PPG - Alimentos, Nutrição e Saúde

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Desenvolvimento e validação de instrumento para avaliar o impacto de um programa de intervenção no ambiente alimentar nos comércios de varejo de alimentos
(Universidade Federal de São Paulo (UNIFESP), 2016-02-18) Sanches, Lucas Daniel [UNIFESP]; Martins, Paula Andrea [UNIFESP]; http://lattes.cnpq.br/1364300323959453; http://lattes.cnpq.br/6993427506457771; Universidade Federal de São Paulo (UNIFESP)
Introduction: Interventions to increase access to healthy foods developed in small food stores have been effective strategies in promoting eating habits to prevent and combat obesity and other chronic diseases worldwide. Instruments based on theories are essential so researchers can adequately measure and evaluate the impact of any intervention. Objective: To develop and validate an instrument to evaluate the impact of an intervention pilot program in the nutritional environment for promoting healthy eating habits in small food stores. Methods: The instrument was developed to evaluate how well the intervention was implemented considering the perspective of Social Cognitive Theory. The instrument, assigned Impact Questionnaire ? Owners (QIP), was developed based on formative research, which included qualitative and quantitative methods. Its development included regular meetings with the research group; scan through the streets in the study setting; community workshops; visits to actors in the food production chain (distribution centers, supermarkets, farmers markets); and in-depth interviews with local small food store owners (n=5). To evaluate the psychometric properties of the instrument, internal consistency analysis were performed to verify QIP?s reliability; as for validity, evaluations of the instrument by specialists (n=8) and store owners (n=3) were carried to test content validity and face validity, respectively. Results and Discussion: The formative research enabled the definition of the questionnaire?s domains, divided in four parts: identification and characterization of the food store (part A); marketing parameters, contemplating mechanisms and frequency of purchasing products, influencers in decision making purchase, community relations and suppliers, and profitability (part B); self-efficacy scales of psychosocial factors in the marketing of healthy foods, expectations of promoted foods, expectations regarding the impact of the intervention, intent in maintaining the intervention?s actions, and knowledge about healthy eating (part C); Healthy Eating Promotion (PAS) scale, which evaluated availability, variety, quality and price of foods (part D). The instrument showed high reliability (Cronbach?s alpha > 0.75) for the scales, expect the one entitled ?Importance factors for the inclusion of a new food?, which can be explained by its few number of evaluating components. Moreover, an instrument with content and face validity was obtained, measuring what it proposes properly. Conclusion: The instrument showed high reliability and validity and can be reproduced in other studies with a similar target population. It can also be used in studies to diagnose small food stores retail environment and for public policies to strengthen this economy segment and healthy food purchasing and consumption habits.
Acesso aberto (Open Access)
Consumo da alimentação oferecida nas escolas públicas brasileiras e sua relação com fatores sociodemográficos e práticas alimentares: resultados da pesquisa nacional de saúde do escolar 2012
(Universidade Federal de São Paulo (UNIFESP), 2016-02-26) Locatelli, Nathalia Tarossi [UNIFESP]; Bandoni, Daniel Henrique [UNIFESP]; http://lattes.cnpq.br/6104429791974852; Universidade Federal de São Paulo (UNIFESP)
INTRODUTION: The National School Food Program (PNAE) is one of the oldest programs in Brazil's food and nutrition security, with nationwide coverage, which serves all students enrolled in public schools in the country. The PNAE advocates to be offered a healthy and adequate food, with a variety of foods, insurance, respecting the culture, traditions, eating habits, according to age and health status in order to contribute to growth and development of students and to better academic performance. Given this context, it is essential that students consume the meals offered. OBJECTIVE: To describe the consumption of the food offered in public schools in Brazil and sociodemographic characteristics and the eating food practices, according to the National Adolescent School-based Health Survey (PeNSE). METHODS: It was used data from the National Adolescent School-based Health Survey (PeNSE) performed in 2012 with students from 9th grade of elementary school enrolled in public schools in all Brazilian capitals and the Federal District and municipalities of non-capital. Sociodemographic characteristics and the eating rotines of students were analyzed. To evaluate the difference between the students who consume and do not consume regularly the meal in school, in terms of sociodemographic characteristics, the chi-square test of Pearson was performed. The association between consumption of school meals and sociodemographic characteristics and eating routines was assessed by Poisson regression models univariate and multiple. As well for the analysis of the food consumed the day before the interview and consumption of food in school. The association analysis between food consumption in the last seven days and consumption of food in school, both adjusted for sociodemographic characteristics, were carried out through multinomial regression. RESULTS: The study included 86,660 students from public schools, of these, 22.8% consume school meals. The consumption of school meals is higher among male students, who do not live in capitals, reside with their mother, living with father, working mothers with low education, for students who eat breakfast and lunch with parents. It was observed that consume school meals is positively associated with moderate and regular consumption of beans, raw or cooked vegetables, cooked vegetables and fruits; and the moderate consumption of raw vegetables. Yet, school feeding was negatively associated with moderate or frequent consumption of salty and cold meats; and the frequent use package of chips, crackers, sweet cookies and candies. For consumption the preceding days before the interview, the consumption of school food significantly influenced the consumption of raw salad, cooked vegetables or vegetables and fresh fruit. CONCLUSIONS: the regular consumption of school food is lower in students of the 9th grade of elementary school who attend public schools, and the consumer is influenced by sociodemographic and eating routines of students. Yet, school food positively influences the consumption of healthy food markers food and protect the teenagers consumption of unhealthy foods.
Acesso aberto (Open Access)
Atenção nutricional ao excesso de peso sob a ótica da integralidade: diagnóstico e avaliação da atenção básica e de média complexidade em município do sudeste brasileiro
(Universidade Federal de São Paulo (UNIFESP), 2016-03-22) Neves, Jose Anael [UNIFESP]; Medeiros, Maria Angélica Tavares de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Background: Chronic noncommunicable diseases (NCDs) are the major public health problem in the world and overweight is one of its main causes and a modifiable risk factor. Prevention and control of this problem are part of health promotion agenda in several countries, including Brazil, where more than half of the adult population is overweight. Objective: To analyze nutritional care provided to adults with overweight in Primary and Secondary Health Care in Brazilian Southeastern, from the perspective of integrality. Methods: It was carried out a census study which identified and assessed the actions of nutritional care to adults with overweight, from the perspective of health comprehensiveness, through semi-structured interviews with managers and/or professionals of all services Primary and Secondary Health Care in Santos muncipality, São Paulo, Brazil. Results: It was found that actions are limited to individual clinical care, to the detriment of health promotion and protection actions; low insertion of dietitians professionals; disjointed practices from territorial contexts of services; limited dialogue between different levels of health care and lack of intersectoral action. Final Considerations: There are several limiting factors for nutritional care to adult with overweight in both health care levels investigated, configured as important obstacles to the achievement of health integrality.
