Wilma Maria Coelho Araújo

Adequação das boas práticas de fabricação em serviços de alimentação

Objective: classify a sample of 50 food producing establishments located in the Federal District (Brasilia, Brazil), according to their fulfillment of essential requisites contained in the sanitary regulation form published by the Agencia Nacional de Vigilância Sanitaria, Brazil’s National Agency for Sanitary Regulation. Methods: a metanalysis of two monographic studies on food production establishments (hotels and commercial restaurants) was performed, and associated to results of these authors’ research evaluating ten Foodservice and Nutrition Units led by nutritionists, and five commercial restaurants. The procedures for good manufacturing were evaluated according to the norms of the mentioned Agency; to this effect, the Agency’s specific forms were utilized to analyze the adequacy of requisites such as: construction, equipments, handling, production flow, and availability of the manual for good manufacturing procedures. Still according to the Agency’s norms, the establishments were further classified into three groups, respective to their fulfillment of the essential requisite items and procedures as defined in the form: in group I, were those establishments fulfilling more than 70% of the requisites; group II, fulfilling 30 to 69.9% of them; and group III, fulfilling less than 30% of the essential items and procedures. Results: according to the analyses, all the hotel foodservices were classified in group II, while the commercial restaurants were classified either in group II (33.3%) or in group III (66.7%). As for the Foodservice and Nutrition Units with a nutritionist, 80% were classified as group II, and 20%, as group I. Conclusion: the results indicate that the Nutrition and Foodservice Units, which had nutritionists available, were better classified in requisites such as equipments and availability of a manual of good manufacturing procedures. The hotels revealed better conditions on items such as construction, manipulation and production flow. The commercial restaurants obtained the worst results when compared to the other food production services.

Psyllium as a Substitute for Gluten in Bread

Celiac disease is an antibody-mediated enteropathy that presents permanent intolerance to ingested gluten. Currently, only one kind of treatment is available: the complete dietary elimination of all sources of gluten. The aim of the present study was to evaluate the effect of replacing gluten with psyllium on sensory characteristics of bread dough and to compare the chemical, nutritional, technological, and sensory characteristics of the modified preparations. This study is experimental and was subdivided into five steps: selection and development of preparation, chemical analysis, sensory analysis, and statistical analysis. Modified samples of the bread dough achieved a 93.0% acceptance rate for individuals with celiac disease and up to 97.0% for individuals without celiac disease. The most affected characteristics were odor and texture. In terms of chemical composition of the bread dough, energy was reduced by 32.1% and the fat fraction was 42.3% before being cooked. Data obtained from sensory analysis of psyllium doughs indicate that the products had good acceptance by individuals with celiac disease as well as by individuals without celiac disease. This suggests that psyllium can replace gluten in preparations. Furthermore, in terms of chemical composition, products made with modified dough had less fat and fewer calories.

Atitudes de risco do consumidor em restaurantes de auto-serviço

OBJECTIVE: The objective of this study is to evaluate the possible forms of food contamination by the costumer during the distribution period. METHODS: Data collection was performed in 10 food service units in Distrito Federal via direct observation of 12 risk attitudes (n=3,447) between October 2003 and September 2004. The risk attitudes were observed during the peak hour of each restaurant; the sample was systematized for each 5 consumers. The data collection instrument related the possible risk attitudes of the consumers while serving themselves. RESULTS: The obtained results demonstrate that there is a probability of contamination of the food by the consumers in restaurants, especially because 96% of the observed individuals did not wash their hands before serving themselves. Furthermore, 50% of the consumers were not concerned with the exclusive use of utensils, while 56% talked about the foods. CONCLUSION: The obtained data show that there is a need to improve the consumers awareness, especially in self-service restaurants. Food contamination by consumers needs to be prevented in order to avoid food intoxication.

A ficha técnica de preparação como instrumento de qualidade na produção de refeições

