Suely Teresinha Schmidt

Bolsa Família: insegurança alimentar e nutricional de crianças menores de cinco anos

This is a descriptive cross-sectional study of the population base conducted in the town of Colombo in the state of Parana. The objectives were to identify the prevalence of food insecurity in families that are beneficiaries of the Bolsa Familia Program and the factors related to this condition, and describe the nutritional status of children under five years of age. Analyses of association were performed using Fishers exact test. The sample included 442 families, of which 168 have children under five years of age. The Brazilian Food Insecurity Scale was applied to evaluate food insecurity and the nutritional status of the 199 children evaluated was determined by the height-for-age, weight-for-age and body mass-for-age indices in accordance with the WHO reference values for 2006. The prevalence of food insecurity was 81.6%. Overweight and stunting among children coexisted. Food insecurity was found to be associated with the height-for-age index among children under two years of age. The per capita income and food deficits influenced the situation of food insecurity significantly.

Prevalence and risk factors of anemia in children

OBJECTIVE To identify the prevalence and factors associated with anemia in children attending Municipal Early Childhood Education Day Care Center (Centros Municipais de Educação Infantil [CMEI]) nurseries in Colombo-PR. METHODS Analytical, cross-sectional study with a representative sample of 334 children obtained by stratified cluster sampling, with random selection of 26 nurseries. Data collection was conducted through interviews with parents, assessment of iron intake by direct food weighing, and hemoglobin measurement using the finger-stick test. Bivariate association tests were performed followed by multiple logistic regression adjustment. RESULTS The prevalence of anemia was 34.7%. Factors associated with anemia were: maternal age younger than 28 years old (p=0.03), male children (p=0.02), children younger than 24 months (p=0.01), and children who did not consume iron food sources (meat+beans+dark green leafy vegetables) (p=0.02). There was no association between anemia and iron food intake in CMEI. However, iron intake was well below the recommended levels according to the National Education Development Fund resolution, higher prevalence of anemia was observed in children whose intake of iron, heme iron, and nonheme iron was below the median. CONCLUSIONS In terms of public health, the prevalence of anemia is characterized as a moderate problem in the studied population and demonstrates the need for coordination of interdisciplinary actions for its reduction in CMEI nurseries.

Consumo alimentar de crianças de 12 a 30 meses que frequentam Centros Municipais de Educação Infantil no município de Colombo, Sul do Brasil

Objetivo:Analisar o consumo alimentar de criancas de 12 a 30 meses que frequentam Centros Municipais de Educacao Infantil.Metodos:Estudo transversal realizado com 86 criancas dos Centros Municipais de Educacao Infantil do municipio de Colombo, Parana. O consumo alimentar nas creches foi avaliado pelo metodo da pesagem direta individual dos alimentos em dois dias nao consecutivos e, no domicilio, utilizando-se o recordatorio alimentar de 24 horas. Foram analisadas as medianas e o risco de inadequacao de energia e de nutrientes de acordo com as Ingestoes Dieteticas de Referencia e as recomendacoes do Programa Nacional de Alimentacao Escolar.Resultados:A maioria dos nutrientes apresentou ingestao mediana diaria acima dos valores recomendados pelas Ingestoes Dieteticas de Referencia; o calcio apresentou o maior risco de inadequacao entre os nutrientes; 43% das criancas mostraram elevada ingestao energetica e o lipideo apresentou valor abaixo do aceitavel. O consumo nas creches foi inferior as recomendacoes do Programa Nacional de Alimentacao Escolar para energia, carboidrato, lipideo, calcio, ferro e fibras. A contribuicao da ingestao de energia e lipideo no domicilio foi superior a 50% em relacao a ingestao diaria.Conclusao:Os valores medianos dos nutrientes, geralmente acima das recomendacoes, associados aos riscos de inadequacao de alguns micronutrientes e ao elevado consumo energetico, evidenciam a importância de adequar o consumo alimentar e promover habitos alimentares saudaveis nas criancas.