Acesso aberto (Open Access)
Evolução do estado nutricional de crianças com tumores do sistema nervoso central durante o primeiro ano do tratamento antineoplásico
(Universidade Federal de São Paulo (UNIFESP), 2016-03-24) Tsutsumi, Renata Candido [UNIFESP]; Speridião, Patrícia da Graça Leite [UNIFESP]; Maia-Lemos, Priscila dos Santos; http://lattes.cnpq.br/6694786767037804; http://lattes.cnpq.br/7520873457028761; http://lattes.cnpq.br/2347747835710040; Universidade Federal de São Paulo (UNIFESP)
Aim: to evaluate the nutritional status of children with central nervous system tumors during the first year of antineoplastic treatment. Methods: A retrospective cohort study included 30 children aged between 2 and 10 years, of both genders with tumors of the central nervous system treated at GRAACC between 2004 and 2011. Body mass index (BMI), percentage of adequacy triceps skinfold (TSF) and arm muscle circumference (AMC) were evaluated at admission, 6 and 12 months. The frequency of tumors of the central nervous system, were astrocytic 33.3% (10/30), embryonal 40% (12/30) of the sellar region 10% (3/30) and ependymal 16.6% (5/30). Statistical analysis repeated measures analysis of anthropometric variables was performed using the Friedman test. Results: The median ESCOREZ Z BMI at admission - 0.66; 6 months after - 0,59 and 12 months - 0.47 (p = 0.648) and the percentage of adequacy of AMC 98.0% at admission; 6 months after 91.1% and 94.2% after 12 months (p = 0.344) showed that children are eutrophic during the first year of antineoplastic treatment. The median percentage of adequacy of triceps skinfold 83.2% at admission; 6 months after 73.6% and 82.5% after 12 months, showed no significant difference (p = 0.291), indicating mild malnutrition. Among the different diagnoses, the presence of embryonal tumors, caused major negative impact on the evolution of the nutritional status of children, median BMI Z - 1.06; - 1.68 -1.61 after 6 months and after 12 months, as a significant result (p = 0.002). Conclusion: In this group according to the Z BMI analysis parameters and DCT and CMB children show good improvement in nutritional status. The presence of embryonal tumors, has greater negative impact on nutritional status.
Acesso aberto (Open Access)
Composição nutricional de frutas da biodiversidade brasileira e seu emprego na alimentação escolar na Região Sudeste
(Universidade Federal de São Paulo (UNIFESP), 2016-04-25) Silva, Camila Pia Delgado da [UNIFESP]; De Rosso, Veridiana Vera [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
The objectives of this study were to compile the nutritional composition data of five native fruit species from biodiversity and evaluate the inclusion of these and other fruit trees in school feeding in the Southeast region of Brazil. To survey the inclusion of fruit species was developed a structured, self-administered, and application through electronic form. To compile the literature search was made in the main available online scientific databases, using as avalaible reference the methodology INFOODS (International Network of Food Data Systems). Of all municipalities in the Southeast 187 agreed to participate and only 5.9% (n = 11) reported making a purchase of fruit species from biodiversity, which are the origin of family farming. The lack of coordination between the actors of the Programa Nacional de Alimentação Escolar was one of the main limiting factors for insertion of native biodiversity fruits on menus of school meals. It was observed that the field of sustainability and biodiversity are still unknown and challenging before the professionals who work in school feeding, since only 40.6% of the dietitians reported taking into account the biodiversity factor in the preparation of school meals menus. Another limiting informed by nutritionists was the lack of information of the nutritional composition of these fruits. The compilation of the nutritional composition data was performed from five species and gathered 24 publications, and the species: 1- Surinam cherry- (Eugenia uniflora L.); 2 Jussara (Euterpe edulis M.); 3- Jenipapo (Genipa americana L.); 4 Jabuticaba or Jaboticaba (Plinia cauliflora M.) and 5- Pink pepper (Schinus terebinthifoli). The ripe pulp Surinam cherry had higher concentrations of dietary fiber, pro-vitamin A and vitamin C, the other species. Additionally, the frozen pulp Surinam cherry was classified as excellent source of carotenoids (> 200 mcg / 100 grams of edible portion). The ripe pulp jussara showed high levels of lipids, dietary fiber, vitamin C and iron. The ripe pulp jenipapo showed intermediate levels of carbohydrate, vitamin C, ß carotene, lycopene and phenolic compounds when compared to other species without study. Three publications have been found on the nutritional composition of jabuticaba and no study has been obtained on the nutritional composition of the pink pepper species. Therefore it was concluded that despite the challenges to inclusion of fruit species biodiversity in school feeding, some municipalities in the Southeast are already making the purchase and offering these foods on school menus. Also, species such as Surinam cherry and jussara show nutritional value highlighted and has the potential for insertion in school
Acesso aberto (Open Access)
Estado nutricional ao diagnóstico oncológico como possível marcador do excesso de peso em crianças e adolescentes sobreviventes do câncer
(Universidade Federal de São Paulo (UNIFESP), 2016-04-28) Teixeira, Julia Ferrari Carneiro [UNIFESP]; Pisani, Luciana Pellegrini [UNIFESP]; http://lattes.cnpq.br/3983527783636073; http://lattes.cnpq.br/8527161806485649; Universidade Federal de São Paulo (UNIFESP)
Obesity is a late effect recognized in survivors of childhood cancer, but news studies have shown that the most recent survivors, no different from population estimates and suggest that external factors, as well as the genetic characteristics of the individual, may have greater influence on gain weight among the survivors. Within this reality, the question is about the quantity and quality of food from this group and its possible correlation with obesity. Moreover, the limitation of studies with survivors in developing countries and reduced work with measured data justifies this work. Thus, we had as objective to evaluate the previous and current nutritional status and food intake and antineoplastic treatment and their relationship with obesity in childhood cancer survivors. All patients treated at a referral center and attended the clinic of late effects, which survived for at least 2 years after treatment, they were eligible for inclusion. Anthropometric data and information on the antineoplastic treatment were collected. For analysis of nutritional status, as well as for the food characteristics, we divided the patients into two groups, group 1 consisting of leukemia survivors and CNS, grouped due to similar treatment and group 2, consisting of the remaining survivors. The main finding of our study was the correlation of BMI at diagnosis with excess weight after treatment in both groups was not observed correlation with the anticancer treatment. Moreover, we observed changes in body composition, characterized by lean body mass reduction. The feeding of these patients, regardless of cancer diagnosis, is unbalanced, especially the high protein intake and saturated fatty acids, as well as reduced suitability of vitamins and minerals. The treatment helps to change body composition and diseases associated with excess tissue. However, it is believed that current lifestyle associated with individual characteristics, contributes substantially to the development of metabolic complications in survivors. Early identification of risk groups is essential to minimize the adverse effects of antineoplastic therapy and promotion of healthy eating habits.
