Efetividade de programa de suplementação alimentar no ganho ponderal de crianças

Abstract

OBJECTIVE:To evaluate the effectiveness of a governmental supplementary feeding program in child weight gain. METHODS:A cohort study including secondary data on 25,433 low-income children aged between six and 24 months, participating in a fortifi ed milk distribution program known as Projeto Vivaleite, was performed in the state of São Paulo, Southeastern Brazil, between 2003 and 2008. Weight gain was measured using weight-for-age z-score values, calculated according to the World Health Organization standards (2007). These values were obtained in the program routine, when a child started it and every four months during their stay. Children were divided into three z-score groups when starting the program: weight gain not compromised (z>-1); risk of low weight (-2≤z<-1); and low weight (z<-2). Multilevel linear regression (mixed model) was used, enabling the comparison, at each age, of adjusted mean z-scores between children starting the program and those who had been participating for at least four months, adjusted for correlation between repeated measurements. RESULTS:The program had a positive effect on child weight gain, varying according to child nutritional status when starting this program; among those who started it with weight gain not compromised, the mean adjusted gain z-score was 0.183; among those with risk of low weight, 0.566; and among those with low weight, 1.005. CONCLUSIONS:The program is effective for weight gain in children younger than two years, with a more pronounced effect on children who start the program under less favorable weight conditions.

Fatores sociodemográficos e excesso de peso em crianças participantes de programa governamental de distribuição de leite fortificado

“…A survey carried out in 2009 demonstrated the effectiveness of the VIVALEITE program for promoting weight gain in children under two 15 . Given the program´s proven effectiveness for weight gain, some children enrolling at a weight near the upper limit of normality for age may have become overweight during their participation.…”

“…A sample of 1,039 children was drawn from the database of 25,433 participants in the study by AUGUSTO and SOUZA (2010) 15 . The children were participants in the VIVALEITE program, a social project for distribution of free liquid pasteurized milk containing at least 3% fat, enriched with iron and vitamins A and D. In January 2011, management of the program was transferred from the Secretariat of Agriculture to the Secretariat of Social Development.…”

Fatores associados à evolução do peso de crianças em programa de suplementação alimentar

“…Also, body weight is a measure more easily changeable than length since short-term dietary restrictions promptly reduce its value, and weight deficits can be corrected more quickly with dietary adjustments than length ones 2 . Therefore, the W/A index is the most appropriate to evaluate the effect of dietary interventions on the nutritional status of children in a short period of time 3 .…”

Estado nutricional de vitaminas A e D em crianças participantes de programa de suplementação alimentar

“…Essa política pública já teve sua efetividade avaliada apenas para a situação nutricional de ferro 43 e do crescimento infantil 44 . Porém, nenhum estudo foi realizado, até o presente momento, para a investigação da situação nutricional das vitaminas A e D nessas crianças.…”