The Brazilian National School Feeding Program (PNAE) seeks to meet student's nutritional needs during the period they remain in school. This study aimed to determine the nutritional composition of meals provided in municipal day-care centres serving children of 7-11 months (group A) and 12-36 months (group B) of age and to compare observed values with the PNAE's and dietary reference intakes' (DRI) recommendations. This cross-sectional study was conducted in 4 day-care centres in the metropolitan area of Curitiba, Paraná, Brazil, between June and November 2013. Food samples of six daily meals were collected during 20 non-consecutive days, totalling 120 samples. For each meal, average served and consumed portions were submitted for laboratory analysis of moisture, ash, proteins, lipids, carbohydrates, dietary fibre, Na, Ca and Fe and compared with the PNAE's and DRI's values. No statistically significant difference was found between age groups (P=0·793) regarding portion sizes and nutritional composition. The same menu was offered to both groups in 95 % of the meals (n 114), although the groups' nutritional needs were different. For group A, served meals met PNAE's recommendations for energy, carbohydrates, proteins, Na and Ca content, and consumed portions provided 70 % of the nutritional needs for carbohydrates, proteins and Ca. For group B, served portions complied with the PNAE's values for proteins, Na and Ca. Proteins and Na reached 70 % of the nutritional needs when consumed food was evaluated. School feeding in day-care centres partially meet PNAE's guidelines and children's nutritional requirements, contradicting the primary objective established by the national programme.

Few studies have investigated the simultaneous effect of individual and contextual factors on the occurrences of anemia. This study aims to evaluate the variability of children’s hemoglobin levels from municipalities in social vulnerability and its association with factors of individual and municipal nature. This is a cross-sectional, multi-center study, with children data (12-59 months) collected from 48 municipalities of the Southern region of Brazil, that were included in the Brazil Without Poverty Plan. Individuals’ data were collected using a structured questionnaire, and secondary and ecological data of children’s municipalities were collected via national surveys and institutional websites. The outcome was defined as the hemoglobin level obtained by HemoCue. A multilevel analysis was performed using Generalized Linear Models for Location Scale and Shape using R, with a 5% significance level. A total of 1,501 children were evaluated. The mean hemoglobin level was 12.8g/dL (95%CI: 12.7-12.8), with significant variability between municipalities. Lower values of hemoglobin were observed in children who lived in municipalities with a higher urbanization rate and a lower number of Community Health Agents, in relation to the reference categories. At the individual level, lower hemoglobin values were identified for children under 24 months, not enrolled at daycares, who were beneficiaries of the conditional cash transfer program and diagnosed with underweight. The results shed light on important factors at the municipal and the individual levels that were associated to the hemoglobin levels of children living in municipalities in social vulnerability.

BackgroundThe COVID-19 pandemic has reduced access to adequate food in terms of quality and quantity, especially for the most vulnerable population groups. The objective of this study was to evaluate the prevalence of Food Insecurity and its main socioeconomic and health determinants in pregnant women and mothers of children under 2 years of age, during the COVID-19 pandemic.MethodsThis systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42021278033). The descriptors “Pregnant Woman”, “Postpartum Women”, “Breastfeeding Women”, “COVID-19”, “Food Insecurity”, “Food Security” were combined in Scopus (Elsevier), Medline/PubMed (via National Library of Medicine), Embase (Elsevier), Web of Science and Science Direct independently by two researchers in September 2022. Original articles about Food Insecurity in households with pregnant women and mothers of children under 2 years of age during the COVID-19 pandemic were included. The meta-analysis of the prevalence of Food Insecurity was conducted using the RStudio software (4.0.4).ResultsThe initial search resulted in 539 records, and 10 articles met the proposed criteria and were included in this review. The prevalence of Food Insecurity ranged from 11.5 to 80.3% and in the meta-analysis it was 51% (IC: 30–71) (I2 = 100.0%). The main socioeconomic and health determinants were ethnicity, domain language, low education, low income, informal employment, unemployment, occurrence of mental disorders, domestic violence, in addition to the unavailability of food in markets and lack of transport. The inclusion of studies with data collection by telephone stands out as a limitation, due to the non-inclusion of vulnerable groups without access to this means of communication.ConclusionIt is necessary to implement and strengthen specific public policies for the maternal and child group with the objective of protecting and strengthening the rights of women to maintain the physical and mental integrity of this group and guarantee Food Security.

O objetivo da pesquisa foi determinar a quantidade de sódio oferecida nas refeições de crianças de 12 a 36 meses em creches municipais, por meio de análises laboratoriais. O estudo transversal foi realizado em quatro creches de um município da Região Metropolitana de Curitiba/PR, sorteadas aleatoriamente por amostragem estratificada por conglomerados. De junho a novembro/2013 foram coletadas amostras das seis refeições diárias servidas às crianças, durante cinco dias não consecutivos nas quatro creches, totalizando 20 dias e 120 amostras analisadas. O teor de sódio foi determinado pelo método de cloretos por volumetria e os resultados foram comparados a quatro parâmetros: 1) quantidade máxima diária preconizada para o sódio na alimentação escolar, 2) limite superior tolerável de ingestão do nutriente para a idade, 3) atendimento máximo de 70% da recomendação nutricional e 4) teor máximo de sódio recomendado para uma refeição, na alimentação escolar. O teor médio de sódio oferecido foi 1251mg/dia (n=20), atendendo ao preconizado para a alimentação escolar e correspondendo a 83,4% do limite superior de ingestão para a idade. Cem por cento dos almoços e 60% dos jantares apresentaram valores de sódio acima do recomendado para uma refeição, indicando um fator de risco para a hipertensão arterial infantil e necessidade de intervenção nessa população.

