Influência da publicidade de alimentos sobre a escolha alimentar de crianças e adolescentes de escolas públicas do Distrito Federal

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Ciências da Saúde, Departamento de Nutrição, Programa de Pós-Graduação em Nutrição Humana, 2014.O comportamento alimentar é resultado da interação de fatores inerentes ao indivíduo e sua fase do ciclo da vida, características sensoriais, custo e disponibilidade de alimentos, aspectos culturais e religiosos, influência social e aspectos relacionados à publicidade e à mídia. Esta apresenta um papel central no estabelecimento comportamento alimentar de crianças e adolescentes, fato relacionado ao aumento das taxas de excesso de peso e obesidade o que reforça a questão da regulamentação da publicidade de alimentos. Neste sentido, a literatura não demonstra como ocorre a influência da publicidade de alimentos não saudáveis na presença de alertas de saúde nas mensagens publicitárias de alimentos não saudáveis. Dessa maneira, o objetivo geral desta dissertação consistiu em caracterizar o efeito da exposição da publicidade de alimentos sobre o componente cognitivo da atitude, sobre as preferências e sobre as intenções de consumo alimentar de estudantes do ensino fundamental da rede pública do Distrito Federal. De modo a atingir tal objetivo, propuseram-se dois estudos com o objetivo de relacionar os aspectos psicossociais e situacionais com os componentes atitudinais do consumo alimentar de crianças e adolescentes e identificar o efeito da exposição à publicidade com e sem alertas de saúde sobre as normas descritivas e subjetivas, os componentes da atitude sobre os alimentos saudáveis e não saudáveis e à autoavaliação da alimentação entre escolares de 8 a 19 anos. O método de pesquisa se deu em duas etapas, sendo elas um estudo transversal do tipo survey por meio do preenchimento de instrumento autoadministrado e um estudo quase-experimental com aplicação de questionários em momento anterior e posterior ao experimento. Os participantes corresponderam a 786 sujeitos estudantes do 4° ao 9° ano do Ensino Fundamental, com média de idade igual 12 anos, sendo 56% (n = 440) do sexo feminino. Os dados foram analisados com a utilização do programa SPSS no qual foram realizadas análises descritivas, correlacionais, teste t, análise de variância e regressão logistíca, sendo considerado p<0,05 para a significância estatística. Os resultados do estudo 1 apontaram influência de determinantes associados ao tempo destinado à audiência da mídia televisiva e ao computador com o consumo de alimentos não saudáveis. O estudo 2 por sua vez mostrou uma valorização dos aspectos benéficos dos alimentos não saudáveis, havendo aumento da intenção de consumo entre todos os grupos estudados, contudo, o grupo exposto aos alertas de saúde apresentaram impacto na atitude de base cognitiva sobre os mesmos. Assim, os achados trouxeram importantes elementos de como ocorre a escolha e preferência alimentar, tornando-se útil na elaboração de propostas referentes à educação alimentar e nutricional de crianças e adolescentes e demonstrando a necessidade de uma regulamentação eficaz de modo a proteger o público infantil e incentivar hábitos alimentares saudáveis. ______________________________________________________________________________ ABSTRACTThe food behavior results from the interaction of factors inherent to the individual and their stage of the life cycle, sensory characteristics, cost and availability of food, cultural and religious aspects, social influence and aspects related to advertising and media. The media is an important view to food behavior among children and adolescents, which is associated with increased rates of overweight and obesity reinforcing the issue of regulation of food advertising. However, it is not known if the advertising of unhealthy foods with health warnings influences the food choice. Thus, the general aim of this study was to characterize the effect of exposure to food advertising on the cognitive component of attitude, on the preferences and intentions on the food consumption of basic school students in the Federal District. Two studies were conducted with the goal of linking the psychosocial and situational aspects to the attitudinal components of food intake among children and adolescents and identify the effect of exposure to food advertising with and without health warnings on the descriptive and subjective norms, attitudinal components and self-evaluation of eating among students in the age group studied. The research method was performed in two different studies: first, a cross-sectional study by a self-administered instrument and second, a quasi-experimental study with a self-administered questionnaire before and after the experiment. They were realized with 786 students of the 4th to the 9th grade of basic school, with an average age of 12 years and 56% (n = 440) were female. Data were analyzed using SPSS for descriptive, correlational, variance analysis, t test and logistic regression, considering p <0.05 for statistical significance. The results of first study showed the influence between television and computer viewing and unhealthy food intake. Study 2 showed an appreciation of the beneficial aspects of unhealthy foods increasing their preference and consumption. However, the groups that were exposed to health warnings showed impact on cognitive about them. The findings had important elements about food choice and preference that can help the proposals of food and nutrition education for children and adolescents and confirms the need for effective regulation of food advertising to protect the public and encourage children's healthy eating behaviors

