RESUMO
OBJECTIVE: To evaluate the quality of anthropometric data of children recorded in the Food and Nutrition Surveillance System (SISVAN) from 2008 to 2017. METHOD: Descriptive study on the quality of anthropometric data of children under five years of age admitted in primary care services of the Unified Health System, from the individual databases of SISVAN. Data quality was annually assessed using the indicators: coverage, completeness, sex ratio, age distribution, weight and height digit preference, implausible z-score values, standard deviation, and normality of z-scores. RESULTS: In total, 73,745,023 records and 29,852,480 children were identified. Coverage increased from 17.7% in 2008 to 45.4% in 2017. Completeness of birth date, weight, and height corresponded to almost 100% in all years. The sex ratio was balanced and approximately similar to the expected ratio, ranging from 0.8 to 1. The age distribution revealed higher percentages of registrations from the ages of two to four years until mid-2015. A preference for terminal digits "zero" and "five" was identified among weight and height records. The percentages of implausible z-scores exceeded 1% for all anthropometric indices, with values decreasing from 2014 onwards. A high dispersion of z-scores, including standard deviations between 1.2 and 1.6, was identified mainly in the indices including height and in the records of children under two years of age and residents in the North, Northeast, and Midwest regions. The distribution of z-scores was symmetric for all indices and platykurtic for height/age and weight/age. CONCLUSIONS: The quality of SISVAN anthropometric data for children under five years of age has improved substantially between 2008 and 2017. Some indicators require attention, particularly for height measurements, whose quality was lower especially among groups more vulnerable to nutritional problems.
Assuntos
Alimentos , Estado Nutricional , Humanos , Criança , Pré-Escolar , Lactente , Peso Corporal , Brasil/epidemiologia , Distribuição por Idade , EstaturaRESUMO
This study analyzed the trajectory of interests and priorities related to food security expressed in the reports of the five National Food and Nutritional Security Conferences (Conferências Nacionais de Segurança Alimentar e Nutricional - CNSAN) held in Brazil between 1994 and 2015. The documentary research was systematized through content analysis with a quantitative and qualitative focus. Food security dimensions were identified in the 1,181 action proposals assessed through an analysis model consisting of 3 cross-sectional categories, 8 thematic categories, and 10 subcategories. The temporal content analysis revealed: continuous reduction in demands for "universal access to adequate food", especially in the subcategory "employment and income"; constant predominance of the category "structuring sustainable food production and supply systems" with a progressive increase in the subcategory "incentive to agroecology-based production"; and increased demands for "prioritization of traditional peoples and communities". The timeline suggests different contributions of the Conferences to the evolution of the debate on food security in Brazil. However, the insertion of social actors in the process of formulating the Brazilian National Food and Nutritional Security Policy did not guarantee the incorporation of the problems into the public agenda, which should be re-established and deepened in the decision-making processes. The findings attest to the importance of social participation for the theoretical and political qualification of food security in Brazil.
Este estudio analizó la trayectoria de los intereses y prioridades relacionados con la seguridad alimentaria expresados en los informes de las cinco Conferencias Nacionales de Seguridad Alimentaria y Nutricional (Conferências Nacionais de Segurança Alimentar e Nutricional - CNSAN) realizadas en Brasil entre 1994 y 2015. La investigación fue sistematizada a través del análisis de contenido con un enfoque cuantitativo y cualitativo. Las dimensiones de la seguridad alimentaria se identificaron en las 1.181 propuestas de acción evaluadas a través de un modelo de análisis que consta de 3 categorías transversales, 8 categorías temáticas y 10 subcategorías. El análisis de contenido temporal reveló: continua reducción de las demandas de "acceso universal a una alimentación adecuada", especialmente en la subcategoría "empleo e ingresos"; predominio de la categoría "estructuración de sistemas sostenibles de producción y abastecimiento de alimentos" con un aumento progresivo de la subcategoría "incentivo a la producción basada en la agroecología"; y mayores demandas de "priorización de los pueblos y comunidades tradicionales". La línea de tiempo sugiere diferentes contribuciones de las Conferencias a la evolución del debate sobre la seguridad alimentaria en Brasil. Sin embargo, la inserción de los actores sociales en el proceso de formulación de la Política Nacional de Seguridad Alimentaria y Nutricional de Brasil no garantizó la incorporación de los problemas en la agenda pública, que debe ser reconquistada y profundizada en los procesos de toma de decisiones. Los hallazgos atestiguan la importancia de la participación social para la calificación teórica y política de la seguridad alimentaria en Brasil.
