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Item Consumer food environment and overweight.(2019) Freitas, Patrícia Pinheiro de; Menezes, Mariana Carvalho de; Lopes, Aline Cristine SouzaObjectives: The aim of this study was to investigate the association between aspects of the consumer food environment in food stores selling fruit and vegetables (FVs) and the incidence of overweight among users of a Brazilian primary health care service. Methods: This cross-sectional study assessed individual-level and food environment variables, within the context of a representative sample of a primary health care service in a Brazilian city (the Health Academy Program [HAP]) in 2013. Users of HAP units and multiple aspects of the consumer food environment (availability, diversity, variety, quality, advertising, and price) related to FVs and ultraprocessed foods (UPFs) were examined. Multilevel logistic models were used to examine the relationships among overweight and consumer environment characteristics. We analyzed 2810 participants and audited 336 food stores. Results: More than 70% of stores had adequate diversity and variety of FVs; Regarding quality, only 24.5% of stores presented inadequate quality of fruits and 39.6% inadequate quality of vegetables. UPFs were present in 60.6% of FV stores. The results indicated a high prevalence of overweight (62.6%) in participants of the health promotion service and the multilevel models revealed an association with variety of vegetables in stores (0.99; 95% confidence interval, 0.97 0.99; P < 0.05). Conclusions: Given the importance of food environment in food choice at the time of purchase, it is important to consider consumer food environment in determining consumption. The results suggest that increased exposure to healthy foods should be included as guidelines for weight management.Item Evolução dos balanços energético e proteico no pós-operatório de pacientes submetidos a operações abdominais de grande porte.(2021) Silva, Thales Antônio da; Zocrato, Maria Clara Arantes; Mauricio, Silvia Fernandes; Correia, Maria Isabel Toulson Davisson; Generoso, Simone de VasconcelosIntrodução: Acompanhar os balanços energético e proteico é de extrema importância para avaliação e monitoramento do estado nutricional de pacientes cirúrgicos. A adequação das necessidades nutricionais desses indivíduos representa um desafio perante os vários fatores que interferem no estado nutricional, tolerância e aceitação da terapia nutricional. Diante disso, este trabalho objetivou avaliar a evolução dos balanços energético e proteico no pós-operatório de pacientes submetidos a operações abdominais de grande porte, além de observar as repercussões nutricionais e clínicas (complicações pós-operatórias, tempo de internação e óbito) associadas à inadequação das neces- sidades nutricionais preconizadas para o paciente cirúrgico. Método: Sessenta e um pacientes submetidos a operações abdominais eletivas tiveram o gasto energético de repouso mensurado no pré-operatório imediato. Foram realizadas avaliações nutricionais, antropométricas e funcionais no pré-operatório imediato, no 3o e no 7o dia pós-operatório, além de terem sido coletados Recorda- tórios Alimentares de 24 horas. Dados de infusão de dietas enterais e parenterais para cálculos de consumo e adequação calórica e proteica, também, foram registrados. Os desfechos clínicos foram coletados em prontuário. Resultados: 70,5% da amostra apresentou algum grau de desnutrição prévio à internação hospitalar, conforme a Avaliação Global Subjetiva (AGS). Em relação aos balanços energético e proteico, foram observados valores negativos, mesmo naqueles pacientes que estavam em uso de terapia nutricional, sem diferença estatística significativa entre os grupos. Observou-se correlação positiva entre o balanço energético negativo e o tempo de internação, assim como associação negativa entre o estado nutricional obtido pela AGS e as complicações pós-operatórias. Conclusões: As necessidades calóricas e proteicas dos pacientes no período pós-operatório não são alcançadas, mesmo entre aqueles que recebem terapia nutricional, impactando no tempo de internação. Sugere-se mais estudos com outras estratégias metodológicas para avaliação acerca do impacto no estado nutricional desse cenário em pacientes cirúrgicos.Item Protein restriction during pregnancy affects lung development and promotes oxidative stress and inflammation in C57 BL/6 mice offspring.