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Raymundo GP, Souza Dos Santos C, da Rosa SV, Werneck RI, Gasparello GG, Perotta M, Schaia Rocha J, Moysés SJ. Influences in food selection during complementary feeding in breastfeeding infants: A systematic review and metasynthesis of qualitative studies. Appetite 2024; 202:107626. [PMID: 39127348 DOI: 10.1016/j.appet.2024.107626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 07/24/2024] [Accepted: 08/07/2024] [Indexed: 08/12/2024]
Abstract
In the transition period from breastfeeding to the introduction of complementary feeding, the choice of food is extremely important for the child's development as many factors may be related. This study aims to investigate, through a systematic review and qualitative meta-synthesis, influence in the selection of foods in the introduction of complementary foods for children, including qualitative studies without language or publication period restrictions. Searches were performed in PubMed, LILACS, SciELO, Cinahl, Embase, Web of Science, and Scopus. Initially, 12,489 articles were selected for tittle reading, 13 were included in the review. Four analytical themes related to factors influencing complementary feeding were identified: family socioeconomic conditions, cultural and family aspects, guidance and advice from health professionals, and factors inherent to the infant. Economic factors, such as the opportunity to offer foods not consumed during the parents' childhood, were emphasized. The influence of grandmothers' opinions and community beliefs and traditions were considered. Trust in pediatricians and community health agents' advice, although considered, conflicted with cultural and family traditions. Mothers/caregivers often preferred to offer foods the child shows preference for, rather than introducing new flavors. The findings underscore the need for a better understanding of qualitative aspects.
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Affiliation(s)
- Gisele Pontaroli Raymundo
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Life Sciences, Dentistry Department, Curitiba, PR, Brazil.
| | - Caroline Souza Dos Santos
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Life Sciences, Dentistry Department, Curitiba, PR, Brazil.
| | - Saulo Vinicius da Rosa
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Life Sciences, Dentistry Department, Curitiba, PR, Brazil.
| | - Renata Iani Werneck
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Life Sciences, Dentistry Department, Curitiba, PR, Brazil.
| | - Gil Guilherme Gasparello
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Life Sciences, Dentistry Department, Curitiba, PR, Brazil.
| | | | - Juliana Schaia Rocha
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Life Sciences, Dentistry Department, Curitiba, PR, Brazil.
| | - Samuel Jorge Moysés
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Life Sciences, Dentistry Department, Curitiba, PR, Brazil.
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Brito AM, Souto DO, Silva LC, Leite HR, Morais RLS. Social vulnerability among Brazilian children in early childhood: a scoping review. J Pediatr (Rio J) 2024:S0021-7557(24)00099-8. [PMID: 39159916 DOI: 10.1016/j.jped.2024.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 06/08/2024] [Accepted: 06/11/2024] [Indexed: 08/21/2024] Open
Abstract
OBJECTIVE To identify, map, and describe studies involving Brazilian children in early childhood in situations of social vulnerability. SOURCE OF DATA A scoping review including full articles published in Portuguese and English up to March 2023, with no temporal restrictions. Searches were conducted in the MEDLINE/PubMed, Scielo, EMBASE, Cochrane, Scopus, CINAHL, Web of Science, PEDro, and LILACS databases. Journal metrics, sample characteristics, study area, characterization of the situation of social vulnerability, and study outcomes were extracted. SUMMARY OF THE FINDINGS Seventy-six articles involving a total of 107.740 children in early childhood were included in this study. These studies presented relevant findings, including the temporal publication trend, the variability of social vulnerability indicators, the scarcity of intervention studies, and the fact that 100% of eligible studies were from the health area. Negative outcomes were associated with the condition of social vulnerability in almost the entire sample, reinforcing the need for government policies capable of protecting early childhood from the effects of social vulnerability. CONCLUSION This scoping review mapped important findings involving Brazilian children in social vulnerability. It also identified literature gaps such as the need for intervention and multisectoral studies among health, education, and social protection.
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Affiliation(s)
- Alcina M Brito
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Programa de Pós-Graduação em Saúde, Sociedade e Meio Ambiente, Diamantina, MG, Brazil
| | - Deisiane O Souto
- Universidade Federal de Minas Gerais (UFMG), Escola de Educação Física, Fisioterapia e Terapia Ocupacional (EEFFTO), Departamento de Fisioterapia, Programa de Pós-Graduação em Ciências da Reabilitação (PPGCR), Belo Horizonte, MG, Brazil.
