook a collaboration among 13 research groups in Australia, Asia, Western Europe, and North and South America. Each group recorded programming for 2 weekdays and 2 weekend days between 6:00 and 22:00, for the 3 channels most watched by children, between October 2007 and March 2008. We classified food advertisements as core (nutrient dense, low in energy), noncore (high in undesirable nutrients or energy, as defined by dietary standards), or miscellaneous. We also categorized thematic content (promotional characters and premiums). RESULTS Food advertisements composed 11% to 29% of advertisements. Noncore foods were featured in 53% to 87% of food advertisements, and the rate of noncore food advertising was higher during childrens peak viewing times. Most food advertisements containing persuasive marketing were for noncore products. CONCLUSIONS Across all sampled countries, children were exposed to high volumes of television advertising for unhealthy foods, featuring child-oriented persuasive techniques. Because of the proven connections between food advertising, preferences, and consumption, our findings lend support to calls for regulation of food advertising during childrens peak viewing times.

High temporal, geographic, and income variation in body mass index among adults in Brazil

OBJECTIVES Population-based data on body mass index for developing countries are scarce. Body mass index data from two Brazilian surveys were examined to determine regional and temporal variations in the prevalences of underweight, overweight, and obesity. METHODS Nationwide surveys in 1974/75 and 1989 collected anthropometric data in Brazil from 55,000 and 14,455 households, respectively. Trained interviewers used the same methods to measure weight and stature in both surveys, and survey designs were identical. Prevalences of underweight, overweight, and obesity were determined for persons 18 years of age and older. RESULTS In the 1989 survey, body mass index varied greatly according to region of the country, urbanization, and income. In the wealthier South, the prevalence of overweight/obesity was the highest and the prevalence of underweight was the lowest; in the poorer rural Northeast, these patterns were reversed. For both surveys, overweight/obesity was more common among women than among men and peaked at age 45 to 64 years in both sexes. Over the 15 years between surveys, the prevalence of both overweight and obesity increased strikingly. CONCLUSIONS In contrast to findings in developed countries, obesity in Brazil was positively associated with income and was much more prevalent among women than among men. For Brazilian women, the overall prevalence of overweight was nearly as high as that among women in the United States.

Políticas nacionais e o campo da Alimentação e Nutrição em Saúde Coletiva: cenário atual

It is presented a review of the guidelines implementation of the National Food and Nutrition Policy (PNAN) contextualizing the actions in the Brazilian Unified Health System (SUS) scenario. At ten years of its publication, PNAN faces challenges both to expand and qualify the shares of food and nutrition on health. It is challenging to stand as interlocutor and legitimate representative of the area of health, political and institutional context of food security and nutrition. Issues related to the articulation of PNAN and future National Policy on Food and Nutrition Security will be analyzed to demonstrate the convergence of agendas among the priorities for the guarantee of the SAN. The authors identify the potential of this field of action, from the current institutional setting, and the need for comprehensive solutions that address the complexity of food and nutrition in health.

Concepções de profissionais de saúde da atenção básica sobre a alimentação saudável no Distrito Federal, Brasil

Dietary changes in Western society highlight the need for individual and collective health providers to use their strategic positions to actively promote healthy eating habits. Using the research-action methodology in various clinics in the Federal District of Brazil, the present study aimed to identify what these professionals consider a healthy diet. The results indicate an apparent conceptual dichotomy: on the one hand, an idealized version of eating for good health based on the scientific literature; on the other, a concept derived from the ideal, but based on peoples day-to-day reality. In their pursuit of the latter concept, people in social situations make connections between various pieces of information, and what emerges are the eating habits most closely associated with a particular lifestyle. However, both concepts tend to transcend the implicit biological character of the conceptual constructs and to find support in the sociocultural conditions that shape them and which in turn are shaped at the concrete level of reality.

Nutrition capacity development: a practice framework

OBJECTIVE To outline a framework and a process for assessing the needs for capacity development to achieve nutrition objectives, particularly those targeting maternal and child undernutrition. DESIGN Commentary and conceptual framework. SETTING Low- and middle-income countries. Result A global movement to invest in a package of essential nutrition interventions to reduce maternal and child undernutrition in low- and middle-income countries is building momentum. Capacity to act in nutrition is known to be minimal in most low- and middle-income countries, and there is a need for conceptual clarity about capacity development as a strategic construct and the processes required to realise the ability to achieve population nutrition and health objectives. The framework for nutrition capacity development proposed recognises capacity to be determined by a range of factors across at least four levels, including system, organisational, workforce and community levels. This framework provides a scaffolding to guide systematic assessment of capacity development needs which serves to inform strategic planning for capacity development. CONCLUSIONS Capacity development is a critical prerequisite for achieving nutrition and health objectives, but is currently constrained by ambiguous and superficial conceptualisations of what capacity development involves and how it can be realised. The current paper provides a framework to assist this conceptualisation, encourage debate and ongoing refinement, and progress capacity development efforts.

