Viviane Laudelino Vieira

Índices dietéticos na avaliação da qualidade global da dieta

Feeding can act in the prevention of some diseases as well as in the treatment of others. The analysis of food consumption provides information to assess nutritional needs and improve nutrition education programs. Few studies have been carried out in order to perform a global dietary assessment. The dietary indexes have been studied as an alternative to perform this assessment. The objective of this paper is to show some dietary indexes: Nutrient Index, Diet Variety Score, Diet Diversity Score, Diet Quality Index, Healthy Eating Index and Diet Quality Index Revised. These indexes have fundamental importance in the summarization of distinct dietary components in a single variable.

A atuação do nutricionista na Atenção Básica à Saúde em um grande centro urbano

Nutritionists are important professionals for ensuring the implementation of health promotion, treatment and rehabilitation. However, their participation in primary healthcare from a quantitative standpoint is limited. The city of Sao Paulo has experienced an uneven urbanization process triggering new problems of insecurity in terms of food and nutrition. This article analyzes the performance of the primary healthcare nutritionist in a large urban center. It is a quantitative study that used data from the Municipal Health Department, population data of Sao Paulo and a semi-structured questionnaire applied in individual interviews. All regions of the city are found to have fewer nutritionists than the recommendation of the Federal Council of Nutritionists. There are 123 nutritionists in the basic healthcare network and 51 in the Family Health Support Nuclei (FHSN) (57.3%). Each nutritionist from the FHSN accompanies 7.1 family health strategy teams on average. The age groups corresponding to children are less frequently seen by nutritionists. Comparing the activities, the transition from a model of primary health care focused on individual care to a model that prioritizes group care was observed.

Insegurança alimentar, vínculo mãe-filho e desnutrição infantil em área de alta vulnerabilidade social

OBJETIVO: analisar a inseguranca alimentar e o vinculo inadequado mae-filho como dois potenciais determinantes da desnutricao em criancas de quatro a seis anos de idade. METODOS: estudo de caso-controle desenvolvido em Escolas Municipais de Educacao Infantil (EMEIs) no Jardim Jaqueline, area de alta vulnerabilidade social do municipio de Sao Paulo, Brasil. Foram aplicados a Escala Brasileira de Inseguranca Alimentar e o Protocolo de Avaliacao do Vinculo Mae-filho, alem de coletadas informacoes biologicas e socio-economicas. Para verificacao dos efeitos de cada variavel independente e controle dos efeitos das demais variaveis incluidas no modelo, foi utilizado o modelo de regressao logistica multipla. RESULTADOS: verificou-se que tanto a inseguranca alimentar familiar (OR=3,6) como o vinculo inadequado mae-filho (OR=9,4) estiveram associados com a desnutricao infantil (p<0,05), mesmo apos o controle para o peso ao nascimento da crianca e idade, estado conjugal e trabalho maternos. CONCLUSOES: tanto a inseguranca alimentar familiar (OR=3,6) como o vinculo mae-filho inadequado (OR=9,4) mostraram-se fatores determinantes da ocorrencia da desnutricao na populacao estudada.

Ações de alimentação e nutrição e sua interface com segurança alimentar e nutricional: uma comparação entre Brasil e Portugal

Abstract This paper aims to compare food and nutrition actions related to foodsecurity (FS) in Brazil and Portugal, keeping in mind that several countries have established guidelines to guarantee adequate food. Both nations are experiencing a reduction in fertility rates, increased life expectancy, and a high prevalence of non-communicable diseases. In Bra-zil, 30.2% of households live in food insecurity; in Portugal, even without estimating food insecurity, 18.0% of its inhabitants are at risk for poverty. The National Food and Nutrition Policy is the current Brazilian document which seeks to ensure univer-sal access to food. Portugal, due to its inclusion in the European Union, is guided by the Second WHO European Action Plan for Food and Nutrition Policy as well as by the Portuguese National Health Plan, which has been updated periodically. Guided by the intersectoral approach, these countries share actions related to FS, such as combating obesity, preventing nutritional deficiences and promoting nutrition education in schools, whereas, specifically in Brazil, some strategies also combat malnutrition and, in Portugal, are linked to industry and the production of safe food. With relation to FS, some distinctions were seen: FS is more widely discussed by Brazilian policies, while this subject is implied in several food and nutrition actions in Portugal. Keywords: Health Public Policy; Food Security; Nu -trition Programs; Brazil; Portugal.

Grupos de educação nutricional em dois contextos da América Latina: São Paulo e Bogotá

Este estudo comparou grupos de Educacao Nutricional (EN), na dimensao teorica e pratica, dentro da Atencao Primaria a Saude, entre Sao Paulo e Bogota. A pesquisa descritiva foi realizada em momentos: identificacao dos profissionais; caracterizacao dos grupos educativos; identificacao das representacoes sociais sobre EN; e comparacao da articulacao entre teoria e pratica dos grupos por cidade. Foram identificadas, por meio de entrevista com 54 nutricionistas, 17 Ideias centrais, classificadas em eixos tematicos, que se relacionaram com os grupos. Nos dois contextos, destacou-se a importância do empoderamento dos participantes com semelhancas no perfil das acoes, mas com diferenciacao na autonomia dos mediadores. Verificou-se que a teoria/pratica dos grupos esta em transicao da abordagem tradicional para outra mais humanista. Entretanto, em uma velocidade lenta comparada as politicas e necessidades de saude.Este estudo comparou grupos de Educacao Nutricional (EN), na dimensao teorica e pratica, dentro da Atencao Primaria a Saude, entre Sao Paulo e Bogota. A pesquisa descritiva foi realizada em momentos: identificacao dos profissionais; caracterizacao dos grupos educativos; identificacao das representacoes sociais sobre EN; e comparacao da articulacao entre teoria e pratica dos grupos por cidade. Foram identificadas, por meio de entrevista com 54 nutricionistas, 17 Ideias centrais, classificadas em eixos tematicos, que se relacionaram com os grupos. Nos dois contextos, destacou-se a importância do empoderamento dos participantes com semelhancas no perfil das acoes, mas com diferenciacao na autonomia dos mediadores. Verificou-se que a teoria/pratica dos grupos esta em transicao da abordagem tradicional para outra mais humanista. Entretanto, em uma velocidade lenta comparada as politicas e necessidades de saude.