(2022) Castro, Thalles de Freitas; Matos, Natália Alves de; Souza, Ana Beatriz Farias de; Costa, Guilherme de Paula; Perucci, Luiza Oliveira; Silva, André Talvani Pedrosa da; Cangussú, Silvia Dantas; Menezes, Rodrigo Cunha Alvim de; Bezerra, Frank SilvaObjectives: The present study aimed to evaluate the effects of maternal protein restriction during pregnancy on the lungs of 1-d and 31-d old offspring of C57BL/6 mice. Methods: The C57BL/6 mice (810 wk) were used for breeding. After pregnancy confirmation, female mice were randomly divided into a control group (CG) receiving a standard diet (22% protein) and a protein- restriction group (PRG) receiving a low-protein diet (6% protein). In the low-protein diet, protein was replaced by carbohydrate. After parturition, female mice that received the low-protein diet were fed the standard diet. Male offspring were euthanized 1 d and 31 d after birth for subsequent analysis. We evaluated the effects of a protein-restricted diet during gestation in pulmonary organogenesis, lung oxidative stress, and pulmonary inflammatory response of the offspring. Results: PRG mice 1 d after birth showed lower body and lung mass, length, relative mass, lung density, and erythrocyte count compared with CG mice. There was an increase in alveolar airspace density and a higher mean linear intercept (Lm), greater oxidative damage, and inflammation in PRG mice compared with CG mice. At 31 d after birth, PRG mice had lower body mass, length, and lung mass values compared with CG mice. PRG mice showed greater recruitment of inflammatory cells to the airways. In addition, there was increased collagen deposition in the lungs, altered inflammatory mediators, and greater oxidative damage compared with CG mice. Conclusions: Protein restriction during pregnancy reduces the body weight of offspring and promotes inflam- mation and oxidative stress, resulting in a simplification of the lung structure.Item Preoperative and postoperative resting energy expenditure of patients undergoing major abdominal operations.(2021) Silva, Thales Antônio da; Maia, Fernanda de Carvalho Pazzini; Zocrato, Maria Clara Arantes; Mauricio, Silvia Fernandes; Correia, Maria Isabel Toulson Davisson; Generoso, Simone de VasconcelosBackground: Nutrition therapy plays a major role in the perioperative management of surgical patients. Understanding energy metabolism and correctly establishing the adequate energy needs is a crucial step to provide optimal nutrition care. The aim of this study was to assess the resting energy expenditure (REE) after major abdominal procedures and its associated factors. Methods: This was a prospective observational study conducted at a single center. REEs of patients admitted for gastrointestinal surgical procedures were measured by indirect calorimetry 24 hours prior to the procedure and reassessed at least once within the fifth postoperative day. Substrate oxidation was calculated according to the Frayn equation. Nutrition status was evaluated using subjective global assessment. Results: There were no significant changes in the REEs throughout the study period; however, there was a decrease in the respiratory quotient during the postoperative period, as well as a decrease in carbohydrate oxidation and an increase in lipid oxidation. Only 33.3% of the patients presented a postoperative increase in REE > 10%. Those patients presented higher blood-monocyte levels. Conclusion: Postoperative REE is not increased in most of the patients. In patients who had increased REE, associated factors included higher levels of monocytes.Item Short-term effect of whey protein supplementation on the quality of life of patients waiting for liver transplantation : a double blinded randomized clinical trial.(2021) D´Alessandro, Michelle Carvalho de Oliveira; Gomes, Amanda Dias; Morais, Jéssica França; Mizubuti, Yani Glaúcia Gomide; Silva, Thales Antônio da; Mauricio, Silvia Fernandes; Mendes, Larissa Loures; Correia, Maria Isabel Toulson Davisson; Generoso, Simone de VasconcelosBackground: Chronic liver disease is associated with malnutrition that negatively impacts a patient’s health-related quality of life (HRQoL). Aim: To evaluate the short-term effect of whey protein supplementation on the HRQoL and nutritional and functional status of patients waiting for liver transplantation. Methods: This was a double-blind randomized clinical trial with patients waiting for liver transplantation who were randomized into two groups: WP (whey protein supplementation) and the control (casein supplementation). Both groups received 