Rita Maria Monteiro Goulart

Consumo alimentar de crianças de 6 a 18 meses em creches

OBJECTIVE: To verify the food intake of children from 6 to 18 months old and to evaluate nutrient adequacy. METHODS: This study was carried out with 106 children, in day-care centers from the city of Sao Paulo. Food intake was evaluated through food weighing during five days. The Organizacion Mundial de la Salud, 1985, Dietary Reference Intakes, 1997 and American Academy of Pediatrics, 1993 were used as references for the analysis of macronutrients, micronutrientes and fibers, respectively. RESULTS: The study revealed insufficient offering of energy, iron, calcium, vitamin A and fiber. Protein and vitamin C were over the recommended amounts. CONCLUSION: The children must receive one milky and one salty meal at home in order to complement food given at centers, mainly regarding, calcium, iron, energy and fiber.

Introdução de alimentos industrializados e de alimentos de uso tradicional na dieta de crianças de creches públicas no município de São Paulo

OBJECTIVE: This study described and discussed the introduction of processed foods to the diets of children attending the nurseries of daycare centers, considering the recommendation of the Ministry of Health for a healthy diet. METHODS: This cross-sectional study included 270 children attending nurseries of eight public and not-for-profit daycare centers in Sao Paulo city. A pre-coded and structured 11-question questionnaire was used to evaluate the introduction of processed foods. For each type of food analyzed, the corresponding age in months was recorded as well as assessed as to whether it was in agreement with the 8th step of the Dietary Guide. The chi-square test was used for determining the associations. The studied variables were mothers age, education level and working status and family income. RESULTS: The results showed that approximately 2/3 of the studied children under 12 months of age were offered foods with obesogenic potential, such as instant noodles, snacks, sandwich cookies, powdered juice, soft drinks and candy/lollipop/chocolate bars. Children born to younger mothers, with low education level and lower income are most vulnerable to the feeding error of introducing processed foods prematurely. CONCLUSION: These results show that educational and preventive actions should be proposed to build healthy eating habits from childhood. Efficient and in-depth campaigns aiming at promoting the consumption of fruits and vegetables are also needed, taking into consideration the cultural, behavioral and emotional factors associated with diet.

Uma revisão das ações de nutrição e do papel do nutricionista em creches

As creches sao uma realidade na vida de grande parcela das criancas brasileiras em idade pre-escolar, sendo que nelas permanecem por um longo periodo. A demanda por esse servico tende a aumentar com a participacao cada vez mais ativa da mulher no mercado de trabalho. Assim o objetivo desse estudo foi revisar a literatura publicada a partir de 1998, disponivel nas bases de dados MedLine, SciELO, Lilacs e Science Direct. Foram selecionados artigos de estudos experimentais, revisao bibliografica, livros, teses e boletins de comites de saude, sobre as acoes desenvolvidas em creches no contexto atual das criancas brasileiras e sobre a atuacao do nutricionista nesta instituicao. A pesquisa revelou a dualidade vivida pelos educadores entre o cuidar e o educar. Destaca a importância da instituicao na formacao de habitos alimentares e discute a necessidade de aprofundamento nas questoes ligadas a educacao alimentar, no sentido de proporcionar a crianca o conhecimento e a autonomia na escolha de alimentos. Entre as principais carencias nutricionais apresentadas pelas criancas frequentadoras de creches publicas destaca-se a anemia ferropriva, sendo que a alimentacao oferecida nas creches tem mostrado deficiencias de calcio, ferro, vitamina A, fibras e energia. Finalmente, apresenta os principais desafios do nutricionista neste segmento e a necessidade de sua constante atualizacao sobre o quadro epidemiologico da nutricao para as faixas etarias que atende, bem como as prioridades estabelecidas pela Politica Nacional de Alimentacao e Nutricao vigente e normas emitidas pelos orgaos de referencia para esta area. Ao nutricionista cabe considerar, alem das necessidades nutricionais da crianca, o vies educativo e de formacao de habitos alimentares.

