Júlia Aparecida Devidé Nogueira

A Política Nacional de Promoção da Saúde e a agenda da atividade física no contexto do SUS

Resumo Este artigo aborda a institucionalizacao da promocao da saude com a aprovacao da Politica Nacional de Promocao da Saude e a escolha da tematica da atividade fisica-praticas corporais como uma de suas prioridades. Sao apresentadas as acoes desenvolvidas pelo Ministerio da Saude na inducao e sustentabilidade de estrategias de reducao do fator de risco do sedentarismo no contexto do Sistema Unico de Saude. Palavras-chave: promocao da saude; atividade fisica; vigilância em Saude Publica; acao intersetorial. Summary This article approaches the institutionalization of health promotion with the approval of the National Policy of Health Promotion, and the election of motor activity-body practices like one of its priorities. It describes the actions developed by the Brazilian Ministry of Health to induce and give sustainability for the strategies of reduction of the risk factor for sedentary lifestyle in the context of the National Health System.

Assessment of nutrient and water intake among adolescents from sports federations in the Federal District, Brazil

Adolescents aged 11-14 years (n 326), belonging to organized sports federations in the Federal District, Brazil were interviewed. Subjects (n 107) provided four non-consecutive days of food consumption and 219 subjects provided two non-consecutive days of intake. The objective was to assess their nutrient and water intake according to dietary reference intake values and their energy and macronutrient intake by sex and sports groups they were engaged in: endurance, strength-skill or mixed, according to the guidelines established by the American College of Sport Medicine (ACSM). Dietary data were corrected for intra-individual variation. Total energy expenditure was higher among endurance athletes (P < 0.001) following their higher training time (P < 0.001) when compared to adolescents engaged in strength-skill or mixed sports. Total energy intake was only significantly higher among endurance-engaged females (P = 0.05). Protein intake of males was above the guidelines established by the ACSM for all sports groups. All male sport groups fulfilled the intake levels of carbohydrate per kg body weight but only females engaged in endurance sports fulfilled carbohydrate guidelines. Intakes of micronutrients with low prevalence of adequate intake were: vitamins B1, E and folate, magnesium and phosphorus. Few adolescents ( < 5 %) presented adequate intake for calcium, fibre, drinking water and beverages. For micronutrients, prevalence of adequacies were lower for females than males, except for liquids and water. Nutrition guidance is needed to help adolescents fulfil specific guidelines of macronutrient intake for their sports and to improve their intake of micronutrients and water. Special attention should be given to female adolescent athletes.

Comportamento alimentar e imagem corporal entre estudantes de medicina

Eating disorderstend to occur in young women, meaningundergraduate students representa risk group. This study aims to identify eating behaviors and body image as risk factors for eating disorders in medical students. It is a cross-sectional study with a random and representative sample that used self-reported body mass index (BMI) , the Body Shape Questionnaire (BSQ) , the Bulimic Investigatory Test Edinburgh (Bite) , and the Eating Attitudes Test (EAT-26) . Statistics were descriptive with Chi-squared and ANOVA tests and a significance level of p<0.05. Mean (SD) of age and BMI were 20.8 (2.2) years and 21.5 (2.6) kg/m2. The prevalences were: 27.7% presented distorted body image by BSQ; 31.7% expressed abnormal eating behavior and 6.3% were at risk for bulimia by BITE, and 7.9% presented moderate/severe symptoms, and 19% were at risk of developing eating disorders by EAT-26. A significant association was found between BMI, body image and risk for TCA. Medical students were at a sub-clinical level of risk or early stage of eating disorderand requireattention so that these disorders do notharm their health and professional practice.