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Habitus, prática e percepção de risco de doenças transmitidas por alimentos: trajetórias de trabalhadores do comércio ambulante por um olhar etnográfico
(Universidade Federal de São Paulo (UNIFESP), 2016-04-29) Andrade, Samantha Jesica Sales [UNIFESP]; Stedefeldt, Elke [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
INTRODUCTION: The relationship between the food handler and the environment is intrinsic to the work process, and this professional may be responsible for outbreaks of foodborne illness. Knowing the habitus of the handlers and the way this influences their perception of risk can have a positive impact on health hygienic quality of food. OBJECTIVE: Identify how the habitus of workers of street food trade influences the practice of food handling and the understanding about the foodborne diseases. METHOD: It is an empirical research, qualitative-quantitative, which through triangulation methods using techniques of ethnography, combined with the application of risk perception scale, allowed to build a study based on individual trajectories of food handlers, analyzed before the Bourdieusian perspective. The research setting was the city of Santos from April to December 2015 and as interlocutores six handlers. RESULTS AND DISCUSSION: The sample was characterized by five male workers and one female, aged 43-67 years old. Regarding schooling three had incomplete primary education and only one completed higher education. It was found that only two workers were trained with the theme good manufacturing practices. It was found that the agents use the cultural and symbolic capital for building your space, and these funds were predictors of the observed practices. The global analysis of the responses of workers showed that the perception of risk related to "practice in which he is involved" was low for three of the street. The perception of risk is strongly influenced by the primary habitus of the agents. Social trajectories demonstrate the lack of school ascension opportunity, inclusion in work activities early on and not have placement opportunities in the formal labor market. CONCLUSION: Workers perpetuated the living conditions of their parents and grandparents regarding the cultural capital, the descendants amounted regarding this capital. The analysis of food handling practices revealed that the lack of adaptation to current legislation can be explained by the difficulties in the understanding of these practices by the street and that several inadequacies are derived from own routine demanded by the job. The perception of workers DTA risk is influenced by the level of education, for their beliefs, religion and the family habitus. Workers were more likely to optimistic bias about the situations that concern the risk of FBD caused by him and related to their family and friends. The practices of these hawkers are related to those seized with their families. The school emerged in the field as one reason for the continuation of these distinctions. The social conditions of each agent, as well as their career choice and how food handlers are strongly influenced by habitus
Acesso aberto (Open Access)
Validação do Indicador de Qualidade para Cardápios da Alimentação Escolar
(Universidade Federal de São Paulo (UNIFESP), 2016-06-24) Camargo, Rafaella Guimarães Moraes [UNIFESP]; Domene, Semíramis Martins Álvares [UNIFESP]; Bandoni, Daniel Henrique [UNIFESP]; http://lattes.cnpq.br/6104429791974852; http://lattes.cnpq.br/7373562130327980; http://lattes.cnpq.br/4245295515636557; Universidade Federal de São Paulo (UNIFESP)
The improvement quality of the school meals is a Food and Nutrition Security strategy seeing as the school is an environment that promotes healthy food habits. The Index of School Food Menu Quality - IQCAE was developed to help monitor the National School Food Program - PNAE. Menu planning must comply with the nutritional parameters and technical norms provided by PNAE's legislation. Compliance is necessary for promoting a healthy diet. However, valid instruments to assess menu quality have not yet been developed. Objective: To assess the reliability and validity of IQCAE. Methods: This methodological study used secondary data from the menu database created for the 2011 Prêmio Gestor Eficiente da Merenda Escolar (Brazilian Prize for School Meal Efficient Manager). The database consists of 2500 menus from 500 Brazilian municipalities. The following were assessed: (1) content validity by using the Delphi method to compare the IQCAE components with the result of a consensus of experts on healthy diet and quality index for school food menus; (2) construct validity by analyzing the association and agreement between the experts? opinions on menu quality and the scores generated by the index; (3) IQCAE reliability by inter-examiner assessment; and (4) analysis of the internal consistency of the items by calculating Pearson?s correlation coefficient between IQCAE's components and the final score. Results: Content analysis verified that the result of the experts' consensus on healthy eating in the school context agreed with the IQCAE components. The study of association (Pearson?s linear correlation coefficient below 0.82 in only two cases) and agreement (Kappa below 0.7 in only three cases) between expert assessment and IQCAE score index showed that the instrument has construct validity. Reliability was ratified by an inter-examiner agreement study (r= 0.94 ? 0,98). IQCAE components and the final score showed weak to strong correlations. The component meats and eggs correlated the most (r= 0.74), followed by vegetables, grains, and tubers (r= 0.73; r= 0.68; and r= 0.59; respectively). Four components presented an inverse correlation: dairy products (r= -0.34), meal compatible with time (r= 0.12), sausages and cured meats (r= 0.19), and sweets as dessert (r= 0.20). Conclusion: The Index of School Food Menu Quality showed characteristics of structural validity and reliability when used for assessing and monitoring the quality of Brazilian school feeding menus.
