Leiko Asakura

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.

Food and Nutrition Surveillance System/SISVAN: getting to know the feeding habits of infants under 24 months of age

The objective of the Food and Nutrition Surveillance System (SISVAN) is to monitor the food intake of individuals attended by the Brazilian Unified Health System (SUS). The objective of this research was to identify the feeding practices of children under 24 months of age who were attended at Primary Healthcare Units (UBS), using SISVAN, and to assess the relationship with maternal sociodemographic profiles. A cross-sectional study was conducted in order to evaluate 350 children using the Food Consumption Marker Form of SISVAN, and maternal demographic data to identify sociodemographic profiles by exploratory factor analysis. Of the children assessed, 41.1% were under 6 months of age and 98.7% of those between 6 and 23 months had an inadequate intake. Two sociodemographic profiles were found: Profile 1 (mothers with lower income, less education, and recipients of the Bolsa Família conditional family grant program) associated with the consumption of water/tea, cows milk and salty baby food; and Profile 2 (older mothers with many children and with a larger number of residents in the household) associated with breast milk consumption (p = 0.048). The use of SISVAN made it possible to identify that children had inadequate feeding practices, and Profile 1 appears to be a risk profile for weaning.

Validation of a quantitative food frequency questionnaire developed to under graduate students

A validity test of a Food Frequency Questionnaire was carried out using 50 students of health occupation in São Paulo, Brazil. Therefore, a three day dietary record was used as reference method and variables such as energy, macronutrients and dietary fiber were analyzed. The accordance between the Food Frequency Questionnaire and average data from dietary record was tested with kappa statistics and intra-class correlation coefficients (ICC). Limits of agreement were estimated by the Bland-Altmans method. Better results were found for calories (ICC 0.43; 95%CI 0.17 - 0.63) and non-energy-adjusted nutrients, except dietary fiber (ICC 0.34; 95%CI 0.07 - 0.56). The percentage of individuals classified in the same category of consumption was nearly half (49.8%), while only 16% of them were classified in opposite categories. With the exception of lipids, other analyzed variables tended to be overestimated by the Food Frequency Questionnaire. The Food Frequency Questionnaire is recommended as a method of assessing food intake of university students in studies which focus on calorie estimates and also intend to classify groups into intake categories.

Ultra-processed foods: Consumption among children at day-care centers and their classification according to Traffic Light Labelling system

Objective: To identify the age at which ultra-processed foods are introduced in the diet of infants enrolled in public daycare centers and analyze these foods nutritional composition according to the Traffic Light Labelling system adapted to the Brazilian norms and recommendations.Methods: Cross-sectional study including 636 nursery age children attending day care centers. Their mothers were interviewed about the age of introduction of instant noodles, snack chips, encased meat, chocolate, ice cream, and stuffed cookies. The proximate composition of these foods was evaluated according to the Traffic Light Labelling adapted to the Brazilian norms and recommendations, which classifies total fat, saturated fat, trans fat, fiber, and sodium amounts as green, yellow, or red indicators.Results: It was found that before 12 months of age 70.6% of children had consumed instant noodles, 65.9% snack chips, 54.7% encased meat, 67.1% chocolate, 36.9% ice cream, and 68.7% stuffed cookies. In addition, all foods were classified as red for saturated fat and sodium and 50.0% were classified as red for total fat.Conclusion: The introduction of ultra-processed foods in the childrens diets occurred early, but it is worth mentioning that such foods have an inadequate nutritional composition, contributing to the excess consumption of total fat, saturated fat, and sodium, as well as low fiber.

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.

[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.

Fatores relacionados aos padrões alimentares de indivíduos com síndrome metabólica que frequentam ambulatório de nutrição em São Paulo

Objective: To identify the dietary patterns of individuals with metabolic syndrome and determine associations with sociodemographic, lifestyle, anthropometric and biochemical features. Methods: We analyzed data of individuals with metabolic syndrome attending the nutrition outpatient clinic at a public university in São Paulo, from 2008 to 2011. We assessed food intake by 24-hour dietary recall and identified the dietary patterns using principal components analysis. Multivariate multiple linear regression models were applied to investigate possible associations between dietary patterns and the independent variables. We applied Pearson’s correlations to evaluate possible associations between dietary patterns and biochemical and anthropometric variables. Results: Of the 166 outpatients enrolled, 65.7% (109) were women; 63.0% (103) were adults (21-59 years) and 37.0% were elderly (60-79 years). Most people were married, sedentary and obese, with incomplete primary education, non-smoking and non-alcoholic. We identified nine dietary patterns. There was a positive association between the “traditional Brazilian” dietary pattern (rice, beans and red meat) with men and a negative association with age, and the “prudent” (whole grains, soups) with women. There was a positive correlation between the “traditional Brazilian”, “compensatory” (snacks, sweeteners, light products) and “mixed” (refined grains, fruits, oils) patterns with fasting glucose, and negative correlation between the “healthy” (vegetables and oilseeds) and waist circumference. Conclusion: The results of this study indicate that these individuals with metabolic syndrome have dietary patterns characterized by the presence of refined foods, fats, red meat and alcohol, associated with biochemical disturbance, as impaired fasting glucose and hypertriglyceridemia.

Ingestión de proteínas, calcio y sodio en guarderías públicas

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.

Ingestão de proteína, cálcio e sódio em creches públicas

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.