Avaliação do consumo alimentar em creches públicas em São Paulo, Brasil

Objective: To evaluate the energy intake and dietary adequacy of children attending nurseries of public and not-for-profit daycare centers in the city of Sao Paulo, Brazil. Methods: Cross-sectional study conducted at 16 nurseries, attended by 236 children between the ages of 12 and 29 months. Data collection was carried out by the direct weighing method over three nonconsecutive days. The DietWin 2.0 Professional software was used for nutritional calculations. The adequacy of energy, protein, iron, vitamin A and vitamin C intake was calculated, also with the aforementioned software, using 2002 National Research Council Estimated Average Requirements as a reference. Adequate Intake (1999) was used as the reference for calcium intake, and Estimated Energy Requirements (2002), for evaluation of energy intake. Data were analyzed using the Epi-Info 3.4.3 software. Results: We identified deficiencies in energy, iron, and calcium intake (mean deficits of 49.78%, 81.67%, and 57.44% respectively), as well as excessive intake of protein (183.27%) and vitamins A and C (126.86% and 57.44% respectively). Regarding macronutrients, fat intake was also found to be inadequate. Endereco para correspondencia: Jose Augusto A. C. Taddei Rua Loefgreen, 1.647 – Vila Clementino CEP 04040-032 – Sao Paulo/SP E-mail: taddei.dped@epm.br; giovana_longo@yahoo.com.br Fonte financiadora: Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP), processo no 2006/02597-0 Conflito de interesse: nada a declarar Recebido em: 4/4/2011 Aprovado em: 9/8/2011OBJETIVO: Avaliar o consumo energetico e a adequacao da dieta de criancas frequentadoras de bercarios de creches publicas e filantropicas no municipio de Sao Paulo. METODOS: Estudo transversal em 16 bercarios, frequentados por 236 criancas com idades entre 12 e 29 meses. A coleta dos dados foi realizada pelo metodo de pesagem direta durante tres dias nao consecutivos. Para o calculo nutricional, foi utilizado o software DietWin Profissional 2.0®, sendo posteriormente calculada a adequacao do consumo de energia, proteina, ferro, vitamina A e vitamina C. Para o calculo de proteina, ferro, vitamina A e C, foi utilizada como referencia a necessidade media estimada (Estimated Average Requiremen) do National Research Council (2002). O calcio foi avaliado pela ingestao adequada (Adequate Intake, 1999). A avaliacao da ingestao de energia foi realizada com base na necessidade energetica estimada (Estimated Energy Requirement, 2002). Os dados foram analisados no programa Epi-Info 2000, versao 3.4.3. RESULTADOS: Foram identificados deficits medios para energia (49,78%), ferro (81,67%), calcio (57,44%), excessos de proteina (183,27%) e vitaminas A (126,86%) e C (57,44%). A distribuicao dos percentuais de adequacao dos macronutrientes mostrou-se inadequada para lipideos. CONCLUSOES: Embora os cardapios servidos em creches sejam planejados por nutricionistas, os resultados apontam possiveis falhas no processo da alimentacao infantil relacionadas a preparacao, porcionamento e/ou praticas de oferta dos alimentos. Tais achados reforcam a necessidade de acoes de educacao e supervisao em saude para garantir o fornecimento de alimentacao adequada a este grupo populacional.

