Nutritional quality of packaged foods targeted at children in Brazil: which ones should be eligible to bear nutrient claims?

This study aimed to assess the nutritional quality of food products marketed at children, with and without nutrient claims, using two different approaches.Analyses were performed on a dataset with food composition and labelling data from every packaged food marketed at children sold in a major Brazilian supermarket (n=535). Foods were classified as 'healthier' and 'less healthy' according to the UK/Ofcom nutrient profile model and to the NOVA classification based on level of food processing. Pearson's chi-squared test was used to compare proportions between models. Agreement was assessed using Cohen's kappa statistic (P<0.05).The NOVA model was stricter than the UK/Ofcom model, classifying more products as 'less healthy' (91.4%) than the nutrient profile based model (75.0%) (P<0.001). Agreement between models was 79.4% (k=0.30), due to 72.9% (n=390) of products being categorised as 'less healthy' by both models, and 6.5% (n=35) as 'healthier'. Half of the food products marketed at children from the database (270; 50.5%) bore nutrient claims. From these products with nutrient claims, 95.9% (92.8-98.0) were classified as 'less healthy' by the NOVA model, whilst this percentage was 74.1% (68.4-79.2) according to the UK/Ofcom model (P<0.05).The high number of foods with low nutritional quality being marketed at children via product packaging and nutrient claims should be of concern to policy makers wanting to improve children's diets and to tackle childhood obesity. The implementation of nutritional quality criteria to ensure that foods targeted at children should be eligible to bear nutrient claims on their labels could avoid a situation where claims mask the overall nutritional status of a food.International Journal of Obesity accepted article preview online, 28 September 2016. doi:10.1038/ijo.2016.167

Nutritional quality of packaged foods targeted at children in Brazil: which ones should be eligible to bear nutrient claims?

This study aimed to assess the nutritional quality of food products marketed at children, with and without nutrient claims, using two different approaches.Analyses were performed on a dataset with food composition and labelling data from every packaged food marketed at children sold in a major Brazilian supermarket (n=535). Foods were classified as 'healthier' and 'less healthy' according to the UK/Ofcom nutrient profile model and to the NOVA classification based on level of food processing. Pearson's chi-squared test was used to compare proportions between models. Agreement was assessed using Cohen's kappa statistic (P<0.05).The NOVA model was stricter than the UK/Ofcom model, classifying more products as 'less healthy' (91.4%) than the nutrient profile based model (75.0%) (P<0.001). Agreement between models was 79.4% (k=0.30), due to 72.9% (n=390) of products being categorised as 'less healthy' by both models, and 6.5% (n=35) as 'healthier'. Half of the food products marketed at children from the database (270; 50.5%) bore nutrient claims. From these products with nutrient claims, 95.9% (92.8-98.0) were classified as 'less healthy' by the NOVA model, whilst this percentage was 74.1% (68.4-79.2) according to the UK/Ofcom model (P<0.05).The high number of foods with low nutritional quality being marketed at children via product packaging and nutrient claims should be of concern to policy makers wanting to improve children's diets and to tackle childhood obesity. The implementation of nutritional quality criteria to ensure that foods targeted at children should be eligible to bear nutrient claims on their labels could avoid a situation where claims mask the overall nutritional status of a food.International Journal of Obesity accepted article preview online, 28 September 2016. doi:10.1038/ijo.2016.167

Associação entre o estado nutricional e a ingestão dietética em pacientes com fibrose cística Association between nutritional status and dietary intake in patients with cystic fibrosis