Consulta aos rótulos de alimentos e bebidas por freqüentadores de supermercados em Brasília, Brasil

OBJETIVO: Investigar se a populacao adulta frequentadora de supermercados do Plano Piloto de Brasilia (DF), Brasil, utiliza as informacoes nutricionais contidas nos rotulos de bebidas e alimentos, assim como caracterizar essa utilizacao. METODOS: Este trabalho foi realizado em duas etapas: uma etapa quantitativa, baseada em um estudo transversal, onde foram entrevistados 250 individuos selecionados aleatoriamente em cinco supermercados; e uma etapa qualitativa, na qual foram feitas 25 entrevistas individuais com participantes da etapa anterior. RESULTADOS: A leitura da informacao nutricional dos rotulos de alimentos era realizada por 187 (74,8%) dos consumidores pesquisados. Contudo, apenas 25,7% dos consumidores nesse grupo liam os rotulos de todos os alimentos. Em geral (59,9%), a consulta se dava somente aos rotulos de alimentos especificos, como leites e derivados, enlatados, embutidos e produtos diet e light. Foram citados como os mais importantes objetivos da consulta aos rotulos o interesse acerca do numero de calorias e da quantidade de gordura e sodio. CONCLUSOES: Os presentes resultados indicam a necessidade de aperfeicoar as estrategias educativas ja existentes para o consumo saudavel de alimentos, e podem ser uteis nesse aperfeicoamento. Sugere-se que, alem dos consumidores, os produtores e distribuidores de alimentos tambem sejam integrados nas estrategias de educacao nutricional.

A formação em Saúde Pública nos cursos de graduação de Nutrição no Brasil

OBJECTIVE: The aim of this cross-sectional study was to characterize the training in public health offered by undergraduate nutrition courses, considering the profile of professors and disciplines in public health nutrition. METHODS: Questionnaires were sent to all public and private Brazilian institutions that offer an undergraduate nutrition course and had at least one class of graduates by the first semester of 2010 (n=296). The following data were assessed: when the course became available, number of openings, availability of graduate courses, disciplines in the area of public health nutrition, course hour load, theoretical class/practical class hour load ratio and education of the respective professors. RESULTS: A total of 65 questionnaires were answered (22.0%). Most courses dedicated at most 30.0% of their hour load to public health nutrition disciplines. On average, 82.2% of the public health nutrition disciplines were compulsory. Almost 25.0% of the hour load of public health nutrition disciplines was dedicated to practical activities. In public institutions, more than 50.0% of the professors of 48.0% of the courses were dieticians, against 17.0% in private institutions. CONCLUSION: The public health nutrition area is characterized by the following disciplines: nutritional assessment, nutrition education, public health nutrition and epidemiology. The studied curricula need to increase the number of disciplines that train students for work at the Unified Health System (Sistema Unico de Saude), students who are capable of analyzing nutrition problems considering historical, political, economic, demographic, environmental and epidemiological contexts. It is also necessary to expand opportunities of learning where nutritional problems are analyzed considering historical, political, economic, demographic and environmental context. There are areas of knowledge that has been gaining importance in professional practice, such as school feeding, food and nutrition security, that still have minimal presence in undergraduate courses.

Implantação da cantina escolar saudável em escolas do Distrito Federal, Brasil

OBJECTIVE: A methodology for assessing the implementation of healthy school canteens in schools of the Federal District was developed and administered. METHODS: A descriptive study was done in 2006 to assess the following: a) an educational intervention that trained canteen owners and implemented ten steps to a healthy school canteen; and b) canteen profiles on three different occasions: before the training course and six and twenty-four months after. A system was then developed for classifying the healthiness of the preparations. RESULTS: Thirty-five canteen owners were trained and nine participated in all three canteen assessments. Compliance with the ten steps to a healthy school canteen and availability of healthier snacks increased from the first to the second assessment, but not to the third. Although canteen owners were no longer compliant with the intervention, they tried to stay more in touch with other canteens interested in offering healthy snacks (p=0.002). CONCLUSION: The training course had positive results, especially in the short run. However, the one-year follow-up for this group was not enough to ensure sustainability of the actions. Effective implementation and maintenance of healthy canteens require systematic monitoring and legal and scholastic support.

Percepção de professores e estudante em relação ao perfil de formação de nutricionista em saúde pública

OBJECTIVE: This study analyzed how professors and students perceive the education of dieticians who specialize in public health. METHODS: This qualitative and quantitative study administered a questionnaire to undergraduate and graduate students and held a focal group with professors. The data collected by the questionnaire was descriptively analyzed and the contents of the focal group were analyzed according to the Discourse of the Collective Subject method. RESULTS: Thirtyfive percent of the students mentioned some kinship with the public health field and 11% of the graduates reported working in public health. Meanwhile, the greatest barriers in public health education, according to professors, were: difficulty of finding a job in the area, the relationship between theory and practice, and the communication difficulty between teaching and health service. CONCLUSION: These results indicate the need broadening and deepening the public health theme in undergraduate nutrition courses.

Saúde coletiva nos cursos de Nutrição: análise de projetos político-pedagógicos e planos de ensino

Objective: To analyze the contents of the teaching plans of the disciplines in the areas of Nutrition in Public Health and political and educational plans of nutrition programs in Brazil.Methods: This is a qualitative, exploratory, document-based study that used the technique of the software Alceste(r) in the corpus generated by the analyzed documents.Results:Of the 392 nutrition programs available in 2010 in Brazil, we collected 46 political and educational plans and 517 teaching plans of disciplines in public health. The categories classified and generated for the political and educational plans were: expected competences; actions in nutritional care; and operationalization of the program. The third category corresponded to 75.5% of the content given that much of the content is related to the operationalization of the programs. The categories classified in the second analysis regarding the teaching plans were: nutritional and clinical assessment and diet therapy throughout life; nutritional epidemiology and health surveillance; nutrition education and communication; education for professional practice and culture and social sciences. The first category of this stage corresponded to 34.2% and to one of the axis of the corpus: therefore, the one that composes the disposition of the elements more strongly. This category approached themes little related to the themes treated by the other categories. The other axis of the other classes established a less distant association in the plane between elements, showing that there is some connection between what is exposed and the objectives, contents, and education process that correlate food with the social context and professional practice.Conclusion:The distance between the analyzed contents indicates a dichotomy when describing objectives, competences, and professional practice. The coordination between the biological elements, social practices, and education is inadequate.