Padrões de cardápios da alimentação escolar e sua relação com a qualidade nutricional e fatores sociodemográficos
Data
2024-05-16
Autores
Martins, Isabela Prado 
Orientadores
Domene, Semíramis Martins Álvares
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: Identificar os padrões de cardápios da alimentação escolar e verificar a relação com variáveis sociodemográficas e sua qualidade. Métodos: Trata-se de um estudo transversal de caráter observacional, realizado com banco de dados composto por cardápios planejados em municípios brasileiros atendidos pelo Programa Nacional de Alimentação Escolar (PNAE). Para iniciar as análises, os alimentos e preparações foram agrupados quanto à similaridade nutricional e avaliados conforme a ocorrência semanal de cada grupo nos cardápios escolares. Os padrões alimentares foram obtidos por meio da Análise Fatorial (AF) com extração por Componentes Principais. Inicialmente, foram aplicados os testes de Kaiser-Meyer-Olkin (KMO) e o teste de esfericidade de Bartlett, para avaliar a adequabilidade da amostra. O número de fatores a serem mantidos na análise foram determinados pelo teste gráfico de Cattell (scree plot). Em seguida, a matriz fatorial passou pela rotação Varimax e foram considerados na análise apenas os grupos com cargas fatoriais superiores a 0,3. Foi aplicado o teste de Kruskal-Wallis para avaliar as diferenças estatisticamente significativas entre padrões alimentares e os dados sociodemográficos dos municípios e a qualidade nutricional do cardápio, e em seguida, teste post-hoc de Wilcoxon com correção de Bonferroni para comparar as categorias aos pares. As variáveis sociodemográficas incluíram a região geográfica, o número de habitantes, Índice de Desenvolvimento Humano Municipal (IDHM) e o Índice de Vulnerabilidade Social (IVS). Para avaliar a qualidade nutricional dos cardápios, foi aplicado o Índice de Qualidade para Cardápios da Alimentação Escolar - Revisado (IQCAE-R), instrumento que leva em consideração a frequência diária e semanal dos componentes alimentares e classifica o cardápio como de baixa, média ou alta qualidade nutricional, de acordo com a sua pontuação final. Resultados: Dois principais padrões alimentares foram identificados: (1) “tradicional”: cereais e massas, raízes e tubérculos, leguminosas, legumes e verduras, carnes e ovos; e (2) “lanche”: pães, bolos e biscoitos, leite e derivados, achocolatado em pó, café e chás. O padrão “tradicional” revelou diferenças significativas entre as variáveis sociodemográficas e a qualidade do cardápio, enquanto o padrão “lanche” apresentou diferenças entre as Regiões, Índice de Vulnerabilidade Social (IVS), com destaque para a diferença entre as categorias “Baixo” e “Muito alto”, e a qualidade do cardápio em todas as categorias. Conclusão: O presente estudo evidenciou diferenças nos padrões quanto à qualidade nutricional dos cardápios e fatores sociodemográficos. Nesse sentido, ratifica-se o incentivo à oferta de refeições compostas por alimentos in natura e minimamente processados, dado o destaque que assume o padrão “tradicional”, relativamente à qualidade nutricional do cardápio. As refeições escolares exercem potencial impacto para o desenvolvimento de padrões alimentares entre os estudantes, e novas abordagens para seu estudo podem fortalecer a ação do PNAE quanto ao fornecimento de refeições mais nutritivas e sustentáveis.