Professional practice of dietitians in the Brazilian School Feeding Program: A multiple case study

Objetivo: Verificar a adequacao dos parâmetros numericos de nutricionistas na alimentacao escolar e discutir limites e possibilidades da atuacao profissional no Programa de Alimentacao Escolar em municipios do Vale do Ivai, Norte do Parana. Metodos: Estudo de casos multiplos realizado por meio de entrevista semiestruturada com nutricionistas da alimentacao escolar de nove municipios do Vale do Ivai. A Resolucao no 465/2010, do Conselho Federal de Nutricionistas, foi utilizada como base para calculo da adequacao da carga horaria do nutricionista. A legislacao do Programa Nacional de Alimentacao Escolar foi utilizada para discussao da atuacao profissional. Resultados: Os municipios contavam com nutricionista responsavel tecnico pelo Programa de Alimentacao Escolar, porem, o percentual de adequacao da carga horaria variou de 20 a 66%. Foram evidenciadas atividades de gestao, licitacao e contabilidade, alem das atribuicoes do nutricionista previstas para o Programa. A maioria dos nutri-cionistas tambem atendia a outras areas dos municipios, como saude, social e eventos, o que sugere um comprometimento das atribuicoes do profissional e, consequentemente, da execucao do Programa. Conclusao: O numero de nutricionistas no Programa Nacional de Alimentacao Escolar nos municipios investigados e insuficiente em relacao ao numero de alunos. A carga horaria insuficiente e a demanda excessiva de atividades podem impedir que o desenvolvimento de atividades privativas do nutricionista. A contratacao de tecnicos em nutricao e dietetica e auxiliares administrativos para tarefas burocraticas deve ser incitada.

Consumption of processed foods among children under two years of age: Foods’ pattern analysis

Objective: To evaluate the consumption of processed foods and their association with socioeconomic, demographic and environmental characteristics. Design: Cross-sectional study. Setting: Through home interviews a pre-coded questionnaire was applied, containing data relating to food consumption and socioeconomic, demographic and environmental characteristics. Subjects: Children (n=376) between six months and two years old assisted by the Family Health Program in Guarapuava, Paraná Brazil. Results: Of the 15 industrialized foods eaten more often, 8 were correlated together: artificial juice powder, soda, candy, lollipop, potato chips, margarine, refined sugar and bologna. It was found that this group of food is consumed, on average, 10 days per month. The factors that were significantly associated with increased consumption of these foods were: maternal age under 25 years, maternal education less than eight years, more than 4 people in the household, presence of other children in the household and household income per capita between 0.5 and 1 minimum wage. Conclusions: It is evident that the early introduction of processed foods among young children is influenced by socio-economic, demographic and environmental factors.

Desafios da nutrição no Sistema Único de Saúde para construção da interface entre a saúde e a segurança alimentar e nutricional

This article discusses the establishment of inter-sector action between health and food and nutritional security in Brazil from 2003 to 2010, when this issue was launched as a priority on the governments agenda. A qualitative study was developed according to constructivist epistemology, using key-informant interviews in the fields nationwide social oversight body. Advances and challenges in this process are addressed as analytical categories. The National Food and Nutrition Policy (PNAN) was mentioned as the link between the two fields, decentralized through a network with activity in the states and municipalities. However, the study found political, institutional, and operational obstacles to the effective implementation of the PNAN in the Brazilian Unified National Health System and consequently to a contribution to the advancement of Health and Food and Nutritional Security in the country. The predominance of the biomedical, curative, and high-complexity model was cited as the principal impediment, while health promotion policies like the PNAN were assigned secondary priority.Discute-se a construcao da intersetorialidade entre o campo da saude e da seguranca alimentar e nutricional (SAN) no Brasil, entre 2003 e 2010, periodo que inaugura a priorizacao deste tema na agenda governamental. Para tanto, desenvolveu-se uma pesquisa qualitativa segundo a epistemologia construcionista, mediante entrevistas com informantes-chave do orgao de controle social do campo da SAN de abrangencia nacional. Os avancos e desafios do processo sao abordados enquanto categorias de analise. A Politica Nacional de Alimentacao e Nutricao (PNAN) foi mencionada como articuladora entre os dois campos, sendo descentralizada por uma rede com atuacao nos estados e municipios. No entanto, registraram-se dificuldades politicas, institucionais e operacionais para que a PNAN possa ser efetiva no Sistema Unico de Saude e assim contribuir para o avanco da SAN no pais. O predominio do modelo biomedico, curativo e de alta complexidade foi referido como o principal impeditivo, conferindo ainda as politicas de promocao da saude, como a PNAN, uma posicao secundaria em termos da sua priorizacao.