Acesso aberto (Open Access)
Pão sem glúten enriquecido com inulina: um estudo de otimização do novo produto e de comparação das suas propriedades físicas, aceitabilidade, vida de prateleira e resposta glicêmica com as de pães convencionais
(Universidade Federal de São Paulo (UNIFESP), 2016-07-11) Muniz, Denise Garcia [UNIFESP]; Capriles, Vanessa Dias [UNIFESP]; http://lattes.cnpq.br/2781360640415360; http://lattes.cnpq.br/6114620619643456; Universidade Federal de São Paulo (UNIFESP)
This study aims to define the appropriate levels of inulin and water in order to add technological, nutritional and functional quality to gluten-free breads (GFB). The central composite design was used, with variations of inulin (I) levels from 0 to 30% and water (W) of 80 140% (on flour basis - fb). Results have shown that the addition of up to 30% I does not affect the physical properties and acceptability of GFB, provided that appropriate setting of the W percentage of the formulations be accomplished. Two formulations were selected: one for the simultaneous optimization of the acceptability by the overall desirability function (D = 0.96), consisting of 10.65% I and 108.5% W (fb) and the other by the overlapping of the acceptability contour graphs, consisting of 30% I and 131.6% W (fb). These formulations, as well as the control one (without I) showed acceptability scores of appearance, color, aroma, flavor, texture and overall acceptability of ? 8 in hybrid hedonic scale of 10 cm. The use of 30% I (fb) in the preparation of GFB resulted in a well-accepted product containing 7.7% of fructan in the formulation and 10.2% total dietary fiber; corresponding to a 3.6 times increase in fiber content compared to the control formulation. The results of the in vivo test for determining the glycemic response showed that this level of addition caused a significant reduction in the glycemic index from 67 to 49, and the glycemic load from 14 to 8 GFB. Results of the shelf life test have shown that the addition of 30% I (fb) did not alter the physical properties of GFB, and these showed higher crumb firmness when compared to the two formulations of bread made of wheat flour (WB1 and WB2). The lowest acceptability scores of texture and taste were the characteristics that differentiate the GFB of WB1 and WB2 bread during the 72 hours storage. It has been observed that 24 hours after production, the GFB control is no longer accepted for texture (scores between 4 and 5) and addition of I allowed the maintenance of moderate acceptance of this attribute (~ 6 scores) during 72 hours storage. The use of 30% I and 131.6% W (fb) in GFB formulation enable to obtain a nutritionally-improved product that can provide nutritional and functional benefits to people who need gluten-free diet and / or glycemic control. Considering the high nutritional and functional potential of this product, further studies leading to extend their shelf life are recommended.
Acesso aberto (Open Access)
Efeito da adição de psyllium (plantago ovata) na qualidade e na resposta glicêmica de pães sem glúten
(Universidade Federal de São Paulo (UNIFESP), 2016-07-26) Fratelli, Camilly [UNIFESP]; Capriles, Vanessa Dias [UNIFESP]; http://lattes.cnpq.br/2781360640415360; http://lattes.cnpq.br/9223869221443353; Universidade Federal de São Paulo (UNIFESP)
This study aims to simultaneously improve the technological, sensorial and nutritional quality of gluten-free bread (GFB) by the addition of psyllium to the formulation. A 22 full factorial design was used to investigate the main and interaction effects of psyllium - P (2.86 to 17.14% flour basis - fb) and water - W (82.14 to 117.86% fb) additions on GFB physical properties and acceptability. A total of 7 trials were carried out, comprising four for the factorial and three as central points. The fitted models (R2= 95.8-99.8%, p?0,02) showed that P and W interaction increases bread specific volume, crumb softness, and appearance, color, aroma, flavor, texture and overall acceptability scores of GFB. The model fitted for sensory acceptability scores were used to optimize GFB. Four promising formulations were defined: one from the multiple response desirability function (D= 0,99), named as formulation A prepared with 2.86% P and 82.14% W (fb) which received acceptability scores ? 8 on a 10-cm hybrid hedonic scale; and the other three, selected by the overlaid contour plot in order to achieve acceptable formulations (scores ? 7) enriched with the highest P levels, formulations B- 7.14% P e 91.10% A, C- 15.35% P e 117.86% A, and D- 17.14% P e 117.86% A (fb). The formulations C and D presented 7.8% and 9.2% of dietary fiber, respectively; which represents a three and four-fold increase of the fiber content compared to the control formulation. These formulations presented 3.9 and 4.6 g of P / 50g portion, physiologically relevant amounts of this dietary fiber with functional properties. A shelf-life study was performed for the formulations A - D, by the monitoring and evaluation the physical properties, microbiological safety and acceptability during 96h-storage, compared to the control GFB formulation and two formulations of wheat bread (WB1 and WB2). The results showed that among the GFB, the formulation D showed the lowest staling rate, and was the only one that maintains good acceptability for 72h-storage; with the same aroma, texture and flavor acceptability scores than WB1 and WB2. The glycemic response evaluation showed that the control GFB (0% P) had a high glycemic index (GI = 67) and glycemic load (GL = 14). The addition of 17.14% P (fb) in GFB formulation (formulation D) caused a significant reduction of the glycemic response, which resulted in a product with low GI (50) and low GL (9). Psyllium could be regarded as a technological and nutritional improver of GFB, which makes possible handling and molding the gluten-free dough, enhancing the structure, texture, appearance, acceptability and shelf-life of GFB, while increased the dietary fiber content and reduced the glycemic response of this food product, which can provide nutritional and functional benefits to patients with gluten related disorders.