RESUMO
ABSTRACT OBJECTIVE To evaluate the quality of anthropometric data of children recorded in the Food and Nutrition Surveillance System (SISVAN) from 2008 to 2017. METHOD Descriptive study on the quality of anthropometric data of children under five years of age admitted in primary care services of the Unified Health System, from the individual databases of SISVAN. Data quality was annually assessed using the indicators: coverage, completeness, sex ratio, age distribution, weight and height digit preference, implausible z-score values, standard deviation, and normality of z-scores. RESULTS In total, 73,745,023 records and 29,852,480 children were identified. Coverage increased from 17.7% in 2008 to 45.4% in 2017. Completeness of birth date, weight, and height corresponded to almost 100% in all years. The sex ratio was balanced and approximately similar to the expected ratio, ranging from 0.8 to 1. The age distribution revealed higher percentages of registrations from the ages of two to four years until mid-2015. A preference for terminal digits "zero" and "five" was identified among weight and height records. The percentages of implausible z-scores exceeded 1% for all anthropometric indices, with values decreasing from 2014 onwards. A high dispersion of z-scores, including standard deviations between 1.2 and 1.6, was identified mainly in the indices including height and in the records of children under two years of age and residents in the North, Northeast, and Midwest regions. The distribution of z-scores was symmetric for all indices and platykurtic for height/age and weight/age. CONCLUSIONS The quality of SISVAN anthropometric data for children under five years of age has improved substantially between 2008 and 2017. Some indicators require attention, particularly for height measurements, whose quality was lower especially among groups more vulnerable to nutritional problems.
RESUMO OBJETIVOS Avaliar a qualidade dos dados antropométricos de crianças registradas no Sistema de Vigilância Alimentar e Nutricional (Sisvan) no período 2008-2017. MÉTODOS Estudo descritivo sobre a qualidade dos dados antropométricos de crianças menores de 5 anos atendidas nos serviços de atenção primária do Sistema Único de Saúde, a partir das bases de dados individuais do Sisvan. A qualidade dos dados foi avaliada anualmente por meio dos indicadores: cobertura, completude, razão entre sexos, distribuição da idade, preferência por dígitos de peso e estatura, valores de escore-z implausíveis, desvio-padrão e normalidade dos escores-z. RESULTADOS No total, 73.745.023 registros e 29.852.480 crianças foram identificados. A cobertura aumentou de 17,7% em 2008 para 45,4% em 2017. A completude da data de nascimento, peso e estatura correspondeu a quase 100% para todos os anos. A razão entre sexos foi equilibrada e aproximadamente similar a razão esperada, variando entre 0,8 e 1. A distribuição da idade revelou maiores percentuais de registros entre as idades de 2 a 4 anos até meados de 2015. Uma preferência pelos dígitos terminais "zero" e "cinco" foi identificada entre os registros de peso e estatura. As porcentagens de escores-z implausíveis excederam 1% para todos os índices antropométricos, com redução dos valores a partir de 2014. Uma alta dispersão dos escores-z, incluindo desvios-padrão entre 1,2 e 1,6, foi identificada principalmente nos índices incluindo estatura e nos registros de crianças menores de 2 anos e residentes das regiões Norte, Nordeste e Centro-Oeste. A distribuição dos escores-z foi simétrica para todos os índices e platicúrtica para estatura/idade e peso/idade. CONCLUSÕES A qualidade dos dados antropométricos do Sisvan para crianças menores de 5 anos melhorou substancialmente entre 2008 e 2017. Alguns indicadores requerem atenção, sobretudo para medidas de estatura, cuja qualidade foi principalmente inferior entre os grupos mais vulneráveis a agravos nutricionais.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Vigilância Alimentar e Nutricional , Criança , Antropometria , Sistemas de Informação em Saúde , Confiabilidade dos DadosRESUMO