40 g (20 g in the morning and 20 g in the evening) for 15 days. Nutritional and functional status were evaluated. Energy balance was calculated as the difference between energy intake (24-hour recall) and total energy expenditure (assessed by indirect calorimetry). The chronic liver disease questionnaire was used to assess HRQoL. All measurements were performed before and after the intervention. Results: Fifty-six patients were evaluated. Malnutrition was present in 56.9%, and it was directly associated with a poor HRQoL (p<0.05). No improvement on the nutritional and functional status was observed, in either group after protein supplementation. HRQoL improved after WP and casein supplementation, with no differences between groups (p>0.05). Patients who met protein requirements and had a positive energy balance demonstrated a higher HRQoL score (4.9, p<0.05), without between-group differences. Conclusion: Malnutrition substantially reduces HRQoL. Short-term WP or casein supplementation improved similarly the HRQoL.Item Association between food intake, both body composition and lifestyle in patients undergoing bariatric surgery.(2021) Vieira, Renata Adrielle Lima; Sá, Cristiane Maria Araújo Tavares de; Costa, Manoel da Cunha; Burgos, Maria Goretti Pessoa de Araújo; Rabelo Filho, Lucio VilarThe number of bariatric surgeries performed in Brazil increased with 85% between 2011 and 2018. Aim: The aim of the present study was to evaluate associations between food intake and both body composition and lifestyle in the preoperative period of bariatric surgery. Methods: A cross-sectional study was conducted with adults scheduled for bariatric surgery at a university hospital in the city of Recife, Brazil. Data were collected on anthropometric characteristics, body composition determined using dual emission x-ray absorptiometry (DXA), lifestyle and food intake. Results: Sixty patients participated in this study (78.3% women; mean age: 38.8 ± 9.6 years). Regarding lifestyle, 31.7% sedentary lifestyle, 33.3% consumed alcoholic beverages and 83.3% never smoked. Absolute values of trunk fat, lean mass and bone mineral density were 26.84 ± 5.34 kg, 55.85 ± 10.19 kg and 11.1 ± 0.08 g/cm2 , respectively. The association tests revealed that a lower amount of trunk fat was associated with a greater intake of carbohydrates, sedentary individuals consumed more carbohydrates and non-smokers consumed more fruits, vegetables and olive oil. Conclusions: A greater sedentary lifestyle was associated with consumption of carbohydrates. Moreover, not smoking in the preoperative period of bariatric surgery was associated with greater consumption of healthy eating markers.Item Percepção e satisfação da imagem corporal em estudantes de um centro universitário de Recife/Pernambuco.(2020) Melo, Patrícia Vargas de Paiva; Vieira, Renata Adrielle LimaPessoas insatisfeitas com a imagem corporal frequentemente adotam comportamentos alimentares inadequados na busca pelo corpo ideal. Por isso, o objetivo desde trabalho foi avaliar a percepção e satisfação da imagem corporal de estudantes de um Centro Universitário particular de Recife-PE. Trata-se de um estudo transversal, com estudantes de nutrição, de ambos os sexos, com idade entre 18 e 40 anos. Para avaliação da percepção da imagem corporal, aplicou-se uma Escala de Silhuetas predefinida. A insatisfação com a imagem corporal foi identificada por meio da discrepância entre o valor correspondente à silhueta atual (autopercepção) e o valor indicado como a silhueta ideal. Foi realizada aferição de peso e altura, e a partir dessas medidas foi calculado Índice de Massa Corporal (IMC) e a classificação do estado nutricional. Participaram 63 alunos, com média de idade de 25,46 ± 5,70 anos. Constatou-se que 22,2% dos acadêmicos estavam com sobrepeso. A insatisfação corporal por magreza e excesso de peso foi de 15,9% e 58,7%, respectivamente. Quando comparado entre os sexos, as mulheres se mostraram mais insatisfeitas (86,5%) em relação ao excesso de peso. Não houve relação entre imagem corporal e idade. Observa-se que a pressão social em relação a sua forma física apresenta importância considerável para a profissão escolhida, sendo atribuído a magreza o significado de capacidade técnica e profissional. A maioria dos universitários do curso de nutrição do Centro Universitário particular de Recife está insatisfeita com sua imagem corporal, principalmente as mulheres pelo excesso de peso.Item Consumo alimentar e sua associação com estado nutricional, atividade física e fatores sociodemográficos de candidatos à cirurgia bariátrica.