| | - Luana C Silva
- Universidade Federal de Minas Gerais (UFMG), Escola de Educação Física, Fisioterapia e Terapia Ocupacional (EEFFTO), Departamento de Fisioterapia, Programa de Pós-Graduação em Ciências da Reabilitação (PPGCR), Belo Horizonte, MG, Brazil
| | - Hércules R Leite
- Universidade Federal de Minas Gerais (UFMG), Escola de Educação Física, Fisioterapia e Terapia Ocupacional (EEFFTO), Departamento de Fisioterapia, Programa de Pós-Graduação em Ciências da Reabilitação (PPGCR), Belo Horizonte, MG, Brazil
| | - Rosane L S Morais
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Programa de Pós-Graduação em Saúde, Sociedade e Meio Ambiente, Diamantina, MG, Brazil
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Andrade-Silva A, Farias DR, Carrilho TRB, de Castro IRR, Kac G, de Castro MBT. Trends in Complementary Feeding Indicators in Children Aged 6-23 Months According to Participation in a Conditional Cash Transfer Program: Data from the Brazilian Food and Nutrition Surveillance System, 2015-2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:923. [PMID: 39063499 PMCID: PMC11276628 DOI: 10.3390/ijerph21070923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 07/05/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024]
Abstract
Inadequate practices during complementary feeding are associated with malnutrition, especially in children experiencing vulnerable conditions and social inequality. The aim of this study was to evaluate the trends in complementary feeding indicators (CFIs) according to participation in a Brazilian cash transferu program-the Bolsa Família Program (BFP). This was a time-series study with secondary data from 600,138 children assisted from 2015 to 2019 and registered within the Brazilian Food and Nutrition Surveillance System. The CFIs assessed were food introduction, minimum meal frequency and appropriate consistency, minimum dietary diversity, iron-rich food, vitamin A-rich food, ultra-processed food consumption, and zero vegetable or fruit consumption. Prevalence and 95% confidence intervals were calculated for the CFIs according to BFP, the region of residence, and the child's age. The Prais-Winsten regression method was used to analyze the temporal trend. There was a steady trend for all CFIs of a healthy diet. A decrease in ultra-processed food consumption for both BFP (-10.02%) and non-BFP children (-9.34%) was observed over the years. Children residing in the North and Northeast regions and those enrolled in the BFP were more distant from the recommended feeding practices when compared to the other regions and non-BFP children. The results highlight the relevance of nutritional surveillance and the need to improve food and nutrition public policies for children aged 6-23 months, particularly for those experiencing greater social vulnerability.
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Affiliation(s)
- Andreia Andrade-Silva
- Department of Social and Applied Nutrition, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro 21941-902, Brazil
| | - Dayana Rodrigues Farias
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro 21941-902, Brazil
| | - Thais Rangel Bousquet Carrilho
- Department of Obstetrics & Gynaecology, Faculty of Medicine, University of British Columbia, Vancouver, BC V6H3N1, Canada
| | - Inês Rugani Ribeiro de Castro
- Department of Social Nutrition, Institute of Nutrition, State University of Rio de Janeiro, Rio de Janeiro 20550-013, Brazil
| | - Gilberto Kac
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro 21941-902, Brazil
| | - Maria Beatriz Trindade de Castro
- Department of Social and Applied Nutrition, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro 21941-902, Brazil
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Martins FA, Ramalho AA, de Andrade AM, Opitz SP, Koifman RJ, de Aguiar DM, da Silva IF. Minimum acceptable diet in a cohort of children aged between 6 and 15 months: Complementary feeding assessment and associated factors in the Brazilian western Amazon. Nutrition 2024; 117:112231. [PMID: 37976617 DOI: 10.1016/j.nut.2023.112231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/17/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE The goal of the article was to assess complementary feeding patterns, and associated factors, of children between 6 and 15-month old in Rio Branco-Acre, Brazil, based on the minimum acceptable diet indicator. METHODS This study was cross-sectional, including 857 children between ages 6 and 15 mo, from a 2015 birth cohort of Rio Branco, Brazil. The prevalence of complementary feeding indicators, minimum meal frequency, minimum dietary diversity, and minimum acceptable diet was estimated based on the recommendations of the World Health Organization. Sociodemographic characteristics, infant and maternal habits, prenatal information, birth characteristics, breastfeeding, and complementary feeding were evaluated. Differences between the proportions were evaluated by the χ2 test and univariate and multiple logistic regression analyses, to determine associated factors with child minimum acceptable diet. RESULTS The minimum frequencies of meals and dietary diversity were observed in 81.0% and 51.8% of the children, respectively. The minimum acceptable diet prevalence was 47.1%. Also, minimum acceptable diet was inversely associated with C, D, and E social classes (adjusted odds ratio = 0.49; 95% CI, 0.33-0.72), number of living siblings (adjusted odds ratio for two or three children = 0.69; 95% CI, 0.48-0.98, and adjusted odds ratio for ≥ 4 children = 0.56; 95% CI, 0.37-0.84). Maternal regular consumption of fruits, vegetables, and legumes (adjusted odds ratio = 2.62; 95% CI, 1.69-4.05), child age from 12 to 15 mo (adjusted odds ratio = 2.05; 95% CI, 1.32-3.18), and receiving guidance regarding complementary feeding during postnatal consultations (adjusted odds ratio = 1.38; 95% CI, 1.03-1.86) were directly associated with minimum acceptable diet. CONCLUSIONS Fewer than 50% of the children received adequate food with adequate frequency and diversity. Low socioeconomic status and having ≥ 2 living siblings reduced the chance of minimum acceptable diet, whereas maternal healthy diet, child age (12-15 mo), and complementary feeding counseling during postnatal appointments increased the chance of minimum acceptable diet.