Time trends and social inequalities in child malnutrition: nationwide estimates from Brazil's food and nutrition surveillance system, 2009-2017

Objective In Brazil, national estimates of childhood malnutrition have not been updated since 2006. The use of health information systems is an important complementary data source for analysing time trends on health and nutrition. This study aimed to examine temporal trends and socio-demographic inequalities in the prevalence of malnutrition in children attending primary health care services between 2009 and 2017. Design Time trends study based on data from Brazil's Food and Nutrition Surveillance System. Malnutrition prevalence (stunting, wasting, overweight and double burden) was annually estimated by socio-demographic variables. Prais-Winsten regression models were used to analyse time trends. Annual percent change (APC) and 95 % CI were calculated. Setting Primary health care services, Brazil. Participants Children under 5 years old. Results In total, 15,239,753 children were included. An increase in the prevalence of overweight (APC = 3·4 %; P = 0·015) and a decline in the prevalence of wasting (-6·2 %; P = 0·002) were observed. The prevalence of stunting (-3·2 %, P = 0·359) and double burden (-1·4 %, P = 0·630) had discrete and non-significant reductions. Despite the significant reduction in the prevalence of undernutrition among children in the most vulnerable subgroups (black, conditional cash transfer's recipients and residents of poorest and less developed areas), high prevalence of stunting and wasting persist alongside a disproportionate increase in the prevalence of overweight in these groups. Conclusions The observed pattern in stunting (high and persistent prevalence) and increase in overweight elucidate setbacks in advances already observed in previous periods and stresses the need for social and political strategies to address multiple forms of malnutrition

Time trends and social inequalities in infant and young child feeding practices: national estimates from Brazil’s Food and Nutrition Surveillance System, 2008–2019

Abstract Objective: To describe the time trends and socio-economic inequalities in infant and young child feeding practices in accordance with the Brazilian deprivation index (BDI). Design: This time-series study analysed the prevalence of multiple breast-feeding and complementary feeding indicators based on data from the Brazilian Food and Nutrition Surveillance System, 2008–2019. Prais–Winsten regression models were used to analyse time trends. Annual percent change (APC) and 95 % CI were calculated. Setting: Primary health care services, Brazil. Participants: Totally, 911 735 Brazilian children under 2 years old. Results: Breast-feeding and complementary feeding practices differed between the extreme BDI quintiles. Overall, the results were more favourable in the municipalities with less deprivation (Q1). Improvements in some complementary feeding indicators were observed over time and evidenced such disparities: minimum dietary diversity (Q1: Δ 47·8–52·2 %, APC + 1·44, P = 0·006), minimum acceptable diet (Q1: Δ 34·5–40·5 %, APC + 5·17, P = 0·004) and consumption of meat and/or eggs (Q1: Δ 59·7–80·3 %, APC + 6·26, P < 0·001; and Q5: Δ 65·7–70·7 %, APC + 2·20, P = 0·041). Stable trends in exclusive breast-feeding and decreasing trends in the consumption of sweetened drinks and ultra-processed foods were also observed regardless the level of the deprivation. Conclusions: Improvements in some complementary food indicators were observed over time. However, the improvements were not equally distributed among the BDI quintiles, with children from the municipalities with less deprivation benefiting the most

Eating disorders and body image satisfaction among Brazilian undergraduate nutrition students and dietitians

