Associated factors with early introduction of ultra-processed foods in feeding of children under two years old

O objetivo deste artigo é verificar a associação entre fatores maternos e antropométricos e o consumo de alimentos ultraprocessados em crianças de 4 a 24 meses de idade. Métodos: Estudo transversal, com 300 crianças internadas em um hospital terciário e suas mães. A entrevista deu-se nas primeiras 72 horas de internação para evitar interferência nas respostas sobre a alimentação da criança. Os fatores maternos investigados foram: idade, escolaridade, renda, paridade, IMC e orientação sobre alimentação complementar. As variáveis referentes às crianças investigadas foram: idade, aleitamento materno, escola infantil, IMC/idade, estatura/idade, peso/idade e introdução de alimentos ultraprocessados. A associação entre os fatores estudados e a introdução de alimentos ultraprocessados foi testada por regressão linear. O nível de significância considerado foi de 0.05. Verificou-se que apenas 21% das crianças ainda não haviam recebido nenhum tipo de alimento ultraprocessado, sendo que 56.5% recebeu algum destes alimentos antes dos seis meses. Na análise multivariada, escolaridade materna, renda familiar, idade materna e paridade foram associadas à oferta de alimentos ultraprocessados. As práticas alimentares de crianças entre 4 e 24 meses estão inadequadas frente às recomendações para a faixa etária.Objective: To verify the association of maternal and anthropometric factors with consumption of ultra-processed foods in children between 4 to 24 months. Methods: cross-sectional study with 300 children hospitalized in a tertiary hospital and their mothers. The interview took place during the first 72 hours of hospitalization to avoid interference in the responses about the child’s diet. Maternal factors investigated: age, schooling, income, parity, BMI and guidance on complementary feeding. Variables related to the child investigated: age, breastfeeding, infant school, BMI/age, height/age, weight/age and introduction of ultra-processed food. The association between the factors studied and introduction of ultra-processed food was tested by linear regression. The significance level considered was 0.05. Results:. It was verified that only 21% of the children had not yet received any type of ultra-processed food, and 56.5% received any of these foods before 6 months. In the multivariate analysis, maternal schooling, family income, maternal age and parity were associated with ultra-processed food supply. Conclusions: The feeding practices of children between 4 and 24 months are inadequate when compared to the recommendations for the age group

Um ano de pandemia: experiência do Serviço de Nutrição e Dietética de um hospital de referência para atendimento de covid-19

Introduction: The 2019 coronavirus disease (COVID-19) pandemic brought changes in work organization in all spheres, requiring the restructuring of routines and teams to meet this new demand. The aim of study was to report the experience of the Nutrition and Dietetics Department (NDD) of Hospital de Clínicas de Porto Alegre (HCPA) and the changes that occurred during the first year of the COVID-19 pandemic. Methods: This is an experience report of the performance of HCPA NDD from April 2020 to March 2021. Results: There was an increase in absenteeism in the NDD, requiring processadjustments and relocations. There was also an increase in enteral nutrition delivery due to the severity of the clinical condition of hospitalized patients, a reduction in the capacity of employees’ cafeteria to meet distancing protocols, and a need to use disposable utensils, deliver motivational messages to patients, make adjustmentsto the human milk bank process, and implement changes in nutritional assessment protocols for inpatients and remote outpatient care.  Conclusion: This experience provided the NDD with a great legacy of learning and overcoming by requiring the NDD to adapt while maintaining quality service and strengthening teamwork relationships.Introdução: A pandemia de coronavírus 2019 (COVID-19) trouxe mudanças nas organizações de trabalho em todas as esferas, exigindo a reestruturação das rotinase das equipes para atender essa nova demanda. O objetivo foi relatar a experiência do Serviço de Nutrição e Dietética (SND) do Hospital de Clínicas de Porto Alegre(HCPA) e as mudanças vivenciadas durante o primeiro ano de pandemia de COVID-19.Métodos: Trata-se de um relato de experiência referente à atuação do SND do HCPA de abril de 2020 a março de 2021.Resultados: Houve aumento do absenteísmo no SND, necessitando ajustes de processos e remanejos. Também houve aumento do consumo de dietas enterais pelagravidade da situação clínica dos pacientes internados, a redução da capacidade do refeitório de funcionários para seguir os protocolos de distanciamento, o uso deutensílios descartáveis, mensagens motivacionais aos pacientes, ajustes no processo do banco de leite humano, modificações nos protocolos de avaliação nutricional ao paciente internado e atendimento ambulatorial remoto.Conclusão: Esta experiência proporcionou ao SND um grande legado de aprendizagem e superação, exigindo importantes adaptações, mantendo a qualidade do atendimento e fortalecendo as relações de trabalho em equipe