(2019) Vieira, Renata Adrielle Lima; Rabelo Filho, Lucio Vilar; Burgos, Maria Goretti Pessoa de AraújoObjetivo: avaliar a associação do consumo alimentar com estado nutricional, atividade física e fatores sociodemográficos no pré-operatório de cirurgia bariátrica. Métodos: estudo transversal, realizado no período de 2018 a 2019, com pacientes internados para a cirurgia bariátrica no Hospital Universitário Oswaldo Cruz da Universidade Federal de Pernambuco. Foram obtidos dados sociodemográficos, estado nutricional pelo índice de massa corporal (IMC), circunferência da cintura, maior peso e peso pré-cirúrgico, consumo alimentar obtido pelo questionário de frequência alimentar baseado na pirâmide alimentar adaptada para o paciente bariátrico e atividade física. Resultados: participaram do estudo 60 pacientes, sendo 78,3% do sexo feminino, com idades de 38,8±9,6 anos, 53,3% casados e 70% dos indivíduos com mais de 12 anos de estudo. Na prática de atividade física, 31,7% eram sedentários. Sobre o estado nutricional, a média de IMC observada foi de 47,3±6,96kg/m2 . O peso pré-operatório, maior peso atingido antes da cirurgia e circunferência da cintura foi maior no sexo masculino (p<0,05). Houve associação entre atividade física e consumo alimentar, sendo que indivíduos sedentários consumiam mais carboidratos (p=0,041). Por outro lado, dados sociodemográficos e estado nutricional não apresentaram associações com o consumo. Conclusão: o nível de atividade física evidenciou associação significativa apenas com o consumo de carboidratos.Item Sedentary behaviors and risk of depression in the Seguimiento Universidad de Navarra cohort : the SUN Project.(2022) Pimenta, Adriano Marçal; Mendonça, Raquel de Deus; Lahortiga Ramos, Francisca; Fernandez Lazaro, Cesar Ignacio; Martínez González, Miguel Ángel; Sánchez Villegas, AlmudenaThe study aimed to prospectively examine the association between different sedentary behaviors and the risk of depression. We included 12,691 Spanish university graduates (mean age: 36.7 year; SD: 11.5), participants of the Se- guimiento Universidad de Navarra cohort (the SUN Project), initially free of depression who were followed-up for a median of 10.9 years. Based on items presented in our baseline questionnaire, time spent in four sedentary behav- iors (hours/day) were evaluated: overall sitting time; TV-viewing; computer use; and driving. Participants were classified as incident cases of depression if they reported a physician diagnosis of depression in at least one of the follow- up assessments conducted after the first two years of follow-up. Cox regression models were used to assess the relationship between sedentary behaviors and depression. A total of 560 incident cases of depression were identified during follow-up. We found no significant association between overall sitting time, TV-viewing or driving and risk of depression. On the other hand, computer use was directly associated with the risk of developing depression during the follow-up (p-value for trend = 0.020), with the participants in the highest quartile of computer use (3.64 to 10 hours/week) having a higher risk of de- veloping depression (HR = 1.33; 95%CI: 1.05-1.70) than those in the lowest quartile (0 to 0.25 hours/week) after adjusting for potential confounders. Pro- longed use of computer was independently associated with an increased risk of developing depression among young middle-aged adult university graduates from a Spanish cohort.Item The intake of flavonoids, stilbenes, and tyrosols, mainly consumed through red wine and virgin olive oil, is associated with lower carotid and femoral subclinical atherosclerosis and coronary calcium.(2022) Salazar, Henry Montero; Mendonça, Raquel de Deus; Laclaustra, Martín; Moreno Franco, Belén; Åkesson, Agneta; Guallar Castillón, Pilar; Donat Vargas, CarolinaPurpose It is suggested that polyphenols back the cardiovascular protection ofered by the Mediterranean diet. This study evaluates the association of specifc types of dietary polyphenols with prevalent subclinical atherosclerosis in middle-aged subjects. Methods Ultrasonography and TC were performed on 2318 men from the Aragon Workers Health Study, recruited between 2011 and 2014, to assess the presence of plaques in carotid and femoral arteries and coronary calcium. Polyphenol intake was assessed using a validated semi-quantitative 136-item food frequency questionnaire. The Phenol Explorer