Giovana Longo-Silva

Introduction of soft drinks and processed juice in the diet of infants attending public day care centers

OBJECTIVE: Identifying at what age infants enrolled in public day care centers are introduced to soft drinks and industrialized juice, as well as comparing the nutritional composition of these goods with natural fruit juice. METHODS: A cross-sectional study with the mothers of 636 children (aged 0 to 36 months) from nurseries of day care centers, who were asked questions about the age of feeding introduction. This study evaluated the proximate composition of soft drinks and artificial juice, comparing them with those of natural fruit juice regarding energy, sugar, fiber, vitamin C, and sodium values. The chemical composition of fruit juice was obtained by consulting the Table of Food Composition and, for industrialized drinks, the average nutritional information on the labels of the five most consumed product brands. RESULTS: The artificial drinks were consumed before the first year of life by more than half of the children studied, however, approximately 10% consumed them before the age of 6 months. With regard to the comparison among the drinks, artificial fruit juice beverages and soft drinks proved to contain from nine to 13 times higher amounts of sodium, and 15 times less vitamin C than natural juices. CONCLUSIONS: The introduction of soft drinks and industrialized juice in the diet of infants was inopportune and premature.. When compared to natural fruit juice, these have inferior nutritional composition, which suggests the urgent need for measures based on strategies for food and nutrition education in order to promote awareness and the maintenance of healthy eating habits.

Estado nutricional de crianças e adolescentes de um município do semiárido do Nordeste brasileiro

Objective: To evaluate the nutritional status of schoolchildren, resident in a semiarid region in the Northeastern Brazil. Methods: This is a cross-sectional study, involving 860 children and adolescents aged from 5-19 years-old, enrolled in three public schools in the county. The selection of schools was non-probabilistic type and unintentional. The initial population, which integrated the database, was composed by 1,035 children and teenagers, and 175 students (16.9%) were excluded because of inconsistency in the anthropometric data, resulting in a sample of 860 students. The following outcomes were considered: stunting (malnutrition), overweight and obesity (overweight), being the height/age and body mass index/age (BMI/Age), indices respectively used. Children and adolescents with height <-2 standard deviations and overweight and obese weight z score ≥1 were considered stunted. The statistical analysis was descriptive. Results: The prevalence of stunting and overweight/obesity was 9.1% and 24.0%, respectively. Overweight and stunting were higher in adolescents aged 15 and over, compared to other age groups analyzed. In relation to gender, malnutrition presented itself in a similar way, but overweight was more frequent among females. Conclusions: The results revealed that excess weight, here represented by the sum of overweight and obesity, was more prevalent than stunting (malnutrition), highlighting the urgent need for attention to this problem in order to design interventions capable of contributing to the improvement of schoolchildren nutritional status.Objective:To evaluate the nutritional status of schoolchildren, resident in a semiarid region in the Northeastern Brazil.Methods:This is a cross-sectional study, involving 860 children and adolescents aged from 5-19 years-old, enrolled in three public schools in the county. The selection of schools was non-probabilistic type and unintentional. The initial population, which integrated the database, was composed by 1,035 children and teenagers, and 175 students (16.9%) were excluded because of inconsistency in the anthropometric data, resulting in a sample of 860 students. The following outcomes were considered: stunting (malnutrition), overweight and obesity (overweight), being the height/age and body mass index/age (BMI/Age), indices respectively used. Children and adolescents with height <-2 standard deviations and overweight and obese weight z score ≥1 were considered stunted. The statistical analysis was descriptive.Results:The prevalence of stunting and overweight/obesity was 9.1% and 24.0%, respectively. Overweight and stunting were higher in adolescents aged 15 and over, compared to other age groups analyzed. In relation to gender, malnutrition presented itself in a similar way, but overweight was more frequent among females.Conclusions:The results revealed that excess weight, here represented by the sum of overweight and obesity, was more prevalent than stunting (malnutrition), highlighting the urgent need for attention to this problem in order to design interventions capable of contributing to the improvement of schoolchildren nutritional status.

