Consumo alimentar entre crianças brasileiras de dois a cinco anos de idade: Pesquisa Nacional de Demografia e Saúde (PNDS), 2006

Socioeconomic status, screen time, and time spent at school, and children’s food consumption

Abstract The present study aimed to evaluate the association of sociodemographic factors and lifestyle with the consumption of in natura or minimally processed (INMP) foods, ultra-processed foods (UPFs), and fruits and vegetables. This was a cross-sectional study conducted with 403 children, aged 4 to 7 years, from a retrospective cohort. Sociodemographic and lifestyle variables were investigated using a sociodemographic questionnaire. Food consumption was assessed by three food records. Bivariate and multivariate linear regression analyses were used to analyze associations. Children with lower income had a higher consumption of INMP foods and a lower consumption of UPFs. A shorter time spent at school was associated with a lower consumption of INMP foods and a higher consumption of UPFs. Children with more screen time and less educated parents consumed less fruits and vegetables. Unfavorable sociodemographic factors were associated with a better profile of food consumption according to the level of processing, except for fruits and vegetables. The longer time spent at school and a shorter screen time contributed to a healthier diet.

Socioeconomic status, screen time, and time spent at school, and children's food consumption

The present study aimed to evaluate the association of sociodemographic factors and lifestyle with the consumption of in natura or minimally processed (INMP) foods, ultra-processed foods (UPFs), and fruits and vegetables. This was a cross-sectional study conducted with 403 children, aged 4 to 7 years, from a retrospective cohort. Sociodemographic and lifestyle variables were investigated using a sociodemographic questionnaire. Food consumption was assessed by three food records. Bivariate and multivariate linear regression analyses were used to analyze associations. Children with lower income had a higher consumption of INMP foods and a lower consumption of UPFs. A shorter time spent at school was associated with a lower consumption of INMP foods and a higher consumption of UPFs. Children with more screen time and less educated parents consumed less fruits and vegetables. Unfavorable sociodemographic factors were associated with a better profile of food consumption according to the level of processing, except for fruits and vegetables. The longer time spent at school and a shorter screen time contributed to a healthier diet.

Tendência temporal (2008-2018) da prevalência de excesso de peso em lactentes e pré-escolares brasileiros de baixa renda

Resumo O objetivo deste estudo foi analisar a tendência temporal da prevalência de excesso de peso (EP) em crianças menores de cinco anos assistidas pelo Programa Bolsa Família (PBF) entre 2008 e 2018. O painel de dados foi baseado nos relatórios de estado nutricional do Sistema de Vigilância Alimentar e Nutricional (SISVAN) (n=30.574.118) e analisado por meio de modelos de regressão joinpoint específicos para idade (lactentes e pré-escolares) e macrorregião. Ainda, calculou-se a cobertura do SISVAN para o PBF e a representatividade nacional, segundo projeção censitária. Na década analisada, o EP em lactentes reduziu de 11,9% (11,8; 12,0 IC95%) para 8,5% (8,4; 8,6 IC95%) (-3,6%/ano [-5,1; -2,0 IC95%]); quanto aos pré-escolares, a prevalência EP aumentou em 3,1%/ano (2,0; 4,2 IC95%) até 2015, seguida por uma retração até 2018 (-6,4%/ano [-10,1; -2,6 IC95%]). Em ambos os grupos etários, a região Norte apresentou a menor prevalência em toda série histórica e a Nordeste o pior desempenho no controle do EP infantil. A cobertura do SISVAN no PBF foi elevada e a representatividade dos dados variou entre 13,9% (Sul) e 42,2% (Nordeste). Apesar da prevalência estar acima do esperado, após 2014, identificou-se redução linear no EP em lactentes e desaceleração na taxa de crescimento nos pré-escolares.

Determinants of ultra-processed food consumption in Brazilian children and adolescents with type 1 diabetes mellitus: a cross-sectional study

OBJECTIVES

To analyze the determinants of UPP consumption among children and adolescents with type 1 diabetes mellitus.

