Este artigo discute aspectos metodologicos dos estudos de consumo alimentar em criancas e adolescentes. Para compreender esses aspectos, descreve, em contexto mais amplo, a importância da Epidemiologia Nutricional no estudo descritivo da relacao da dieta com o surgimento das enfermidades, bem como origem historica, importância, vantagens, limitacoes e usos dos metodos empregados para medir a ingestao alimentar, especialmente em criancas e adolescentes, em estudos epidemiologicos populacionais. Apresenta ainda alguns trabalhos da literatura cientifica classica e contemporânea, demonstrando os resultados obtidos e algumas sugestoes para aperfeicoamento desses metodos. Finalmente, evidencia os aspectos mais relevantes que, por consenso de varios pesquisadores, competem como fatores limitantes ou facilitadores no emprego desses metodos, conferindo a esses, maior validade e reprodutibilidade nos estudos de consumo alimentar de criancas e adolescentes.

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Estudos de consumo alimentar: aspectos metodológicos gerais e o seu emprego na avaliação de crianças e adolescentes

This article discusses methodological as- pects of food consumption studies in children and adolescents. To reach the understanding of these methods it provides the value of Nutritional Epidemi- ology in a general context through a descriptive study of diet relation with the manifestation of disease as well as historical origin, value, advantage, con- straints and use of methods employed to measure food intake, especially in children and adolescents in pop- ulation epidemiological studies. In addition, it pre- sents classic and contemporaneous literature demon- strating results obtained and some suggestions to im- prove these methods. Finally, it discloses the more relevant aspects that by consensus of many re- searchers compete with constraining and facilitating factors in their use providing them with more validity and reproducibility concerning studies of food con-

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Estudos de consumo alimentar: aspectos metodológicos gerais e o seu emprego na avaliação de crianças e adolescentes Food consumption studies: general methodological aspects and its use in the evaluation of children and adolescents aged

OBJECTIVE: This study described and discussed the introduction of processed foods to the diets of children attending the nurseries of daycare centers, considering the recommendation of the Ministry of Health for a healthy diet. METHODS: This cross-sectional study included 270 children attending nurseries of eight public and not-for-profit daycare centers in Sao Paulo city. A pre-coded and structured 11-question questionnaire was used to evaluate the introduction of processed foods. For each type of food analyzed, the corresponding age in months was recorded as well as assessed as to whether it was in agreement with the 8th step of the Dietary Guide. The chi-square test was used for determining the associations. The studied variables were mother's age, education level and working status and family income. RESULTS: The results showed that approximately 2/3 of the studied children under 12 months of age were offered foods with obesogenic potential, such as instant noodles, snacks, sandwich cookies, powdered juice, soft drinks and candy/lollipop/chocolate bars. Children born to younger mothers, with low education level and lower income are most vulnerable to the feeding error of introducing processed foods prematurely. CONCLUSION: These results show that educational and preventive actions should be proposed to build healthy eating habits from childhood. Efficient and in-depth campaigns aiming at promoting the consumption of fruits and vegetables are also needed, taking into consideration the cultural, behavioral and emotional factors associated with diet.

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Introdução de alimentos industrializados e de alimentos de uso tradicional na dieta de crianças de creches públicas no município de São Paulo

OBJECTIVE: To perform a review of studies of food consumption and nutritional adaptation in Brazilian infants pointing the main findings and limitations of these studies. DATA SOURCE: The articles were selected from Literatura Latino-Americana e do Caribe em Ciencias da Saude (Lilacs) (Latin-American and Caribbean Literature in Health Sciences), Scientific Electronic Library Online (SciELO) and Science Direct in Portuguese and in English. The descriptors were: ''food consumption'', ''nutritional requirements'', ''infant nutrition'' and ''child''. The articles selected were read by two evaluators that decided upon their inclusion. The following were excluded: studies about children with pathologies; studies that approached only food practices or those adaptation of the food groups or the food offert; and studies that did not utilize the Dietary Reference Intakes (DRI). DATA SYNTHESIS: Were selected 16 studies published between 2003 and 2013. In the evaluation of the energy consumption, four studies presented energetic consumption above the individual necessities. The prevalence of micronutrients inadequacy ranged from 0.4% to 65% for iron, from 20% to 59.5% for vitamin A, from 20% to 99.4% for zinc, from 12.6% to 48.9% for calcium and from 9.6% 96.6% for vitamin C. CONCLUSIONS: The food consumption of Brazilian infants is characterized by high frequencies of inadequacy of micronutrients consumption, mainly iron, vitamin A and zinc. These inadequacies do not exist only as deficiencies, but also as excesses, as noted for energetic consumption.

https://www.scielo.br/pdf/rpp/v33n2/0103-0582-rpp-33-02-00211.pdf

Food consumption and nutritional adequacy in Brazilian children: a systematic review

As creches sao uma realidade na vida de grande parcela das criancas brasileiras em idade pre-escolar, sendo que nelas permanecem por um longo periodo. A demanda por esse servico tende a aumentar com a participacao cada vez mais ativa da mulher no mercado de trabalho. Assim o objetivo desse estudo foi revisar a literatura publicada a partir de 1998, disponivel nas bases de dados MedLine, SciELO, Lilacs e Science Direct. Foram selecionados artigos de estudos experimentais, revisao bibliografica, livros, teses e boletins de comites de saude, sobre as acoes desenvolvidas em creches no contexto atual das criancas brasileiras e sobre a atuacao do nutricionista nesta instituicao. A pesquisa revelou a dualidade vivida pelos educadores entre o cuidar e o educar. Destaca a importância da instituicao na formacao de habitos alimentares e discute a necessidade de aprofundamento nas questoes ligadas a educacao alimentar, no sentido de proporcionar a crianca o conhecimento e a autonomia na escolha de alimentos. Entre as principais carencias nutricionais apresentadas pelas criancas frequentadoras de creches publicas destaca-se a anemia ferropriva, sendo que a alimentacao oferecida nas creches tem mostrado deficiencias de calcio, ferro, vitamina A, fibras e energia. Finalmente, apresenta os principais desafios do nutricionista neste segmento e a necessidade de sua constante atualizacao sobre o quadro epidemiologico da nutricao para as faixas etarias que atende, bem como as prioridades estabelecidas pela Politica Nacional de Alimentacao e Nutricao vigente e normas emitidas pelos orgaos de referencia para esta area. Ao nutricionista cabe considerar, alem das necessidades nutricionais da crianca, o vies educativo e de formacao de habitos alimentares.

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Uma revisão das ações de nutrição e do papel do nutricionista em creches

OBJECTIVE: To verify the food intake of children from 6 to 18 months old and to evaluate nutrient adequacy. METHODS: This study was carried out with 106 children, in day-care centers from the city of Sao Paulo. Food intake was evaluated through food weighing during five days. The Organizacion Mundial de la Salud, 1985, Dietary Reference Intakes, 1997 and American Academy of Pediatrics, 1993 were used as references for the analysis of macronutrients, micronutrientes and fibers, respectively. RESULTS: The study revealed insufficient offering of energy, iron, calcium, vitamin A and fiber. Protein and vitamin C were over the recommended amounts. CONCLUSION: The children must receive one milky and one salty meal at home in order to complement food given at centers, mainly regarding, calcium, iron, energy and fiber.

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Arali Luiza Primo Santos

Papers

Consumo alimentar de crianças de 6 a 18 meses em creches