Rita Maria Monteiro Goulart

Bio: Rita Maria Monteiro Goulart is an academic researcher from Universidade São Judas Tadeu. The author has contributed to research in topics: Quality of life & Kidney disease. The author has an hindex of 8, co-authored 25 publications receiving 282 citations. Previous affiliations of Rita Maria Monteiro Goulart include Universidade Municipal de São Caetano do Sul & Universidade de Mogi das Cruzes.

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

Abstract: 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.

Consumo alimentar de crianças de 6 a 18 meses em creches

Abstract: 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.

Fatores relacionados à qualidade de vida de idosos em programas para a terceira idade

Abstract: Population aging is a social phenomenon that demands the attention of health professionals. This article seeks to analyze the influence of possible intervening factors on the quality of life of the elderly. It was a cross-sectional, quantitative, descriptive and exploratory study, in which 182 elderly of both genders participated. They were aged ≥ 60 years and were enrolled in programs for senior citizens from three universities located in the cities of Sao Paulo, Sao Caetano do Sul and Mogi das Cruzes. To evaluate the subjective perception of quality of life, the World Health Organization Quality of Life questionnaire (WHOQOL-Bref) was used. Multiple linear regression analysis was performed on the dependent and independent variables. A significance level of 5% was adopted. The results showed that the absence of disease positively influenced the quality of life on the four domains evaluated. In the environmental domain, full tertiary education, old age, the absence of disease and being a resident in Sao Caetano do Sul positively influenced the quality of life of the elderly. The factors associated with better quality of life were: full tertiary education, old age, the absence of disease and being a resident in Sao Caetano do Sul, in that order of importance.

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

Abstract: 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.

Envelhecimento e qualidade de vida: análise da produção científica da SciELO

Abstract: A producao cientifica e um processo continuo de descoberta e democratizacao do conhecimento para a comunidade cientifica e a sociedade. As pesquisas metacientificas tornaram-se um instrumento importante de avaliacao. Analisaram-se 69 artigos sobre envelhecimento e qualidade de vida, quanto as variaveis: titulo, autoria, sexo, areas de conhecimento e periodicos. Observaram-se algumas diferencas estatisticamente significantes nos resultados obtidos: titulos com ate 12 vocabulos, autoria multipla e sexo feminino. Houve concentracao da publicacao nas areas de Psicologia e de Medicina. A Revista de Saude Publica teve predominio na area de Ciencias da Saude em relacao as Ciencias Humanas. Houve adequacao dos titulos e da autoria multipla, porem, maior producao feminina. Psicologia, Medicina e a Revista de Saude Publica foram as areas de conhecimento e o periodico que mais publicaram sobre o tema. Concluiu-se que a avaliacao sistematica da producao, desde a autoria ate o delineamento, pode contribuir para estabelecer uma politica de pesquisa na area.

Specially formulated foods for treating children with moderate acute malnutrition in low‐ and middle‐income countries

