Samantha Caesar de Andrade

Índice de Qualidade da Dieta Revisado para população brasileira

The revised version of the Brazilian Healthy Eating Index is an indicator of dietary quality developed according to current nutritional recommendations. Dietary data were obtained from a population-based survey, the 2003 Inquérito de Saúde e Alimentação (ISA - Health and Diet Survey)-Capital. The Revised Index consists of 12 components: nine food groups included in the 2006 Brazilian Dietary Guidelines, in which daily portions are expressed in terms of energy density; two nutrients (sodium and saturated fats), and SoFAAS (calories from solid fat, alcohol and added sugar). The Revised Brazilian Healthy Eating Index allows for the measurement of dietary risk factors for chronic diseases, evaluating and monitoring the diet at both individual and population levels.

Dietary quality index and associated factors among adolescents of the state of Sao Paulo, Brazil.

OBJECTIVE To assess dietary quality and associated factors in adolescents. STUDY DESIGN We conducted a population-based cross-sectional study in a sample of 1584 adolescents living in areas of the state of São Paulo, Brazil. Dietary intake was measured with the 24-hour recall method, and dietary quality was assessed by means of the Health Eating Index (HEI), adapted to fit to the local requirements. Linear regression analyses were performed to assess the association between the HEI and demographic, socioeconomic, and lifestyle variables. RESULTS A total of 97.1% of the adolescents studied had an inadequate diet or a diet that needed improvement. The mean overall HEI score was 59.7. Lower mean HEI scores were found for fruits, dairy products, and vegetables. Male adolescents who were physically active and lived in a house or apartment had higher HEI scores. The multiple regression analyses showed that the quality of the diet improved as age decreased. Adolescents who lived in houses or apartments had higher HEI scores than adolescents living in shacks or slums, regardless of age and energy intake. CONCLUSIONS Dietary quality is associated with income and age. A better understanding of the factors associated can provide input to the formulation of policies and development of nutritional actions.

Índice de qualidade da dieta de adolescentes residentes no distrito do Butantã, município de São Paulo, Brasil

Universidade de Sao Paulo Faculdade de Saude Publica Departamento de Nutricao e Epidemiologia

A revised version of the Healthy Eating Index for the Brazilian population

The revised version of the Brazilian Healthy Eating Index is an indicator of dietary quality developed according to current nutritional recommendations. Dietary data were obtained from a population-based survey, the 2003 Inquérito de Saúde e Alimentação (ISA - Health and Diet Survey)-Capital. The Revised Index consists of 12 components: nine food groups included in the 2006 Brazilian Dietary Guidelines, in which daily portions are expressed in terms of energy density; two nutrients (sodium and saturated fats), and SoFAAS (calories from solid fat, alcohol and added sugar). The Revised Brazilian Healthy Eating Index allows for the measurement of dietary risk factors for chronic diseases, evaluating and monitoring the diet at both individual and population levels.

Avaliacao da confiabilidade e validade do Indice de Qualidade da Dieta Revisado

OBJECTIVE Evaluate validity and reliability of the Brazilian Healthy Eating Index Revised according to the psychometric properties. METHODS Cross-sectional study of a random sample of 2,375 individuals of both sexes, aged 12 or older from the city of São Paulo, Southeastern Brazil, drawn from the Health Survey carried out in 2003. Information on the population characteristics was acquired using a questionnaire. Food intake was obtained using 24h Recall, used to calculate the Brazilian Healthy Eating Index Revised (BHEI-R). The following aspects were evaluated: (1) content validity, by comparing the components with the Dietary Guidelines for the Brazilian Population; (2) construct validity, factor analysis using principal components method and verifying whether the index can measure diet quality regardless of energy intake; (3) discriminating validity; and (4) the reliability of the BHEI-R by analyzing the internal consistency of the items using Cronbachs alpha coefficient. RESULTS The correlations between the component scores and energy intake were weak (r < 0.30). Principal component analysis indicated the presence of four factors with eigenvalues > 1 that represented 67% of the index variance. The discriminating validity of the BHEI-R was observed by comparing the individuals by sex and smoking habit, and identifying statistically significant differences between the means of the components of the BHEI-R and the final score. The Cronbachs alpha value (α = 0.7) indicated the presence of internal consistency between the components of the BHEI-R. The SoFAAS component followed by the total fruit component and whole fruit component presented greater correlation with the final index scores. CONCLUSIONS The Brazilian Healthy Eating Index Revised showed itself to be reliable and structurally valid when used to evaluate and monitor the diet quality of Brazilians.