Reducing risk factors in overweight adult users of the family health strategy of the Distrito Federal

OBJECTIVE: To evaluate the results of a multidisciplinary program to promote healthy habits on anthropometric and biochemical parameters on participants of the Family Health Strategy of the Distrito Federal. METHODS: The sample consisted of 279 overweight and obese adults of both sexes divided into two groups: intervention (IG, n=198) and control group (CG, n=89). The IG received standard Family Health Strategy care plus a multidisciplinary health promoting program that included dietary interventions and physical activity, called Set Waist Program. The control group received only standard ESF care. Data were collected at baseline and after 4 and 8 months of follow up. Body mass index, waist circumference, fasting blood glucose and lipid profile were assessed. RESULTS: Prevalence of obesity (63.3% to 49.4%, p=0.027) and waist circumference (102.2cm to 94.8cm, p<0.0001) were significantly reduced in IG. Total cholesterol, LDL and HDL-cholesterol were reduced in both groups. CONCLUSION: Reductions in anthropometric measures were maximized through simple interventions that stimulated lifestyle changes. These results suggest that multidisciplinary initiatives such the Set Waist Program can be incorporated into other Family Health Strategy teams to optimize the control of obesity and health promotion. Participant compliance is an issue that deserves further investigation.

Estratégias de capacitação de professores do ensino fundamental em atividade física e alimentação saudável

The study evaluated the learning effects generated by long (IL) and short (IC) educational interventions in health eating and physical activity knowledge. 42 teachers from two public elementary schools completed knowledge questionnaires with a 0-10 grade, pre and post-intervention. IL offered a 40 hours course and IC offered a 30 minutes lecture, and both groups received the same printed educational material. The intervention produced a statistically significant (p<0.05) increased in averaged health eating knowledge [IL: +1.19 (SE=0.31) and CI: +1.18 (SE 0.34) points]. In physical activity, change in average knowledge was only statically significant in IL [IL + 1.69 (SE=0.52) and IC -0.36; (SE=0.45) points]. There were significant differences between groups in final notes for physical activity knowledge. Simple educational activities produced positive effects on health eating knowledge however, for physical activity may be necessary longer intervention.

Saúde Coletiva e Educação Física: distanciamentos e interfaces

Resumo O artigo examina distanciamentos e interfaces entre os campos da Educacao Fisica (EF) e da Saude Coletiva (SC) no contexto brasileiro, explicitando tensionamentos na luta pela autoridade e competencia cientificas, consoante os conceitos de “campo cientifico” e “nucleos de saberes”. Compreendendo a SC como campo institucionalizado, legitimado e cientificamente consolidado com tres nucleos fundamentais: Epidemiologia; Ciencias Sociais e Humanas; e Politicas, Planejamento e Gestao; evidenciamos sua aproximacao com o campo da EF, resultando em saberes e praticas especificas da EF em SC. Ao naturalizar a linguagem do risco do sedentarismo, a Epidemiologia foi o primeiro nucleo de vinculacao desse novo campo. Nao obstante, reflexoes vindas das Ciencias Sociais ampliam a visao dos objetos de estudo da EFSC ao reconhecer a natureza multidimensional da cultura corporal vinculada a saude. Ja o nucleo Politicas so adquire contornos recentemente, quando a atividade fisica se torna prioridade no conjunto de politicas e programas de combate as doencas cronicas e de promocao da saude. Tensoes entre os paradigmas biologico e social marcam a conformacao dos campos e representam um desafio a ser vencido pela EFSC, mas o referencial critico em saude oferece um caminho promissor para esta superacao.

The food pyramid adapted to physically active adolescents as a nutrition education tool

