abstract: Diet quality is closely intertwined with overall health status and deserves close examination. Healthcare providers are stretched thin in the current stressed system and would benefit from a validated tool for rapid assessment of diet quality. The Rapid Eating and Activity Assessment for Participants Short Version (REAP-S) represents one such option. The objective of the current study was to evaluate the effectiveness of the REAP-S and Healthy Eating Index 2010 (HEI-2010) for scoring the diet quality of omnivorous, vegetarian and vegan diets. Eighty-one healthy male and female subjects with an average age of 30.9 years completed the REAP-S as well as a 24-hour dietary recall. REAP-S and HEI-2010 scores were calculated for each subject and evaluated against each other using Spearman correlations and Chi Square. Further analysis was completed to compare diet quality scores of the HEI-2010 and REAP-S by tertiles to examine how closely these two tools score diet quality. The mean HEI-2010 score was 47.4/100 and the mean REAP-S score was 33.5/39. The correlation coefficient comparing the REAP-S to the HEI-2010 was 0.309 (p=0.005), and the REAP-S exhibited a precision of 44.4% to the HEI-2010 for diet quality. The REAP-S significantly correlated with the HEI-2010 for whole fruit (r=0.247, p=0.026), greens and beans (r=0.276, p=0.013), seafood proteins (r=0.298, p=0.007), and fatty acids (r=0.400, p<0.001). When evaluated by diet type, the REAP-S proved to have increased precision in plant-based diets, 50% for vegetarian and 52% for vegan, over omnivorous diets (32%). The REAP-S is a desirable tool to rapidly assess diet quality in the community setting as it is significantly correlated to the HEI-2010 and requires less time, labor and money to score and assess than the HEI-2010. More studies are needed to evaluate the precision and validity of REAP-S in a broader, more diverse population. / Dissertation/Thesis / Masters Thesis Nutrition 2015

Poor nutrition and impaired dietary intakes are associated with certain chronic disease states such as obesity, cardiovascular disease and diabetes. There have been a number of school-based, nutrition-focused interventions which have been used to measure and determine healthy eating behaviours in UK school children but with varying degrees of success. The main aim of this thesis was to develop, pilot and evaluate the Children’s Health, Activity and Nutrition: Get Educated! (CHANGE!), a healthy eating curriculum for year 6 children. A formative study, unique in this type of intervention study, was carried out to investigate the behaviours, habits and attitudes to food of the children and the data collected used to inform the design of the intervention teaching curriculum. It revealed the diversity of the food and eating environments to which the children were exposed. Some of their perceptions about health and food, food choices and eating behaviours were inter-related. The key health messages included in the teaching curriculum were developed from these findings. At baseline, the participants’ food intakes, knowledge about food and nutrition and their attitudes to eating were measured using questionnaires. Additionally anthropometric measurements were taken and the children’s postcodes used to assess the socio-economic status of the children. The results showed that the control and intervention groups were alike at baseline. At post-intervention, the results indicated that there were some positive changes to food intakes, with a slight decrease in the consumption of negative marker foods. There was an increase in the total mean food knowledge scores, with children from the areas of lower deprivation scoring highest. There was no significant difference between control and intervention groups. The children’s eating attitudes displayed some trends with cues to eating. There was a significant increase in height in all children but this did not alter the body mass index status of the overweight or obese children. The importance of the use of CHANGE! as an intervention at the school-level is demonstrated by some of the more important findings from the study, such as the increased self-assessed ability to make certain foods, and that there was an increase in total food knowledge scores from the children who lived in areas of lower deprivation. These results could potentially be the starting point for some children to start questioning the types of food they are habitually eating and maybe looking to make some adjustments to their behaviours, as even small changes can be nutritionally significant in the longer-term for the future health of the children. Furthermore, the sustainability and long-term effects of CHANGE! need additional assessment and evaluation.