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.

Professional training in the context of food and nutrition security.

BACKGROUND Primary care is an important area in which to confront situations of food and nutrition insecurity. To undertake action in this area, well-prepared professionals are necessary. Courses of health training are not yet, however, equipped to offer the necessary preparation. Aim To analyse the topics taught in nutrition graduation courses related to the abilities and competencies demanded by professional work in this area. METHODS The curricula of the nutrition courses offered in the municipality of São Paulo, Brazil were analysed. Nutritionists and teachers were interviewed. The triangulation of the data obtained was undertaken by means of a qualitative approach taking the theory of social representations as the frame of reference. RESULTS The concepts necessary to act within the context of food and nutrition security are related to a humanistic approach, the unity of theory and practice, the nutritionists role as educator, teamwork and reflection on public health.

Promoting healthy eating in primary health care from the perspective of health professionals: a qualitative comparative study in the context of South America

BackgroundEducational interventions designed to promote healthy eating are essential in primary health care. Nevertheless, given the nutrition controversies about what is healthy, the contradictions created by the media, and the situation of users with complex needs, the prioritization of the themes to be addressed in the services has scarcely been described in the planning process. This study aimed to identify the process of implementing the themes discussed by health professionals in nutrition education groups in two primary health care models.MethodsOur study followed a qualitative comparative approach. It included the systematic observation of nutrition education group meetings to identify the key messages addressed and semi-structured interviews with health professionals in São Paulo, Brazil, and in Bogotá, Colombia. We used thematic networks to classify the messages and the collective subject discourse technique to organize the information obtained from interviews. We observed 28 nutrition education groups in São Paulo, and 13 in Bogotá, and conducted 27 interviews with nutritionists in each city.ResultsThe messages identified were grouped into four global themes: feeding habits, life cycle, disease, and “being a multiplier”. The process of implementing the themes, understood as identification, selection, consultation, and application of themes, is intermediated by social representations of the health professionals about service requirements, training and professional performance, and the relationship with users. Two notions shape these representations: Control, although the time and the physical space dedicated to health services are restricted to the disease in São Paulo, in Bogotá only limited health promotion is provided; and specificity, which is portrayed as therapeutic support within a more educational model in São Paulo and as health promotion training courses within a prescriptive model in Bogotá.ConclusionsUnderstanding the process of implementing the themes discussed in nutrition education groups can reveal mechanisms that support the approach to themes on healthy eating, including communicative and educational adaptations of health professionals. This study contributes to the discussion about educational models in health care and their effects on the qualifications of health professionals within the service, especially those included in the context of low- and middle-income settings.

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

Grupos de educación nutricional en dos contextos de América Latina: São Paulo y Bogotá

Este estudo comparou grupos de Educacao Nutricional (EN), na dimensao teorica e pratica, dentro da Atencao Primaria a Saude, entre Sao Paulo e Bogota. A pesquisa descritiva foi realizada em momentos: identificacao dos profissionais; caracterizacao dos grupos educativos; identificacao das representacoes sociais sobre EN; e comparacao da articulacao entre teoria e pratica dos grupos por cidade. Foram identificadas, por meio de entrevista com 54 nutricionistas, 17 Ideias centrais, classificadas em eixos tematicos, que se relacionaram com os grupos. Nos dois contextos, destacou-se a importância do empoderamento dos participantes com semelhancas no perfil das acoes, mas com diferenciacao na autonomia dos mediadores. Verificou-se que a teoria/pratica dos grupos esta em transicao da abordagem tradicional para outra mais humanista. Entretanto, em uma velocidade lenta comparada as politicas e necessidades de saude.Este estudo comparou grupos de Educacao Nutricional (EN), na dimensao teorica e pratica, dentro da Atencao Primaria a Saude, entre Sao Paulo e Bogota. A pesquisa descritiva foi realizada em momentos: identificacao dos profissionais; caracterizacao dos grupos educativos; identificacao das representacoes sociais sobre EN; e comparacao da articulacao entre teoria e pratica dos grupos por cidade. Foram identificadas, por meio de entrevista com 54 nutricionistas, 17 Ideias centrais, classificadas em eixos tematicos, que se relacionaram com os grupos. Nos dois contextos, destacou-se a importância do empoderamento dos participantes com semelhancas no perfil das acoes, mas com diferenciacao na autonomia dos mediadores. Verificou-se que a teoria/pratica dos grupos esta em transicao da abordagem tradicional para outra mais humanista. Entretanto, em uma velocidade lenta comparada as politicas e necessidades de saude.