database was used to derive polyphenol class intake. Logistic and linear regressions were used to estimate the cross-sectional association of polyphenols intake with femoral and carotid subclinical atherosclerosis and coronary calcium. Results A higher intake of favonoids (third vs. frst tertile) was associated with a lower risk of both carotid (OR 0.80: CI 95% 0.62–1.02; P trend 0.094) and femoral (0.62: 0.48–0.80, P trend<0.001) subclinical atherosclerosis. A higher intake of stilbenes was associated with a lower risk of femoral subclinical atherosclerosis (0.62: 0.46–0.83; P trend 0.009) and positive coronary calcium (0.75: 0.55–1.03; P trend 0.131). A higher intake of tyrosols was also associated with a lower risk of positive coronary calcium (0.80: 0.62–1.03; P trend 0.111). The associations remained similar when adjusted for blood lipids and blood pressure. Conclusion Dietary favonoids, stilbenes, and tyrosols, whose main sources are red wine and virgin olive oil, are associated with lower prevalence of subclinical atherosclerosis in middle-aged subjects.Item Diferenças no consumo alimentar nas áreas urbanas e rurais do Brasil : Pesquisa Nacional de Saúde.(2021) Costa, Danielle Vasconcellos de Paula; Lopes, Mariana Souza; Mendonça, Raquel de Deus; Malta, Deborah Carvalho; Freitas, Patrícia Pinheiro de; Lopes, Aline Cristine SouzaObjetivou-se identificar diferenças no consumo alimentar, segundo marcadores de ali- mentação saudável e não saudável, entre adultos residentes nas áreas urbanas e rurais do Brasil. Realizou-se estudo transversal com dados da Pes- quisa Nacional de Saúde (2013). A alimentação foi avaliada por marcadores de alimentação sau- dável e não saudável. Estimou-se as prevalências (%) e modelos de regressão logística sequencial fo- ram ajustados para estimar odds ratio (OR) e in- tervalos de confiança (IC95%). Verificou-se maior consumo de frutas e hortaliças, peixes, refrigeran- tes e substituições de refeições nas áreas urbanas, enquanto que, o consumo de carne com gorduras e feijão foi maior nas áreas rurais. Análises ajusta- das mostraram maior consumo regular de feijão e de carne com excesso de gordura; e menor con- sumo de refrigerantes, de frutas e hortaliças e de substituição de refeições por lanches nas áreas ru- rais em comparação com as urbanas. Tendências semelhantes foram observadas nas macrorregiões do país. As diferenças no consumo alimentar de brasileiros residentes em áreas rurais e urbanas denotam a importância de fomentar políticas de alimentação que respeitem e valorizem as tradi- ções e a cultura alimentar.Item Redução da desigualdade de acesso ás ações de promoção da saúde na atenção primária brasileira : Programa Academia da Saúde.(2021) Caram, Carolina da Silva; Mendonça, Raquel de Deus; Marques, Rayane Jeniffer Rodrigues; Brito, Maria José Menezes; Lopes, Aline Cristine SouzaIntrodução: A situação de saúde marcada pela elevada prevalência de doenças crônicas não transmissíveis revela a necessidade de reestruturar a atenção à saúde. Nesse sentido, serviços como o Programa Academia da Saúde (PAS) foram implantados na Atenção Primária à Saúde (APS) brasileira. Objetivo: Analisar, sob a perspectiva dos usuários, o PAS como oportunidade de redução das desigualdades de acesso às ações de promoção da saúde na APS. Método: Trata-se de estudo qualitativo realizado na primeira unidade do PAS implantada em Belo Horizonte-MG, com ingressantes no serviço entre 2007 a 2011. A coleta de dados foi realizada mediante entrevista semiestruturada. Realizaram-se descrição dos dados sociodemográficos e análise de conteúdo do tipo temática. Resultado: Ingressaram no PAS, entre 2007 e 2011, 1.059 usuários, a maioria mulheres, adultos de meia idade, com baixa renda e elevadas prevalências de doenças crônicas não transmissíveis. Na perspectiva dos usuários, o PAS possibilitou o acesso às ações de promoção da saúde na APS, oportunizando a construção de escolhas mais saudáveis e mudanças nos modos de viver, sobretudo relacionados à atividade física e alimentação adequada e saudável, promovendo o empoderamento dos usuários. No entanto, foram identificadas limitações na integração do PAS com a Unidade Básica de Saúde adstrita. Conclusão: O PAS tem potencial para favorecer o acesso às ações de promoção da saúde na APS, embora ainda seja necessária maior integração com os demais pontos de atenção à saúde visando fortalecer o cuidado integral em rede e as ações de promoção da saúde.Item Healthy lifestyle by race/skin color and educational level in Brazil.