Consumption of industrialized food by infants attending child day care centers

Objective: To identify the age of introduction of petit suisse cheese and instant noodles in the diet of infants attending nurseries of public day care centers and to compare the nutritional composition of these foods with the healthy recommended diet (breast milk and salt meal) for this age, in order to estimate nutritional errors. Methods: Cross-sectional study of 366 children (from nine to 36 months old) who attended day care centers, whose mothers were interviewed about the age of introduction of those foods. The means of the nutrients indicated on the labels of the most consumed brands were considered. For the calculation of the percent composition of breast milk and salt meal, Tables of Food Composition were used. To assess the nutritional adequacy, we used the Dietary Reference Intakes by age group. The percentage of adequacy evaluation of the petit suisse cheese and the instant noodles nutritional compositions was made by comparing them with those of the human milk and the salt meal, respectively. Results: The petit suisse cheese and the instant noodles were consumed by 89.6 and 65.3% of the children in the first year of life. The percentages of adequacy for carbohydrates were more than twice and the percentages for sodium were 20 times higher than those found in the recommended foods. Conclusions: Both industrialized products are inappropriate for infants, emphasizing the need for adoption of norms that can inform health professionals, educators and parents about the risks of consumption.Objetivo: Identificar a idade de introducao do queijo petit suissee do macarrao instantâneo na dieta de lactentes matriculados em bercarios de creches publicas/filantropicas e comparar suas composicoes nutricionais com a alimentacao recomendada para a idade (leite materno e refeicao salgada), visando estimar erros nutricionais.Metodos:Estudo transversal com 366 criancas (de nove a 36 meses) de bercarios de creches, cujas maes foram entrevistadas sobre idade de introducao dos alimentos. Consideraram-se as medias de nutrientes indicadas nos rotulos das marcas mais consumidas. No calculo da composicao centesimal do leite materno e da refeicao salgada, utilizaram-se Tabelas de Composicao de Alimentos. Para avaliacao da adequacao nutricional, utilizaram-se as Recomendacoes de Ingestao Diaria por faixa etaria. A avaliacao dos percentuais de adequacao das composicoes nutricionais do petit suissee do macarrao instantâneo foi feita comparando-as com as do leite materno e da refeicao salgada, respectivamente.Resultados: O petit suisse e o macarrao instantâneo foram consumidos por 89,6 e 65,3% dos lactentes ainda no primeiro ano de vida. Os percentuais de adequacao para carboidrato foram superiores a duas vezes o recomendado e os percentuais de sodio, 20 vezes superiores aos encontrados nos alimentos recomendados.Conclusoes: Os dois produtos industrializados sao improprios para lactentes, ressaltando-se a necessidade de adocao de normatizacao que possa informar os profissionais de saude, os educadores e os pais sobre os riscos do consumo.