Food insecurity is a critical global problem with social and public health consequences. In Brazil, access to adequate food is a fundamental human right guaranteed under the country's Constitution since 2010. As such, the State assumes the distinct and complementary obligations to respect, protect, promote and provide the Right to Adequate Food. The aim of this study is to present actions related to the "provision" dimension that have been developed as part of a network of public infrastructure strategies for food and nutrition security in Brazil. Through an exploratory, analytical literature review, the paper focuses on the operational designs and logistics of three main strategies: Food Banks, Community Kitchens, and Popular Restaurants. The Brazilian experience indicates that public actions are necessary, especially considering the urgency for those groups living with hunger and poverty. While similar programs can be found in other countries in South and North America, they are mostly offered by civil society organizations, and have not advanced toward public institutionalization. In fact, private programs are criticized for negating governments' obligation and responsibility in this area. Brazil's experience sheds light on public initiatives in meeting the State's obligations towards the Right to Adequate Food. Supplementary Information: The online version contains supplementary material available at 10.1007/s12571-022-01272-1.
RESUMO
Resumo O estudo teve como objetivo analisar a percepção de gestores e profissionais de saúde sobre o cuidado disponível para crianças e adolescentes com sobrepeso e obesidade no Sistema Único de Saúde em Sergipe, Brasil. Trata-se de estudo qualitativo e exploratório, com amostra composta por 46 atores e coleta de dados por meio de entrevistas semiestruturadas. O cuidado existente foi percebido como falho e fragmentado, independentemente do nível de atenção à saúde. As principais dificuldades abrangeram o processo de trabalho, a gestão e organização do cuidado, a adesão familiar e a insuficiência de recursos. Potencialidades relacionadas à gestão, equipes e profissionais, que poderiam contribuir para a implantação de uma linha de cuidado integral, foram também identificadas. Contudo, a organização do cuidado à obesidade infantil ainda requer uma conectividade dos papéis e tarefas dos diversos atores, por meio da pactuação e corresponsabilização entre os serviços, profissionais e a família.
Abstract The study aimed to analyze the perception of health managers and professionals on the care of children and adolescents with overweight and obesity in the Unified Health System of Sergipe, Brazil. This is a qualitative and exploratory study with sample composed of 46 actors and semi-structured interviews as data collection method. The existing care was perceived as poor and fragmented, regardless of the health care level. The main difficulties were the professionals' work process, care management and organization, family support and insufficient resources. Potentialities related to management, teams and professionals, which could contribute to the implementation of a comprehensive care line, were also identified. However, the organization of care for child obesity still requires the connectivity of different actors' roles and tasks, with the agreement and co-responsibility between services, professionals and family.
Assuntos
Humanos , Percepção , Sistema Único de Saúde , Pessoal de Saúde , Assistência Integral à Saúde , Gestor de Saúde , Obesidade Infantil , BrasilRESUMO
ABSTRACT Objective Although school is considered a suitable space for health promotion, there have been difficulties adopting healthy eating practices due to many ultra-processed foods offered in school canteens and irregularities in Food and Nutrition Education actions. This study aimed to propose a certification seal to encourage school canteens' managers in Brazil to adopt actions for the Promotion of Appropriate and Healthy Diets. Methods It is a methodological study in which the "Healthy Canteen Certification Seal" was developed, containing ten guidelines based on the Dietary Guidelines for the Brazilian Population. The instrument was built based on national and international documents and later was consensually agreed upon by experts using the Delphi method. Results Ten guidelines for the Seal were developed around the following topics: the creation of a Council, availability of written and accessible standards; stimulation of water intake; offer of natural foods, limitation of processed and ultra-processed foods, promotion of educational actions, prohibition of abusive food advertisements, structural changes, and staff training. The overall evaluation of the proposal by the experts was positive concerning its relevance, and more than 70% of positive results were attained for all guidelines. The participants agreed that the Seal would contribute to expanding and enhancing healthy eating practices in schools. Conclusion We believe that this proposal will encourage educational institutions to adopt and implement actions for the Promotion of Appropriate and Healthy Diets, thus contributing to ensuring Food and Nutrition Safety for students.
