The objective of the study was to test the link between the preparation of professionals and the operational conditions of food and nutrition actions in primary healthcare in the state of São Paulo, Brazil. This cross-sectional study involved 220 primary healthcare clinics in 65 municipalities of the state. Of the 1873 participating healthcare professionals, 71.8% reported having provided guidance on food and nutrition to different groups, ranging from 56% for pregnant women to 17% for families. Only 19% of the primary healthcare clinics employed nutritionists. Primary healthcare clinics with fewer than two partnerships with other institutions reported 28% and 41% fewer of food and nutrition actions for adults and for families, respectively. Among the variables applied to evaluate professional preparation and operational conditions, work guidance and community partnerships were important for food and nutrition actions, which remains incipient in primary healthcare. RESUMENEl objetivo del estudio fue contrastar la asociación entre preparación profesional y condiciones operacionales de actuación con el ofrecimiento de acciones de alimentación y nutrición en la Atención Primaria a la Salud en el Estado de São Paulo, Brasil. Estudio transversal, incluyendo 220 unidades de Atención Primaria a la Salud de 65 municipios del Estado. De los 1873 profesionales de salud participantes, 71,8% relataron haber realizado acciones de alimentación y nutrición, variando de 56% para gestantes a 17% para las familias entre las unidades de salud. Apenas 19% de las unidades de salud contaban con nutricionistas. En unidades de salud con menos de dos convenios hubo prevalencia de 28% y 41% menos de oferta de acciones de alimentación y nutrición para adultos y familias, respectivamente. Entre las variables utilizadas para evaluar la preparación profesional y las condiciones operacionales, la orientación para el trabajo y los convenios en la comunidad fueron determinantes para la oferta de acciones de alimentación y nutrición, aun incipientes en la Atención Primaria a la Salud.Palabras clave: Alimentación y nutrición; Atención primaria a la salud; Educación Alimentaria y Nutricional; Educación en salud; Promoción de la salud.Determinantes de las acciones de alimentación y nutrición en las clínicas de atención primaria en el estado de São Paulo, Brasil

Objective This article aims to describe the protocol of a randomized clinical trial and the baseline results of the study of a one-year interdisciplinary intervention in users of the public health system in the bariatric surgery waiting list. Methods A randomized, single-blind clinical trial will be conducted including 88 participants recruited on an outpatient clinic of the public health system. Participants were randomized into the control group (n=44), receiving the usual treatment; and into the intervention group (n=44), participating in the educational intervention. Participants had their food intake, negative affectivity and physical inactivity/sedentary behavior assessed, as well as anthropometric and body composition measurements; their blood samples were collected; and also had different physical capacity tests. Results Of the 157 participants invited, 27 had severe functional limitations, one was under-age, and four declined the study due to associated diseases. Eighty-eight participants were randomized: 44 for the Control Group and 44 for the Intervention Group. When comparing the demographic and biochemical characteristics, there were no differences between groups except for serum glucose (GC=110.4±46.8mg/dL and GI93.1±16.9mg/dL, p=0.039). Conclusion This study protocol describes the methodology used in the study of educational intervention for the promotion of health care of patients on the waiting list for bariatric surgery. It shows that there is similarity between the baseline comparison groups. Registro Brasileiro de Ensaios Clínicos (Brazilian Clinical Trials Registry), RBR-775y3d.

The present study is a qualitative research with the objective of analyzing the perceptions of patients in the face of the challenges in the bariatric surgery line through focal groups. All patients were treated with an outpatient protocol, however, they were divided into two groups, one participated in the educational process and the other did not. Four categories of analysis were drawn up and discussed in the light of the current literature. Patients from the educational process were able to express themselves with greater positivity in view of the challenges and they showed better resources for going through the emotional suffering, the worsening of comorbidities and the risk of death. The results show the potential of education in health and of group work in the promotion of self-care and well-being.

ResumoIntrodução: Mudanças no perfil nutricional da população demonstradas nas últimas décadas acarretaram um aumento da prevalência de sobrepeso e obesidade em todas as idades. Objetivo: Avaliar a influência dos hábitos e estilo de vida no excesso de peso corporal de adolescentes da rede pública de ensino fundamental. Casuística e Métodos: Trata-se de um estudo transversal que avaliou 45 estudantes, dos quais 20 se encontravam com excesso de peso corporal. Foram analisados o índice de massa corporal, circunferência abdominal, percentual de gordura corporal, hábitos e estilo de vida dos estudantes. Os dados foram avaliados por meio de estatística descritiva e teste de regressão logística simples. Resultados: A prevalência global de sobrepeso e obesidade foi de 15,55% (n = 7) e 28,89% (n = 13), respectivamente. Dentre os indivíduos que apresentaram excesso de peso corporal, 60% (n = 12) foram diagnosticados com adiposidade central e 77,78% (n = 14) com excesso de gordura corporal pelas dobras cutâneas. Ao avaliar a influência dos hábitos e estilo de vida no excesso de peso corporal, verificou-se que somente o hábito intestinal mostrou-se significativamente (p ≤ 0,05) associado à circunferência abdominal. Conclusão: Constata-se a necessidade de se realizar estudos complementares no intuito de avaliar possíveis situações que comprovem a relação entre as variáveis analisadas.Descritores: Antropometria; Adolescente; Sobrepeso; Obesidade Abstract Introduction: Changes in the population nutritional profile demonstrated in recent decades has led to an increased prevalence of overweight and obesity in all ages. Objective: Evaluate the influence of habits and lifestyle in overweight adolescents of a public elementary school. Patients and Methods: This transversal study evaluated 45 students. Of these, 20 students were overweight. We analyzed the following variables: body mass index, abdominal circumference, body-fat percentage, habits, and lifestyle. Data were analyzed using descriptive statistics and simple logistic regression test. Results: The overall prevalence of overweight and obesity was 15.55% (n = 7) and 28.89% (n = 13), respectively. Among individuals with body weight excess, 60% (n = 12) were diagnosed with central adiposity, and 77.78% (n = 14) with excessive body fat caused by skinfold thickness. When evaluating the influence of habits and lifestyle over body weight excess, we could verify that only intestinal habit was significantly (p ≤ 0.05) associated to abdominal circumference. Conclusion: It is quite clear the need to carry out complementary studies to evaluate possible situations that can prove the relationship between the variables analyzed