Consumo de alimentos industrializados por lactentes matriculados em creches

Objective: To identify the age of introduction of petit suisse cheese and instant noodles in the diet of infants attending nurseries of public day care centers and to compare the nutritional composition of these foods with the healthy recommended diet (breast milk and salt meal) for this age, in order to estimate nutritional errors. Methods: Cross-sectional study of 366 children (from nine to 36 months old) who attended day care centers, whose mothers were interviewed about the age of introduction of those foods. The means of the nutrients indicated on the labels of the most consumed brands were considered. For the calculation of the percent composition of breast milk and salt meal, Tables of Food Composition were used. To assess the nutritional adequacy, we used the Dietary Reference Intakes by age group. The percentage of adequacy evaluation of the petit suisse cheese and the instant noodles nutritional compositions was made by comparing them with those of the human milk and the salt meal, respectively. Results: The petit suisse cheese and the instant noodles were consumed by 89.6 and 65.3% of the children in the first year of life. The percentages of adequacy for carbohydrates were more than twice and the percentages for sodium were 20 times higher than those found in the recommended foods. Conclusions: Both industrialized products are inappropriate for infants, emphasizing the need for adoption of norms that can inform health professionals, educators and parents about the risks of consumption.Objetivo: Identificar a idade de introducao do queijo petit suissee do macarrao instantâneo na dieta de lactentes matriculados em bercarios de creches publicas/filantropicas e comparar suas composicoes nutricionais com a alimentacao recomendada para a idade (leite materno e refeicao salgada), visando estimar erros nutricionais.Metodos:Estudo transversal com 366 criancas (de nove a 36 meses) de bercarios de creches, cujas maes foram entrevistadas sobre idade de introducao dos alimentos. Consideraram-se as medias de nutrientes indicadas nos rotulos das marcas mais consumidas. No calculo da composicao centesimal do leite materno e da refeicao salgada, utilizaram-se Tabelas de Composicao de Alimentos. Para avaliacao da adequacao nutricional, utilizaram-se as Recomendacoes de Ingestao Diaria por faixa etaria. A avaliacao dos percentuais de adequacao das composicoes nutricionais do petit suissee do macarrao instantâneo foi feita comparando-as com as do leite materno e da refeicao salgada, respectivamente.Resultados: O petit suisse e o macarrao instantâneo foram consumidos por 89,6 e 65,3% dos lactentes ainda no primeiro ano de vida. Os percentuais de adequacao para carboidrato foram superiores a duas vezes o recomendado e os percentuais de sodio, 20 vezes superiores aos encontrados nos alimentos recomendados.Conclusoes: Os dois produtos industrializados sao improprios para lactentes, ressaltando-se a necessidade de adocao de normatizacao que possa informar os profissionais de saude, os educadores e os pais sobre os riscos do consumo.

Intake of protein, calcium and sodium in public child day care centers

OBJETIVO:Avaliar a ingestao de calcio, proteina e sodio e compara-la com a recomendada, em criancas que frequentam creches publicas.METODOS:Estudo transversal descritivo realizado em bercarios de sete creches publicas do municipio de Sao Paulo, que atendiam 366 criancas entre 12 e 36 meses, com coleta entre setembro a dezembro de 2010. Avaliou-se cada creche durante tres dias nao consecutivos, totalizando 42 dias e 210 refeicoes. O consumo alimentar foi avaliado por metodo de pesagem direta de alimentos. Para o calculo nutricional, utilizou-se o software DietWin Profissional 2.0(r) e a adequacao foi calculada segundo as recomendacoes do Programa Nacional de Alimentacao Escolar (PNAE) para energia, proteina, calcio e sodio. A relacao calcio/proteina e a densidade de calcio (mg/1.000kcal) tambem foram computadas.RESULTADOS:Constatou-se que o consumo de energia (406,4kcal), de proteina (18,2g) e de calcio (207,6mg) nao atingiu os valores recomendados em todas as creches estudadas, sendo que a ingestao de sodio ultrapassou em ate tres vezes a recomendacao. A relacao calcio/proteina de 11,7mg/g foi inferior a adequacao (20mg/g).CONCLUSOES:Ha inadequacao do consumo alimentar de calcio, proteina e sodio, em criancas inseridas no contexto de creches publicas.OBJECTIVE: To assess calcium, protein and sodium intake, of children that attend public day-care centers and to compare it with the recommended one. METHODS: Cross-sectional descriptive study in seven public day care centers of São Paulo city, Southeast Brazil, which enrolled 366 children between 12 and 36 months of age. The data collection occurred between September and December 2010. Each day care center was evaluated for three non-consecutive days, totaling 42 days and 210 meals. Dietary intake was assessed by a direct food weighing method. For the nutritional calculation, DietWin(r) Profissional 2.0 was used, and the adequacy was calculated according to the recommendations of the National School Feeding Program for energy, protein, calcium and sodium. The calcium/protein relation was also calculated, as well as calcium density (mg/1,000kcal). RESULTS: The energy (406.4kcal), protein (18.2g) and calcium (207.6mg) consumption did not reach the recommended values in all the evaluated day care centers. Sodium intake exceeded up to three times the recommendation. The calcium/protein ratio of 11.7mg/g was less than the adequate one (20mg/g). CONCLUSIONS: There was inadequacy of calcium, protein and sodium dietary intake, in children attending public day-care centers.