RESUMO Objetivo Embora a escola seja considerada um espaço adequado para a promoção da saúde, dificuldades na adoção de práticas alimentares saudáveis têm sido observadas devido à oferta de uma grande quantidade de alimentos ultraprocessados em cantinas escolares e irregularidades nas ações de Educação Alimentar e Nutricional. Este estudo teve por objetivo propor um selo de certificação para estimular cantinas escolares do Brasil a adotarem ações de Promoção da Alimentação Adequada e Saudável. Métodos Trata-se de um estudo de natureza metodológica no qual se desenvolveu o instrumento "Selo de Certificação Cantina Saudável", contendo dez orientações coerentes com as diretrizes do Guia Alimentar da População Brasileira. O instrumento foi elaborado com base em documentos nacionais e internacionais e posteriormente pactuado via consenso com especialistas por meio da metodologia Delphi. Resultados As dez orientações foram elaboradas em torno das seguintes questões: criação de um Conselho, presença de normas escritas e acessíveis, incentivo à ingestão de água, oferta de alimentos in natura e limitação de processados e ultraprocessados, estímulo a ações educativas, proibição de propagandas abusivas sobre alimentos, mudanças estruturais e treinamento de funcionários. A avaliação global da proposta pelos especialistas foi positiva quanto à sua relevância, sendo obtidos resultados superiores a 70% para todas as orientações. Os participantes concordaram que o Selo contribuirá para ampliar e aprimorar a alimentação saudável nas escolas. Conclusão Acredita-se que essa proposta incentivará as instituições educativas a aderirem e implementarem ações de Promoção da Alimentação Adequada e Saudável, devendo contribuir para a garantia da segurança alimentar e nutricional dos escolares.
Assuntos
Humanos , Criança , Adolescente , Alimentação Escolar/normas , Educação Alimentar e Nutricional , Serviços de Alimentação/normas , Dieta Saudável/métodos , Abastecimento de Alimentos , Técnica Delphi , Guias como AssuntoAssuntos
Abastecimento de Alimentos , Política Nutricional , Brasil , Alimentos , Humanos , PolíticaRESUMO
INTRODUCTION: Boardwalk Cisterns is a government program that aims to attend a population with precarious access to water in Brazil. Developed as part of the Zero Hunger strategy, it intends to increase food security and contribute to the realization of the human right to food. The objective of this study was to assess farmers' perceptions of the Boardwalk Cisterns program and its impact on the food security situation of beneficiary households. METHODS: Data were collected through a descriptive cross-sectional quali-quantitative survey. Questionnaires were applied to farming families selected from two municipalities in the state of Alagoas (Northeast Brazil), containing questions on sociodemographic characteristics, production methods, and food security status. The Free Evocation Technique for social representation, analyzed through the software Ensemble of Programs Permettant L'analyze des Évocations, was used to ascertain farmers' perceptions of the program. RESULTS: The study showed a positive perception of the interviewees in relation to the boardwalk cisterns. The program brought some improvement in the agricultural production conditions and, consequently, in the food security situation of the households. Corn, beans and cassava were the most common crops, with almost half of this production (48.3%) destined for consumption by the families themselves. Farmers also reported having more water, allowing them to plant more fruit trees, as well as medicinal and ornamental plants. Nevertheless, 79.1% of the households interviewed were still in a situation of food insecurity, of which 28.1% were classified as mild food insecurity, 26% as moderate food insecurity, and 25% as severe food insecurity. CONCLUSION: Farmers were correct in their perception that the Boardwalk Cisterns program improved their food security situation. The program resulted in greater access to water, and greater production and consumption of food. However, by itself, the Boardwalk Cisterns program was not enough to raise beneficiary families above their food-insecure status. The program alleviated the problem of food insecurity, but other complementary government interventions are needed to guarantee the food security of families living in extreme poverty.