Somente Metadadados
Avaliação do impacto de estratégias de marketing social utilizadas em uma intervenção no ambiente alimentar, sobre a aquisição de alimentos saudáveis em pequenos comércios
(Universidade Federal de São Paulo (UNIFESP), 2016-07-28) Lopes, Renata Fagundes [UNIFESP]; Martins, Paula Andrea [UNIFESP]; http://lattes.cnpq.br/1364300323959453; Universidade Federal de São Paulo (UNIFESP)
Introduction: The high consumption of low nutritional quality foods is a current overview, encompassing social, individual, economic and cultural. Nutritional intervention in the environment to improve the availability of healthy food in urban areas has been identified as a promising and sustainable strategy. Objective: To evaluate the impact of social marketing strategies used in an intervention program in trades of food to promote healthy eating in a population of low socioeconomic status who lives in the urban area of Santos. Methods: This is a quasi-experimental prospective study to compare data before and after the intervention of two groups of trades food, intervention group (n=5) and control (n=4). The adaptation of the methodology used in intervention studies in small trades of food in low socioeconomic areas was conducted, applied by research group at Johns Hopkins University (USA), with the use of social marketing between action strategies. In each trade was assessed through interviews, socioeconomic characteristics and the household food purchases profiling 227 consumers in the intervention group and 153 consumers in the control group, resulting in a sample of 380 consumers. The changes in the procurement of food profile was evaluated by calculating the differences between the pre- and post-intervention and the comparison of the difference between the intervention and control groups. The effect of exposure to social marketing actions in changes in food acquisition score, comparing the group (intervention and control), adjusted for different variables that measured exposure (scores combining range offered dose and dose received and the variables frequency of exposure to shares obtained from the process evaluation and IEQ), and demographic variables. All analyzes used Statistical Package for Social Sciences ® (SPSS), with the significance level of 0.05. Results: The intervention was performed with high fidelity, children were exposed, adults and seniors. There was much interest in the intervention, revenue and promoted food. It was noted a small increase in the consumption of healthier foods with the most exposed the actions of social marketing. Conclusion: Although the increased consumption of healthy foods has occurred, one can not say that is because the actions of the intervention.
Acesso aberto (Open Access)
Análise dos efeitos da ingestão da polpa de juçara (euterpe edulis mart) sobre a atividade física espontânea e homeostase energética de camundongos alimentados com dieta hiperlipídica
(Universidade Federal de São Paulo (UNIFESP), 2016-08-23) Barthichoto, Marcela [UNIFESP]; Oliveira, Camila Aparecida Machado de [UNIFESP]; Pisani, Luciana Pellegrini [UNIFESP]; http://lattes.cnpq.br/3983527783636073; http://lattes.cnpq.br/4886067148875464; http://lattes.cnpq.br/8932541336027973; Universidade Federal de São Paulo (UNIFESP)
Introduction: Obesity is considered a major public health issue, associated with metabolic, inflammatory and hemodynamic abnormalities. On the other hand, the consumption of proper amounts of fruit and vegetables with antioxidant properties lowers the risk for developing non-communicable chronic diseases. The fruit of juçara palm is rich in flavonoids, specifically anthocyanins, compounds with antioxidant and anti-inflammatory properties, which has also been shown to improve insulin sensitivity and reduce weight gain. Objective: Characterize the effect of juçara intake (Euterpe edulis Mart.) on energy homeostasis, spontaneous physical activity and glucose homeostasis in mice fed with high-fat diet. Methods: C57BL/6 mice were divided into 4 groups, according to the diet they received during 16 weeks: control diet (C), control diet supplemented with 0,5% juçara (CJ), high-fat diet (H) (34% fat) and high-fat diet supplemented with 0,5% juçara (HJ). Food intake, energy expenditure, feed efficiency, metabolic efficiency, spontaneous physical activity, glucose tolerance and insulin sensitivity (glucose and insulin tolerance test, respectively), brown adipose tissue UCP-1 protein expression and histopathologic analysis of the liver were analyzed. Results: Weight gain was higher in groups fed with high-fat diet (H and HJ > C and CJ). Supplementation with juçara increased weight gain in the control group (CJ> C), but decreased in high-fat group (HJ< H). Caloric intake (kcal/day) was higher in high-fat groups (H and HJ > C and CJ) and lower in juçara groups (CJ< C; HJ < H) in the first week. However, at 30, 60, 90 and 120 days, the intake was higher in the CJ compared to the C group, with no difference between H and HJ. Metabolic efficiency was lower and feed efficiency was higher in high-fat groups (H and HJ < C and CJ). Also, feed efficiency was higher in H than HJ, with no difference between C and CJ. Juçara increased energy expenditure in the high-fat group (HJ > H), but no differences were found in brown adipose tissue UCP-1 protein expression between H and HJ. There was no change in locomotor activity. High-fat diet decreased glucose tolerance and insulin sensitivity (H and HJ < C and CJ), but juçara improved sensitivity to this hormone (HJ > H). Juçara supplementation also reduced hepatic steatosis caused by high-fat diet (HJ < H). Conclusion: In mice fed high-fat diet, supplementation with juçara had important benefits: reduced weight gain, increased energy expenditure, improved insulin sensitivity and reduced hepatic steatosis. Spontaneous physical activity was not affected by high-fat diet or by juçara. In contrast, for mice fed with control diet, the juçara pulp resulted in greater weight gain, due to increased caloric intake.
Acesso aberto (Open Access)
Efeito da terapia interdisciplinar no consumo de alimentos palatáveis e nos sintomas de transtorno de compulsão alimentar periódica em indivíduos obesos
(Universidade Federal de São Paulo (UNIFESP), 2016-08-26) Leite, Paula Bresciani [UNIFESP]; Oliveira, Camila Aparecida Machado de [UNIFESP]; http://lattes.cnpq.br/4886067148875464; http://lattes.cnpq.br/1124406576194567; Universidade Federal de São Paulo (UNIFESP)
Introduction: Obesity prevalence has risen steadily in most industrialized and developed countries and a major determinant of this pandemic relates to excessive food intake. The palatability of food can be an important predictor of intake, since it is closely related to activation of the reward system in the central nervous system. The higher activity of this reward circuit may contribute to excessive consumption and hence to increased weight, binge eating disorder (BED) symptoms and obesity. Due to the multifactorial etiology of obesity, it is believed that a long term interdisciplinary treatment focused on lifestyle changes, be the most effective strategy for its control. Objective: To evaluate the effect of interdisciplinary therapy on the consumption of palatable food and the symptoms of binge eating in obese. Methods: Forty-seven (47) subjects completed the long-term therapy consisting of nutritionists, psychologists, physical trainers and physiotherapists. Lipid and glucose profile and the perimeters (hip, abdomen, neck), body mass index (BMI) and body mass were evaluated. Symptoms of BED were assessed by Binge Eating Scale (BES). Dietary intake was assessed by the semi-quantitative Food Frequency Questionnaire (FFQ). Results: After the intervention there was a reduction of anthropometric variables and increased HDL-c, both significant (p < 0.001). BES score reduced. Before intervention 18% of subjects were classified as moderate bingers and 9% as severe bingers. After therapy all subjects were classified as without binge eating symptoms. There was a significant reduction in the consumption of palatable foods after therapy (p < 0.001). Strong correlations among symptoms of binge eating and anthropometric and serum variables and frequency of consumption of palatable foods weren?t observed (p> 0.05). Neither were found significant correlation among consumption of palatable food and anthropometric and serum variables (P > 0.05). Conclusion: The therapy is effective in reducing the consumption of palatable food and the prevalence of BED, highlighting the importance of this approach.