Challenges in the management of nutritional disorders and communicable diseases in child day care centers: a quantitative and qualitative approach:

In Brazil, although many children from low income families attend day care centers with appropriate hygiene practices and food programs, they have nutritional disorders and communicable diseases. This quantitative and qualitative cross-sectional study identified staff challenges in child day care centers and suggested alternative activity management to prevent nutritional disorders and communicable diseases. The study included 71 nursery teachers and 270 children from public and philanthropic day care centers (teacher to child ratios of 1:2.57 and 1:6.40, respectively). Interviews and focus groups were conducted with teachers and parents, and anthropometry and blood samples were drawn from the children by digital puncture. Children in philanthropic child day care centers were more likely to be hospitalized due to communicable diseases. Teachers from philanthropic child day care centers had lower age, income and education and higher work responsibilities based on the number of children and working time. The focus groups characterized institutions with organized routines, standard food practices, difficulties with caretaking, and lack of training to provide healthcare to children. Strategies to improve children’s health in day care settings should focus on training of teachers about healthcare and nutrition.

Prevalence and Factors Associated with Metabolic Syndrome among Brazilian Adult Population: National Health Survey - 2013

Background In Brazil, population-based researches analyzing prevalence and factors associated with metabolic syndrome (MS), a recognized predictor of cardiovascular diseases (CVD), and an important cause of disability and death in the country are scarce. Objective To evaluate prevalence of MS and its associated factors in Brazilian population. Methods Secondary analysis of the 2013 National Health Survey, a cross-sectional survey with national representativeness of Brazilian adult population (n = 59,402). MS was the outcome variable, defined from harmonization of cardiology international consensus as load ≥ 3 of the following components: self-reported diabetes and hypercholesterolemia, high blood pressure and high waist circumference. Analysis were stratified by sex and prevalence ratios, with their respective 99% confidence intervals (PR [CI 99%]) calculated by simple and multiple Poisson regression models. Results MS prevalence was 8.9%, being significantly higher among women compared to men; in general, this pattern was maintained in relation to exposure variables studied. Additionally, less than 25% of population did not present any MS component. In final multiple models, sociodemographic, behavioral and comorbidity variables were associated with MS, however, while low schooling (1.46 [1.23-1.74], cerebrovascular accident (1.36 [1], 00] (1.28 [1.03-1.62]) were associated among women, chronic renal failure (1.85 [2.23-2.76]) was associated exclusively among men. Conclusion We identified MS high prevalence in Brazilian population; on the other hand, factors associated with this condition were different depending on sex.

Age at introduction of ultra-processed food among preschool children attending day-care centers.

OBJECTIVE To identify the age of introduction of ultra-processed food and its associated factors among preschool children. METHODS Cross-sectional study carried out from March to June 2014 with 359 preschool children aged 17 to 63 months attending day-care centers. Time until ultra-processed food introduction (outcome variable) was described by the Kaplan-Meier analysis, and the log-rank test was used to compare the survival functions of independent variables. Factors associated with ultra-processed food introduction were investigated using the multivariate Cox proportional hazards model. The results were shown as hazard ratios with their respective 95% confidence intervals. RESULTS The median time until ultra-processed food introduction was six months. Between the 3rd and 6th months, there is a significant increase in the probability of introducing ultra-processed food in the childrens diet; and while the probability in the 3rd month varies from 0.15 to 0.25, at six months the variation ranges from 0.6 to 1.0. The final Cox proportional hazards model showed that unplanned pregnancy (1.32 [1.05-1.65]), absence of prenatal care (2.50 [1.02-6.16]), and income >2 minimum wages (1, 50 [1.09-2.06]) were independent risk factors for the introduction of ultra-processed food. CONCLUSION Up to the 6th month of life, approximately 75% of preschool children had received one or more ultra-processed food in their diet. In addition, it was observed that the poorest families, as well as unfavorable prenatal factors, were associated with early introduction of ultra-processed food.

[Short stature in children of Karapotó ethnic background, São Sebastião, Alagoas, Brazil].