Nutritional rehabilitation of undernourished and nutritionally at-risk children admitted to a supplementary food program in Mogi das Cruzes, São Paulo, Brazil

Este estudo teve como objetivo avaliar a recuperacao nutricional de criancas inscritas no programa Incentivo ao Combate as Carencias Nutricionais (ICCN) no Municipio de Mogi das Cruzes, Sao Paulo, Brasil. Foram estudadas 724 criancas de 6 a 24 meses inscritas no ICCN, no periodo de julho de 1999 a julho de 2001. Para avaliar o estado nutricional inicial, utilizaram-se os indices peso/idade, peso/comprimento e comprimento/idade, sendo considerada eutrofica criancas com escore z > -1; em risco > -2 e -3 e desnutrida grave < -3. A evolucao nutricional foi avaliada por meio do comprimento/idade, e os resultados foram analisados segundo a variacao media do escore z ao final de 12 meses. A condicao nutricional encontrava-se melhor para todas as categorias apos 12 meses, cujos melhores resultados foram obtidos pelas criancas que apresentaram deficiencia nutricional mais intensa no inicio. Observaram-se ganhos em comprimento de 1,12, 0,82, 0,57 e 0,45 escore z para os desnutridos graves, moderados, em risco nutricional e eutroficos, respectivamente. A experiencia do ICCN em Mogi das Cruzes resultou efetivamente na melhora nutricional dos beneficiarios.

Fatores relacionados à qualidade de vida de idosos em programas para a terceira idade

Population aging is a social phenomenon that demands the attention of health professionals. This article seeks to analyze the influence of possible intervening factors on the quality of life of the elderly. It was a cross-sectional, quantitative, descriptive and exploratory study, in which 182 elderly of both genders participated. They were aged ≥ 60 years and were enrolled in programs for senior citizens from three universities located in the cities of Sao Paulo, Sao Caetano do Sul and Mogi das Cruzes. To evaluate the subjective perception of quality of life, the World Health Organization Quality of Life questionnaire (WHOQOL-Bref) was used. Multiple linear regression analysis was performed on the dependent and independent variables. A significance level of 5% was adopted. The results showed that the absence of disease positively influenced the quality of life on the four domains evaluated. In the environmental domain, full tertiary education, old age, the absence of disease and being a resident in Sao Caetano do Sul positively influenced the quality of life of the elderly. The factors associated with better quality of life were: full tertiary education, old age, the absence of disease and being a resident in Sao Caetano do Sul, in that order of importance.

Fatores associados à recuperação nutricional de crianças em programa de suplementação alimentar

OBJETIVOS: Identificar os fatores associados a recuperacao nutricional de criancas inscritas no Programa de Incentivo ao Combate as Carencias Nutricionais (ICCN) no Municipio de Mogi das Cruzes. METODOS: Foi realizado um ensaio institucional nao controlado com 570 criancas inscritas no ICCN, que foram seguidas de julho de 1999 a julho de 2001. O estado nutricional foi avaliado segundo indice altura/idade, sendo consideradas eutroficas as criancas com escore z > - 1; de risco as que apresentaram z > - 2 e - 3; e desnutridas graves as que apresentavam z < - 3. O impacto do ICCN foi analisado atraves de modelo multivariado com o uso de equacoes de estimacao (GEE - Generalized Estimating Equations), sendo considerado significativo p<0,05. RESULTADOS/CONCLUSAO: Ao final do seguimento, houve a melhora nutricional das criancas, com um gradiente, sendo maior a recuperacao quanto maior a deficiencia nutricional inicial. Observaram-se ganhos em altura de 1,12, 0,82, 0,57 e 0,45 desvios-padrao para as desnutridas graves, moderadas, em risco nutricional e eutroficas, respectivamente. Os fatores associados a evolucao nutricional das criancas desnutridas foram a idade de 12 a 24 meses ao ingressar no ICCN, o peso ao nascer igual ou superior a 3 kg e o aleitamento materno. Os fatores associados negativamente a evolucao nutricional neste grupo foram idade da mae entre 20 a 40 anos e a ausencia de trabalho remunerado materno. Para as criancas em risco, a renda familiar tambem se mostrou associada a melhor evolucao nutricional. A experiencia do ICCN em Mogi das Cruzes sugere que os programas de suplementacao alimentar tem papel relevante na recuperacao nutricional de desnutridos.