As profundas transformacoes nos metodos e tecnologias de trabalho tem gerado mudancas no processo de producao de refeicoes. A ficha tecnica de preparacao foi objeto de uma analise, na perspectiva de discuti-la como instrumento de qualidade na producao de refeicoes. Foram utilizadas bases de dados, livros e formas eletronicas de artigos para a pesquisa bibliografica. A compreensao de que o nutricionista, na condicao de profissional de saude, possui como atribuicao a atencao dietetica, e de que esta deve estar associada a racionalizacao e a otimizacao do processo de producao de refeicao, seguindo principios dieteticos, faz com que a Ficha Tecnica de Preparo seja um instrumento de promocao a saude. Sua construcao como ferramenta de atencao dietetica e, portanto, um dos desafios com vistas a necessaria mudanca de atitude dos profissionais, no que tange ao aprendizado e a aplicacao de novas tecnologias, e ao fornecimento de alimento seguro.As profundas transformacoes nos metodos e tecnologias de trabalho tem gerado mudancas no processo de producao de refeicoes. A ficha tecnica de preparacao foi objeto de uma analise, na perspectiva de discutila como instrumento de qualidade na producao de refeicoes. Foram utilizadas bases de dados, livros e formas eletronicas de artigos para a pesquisa bibliografica. A compreensao de que o nutricionista, na condicao de profissional de saude, possui como atribuicao a atencao dietetica, e de que esta deve estar associada a racionalizacao e a otimizacao do processo de producao de refeicao, seguindo principios dieteticos, faz com que a Ficha Tecnica de Preparo seja um instrumento de promocao a saude. Sua construcao como ferramenta de atencao dietetica e, portanto, um dos desafios com vistas a necessaria mudanca de atitude dos profissionais, no que tange ao aprendizado e a aplicacao de novas tecnologias, e ao fornecimento de alimento seguro. Termos de indexacao: ficha tecnica de preparacao, padronizacao, qualidade, servicos de alimentacao. A B S T R A C T

Doença celíaca, hábitos e práticas alimentares e qualidade de vida

Esta comunicacao apresenta o cenario da doenca celiaca e suas implicacoes em habitos, praticas alimentares e qualidade de vida de individuos intolerantes ao gluten. Apresenta dados importantes sobre a questao que, mundialmente, e considerada problema de saude publica. Por ser uma doenca cujo tratamento e fundamentalmente dietetico, a terapia durante a transicao alimentar deve ser bem conduzida pelo nutricionista para melhor adesao do paciente a dieta, considerando que a inclusao de novas praticas alimentares pode significar uma ruptura com a identidade individual e cultural: a alimentacao de cada cidadao nao pode ser deslocada da sociedade. Nesse contexto, a melhoria da qualidade de vida passa a ser um dos resultados esperados tanto das praticas assistenciais quanto das politicas publicas para o setor nos campos da promocao da saude e da prevencao de doencas. A vigilância sanitaria contempla as acoes capazes de eliminar, diminuir ou prevenir riscos a saude e de intervir nos problemas sanitarios decorrentes do meio ambiente, da producao e circulacao de bens e da prestacao de servicos de interesse da saude. O conhecimento do cenario da doenca celiaca no Pais se justifica pela necessidade de fundamentar as acoes da politica de alimentacao e nutricao ancoradas no conceito de alimentacao saudavel com enfase na dieta isenta de gluten. Os artigos pesquisados foram selecionados nas bases de dados MedLine e SciELO, considerando o periodo de 1995 a 2006.

Are fat acids of human milk impacted by pasteurization and freezing

The Human Milk Bank undergo human milk to pasteurization, followed by storage in a freezer at -18° C for up to six months to thus keep available the stocks of this product in maternal and infant hospitals. The objective of this study was to evaluate the effects of processing on the lipid fraction of human milk. A sample of human milk was obtained from a donor and was subdivided into ten sub-samples that was subjected to the following treatments: LC = raw milk; T0 = milk after pasteurization; T30 = milk after pasteurization and freezing for 30 days; T60 = milk after pasteurization and freeze for 60 days, and so on every 30 days until T240 = milk after pasteurization and freezing for 240 days, with 3 repetitions for each treatment. Lipids were extracted, methylated and fatty acid profiles determined by gas chromatography. The fatty acids were characterized by nuclear magnetic resonance and functional groups were identified by infrared spectroscopy. There were variations in the concentration of fatty acids. For unsaturated fatty acids there was increasing trend in their concentrations. The IR and NMR analyze characterized and identified functional groups presents in fatty acids.

Development of a tool for quality control audits in hospital enteral nutrition

BACKGROUND AND AIMS Malnutrition is very prevalent in hospitals, causing physical capacity deterioration, increasing complications and raising mortality. This scenario overloads public health costs enormously. Enteral nutrition (EN) is the first option to fight against malnutrition. Nutrition support teams (NST) work combating such conditions, promoting humanization, but also analyzing the cost benefit of EN therapy. Brazil is one of the first Latin American countries to develop EN laws. Quality control it is in the core of this legal instrument, playing an essential role in NST`s task of providing care. Nowadays, tools to access quality control represent a gap in the area. The aim of this study was to develop a quality control tool, according to Brazilian law for EN Therapy regarding multidisciplinary approach, good practices, standard operating procedures, protocol implementation, proper registration and electronic health record. METHODS A content validation method was utilized in this four stages development process: bibliographic research, expert opinion (subjective), semantic evaluation and expert opinion (objective). In the latter stage ten specialists, expressed their opinion, evaluating the tools by four different attributes: utility, simplicity, objective and low cost on a 5-point Likert scale (1-5). RESULTS We elaborate three independent tools that together, represent the whole evaluation process, named: NST Activities, EN Preparation and EN Administration. Content Validation Index to the four different attributes ranged form 0,9 to 1. CONCLUSION This tool had positive approval from experts and is of great value guiding hospital audits, or even serving as checklist to implement a plan on EN therapy.