Acesso aberto (Open Access)
Alimentação e nutrição no projeto mais médicos para o Brasil
(Universidade Federal de São Paulo (UNIFESP), 2016-08-26) Soares, Amanda Massi [UNIFESP]; Furtado, Juarez Pereira [UNIFESP]; http://lattes.cnpq.br/6869345414404363; http://lattes.cnpq.br/9698610793091233; Universidade Federal de São Paulo (UNIFESP)
This dissertation is composed of theoretical reflection on the social space of the "field of food and culture" in Brazil articulated at empirical research conducted within this same social space. Starting from theoretical foundations of Pierre Bourdieu, on habitus and field, we investigated the influence of cultural formation of Cuban doctors on nutritional counseling in the Brazilian context of the Programa Mais Médicos. A case study was carried out with triangulation through ethnography, focus groups and interviews with users, we concluded that, to care, socio-cultural factors of feeding process play a secondary role when compared to the biomedical paradigm, reducing possible influences of the Cuban habitus. The research carried out within the Program More Doctors, led us to investigate the social space of Food and Culture in Brazil. Through literature review and consideration of the trajectory of the authors, this space was characterized and analyzed, highlighting their potentialities and limitations. The use of Bourdieusian reference contributed to the research of social phenomenon on interdisciplinary perspective.
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Investigação do potencial preventivo do extrato de maçã contra os danos induzidos pelo cádmio em parâmetros reprodutivos de ratos wistar
(Universidade Federal de São Paulo (UNIFESP), 2016-11-28) Schonhaus, Juliana Parusia [UNIFESP]; Aguiar, Odair [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Aims: Check the effects of previous consumption of apple extract on reproductive parameters of cadmium-exposed male rats. Methods: A total of 40 male adult Wistar rats (90 days) were distributed in the following groups: Control (CTRL) (without treatment); Cadmium (CD); Apple extract (M) (1ml/day); Cadmium and apple extract (CDM) (1ml/day). The administration of cadmium chloride (1,2 mg/kg) occurred only once, via intraperitoneal injection on the 21st day of design, and the apple extract daily by gavage for 28 days (21 days before and 7 after intoxication). The parameters analyzed were: body mass gain, weight of reproductive organs and accessory glands, daily sperm production, sperm motility, testicular histopathological and histomorphometric characteristics, testicular antioxidant markers (CAT and SOD) and formation of 8-hydroxy-2'deoxyguanosine (8-OHdG). Results: None of the groups presented differences in relation to weight gain. The groups intoxicated with cadmium, independent of the previous administration of apple extract, presented reduction in the relative mass of the epididymis (p=0,001), ventral prostate (p=0,041), dorso-lateral prostate (p=0,001), seminal vesicle (p=0,002) and testis (p=0,001), daily sperm production (p=0,001), serum testosterone levels (p=0,001), diameter and tubular área (p=0,001). Sperm motility was characterized by a significant reduction in spermatozoa classified as Type A (mobile, with progressive trajectory) in groups also poisoned by metal (p=0,006) and consequent increase in spermatozoa classified as Type C (immobile) (p=0,003). Histopathological changes were observed in all groups exposed to the metal, also showing no influence of the apple extract in these parameters (p=0.001 for CD and p=0.005 for CDM). There was no significant difference in any group regarding the enzymatic activity of CAT and total SOD. However, it was evidenced a reduction in the enzymatic activity of the mitochondrial fraction of SOD in the CD group (p=0.001) and a larger reduction in the CDM group in relation to the CD group (p=0.001). The 8-OHdG immunoexpression was increased in the Cd intoxicated groups (p=0.001 for CD and p=0.007 for CDM). Conclusions: The previously offered dose of apple extract (1/mL/day) was ineffective in protecting the male reproductive system against damage induced by single dose intraperitoneal cadmium chloride (1,2 mg/kg).
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Composição centesimal, de minerais e bioativos, de frutas da biodiversidade brasileira, provenientes da Região Sudeste
(Universidade Federal de São Paulo (UNIFESP), 2017-02-17) Vasconcelos, Tarsilla Fernandes Silva [UNIFESP]; Rosso, Veridiana Vera de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Brazil concentrates a range of natural resources in its territory, especially in its biological diversity. This biodiversity is responsible for the infinity of species with great potential food, but little explored and / or underutilized in the culinary and cultural scenario of the country. Faced with this environment still unknown to many, strategies for the use of biodiversity for food and nutrition are being considered, since most of these foods are not yet used by Brazilians. The objective of this study was to evaluate the physicochemical, centesimal and mineral characteristics of four fruits of Brazilian biodiversity in the Southeast region, as well as to standardize the Brazilian biodiversity and to increase the number of native species used in the Brazilian diet. the data found in literature since then, using the official methodologies described by the Association of Official Analytical Chemists (AOAC). They are: cambuci (Campomanesia phaea), jabuticaba (Myrciaria cauliflora), pink pepper (Schinus terbinthifolius) and pitanga (Eugenia uniflora). The fruits were collected in the states of Espírito Santo, Minas Gerais, Rio de Janeiro and São Paulo, at three different collection points for each of them, most of which were collected in the state of São Paulo. The following parameters were evaluated for physical- chemical characterization: fruit weight, height, diameter, bark weight, seed weight, edible portion, pH and total soluble solids. In the centesimal composition the following analyzes were carried out: moisture, ashes, proteins, lipids, total dietary fiber, total carbohydrates and energy value. In the mineral analysis, the values of Calcium (Ca), Iron (Fe), Copper (Cu), Zinc (Zn), Potassium (K), Magnesium (Mg), Sodium (Na), Selenium Phosphorus (P) and Manganese (Mn). The four fruits analyzed had fiber contents between 4% and 7.5%, varying between 4.6 and 4.8% for cambuci, 7 and 7.6% for jabuticaba, 4.3 and 4.5% for the pink pepper and 5 and 6.3% for the cherry. Among them, jabuticaba stands out, with greater percentage of fibers found. The pink pepper, on the other hand, presents a higher value of proteins, especially the fruits harvested in the Native - ES, counting with 3.2% of proteins in its composition. In