Introdução alimentar convencional versus introdução alimentar com baby-led weaning (BLW): Revisão da literatura

A introdução alimentar deve ocorrer de forma lenta e gradual, respeitando a individualidade do bebê e da família. A alimentação complementar deve atender as necessidades energéticas em complementação ao leite materno além de ser variada, garantindo aporte nutricional de vitaminas e minerais necessários para o crescimento do bebê.O objetivo do artigo é comparar dois métodos de introdução alimentar, o método tradicional que prevê a oferta de alimentos através de papas e purês, e o método de desmame guiado pelo bebê (BLW), onde a criança recebe o alimento em formas de bastões, se alimentando sozinho, promovendo assim a autonomia alimentar.A presente revisão demonstrou que método BLW pode ser uma boa alternativa para iniciar a alimentação infantil. O essencial para os pais é saber que independentemente do método escolhido para iniciar a alimentação do bebê, o acompanhamento com pediatra e/ou nutricionista é importante para garantir as necessidades nutricionais desta fase.Palavras chave: Introdução alimentar, alimentação complementar, beby led-weaning;A introdução alimentar deve ocorrer de forma lenta e gradual, respeitando a individualidade do bebê e da família. A alimentação complementar deve atender as necessidades energéticas em complementação ao leite materno além de ser variada, garantindo aporte nutricional de vitaminas e minerais necessários para o crescimento do bebê.O objetivo do artigo é comparar dois métodos de introdução alimentar, o método tradicional que prevê a oferta de alimentos por meio de papas e purês, e o método de desmame guiado pelo bebê (BLW), onde a criança recebe o alimento em formas de bastões, se alimentando sozinho, promovendo assim a autonomia alimentar.A presente revisão demonstrou que o método BLW pode ser uma boa alternativa para iniciar a alimentação infantil. O essencial para os pais é saber que independentemente do método escolhido para iniciar a alimentação do bebê, o acompanhamento com pediatra e/ou nutricionista é importante para garantir as necessidades nutricionais desta fase.Palavras-chave: Introdução alimentar; alimentação complementar; baby-led weanin

Assessing eating disorder symptoms in low and middle-income countries : a systematic review of psychometric studies of commonly used instruments

Background: Various well-validated interview and self-report instruments are available to assess eating disorder symptomatology. However, most psychometric studies have been conducted in high-income countries. The aim of the present study was to systematically review the available psychometric studies conducted in low- and middleincome countries on well-known measures for assessing eating disorder symptoms. Methods: Psychometric studies with the following instruments were included: the Eating Disorder Examination (EDE), the Eating Disorder Examination Questionnaire (EDE-Q), the Eating Disorder Inventory (EDI), the Eating Attitudes Test (EAT), and the Children’s Eating Attitudes Test (ChEAT). Searches were conducted on August 30, 2021, in the following databases: MEDLINE, EMBASE, LILACS, Web of Science, PsycINFO, and CABI. The methodological quality of the studies was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). The studies were considered to have conducted the minimum psychometric evaluation if they assessed at least the three types of validity (content, criteria, and construct) or diagnostic performance. The psychometric properties were also evaluated considering the cut-off points described in the literature for each of the analysis methods used to evaluate validity and reliability and two reviewers independently selected the studies and evaluated the quality criteria. Results: A total of 28 studies were included. The studies were conducted in 13 countries (10 middle income and 3 low income). The instruments that were most used in the studies were the EAT and EDE-Q. According to the overall COSMIN assessment, in most (57%) of the studies the psychometric properties assessed were not described. Fortythree percent of the studies conducted the minimum psychometric evaluation. However, according to the described cut-off points, the results for the psychometric properties assessed showed, in general, acceptable validity and reliability. Conclusion: The results of this review suggest a lack of studies with the recommended psychometric properties in low- and middle-income countries on these commonly used instruments. With the steady increase in the prevalence of eating disorders globally, psychometric investigations of instruments for measuring eating disorder symptoms in these countries should be encouraged to promote their early detection and treatment. Plain English summary: The prevalence of eating disorders has increased worldwide. Various instruments are available to assess eating disorder symptomatology, but most psychometric studies have been conducted in high-income countries. The current study aimed to systematically review studies from low- and middle-income countries that have examined the psychometric properties of commonly used measures for assessing eating disorder symptoms. The findings of this study suggest a lack of research in low- and middle-income countries on the psychometric properties of commonly used eating disorder instruments. To promote the early detection and treatment of eating disorder symptoms, instruments with adequate psychometric properties must be available worldwide