METHODS

Cross-sectional study at a reference hospital for the treatment of diabetes in Rio de Janeiro, Brazil. The sociodemographic, anthropometric, dietary, and clinical factors associated with the percentage of total energy intake (TEI) consumed in the form of UPP were investigated. Food consumption was assessed by 24 h recall and the foods were classified according to the degree of processing as described in the NOVA classification, after which the TEI of each food group was calculated. Multiple linear regression was adopted in the analysis, and associations with p<0.05 were considered significant.

RESULTS

The study included 120 children and adolescents with a mean age of 11.74 ± 2.88 years, 53.3% female. Body mass index z-score was 0.65 (± 0.89) and 31.7% (n=38) were overweight. The average total energy consumption was 1,756.38 kcal (± 518.38). The mean percentage of TEI from UPP was 24.2% ± 17.9, meaning that 425.59 kcal (± 380.15) of all calories ingested came from such foods. The independent variables associated with the percentage of ultra-processed foods (UPP) in TEI were: per capita household income up to one the minimum wage (β: -22.03; CI 95% -35.24 to -8.82); and parents/guardians schooling of the up to nine years in formal education (β: 19.86; CI 95% 8.27-31.45).

CONCLUSIONS

Lower household income and fewer years in formal education seem to determine a preference for UPP over fresh and minimally processed foods.

Contribution to the Journal Ciência & Saúde Coletiva on Food and Nutrition in Brazil

A systematic review conducted in January 2020 using SciELO database with the objective of analyzing the scientific production from 1996-2019, of the Journal Ciência & Saúde Coletiva in the area of food and nutrition. We selected 509 out of the 904 articles screened by titles and abstracts. We grouped the articles into ten themes and discussed the most frequent ones: Nutritional Status Assessment (n=142), Food Intake (n=111), Food and Nutrition Policies and Programmes (n=105) and Breastfeeding (n=35). The publications were mostly original articles (75.6%) employing quantitative method (81.6%) and, among these, 18.8% used a probabilistic sampling. We assembled a wide range of topics and subthemes, a relevant production and repository of data and knowledge for health professionals and managers. As gaps, there was a scarcity of publications focused on micronutrient deficiency; the promotion of the Food Guide for the Brazilian Population; supporting the rise of breastfeeding, the impact and analyses of the disruption of the National Food and Nutrition Security Policy and its multi sector interactions with social policies to fight hunger.

Food consumption of children enrolled in five municipal schools according to socio-demographics characteristics

ABSTRACT Objective To describe children food consumption in the five municipal schools in Pelotas, Rio Grande do Sul, and their main characteristics. Methods Cross-sectional study of children enrolled in five municipal schools. The mothers were interviewed at the school. The questionnaire about habitual food consumption was based on the guidelines of the Food and Nutrition Surveillance System. The data were entered in EpiData 3.1 and reviewed in Stata 14.0. The consumption frequency was reported according to each exposure category. Statistical tests based on Chi-Square test with 5% significance level and adjusted analyses through Poisson regression were used. Results A total of 548 children were included. Females represented 51.1% of the total sample; the average age was 48.3 months. Children up to two years of age were those who consumed the most fruits and vegetables while sweets were mostly consumed by older children, aged between three and four years. Unhealthy foods had a high frequency of consumption, with sweet being the most consumed (58.8%), followed by packet snacks (53.3%). In the adjusted analysis, eating meals in front of the screens remained associated with lower consumption of vegetables. Conclusion Eating meals in front of the screens reduces children’s vegetables consumption. At the same time, the child’s age and maternal education seem to have some influence on the consumption of unhealthy foods, indicating the need for nutritional education interventions.

[Eating patterns among children aged 13 to 35 months and association with maternal characteristics]

This study sought to identify eating patterns among children and to verify their association with maternal characteristics. We studied 1,185 children aged 13 to 35 months. Food consumption was investigated using the 24h dietary recall and the eating patterns were identified using principal components factor analysis, followed by orthogonal varimax rotation. We carried out a hierarchical modeling using poisson regression with robust variance estimates in order to estimate prevalence ratios. We identified four eating patterns: common Brazilian, dairy/porridge, healthy and unhealthy. The variance explained by these factors was of 34.3% and the common Brazilian pattern was the one that most contributed to proportional variance. We highlight the dairy/porridge pattern, in which breast milk had negative factorial loading, suggesting its substitution by cow and modified milk. The data reveal that the characterization of children's eating patterns diverges according to maternal characteristics, such as age, educational level and number of children. Three of the four patterns we found are represented by foods rich in starch, saturated fat and simple sugar and poor in vitamins, minerals and fibers. Multiparity, lower educational levels and maternal age under 20 years were associated with a lower consumption of foods considered to be healthy and important in child development.