Trends in diet quality among adolescents, adults and older adults: A population-based study

This study aimed to monitor diet quality and associated factors in adolescents, adults and older adults from the city of São Paulo, Brazil. We conducted a cross-sectional population-based study involving 2376 individuals surveyed in 2003, and 1662 individuals in 2008 (Health Survey of São Paulo, ISA-Capital). Participants were of both sexes and aged 12 to 19 years old (adolescents), 20 to 59 years old (adults) and 60 years old or over (older adults). Food intake was assessed using the 24-h dietary recall method while diet quality was determined by the Brazilian Healthy Eating Index (BHEI-R). The prevalence of descriptive variables for 2003 and 2008 was compared adopting a confidence interval of 95%. The means of total BHEI-R score and its components for 2003 and 2008 were compared for each age group. Associations between the BHEI-R and independent variables were evaluated for each survey year using multiple linear regression analysis. Results showed that the mean BHEI-R increased (54.9 vs. 56.4 points) over the five-year period. However, the age group evaluation showed a deterioration in diet quality of adolescents, influenced by a decrease in scores for dark-green and orange vegetables and legumes, total grains, oils and SoFAAS (solid fat, alcohol and added sugar) components. In the 2008 survey, adults had a higher BHEI-R score, by 6.1 points on average, compared to adolescents. Compared to older adults, this difference was 10.7 points. The diet quality remains a concern, especially among adolescents, that had the worst results compared to the other age groups.

Evaluation of the reliability and validity of the Brazilian Healthy Eating Index Revised

OBJECTIVE Evaluate validity and reliability of the Brazilian Healthy Eating Index Revised according to the psychometric properties. METHODS Cross-sectional study of a random sample of 2,375 individuals of both sexes, aged 12 or older from the city of São Paulo, Southeastern Brazil, drawn from the Health Survey carried out in 2003. Information on the population characteristics was acquired using a questionnaire. Food intake was obtained using 24h Recall, used to calculate the Brazilian Healthy Eating Index Revised (BHEI-R). The following aspects were evaluated: (1) content validity, by comparing the components with the Dietary Guidelines for the Brazilian Population; (2) construct validity, factor analysis using principal components method and verifying whether the index can measure diet quality regardless of energy intake; (3) discriminating validity; and (4) the reliability of the BHEI-R by analyzing the internal consistency of the items using Cronbachs alpha coefficient. RESULTS The correlations between the component scores and energy intake were weak (r < 0.30). Principal component analysis indicated the presence of four factors with eigenvalues > 1 that represented 67% of the index variance. The discriminating validity of the BHEI-R was observed by comparing the individuals by sex and smoking habit, and identifying statistically significant differences between the means of the components of the BHEI-R and the final score. The Cronbachs alpha value (α = 0.7) indicated the presence of internal consistency between the components of the BHEI-R. The SoFAAS component followed by the total fruit component and whole fruit component presented greater correlation with the final index scores. CONCLUSIONS The Brazilian Healthy Eating Index Revised showed itself to be reliable and structurally valid when used to evaluate and monitor the diet quality of Brazilians.

Using Two Different Approaches to Assess Dietary Patterns: Hypothesis-Driven and Data-Driven Analysis