Reducing fat content of Brazilian traditional preparations does not alter food acceptance: development of a model for fat reduction that conciliates health and culture.

Typical treatment for obesity and/or other chronic degenerative diseases should always include a dietetic approach. Diet success depends on several individual aspects, such as patients personal motivation and attitudes; unfortunately, dietary planning does not always take into account the patients cultural habits, which minimizes the impact of the nutritional intervention. The objective of the present study was to analyze and reduce the fat content of 10 representative recipes from Brazilian regional gastronomy, maintaining their acceptability and developing a standard protocol that could be used for improving nutritional content of any type of fat-rich traditional preparation. The recipes selected were tapioca flan (pudim de tapioca) and banana pie (torta de banana) from the northern region; hominy porridge (mungunzá) and corn cake (bolo de milho verde) from the northeast region; goianian pie (empadão goiano) and cassava cake (mané pelado) from the central west region; tropeiro beans (feijão tropeiro) and spiced chicken with rice (galinhada) from the southeast region; and carreteiro rice (arroz carreteiro) and ground corn with pork ribs (quirera lapiana) from the southern region. The preparations were submitted to a chemical composition analysis for humidity, protein, ashes, and total lipid content according to official methods of the Association of Analytical Chemists (AOAC, 1998) in duplicate. After the average nutrient content was determined, sensorial analysis was performed in order to investigate the acceptance rate of each preparation. The results were analyzed according to the hedonic scale of 7 points considering good acceptance those rates higher than 70%. Additionally, for statistical analysis the test F was applied, determining whether the samples were accepted significantly different to a level of 95% confidence. Some recipes had main ingredients with characteristically high lipid content, thus, in order to keep the regional characteristics of the preparation, those ingredients were not changed. Also, according to sensorial analysis, although there were some differences between the standard and modified samples, the recipes obtained similar acceptance rates (p > 0.05), except for carreteiro rice and banana pie recipes. In the case of the carreteiro rice, the acceptance of the modified recipe was greater than the standard and for the banana pie the inverse occurred, although the final acceptance of the modified recipe was greater than 70%. The results show that it is possible to conciliate healthy food and alimentary culture, once the adequate preparation technique is used, in particular those concerning the nutritional composition of the main ingredients (respecting the recipe characterization) and healthier methods of cooking. Moreover, those techniques can be applied for any regional/typical recipes in order to facilitate the patients adherence to the prescribed diet plans or even for major actions concerning public health matters.

Conformity of food service units with legislation

ABSTRACT The objective of this study was to evaluate the conformity of Brazilian food service units (FSUs) to their adequacy to Brazilian legislation. Thirty-seven FSUs participating in a Brazilian public social program in 2010 and distributed proportionally among the five geographic regions of Brazil were the sample. An evaluation instrument was constructed to assess the adequacy of them to legislation. The data indicate that water supply and sewage had the highest percentage of satisfactory results (54%), followed by production and transport of food (35.1%). Buildings and procedures fell into the range of satisfactory with restrictions, while items related to hygiene, distribution area, documentation were classified as unsatisfactory. There was a significant difference between the group items when considering the management model. Of the managers, 56.8% stated that the legal obligation is very important. The FSUs did not meet the requirements for the implementation of food safety, although managers consider meals safe production important.

Psyllium as a Substitute for Gluten in Pastas

The aim of the present study was to evaluate the effect of replacing gluten in favor of psyllium in pasta’s characteristics. This study takes an exploratory and quantitative approach and was sub-divided into four steps: selection and development of recipes and chemical and sensorial analysis. Modified samples of the pasta presented 100.0% of acceptance for individuals with celiac disease and up to 94.0% for individuals without celiac disease. The most affected characteristics were odor and texture. In terms of chemical composition, reduction of energy value was 26.5% and of proportional fat was 85.4% before being cooked. Substituting wheat flour for a mixture of gluten-free flours with psyllium did not alter preference or acceptability of modified products in relation to standardized ones and amplified feeding options for celiac disease patients. Thus, there were no damages in sensorial characteristics of these products.