The objective of this study was to evaluate the prevalence of risk behaviors related to eating disorders and body image satisfaction among Brazilian dietitians and undergraduate Nutrition students. The national representative sample was composed of 427 undergraduate students of Nutrition and 318 dietitians. Data were collected via an online questionnaire. Body image satisfaction was assessed by the Body Shape Questionnaire, and attitudes suggestive of an eating disorder (called positive EAT) were assessed by the Eating Attitudes Test. Adjusted Prevalence Ratios were performed by Poisson&rsquo;s regression. More than 50.0% of women were dissatisfied with their body image, but severe dissatisfaction was more prevalent among students (26.7% versus 16.0%). There was no difference in the prevalence of positive EAT test between both groups. Students with positive EAT had more chance of body dissatisfaction (PRadj 1.31; 95%CI 1.03-1.66). Dietitians with positive EAT had 35% more chance of being dissatisfied with their body image (PRadj 1.35; 95%IC 1.01-1.80). Undergraduate Nutrition students and dietitians are likely to develop attitudes suggestive of an eating disorder and being dissatisfied with their body image. The susceptibility of developing an eating disorder might have a relation with their professional field.O objetivo deste estudo foi avaliar a preval&ecirc;ncia de comportamentos de risco relacionados com dist&uacute;rbios alimentares e satisfa&ccedil;&atilde;o com a imagem corporal entre mulheres nutricionistas e estudantes de Nutri&ccedil;&atilde;o brasileiras. Adotou-se uma amostra representativa nacional, composta por 427 estudantes de Nutri&ccedil;&atilde;o e 318 nutricionistas. Os dados foram coletados por meio de um question&aacute;rio on-line. A satisfa&ccedil;&atilde;o com a imagem corporal foi avaliada pelo Body Shape Questionnaire, e as atitudes sugestivas de transtorno alimentar (denominadas EAT positivo) foram avaliadas por meio do Eating Attitudes Test. Raz&otilde;es de Preval&ecirc;ncias Ajustadas foram calculadas usando Regress&atilde;o de Poisson. Mais de 50,0% das mulheres estavam insatisfeitas com sua imagem corporal, mas a insatisfa&ccedil;&atilde;o severa foi mais prevalente entre as estudantes (26,7% versus 16,0%). N&atilde;o houve diferen&ccedil;a na preval&ecirc;ncia de EAT positivo entre os grupos. Estudantes com EAT positivo tinham mais chances de ter insatisfa&ccedil;&atilde;o corporal (PRadj 1,31; 95%CI 1,03-1,66). Nutricionistas com EAT positivo tinham 35% mais chances de estarem insatisfeitas com sua imagem corporal (PRadj 1,35; 95%IC 1,01-1,80). Estudantes de Nutri&ccedil;&atilde;o e nutricionistas tendem a desenvolver atitudes sugestivas de transtornos alimentares e estarem insatisfeitas com sua imagem corporal. Sua susceptibilidade a transtornos alimentares pode ter uma rela&ccedil;&atilde;o com sua &aacute;rea de atua&ccedil;&atilde;o profissional

Eating disorders and body image satisfaction among Brazilian undergraduate nutrition students and dietitians

The objective of this study was to evaluate the prevalence of risk behaviors related to eating disorders and body image satisfaction among Brazilian dietitians and undergraduate Nutrition students. The national representative sample was composed of 427 undergraduate students of Nutrition and 318 dietitians. Data were collected via an online questionnaire. Body image satisfaction was assessed by the Body Shape Questionnaire, and attitudes suggestive of an eating disorder (called positive EAT) were assessed by the Eating Attitudes Test. Adjusted Prevalence Ratios were performed by Poisson’s regression. More than 50.0% of women were dissatisfied with their body image, but severe dissatisfaction was more prevalent among students (26.7% versus 16.0%). There was no difference in the prevalence of positive EAT test between both groups. Students with positive EAT had more chance of body dissatisfaction (PRadj 1.31; 95%CI 1.03-1.66). Dietitians with positive EAT had 35% more chance of being dissatisfied with their body image (PRadj 1.35; 95%IC 1.01-1.80). Undergraduate Nutrition students and dietitians are likely to develop attitudes suggestive of an eating disorder and being dissatisfied with their body image. The susceptibility of developing an eating disorder might have a relation with their professional field