Navegando por Palavras-chave "Ambiente nutricional"
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- ItemSomente MetadadadosAssociações entre o ambiente nutricional e o acúmulo de gordura abdominal em crianças no município de Santos(Universidade Federal de São Paulo (UNIFESP), 2015-09-30) Melzer, Matheus Ribeiro Theodosio Fernandes [UNIFESP]; Martins, Paula Andrea [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Childhood obesity and abdominal obesity are current public health problems, considering the risk of chronic diseases associated to this issue. Among the determinants of weight gain, the nutritional environment around the household neighborhood has been highlighted for its effect on food intake and physical activity given the availability, price and quality of foods and meals offered in food establishments and spaces available for physical activity practice. Objective: To analyze the relationship between aspects of the nutritional environment on abdominal obesity in children living in the urban area of Santos city, Brazil. Methods: A crosssectional design study with household-based survey with 357 mothers and children 3-10 years residents of 36 randomly selected census tracts in the city. Questionnaires regarding socioeconomic status, perception of the environment, sedentary habits, eating habits and 24h recall were applied and anthropometric measurements were collected. Abdominal obesity was classified as a waist-to-height ratio higher or equal to 0.5. Simultaneously, 1800 food and meal selling establishments and 70 public facilities for physical activity were identified in the different regions of the city, and specific questionnaires to assess the availability and quality of food groups and sites were applied. Geographic coordinates were collected in all places assessed and incorporated to a geographic information system. The nutritional environment was bordered by an Euclidean buffer with a 400m radius from the household of each child, accounting for the presence of each establishment and public facility in the covered area, mean quality score of fruits and vegetables available and mean score of healthy eating promotion of food stores close to household. Differences in the characteristics of the nutritional environment between the regions of the city were assessed by Kruskal-Wallis test. Regarding children?s abdominal obesity, the chi-square test was performed for testing the individual and environmental independent variables and those which obtained an association at a p value ? 0.2 were subsequently tested using multilevel multiple logistic regression. Analyzes were performed using the Statistical Package for the Social Sciences® software (SPSS) v.18 and Stata® SE software v.12. The level of significance used was 0.05. Results: 30.8% of children and 65.2% of mothers had abdominal obesity. Ultra processed foods itens were more frequent in the evaluated stores and the score of healthy eating promotion and the score of quality of fruits and vegetables showed inequities between regions of different socioeconomic levels. Children not 15 consuming school meals and whose mothers had abdominal obesity and worked were more likely to have abdominal obesity. The presence of at least one bakery (OR: 0.32; 95% CI: 0.12?0.85) or one specialized fruit and vegetable grocery store (OR: 0.46; 95% CI: 0.22?0.96) near the household were protective factors to abdominal obesity, even when adjusting for socioeconomic status. The same was observed regarding children living near the establishments offering vegetables of highest quality (OR: 0.45; CI95%: 0.21?0.95). Conclusion: A nutritional environment with the presence of establishments that are primarily engaged in selling fruits and vegetables and breads can positively affect children?s nutritional status. Urban planning policies of the city must allow a nutritional environment with the presence of establishments with selling affordable and high quality food for the entire population. Nutritional education interventions with children should be designed for the family environment in order to result in a greater chance of impact on nutritional status.