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Affiliation(s)
| | | | | | - Simone Perufo Opitz
- Graduate Program of Community Health, Federal University of Acre, Rio Branco, Brazil
| | - Rosalina Jorge Koifman
- Department of Epidemiology and Quantitative Methods of Health, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Debora Melo de Aguiar
- Graduate Program of Community Health, Federal University of Acre, Rio Branco, Brazil
| | - Ilce Ferreira da Silva
- Department of Epidemiology and Quantitative Methods of Health, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
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Dallazen C, Tietzmann DC, da Silva SA, Nilson EAF, Gonçalves VSS, Lang RMF, Crispim SP, Moreira JD, Garcia SC, Vítolo MR. Vitamin A deficiency and associated risk factors in children aged 12-59 months living in poorest municipalities in the South Region of Brazil. Public Health Nutr 2023; 26:132-142. [PMID: 35125127 PMCID: PMC11077461 DOI: 10.1017/s1368980022000325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 12/20/2021] [Accepted: 02/03/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To estimate the prevalence of vitamin A deficiency (VAD) in children and associated risk factors. DESIGN Analysis of data from a cross-sectional multicentre study performed in the primary care units of the municipalities from January to June 2015. The children's legal guardians answered a socio-economic questionnaire, and the children's blood samples were obtained by venipuncture. Plasma retinol was determined by HPLC. Plasma retinol values of <0·70 μmol/l were considered VDA. Poisson multiple regression with robust variance was used. Values of P < 0·05 were considered significant. The data were analysed in the SPSS software, 21.0. SETTING Forty-eight poorest municipalities in the South Region of Brazil. PARTICIPANTS Children (n 1503) aged 12-59 months. RESULTS The prevalence of VAD in the sample was 1·9 % (95 % CI (0·5, 6·8)). The following risk factors were associated with the outcome in the final explanatory model: family received Bolsa Familia program benefits (PR = 3·19; 95 % CI (1·69, 6·02)), child was not being breastfed (PR = 5·22; 95 % CI (1·68, 16·18)) and stunting (PR = 4·75; 95 % CI (2·10, 10·73)). CONCLUSIONS VAD did not represent a public health problem for children living in socio-economically vulnerable municipalities in the South Region of Brazil, suggesting a new panorama of this nutritional deficiency even in regions of low socio-economic conditions in these three states. Thus, in view of the current nutritional transition scenario, it is necessary to continuously monitor and improve public policies related to vitamin A supplementation in the country.
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Affiliation(s)
- Camila Dallazen
- Nutrition Research Group (NUPEN), Federal University of Health Sciences of Porto Alegre, Sarmento Leite 245, Porto Alegre90050-170, Brazil
| | - Daniela Cardoso Tietzmann
- Nutrition Research Group (NUPEN), Federal University of Health Sciences of Porto Alegre, Sarmento Leite 245, Porto Alegre90050-170, Brazil
| | | | | | | | | | | | | | | | - Márcia Regina Vítolo
- Nutrition Research Group (NUPEN), Federal University of Health Sciences of Porto Alegre, Sarmento Leite 245, Porto Alegre90050-170, Brazil
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da Mata MM, Neves JA, de Medeiros MAT. Hunger and its associated factors in the western Brazilian Amazon: a population-based study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2022; 41:36. [PMID: 35978447 PMCID: PMC9383661 DOI: 10.1186/s41043-022-00319-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 08/04/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Hunger affects millions of people worldwide. In the current pandemic scenario of coronavirus Brazil has experienced an epidemic peak of hunger, amplifying existing prepandemic vulnerabilities, mainly in the North Region of the country. The aim of the present study was to investigate the prevalence of food insecurity and its associated factors in homes with children under 5 years of age in an urban area of a municipality of the western Brazilian Amazon. METHODS A household survey was conducted with a probabilistic sample of 557 children and their families. Food insecurity (FI) was determined using the Brazilian Food Insecurity Scale. Associations between variables were analyzed based on the prevalence ratio (PR) and respective 95% confidence intervals (CI) calculated through multiple Poisson regression analysis. Variables with a P value < 0.05 after adjustments were considered significantly associated with the outcome. RESULTS A prevalence of 76.5% (CI 1.36-2.67) food insecurity was found among the families in the study; 42.9% had moderate (CI 1.31-2.83) and severe (CI 1.10-1.83) food insecurity. Moderate and severe FI was associated with low family income (P = 0.00), participation in governmental income transfer programs (P = 0.01), and heads of household with less than 7 years of schooling (P = 0.02). Moreover, substantial frequencies of height deficit and being overweight were found among the children. CONCLUSIONS The high prevalence of hunger and food insecurity and its associated factors reflects the context of geographic isolation and social exclusion in which these families live, suggesting that a substantial portion of the population under 5 years of age had experienced episodes of hunger in the 90 days prior to the survey. The prevalence of height deficit and being overweight among the children reveals a scenario of epidemiological/nutritional polarization, requiring the formulation of specific public policies for this population.