(2021) Lopes, Mariana Souza; Freitas, Patrícia Pinheiro de; Silva, Caroline Otoni da; Mendonça, Raquel de Deus; Campos, Suellen Fabiane; Malta, Deborah Carvalho; Lopes, Aline Cristine SouzaThis study aimed to describe the prevalence of healthy lifestyles and examine its association to the combined effects of race and educational level in Brazil. Cross-sectional study. Data were obtained from the 2013 NationalHealth Survey. Race was categorized as white, brown, or black, and educational level as low, medium, or high. To assess the combined effects of race and educational level, a combined variable was created. Healthy lifestyle factors were: non current smoker;non risk use of alcohol; daily consumption of fruit, and vegetables and being active. Lifestyle status was categorized as less healthy or healthier. Of the 59,249 participants, 18.4% of the whites and 6.8% of blacks reported higher education, respectively. Healthy lifestyle status differed by race and educational level. The prevalence of 3 or more parameters were higher than 80% among individuals with high educational levels, regardless of race. The association of healthy lifestyle status with the combined effects of both race and educational levels remained significant after adjustments, except in blacks and browns with high educational levels. Education may be one of an important structural determinant of health status in Brazil, especially among blacksand browns. Investments in education can be helpfull to reduce racial inequalities.Item Dimensões da escala brasileira de insegurança alimentar na atenção primária à saúde.(2021) Araújo, Melissa Luciana de; Mendonça, Raquel de Deus; Pereira, Simone Cardoso Lisboa; Lopes, Aline Cristine SouzaObjetivo: Analisar a relevância das dimensões da Escala Brasileira de Insegurança Alimentar (EBIA). Método: Conduziu-se estudo a partir da linha de base com amostra representativa de usuários do Programa Academia da Saúde de Belo Horizonte-MG. A mensuração da insegurança alimentar foi obtida pela EBIA. Utilizou-se análise fatorial para identificar as dimensões da EBIA relevantes para os usuários do Programa. Resultado: Verificou-se elevada prevalência de insegurança alimentar (31,1%), sobretudo entre as famílias com menores de 18 anos (41,0%). Foi identificada redução do percentual de respostas afirmativas segundo a gravidade de insegurança alimentar implicada na questão, sendo que itens relacionados à insegurança alimentar leve (preocupação e acesso à alimentação saudável) apresentaram maior percentual de respostas afirmativas, enquanto aqueles correlatos à insegurança alimentar severa (fome e perda de peso), menores percentuais. Foram identificados três fatores relevantes da EBIA para famílias com menores de 18 anos: preocupação, privação e crianças/adolescentes; e para as demais famílias: preocupação, privação e fome. Conclusão: Sugere-se, assim, o uso da EBIA na Atenção Primária, visando avaliar o risco de insegurança alimentar e o delineamento de ações de promoção da saúde mais abrangentes.Item Intervention for promoting intake of fruits and vegetables in Brazilians : a randomised controlled trial.(2021) Mendonça, Raquel de Deus; Mingoti, Sueli Aparecida; Bethony, Maria Flávia Gazzinelli; Martínez González, Miguel Ángel; Bes Rastrollo, Maira; Lopes, Aline Cristine SouzaObjective: To evaluate the effectiveness of a nutritional intervention to promote fruit and vegetable (FV) intake. Design: A randomised controlled community trial was conducted to evaluate the effectiveness of a 7-month nutritional intervention and to promote FV intake, separately and together. All participants attended physical exercise sessions. The intervention was based on the transtheoretical model and Paulo Freire’s pedagogy. The interventions included group educational sessions, motivational cards and informational materials. The primary outcome was a change in FV intake (g/d), and secondary outcomes included stages of change, self-efficacy, decisional balance and knowledge on FV. All data were collected face-to-face; and FV intake was assessed using a validated brief questionnaire. Setting: Health promotion services of Brazilian Primary Health Care. Participants: 3414 users of Brazilian Primary Health Care (1931 in the control group and 1483 in the intervention group (IG)). Results: At baseline, the average daily FV intake was 370·4 g/d (95 % CI 364·2, 376·6). The increase in FV intake (23·4 g/d; 95 % CI 6·7, 40·0) and fruit intake (þ17·3 g/d; 95 % CI 5·1, 29·4; P = 0·01) was greater in the IG among participants in the lowest baseline intake. Participants in the IG also showed progression in the stages of change (P < 0·001), increased self-efficacy (P < 0·001) and improved knowledge of FV crops (P < 0·001). Conclusions: The nutritional intervention was effective in increasing FV intake and fruits intake among individuals with a lower intake at baseline and in maintaining FV intake among those who reported consuming FV as recommended (400 g/d).Item Pandemia COVID-19 e ações do Núcleo Ampliado de Saúde da Família e Atenção Básica na Rede SUS.