- ItemAcesso aberto (Open Access)Efeito de fatores ambientais sobre a disponibilidade domiciliar de alimentos de famílias moradoras do município de Santos(Universidade Federal de São Paulo, 2012-04-24) Abreu, Débora Silva Costa de [UNIFESP]; Martins, Paula Andrea [UNIFESP]; http://lattes.cnpq.br/1364300323959453; http://lattes.cnpq.br/8671258906481746; Universidade Federal de São Paulo (UNIFESP)Introdução: A investigação a cerca da oferta de alimentos na região de moradia como um fator determinante para o aumento de epidemia da obesidade tem motivado pesquisadores no campo da epidemiologia nutricional dada a relação entre a disponibilidade de alimentos no domicílio e o consumo alimentar. Objetivo: Compreender o efeito independente de fatores ambientais relacionados ao acesso a alimentos na vizinhança sobre a disponibilidade domiciliar de alimentos de famílias moradoras do município de Santos. Métodos: O estudo teve delineamento transversal. A amostra, representativa da população do município, compreendeu 530 domicílios, nos quais foram realizadas entrevistas com mães de crianças de até 10 anos de idade (componente domiciliar) e 672 comércios de alimentos (componente ambiental). Foram realizadas análises descritivas das características socioeconômicas dos domicílios e dos tipos de comércios de alimentos. Foi realizada análise de regressão logística múltipla para verificar a influencia dos fatores socioeconômicos sobre a disponibilidade de alimentos no domicílio. As diferenças entre as regiões quanto à disponibilidade de frutas e hortaliças foram verificadas, por meio do teste de Kruskal Wallis. Para avaliar o efeito do ambiente sobre a aquisição de frutas e hortaliças, foi realizada análise de regressão linear multinível, ajustando modelos distintos para os estratos de domicílios localizados nos setores censitários do primeiro e do último tercil de renda média do chefe de família dos domicílios, de acordo com os dados do censo demográfico. Resultados: A região Noroeste, de menor nível socioeconômico, apresentou maior chance de disponibilidade de alimentos menos saudáveis nos domicílios e maior oferta de alimentos menos saudáveis pelos comércios presentes na vizinhança. Ao analisar o efeito do ambiente sobre a aquisição de frutas e hortaliças, foi observada associação positiva com o número de comércios classificados como promotores de uma alimentação saudável no terceiro tercil de renda. Conclusão: Foram observadas iniquidades no acesso e oferta de alimentos entre as três regiões do município de Santos. Foi possível observar efeitos do ambiente sobre a disponibilidade de frutas e hortaliças nos domicílios, especialmente entre as famílias de maior poder aquisitivo. Intervenções articuladas entre a comunidade, secretarias do município, universidades e outras organizações são necessárias para promover maior disponibilidade de alimentos saudáveis nos comércios e para aumentar a oportunidade de compra desses alimentos pelas famílias menos favorecidas.
- ItemAcesso aberto (Open Access)Efeitos do ambiente alimentar e nutricional sobre o excesso de peso em crianças menores de 10 anos(Universidade Federal de São Paulo (UNIFESP), 2011-02-22) Cremm, Elena de Carvalho [UNIFESP]; Martins, Paula Andrea [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: The prevalence of childhood overweight has been increasing throughout the world. Given the consequences of overweight to individuals and society, researchers have been trying to identify the economic, social, environmental and biological variables associated with overweight. It has been suggested that the environment has a important part in the etiology of overweight, in that relates to physical activity and food intake. Objectives: To analyze the relationship between the BMI of children under 10 years of age in the city of Santos and socio-economic and environmental factors. Methods: In a cross sectional, population based study, 531 children under 10 years living in the city of Santos were assessed. Socio-economic, physical activity and food intake data were collected at the individual level. Logistic regression was performed to analyze the influence of the individual level variables on overweight. To evaluate the nutrition environment, questionnaires adapted and validated for the Brazilian population were created. Food stores and food service places were assessed in the whole city and also in a 500m area around the children´s census tract. The individual and environmental data were analyzed in an ecological model in order to assess possible correlations. Results: Lower socio-economic status was associated with overweight in children at the individual level and was also associated with less access to healthy food and healthy establishments at the environment level. The presence of health promoting food stores was associated with lower BMI/age. Conclusion: The ecological analysis showed a negative association between the nutritional status and the nutrition environment. However, in order to assess the individual influence of the environment on the individual, more advanced statistical methods are necessary. The area and the population’s socio-economic status should be considered when planning interventions focused on the nutrition environment.