Orientador: Eliana Goldfarb Cyrino / Banca: Alice Yamashita Prearo / Banca: Luciana Maria Lunardi Campos / Resumo: Considerando-se que a alimentação e a nutrição são aspectos fundamentais para a promoção da saúde da criança, a presente pesquisa tem por objetivo identificar a concepção da criança em idade escolar em relação à alimentação e nutrição. Trata-se de uma pesquisa qualitativa, de abordagem interpretativa, na qual foram entrevistadas dezessete crianças com idade de 9 a 11 anos de uma escola municipal de Botucatu, no interior paulista, no ano de 2011. Foram realizadas duas entrevistas semi-estruturadas; questionário com questões abertas; observação participativa com uma oficina culinária, leitura e interpretação de histórias infantis e trabalho com desenhos e; diário de campo, como material para coleta de dados. As entrevistas abordaram as concepções das crianças em relação à alimentação e a nutrição. Essas foram gravadas e tiveram a duração de cerca de uma hora cada uma As transcrições foram feitas pela pesquisadora. Os dados foram apresentados de forma descritiva e as entrevistas foram interpretadas através de análise de conteúdo, sendo que emergiram dos dados empíricos cinco categorias de análise. Como resultados, esse estudo possibilitou identificar que as crianças têm noção do caminho por que passam os alimentos nos seus sistemas digestivos e percebem a digestão nas suas diferentes etapas. Além disso, aponta a presença da mãe na prática alimentar e na escolha dos cardápios. Há, ainda, preocupação com a concepção dos alimentos como promotores de saúde e também como produtores de doenças e até como sua falta ou excesso pode contribuir para o óbito. As crianças destacam as funções dos alimentos assim como seus componentes específicos e apresentam concepções adequadas sobre as qualidades especificas de alimentos considerados promotores de saúde. No entanto... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Considering that alimentation and nutrition are crucial for the child health promotion, the present work aims to identify the school-age child's conception in relation to alimentation and nutrition. This is a qualitative-interpretive approach-research in with seventeen children aged 9-11 years have been interviewed on a municipal school of Botucatu in the countryside of São Paulo in 2011. Several activities were realized as two semi-structured interviews; a questionnaire with open questions; a culinary workshop dynamic observation; children's stories reading and drawings interpretation; and work with a field journal, as material for data collection. The interviews approached the children conception about alimentation and nutrition. They were recorded and lasted approximately one hour each. The interviews approached the children conception about alimentation and nutrition. They were recorded and lasted approximately one hour each. The transcripts were made by the researcher. Data were presented descriptively and interviews were interpreted using content analysis. Five categories of analysis emerged from empirical data. As a result, this study identified that children have notion of the way the food passes in their digestive systems have the perception of digestion in its different stages. Furthermore, it indicates the presence of the mother in eating habits and choice of menus. There is also concern about the concept of food as health promoters as well as producers of disease and even as their lack or excess can contribute to death. Children highlight the roles of food as well as their specific components and have adequate conceptions about the special qualities of foods considered health promoters. However, it was revealed that they do not like foods such as vegetables and some fruits and this may be related to the habits... (Complete abstract click electronic access below) / Mestre

