Eating, nourishment or nutrition circulate in our culture as synonyms and thus do not account for the changes that occur in nourishment, which intended or unintended, have a hybridization pattern that represents a change of rules and food preferences. This paper aims to take these common sense conceptions as analytic categories for analyzing and interpreting research for the Humanities and Health Sciences in a theoretical perspective, through conceptualization. The food is associated with a natural function (biological), a concept in which nature is opposed to culture, and nourishment takes cultural meanings (symbolic), expressing the division of labor, wealth, and a historical and cultural creation through which one can study a society. One attributes to Nutrition a sense of rational action, derived from the constitution of this science in modernity, inserted in a historical process of scientific rationalization of eating and nourishing. We believe that through the practice of conceptualization in interdisciplinary research, which involves a shared space of knowledge, we can be less constrained by a unified theoretical model of learning and be freer to think about life issues.

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Este trabalho reflete sobre a dificuldade em interpretar sentidos e significados culturais construídos com base nas práticas de saúde. Tem como objetivo atualizar os instrumentos teóricos acessíveis para uma análise interpretativa desse processo de construção. Segue um roteiro de tópicos encadeados que se inicia com a apresentação de dois paradigmas ligados à saúde: o clássico e o da vitalidade. Discute-se um desenho de estrutura social que, juntamente com os atores das práticas e um conjunto de elementos, engendra reações e transformações sociais. Explora-se a concepção de percepção como construção social e o conceito de habitus enquanto mediação entre estrutura e práxis. Foram construídas figuras para posicionar elementos interpretativos. Concluímos que é na condição de praticante que podemos construir novos sentidos e significados e "sermos construídos" por eles, e que as práticas de saúde podem produzir novos modelos de enfrentamento da crise sanitária como "respiradouros" numa realidade de desigualdades sociais.

O artigo examina a construção de conceitos na área da saúde e sua utilização como um instrumento metodológico na dissolução de dicotomias limitantes como a de corpo/mente. O trabalho parte de uma perspectiva da filosofia em busca de uma aproximação com a realidade complexa da saúde coletiva, aplicada à problemática da obesidade. Discute a superação de oposições como a do "comer porque quero e não comer porque engorda" numa compreensão ética dos conflitos alimentares e agravos nutricionais, de modo a articular teoria e prática na contemporaneidade. Foram elaboradas, como exercício de conceituação, duas definições de obesidade. Uma levando em conta a capacidade singular de as pessoas estarem ativas e potentes na vida, e outra considerando os padrões atuais de normalidade para os corpos. Concluímos descrevendo algumas possibilidades de utilização desse recurso na área de alimentação e saúde de forma que o ser humano não seja reduzido a uma metade, seja ela corpo ou alma, mas que seja compreendido em sua integralidade.

All the contents of this work, except where otherwise noted, is licensed under a Creative Commons Attribution 4.0 International license. Todo o conteúdo deste trabalho, exceto quando houver ressalva, é publicado sob a licença Creative Commons Atribição 4.0. Todo el contenido de esta obra, excepto donde se indique lo contrario, está bajo licencia de la licencia Creative Commons Reconocimento 4.0. Amamentação no Brasil discurso científico, programas e políticas no século XX

Background Periodontitis is a common oral inflammation, which is a risk factor for adverse pregnancy outcomes. Intakes of vitamin D and calcium are inversely associated with occurrence and progression of periodontitis. This study aims to assess the feasibility of a multi-component intervention, including provision of milk powder supplemented with calcium and vitamin D and periodontal therapy (PT), for improving maternal periodontal health and metabolic and inflammatory profiles of low-income Brazilian pregnant women with periodontitis. Methods The IMPROVE trial is a feasibility randomised controlled trial (RCT) with a 2 × 2 factorial design with a parallel process evaluation. Pregnant women with periodontitis, aged 18–40 years and with < 20 gestational weeks ( n = 120) were recruited and randomly allocated into four groups: (1) fortified sachet (vitamin D and calcium) and powdered milk plus PT during pregnancy, (2) placebo sachet and powdered milk plus PT during pregnancy, (3) fortified sachet (vitamin D and calcium) and powdered milk plus PT after delivery and (4) placebo sachet and powdered milk plus PT after delivery. Dentists and participants are blinded to fortification. Acceptability of study design, recruitment strategy, random allocation, data collection procedures, recruitment rate, adherence and attrition rate will be evaluated. Data on serum levels of vitamin D, calcium and inflammatory biomarkers; clinical periodontal measurements; anthropometric measurements; and socio-demographic questionnaires are collected at baseline, third trimester and 6–8 weeks postpartum. Qualitative data are collected using focus group, for analysis of favourable factors and barriers related to study adherence. Discussion Oral health and mineral/vitamin supplementation are much overlooked in the public prenatal assistance in Brazil and of scarcity of clinical trials addressing these issues in low and middle-income countries,. To fill this gap the present study was designed to assess the feasibility of a RCT on acceptability of a multi-component intervention combining conventional periodontal treatment and consumption of milk fortified with calcium-vitamin D for improving periodontal conditions and maternal metabolic and inflammation status, among Brazilian low-income pregnant women with periodontitis. Thus, we hope that this relatively low-cost and safe multicomponent intervention can help reduce inflammation, improve maternal periodontal health and metabolic profile and consequently prevent negative gestational outcomes. Trial registration NCT, NCT03148483 . Registered on May 11, 2017.