Instrumento brasileño para la evaluación de los trastornos alimentarios en niños y adolescentes

Objective: This study aimed to develop the Brazilian instrument for assessing eating disorders in children and adolescents and test its psychometric quality using item response theory (IRT). Design: Cross-sectional study. Participants: Participants aged between five and twelve years old of both sexes. Main measures: IRT logistic model of two parameters was used to evaluate the item’s severity and discrimination and test information curve of symptoms of eating disorders’ latent trait symptoms. Content validity and reliability were also assessed. The IRT evaluation suggested that the instrument contained items that performed differently concerning severity, discrimination, and test information curve presented good accuracy. Results: There was agreement on the clarity of language (83.3%) and theoretical relevance (91.7%), indicating good content validity. The value of the Cronbach’s Alpha was 0.63 (95% confidence interval), and the result of the Spearman---Brown test was 0.65. Conclusion: These results indicate good performance of the screening tool in assessing the level of eating disorders in children and adolescents.Objetivo: Este estudio tuvo como objetivo desarrollar un instrumento brasileno para la evaluación de los trastornos alimentarios en ninos y adolescentes, y testar el análisis psicométrico utilizando la teoría de respuesta al ítem (TRI). Diseno: ˜ Estudio observacional, transversal. Participantes: Individuos de ambos sexos entre los 5 y 12 anos ˜ de edad. Mediciones principales: Se utilizó el modelo logístico TRI de 2 parámetros para evaluar la gravedad y la discriminación del ítem, y probar la curva características del test (CCT) de los síntomas del rasgo latente de los trastornos alimentarios. También se evaluaron la validez de contenido y la confiabilidad. Resultado: La evaluación TRI sugirió que el instrumento contenía ítems que funcionaban de manera diferente en cuanto a severidad, discriminación y la CCT presentando una buena precisión. Hubo concordancia en la claridad del lenguaje (83,3%) y en la relevancia teórica (91,7%), indicando buena validez de contenido. El valor del alfa de Cronbach fue de 0,63 (intervalo de confianza del 95%) y el resultado de la prueba de Spearman-Brown fue de 0,65. Conclusión: Estos resultados indican un buen desempeno˜ de la herramienta de detección en la evaluación del nivel de los trastornos alimentarios en ninos y adolescentes

Validation of the family health behavior scale for the brazilian population

Objective: To validate the Family Health Behavior Scale (FHBS) for Brazilian families. Methods: The sample included 272 children aged 5 to 12 years old. Caregivers and their healthy answered the FHBS and questions about physical activity. In addition, anthropometric measurements of the children’s weight and height were performed, as well as the bioimpedance exam. The scale was translated and the following validities were assessed: content (qualitative analysis and content validity index), construct (factor analysis) and concurrent validity (difference between domains and the total score with the categories of BMI, fat percentage and physical activity). Reliability (Cronbach's alpha, ceiling-floor effect, two-half test, intraclass correlation and Bland - Altman) was also assessed. Results: FHBS instrument performed well with regard to the psychometric properties in the Brazilian population. The content validity index was 0.987. Fit indices of the factor analysis were considered satisfactory, according to Bartlett's sphericity test (x 2 = 1927, df = 351; p < 0.001) and the Kaiser-Meyer-Olkin index (KMO = 0.789). Concurrent validity, the differences between the mean of the domains and the total score between the categories of BMI (p = 0.011), percentage of fat (0.004) and physical activity (p < 0.001) were all significant. The reliability results were Cronbach's alpha internal consistency = 0.83, adequate ceiling-floor effect, 0.8105 (0.09 SD) two-half test, 0.626 intraclass correlation (95% CI: 0.406 to 0.777) and Bland – Altman -0.840 (-22.76 to 21.07). Conclusion: The FHBS adapted for the Brazilian population showed evidence of adequate psychometric performance