OBJETIVO: Determinar a relação entre o estado nutricional e a ingestão dietética de pacientes com fibrose cística. MÉTODOS: Estudo transversal com 85 pacientes com fibrose cística entre 6 e 18 anos de idade. A ingestão dietética foi avaliada pelo registro alimentar de 3 dias com a pesagem dos alimentos consumidos. Os desfechos avaliados foram os seguintes indicadores do estado nutricional: percentual da relação peso/estatura (%P/E), percentil do índice de massa corpórea (IMC), escore Z para estatura/idade (E/I) e peso/idade (P/I), e percentual de ingestão dietética comparada a Recommended Dietary Allowances (RDAs). RESULTADOS: A prevalência de pacientes eutróficos foi de 77,7%, considerando o IMC acima do percentil 25 como ponto de corte, e 83,5% estavam acima de 90% do %P/E. A média de ingestão, avaliada em 82 pacientes, foi de 124,5% da RDA. Nas análises de regressão logística univariada, encontrou-se uma associação significativa entre a variável independente ingestão calórica e o desfecho escore Z E/I. O modelo de análise multivariado, elaborado a partir do desfecho escore Z E/I e ajustado para idade, VEF1, colonização por Staphylococcus aureus resistente à meticilina e número de internações hospitalares, demonstrou que um aumento de 1% da ingestão calórica em relação à RDA diminui em 2% a chance de ter déficit de estatura (OR = 0,98; IC95%: 0,96-1,00). A escolaridade materna demonstrou uma associação limítrofe (p = 0,054). CONCLUSÕES: Houve baixa prevalência de desnutrição nesta amostra. O modelo de estudo demonstrou evidências da associação entre a ingestão dietética e o estado nutricional, sendo esta ingestão um fator preditor de crescimento nesses pacientes.<br>OBJECTIVE: To determine the relationship between nutritional status and dietary intake in patients with cystic fibrosis. METHODS: Cross-sectional study involving 85 cystic fibrosis patients between 6 and 18 years of age. Dietary intake was evaluated by the 3-day diet record (weighing the food consumed). The outcome measures were the following nutritional status indicators: weight/height (W/H%) percentage, body mass index (BMI) percentiles, Z score for weight/age (W/A), Z score for height/age (H/A) and percentage of dietary intake compared with the Recommended Dietary Allowance (RDA). RESULTS: The prevalence of well-nourished patients was 77.7%, using BMI above the 25th percentile as the cut-off value, and the W/H% was above 90% in 83.5%. The mean dietary intake, evaluated in 82 patients, was 124.5% of the RDA. In the univariate logistic regression analyses, we found a significant association between the independent variable calorie intake and the Z score for W/A. The multivariate analysis, based on the Z score for H/A and adjusted for FEV1, methicillin-resistant Staphylococcus aureus colonization and number of hospitalizations, demonstrated that a 1% increase in the calorie intake decreases the chance of having short stature by 2% (OR: 0.98; 95% CI: 0.96-1.00). Maternal level of education showed a borderline association (p = 0.054). CONCLUSIONS: The prevalence of malnutrition was low in this sample of patients. The study model demonstrated an association between dietary intake and nutritional status. Dietary intake was a predictive factor of statural growth in patients with cystic fibrosis

Barriers, facilitators and preferences for the physical activity of school children. Rationale and methods of a mixed study

<p>Abstract</p> <p>Background</p> <p>Physical activity interventions in schools environment seem to have shown some effectiveness in the control of the current obesity epidemic in children. However the complexity of behaviors and the diversity of influences related to this problem suggest that we urgently need new lines of insight about how to support comprehensive population strategies of intervention. The aim of this study was to know the perceptions of the children from Cuenca, about their environmental barriers, facilitators and preferences for physical activity.</p> <p>Methods/Design</p> <p>We used a mixed-method design by combining two qualitative methods (analysis of individual drawings and focus groups) together with the quantitative measurement of physical activity through accelerometers, in a theoretical sample of 121 children aged 9 and 11 years of schools in the province of Cuenca, Spain.</p> <p>Conclusions</p> <p>Mixed-method study is an appropriate strategy to know the perceptions of children about barriers and facilitators for physical activity, using both qualitative methods for a deeply understanding of their points of view, and quantitative methods for triangulate the discourse of participants with empirical data. We consider that this is an innovative approach that could provide knowledges for the development of more effective interventions to prevent childhood overweight.</p

Vitaminas antioxidantes e prevenção da arteriosclerose na infância Antioxidant vitamins and prevention of atherosclerosis in childhood