(2021) Coelho, Otamares Castro Simões; Ferreira, Anelisa Terrola Martins; Mendonça, Raquel de DeusO Núcleo Ampliado de Saúde da Família e Atenção Básica (NASF-AB) visa ampliar as ações desenvolvidas pela Estratégia de Saúde da Família. Entretanto, suas atividades sofreram alterações temporárias, devido à pandemia da COVID-19. O objetivo deste trabalho é descrever as atividades e serviços realizados pelos profissionais do NASF-AB de uma regional na rede SUS-BH durante a pandemia de SARS-CoV-2. Trata-se de um estudo transversal com amostra de conveniência em Belo Horizonte-MG. Os dados foram coletados por um questionário online autoaplicado. Participaram 38 profissionais, dos quais 71% atuavam na Atenção Básica há mais de 5 anos. Na pandemia, observou-se falta de acesso a treinamentos (71%) e equipamentos tecnológicos (53%) para acompanhamento dos usuários. Os grupos operativos foram 100% suspensos e 90% relataram acesso aos Equipamentos de Proteção Individual. Apesar dos desafios que dificultaram a reorganização dos trabalhos e o acompanhamento dos usuários durante eventos excepcionais, o NASF-AB apresenta-se como uma potente estratégia de cuidado.Item Adherence to healthy lifestyles in the Programa Academia da Saúde.(2020) Mendonça, Raquel de Deus; Lopes, Mariana Souza; Carvalho, Maria Cecília Ramos de; Freitas, Patrícia Pinheiro de; Lopes, Aline Cristine SouzaThis study aims to measure healthy lifestyles according to the time of participation in the Programa Academia da Saúde (PAS). We used baseline data from a randomized controlled community trial with a representative sample of PAS users from Belo Horizonte, Brazil (n = 3,414). The data on healthy lifestyles collected were: daily fruit and vegetables intake (≥5 servings); physical activity en- gagement (≥180min/week); body mass index (18.5kg/m2 ≥ BMI ≤ 24.9kg/m2), smoking and drink- ing habits. The time of participation in the PAS was calculated by the difference between the date of registration in the program and the date of the data collection. Logistic regression models were used to evaluate associations between healthy lifestyles and time of participation in the PAS. Almost half of the participants (43.3%) had three healthy lifestyle factors. The prevalence of having all five factors varied according to the time of participation in the service; the lowest rates were in the first quartile (4.9%) and the highest rates in the fourth quartile (8.1%). Those who have attended the service for the longest time (fourth quartile) were more likely to have a healthy BMI (OR = 1.43; 95%CI: 1.14- 1.80; p = 0.002) and to avoid smoking (OR = 1.62; 95%CI: 1.06-4.49; p = 0.01), compared to those who have attended the program for less time (first quartile). The prevalence of healthy lifestyles in PAS users was low. However, a longer permanence in the program seems to favor positive changes on BMI and on smoking habits.Item Ultra-processed and fresh food consumption and symptoms of anxiety and depression during the COVID-19 pandemic : COVID Inconfidentes.(2022) Coletro, Hillary Nascimento; Mendonça, Raquel de Deus; Meireles, Adriana Lúcia; Coelho, George Luiz Lins Machado; Menezes, Mariana Carvalho deBackground & aim: Psychological disorders are an important health problem worldwide. A healthy diet is recommended as one of the measures to prevent and control mental disorders. Epidemiological studies have shown important associations between the consumption of diets rich in nutrients and a lower risk of developing anxiety and depression. Therefore, the aim of this study was to evaluate the association between the prevalence of anxiety and depression symptoms and food consumption, according to the degree of processing, during the COVID-19 pandemic. Methods: An epidemiological household survey was conducted in two cities in Brazil. Anxiety and depression symptoms were assessed using validated scales (Generalized Anxiety Disorder 7-item/Patient