The use of dietary patterns to assess dietary intake has become increasingly common in nutritional epidemiology studies due to the complexity and multidimensionality of the diet. Currently, two main approaches have been widely used to assess dietary patterns: data-driven and hypothesis-driven analysis. Since the methods explore different angles of dietary intake, using both approaches simultaneously might yield complementary and useful information; thus, we aimed to use both approaches to gain knowledge of adolescents’ dietary patterns. Food intake from a cross-sectional survey with 295 adolescents was assessed by 24 h dietary recall (24HR). In hypothesis-driven analysis, based on the American National Cancer Institute method, the usual intake of Brazilian Healthy Eating Index Revised components were estimated. In the data-driven approach, the usual intake of foods/food groups was estimated by the Multiple Source Method. In the results, hypothesis-driven analysis showed low scores for Whole grains, Total vegetables, Total fruit and Whole fruits), while, in data-driven analysis, fruits and whole grains were not presented in any pattern. High intakes of sodium, fats and sugars were observed in hypothesis-driven analysis with low total scores for Sodium, Saturated fat and SoFAA (calories from solid fat, alcohol and added sugar) components in agreement, while the data-driven approach showed the intake of several foods/food groups rich in these nutrients, such as butter/margarine, cookies, chocolate powder, whole milk, cheese, processed meat/cold cuts and candies. In this study, using both approaches at the same time provided consistent and complementary information with regard to assessing the overall dietary habits that will be important in order to drive public health programs, and improve their efficiency to monitor and evaluate the dietary patterns of populations.

Association of the conicity index with diabetes and hypertension in Brazilian women

Objective The goal of this study was evaluate the conicity index (C index) in women and its association with hypertension (SAH) and diabetes mellitus (DM). Subjects and methods This was a cross-sectional study, with 573 women between 20 and 59 years of age. After analysis of clinical and demographic characteristics, anthropometric variables were measured and used to calculate the C index. Plasma glucose and lipid profile were evaluated by standard methods. The analysis of the results was based on logistic regression and the odds ratio (OR) was calculated, which was used to assess the association of the variable outcome with the variable exposure using two logistic regression models that tested the possible influence of the C index in the chance of developing SAH or DM. A confidence interval of 95% was used. Results In the crude and adjusted models, the OR confirmed the association of the C index with DM and SAH. Compared with women that showed C index p < 75, the risk of women with C index (p ≥ 75) developing DM and SAH was 1.72 and 1.75, respectively. Results demonstrated that the negative impact of age on these associations significantly raised the odds of women having DM and SAH. The high C index was also linked to low HDL-C. Conclusion The C index is an important tool in estimating the risk of diabetes and hypertension in women. Besides, high C indexes are negatively associated with HDL-C, an important lipid marker related to cardiovascular risk.

INOVAÇÃO NA FORMAÇÃO DE GRADUANDOS EM NUTRIÇÃO: USO DO DIÁRIO DE CAMPO EM GRUPOS DE EDUCAÇÃO ALIMENTAR E NUTRICIONAL

Objective: To describe the use of field diary as a training strategy for undergraduate students in the facilitation of groups of food and nutrition education. Methodology: Twelve reports of field diaries produced by undergraduate students (G1 and G2) were used, who facilitated groups of food and nutrition education constructed upon the benchmarks of Operative Group, from the Food and Nutrition Reference Center – CRNutri. After each of the six meetings, the students wrote their diaries, containing a detailed description of the meetings and their perceptions about the group. To evaluate the facilitation process,the contents of the diaries were confronted with skills and competencies required to a nutritionist in food and nutrition education. The group process was characterized by the evaluation of the Operative Group vectors. Results and Discussion: Fourteen skills and competencies were identified. Changes in facilitation held by students were noticeable, such as: the need for preparation prior to the meeting, the search for complementary theoretical references, self-perception of the initial difficulties and reflection on the educational process. The evaluation of the Operative Group vectors (learning, communication, belonging, cooperation, pertinence and tele) was identified in both groups, showing how the group process was built throughout each meeting. Conclusions: The field diary, inserted in the student training process, represented not only an instrument which explained how training was taking place, but also provided an opportunity to reflect on the work done, given the scenery students had to report their experience, contemplating their difficulties and advances. Viviane Laudelino Vieira1 Bruna Zillesg Borges dos Santos2 Samantha Caesar de Andrade1 1 Universidade de São Paulo, Faculdade de Saúde Pública, Centro de Saúde Escola Geraldo de Paula Souza. São Paulo-SP, Brasil. 2 Universidade de São Paulo, Faculdade de Saúde Pública, Departamento de Nutrição. São Paulo-SP, Brasil. Funding: Project with FAPESP funding (process 2015/13716-0). Correspondence Viviane Laudelino Vieira E-mail: vivianevieira@usp.br DOI: 10.12957/demetra.2017.28591