Assuntos
Fazendeiros , Segurança Alimentar , Brasil , Estudos Transversais , Abastecimento de Alimentos , Humanos , PercepçãoRESUMO
INTRODUCTION: Introduction: the simultaneous increase in the prevalence of cardiometabolic diseases and in the consumption of ultraprocessed foods (UPF) suggests a possible relationship between UPF and cardiometabolic risk (CMR). Objective: to evaluate the association between food consumption, according to the degree of processing, and CMR in young adults. Methods: this is a comparative cross-sectional study in 120 Brazilian young adults aged 18-25 years, categorized by the presence of CMR. Food consumption was investigated using a semi-quantitative food frequency questionnaire, and classified according to the extent of food processing. Food groups and tertiles in grams of unprocessed, minimally processed (MPF), processed and ultra-processed foods (UPF) were compared using the Kruskal-Wallis test. The associations of food consumption, according to level of processing (MPF and UPF), with CMR components were evaluated using logistic regression models. Results: a high caloric contribution of UPF was observed in the diet of this study population. The total energy intake from lipids in all foods (p = 0.04) and in UPF (p = 0.03) was greater in the group with CMR. A greater consumption of UPF was a risk factor for abdominal obesity (OR = 1.09; 95 % CI = 1.00-1.18) while a greater consumption of MPF was protective for LDL-c alterations independently of sex, physical activity, and alcohol intake (OR = 0.70; 95 % CI = 0.50-0.98). Conclusions: UPF contributed to a greater caloric intake from fat in the CMR, and was a risk factor for abdominal obesity. MPF was an independent protective factor for LDL-c alterations.
INTRODUCCIÓN: Introducción: la alta prevalencia de enfermedades cardiometabólicas y el avance de los alimentos ultraprocesados en la dieta sugieren una posible relación entre ellos. Objetivo: valorar la asociación entre el consumo de alimentos clasificado por el grado de procesamiento y el riesgo cardiometabólico en adultos jóvenes. Métodos: estudio transversal con una muestra compuesta por 120 jóvenes brasileños de 18 a 25 años, que fueron categorizados según el riesgo cardiometabólico (presencia o ausencia). El consumo de alimentos se evaluó mediante un cuestionario semicuantitativo de frecuencias a partir del que se clasificó la ingesta de acuerdo con el grado de procesamiento. Estos resultados se dividieron en terciles de gramos de alimentos (procesados y mínimamente procesados, procesados y ultraprocessados). Las diferencias de consumo diario de alimentos entre los terciles se compararon por medio del test de Kruskal-Wallis. Se realizó una regresión logística para asociar el grado de procesamiento con los componentes del riesgo cardiometabólico. Resultados: se observó una alta contribución energética de los alimentos ultraprocesados en la dieta de la muestra estudiada. La ingestión de grasas totales (p = 0,04) y alimentos ultraprocesados (p = 0,03) fue mayor entre el grupo con riesgo cardiometabólico. El consumo de alimentos ultraprocesados fue un factor de riesgo de obesidad abdominal (OR = 1,09; IC 95 %: 1,00-1,18), mientras que el consumo de los mínimamente procesados fue protector frente a las alteraciones del LDL-c, independientemente del sexo, la actividad física y la ingesta de alcohol (OR = 0,70; IC 95 % = 0,50-0,98). Conclusión: los alimentos ultraprocesados contribuyeron a aumentar la ingesta de grasas y a la obesidad abdominal; en cambio, los alimentos no procesados y mínimamente procesados redujeron los niveles de LDL-c.