Consumo alimentar e gasto energético em adolescentes obesos e eutróficos

Objective: To compare food consumption and energy expenditure between obese and non-obese adolescents. Methods: This cross-sectional study comprised 23 adolescents recruited from schools and recreation centers from Sao Paulo (SP), Brazil, distributed in two groups: 11 obese and 12 non-obese. The following variables were analyzed: body weight, height, body mass index, waist circumference, fat and lean mass (estimated from bioelectrical impedance), three days’ 24-hour food recall, daily energy expenditure from three different methods (three days’ physical activity recall, predictive equations and indirect calorimetry), resting energy expenditure and aerobic power test. Results: Daily energy expenditure was higher in the obese group, but food ingestion presented no difference between groups. There was no difference in resting energy expenditure between obese and non-obese groups and aerobic power was higher in non-obese group. Neither obese nor non-obese adolescents presented adequate feeding behavior; however, the obese group presented lower consumption of healthy foods like vegetables. There was disagreement among different methods of analysis of daily energy expenditure. Conclusions: All adolescents presented feeding behaviors related to risk for chronic diseases. New studies are necessary to identify the best way to analyze energy expenditure. Nutritional education strategies directed towards adolescents are needed.

Envelhecimento e qualidade de vida: análise da produção científica da SciELO

Scientific production is a continuous process of discovery and democratization of knowledge for the scientific community and society. Metascientific studies have become an important evaluation tool. A total of 69 articles on aging and quality of life were analyzed, considering: title, authorship, authors gender, knowledge area, and journal. Some statistically significant differences in the results were: titles up to 12 words; multiple authors and female authors. There was a concentration of publishing in the areas of Psychology and Medicine. The Journal of Public Health was predominant in the area of Health Sciences in relation to the Humanities. Titles and multiple authors were adequate, however, female production was higher. Psychology, Medicine and the Journal of Public Health were the areas of knowledge and the journal that published more on the subject. It was concluded that systematic evaluation of the production, from author to the study design, can help to establish a research policy in the area. Uniterms: Scientific research; Quality of life; Old age.

Índice de desenvolvimento humano e qualidade de vida de idosos frequentadores de universidades abertas para a terceira idade

Objetivo: Verificar a relacao entre IDH e qualidade de vida de idosos. Metodo: Estudo transversal, quantitativo-descritivo de campo, com 182 idosos, de ambos os generos, ≥ 60 anos, frequentadores de Universidades Abertas para a Terceira Idade, dos municipios de Sao Caetano do Sul, Sao Paulo e Mogi das Cruzes. A qualidade de vida foi avaliada pelo WHOQOL - BREF. Foram utilizados os testes estatisticos Kruskal-Wallis e Mann-Whitney, adotando-se nivel de significância de 5%. Resultados: Nao houve diferenca estatisticamente significante quando comparada a qualidade de vida dos idosos dos tres municipios entre si; houve no dominio ambiental comparando-se Sao Caetano com os outros municipios; e nos dominios social e ambiental comparando-se Sao Caetano com Mogi. Conclusao: Concluiu-se que a influencia do IDH sobre os dominios social e ambiental nao foi percebida pelos idosos, o que pode representar uma barreira para a busca de uma melhor qualidade de vida em seus municipios.We investigated the relationship between “human development” and quality of life of elderly in a cross-sectional, quantitative-descriptive study, with 182 elderly of both genders, ≥ 60 years, attending the Universities of the Third Age, in districts A, B, C. The quality of life was evaluated by WHOQOL–BREF. Kruskal-Wallis and Mann-Whitney statistical tests were applied, considering a significance level of 5%. There was no statistically significant difference when comparing the quality of life of the three districts together; there was in environmental domain when comparing A with the other districts; and in social and environmental domains when comparing A with C. It was concluded that the “human development”, measured by HDI, influenced on the quality of life of elderly in social and environmental domains, and the best results were obtained among the inhabitants of A and B, compared to the inhabitants of C.