Objective: To identify the menu patterns of school meals and evaluate their relationship with sociodemographic variables and quality. Methods: This is a crosssectional observational study, conducted using a database composed of menus planned in Brazilian municipalities supported by the National School Meal Program (PNAE). To commence the analyses, foods and preparations were grouped according to nutritional similarity and evaluated based on the weekly occurrence of each group on school menus. Dietary patterns were obtained through Factor Analysis (FA) with extraction by Principal Components. Initially, the Kaiser-Meyer-Olkin (KMO) test and Bartlett's sphericity test were applied to assess the sample's adequacy. The number of factors to be maintained in the analysis was determined by Cattell's graphical test (scree plot). Then, the factor matrix underwent Varimax rotation, and only groups with factor loadings greater than 0.3 were considered in the analysis. The Kruskal-Wallis test was applied to assess statistically significant differences among dietary patterns and the sociodemographic data of the municipalities, and the nutritional quality of the menu, and subsequently the Wilcoxon post-hoc test with Bonferroni correction was utilized to conduct pairwise comparisons between categories. The sociodemographic variables analyzed included the number of inhabitants, Municipal Human Development Index (IDHM), and the Social Vulnerability Index (IVS). To evaluate the nutritional quality of the menus, the Quality Index for School Meal Menus - Revised (IQCAE-R) was applied, which considers the daily and weekly frequency of food components and classifies the menu as low, medium, or high quality, according to its final score. Results: Two main dietary patterns were identified: (1) "traditional": cereals and pasta, roots and tubers, legumes, vegetables, meat and eggs; and (2) "snack": bread, cakes and cookies, milk and dairy products, chocolate powder, coffee and teas. The “traditional” pattern showed significant differences in all analyzed variables, while the “snack” pattern exhibited differences among Brazilian Regions, IVS, notably between the “Low” and “Very High” categories, and the nutritional quality of menus across all categories. Conclusion: The present study showed differences in menu patterns regarding the nutritional quality of menus and sociodemographic factors. In this sense, the incentive to offer meals composed of fresh and minimally processed foods is ratified, given the emphasis that the “traditional” pattern assumes, in relation to the quality of the menu. School meals have a potential impact on the development of eating patterns among students, and new approaches to their study can strengthen PNAE's action in providing more nutritious and sustainable meals.
Objective: To identify the menu patterns of school meals and evaluate their relationship with sociodemographic variables and quality. Methods: This is a crosssectional observational study, conducted using a database composed of menus planned in Brazilian municipalities supported by the National School Meal Program (PNAE). To commence the analyses, foods and preparations were grouped according to nutritional similarity and evaluated based on the weekly occurrence of each group on school menus. Dietary patterns were obtained through Factor Analysis (FA) with extraction by Principal Components. Initially, the Kaiser-Meyer-Olkin (KMO) test and Bartlett's sphericity test were applied to assess the sample's adequacy. The number of factors to be maintained in the analysis was determined by Cattell's graphical test (scree plot). Then, the factor matrix underwent Varimax rotation, and only groups with factor loadings greater than 0.3 were considered in the analysis. The Kruskal-Wallis test was applied to assess statistically significant differences among dietary patterns and the sociodemographic data of the municipalities, and the nutritional quality of the menu, and subsequently the Wilcoxon post-hoc test with Bonferroni correction was utilized to conduct pairwise comparisons between categories. The sociodemographic variables analyzed included the number of inhabitants, Municipal Human Development Index (IDHM), and the Social Vulnerability Index (IVS). To evaluate the nutritional quality of the menus, the Quality Index for School Meal Menus - Revised (IQCAE-R) was applied, which considers the daily and weekly frequency of food components and classifies the menu as low, medium, or high quality, according to its final score. Results: Two main dietary patterns were identified: (1) "traditional": cereals and pasta, roots and tubers, legumes, vegetables, meat and eggs; and (2) "snack": bread, cakes and cookies, milk and dairy products, chocolate powder, coffee and teas. The “traditional” pattern showed significant differences in all analyzed variables, while the “snack” pattern exhibited differences among Brazilian Regions, IVS, notably between the “Low” and “Very High” categories, and the nutritional quality of menus across all categories. Conclusion: The present study showed differences in menu patterns regarding the nutritional quality of menus and sociodemographic factors. In this sense, the incentive to offer meals composed of fresh and minimally processed foods is ratified, given the emphasis that the “traditional” pattern assumes, in relation to the quality of the menu. School meals have a potential impact on the development of eating patterns among students, and new approaches to their study can strengthen PNAE's action in providing more nutritious and sustainable meals.
Descrição
Citação
MARTINS, Isabela Prado. Padrões de cardápios da alimentação escolar e sua relação com a qualidade nutricional e fatores sociodemográficos. 2024. 96 f. Dissertação (Mestrado em Nutrição) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP). São Paulo, 2024.