This study aimed to assess the understanding of the Food Pyramid Adapted to Physically Active Adolescents as an educational tool to improve nutrition knowledge. Adolescents engaged in sport training responded to a nutrition knowledge questionnaire before and after the intervention. The pyramid intervention group received the printed educational material, and the broad intervention group received the printed material followed by a lecture. As a result, mean initial nutrition knowledge was average (59.9 ± 18 points), increasing (p<0.001) after the intervention (69.1 ± 20 points) without significant difference between interventions. In conclusion, adolescents’ nutrition knowledge improved, even with the use of the Food Pyramid alone, indicating its use to promote nutritional knowledge.This study aimed to assess the understanding of the Food Pyramid Adapted to Physically Active Adolescents as an educational tool to improve nutrition knowledge. Adolescents engaged in sport training responded to a nutrition knowledge questionnaire before and after the intervention. The pyramid intervention group received the printed educational material, and the broad intervention group received the printed material followed by a lecture. As a result, mean initial nutrition knowledge was average (59.9 ± 18 points), increasing (p<0.001) after the intervention (69.1 ± 20 points) without significant difference between interventions. In conclusion, adolescents’ nutrition knowledge improved, even with the use of the Food Pyramid alone, indicating its use to promote nutritional knowledge.

Body Image and Eating Behavior among Medical Students: Eating Disorders among Medical Students

Maria Lúcia Magalhães Bosi1*, Júlia Aparecida Devidé Nogueira2, Carlos Henrique Alencar1 and Joanne Alves Moreira1 1Department of Community Health, School of Medicine, Federal University of Ceará, Brazil 2School of Physical Education, University of Brasília, Brazil *Corresponding author: Maria Lúcia Magalhães Bosi, Department of Community Health, School of Medicine, Federal University of Ceará, Brazil. Tel: +55-85-3366-8045; Email: malubosi@ufc.br

Práticas corporais e atividades físicas na perspectiva da Promoção da Saúde na Atenção Básica

O presente artigo busca refletir criticamente sobre o processo de institucionalizacao e fortalecimento das praticas corporais e atividades fisicas como acoes de Promocao da Saude na Atencao Basica do Sistema Unico de Saude (SUS). Para examinar a configuracao dessa forma de cuidado e eixo de acao que emerge e vem se consolidando na saude publica brasileira, optamos por revisitar historicamente, de forma sucinta, o processo de conformacao e desenvolvimento da Promocao da Saude no SUS de modo a, na sequencia, apresentar alguns dados sobre as praticas corporais e atividades fisicas nesta realidade. Por fim, ha a analise critica das interacoes, interfaces e distanciamentos que se processam entre as praticas corporais e atividades fisicas e os referenciais teoricos da Promocao da Saude, em sua vertente critica. Argumenta-se que parte do problema reside na producao de saberes que desconsideram os aspectos epistemologicos da relacao entre praticas corporais e atividades fisicas. Conclui-se que apesar do exponencial crescimento da oferta dessas acoes, ainda nao e possivel afirmar que esta forma de cuidado possa ser caracterizada como Promocao da Saude ja que seria necessario observar alguns principios para isso, tais como empoderamento, participacao social, autonomia, equidade, integralidade, entre outros.

Fatores condicionantes de saúde relacionados ao trabalho de professores universitários da área da saúde: uma revisão integrativa

Objetivo: sistematizar estudos que abordam o tema da saude dos professores universitarios da grande area da saude e os fatores ocupacionais condicionantes e determinantes de saude associados, e realizar uma reflexao sobre o tema. Metodos: revisao integrativa descritiva e analitica realizada em bases bibliograficas eletronicas brasileiras e internacionais, baseada em estudos publicados em portugues e ingles entre janeiro de 2005 e marco de 2016. Resultados: as buscas e as aplicacoes dos criterios de selecao resultaram na inclusao de vinte estudos (tres teses, cinco dissertacoes e doze artigos). No geral, os estudos apontam que os docentes identificam como aspectos negativos a saude as condicoes fisicas e psicologicas de trabalho e, como aspectos promotores da saude, a satisfacao com a profissao, envolvendo a producao e o compartilhamento sistematizado de saberes, e o impacto social que suas atividades promovem dentro e fora do ambiente de trabalho. Conclusao: evidencias da percepcao de docentes universitarios da grande area da saude sobre os seus proprios processos de saude e adoecimento no trabalho apontam que as esferas pessoais, sociais e institucionais devem atuar conjuntamente para atender as complexas necessidades contemporâneas em saude.