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Affiliation(s)
- Mayline Menezes da Mata
- Nutrition and Health, Health and Society Institute, Federal University of São Paulo (UNIFESP), Silva Jardim Street, 136, Vila Mathias, Santos, São Paulo, SP 11015-020 Brazil
- Federal University of São Paulo, 862, Botucatu Street, Vila Clementino, SP 04039-032 Brazil
| | - José Anael Neves
- Health and Society Institute, Federal University of São Paulo (UNIFESP), Silva Jardim Street, 136, Vila Mathias, Santos, SP 11015-020 Brazil
| | - Maria Angélica Tavares de Medeiros
- Department of Public Policies and Collective Health, Health and Society Institute, Federal University of São Paulo (UNIFESP), Silva Jardim Street, 136, Vila Mathias, Santos, SP 11015-020 Brazil
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CIOCHETTO CR, BOLZAN GDP, WEINMANN ARM. Influence of Kangaroo Mother Care on breastfeeding, the introduction of complementary feeding and diet quality in the first year of life. REV NUTR 2022. [DOI: 10.1590/1678-9865202235e220054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
ABSTRACT Objective To assess the influence of Kangaroo Mother Care on breastfeeding rates in preterm neonates, both at hospital discharge and throughout the first year of life, as well as its relation with the time of introduction of early complementary feeding and diet quality. Methods Observational, prospective and analytical longitudinal study conducted in a public hospital in southern Brazil. The study included 46 preterm neonates, who were admitted to a Kangaroo Neonatal Intermediate Care Unit or Conventional Neonatal Intermediate Care Unit. Results The frequency of exclusive breastfeeding at hospital discharge was higher in preterm neonates of Kangaroo Neonatal Intermediate Care Unit (p<0.001), and at four months of corrected age, 35% of them continued on exclusive breastfeeding (p=0.029), as compared to infants in Conventional Neonatal Intermediate Care Unit. However, at six and 12 months, no difference was found in breastfeeding rates between the participating groups. At four months of corrected age, approximately 45% of the breastfeeding infants in both groups were already on complementary feeding. At 12 months of corrected age, consumption of ultra-processed foods was 38.9% in infants from the Kangaroo Neonatal Intermediate Care Unit and 70% in infants from the Conventional Neonatal Intermediate Care Unit (p=0.054), and no significant differences were found. Conclusion The Kangaroo Mother Care fostered exclusive breastfeeding at hospital discharge and at 4 months of corrected age. On the other hand, with regard to the early introduction of complementary feeding, Kangaroo Mother Care was not protective, and a high rate of consumption of processed foods by infants was found.
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Indexes to assess feeding practices of children under 2 years old: a systematic review. Public Health Nutr 2021; 24:2033-2049. [PMID: 33504386 DOI: 10.1017/s1368980021000410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To systematically review studies that used indexes to assess feeding practices of children under 2 years. DESIGN Seven databases were searched with no limit on language or publication date. SETTING The reviewed studies included thirteen Asian, ten Latin American, four European, four North American, three Oceanian and three African. PARTICIPANTS Children under 2 years. RESULTS We analysed thirty-six studies: twenty-two presenting original indexes and fourteen using adapted indexes. Among the original indexes, thirteen assess breast-feeding, fourteen food consumption, ten food groups, and ten other feeding practices. Original indexes were mainly adapted to fit the data available in the study, to update for current nutritional recommendations or to add components not present in the original indexes. Seven studies evaluated the associations between the indexes and nutrient intake or nutritional status. The main limitations cited by the authors were: flaws in the definition of the index components, criteria for cut-off points and weighting of the evaluated index components. CONCLUSIONS The assessment of feeding practices for young children and its comparison across countries remains a challenge, especially due to the lack of consensus on the construction of indexes and regional differences in dietary recommendations and practices. Lack of validation for some indexes also makes it difficult to choose the most appropriate index for a given objective. Adapting existing indexes is a viable option. We point out relevant recommendations that may contribute to future research. Validation and longitudinal studies in diverse populations are favourable to qualify the assessment of feeding practices in this group.
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Rebouças AG, Bernardino ÍDM, Dutra ER, Imparato JCP, Duarte DA, Flório FM. Factors associated with feeding practices among Brazilian children aged 12 to 23 months old. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2020. [DOI: 10.1590/1806-93042020000400007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: a quantitative analytical cross-sectional study aimed to identify demographic characteristics to access health services and housing conditions in relation to inadequate feeding practices among Brazilian children from 12 to 23 months of age. Methods: the analysis of the feeding practices (consumption of recommended food groups) of 2541 Brazilian children (aged 12-23 months old) was performed using data from the Pesquisa Nacional de Saúde 2013 (National Health Survey). Descriptive and multivariate statistics used the Decision Tree Analysis based on CHAID (Chi-squared Automatic Interaction Detector) algorithm, as well as hierarchically adjusted Poisson regression analyses were performed. The variables were entered in a hierarchical model at distal (demographic), intermediate (access to health) and proximal (housing conditions) levels. Results: the results showed a high prevalence of sugar consumption (85.5%; CI95%=83.7-87.2) and highlighted inadequate feeding practices among non-white children (p=0.001), resident in the North (p<0.001) and Northeast (p=0.010) of Brazil and in towns in the countryside (p<0.001) presented feeding practices that were not recommended for consumption in the food groups. Conclusions: non-white children, who lived in the North and Northeast regions of Brazil and in the countryside, which are known to be more socioeconomically vulnerable, were more likely to experience inadequate feeding practices.
