Esta comunicação apresenta o cenário da doença celíaca e suas implicações em hábitos, práticas alimentares e qualidade de vida de indivíduos intolerantes ao glúten. Apresenta dados importantes sobre a questão que, mundialmente, é considerada problema de saúde pública. Por ser uma doença cujo tratamento é fundamentalmente dietético, a terapia durante a transição alimentar deve ser bem conduzida pelo nutricionista para melhor adesão do paciente à dieta, considerando que a inclusão de novas práticas alimentares pode significar uma ruptura com a identidade individual e cultural: a alimentação de cada cidadão não pode ser deslocada da sociedade. Nesse contexto, a melhoria da qualidade de vida passa a ser um dos resultados esperados tanto das práticas assistenciais quanto das políticas públicas para o setor nos campos da promoção da saúde e da prevenção de doenças. A vigilância sanitária contempla as ações capazes de eliminar, diminuir ou prevenir riscos à saúde e de intervir nos problemas sanitários decorrentes do meio ambiente, da produção e circulação de bens e da prestação de serviços de interesse da saúde. O conhecimento do cenário da doença celíaca no País se justifica pela necessidade de fundamentar as ações da política de alimentação e nutrição ancoradas no conceito de alimentação saudável com ênfase na dieta isenta de glúten. Os artigos pesquisados foram selecionados nas bases de dados MedLine e SciELO, considerando o período de 1995 a 2006.
(1) Background: Celiac disease (CD) is a common autoimmune disorder. The manifestations of the disease and the obligatory life-long gluten-free diet (GFD) are associated with the impairment of patients’ quality of life. Therefore, the present study aimed to translate, culturally adapt and validate a celiac disease quality of life (CD-QoL) questionnaire and apply it to a representative number of Brazilian CD patients. (2) Methods: A cross-cultural Brazilian-Portuguese version of the CD-QoL was developed according to revised international guidelines. The questionnaire was administered to 450 celiac patients. The reliability, reproducibility and validity were studied. (3) Results: The Brazilian CD-QoL questionnaire presents valid measures of reproducibility and internal consistency. Early diagnosis is related to higher scores of Brazilian CD-QoL social, sub- and total scale. There was a positive correlation between higher education level and higher QoL. Individuals with partners tend to have a better emotional subscale of QoL. CD-patients who follow a strict GFD have highest QoL scale values. Men scored higher than women on the CD-QoL. All results were statistically significant except for the gastrointestinal subscale. (4) Conclusions: Brazilian CD-QoL allows comparative research between different celiac populations in the world. QoL research will help in the development of effective strategies to improve Brazilian celiac patients’ quality of life.
Sustainability is the integration of actions focused on three pillars: environmental, social, and economical. Implementing sustainable development ranges from the pursuit of quality of life, and from environmental balance to break with the current pattern of development. Therefore, the objective of this work was to understand and analyze the sustainability indicators implemented in the production of meals in food services. The authors developed specific search strategies for Scopus, Web of Science, Pubmed, Lilacs, Google Scholar, and ProQuest Dissertations & Theses Global to perform the systematic review. The authors evaluated the methodological quality of the included studies using the Meta-analysis Statistical Assessment and Review Instrument (MASTARI). A total of 31 cross-sectional studies were analyzed. Twenty four (77.41%) of the studies had activities that covered the three indicators (environmental, social, and economic); 22.59% (n = 7) used two indicators in which 12.90% (n = 4) presented environmental and economic indicators and 9.67% (n = 3) with environmental and social indicators. This research indicates that the studies in food services are seeking to insert indicators that cover the three pillars of sustainable meal production. It is worth mentioning that in the literature, many works encompasses the importance of sustainability, but few explore which indicators are most applied or detail their implementation in food services. More studies are needed to estimate better the indicators being applied in food services.
Despite the growing demand for green banana (GB) products, there is no review study regarding their potential health benefits. We aimed to compare the health benefits among different GB products by a systematic review. We researched six electronic databases (PubMed, EMBASE, Scopus, Science Direct, Web of Science, and Google Scholar) from inception to March 2019. We found 1009 articles in these databases. After duplicate removal, we screened 732 articles’ titles and abstracts, and selected 18 potentially relevant studies for full-text reading. We added five records from the reference list of the fully-read articles and seven suggested by the expert. Twelve articles were excluded. In the end, 18 studies were considered for this systematic review. Ten studies were conducted with green banana flour and eight with the green banana pulp/biomass. Most of the GB health benefits studied were related to the gastrointestinal symptoms/diseases, followed by the glycemic/insulin metabolism, weight control, and renal and liver complications associated to diabetes. Only one study did not confirm the health benefit proposed. It is necessary to standardize the GB dose/effect to different age groups and different health effects considering the GB variety and ripeness level. Further studies are necessary to present better detailing of GB product and their health effects considering all the raw-material characteristics.
ObjetivoO objetivo deste estudo foi avaliar as possibilidades de contaminação dos alimentos no balcão de distribuição, causada por usuários de Unidades Produtoras de Refeições. MétodosA coleta de informações foi realizada em 10 Unidades Produtoras de Refeições do Distrito Federal, via observação direta de 12 atitudes de risco cometidas pelos consumidores (n=3.447), no período de outubro de 2003 a setembro de 2004. O horário selecionado para observação das atitudes foi o de maior movimento de cada unidade; a amostra foi sistematizada a cada 5 consumidores. O instrumento para coletar os dados relacionava as possíveis atitudes de risco de contaminação, no momento em que cada consumidor montava sua refeição. ResultadosOs resultados obtidos demonstram que há probabilidade de contaminação alimentar causada por consumidores dos restaurantes de auto-serviço. Em 96% dos casos observados, os usuários não costumavam higienizar as mãos antes de se servirem. Observou-se também que não houve preocupação com o uso exclusivo de utensílios de servir por parte de 50% desses consumidores, enquanto 56% conversavam ou falavam sobre as preparações. ConclusãoConclui-se que é necessário conscientizar os consumidores, principalmente os usuários de auto-serviço, a fim de evitar a contaminação de alimentos e as possíveis ocorrências de toxinfecções alimentares.Termos de indexação: contaminação de alimentos; higiene dos alimentos; restaurantes.
This study aimed to develop and carry out content validation, semantic evaluation, reproducibility, and internal consistency of a checklist designed to verify the sustainability indicators in foodservice. The preliminary version of the checklist was prepared based on the international standards ISO (International Organization for Standardization) 14000, ISO 14001, ISO 14004 and documents from the Sustainable Restaurant Association (SRA) Certification, Green Seal Certifications, and Green Restaurant Association (GRA) certification, in addition to the American Dietetic Association (ADA) position. Thirteen experts in the study topic performed the content validation and semantic evaluation of the checklist (a minimum of 80% agreement among experts and mean value ≥4 on a 5-point Likert scale were needed to keep the item in the instrument). After consensus was reached by the experts’ panel, two different researchers applied the checklist in 20 restaurants (at the same time, in the same place, without communication between them) for the analysis of reproducibility and internal consistency (Federal District, Brazil). The agreement among answers was verified by Cohen’s Kappa coefficient. The final version of the checklist consisted of 76 items, divided into three sections (1. water, energy, and gas supply; 2. menu and food waste; 3. waste reduction, construction materials, chemicals, employees, and social sustainability). The developed checklist was validated concerning the content, approved in the semantic evaluation, reproducible, and with good reliability (Intraclass Correlation Coefficient (ICC) > 0.9 and alpha > 0.672).
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