the mineral composition the fruits can not be considered source of minerals because they have few concentrations of the same ones. Some evaluated components had different results for the same fruit, as in the case of the humidity for the native pepper, which presented 50.6%, different from the results obtained in the same parameter for the fruits harvested in São Mateus and Búzios, which respectively, and total soluble solids content in the cambuci, which varied according to the locality, presenting 8,3 ° Brix for fruits harvested in Ubatuba, 10,6 ° Brix for samples from Natividade da Serra and 13.7 ° Brix for fruits originating in the Municipality of Ribeirão Pires. These statistically significant differences may have been caused by abiotic factors, such as: soil, rainfall index and solar radiation, which are able to interfere significantly in the chemical composition of these fruits. Thus, based on the results found, it is possible to infer that the fruits analyzed have different characteristics, thus allowing their consumption in various culinary preparations. High fiber jabuticaba stands out, where 100g of the edible fraction provides up to 7.6% of this nutrient, giving it, within the suggested portion, the claim of food with high fiber content according to RDC 54/2012. Regarding the mineral composition, the fruits analyzed do not present large concentrations of minerals, and can be widely consumed by individuals who have any dietary restrictions. Therefore, the consumption of these fruits, together with a healthy diet, contributes to the maintenance of human health, combating free radicals and preventing the body against harmful substances. In addition to the health context, the contact with endemic fruits of the locality also allows the social, economic and sustainable development of the region, strengthening the sustainable management of these species, and adding value through the use of socio-biodiversity products. It is important to point out that the data obtained in this work will also be part of a database fed world-wide through the BFN, with fruit data studied in the countries where these projects are being executed.
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Suplementação Com A Polpa Do Fruto De Juçara (Euterpe Edulis Mart) Durante A Gestação E Lactação Sobre A Inflamação E Expressão Da Proteína Desacopladora 1 (Ucp-1) No Tecido Adiposo Marrom E Função Mutagênica No Fígado Da Prole Aos 21 Dias
(Universidade Federal de São Paulo (UNIFESP), 2017-03-17) Argentato, Perla Pizzi [UNIFESP]; Pisani, Luciana Pellegrini [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Introduction: The fruit of the jussara palm (Euterpe edulis Mart.) is a species native to Brazil. Studies investigating jussara consumption are least explored at literature, especially under fetal metabolic programming. Objective: To investigate the effect of maternal supplementation with jussara fruit pulp in rats treated with hydrogenated vegetable fat (HVF) during gestation and lactation on the expression of decoupling protein 1 (UCP-1), inflammatory markers in brown adipose tissue (BAT) and mutagenic activity in the liver of 21-day-old of offspring. Methods: The groups were composed of male Wistar rats: Group C - offspring of mothers who received control diet containing soybean oil. Group CJ - offspring of mothers who received C diet with 0.5% supplementation the lyophilized jussara pulp (J). Group T - offspring of mothers who received a diet containing HVF, rich in trans fatty acids (TFAs) and TJ Group - offspring of mothers who received HVF containing diet plus 0.5% of J. Growth and weight gain were evaluated, serum concentrations of HDL-cholesterol, total cholesterol (TC), triglycerides (TG) and glucose, protein contents, the carcass lipid, e TNF-α, IL-10 and IL-6 cytokines, the protein expression of UCP-1, NFκBp50 and RITNF-α in the BAT and the histopathological changes, cytogenetics and immunoreactivity of TNF-α and COX-2 in the liver. To verify the effect the treatment and comparison between the groups, the two-way ANOVA followed by Bonferroni's post hoc test was used. The results were expressed as mean ± standard error of the mean(SEM) and the significance level was p≤0.05. Results: We found that TFAs promoted birth weight gain in first and second week of lactation (TJ> CJ), reduced carcass protein (T C), the concentrations of CT (T> C; TJ> CJ) and TG (T> C) also increased TNF-α (T> C; TJ> CJ), RITNF-α (T> CJ) and UCP-1 (TJ> CJ) in BAT, altered histopathology (T> C), increased the frequency of micronuclei (T> C; T> TJ), immunoexpression to TNF and COX-2 (T> C) in the liver of offspring. In contrast supplementation with jussara reduced the weight gain in the third week of lactation and the total weight gain (CJ T), reduced carcass lipid (CJ T), decreased glycemic (TJ C) and UCP-1 (TJ> T) in BAT, decreased the number of micronucle the hepatocytes (TJ
Acesso aberto (Open Access)
Implementação da estratégia NUTRISUS: a experiência de quem fez
(Universidade Federal de São Paulo (UNIFESP), 2017-04-10) Oliveira, Gabriele Caldas de [UNIFESP]; Bandoni, Daniel Henrique [UNIFESP]; http://lattes.cnpq.br/6104429791974852; http://lattes.cnpq.br/3629099992025146; Universidade Federal de São Paulo (UNIFESP)
Entre as causas de anemia em mulheres e crianças no mundo, aproximadamente 50% e 42% respectivamente estão relacionadas à deficiência de ferro, podendo variar de acordo com a região. Crianças entre os 6-24 meses passam a necessitar de fontes de ferro adicionais advindas da alimentação para suprir a demanda devido ao intenso crescimento nessa faixa etária. Quando há consumo insuficiente de alimentos-fonte de ferro e/ou de baixa biodisponibilidade aumenta o risco para a ocorrência de anemia por deficiência de ferro. As intervenções com micronutrientes em pó (MNP) trazem uma alternativa para a adição de ferro e outros micronutrientes na nutrição infantil permitindo a fortificação de qualquer alimento semissólido em diversos locais. A partir de 2014 o Programa Saúde na Escola (PSE) incorpora a Estratégia NutriSUS: fortificação da alimentação infantil com micronutrientes (vitaminas e minerais) em pó como uma de suas ações e passa a ser implementada em Unidades de Educação Infantil (UEI) do Brasil para crianças na faixa etária de 6 a 48 meses. Em políticas públicas, a avaliação da etapa de implementação é uma importante ferramenta que permite transformação e aprendizado da política e stakeholders de modo a trazer benefícios para a sociedade. O presente estudo tem como objetivo avaliar a experiência de implementação da Estratégia NutriSUS: fortificação da alimentação infantil com micronutrientes (vitaminas e minerais) em pó nas Unidades de Educação Infantil da Região Metropolitana da Baixada Santista (RMBS). Trata-se de um estudo