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Morais DDC, Lopes SO, Priore SE. [Evaluation indicators of Food and Nutritional Insecurity and associated factors: systematic review]. CIENCIA & SAUDE COLETIVA 2020; 25:2687-2700. [PMID: 32667551 DOI: 10.1590/1413-81232020257.23672018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 11/26/2018] [Indexed: 11/22/2022] Open
Abstract
The scope of this paper was to systematically investigate the indicators used in the evaluation of food and nutritional insecurity and associated factors in Brazilian studies. After selection in the databases using search terms and reverse search, 89 articles were included. The majority of the articles evaluated food and nutritional insecurity according to the indicator of perception, using the Brazilian Scale of Food Insecurity (83.1%), the American Scale (5.62%) and isolated questions (2.25%). The other articles evaluated the presence of malnutrition among children (1.12%), expenditure on food (1.12%), adult-equivalent dietary intake (1.12%), protocols (2.25%), and prediction models (2.25%). Food and nutritional insecurity (measured by the different indicators) was associated with socioeconomic and demographic factors, health and lifestyle conditions, food consumption and nutritional status, based on families, specific age groups, beneficiaries of government programs, among others, as sample units. The majority of the studies merely evaluated the food dimension of the insecurity, thereby increasing the difficulty in evaluating this complex situation.
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Affiliation(s)
- Dayane de Castro Morais
- Departamento de Nutrição e Saúde, Centro de Ciências Biológicas e da Saúde, Universidade Federal de Viçosa. Av. P. H. Rolfs s/n, Centro. 36570-000 Viçosa MG Brasil.
| | - Sílvia Oliveira Lopes
- Departamento de Nutrição e Saúde, Centro de Ciências Biológicas e da Saúde, Universidade Federal de Viçosa. Av. P. H. Rolfs s/n, Centro. 36570-000 Viçosa MG Brasil.
| | - Silvia Eloíza Priore
- Departamento de Nutrição e Saúde, Centro de Ciências Biológicas e da Saúde, Universidade Federal de Viçosa. Av. P. H. Rolfs s/n, Centro. 36570-000 Viçosa MG Brasil.
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Spaniol AM, da Costa THM, Bortolini GA, Gubert MB. Breastfeeding reduces ultra-processed foods and sweetened beverages consumption among children under two years old. BMC Public Health 2020; 20:330. [PMID: 32171266 PMCID: PMC7071637 DOI: 10.1186/s12889-020-8405-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 02/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breastfeeding and adequate complementary feeding are associated with healthy eating habits, prevention of nutritional deficiencies, obesity and non-communicable diseases. Our aim was to identify feeding practices and to evaluate the association between breastmilk intake and complementary feeding, focusing on ultra-processed foods (UPF) and sweetened beverages, among children under 2 years old. METHODS We conducted a cross-sectional study including 847 children from 20 Primary Health Units. We evaluated children's food consumption using a food intake markers questionnaire. We conducted a logistic regression to evaluate the effect of breastmilk intake on feeding practices. RESULTS The breastmilk intake was associated with lower odds of consuming non-recommended foods, such as cookies or crackers (OR: 0.29; IC 95%: 0.20-0.41) for children under 6 months, yogurt (OR: 0.33; CI 95%: 0.12-0.88) for children between 6 and 12 months and soft drinks (OR: 0.36; CI 95%: 0.17-0.75) for children between 12 and 24 months. Moreover, the breastmilk intake was associated with lower odds of consuming UPF (OR: 0.26; CI 95%: 0.09-0.74) and sweetened beverages (OR: 0.13; CI 95%: 0.05-0.33) for children under 6 months. For children between 12 and 24 months, breastmilk intake was associated with lower odds of consuming sweetened beverages (OR: 0.40; CI 95%: 0.24-0.65). CONCLUSION Breastmilk intake was associated with a reduced consumption of UPF and sweetened beverages. Investment in actions to scale up breastfeeding can generate benefits, besides those of breastmilk itself, translating into better feeding habits and preventing health problems in childhood.
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Affiliation(s)
- Ana Maria Spaniol
- Postgraduate Program in Human Nutrition, Center for Epidemiological Studies in Health and Nutrition – NESNUT, University of Brasilia, Brasilia, Federal District Brazil
| | | | - Gisele Ane Bortolini
- General Coordination of Food and Nutrition, Ministry of Health, Brasília, Federal District Brazil
| | - Muriel Bauermann Gubert
- Department of Nutrition, Center for Epidemiological Studies in Health and Nutrition – NESNUT, University of Brasilia, Brasilia, Federal District Brazil
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Carneiro LBV, Castro IRRD, Juvanhol LL, Gomes FDS, Cardoso LDO. Associação entre insegurança alimentar e níveis de hemoglobina e retinol em crianças assistidas pelo Sistema Único de Saúde no Município do Rio de Janeiro, Brasil. CAD SAUDE PUBLICA 2020; 36:e00243418. [DOI: 10.1590/0102-311x00243418] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 05/20/2019] [Indexed: 11/22/2022] Open
Abstract
Neste trabalho foi analisada a associação entre insegurança alimentar e níveis de hemoglobina e retinol em crianças de 6 a 59 meses de idade. Trata-se de um estudo seccional, realizado em 2014, com amostra representativa da população de crianças nessa faixa etária, atendidas em unidades básicas de saúde do Município do Rio de Janeiro, Brasil. Para a análise dos níveis de insegurança alimentar foi utilizada a Escala Brasileira de Insegurança Alimentar e, para a determinação de hemoglobina e de retinol sérico, foi realizada a punção venosa. A associação entre as variáveis foi avaliada por intermédio de modelos de regressão quantílica. Do total de crianças estudadas, 40,3% apresentavam insegurança alimentar e as prevalências de anemia e de deficiência de vitamina A foram 13,7% e 13%, respectivamente. Os resultados do estudo revelaram associação inversa, estatisticamente significativa, entre insegurança alimentar leve e níveis de retinol. Para os demais níveis de insegurança alimentar (moderada e grave), os resultados também sugerem a presença de associação inversa para hemoglobina e, quanto aos níveis de retinol, as estimativas pontuais parecem menores em crianças com insegurança alimentar grave, entretanto, estas estimativas não foram estatisticamente significativas. Esses resultados sugerem que a insegurança alimentar pode estar associada com carências de micronutrientes em crianças menores de 5 anos.