OBJETIVO: Revisar os potenciais efeitos antioxidantes das vitaminas A, C e E na prevenção do desenvolvimento da arteriosclerose na infância, com ênfase na prevenção da dislipidemia. FONTES DE DADOS: Pesquisa bibliográfica em revistas científicas, livros técnicos e publicações de órgãos oficiais dos últimos 20 anos. Utilizaram-se as bases de dados Lilacs, SciELo e Medline em português, inglês e espanhol, com as palavras-chave: "antioxidantes", "arteriosclerose", "dislipidemias", "peroxidação de lipídeos", "infância", "vitamina A", "vitamina C" e "vitamina E". SÍNTESE DE DADOS: A prevalência de dislipidemia na infância e na adolescência mostra frequência crescente, provavelmente relacionada às mudanças dos hábitos alimentares e à redução na prática de atividades físicas. O elevado nível plasmático da lipoproteína de baixa densidade (LDL-c) é fator de risco para o desenvolvimento da arteriosclerose. O consumo de frutas, verduras e legumes, ricos em antioxidantes, é um dos fatores de maior importância na prevenção da peroxidação lipídica. A baixa ingestão dessas fontes naturais de antioxidantes sugere a necessidade de intervenção nutricional para atingir as metas diárias de consumo de vitaminas A, C e E, não sendo preconizada a sua suplementação medicamentosa. CONCLUSÕES: O pediatra e o nutricionista devem orientar as famílias sobre o consumo de alimentos saudáveis, principalmente frutas, verduras e legumes, por seu potencial efeito antioxidante, especialmente nos primeiros anos de vida.<br>OBJECTIVE: To review the potential antioxidant effects of vitamins A, C and E in the prevention of atherosclerosis development during childhood, emphasizing the prevention of dyslipidemia. DATA SOURCES: Bibliographic search in scientific journals, technical books and official publications of the last 20 years. Lilacs, SciElo and Medline databases were searched for articles in Portuguese, Spanish and English using a combination of the following terms: "antioxidants", "atherosclerosis", "dyslipidemia", "lipid peroxidation", "childhood", "vitamin A", "vitamin C" and "vitamin E". DATA SYNTHESIS: There is an increasing prevalence of dyslipidemia in children and adolescents, probably related to changes in dietary habits and to the reduced practice of physical activities. The high plasma concentration of low-density lipoprotein (LDL-c) is a risk factor for atherosclerosis development. The consumption of nutrients rich in antioxidants, such as fruits and vegetables, is very important to prevent lipid peroxidation. The low intake of these natural antioxidants sources suggests the need for nutritional intervention to achieve the daily ingestion targets of vitamins A, C and E. Vitamin supplementation is not recommended. CONCLUSIONS: Children should be encouraged to increase ingestion of fruits and vegetables due to their potential antioxidant effect, especially in the first years of life

Modernidade alimentar e consumo de alimentos: contribuições sócio-antropológicas para a pesquisa em nutrição Dietary modernity and food consumption: socio-anthropological contributions to research in nutrition

Este trabalho buscou apresentar o que a modernidade alimentar representa para a sociologia e a antropologia, questão que é discutida a partir de revisão bibliográfica. Considera-se inicialmente a presença do tema alimentação nos estudos das ciências sociais, enfocando-se as abordagens relacionadas à modernidade alimentar, especialmente o trabalho de Claude Fischler. Privilegiou-se o registro das questões relacionadas à alimentação e às mudanças no mundo do trabalho, ampliação do comércio, feminização da sociedade e a questão das identidades. Ao compreender o fenômeno alimentar e o seu consumo em uma abordagem mais qualitativa pode-se avançar na construção das ciências nutricionais, privilegiando-se uma abordagem compreensiva sobre o alimento e a alimentação nos dias atuais. Como recomendação os estudos atuais devem se dedicar à investigação do consumo alimentar como um fenômeno social para que se agreguem novos componentes analíticos ao conjunto de resultados com o enfoque biomédico.<br>The scope of this work was to illustrate what dietary modernity represents for sociology and anthropology, which is a subject based on a bibliographic review that is discussed in this article. Initially, the presence of the theme of food and nutrition was assessed in studies in the social sciences, by focusing on the approaches related to dietary modernity, especially as found in the works of Claude Fischler. The main subjects of discussion were related to food and nutrition and changes in the work environment, the expansion of commerce, the feminization of society and the question of identity. By understanding the food phenomenon and consumption thereof using a more qualitative approach, it is possible to make progress in configuring the nutritional sciences, adopting a comprehensive approach to food and nutrition in this day and age. Future studies should be dedicated to investigating food consumption as a social phenomenon in order to aggregate new analytical components with a biomedical emphasis to the body of results