Child healthcare has been a priority subject in several programs and public policies developed over the decades. However, initiatives implemented seem insufficient to overcome the challenges regarding the integral development and improvement of the nutritional status of children in Brazil. The initial developmental stages of a child include pregnancy, breastfeeding, and complementary feeding, which are determinants in future aspects of health and nutritional status. Therefore, the strategies addressing problems during these three periods of life have the potential to positively impact the promotion of healthy eating habits and food security throughout life. Developing countries with huge dimensions and vast inequalities, like Brazil, are marked by differences in regional, cultural, and social contexts that may hinder the implementation of programs and policies with a broad scope. Extensive operational and professional costs, in addition to time-consuming activities that are necessary to apply, monitor, and evaluate interventions may jeopardize the proper assessment of programs and policy goals, generating the inefficiency and waste of resources in the health system. Thus, programs and policies aimed at creating and modifying habits should consider an intersectoral action within local contexts, involving health professionals, universities, policy managers, and the community. Therefore, this article aimed to discuss the preliminary conception of an integrated approach of decentralized strategies to promote healthy eating habits and food security of children in Brazil.
Objective To evaluate the association between sugar-sweetened beverages consumption and dietary quality in adolescents, adults, and older adults living in São Paulo, Brazil. Methods Data were drawn from a cross-sectional population-based study conducted in 2008 in a representative urban city sample involving 1494 consumers of sugar-sweetened beverages. Dietary intake was evaluated through two 24-Hour Dietary Recalls, and the usual sugar-sweetened beverages consumption was estimated using the Multiple Source Method. Dietary quality was evaluated using the Brazilian Healthy Eating Index – Revised. The association between total score of the revised index and components with sugar-sweetened beverages consumption tertiles was assessed using multiple linear regression models for each age group, considering the sample design. Results Regardless of age group, the increase of sugar-sweetened beverages consumption was associated with a decrease in the total Healthy Eating Index – Revised score and in the components “total fruit”; “whole fruit”; “meat, eggs and legumes”, and the “solid fat, alcohol and added sugar”. Conclusion The results of our study suggest that higher sugar-sweetened beverages consumption was associated with poorer dietary quality. Planning public health policies aimed at decreasing sugar-sweetened beverages consumption is essential to increase dietary quality and reduce the incidence of noncommunicable diseases.
Background: Misreporting of energy intake (EI) in self-reported dietary assessment is inevitable, and even less is known about which food items are misreported by low-middle income adolescents. We evaluated the prevalence of misreporting of energy intake and its relationship with nutrients and food intake. Methods: We analyzed 24 h dietary recalls collected from 576 adolescents (52.08% boys) from southeastern Santiago. Anthropometrics measurements and information about sociodemographic characteristics were obtained during clinical visits. The method proposed by McCrory et al. was used to identify under-reporters (UnRs), over-reporters (OvRs), or plausible reporters (PRs). Food items were collapsed into 28 categories and every food item was expressed as a percentage of total EI. Logistic regression models were performed to investigate the factors associated with misreporting, and a two-part model was used to estimate the difference in the percentage of EI between UnRs versus PRs, and OvRs versus PRs in each food item. Results: Half of the participants were classified as UnRs and 9% were OvRs. UnR was higher among boys (62%) and adolescents with overweight and obesity (72%). OvR was higher among adolescents with normal weight. UnRs had a lower intake of energy from cookies/cake, chocolate/confectionery, and a higher intake of vegetables and eggs than PRs. OvRs had a higher intake of cookies/cake, chocolate/confectionery, and a lower intake of fruit, white milk, and yogurt than PRs. Conclusions: A high frequency of UnR among boys and participants with excess weight was found in this study. Healthy and unhealthy foods are reported differently between UnRs and OvRs of energy intake, indicating that bias is specific for some food items that adolescents commonly eat.
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