(1) Measuring usual iodine intake is a complex task due to the food consumption variability and its natural concentration in food. Therefore, the use of covariates to adjust statistical methods to estimate usual intake could improve the estimates obtained through dietary surveys. This study aims to evaluate the influence of salt and seasoning usage covariates on the estimates of usual iodine intake and the prevalence of its inadequacy. (2) A cross-sectional study was conducted with Brazilian pregnant women’s food consumption data obtained with 24-h recall (n = 2247). The usual iodine intake was adjusted for intraindividual variability, supplement use, temporal effects, data collection methods, and sociodemographic characteristics with the tool UCD/NCI SIMPLE in the SAS software. Then, salt and seasoning usage covariates were used to adjust the distribution. The harmonized intake reference values for populations were used to assess intake adequacy. (3) The adjustments for salt and seasoning usage yielded a higher mean of usual iodine intakes. The only exception was the adjustment for the “habit of adding salt to meals after preparing/cooking”, which produced a lower mean of usual intake and increased the prevalence of insufficient intake. (4) Salt and seasoning usage covariates affect the estimates evaluated. However, more studies are necessary to evaluate the influence observed.

Introdução: Dados sobre a ingestão de iodo de gestantes são limitados no Brasil e é esperado que essa ingestão seja insuficiente para atender as necessidades nutricionais. Objetivo: Avaliar a ingestão habitual de iodo de gestantes brasileiras. Metodologia: A revisão sistemática sobre a ingestão de iodo de gestantes foi baseada no método Preferred Reporting Items for Systematic Reviews and Meta- analyses, registrada no International Prospective Register of Systematic Reviews, e a sua metanálise conduzida no software R. Os artigos originais são transversais e foram realizados com dados de consumo alimentar de gestantes (n=2247) do Estudo Multicêntrico de Deficiência de Iodo, coletados com a aplicação do recordatório de 24 horas e tabulados no software GloboDiet. Os alimentos consumidos foram classificados de acordo com os grupos e subgrupos de alimentos da Food and Agriculture Organization/World Health Organization Global Individual Food Consumption Data Tool e a ingestão habitual de iodo foi ajustada para a variabilidade intraindividual pela macro Simulating intake of micronutrients for Policy Learning and Engagement. Covariáveis sobre o uso de suplemento, efeito temporal, método de coleta de dados, características sociodemográficas e sobre o uso de sal e de temperos foram usadas no ajuste das estimativas de ingestão e prevalência de inadequação. A contribuição dos itens alimentares para a ingestão de iodo e para a variabilidade interindividual foi avaliada pelo método da proporção de médias e por regressão linear, respectivamente. Os valores de referência de ingestão harmonizados foram usados para avaliar a adequação da ingestão. O software Statistical Analysis System foi utilizado nas análises sobre a ingestão habitual de iodo. Resultados: A revisão sistemática com metanálise indicou ingestão habitual mediana de iodo aquém ( 156,7 mcg) do recomendado pela Organização Mundial de Saúde (250 mcg). Já a ingestão habitual média das gestantes brasileiras proveniente apenas do consumo de alimentos e ajustada para a variabilidade intraindividual foi de 163,1 mcg, sendo observadas variações segundo as características sociodemográficas. O “sal”, incluído no grupo “temperos e condimentos” e no subgrupo “ervas e especiarias”, foi o maior contribuinte da ingestão de iodo e o alimento que explicou maior percentual da variação da ingestão entre as gestantes brasileiras. Apesar disso, arroz, feijão, leite, ovos e pães mostraram sua importância para a ingestão de iodo. A incorporação de covariáveis inerentes ao uso de sal e de temperos alterou as estimativas de ingestão habitual de iodo, especialmente a variável sobre o “hábito de adicionar sal às refeições prontas para consumo”. Pelo melhor modelo de ajuste a ingestão habitual média de iodo foi de 136,6 mcg, a contribuição do uso de suplementos para a ingestão de iodo foi de 19,8 mcg e as prevalências de ingestão insuficiente e excessiva de 60,9% e 0,1%, respectivamente. Conclusão: Os resultados reforçam a vulnerabilidade das gestantes à ingestão inadequada de iodo e alertam para a necessidade de ações específicas as particularidades desse grupo populacional, sobretudo para garantir o consumo de sal adequadamente iodado; o monitoramento contínuo da ingestão de iodo e de hábitos alimentares relacionados; e para a expansão das orientações nutricionais relacionadas à ingestão desse nutriente. Palavras-chave: Gestante. Dieta. Alimento. Consumo alimentar. Iodo. Deficiência de iodo. Brasil