Maria Alice Araújo Oliveira

Anemia em escolares da primeira série do ensino fundamental da rede pública de Maceió, Alagoas, Brasil

A cross-sectional study was conducted in a representative sample of 426 randomly selected first graders (ages 6 to 10 years) from public schools in Maceió, State of Alagoas, Brazil. The aim was to determine the prevalence of anemia, as well as its association with growth retardation. Data were collected from May to July 2000, and determination of hemoglobin (HGB) employed an STKS Coulter counter. Two cut-off points were used to classify anemia, both established by the World Health Organization: HGB < 11.5g/dl and HGB < 12.0g/dl. The indicators height/age (H/A), weight/age (W/A), and weight/height (W/H) below -2.0 standard deviations from the NCHS reference were diagnosed as growth retardation. Prevalence of anemia was 9.9% when HGB < 11.5g/dl was used, and 25.4% when the cut-off point was HGB < 12.0g/dl. Growth retardation was detected in 6.2% of children according to H/A, 4.0% for W/A, and 3.0% for W/H. There was no statistically significant association between the variables in the study. These findings confirm results of previous surveys where prevalence of anemia was much higher than that of growth retardation. The severe consequences of anemia in this age group justify the implementation of broad public policies to overcome this nutritional deficiency.

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.

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.

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.

Quem participa em quê?: experiências de construção compartilhada no âmbito da cooperação Brasil - Canadá para o aperfeiçoamento da gestão na Atenção Primária à Saúde

Abstract The article examines processes and outcomes of the shared construction of knowledge and intervention in the Project for Improving Management of Pri-mary Health Care (AGAP) developed cooperatively between Brazil and Canada. It involves four states in the Northeast region, uses the evaluation metho -dology with focus on achievements and learning and presupposes the cooperation and participation of stakeholders; the project, characterized as using multi methods, advocates triangulation through a combination of quantitative and qualitative approa -ches and techniques after identifying the moments in which sharing encounters happened, as well as the elements which hinder or facilitate this process and lessons learned. Evaluative research used the following methodology: document analysis; obser-vation of meetings; workshop with the Evaluation Steering Committee for presentation and agreement of the proposal submitted; evaluation workshops on local projects, observation of health care services in the municipalities, semi–structured interviews with strategic interlocutors of local, regional, national and international levels. The results showed that the cooperation relationship between Brazil and Canada is promising, but needs to be built in a more cooperative and dialogical way, in which objects of cooperation are constructed in a shared form.Keywords: Collective Construction; Primary Health Care; International Cooperation.