transversal realizado nos municípios que implementaram a Estratégia NutriSUS no ano de 2015 na RMBS. A amostra do estudo foi constituída por 23 UEI de dois municípios da região. Os instrumentos para a coleta de dados foram quatro questionários direcionados para os responsáveis pela Estratégia na Secretaria de Educação e de Saúde de cada município e para os gestores de unidade e funcionários responsáveis pela administração do sachê de cada UEI. Também foram produzidos diários de campo após cada entrevista realizada. A análise dos dados qualitativos foi feita por meio da análise de conteúdo temática e dos dados quantitativos por meio da frequência para descrever a amostra e as respostas das questões fechadas. Com a avaliação foi possível identificar que a implementação da Estratégia NutriSUS na RMBS foi considerada uma experiência negativa pelos implementadores. Duas questões foram importantes influenciadoras das considerações negativas quanto a essa experiência: a falta de intersetorialidade e a comunicação malsucedida para a introdução da Estratégia. Não houve um trabalho de sensibilização e comunicação efetivo para a introdução da Estratégia NutriSUS e a intersetorialidade prevista na formulação da ação não foi efetuada em sua implementação. Identificou-se compreensão das necessidades nutricionais específicas da faixa etária do público alvo, porém mantinham-se dúvidas quanto à fortificação com micronutrientes em pó. A avaliação dessa experiência de implementação construiu hipóteses sobre a recepção e construção da Estratégia NutriSUS pelos implementadores da RMBS e oferece ferramentas para o desenvolvimento dessa política pública, além de servir como fundação para novas avaliações.
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Ingestão alimentar entre crianças e adolescentes com excesso de peso: o que mostra o perfil de ácidos graxos da dieta em relação ao grau de processamento de alimentos
(Universidade Federal de São Paulo (UNIFESP), 2017-04-26) Almeida, Viviane Bellucci Pires de [UNIFESP]; Domene, Semíramis Martins Álvares [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Diet for overweight children and adolescents is aimed at reducing adipose tissue without compromising the supply of nutrients and bioactive compounds necessary for growth and development. It has been shown that fat intake greater than 35% of dietary energy, with more than 8% saturated fat and 1% trans fat, constitutes a risk factor for chronic diseases. The effects of excess fat intake include an increase in energy density and stimulation of the inflammatory processes related to obesity. The Food Guide for the Brazilian Population highlights the health benefits associated with reducing consumption of ultra-processed foods. However, little is known about dietary fatty acids and food intake as related to the extent of food processing in these life stages. Objective. To analyze the diet of overweight children and adolescents and to assess the association between dietary variables, especially the intake of fatty acids that have been identified as potential modulators of inflammation, according to the extent of food processing. Method. Cross-sectional study based on convenience sampling of 149 overweight schoolchildren ages 8 to 11 in the city of São Paulo. Selected individuals were overweight, with Body Mass Index for age Z score >1. The sample was composed of 149 students and food intake was estimated from responses to an Eating Frequency Questionnaire; the data were processed by the NDS program, which produced the energy and nutrient estimates. The foods were organized in accordance with the NOVA system, which classifies food based on the extend of industrial processing. The difference between the means were tested using Student’s t-test (for categorical variables) or Anova (for variables with more than two categories), using a significance level of 5%. Results: The average age of students was 9.6 years. The average daily energy intake was 2,032 Kcal. Carbohydrates supplied 51.2% of total energy, while proteins accounted for 15.5% and fats 33.3%. The components with the highest prevalence of inadequate intake were calcium and vitamin E (> 81%); vitamin D (> 94%) and saturated fat, dietary fiber and added sugar (> 97%). Approximately 20% of subjects had omega 6:3 ratios above 10:1. All students consumed more omega 6 than recommended and more sodium than the maximum tolerable amount. Among the intake tertiles in group 1 (raw/ minimally processed foods), higher consumption was associated with an increase in the intake of n6 and n3, with a significant reduction in the n6:n3 ratio, while for the tertiles in group 3 (ultra-processed foods), there was a significant increase in both the intake of omega 6 and 3, as in the n6:n3 ratio. Ultra-processed foods represented 36% of total dietary energy intake.
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Razão Ômega-6:Ômega-3 na dieta segundo variáveis sociodemográficas, alimentares e de saúde: estudo de base populacional em Campinas
(Universidade Federal de São Paulo (UNIFESP), 2017-06-05) Ghedini, Natalia Simonian Rodrigues Valente [UNIFESP]; Domene, Semíramis Martins Álvares [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Although the effect of diet on health status is widely recognized, few studies have evaluated the profile of fat consumption by the Brazilian population. The imbalance in the consumption of omega-6:omega-3 (n6:n3) fatty acids is related to inflammatory processes that increase the risk of developing non-communicable chronic diseases. The aim of this study was to analyze the associations between the ratio of n6: n3 fatty acids and sociodemographic, food and health variables. This is a research carried out with secondary data from the ISA-Camp, a population-based cross-sectional study with a sample stratified by clusters and in two stages, conducted between 2008-09, in the city of Campinas, SP, Brazil. Fat intake was estimated using the 24-Hour Recall, and data were entered into the Nutrition Data System for Research software. In the analysis of the data, the means of the n6:n3 ratio were calculated according to the independent variables, using simple and multiple linear regression, with significance level of 5%. The food records of 3,303 individuals, aged 10 years or more, were considered. Lower values of the n6:n3 ratio were observed in the strata of adults and elderly (p <0.001), in those who ate fruits, vegetables and milk daily (p <0.01), and in those who were physically active in leisure time (p < 0.009). These findings show the association between eating habits, sociodemographic indicators and the n6:n3 ratio, and may contribute to the elaboration of strategies aimed at the adoption of changes in lifestyle.

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