INTRODUÇÃO: a introdução de esquemas antirretrovirais altamente potentes, no tratamento da Aids pode estar associada ao aparecimento de alterações metabólicas em pacientes com HIV/Aids. Além da terapia antirretroviral, outros fatores, como a dieta podem contribuir para o aparecimento dessas alterações em adolescentes com HIV/Aids. Assim, faz-se necessária a avaliação da qualidade da dieta de indivíduos dessa população. OBJETIVO: analisar a qualidade da dieta de adolescentes com HIV/Aids. MÉTODOS: Trata-se de um estudo transversal aninhado a uma coorte de pacientes com HIV/Aids atendidos pela Unidade de Infectologia do Instituto da Criança (ICr-São Paulo). Foram avaliados 88 adolescentes (10 a 19 anos). Informações sobre o histórico da doença e uso de medicamentos foram obtidas a partir de prontuários médicos. Os adolescentes responderam a dois recordatórios de 24 horas e um questionário sobre atividade física habitual. Peso, altura e circunferência da cintura foram medidos em duplicata. A qualidade da dieta foi avaliada por meio do Índice de Qualidade da Dieta (IQD-R). O IQD-R é composto de 12 itens e a pontuação final varia de 0 a 100 pontos. Foram calculados os coeficientes de correlação de Pearson entre o IQD-R e as variáveis independentes. Também foram feitas as comparações das médias do IQD-R segundo as variáveis independentes pelo teste t-Student ou Mann-Whitney. RESULTADOS: a média para o IQD-R foi 51,90 pontos (EP=0,90 pontos). Os componentes que apresentaram menores médias foram cereais integrais e sódio. Os componentes que tiveram maiores médias foram cereais totais e óleos. Adolescentes moradores de casas de apoio tiveram média maior para fruta total e menor para carnes e leguminosas, quando comparados aos adolescentes que moravam com a família. Meninas apresentaram média maior para leite e derivados e menor para calorias provenientes de gorduras sólidas, bebidas alcoólicas e açúcares adicionados quando comparadas com meninos. CONCLUSÃO: os adolescentes com HIV/Aids avaliados apresentaram padrão de consumo alimentar semelhante ao de adolescentes da população geral: alto consumo de açúcar, gordura saturada e sódio e consumo insuficiente de cereais integrais e frutas. Atenção especial deve ser dada à dieta de adolescentes com HIV/Aids, pois eles estão em maior risco de desenvolver doenças cardiovasculares ou outras doenças crônicas. / INTRODUCTION: the introduction of the highly active antiretroviral therapy in the treatment of AIDS might be associated with the emergence of metabolic disturbances in patients with HIV/AIDS. Apart from the antiretroviral therapy, other factors, such as diet may contribute to the emergence of these disturbances in adolescents with HIV/Aids. Therefore, it is necessary to evaluate diet quality of individuals from this population. OBJECTIVE: to assess diet quality among adolescents with HIV/AIDS. METHODS: in a cross-sectional study nested in a cohort of patients with HIV/AIDS treated at the Infectious Disease Unity of the Instituto da Criança (ICr-São Paulo) 88 adolescents (10 to 19 years old) were assessed. Information on disease history and use of medication were obtained from medical records. Adolescents responded to two 24-hour recalls and one questionnaire on habitual physical activity. Weight, height and waist circumference were measured twice. Diet quality was assessed by means of the Healthy Eating Index-2005 (HEI-2005). The HEI-2005 is composed of 12 items and the final score ranges from 0 to 100 points. Pearson´s correlation coefficients between the HEI-2005 and the independent variables were calculated. HEI-2005 means were also compared according to the independent variables by means of Student´s t-test or Mann-Whitney test. RESULTS: The mean for the HEI-2005 was 51.90 points (SE=0.90 points). The components with the lowest means were whole grains and sodium. The components with highest means were total grains and oils. Adolescents living in foster homes had higher mean for total fruit and lower mean for meats and beans when compared to adolescents living with their families. Girls had higher mean for milk and dairy products and lower for calories from solid fats, alcoholic beverages, and added sugars when compared to boys. CONCLUSION: Adolescents with HIV/Aids showed an eating pattern similar to the adolescents from the general population: high consumption of added sugar, saturated fat and sodium and inadequate ingestion of whole grains and fruits. Special attention should be paid to the diet of adolescents with HIV/AIDS, because they are at higher risk of developing cardiovascular and other chronic diseases.

The theoretical part of the diploma thesis deals with specific nutritional needs and the concept of healthy nutrition during period of adolescence. Knowledge and attitudes are constantly evolving in period of adolescence and can also be negatively affected in many ways (most often through media), so emphasis is placed on the risks of excessive or inadequate intake of energy and nutrients. A special chapter deals with eating disorders. The paper analyses individual categories of the food pyramid in detail, focusing on needs and pitfalls related to adolescents. The practical part of the diploma thesis focuses on mapping of the knowledge and attitudes of adolescents towards healthy nutrition. Main aims of this work were to compare the knowledge of adolescents about healthy nutrition, depending on the currently studied school and age (in this work was compared the younger group aged 13−15 with the older group aged 17− 19). Another aim of the work was to investigate the relationship between the attitude towards healthy nutrition and the sex and also the difference in attitudes between the two adolescent age categories. The used methodology was a questionnaire survey. From mid-February to the end of March 2017, data was collected at schools in the Central Bohemia Region, specifically in the town of...