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Rinaldi AEM, Conde WL. Socioeconomic inequality in dietary intake begins before 24 months in Brazilian children. Rev Saude Publica 2019; 53:9. [PMID: 30726490 PMCID: PMC6390684 DOI: 10.11606/s1518-8787.2019053000679] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 04/12/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE: To assess dietary patterns by socioeconomic gradient of Brazilian infants and young children in 2006 and 2013. METHODS: Data from the National Demographic Survey (2006) and the National Health Survey (2013) were used. Food intake were described by wealth index, age range and survey year. Dietary patterns were defined by principal component analysis. Association of wealth index and dietary patterns were modelled using linear regression. RESULTS: Breast milk intake was higher for poor infants and young children, while fresh food intake (fruits, vegetables, meats, beans) was higher for the richer ones in 2006 and 2013. Biscuits and sweetened beverages were more consumed by rich infants and young children in 2006 and by poor and rich children in 2013. Three dietary patterns (DP1, DP2, and DP3) were identified in 2006 and four in 2013 (DP1, DP2, DP3, and DP4). DP1 was composed mainly of fresh foods, and it was positively associated with the wealth index for infants and young children in both years. DP2 was composed of biscuits, cookies and sweetened beverages, and it was positively associated with the wealth index for young children in 2006 and for poor and rich infants and young children in 2013. DP3 was composed of milk, water and porridge in both years, and it was not associated with the wealth index. DP4 was composed of breast milk and porridge, and it was negatively associated with the wealth index. CONCLUSIONS: DP1 is a characteristic pattern for richer infants and young children since 2006, while DP2 is a characteristic pattern for all infants and young children in 2013, regardless of wealth index. Dietary inequality between the poor and the rich seems to begin in childhood.
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Affiliation(s)
| | - Wolney Lisboa Conde
- Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Nutrição. São Paulo, SP, Brasil
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Alderete E, Sonderegger L, Pérez-Stable EJ. Emerging themes in food security: environmental justice, extended families and the multiple roles of grandmothers. Int J Equity Health 2018; 17:139. [PMID: 30208934 PMCID: PMC6134785 DOI: 10.1186/s12939-018-0856-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 09/03/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Pre- and perinatal nutritional status defines the development of adult metabolism and energy balance in humans. Young children in poor households are disproportionately more vulnerable to food insecurity given the cumulative impact of chronic stress on susceptibility to chronic diseases as an adult. Qualitative studies focusing on the experience of food insecurity in Latin America are scarce. In Argentina, although socioeconomic indicators improved in the aftermath of the 2001ecomomic crisis, the disadvantaged provinces in the north continue to bear the burden of historical inequities. The study was conducted among Primary Health Care patients in the city of San Salvador de Jujuy, Argentina. It analyzes environmental and household level stressors through the narratives of mothers with young children living with food insecurity, from the perspectives of eco-developmental conceptual frameworks. METHODS We conducted 11 semi-structured interviews with mothers of children < 1 to 6 years of age who participated in maternal-child health programs in Primary Health Care clinics and lived in food insecure households. Interviews focused on the environmental context and the resources and processes for obtaining and preparing daily meals. RESULTS The Eco-bio-developmental (EBD) framework and the vulnerability-assets approach, provided a basis for conceptualizing the significance of findings. Our results indicated the need to understand pathways in the association of stressors, vulnerability and ill health, as well as the mitigating role of social relationships. For example, understanding the link between the stress of being exposed to environmental contaminants and the capacity to overcome food insecurity, or developing strategies to integrate the support provided by kinship networks like extended families into food security programs. The results also indicate the importance of developing support mechanisms for vulnerable family members like grandmothers in food insecure households who play instrumental roles as providers and caretakers of younger relatives. CONCLUSION The empirical evidence generated by this study may inform community based strategies and public health policies to address food insecurity in vulnerable population groups who face health effects from multiple stressors.
