Renata Alves Monteiro

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.

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.

Norma brasileira de comercialização de alimentos para lactentes e crianças de primeira infância: histórico, limitações e perspectivas

The objective of this paper is to present and discuss Brazilian policy concerning actions to protect breastfeeding, especially the history, international and national background, limitations, and perspectives of the Brazilian Guidelines for the Marketing of Baby Food, Pacifiers and Bottles. The Brazilian Guidelines, which play a crucial role in protecting breastfeeding against industry marketing strategies, were based on the International Code of Marketing of Breastmilk Substitutes, proposed by the World Health Organization in 1981. The first version of the Brazilian Guidelines was released in 1988, and there were subsequent revisions in 1992 and 2001/2002. In 2006, the Guidelines became national law. However, the strides made over this period in terms of regulation have been few because the law is not always observed. Thus, it is essential that all actors involved, including government officials, manufacturers and sellers of baby food and other baby products, teaching and health professionals and their associations, international bodies, and non-governmental organizations make a commitment to enforce the current law.

Infant mortality in the Federal District, Brazil: time trend and socioeconomic inequalities

This study examined the trend in the infant mortality rate in the Federal District of Brazil (or Greater Metropolitan Brasilia, the national capital) from 1990 to 2000, analyzing the rate according to 5 administrative areas stratified by mean family income, from 1996 to 2000. An ecological time-series study was conducted using the Information Systems on Live Births and Mortality, produced by the Brazilian Ministry of Health. The infant mortality rate (IMR) decreased by 45.2% from 1990 to 2000, from 26.3 per 1000 live births to 14.4, or a mean annual reduction of 5.34% (R(2) = 0.9397; p < 0.0001). During this period there was a higher proportion of neonatal deaths. However, a higher percentage change occurred in the post-neonatal period (-59.0%, R(2) = 0.8452, p < 0.0001). Investigation of the IMR in the various areas of the Federal District showed a reduction in differences among the regions with respect to the component rates; however, substantial disparities persisted in relation to the income variable. The results suggest the need for effective interventions in the determinants of neonatal and post-neonatal mortality in order to improve maternal and infant health in all socioeconomic groups in the Federal District.

Análise dos pareceres conclusivos dos Conselhos de Alimentação Escolar sobre a execução do Programa Nacional de Alimentação Escolar

OBJECTIVE: This study analyzed the conclusive reports of the Brazilian School Food Council on the implementation of the National School Food Program. METHODS: This quantitative and qualitative study analyzed 4,256 reports in the quantitative phase and 2,299 reports in the qualitative phase. The reports were issued in 2009. A total of 4,135 annual synthetic statements on physical and financial implementation of the Program were also analyzed. The reports were analyzed in the qualitative phase by content analysis. RESULTS: Quantitative analysis showed that the implementing party provided no consideration for food purchase in 24.4% (n=1,009) of the locations, and 78.7% (n=3,348) of the reports were signed by a single council member. Qualitative analysis of the reports showed that 64.5% (n=1,483) of the locations were under a central management and that 23.9% (n=549) of the implementing parties purchased food with their own funds. Most auctions were open ascending price auctions (32.7%, n=751) and only 4.9% (n=112) of the reports disclosed buying foods from family farms. The main council responsibilities are analyzing the expense reports (59.1%, n=1,359) and following menu development (36.5%, n=838). CONCLUSION: Execution of the different parts of the National School Food Program was evidenced by analyzing the School Food Council reports and annual synthetic statements, which characterized them as program-monitoring tools. The findings may help to support the strategies used for improving the quality of school food and strengthening the School Food Council.

Principais causas básicas da mortalidade infantil no Distrito Federal, Brasil: 1990 a 2000

OBJETIVOS: caracterizar a tendencia da mortalidade infantil no Distrito Federal por causa basica de morte e segundo causas evitaveis entre 1990 e 2000. METODOS: estudo ecologico a partir do total de obitos infantis e nascimentos ocorridos, utilizando-se os sistemas de informacao produzidos pelo Ministerio da Saude. Para avaliacao, segundo causa basica de morte, usou-se a Classificacao Internacional de Doencas. Para a analise, segundo causas evitaveis, foi utilizado o criterio estabelecido pela Fundacao SEADE. RESULTADOS: predominaram os obitos devido a afeccoes perinatais, seguidos das mortes em decorrencia de anomalias congenitas, porem a maior reducao ocorreu no coeficiente de mortalidade por doencas infecciosas e parasitarias. Quando se avalia cada coeficiente em separado, destacam-se, nos obitos neonatais, aqueles redutiveis por meio de acoes de diagnostico e tratamento precoces e os nao evitaveis. Entre as mortes pos-neonatais, destacam-se aquelas tambem redutiveis por acoes precoces de diagnostico e tratamento e por meio de parcerias com outros setores, como aqueles obitos por diarreia e infeccoes respiratorias agudas. CONCLUSOES: verifica-se a necessidade de intervencao efetiva nas causas de morte e componentes da mortalidade infantil, principalmente naquelas relacionadas ao cuidado durante a gravidez, parto e puerperio, alem daquelas que implicam na acao conjunta de varios setores.

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.

Alimentación y nutrición en atención primaria en Brasil

OBJECTIVE To describe food and nutrition actions in primary health care in Brazil. METHODS Exploratory review of articles published between 2007 and 2016. Lilacs, PubMed, Scopus and Web of Science databases were consulted. RESULTS 103 articles were included, mostly published between 2012 and 2016 and developed mainly in the Southeast region of Brazil. The most prevalent research topics were food behaviour or consumption, nutritional status and non-communicable diseases. Most research was led by universities and was focused on diagnosis. Few actions on health promotion, healthy eating, assistance, treatment, integral health care and prevention of diseases related to food and nutrition were found in the review. CONCLUSION National interest in food and nutrition has increased, however academic production is still far from the actual needs for providing evidence that impacts health status. More research is needed to describe, propose and evaluate programmes and actions. Therefore, it is essential for closer relationships to be forged between universities, managers and health services in order to identify common interests and to develop research that meets the needs of the area and contribute to planning and improving programmes and actions.