Despite widespread health promotion and nutrition education efforts, gaps between official healthy eating messages and people’s actual eating practices persist. There is increasing recognition that emphasizing individual responsibility for eating may have limited applicability in improving people’s health. Many experts advocate that future research on healthy eating should involve exploration of how food practices are shaped by social structures (or determinants) and individual agency. The purpose of this study was to explore the ways in which people engage with food structures to construct everyday notions of healthy eating. ‘Food structures’ draws on the concept of ‘structure,’ described by the social theorist Anthony Giddens, to refer to the range of food rules and resources people draw on. The research was conducted as part of a qualitative study on family food decision-making that included 144 participants from 13 African Nova Scotian, 10 European Nova Scotian, 12 Punjabi British Columbian and 11 European British Columbian families. These groups were chosen for their potential differences in perspectives based on place, ethnocultural background and histories of immigration to Canada. Data collection consisted of individual interviews with three or more family members aged 13 and older, and, with each family, observation of a grocery shopping trip and a family meal. Analysis followed common qualitative procedures including coding, memoing and thematic analysis. Together, the analyses support views that the gaps between official healthy eating messages and people’s eating practices may not be closed by further education about how to eat. Drawing on the theoretical concepts of Anthony Giddens and Michael Foucault, the findings suggest that one way to understand why people eat the way they do and how changes in eating habits occur is to think about the constant exposure to change through everyday, taken-for-granted practices. The findings also suggest that further healthy eating discourses may require more reflection with respect to the roles of nutrition educators and the social roles/autonomy of people in goals for health and well-being. Dietary goals for the population cannot be considered as isolated scientific objectives without taking into consideration how healthy eating discourses provide social standards beyond messages about healthy eating. / Land and Food Systems, Faculty of / Graduate

The transition to college is marked by poorer eating behaviors. The Theory of planned behavior (TPB) represents a promising tool for predicting eating behaviors through the examination of attitudes (ATT), subjective norms (SN), perceived behavioral control (PBC), and intention (INT). Despite prior application of the TPB, there exist several key methodological issues in the literature addressing eating behaviors. The present study utilized an enhanced dietary assessment methodology, the ASA24 dietary recall, and a short-term prospective design to assess the healthy eating behaviors of emerging adults in college. Dietary recalls of 68 participants (average age = 20.76 years; 70.6% female; 70.6% non-Hispanic, 48.5% White, 22.10% Black/African American, 13.20% Asian) were analyzed using the Healthy Eating Index (HEI)-2010 scoring system. Results revealed that very few college students are meeting recommended dietary guidelines. Linear regression indicated that the indirect TPB variables (ATT, SN, and PBC) were related to INT (F[3,64] = 19.67, p < .001), although SN did not account for unique variance. Further, the direct TPB variables (INT and PBC) were related to HEI-2010 scores (F[2,65] = 4.00, p = .023); however, only PBC accounted for significant variance. Overall, findings suggest that more favorable attitudes relate to intention, but only perceived behavioral control consistently relates to actual healthy eating behavior.

Health experts are recommending an average of 10,000 steps daily to attain certain health benefits and suggesting the use of pedometers for calculating ambulatory activity, such as walking. A 13-week, worksite walking program was implemented with teachers at an elementary school providing pedometers, weekly walking groups, bimonthly supplemental nutrition information, and a survey upon program completion to evaluate the effectiveness. Results showed that of the 31.3% that participated, 93.6% have tried to increase their daily activity in the past and 58.1% found the Bee Active walking program to be more effective than previous attempts. Participants reported that wearing the pedometer helped motivate more physical activity and increase total daily steps taken. For non-participants (63.6%), schedule conflicts and lack of time were the top two participation barriers. As a result of providing the bimonthly nutritional information, both participants and non-participants have attempted to make healthier food choices, while increasing their daily consumption of fruits and vegetables significantly.

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