Avaliou-se a execução do Programa Nacional de Alimentação Escolar em município do Sudoeste do Paraná. Tratou-se de estudo quanti-qualitativo, descritivo, realizado em junho de 2011, em 7 escolas de ensino fundamental da rede pública (urbanas e rurais). Analisou-se a adesão ao programa em oito dias não consecutivos, em cada escola, definindo-a como o ato do estudante de se servir da alimentação escolar. Calculou-se o Índice de Atendimento Efetivo (%IAE = total de alunos atendidos/total de alunos presentes na escola x 100), classificando-o em: alta (acima de 70%), média (50 a 70%), baixa (30 a 50%) e muito baixa adesão (> 30%). Foram entrevistados atores envolvidos na gestão e na execução do programa, incluindo-se nutricionista responsável técnica na época, o coordenador administrativo do programa e um servidor do setor de Vigilância Sanitária. As entrevistas foram feitas com questionário aberto e semiestruturado. Observou-se alta adesão (75,2%) nas 56 refeições avaliadas e alta adesão/escola em 71,42% das mesmas. A adesão mais alta foi em escola da zona rural. Ao analisar cada escola, somente 1 teve todas as preparações com alta adesão, também na zona rural. Preparações completas foram ofertadas em sua maioria na zona rural, e, nas urbanas, lanches e sobremesas. As entrevistas mostraram fragilidades no Conselho de Alimentação Escolar e variedade expressiva de frutas, legumes e verduras adquiridos da agricultura familiar.Palavras-chave: alimentação escolar, adesão ao programa, políticas públicas.
Evidence of impact of dietary factors on development of coronary artery calcification remains uncertain. The objective of the study was to evaluate the association between the intake carbohydrates, proteins, total fats, saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA), trans fatty acids (TFA) cholesterol and fiber with cardiovascular risk. Cross-sectional analysis from 181 dyslipidemic patients. The Coronary Calcium Score (CCS) was used to measure cardiovascular risk. 24-hour recalls were applied and the Multiple Source Method was used to adjust dietary variability. The mean values of the cardiovascular risk categories were compared by analysis of variance, using ANOVA and Kruskal-Wallis. Tukey's post-test was used for multiple analyzes. Simple and multiple binary logistic regression, was used as a measure of association between nutrient intake and cardiovascular risk. Age, male gender, comorbidities and drug treatment were significantly prevalent in those with CCS>100. The average total energy intake was 1315.6 kcal. Total energy and macronutrient intake were higher among men (p < 0.05). No significant results were found regarding the association between cardiovascular risk and macronutrient intake. Fiber intake was inversely associated with cardiovascular risk, regardless of confusion factors (OR:0.918; 95% CI:0.845-0.999; p=0.047). The resultes that there was no association between nutrientes analyzed to cardiovascular risk assessed by CCS. However, the increase of dietary fiber intake in 1 g/day has been shown to reduce the of future cardiovascular events in 8.2% among individuals in the highest risk category. Therefore, we strongly recommend that fiber intake be encouraged.
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