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Affiliation(s)
- Ethel Alderete
- Universidad Nacional de Jujuy, Consejo Nacional de Investigaciones Científicas y Técnicas, Instituto de Ciencia y Tecnología Regional. Currently at Centro de Investigaciones Sociales y Regionales (CISOR), Independencia 575, 4600 San Salvador de Jujuy, Argentina
| | - Lauren Sonderegger
- San Francisco School of Medicine, University of California, San Francisco, USA
- Present address: Swedish Family Medicine Residency Cherry Hill, 550 16th Ave, #400, Seattle, Washington 98122 USA
| | - Eliseo J. Pérez-Stable
- Division of Intramural Research, National Heart, Lung and Blood Institute, and Office of the Director, National Institute on Minority health and Health Disparities, National Institutes of Health, 6707 Democracy Boulevard, Suite 800, Bethesda, MD 20892-5465 USA
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Cunha MPL, Marques RC, Dórea JG. Child Nutritional Status in the Changing Socioeconomic Region of the Northern Amazon, Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 15:E15. [PMID: 29295489 PMCID: PMC5800115 DOI: 10.3390/ijerph15010015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 12/08/2017] [Accepted: 12/20/2017] [Indexed: 11/25/2022]
Abstract
The living conditions (i.e., socioeconomic, healthcare-related, nutritional, and environmental) to which children are exposed may influence their ability to reach their optimal growth potential. This review focuses on the relationship between the nutritional status of children under five years of age and social and environmental factors in Northern Brazil. Children living in this region have limited access to healthcare and face precarious socioeconomic and environmental conditions. This analysis was based on data from national health surveys, the consolidated food, nutrition surveillance system (SISVAN), and indicators of the DPSEEA (driving force, pressure, state, exposures, health effects, and actions) framework. The northern region has the worst living conditions in the country, and children under five years of age have significant height-for-age, weight-for-age, and weight-for-height deficits. Concomitantly, the prevalence of children who are overweight has increased significantly, although it remains lower than that in more developed Brazilian regions. Insufficient and/or inadequate dietary practices and early exposure to unfavorable living conditions are risk factors for nutritional deviations. Further advances in public health policies that consider regional characteristics, particularly in the north, where progress has been slower, are needed.
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Affiliation(s)
- Mônica P L Cunha
- Fundação Universidade Federal de Rondônia, Porto Velho CEP 76801-059, RO, Brasil.
- Department of Nutrition, Faculty of Health Sciences, Universidade de Brasilia, Brasília CEP 70919-970, DF, Brasil.
| | - Rejane C Marques
- Universidade Federal do Rio de Janeiro, Campus Macaé, Rio de Janeiro CEP 27930-560, RJ, Brasil.
| | - José G Dórea
- Department of Nutrition, Faculty of Health Sciences, Universidade de Brasilia, Brasília CEP 70919-970, DF, Brasil.
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Food security measurement and governance: Assessment of the usefulness of diverse food insecurity indicators for policy makers. GLOBAL FOOD SECURITY-AGRICULTURE POLICY ECONOMICS AND ENVIRONMENT 2017. [DOI: 10.1016/j.gfs.2017.06.003] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
OBJECTIVE To describe dietary patterns (DP) from 1996 to 2006 and in the first 5 years of life and to explore individual and contextual characteristics associated with each DP. DESIGN DP were defined by principal component analysis. The association between DP and individual (sociodemographic, maternal and child) and contextual (geographic regional and year) characteristics was analysed by multilevel analysis. SETTING Two complex probabilistic Brazilian Demographic and Health Surveys (BDHS 1996, 2006). SUBJECTS Brazilian children under 5 years of age. RESULTS DP1 included yoghurt, vegetables, fruits, tubers, red meat. DP2 included liquids, milk, fruits, egg/chicken/fish, red meat, breast milk (negative loading). DP3 included fruit juices, 'papilla', yoghurt, red meat (negative loading). DP4 included formulas, milk, enriched 'papilla', egg/chicken/fish (negative loading). DP prevalence within the age range from 1996 to 2006 remained constant for DP1; increased after 12 and 6 months, respectively, for DP2 and DP3; and decreased for DP4. DP1 was explained by higher maternal education, wealth, lower number of children at home; DP2 by living in rural area and younger mothers; and DP4 by lower maternal education and wealth. The total variance of the model attributable to geographic region was 30·2, 20·7 and 54·2 % for DP2, DP3 and DP4, respectively. CONCLUSIONS DP trends observed from 1996 to 2006 show positive aspects, such as: maintenance of DP1 as the main DP after 12 months; an increase in the prevalence of DP2 and DP3 followed by a decrease of DP4 after 6 months. DP1 is explained mainly by socio-economic factors, regardless of contextual characteristics, and DP2, DP3, DP4 are partially explained by contextual effects.