Dietary patterns and body adiposity in children in Brazil: a cross-sectional study

OBJECTIVES

Many factors are associated with the increase in total and central body adiposity in children, especially eating habits. This has led to an increasing number of studies analysing food patterns, which consider the synergistic effect of food and nutrient intake on the nutritional status. The objective of this study was to identify the dietary patterns of children aged 4-7 years and associate these with different indicators of total and central body adiposity.

STUDY DESIGN

Cross-sectional study METHODS: The study consisted of 403 children from a retrospective cohort in Minas Geraes, Brazil. Four indicators of body adiposity were evaluated: body mass index (BMI), waist-to-height ratio (WHtR) and percentages of total and central body fat (assessed by dual-energy X-ray absorptiometry). The dietary habits of the children were evaluated by identifying the dietary patterns using principal component analysis. The adjustment predictor variables were related to the socio-economic characteristics, lifestyle and duration of exclusive breastfeeding. Food patterns were identified by factor analysis. Linear regression was used to estimate the regression coefficient and the confidence interval, considering statistical significance of α = 5%.

RESULTS

Five dietary patterns were identified, which explained 42.3% of the data variance: 'Traditional', 'Unhealthy', 'Milk and chocolate', 'Snack' and 'Healthy'. The multiple linear regression model showed that a greater adherence to the 'Traditional' and 'Unhealthy' patterns was related to higher BMI, WHtR, and total and central body adiposity.

CONCLUSION

Children with a higher intake of food from the 'Traditional' and 'Unhealthy' patterns showed an increase in total and central body adiposity.

Training in nutritional counseling: knowledge assessment and applicability in child's healthcare

Abstract Objectives: to assess the primary healthcare professionals’ knowledge before and after the training in nutritional counseling and the applicability in child’s healthcare. Methods: a non-controlled ‘before and after’ intervention study, in a quantitative approach was conducted in Itupeva city in, Sao Paulo State. Training as an intervention was implemented for nurses, nursing assistants (NA) and community health agents (CHA), based on the critical-reflexive education. The professionals’ knowledge was evaluated by applying a test with 16 multiple choice questions before and after the training. The nutritional counseling applicability in the services was evaluated by an open question test. The descriptive statistics and Fisher’s Exact Test with significance of 5% were used Results: after training, the 'satisfactory' knowledge increased 71% in the nurses group and the NA/CHA groups. The professionals pointed out that training as an opportunity for qualification but the applicability lacks on political support and service organization. Conclusions: training in nutritional counseling contributes to expand the primary care professionals' knowledge, although, the applicability in the routine depends on the efforts of local management and service organization.

Influence of parents' behavior during the meal and on overweight in childhood

Abstract Objective: To assess the influence of parents' behavior during meals and on the overweight in childhood. Methods: Cross-sectional and analytical study, with a quantitative approach, performed with children aged between 12 and 59 months, belonging to the enrolled population of a Family Health Strategy team, in Montes Claros (MG). In order to collect data, it was used a questionnaire with sociodemographic variables related to food consumption and family influence over the eating habits. The anthropometric parameters of weight and height were assessed. We used the Student's t-test (p < 0.05) to compare the averages of the eating behavior of parents and the overweight in childhood. Results: 115 children participated. The overweight in childhood was statistically related to the behavior of parents during meals in the domains "model of sweets consumption" and "special meals". Conclusion: The family environment is associated with the formation of eating habits and the overweight in childhood.