Health Questionnaire-9), and food consumption was assessed using a qualitative food frequency ques- tionnaire referring to consumption within the last 3 months. The foods were categorized according to the NOVA classification for fresh/minimally processed food and ultra-processed food, using the average weekly consumption as the cutoff. For data analysis, adjusted Poisson regression with robust variance was utilized to estimate the prevalence ratio and 95% confidence interval (CI). Results: The consumption of fresh/minimally processed foods above the weekly average frequency was associated with a lower prevalence of symptoms of depression (PR: 0.5, 95% CI: 0.3; 0.7). Consumption above the weekly average of ultra-processed foods was associated with a higher prevalence of anxiety (PR: 1.5 and 95% CI: 1.03; 2.3) and depression symptoms (PR: 1.5, 95% CI: 1.0; 2.1, P 1⁄4 0.034). Conclusion: Increased consumption of ultra-processed foods is associated with a higher occurrence of anxiety and depression symptoms; therefore, we recommend an increase in the consumption of fresh/ minimally processed foods, as endorsed by the Dietary Guidelines for the Brazilian Population.Item Racial inequities in self-rated health across Brazilian cities : does residential segregation play a role?(2022) Guimarães, Joanna Miguez Nery; Yamada, Goro; Barber, Sharrelle; Caiaffa, Waleska Teixeira; Friche, Amélia Augusta de Lima; Menezes, Mariana Carvalho de; Santos, Gervasio; Santos, Isabel; Cardoso, Leticia de Oliveira; Roux, Ana V. DiezRacial health inequities may be partially explained by area-level factors such as residential segregation. In this cross-sectional study, using a large, multiracial, representative sample of Brazilian adults (n = 37,009 individuals in the 27 state capitals; National Health Survey (Pesquisa Nacional de Saúde), 2013), we investigated 1) whether individual-level self-rated health (SRH) (fair or poor vs. good or better) varies by race (self-declared White, Brown, or Black) and 2) whether city-level economic or racial residential segregation (using dissimilarity index values in tertiles: low, medium, and high) interacts with race, increasing racial inequities in SRH. Prevalence of fair or poor SRH was 31.5% (Black, Brown, and White people: 36.4%, 34.0%, and 27.3%, respectively). Marginal standardization based on multilevel logistic regression models, adjusted for age, gender, and education, showed that Black and Brown people had, respectively, 20% and 10% higher prevalence of fair or poor SRH than did White people. Furthermore, residential segregation interacted with race such that the more segregated a city, the greater the racial gap among Black, Brown, and White people in fair or poor SRH for both income and race segregation. Policies to reduce racial inequities may need to address residential segregation and its consequences for health.Item Retail food environment in a Brazilian metropolis over the course of a decade : evidence of restricted availability of healthy foods.(2022) Justiniano, Irene Carolina Sousa; Menezes, Mariana Carvalho de; Mendes, Larissa Loures; Pessoa, Milene CristineObjective: To evaluate changes in the retail food environment profile in a Brazilian metropolis over a 10-year period. Design: An ecological study was conducted in the city of Belo Horizonte, Minas Gerais, Brazil. The addresses of formal food establishments were geocoded and classified according to their sold-food profile. Density changes were analysed according to neighbourhood, population size, income level and geospatial distribution. Setting: Totally, 468 neighbourhoods in the city of Belo Horizonte, Minas Gerais, Brazil. Participants: Totally, 83 752 formal food establishments registered for operation in any one or more of those years: 2008, 2011, 2015 and 2018. Results: There was an increase in unhealthy establishments (154 %), followed by mixed (51 %) and healthy establishments (32 %), during the period evalu- ated, in addition to an increase in density according to income categories. There was a higher proportion of unhealthy establishments in relation to healthy establishments, indicating worsening of the community food environ- ment over time. Conclusions: Over the course of 10 years, changes in the neighbourhood’s food environment were unfavourable for adequate access to healthy foods in lower- income neighbourhoods. The findings reinforce the need for interventions aimed at increasing the availability of businesses that offer healthy food in the city.