The aim of the present study was to describe a range of comprehensive analyzes of conceptions of healthy nourishment among a group of elderly persons. Nourishment represents a complex overlapping of the biological and the cultural spheres, and as a result ideas of healthy nourishment are defined by both social and psychological guidelines. This study is a selection of analyzes of the conceptions of healthy nourishment of elderly persons attending the University of the Third Age, performed via a qualitative ethnographic approach based on the direct observation of nutrition classes for the elderly. The group displayed a conception of healthy nourishment related to growing old with as few limitations as possible, or in other words, with better health conditions, that allowed the possibility of a range of life experiences. The elderly persons considered healthy food to be "that which doesn't make one ill", as they understood that not all types of food were good for them, that the older body cannot withstand excess eating and that diseases result in dietary restrictions. There was a perception of the difference between body limitations (internal rule) and medical recommendations (external rule). At the same time, practicality was also a determinant in the eating habits of the elderly persons who, in keeping with the pace of modern life "did not have time to waste". There was a consensus among the group that learning about nutrition was necessary in later life, in order to find a balance between scientific knowledge relating to a longer life, the demands of the modern world, the aging of the body and the pleasures of eating.

Background: There are difficulties in carrying out research in low-income urban communities, but the methodological challenges and suggestions on how to deal with them are often undocumented. The aims of this study are to describe the challenges of recruiting and enrolling low-income pregnant women with periodontitis to a clinical trial on vitamin D/calcium milk fortification and periodontal therapy and also to describe the patient-, study protocol-and setting-related factors related to women's ineligibility and refusal to participate in the study. Methods: A mixed-method sequential exploratory design was applied. Qualitative and quantitative data on recruitment to a 2 × 2 factorial feasibility clinical trial were used. Eighteen women attending the health centre in a low-income area in Duque de Caxias (Rio de Janeiro, Brazil) took part in focus group discussions, and the data were thematically analysed. Quantitative data were analysed using appropriate descriptive statistics, including absolute and relative frequencies. Results: Of all referrals (767), 548 (78.5%) did not meet the initial eligibility criteria. The main reason for exclusion (58%) was advanced gestational age (> 20 weeks) at first prenatal appointment. In the periodontal examination (dental screen), the main reason for exclusion was the presence of extensive caries (64 out of 127 exclusions). Nonparticipation of those eligible after the periodontal examination was approximately 24% (22 out 92 eligible women) and predominantly associated with patient-related barriers (e.g. transportation barriers, family obligations, patients being unresponsive to phone calls and disconnected telephones). The study recruited 70 women with periodontitis in 53 weeks and did not reach the benchmark of 120 women in 36 weeks (58.3% of the original target). Recruitment was severely hindered by health centre closures due to general strikes. The recruitment yields were 9.1% (70/767) of all women contacted at first prenatal visit and 76.1% (70/92) of those screened eligible and enrolled in the trial. Women did not report concerns regarding random allocation and considered fortified milk as a healthful and safe food for pregnant women. Some women reported that financial constraints (e.g. transportation costs) could hinder participation in the study. Conclusion: Engagement between the research team and health centre staff (e.g. nurses) facilitated referral and recruitment, yet some pregnant women failed to participate in the study largely due to significant patient-related sociodemographic barriers and setting-related factors. Our data illustrate the complexity of overcoming recruitment and enrolment challenges for clinical trials in resource-limited settings. Trial registration: ClinicalTrials.gov, NCT03148483. Registered on 11 May 2017.