Abstract Objective: To describe the prevalence of short stature among children of Karapotó ethnic background. Methods: Cross-sectional, population-based study that included children between 6 and 59 months of age from the Plak-Ô native village and the Terra Nova settlement, São Sebastião, Alagoas, carried out between 2008 and 2009. Short stature was evaluated by the Height/Ageindex, using as cutoff z score≤−2. The prevalence of short stature was determined by compa-ring simple and relative frequencies. The population growth curves were compared to the WHO reference curves. Data analysis included the outcome variable: Height/Age and the predictor variables: place of residence, gender, age, anemia, birth weight, family income, maternal literacy. The chi-square test was used to compare the categorical variables, where as the chi-square test with Yates correction was used for dichotomous variables, considering as statistically significant p-values≤0.05. Results: The prevalence of short stature was 15.6% for children from the Terra Nova settlement and 9.1% for those from Plak-Ô native village. The prevalence of short stature among the Karapotó ethnicity was 13.4%. The variables: maternal literacy, family income and low birth weight were statistically associated with short stature. Conclusions: The observed short stature prevalence rates are significant, being characterized as a public health problem. Among the associated factors, the following are noteworthy: unfavorable conditions of maternal literacy, family income and low birth weight. The planning of strategies to reverse the situation must take such factors into consideration.

Consumo de alimentos industrializados por lactantes matriculados en guarderías

Objective: To identify the age of introduction of petit suisse cheese and instant noodles in the diet of infants attending nurseries of public day care centers and to compare the nutritional composition of these foods with the healthy recommended diet (breast milk and salt meal) for this age, in order to estimate nutritional errors. Methods: Cross-sectional study of 366 children (from nine to 36 months old) who attended day care centers, whose mothers were interviewed about the age of introduction of those foods. The means of the nutrients indicated on the labels of the most consumed brands were considered. For the calculation of the percent composition of breast milk and salt meal, Tables of Food Composition were used. To assess the nutritional adequacy, we used the Dietary Reference Intakes by age group. The percentage of adequacy evaluation of the petit suisse cheese and the instant noodles nutritional compositions was made by comparing them with those of the human milk and the salt meal, respectively. Results: The petit suisse cheese and the instant noodles were consumed by 89.6 and 65.3% of the children in the first year of life. The percentages of adequacy for carbohydrates were more than twice and the percentages for sodium were 20 times higher than those found in the recommended foods. Conclusions: Both industrialized products are inappropriate for infants, emphasizing the need for adoption of norms that can inform health professionals, educators and parents about the risks of consumption.Objetivo: Identificar a idade de introducao do queijo petit suissee do macarrao instantâneo na dieta de lactentes matriculados em bercarios de creches publicas/filantropicas e comparar suas composicoes nutricionais com a alimentacao recomendada para a idade (leite materno e refeicao salgada), visando estimar erros nutricionais.Metodos:Estudo transversal com 366 criancas (de nove a 36 meses) de bercarios de creches, cujas maes foram entrevistadas sobre idade de introducao dos alimentos. Consideraram-se as medias de nutrientes indicadas nos rotulos das marcas mais consumidas. No calculo da composicao centesimal do leite materno e da refeicao salgada, utilizaram-se Tabelas de Composicao de Alimentos. Para avaliacao da adequacao nutricional, utilizaram-se as Recomendacoes de Ingestao Diaria por faixa etaria. A avaliacao dos percentuais de adequacao das composicoes nutricionais do petit suissee do macarrao instantâneo foi feita comparando-as com as do leite materno e da refeicao salgada, respectivamente.Resultados: O petit suisse e o macarrao instantâneo foram consumidos por 89,6 e 65,3% dos lactentes ainda no primeiro ano de vida. Os percentuais de adequacao para carboidrato foram superiores a duas vezes o recomendado e os percentuais de sodio, 20 vezes superiores aos encontrados nos alimentos recomendados.Conclusoes: Os dois produtos industrializados sao improprios para lactentes, ressaltando-se a necessidade de adocao de normatizacao que possa informar os profissionais de saude, os educadores e os pais sobre os riscos do consumo.