Abstract: Background Moderate acute malnutrition, also called moderate wasting, affects around 10% of children under five years of age in low- and middle-income countries. There are different approaches to addressing malnutrition with prepared foods in these settings; for example, providing lipid-based nutrient supplements or blended foods, either a full daily dose or in a low dose as a complement to the usual diet. There is no definitive consensus on the most effective way to treat children with moderate acute malnutrition. Objectives To evaluate the safety and effectiveness of different types of specially formulated foods for children with moderate acute malnutrition in low- and middle-income countries, and to assess whether foods complying or not complying with specific nutritional compositions, such as the WHO technical specifications, are safe and effective. Search methods In October 2012, we searched CENTRAL, MEDLINE, LILACS, CINAHL, BIBLIOMAP, POPLINE, ZETOC, ICTRP, mRCT, and ClinicalTrials.gov. In August 2012, we searched Embase. We also searched the reference lists of relevant papers and contacted nutrition-related organisations and researchers in this field. Selection criteria We planned to included any relevant randomised controlled trials (RCTs), controlled clinical trials (CCTs), controlled before-and-after studies (CBAs), and interrupted time series (ITS) that evaluated specially formulated foods for the treatment of moderate acute malnutrition in children aged between six months and five years in low- and middle-income countries. Data collection and analysis Two authors assessed trial eligibility and risk of bias, and extracted and analysed the data. We summarised dichotomous outcomes using risk ratios (RR) and continuous outcomes using mean differences (MD) with 95% confidence intervals (CI). Where appropriate, we combined data in meta-analyses using the random-effects model and assessed heterogeneity. The quality of evidence was assessed using GRADE methods. Main results Eight randomised controlled trials, enrolling 10,037 children, met our inclusion criteria. Seven of the trials were conducted in Africa. In general, the included studies were at a low risk of bias. There may have been a risk of performance bias as trial participants were aware which intervention group they were in, but we did not consider this likely to have biased the outcome measurement. We were unable to assess the risk of reporting bias in half of the trials and two trials were at high risk of attrition bias. Any specially formulated food versus standard care - the provision of food increased the recovery rate by 29% (RR 1.29, 95% CI 1.20 to 1.38; 2152 children, two trials; moderate quality evidence), decreased the number dropping out by 70% (RR 0.30, 95% CI 0.22 to 0.39; 1974 children, one trial; moderate quality evidence), and improved weight-for-height (MD 0.20 z-score, 95% CI 0.03 to 0.37; 1546 children, two trials; moderate quality evidence). The reduction in mortality did not reach statistical significance (RR 0.44; 95% CI 0.14 to 1.36; 1974 children, one trial; low quality evidence). Lipid-based nutrient supplements versus any blended foods (dry food mixtures, without high lipid content), at full doses - there was no significant difference in mortality (RR 0.93, 95% CI 0.54 to 1.62; 6367 children, five trials; moderate quality evidence), progression to severe malnutrition (RR 0.88, 95% CI 0.72 to 1.07; 4537 children, three trials; high quality evidence), or the number of dropouts from the nutritional programme (RR 1.14, 95% CI 0.62 to 2.11; 5107 children, four trials; moderate quality evidence). However, lipid-based nutrient supplements significantly increased the number of children recovered (RR 1.10, 95% CI 1.04 to 1.16; 6367 children, five trials; moderate quality evidence), and decreased the number of non-recovering children (RR 0.53, 95% CI 0.40 to 0.69; 4537 children, three trials; high quality evidence). LNS also improved weight gain, weight-for-height, and mid-upper arm circumference, although for these outcomes, the improvement was modest (moderate quality evidence). One trial observed more children with vomiting in the lipid-based nutrient supplements group compared to those receiving blended food (RR 1.43, 95% CI 1.11 to 1.85; 2712 children, one trial; low quality evidence). Foods at complementary doses - no firm conclusion could be drawn on the comparisons between LNS at complementary dose and blended foods at complementary or full dose (low quality evidence). Lipid-based nutrient supplements versus specific types of blended foods - a recently developed enriched blended food (CSB++) resulted in similar outcomes to LNS (4758 children, three trials; moderate to high quality evidence). Different types of blended foods - in one trial, CSB++ did not show any significant benefit over locally made blended food, for example, Misola, in number who recovered, number who died, or weight gain (moderate to high quality evidence). Improved adequacy of home diet - no study evaluated the impact of improving adequacy of local diet, such as local foods prepared at home according to a given recipe or of home processing of local foods (soaking, germination, malting, fermentation) in order to increase their nutritional content. Authors' conclusions In conclusion, there is moderate to high quality evidence that both lipid-based nutrient supplements and blended foods are effective in treating children with MAM. Although lipid-based nutrient supplements (LNS) led to a clinically significant benefit in the number of children recovered in comparison with blended foods, LNS did not reduce mortality, the risk of default or progression to SAM. It also induced more vomiting. Blended foods such as CSB++ may be equally effective and cheaper than LNS. Most of the research so far has focused on industrialised foods, and on short-term outcomes of MAM. There are no studies evaluating interventions to improve the quality of the home diet, an approach that should be evaluated in settings where food is available, and nutritional education and habits are the main determinants of malnutrition. There are no studies from Asia, where moderate acute malnutrition is most prevalent.

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

Abstract: 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.

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

Abstract: 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-

Amamantamiento materno, alimentación complementaria, sobrepeso y obesidad en preescolares

Abstract: OBJETIVO: Analizar la asociacion del sobrepeso y de la obesidad con el amamantamiento materno y la alimentacion complementaria en preescolares. METODOS: Estudio transversal envolviendo 566 ninos matriculados en escuelas privadas en el municipio de Sao Paulo (Sureste de Brasil), 2004-2005. La variable dependiente fue sobrepeso y obesidad. Para la clasificacion del estado nutricional de los ninos fueron utilizadas las curvas de percentiles del indice de masa corporal para edad, clasificando como sobrepeso valores ?P85 y

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

Abstract: 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.