Sedentary lifestyle and poor eating habits in childhood:a cohort study

Worldwide, about 22 million children under five years old are overweight. Environmental factors are the main trigger for this epidemic. The purpose of this study was to evaluate the eating and physical activity habits in a cohort of eight-year-old children in Pelotas, Brazil. Eating habits were assessed based on the Ten Steps to Healthy Eating proposed by the Ministry of Health. To assess the level of physical activity, the physical activity questionnaire for children and adolescents (PAQ-C) was used. Of the 616 interviewed children at 8 years, it was observed that 50.3% were male; 70.3% were white and just over half belonged to economic class C. None of the children were classified as very active and none acceded to a daily consumption of six servings of the cereals, tubers, and roots. The steps that had higher adhesion were 8 (do not add salt to ready foods); 4 (consumption of beans, at least 5 times per week) and 1 (have 3 meals and 2 snacks per day), respectively. The high prevalence of physical inactivity and low level of healthy eating habits confirm the importance of strategies to support and encourage the practice of physical activity and healthy eating among youth.

Excess weight in preschool children: The role of food intake

ABSTRACT Objective: The study aimed to compare the food intake of overweight/obese and normal weight preschoolers and to verify whether excess weight is associated with low birth weight, catch-up growth, early weaning, and physical activity/inactivity Methods: This case-control study was conducted in family healthcare units of the city of Olinda, Pernambuco, from May to August 2014 Results: A total of 253 children were studied, 84 with 'excess weight' and 164 with 'normal weight'. In the 'overweight/obese' and 'normal weight' groups, 77% and 43% of the children, respectively, had high calorie intake. The 'overweight/obese' group had lower fruit intake, higher maternal education level, higher family income, higher maternal excess weight, and presence of catch-up growth and inactivity Conclusion: The results suggest that food intake has an important role, but that other variables contribute to excess weight in children. Recognition of the problem's many causes should guide the public policies directed at this age group to prevent this nutritional disorder.

Consumo habitual de alimentos fonte de vitamina A em pré-escolares da zona rural no Norte de Minas Gerais

Objetivo: Avaliou-se o consumo habitual de alimentos fontes de vitamina A em pré-escolares da zona rural de Montes Claros, Minas Gerais.Métodos: Em estudo do tipo transversal foram pesquisados 337 pré-escolares por meio de entrevista com seus pais. Foram avaliados: a) características socioeconômicas da família; b) recebimento de suplementação de vitamina A provida pelo governo, c) o hábito de consumo de alimentos fontes de vitamina A através de um Questionário de Frequência Alimentar. O hábito de consumo foi classificado entre alto/moderado ou baixo e associado às variáveis socioeconômicas usando-se o modelo de regressão de Poisson para calcular a razão de prevalência e respectivo intervalo de confiança a 95%.Resultados: A maioria das crianças era de famílias de baixa renda. Apenas 51% delas receberam pelo menos 4 doses de suplementação de vitamina A. O hábito de consumo de fontes dessa vitamina inferido pelo Questionário de Frequência Alimentar foi considerado alto/moderado para apenas 75 dos pré-escolares e baixo para 262 deles. O baixo consumo de alimentos fontes de vitamina A foi associado à renda ≤1 salário mínimo (RP=1,178) e consumo habitual de guloseimas (RP=1,256).Conclusão: As crianças avaliadas apresentaram baixo registro de recebimento da suplementação de vitamina A provida pelo governo e baixo consumo de alimentos fonte desse nutriente, sendo este último associado à baixa renda familiar e ao alto consumo de guloseimas.

Use and records of child health handbook focused on growth and development

Objective To evaluate the use and records of the Child Health Handbook (CHH), especially growth and development. Method Cross-sectional study with 358 mother-child pairs registered in 12 Primary Health Centers (PHCs) of a small municipality. Mothers were interviewed at the PHC from February to April 2013 using a questionnaire. Data analysis was done using WHO Anthro software, Epi InfoTM and Stata. Results Fifty-three percent of the mothers were carrying the CHH at the time of the interview, similar to the proportion of mothers who were instructed to bring the CHH to health appointments. Annotations in the CHH during the visits were reported by 49%. The vaccination schedule was completed in 97% of the CHH, but only 9% and 8% of the CHH, respectively, contained growth charts and properly completed developmental milestones. Conclusion Low rates of use and unsatisfactory record-keeping in the CHH reinforce the need for investment in professional training and community awareness for the CHH to become an effective instrument of promotion of child health.