Insegurança alimentar e consumo alimentar inadequado em escolares da rede municipal de São Leopoldo, RS, Brasil

The contribution of school meals to food security among households with children and adolescents in Brazil

OBJECTIVES

This study aimed to analyze the relationship between food insecurity and school meal consumption, adjusted for sociodemographic variables.

METHODS

This cross-sectional study investigated households with children and adolescents living in Brazilian municipalities. A semistructured survey was administered to parents/guardians at a parent-teacher meeting to assess their socioeconomic conditions and access to food, using the Brazilian Food Insecurity Scale to classify households as having food security or mild, moderate, or severe food insecurity. Parents and students were asked about the frequency of their consumption of school meals offered by the Brazilian School Food Program, which is one of the largest public policies in Brazil and offers free meals to all students in all public schools. Multinomial regression was performed to assess the relationship between food security and frequency of school meal consumption.

RESULTS

A total of 1705 students participated in the study, most of whom displayed some degree of food insecurity (56.5%) per the Brazilian Food Insecurity Scale. Regular consumption of school meals (>3 times/wk) was reported by 78.5% of students. Regarding the frequency of school meal consumption adjusted by sociodemographic variables, students from households with food insecurity (moderate or severe) were more likely to regularly consume school meals. The prevalence of households with moderate or severe food insecurity was twice as high as for those who lived in households with food security after adjusting for sociodemographic variables (odds ratio: 2.35; 95% confidence interval 1.53-3.61).

CONCLUSIONS

The Brazilian School Food Program has contributed greatly to food security. Although the guarantee of universality is essential for the program to reach all school children who are experiencing food insecurity, the program should also aim for greater equity.

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

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.

Disordered eating behaviors and energy and nutrient intake in a regional sample of Brazilian adolescents from public schools

PURPOSE

To estimate the prevalence of disordered eating behaviors and the association with energy and nutrient intake and nutritional status in adolescents.

METHODS

A school-based cross-sectional study was performed involving a probabilistic sample of 487 teenagers (aged 15-19 years) from public schools in the Metropolitan area of Rio de Janeiro, Brazil. The Eating Attitude Test and the Bulimic Investigatory Test Edinburgh questionnaires were applied to identify abnormal eating patterns and unusual dietary patterns, respectively. Nutritional status was defined by sex- and age-specific body mass index cutoffs. Energy and nutrient intake were assessed by a 3-day food record. The association between variables was assessed by the prevalence ratio and 95% confidence intervals, Pearson's Chi-square test, and linear regression.

RESULTS

The prevalence of abnormal eating patterns was 7.4% and that of unusual dietary patterns was 18.9%. Vitamin C intake was higher among girls with abnormal dietary patterns, with a consequent lower frequency of vitamin C deficiency when compared to those with normal dietary patterns. Calcium intake was lower in boys with unusual dietary pattern than in those without this behavior. Excess weight was associated with the presence of unusual dietary pattern in girls (PR: 2.4, 95% CI 1.6-3.5).

CONCLUSIONS

The prevalence of disordered eating behaviors was high, mainly in those who were overweight. It was associated with lower calcium intake in boys and with higher Vitamin C intake in girls.

LEVEL OF EVIDENCE

Level V, descriptive studies.