Cárie dentária e práticas alimentares entre crianças de creches do município de São Paulo

Influence of socioeconomic inequalities on levels of dental caries in adolescents: A cohort study

BACKGROUND

Socioeconomic factors at both contextual and individual levels influence health.

AIM

Evaluate the influence of socioeconomic inequalities on the incidence of dental caries in adolescents.

DESIGN

This cohort study was conducted with a multistage random sample of 1134 12-year-old adolescents from Southern Brazil. The experience of dental caries was assessed according to the decayed, missed, or filled surfaces (DMF-S) index. The Basic Education Development Index (IDEB) was collected during baseline as a school-level variable. Individual variables included demographic, socioeconomic, behavior-related, and oral health measures. Multilevel Poisson regression analysis through a hierarchical approach was used to explore the influence of exploratory variables on the mean of decayed surfaces.

RESULTS

770 14-year-old adolescents were reevaluated (follow-up rate of 68%) after 2 years. Examiner's Kappa values for the assessment of dental caries ranged from 0.81 to 0.90. Adolescents with low household income and lower school's IDEB had higher mean of decayed surfaces. Non-white adolescents, lower frequency of dental attendance, parents' poor perception of child's oral health, and dental plaque were also associated with the incidence of dental caries.

CONCLUSION

Adolescents from a lower socioeconomic background and poor school context had higher levels of dental caries over time.

Ultra-processed foods: Consumption among children at day-care centers and their classification according to Traffic Light Labelling system

Objective: To identify the age at which ultra-processed foods are introduced in the diet of infants enrolled in public daycare centers and analyze these foods' nutritional composition according to the Traffic Light Labelling system adapted to the Brazilian norms and recommendations.Methods: Cross-sectional study including 636 nursery age children attending day care centers. Their mothers were interviewed about the age of introduction of instant noodles, snack chips, encased meat, chocolate, ice cream, and stuffed cookies. The proximate composition of these foods was evaluated according to the Traffic Light Labelling adapted to the Brazilian norms and recommendations, which classifies total fat, saturated fat, trans fat, fiber, and sodium amounts as green, yellow, or red indicators.Results: It was found that before 12 months of age 70.6% of children had consumed instant noodles, 65.9% snack chips, 54.7% encased meat, 67.1% chocolate, 36.9% ice cream, and 68.7% stuffed cookies. In addition, all foods were classified as red for saturated fat and sodium and 50.0% were classified as red for total fat.Conclusion: The introduction of ultra-processed foods in the children's diets occurred early, but it is worth mentioning that such foods have an inadequate nutritional composition, contributing to the excess consumption of total fat, saturated fat, and sodium, as well as low fiber.

[Introduction of soft drinks and processed juice in the diet of infants attending public day care centers]

OBJECTIVE

Identifying at what age infants enrolled in public day care centers are introduced to soft drinks and industrialized juice, as well as comparing the nutritional composition of these goods with natural fruit juice.

METHODS

A cross-sectional study with the mothers of 636 children (aged 0 to 36 months) from nurseries of day care centers, who were asked questions about the age of feeding introduction. This study evaluated the proximate composition of soft drinks and artificial juice, comparing them with those of natural fruit juice regarding energy, sugar, fiber, vitamin C, and sodium values. The chemical composition of fruit juice was obtained by consulting the Table of Food Composition and, for industrialized drinks, the average nutritional information on the labels of the five most consumed product brands.

RESULTS

The artificial drinks were consumed before the first year of life by more than half of the children studied, however, approximately 10% consumed them before the age of 6 months. With regard to the comparison among the drinks, artificial fruit juice beverages and soft drinks proved to contain from nine to 13 times higher amounts of sodium, and 15 times less vitamin C than natural juices.

CONCLUSIONS

The introduction of soft drinks and industrialized juice in the diet of infants was inopportune and premature. When compared to natural fruit juice, these have inferior nutritional composition, which suggests the urgent need for measures based on strategies for food and nutrition education in order to promote awareness and the maintenance of healthy eating habits.

Diagnóstico das práticas de alimentação complementar para o matriciamento das ações na Atenção Básica

A alimentação complementar adequada e oportuna é essencial para o crescimento e o desenvolvimento saudáveis da criança, sendo a Atenção Primária à Saúde, em especial os Núcleos de Apoio à Saúde da Família, o lócus ideal para o desenvolvimento de ações pertinentes a esta prática. Estudo transversal com aplicação de questionário para mães e avaliação antropométrica de 324 crianças visou desenvolver um escore de inadequações na alimentação complementar e estudar suas relações com variáveis socioeconômicas, clínico-epidemiológicas e nutricionais. Para quantificação das inadequações alimentares foi criado um escore por meio do Método Delphi. Foram observadas altas frequências para todas as inadequações, especialmente na introdução tardia de sólidos (80,2%), precoce de açúcares/engrossantes (78,1%) e precoce de líquidos (73,5%). Entre as variáveis mais significantemente associadas com o escore estão desmame precoce do aleitamento materno exclusivo (p = 0,000) e total (p = 0,005), ausência de companheiro (p = 0,001) e a mãe ser chefe da família (p = 0,025). A utilização do escore identifica situações de maior risco para subsidiar as ações prioritárias da assistência nutricional, especialmente para promover o trabalho matricial.