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Nunes LM, Vigo Á, Oliveira LDD, Giugliani ERJ. [Effect of a healthy eating intervention on compliance with dietary recommendations in the first year of life: a randomized clinical trial with adolescent mothers and maternal grandmothers]. CAD SAUDE PUBLICA 2017; 33:e00205615. [PMID: 28678940 DOI: 10.1590/0102-311x00205615] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 07/28/2016] [Indexed: 11/22/2022] Open
Abstract
The objective was to evaluate the effect of a healthy eating intervention targeting adolescent mothers and maternal grandmothers on compliance with dietary recommendations in the first year of life. This was a randomized clinical trial involving 320 adolescent mothers, their infants, and 169 maternal grandmothers (when the three generations were living together), randomly assigned to the intervention versus control group. The intervention consisted of six counseling sessions on healthy feeding during the child's first year of life, the first of which held at the maternity ward and the others at 7, 15, 30, 60, and 120 days, at the homes. Information on the infant's diet was obtained monthly during the first 6 months and then every 2 months until the child reached 12 months of age, using a Food Frequency Questionnaire, in addition to questions on mealtimes, consistency of the foods, hygiene, preparation of meals, conservation of foods, and the mother's or grandmother's approach to the child's diet in the presence of illness. The outcome was defined as meeting the Ten Steps to a Healthy Diet: A Food Guide for Children Under Two Years Old, assessed by a score. The mean sum of the scores for each step obtained in the intervention group was higher than in the control group; the intervention doubled the odds of the total score being greater than or equal to the median. Living with grandmother did not influence the score either in the intervention group or the control group. The proposed intervention had a positive effect on meeting the Ten Steps, independently of participation by the maternal grandmother, showing that educational interventions can improve quality of diet for children in the first year of life.
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Affiliation(s)
- Leandro Meirelles Nunes
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil.,Universidade Feevale, Novo Hamburgo, Brasil
| | - Álvaro Vigo
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
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Hidalgo-Troya A, Guerrero-Díaz GF, Estupiñan-Ferrín VL, Rocha-Buelvas A. [Family vulnerability index in the municipality of Pasto, Colombia, 2012]. CAD SAUDE PUBLICA 2017; 33:e00122315. [PMID: 28380142 DOI: 10.1590/0102-311x00122315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 04/28/2016] [Indexed: 11/22/2022] Open
Abstract
This study's objective was to measure the vulnerability index of families in the municipality of Pasto, Colombia. In a sample of 270 families of all socioeconomic strata (239 urban and 31 rural), a confidential survey was conducted using the vulnerability index, consisting of five dimensions: demographic, social, economic, environmental, and geography, forecasting, and prevention. The families in strata 1 and 2 and the houses in the center, west, northwest, and northeast of the urban area showed high vulnerability, even higher than those in rural areas. Fifty percent of the families showed low vulnerability and 42% medium vulnerability. The poorest families were the most vulnerable, but poor families were also vulnerable in the municipality of Pasto.
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Affiliation(s)
| | | | | | - Anderson Rocha-Buelvas
- Maestría en Salud Pública y Desarrollo Social, Fundación Universitaria del Área Andina, Bogotá, Colombia
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Hidaka BH, Kerling EH, Thodosoff JM, Sullivan DK, Colombo J, Carlson SE. Dietary patterns of early childhood and maternal socioeconomic status in a unique prospective sample from a randomized controlled trial of Prenatal DHA Supplementation. BMC Pediatr 2016; 16:191. [PMID: 27884184 PMCID: PMC5123236 DOI: 10.1186/s12887-016-0729-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 11/08/2016] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Dietary habits established in early childhood and maternal socioeconomic status (SES) are important, complex, interrelated factors that influence a child's growth and development. The aim of this study was to define the major dietary patterns in a cohort of young US children, construct a maternal SES index, and evaluate their associations. METHODS The diets of 190 children from a randomized, controlled trial of prenatal supplementation of docosahexaenoic acid (DHA) were recorded at 6-mo intervals from 2-4.5 years by 24-h dietary recall. Hierarchical cluster analysis of age-adjusted, average daily intake of 24 food and beverage groups was used to categorize diet. Unrotated factor analysis generated an SES score from maternal race, ethnicity, age, education, and neighborhood income. RESULTS We identified two major dietary patterns: "Prudent" and "Western." The 85 (45%) children with a Prudent diet consumed more whole grains, fruit, yogurt and low-fat milk, green and non-starchy vegetables, and nuts and seeds. Conversely, those with a Western diet had greater intake of red meat, discretionary fat and condiments, sweet beverages, refined grains, French fries and potato chips, eggs, starchy vegetables, processed meats, chicken and seafood, and whole-fat milk. Compared to a Western diet, a Prudent diet was associated with one standard deviation higher maternal SES (95% CI: 0.80 to 1.30). CONCLUSIONS We found two major dietary patterns of young US children and defined a single, continuous axis of maternal SES that differed strongly between groups. This is an important first step to investigate how child diet, SES, and prenatal DHA supplementation interact to influence health outcomes. TRIAL REGISTRATION NCT00266825 . Prospectively registered on December 15, 2005.
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Affiliation(s)
- Brandon H Hidaka
- Department of Dietetics and Nutrition, University of Kansas Medical Center, MS 4013, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA
| | - Elizabeth H Kerling
- Department of Dietetics and Nutrition, University of Kansas Medical Center, MS 4013, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA
| | - Jocelynn M Thodosoff
- Department of Dietetics and Nutrition, University of Kansas Medical Center, MS 4013, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA
| | - Debra K Sullivan
- Department of Dietetics and Nutrition, University of Kansas Medical Center, MS 4013, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA
| | - John Colombo
- Department of Psychology, University of Kansas, 1415 Jayhawk Blvd., Lawrence, KS, 66045, USA
| | - Susan E Carlson
- Department of Dietetics and Nutrition, University of Kansas Medical Center, MS 4013, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA.
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