Nutritional challenges in the Brazilian Unified National Health System for building the interface between health and food and nutritional security

This article discusses the establishment of inter-sector action between health and food and nutritional security in Brazil from 2003 to 2010, when this issue was launched as a priority on the governments agenda. A qualitative study was developed according to constructivist epistemology, using key-informant interviews in the fields nationwide social oversight body. Advances and challenges in this process are addressed as analytical categories. The National Food and Nutrition Policy (PNAN) was mentioned as the link between the two fields, decentralized through a network with activity in the states and municipalities. However, the study found political, institutional, and operational obstacles to the effective implementation of the PNAN in the Brazilian Unified National Health System and consequently to a contribution to the advancement of Health and Food and Nutritional Security in the country. The predominance of the biomedical, curative, and high-complexity model was cited as the principal impediment, while health promotion policies like the PNAN were assigned secondary priority.Discute-se a construcao da intersetorialidade entre o campo da saude e da seguranca alimentar e nutricional (SAN) no Brasil, entre 2003 e 2010, periodo que inaugura a priorizacao deste tema na agenda governamental. Para tanto, desenvolveu-se uma pesquisa qualitativa segundo a epistemologia construcionista, mediante entrevistas com informantes-chave do orgao de controle social do campo da SAN de abrangencia nacional. Os avancos e desafios do processo sao abordados enquanto categorias de analise. A Politica Nacional de Alimentacao e Nutricao (PNAN) foi mencionada como articuladora entre os dois campos, sendo descentralizada por uma rede com atuacao nos estados e municipios. No entanto, registraram-se dificuldades politicas, institucionais e operacionais para que a PNAN possa ser efetiva no Sistema Unico de Saude e assim contribuir para o avanco da SAN no pais. O predominio do modelo biomedico, curativo e de alta complexidade foi referido como o principal impeditivo, conferindo ainda as politicas de promocao da saude, como a PNAN, uma posicao secundaria em termos da sua priorizacao.

Desafíos de la nutrición en el Sistema Único de Salud brasileño para la construcción de la interfaz entre la salud y seguridad alimentaria y nutricional

This article discusses the establishment of inter-sector action between health and food and nutritional security in Brazil from 2003 to 2010, when this issue was launched as a priority on the governments agenda. A qualitative study was developed according to constructivist epistemology, using key-informant interviews in the fields nationwide social oversight body. Advances and challenges in this process are addressed as analytical categories. The National Food and Nutrition Policy (PNAN) was mentioned as the link between the two fields, decentralized through a network with activity in the states and municipalities. However, the study found political, institutional, and operational obstacles to the effective implementation of the PNAN in the Brazilian Unified National Health System and consequently to a contribution to the advancement of Health and Food and Nutritional Security in the country. The predominance of the biomedical, curative, and high-complexity model was cited as the principal impediment, while health promotion policies like the PNAN were assigned secondary priority.Discute-se a construcao da intersetorialidade entre o campo da saude e da seguranca alimentar e nutricional (SAN) no Brasil, entre 2003 e 2010, periodo que inaugura a priorizacao deste tema na agenda governamental. Para tanto, desenvolveu-se uma pesquisa qualitativa segundo a epistemologia construcionista, mediante entrevistas com informantes-chave do orgao de controle social do campo da SAN de abrangencia nacional. Os avancos e desafios do processo sao abordados enquanto categorias de analise. A Politica Nacional de Alimentacao e Nutricao (PNAN) foi mencionada como articuladora entre os dois campos, sendo descentralizada por uma rede com atuacao nos estados e municipios. No entanto, registraram-se dificuldades politicas, institucionais e operacionais para que a PNAN possa ser efetiva no Sistema Unico de Saude e assim contribuir para o avanco da SAN no pais. O predominio do modelo biomedico, curativo e de alta complexidade foi referido como o principal impeditivo, conferindo ainda as politicas de promocao da saude, como a PNAN, uma posicao secundaria em termos da sua priorizacao.