One year of a pandemic : experience of the Nutrition and Dietetics Department of a referral hospital for COVID-19 care

Introdução: A pandemia de coronavírus 2019 (COVID-19) trouxe mudanças nas organizações de trabalho em todas as esferas, exigindo a reestruturação das rotinas e das equipes para atender essa nova demanda. O objetivo foi relatar a experiência do Serviço de Nutrição e Dietética (SND) do Hospital de Clínicas de Porto Alegre (HCPA) e as mudanças vivenciadas durante o primeiro ano de pandemia de COVID-19. Métodos: Trata-se de um relato de experiência referente à atuação do SND do HCPA de abril de 2020 a março de 2021. Resultados: Houve aumento do absenteísmo no SND, necessitando ajustes de processos e remanejos. Também houve aumento do consumo de dietas enterais pela gravidade da situação clínica dos pacientes internados, a redução da capacidade do refeitório de funcionários para seguir os protocolos de distanciamento, o uso de utensílios descartáveis, mensagens motivacionais aos pacientes, ajustes no processo do banco de leite humano, modificações nos protocolos de avaliação nutricional ao paciente internado e atendimento ambulatorial remoto. Conclusão: Esta experiência proporcionou ao SND um grande legado de aprendizagem e superação, exigindo importantes adaptações, mantendo a qualidade do atendimento e fortalecendo as relações de trabalho em equipe.Introduction: The 2019 coronavirus disease (COVID-19) pandemic brought changes in work organization in all spheres, requiring the restructuring of routines and teams to meet this new demand. The aim of study was to report the experience of the Nutrition and Dietetics Department (NDD) of Hospital de Clínicas de Porto Alegre (HCPA) and the changes that occurred during the first year of the COVID-19 pandemic. Methods: This is an experience report of the performance of HCPA NDD from April 2020 to March 2021. Results: There was an increase in absenteeism in the NDD, requiring process adjustments and relocations. There was also an increase in enteral nutrition delivery due to the severity of the clinical condition of hospitalized patients, a reduction in the capacity of employees’ cafeteria to meet distancing protocols, and a need to use disposable utensils, deliver motivational messages to patients, make adjustments to the human milk bank process, and implement changes in nutritional assessment protocols for inpatients and remote outpatient care. Conclusion: This experience provided the NDD with a great legacy of learning and overcoming by requiring the NDD to adapt while maintaining quality service and strengthening teamwork relationships

Outcomes of the first 54 pediatric patients on long-term home parenteral nutrition from a single Brazilian center

Objectives: Data on multidisciplinary programs dedicated to home parenteral nutrition (HPN) in Latin America are limited. This study describes the results of the first multidisciplinary pediatric intestinal rehabilitation program for HPN at a public tertiary hospital in Brazil. Methods: We retrospectively reviewed patients aged 0–18 years with intestinal failure (IF) who required parenteral nutrition (PN) for >60 days between January/2014 and December/2020. Results: Fifty-four patients were discharged on HPN (15 achieved enteral autonomy, 34 continued on HPN at the end of the study, 1 underwent intestinal transplantation, and 4 died). The median (IQR) age at the study endpoint of patients who achieved enteral autonomy was 14.1 (9.7–19) versus 34.7 (20.4–53.9) months in those who did not achieve enteral autonomy. Overall prevalence of catheter-related thrombosis was 66.7% and catheterrelated bloodstream infection rate was 0.39/1000 catheter-days. Intestinal failure-associated liver disease (IFALD) was present in 24% of all patients; none of the patients who achieved enteral autonomy had IFALD. All patients showed significant improvement in anthropometric parameters during the HPN period. The sociodemographic characteristics of the patients’ family members were mothers less than 20 years old (7.5%), schooling time more than 10 years (55.5%), and household income between 1 and 3 times the minimum wage (64.8%). The 5-year survival rate for HPN is 90%, and 27.7% of patients achieve enteral autonomy. Conclusion: The treatment of pediatric patients with IF followed by a multidisciplinary pediatric intestinal rehabilitation program with HPN is feasible and safe in the Brazilian public health system